Emotional symptoms are common in children with attention-deficit/hyperactivity disorder (ADHD) and are often associated with long-term adverse outcomes. However, little is known about how emotional symptoms develop from middle childhood to early adolescence in individuals with ADHD, including how they differ between boys and girls. This study investigated the trajectories of emotional symptoms in children with ADHD during this transition period and compared to neurotypical peers, using longitudinal data from the UK Millennium Cohort Study, while also examining potential sex differences. Latent growth curve modeling was employed to model emotional symptoms at ages 7, 11, and 14. Children with ADHD had significantly higher levels of emotional symptoms than neurotypical peers across all three waves, with levels remaining stable over time. Boys and girls with ADHD did not differ in their emotional symptoms levels at any wave. Girls with ADHD however did show a significant increase in emotional symptoms over time, whilst boys’ levels remained relatively stable over the same period. These findings highlight the importance of early screening for emotional symptoms in children with early-diagnosed ADHD, with particular attention to the increasing levels of emotional symptoms in girls as they transition into adolescence.

Research shows that parenting plays an important role in the development of callous-unemotional (CU) traits in children. Yet, the specific aspects of positive parenting that may offer the strongest protection against the development of CU traits, as well as the potential role of child attachment to parent in this protection, remain poorly understood. This longitudinal multi-informant study aimed to investigate the mediating role of early mother–child attachment security in the prospective associations between three aspects of maternal sensitivity (positivity, attunement, availability) and subsequent CU traits in children. Maternal sensitivity and mother–child attachment security were observed in the home when children were 12 and 15 months old respectively. Child CU traits were reported by mothers, fathers, and teachers at age 4 years. Analyses revealed that maternal attunement was linked to lower levels of CU traits indirectly through the mediating role of attachment security. There was also a direct, non-mediated negative association between maternal availability and CU traits. Consistent with the notion of equifinality, these findings suggest that different aspects of parenting may be linked to child CU traits via distinct mechanisms, with some but not all of those mechanisms involving parent–child attachment.