Direction and magnitude of mother-father discrepancies in ADHD symptom ratings: associated factors in a child and adolescent mental health sample.

Background/objectives: This study examined mother-father discrepancies in ratings of inattention (IA), hyperactivity/impulsivity (HI), and oppositional defiant (OD) symptoms in children and adolescents with ADHD, and explored child, parental, and family factors associated with discrepancy direction and magnitude. Methods: This single-center cross-sectional clinical study included 460 Chinese children and adolescents aged 6-17 years with clinically confirmed ADHD. Mothers and fathers independently completed the SNAP-IV. Inter-parental agreement was assessed using intraclass correlation coefficients (ICCs), and paired-samples t tests were used to compare maternal and paternal ratings. Standardized signed discrepancy scores were used to examine factors associated with discrepancy direction. Sensitivity analyses were conducted using raw signed discrepancy scores and absolute raw discrepancy scores to examine robustness and disagreement magnitude. Results: Mothers rated symptom severity significantly higher than fathers across IA, HI, and OD symptoms. Inter-parental agreement was lowest for IA and higher for HI and OD symptoms. Paternal belief that the child had ADHD was consistently associated with discrepancy direction across all three domains. Additional factors associated with discrepancy direction included maternal belief that the child had ADHD and perceived parenting consensus, although their patterns differed across symptom domains. The primary standardized signed discrepancy models explained modest proportions of the variance (R² = 0.055-0.107). In sensitivity analyses, associations between mean standardized symptom level and absolute raw discrepancy were positive and statistically significant in all three domains; corresponding associations with raw signed discrepancy were not statistically significant in any domain. Conclusions: Mother-father discrepancies in ADHD-related ratings were common and differed across symptom domains. These discrepancies were associated with parental beliefs, perceived parenting consensus, and symptom level. They may offer potentially informative contextual information for multi-informant assessment; however, given the cross-sectional design and modest explanatory power of the regression models, their clinical significance remains to be established.