Skip to main content

Parenting Stress during Late Adolescence in Mothers of Individuals with ADHD with and without ODD

Abstract

Although children with ADHD continue to experience impairment well into adolescence, research exploring the experiences of their parents during late adolescence is lacking. Thus, we examined changes in parenting stress and family conflict in mothers of adolescents with ADHD during the transition to early adulthood. We also explored predictors of these changes in addition to investigating differences in these trajectories due to comorbid ODD. Forty-nine mothers of adolescents with ADHD only and thirty-seven mothers of adolescents with ADHD/ODD reported on parenting stress and perceptions of family conflict at baseline (mean age = 16.88) and at 3-month, 9-month, and 15-month follow up assessments. Growth curve modeling indicated that both groups of mothers reported relative declines in parenting stress and family conflict across time. However, the mothers of adolescents with ADHD/ODD persistently reported more stress and conflict. Furthermore, decreases in family conflict were more predictive of reduced parenting stress in families of adolescents only diagnosed with ADHD. Our findings suggest that comorbid ODD is associated with parenting stress during late adolescence. Thus, interventions should focus on further reducing this stress as adolescents with ADHD/ODD transition to adulthood.

Highlights

  • We explored parenting stress in mothers of adolescents with ADHD in late adolescence.

  • All mothers experienced reductions in maternal stress during this period.

  • Mothers of adolescents with ADHD and comorbid ODD reported higher levels of stress than mothers of adolescents with ADHD only.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Abidin, R. R. (1992). The determinants of parenting behavior. Journal of Clinical Child Psychology, 21(4), 407–412. https://doi.org/10.1207/s15374424jccp2104_12.

    Article  Google Scholar 

  2. Abidin, R. R., & Brunner, J. F. (1995). Development of a parenting alliance inventory. Journal of Clinical Child Psychology, 24(1), 31–40.

    Article  Google Scholar 

  3. Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles. Research Center for Children, Youth, and Families.

  4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Publishing.

    Book  Google Scholar 

  5. Anderson, S. B., & Guthery, A. M. (2015). Mindfulness-based psychoeducation for parents of children with attention-deficit/hyperactivity disorder: an applied clinical project. Journal of Child and Adolescent Psychiatric Nursing, 28(1), 43–49. https://doi.org/10.1111/jcap.12103.

    Article  PubMed  Google Scholar 

  6. Barber, B. K., Maughan, S. L., & Olsen, J. A. (2005). Patterns of parenting across adolescence. In J. Smetana, J. Smetana (Eds.), Changing Boundaries of Parental Authority during Adolescence (pp. 5–16). Jossey-Bass.

  7. Barkley, R. A., Anastopoulos, A. D., Guevremont, D. C., & Fletcher, K. E. (1992). Adolescents with attention deficit hyperactivity disorder: Mother-adolescent interactions, family beliefs and conflicts, and maternal psychopathology. Journal of Abnormal Child Psychology, 20(3), 263–288. https://doi.org/10.1007/BF00916692.

    Article  PubMed  Google Scholar 

  8. Branje, S. (2018). Development of parent–adolescent relationships: Conflict interactions as a mechanism of change. Child Development Perspectives, 12(3), 171–176.

    Article  Google Scholar 

  9. Brannan, A. M., Heflinger, C. A., & Bickman, L. (1997). The caregiver strain questionnaire: Measuring the impact on the family of living with a child with serious emotional disturbance. Journal of Emotional and Behavioral Disorders, 5(4), 212–222. https://doi.org/10.1177/106342669700500404.

    Article  Google Scholar 

  10. Biederman, J., Petty, C. R., Evans, M., Small, J., & Faraone, S. V. (2010). How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD. Psychiatry Research, 177(3), 299–304. https://doi.org/10.1016/j.psychres.2009.12.010.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Booker, J. A., Capriola-Hall, N. N., Dunsmore, J. C., Greene, R. W., & Ollendick, T. H. (2018). Change in maternal stress for families in treatment for their children with oppositional defiant disorder. Journal of Child Family Studies, 27(8), 2552–2561. https://doi.org/10.1007/s10826-018-1089-1.

    Article  PubMed  Google Scholar 

  12. Brown, C. A., Granero, R., & Ezpeleta, L. (2017). The reciprocal influence of callous-unemotional traits, oppositional defiant disorder and parenting practices in preschoolers. Child Psychiatry and Human Development, 48(2), 298–307. https://doi.org/10.1007/s10578-016-0641-8.

    Article  PubMed  Google Scholar 

  13. Bussing, R., Gary, F. A., Mason, D. M., Leon, C. E., Sinha, K., & Garvan, C. W. (2003). Child temperament, ADHD and caregiver strain: Exploring relationships in an epidemiological sample. Journal of the American Academy of Child & Adolescent Psychiatry, 42(2), 184–192. https://doi.org/10.1097/00004583-200302000-00012.

    Article  Google Scholar 

  14. Deault, L. C. (2010). A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry and Human Development, 41(2), 168–192. https://doi.org/10.1007/s10578-009-0159-4.

    Article  PubMed  Google Scholar 

  15. Dishion, T. J., Nelson, S. E., & Bullock, B. M. (2004). Premature adolescent autonomy: Parent Disengagement and deviant peer process in the amplification of problem behaviour. Journal of Adolescence, 27(5), 515–530. https://doi.org/10.1016/j.adolescence.2004.06.005.

    Article  PubMed  Google Scholar 

  16. Dixon, S. V., Graber, J. A., & Brooks-Gunn, J. (2008). The roles of respect for parental authority and parenting practices in parent-child conflict among African American, Latino, and European American families. Journal of Family Psychology, 22(1), 1.

    Article  Google Scholar 

  17. Edwards, G., Barkley, R. A., Laneri, M., Fletcher, K., & Metevia, L. (2001). Parent–adolescent conflict in teenagers with ADHD and ODD. Journal of Abnormal Child Psychology, 29(6), 557–572. https://doi.org/10.1023/A:1012285326937.

    Article  PubMed  Google Scholar 

  18. Evans, S. W., Brady, C. E., Harrison, J. R., Bunford, N., Kern, L., State, T., & Andrews, C. (2013). Measuring ADHD and ODD symptoms and impairment using high school teachers’ ratings. Journal of Clinical Child and Adolescent Psychology, 42(2), 197–207. https://doi.org/10.1080/15374416.2012.738456.

    Article  PubMed  Google Scholar 

  19. Evans, S. W., Sibley, M., & Zewelanji, N. S. (2009). Changes in caregiver strain over time in young adolescents with ADHD. Journal of Attention Disorders, 12(6), 516–524. https://doi.org/10.1177/1087054708322987.

    Article  PubMed  Google Scholar 

  20. Faraone, S. V., Biederman, J., & Mick, E. (2006). The age-dependent decline of attention deficit hyperactivity disorder: A meta-analysis of follow-up studies. Psychological Medicine, 36(2), 159–165. https://doi.org/10.1017/S003329170500471X.

    Article  PubMed  Google Scholar 

  21. Fabiano, G. A., Pelham, W. J., Waschbusch, D. A., Gnagy, E. M., Lahey, B. B., Chronis, A. M., Onyango, A. N., Kipp, H., & Burrows-MacLean, L. (2006). A practical measure of impairment: Psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. Journal of Clinical Child and Adolescent Psychology, 35(3), 369–385. https://doi.org/10.1207/s15374424jccp3503_3.

    Article  PubMed  Google Scholar 

  22. Fletcher, K. E., Fischer, M., Barkley, R. A., & Smallish, L. (1996). A sequential analysis of the mother-adolescent interactions of ADHD, ADHD/ODD, and normal teenagers during neutral and conflict discussions. Journal of Abnormal Child Psychology, 24(3), 271–297.

    Article  Google Scholar 

  23. Garson, D. (2013). Hierarchical linear modeling guide and applications. Sage.

  24. Gordon, C. T., & Fabiano, G. A. (2019). The transition of youth with ADHD into the workforce: Review and future directions. Clinical Child and Family Psychology Review, 22, 316–347.

    Article  Google Scholar 

  25. Gordon, C. T., & Hinshaw, S. P. (2017). Parenting stress and youth symptoms among girls with and without attention-deficit/hyperactivity disorder. Parenting: Science and Practice, 17(1), 11–29. https://doi.org/10.1080/15295192.2016.1262178.

    Article  Google Scholar 

  26. Graziano, P. A., McNamara, J. P., Geffken, G. R., & Reid, A. (2011). Severity of children’s ADHD symptoms and parenting stress: A multiple mediation model of self-regulation. Journal of Abnormal Child Psychology, 39(7), 1073–1083. https://doi.org/10.1007/s10802-011-9528-0.

    Article  PubMed  Google Scholar 

  27. Greene, R. W., Ablon, J. S., Goring, J. C., Raezer-Blakely, L., Markey, J., Monuteaux, M. C., Henin, A., Edwards, G., & Rabbitt, S. (2004). Effectiveness of collaborative problem solving in affectively dysregulated children with oppositional-defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72(6), 1157–1164. https://doi.org/10.1037/0022-006X.72.6.1157.

    Article  PubMed  Google Scholar 

  28. Gregory, A., Fabiano Nicole, K., Schatz Karen, L. Morris Michael, T., Willoughby Rebecca, K., Vujnovic Kevin, F., Hulme, Jessica., Riordan, Marlana., Howard, Dwight. Hennessy, Kemper. Lewis, Larry. Hawk, Amanda. & Wylie William, E Pelham. (2016). Efficacy ofa family-focused intervention for young drivers with attention-deficit hyperactivity disorder. Journal of Consulting and Clinical Psychology, 84, 1078–1093. https://doi.org/10.1037/ccp0000137.

    Article  Google Scholar 

  29. Haack, L. M., Villodas, M., McBurnett, K., Hinshaw, S., & Pfiffner, L. J. (2017). Parenting as a mechanism of change in psychosocial treatment for youth with ADHD, predominantly inattentive presentation. Journal of Abnormal Child Psychology, 45(5), 841–855. https://doi.org/10.1007/s10802-016-0199-8.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Harold, G. T., Leve, L. D., Barrett, D., Elam, K., Neiderhiser, J. M., Natsuaki, M. N., Shaw, D. S., Reiss, D., & Thapar, A. (2013). Biological and rearing mother influences on child ADHD symptoms: Revisiting the developmental interface between nature and nurture. Journal of Child Psychology and Psychiatry, 54(10), 1038–1046. https://doi.org/10.1111/jcpp.12100.

    Article  PubMed  Google Scholar 

  31. Howard, A. L., Strickland, N. J., Murray, D. W., Tamm, L., Swanson, J. M., Hinshaw, S. P., Arnold, B. S. G., & Molina, B. G. (2016). Progression of impairment in adolescents with attention-deficit/hyperactivity disorder through the transition out of high school: Contributions of parent involvement and college attendance. Journal of Abnormal Psychology, 125(2), 233–247. https://doi.org/10.1037/abn0000100.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hudec, K. L., & Mikami, A. Y. (2018). Diagnostic issues for ODD/CD with ADHD comorbidity. In J. E. Lochman & W. Matthys (Eds.), The Wiley handbook of disruptive and impulse-control disorders (pp. 55–71). Wiley Blackwell.

  33. Huq, N., Stein, G. L., & Gonzalez, L. M. (2016). Acculturation conflict among Latino youth: Discrimination, ethnic identity, and depressive symptoms. Cultural Diversity and Ethnic Minority Psychology, 22(3), 377.

    Article  Google Scholar 

  34. Johnston, C., & Chronis-Tuscano, A. (2015). Families and ADHD. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment., 4th ed. (pp. 191–209). The Guilford Press.

  35. Johnston, C., Murray, C., Hinshaw, S. P., Pelham, W. J., & Hoza, B. (2002). Responsiveness in interactions of mothers and sons with ADHD: Relations to maternal and child characteristics. Journal of Abnormal Child Psychology, 30(1), 77–88. https://doi.org/10.1023/A:1014235200174.

    Article  PubMed  Google Scholar 

  36. Juang, L. P., Hou, Y., Bayless, S. D., & Kim, S. Y. (2018). Time-varying associations of parent–adolescent cultural conflict and youth adjustment among Chinese American families. Developmental psychology, 54(5), 938.

    Article  Google Scholar 

  37. Lamb, M. E. (Ed.). (2004). The role of the father in child development. John Wiley & Sons.

  38. Lamb, M. E. (2010). How do fathers influence children’s development? Let me count the ways. In M. E. Lamb (Ed.), The role of the father in child development (pp. 1–26). John Wiley & Sons Inc.

  39. Laursen, B., Coy, K. C., & Collins, W. A. (1998). Reconsidering changes in parent–child conflict across adolescence: A meta-analysis. Child Development, 69(3), 817–832. https://doi.org/10.2307/1132206.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Markel, C., & Wiener, J. (2014). Attribution processes in parent–adolescent conflict in families of adolescents with and without ADHD. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 46(1), 40.

    Article  Google Scholar 

  41. Maughan, B., Rowe, R., Messer, J., Goodman, R., & Meltzer, H. (2004). Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. Journal of Child Psychology and Psychiatry, 45(3), 609–621.

    Article  Google Scholar 

  42. Molina, B. S. G., Howard, A. L., Swanson, J. M., Stehli, A., Mitchell, J. T., Kennedy, T. M., Epstein, J. N., Arnold, L. E., Hechtman, L., Vitiello, B., & Hoza, B. (2018). Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: findings from the MTA longitudinal study. Journal of Child Psychology and Psychiatry. Advance online publication. https://doi.org/10.1111/jcpp.12855.

    Article  Google Scholar 

  43. Nomaguchi, K., & Milkie, M. A. (2017). Sociological perspectives on parenting stress: How social structure and culture shape parental strain and the well-being of parents and children. In Parental stress and early child development (pp. 47–73). Springer/

  44. Pelham, W. J., Fabiano, G. A., & Massetti, G. M. (2005). Evidence-Based Assessment of Attention Deficit Hyperactivity Disorder in Children and Adolescents. Journal of Clinical Child and Adolescent Psychology, 34(3), 449–476. https://doi.org/10.1207/s15374424jccp3403_5.

    Article  PubMed  Google Scholar 

  45. Pelham, W. E., Gnagy, E. M., Greenslade, K. E., & Milich, R. (1992). Teacher ratings of DSM-III—R symptoms for the disruptive behavior disorders. Journal of The American Academy of Child & Adolescent Psychiatry, 31(2), 210–218. https://doi.org/10.1097/00004583-199203000-00006.

    Article  Google Scholar 

  46. Pettit, G. S., Keiley, M. K., Laird, R. D., Bates, J. E., & Dodge, K. A. (2007). Predicting the developmental course of mother-reported monitoring across childhood and adolescence from early proactive parenting, child temperament, and parents’ worries. Journal of Family Psychology, 21(2), 206–217. https://doi.org/10.1037/0893-3200.2.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Podolski, C., & Nigg, J. T. (2001). Parent stress and coping in relation to child ADHD severity and associated child disruptive behavior problems. Journal of Clinical Child Psychology, 30(4), 503–513. https://doi.org/10.1207/S15374424JCCP3004_07.

    Article  PubMed  Google Scholar 

  48. Prinz, R. J., Foster, S., Kent, R. N., & O’Leary, K. D. (1979). Multivariate assessment of conflict in distressed and nondistressed mother-adolescent dyads. Journal of Applied Behavior Analysis, 12, 691–700. https://doi.org/10.1901/jaba.1979.12-691.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Rajwan, E., Chacko, A., Wymbs, B. T., & Wymbs, F. A. (2014). Evaluating clinically significant change in mother and child functioning: comparison of traditional and enhanced behavioral parent training. Journal of Abnormal Child Psychology, 42(8), 1407–1412. https://doi.org/10.1007/s10802-014-9877-6.

    Article  PubMed  Google Scholar 

  50. Robin, A. L. & Foster, S. L. (1989). Negotiating Parent-Adolescent Conflict: A Behavioral-Family Systems Approach. Guilford Press.

  51. Seipp, C. M., & Johnston, C. (2005). Mother-Son Interactions in Families of Boys with Attention-Deficit/Hyperactivity Disorder with and Without Oppositional Behavior. Journal of Abnormal Child Psychology, 33(1), 87–98. https://doi.org/10.1007/s10802-005-0936-x.

    Article  PubMed  Google Scholar 

  52. Sibley, M. H., Pelham, Jr, W. E., Molina, B. S., Gnagy, E. M., Waxmonsky, J. G., Waschbusch, D. A., & Kuriyan, A. B. (2012). When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. Journal of consulting and clinical psychology, 80(6), 1052.

    Article  Google Scholar 

  53. Steinberg, L., & Silk, J. S. (2002). Parenting adolescents. In M. H. Bornstein, M. H. Bornstein (Eds.), Handbook of parenting: Children and parenting (pp. 103–133). Lawrence Erlbaum Associates Publisher.

  54. 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(1), 3–17.

    Article  Google Scholar 

  55. Wiener, J., Biondic, D., Grimbos, T., & Herbert, M. (2016). Parenting stress of parents of adolescents with attention-deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 44(3), 561–574. https://doi.org/10.1007/s10802-015-0050-7.

    Article  PubMed  Google Scholar 

  56. Yoshimasu, K., Barbaresi, W. J., Colligan, R. C., Voigt, R. G., Killian, J. M., Weaver, A. L., & Katusic, S. K. (2012). Childhood ADHD is strongly associated with a broad range of psychiatric disorders during adolescence: A population-based birth cohort study. Journal of Child Psychology and Psychiatry, 53(10), 1036–1043. https://doi.org/10.1111/j.1469-7610.2012.02567.x.

    Article  PubMed  Google Scholar 

Download references

Funding

This investigation utilizes data from a project funded by the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number 1R01HD058588).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Chanelle T. Gordon.

Ethics declarations

Conflict of Interest

G.A.F. has received investigator-initiated research grants from Shire Pharmaceuticals and Adlon Therapeutics. The other authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Gordon, C.T., Fabiano, G.A., Schatz, N.K. et al. Parenting Stress during Late Adolescence in Mothers of Individuals with ADHD with and without ODD. J Child Fam Stud 30, 2966–2979 (2021). https://doi.org/10.1007/s10826-021-02131-x

Download citation

Keywords

  • ADHD
  • ODD
  • Parent-child relationships
  • Parenting stress
  • Family conflict