Maternal Functioning Differences Based on ADHD Subtype

Assessment of ADHD Subtypes Using Motion Tracking Recognition Based on Stroop Color-Word Tests

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder known for its significant heterogeneity and varied symptom presentation. Describing the different subtypes as predominantly inattentive (ADHD-I), combined (ADHD-C), and hyperactive-impulsive (ADHD-H) relies primarily on clinical observations, which can be subjective. To address the need for more objective diagnostic methods, this pilot study implemented a Microsoft Kinect-based Stroop Color-Word Test (KSWCT) with the objective of investigating the potential differences in executive function and motor control between different subtypes in a group of children and adolescents with ADHD. A series of linear mixture modeling were used to encompass the performance accuracy, reaction times, and extraneous movements during the tests. Our findings suggested that age plays a critical role, and older subjects showed improvements in KSWCT performance; however, no significant divergence in activity level between the subtypes (ADHD-I and ADHD-H/C) was established. Patients with ADHD-H/C showed tendencies toward deficits in motor planning and executive control, exhibited by shorter reaction times for incorrect responses and more difficulty suppressing erroneous responses. This study provides preliminary evidence of unique executive characteristics among ADHD subtypes, advances our understanding of the heterogeneity of the disorder, and lays the foundation for the development of refined and objective diagnostic tools for ADHD.

Does Child Anxiety Exacerbate or Protect Against Parent–Child Relationship Difficulties in Children with Elevated ADHD Symptoms?

Pediatric ADHD is associated with parent–child relationship difficulties. However, the extent to which these relations are attributable to specific ADHD symptom clusters (i.e., inattentive vs. hyperactive/impulsive), and the extent to which child anxiety symptoms may exacerbate or protect against these difficulties, remains unclear. To address these gaps in the literature, the current study combined multi-informant measures (parent, teacher, child) with a clinically-evaluated and carefully-phenotyped sample of 188 children with and without ADHD and anxiety (ages 8–13; 63 girls). Results indicated that child-reported anxiety (β = .46) and teacher-reported inattentive (β = .71) symptoms, and their interaction (β = -1.06), along with child age and IQ (β = -.14 to -.15), predict the extent to which parents perceive themselves as confident and competent parents (all p < .05). In contrast, only comorbid oppositional-defiant disorder conferred risk for increased parent-reported relational frustration, and we were unable to detect any reliable child-level demographic, diagnostic, or behavioral predictors of parent-reported discipline practices. These findings were robust to control for child demographic characteristics, clinical diagnoses, and intellectual functioning, with sensitivity analyses highlighting the importance of assessing ADHD inattentive vs. hyperactive/impulsive symptoms separately for understanding parenting outcomes. Taken together, the current findings suggest that child ADHD and anxiety symptoms may influence specific rather than broad-based aspects of the parent–child relationship, and produce differently valenced outcomes in the presence vs. absence of the other condition. Interestingly, it appears that the combination of greater child inattention and anxiety, rather than elevations in either symptom domain independently, predict adverse parenting outcomes in terms of reduced parental confidence.

Parenting Self-Efficacy in Immigrant Families-A Systematic Review

Introduction: Parenting self-efficacy (PSE) refers to parents' belief in their ability to perform the parenting role successfully, and derives from Bandura's concept of personal self-efficacy formulated within the social cognitive theory. PSE has been demonstrated to be a strong predictor of parenting functioning. At the same time, relatively less is known about its possible role in the situation of migration, when a family experiences acculturation stress in the process of adaptation to the new culture. Therefore, the aim of this systematic review was to summarize available data on the conceptualization, measurement, and the role of parenting self-efficacy in the context of acculturation processes, and in various groups of immigrant parents.

Methods: An extensive search of eight electronic databases was conducted in August 2018 and updated in February 2020 to identify peer-reviewed articles on parenting self -efficacy among immigrants. Eleven studies met pre-specified criteria for inclusion. Nine of the studies employed a quantitative design, whereas the remaining two studies used qualitative methods. In three of the quantitative studies, interventions/programs for immigrants were assessed.

Results: Three different approaches to conceptualizing and measuring PSE were identified in the analyzed papers: domain-general, domain-specific, and narrow domain. Incongruent results were found with regards to the links between the strength of PSE and immigrants' cultural orientation. Additionally, PSE was identified as a mediator between a stronger orientation toward the mainstream culture and more supportive parenting. The qualitative studies indicated that a reduction in PSE was typical for the initial period of immigration and might be a consequence of a forced orientation toward the standards of the receiving country, which was a consequence of the parents wanting to maintain close relations with their teenage children.

Discussion: Overall, the theoretical and methodological quality of the reported studies varied and hence their findings have to be interpreted with caution. Our analysis clearly points to the usefulness of a multifaceted approach to PSE. Further research is needed to understand the mechanisms by which parental self-efficacy may exert a positive effect on the functioning of immigrant families.

Family Functioning in Latinx Families of Children with ADHD: The Role of Parental Gender and Acculturation

OBJECTIVES

It has been well-established that parents of children with ADHD report significantly higher levels of parenting stress and home chaos, and lower levels of parental efficacy than parents of children without ADHD. Unfortunately, most of the extant ADHD literature has focused on European American children and families, resulting in a paucity of research focusing on ethnic minority families of children with ADHD. The current study aimed to expand what is known about Latinx parents of children with ADHD by exploring contextual and cultural factors, such as parental gender and acculturation, which may account for variations in parenting experiences within this population.

METHODS

The present study utilized secondary data analysis to analyze ratings of parenting stress, home chaos, and parental efficacy among a sample of Latinx mothers and fathers of children with ADHD (n = 46 dyads).

RESULTS

Results indicated that Latinx mothers of children with ADHD reported higher levels of parenting stress than Latinx fathers of children with ADHD; however, no significant parental gender differences were found in ratings of parental efficacy or home chaos. Additionally, several significant relationships were found between parental acculturation and family functioning variables.

CONCLUSIONS

Latinx families of children with ADHD are an understudied and underserved population within the field of clinical psychology. The current study provides critical information on Latinx family functioning within the context of ADHD treatment, specifically pertaining to the complex interplay of parenting and acculturation variables.

Belastungserleben von Müttern mit Kindern mit ADHS

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.

Mothers' parenting stress is associated with salivary cortisol profiles in children with attention deficit hyperactivity disorder

The aim of this study was to explore the relation between mothers' parenting stress and the functioning of the hypothalamic-pituitary-adrenal axis (HPAA), as expressed by daily salivary cortisol concentrations, in their children diagnosed with attention deficit hyperactivity disorder (ADHD). Seventy-five children aged 6-11 years diagnosed with ADHD predominant hyperactive-impulsive/combined (ADHD-HI/C, N = 49) and inattentive symptoms (ADHD-I, N = 26) and 45 healthy peers and their mothers participated in the study. Μothers completed measures assessing their children's ADHD status, perceived parenting stress (Parenting Stress Index - Short Form, PSI-SF), mothers' symptoms of psychopathology, social support and socioeconomic status. Children's salivary cortisol samples were collected at six different time points on a single day. Mothers of children with ADHD-HI/C reported higher levels of parenting stress than mothers of children with ADHD-I and controls. All PSI-SF subscales showed significant associations with children's cortisol awakening response (CAR) in both ADHD groups, with the exception of the parental distress subscale in the ADHD-I group. In both ADHD groups, the parent-child dysfunctional interaction subscale, the difficult child subscale and the PSI total score were significantly associated with children's CAR. An interrelation is revealed between mothers' high levels of parenting stress and HPAA functioning in children with ADHD. In this population, CAR has been identified as a sensitive peripheral measure of HPAA functioning in children. Lay summaryThis study showed that in families of children diagnosed with ADHD, there is a complex relation between the mothers' high levels of parenting stress and children's atypical hypothalamic-pituitary-adrenal axis functioning.

Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder

Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6–16 years) and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI) and Child Behavior Checklist for ages 6–18 (CBCL/6–18). Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder.