The Relation Between Maternal ADHD Symptoms &amp; Improvement in Child Behavior Following Brief Behavioral Parent Training is Mediated by Change in Negative Parenting

Chronis‐Tuscano, Andrea; O’Brien, Kelly; Johnston, Charlotte; Jones, Heather A.; Clarke, Tana L.; Raggi, Veronica L.; Rooney, Mary; Diaz, Yamalis; Pian, Jessica; Seymour, Karen E.

doi:10.1007/s10802-011-9518-2

Cited by 118 publications

(117 citation statements)

References 47 publications

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“…First, results generally support previous intervention research with predominantly ADHD-C samples indicating that reductions in negative parenting following treatment mediate improvement of child impairment (e.g., Chronis et al, 2011; Hinshaw et al, 2000). Furthermore, given results suggesting that both inattention and positive/negative parenting related to impairment displayed by children with ADHD-I as observed by parents in the home setting, it appears that a multi-pronged treatment approach (e.g., targeting parenting skills and child symptoms) may be needed to produce meaningful outcomes in the various domains of functional impairment experienced by children with ADHD-I.…”

Section: Discussionsupporting

confidence: 81%

Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type

Haack

Villodas

McBurnett

et al. 2014

Journal of Clinical Child & Adolescent Psychology

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The current study investigates potential pathways between inattentive symptom severity, positive and negative parenting practices, and functional impairment (i.e., academic, social, and home impairment) in a sample of children diagnosed with ADHD, Predominantly Inattentive Type (ADHD-I). Participants included 199 children and their parents and teachers enrolled in a randomized clinical trial investigating the efficacy of an integrated psychosocial intervention for children with ADHD-I. Boys constituted just over half the sample; children averaged 8.6 years of age (range 7–11) and were from varied ethnic/racial backgrounds. As part of the initial screening and assessment procedures, parents and teachers completed questionnaires assessing child behavior and parent/family functioning. Results supported both main effects of symptoms and parenting on impairment, as well as a mediational path between symptoms and impairment via parenting, as observed by parents in the home setting. Specifically, higher severity of inattention was associated with higher rates of homework, social, and home impairment. Negative parenting contributed to homework and home impairment, and positive and negative parenting contributed to social impairment, incrementally above and beyond the impact of inattention symptom severity alone. Negative parenting partially mediated the relationship between inattentive symptom severity and impairment, such that higher rates of inattention were associated with higher rates of negative parenting, which in turn was associated with higher rates of homework, social, and home impairment. Results provide support for underlying mechanisms for associations between symptoms and impairment in children with ADHD-I, and also identify potential intervention targets to improve impairment experienced by these children.

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Section: Discussionsupporting

confidence: 81%

Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type

Haack

Villodas

McBurnett

et al. 2014

Journal of Clinical Child & Adolescent Psychology

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“…behavioural and pharmacological) treatment. [29,44] Unfortunately, the presence of parental ADHD is associated with an attenuated response to behavioural treatments, [26,28,31] highlighting the need to screen (and, if necessary, treat) parents of youth with ADHD for adult ADHD. Thus, the presence of a child with ADHD should increase the clinician's suspicion of parental ADHD, which may be more subtle if not previously identified.…”

Section: Discussionmentioning

confidence: 99%

“…It is therefore no surprise that ADHD in parents is associated with an attenuated response to behavioural parent training programmes for children with ADHD. [26][27][28] In the National Institute of Mental Health (NIMH)-funded Multimodal Treatment Study of Children with ADHD (MTA), the combination of child stimulant treatment plus behaviour modification was associated with the most dramatic improvements in parenting and family interaction. [29] However, maternal psychopathology moderated response to both pharmacological and behavioural treatments, [30] and higher parental inattention predicted less child improvement at 3-year follow-up.…”

Section: Parental Adhd Negatively Impacts Evidence-based Treatments Fmentioning

confidence: 99%

“…[31] Furthermore, in a recent study, ADHD mothers' observed failure to inhibit their negative responses to child misbehaviour mediated poorer child behavioural treatment outcomes. [26] Thus, examination of relations between treatment of parental ADHD and parenting behaviour has important clinical implications for both children and adults with the disorder.…”

Section: Parental Adhd Negatively Impacts Evidence-based Treatments Fmentioning

confidence: 99%

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Pharmacotherapy for Parents with Attention-Deficit Hyperactivity Disorder (ADHD)

Chronis‐Tuscano

Stein

2012

CNS Drugs

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Given the high heritability of the disorder, attention-deficit hyperactivity disorder (ADHD) is common among parents of children with ADHD. Parental ADHD is associated with maladaptive parenting, negative parent-child interaction patterns and a diminished response to behavioural parent training. We describe our previous research demonstrating that stimulant medications for mothers with ADHD are associated with reductions in maternal ADHD symptoms. Although limited beneficial effects on self-reported parenting were also found in our study, the impact of ADHD medications on functional outcomes related to parenting and family interactions may not be sufficient for many families. Many questions remain with regard to how best to treat multiplex ADHD families in which a parent and child have ADHD. In particular, future studies are needed: (1) to evaluate how best to sequence pharmacotherapy, psychosocial treatment for adult ADHD and behavioural parenting interventions; (2) to determine the best approach to maintaining treatment effects over the long term for both parents and children; and (3) to identify individual predictors of treatment response.

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“…Similarly, Chronis-Tuscano and colleagues (2011) found that 6–10 year old children of mothers who reported more ADHD symptoms displayed less improvement in their disruptive behavior symptoms immediately following BPT than did the children of parents reporting fewer ADHD symptoms. Like Sonuga-Barke and colleagues (2002), this study examined BPT only.…”

mentioning

confidence: 89%

The Role of Parental ADHD in Sustaining the Effects of a Family-School Intervention for ADHD

Dawson

Wymbs

Marshall

et al. 2014

Journal of Clinical Child & Adolescent Psychology

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Objective This study investigated the extent to which parental Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms impact child and parent outcomes following a multimodal family-school intervention, the Family School Success (FSS) program, when compared to an active-control condition (CARE). Method Participants were 139 children with ADHD (67% male; 91% non-Hispanic; 77% Caucasian; grades 2–6) and their primary caretaker (91% female; aged 26–59) who participated in a randomized clinical trial evaluating the efficacy of FSS. Associations were examined between parent-reported ADHD symptoms at baseline and intervention outcomes reported by parents and teachers after treatment and at a 3-month follow-up, including child homework and classroom impairments, child ADHD and oppositional defiant disorder symptoms, parenting behaviors, and parent-teacher relationship quality. Results Across both treatment conditions, parental ADHD was not associated with parent or child outcomes at post-assessment. However, differences emerged between the two treatment groups at follow-up for parents with ADHD, particularly when an empirically-supported symptom cutoff was used to identify parents at-risk for having ADHD. In FSS, but not in CARE, parental ADHD was associated with declines in treatment gains in the quality of the parent-teacher relationship and the child’s homework performance. Conclusions Parents at-risk for ADHD had difficulty maintaining treatment effects for themselves and their child in the FSS intervention, but not in CARE. The supportive and educational components central to the CARE intervention may be helpful in promoting the sustainability of psychosocial interventions for children with ADHD who have parents with elevated ADHD symptoms.

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The Relation Between Maternal ADHD Symptoms & Improvement in Child Behavior Following Brief Behavioral Parent Training is Mediated by Change in Negative Parenting

Cited by 118 publications

References 47 publications

Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type

Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type

Pharmacotherapy for Parents with Attention-Deficit Hyperactivity Disorder (ADHD)

The Role of Parental ADHD in Sustaining the Effects of a Family-School Intervention for ADHD

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