Responsiveness in interactions of mothers and sons with ADHD: relations to maternal and child characteristics

Testing Parenting Self-Esteem as an Indicator of Mothers and Fathers Who Are at Risk for Aversive Responses to Disruptive Child Behavior

Extensive literature demonstrates that parents of children with disruptive behaviors consistently report lower parenting self-esteem (i.e., satisfaction and efficacy) compared to parents of children without disruptive behaviors. However, little is known about whether having low parenting self-esteem results in negative parenting behavior while managing disruptive child behavior, and whether associations vary in strength depending on the clinical significance of the child's disruptive behavior. The current study examines 90 parent couples who were randomly assigned to interact with a 9- to 12-year-old confederate exhibiting either typical or disruptive behaviors. Parenting self-esteem moderated the association between disruptive child behavior and positive parenting behavior, such that mothers with low efficacy had a stronger positive association between disruptive child behavior and positive parenting behaviors. However, fathers with low efficacy had a stronger negative association between disruptive behaviors and positive parenting behavior. Exploratory analyses yielded mixed results. Specifically, mothers with low self-esteem and a child with ADHD had a stronger negative association between disruptive child behaviors and positive parenting compared to mothers who interacted with a confederate or did not have a child with ADHD. Results from the current study extend findings regarding the influence of parenting self-esteem on the association of disruptive child behavior and parenting behaviors, as moderating effects of parenting self-esteem was demonstrated for both mothers and fathers within the study.

Clinical, socio-demographic, and parental correlates of early autism traits in a community cohort of toddlers

Identifying factors linked to autism traits in the general population may improve our understanding of the mechanisms underlying divergent neurodevelopment. In this study we assess whether factors increasing the likelihood of childhood autism are related to early autistic trait emergence, or if other exposures are more important. We used data from 536 toddlers from London (UK), collected at birth (gestational age at birth, sex, maternal body mass index, age, parental education, parental language, parental history of neurodevelopmental conditions) and at 18 months (parents cohabiting, measures of socio-economic deprivation, measures of maternal parenting style, and a measure of maternal depression). Autism traits were assessed using the Quantitative Checklist for Autism in Toddlers (Q-CHAT) at 18 months. A multivariable model explained 20% of Q-CHAT variance, with four individually significant variables (two measures of parenting style and two measures of socio-economic deprivation). In order to address variable collinearity we used principal component analysis, finding that a component which was positively correlated with Q-CHAT was also correlated to measures of parenting style and socio-economic deprivation. Our results show that parenting style and socio-economic deprivation correlate with the emergence of autism traits at age 18 months as measured with the Q-CHAT in a community sample.

Cognitive training for children with ADHD: composite cognitive score outcome in a randomized controlled trial

PURPOSE OF THE ARTICLE

Cognitive training for Attention Deficit/Hyperactivity Disorder (ADHD) has shown promising, although mixed results. In post-hoc analyses, we evaluate effects of cognitive training using a novel composite cognition score as the outcome for children attending at least 16 sessions of training, dose-response of training and associations between symptoms and cognitive functioning.

MATERIALS AND METHODS

Children (age 6-13) with ADHD were randomized to intervention (n = 26) or control (n = 34). For the current analysis, we restricted the intervention group to children, who completed at least 16 sessions of cognitive training (n = 26) and examined a dose response within that group.

RESULTS

Cognition improved significantly in the intervention, but not control group. Amount of the completed training sessions correlated significantly with the amount of cognitive improvement.

CONCLUSION

Variations in dose and frequency of training may be an important source of the variance in previous studies.

Parental Factors That Confer Risk and Resilience for Remote Learning Outcomes During the COVID-19 Pandemic Among Children With and Without Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

To test whether parental factors including internalizing symptoms, parenting style, and confidence in assisting with remote learning conferred risk/resilience for children with/without ADHD's learning and emotional outcomes during the COVID-19 pandemic.

METHOD

291 parents of children (ages 6-13; n = 180 males) with (n = 148) and without ADHD completed questionnaires online (April-July 2020).

RESULTS

Structural equation modeling identified parental risk/resilience factors. Across groups, risk predicted greater difficulties with learning, internalizing and externalizing symptoms, while parent confidence in educating their child predicted better outcomes. A positive association was observed between parental involvement and child difficulties, which was stronger in families of children with ADHD. Children with/without ADHD did not differ in remote learning difficulties.

CONCLUSION

Parent factors impacted child emotional and learning outcomes during the pandemic. With increases in remote learning practices, there is a need for improved understanding of how parent factors impact outcomes of children with/without ADHD.

Socio-demographic and clinical correlates of parenting style among parents having ADHD children: a cross-section study

Background

ADHD affects 7.8% of the school-aged population, making it one of the most common childhood brain illnesses. It is characterized by abnormally high levels of inattention, activity, and impulsivity at a young age. Being a parent of a child with ADHD is a real challenge, as the parents tend to be more disapproving, critical, and provide more impulse control directions; such parenting style can have an impact on the illnesses course, accentuate its signs and symptoms, and lead to secondary development of co-morbid psychiatric and behavioral problems. This makes the parent-child effect a matter of clinical importance that needs to be carefully assessed and managed. We aimed to estimate the sociodemographic and clinical correlates of parenting attitudes among parents having ADHD children. This cross-sectional study included 48 ADHD children from both sexes, aged from 6 to 12 years old, and their parents. In our study, we applied the Stanford-Binet Intelligence Scale 5th edition, the Conner’s Parent Rating Scale-revised, the parenting style as perceived by children questionnaire, and the Fahmy and El-Sherbini questionnaire for the measurement of socioeconomic status.

Results

Mothers of ADHD children had significantly lower scores of over-protections parenting style than the fathers; the current study showed a significant increase in total parenting scores and warmth/support in mild ADHD cases than in moderate and severe ones, and there is a significant increase in the mother’s positive parenting style toward ADHD children with lower levels of social problems, mild cases, and older age. There is a significant increase of positive parenting style toward ADHD children exerted by post graduated, professionally working, and high social class fathers and by working mothers among rural residents and high social class mothers. There is a positive correlation between IQ and a mother’s warmth/support.

Conclusion

ADHD children with mild symptoms, higher social functioning of the child, high socioeconomic level of the family, better education, and professional occupations of parents were associated with positive parenting style.

Parenting Stress during Late Adolescence in Mothers of Individuals with ADHD with and without ODD

Although children with ADHD continue to experience impairment well into adolescence, research exploring the experiences of their parents during late adolescence is lacking. Thus, we examined changes in parenting stress and family conflict in mothers of adolescents with ADHD during the transition to early adulthood. We also explored predictors of these changes in addition to investigating differences in these trajectories due to comorbid ODD. Forty-nine mothers of adolescents with ADHD only and thirty-seven mothers of adolescents with ADHD/ODD reported on parenting stress and perceptions of family conflict at baseline (mean age = 16.88) and at 3-month, 9-month, and 15-month follow up assessments. Growth curve modeling indicated that both groups of mothers reported relative declines in parenting stress and family conflict across time. However, the mothers of adolescents with ADHD/ODD persistently reported more stress and conflict. Furthermore, decreases in family conflict were more predictive of reduced parenting stress in families of adolescents only diagnosed with ADHD. Our findings suggest that comorbid ODD is associated with parenting stress during late adolescence. Thus, interventions should focus on further reducing this stress as adolescents with ADHD/ODD transition to adulthood.

How Do Child ADHD Symptoms and Oppositionality Impact Parent-Child Interactions When Crossing Virtual Roads?

OBJECTIVE

This study examined how parents and children interact when crossing virtual roads together. We examined (1) whether children's inattention/hyperactivity and oppositionality and children's failure to jointly perform the task interfered with parents' efforts to scaffold children's road-crossing skill and (2) whether experience with the joint road-crossing task impacted children's subsequent performance in a solo road-crossing task.

METHODS

Fifty-five 8- to 10-year-old children with and without attention-deficit/hyperactivity disorder and their parents first jointly crossed a lane of traffic in an immersive pedestrian simulator. Children then completed the same road-crossing task alone. Parents completed questionnaires about children's symptoms of inattention/hyperactivity and oppositionality.

RESULTS

Analyses of the joint road-crossing task showed that when parents and children crossed different gaps, parents suggested and opposed more gaps and were less likely to use a prospective gap communication strategy (i.e., communicating about a crossable gap prior to its arrival). Crossing different gaps was also associated with increased expressions of negative affect among parents and children and an increase in collisions among children. Children's level of parent-reported oppositionality also predicted an increase in child defiance and parental redirection of child behavior. Analyses of children's subsequent crossing performance indicated that parents' use of a prospective gap communication strategy during the joint road-crossing task predicted selection of larger gaps during the solo crossing task.

CONCLUSIONS

Not crossing through the same gap and increased levels of child oppositionality interfered with the scaffolding process, potentially informing future parent-based intervention efforts for increasing children's road-crossing safety.

Parenting and Youth Onset of Depression Across Three Years: Examining the Influence of Observed Parenting on Child and Adolescent Depressive Outcomes

Concurrent associations between parenting behaviors and youth depression are well established. A smaller body of work has demonstrated longitudinal associations between aspects of parenting and youth risk for depression; however, this limited longitudinal work has predominantly relied upon self- and parent-report questionnaire measures and is thus affected by biases related to retrospective recall and common method variance. The present study used behavioral observation measures of parenting and clinical interview measures of youth depression to examine prospective relationships between observed parental support, responsiveness, criticism, and conflict and youths' onset of a depressive episode in a 3-year longitudinal design. Participants included 585 community youth age 8-16 (M = 11.92, SD = 2.39, 56.6% female) and a participating caregiver. Parental behavior was coded by trained observers in the context of a 5-min conflict resolution discussion at the baseline assessment. Youth onset of depression was subsequently assessed every 6 months for a period of 3 years using the Schedule for Affective Disorders and Schizophrenia for School Aged Children (KSADS) to ascertain whether youth experienced onset of depressive episode over the follow-up. Logistic regression analyses indicated that greater parental conflict at baseline predicted higher odds of youth experiencing a depressive onset across the 3-year follow up period, even after controlling for youth and caregiver history of depression at baseline. Findings suggest that parental conflict is particularly influential in youth vulnerability to depression.

Association Between Parenting Style and Socio-Emotional and Academic Functioning in Children With and Without ADHD: A Community-Based Study

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.

Paternal Antisocial Behavior (But Not Paternal ADHD) Is Associated With Negative Parenting and Child Conduct Problems

OBJECTIVE

Parental psychopathology and parenting quality robustly predict negative outcomes among children with ADHD. Little research has investigated associations between paternal ADHD symptoms and parenting, though there is clear evidence linking maternal ADHD symptoms with both suboptimal parenting and child conduct problems, and considerable research supporting fathers' significant contributions to their children's development.

METHOD

This cross-sectional study examined psychopathology and parenting in a sample of fathers ( N = 102) and their 5- to 12-year-old children with previously diagnosed ADHD.

RESULTS

Results suggested that paternal antisocial personality disorder (ASPD) symptoms (rather than ADHD symptoms) were robustly associated with child conduct problems, with an indirect effect through paternal negative parenting.

CONCLUSION

This study suggests that negative parenting may be a potential mechanism by which paternal ASPD is associated with child conduct problems, and demonstrates the importance of considering co-occurring psychopathology in research examining adult ADHD, parenting, and child outcomes.

Child Maltreatment and Associated Parental Factors Among Children With ADHD: A Comparative Study

OBJECTIVE

This study investigated the role of child and parental factors in maltreatment of children with ADHD compared with a healthy control group.

METHOD

We examined the rates and correlations of child maltreatment by parents in a sample of children with ADHD ( n = 100) and a matched comparison sample of children without ADHD ( n = 100), all aged 6 to 11 years. Parent and child ratings evaluated demographic characteristics, severity of ADHD symptoms, and childhood trauma exposure.

RESULTS

According to regression analysis, maternal hyperactivity/impulsivity and male gender of the child increase the emotional abuse; whereas maternal history of emotional abuse and physical neglect and paternal attention deficit increase sexual abuse, and higher maternal hyperactivity/impulsivity increases emotional neglect of ADHD children.

CONCLUSION

The study's findings provide strong evidence that the maltreatment of children with ADHD is more associated with parental factors than with the symptoms of ADHD in children.

How Good Am I? Implicit and Explicit Self-Esteem as a Function of Perceived Parenting Styles Among Children With ADHD

OBJECTIVE

To investigate implicit and explicit self-esteem and academic self-evaluation among children with ADHD as a function of parenting styles, namely, authoritarian, authoritative and permissive parenting.

METHOD

Participants included 43 children with ADHD and 35 non-ADHD controls who filled out self-concept and perceived parenting style questionnaires. They also took an Implicit Association Test (IAT) that measured unacknowledged self-esteem.

RESULTS

Lower self-esteem was found among children with ADHD than among controls, with stronger effect on the implicit level. Perceived authoritarian parenting was related to lower implicit self-esteem among children with ADHD. Higher self-esteem was found in the authoritative than in the permissive parenting groups in the non-ADHD control group but not among children with ADHD.

CONCLUSION

The role of parental support versus authoritarian parenting in terms of implicit self-esteem points to the importance of promoting responsiveness strategies among parents in the treatment of children with ADHD.

Mothers' negative emotional expression and preschoolers' negative emotional regulation strategies in Beijing, China: The moderating effect of maternal educational attainment

The relationship between mothers' negative emotional expression and preschoolers' negative emotional regulation has been a topic of debate. Studies have confirmed the unique effect of maternal education on children's emotional regulation. Further understanding of the role of maternal educational attainment in the relationship between mothers' emotional expression and children's emotional regulation strategies will help us better explain the possible reasons for the differences in children's emotional regulation abilities. In this study, 503 Chinese mother-child dyads were recruited. The Chinese version of the Self-Expressiveness in the Family Questionnaire (SEFQ) was used to measure the mothers' negative emotional expression, and the Emotional Regulatory Strategy Questionnaire (ERQ) was used to measure the children's negative emotional regulation strategies. The results indicated that mothers' negative emotional expression was positively related to children's negative emotional regulation strategies. Moreover, maternal educational attainment moderated this relationship. The findings of the current study demonstrate the importance of mothers' educational background, providing an important supplement to and extension of previous research on family emotions.

Irritability and Parenting Styles in Adolescents With Attention-Deficit/Hyperactivity Disorder: A Controlled Study

Attention-deficit/hyperactivity disorder (ADHD) affects functioning of the family, decreasing interactions and loyalty and increasing conflict between adolescents with ADHD and their families. Irritable mood and difficulties with emotional dysregulation are common in children with ADHD. The objective of the current study was to assess levels of irritability in adolescents with ADHD using self- and parent-report scales, and investigate the relationship between irritability levels and parental attitudes. A total of 47 adolescents with ADHD and 39 adolescents with typical development participated in the current study. Findings demonstrated that higher levels of parent-reported irritability were associated with decreased egalitarian attitudes in the ADHD group. Although other parental attitudes were not associated with self- and parent-reported irritability, evaluation of the relationship between parental attitudes and irritability in adolescents with ADHD, which can guide diagnosis and treatment of ADHD, is of critical importance. [Journal of Psychosocial Nursing and Mental Health Services, 56(9), 33-43.].

Mother-Child Interactions and Externalizing Behavior Problems in Preschoolers over Time: Inhibitory Control as a Mediator

Previous research has shown links between parenting and externalizing behavior problems in young children over time. Associations between inhibitory control, one of the executive functions, and externalizing behavior problems are widely established as well. Yet, the role of inhibitory control in the maintenance and change of externalizing behavior problems over time remains unclear. We examined whether inhibitory control could explain the link between mother-child interactions measured on a moment-to-moment timescale and preschoolers’ externalizing behavior problems as reported by teachers. With a sample of 173 predominantly clinically referred preschoolers (76.9% boys) we tested a longitudinal model proposing that affective dyadic flexibility and maternal negative affect predict as well as interact in predicting hyperactive/impulsive behavior and aggressive behavior, with preschoolers’ inhibitory control as a mediator. Our results provide support for this model for preschoolers’ hyperactive/impulsive behavior, but not for aggressive behavior. Hence, inhibitory control is identified as a mechanism linking the content and structure of mother-child interactions to preschoolers’ hyperactivity and impulsivity over time.

Systematic review of meditation-based interventions for children with ADHD

Meditation-based interventions such as mindfulness and yoga are commonly practiced in the general community to improve mental and physical health. Parents, teachers and healthcare providers are also increasingly using such interventions with children. This review examines the use of meditation-based interventions in the treatment of children with Attention-Deficit Hyperactivity Disorder (ADHD). Electronic databases searched included PsycINFO, Medline, CINAHL, and AMED. Inclusion criteria involved children (aged to 18 years) diagnosed with ADHD, delivery of a meditation-based intervention to children and/or parents, and publication in a peer-reviewed journal. Studies were identified and coded using standard criteria, risk of bias was assessed using Risk of Bias in Non-randomised Studies- of interventions (ROBINS-I), and effect sizes were calculated. A total of 16 studies were identified (8 that included children in treatment, and 8 that included combined parent-child treatment). Results indicated that risk of bias was high across studies. At this stage, no definitive conclusions can be offered regarding the utility of meditation-based interventions for children with ADHD and/or their parents, since the methodological quality of the studies reviewed is low. Future well designed research is needed to establish the efficacy of meditation-based interventions, including commonly used practices such as mindfulness, before recommendations can be made for children with ADHD and their families.

ADHD and Depression Symptoms in Parent Couples Predict Response to Child ADHD and ODD Behavior

Parents of children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) often have elevated ADHD and depressive symptoms, both of which increase the risk of ineffective parenting and interparental discord. However, little is known about whether child ADHD/ODD behavior and parent ADHD or depressive symptoms uniquely or synergistically predict the quality of parenting and interparental communication during triadic (mother-father-child) interactions. Ninety parent couples, including 51 who have children diagnosed with ADHD, were randomly assigned to interact with a 9-12 year-old confederate child (84 % male) exhibiting either ADHD/ODD-like behavior or typical behavior. Parents reported their own ADHD and depressive symptoms, and parents and observers rated the quality of parenting and interparental communication during the interaction. Actor-partner interdependence modeling indicated that child ADHD/ODD behavior predicted less positive and more negative parenting and communication, independent of adult ADHD and depressive symptoms. Parent couples including two parents with elevated ADHD communicated more positively while managing children exhibiting ADHD/ODD behavior than couples managing children behaving typically or couples with only one parent with elevated ADHD symptoms. Couples including one parent with, and one parent without, elevated ADHD or depressive symptoms parented less positively and more negatively, and communicated more negatively, when managing children exhibiting ADHD/ODD behavior than when managing children behaving typically. Taken together, depending on the similarity of ADHD and depressive symptom levels in parent couples, adults managing children exhibiting ADHD/ODD behavior may parent or communicate positively or negatively. Findings highlight the need to consider the psychopathology of both parents when treating children with ADHD in two-parent homes.

COMT and DAT1 polymorphisms moderate the indirect effect of parenting behavior on youth ADHD symptoms through neurocognitive functioning

Although gene × environment interactions contribute to youth attention-deficit/hyperactivity disorder (ADHD) symptoms, the pathways mediating these influences are unknown. We tested genetic moderation of indirect effects from parenting behavior to youth ADHD symptoms through multiple neurocognitive factors. Two hundred and twenty-nine youth with and without ADHD were assessed at baseline (Wave 1; ages 5-10) and at a 2-year follow-up (Wave 2; ages 7-13). At Wave 1, youth completed a neurocognitive battery including measures of response inhibition, visuospatial working memory, and fluid reasoning, and a standardized parent-child interaction task yielding observational measures of positive and negative parenting. At Wave 2, youth psychopathology was rated by parents and teachers using multiple methods (i.e., structured interview, rating scale). We employed moderated multiple mediation and compared conditional indirect effects across youth genotypes at two biologically plausible genetic loci. Controlling for parent ADHD symptoms as well as youth demographic factors and co-occurring externalizing symptoms, these genetic factors moderated the indirect effect from Wave 1 parenting to multi-method/informant Wave 2 ADHD symptoms through Wave 1 neurocognitive functioning. This preliminary study is the first to identify genetic moderation of mediated effects underlying ADHD symptoms and suggests that specific gene × parenting interactions may underlie neurocognitive functioning deficits and subsequent ADHD.

Maternal psychopathology and offspring clinical outcome: a four-year follow-up of boys with ADHD

Previous cross-sectional research has shown that parents of children with attention deficit hyperactivity disorder (ADHD) have high rates of psychopathology, especially ADHD and depression. However, it is not clear whether different types of parent psychopathology contribute to the course and persistence of ADHD in the child over time. The aim of this two wave study was to investigate if mother self-reported ADHD and depression influence persistence of offspring ADHD and conduct disorder symptom severity in adolescents diagnosed with ADHD in childhood. A sample of 143 males with a confirmed diagnosis of ADHD participated in this study. ADHD and conduct disorder symptoms were assessed at baseline and reassessed 4 years later. The boys in this sample had a mean age of 10.7 years at Time 1 (SD 2.14, range 6-15 years) and 13.73 years at Time 2 (SD 1.74, range 10-17 years). Questionnaire measures were used to assess ADHD and depression symptoms in mothers at Time 1. Mother self-reported ADHD was not associated with a change in child ADHD or conduct symptom severity over time. Mother self-reported depression was found to predict an increase in child conduct disorder symptoms, but did not contribute to ADHD symptom levels. This study provides the first evidence that concurrent depression in mothers may be a predictor of worsening conduct disorder symptoms in adolescents with ADHD. It may, therefore, be important to screen for depression in mothers of children with ADHD in clinical practice to tailor interventions accordingly.

The role of socio-economic disadvantage in the development of comorbid emotional and conduct problems in children with ADHD

Previous research shows that, compared to children without ADHD, children with ADHD have worse socio-emotional outcomes and more experience of socio-economic disadvantage. In this study, we explored if and how the increased emotional and behavioural difficulties faced by children with ADHD may be accounted for by their more disadvantaged socio-economic circumstances. Our study, using data from 180 children (149 boys) with ADHD from the Millennium Cohort Study, had two aims. First, to examine the role of socio-economic disadvantage in the trajectories of emotional and conduct problems in children with ADHD at ages 3, 5, 7 and 11 years. Second, to explore the roles of the home environment (household chaos) and parenting (quality of emotional support, quality of the parent-child relationship and harsh parental discipline) in mediating any associations between socio-economic disadvantage and child emotional and conduct problems. Using growth curve models, we found that socio-economic disadvantage was associated with emotional and conduct problems but neither the home environment nor parenting attenuated this association. Lower quality of the parent-child relationship and harsher discipline were associated with more conduct problems. It appears that socio-economic disadvantage and parenting contribute independently to the prediction of comorbid psychopathology in children with ADHD.

Parental Serotonin Transporter Polymorphism (5-HTTLPR) Moderates Associations of Stress and Child Behavior With Parenting Behavior

The serotonin transporter-linked polymorphic region (5-HTTLPR) is associated with caregiving in nonhuman animals and with affective and cognitive correlates of human parenting, yet its association with human parenting is largely unknown. Using a well-characterized sample of parents and offspring, we evaluated the association of parental 5-HTTLPR with observed positive and negative parenting behavior, as well as its biologically plausible moderation of child-related stress and disruptive child behavior as predictors of parenting. One hundred and sixty-two parents (86% mothers) and their 6- to 9-year-old children with and without attention-deficit/hyperactivity disorder were ascertained using multiple methods including structured interviews, rating scales, and observed parent-child interaction, yielding strong measures of key constructs. Controlling for multiple youth-level (e.g., sex, 5-HTTLPR genotype, disruptive behavior) and parent-level (e.g., demographics, depression, attention-deficit/hyperactivity disorder) factors, parents with an S allele exhibited significantly less observed positive parenting than those with the LL genotype. Significant Gene × Environment interactions were also observed: Child-related stress was negatively associated with observed parental negativity among SS/SL genotype parents but not LL genotype parents; next, observed disruptive child behavior was positively associated with parental negativity for both genotypes, but the effect was strongest in SS/SL parents. These preliminary findings suggest that parental 5-HTTLPR is uniquely associated with positive and negative parenting behavior, with more specific patterns according to child-related stress and disruptive child behavior. We consider implications for future research evaluating genetic influences on parenting as well as considerations for designing and delivering parenting-based interventions.

Towards a model of contemporary parenting: the parenting behaviours and dimensions questionnaire

The assessment of parenting has been problematic due to theoretical disagreement, concerns over generalisability, and problems with the psychometric properties of current parenting measures. The aim of this study was to develop a comprehensive, psychometrically sound self-report parenting measure for use with parents of preadolescent children, and to use this empirical scale development process to identify the core dimensions of contemporary parenting behaviour. Following item generation and parent review, 846 parents completed an online survey comprising 116 parenting items. Exploratory and confirmatory factor analyses supported a six factor parenting model, comprising Emotional Warmth, Punitive Discipline, Anxious Intrusiveness, Autonomy Support, Permissive Discipline and Democratic Discipline. This measure will allow for the comprehensive and consistent assessment of parenting in future research and practice.

ADHD symptoms and academic adjustment to college: the role of parenting style

OBJECTIVE

The primary aim of this study was to examine relationships among parenting style, symptoms of ADHD, and academic adjustment in college students. Specifically, we investigated whether parenting style may act as a buffer in the negative relationship between ADHD symptoms and academic adjustment.

METHOD

Participants were 200 undergraduate students attending a large public university. Questionnaires measuring their ADHD symptoms, parent's parenting style, and academic adjustment were completed.

RESULTS

Results indicated small but significant moderation effects for authoritarian parenting and authoritative parenting on the relationship between ADHD symptoms and academic adjustment.

CONCLUSION

Although research has revealed that different parenting styles may relate to different outcomes in children with ADHD, for young adults, the effects of parenting on academic adjustment may be diluted. Future research should investigate variables that may be more salient predictors of functional outcomes for this population, such as organizational skills.

Maternal emotion regulation mediates the association between adult attention-deficit/hyperactivity disorder symptoms and parenting

Mothers with elevated Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms demonstrate parenting deficits, as well as difficulties in emotion regulation (ER), which may further impact their ability to effectively parent. However, no empirical research has examined potential mediators that explain the relations between maternal ADHD symptoms and parenting. This prospective longitudinal study examined difficulties with ER as a mediator of the relation between adult ADHD symptoms and parenting among 234 mothers of adolescents recruited from the community when they were between the ages of nine to twelve. Maternal ratings of adult ADHD symptoms, difficulties with ER, and parenting responses to their adolescents' expressions of negative emotions were collected over the course of three years. We found that maternal ADHD symptoms were negatively associated with positive parenting responses to adolescents' negative emotions, and positively associated with harsh parenting and maternal distress reactions. Moreover, maternal ER mediated the relation between adult ADHD symptoms and harsh parenting responses, while controlling for adolescent ADHD and disruptive behavior symptoms. However, maternal ER did not mediate the relation between ADHD symptoms and positive or distressed parental responses. Thus, it appears that ER is one mechanism by which maternal ADHD symptoms are associated with harsh responses to their adolescents' expressions of negative emotion. These findings may have downstream implications for adolescent adjustment.

Beyond symptom control for attention-deficit hyperactivity disorder (ADHD): what can parents do to improve outcomes?

Attention-deficit hyperactivity disorder (ADHD) and its associated behavioural manifestations develop and progress as the result of complex gene-environment interactions. Parents exert a substantial influence and play a major role in their child's social environment. Despite this, recent evidence has suggested that adapting the child's environment via parenting interventions has minimal effects on child ADHD symptoms when analysing data from informants who are probably blind to treatment allocation. However, adverse parenting and family environments may act as a source of environmental risk for a number of child outcomes beyond ADHD symptoms. This is a narrative review that critically discusses whether parenting interventions are beneficial for alternative functioning outcomes in ADHD including neuropsychological, academic and social functioning and disruptive behaviour and how parenting and familial environments may be associated with these outcomes. In addition, the review explores how parental depression and parenting efficacy impact on capacity for optimal parenting and whether parenting interventions benefit parents too. A review of the evidence suggests that with modification, parenting interventions are beneficial for a number of outcomes other than ADHD symptom reduction. Improving the parent-child relationship may have indirect benefits for disruptive behaviour. Furthermore, parenting behaviours may directly benefit child neuropsychological, academic and social functioning. Parenting interventions can have therapeutic benefits for parents as well as children, which is important as parent and child well-being is likely to have a transactional relationship. Evaluation of the clinical success of parenting interventions should focus on a wider range of outcomes in order to aid understanding of the multifaceted benefits that they may be able to offer. Parenting interventions should not be seen as a redundant adjunct to medication in multi-modal treatment approaches for ADHD; they have the potential to target outcomes that, at present, medication seems less able to improve.

Linguistic analysis of the Preschool Five Minute Speech Sample: what the parents of preschool children with early signs of ADHD say and how they say it?

A linguistic analysis was performed on the Preschool Five Minute Speech Sample (PFMSS) of 42 parents. PFMSS is a validated measure for Expressed Emotion (EE) to assess parent-child relationship. Half of these parents (n = 21, clinical group) had preschool children with early symptoms of attention deficit hyperactivity disorder (ADHD), the rest had typically developing children. Early symptoms of ADHD were identified with the Werry-Weiss Peters Rating Scale. The linguistic component of the PFMSS was analysed with keyword and linguistic pattern identification. The results of these two complementary analyses (i.e., EE and linguistic analysis) provided relevant recommendations that may improve the efficacy of psychological treatment for ADHD such as parenting interventions. We discuss the practical implications of these findings.

Contributions of maternal emotional functioning to socialization of coping

This study examined whether maternal emotional functioning-emotional awareness and depression-guides the coping suggestions mothers make to their children in the context of a common childhood stressor (peer victimization). Across two waves of a longitudinal study, 330 mothers and their second graders (mean age (M) = 7.95 years, SD = .33; 158 boys and 172 girls) completed questionnaires. Emotional awareness predicted more primary control engagement suggestions (directly addressing stress or emotions). Depression predicted fewer cognitive restructuring suggestions (thinking positively) and more cognitive avoidance suggestions (orienting thoughts away from stress). Interactive effects between maternal emotional functioning and child sex also emerged. This study elucidates the impact of mothers' emotional functioning on how they teach their children to cope with stress.

It is time for a more integrated bio-psycho-social approach to ADHD

The role of psychosocial factors in perpetuating and predisposing towards the development of attention deficit hyperactivity disorder (ADHD) symptoms has been neglected within the field of child mental health. Clinicians, when told that a child had a diagnosis of ADHD, have been found to underestimate the presence of psychosocial factors, and are less likely to ask about the possibility of neglect or abuse. This article details the considerable research showing links between ADHD symptoms and parental mental illness, child maltreatment, post-traumatic stress disorder (PTSD), attachment disorders and other environmental factors. Recent neuro-biological findings showing the impact on brain development of early abuse and attachment concerns are cited. The implications of these findings both for clinicians, and at policy level, are discussed, and the reasons underlying the need for a more integrated Bio-Psycho-Social approach to ADHD are outlined.

The role of caregiver contingent responsiveness in promoting compliance in young children

The purpose of this study was to examine relations between parents' contingent responding and the behavior of their young children, in the context of other relevant parenting behaviors. Parents were observed interacting with their 3-6 year-old children during two laboratory tasks. Parent responses to child bids were classified into four mutually exclusive categories: contingent responses, non-contingent non-negative responses, negative responses, and no response. Hierarchical regression analyses were used to examine relations between contingent responsiveness and child compliance, after accounting for the quality of parent directives and parent negativity. Contingent responsiveness was uniquely associated with greater child compliance for mothers during both tasks and for fathers during one task. An interaction effect was found, indicating that fathers' responsiveness during the second task was associated with greater child compliance in older, but not younger, children. Implications for clinical practice and future research directions are discussed.

Parental efficacy and child behavior in a community sample of children with and without attention-deficit hyperactivity disorder (ADHD)

Most studies of attention-deficit hyperactivity disorder (ADHD) youth have obtained data from the perspective of either children or parents, but not both simultaneously. The purpose of this study was to examine child and parent perspectives on parenting in a large community-based sample of children with and without ADHD. We identified children in grades 4-6 and their parents through surveys administered to a random sample of public schools. We used multivariable logistic regression to determine independent associations between child and parent characteristics and the presence of ADHD while controlling for covariates and clustering by school. Sufficient data were achieved for 2,509 child/parent dyads. Ten percent of youths (n = 240) had been diagnosed with ADHD. Compared with those without ADHD, those with ADHD were more commonly male (67.9 vs. 48.0 %, p < .001) and age 12 or over (16.3 vs. 10.3 %). After adjusting for covariates and clustering, compared to children without ADHD, children with ADHD were significantly more likely to report lower self-regulation (OR = 0.68, 95 % CI = 0.53, 0.88) and higher levels of rebelliousness (OR = 2.00, 95 % CI = 1.52, 2.69). Compared with parents whose children did not have ADHD, parents of children with ADHD rated their overall parental efficacy substantially lower (OR = 0.23, 95 % CI = 0.15, 0.33). However, child assessment of parenting style was similar by ADHD. Despite the internal challenges community-based youth with ADHD face, many parents of ADHD youth exhibit valuable parental skills from the perspective of their children. Feedback of this information to parents may improve parental self-efficacy, which is known to be positively associated with improved ADHD outcomes.

The Effectiveness of Mindfulness Training on Behavioral Problems and Attentional Functioning in Adolescents with ADHD

The effectiveness of an 8-week mindfulness training for adolescents aged 11-15 years with ADHD and parallel Mindful Parenting training for their parents was evaluated, using questionnaires as well as computerized attention tests. Adolescents (N = 10), their parents (N = 19) and tutors (N = 7) completed measurements before, immediately after, 8 weeks after and 16 weeks after training. Adolescents reported on their attention and behavioral problems and mindful awareness, and were administered two computerized sustained attention tasks. Parents as well as tutors reported on adolescents' attention and behavioral problems and executive functioning. Parents further reported on their own parenting, parenting stress and mindful awareness. Both the mindfulness training for the adolescents and their parents was delivered in group format. First, after mindfulness training, adolescents' attention and behavior problems reduced, while their executive functioning improved, as indicated by self-report measures as well as by father and teacher report. Second, improvements in adolescent' actual performance on attention tests were found after mindfulness training. Moreover, fathers, but not mothers, reported reduced parenting stress. Mothers reported reduced overreactive parenting, whereas fathers reported an increase. No effect on mindful awareness of adolescents or parents was found. Effects of mindfulness training became stronger at 8-week follow-up, but waned at 16-week follow-up. Our study adds to the emerging body of evidence indicating that mindfulness training for adolescents with ADHD (and their parents) is an effective approach, but maintenance strategies need to be developed in order for this approach to be effective in the longer term.

Parenting in adults with attention-deficit/hyperactivity disorder (ADHD)

Although the validity of adult ADHD is well established and research has identified a variety of impairments associated with the condition in adults, study of how ADHD impacts an adult's ability to parent has been relatively neglected. Parenting is a particularly important domain of functioning given the familial nature of the disorder and emerging evidence that parenting behaviors play a role in the development or maintenance of child ADHD symptoms, comorbid psychopathologies, and other associated difficulties. In this paper, we focus on three broad categories of cognitive dysfunction proposed across models of ADHD - cognitive processes (e.g., working memory, planning, and inhibitory control), self-regulation deficits (e.g., self-monitoring of performance to detect errors or the need for regulation of behavior and/or emotions), and motivational or arousal difficulties (e.g., response to incentives, delay aversion). We consider how these deficits may lead to impairments in the parenting behaviors of effective behavioral control and emotional responsiveness, and review the available evidence regarding parenting in adults with ADHD symptoms. We conclude by noting the limitations in existing studies, and argue for further research that is theoretically grounded in how core deficits of ADHD may be related to dimensions of parenting. The implications of an improved understanding of how ADHD impacts parenting for the development of early intervention or prevention programs are outlined.

The interplay among preschool child and family factors and the development of ODD symptoms

The present study examined (a) the interactions between early behavior, early parenting, and early family adversity in predicting later oppositional defiant disorder (ODD) symptoms, and (b) the reciprocal relations between parent functioning and ODD symptoms across the preschool years. Participants were 258 three-year-old children (138 boys, 120 girls) and their parents from diverse backgrounds who participated in a 4-year longitudinal study. Early child behavior, parenting, and family adversity did not significantly interact in the predicted direction. Reciprocal relations between ODD symptoms and parent functioning were observed for maternal and paternal depression, and maternal warmth. Paternal laxness at age 4 predicted ODD symptoms at age 5 and paternal laxness at age 5 predicted ODD symptoms at age 6, but child ODD did not significantly predict paternal laxness. Results suggest that ODD symptoms may develop through a transactional process between parent and child functioning across the preschool years.

The Longitudinal Israeli Study of Twins (LIST): Children's Social Development as Influenced by Genetics, Abilities, and Socialization

The goals, prospects and methods of the Longitudinal Israeli Study of Twins (LIST) are described. This study is interested in children's prosocial development from phenotypic, genetic and environmental perspectives. It focuses on measuring prosociality with a multi-trait multi-method approach, and relating it to children's general cognitive and sociocognitive abilities, and to parenting in the family. Other variables of interest such as children's temperament and parental values are discussed, as are ideas for further research.

The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents

This study evaluated the effectiveness of an 8-week mindfulness training for children aged 8-12 with ADHD and parallel mindful parenting training for their parents. Parents (N = 22) completed questionnaires on their child's ADHD and ODD symptoms, their own ADHD symptoms, parenting stress, parental overreactivity, permissiveness and mindful awareness before, immediately after the 8-week training and at 8-week follow-up. Teachers reported on ADHD and ODD behavior of the child. A within-group waitlist was used to control for the effects of time and repeated measurement. Training was delivered in group format. There were no significant changes between wait-list and pre-test, except on the increase of teacher-rated ODD behavior. There was a significant reduction of parent-rated ADHD behavior of themselves and their child from pre-to posttest and from pre- to follow-up test. Further, there was a significant increase of mindful awareness from pre-to posttest and a significant reduction of parental stress and overreactivity from pre-to follow-up test. Teacher-ratings showed non-significant effects. Our study shows preliminary evidence for the effectiveness of mindfulness for children with ADHD and their parents, as rated by parents. However, in the absence of substantial effects on teacher-ratings, we cannot ascertain effects are due to specific treatment procedures.

Social adjustment among Taiwanese children with symptoms of ADHD, ODD, and ADHD comorbid with ODD

This study examined social problems at school and relationships with peers, siblings, mothers, and fathers among children with ADHD only (n = 41), ODD only (n = 14), ADHD + ODD (n = 47), and normal controls (n = 204) from a school-based sample of 2,463 first to ninth graders in Taiwan. ADHD and ODD symptoms were determined by teacher and mother reports on the Conners' Rating Scales and social adjustment problems were assessed by mother reports on the Social Adjustment Inventory for Children and Adolescents. Results indicated that relative to normal controls, children with ADHD + ODD displayed greater levels of social adjustment problems across domains (i.e., school, peers, siblings, and parents) while children with ADHD were significantly more impaired only in social adjustment at schools and children with ODD were more impaired only in social adjustment at home. Some similarities and differences in our findings, in relation to the Western literature, were discussed.

Fathering and mothering of preschool boys with hyperactivity

This study examined links between paternal and maternal parenting factors and preschool hyperactivity in a community sample. Forty-one hyperactive and 38 comparison boys (aged 47—62 months) and their fathers and mothers were assessed on a range of interview, parent questionnaire, and observational measures of parenting and child behavior. Results showed that less observed maternal warmth, fathers’ self-reported overreactive and less authoritative parenting practices, and less satisfaction with parenting (fathers and mothers) were all significantly related to child hyperactivity, following statistical adjustment for the effects of child conduct problems and maternal age. Lower rates of observed paternal and maternal sensitivity were not significantly associated with preschool hyperactivity, after controlling for child conduct problems and maternal age. Findings highlight the importance of considering the role of both fathers’ and mothers’ parenting in the development of boys with early onset hyperactive and attentional behavior difficulties.

Child effects on communication between parents of youth with and without attention-deficit/hyperactivity disorder

Numerous studies indicate interparental conflict causes child externalizing behavior. However, far less is known about the inverse relationship. Exploring this gap in the literature has clear implications for parents of children with externalizing disorders (e.g., attention-deficit/hyperactivity disorder [ADHD]). Adapting an experimental child behavior manipulation paradigm (Lang, Pelham, Atkeson, & Murphy, 1999; Pelham et al., 1997, 1998), parent couples of 9- to 12-year-old boys and girls with ADHD (n = 51) and without ADHD (n = 39) were randomly assigned to interact with a "disruptive" or "typical" confederate child. According to parent and observer ratings, parents interacting with disruptive confederates communicated less positively and more negatively with each other during and after the interactions than did parents who interacted with typical confederates. Observational coding also indicated that child effects on negative interparental communication were more noticeable among parents of youth with ADHD, particularly those with comorbid oppositional defiant disorder or conduct disorder, compared with parents of youth without ADHD. These findings extend results of prospective studies highlighting child effects on marital quality.

Reciprocal influences between parents' perceptions of mother-child and father-child relationships: a short-term longitudinal study in Chinese preschoolers

To examine the reciprocal influences between mother-child and father-child relationships, the authors analyzed cross-lagged longitudinal data on children's relationships with both parents using a structural equation modeling approach. Mothers and fathers of 100 Chinese preschoolers aged 2-3 years filled in the Child-Parent Relationship Scale (R. Pianta, 1992) across 2 time periods 9 months apart. The results showed stability of mother-child and father-child relationships and longitudinal reciprocal influences between the relationships in that over a 9-month follow-up period, mother-child closeness negatively predicted conflict in father-child relationships, and father-child conflict positively predicted mother-child conflict.

Parental ADHD Symptomology and Ineffective Parenting: The Connecting Link of Home Chaos

SYNOPSIS: OBJECTIVE: This study examines links between maternal and paternal ADHD symptoms and parenting practices that require inhibition of impulses, sustained attention, and consistency; the role of home chaos in these associations is also assessed. DESIGN: ADHD symptoms, the level of home chaos, and parenting practices (involvement, inconsistent discipline, supportive and non-supportive responses to children's negative emotions, and positive parenting) were assessed through self-reports of 311 mothers and 149 fathers of middle-childhood children. Child ADHD symptoms were assessed by teachers. RESULTS: Mothers reported higher home chaos when they or their children had higher levels of ADHD symptoms; for fathers, only their own ADHD symptoms predicted higher levels of home chaos. Mothers' ADHD symptoms were positively associated with inconsistent discipline and non-supportive responses to children's negative emotions, and these associations were mediated by home chaos. Higher levels of fathers' ADHD symptoms predicted more inconsistent discipline, low involvement, and a low level of supportive and a high level of non-supportive responses to children's negative emotions. Home chaos moderated the link between paternal ADHD and inconsistent discipline and mediated the link between paternal ADHD and involvement. Overall, positive aspects of parenting, and those that require attention and ability to control one's impulses, may be compromised in fathers with high levels of ADHD symptoms. CONCLUSIONS: Effectiveness of specific parenting practices for both mothers and fathers may be compromised in parents with ADHD symptoms. In certain cases, parental ADHD symptoms translate into ineffective parenting through disorganized homes.

A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD)

This review synthesizes recent research evidence regarding the parenting characteristics associated with families with children with Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is a complex, heterogeneous disorder with a range of genetic and environmental factors that contribute to its behavioral expression and different developmental trajectories. The current review adopts a developmental psychopathology perspective to conceptualize the risk and protective factors that might shape the developmental pathways of the disorder across different domains. Following from Johnston and Mash's review (Johnston and Mash, Clin Child Fam Psychol Rev 4:183-207, 2001), the present review systematically examines empirical studies from 2000-2008 that investigate parenting variables in relation to the development of children with ADHD, with a particular focus on the development of externalizing and internalizing comorbidities, as well as functional impairments in academic and social contexts. The most recent research evidence uses correlational designs to show that ADHD is associated with problematic family functioning, including greater stress within the family, higher rates of parental psychopathology and conflicted parent-child relationships, which appears to be exacerbated in children with comorbid oppositional and conduct problems. However, there is an absence of literature that considers the role that parents play in contributing to children's development in areas such as academic achievement and peer competence, as well as the development of internalizing difficulties. Future research should examine family factors that are associated with resilience in children with ADHD, using longitudinal designs that reflect the dynamic changes associated with a developmental psychopathology framework.

Contextual risk, maternal parenting and adolescent externalizing behaviour problems: the role of emotion regulation

BACKGROUND

The objective of this study was to test if emotion regulation mediates the association between mothers' parenting and adolescents' externalizing behaviour problems (conduct problems and hyperactivity). The parenting dimensions were warmth, psychological control and behavioural control (measured with knowledge, monitoring and discipline). Adjustment was made for contextual risk (measured with the number of proximal adverse life events experienced), gender, age and English as an additional language.

METHOD

Data were from a UK community sample of adolescents aged 11-18 from a comprehensive school in a disadvantaged area.

RESULTS

At the multivariate level, none of the parenting variables predicted hyperactivity, which was associated only with difficulties in emotion regulation, contextual risk and English as a first language. The parenting variables predicting conduct problems at the multivariate level were warmth and knowledge. Knowledge did not predict emotion regulation. However, warmth predicted emotion regulation, which was negatively associated with conduct problems. Contextual risk was a significant predictor of both difficulties in emotion regulation and externalizing behaviour problems. Its effect on conduct problems was independent of parenting and was not via its association with difficulties in emotion regulation.

CONCLUSIONS

The findings add to the evidence for the importance of maternal warmth and contextual risk for both regulated emotion and regulated behaviour. The small maternal control effects on both emotion regulation and externalizing behaviour could suggest the importance of paternal control for adolescent outcomes.

Interactions between maternal parenting and children's early disruptive behavior: bidirectional associations across the transition from preschool to school entry

This study was a prospective 2-year longitudinal investigation of associations between negative maternal parenting and disruptive child behavior across the preschool to school transition. Our main goals were to 1) determine the direction of association between early maternal negativity and child disruptive behaviors across this important developmental transition and 2) examine whether there would be different patterns of associations for boys and girls. Participants were 235 children (111 girls; T1; M = 37.7 months, T2; M = 63.4 months) and their mothers and teachers. Observational and multi-informant ratings of child disruptive behavior showed differential patterns of stability and associations with measures of parenting risk. Results indicated bidirectional and interactive contributions of externalizing behavior and negative parenting across time. Results also indicated that risk mechanisms operate similarly for both sexes. Findings support transactional models of disruptive child behavior that highlight the joint contributions of parents and children.

Patterns of parenting in Korean mothers of children with ADHD: A Q-methodology study

The purpose of this study was to investigate patterns of parenting in Korean mothers of children with attention-deficit/hyperactivity disorder (ADHD) and identify major threads that structured various patterns of parenting. Q-methodology, a technique for extracting subjective attitudes, was used for data collection and analysis. Participants were asked to sort statements on issues associated with parenting. Factor analysis was applied to identify patterns in the ranking of statements. Participants were 45 Korean mothers of children with ADHD. As a result, three patterns of parenting emerged: Praise-Fairness, Strict-Control, and Sensitive Response-Balanced. These patterns differed on two axes: external and internal control and positive and negative reinforcement. This study provides an opportunity to enhance our understanding of the parenting patterns of mothers of children with ADHD in Korea. The findings can function as a cornerstone for developing future models of parenting children with ADHD and parent-child interactions.