Exposure to maternal mental health problems during pregnancy and the first year of life has been associated with the development of ADHD. One pathway through which maternal mental health may influence children’s outcomes is via its effects on parenting. This study aimed to investigate the mediating role of parenting behavior in the pathway between maternal postnatal distress and later symptoms of ADHD in the child. Biological mothers living with their children participating in the Longitudinal Study of Australian Children with data available from waves 1 (child age 3–12 months) and 5 (child age 8–9 years) were included in the current study (n = 3456). Postnatal distress was assessed by parent report at wave 1. Parenting warmth, hostility and consistency were assessed by parent report at wave 5. ADHD status at wave 5 was ascertained by parent report of the child having a diagnosis of ADHD/ADD or by elevated ADHD symptoms by both parent and teacher report. There was evidence of an indirect pathway from maternal postnatal distress to child ADHD at age 8–9 years via parenting hostility, but not through parenting warmth or consistency, even after accounting for concurrent maternal mental health. Our findings highlight the importance of early identification and intervention for maternal postnatal distress, as treatment may prevent mothers from developing hostile parenting practices and also disrupt the pathway to ADHD in their offspring.
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Polanczyk G, de Lima M, Horta B, Biederman J, Rohde L (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164(6):942–948. https://doi.org/10.1176/ajp.2007.164.6.942
American Psychiatric Association (2013) DSM 5. American Psychiatric Association, Arlington, VA
Biederman J, Faraone SV (2005) Attention-deficit hyperactivity disorder. Lancet 366(9481):237–248. https://doi.org/10.1016/S0140-6736(05)66915-2
Halmøy A, Klungsøyr K, Skjærven R, Haavik J (2012) Pre-and perinatal risk factors in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry 71(5):474–481. https://doi.org/10.1016/j.biopsych.2011.11.013
Silva D, Colvin L, Hagemann E, Bower C (2014) Environmental risk factors by gender associated with attention-deficit/hyperactivity disorder. Pediatrics 133(1):e14–e22. https://doi.org/10.1542/peds.2013-1434
Sciberras E, Ukoumunne OC, Efron D (2011) Predictors of parent-reported attention-deficit/hyperactivity disorder in children aged 6–7 years: a national longitudinal study. J Abnorm Child Psychol 39(7):1025–1034. https://doi.org/10.1007/s10802-011-9504-8
Elgar FJ, Mills RSL, McGrath PJ, Waschbusch DA, Brownridge DA (2007) Maternal and paternal depressive symptoms and child maladjustment: the mediating role of parental behavior. J Abnorm Child Psychol 35(6):943–955. https://doi.org/10.1007/s10802-007-9145-0
Giallo R, Cooklin A, Wade C, D’Esposito F, Nicholson JM (2014) Maternal postnatal mental health and later emotional–behavioural development of children: the mediating role of parenting behaviour. Child Care Health Dev 40(3):327–336. https://doi.org/10.1111/cch.12028
Rice F, Harold GT, Boivin J, van den Bree M, Hay DF, Thapar A (2010) The links between prenatal stress and offspring development and psychopathology: disentangling environmental and inherited influences. Psychol Med 40(2):335–345. https://doi.org/10.1017/S0033291709005911
Rodriguez A, Bohlin G (2005) Are maternal smoking and stress during pregnancy related to ADHD symptoms in children? J Child Psychol Psychiatry 46(3):246–254. https://doi.org/10.1111/j.1469-7610.2004.00359.x
Talge NM, Neal C, Glover V (2007) Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry 48(3/4):245–261. https://doi.org/10.1111/j.1469-7610.2006.01714.x
Van den Bergh BRH, Marceon A (2004) High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8- and 9-year-olds. Child Dev 4:1085–1097. https://doi.org/10.1111/j.1467-8624.2004.00727.x
O’Connor TG, Heron J, Golding J, Beveridge M, Glover V (2002) Maternal antenatal anxiety and children’s behavioural/emotional problems at 4 years: report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry 180(6):502–508. https://doi.org/10.1192/bjp.180.6.502
Clements CC, Castro VM, Blumenthal SR, Rosenfield HR, Murphy SN, Fava M, Erb JL, Churchill SE, Kaimal AJ, Doyle AE, Robinson EB, Smoller JW, Kohane IS, Perlis RH (2015) Prenatal antidepressant exposure is associated with risk for attention-deficit hyperactivity disorder but not autism spectrum disorder in a large health system. Mol Psychiatry 20(6):727–734. https://doi.org/10.1038/mp.2014.90
Laugesen K, Olsen MS, Andersen ABT, Frøslev T, Sørensen HT (2013) In utero exposure to antidepressant drugs and risk of attention deficit hyperactivity disorder: a nationwide Danish cohort study. BMJ Open. https://doi.org/10.1136/bmjopen-2013-003507
Elgar FJ, Curtis LJ, McGrath PJ, Washbusch DA, Stewart SH (2003) Antecedent-consequence conditions in maternal mood and child adjustment: a four-year cross-lagged study. J Clin Child Adolesc Psychol 32(3):362. https://doi.org/10.1207/S15374424JCCP3203_05
Romano E, Tremblay RE, Farhat A, Côté S (2006) Development and prediction of hyperactive symptoms from 2 to 7 years in a population-based sample. Pediatrics 117(6):2101–2110. https://doi.org/10.1542/peds.2005-0651
Clavarino AM, Mamun AA, O’Callaghan M, Aird R, Bor W, O’Callaghan F, Williams GM, Marrington S, Najman JM, Alati R (2010) Maternal anxiety and attention problems in children at 5 and 14 years. J Atten Disord 13(6):658–667. https://doi.org/10.1177/1087054709347203
Goodman SH, Gotlib IH (1999) Risk for psychopathology in the children of depressed mothers: a developmental model for understanding mechanisms of transmission. Psychol Rev 106(3):458
Rapee RM (2012) Family factors in the development and management of anxiety disorders. Clin Child Fam Psychol Rev 15(1):69–80. https://doi.org/10.1007/s10567-011-0106
Elgar FJ, McGrath PJ, Waschbusch DA, Stewart SH, Curtis LJ (2004) Mutual influences on maternal depression and child adjustment problems. Clin Psychol Rev 24(4):441–459. https://doi.org/10.1016/j.cpr.2004.02.002
Gau SS-F, Chang JP-C (2013) Maternal parenting styles and mother–child relationship among adolescents with and without persistent attention-deficit/hyperactivity disorder. Res Dev Disabil 34(5):1581–1594. https://doi.org/10.1016/j.ridd.2013.02.002
Bhide S, Sciberras E, Anderson V, Hazell P, Nicholson JM (2016) Association between parenting style and socio-emotional and academic functioning in children with and without ADHD: a community-based study. J Atten Disord. https://doi.org/10.1177/1087054716661420
Cussen A, Sciberras E, Ukoumunne OC, Efron D (2012) Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning: a community-based study. Eur J Pediatr 171(2):271–280. https://doi.org/10.1007/s00431-011-1524-4
Alizadeh H, Applequist KF, Coolidge FL (2007) Parental self-confidence, parenting styles, and corporal punishment in families of ADHD children in Iran. Child Abuse Negl 31(5):567–572. https://doi.org/10.1016/j.chiabu.2006.12.005
Zubrick SR, Lucas N, Westrupp EM, Nicholson JM (2014) Parenting measures in the Longitudinal Study of Australian Children: construct validity and measurement quality, waves 1 to 4. LSAC Tech Paper 12:1–110
Baumrind D (1971) Current patterns of parental authority. Dev Psychol 4(1p2):1
Modesto-Lowe V, Danforth JS, Brooks D (2008) ADHD: does parenting style matter? Clin Pediatr 47(9):865–872. https://doi.org/10.1037/h0030372
Soloff C, Lawrence D, Johnstone R (2005) LSAC technical paper no. 1: sample design. Australian Institute of Family Studies, Melbourne
Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand S-LT, Manderscheid RW, Walters EE (2003) Screening for serious mental illness in the general population. Arch Gen Psychiatry 60(2):184–189. https://doi.org/10.1001/archpsyc.60.2.184
Furukawa TA, Kessler RC, Slade T, Andrews G (2003) The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med 33(02):357–362. https://doi.org/10.1017/S0033291702006700
Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40(11):1337–1345. https://doi.org/10.1097/00004583-200111000-00015
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Press, Washington, DC
Hawes DJ, Dadds MR (2004) Australian data and psychometric properties of the Strengths and Difficulties Questionnaire. Aust N Z J Psychiatry 38(8):644–651. https://doi.org/10.1080/j.1440-1614.2004.01427.x
Paterson G, Sanson A (1999) The association of behavioural adjustment to temperament, parenting and family characteristics among 5-year-old children. Soc Dev 8(3):293–309. https://doi.org/10.1111/1467-9507.00097
Statistics Canada (1995) National Longitudinal Survey of Children: survey instruments for 1994–1995 data collection, cycle 1. Statistics Canada, Ottawa
Blakemore T, Strazdins L, Gibbings J (2009) Measuring family socioeconomic position. Aust Soc Policy 8:121–168
Muthen L, Muthen B (1998) Mplus user’s guide. Muthen & Muthen, Los Angeles
Bentler PM (1990) Comparative fit indexes in structural models. Psychol Bull 107(2):238–246. https://doi.org/10.1037/0033-2909.107.2.238
Hu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model Multidiscip J 6(1):1–55. https://doi.org/10.1080/10705519909540118
MacKinnon DP, Lockwood CM, Hoffman JM, West SG, Sheets V (2002) A comparison of methods to test mediation and other intervening variable effects. Psychol Methods 7(1):83–104
Martin J, Hiscock H, Hardy P, Davey B, Wake M (2007) Adverse associations of infant and child sleep problems and parent health: an Australian population study. Pediatrics 119(5):947–955. https://doi.org/10.1542/peds.2006-2569
Wake M, Morton-Allen E, Poulakis Z, Hiscock H, Gallagher S, Oberklaid F (2006) Prevalence, stability, and outcomes of cry-fuss and sleep problems in the first 2 years of life: prospective community-based study. Pediatrics 117(3):836–842. https://doi.org/10.1542/peds.2005-0775
Harold GT, Leve LD, Barrett D, Elam K, Neiderhiser JM, Natsuaki MN, Shaw DS, Reiss D, Thapar A (2013) Biological and rearing mother influences on child ADHD symptoms: revisiting the developmental interface between nature and nurture. J Child Psychol Psychiatry 54(10):1038–1046. https://doi.org/10.1111/jcpp.12100
Lawrence D, Hafekost J, Johnson SE, Saw S, Buckingham WJ, Sawyer MG, Ainley J, Zubrick SR (2016) Key findings from the second Australian child and Adolescent Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 50(9):876–886. https://doi.org/10.1177/0004867415617836
This paper used data from the Longitudinal Study of Australian Children. The study was conducted in partnership between the Department of Social Services (DSS), the Australian Institute of Family Studies (AIFS) and the Australian Bureau of Statistics (ABS). The findings reported in this paper are those of the authors and should not be attributed to DSS, AIFS or the ABS. Professor Stephanie Brown is funded by an Australian National Health and Medical Research Council Senior Research Fellowship (1103976). Professor Nicholson is supported by the Australian Communities Foundation (Coronella sub-fund). Dr Sciberras is funded by an Australian National Health and Medical Research Council Career Development Fellowship (1110688) and a veski Inspiring Women’s Fellowship. Dr Efron’s position is funded by a Clinician Scientist Fellowship from the Murdoch Children’s Research Institute. This research was supported by the Victorian Government’s Operational Infrastructure Support Program to the MCRI.
Conflict of interest
On behalf of all authors, the corresponding author states there is no conflict of interest.
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Mulraney, M., Giallo, R., Efron, D. et al. Maternal postnatal mental health and offspring symptoms of ADHD at 8–9 years: pathways via parenting behavior. Eur Child Adolesc Psychiatry 28, 923–932 (2019). https://doi.org/10.1007/s00787-018-1254-5
- Attention-deficit/hyperactivity disorder
- Postnatal distress