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Change in Maternal Stress for Families in Treatment for their Children with Oppositional Defiant Disorder

Abstract

Our objective was to predict change in maternal stress over the course of a randomized clinical trial comparing the efficacy of two interventions for Oppositional Defiant Disorder (ODD): Parent Management Training and Collaborative & Proactive Solutions. In a secondary analysis of data collected from this randomized clinical trial, we examined whether children’s self-reported positive relations with their parents impacted responsiveness to treatment, which in turn impacted maternal stress. One hundred thirty-four children and their parents (38.1% female, ages 7–14, M age = 9.51, SD = 1.77) were tracked across three time points: pre-treatment; one-week post-treatment; and six-month post-treatment. Hierarchical linear models tested change in children’s reports of positive relations with parents, clinician reports of ODD severity, and maternal reports of parenting stress. Models then tested multilevel mediation from positive relations with parents, through ODD severity, onto maternal stress. Hypothesized indirect effects were supported such that children’s reports of positive views toward parents uniquely predicted reductions in ODD severity over time, which in turn uniquely predicted reductions in maternal stress. Results highlight the promise of potential secondary benefits for parents following interventions for children with oppositional problems. Furthermore, results underscore the importance of the parent–child relationship as both a protective factor and as an additional target to complement interventions for child disruptive behaviors.

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References

  • Abidin, R. R. (1995). Parenting stress index-short form. Charlottesville, VA: Pediatric Psychology Press.

    Google Scholar 

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

    Book  Google Scholar 

  • Anderson, S. R., & Ollendick, T. H. (2012). Diagnosing oppositional defiant disorder using the anxiety disorders interview schedule for DSM-IV: Parent version and the diagnostic interview schedule for children. Journal of Psychopathology and Behavioral Assessment, 34, 467–475.

    Article  Google Scholar 

  • Anthony, L. G., Anthony, B. J., Glanville, D. N., Naiman, D. Q., Waanders, C., & Shaffer, S. (2005). The relationships between parenting stress, parenting behaviour and preschoolers’ social competence and behaviour problems in the classroom. Infant and Child Development, 14, 133–154. https://doi.org/10.1002/icd.385.

    Article  Google Scholar 

  • Barkley, R. A. (1997). Defiant children: A clinician’s manual for parent training (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Bates, D., Maechler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67, 1–48.

    Article  Google Scholar 

  • Bauer, D. J., Pracher, K. J., & Gil, K. M. (2006). Conceptualizing and testing random indirect effects and moderated mediation in multilevel models: New procedures and recommendations. Psychological Methods, 11, 142–163. https://doi.org/10.1037/1082-989X.11.2.142.

    Article  PubMed  Google Scholar 

  • Benzies, K. M., Harrison, M. J., & Magill-Evans, J. (2004). Parenting stress, marital quality, and child behavior problems at age 7 years. Public Health Nursing, 21, 111–121.

    Article  PubMed  Google Scholar 

  • Booker, J. A., & Dunsmore, J. C. (2017). Affective social competence in adolescence: Current findings and future directions. Social Development, 26, 3–20. https://doi.org/10.1111/sode.12193.

    Article  Google Scholar 

  • Booker, J. A., Ollendick, T. H., Dunsmore, J. C., & Greene, R. W. (2016). Perceived parent-child relations, conduct problems, and clinical improvement following the treatment of oppositional defiant disorder. Journal of Child and Family Studies, 25, 1623–1633. https://doi.org/10.1007/s10826-015-0323-3.

    Article  PubMed  Google Scholar 

  • Brestan, E. V., & Eyberg, S. M. (1998). Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids. Journal of Clinical Child Psychology, 27, 180–189. https://doi.org/10.1207/s15374424jccp2702_5.

    Article  PubMed  Google Scholar 

  • Burke, J. D., Pardini, D. A., & Loeber, R. (2008). Reciprocal relationships between parenting behavior and disruptive psychopathology from childhood through adolescence. Journal of Abnormal Child Psychology, 36, 679–692.

    Article  PubMed  PubMed Central  Google Scholar 

  • Campbell, S., Pierce, E., Moore, G., Marakovitz, S., & Newby, K. (1996). Boys’ externalizing problems at elementary school age: Pathways from early behavior problems, maternal control, and family stress. Development and Psychopathology, 8, 701–719.

    Article  Google Scholar 

  • Chaplin, T. M., & Aldao, A. (2013). Gender differences in emotion expression in children: A meta-analytic review. Psychological Bulletin, 139, 735–765.

    Article  PubMed  Google Scholar 

  • Core Team, R. (2016). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. https://www.R-project.org/.

    Google Scholar 

  • Crnic, K. A., Gaze, C., & Hoffman, C. (2005). Cumulative parenting stress across the preschool period: Relations to maternal parenting and child behaviour at age 5. Infant and Child Development, 14, 117–132. https://doi.org/10.1002/icd.384.

    Article  Google Scholar 

  • Crnic, K., & Greenberg, M. (1990). Minor parenting stresses with young children. Child Development, 61, 1628–1637.

    Article  PubMed  Google Scholar 

  • Deater-Deckard, K. (1998). Parenting stress and child adjustment: Some old hypotheses and new questions. Clinical Psychology: Science and Practice, 5, 314–332.

    Google Scholar 

  • Deater-Deckard, K., & Scarr, S. (1996). Parenting stress among dual-earner mothers and fathers: Are there gender differences? Journal of Family Psychology, 10, 45–59.

    Article  Google Scholar 

  • Graham, J. W., Olchowski, A. E., & Gilreath, T. D. (2007). How many imputations are really needed? Some practical clarifications of multiple imputation theory. Prevention Science, 8, 206–213.

    Article  PubMed  Google Scholar 

  • Greene, R. W. (1998). The explosive child. New York: Harper Collins.

    Google Scholar 

  • Greene, R. W., Biederman, J., & Zerwas, S. (2002). Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. American Journal of Psychiatry, 159, 1214–1224.

    Article  PubMed  Google Scholar 

  • Greene, R.W. (2010) Collaborative problem solving. In R. C. Murrihy, A. D. Kidman, & T. H. Ollendick (Eds.), Clinical handbook of assessing and treating conduct problems in youth (pp. 193–220). New York: Springer.

  • Hoza, B., Pelham, W. E., Dobbs, J., Owens, J. S., & Pillow, D. R. (2002). Do boys with attention-deficit/hyperactivity disorder have positive illusory self-concepts? Journal of Abnormal Psychology, 111, 268–278.

    Article  PubMed  Google Scholar 

  • IBM Corp. (2016). IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.

    Google Scholar 

  • Kazdin, A. E. (2005). Parent management training: Treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. New York: Oxford University Press.

    Google Scholar 

  • Kenny, D. A., Korchmaros, J. D., & Bolger, N. (2003). Lower level mediation in multilevel models. Psychological Methods, 8, 115–128.

    Article  PubMed  Google Scholar 

  • Kuznetsova, A., Brockhoff, P. B., & Christensen, R. H. B. (2016). lmerTest: Tests in linear mixed effects models. R package version 2.0.-.30. https://CRAN.R-project.org/package=lmerTest.

  • Larsson, B., Fossum, S., Clifford, G., Drugli, M. B., Handegård, B. H., & Mørch, W.-T. (2009). Treatment of oppositional defiant and conduct problems in young Norwegian children. European Child & Adolescent Psychiatry, 18, 42–52.

    Article  Google Scholar 

  • Laursen, B., & Mooney, K. S. (2008). Relationship network quality: adolescent adjustment and perceptions of relationships with parents and friends. American Journal of Orthopsychiatry, 78, 47–53.

    Article  PubMed  Google Scholar 

  • Lerner, R. M. (1982). Children and adolescents as producers of their own development. Developmental Review, 2, 342–370.

    Article  Google Scholar 

  • Loeber, R., Burke, J. D., Lahey, B. B., Winters, A., & Zera, M. (2000). Oppositional defiant and conduct disorder: A review of the past 10 years, part I. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1468–1484.

    Article  PubMed  Google Scholar 

  • Mackler, J. S., Kelleher, R. T., Shanahan, L., Calkins, S. D., Keane, S. P., & O’Brien, M. (2015). Parenting stress, parental reactions, and externalizing behavior from ages 4 to 10. Journal of Marriage and Family, 77, 388–406.

    Article  PubMed  Google Scholar 

  • Mikami, A. Y., & Lorenzi, J. (2011). Gender and conduct problems predict peer functioning among children with attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 40, 777–786.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mitchell, S. J., See, H. M., Tarkow, A. K. H., Cabrera, N., McFadden, K. E., & Shannon, J. D. (2007). Conducting studies with fathers: Challenges and opportunities. Applied Developmental Science, 11, 239–244.

    Article  Google Scholar 

  • Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., & Altman, D. G. (2010). CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. Journal of Clinical Epidemiology, 63, 1–37.

    Article  Google Scholar 

  • Murrihy, R. C., Kidman, A. D., & Ollendick, T. H. (2010). Clinical handbook of assessing and treating conduct problems in youth. New York: Springer.

    Google Scholar 

  • Nash, S. G., McQueen, A., & Bray, J. H. (2005). Pathways to adolescent alcohol use: Family environment, peer influence, and parental expectations. Journal of Adolescent Health, 37, 19–28.

    Article  PubMed  Google Scholar 

  • Nixon, R. D. V., Sweeney, L., Erickson, D. B., & Touyz, S. W. (2003). Parent-child interaction therapy: A comparison of standard and abbreviated treatments for oppositional defiant preschoolers. Journal of Counseling and Clinical Psychology, 71, 251–260.

    Article  Google Scholar 

  • Ollendick, T. H., Greene, R. W., Austin, K. E., Fraire, M. G., Halldorsdottir, T., Allen, K. B., & Wolff, J. C. (2016). Parent management training and collaborative & proactive solutions: A randomized control trial for oppositional youth. Journal of Clinical Child and Adolescent Psychology, 45, 591–604. https://doi.org/10.1080/15374416.2015.1004681.

    Article  PubMed  Google Scholar 

  • Perren, S., von Wyl, A., Burgin, D., Simoni, H., & von Klitzing, K. (2005). Depressive symptoms and psychosocial stress across the transition to parenthood: Associations with parental psychopathology and child difficulty. Journal of Psychosomatic Obsterics and Gynecology, 26, 173–183. https://doi.org/10.1080/01674820400028407.

    Article  Google Scholar 

  • Reitman, D., Currier, R. O., & Stickle, T. R. (2002). A critical evaluation of the parenting stress index-short form (PSI-SF) in a head start population. Journal of Clinical Child & Adolescent Psychology, 31, 384–392.

    Article  Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2000). Behavior assessment system for children (2nd ed.). Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Sanders, M. R. (1999). Triple P-positive parenting program: Towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clinical Child and Family Psychology Review, 2, 71–90.

    Article  PubMed  Google Scholar 

  • Selig, J. P., & Preacher, K. J. (2008, June). Monte Carlo method for assessing mediation: An interactive tool for creating confidence intervals for indirect effects [Computer software]. http://quantpsy.org/.

  • Silverman, W. K., & Albano, A. M. (1996). Anxiety disorders interview schedule for DSM-IV: Child and parent versions. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Sollie, H., Mørch, W.-T., & Larsson, B. (2016). Parent and family characteristics and their associates in a follow-up of outpatient children with ADHD. Journal of Child and Family Studies, 25, 2571–2584.

    Article  Google Scholar 

  • Theule, J., Wiener, J., Tannock, R., & Jenkins, J. M. (2013). Parenting stress in families of children with ADHD: A meta-analysis. Journal of Emotional and Behavioral Disorders, 21, 3–17.

    Article  Google Scholar 

  • von Salisch, M. (2001). Children’s emotional development: Challenges in their relationships to parents, peers, and friends. International Journal of Behavioral Development, 25, 310–319. https://doi.org/10.1080/01650250143000058.

    Article  Google Scholar 

  • Williford, A. P., Calkins, S. D., & Keane, S. P. (2007). Predicting change in parenting stress across early childhood: Child and maternal factors. Journal of Abnormal Child Psychology, 35, 251–263.

    Article  PubMed  Google Scholar 

  • Zhang, Z., Zyphur, M. J., & Preacher, K. J. (2009). Testing multilevel mediation using hierarchical linear models: Problems and solutions. Organizational Research Methods, 12, 695–719. https://doi.org/10.1177/1094428108327450.

    Article  Google Scholar 

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Acknowledgements

Funding was provided by R01 MH076141 from NIMH and by the Institute for Society, Culture, and Environment at Virginia Tech. We wish to express appreciation to the graduate students and research scientists who assisted us with various aspects of this project, including data reduction, assessment, and treatment of these youth. We also wish to extend thanks to the many undergraduate students at Virginia Tech who assisted us with data coding, entry, and verification. Finally, we are grateful to the youth and families who participated in this clinical research.

Author contributions

J.A.B.: Conducted the data analyses and contributed to writing the paper. N.N.C.-H.: Contributed to data analyses and writing the paper. J.C.D.: Contributed to the study design and editing the paper. R.W.G.: Co-designed the study, contributed to editing the paper. T.H.O.: PI of the grant supporting this research, co-designed and executed the study, contributed to writing and editing the paper.

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Correspondence to Jordan A. Booker.

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Conflict of Interest

R.W.G.: Received royalties related to work concerning Collaborative and Proactive Solutions. The remaining authors declare that they have no conflict of interest.

Ethics Statement

All procedures performed in this study were in accordance with the ethical standards of the overseeing institutional review board and with the 1964 Helsinki declaration and its later amendments.

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All participating families completed informed consent and informed assent before participating.

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Booker, J.A., Capriola-Hall, N.N., Dunsmore, J.C. et al. Change in Maternal Stress for Families in Treatment for their Children with Oppositional Defiant Disorder. J Child Fam Stud 27, 2552–2561 (2018). https://doi.org/10.1007/s10826-018-1089-1

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  • DOI: https://doi.org/10.1007/s10826-018-1089-1

Keywords

  • Oppositional defiant disorder
  • Parent–child relationship
  • Maternal stress