ArticlePDF Available

Abstract

Examined temporal relations between maternal mood and disruptive child behaviour using daily assessments of 30 mother-child dyads carried out over 8 consecutive weeks (623 pooled observations). Pooled time-series analyses showed synchronous fluctuation in child behaviour and maternal distress. Time-lagged models showed temporal relations between maternal and child outcomes that changed according to the type of maternal mood and child behaviour being reported. Controlling for cross-sectional relations, maternal anger and fatigue were related to previous child inattentive/impulsive/overactive behaviour (IO) and maternal confusion related to previous child oppositional/defiant behaviour (OD). However, maternal depression, low vigour, anger, and anxiety each predicted subsequent child IO and maternal confusion and anxiety each predicted subsequent child OD. Mutual influences on maternal and child functioning were interpreted in the context of interpersonal mechanisms that mediate psychological problems within families and their implications for treatment.
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
Journal of Abnormal Child Psychology, Vol. 32, No. 3, June 2004, pp. 237–247 ( C
°2004)
Temporal Relations in Daily-Reported Maternal Mood
and Disruptive Child Behavior
Frank J. Elgar,1,4Daniel A. Waschbusch,2Patrick J. McGrath,2
Sherry H. Stewart,2and Lori J. Curtis3
Received May 21, 2003; revision received September 5, 2003; accepted October 21, 2003
Examined temporal relations between maternal mood and disruptive child behaviour using daily
assessments of 30 mother–child dyads carried out over 8 consecutive weeks (623 pooled observa-
tions). Pooled time-series analyses showed synchronous fluctuation in child behaviour and mater-
nal distress. Time-lagged models showed temporal relations between maternal and child outcomes
that changed according to the type of maternal mood and child behaviour being reported. Control-
ling for cross-sectional relations, maternal anger and fatigue were related to previous child inatten-
tive/impulsive/overactive behaviour (IO) and maternal confusion related to previous child opposi-
tional/defiant behaviour (OD). However, maternal depression, low vigour, anger, and anxiety each
predicted subsequent child IO and maternal confusion and anxiety each predicted subsequent child
OD. Mutual influences on maternal and child functioning were interpreted in the context of inter-
personal mechanisms that mediate psychological problems within families and their implications for
treatment.
KEY WORDS: maternal mood; disruptive behaviour disorders; attention deficit/hyperactivity disorder;
oppositional defiant disorder; pooled time-series analysis.
Mood disturbance in mothers and disruptive behav-
ioral problems in children are common conditions that
coexist in many families. Mothers with difficult children
tend to feel more fatigued, depressed, and anxious than
mothers of healthy children (Cunningham, Benness, &
Siegel,1988) and, conversely, children ofdistressed moth-
ers tend to show more hyperactive, inattentive, and op-
positional behavior than children of nondistressed moth-
ers (Cummings & Davies, 1994). The co-occurrence of
theseconditions isconsistent with evidenceof deleterious,
mutual influences on maternal mood and child behavior.
Emotional problems in the mother may inherited by the
1School of Social Sciences, Cardiff University, Wales, United Kingdom.
2DepartmentofPsychology,DalhousieUniversity, Halifax,NovaScotia.
3Department of Community Health and Epidemiology, Dalhousie Uni-
versity, Halifax, Nova Scotia.
4AddressallcorrespondencetoFrankJ.Elgar,SchoolofSocialSciences,
Cardiff University, Glamorgan Building, King Edward VII Avenue,
Cardiff CF10 3WT, Wales, United Kingdom; e-mail: elgarf@cardiff.
ac.uk.
child, affect prenatal neuroendocrine development, inter-
fere with parenting behaviors, strain family functioning,
and present long-term risk for developmental and adjust-
ment problems in children (Cummings & Davies, 1994;
Goodman & Gotlib, 1999; Kurstjens & Wolke, 2001;
Turner, Beidel, Roberson-Nay, & Tervo, 2003). On the
other hand, disruptive behavior in children may compro-
mise mothers’ perceived abilities as parents and elicit ma-
ternal stress and emotional distress (Mash & Johnston,
1990; Pelham et al., 1997). The transactional nature of
these common psychological problems has direct impli-
cations for their aetiology, course, and treatment (Elgar &
McGrath, 2003; Hoza et al., 2000). For example, mood
disturbance in the mother may contribute to parenting
behavior that is either too intrusive or withdrawn, trig-
gering a disruptive outburst in the child which the de-
pressed mothers has difficulty managing, thereby exacer-
bating the child’s behavior, and so on. These conditions,
although typically studied as chronic disorders, may be
state-dependent and thus fluctuate and influence one an-
other over short periods of time.
237
0091-0627/04/0600-0237/0 C
°2004 Plenum Publishing Corporation
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
238 Elgar, Waschbusch, McGrath, Stewart, and Curtis
Patterson described transactional influences in a de-
velopmental model of child aggression, suggesting that
the effectiveness of parents’ management of disruptive
child behavior will likely influence the course of the be-
havior(Patterson,1982;Patterson,DeBaryshe, & Ramsey,
1989). Studies have shown that disruptive child behavior
tends to increase as the mother becomes more emotion-
ally distressed, ultimately resulting in worse parenting and
family functioning (Cunningham et al., 1988; Lovejoy,
Craczyk, O’Hare, & Neuman, 2000; Webster-Stratton &
Hammond, 1988). Transactional influences on maternal
mood and child disruptive behavioral disorders (DBDs)
may be moderated by paternal support and involvement
and external social support (Goodman & Gotlib,
1999).
Despite evidence for their mutual influences, few
studies have attempted to unravel the temporal relations
in maternal mood and child DBDs. Notable exceptions in-
clude a study by Forehand and McCombs (1988) in which
child behavioral problems and maternal depression were
assessed twice 1-year apart. With stronger relations found
between maternal depression at Time 1 and child prob-
lems at Time 2 than between child problems at Time 1
and maternal depression at Time 2, the authors concluded
that maternal depression was the antecedent in the relation
between maternal depression and adolescent functioning.
Unfortunately, with just two assessments and discrepant
test–retest reliability of their measures of maternal depres-
sion (r=.71) and child adjustment problems (r=.26–
.51), differences in cross-lagged relations were difficult to
interpret.
In another panel study, child and parental depression,
anxietyand hostility were assessedin368 families on three
occasions 1-year apart (Ge, Conger, Lorenz, Shanahan, &
Elder, 1995). Symptoms of parent and adolescent distress
were reciprocally related over time after earlier symp-
toms were statistically controlled, but the study did not
find differences in cross-lagged relations. This omission
may be attributed to the application of structural equa-
tion modelling that included a single construct of distress
representing depression, anxiety, and hostility and there-
fore would not have found differences across domains of
maladjustment.
Our group recently conducted a 4-year cross-lagged
panel study of maternal depression and child adjustment
problems (i.e., hyperactivity, aggression, and emotional
problems) with the objective of examining their
antecedent-consequence conditions (Elgar, Curtis,
McGrath, Waschbusch, & Stewart, 2003). Three waves
of panel data collected in 2-year intervals from 20,849
families showed stability in, and relations between,
maternal depression and child hyperactivity, aggression,
and emotional problems. Interestingly, differences bet-
ween cross-lagged panel correlations suggested that
maternal depressive symptoms tended to coincide with
or precede child emotional problems but tended to
change as a consequence of child aggression and hyper-
activity.
Although informative of temporal relations in sta-
ble underlying psychopathology, the long assessment in-
tervals of these panel studies have not captured tempo-
ral relations in more transient, day-to-day fluctuations in
functioning. Temporal relations in daily-reported
maternal mood and child behavior may well be differ-
ent than those found using annual or biannual data cy-
cles. Unfortunately, little research has been conducted
involving intensive, repeated measurement of maternal
and child symptoms. Some studies have demonstrated
the variable nature of daily-reported mood in mothers.
Eckenrode (1984) found that the number of stressors not
only influenced daily-reported mood but also moderated
the influence of previous life events and chronic stress
on mood. Williams and colleagues studied the effects of
multiple role juggling by working mothers by assessing
mood and activities eight times a day for 8 days (Williams,
Suls, Alliger, Learner, & Wan, 1991). Their data showed
that mood fluctuated greatly from day to day and that
multiple responsibilities had cumulative, immediate in-
fluences on mood. Two studies used pooled time-series
analysistostudy influences on dailychangeinchild behav-
ioral problems. Soliday, Moore, and Lande (2002) stud-
ied the behavioral side effects of steroid medications used
to treat steroid-sensitive nephrotic syndrome, and Moore,
Osgood, Larzelere, and Chamberlain (1994) studied be-
havioral disturbances in foster children as a function of
the number of children residing in the home. We are not
aware of a study that examined temporal relations be-
tween daily-reported maternal mood and disruptive child
behavior.
The objective of the present study was to utilise daily
assessments of maternal and child functioning to explore
which dimensions of maternal mood (tension–anxiety,
depression–dejection, anger–hostility, fatigue–inertia,
vigour–activity, and confusion–bewilderment) relate—
concurrently, retrospectively, and prospectively—to DBD
symptoms in their children. On the basis of previous stud-
ies, it was hypothesised that general mood disturbance
in mothers would relate to previous and subsequent child
symptoms, but that maternal fatigue and frustration would
relate more to earlier child symptoms than to subsequent
symptoms, reflecting the effects of such behavior on
maternal functioning.
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
Maternal Mood and Child Behavior 239
METHODS
Setting
Families were recruited from the 2002 Dalhousie
UniversitySummerTreatmentProgram(STP)for children
with DBDs. The STP was an 8-week day camp and clin-
ical research program that provided a cost-free day camp
to children in the Halifax area (Nova Scotia, Canada). The
STP enrolled children with ADHD or ODD/CD and also
enrolled healthy non-DBD children to facilitate psychoso-
cial treatments as well as for research purposes. Children
attended the STP from 8:00 a.m. to 5:00 p.m., Monday
through Friday, and participated in academic, art, and
recreational activities led by a staff of counsellors, teach-
ers, and teacher aides. A behavioral point system was in
effect throughout the day in which children earned points
for appropriate behaviors and lost points for inappropri-
ate behaviors. Staff members gave continual behavioral
feedback and children exchanged points for privileges and
honours. Parents met in a weekly support group to receive
training on the use of daily report cards, time-out pro-
cedures, token systems, and effective discipline. Further
details about the STP, including specifics about the pro-
tocol, are available elsewhere (see Pelham et al., 2002;
Pelham, Gnagy, & Greiner, 1998; Pelham & Hoza, 1996).
Participants
Families volunteered to enrol their children in the
STP through advertisements in local newspapers through-
outthe community. All36 families thatenrolled during the
summer of 2002 were asked to participate in the present
study. Inclusion criteria were that the child was between
7 and 12 years of age at the start of treatment and that
mothers had sufficient fluency in English to provide in-
formed consent and complete daily assessments. Thirty
of the 36 (83.33%) families enrolled in the STP agreed
to participate. Participating and nonparticipating families
were not significantly different in terms of the age, sex,
and number of siblings of the child, and the age, educa-
tion, income, and marital status of the mother. The STP
protocol was approved by the Human Ethics Board at the
IWK Health Centre and additional procedures carried for
this study was approved by the Health Sciences Human
Ethics Board at Dalhousie University (Halifax, Canada).
Diagnoses of DBDs (ADHD and/or ODD/CD) were
assigned if the child met DSM-IV criteria according to
parent ratings, teacher ratings, or a structured clinical in-
terview (each described below), with data combined on a
symptom-by-symptom basis (Piacentini, Cohen, &
Cohen,1992). Twentyof the 30participants were assigned
diagnoses, including four children (13.3% of sample) who
metcriteria for ADHD-only,one child (3.3%) whometcri-
teria for ODD/CD-only and 15 children (50%) who met
criteria for both ADHD and ODD/CD. Thus, 19 of 20
children met criteria for ADHD and 16 of 20 children met
criteria for ODD/CD. Mother–child dyads were assigned
to non-DBD and DBD groups on the basis of whether the
child was assigned a diagnosis.
Materials
Intake Assessments
A number of measures were completed as part of the
intake assessments for the STP. Of relevance to this study
are a brief demographic measure that parents completed
on the family, the Beck Depression Inventory-II (BDI-II)
thatmothers completedon themselves, theChild Behavior
Checklist(CBCL) that motherscompleted on thechildren,
the National Institutes of Mental Health Diagnostic Inter-
view Schedule for Children (DISC) that either mothers
or fathers completed on their children, and the Disruptive
Behavior Disorders Rating Scales (DBD) that mothers,
fathers, and teachers completed on each child.
The Beck Depression Inventory is a well-established
adult self-report assessment of the severity of depressive
symptoms (Beck, Ward, Mendelson, Mock, & Erbaugh,
1961). Its latest revision, the BDI-II (Beck, Steer, &
Brown, 1996), matches diagnostic criteria for major de-
pressive episodes as described in the fourth edition of the
Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV; American Psychiatric Association, 1994). The
BDI-II includes 21 items, each consisting of four self-
evaluative statements, scored 0–3, describing a depres-
sive symptom to varying magnitudes. Scores range from
0 to 63 with higher scores indicating greater depression
severity. Using a cutoff score of 14, the BDI-II has been
found to have a 84% sensitivity and a 81% specificity in
identifying major depressive disorder in community pop-
ulations (Beck et al., 1996). The BDI-II also has high
predictive validity, test–retest reliability, and internal con-
sistency, showing a coefficient alpha of .91 in a sample
of depressed outpatients (Beck et al., 1996) and .94 in the
present study.
The CBCL is a 118-item parent-rated measure of
child behavior that assesses social competencies and emo-
tional and behavioral problems of children and adoles-
cents age 6 to 18 years (Achenbach, 1991). The CBCL
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
240 Elgar, Waschbusch, McGrath, Stewart, and Curtis
assesses eight areas of functioning—anxious/depressed
symptoms, somatic complaints, thought problems, with-
drawn/depressive, aggressive behavior, attention pro-
blems, rule-breaking behavior, and social problems.
Results are reliable and can be summarised in sex-
appropriate tscores on internalising and externalising
problem scales. Internal consistency of the CBCL in this
study was α=.85 for internalising problems and α=.76
for externalising problems.
The DISC is a structured diagnostic interview de-
signed to assess over 31 psychiatric disorders in children
age 6 to 17 years (Shaffer, Fisher, Lucas, & the NIMH
DISC Editorial Board, 1998). A computerised version of
the parent interview can be conducted in about 1 hr. DISC
items are organised by diagnosis and parents are asked di-
chotomous questions about whether the child had specific
symptoms during the past year and the previous 4 weeks.
The criterion validity, acceptability, interrater reliability,
and test–retest reliability of the DISC have been well-
established (Piacentini et al., 1993; Schwab-Ston et al.,
1993; Shaffer et al., 1993, 1996).
The DBD consists of 45 questions designed to mea-
sure DSM-IV symptoms of ADHD, ODD, and CD
(Pelham, Gnagy, Greenslade, & Milich, 1992). Symptoms
are rated using Likert scales that range from 0 =not at
all to3=very much. Symptoms were considered present
if they were rated pretty much or very much. The DBD is
widely used with demonstrated reliability and validity for
the assessment of ADHD, ODD, and CD (Pelham et al.,
1992).
Daily Report Assessments
To minimise burden, missing data and sample attri-
tion, mothers’ daily reports were made as brief as possible
byformatting two measures intobooklets. These measures
were the short version of Profile of Mood States (POMS;
Shacham, 1983) which mothers completed on themselves
andthe Inattention/OveractivityWithAggression(IOWA)
Conners Scale (Loney & Milich, 1982) which mothers
completed on their children. The POMS and IOWA were
chosen for their sensitivity to change and because they do
not include fixed time parameters relating to diagnostic
criteria. Thus, their data reflect mood and behavior, re-
spectively, at the time of assessment. Assessment order of
the POMS and IOWA alternated each day of the study to
control for possible transfer effects.
The POMS is a measure of transient but distinct di-
mensions of mood disturbance which, if severe and persis-
tent enough would resemble symptoms of depression or
feelings that often accompany depression. Respondents
indicate how well a set of mood adjectives (e.g., tense,
angry, worn-out) describes their current mood using a 5-
point scale ranging from not at all to extremely. Six factor
analytically derived subscales measure dimensions of
mooddisturbance:tension–anxiety,depression–dejection,
anger–hostility, fatigue–inertia, vigour–activity, and
confusion–bewilderment.Using the original65-item scale
(McNair, Lorr, & Droppleman, 1981), Shacham (1983)
used the internal consistency of each scale and factor
loadings of its items to shorten the instrument from 65
to 37 items. Shacham found that factor scores of the short
scale correlated highly with the original (rs=.95–
.98) and had similar internal consistency (αs=.78–.91).
The internal consistency of the POMS scales in this study
was αs=.84–.87 (tension–anxiety), .80–.88 (depression–
dejection), .85–.90 (anger–hostility), .81–.86 (fatigue–
inertia), .85–.91 (vigour–activity), and .78–.83 (confu-
sion–bewilderment).
The IOWA Conners is a 10-item parent or teacher
measure of disruptive behavioral problems in children age
6–17 years (Loney & Milich, 1982). Items were consistent
with descriptions of behaviors that are typical of ADHD
or ODD/CD each of which is rated on a 4-point scale rang-
ing from not at all to very much. The IOWA yields two
scores, an inattentive/impulsive/overactive (IO) score and
an oppositional/defiance (OD) score. Five items comprise
the IO score: fidgeting, hums and makes other odd noises,
excitable/impulsive, inattentive/easily distracted, and fails
to finish things he or she starts. Five items comprise the
OD score: quarrelsome, acts “smart,” temper outburst (ex-
plosive, unpredictable behavior), defiant, and uncoopera-
tive. The IOWA requires minimal time to complete and
has good reliability, predictive validity, and sensitivity to
behavior change (Pelham, Milich, Murphy, & Murphy,
1989).The internal consistencyof the IOWAin the present
study was αs=.72–.82 for IO and .64–.72 for OD.
Procedure
Intake assessments (rating scales and clinical inter-
view) were completed 1–3 months prior to the STP. Moth-
ers’and fathers’ ratingsof child symptomswere combined
on a symptom-by-symptom basis and symptoms were
scored if either the mother or father reported it. Cross-
informant rating scale assessments have been found to
yield more accurate results than using single informants
(Piacentini et al., 1992). Additional data were collected
at intake using the BDI-II to measure maternal depressive
symptoms and CBCL to measure child behavioral prob-
lems.Mothersweresuppliedwith booklets containing daily
assessments for each day the STP ran during the Summer
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
Maternal Mood and Child Behavior 241
of 2002. Because the STP operated from Mondays to
Fridays, there were five assessments per week, except for
fourassessmentson the firstandlastweeks, yielding atotal
of 38 data cycles. One-day intervals were chosen to pro-
vide as many assessments as possible with consideration
for the fatigue and compliance problems that could have
arisen with even shorter intervals (e.g., every 4 or 8 hr).
Mothers completed assessments at home in the evenings
after their child had returned home from the STP and the
family had dinner. Mothers brought their completed as-
sessmentstoa specified drop-offlocationattheend of each
week. Staff members were in regular contact with mothers
to encourage compliance. Participants were compensated
$40 at the end of data collection.
Data Analysis
Descriptive analysis of baseline data was carried out
using cross-tabulation (χ2) analysis and ANOVAs. Pooled
time-series analysis was used to study temporal relations
between dimensions of maternal mood and child symp-
toms whereas controlling for a lack of independent obser-
vations, individual differences, and ongoing time trends.
This analysis has the form of a linear model that treats
each observation for each participant as a separate case.
Pooled time-series analysis is one of the strongest quasi-
experimentaldesigns available for itscontrol for selection,
maturation, and history in the assessment of change (Cook
& Campbell, 1979). Time-series models are not often seen
inpsychological research, possibly becauseordinary time-
series analysis requires more observations than are avail-
ablein most psychologicalstudies, or because analysesare
limited to a single case and provide no basis for general-
ization, or because visual data analysis is too cumbersome
when large individual differences exist (Soliday et al.,
2002). Pooled time series analysis avoided such limita-
tions through a regression-based analysis that is more tol-
erant of missing data and serial dependence than more tra-
ditional methods (e.g., repeated-measures ANOVA) and
yields high statistical power from small samples. Anal-
ysis involved two procedures for meeting the statistical
assumptions of regression analysis. First, dummy vari-
ables were used to control for between-subjects variance,
leaving only within-subjects variance over time.5Sec-
5The number of dummy variables required equals the number of partic-
ipants in the sample minus one. The use of dummy variables to control
individual differences is only appropriate in fixed effects models. Error
components or “random effects” models require different procedures
(see Dielman, 1989). We adopted a fixed effects model because of high
levels of between-subjects variance (see Results). The error compo-
nents model in pooled time-series analysis provides less control for
individual differences because it reduces between-subject variance to
ond, to address the assumption of independent residu-
als, a version of generalized least squares was used in
which data are transformed to statistically remove auto-
correlation (Moore et al., 1994). This procedure involved
(1) pooling the data and estimating the regression model
of interest, (2) estimating the degree of correlation among
the residuals that are adjacent in time, (3) transforming the
dependent variables to remove that correlation, (4) con-
ducting the regression analysis again on the transformed
variables, and (5) reexamining correlations among residu-
als from this second analysis to ensure the transformation
was successful.6Transformed data and block regression
models were then used whereby the child’s age and sex,
mother’s age and education, family income, and number
of children were entered in Block 1, dummy variables to
control for individual differences were entered in Block
2, and pooled observations of maternal mood were en-
tered in Block 3. Separate analyses were performed on
previous, concurrent, or subsequent child symptoms and
on non-DBD and DBD groups.
RESULTS
A demographic profile of the sample is shown in
Table I. Children in the DBD group, compared to the
non-DBD group, were more likely male than female and
they showed significantly more internalising, externalis-
ing, and total problems. A cross-tabulation showed that
of the 10 (33.33%) mothers who scored above the cutoff
on the BDI-II, their children were no more likely to re-
ceive a diagnosis compared to children of mothers who
scored below the cutoff. However, with regard to prob-
lem scores on the CBCL, children of mothers who scored
a level consistent with within-subject variance rather than eliminate it
altogether (Dielman, 1989).
6This procedure utilizes the Durbin–Watson statistic, dw, which can be
transformed to an autocorrelation estimate, r.
r=(2 dw)
2
Dependent variables were then transformed separately for each analysis
using the formula:
Xt=Xt r(Xt 1)
where Xtis the new version of the variable at time t,tis the original
version, ris the autocorrelation estimate, and t1 is the time (day) pe-
riodprevioustot.Eachnewlytransformed value becomes the difference
between the old value and the product of rand the value from the previ-
ous assessment. Ostrom (1990) recommended repeating this procedure
until autocorrelation drops below r=.15. Although the procedure is
tedious, failure to correct for autocorrelation leads to overestimates of
the statistical significance of time series relations. Interested readers
are referred to Soliday et al. (2002) for an accessible demonstration of
pooled time-series analysis in clinical research.
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
242 Elgar, Waschbusch, McGrath, Stewart, and Curtis
Table I. Descriptive Statistics on Maternal and Child Functioning in Non-DBD and DBD Groupsa
Variable Non-DBD (N=10) DBD (N=20) Comparison
Child
Male (%) 5 (50.00) 17 (85.00) χ2(df 1) =4.18, p=.04
Female (%) 5 (50.00) 3 (15.00)
Age in years (SD) 9.40 (1.36) 9.40 (1.88) F(1, 28) =0.01, p=.99
Number of siblings (SD) 2.00 (0.94) 1.45 (1.28) F(1, 28) =1.45, p=.24
Has 2+siblings (%) 4 (40.00) 4 (20.00) χ2(df 1) =1.36, p=.24
Lives with father (%) 10 (100.00) 14 (70.00) χ2(df 1) =1.09, p=.30
Internalising problems (SD) 41.30 (7.21) 59.47(11.62) F(1, 27) =20.17, p<.001
Externalising problems (SD) 40.30 (8.43) 63.40 (8.39) F(1, 27) =50.39, p<.001
Total problems (SD) 37.70 (7.96) 65.26 (9.57) F(1, 27) =60.54, p<.001
Mother
Age (SD) 38.20 (4.10) 41.00 (3.61) F(1, 25) =3.43, p=.08
Education (SD)b2.00 (1.12) 2.12 (1.05) F(1, 25) =.07, p=.79
Family income (SD)c4.70 (2.67) 4.45 (2.98) F(1, 28) =.05, p=.83
Marital status
Single or separated (%) 2 (20.00) 8 (40.00) χ2(df 2) =1.20, p=.27
Married or common-law (%) 8 (80.00) 12 (60.00)
Depressive symptoms (SD) 7.00 (8.34) 12.45 (14.43) F(1, 28) =1.21, p=.28.
Depressed (%)d3 (30.00) 7 (35.00) χ2(df 1) =.75, p=.78.
a“DBD” refers to diagnosis of either ADHD or ODD/CD.
bScale: 1 =no high school;2=high school;3=technical school;4=graduated from college or university
(bachelor’s degree), 5 =postgraduate degree.
cScale: 1 =<$10,000, 2 =$10,000–19,999, 3 =$20,000–29,999, 4 =$30,000–39,999, 5 =$40,000–49,999,
6=$50,000–59,999, 7 =$60,000–69,999, 8 =$70,000–79,999, 9 =$80,000–89,999, 10 =$90,000–99,999,
11 =$100,000–125,000, 12 =>$125,000 (Canadian dollars).
dBeck Depression Inventory-II scores above the recommended cut point of 14.
above the cutoff on the BDI-II rated their child as hav-
ing marginally more internalising problems (M=63.50
vs. M=51.80), F(1,28) =4.07, p=.05, and signifi-
cantly more externalising problems (M=62.00 vs. M=
52.95), F(1,28) =5.53, p<.05,butnotmore total prob-
lems (M=60.33 vs. M=50.00), F(1, 28) =2.05, p=
.16, than children whose mothers scored below the cutoff.
Of a possible 1,170 recordings across 38 data cycles,
mothers provided a total of 623 recordings on the daily
assessments, indicating 54.56% compliance. The mean
number of recordings per mother was 21.07 (SD =10.63,
Minimum =1.00, Maximum =35.00). Four hundred and
twelve recordings were from mothers of children in the
DBD group—378 from mothers of ADHD children, 323
from mothers of ODD/CD children (70.14% overlap) and
212 from mothers of non-DBD children. Test order of the
POMS and IOWA did not affect these data.
Preliminary results lent some support to the notion
that mood disturbance in mothers coincided with disrup-
tive child behavior. By pooling the data so that all 623
observations were considered independent, it was found
that maternal mood disturbance correlated positively with
child IO, rs =.22 (depression–dejection), .22 (vigour–
activity), .28 (anger–hostility), .40 (tension–anxiety), .24
(confusion–bewilderment), and .22 (fatigue–inertia), all
ps<.001, and all but vigour-activity correlated with
child OD, rs =.32 (depression–dejection), .36 (anger–
hostility),.42 (tension–anxiety), .32(confusion–bewilder-
ment), and .34 (fatigue–inertia), all ps<.001. Because
pooling data in this way was not entirely justified, pooled
time-series analysis was used to extract individual differ-
ences and autocorrelation before looking further at rela-
tions between maternal mood and child functioning.
Between-Subject Variance and Autocorrelation
In pooled time-series analysis, dichotomous dummy
variables representing each of the 30 participants were
used to control for individual differences in the data
(Dielman, 1989). The degree of between-subject variance
was high, accounting for 78% of the variance in child IO
and 36% of the variance in child OD. With respect to ma-
ternal mood, individual differences accounted for 79% of
the variance in depression–dejection, 74% in confusion–
bewilderment, 66% in tension–anxiety, 64% in vigour–
activity, 62% in anger–hostility, and 47% in fatigue–
inertia. Data transformations involved estimating
autocorrelation using multiple regressions on child out-
comes with the following predictors: child age and sex,
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
Maternal Mood and Child Behavior 243
maternal age and education, family income, and number
of children (Block 1), dummy variables to control for in-
dividual differences (Block 2), and pooled observations of
maternal mood (Block 3). Block 1 controlled for sociode-
mographic factors that may have constituted shared envi-
ronmentalrisk for mothersand children.Block 1 predicted
3% of the variance in child inattention/impulsiveness, 2%
of the variance in child opposition/defiance, and 2 to 12%
of the variance in maternal mood (2% vigour–activity,
5%fatigue–inertia, 10% tension–anxiety, 11% confusion–
bewilderment, 11% anger–hostility, and 12% depression–
dejection. Data were transformed using the procedures
described above. One iteration of the procedure was suf-
ficient to reduce autocorrelation to below r=.15.
Cross-Sectional Relations
Pooledtime-seriesmodels included dummy variables
to control for between-subject variance, transformed data
to control for autocorrelation, and hierarchical regression
models, described above, to control for shared environ-
mental risk factors. Using this method, cross-sectional re-
lations were analysed between maternal mood and child
IO (Table II, centre column) and between maternal mood
Table II. Pooled Time Series Analysis of Child IO on the Day Previous, Same Day as, and Day After
Maternal Mood
Previous day Same day Next day
Predictor B(SE)βB(SE)βB(SE)β
Non-ADHD (N=11; 244 pooled observations)
R2=.065 (previous day), .112 (same day), .105 (next day)
Maternal
Depression–dejection .04 (.09) .09 .16 (.06) .35∗∗ .17 (.06) .34∗∗
Vigour–activity .08 (.02) .06 .03 (.01) .21.03 (.02) .22
Anger–hostility .19 (.07) .39∗∗ .22 (.04) .44∗∗ .09 (.04) .20
Tension–anxiety .09 (.07) .23 .02 (.04) .03 .16 (.04) .47∗∗
Confusion–bewilderment .09 (.06) .18 .05 (.04) .10 .03 (.04) .06
Fatigue–inertia .03 (.02) .24.02 (.01) .09 .01 (.02) .00
ADHDa(N=19; 378 pooled observations)
R2=.023 (previous day), .079 (same day), .034 (next day)
Maternal
Depression–dejection .11 (.13) .08 .09 (.10) .06 .12 (.05) .21
Vigour–activity .05 (.06) .09 .11 (.05) .18.07 (.12) .05
Anger–hostility .05 (.11) .04 .32 (.08) .26∗∗ .20 (.09) .15
Tension–anxiety .19 (.11) .15 .14 (.09) .10 .20 (.08) .17
Confusion–bewilderment .08 (.11) .01 .05 (.08) .04 .08 (.09) .06
Fatigue–inertia .13 (.05) .19∗∗ .04 (.04) .05 .02 (.04) .01
Note. Controlled for between-subject variance, child’s age and sex, maternal age, education, marital status,
and household income. Time-lagged analyses were based on four recordings per week in order to avoid the
lag extending over a weekend.
aDiagnosisofAttentionDeficitHyperactivityDisorder(eitherPredominantlyInattentiveorCombinedType).
Dissimilar ns between Tables II and III were due to comorbidity of ADHD and ODD.
p<.05. ∗∗ p<.01.
and child OD (Table III, centre column). Separation of
DBD and non-DBD cases varied in these analyses to cor-
respond to child symptoms. Table II (maternal mood and
IO)shows results from 11 non-ADHDand 19 ADHD chil-
dren and Table III (maternal mood and child OD) shows
results from 14 non-ODD/CD and 16 ODD/CD children.
Innon-ADHDand ADHD children, significant cross-
sectional relations were found between child IO and
maternal anger–hostility and significant inverse relations
were found between child IO and maternal vigour–
activity. A significant cross-sectionalrelationalsoemerged
between child IO and maternal depression–dejection but
only in the non-ADHD group. Quite different results
emerged in cross-sectional relations between child OD
and maternal mood. Interestingly, child OD was associ-
ated with maternal tension–anxiety, but only in ODD/CD
children. No other cross-sectional relations were found
between child OD and maternal mood.
Time-Lagged Relations
Tables II and III show the results of time-lagged
pooled time-series analyses in which the criterion, child
symptoms, alternated from 1 day prior to when maternal
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
244 Elgar, Waschbusch, McGrath, Stewart, and Curtis
Table III. Pooled Time Series Analysis of Child OD on the Day Previous, Same Day as, and Day After
Maternal Mood
Previous day Same day Next day
Predictor B(SE)βB(SE)βB(SE)β
Non-ODD ICD (N=14; 250 pooled observations)
R2=.018 (previous day), .026 (same day), .035 (next day)
Maternal
Depression–dejection .32 (.31) .11 .06 (.23) .02 .03 (.23) .01
Vigour–activity .05 (.05) .06 .06 (.05) .06 .08 (.05) .10
Anger–hostility .18 (.19) .07 .30 (.16) .11 .27 (.15) .11
Tension–anxiety .08 (.19) .08 .24 (.13) .13 .24 (.11) .15
Confusion–bewilderment .48 (.19) .18.25 (.14) .10 .22 (.15) .10
Fatigue–inertia .01 (.05) .00 .07 (.05) .08 .08 (.06) .08
ODD/CDa(N=16; 373 pooled observations)
R2=.058 (previous day), .144 (same day), .067 (next day)
Maternal
Depression–dejection .18 (.20) .11 .11 (.15) .07 .30 (.19) .19
Vigour–activity .10 (.10) .15 .10 (.08) .14 .01 (.09) .02
Anger–hostility .17 (.18) .11 .28 (.13) .18 .02 (.14) .01
Tension–anxiety .05 (.18) .04 .45 (.13) .32∗∗ .43 (.14) .30∗∗
Confusion–bewilderment .49 (.17) .31∗∗ .10 (.13) .06 .29 (.14) .19
Fatigue–inertia .01 (.08) .01 .03 (.06) .03 .02 (.06) .02
Note. Controlled for between-subject variance, child’s age and sex, maternal age, education, marital status,
and household income. Time-lagged analyses were based on four recordings per week in order to avoid the
lag extending over a weekend.
aDiagnosis of either Oppositional Defiant Disorder or Conduct Disorder.
p<.05. ∗∗ p<.01.
moodwasmeasuredto 1 day subsequenttomaternalmood.
Because pooled time-series analysis assumes equivalent
assessment intervals, 18–21% of the data were censored
in these analyses to prevent time-lags from extending over
a weekend.
ChildIOwassignificantly related to maternalfatigue–
inertiaonthe followingday in both non-ADHDandADHD
groups (Table II, left column). Child IO was also signifi-
cantly related to subsequent maternal anger–hostility, but
only in the non-ADHD group. As shown in Table III (left
column), child OD was related to maternal confusion–
bewilderment on the following day in both non-ODD/CD
and ODD/CD groups. However, child OD was not signif-
icantly related to any other subsequent maternal mood.
Tables II and III (right columns) also show relations
between maternal mood and subsequent child behavior.
In non-ADHD and ADHD children, maternal depression–
dejection, tension–anxiety, and anger–hostility related to
child IO on the following day. Maternal vigour–activity
was inversely related to child IO on the following day but
only in the non-ADHD group. Finally, maternal tension–
anxiety was related to child OD on the following day in
both non-ODD/CD and ODD/CD groups. Children in the
ODD/CD group also showed OD as a consequence of
maternal confusion–bewilderment.
DISCUSSION
The objective of the study was to examine temporal
relations between daily fluctuations in maternal mood and
disruptive child behavior. Temporal relations changed as
a function of mood dimensions in the mother and type of
disruptive child behavior. As expected, fatigue in moth-
ers was related to prior, but not subsequent, child IO, in-
dicating that fatigue occurred as a consequence of child
inattentiveness, impulsiveness, and overactivity. That is,
mothers reported feeling more tired in response to child
overactivity and impulsivity. However, maternal depres-
sion and anxiety were both antecedents to child IO and
maternal anxiety was an antecedent to child OD. Feel-
ings of anger and hostility in mothers were independently
related to previous, concurrent, and subsequent child IO,
possibly reflecting transactional relations between mater-
nal moods and child behaviors. Similarly, confusion in the
mother was independently related to previous and subse-
quent child oppositional defiant behavior.
Theconsequencesof difficultchild behaviors in terms
of maternal functioning were significant and consistently
negative, even with non-DBD children. These influences
are indicative of the frustration and hopelessness that can
be elicited by difficult and annoying child behavior,
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
Maternal Mood and Child Behavior 245
irrespective of whether symptoms are severe enough to
meet diagnostic criteria. Mediating mechanisms may in-
clude interpersonal stress (Pelham et al., 1997), feeling in-
adequateasa parent or “maternal efficacy”(Teti& Gelfand,
1991),passivecopingstrategies(Wells-Parker et al., 1990),
or difficulties in family and marital relationships (Kelly,
2000). These findings are consistent with data that has
shown that mothers who feel sad, anxious, or hostile have
more difficulty communicating with and disciplining their
children than mothers who feel contented and are respon-
sive in their interactions with their children (Cunningham
et al., 1988; Turner et al., 2003).
It was also found that state-like fluctuation in ma-
ternal emotional distress (anxiety, depression, and anger
in particular) had short-term consequences for child be-
havior. Unfortunately, without measures of potential me-
diators it remains for further research to determine which
most actively transmit influences between maternal mood
and disruptive child behavior. It was clear that distress in
mothers and children was dynamically interrelated, evi-
denced by independent relations shown between maternal
anger and both prior and subsequent child IO and between
maternal confusion and both prior and subsequent child
OD. As many frustrated mothers well know, living with
a disruptive child is stressful and demoralising at times
(Mash & Johnston, 1990; Teti & Gelfand, 1991). This
study showed that as child behavior became increasingly
disruptive, mothers grew more frustrated, fatigued, and
anxious.
Though it has been suggested that maternal mood
influences only serious forms of child behavioral prob-
lems—an association that may be obscured in community
populations (e.g., Downey & Coyne, 1990), these results
suggest otherwise. In DBD and non-DBD groups, child
problems of inattention, hyperactivity, and conduct were
significantly influenced by mothers’ feelings of depres-
sion, anxiety, and anger. As well, the mutual influences
shown here are inconsistent with an assumption of equiv-
alent temporal relations across dimensions of maternal
mood and disruptive child behavior. Consideration for dis-
tinctmoodstates in mothersmayidentify potential areas of
intervention. For example, helping mothers feel less sad,
worried, and angry, may result in a 3.4–10.5% reduction
in child hyperactivity on the following day. Such results
couldnot have been shown with generalized(and therefore
confounded) screening instruments of depression such as
the CES-D.
An important advantage of the pooled time-series de-
sign was its capacity to test relations in time-ordered data
while controlling for autocorrelation that would plague
most other analyses. Another advantage was that the pos-
sibility of spurious time-lagged relations was diminished
by exploiting hundreds of observations over an extended
period of time. Pooled time-series analysis controlled his-
torical effects and yielded high statistical power from a
small sample. But although internal validity of the design
was strong, the generalizability of these findings was still
limited by the small size and unique features of the sam-
ple. Participants were self-selected and it is worth noting
that families who seek help are likely to be importantly
different from families with similar problems who do not
seek help.
Anothercaveatis the possibilitythat distressedmoth-
ers were more likely than nondistressed mothers to ex-
aggerate the severity of their children’s symptoms. This
possibility is consistent with cognitive theories of depres-
sion, but the evidence is mixed. In a systematic review,
Richters (1992) concluded that studies in which mater-
nal reports of child behavior were compared with behav-
ioral observations and teacher reports did not consistently
show that distressed mothers were any less accurate in as-
sessing child behavior than nondistressed mothers. Stud-
ies have shown that maternal mood does not affect the
reliability or accuracy of their assessments of child psy-
chopathology and that distressed mothers are not neces-
sarily biased to report child problem behaviors that have
not occurred (Faraone, Biederman, & Milberger, 1995;
Querido, Eyberg, & Boggs, 2001). However, reliance on a
single source of information was a limitation of the study.
The possibility remains that sources of method variance
(e.g., social desirability) could have inflated associations
between maternal mood and child behavioral problems.
Replication of these findings using additional sources of
data would be helpful in testing the accuracy of mothers’
daily reports and, given the low return rates, whether the
mothers were more or less likely to complete assessments
on days when their mood was low or their child’s behavior
was especially disruptive.
Maternal mood and disruptive child behavior are in-
trinsically intertwined and this study demonstrated their
mutual influences and temporal relations over a very short
and relevant time frame. Further study is needed of me-
diating mechanisms in day-to-day relations in maternal
and child functioning and experimental data are needed
to help determine how psychosocial interventions that
are intended to treat either maternal depression or child
DBDs indirectly change functioning in the other over re-
peated follow-up. Clinically, it is recognised that dyadic
assessment and treatment for parents and children may
interrupt transmission of illness between generations
(Rutter,1990).When parents facilitatetreatmentsfor child
DBD, it is likely that their emotions and cognitions will
influence the success of these interventions (Hoza et al.,
2000)—especially when treatment is self-administered
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
246 Elgar, Waschbusch, McGrath, Stewart, and Curtis
with limited contact with a therapist (Elgar & McGrath,
2003). As well, inclusion of children in psychotherapy
for maternal depression may show lasting benefits to both
mothers and children (Cicchetti, Rogosch, & Toth, 2000).
Mutual influences such as these can be demonstrated over
very short time parameters.
ACKNOWLEDGMENTS
Supported by doctoral fellowships from the Hospital
for Sick Children Foundation and Nova Scotia Health Re-
search Foundation awarded to the first author, grants from
the Children’s Miracle Network/Canadian Psychiatric Re-
search Foundation, IWK Foundation, Nova Scotia Health
Research Foundation, and Social Sciences and Humani-
ties Research Council of Canada awarded to the second
author, and a research grant from the Canadian Institutes
for Health Research awarded to the third author. We also
thank the STP staff for their assistance in recruitment and
data collection. Appreciation is also extended to Dr. Dan
Offord and three blind reviewers for their comments on
earlier drafts of this paper.
REFERENCES
Achenbach, T. M. (1991). Manual for the Child Behavior Checklist 4-18
and 1991 Profile. Burlington, VT: University of Vermont, Depart-
ment of Psychiatry.
American Psychiatric Association. (1994). Diagnostic and statistical
manual of mental disorders (4th ed., Rev.). Washington, DC:
Author.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck Depression
Inventory Manual (2nd ed). San Antonio, TX: The Psychological
Corporation.
Beck,A. T.,Ward, C. H., Mendelson, M., Mock, J., &Erbaugh,J.(1961),
An inventory for measuring depression. Archives of General Psy-
chiatry,4, 53–63.
Cicchetti, D., Rogosch, F. A., & Toth, S. L. (2000). The efficacy of
toddler–parent psychotherapy for fostering cognitive development
in offspring of depressed mothers. Journal of Abnormal Child Psy-
chology,28, 135–148.
Cook, T. D., & Campbell, D. T. (1979). Quasi-experimentation: De-
sign and analysis issues for field settings. Boston, MA: Houghton
Mifflin.
Cummings, M. E., & Davies, P. T. (1994). Maternal depression and child
development. Journal of Child Psychology, Psychiatry and Allied
Disciplines,35, 73–112.
Cunningham, C. E., Benness, B. B., & Siegel, L. S. (1988). Family func-
tioning, time allocation, and parental depression in the families of
normal and ADHD children. Journal of Clinical Child Psychology,
17, 160–177.
Dielman, T. E. (1989). Pooled cross-sectional and time series data anal-
ysis. New York: Marcel Dekker.
Downey, G., & Coyne, J. C. (1990). Children of depressed parents: An
integrative review. Psychological Bulletin,108, 50–76.
Eckenrode J. (1984). Impact of chronic and acute stressors on daily
reports of mood. Journal of Personality and Social Psychology,46,
907–918.
Elgar, F. J., Curtis, L. J., McGrath, P. J., Waschbusch, D. A., & Stewart,
S.H.(2003).Antecedent-consequenceconditionsinmaternalmood
and child adjustment: A four-year cross-lagged study. Journal of
Clinical Child and Adolescent Psychology,3, 362–374.
Elgar, F. J., & McGrath, P. J. (2003). Self-administered psychosocial
treatments for children and families. Journal of Clinical Psychol-
ogy,59, 321–339.
Faraone, S. V., Biederman, J., & Milberger, S. (1995). How reliable
are maternal reports of their children’s psychopathology? One-year
recall of psychiatric diagnoses of ADHD children. Journal of the
American Academy of Child and Adolescent Psychiatry,34, 1001–
1008.
Forehand, R., & McCombs, A. (1988). Unravelling the antecedent-
consequence conditions in maternal depression and adolescent
functioning. Behavioral Research and Therapy,26, 399–405.
Ge, X., Conger, R. D., Lorenz, F. O., Shanahan, M., & Elder, G. H., Jr.
(1995). Mutual influences in parent and adolescent psychological
distress. Developmental Psychology,31, 406–419.
Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the
children of depressed mothers: A developmental model for under-
standing mechanisms of transmission. Psychological Review,106,
458–490.
Hoza, B., Owens, J. S., Pehlam, W. E., Jr., Swanson, J. M., Conners,
C. K., Hinshaw, S. P., et al., (2000). Parent cognitions as predic-
tors of child treatment response in Attention-Deficit/Hyperactivity
Disorder. Journal of Abnormal Child Psychology,28, 569–
583.
Kelly, J. B. (2000). Childrenˆa?’s adjustment in conflicted marriage and
divorce: A decade review of research. Journal of the American
Academy of Child and Adolescent Psychiatry,39, 963–973.
Kurstjens, S., & Wolke, D. (2001). Effects of maternal depression on
cognitive development of children over the first 7 years of life.
Journal of Child Psychology, Psychiatry and Allied Disciplines,
42, 623–636.
Loney,J., & Milich, R. (1982). Hyperactivity,in attention, and aggression
in clinical practice. In M. Wolraich& D. K. Rough (Eds.), Advances
in development and behavioral paediatrics (Vol. 3, pp. 113–147).
Greenwich, CT: JAI Press.
Lovejoy, M. C., Craczyk, P. A., O’Hare, E., & Neuman, G. (2000). Ma-
ternal depression and parenting behavior: A meta-analytic review.
Clinical Psychology Review,20, 561–592.
Mash, E. J., & Johnston, C. (1990). Determinants of parenting stress:
Illustrations from families of hyperactive children and families of
physically abused children. Journal of Clinical Child Psychology,
19, 313–328.
McNair, D.M., Lorr, M., & Droppleman, L.F. (1981). Manual for the
Profile of Mood States. San Diego, CA: Educational and Industrial
Testing Service.
Moore, K. J., Osgood, D. W.,Larzelere, R. E., & Chamberlain, P. (1994).
Use of pooled time series in the study of naturally occurring clinical
events and problem behavior in a foster care setting. Journal of
Consulting and Clinical Psychology,62, 718–728.
Ostrom, C. W., Jr. (1990). Time series analysis: Regression techniques
(2nded.,SeriesNo.07–009).SageUniversityPaperseriesonQuan-
titative Applications in the Social Sciences. Newbury Park, CA:
Sage.
Patterson, G. R. (1982). Coercive family process. Eugene, OR: Castalia.
Patterson, G. R., DeBaryshe, B. D., & Ramsey, E. (1989). A develop-
mental perspective on antisocial behavior. American Psychologist,
44, 329–335.
Pelham, W. E., Gnagy, E. M., Greenslade, K. E., & Milich, R. (1992).
Teacher ratings of DSM-III-R symptoms for the disruptive behavior
disorders. Journal of the American Academy of Child and Adoles-
cent Psychiatry,31, 210–218.
Pelham,W. E., Gnagy,E.M.,& Greiner, A. R.(1998).Children’ssummer
day treatment program manual. Buffalo, NY: CTADD.
Pelham, W. E., & Hoza, B. (1996). Intensive treatment: A summer treat-
ment program for children with ADHD. In E. Hibbs & P. Jensen
(Eds.), Psychosocial treatments for child and adolescent disorders:
P1: JLS
Journal of Abnormal Child Psychology PP1186-jacp-485525 April 19, 2004 11:52 Style file version May 30th, 2002
Maternal Mood and Child Behavior 247
Empirically based strategies for clinical practice (pp. 311–340).
New York: APA Press.
Pelham, W. E., Hoza, B., Pillow, D. R., Gnagy, E. M., Kipp, H.
L., Greiner, A. R., et al. (2002). Effects of methylphenidate and
expectancy on children with ADHD: Behavior, academic perfor-
mance,andattributionsin a Summer TreatmentProgramandregular
classroom setting. Journal of Consulting and Clinical Psychology,
70, 320–335.
Pelham, W. E., Lang, A. R., Atkeson, B., Murphy, D. A., Gnagy, E.
M., Greiner, A. R., et al. (1997). Effects of deviant child behavior
on parental distress and alcohol consumption in laboratory interac-
tions. Journal of Abnormal Child Psychology,25, 413–424.
Pelham, W. E., Milich, R., Murphy, D. A., & Murphy, H. A. (1989). Nor-
mative data on the IOWA Conners Teacher Rating Scale. Journal
of Consulting and Clinical Psychology,18, 259–262.
Piacentini, J. C., Cohen, P., & Cohen, J. (1992). Combining discrepant
diagnostic information from multiple sources: Are complex algo-
rithms better than simple ones? Journal of Abnormal Child Psy-
chology,20, 51–63.
Piacentini, J., Shaffer, D., Fisher, P., Schwab-Stone, J., Davies, M., &
Gioia, P. (1993), The Diagnostic Interview Schedule for Children—
Revised version (DISC-R), III: Concurrent criterion validity. Jour-
nal of the American Academy of Child and Adolescent Psychiatry,
32, 658–665.
Querido, J. G., Eyberg, S. M., & Boggs, S. R. (2001). Revisiting the
accuracy hypothesis in families of young children with conduct
problems. Journal of Clinical Child Psychology,30, 253–261.
Richters, J. E. (1992). Depressed mothers as informants about their chil-
dren: A critical review of the evidence for distortion. Psychological
Bulletin,112, 485–499.
Rutter, M. (1990). Some focus and process considerations regarding
effects of parental depression on children. Developmental Psychol-
ogy,26, 60–67.
Schwab-Stone, M., Fisher, P., Piacentini, J., Shaffer, D., Davies, M.,
& Briggs M. (1993). The Diagnostic Interview Schedule for
Children—Revised version (DISC-R): II. Test–retest reliability.
Journal of the American Academy of Child and Adolescent Psy-
chiatry,32, 651–657.
Shacham, S. (1983). A shortened version of the Profile of Mood States.
Journal of Personality Assessment,47, 305–306.
Shaffer, D., Fisher, P., Dulcan, M. K., Davies, M., Piacentini, J., Schwab-
Stone, M. E., et al. (1996), The NIMH Diagnostic Interview Sched-
ule for Children version 2.3 (DISC-2.3): Description, acceptability,
prevalence rates, and performance in the MECA study. Journal of
the American Academy of Child and Adolescent Psychiatry,35,
865–877.
Shaffer, D., Fisher, P., Lucas, C., & the NIMH DISC Editorial Board.
(1998). Diagnostic Interview Schedule for Children, version IV.
New York: Columbia University, Division of Psychiatry.
Shaffer, D., Schwab-Stone, M., Fisher, P., Cohen, P., Piacentini,
J., Davies, M., (1993), The Diagnostic Interview Schedule
for Children—Revised version (DISC-R), I: Preparation, field
testing, interrater reliability and acceptability. Journal of the
American Academy of Child and Adolescent Psychiatry,32, 643–
650.
Soliday, E., Moore, K. J., & Lande, M. B. (2002). Daily reports and
pooled time series analysis: Pediatric psychology applications.
Journal of Pediatric Psychology,27, 67–76.
Teti, D. M., & Gelfand, D. M. (1991). Behavioral competence
among mothers of infants in the first year: The mediational
role of maternal selfefficacy. Child Development,62, 918–
929.
Turner, S. M., Beidel, D. C., Roberson-Nay, R., & Tervo, K. (2003).
Parenting behaviors in parents with anxiety disorders. Behavior
Research and Therapy,41, 541–554.
Webster-Stratton, C., & Hammond, M. (1988). Maternal depression and
its relationship to life stress, perceptions of child behavior prob-
lems, parenting behaviors, and child conduct problems. Journal of
Abnormal Child Psychology,16, 299–315.
Wells-Parker, E., Miller, D. I., & Topping, J. S. Development of control-
of-outcome scales and self-efficacy scales for women in four life
roles. Journal of Personality Assessment,54, 564–575.
Williams, K. J., Suls, J., Alliger, G. M., Learner, S. M., & Wan, C. K.
(1991). Multiple role juggling and daily mood states in working
mothers: An experience sampling study. Journal of Applied Psy-
chology,76, 664–674.
... Studies comparing mothers and fathers showed a greater presence of depression and anxiety symptoms in mothers than in fathers (18,19). However, data are inconsistent because other studies did not find the same differences in psychopathology between parents of children with ADHD and parents of children in the control group, suggesting the need to further investigate this controversial issue (20). A recent meta-analysis showed that the research on these topics has largely focused on mothers, with fewer studies on fathers (21). ...
... However, Johnston and Mash (5) highlighted that the association between parental affective disorder and child ADHD is not as strong. Some studies have not found differences in either the mothers or fathers of children with ADHD or the parents of control children (20,52). Furthermore, only a few studies have focused on paternal psychopathology (53,54). ...
... No differences emerged with regard to anxious symptoms in mothers and fathers. These results seem to be in line with evidence of a greater risk of behavioral problems, including ADHD, in children of mothers with depression (20,55,56). These findings suggest the importance of considering fathers' depressive symptoms in further studies, as well as in clinical setting, because it seems that it is an important factor in families of children with ADHD. ...
Article
Full-text available
Parental factors contribute to ADHD, partly in an etiological way and partly as moderators and mediators of child outcomes and treatment effects. An important aspect of parenting seems to be parental reflective functioning (PRF), defined as the parent’s capacity to reflect upon his own and his child’s internal mental experience. The studies on parenting factors linked to ADHD have not extensively investigated the role of PRF. Recent findings on interventions have begun to consider mentalization to promote empathy and emotion regulation in parents, but empirical studies assessing PRF are still scarce. The aim of this cross-sectional study was to compare specific familial and parental functioning characteristic between parents of children with attention deficit/hyperactivity disorder (ADHD) and parents of controls without ADHD. A clinical sample of 41 children with ADHD aged 8–11 years and their parents was compared with a matched, non-clinical sample of 40 children. Three aspects of parental functioning were investigated: parental symptomatology, parental alliances and PRF; children’s differences in strength and difficulty profiles were also assessed. The results showed that families of children with ADHD had lower socioeconomic status, and both mothers and fathers of the same families reported higher scores for depression and lower PRF than did the control group; only mothers showed lower parental alliance. Logistic regression highlighted the fact that several of these familial and parental factors contributed to the increased risk of belonging to the clinical group, specifically both mothers’ and fathers’ depressive symptoms and lower PRF. These data represent new findings with potentially meaningful clinical implications for both assessment and intervention.
... Studies comparing mothers and fathers showed a greater presence of depression and anxiety symptoms in mothers than in fathers (18,19). However, data are inconsistent because other studies did not find the same differences in psychopathology between parents of children with ADHD and parents of children in the control group, suggesting the need to further investigate this controversial issue (20). A recent meta-analysis showed that the research on these topics has largely focused on mothers, with fewer studies on fathers (21). ...
... However, Johnston and Mash (5) highlighted that the association between parental affective disorder and child ADHD is not as strong. Some studies have not found differences in either the mothers or fathers of children with ADHD or the parents of control children (20,52). Furthermore, only a few studies have focused on paternal psychopathology (53,54). ...
... No differences emerged with regard to anxious symptoms in mothers and fathers. These results seem to be in line with evidence of a greater risk of behavioral problems, including ADHD, in children of mothers with depression (20,55,56). These findings suggest the importance of considering fathers' depressive symptoms in further studies, as well as in clinical setting, because it seems that it is an important factor in families of children with ADHD. ...
Article
Full-text available
Parental factors contribute to ADHD, partly in an etiological way and partly as moderators and mediators of child outcomes and treatment effects. An important aspect of parenting seems to be parental reflective functioning (PRF), defined as the parent's capacity to reflect upon his own and his child's internal mental experience. The studies on parenting factors linked to ADHD have not extensively investigated the role of PRF. Recent findings on interventions have begun to consider mentalization to promote empathy and emotion regulation in parents, but empirical studies assessing PRF are still scarce. The aim of this cross-sectional study was to compare specific familial and parental functioning characteristic between parents of children with attention deficit/hyperactivity disorder (ADHD) and parents of controls without ADHD. A clinical sample of 41 children with ADHD aged 8–11 years and their parents was compared with a matched, non-clinical sample of 40 children. Three aspects of parental functioning were investigated: parental symptomatology, parental alliances and PRF; children's differences in strength and difficulty profiles were also assessed. The results showed that families of children with ADHD had lower socioeconomic status, and both mothers and fathers of the same families reported higher scores for depression and lower PRF than did the control group; only mothers showed lower parental alliance. Logistic regression highlighted the fact that several of these familial and parental factors contributed to the increased risk of belonging to the clinical group, specifically both mothers' and fathers' depressive symptoms and lower PRF. These data represent new findings with potentially meaningful clinical implications for both assessment and intervention.
... Specifically, depressed mothers' ineffective parenting behaviors that do not meet children's developmental needs are indicated as important elements that can explain the relationship between mothers' depression and children's behavioral problems (Downey & Coyne, 1990;Elgar et al., 2004;Goodman & Gotlib, 1999). Above all, previous studies have indicated that parenting characteristics such as warmth, sensitivity, and emotional supportiveness are associated with preschool-age children's ability to manage emotions and behaviors (Blair et al., 2011;Eisenberg et al., 2010;Gustafsson et al., 2012). ...
... In a study that examined different racial groups, the effect of mothers' depression on children's behavioral problems was partially mediated by parenting in the White and Latino samples, and an unmediated direct effect was detected in the Black sample (Pachter et al., 2006). To explain the direct effect of mothers' depression on children's behavioral problems, mechanisms such as the intergenerational transmission of genetic vulnerability and neuroregulatory systems, children's learning of mothers' cognitive processes, marital conflict associated with mothers' depression and environmental stress are being suggested (Cummings & Davis, 1994;Elgar et al., 2004;Goodman & Gotlib, 1999). ...
Article
Full-text available
The COVID-19 pandemic is affecting families and children worldwide. Experiencing the pandemic leads to stress in families resulting from fear of infection and social isolation derived from social distancing. For families raising preschoolers, the prolonged closure of childcare centers puts additional childcare burden on family members, especially mothers. Due to the limited research exploring the impact of COVID-19 on preschool children’s problem behaviors, this study examines the association between stress due to COVID-19 and preschool children’s internalizing and externalizing problem behaviors related to mother’s depression and parenting behavior. The study sample included data collected from 316 South Korean mothers raising preschool-aged children aged 3 to 5. The study findings suggest that mother’s COVID-19 stress was indirectly associated with preschool children’s internalizing and externalizing problem behaviors resulting from the mother’s depression and parenting behaviors, although the direct effect of COVID-19 stress on preschool children’s outcomes was not statistically significant. Increase in mother’s COVID-19 stress was associated with increase in depression, and sequentially decreased positive parenting behaviors, which in turn resulted in preschool children’s internalizing and externalizing problem behaviors. The study findings highlight the need to focus on enhancing mental health of mothers and preschool children’s adjustment by implementing supportive interventions to reduce the adverse impacts of the prolonged COVID-19 pandemic.
... Parent ADHD is associated with poorer monitoring of child behaviour, less consistent discipline [8], and greater severity of child ADHD symptoms [9]. Moreover, parenting stress [10], poorer parent mental health [11] and associated negative parenting practices [12,13] have been reported to predict child ADHD symptoms. Conversely, children's ADHD symptoms exacerbate parenting stress [5]. ...
... This is consistent with the developmental-transactional model of ADHD and family functioning, where improvement in one aspect of child, parent or family functioning may positively impact other domains [60]. Prior research has identified that increased parenting stress [10], poor parent mental health [11] and negative parenting practices [12,13] exacerbate child ADHD symptoms. Thus, parent-only MP interventions may lead to positive improvements in both parent and child functioning. ...
Article
Full-text available
This mixed-methods single arm pilot study examined the feasibility, acceptability, and preliminary outcomes of a co-designed mindful parenting intervention for parents of children with ADHD, Parents that Mind (PTM). The 5-week parent-only intervention comprised two face-to-face group retreats and 5 weeks home practice. Eighteen parents of children with ADHD participated in PTM, completing self-report questionnaires and semi-structured interviews. Indicating high acceptability, 100% of parents interviewed reported PTM was helpful and they would recommend PTM. High feasibility of parents attending one face-to-face retreat was observed, with all parents attending the first retreat, however intervention adherence was challenging, with 55% of parents attending the second retreat. Barriers to intervention adherence included: lack of time, work commitments, illness and exhaustion. Quantitative data indicate promising preliminary effects for parents and children. Addressing the barriers raised by parents in this pilot appear necessary, before examining efficacy in a blinded RCT.
... Children of mothers with depressive symptoms show a higher prevalence of behavior problems than children of non-depressed mothers [6]. Several studies have demonstrated the influence of maternal or parental depressive symptoms [7][8][9][10][11][12][13][14][15][16], maternal or parental anxiety [8,9,15,17] and maternal or parental stress [16,[18][19][20][21] on conduct or externalizing behavior problems in children and adolescents. However, due to the cross-sectional nature of some of these studies, it is difficult to draw conclusions regarding causality [8-10, 13, 15, 19]. ...
... Instead of a unidirectional influence from parental psychopathology to child ODD/CD symptoms, a bidirectional relationship with mutual influences is considered more likely [4, 8-10, 19, 26-28]. Indeed, several studies found evidence for a bidirectional model of the relationship between child and parental psychopathology [17,[29][30][31][32][33] and between child externalizing psychopathology and parental stress [5,34,35]. An experimental study found that deviant child behavior was causally related to parental stress and a negative parental mood [36]. ...
Article
Full-text available
Previous research has shown that child-oppositional defiant disorder (ODD) and conduct disorders (CD) are associated with parental symptoms of depression, anxiety and/or stress, probably in a bidirectional relationship with mutual influences. It is, therefore, reasonable to assume that in child-centered treatment, a decrease in child-oppositional behavior problems constitutes (at least in part) a mechanism of change for a subsequent reduction in parental psychopathology. The aim of the present study (Clinical trials.gov Identifier: NCT01406067) was to examine whether the reduction in ODD symptoms due to child-based cognitive behavioral treatment (CBT) led to a reduction in parental depression, anxiety and stress. Eighty-one boys (age 6–12 years) with a diagnosis of ODD/CD were randomized either to a cognitive behavioral intervention group or an educational play group (acting as control group). Mediation analyses were conducted using path analysis. The stronger reduction in child ODD symptoms in the CBT group compared to the control group led to a decrease in parental depression and stress, as indicated by significant indirect effects (ab = 0.07 and ab = 0.08, p < 0.05). The proposed model for mechanisms of change was, therefore, confirmed for two of the three outcome parameters. Parental psychopathology and stress can be modified by child-centered CBT. The preceding reduction in ODD symptoms acts as a mediator for at least some of the changes in parental depression and stress. However, due to some limitations of the study, other possible explanations for the results found cannot be completely ruled out and are, therefore, discussed.
... Regarding depressive characteristics, complicated relations have been found between maternal depressive symptoms and child's disruptive behaviours. Elgar, Waschbusch, McGrath, Stewart and Curtis (2004) examined temporal relations between daily fluctuations in maternal mood and disruptive behaviour in 30 motherschool age child dyads. The results revealed synchronous fluctuation in child behaviour and maternal distress. ...
Thesis
p>Children’s AD/HD often elicits a negative parental response but little is known about the impact of parental AD/HD on parenting. In this thesis, I examined the impact of child and parent AD/HD and their interaction on parenting. In Study 1, these effects were examined using questionnaire-based measures of parenting provided by 95 mothers of school children. In Study 2, these self reports were replaced by direct observations of mother-child interactions and Expressed Emotion (EE) in 192 mothers of preschoolers. In Study 3, they were extended further by adding measures of empathy and by examining both mothers’ (N= 277) and fathers’ (N-86) parenting. The results demonstrated that child AD/HD symptoms were associated with negative parenting and hostile EE. Maternal AD/HD symptoms were positively associated with hostile EE, and negatively with empathy and positive parenting. Interestingly, mothers with high AD/HD symptoms had more positive and less negative parenting and personal distress for the children with high AD/HD symptoms. In contrast, fathers with high AD/HD symptoms had more negative parenting for the children with high AD/HD symptoms. These findings raised the question of whether the effects of child-parental similarity in AD/HD generalise to emotional/depressive characteristics. An analysis revealed that child-mother similarity in emotional/depressive characteristics decreased Negative Expressed Emotion (NEE). Indeed, mothers with high depressive characteristics displayed the same levels of NEE regardless of the severity of child emotional symptoms. The results of the thesis highlight the importance of taking account of maternal (and paternal) AD/HD when assessing the parenting of children with AD/HD. The findings may be especially significant in planning new clinical services and treatments for AD/HD.</p
... Li and her colleagues advocated that the moderating role of child emotion regulation in the association between parental emotion dysregulation and parent-child conflict was not significant. Depressed parents were characterized by indifference and insensitivity, and apt to adopt a negative parenting style with low warmth and high rejection (Elgar et al. 2004). As such, compared with parentchild closeness, the association between parental depression and parent-child conflict was more prominent, which was showed exactly in our study. ...
Article
Full-text available
Migrant children have greatly increased in number due to the China’s urbanization and migrant children with oppositional defiant disorder (ODD) symptoms are at high risk of conduct problems. The present study aimed to examine the relationship between parental depression and conduct problems among Chinese migrant children with ODD symptoms, and to investigate whether parent-child closeness and parent-child conflict mediated and child emotion regulation moderated the linkage. Totally, 370 parents of migrant children who met the DSM-IV-TR diagnosis of ODD symptoms from 10 elementary schools participated in the study. Their class master teachers were included as well. Results revealed that parental depression was positively associated with conduct problems of migrant children with ODD symptoms. Both parent-child closeness and conflict partially mediated the link between parental depression and child conduct problems, while the mediating role of parent-child conflict was stronger. Child emotion regulation moderated the association between parental depression and parent-child closeness. Specifically, for children with low level, but not high, of emotion regulation, parental depression was negatively related to parent-child closeness. The study applied existing emotional security theory into migrant children with ODD symptoms and suggested that interventions may effectively reduce conduct problems in migrant children with ODD symptoms by targeting parental depression, parent-child closeness as well as conflict, and child emotion regulation.
... Recent evidence suggests that mothers of children with ADHD experience higher levels of parenting stress than mothers of children of typical development (Anastopoulos, Guevremont, Shelton, & DuPaul, 1992;Kazdin & Whitley, 2003), which in turn results in higher rates of psychopathological symptoms (Theule, Wiener, Tannock, & Jenkins, 2013). Specifically, mothers of children with ADHD have been found to report greater levels of marital struggle and higher rates of divorce (Wymbs, Pelham, Molina, & Gnagy, 2008), mood problems (Elgar, Waschbusch, McGrath, Stewart, & Curtis, 2004), and addictive disorders (Chronis et al., 2003) than mothers of children of typical development. All of these factors contribute to the notion that attending to the needs of children with ADHD should be considered within a clinical context, since it could be pertinent to the stress and early psychopathological symptoms experienced by the mothers of these children. ...
Article
Full-text available
The current study investigated the relationship between various behaviors of children with ADHD and their mothers’ parenting stress. Furthermore, the study investigated the relationship of parenting stress and the psychopathological symptomatology in mothers of children with different subtypes of ADHD. The sample of the study comprised 120 children, together with their mothers, classified in two groups, ADHD - Combined subtype and ADHD-Inattention subtype. The results showed that mothers of children with ADHD reported positive associations between the various aspects of their children’s behaviors and their parenting stress levels, as well as positive relations between the various aspects of their parenting stress levels and different kinds of psychopathological symptoms. The findings of the present study highlight the need for further research in this area and the development of more intervention programs focused on the mothers of ADHD children. Education Research Journal. ISSN 2026-6332 Volume (8) Issue (2): 47 – 56, February 2018
Article
Background Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed developmental disorders and is common among referrals to child guidance clinics. Aim This study aimed to study the impact of the lockdown during the coronavirus disease 2019 (COVID-19) pandemic on the mother's understanding of ADHD and the burden faced by her. Materials and Methods A mixed-methods design with a combination of a qualitative and quantitative approach was adopted. An in-depth in-person semi-structured interview with the participant's mother was conducted. The qualitative and quantitative part of the study consisted of burden assessment by the Zarit Caregiver Burden Scale. The responses were transcribed, and themes were identified. Results As far as understanding the disorder was concerned, the major themes identified were “Knew about the child's problems from teachers but online schooling made me see the child's issues in person” and “Knew about the illness but more time led to bonding and understanding the child.” When questioned about the burden faced, the major themes that evolved were “Increased exhaustion taking care of a child 24/7” and “Increased burden as one felt angry and irritated with the child, the school, and the family.” The Zarit caregiver questionnaire revealed a statistically significant difference in the burden of care before and after the pandemic, with a greater number of mothers falling in the mild to moderate and severe categories of burden. Conclusion The COVID-19 pandemic increased the caregiver burden for mothers of children with ADHD. Their understanding of their child's disorder increased significantly as they could spend more time and devise different ways and means of helping their child in academics and other areas.
Article
Very little is known about the impact of parental psychopathology on treatment outcome for youth with conduct problems (CPs) and callous–unemotional (CU) traits. This case study describes behavioral parent training (BPT) for “Amy,” an 11-year-old girl presenting with CP/CU traits who had a mother diagnosed with posttraumatic stress disorder (PTSD). Maternal and paternal reports of child behavior problems and impairments were collected to assess treatment outcome. Weekly ratings of maternal PTSD were also collected to examine changes in maternal psychopathology over the course of BPT. Parent ratings showed that treatment was associated with reductions in oppositional defiant disorder (ODD) symptoms, conduct disorder (CD) symptoms, and impairment, and with improvements in treatment goal progress. However, the frequency of negative behaviors remained high throughout treatment. Maternal PTSD symptoms remained in the clinical range throughout BPT, but there was some evidence of synchrony between maternal PTSD symptoms and child negative behaviors. These findings highlight the importance of examining parental psychopathology in understanding BPT outcomes for children with CP/CU traits and call for greater attention to addressing child and parent difficulties that may impede improvement in treatment for youth with CP/CU traits.
Article
Examines the relative contributions of environmental, child, and Parental characteristics to parent-child interactive stress for families of hyperactive children and those of physically abused children. In families of hyperactive children, difficult child characteristics represent a probable source of parent-child interactive stress, whereas in abusive families such stress more likely arises from parental characteristics and adverse environments. The role of maternal cognitions as a mediator of stress in the two types of families is considered and relevant research into maternal perceptions, maternal attributions, and maternal self-efficacy is reviewed. Recommendations for the study of maternal cognitions in the context of interactive stress include: studying the interface between cognition and affect; assessing cognitions as ongoing processes; examining the role of cognitions in mediating situational influences; adopting a systems framework; and establishing the modifiability of specific types of parental cognitions.
Article
Obtained ratings on the IOWA Conners Teacher Rating Scale for 608 boys and girls from kindergarten through fifth grade in two elementary schools. Means, standard deviations, and suggested cutoff scores are reported by grade and sex for this sample on the Inattention/Overactivity and the Aggression (Oppositional/Defiant) subscales. Significant grade and sex effects are discussed, and implications for differential diagnosis of attention deficit and conduct disorders are addressed.