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Klemp MT, Dose C, Hautmann C, Jendreizik LT, Mühlenmeister J, Plück J, Wähnke L, Döpfner M. Parenting Behaviors as Mediators of the Association Between Parental Internalizing Symptoms and Child Externalizing Symptoms. Child Psychiatry Hum Dev 2024; 55:916-928. [PMID: 36306027 PMCID: PMC11245424 DOI: 10.1007/s10578-022-01462-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 11/03/2022]
Abstract
This study analyzes whether the association between parental internalizing symptoms (depression, anxiety, stress) and child symptoms of attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD) is mediated by positive and negative parenting behaviors. Cross-sectional data of 420 parents of children (age 6-12 years) with elevated levels of externalizing symptoms were collected in a randomized controlled trial. Measures included parent ratings of their internalizing symptoms and parenting behaviors and of their child's externalizing symptoms. Two mediation models were examined, one including ADHD symptoms and one including ODD symptoms as the dependent variable. Parental internalizing symptoms were modeled as the independent variable and positive and negative parenting behaviors were modeled as parallel mediators. Regression analyses support negative parenting behavior as a mediator of the association between parental internalizing symptoms and child ODD symptoms. For the ADHD model, no significant mediator could be found. Future studies should use prospective designs and consider reciprocal associations.
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Affiliation(s)
- Marie-Theres Klemp
- Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany.
| | - Christina Dose
- Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Christopher Hautmann
- Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Lea T Jendreizik
- Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Judith Mühlenmeister
- Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Julia Plück
- Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Laura Wähnke
- Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
| | - Manfred Döpfner
- Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP), University of Cologne, Pohligstr. 9, 50969, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany
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Jareebi MA, Alqassim AY, Gosadi IM, Zaala M, Manni R, Zogel T, Robidiy E, Qarn F, Moharaq S, Alharbi W, Alhobani A, Mohrag M. Quality of Life Among Saudi Parents of Children With Attention-Deficit/Hyperactivity Disorder: A Cross-Sectional Study. Cureus 2024; 16:e63911. [PMID: 39100067 PMCID: PMC11298215 DOI: 10.7759/cureus.63911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) in children can adversely impact parental quality of life (QoL). However, limited research exists among families in Saudi Arabia, especially in understudied regions like Jazan. This study was designed to determine the QoL in parents of children with ADHD in Jazan, Saudi Arabia. Methodology This cross-sectional study was conducted in the Jazan region of Saudi Arabia from June 2023 to December 2023. Online questionnaires were used to collect data from parents of children with ADHD residing in the country. A structured questionnaire was developed in consultation with the National Institute for Children's Health Quality (NICHQ) guidelines. The total sample size was 276. The study participants were recruited through convenient non-random snowballing sampling where the promotion of the questionnaire web link aided in reaching the required sample size of the study. Participants aged more than 18 years, residents of the Jazan area, and both genders were included. R software was used for data analysis. Results The study, involving 275 participants, revealed that 45 (16%) children were diagnosed with ADHD by doctors, with a higher prevalence among males 36 (80%). The NICHQ scale identified ADHD in 50 (18%) participants, with the predominant subtypes being inattentive 28 (56%), hyperactive/impulsive 28 (56%), and combined 19 (38%). The median QoL score was 8.6, with good QoL reported by 51.27% of parents and poor QoL by 48.73%. Gender significantly influenced QoL (p < 0.01), with 57% of males and 43% of females reporting good QoL, while 61% of females and 39% of males reported poor QoL. Oppositional defiant symptoms were significantly associated with poorer QoL (p < 0.05). There was a notable alignment between ADHD diagnoses from parental reports and the NICHQ scale. Conclusions This cross-sectional study found that parents of children with ADHD behaviors, especially those exhibiting oppositional defiant symptoms, experienced significantly lower QoL, particularly in personal fulfillment and psychosocial well-being. The findings emphasize the need for culturally tailored psychosocial interventions in Saudi Arabia to improve parental coping and QoL, benefiting overall family well-being and child outcomes.
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Affiliation(s)
| | - Ahmad Y Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Ibrahim M Gosadi
- Family and Community Medicine Department, Jazan University, Jazan, SAU
| | - Mousa Zaala
- Psychiatry, King Khalid University, Abha, SAU
| | - Ramis Manni
- Faculty of Medicine, Jazan University, Jazan, SAU
| | - Taif Zogel
- Family and Community Medicine Department, Jazan University, Jazan, SAU
| | | | - Fatimah Qarn
- Faculty of Medicine, Jazan University, Jazan, SAU
| | | | - Wafa Alharbi
- Family and Community Medicine Department, Jazan University, Jazan, SAU
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Mesfin W, Habtamu K. Challenges and coping mechanisms of parents of children with attention deficit hyperactivity disorder in Addis Ababa, Ethiopia: a qualitative study. BMC Psychol 2024; 12:354. [PMID: 38886856 PMCID: PMC11184847 DOI: 10.1186/s40359-024-01828-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 05/28/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has manifestations of inattention, hyperactivity, and impulsivity. It affects every facet of a child's life, including one's own emotions, family and school life, and social interaction. The few available studies on ADHD conducted in Ethiopia focus on teachers' awareness and the prevalence of ADHD. None of these studies has taken into account parents of children who have ADHD. The present study, therefore, aimed to find out the challenges and coping mechanisms of parents who have children with ADHD. METHODS A phenomenological qualitative study was conducted to explore the experiences of parents who have children with ADHD. The study was carried out in Addis Ababa, the capital city of Ethiopia. Fourteen parents and two healthcare providers were involved in the study. Participants were selected using a purposive sampling technique. In-depth interviews were conducted with parents of children with ADHD (n = 8) and healthcare providers (n = 2). One focus group discussion (FGD), consisting of six members, was also conducted with parents. A topic guide for conducting the interviews and FGD was developed. Interviews and the FGD were audio-recorded. The data were transcribed verbatim, translated into English, and then analyzed using a thematic analysis approach. RESULTS With regard to challenges of parents of children with ADHD, three themes emerged: social challenges, economic challenges and psychological challenges. Stigma is found to be the most common challenge. Other challenges included worry about the child's future, lack of social support, strained relationships with others, impact on their job, and marital conflict. Concerning coping mechanisms, two themes emerged: Inward and outward means of coping. The inward means of coping included prayer and developing an optimistic mindset whereas the outward means were family support, healthcare providers' guidance, and social avoidance. CONCLUSIONS The study found that parents of children with ADHD experience several aspects of psychological, social, and economic challenges. Support from healthcare professionals, family members, and the community at large is found to be useful for parents to cope with these challenges. Future research should focus on evaluating interventions that would help parents with ADHD cope with the challenges they experience.
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Affiliation(s)
- Wongelawit Mesfin
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, P.O.BOX: 1176, Addis Ababa, Ethiopia
| | - Kassahun Habtamu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, P.O.BOX: 1176, Addis Ababa, Ethiopia.
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Chacón-Candia JA, Ponce R, Marotta A. The reverse congruency effect elicited by eye-gaze as a function of attention-deficit/hyperactivity disorder symptoms. Front Psychol 2024; 15:1377379. [PMID: 38947900 PMCID: PMC11212038 DOI: 10.3389/fpsyg.2024.1377379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
Individuals diagnosed with attention deficit/hyperactivity disorder (ADHD) have been found to have impairments in multiple aspects of social cognition, thus including the attentional processing of socially relevant stimuli such as eye-gaze. However, to date, it remains unclear whether only the social-specific but not the domain-general directional components, elicited by eye-gaze are affected by ADHD symptomatology. To address this issue, the present study aimed to investigate the impact of ADHD-like traits on the social-specific attentional processing of eye-gaze. To this purpose, we conducted an online experiment with a sample of 140 healthy undergraduate participants who completed two self-reported questionnaires designed to assess ADHD-like traits, and a social variant of an interference spatial task known to effectively isolate the social-specific component of eye-gaze. To make our research plan transparent, our hypotheses, together with the plans of analyses, were registered before data exploration. Results showed that while the social-specific component of eye-gaze was evident in the sample, no significant correlation was found between this component and the measured ADHD-like traits. These results appear to contradict the intuition that the attentional processing of the social-specific components of eye-gaze may be impaired by ADHD symptomatology. However, further research involving children and clinical populations is needed in order to clarify this matter.
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Affiliation(s)
- Jeanette A. Chacón-Candia
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Renato Ponce
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Marotta
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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Neuperdt L, Beyer AK, Junker S, Mauz E, Hölling H, Schlack R. [Parental strain, inattention/hyperactivity symptoms and parent-reported ADHD in children and adolescents: results of the KiGGS study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:429-438. [PMID: 38536438 PMCID: PMC10995013 DOI: 10.1007/s00103-024-03859-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND A child's attention deficit hyperactivity disorder (ADHD) is associated with strain for the parents. In turn, psychosocial parental strain is associated with higher probabilities for the occurrence of inattention/hyperactivity symptoms (IHS) in their children. The aim of this paper is to assess the association between parental strain, IHS, and a parent-reported ADHD diagnosis of the children. METHODOLOGY Based on data from n = 4596 participants of the KiGGS cohort (wave 2: 2014-2017), the type and extent of parental strain was set in relation to IHS and an ADHD diagnosis of the child in cross-sectional analysis. Frequencies, means, beta coefficients, and odds ratios adjusted for sex, age, socioeconomic status, and migration background are reported. RESULTS In individual consideration, a greater number of parental strains were associated with IHS than with an ADHD diagnosis. In a multivariate analysis, financial worries and parenting problems/conflicts with the children were significant predictors of IHS and an ADHD diagnosis, respectively. In addition, four or more types of parental strain were associated with a higher likelihood of both IHS and an ADHD diagnosis. DISCUSSION Financial and child-rearing strain are relevant to parents of children with IHS and an ADHD diagnosis. Interrelationships between parental stress and a child's IHS or an ADHD diagnosis can be assumed. To relieve their burden, prevention can either aim at improving the situation of ADHD-affected families or at improving the family's handling of the child's ADHD.
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Affiliation(s)
- Laura Neuperdt
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Ann-Kristin Beyer
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Stephan Junker
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Elvira Mauz
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Heike Hölling
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Robert Schlack
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
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Karadağ M, Yılmaz Saygılı G, Topal Hangül Z, Subaşı Turgut F. Does attention deficit hyperactivity disorder worsen family functioning and parenting styles? A case control study. Int J Psychiatry Clin Pract 2024; 28:2-8. [PMID: 38014674 DOI: 10.1080/13651501.2023.2283221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE A bidirectional relationship between family functioning and parenting styles and Attention Deficit and Hyperactivity Disorder (ADHD) is proposed. The aim of this study is to examine the effect of ADHD symptoms on parenting styles and the general functionality of the family as well as symptoms of depression and anxiety. METHODS 73 children with ADHD (56%) and 56 controls (43%) (a total of 129 participants, 31% female, 69% male) with a mean age of 11.3 (7-17, n: 129) were included in the study, which was conducted in Gaziantep University Hospital Child Psychiatry Department in 2022. The participants completed psychometric scales. RESULTS Parents of children with ADHD showed higher positive parenting scores than the control group (p < 0.05). Inconsistent discipline scores were substantially higher in the ADHD combined subtype (14.38 ± 5.2) than in the attention deficit dominant group (17.59 ± 3.96) In addition, a strong correlation was found between familial functionality scores and ADHD severity in the ADHD attention deficit dominant subtype (r:0.601; p:0.027) and as ADHD severity increased, family functionality decreased. CONCLUSIONS This study shows that parents of children with ADHD have different parenting styles and ADHD affects the overall functionality of the family in the Turkish sample.
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Affiliation(s)
- Mehmet Karadağ
- Department of Child and Adolescent Psychiatry, Gaziantep University, Gaziantep, Turkey
| | - Gizem Yılmaz Saygılı
- Department of Child and Adolescent Psychiatry, Gaziantep University, Gaziantep, Turkey
| | - Zehra Topal Hangül
- Department of Child and Adolescent Psychiatry, Gaziantep University, Gaziantep, Turkey
| | - Fatma Subaşı Turgut
- Department of Child and Adolescent Psychiatry, Medicine Faculty of Dicle University, Diyarbakir, Turkey
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Bhide S, Efron D, Ukoumunne OC, Anderson V, Nicholson JM, Silk T, Hazell P, Gulenc A, Sciberras E. Family Functioning in Children With ADHD and Subthreshold ADHD: A 3-Year Longitudinal Study. J Atten Disord 2024; 28:480-492. [PMID: 38084374 PMCID: PMC10838481 DOI: 10.1177/10870547231217089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To compare family functioning over time for elementary school children with Attention-Deficit/Hyperactivity Disorder (ADHD; N = 179) and subthreshold ADHD (ST-ADHD; N = 86), to children without ADHD (Control; N = 212). METHOD ADHD was assessed using the Conners 3 ADHD Index and Diagnostic Interview Schedule for Children IV. At baseline, 18-month follow-up and 36-month follow-up, parents completed measures assessing a range of family functioning domains. RESULTS At baseline, the ADHD group reported higher psychological distress, less parenting self-efficacy, less parenting consistency, and more stressful life events; and both groups reported poorer family quality of life (QoL) and greater parenting anger. Trajectories were largely similar to controls (i.e., stable over time), but unlike controls, ADHD and ST-ADHD groups showed lessening parent-partner support and parenting warmth, respectively; and both groups showed worsening aspects of family QoL. CONCLUSION Families of children with ADHD and ST-ADHD report persistently poor or worsening family functioning; highlighting a need for tailored psycho-social supports.
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Affiliation(s)
- Sampada Bhide
- School of Pychology, Deakin University, Geelong, VIC, Australia
- Allied Health - Psychology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Daryl Efron
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Medical School, The University of Melbourne, Parkville, VIC, Australia
- The Royal Children's Hospital, Parkville, VIC, Australia
| | - Obioha C Ukoumunne
- National Institute for Health and Care Research Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, United Kingdom
| | - Vicki Anderson
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Medical School, The University of Melbourne, Parkville, VIC, Australia
- The Royal Children's Hospital, Parkville, VIC, Australia
| | - Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Bundoora, VIC, Australia
| | - Tim Silk
- School of Pychology, Deakin University, Geelong, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Philip Hazell
- Discipline of Psychiatry, School of Medicine, The University of Sydney and Westmead Hospital, NSW, Australia
| | - Alisha Gulenc
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Emma Sciberras
- School of Pychology, Deakin University, Geelong, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
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Eng AG, Nirjar U, Elkins AR, Sizemore YJ, Monticello KN, Petersen MK, Miller SA, Barone J, Eisenlohr-Moul TA, Martel MM. Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence. Horm Behav 2024; 158:105466. [PMID: 38039899 PMCID: PMC10872410 DOI: 10.1016/j.yhbeh.2023.105466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/14/2023] [Accepted: 11/24/2023] [Indexed: 12/03/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that exhibits striking sex differences in symptoms, prevalence, and associated problems across development. Etiological factors and mechanisms underlying these sex differences remain one of the most understudied aspects of this disorder. The current paper seeks to provide a novel theoretical framework for understanding this phenomenon by reviewing evidence that females with ADHD may experience a "double whammy" of organizational and activational pubertal hormonal effects. We propose a novel theory of activational effects of cyclical circulating ovarian hormones on ADHD with increasing risk at times of rapid declines in estrogen. These declines may decrease executive function and trait control at two points of the cycle characterized by biphasic affective risk: (1) increases in approach/risk-taking behaviors at mid-cycle (periovulatory) and (2) increases in avoidance/negative affect perimenstrually. Low estrogen and control may then interact with increases in positive and negative affect, respectively, to increase hyperactivity-impulsivity symptoms post-ovulation and inattention symptoms perimenstrually. These interactions may be exacerbated by organizational pubertal effects on relatively overdeveloped limbic circuitry and adolescent-specific social pressures magnified in females with ADHD.
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Affiliation(s)
- Ashley G Eng
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America.
| | - Urveesha Nirjar
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Anjeli R Elkins
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Yancey J Sizemore
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Krystina N Monticello
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Madeline K Petersen
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Sarah A Miller
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Jordan Barone
- University of Illinois Chicago at Chicago College of Medicine, Department of Psychiatry, 912 S. Wood St, Chicago, IL 60612, United States of America
| | - Tory A Eisenlohr-Moul
- University of Illinois Chicago at Chicago College of Medicine, Department of Psychiatry, 912 S. Wood St, Chicago, IL 60612, United States of America
| | - Michelle M Martel
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
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Pachiti I, Milienos FS, Dimitropoulou P. Child ViReal Support Program: A Randomized Controlled Trial Study for Effective Support of Parents Raising Children with Attention Deficits. Behav Sci (Basel) 2023; 13:691. [PMID: 37622831 PMCID: PMC10451949 DOI: 10.3390/bs13080691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/25/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) results in various functioning impairments in children's lives and families. Parents of children with ADHD report high levels of parenting stress, low levels of parental self-efficacy, and use of more authoritarian and/or permissive parenting practices than parents of typically developing children. Intervention programs need to address both children's and parents' needs and multimodal intervention programs could cover this demand. The aim of this study was to examine the efficacy of "Child ViReal Support Program"-a multi-level evidence-based comprehensive program-on parenting stress, parental self-efficacy, parenting practices, and the core symptoms of children's ADHD. Families with a child diagnosed with ADHD (n = 16) were randomly allocated to two groups (PC and CP; P = parent training, C = child training), and a cross-over design was utilized. Participating parents completed, in four different times during the study, the Parenting Stress Index-Short Form, the Parenting Sense of Competence Scale, the Parenting Styles and Dimensions Questionnaire-Short Version, and the parent form of the ADHD Rating Scale-IV. Parents from both groups, after their participation in the parent training, demonstrated reduced parenting stress, enhanced parental self-efficacy, and increased the employ of democratic parenting practices. More than that, they reported decreased levels of inattention and impulsivity/hyperactivity for their children. Evidence-based multi-level intervention programs could produce positive effects on parents and children by incorporating effective methods and tools in accordance with the needs and the demands of the family context.
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Affiliation(s)
- Iouliani Pachiti
- Department of Psychology, University of Crete, 74150 Rethymno, Greece;
- Applied Psychology Laboratory, Center for Research and Studies, University of Crete, 74150 Rethymno, Greece
| | - Fotios S. Milienos
- Department of Sociology, Panteion University of Social and Political Sciences, 17671 Athens, Greece;
| | - Panagiota Dimitropoulou
- Department of Psychology, University of Crete, 74150 Rethymno, Greece;
- Applied Psychology Laboratory, Center for Research and Studies, University of Crete, 74150 Rethymno, Greece
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Chen W, Epstein A, Toner M, Murphy N, Rudaizky D, Downs J. Enabling successful life engagement in young people with ADHD: new components beyond adult models of recovery. Disabil Rehabil 2023; 45:2288-2300. [PMID: 35944517 DOI: 10.1080/09638288.2022.2087763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 05/31/2022] [Accepted: 06/05/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To examine the lived experiences of young people successfully managing life with ADHD and investigate the applicability of adult models of Recovery to these individuals. METHODS Twenty-seven young people aged 15-31 years participated in qualitative interviews. Participants' success was indicated by employment, school attendance, absence of acute mental health episodes, or absence of chronic alcohol or drug use. Thematic analysis identified specific components of their life successes and challenges. RESULTS The emergent framework comprised four elements: (i) Recovernance (RE) (a portmanteau merging 'Recovery' and 'Maintenance'; ongoing adjustment to maintain one's personal best without an end point); (ii) Personal Optimization (PO) (continuously striving to maximize function and adjust one's goals given fluctuating impairments and internal resources); (iii) Self (S) (facing internal challenges and developing internal resilience); and (iv) Environment (E) (facing external challenges and fostering external resilience). These four elements yielded the acronym 'REPOSE'. CONCLUSIONS Recovery in young people with ADHD was not a linear journey, with many missteps leading to greater self-knowledge, life skills and mastery. Progress was leveraged on securely anchored internal and external resilience factors against the prospect of setbacks. Findings provide new concepts and novel lexicons to extend existing concepts in Recovery. Implications for rehabilitationCounselling and therapy for young people with ADHD should foster self-understanding, goal setting and self-vigilance as an ongoing process to build their capacity to tackle setbacks and adversities.Counselling and therapy for young people with ADHD focus on a strengths-based approach building internal and external resources, such as developing skills and establishing social connections that build infrastructure in the environment for meaningful participation.
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Affiliation(s)
- Wai Chen
- Fiona Stanley Hospital, Perth, Australia
- Graduate School of Education, The University of Western Australia, Perth, Australia
- School of Psychology and Exercise Sciences, Murdoch University, Perth, Australia
- School of Medicine (Fremantle), Notre Dame University Australia, Perth, Australia
- Curtin Medical School, Curtin University, Perth, Australia
- Curtin enAble Institute, Curtin University, Perth, Australia
| | - Amy Epstein
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | | | - Nada Murphy
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Daniel Rudaizky
- School of Psychological Science, The University of Western Australia, Perth, Australia
- School of Population Health, Curtin University, Perth, Australia
| | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Curtin School of Allied Health, Curtin University, Perth, Australia
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Liljenwall H, Lean RE, Smyser TA, Smyser CD, Rogers CE. Parental ADHD and ASD symptoms and contributions of psychosocial risk to childhood ADHD and ASD symptoms in children born very preterm. J Perinatol 2023; 43:458-464. [PMID: 35840709 PMCID: PMC9840718 DOI: 10.1038/s41372-022-01463-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/02/2022] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Examine maternal and paternal ADHD and ASD symptoms in relation to very preterm (VPT) and full-term (FT) children's ADHD and ASD symptoms. STUDY DESIGN In this longitudinal study, maternal- and teacher-report of child ADHD and ASD symptoms were obtained for 119 children (VPT = 79, FT = 40) at age 5-years using the Conner's Rating Scale-Revised (CRS-R) and Social Responsiveness Scale-2 (SRS-2). A biological parent completed self- and observer-report CRS-R and SRS-2, and measures of mood/affect, stress, and social support to assess psychosocial distress. Data were analyzed using mixed-effect models adjusted for covariates. RESULTS Child ADHD symptoms were associated with VPT birth, maternal distress, and maternal ADHD symptoms (p ≤ 0.02), and paternal ADHD symptoms (p < 0.001). Regarding ASD, VPT birth and parental ASD symptoms were associated with child ASD symptoms (p ≤ 0.009). Parental symptoms and birth group had no interaction. CONCLUSIONS VPT birth and parental psychopathology represent independent risks for ADHD and ASD.
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Affiliation(s)
- Helen Liljenwall
- Medical Education, Washington University School of Medicine, St Louis, MO, USA
| | - Rachel E Lean
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA.
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA.
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12
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Miyasaka M, Nomura M. Effect of financial and non-financial reward and punishment for inhibitory control in boys with attention deficit hyperactivity disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 134:104438. [PMID: 36701956 DOI: 10.1016/j.ridd.2023.104438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The development of inhibitory processes is disturbed in children with attention deficit hyperactivity disorder (ADHD); however, little is known about the effect of negative punishment for inhibitory performance in this population. AIMS We investigated differences in the effects of reward and punishment, developmental changes, and response inhibition between children with and without ADHD, using financial (F-FB) and non-financial (NF-FB) feedback. METHODS AND MATERIALS We conducted financial and non-financial go/no-go tasks under reward and punishment conditions with 21 boys with ADHD and 21 healthy controls (HCs), in Japan. OUTCOMES AND RESULTS We found group-related significant interactions between group, feedback type, and punishment (p = .013), and group, feedback type, and age (p = .009). There were significant differences in inhibitory error under F-FB only in HCs between the punishment-absent and punishment-present conditions (p = .003). In the ADHD group, age-dependent effects were found for both feedback types (ps < .01), but only F-FB effects were found in HCs (p = .008). CONCLUSIONS AND IMPLICATIONS Punishment for inhibitory control had different effects on the ADHD and HC groups. Children with ADHD respond differently to external motivation than HCs, leading to difficulties with peers or confusion among teachers and caregivers.
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Affiliation(s)
- Mami Miyasaka
- Graduate School of Education, Kyoto University, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Michio Nomura
- Graduate School of Education, Kyoto University, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan.
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13
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Reed M, Bedard C, Perlman CM, Browne DT, Ferro MA. Family Functioning and Health-Related Quality of Life in Parents of Children with Mental Illness. JOURNAL OF CHILD AND FAMILY STUDIES 2023:1-12. [PMID: 37362627 PMCID: PMC9958324 DOI: 10.1007/s10826-023-02556-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 06/28/2023]
Abstract
Previous research suggests that family dysfunction may be related to lower health-related quality of life (HRQoL) in parent caregivers, but it is unknown if this association exists in the context of child mental illness. Therefore, the objectives of this study were to compare HRQoL between parent caregivers and Canadian population norms using the Short Form 36 Health Survey (SF-36); examine associations between family functioning and parental HRQoL; and investigate whether child and parental factors moderate associations between family functioning and parental HRQoL. Cross-sectional data were collected from children receiving mental healthcare at a pediatric hospital and their parents (n = 97). Sample mean SF-36 scores were compared to Canadian population norms using t-tests and effect sizes were calculated. Multiple regression was used to evaluate associations between family functioning and parental physical and mental HRQoL, adjusting for sociodemographic and clinical covariates. Proposed moderators, including child age, sex, and externalizing disorder, and parental psychological distress, were tested as product-term interactions. Parents had significantly lower physical and mental HRQoL versus Canadian norms in most domains of the SF-36, and in the physical and mental component summary scores. Family functioning was not associated with parental physical HRQoL. However, lower family functioning predicted lower parental mental HRQoL. Tested variables did not moderate associations between family functioning and parental HRQoL. These findings support the uptake of approaches that strive for collaboration among healthcare providers, children, and their families (i.e., family-centered care) in child psychiatry settings. Future research should explore possible mediators and moderators of these associations.
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Affiliation(s)
- Madeline Reed
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON Canada
| | - Chloe Bedard
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON Canada
| | - Christopher M. Perlman
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON Canada
| | - Dillon T. Browne
- Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON Canada
| | - Mark A. Ferro
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON Canada
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14
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Lin PY, Chou WJ, Hsiao RC, Liu TL, Yen CF. Association of Affiliate Stigma with Parenting Stress and Its Moderators among Caregivers of Children with Attention-Deficit/Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3192. [PMID: 36833887 PMCID: PMC9959478 DOI: 10.3390/ijerph20043192] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 05/31/2023]
Abstract
Caring for children with attention-deficit/hyperactivity disorder (CADHD) is stressful for caregivers. Identifying factors related to parenting stress in caregivers of CADHD can facilitate the development of intervention programs. This study aimed to examine the associations between affiliate stigma and various domains of parenting stress among caregivers of CADHD. This study also analyzed the moderating effects of demographic characteristics and the symptoms of childhood ADHD and oppositional defiant disorder (ODD) on the associations between affiliate stigma and parenting stress. In total, 213 caregivers of CADHD participated in this study. Parenting stress was assessed using the Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF). Affiliate stigma was assessed using the Affiliate Stigma Scale. ADHD and ODD symptoms were assessed using the Parent Form of the Swanson, Nolan, and Pelham Scale, Version IV. The results indicated that higher affiliate stigma was significantly associated with greater parenting stress in all three domains of the PSI-4-SF. ODD symptoms increased the magnitude of parenting stress in two domains of parenting stress among caregivers with affiliate stigma. Intervention programs for relieving parenting stress among caregivers of CADHD should take affiliate stigma and child ODD symptoms into consideration.
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Affiliation(s)
- Pei-Yun Lin
- Department of Psychiatry, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 81267, Taiwan
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Wen-Jiun Chou
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98295, USA
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98105, USA
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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15
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Brinksma DM, Hoekstra PJ, de Bildt A, Buitelaar JK, van den Hoofdakker BJ, Hartman CA, Dietrich A. Parental rejection in early adolescence predicts a persistent ADHD symptom trajectory across adolescence. Eur Child Adolesc Psychiatry 2023; 32:139-153. [PMID: 34275051 PMCID: PMC9908736 DOI: 10.1007/s00787-021-01844-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 07/07/2021] [Indexed: 12/16/2022]
Abstract
Despite a general decrease of attention-deficit/hyperactivity disorder (ADHD) symptoms during adolescence, these may persist in some individuals but not in others. Prior cross-sectional studies have shown that parenting style and their interaction with candidate genes are associated with ADHD symptoms. However, there is a lack of longitudinal research examining the independent and interactive effects of parenting and plasticity genes in predicting the course of attention-deficit/hyperactivity disorder (ADHD) symptoms across adolescence. Here, we investigated how children perceived their parents' parenting style (i.e., rejection, overprotection, and emotional warmth) at the age of 11, and their interaction with DRD4, MAOA, and 5-HTTLPR genotypes on parent-reported ADHD symptoms at three time points (mean ages 11.1, 13.4, and 16.2 years) in 1730 adolescents from the TRacking Adolescents' Individual Lives Survey (TRAILS). Growth Mixture Modeling in Mplus identified four ADHD symptom trajectories: low, moderate stable, high decreasing, and high persistent. Perceived parental rejection predicted class membership in the high persistent trajectory compared to the other classes (p < 0.001, odds ratios between 2.14 and 3.74). Gene-environment interactions were not significantly related to class membership. Our results indicate a role of perceived parental rejection in the persistence of ADHD symptoms. Perceived parental rejection should, therefore, be taken into consideration during prevention and treatment of ADHD in young adolescents.
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Affiliation(s)
- Djûke M Brinksma
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Lübeckweg 2, NL-9723 HE, Groningen, The Netherlands.
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16
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Zhang Z, Li R, Zhou Z, Wang P, Yang B, Wang X. The effect of physical activity on quality of life and parenting stress in children with attention-deficit/hyperactivity disorder: A randomized controlled trial. Disabil Health J 2023; 16:101377. [PMID: 36202733 DOI: 10.1016/j.dhjo.2022.101377] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Poorer quality of life (QoL) is commonly observed in children with Attention-deficit/Hyperactivity Disorder (ADHD). Parents of children with ADHD also perceived elevated levels of parenting stress. Previous research has documented the positive effects of physical activity (PA) on managing ADHD symptoms. It is critical to implement ADHD management with broader functioning from both children's and parents' perspectives. OBJECTIVE This study aimed to examine whether PA would exert an influence on the QoL of children with ADHD and parenting stress of their parents. METHODS Forty-three children with ADHD (6-12 years) were randomly assigned to the PA intervention and waitlist control groups. Children in the intervention group participated in a 12-week PA program. Parent-reported QoL and parenting stress were assessed before and immediately after the intervention. Analysis of covariance with a mixed factorial design of 2 (time: before vs. after intervention) × 2 (group: PA intervention vs. waitlist control) was conducted to examine changes in QoL and parenting stress over the 12 weeks. RESULTS Compared to the control group, parents of children in the intervention group reported significant reduced overall parenting stress (p = .021, η2 = 0.142) and child domain of parenting stress (p = .024, η2 = 0.138) after the intervention. No significant improvement in QoL was documented in either group. CONCLUSIONS The participation of PA intervention positively impacts parenting stress perceived by parents of children with ADHD, which provides further evidence of the family-wide benefits of the PA intervention.
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Affiliation(s)
- Zhenzhen Zhang
- Faculty of Physical Education, Shenzhen University, Shenzhen, China
| | - Ru Li
- Faculty of Physical Education, Shenzhen University, Shenzhen, China.
| | - Ziwei Zhou
- Faculty of Physical Education, Shenzhen University, Shenzhen, China
| | - Peng Wang
- Cardiac Rehabilitation Center, Fuwai Hospital, CAMS&PUMC, Beijing, China
| | - Binrang Yang
- Children's Healthcare & Mental Health Center, Shenzhen Children's Hospital, Shenzhen, China
| | - Xiaodong Wang
- Faculty of Physical Education, Shenzhen University, Shenzhen, China
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17
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Propper L, Sandstrom A, Rempel S, Howes Vallis E, Abidi S, Bagnell A, Lovas D, Alda M, Pavlova B, Uher R. Attention-deficit/hyperactivity disorder and other neurodevelopmental disorders in offspring of parents with depression and bipolar disorder. Psychol Med 2023; 53:559-566. [PMID: 34140050 DOI: 10.1017/s0033291721001951] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Offspring of parents with major mood disorders (MDDs) are at increased risk for early psychopathology. We aim to compare the rates of neurodevelopmental disorders in offspring of parents with bipolar disorder, major depressive disorder, and controls. METHOD We established a lifetime diagnosis of neurodevelopmental disorders [attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, communication disorders, intellectual disabilities, specific learning disorders, and motor disorders] using the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version in 400 participants (mean age 11.3 + s.d. 3.9 years), including 93 offspring of parents with bipolar disorder, 182 offspring of parents with major depressive disorder, and 125 control offspring of parents with no mood disorder. RESULTS Neurodevelopmental disorders were elevated in offspring of parents with bipolar disorder [odds ratio (OR) 2.34, 95% confidence interval (CI) 1.23-4.47, p = 0.010] and major depressive disorder (OR 1.87, 95% CI 1.03-3.39, p = 0.035) compared to controls. This difference was driven by the rates of ADHD, which were highest among offspring of parents with bipolar disorder (30.1%), intermediate in offspring of parents with major depressive disorder (24.2%), and lowest in controls (14.4%). There were no significant differences in frequencies of other neurodevelopmental disorders between the three groups. Chronic course of mood disorder in parents was associated with higher rates of any neurodevelopmental disorder and higher rates of ADHD in offspring. CONCLUSIONS Our findings suggest monitoring for ADHD and other neurodevelopmental disorders in offspring of parents with MDDs may be indicated to improve early diagnosis and treatment.
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Affiliation(s)
- L Propper
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - A Sandstrom
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - S Rempel
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - E Howes Vallis
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - S Abidi
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - A Bagnell
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - D Lovas
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- IWK Health Centre, Halifax, NS, Canada
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - B Pavlova
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
| | - R Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Health Authority, Halifax, NS, Canada
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18
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Associations between Family Functioning and Symptoms of Attention-Deficit Hyperactivity Disorder (ADHD): A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10081502. [PMID: 36011159 PMCID: PMC9408192 DOI: 10.3390/healthcare10081502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Poor family functioning is linked with poor child ADHD symptoms. However, there are many dimensions of family functioning. Thus, this study aims to find the association between each dimension of family functioning and controlled ADHD symptoms in an Asian culture. This cross-sectional study involved caregivers of 113 Thai children with ADHD ages 4–16 years old who visited the Outpatient Department at Maharaj Nakorn Chiang Mai Hospital between October 2017 and March 2018. The caregivers completed the Chulalongkorn Family Inventory and the SNAP-IV Thai version. Logistic regression was used to examine each dimension of family functioning adjusting for potential confounders. In univariate analyses, six of the seven dimensions of family functioning were associated with controlled ADHD symptoms. In multivariate analyses, findings revealed that good family roles (aOR 7.48, 95% CI = 1.56 to 35.85, p = 0.01) and behavior control (aOR 2.56, 95% CI = 1.08 to 6.03, p = 0.03) were associated with controlled ADHD symptoms. In children with ADHD with poor symptom control, the assessment of family functioning could be helpful. Developing a more specific intervention for caregivers that promotes good family roles and behavioral control may be beneficial.
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19
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Parent training in non-violent resistance for children with attention deficit hyperactivity disorder: a controlled outcome study. Eur Child Adolesc Psychiatry 2022; 31:929-938. [PMID: 33528659 DOI: 10.1007/s00787-021-01723-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Current forms of parent training for childhood attention deficit hyperactivity disorder (ADHD) are often insufficient. Many families drop out of the training, and treatment gains are often not maintained. Nonviolent resistance parent training (NVR) focuses on helping parents resist the child's negative behaviors without escalating the problem. NVR helps parents to fulfill an anchoring function, supporting the child through presence, self-regulation, structure, and support network. This study is a randomized controlled trial designed to assess the efficacy of NVR in the treatment of childhood ADHD. Participants were Israeli parents of children with primary ADHD diagnosis (N = 101; 5-13 years old; 79% male participants) randomly assigned to either 12-session NVR (N = 50) or waiting list (N = 51). Measures were administered before and after treatment and at a 4-month follow-up. ADHD outcomes included the Conners and Child Behavior Checklist. Parenting outcomes included parental helplessness, emotional regulation, anchoring function, and family chaos. Participants in the NVR condition reported significant improvements in the child's internalizing, externalizing, and ADHD symptoms, as well as improvement in paternal and maternal helplessness and anchoring. Participants in the control condition did not report changes in the child's symptoms or the parents' condition. The results at follow-up revealed maintenance of change in the child's externalizing and internalizing symptoms, but failure to maintain gains in ADHD core symptoms. Maternal helplessness and anchoring, as well as family chaos continued to improve at follow-up. Dropout rates in the treatment group were low (5%), and fathers' engagement was close to 100%. NVR is an efficient treatment for childhood ADHD, with benefits extending beyond the child's symptoms to the entire family. NVR's special focus on parental distress may have contributed to low dropout, high paternal engagement, and maintenance of change.
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20
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Nylén-Eriksen M, Lara-Cabrera ML, Grov EK, Skarsvaag H, Lie I, Dahl-Michelsen T, Sæterstrand TM, Mandahl A, Hafstad H, Lersveen MB, Bjørnnes AK. Fighting the waves; Covid-19 family life interference in a neurodevelopmental disorder-caregiver population. BMC Health Serv Res 2022; 22:472. [PMID: 35399084 PMCID: PMC8994698 DOI: 10.1186/s12913-022-07836-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/17/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The current COVID-19 pandemic interferes with family lives across the world, particularly families of children with neurodevelopmental disorders (NDDs) are at a greater risk for being negatively impacted by the pandemic. Together with representatives from this caregiver population the aim was to explore the interference associated with normal family life caused by the COVID-19 pandemic. Method This is a descriptive study using a cross-sectional design. Following a strategic network sampling strategy, a user-developed national survey was completed by a larger sample (N = 1,186) of parents and informal caregivers of children with NDDs. The survey utilized a combination of both closed and open-ended questions, and a logistic regression analysis was carried out to assess the association between family characteristics, characteristics of the child, and COVID-19 related family life interference. Before carrying out the regression an inductive content analysis of the open-ended question on `How has the isolation affected the family´ was carried out to construct the outcome variable. Results The initial analysis indicated that the COVID-19 pandemic induced a shift in everyday family life and a lack of guidance and support related to managing the challenges they were facing. Caregivers who reported that COVID-19 had significantly interfered with their family life, were more likely to report having anxious children, and to have experienced an increased number of conflicts at home. The logistic regression showed that both anxious children and increased conflicts considerably increased the risk for reporting family life interference compared to those that reported no increased conflicts or anxious children. Discussion Considering how the COVID-19 related increased conflicts at home and anxious children threaten the family life of the NDD caregiver population, as an external source of family stress, which might lead to negative impact on their mental and physical well-being, the need for further research in collaboration with user representatives is apparent. Our study suggests that more information should be provided to healthcare providers, social professionals, peers, people with NDDs, and caregivers of people with NDDs about the potential threats that a stressful life event such as the current pandemic can pose to their mental and physical health and their family life.
Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07836-3.
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21
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Kostyrka-Allchorne K, Ballard C, Byford S, Cortese S, Daley D, Downs J, French B, Glazebrook C, Goldsmith K, Groom MJ, Hall CL, Hedstrom E, Ibrahim Z, Jarvis C, Kovshoff H, Kreppner J, Lean N, Morris A, Gutierrez WM, Sayal K, Shearer J, Simonoff E, Thompson M, Zalewski L, Sonuga-Barke EJS. The feasibility of a strategy for the remote recruitment, consenting and assessment of recent referrals: a protocol for phase 1 of the On-Line Parent Training for the Initial Management of ADHD referrals (OPTIMA). Pilot Feasibility Stud 2022; 8:1. [PMID: 34980279 PMCID: PMC8720938 DOI: 10.1186/s40814-021-00959-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the UK, children with high levels of hyperactivity, impulsivity and inattention referred to clinical services with possible attention-deficit/hyperactivity disorder (ADHD) often wait a long time for specialist diagnostic assessment. Parent training (PT) has the potential to support parents during this difficult period, especially regarding the management of challenging and disruptive behaviours that often accompany ADHD. However, traditional face-to-face PT is costly and difficult to organise in a timely way. We have created a low-cost, easily accessible PT programme delivered via a phone app, Structured E-Parenting Support (STEPS), to address this problem. The overall OPTIMA programme will evaluate the efficacy and cost-effectiveness of STEPS as a way of helping parents manage their children behaviour while on the waitlist. To ensure the timely and efficient evaluation of STEPS in OPTIMA, we have worked with children's health services to implement a remote strategy for recruitment, screening and assessment of recently referred families. Part of this strategy is incorporated into routine clinical practice and part is OPTIMA specific. Here, we present the protocol for Phase 1 of OPTIMA-a study of the feasibility of this remote strategy, as a basis for a large-scale STEPS randomised controlled trial (RCT). METHODS This is a single arm observational feasibility study. Participants will be parents of up to 100 children aged 5-11 years with high levels of hyperactivity/impulsivity, inattention and challenging behaviour who are waiting for assessment in one of five UK child and adolescent mental health or behavioural services. Recruitment, consenting and data collection will occur remotely. The primary outcome will be the rate at which the families, who meet inclusion criteria, agree in principle to take part in a full STEPS RCT. Secondary outcomes include acceptability of remote consenting and online data collection procedures; the feasibility of collecting teacher data remotely within the required timeframe, and technical difficulties with completing online questionnaires. All parents in the study will receive access to STEPS. DISCUSSION Establishing the feasibility of our remote recruitment, consenting and assessment strategy is a pre-requisite for the full trial of OPTIMA. It can also provide a model for future trials conducted remotely.
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Affiliation(s)
- Katarzyna Kostyrka-Allchorne
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Claire Ballard
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Sarah Byford
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA
| | - David Daley
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Johnny Downs
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Blandine French
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Cristine Glazebrook
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Kimberley Goldsmith
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Madeleine J Groom
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Charlotte L Hall
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Ellen Hedstrom
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Zina Ibrahim
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Hanna Kovshoff
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Jana Kreppner
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Nancy Lean
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Anna Morris
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Walter Muruet Gutierrez
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kapil Sayal
- Academic Unit of Mental Health & Clinical Neurosciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - James Shearer
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Margaret Thompson
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
| | - Lukasz Zalewski
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
- Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark.
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22
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Childress AC, Foehl HC, Newcorn JH, Faraone SV, Levinson B, Adjei AL. Long-Term Treatment With Extended-Release Methylphenidate Treatment in Children Aged 4 to <6 Years. J Am Acad Child Adolesc Psychiatry 2022; 61:80-92. [PMID: 33892111 DOI: 10.1016/j.jaac.2021.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 03/09/2021] [Accepted: 03/26/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate long-term (12-month) safety and symptom control of extended-release methylphenidate (MPH-MLR) in children aged 4 to <6 years after treatment optimization. METHOD A total of 90 children aged 4 to <6 years with attention-deficit/hyperactivity disorder (ADHD) were enrolled from 2 MPH-MLR studies. Treatment-emergent adverse events (TEAEs) and ADHD symptom control were assessed in the safety population (n = 89) and modeled with mixed model analyses. RESULTS Most TEAEs (89.9%) were rated by investigators as of mild or moderate severity. One serious AE was reported (unrelated to study drug). Ten children discontinued because of TEAEs. Two discontinued because of weight loss; no significant increase in the rate of underweight children from baseline to endpoint was observed. Overall, 18% lost weight and 18% reported decreased appetite. Weight and height z scores and obesity rates decreased significantly from baseline to endpoint. Insomnia was reported (9%); none of these children discontinued. Sleep quality did not change significantly. Hypertension was reported (6.7%); none of these children dropped out. Diastolic, but not systolic, blood pressure increased significantly during the follow-up. Control of ADHD symptoms was maintained throughout follow-up. CONCLUSION These data contribute to the understanding of the long-term safety of an extended-release stimulant in children 4 to <6 years of age. The observed risk of a TEAE-related discontinuation was ∼11%. TEAEs were not dose related, and most were of mild to moderate severity. Symptom control was maintained through the year-long study. CLINICAL TRIAL REGISTRATION INFORMATION A 12-Month Open Label Safety Study of Aptensio XR® in Children Ages 4-5 Years Diagnosed With ADHD (EF004); https://clinicaltrials.gov; NCT02677519.
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Affiliation(s)
- Ann C Childress
- Dr. Childress is with the Center for Psychiatry and Behavioral Medicine, Inc., Las Vegas, Nevada
| | - Henry C Foehl
- Dr. Foehl is with Foehl Statistics & Analytics LLC, Glenmoore, Pennsylvania
| | - Jeffrey H Newcorn
- Dr. Newcorn is with Icahn School of Medicine at Mount Sinai, New York
| | - Stephen V Faraone
- Dr. Faraone is with SUNY Upstate Medical University, Syracuse, New York
| | - Benjamin Levinson
- Drs. Levinson and Adjei are currently retired. At the time of the study, Drs. Levinson and Adjei were with Rhodes Pharmaceuticals, Coventry, Rhode Island
| | - Akwete L Adjei
- Drs. Levinson and Adjei are currently retired. At the time of the study, Drs. Levinson and Adjei were with Rhodes Pharmaceuticals, Coventry, Rhode Island.
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23
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Keating J, Bramham J, McNicholas F, Carr A, Hasshim N, Downes M. An Exploration of Sleep and Family Factors in Young Children at Familial Risk for ADHD. Behav Sleep Med 2021; 19:754-768. [PMID: 33350348 DOI: 10.1080/15402002.2020.1862119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: The aim of the current study was to examine relations between sleep problems and family factors and early markers of ADHD in young children with and without a familial risk for ADHD.Methods: Differences in sleep behavior and family functioning in children under 6 years with (n = 72) and without (n = 139) a familial risk for ADHD were investigated. The influence of family and sleep factors on the development of early temperament markers of ADHD (effortful control and negative affect) was explored. Parents/caregivers completed questionnaires on family functioning, child sleep behavior, and general regulatory behaviors.Results: A significant difference was observed between high-risk and low-risk groups for family functioning in the infant/toddler (<3 years) and preschool (>3 years) cohorts. Parents of infants/toddlers in the high-risk group reported poorer infant sleep. However, there were no sleep differences reported for the preschool cohort. Family functioning was found to predict effortful control, while sleep quality predicted negative affect.Conclusion: The results of this study highlight potential family and sleep issues for young children with a familial history of ADHD and the potential influence of these factors on early temperament markers of ADHD. Future research should explore these relations further in order to better establish whether early sleep and family interventions could mitigate later ADHD symptomatology.
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Affiliation(s)
- J Keating
- School of Psychology, University College Dublin, Dublin, Ireland
| | - J Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - F McNicholas
- School of Psychiatry, University College Dublin, Dublin, Ireland
| | - A Carr
- School of Psychology, University College Dublin, Dublin, Ireland
| | - N Hasshim
- School of Psychology, University College Dublin, Dublin, Ireland.,Divison of Psychology, De Montfort University, Leicester, UK
| | - M Downes
- School of Psychology, University College Dublin, Dublin, Ireland
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24
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Yousef AM, Sehlo MG, Mohamed AE. The negative psychological impact of COVID-19 pandemic on mothers of children with attention deficit hyperactivity disorder (ADHD): a cross-section study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [PMCID: PMC8413698 DOI: 10.1186/s43045-021-00139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background ADHD is an important cause for psychiatric care as one of the most prominent neurodevelopmental conditions. Being an ADHD child’s parent is a daunting and sometimes stressful job that becomes more challenging during the COVID-19 pandemic and its negative consequences. This cross-sectional study was applied to 54 mothers of ADHD children and adolescents; the data of the ADHD children and adolescents have been registered before the lockdown on their regular follow-up visits on the child and adolescent’s clinic of the psychiatry department. Data of the study were collected through an electronic Google form included a COVID-19 questionnaire, The Depression, Anxiety, and Stress Scale—21 Items (DASS-21) (Arabic version), and Conners’ Parent Rating Scale Revised-short version (CPRS-48). We aimed to assess symptoms of anxiety, depression, and stress symptoms among the mothers of ADHD children and adolescents during COVID-19 outbreaks and determine the relationship between these symptoms and the changed circumstances that occurred by the COVID-19 pandemic, also with the behavioral problem of their children that may deteriorate by their mothers’ psychological state. Results Most of our participants were from the low socioeconomic class and were married. In total, 29.6% of the mother of ADHD children had confirmed COVID-19 cases among their family members, while 11.1% of our subjects lost a family member due to this epidemic, 22% of our sample lost their work because of COVID-19. We found that the COVID-19 pandemic has a big financial drawback on the family of our participants by a percentage of 31.5%. We noticed that 48.1% of our sample documented domestic violence toward them compared to before COVID-19. A total of 92.6% of the mothers who participated in our study assessed the period of change and restrictions as being very demanding. We found that 74.1% of ADHD patients were not compliant with their medications than before the epidemic. Also, we found that the mothers of ADHD children have bigger challenges in managing the child’s meals, structured activities, and sleep compared to before COVID-19. We showed that 53.7% of the mothers had depressive symptoms, 61% had anxiety symptoms, and 53.7% had stress symptoms. These symptoms were statistically associated with the lost family member due to COVID-19, the financial drawbacks of the COVID-19 outbreak, and the domestic violence toward mothers, compared to before COVID-19, the non-compliance of their children on the medications compared to before COVID-19, the presence of confirmed COVID-19 cases among family members, mother’s assessment of the period of change and restrictions as being very demanding compared to before COVID-19, and the non-compliance of their children on the medications compared to before COVID-19 as well as the increased behavioral symptoms of their children. Conclusion COVID-19 pandemic has psychological influences on mothers of children with ADHD. A significant number of them may have depression, anxiety, and stress symptoms that could affect their children’s compliance with the medication and, consequently, their symptomatology.
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25
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Chou WJ, Hsiao RC, Chang CC, Yen CF. Predictors of Depressive Symptoms in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder: A One-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168835. [PMID: 34444584 PMCID: PMC8393252 DOI: 10.3390/ijerph18168835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/14/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022]
Abstract
This 1-year follow-up study examined the predictive values of the demographics, depressive symptoms, stress-coping orientations, and perceived family support of caregivers as well as the internalizing, externalizing and ADHD symptoms of children with attention-deficit/hyperactivity disorder (ADHD) at baseline on the depressive symptoms of the caregivers after 1 year. A total of four hundred caregivers of children with ADHD were recruited. The baseline levels of the caregivers' depressive symptoms, stress-coping orientations, and perceived family support and the internalizing and externalizing problems of the children were assessed using the Center for Epidemiological Studies Depression Scale, the Coping Orientation to Problems Experienced, Family Adaptation, Partnership, Growth, Affection, Resolve Index, and the Child Behavior Checklist For Ages 6-18, respectively. Their predictions for the caregiver's depressive symptoms 1 year after the baseline were examined using linear regression analysis. In total, 382 caregivers of children with ADHD underwent the follow-up assessment 1 year from the baseline. A marital status of being separated or divorced, less effective coping and depressive symptoms orientation, and children with internalizing problems and ADHD symptoms at baseline were positively associated with the caregivers' depressive symptoms at follow-up, whereas the caregivers' perceived family support and an emotion-focused coping orientation at baseline were negatively associated with depressive symptoms at follow-up. Multiple characteristics of the caregivers and children with ADHD at baseline predicted the caregivers' depressive symptoms 1 year later.
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Affiliation(s)
- Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA;
- Department of Psychiatry, Children’s Hospital and Regional Medical Center, Seattle, WA 98105, USA
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan
- Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan 71101, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6816) (C.-F.Y.); Fax: +886-6-2203702 (C.-C.C.); +886-7-3134761 (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (C.-C.C.); (C.-F.Y.); Tel.: +886-6-2228116 (ext. 58604) (C.-C.C.); +886-7-3121101 (ext. 6816) (C.-F.Y.); Fax: +886-6-2203702 (C.-C.C.); +886-7-3134761 (C.-F.Y.)
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26
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Did Affiliate Stigma Predict Affective and Behavioral Outcomes in Caregivers and Their Children with Attention-Deficit/Hyperactivity Disorder? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147532. [PMID: 34299983 PMCID: PMC8304190 DOI: 10.3390/ijerph18147532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/05/2021] [Accepted: 07/13/2021] [Indexed: 12/17/2022]
Abstract
The aim of this follow-up study was to examine the predictive values of caregivers' affiliate stigma at baseline for depression in caregivers and internalizing and externalizing symptoms in children with attention-deficit/hyperactivity disorder (ADHD) 1 year later. The Study on Affiliate Stigma in Caregivers of Children with ADHD surveyed the levels of affiliate stigma and depression in 400 caregivers and the behavioral problems of their children with ADHD. The levels of the caregivers' depression and children's behavioral problems were assessed 1 year later. The associations of caregivers' affiliate stigma at baseline with depression in caregivers and internalizing and externalizing symptoms in children with ADHD at follow-up were examined using stepwise multiple regression. The results indicated that before caregivers' depression and children's behavioral problems at baseline were controlled, caregivers' affiliate stigma at baseline positively predicted caregivers' depression and all children's behavioral problems. After caregivers' depression and children's behavioral problems at baseline were controlled, caregivers' affiliate stigma at baseline still positively predicted children's affective and somatic problems. Parenting training and cognitive behavioral therapy should be provided to caregivers with intense affiliate stigma to prevent emotional problems and difficulties in managing their children's behavioral problems.
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27
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Coll-Martín T, Carretero-Dios H, Lupiáñez J. Attentional networks, vigilance, and distraction as a function of attention-deficit/hyperactivity disorder symptoms in an adult community sample. Br J Psychol 2021; 112:1053-1079. [PMID: 34089269 DOI: 10.1111/bjop.12513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/09/2021] [Indexed: 01/29/2023]
Abstract
Attentional difficulties are a core axis in attention-deficit/hyperactivity disorder (ADHD). However, establishing a consistent and detailed pattern of these neurocognitive alterations has not been an easy endeavour. Based on a dimensional approach to ADHD, the present study aims at comprehensively characterizing three key attentional domains: the three attentional networks (alerting, orienting, and executive attention), two components of vigilance (executive and arousal vigilance), and distraction. To do so, we modified a single, fine-grained task (the ANTI-Vea) by adding irrelevant distractors. One hundred and twenty undergraduates completed three self-reports of ADHD symptoms in childhood and adulthood and performed the ANTI-Vea. Despite the low reliability of some ANTI-Vea indexes, the task worked successfully. While ADHD symptoms in childhood were related to alerting network and arousal vigilance, symptoms in adulthood were linked to executive vigilance. No association between ADHD symptom severity and executive attention and distraction was found. In general, our hypotheses about the relationships between ADHD symptoms and attentional processes were partially supported. We discuss our findings according to ADHD theories and attention measurement.
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Affiliation(s)
- Tao Coll-Martín
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain.,Department of Behavioral Sciences Methodology, University of Granada, Spain
| | - Hugo Carretero-Dios
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain.,Department of Behavioral Sciences Methodology, University of Granada, Spain
| | - Juan Lupiáñez
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Spain.,Department of Experimental Psychology, University of Granada, Spain
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28
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Stickley A, Shirama A, Kitamura S, Kamio Y, Takahashi H, Saito A, Haraguchi H, Kumazaki H, Mishima K, Sumiyoshi T. Attention-deficit/hyperactivity disorder symptoms and sleep problems in preschool children: the role of autistic traits. Sleep Med 2021; 83:214-221. [PMID: 34049039 DOI: 10.1016/j.sleep.2021.04.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Sleep problems are elevated in children with attention-deficit/hyperactivity disorder (ADHD). However, until now there has been comparatively little research on the role of autistic traits in this association. The current study examined the association between ADHD symptoms and sleep problems in Japanese preschool children and whether autistic traits might also be important for this relationship. METHODS Data were analyzed from 1053 children (average age 64.14 months, range 58-71; 50.3% male) that were drawn from the Tama Children's Survey (TCS). Parent-reported information was obtained on ADHD symptoms using the Strengths and Difficulties Questionnaire (SDQ) and autistic traits with the Social Responsiveness Scale Second Edition (SRS-2). Parents also provided information on three different categories of sleep problems experienced by their children - parasomnias, sleep disordered breathing and awakening/daytime problems. Ordinal logistic regression analysis was used to examine the associations. RESULTS In analyses adjusted for sociodemographic factors, the mother's mental health and child's emotional problems, compared to children with no ADHD symptoms or autistic traits, children with only ADHD symptoms had significantly increased odds for only one of 11 individual sleep problems - waking in a negative mood. In contrast, children with comorbid ADHD symptoms and autistic traits had elevated odds for five sleep problems with odds ratios ranging from 2.10 (takes time to become alert in the morning) to 3.46 (excessive body movement while sleeping). CONCLUSIONS Sleep problems may be especially elevated in children with comorbid ADHD symptoms and autistic traits.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan.
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan
| | - Shingo Kitamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan
| | - Yoko Kamio
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan; Institute of Education and Human Development, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo, 112-8610, Japan
| | - Hidetoshi Takahashi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan; Kochi Medical School Department of Child and Adolescent Psychiatry, Kochi University, 185-1 Kohasu, Oko-cho, Nankoku-shi, Kochi, 783-8505, Japan
| | - Aya Saito
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan; Human Science Division, Faculty of Core Research, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo, 112-8610, Japan
| | - Hideyuki Haraguchi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan
| | - Hirokazu Kumazaki
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan
| | - Kazuo Mishima
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashicho, Kodaira, Tokyo, 187-8553, Japan
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29
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Chen YL, Chang CC, Chen YM, Liu TL, Hsiao RC, Chou WJ, Yen CF. Association between affiliate stigma and depression and its moderators in caregivers of children with attention-deficit/hyperactivity disorder. J Affect Disord 2021; 279:59-65. [PMID: 33038701 DOI: 10.1016/j.jad.2020.09.121] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND This study aimed to determine the association between affiliate stigma and depression in caregivers of children with attention-deficit/hyperactivity disorder (ADHD) in Taiwan and evaluated the moderating effects of perceived family support, self-esteem, and children's behavioral problems on the association. METHODS The affiliate stigma and depressive symptoms of 400 caregivers of children with ADHD were assessed using the Affiliate Stigma Scale and Center for Epidemiological Studies Depression Scale, respectively. A general linear model (GLM) was used to examine the association between affiliate stigma and depression symptoms. The interaction models of the GLM and the Johnson-Neyman technique were used to examine the moderating effects of caregivers' family support and self-esteem and children's internalizing problems and ADHD symptoms on the association. RESULTS Affiliate stigma was positively associated with the depression level in caregivers of children with ADHD. The level of the association between affiliate stigma and depression symptoms was negatively associated with the levels of family support and self-esteem but positively associated with the levels of child's internalizing problems and ADHD symptoms. LIMITATIONS The cross-sectional design limited the possibility of determining the causal relationships among the variables. CONCLUSIONS Prevention and intervention strategies should aim to reduce affiliate stigma and depression symptoms, as well as to target the moderators of the association.
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Affiliation(s)
- Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung, Taiwan; Department of Psychology, Asia University, Taichung, Taiwan
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan; Department of Health Psychology, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan
| | - Yu-Min Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ray C Hsiao
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States; Department of Psychiatry, Children's Hospital and Regional Medical Center, Seattle, WA, United States
| | - Wen-Jiun Chou
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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30
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Prenatal and Postnatal Predictive Factors for Children's Inattentive and Hyperactive Symptoms at 5 Years of Age: The Role of Early Family-related Factors. Child Psychiatry Hum Dev 2021; 52:783-799. [PMID: 32951139 PMCID: PMC8405488 DOI: 10.1007/s10578-020-01057-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 11/06/2022]
Abstract
We examined several parent-reported prenatal and postnatal factors as potential risk factors for attention-deficit and hyperactivity disorder (ADHD) symptomatology in 5-year-old children. Our study is based on the CHILD-SLEEP birth cohort. Several parental questionnaires were collected prenatally (32nd pregnancy week) and postnatally (i.e. child aged 3, 8, and 24 months and at 5 years). At 5 years of age, ADHD symptoms were assessed using questionnaires. Our main results showed that being a boy, parental depressive symptoms, more negative family atmosphere or a child's shorter sleep duration, and maternal authoritarian parenting style predicted inattentive/hyperactive symptoms. Maternal and paternal authoritative parenting style predicted less inattentive/hyperactive symptoms. Children with several risk factors together had the highest risk for inattentive/hyperactive symptoms. Our findings emphasise the need for early screening and treatment of parental mental health, and early evidence-based targeted parental support, to enable early intervention in those children at a risk of developing ADHD.
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Nestor B, Sutherland S, Kouros CD, Brunwasser SM, Weersing VR, Hollon SD, Gladstone TR, Clarke G, Beardslee W, Brent D, Garber J. Effects of an adolescent depression prevention program on maternal criticisms and positive remarks. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:927-937. [PMID: 32658515 PMCID: PMC8022270 DOI: 10.1037/fam0000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study examined effects of an adolescent depression prevention program on maternal criticisms and positive remarks, whether the extent of adolescents' depression accounted for effects, and whether effects of the program on maternal criticisms and positive remarks differed by adolescents' gender. Participants were 298 adolescent (Mage = 14.79, SD = 1.36; 59% female) offspring of mothers with histories of depression; youth were randomized to either a cognitive-behavioral prevention (CBP) program or usual care (UC). At baseline and 9-month postintervention evaluations, mothers were administered the Five-Minute Speech Sample to measure number of criticisms and positive remarks made during an open-ended description of their child and their relationship. Adolescents' depression from pre- through postintervention was assessed with interviews. A hierarchical generalized linear model showed a significant condition-by-gender interaction, indicating that, controlling for baseline criticism, at postintervention mothers of girls in CBP made significantly more criticisms than did mothers of girls in UC, whereas mothers of boys in CBP made fewer criticisms than did mothers of boys in UC. The extent of adolescents' depression from pre- through postintervention partially mediated the relation between intervention condition and mothers' criticisms, for boys but not for girls. Second, controlling for preintervention positive remarks, at postintervention, mothers of youth in CBP made significantly more positive remarks about their child than did mothers of youth in UC, regardless of gender; this relation was not mediated by adolescent depression from pre- through postintervention. We suggest possible explanations for the observed effects of CBP on mothers' criticisms and positive remarks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Bridget Nestor
- Department of Psychology and Human Development and Department of Psychology, Vanderbilt University
| | - Susanna Sutherland
- Department of Psychology and Human Development and Department of Psychology, Vanderbilt University
| | | | | | - V. Robin Weersing
- Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California, San Diego
| | - Steven D. Hollon
- Department of Psychology and Human Development and Department of Psychology, Vanderbilt University
| | | | - Greg Clarke
- Kaiser Permanente Center for Health Research
| | - William Beardslee
- Department of Psychiatry, Children’s Hospital Boston, and Judge Baker Children’s Center
| | - David Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine
| | - Judy Garber
- Department of Psychology and Human Development and Department of Psychology, Vanderbilt University
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Faleschini S, Matte-Gagné C, Luu TM, Côté S, Tremblay RE, Boivin M. Trajectories of Overprotective Parenting and Hyperactivity-Impulsivity and Inattention Among Moderate-Late Preterm Children: A Population-Based Study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1555-1568. [PMID: 32936392 DOI: 10.1007/s10802-020-00704-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 11/24/2022]
Abstract
Parents of preterm children are more likely to adopt non-optimal parenting behaviors than parents of full-term (FT) children. However, there is a lack of studies on parents of children born moderate to late preterm (MLP; 32-36 gestational weeks). In this study, we aimed to examine: (1) the association between MLP birth status and the trajectory of parental overprotection throughout preschool years, and (2) the role of parental overprotection, MLP birth status, and their interaction in the prediction of the trajectories of hyperactivity-impulsivity and inattention throughout childhood. Data comes from a Canadian representative population-based cohort including 2028 FT, 100 MLP children, and their parents. Overprotective parenting was measured when children were 5, 17, and 29 months old. Hyperactivity-impulsivity and inattention symptoms were measured repeatedly from 4 to 8 years of age. Trajectories of parents' overprotectiveness and children's hyperactivity-impulsivity and inattention were modeled. MLP birth status was associated with an increase in parental overprotectiveness across the preschool period. MLP birth status and parental overprotection were both found to be associated with higher levels of hyperactivity-impulsivity symptoms across childhood. No interaction was found between birth status and parental overprotection. The results suggest that parents of MLP children become more overprotective across time compared to parents of FT children and that children born MLP and/or exposed to higher levels of parental overprotection demonstrated higher levels of hyperactivity-impulsivity symptoms across childhood.
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Affiliation(s)
| | | | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine University Hospital Research Centre, University of Montreal, Montreal, Canada
| | - Sylvana Côté
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
| | - Richard E Tremblay
- Department of Pediatrics, Sainte-Justine University Hospital Research Centre, University of Montreal, Montreal, Canada
| | - Michel Boivin
- School of Psychology, Laval University, Quebec, Canada
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Pollak Y, Poni B, Gershy N, Aran A. The Role of Parental Monitoring in Mediating the Link Between Adolescent ADHD Symptoms and Risk-Taking Behavior. J Atten Disord 2020; 24:1141-1147. [PMID: 28823191 DOI: 10.1177/1087054717725875] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: ADHD in adolescents and low level of parental monitoring have been associated with increased risk-taking behavior. The present study examined whether parental knowledge of the child's whereabouts mediates the correlations between adolescent ADHD symptoms and risk-taking behavior. Method: Ninety-two adolescents and their parents completed questionnaires assessing perceptions of parents' monitoring, engagement in risk-taking behaviors, and ADHD symptoms. Results: Greater engagement in risk-taking behavior correlated with higher levels of ADHD symptoms and decreased parental monitoring. Mediation analysis revealed both direct effect of ADHD symptoms on risk-taking behavior and an indirect effect mediated by level of parental knowledge. Conclusion: These findings suggest that parental knowledge is negatively affected by the presence of ADHD symptoms, and may in turn lead to risk-taking behavior. The findings emphasize the need to target parenting and in particular parental knowledge of the child's whereabouts to reduce risk-taking behaviors among youth with ADHD.
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Affiliation(s)
| | - Bella Poni
- The Hebrew University of Jerusalem, Israel
| | | | - Adi Aran
- Shaare Zedek Medical Center, Jerusalem, Israel
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Hong M, Park B, Lee SM, Bahn GH, Kim MJ, Park S, Oh IH, Park H. Economic Burden and Disability-Adjusted Life Years (DALYs) of Attention Deficit/Hyperactivity Disorder. J Atten Disord 2020; 24:823-829. [PMID: 31364445 DOI: 10.1177/1087054719864632] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: We investigated the economic burden and disability-adjusted life years (DALYs) for attention deficit/hyperactivity disorder (ADHD) in the Republic of Korea. Method: Using the National Health Insurance Service claims data for the population aged 19 years or younger, a prevalence-based approach was used to calculate the DALYs of ADHD. Direct medical costs, direct nonmedical costs, and indirect costs resulting from ADHD were estimated to calculate the economic burden of ADHD. Results: A total of 69,353 people in Korea were diagnosed with ADHD in 2012. The burden of ADHD as measured by the prevalence-based approach was 32,605 DALYs. The total economic burden of ADHD was US$47.55 million, which accounted for approximately 0.004% of Korean GDP (gross domestic product) in 2012. Conclusion: Our findings shed light on the considerable burden of ADHD, emphasizing the need for policies that can encourage ADHD treatment and enhance compliance.
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Affiliation(s)
- Minha Hong
- Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Bomi Park
- Ewha Womans University, Seoul, Korea
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Schwörer MC, Nitkowski D, Petermann† F, Petermann U. Belastungserleben von Müttern mit Kindern mit ADHS. KINDHEIT UND ENTWICKLUNG 2020. [DOI: 10.1026/0942-5403/a000299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Zusammenfassung. Eltern von Kindern mit ADHS berichten von einer hohen psychischen Belastung, die durch die eigene und die kindliche Symptomatik bedingt scheint. Ziel der Studie ist es erstens zu prüfen, ob sich die mütterliche Belastung in Abhängigkeit davon unterscheidet, welche ADHS-Erscheinungsform bei den Kindern vorliegt und ob eine komorbide Symptomatik einer Störung mit oppositionellem Trotzverhalten (SOT) besteht. Zum zweiten soll untersucht werden, welche kindlichen und welche elterlichen Faktoren am besten die Gesamtbelastungen der Mütter aufklären können. An der Studie nahmen 207 Kinder ( M = 9.00 Jahre; SD = 1.52; 65.2 % männlich) teil. Von diesen wurden 138 Kinder nach dem ADHS-Erscheinungsbild (DSM-5) und nach der SOT in vier Untergruppen eingeteilt (unaufmerksames und gemischtes Erscheinungsbild mit/ohne SOT). Bei 157 Kindern wurden die mütterlichen (ADHS, Depression und Erziehungsstatus) und kindlichen Faktoren (ADHS, SOT und die Anzahl der im Haushalt lebenden Kinder) erhoben. Die Ergebnisse belegen, dass Mütter von Kindern, die neben einer ADHS eine zusätzliche SOT aufweisen, die größte Belastung berichten. Die mütterliche Depression und die gemischte ADHS-Erscheinungsform mit komorbider SOT des Kindes sagten die Belastung der Mütter am besten vorher. Im klinischen Kontext sollte bei Müttern von Kindern, die ein gemischtes ADHS-Erscheinungsbild mit SOT aufweisen, gezielt eine depressive Symptomatik abgeklärt werden.
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Affiliation(s)
| | - Dennis Nitkowski
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann†
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Ulrike Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Waltes R, Freitag CM, Herlt T, Lempp T, Seitz C, Palmason H, Meyer J, Chiocchetti AG. Impact of autism-associated genetic variants in interaction with environmental factors on ADHD comorbidities: an exploratory pilot study. J Neural Transm (Vienna) 2019; 126:1679-1693. [PMID: 31707462 DOI: 10.1007/s00702-019-02101-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is determined by genetic and environmental factors, and shares genetic risk with ASD. Functional single-nucleotide polymorphisms of the metabotropic glutamatergic signaling pathway are reported to increase the risk for ASD. The aim of this pilot study was to explore the main effects of respective ASD variants as well as their interaction effects with well-replicated ADHD environmental risk factors on the risk for ADHD, ADHD symptom severities, and comorbidities. We included 318 children with ADHD, aged 5-13 years, and their parents (N = 164 trios, N = 113 duos, N = 41 singletons). Interaction of ASD risk variants CYFIP1-rs7170637, CYFIP1-rs3693, CAMK4-rs25925, and GRM1-rs6923492 with prenatal biological and lifetime psychosocial risk factors was explored in a subsample with complete environmental risk factors (N = 139 trios, N = 83 duos, two singletons) by transmission disequilibrium test and stepwise regression analyses. We identified nominally significant (alpha < 0.05) GxE interactions of acute life events with CYFIP1-rs3693 on ADHD diagnosis (p = 0.004; fdr = 0.096) but no significant association of any single marker. Further results suggest that the risk for comorbid disruptive disorders was significantly modulated by GxE interactions between familial risk factors and CAMK4-rs25925 (p = 0.001; fdr = 0.018) and prenatal alcohol exposure with CYFIP1-rs3693 (p = 0.003; fdr = 0.027); both findings survived correction for multiple testing (fdr value < 0.05). Nominal significant GxE interactions moderating the risk for anxiety disorders have also been identified, but did not pass multiple testing corrections. This pilot study suggests that common ASD variants of the glutamatergic system interact with prenatal and lifetime psychosocial risk factors influencing the risk for ADHD common comorbidities and thus warrants replication in larger samples.
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Affiliation(s)
- Regina Waltes
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, JW Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, JW Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Timo Herlt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, JW Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Thomas Lempp
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, JW Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Christiane Seitz
- Department of Child and Adolescent Psychiatry and Psychotherapy, Saarland University Hospital, 66421, Homburg, Germany
| | - Haukur Palmason
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, 54290, Trier, Germany
| | - Jobst Meyer
- Department of Neurobehavioral Genetics, Institute of Psychobiology, University of Trier, 54290, Trier, Germany
| | - Andreas G Chiocchetti
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, JW Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany.
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Mazzeschi C, Buratta L, Germani A, Cavallina C, Ghignoni R, Margheriti M, Pazzagli C. Parental Reflective Functioning in Mothers and Fathers of Children With ADHD: Issues Regarding Assessment and Implications for Intervention. Front Public Health 2019; 7:263. [PMID: 31572704 PMCID: PMC6753962 DOI: 10.3389/fpubh.2019.00263] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/29/2019] [Indexed: 11/19/2022] Open
Abstract
Parental factors contribute to ADHD, partly in an etiological way and partly as moderators and mediators of child outcomes and treatment effects. An important aspect of parenting seems to be parental reflective functioning (PRF), defined as the parent's capacity to reflect upon his own and his child's internal mental experience. The studies on parenting factors linked to ADHD have not extensively investigated the role of PRF. Recent findings on interventions have begun to consider mentalization to promote empathy and emotion regulation in parents, but empirical studies assessing PRF are still scarce. The aim of this cross-sectional study was to compare specific familial and parental functioning characteristic between parents of children with attention deficit/hyperactivity disorder (ADHD) and parents of controls without ADHD. A clinical sample of 41 children with ADHD aged 8–11 years and their parents was compared with a matched, non-clinical sample of 40 children. Three aspects of parental functioning were investigated: parental symptomatology, parental alliances and PRF; children's differences in strength and difficulty profiles were also assessed. The results showed that families of children with ADHD had lower socioeconomic status, and both mothers and fathers of the same families reported higher scores for depression and lower PRF than did the control group; only mothers showed lower parental alliance. Logistic regression highlighted the fact that several of these familial and parental factors contributed to the increased risk of belonging to the clinical group, specifically both mothers' and fathers' depressive symptoms and lower PRF. These data represent new findings with potentially meaningful clinical implications for both assessment and intervention.
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Affiliation(s)
- Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Livia Buratta
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Alessandro Germani
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Clarissa Cavallina
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
| | - Roberta Ghignoni
- Istituto Agazzi "Futurabile"-Outpatient Center of the Developmental Age, Arezzo, Italy
| | - Michele Margheriti
- Center for Clinical Neuropsychology of Developmental Age "Giorgio Sabbadini", Perugia, Italy
| | - Chiara Pazzagli
- Department of Philosophy, Social Sciences and Education, University of Perugia, Perugia, Italy
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Moderation of parenting by inhibitory control in the prediction of the common and unique variance of hyperactivity-impulsivity and inattention. Dev Psychopathol 2019; 32:909-921. [DOI: 10.1017/s0954579419000774] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
AbstractThis study examined whether the interaction between parenting and inhibitory control predicts hyperactivity-impulsivity and inattention in 195 children. Observation data of positive parenting were collected at 4 years, and mother reports of coercive parenting at 5 years, inhibitory control at 6 years, and hyperactivity-impulsivity/inattention at 7 years were obtained. The common and unique variance of hyperactivity-impulsivity and inattention symptoms were examined as outcomes using a bifactor model. Results indicated that positive parenting practices predicted lower levels of hyperactivity-impulsivity/inattention behaviors at age 7 only when children's inhibitory control was high. These results support the vantage sensitivity model, which posits that some individuals show an increased sensitivity to positive experiences exclusively, and support the appropriateness of a targeted prevention approach in early childhood.
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Mulraney M, Giallo R, Efron D, Brown S, Nicholson JM, Sciberras E. Maternal postnatal mental health and offspring symptoms of ADHD at 8-9 years: pathways via parenting behavior. Eur Child Adolesc Psychiatry 2019; 28:923-932. [PMID: 30446823 DOI: 10.1007/s00787-018-1254-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/10/2018] [Indexed: 10/27/2022]
Abstract
Exposure to maternal mental health problems during pregnancy and the first year of life has been associated with the development of ADHD. One pathway through which maternal mental health may influence children's outcomes is via its effects on parenting. This study aimed to investigate the mediating role of parenting behavior in the pathway between maternal postnatal distress and later symptoms of ADHD in the child. Biological mothers living with their children participating in the Longitudinal Study of Australian Children with data available from waves 1 (child age 3-12 months) and 5 (child age 8-9 years) were included in the current study (n = 3456). Postnatal distress was assessed by parent report at wave 1. Parenting warmth, hostility and consistency were assessed by parent report at wave 5. ADHD status at wave 5 was ascertained by parent report of the child having a diagnosis of ADHD/ADD or by elevated ADHD symptoms by both parent and teacher report. There was evidence of an indirect pathway from maternal postnatal distress to child ADHD at age 8-9 years via parenting hostility, but not through parenting warmth or consistency, even after accounting for concurrent maternal mental health. Our findings highlight the importance of early identification and intervention for maternal postnatal distress, as treatment may prevent mothers from developing hostile parenting practices and also disrupt the pathway to ADHD in their offspring.
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Affiliation(s)
- Melissa Mulraney
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, 3052, Australia. .,The University of Melbourne, Melbourne, Australia.
| | - Rebecca Giallo
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, 3052, Australia
| | - Daryl Efron
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, 3052, Australia.,The Royal Children's Hospital, Melbourne, Australia
| | - Stephanie Brown
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, 3052, Australia.,The University of Melbourne, Melbourne, Australia
| | | | - Emma Sciberras
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Melbourne, 3052, Australia.,The University of Melbourne, Melbourne, Australia.,Deakin University, Geelong, Australia
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Bhide S, Sciberras E, Anderson V, Hazell P, Nicholson JM. Association Between Parenting Style and Socio-Emotional and Academic Functioning in Children With and Without ADHD: A Community-Based Study. J Atten Disord 2019; 23:463-474. [PMID: 27474160 DOI: 10.1177/1087054716661420] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In a community-based study, we examined parenting style and its relationship to functioning in 6- to 8-year-old children ( n = 391; 66.2% male) with ADHD ( n = 179), compared with non-ADHD controls ( n = 212). METHOD Parenting style was assessed using parent-reported (93.5% female) measures of warmth, consistency, and anger. Child socio-emotional and academic functioning was measured via parent- and teacher-reported scales, and direct academic assessment. RESULTS Parents reported less consistency and more anger in the ADHD group compared with non-ADHD controls, with no differences in warmth. Parenting warmth, consistency, and anger were associated with parent-reported aspects of socio-emotional functioning for children with ADHD and non-ADHD controls, after adjusting for socio-demographic variables, externalizing comorbidities, and ADHD symptom severity. Parenting style was no longer related to academic functioning and most teacher-reported outcomes after adjustment. CONCLUSION Generic parenting interventions that promote warm, consistent, and calm parenting may help alleviate socio-emotional impairments in children with ADHD.
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Affiliation(s)
- Sampada Bhide
- 1 Murdoch Childrens Research Institute, Melbourne, Australia.,2 University of Melbourne, Australia
| | - Emma Sciberras
- 1 Murdoch Childrens Research Institute, Melbourne, Australia.,2 University of Melbourne, Australia.,3 The Royal Childrens Hospital, Melbourne, Australia.,4 Deakin University, Melbourne, Australia
| | - Vicki Anderson
- 1 Murdoch Childrens Research Institute, Melbourne, Australia.,2 University of Melbourne, Australia.,3 The Royal Childrens Hospital, Melbourne, Australia
| | | | - Jan M Nicholson
- 1 Murdoch Childrens Research Institute, Melbourne, Australia.,6 La Trobe University, Melbourne, Australia
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Al-Balushi N, Al-Alawi M, Al Shekaili M, Al-Balushi M, Mirza H, Al-Huseini S, Panchatcharam SM, Al-Sibani N, Cucchi A, Al-Adawi S. Predictors of Burden of Care Among Caregivers of Drug-Naive Children and Adolescents With ADHD: A Cross-Sectional Correlative Study From Muscat, Oman. J Atten Disord 2019; 23:517-526. [PMID: 30371135 DOI: 10.1177/1087054718808381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE the study assessed the prevalence of burden of care among caregivers of children with ADHD in Oman. A related aim is to explore the predictors of the burden of care, subtypes of ADHD, and socio-demographic factors. METHOD Arabic version of the Zarit Burden Interview (ZBI) was administered to 117 caregivers of drug-naive children with ADHD. Sociodemographic background and clinical data were gathered from medical records and from the attending caregivers themselves. The ADHD symptoms were grouped under three categories : hyperactive, inattentive, or mixed. RESULTS the prevalence of the burden of care was estimated to be 34%. Income levels and the child's ADHD diagnosis being of "mixed" type have significant impact on the burden of care. CONCLUSION the results of this study indicate that the prevalence of the burden of care among the caregivers of ADHD children in Oman is comparable with that in the other regions of the world.
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Affiliation(s)
| | - Mohammed Al-Alawi
- 1 Oman Medical Specialty Board, Muscat, Oman.,2 Sultan Qaboos University, Muscat, Oman
| | - Muna Al Shekaili
- 1 Oman Medical Specialty Board, Muscat, Oman.,3 Ministry of Health, Muscat, Oman
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Cleaton MAM, Lorgelly PK, Kirby A. Developmental coordination disorder: the impact on the family. Qual Life Res 2018; 28:925-934. [PMID: 30536221 DOI: 10.1007/s11136-018-2075-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Developmental coordination disorder (DCD) is a neurodevelopmental disorder with an estimated prevalence of 2-6% in school-aged children. Children with DCD score lower in multiple quality of life (QOL) domains. However, the effect of a child's DCD on their parents' and family's QOL has not previously been assessed in a UK population. We aimed to assess parental and family QOL within UK families containing at least one child aged 6-18 years who was diagnosed with DCD. METHODS A mixed-methods study was designed, using an online questionnaire that incorporated the Family QOL Scale and the 12-Item Short Form Health Survey. RESULTS The emotional and disability support domains of family QOL were markedly negatively affected by DCD, with lack of support by medical and educational professionals cited as a major source of stress. Parental mental health was also negatively affected. In many cases, the child's DCD impacted on parental work life, family social life and siblings' well-being. CONCLUSIONS Having a child with DCD has a considerable impact on families. This needs to be recognised by healthcare and other professionals; otherwise, services and support may not be appropriately targeted and the negative sequelae of DCD may ripple beyond the individual with costly social and economic consequences.
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Affiliation(s)
- Mary Ann Megan Cleaton
- Dyscovery Centre, University of South Wales, Innovation House, William Price Business Park, Treforest, Pontypridd, UK
| | | | - Amanda Kirby
- Dyscovery Centre, University of South Wales, Innovation House, William Price Business Park, Treforest, Pontypridd, UK.
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43
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Fredrick JW, Luebbe AM, Mancini KJ, Burns GL, Epstein JN, Garner AA, Jarrett MA, Becker SP. Family environment moderates the relation of sluggish cognitive tempo to attention-deficit/hyperactivity disorder inattention and depression. J Clin Psychol 2018; 75:221-237. [PMID: 30368829 DOI: 10.1002/jclp.22703] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 07/24/2018] [Accepted: 08/30/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The current study investigated whether a maladaptive family environment would moderate the strength of the relations of sluggish cognitive tempo (SCT) to attention-deficit/hyperactivity disorder inattention (ADHD-IN) and to depressive symptoms in a large sample of college students. METHODS Participants (n = 3,172), between the ages of 18-29 (M ± SDage = 19.24 ± 1.52; 69.8% women; 80.4% White) and enrolled in five universities in the United States completed self-report measures of symptomatology, interparental conflict, and family expressiveness of emotions. RESULTS A negative emotional climate strengthened relations of SCT with ADHD-IN and depressive symptoms. Moreover, the lack of a positive emotional climate strengthened the co-occurrence of SCT with depressive symptoms, though not with ADHD-IN. CONCLUSIONS The current study is the first to demonstrate that the family environment moderates the association between SCT and co-occurring symptomatology in young adults.
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Affiliation(s)
| | | | | | - G Leonard Burns
- Department of Psychology, Washington State University, Pullman, WA
| | - Jeffery N Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Annie A Garner
- Department of Psychology, Saint Louis University, Saint Louis, MO
| | | | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
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Association Between Parenting Style and Social Outcomes in Children with and Without Attention-Deficit/Hyperactivity Disorder: An 18-Month Longitudinal Study. J Dev Behav Pediatr 2018; 38:369-377. [PMID: 28661954 DOI: 10.1097/dbp.0000000000000453] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE In a community-based sample of children with attention-deficit/hyperactivity disorder (ADHD) (n = 179) and non-ADHD controls (n = 212), this longitudinal study explored changes in parenting style over time; and whether parenting style prospectively predicts child functional outcomes. METHODS Attention-deficit/hyperactivity disorder diagnosis was assessed using the Conners ADHD index and Diagnostic Interview Schedule for Children IV. Children (70.3% boys) were assessed at baseline (mean age: 7.3 yr) and after 18 months (mean age: 8.9 yr) using a range of parent- and teacher-reported measures of child socioemotional and academic functioning. Parenting style was assessed through parent-reported measures of warmth, consistency, and anger. RESULTS At 18-month follow-up, there was a small significant decline in parenting warmth and parenting anger, and an increase in parenting consistency across groups. In the ADHD group, parenting warmth at baseline was positively related to 18-month prosocial behavior and responsibility by parent report, whereas parenting consistency predicted these child outcomes by teacher report. Parenting anger was positively associated with peer problems and negatively associated with prosocial behavior, self-control, and responsibility by parent report. Associations were similar for non-ADHD controls and all associations held after adjusting for a range of family, child, and parent factors. After additional adjustment of baseline levels of child functioning, parenting warmth and consistency continued to be associated with 18-month child outcomes. Parenting style was unrelated to emotional problems and academic competence over time. CONCLUSION Parenting style is independently related to aspects of future social outcomes of children with ADHD. Results hold implications for parenting interventions aimed at managing ADHD-related social impairments over time.
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45
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Westrupp EM, Brown S, Woolhouse H, Gartland D, Nicholson JM. Repeated early-life exposure to inter-parental conflict increases risk of preadolescent mental health problems. Eur J Pediatr 2018; 177:419-427. [PMID: 29273942 DOI: 10.1007/s00431-017-3071-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 11/30/2022]
Abstract
UNLABELLED This study investigated the association between inter-parental conflict at a single occasion, or repeated over early childhood, and children's internalizing and externalizing problems at 10-11 years; and examined potential mechanisms via social risk, maternal mental health, and parenting. Data were five time points from the Baby cohort of the Longitudinal Study of Australian Children (N = 3696, recruited in 2004). Verbal or physical inter-parental conflict was measured at 0-1, 2-3, 4-5, and 6-7 years. Internalizing and externalizing problems (Strengths and Difficulties Questionnaire) were measured via mother-, father-, teacher-, and child-report at 10-11 years. A series of regression models accounted for social risk at 0-1 years, parenting, and maternal psychological distress at 8-9 years. Physical and verbal inter-parental conflict (reported by 16 and 33% of mothers, respectively) consistently predicted mother-, father-, and child-reported externalizing and internalizing problems, and teacher-reported externalizing (but not internalizing) problems (adjusted regression coefficients [β] = 0.4-1.1). Repeated compared to single report of verbal conflict was associated with more behavior problems (adjusted mean = 0.8-1.1 compared to 0.4-0.6). CONCLUSION Children are sensitive to inter-parental conflict, with long-term negative effects for child mental health even when reported at one time point within the first 6 years of life. What is Known: • Studies of children born prior to 1990 show that children exposed to verbal conflict or severe forms of family violence are at greater risk of mental health problems. What is New: • Physical and verbal inter-parental conflict reported once or at multiple time points over the first 6 years of life was associated with externalizing and internalizing problems reported by mothers, fathers, children, and teachers. • Associations between inter-parental conflict and child problems were not explained by family social risk, maternal mental health, or parenting.
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Affiliation(s)
- Elizabeth M Westrupp
- School of Psychology, Deakin University, Burwood, Victoria, Australia. .,La Trobe University, Bundoora, Victoria, Australia. .,Murdoch Children's Research Institute, Melbourne, Victoria, Australia. .,The University of Melbourne, Melbourne, Victoria, Australia.
| | - Stephanie Brown
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| | - Hannah Woolhouse
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Deirdre Gartland
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| | - Jan M Nicholson
- La Trobe University, Bundoora, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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46
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Muñoz-Silva A, Lago-Urbano R, Sanchez-Garcia M, Carmona-Márquez J. Child/Adolescent's ADHD and Parenting Stress: The Mediating Role of Family Impact and Conduct Problems. Front Psychol 2017; 8:2252. [PMID: 29312090 PMCID: PMC5744077 DOI: 10.3389/fpsyg.2017.02252] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/11/2017] [Indexed: 11/30/2022] Open
Abstract
Objective: The demands of parenting are usually associated with some stress, and elevated levels of stress may affect the parent-child relationships and parenting practices. This is especially the case of families where children have special needs conditions or disorders, like Attention Deficit Hyperactivity Disorder (ADHD). Method: This study examined parenting stress among mothers of children and adolescents with ADHD. The sample comprised 126 mothers of girls (36; 29%) and boys (90; 71%) aged 6-17 years old. Results: Mothers reported their own stress levels as well as the children and adolescents' variables (severity of their ADHD symptoms, conduct, and emotional problems) and family-contextual variables (negative impact on family's social life, impact on couple relationship, and perceived social support). Hierarchical multiple regression showed that (a) negative impact on social life and conduct problems were the strongest predictors of mother's stress. Bootstrap mediation analyses revealed that (b) the association between child and adolescent's ADHD and parenting stress was mediated by children's conduct problems and by negative impact on family's social life, and not by children's emotional problems nor by mother's perceived social support. The mediation analysis also suggested (c) a pathway from child/adolescent's ADHD through children's conduct problems and then through their negative impact on family's social life to mother's parenting stress. Conclusion: These results suggest that both child/adolescent's and family factors should be considered in the designing of interventions for reducing parenting stress in families of children and adolescents with ADHD.
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Affiliation(s)
- Alicia Muñoz-Silva
- Department of Social, Developmental and Educational Psychology, University of Huelva, Huelva, Spain
| | | | - Manuel Sanchez-Garcia
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | - José Carmona-Márquez
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
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47
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Demmer DH, Puccio F, Stokes MA, McGillivray JA, Hooley M. The Influence of Child Gender on the Prospective Relationships between Parenting and Child ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 46:113-125. [DOI: 10.1007/s10802-017-0284-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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48
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Fridman M, Banaschewski T, Sikirica V, Quintero J, Erder MH, Chen KS. Caregiver perspective on pediatric attention-deficit/hyperactivity disorder: medication satisfaction and symptom control. Neuropsychiatr Dis Treat 2017; 13:443-455. [PMID: 28243096 PMCID: PMC5315351 DOI: 10.2147/ndt.s121639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The caregiver perspective on pediatric attention-deficit/hyperactivity disorder (ADHD) study (CAPPA) was a web-based, cross-sectional survey of caregivers of children and adolescents (6-17 years of age) with ADHD and was conducted in 10 European countries. CAPPA included caregiver assessments of global medication satisfaction, global symptom control, and satisfaction with ADHD medication attributes. Overall, 2,326 caregiver responses indicated that their child or adolescent was currently receiving ADHD medication and completed the "off medication" assessment required for inclusion in the present analyses. Responses to the single-item global medication satisfaction question indicated that 88% were satisfied (moderately satisfied to very satisfied) with current medication and 18% were "very satisfied" on the single-item question. Responses to the single-item global symptom control question indicated that 47% and 19% of caregivers considered their child or adolescent's symptoms to be "controlled" or "very well controlled", respectively. Significant variations in response to the questions of medication satisfaction and symptom control were observed between countries. The correlation between the global medication satisfaction and global symptom control questions was 0.677 (P<0.001). Global medication satisfaction was significantly correlated (P<0.001) with all assessed medication attributes, with the highest correlations observed for symptom control (r=0.601) and effect duration (r=0.449). Correlations of medication attributes with global symptom control were generally lower than with global medication satisfaction but were all statistically significant (P<0.001). CAPPA medication satisfaction and symptom control were also significantly correlated (P<0.001) with symptom control as based on the ADHD-Rating Scale-IV symptom score and the number of bad days per month when on medication. In conclusion, caregiver responses in this European sample suggest that current treatment could potentially be improved. The observed correlations of global medication satisfaction with global symptom control and other CAPPA assessments, including medication attributes, provide support for the inter-connectivity of the medication satisfaction and symptom control.
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Affiliation(s)
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Vanja Sikirica
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Javier Quintero
- Psychiatry Department, Hospital Universitario Infanta Leonor, Complutense University, Madrid, Spain
| | - M Haim Erder
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Kristina S Chen
- Global Health Economics Outcomes Research and Epidemiology, Shire, Lexington, MA, USA
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49
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Fridman M, Banaschewski T, Sikirica V, Quintero J, Erder MH, Chen KS. Factors associated with caregiver burden among pharmacotherapy-treated children/adolescents with ADHD in the Caregiver Perspective on Pediatric ADHD survey in Europe. Neuropsychiatr Dis Treat 2017; 13:373-386. [PMID: 28223810 PMCID: PMC5308565 DOI: 10.2147/ndt.s121391] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Burden on caregivers of children/adolescents with attention-deficit/hyperactivity disorder (ADHD) is multidimensional, but incompletely understood. OBJECTIVE To analyze caregiver burden across the concepts of work, social/family life, and parental worry/stress, in relation to selected contributing factors. METHODS The online Caregiver Perspective on Pediatric ADHD survey was fielded in ten European countries. Analysis included children/adolescents (6-17 years) who were receiving/had received ADHD pharmacotherapy in the previous 6 months. Caregivers recorded their child's/adolescent's symptoms "on"/"off" medication (ie, when the caregiver reported that the child/adolescent forgot/chose not to take medication, before the onset of medication effect, or medication worn off). Effects of ADHD severity, comorbidities, and medication adherence on each burden outcome were assessed (multiple regression models). RESULTS In total, 2,326 caregivers were included (children/adolescents' mean age: 11.5 years, 80% male). Caregivers reported missed/altered work, avoiding social activity, increased parental worry/stress, and strain on family life, despite using ADHD pharmacotherapy. Child/adolescent comorbidities and ADHD severity were significantly related to all burden concepts measured; the strongest comorbidity associations were with altered work (odds ratios [ORs] =1.68 [95% confidence interval {CI} 1.33, 2.12], 1.87 [1.37, 2.54], 3.47 [2.51, 4.78] for 1, 2, 3+ comorbidities, respectively) and planning the day around the child/adolescent (OR =1.42 [95% CI 1.17, 1.72], 1.73 [1.33, 2.15], 2.65 [1.99, 3.53]); the strongest severity associations were: quitting a job (OR =1.41 [95% CI 1.26, 1.59]) and planning a day around the child/adolescent (OR =1.26 [95% CI 1.20, 1.32]). Increased medication adherence was most associated with reducing the caregiver burden for altered work (OR =0.57 [95% CI 0.45, 0.72]), worrying about how they are being perceived as a parent (OR =0.68 [0.56, 0.83]), and avoiding social activity (OR =0.56 [0.45, 0.68]), but not family or stress burden. CONCLUSION Burdens related to work, social activity, family life, and parental worry/stress were experienced by the caregivers of children/adolescents with ADHD, despite using ADHD pharmacotherapy. Better understanding of clinical/treatment characteristics most associated with the components of caregiver burden may help improve ADHD management and may ease caregiver burden.
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Affiliation(s)
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Vanja Sikirica
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Javier Quintero
- Psychiatry Department, Hospital Universitario Infanta Leonor, Complutense University, Madrid, Spain
| | - M Haim Erder
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Kristina S Chen
- Global Health Economics Outcomes Research and Epidemiology, Shire, Lexington, MA, USA
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50
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Green JL, Rinehart N, Anderson V, Efron D, Nicholson JM, Jongeling B, Hazell P, Sciberras E. Association between autism symptoms and family functioning in children with attention-deficit/hyperactivity disorder: a community-based study. Eur Child Adolesc Psychiatry 2016; 25:1307-1318. [PMID: 27154048 DOI: 10.1007/s00787-016-0861-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 04/25/2016] [Indexed: 12/11/2022]
Abstract
Autism spectrum disorder (ASD) symptoms are elevated in populations of children with attention-deficit/hyperactivity disorder (ADHD). This study examined cross-sectional associations between ASD symptoms and family functioning in children with and without ADHD. Participants were recruited to a longitudinal cohort study, aged 6-10 years (164 ADHD; 198 controls). ADHD cases were ascertained using community-based screening and diagnostic confirmation from a diagnostic interview. ASD symptoms were measured using the Social Communication Questionnaire. Outcome variables were parent mental health, family quality of life (FQoL), couple conflict and support, and parenting behaviours. After adjustment for a range of child and family factors (including other mental health comorbidities), higher ASD symptoms were associated with poorer FQoL across all three domains; emotional impact (p = 0.008), family impact (p = 0.001) and time impact (p = 0.003). In adjusted analyses by subgroup, parents of children with ADHD+ASD had poorer parent self-efficacy (p = 0.01), poorer FQoL (p ≤ 0.05), with weak evidence of an association for less couple support (p = 0.06), compared to parents of children with ADHD only. Inspection of covariates in the adjusted analyses indicated that the association between ASD symptoms and most family functioning measures was accounted forby child internalising and externalising disorders, ADHD severity, and socioeconomic status; however, ASD symptoms appear to be independently associated with poorer FQoL in children with ADHD. The presence of ASD symptoms in children with ADHD may signal the need for enhanced family support.
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Affiliation(s)
- Jessica L Green
- School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
- Murdoch Childrens Research Institute, Parkville, VIC, 3125, Australia.
- Deakin Child Study Centre, School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
| | - Nicole Rinehart
- Murdoch Childrens Research Institute, Parkville, VIC, 3125, Australia
- Deakin Child Study Centre, School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - Vicki Anderson
- Murdoch Childrens Research Institute, Parkville, VIC, 3125, Australia
- The Royal Children's Hospital, Parkville, VIC, Australia
- The University of Melbourne, Parkville, VIC, Australia
| | - Daryl Efron
- Murdoch Childrens Research Institute, Parkville, VIC, 3125, Australia
- The Royal Children's Hospital, Parkville, VIC, Australia
- The University of Melbourne, Parkville, VIC, Australia
| | - Jan M Nicholson
- Murdoch Childrens Research Institute, Parkville, VIC, 3125, Australia
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
| | - Brad Jongeling
- Child Development Service, Joondalup, WA, Australia
- The University of Western Australia, Perth, WA, Australia
| | - Philip Hazell
- Discipline of Psychiatry, The University of Sydney, Sydney, NSW, Australia
| | - Emma Sciberras
- Murdoch Childrens Research Institute, Parkville, VIC, 3125, Australia
- Deakin Child Study Centre, School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
- The Royal Children's Hospital, Parkville, VIC, Australia
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