childhood attention deficit/hyperactivity disorder symptomatology in parents: a risk factor for...
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Childhood Attention Deficit/Hyperactivity Disorder Symptomatology in Parents: A Risk Factor for Children with ADHD?
Presented at the
UCI Undergraduate Research Symposium
by
David A. Hallowell
May 15, 2004
Acknowledgments: Professor Carol Whalen Professor Valerie Jenness Dr. Sharon Ishikawa Project Coordinators Tina Merrilees
and Cara Kiff This ongoing study is being
supported by funding from Eli Lilly and Company
The Parents and Children from the Community who Participated in Week-Long, Labor Intensive Study
Attention/Deficit Hyperactivity Disorder (ADHD)
Difficulty paying attention, following directions, or being quiet from time to time are features intrinsic to childhood
Children with ADHD display these problems more frequently, causing significant disruptions for those in their social environment
According to the DSM-IV, the diagnostic criteria are:
a) Displaying at least 6 of the 9 symptoms for either the inattentive, the hyperactive/impulsive, or combined subtype features of the disorder
b) Problematic behaviors must surface prior to age 7 and have persisted for at least 6 months
c) The symptoms must be negatively affecting the child across at least two settings
Constructs Perceptions of Parenting Efficacy- An individual’s
beliefs about their level of ability to function in the role of parent
Attributions- Perceived causes that people assign to events that occur in their environment
Learned Helplessness- Attribution style that assigns stable, internal, uncontrollable causes to negative events associated with an individual
Dyad- A group of two units that are related to each other in some way
Affect- Emotional State
Parenting Efficacy
Socio-Economic
Status
Depression
Perceptions of
Infant Temperament
Ratings of
Actual Parenting
Competence
Perceptions of
Parenting Efficacy
Teti & Gelfand, 1991
Efficacy and Mood
Learned Helplessness
Negative Event
UncontrollableStableInternal
ControllabilityStabilityLocus Negative
Affect
Assign Causation
Possible Attribution Style
Efficacy and Mood (Continued)
1 Mash & Johnston, 1983, Coleman and Karraker, 1997; 2 Bugental & Johnston, 2000; 3 Rucklidge & Kaplan, 2000
Past Research: Relationships found Between
Learned Helplessness Attribution Style for Child Behaviors1
Low Perceptions of Parenting Efficacy and
Child Attributions for Child Behaviors2
Parent Attributions for Child Behaviors and
Adult Learned Helplessness3Childhood ADHD and
Major Depressive Disorder3Learned Helplessness and
Research: Negative Affect
Bandura, 1989
Attributions Emotions
Bidirectional Priming Effect
Psychological Symptoms
Childhood
Hyperactivity
ADHD
Major Depressive Disorder
Personality Disorders
Adulthood13-Year Follow-Up Study(Fischer et al., 2002)
Methodology
Convenience sample of 24 parent-child dyads recruited from local area schools and from physician practices
Children’s ages between 8 and 12 years old All children diagnosed with ADHD and being treated
with a long-acting stimulant medication, taken once daily during the study
N Mean Age Gender
Parents 24 43.6 M=1, F=23
Children 24 10.6 M=14, F=10
• All but one dyad white, non-hispanic ethnicity. Participants mostly well-educated, upper-middle class.
Methodology (Continued)Measures
Assessment of Hyperactivity (AHA)
Mehringer et al., 2002
Childhood ADHD
Characteristics Brief Symptom Inventory (BSI)
Derogatis, 1983
The Mood Disorder Questionnaire (MDQ),
Hirschfeld, 2000
Psychological Symptoms
Methodology (Continued) Rationale: Observe the daily lives of children
and parents in their natural environment Child Moods: Diary Programs on PalmPilots Parental Perceptions of Their Own Parenting
Efficacy: Morning and evening summary diaries completed daily
Palm Pilot Child Diary Screenshots
Positive Mood Negative Mood
Hypothesis One
1) Among parents of children with ADHD, parents whose self-reported childhood ADHD characteristics meet DSM-IV criteria will exhibit more adult psychological symptoms than parents whose self-reported ADHD characteristics do not meet diagnostic criteria
Hypothesis Two
2) Among parents of children with ADHD, parents whose self-reported childhood ADHD characteristics meet DSM-IV criteria will report lower perceptions of parenting efficacy than parents whose self- reported ADHD characteristics do not meet diagnostic criteria
Hypothesis Three
3) Among children with ADHD, those whose parents’ self-reported childhood ADHD characteristics meet DSM-IV criteria will report more negative moods and fewer positive moods than children whose parents’ self-reported ADHD characteristics do not meet DSM-IV criteria
Results: Psychological Symptoms
00.05
0.10.15
0.20.25
0.30.35
0.40.45
0.5
Brief Symptom Inventory *
Low ADHDGroupHigh ADHDGroup
0
1
2
3
4
5
6
7
8
9
Mood Disorder Questionnaire+
Low ADHDGroupHigh ADHDGroup
* Results significant for < 0.05 + Results significant for < 0.01
Brief Symptom Inventory Mood Disorder Questionnaire
Results: Perceptions of Parenting Efficacy
2.52.62.72.82.9
33.13.23.33.43.5
Parenting Efficacy *
Low ADHDGroupHigh ADHDGroup
* Results approached significance (p = .106). Tendency not present for evening summary diaries
Parenting Efficacy for Morning Summary Diaries
Results: Child Moods
Composite Child Mood Profiles
00.20.40.60.8
11.2
1.41.61.8
PositiveMoods
NegativeMoods
Children of LowADHD Group
Children ofHigh ADHDGroup
No Significant Differences
Discussion: Psychological Symptoms
Parents exhibiting a childhood history of high childhood ADHD characteristics may be at greater risk for psychological symptoms than their low childhood ADHD counterparts
Discussion: Parenting Efficacy Group differences in perceptions of parenting
efficacy during morning times approached significance
Perhaps interactions before school are particularly stressful and parents with a history of high childhood ADHD characteristics come away from challenging interactions feeling less capable than those without such a history
We are continuing to enroll participants in this study so that we will be able to repeat these analyses with an adequate sample size
Discussion: Mood Profiles
The lack of group differences may have been related to methodological limitations:
- Emotions were reported on a three-point scale
- Positive response bias may have operated
Pharmacology treatment in children linked to reversal of the learned helplessness attribution style in parents (Johnston et al, 2000)
Limitations
Non-representative Convenience Sample Small Sample Size Self-Selection Process May Have Precluded the
Most Severely Affected Families (Whalen et al, 2002)
Retrospective Self-Diagnosis of Parental ADHD in Childhood
Efficacy measures were pen-and-paper surveys Primarily Mother-Child Dyad Characteristics
Implications
These findings suggest that parents with childhood histories of ADHD may benefit from special resources and training aimed at:
- Helping them manage their own children with ADHD
- Improving their perceived parenting efficacy
David Hallowell
Dept. of Psychology and Social Behavior
University of California, Irvine
For further information I can be reached at: