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ADHD in Families

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ADHD in Adults

Part of the book series: Current Clinical Psychiatry ((CCPSY))

Abstract

Adult ADHD is associated with significant psychosocial impairment comprising problems at work, financial troubles, interpersonal conflicts, delinquency, and family dysfunction. Family impact of ADHD contributes to marital problems and conflicts with children. Skills to cope with these interpersonal problems are often limited, including impaired parental skills. Conflicts might be catalyzed by comorbid psychiatric disorders. Moreover, the hereditability of ADHD is associated with problems involved with raising affected children. All in all, in adult ADHD patients multiple stressors are interlinked leading to vicious circles widely affecting family life. Multimodal assessment of adult ADHD has to be broad enough to cover these personal and environmental factors. The patient’s partner and child(ren) should also be screened for psychiatric disorders. The need to stabilize family function does not imply that family-focused interventions are the first line of therapy. ADHD and comorbid conditions have to be treated first. Medication and psychoeducational advice to the patient and his or her partner can lead to significant improvements in family function. Applying skills acquired during individual psychotherapy to family problems could also reduce family conflict. In addition, strengthening parenting skills by the implementation of parent training is often useful. In the case of psychiatric disorders in children the implementation of treatment is crucial. However, treatment of the ADHD parent seems to be an important precondition of a successful psychosocial intervention to target the child’s externalizing symptoms. Reduction of ADHD symptoms in children may also reduce family conflict more effectively than specific family interventions. This points to the need for close cooperation between child and adult mental health services. More specific couples therapy or family therapy may be indicated if the therapeutic strategies stated above do not lead to a significant reduction of family conflict.

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Notes

  1. 1.

    However, it has to be stated that in clinical studies a selection bias in the opposite directions is frequently present implying an exclusion of severely affected patients with major comorbidities and severe psychosocial burden [60]. Thus, the representativeness of study samples may be affected by the exclusion of both highly functioning ADHD patients and severely impaired patients.

References

  1. Faraone SV, Perlis RH, Doyle AE, et al. Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57(11):1313–23.

    Article  PubMed  CAS  Google Scholar 

  2. Albayrak O, Friedel S, Schimmelmann BG, Hinney A, Hebebrand J. Genetic aspects in attention-deficit/hyperactivity disorder. J Neural Transm. 2008;115(2):305–15.

    Article  PubMed  CAS  Google Scholar 

  3. Wender PH. Adult attention deficit hyperactivity disorder. Oxford: University Press; 1995.

    Google Scholar 

  4. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (Text Revision). 4th ed. Washington, DC: American Psychiatric Association; 2000.

    Google Scholar 

  5. Biederman J, Faraone SV, Spencer T, et al. Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. Am J Psychiatry. 1993;150(12):1792–8.

    PubMed  CAS  Google Scholar 

  6. Murphy K, Barkley RA. Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments. Compr Psychiatry. 1996;37(6):393–401.

    Article  PubMed  CAS  Google Scholar 

  7. Barkley RA, Fischer M, Smallish L, Fletcher K. Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry. 2006;45(2):192–202.

    Article  PubMed  Google Scholar 

  8. Rösler M, Retz W, Retz-Junginger P, et al. Prevalence of attention deficit-/hyperactivity disorder (ADHD) and comorbid disorders in young male prison inmates. Eur Arch Psychiatry Clin Neurosci. 2004;254(6):365–71.

    Article  PubMed  Google Scholar 

  9. Rösler M, Retz W, Yaqoobi K, Burg E, Retz-Junginger P. Attention deficit/hyperactivity disorder in female offenders: prevalence, psychiatric comorbidity and psychosocial implications. Eur Arch Psychiatry Clin Neurosci. 2009;259(2):98–105.

    Article  PubMed  Google Scholar 

  10. Jacob CP, Romanos J, Dempfle A, et al. Co-morbidity of adult attention-deficit/hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center. Eur Arch Psychiatry Clin Neurosci. 2007;257(6):309–17.

    Article  PubMed  Google Scholar 

  11. Ninowski JE, Mash EJ, Benzies KM. Symptoms of attention-deficit/hyperactivity disorder in first-time expectant women: relations with parenting cognitions and behaviors. Infant Ment Health J. 2007;28(1):54–75.

    Article  Google Scholar 

  12. Minde K, Eakin L, Hechtman L, et al. The psychosocial functioning of children and spouses of adults with ADHD. J Child Psychol Psychiatry. 2003;44(4):637–46.

    Article  PubMed  Google Scholar 

  13. Biederman J, Faraone SV, Monuteaux MC. Impact of exposure to parental attention-deficit hyperactivity disorder on clinical features and dysfunction in the offspring. Psychol Med. 2002;32(5):817–27.

    Article  PubMed  CAS  Google Scholar 

  14. Eakin L, Minde K, Hechtman L, et al. The marital and family functioning of adults with ADHD and their spouses. J Atten Disord. 2004;8(1):1–10.

    Article  PubMed  CAS  Google Scholar 

  15. Harvey E, Danforth JS, McKee TE, Ulaszek WR, Friedman JL. Parenting of children with attention-defecit/hyperactivity disorder (ADHD): the role of parental ADHD symptomatology. J Atten Disord. 2003;7(1):31–42.

    Article  PubMed  CAS  Google Scholar 

  16. Arnold EH, O’Leary SG, Edwards GH. Father involvement and self-reported parenting of children with attention deficit-hyperactivity disorder. J Consult Clin Psychol. 1997;65(2):337–42.

    Article  PubMed  CAS  Google Scholar 

  17. Murray C, Johnston C. Parenting in mothers with and without attention-deficit/hyperactivity disorder. J Abnorm Psychol. 2006;115(1):52–61.

    Article  PubMed  Google Scholar 

  18. Banks T, Ninowski JE, Mash EJ, Semple DL. Parenting behavior and cognitions in a community sample of mothers with and without symptoms of attention-deficit/hyperactivity disorder. J Child Fam Stud. 2008;17(1):28–43.

    Article  Google Scholar 

  19. Johnston C, Ohan JL. The importance of parental attributions in families of children with attention-deficit/hyperactivity and disruptive behavior disorders. Clin Child Fam Psychol Rev. 2005;8(3):167–82.

    Article  PubMed  Google Scholar 

  20. Weiss M, Hechtman L, Weiss G, Jellinek MS. ADHD in parents. J Am Acad Child Adolesc Psychiatry. 2000;39(8):1059–61.

    Article  PubMed  CAS  Google Scholar 

  21. Waldman ID. Gene–environment interactions reexamined: does mother’s marital stability interact with the dopamine receptor D2 gene in the etiology of childhood attention-deficit/hyperactivity disorder? Develop Psychopathol. 2007;19(4):1117–28.

    Article  Google Scholar 

  22. Biederman J, Faraone SV, Keenan K, et al. Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder. Patterns of comorbidity in probands and relatives psychiatrically and pediatrically referred samples. Arch Gen Psychiatry. 1992;49(9):728–38.

    Article  PubMed  CAS  Google Scholar 

  23. Chronis AM, Lahey BB, Pelham Jr WE, Kipp HL, Baumann BL, Lee SS. Psychopathology and substance abuse in parents of young children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2003;42(12):1424–32.

    Article  PubMed  Google Scholar 

  24. Ghanizadeh A, Mohammadi MR, Moini R. Comorbidity of psychiatric disorders and parental psychiatric disorders in a sample of Iranian children with ADHD. J Atten Disord. 2008;12(2):149–55.

    Article  PubMed  Google Scholar 

  25. Pimentel MJ, Vieira-Santos S, Santos V, Vale MC. Mothers of children with attention deficit/hyperactivity disorder: relationship among parenting stress, parental practices and child behaviour. Atten Defic Hyperact Disord. 2011;3(1):61–8.

    Article  PubMed  Google Scholar 

  26. Schilling V, Petermann F, Hampel P. Psychosoziale Situation bei Familien von Kindern mit ADHS. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie. 2006;54(4):293–301.

    Article  Google Scholar 

  27. Linderkamp F. Komorbidität und elterliche Psychopathologie bei externalisierenden Verhaltensstörungen im Kindesalter. Zeitschrift für Entwicklungspsychologie und Pädagogische Psychologie. 2006;38(1):43–52.

    Article  Google Scholar 

  28. Pelham WE, Lang AR, Atkeson B, et al. Effects of deviant child behavior on parental distress and alcohol consumption in laboratory interactions. J Abnorm Child Psychol. 1997;25(5):413–24.

    Article  PubMed  CAS  Google Scholar 

  29. Johnston C, Mash EJ. Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clin Child Fam Psychol Rev. 2001;4(3):183–207.

    Article  PubMed  CAS  Google Scholar 

  30. Cunningham CE, Boyle MH. Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: family, parenting, and behavioral correlates. J Abnorm Child Psychol. 2002;30(6):555–69.

    Article  PubMed  Google Scholar 

  31. Bauermeister JJ, Puente A, Martinez JV, Cumba E, Scandar RO, Bauermeister JA. Parent ­perceived impact of Spaniard boys’ and girls’ inattention, hyperactivity, and oppositional defiant behaviors on family life. J Atten Disord. 2010;14(3):247–55.

    Article  PubMed  Google Scholar 

  32. Harvey E, Danforth JS, Ulaszek WR, Eberhardt TL. Validity of the parenting scale for parents of children with attention-deficit/hyperactivity disorder. Behav Res Ther. 2001;39(6):731–43.

    Article  PubMed  CAS  Google Scholar 

  33. Podolski CL, Nigg JT. Parent stress and coping in relation to child ADHD severity and associated child disruptive behavior problems. J Clin Child Psychol. 2001;30(4):503–13.

    Article  PubMed  CAS  Google Scholar 

  34. Seipp CM, Johnston C. Mother-son interactions in families of boys with Attention-Deficit/Hyperactivity Disorder with and without oppositional behavior. J Abnorm Child Psychol. 2005;33(1):87–98.

    Article  PubMed  Google Scholar 

  35. Modesto-Lowe V, Danforth JS, Brooks D. ADHD: does parenting style matter? Clin Pediatr. 2008;47(9):865–72.

    Article  Google Scholar 

  36. Smith AJ, Brown RT, Bunke V, Blount RL, Christophersen E. Psychosocial adjustment and peer competence of siblings of children with Attention-Deficit/Hyperactivity Disorder. J Atten Disord. 2002;5(3):165–77.

    Article  PubMed  CAS  Google Scholar 

  37. Tarver-Behring S, Barkley RA, Karlsson J. The mother-child interactions of hyperactive boys and their normal siblings. Am J Orthopsychiatry. 1985;55(2):202–9.

    Article  PubMed  CAS  Google Scholar 

  38. Psychogiou L, Daley DM, Thompson MJ, Sonuga-Barke EJS. Mothers’ expressed emotion toward their school-aged sons. Eur Child Adolesc Psychiatry. 2007;16(7):458–64.

    Article  PubMed  Google Scholar 

  39. Wells KC, Epstein JN, Hinshaw SP, et al. Parenting and family stress treatment outcomes in attention deficit hyperactivity disorder (ADHD): an empirical analysis in the MTA study. J Abnorm Child Psychol. 2000;28(6):543–53.

    Article  PubMed  CAS  Google Scholar 

  40. Lifford KJ, Harold GT, Thapar A. Parent–child hostility and child ADHD symptoms: a genetically sensitive and longitudinal analysis. J Child Psychol Psychiatry. 2009;50(12):1468–76.

    Article  PubMed  Google Scholar 

  41. Vuchinich S, Bank L, Patterson GR. Parenting, peers, and the stability of antisocial behavior in preadolescent boys. Dev Psychol. 1992;28(3):510–21.

    Article  Google Scholar 

  42. Monuteaux MC, Faraone SV, Michelle GL, Biederman J. Predictors, clinical characteristics, and outcome of conduct disorder in girls with attention-deficit/hyperactivity disorder: a longitudinal study. Psychol Med. 2007;37(12):1731–41.

    Article  PubMed  Google Scholar 

  43. Hoza B, Owens JS, Pelham Jr WE, et al. Parent cognitions as predictors of child treatment response in attention-deficit/hyperactivity disorder. J Abnorm Child Psychol. 2000;28(6):569–83.

    Article  PubMed  CAS  Google Scholar 

  44. Pardini DA. Novel insights into longstanding theories of bidirectional parent–child influences: introduction to the special section. J Abnorm Child Psychol. 2008;36(5):627–31.

    Article  PubMed  Google Scholar 

  45. Anastopoulos AD, Guevremont DC, Shelton TL, DuPaul GJ. Parenting stress among families of children with attention deficit hyperactivity disorder. J Abnorm Child Psychol. 1992;20(5):503–20.

    Article  PubMed  CAS  Google Scholar 

  46. Pelham W, Wheeler T, Chronis A. Empirically supported psychosocial treatments for attention deficit hyperactivity disorder. J Clin Child Psychol. 1998;27(2):190–205.

    Article  PubMed  Google Scholar 

  47. Pelham W, Fabiano G. Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. J Clin Child Adolesc Psychol. 2008;37(1):184–214.

    Article  PubMed  Google Scholar 

  48. Anastopoulos AD, Shelton TL, DuPaul GJ, Guevremont DC. Parent training for attention-deficit hyperactivity disorder: its impact on parent functioning. J Abnorm Child Psychol. 1993;21(5):581–96.

    Article  PubMed  CAS  Google Scholar 

  49. Wells KC, Chi TC, Hinshaw SP, et al. Treatment-related changes in objectively measured parenting behaviors in the multimodal treatment study of children with attention-deficit/hyperactivity disorder. J Consult Clin Psychol. 2006;74(4):649–57.

    Article  PubMed  Google Scholar 

  50. Hinshaw SP, Owens EB, Wells KC, et al. Family processes and treatment outcome in the MTA: negative/ineffective parenting practices in relation to multimodal treatment. J Abnorm Child Psychol. 2000;28(6):555–68.

    Article  PubMed  CAS  Google Scholar 

  51. Barkley RA. Defiant children: a clinician’s manual for assessment and parent training. 2nd ed. New York: Guilford Press; 1997.

    Google Scholar 

  52. Sonuga-Barke EJ, Daley D, Thompson M. Does maternal ADHD reduce the effectiveness of parent training for preschool children’s ADHD? J Am Acad Child Adolesc Psychiatry. 2002;41(6):696–702.

    Article  PubMed  Google Scholar 

  53. Evans SW, Vallano G, Pelham W. Treatment of parenting behavior with a psychostimulant: a case study of an adult with attention-deficit hyperactivity disorder. J Child Adolesc Psychopharmacol. 1994;4(1):63–9.

    Article  Google Scholar 

  54. Daly JM, Fritsch SL. Case study: Maternal residual attention deficit disorder associated with failure to thrive in a two-month-old infant. J Am Acad Child Adolesc Psychiatry. 1995;34(1):55–7.

    Article  PubMed  CAS  Google Scholar 

  55. Chronis-Tuscano A, Seymour KE, Stein MA, et al. Efficacy of osmotic-release oral system (OROS) methylphenidate for mothers with attention-deficit/hyperactivity disorder (ADHD). J Clin Psychiatry. 2008;69(12):1938–47.

    Article  PubMed  CAS  Google Scholar 

  56. Chronis-Tuscano A, Rooney M, Seymour K, et al. Effects of maternal stimulant medication on observed parenting in mother-child dyads with attention-deficit/hyperactivity disorder. J Clin Child Adolesc Psychol. 2010;39(4):581–7.

    Article  PubMed  Google Scholar 

  57. Jans T, Philipsen A, Graf E, Ihorst G, Gerlach M, Warnke A. Does the treatment of maternal attention deficit and hyperactivity disorder (ADHD) enhance the efficacy of a behavioural parent training for the treatment of their children’s ADHD? Study protocol of a randomized controlled multicentre trial. Atten Defic Hyperact Disord. 2009;1(1):33–45.

    Article  PubMed  Google Scholar 

  58. Chronis A, Gamble S, Roberts J, Pelham Jr W. Cognitive-behavioral depression treatment for mothers of children with attention-deficit/hyperactivity disorder. Behav Ther. 2006;37(2):143–58.

    Article  PubMed  Google Scholar 

  59. Gerdes AC, Hoza B, Arnold LE, et al. Maternal depressive symptomatology and parenting behavior: exploration of possible mediators. J Abnorm Child Psychol. 2007;35(5):705–14.

    Article  PubMed  Google Scholar 

  60. Surman CB, Monuteaux MC, Petty CR, et al. Representativeness of participants in a clinical trial for attention-deficit/hyperactivity disorder? Comparison with adults from a large observational study. J Clin Psychiatry. 2010;71(12):1612–6.

    Article  PubMed  Google Scholar 

  61. Gibbins C, Weiss M. Clinical recommendations in current practice guidelines for diagnosis and treatment of ADHD in adults. Curr Psychiatry Rep. 2007;9(5):420–6.

    Article  PubMed  Google Scholar 

  62. National Collaborating Centre for Mental Health commissioned by the National Institute for Health & Clinical Excellence. Attention deficit hyperactivity disorder. Diagnosis and management of ADHD in children, young people and adults: National Clinical Practice Guideline Number 72. London: The British Psychological Society and The Royal College of Psychiatrists; 2009.

    Google Scholar 

  63. Kooij SJJ, Bejerot S, Blackwell A, et al. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry. 2010;10(1):67.

    Article  PubMed  Google Scholar 

  64. Coghill D, Soutullo C, d’Aubuisson C, et al. Impact of attention-deficit/hyperactivity disorder on the patient and family: results from a European survey. Child Adolesc Psychiatry Ment Health. 2008;2(1):31.

    Article  PubMed  Google Scholar 

  65. Barkley RA, Edwards G, Laneri M, Fletcher K, Metevia L. The efficacy of problem-solving communication training alone, behavior management training alone, and their combination for parent-adolescent conflict in teenagers with ADHD and ODD. J Consult Clin Psychol. 2001;69(6):926–41.

    Article  PubMed  CAS  Google Scholar 

  66. Weiss M, Safren SA, Solanto MV, et al. Research forum on psychological treatment of adults with ADHD. J Atten Disord. 2008;11(6):642–51.

    Article  PubMed  Google Scholar 

  67. Young S, Amarasinghe JM. Practitioner review: non-pharmacological treatments for ADHD: a lifespan approach. J Child Psychol Psychiatry. 2010;51(2):116–33.

    Article  PubMed  Google Scholar 

  68. Safren S, Perlman C, Sprich S, Otto M. Mastering your adult ADHD: a cognitive behavioral treatment program [therapist guide and client workbook]. New York: Oxford University Press; 2005.

    Google Scholar 

  69. Hesslinger B, Philipsen A, Richter H. Psychotherapie der ADHS im Erwachsenenalter: ein Arbeitsbuch (psychotherapy of adult attention deficit disorder with hyperactivity: a manual). Göttingen: Hogrefe; 2004.

    Google Scholar 

  70. Robbins CA. ADHD couple and family relationships: enhancing communication and understanding through Imago Relationship Therapy. J Clin Psychol. 2005;61(5):565–77.

    Article  PubMed  Google Scholar 

  71. Chronis AM, Jones HA, Raggi VL. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Clin Psychol Rev. 2006;26(4):486–502.

    Article  PubMed  Google Scholar 

  72. Abikoff H. Cognitive training in ADHD children: less to it than meets the eye. J Learn Disabil. 1991;24(4):205–9.

    Article  PubMed  CAS  Google Scholar 

  73. Abidin R. Parenting stress index (PSI)—professional manual. 3rd ed. Odessa: Psychological Assessment Resources; 1995.

    Google Scholar 

  74. Johnston C, Mash E. A measure of parenting satisfaction and efficacy. J Clin Child Adolescent Psychol. 1989;18(2):167–75.

    Article  Google Scholar 

  75. Campis L, Lyman R, Prentice-Dunn S. The parental locus of control scale: development and validation. J Clin Child Adolescent Psychol. 1986;15(3):260–7.

    Article  Google Scholar 

  76. Arnold DS, O’Leary SG, Wolff LS, Acker MM. The parenting scale: a measure of dysfunctional parenting in discipline situations. Psychol Assess. 1993;5(2):137–44.

    Article  Google Scholar 

  77. Spanier G. Dyadic adjustment scale—manual. Toronto: Multi-Health Systems; 1989.

    Google Scholar 

  78. Epstein NB, Baldwin LM, Bishop DS. The McMaster family assessment device. J Marital Fam Ther. 1983;9(2):171–80.

    Article  Google Scholar 

  79. Donenberg G, Baker BL. The impact of young children with externalizing behaviors on their families. J Abnorm Child Psychol. 1993;21(2):179–98.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

Our research on the treatment of ADHD is supported in part by the German Federal Ministry of Education and Research (BMBF; 01GV0605, 01GV0606) within the framework “research networks on psychotherapy.”

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstr. 15, Wuerzburg, Germany, D97080

    Thomas Jans Ph.D.

  2. Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Fuechsleinstr. 15, Wuerzburg, Germany

    Christian Jacob P.D., M.D.

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Correspondence to Thomas Jans Ph.D. .

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  1. Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Alewife Brook Parkway, Suite 2000 185, Cambridge, 02138, USA

    Craig B.H. Surman

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Jans, T., Jacob, C. (2013). ADHD in Families. In: Surman, C. (eds) ADHD in Adults. Current Clinical Psychiatry. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-248-3_10

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