Maternal Depression and Early Positive Parenting Predict Future Conduct Problems in Young Children With Attention-Deficit/Hyperactivity Disorder Approximately 20% to 50% of children and 44% to 50% of adolescents with ADHD

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Developmental Psychology (Impact Factor: 3.21). 01/2007; 43(1):70-83. DOI: 10.1037/0012-1649.43.1.70

ABSTRACT Children with attention-deficit/hyperactivity disorder (ADHD) are at risk for adverse outcomes such as
substance abuse and criminality, particularly if they develop conduct problems. Little is known about
early predictors of the developmental course of conduct problems among children with ADHD, however.
Parental psychopathology and parenting were assessed in 108 children who first met Diagnostic and
Statistical Manual of Mental Disorders (4th ed.) criteria for ADHD at 4–7 years old. When demographic
variables and baseline ADHD and conduct problems were controlled, maternal depression predicted
conduct problems 2–8 years following the initial assessment, whereas positive parenting during the
structured parent– child interaction task predicted fewer future conduct problems. These findings suggest
that maternal depression is a risk factor, whereas early positive parenting is a protective factor, for the
developmental course of conduct problems among children with ADHD.

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    ABSTRACT: Mothers of children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for an ADHD diagnosis themselves, which is likely associated with impairments in parenting. The present study utilized a multi-method assessment of maternal ADHD and parenting to examine the extent to which maternal ADHD symptoms are associated with maladaptive parenting. Participants included 70 6-10 year old children with DSM-IV ADHD and their biological mothers. Results suggested that mothers with higher levels of ADHD symptoms reported lower levels of involvement and positive parenting and higher levels of inconsistent discipline. During observed parent-child interactions, maternal ADHD symptoms were negatively associated with positive parenting, and positively associated with negative parenting and repeated commands before giving the child an opportunity to comply. Given prior research suggesting that maladaptive parenting behaviors are risk factors for the later development of conduct problems among children with ADHD, these findings have important clinical implications for family-based assessment and treatment of ADHD.
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    ABSTRACT: Maternal depression and parenting are robust predictors of developmental outcomes for children with attention-deficit/hyperactivity disorder (ADHD). However, methods commonly used to examine parent-child interactions in these families do not account for temporal associations between child and parent behavior that have been theorized to maintain negative child behavior. Moreover, studies examining associations between maternal depression and parenting in families of children with ADHD have not compared mothers who were currently depressed, remitted, and never clinically depressed. This study utilized sequential analysis to examine how maternal reinforcement of compliant and noncompliant child behavior differs as a function of maternal depression history. Within the 82 participating mother-child dyads, 21 mothers were currently depressed, 29 mothers had a lifetime history of depression but were in remission for at least 1 month, and 32 mothers had never been clinically depressed. 24 girls (29.6 %) and 57 boys (70.4 %) between the ages of 6-12 years old (M = 8.7, SD = 2.0) and were diagnosed with ADHD. Results indicated that all mothers were less likely to respond optimally than non-optimally to child compliant and noncompliant behaviors during observed parent-child interactions; however, currently depressed mothers were least likely to reinforce child compliance and responded most coercively to child noncompliance relative to the other groups. Remitted mothers in this sample were more coercive than never clinically depressed mothers, but were more likely to follow through with commands than never clinically depressed mothers. Implications for behavioral parent training programs aimed at skill development for depressed mothers of children with ADHD are discussed.
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