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Mediators and Moderators of the Relation between Parental ADHD Symptomatology and the Early Development of Child ADHD and ODD Symptoms


The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children’s ADHD.

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  1. 1.

    For six of the families in the sample, parents were not biological parents. In five of these families, primary caregivers were adoptive parent(s) and for one family, primary caregivers were a grandmother and step-grandfather. For seven additional families, the second caregiver was a stepfather or the mother’s partner. Analyses included all caregivers to enhance generalizability of findings; results including only biological parents were nearly identical.

  2. 2.

    Clinical diagnoses were made only at the 3-year follow-up and were based on a diagnostic and psychosocial interview as well as parent and teacher rating scales and are described more fully in Harvey et al. (2011).

  3. 3.

    At T1, the interview was completed by the parents together for 55 % of families, by the mother alone for 41 % of families, by the father alone for 1 % of families, and by grandparents without a parent present for 1 % of families; this information was not recorded for 2 % of families at T1. At T4, the interview was completed by the parents together for 28 % of families, by the mother alone for 68 % of families, by the father alone for 2 % of families, and by grandparents without a parent present for 1 % of families.

  4. 4.

    To examine whether the lack of relation between fathers’ and children’s ADHD symptoms was because mothers were more likely to participate in the diagnostic interview, we ran the base model using mothers’ and fathers’ reports of child ADHD from the Disruptive Behavior Rating Scale (DBRS; Barkley and Murphy 1998). Mothers’ ADHD symptoms predicted T4 child ADHD based on mothers’ and fathers’ report, but fathers’ ADHD symptoms predicted T4 child ADHD symptoms only based on fathers’ report of child ADHD.

  5. 5.

    To explore which aspect of comorbid psychopathology was driving these relations, this combined model was rerun with each psychopathology symptom in place of the latent variable. Paternal depression and anxiety, but not antisocial symptoms were predictive of T4 child ADHD and ODD when parental ADHD symptoms and family history of ADHD were included in the model.

  6. 6.

    To explore the lack of a relation between comorbid maternal psychopathology and T4 child ADHD and ODD, analyses were re-run removing maternal ADHD symptoms from the model. Without controlling for maternal ADHD symptoms, maternal comorbid psychopathology was predictive of T4 child ADHD, β = 0.20, SE = 0.07, p = 0.003, and marginally predictive of T4 child ODD, β = 0.14, SE = 0.08, p = 0.06.

  7. 7.

    To explore whether the difference in findings for overreactivity and warmth could be due to measuring parenting via self-report versus observation, we tested a model using observational T1 and T4 maternal negative affect based on audiotaped interactions in place of self-reported overreactivity. (We did not have audiotaped interactions at T2 or T3, and our coding of negative affect for the videotaped interactions at T2 and T3 yielded too little negative affect to be useful.) Mothers’ ADHD symptoms significantly predicted greater negative affect at T1 and T4, β = 0.23, SE = 0.08, p = 0.004, and β = 0.19, SE = 0.09, p = .03, respectively. In turn, T4 maternal negative affect significantly predicted greater T4 child ADHD and ODD symptoms, β = 0.14, SE = 0.06, p = 0.04, and β = 0.14, SE = 0.07, p = 0.05, respectively. This suggests that the differences between overreactivity and warmth were likely not due to measurement, but rather the result of difference in effects for negative versus positive parenting practices.


  1. Agha, S. S., Zammit, S., Thapar, A., & Langley, K. (2013). Are parental ADHD problems associated with a more severe clinical presentation and greater family adversity in children with ADHD? European Child & Adolescent Psychiatry, 22, 369–377. doi:10.1007/s00787-013-0378-x.

  2. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5). Washington, D.C.: American Psychiatric Association.

  3. Applegate, B., Lahey, B. B., Hart, E. L., Biederman, J., Hynd, G. W., Barkley, R. A., et al. (1997). Validity of the age-of-onset criterion for ADHD: a report from the DSM-IV field trials. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 1211–1221. doi:10.1097/00004583-199709000-00013.

  4. Arnold, D. S., O’Leary, S. G., Wolff, L. S., & Acker, M. M. (1993). The parenting scale: a measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5, 137–144. doi:10.1037/1040-3590.5.2.137.

  5. Ashman, S. B., Dawson, G., & Panagiotides, H. (2008). Trajectories of maternal depression over 7 years: relations with child psychophysiology and behavior and role of contextual risks. Development and Psychopathology, 20, 55–77. doi:10.1017/S0954579408000035.

  6. Babinski, D. E., Waxmonsky, J. G., & Pelham Jr., W. E. (2014). Treating parents with attention-deficit/hyperactivity disorder: the effects of behavioral parent training and acute stimulant medication treatment on parent–child interactions. Journal of Abnormal Child Psychology, 42, 1129–1140. doi:10.1007/s10802-014-9864-y.

  7. Banks, T., Ninowski, J. E., Mash, E. J., & Semple, D. L. (2008). Parenting behavior and cognitions in a community sample of mothers with and without symptoms of attention-deficit/hyperactivity disorder. Journal of Child and Family Studies, 17, 28–43. doi:10.1007/s10826-007-9139-0.

  8. Barkley, R., & Murphy, K. (1998). Attention-deficit hyperactivity disorder: a clinical workbook (2nd ed.). New York: Guilford Press.

  9. Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology, 111, 279–289. doi:10.1037/0021-843X.111.2.279.

  10. Barkley, R. A., Knouse, L. E., & Murphy, K. R. (2011). Correspondence and disparity in the self- and other ratings of current and childhood ADHD symptoms and impairment in adults with ADHD. Psychological Assessment, 23, 437–446. doi:10.1037/a0022172.

  11. Biederman, J., Faraone, S., Keenan, K., Benjamin, J., Krifcher, B., Moore, C., et al. (1992). Further evidence for family-genetic risk factors in attention-deficit hyperactivity disorder. Archives of General Psychiatry, 49, 728–738. doi:10.1001/archpsyc.1992.01820090056010.

  12. Biederman, J., Petty, C. R., Wilens, T. E., Fraire, M. G., Purcell, C. A., Mick, E., et al. (2008). Familial risk analyses of attention deficit hyperactivity disorder and substance use disorders. The American Journal of Psychiatry, 165, 107–115. doi:10.1176/appi.ajp. 2007.07030419.

  13. Blazei, R. W., Iacono, W. G., & McGue, M. (2008). Father-child transmission of antisocial behavior: the moderating role of father’s presence in the home. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 406–415. doi:10.1097/CHI.0b013e3181642979.

  14. Bornovalova, M. A., Hicks, B. M., Iacono, W. G., & McGue, M. (2010). Familial transmission and heritability of childhood disruptive disorders. The American Journal of Psychiatry, 167, 1066–1074. doi:10.1176/appi.ajp.2010.09091272.

  15. Brammer, W. A., Galán, C. A., Mesri, B., & Lee, S. S. (2016). Parental ADHD and depression: time-varying prediction of offspring externalizing psychopathology. Journal of Clinical Child & Adolescent Psychology, 1–13. doi:10.1080/15374416.2016.1183495.

  16. Burt, S. A. (2009). Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences. Psychological Bulletin, 135, 608–637. doi:10.1037/a0015702.

  17. Burt, S. A., Larsson, H., Lichtenstein, P., & Klump, K. L. (2012). Additional evidence against shared environmental contributions to attention-deficit/hyperactivity problems. Behavior Genetics, 42, 711–721. doi:10.1007/s10519-012-9545-y.

  18. Chen, M., & Johnston, C. (2007). Maternal inattention and impulsivity and parenting behaviors. Journal of Clinical Child and Adolescent Psychology, 36, 455–468. doi:10.1080/15374410701448570.

  19. Chronis, A. M., Gamble, S. A., Roberts, J. E., & Pelham, W. E. (2006). Cognitive-behavioral depression treatment for mothers of children with attention-deficit/hyperactivity disorder. Behavior Therapy, 37, 143–158. doi:10.1016/j.beth.2005.08.001.

  20. Chronis-Tuscano, A., Raggi, V. L., Clarke, T. L., Rooney, M. E., Diaz, Y., & Pian, J. (2008). Associations between maternal attention-deficit/hyperactivity disorder symptoms and parenting. Journal of Abnormal Child Psychology, 36, 1237–1250. doi:10.1007/s10802-008-9246-4.

  21. Chronis-Tuscano, A., O’Brien, K. A, Johnston, C., Jones, H. A, Clarke, T. L., Raggi, V. L., … Seymour, K. E. (2011). The relation between maternal ADHD symptoms & improvement in child behavior following brief behavioral parent training is mediated by change in negative parenting. Journal of Abnormal Child Psychology, 39, 1047–1057. doi: 10.1007/s10802-011-9518-2

  22. Chronis-Tuscano, A., Clarke, T. L., O’Brien, K. A., Raggi, V. L., Diaz, Y., Mintz, A. D., et al. (2013). Development and preliminary evaluation of an integrated treatment targeting parenting and depressive symptoms in mothers of children with attention-deficit/hyperactivity disorder. Journal of Consulting and Clinical Psychology, 81, 918–925. doi:10.1037/a0032112.

  23. Counts, C. A., Nigg, J. T., Stawicki, J. A., Rappley, M. D., & Von Eye, A. (2005). Family adversity in DSM-IV ADHD combined and inattentive subtypes and associated disruptive behavior problems. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 690–698. doi:10.1097/01.chi.0000162582.87710.66.

  24. Doerr, M., & Teng, K. (2012). Family history: still relevant in the genomics era. Cleveland Clinic Journal of Medicine, 79, 331–336. doi:10.3949/ccjm.79a.11065.

  25. DuPaul, G. J., McGoey, K. E., Eckert, T. L., & VanBrakle, J. (2001). Preschool children with attention-deficit/hyperactivity disorder: impairments in behavioral, social, and school functioning. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 508–515. doi:10.1097/00004583-200105000-00009.

  26. Ellis, B., & Nigg, J. (2009). Parenting practices and attention-deficit/hyperactivity disorder: new findings suggest partial specificity of effects. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 146–154. doi:10.1097/CHI.0b013e31819176d0.

  27. Frick, P. J., Lahey, B. B., Christ, M. A. G., Loeber, R., & Green, S. (1991). History of childhood behavior problems in biological relatives of boys with attention-deficit hyperactivity disorder and conduct disorder. Journal of Clinical Child Psychology, 20, 445–451. doi:10.1207/s15374424jccp2004_14.

  28. Frick, P. J., Lahey, B. B., Loeber, R., Stouthamer-Loeber, M., Christ, M. A. G., & Hanson, K. (1992). Familial risk factors to oppositional defiant disorder and conduct disorder: parental psychopathology and maternal parenting. Journal of Consulting and Clinical Psychology, 60, 49–55. doi:10.1037/0022-006X.60.1.49.

  29. Galéra, C., Coté, S. M., Bouvard, M. P., Pingault, J.-B., Melchio, M., Michel, G., et al. (2011). Early risk factors for hyperactivity-impulsivity and inattention trajectories from age 17 months to 8 years. Archives of General Psychiatry, 68, 1267–1275. doi:10.1001/archgenpsychiatry.2011.138.

  30. Goodman, S. H., Rouse, M. H., Connell, A. M., Broth, M. R., Hall, C. M., & Heyward, D. (2011). Maternal depression and child psychopathology: a meta-analytic review. Clinical Child and Family Psychology Review, 14, 1–27. doi:10.1007/s10567-010-0080-1.

  31. Goos, L. M., Ezzatian, P., & Schachar, R. (2007). Parent-of-origin effects in attention-deficit hyperactivity disorder. Psychiatry Research, 149, 1–9. doi:10.1016/j.psychres.2006. 08.006.

  32. Grant, K. E., Compas, B. E., Thurm, A. E., McMahon, S. D., Gipson, P. Y., Campbell, A. J., et al. (2006). Stressors and child and adolescent psychopathology: evidence of moderating and mediating effects. Clinical Psychology Review, 26(3), 257–283. doi:10.1016/j.cpr.2005.06.011.

  33. Harvey, E., Danforth, J. S., Ulaszek, W. R., & Eberhardt, T. L. (2001). Validity of the parenting scale for parents of children with attention-deficit/hyperactivity disorder. Behaviour Research and Therapy, 39, 731–743. doi:10.1016/S0005-7967(00)00052-8.

  34. Harvey, E., Danforth, J. S., McKee, T., Ulaszek, W. R., & Friedman, J. L. (2003). Parenting of children with attention-deficit/hyperactivity disorder (ADHD): the role of parental ADHD symptomatology. Journal of Attention Disorders, 7, 31–42. doi:10.1177/108705470300700104.

  35. Harvey, E. A., Metcalfe, L. A., Herbert, S. D., & Fanton, J. H. (2011). The role of family experiences and ADHD in the early development of oppositional defiant disorder. Journal of Consulting and Clinical Psychology, 79, 784–795. doi:10.1037/a0025672.

  36. Hawes, D. J., Dadds, M. R., Frost, A. D. J., & Russell, A. (2013). Parenting practices and prospective levels of hyperactivity/inattention across early- and middle-childhood. Journal of Psychopathology and Behavioral Assessment, 35, 273–282. doi:10.1007/s10862-013-9341-x.

  37. Humphreys, K. L., Mehta, N., & Lee, S. S. (2012). Association of parental ADHD and depression with externalizing and internalizing dimensions of child psychopathology. Journal of Attention Disorders, 16, 267–275. doi:10.1177/1087054710387264.

  38. Johnston, C., & Mash, E. J. (2001). Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clinical Child and Family Psychology Review, 4, 183–207. doi:10.1023/A:1017592030434.

  39. Keown, L. J. (2012). Predictors of boys’ ADHD symptoms from early to middle childhood: the role of father-child and mother-child interactions. Journal of Abnormal Child Psychology, 40, 569–581. doi:10.1007/s10802-011-9586-3.

  40. Larson, K., Russ, S. A., Kahn, R. S., & Halfon, N. (2011). Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics, 127, 462–470. doi:10.1542/peds.2010-0165.

  41. Lavigne, J. V., LeBailly, S. A., Hopkins, J., Gouze, K. R., & Binns, H. J. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. Journal of Clinical Child & Adolescent Psychology, 38, 315–328. doi:10.1080/15374410902851382.

  42. LeMoine, K. A., Romirowsky, A. M., Woods, K. E., & Chronis-Tuscano, A. (2015). Paternal antisocial behavior (but not paternal ADHD) predicts negative parenting and child conduct problems. Journal of Attention Disorders, Advance Online Publication. doi:10.1177/1087054715604361.

  43. Macek, J., Gosar, D., & Tomori, M. (2012). Is there a correlation between ADHD symptom expression between parents and children? Neuroendocrinology Letters, 33, 201–206. Retrieved from

  44. Millon, T., & Davis, R. D. (1997). Manual for the Millon clinical multiaxial inventory-III (MCMI-III). Minneapolis, MN: National Computer Systems.

  45. Muthén, L. K., & Muthén, B. O. (1998-2012). Mplus user’s guide (seventh ed.). Los Angelos, CA: Muthén & Muthén.

  46. O’Connor, T. G., 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. British Journal of Psychiatry, 180, 502–508. doi:10.1192/bjp.180.6.502.

  47. Ramchandani, P., Stein, A., Evans, J., O’Connor, T. G., & ALSPAC Study Team (2005). Paternal depression in the postnatal period and child development: a prospective population study. The Lancet, 365, 2201–2205. doi:10.1016/S0140-6736(05)66778-5.

  48. Ramchandani, P. G., Stein, A., O’Connor, T. G., Heron, J., Murray, L., & Evans, J. (2008). Depression in men in the postnatal period and later child psychology: a population cohort study. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 390–398. doi:10.1097/CHI.0b013e31816429c2.

  49. Reynolds, C. R., & Kamphaus, R. W. (1992). Behavior assessment system for children: manual. Circle Pines, MN: American Guidance Service.

  50. Romirowsky, A. M., & Chronis-Tuscano, A. (2014). Paternal ADHD symptoms and child conduct problems: is father involvement always beneficial? Child: Care, Health, & Development, 40, 706–714. doi:10.1111/cch.12092.

  51. Rydell, A. M. (2010). Family factors and children’s disruptive behaviour: an investigation of links between demographic characteristics, negative life events and symptoms of ODD and ADHD. Social Psychiatry and Psychiatric Epidemiology, 45, 233–244. doi:10.1007/s00127-009-0060-2.

  52. Sanders, M. R., Markie-Dadds, C., Tully, L. A., & Bor, W. (2000). The triple P-positive parenting program: a comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68, 624–640. doi:10.1037/0022-006X.68.4.624.

  53. Sarason, I. G., Johnson, J. H., & Siegel, J. M. (1978). Assessing the impact of life changes: development of the life experiences survey. Journal of Consulting and Clinical Psychology, 46, 932–946. doi:10.1037/0022-006X.46.5.932.

  54. Sciberras, E., Ukoumunne, O. C., & Efron, D. (2011). Predictors of parent-reported attention-deficit/hyperactivity disorder in children aged 6-7 years: a national longitudinal study. Journal of Abnormal Child Psychology, 39, 1025–1034. doi:10.1007/s10802-011-9504-8.

  55. Segenreich, D., Paez, M. S., Regalla, M. A., Fortes, D., Faraone, S. V., Sergeant, J., & Mattos, P. (2015). Multilevel analysis of ADHD, anxiety and depression symptoms aggregation in families. European Child & Adolescent Psychiatry, 24, 525–536. doi:10.1007/s00787-014-0604-1.

  56. Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 28–38. doi:10.1097/00004583-200001000-00014.

  57. Sonuga-Barke, E. J., Daley, D., Thompson, M., Laver-Bradbury, C., & Weeks, A. (2001). Parent-based therapies for preschool attention-deficit/hyperactivity disorder: a randomized, controlled trial with a community sample. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 402–408. doi:10.1097/00004583-200104000-00008.

  58. Starck, M., Grünwald, J., & Schlarb, A. A. (2016). Occurrence of ADHD in parents of ADHD children in a clinical sample. Neuropsychiatric Disease and Treatment, 12, 581–588. doi:10.2147/NDT.S100238.

  59. Takeda, T., Stotesbery, K., Power, T., Ambrosini, P. J., Berrettini, W., Hakonarson, H., & Elia, J. (2010). Parental ADHD status and its association with proband ADHD subtype and severity. The Journal of Pediatrics, 157, 995–1000. doi:10.1016/j.jpeds.2010.05.053.

  60. Thomas, R., Sanders, S., Doust, J., Beller, E., & Glasziou, P. (2015). Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics, 135, e994–e1001. doi:10.1542/peds.2014-3482.

  61. Tully, E. C., Iacono, W. G., & McGue, M. (2008). An adoption study of parental depression as an environmental liability for adolescent depression and childhood disruptive disorders. American Journal of Psychiatry, 165, 1148–1154. doi:10.1176/appi.ajp.2008.07091438.

  62. Tung, I., Brammer, W. A., Li, J. J., & Lee, S. S. (2014). Parenting behavior mediates the intergenerational association of parent and child offspring ADHD symptoms. Journal of Clinical Child and Adolescent Psychology, 44, 787–799. doi:10.1080/15374416. 2014.913250.

  63. van Lieshout, M., Luman, M., Twisk, J. W. R., van Ewijk, H., Groenman, A. P., Thissen, A. J. A. M., et al. (2016). A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood. European Child & Adolescent Psychiatry, Advanced Online Publication. doi:10.1007/s00787-016-0820-y.

  64. Wooldridge, J. (2012). Introductory econometrics: a modern approach (5th ed.). Mason, OH: South-Western Cengage Learning.

  65. Zisser, A. R., & Eyberg, S. M. (2012). Maternal ADHD: parent-child interactions and relations with child disruptive behavior. Child & Family Behavior Therapy, 34, 33–52. doi:10.1080/07317107.2012.654450.

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This research was supported by a grant from the National Institutes of Health (MH60132) awarded to the third author.

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Correspondence to Elizabeth A. Harvey.

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Breaux, R.P., Brown, H.R. & Harvey, E.A. Mediators and Moderators of the Relation between Parental ADHD Symptomatology and the Early Development of Child ADHD and ODD Symptoms. J Abnorm Child Psychol 45, 443–456 (2017).

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  • ADHD
  • Parenting
  • Parental psychopathology
  • Family adversity
  • Oppositional defiant disorder