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

Abstract

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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Notes

  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.

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Acknowledgments

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

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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). https://doi.org/10.1007/s10802-016-0213-1

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Keywords

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