Journal of Abnormal Child Psychology

, Volume 30, Issue 4, pp 387–400 | Cite as

Mother–Child Relationships of Children with ADHD: The Role of Maternal Depressive Symptoms and Depression-Related Distortions

  • Terry C. Chi
  • Stephen P. Hinshaw
Article

Abstract

We investigated the DepressionDistortion hypothesis by examining the effects of maternal depressive symptoms on cross-informant discrepancies in reports of child behavior problems and several measures of parent–child relationship. The sample included ninety-six 6 to 10-year-old children diagnosed with ADHD-Combined Type, and their mothers, who provided baseline data before participating in a randomized clinical trial. Measures incorporated child characteristics, self-reports of maternal depressive symptoms, parenting practices, and laboratory mother–child interactions. Elevations in maternal depressive symptoms were associated with maternal reports of negative parenting style but not with observed laboratory interactions. Mothers' levels of depressive symptoms predicted negative biases in their reports of their child's ADHD symptoms, general behavior problems, and their own negative parenting style. Whereas levels of depressive symptoms did not predict observed parenting behaviors, maternal distortions did predict problematic parent–child interactions. Exploratory analyses showed a marginally significant mediation effect of the relationship between maternal depressive symptomatology and reports of negative parenting by depressive distortions. We discuss implications of linkages between depressive symptoms in mothers, depression-related distortions, and mother–child relationships for research and intervention in developmental psychopathology.

attention-deficit hyperactivity disorder depression-related distortions parenting styles parent–child interactions 

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REFERENCES

  1. Achenbach, T. M. (1991a). Manual for the Child Behavior Checklist and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry.Google Scholar
  2. Achenbach, T. M. (1991b). Manual for the Teacher's Report Form and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry.Google Scholar
  3. Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213-232.Google Scholar
  4. Ackerman, R., & DeRubeis, R. J. (1991). Is depressive realism real? Clinical Psychology Review, 11, 565-584.Google Scholar
  5. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  6. Barkley, R. A. (1998). Attention-deficit hyperactivity disorder: A hand-book for diagnosis and treatment (2nd ed.). New York: Guilford.Google Scholar
  7. Barkley, R. A., & Cunningham, C. E. (1979). The effects of methylphenidate on the mother-child interactions of hyperactive children. Archives of General Psychiatry, 36, 201-208.Google Scholar
  8. Barkley, R. A., Fischer, M., Edelbrock, C. S., & Smallish, L. (1991). The adolescent outcome of hyperactive children diagnosed by research criteria: III. Mother-child interactions, family conflicts, and maternal psychopathology. Journal of Child Psychology and Psychiatry, 32, 233-256.Google Scholar
  9. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182.Google Scholar
  10. Baumrind, D. (1971). Current patterns of parental authority. Developmental Psychology, 4, 1-103.Google Scholar
  11. Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100.Google Scholar
  12. Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.Google Scholar
  13. Biederman, J., Faraone, S. V., Taylor, A., Sienna, M., Williamson, S., & Fine, C. (1998). Diagnostic continuity between child and adolescent ADHD: Findings from a longitudinal clinical sample. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 305-313.Google Scholar
  14. Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention-deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry, 148, 564-577.Google Scholar
  15. Boyle, M. H., & Pickles, A. (1997). Maternal depressive symptoms and ratings of emotional disorder symptoms in children and adolescents. Journal of Child Psychology and Psychiatry, 38, 981-991.Google Scholar
  16. Chilcoat, H. D., & Breslau, N. (1997). Does psychiatric history bias mothers' reports? An application of a new analytic approach. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 971-979.Google Scholar
  17. Cohen, J., & Cohen, P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  18. Conners, C. K. (1997). Conners' rating scales—revised: Technical manual. North Tonawanda, NY: Multi-Health Systems.Google Scholar
  19. Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998a). The revised Conners' Parenting Rating Scale (CPRS-R): Factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 257-268.Google Scholar
  20. Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998b). Revision and restandardization of the Conners Teacher Rating Scale (CTRS-R): Factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.Google Scholar
  21. Cunningham, C. E., Benness, B. B., & Siegel, L. S. (1988). Family functioning, time allocation, and parental depression in the families of normal and ADDH children. Journal of Clinical Child Psychology, 17, 169-177.Google Scholar
  22. Fletcher, K., 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 discussions. Journal of Abnormal Child Psychology, 24, 271-297.Google Scholar
  23. Furman, W., & Giberson, R. S. (1995). Identifying the links between parents and their children's sibling relationships. In S. Shurman (Ed.), Close relationships in socioemotional development (pp. 95-108). Norwood, NJ: Ablex.Google Scholar
  24. Hinshaw, S. P. (2000). Attention-deficit/hyperactivity disorder: The search for viable treatments. In P. C. Kendall (Ed.), Child and adolescent therapy: Cognitive-behavioral procedures (2nd ed., pp. 88-128). New York: Guilford.Google Scholar
  25. Hinshaw, S. P., March, J. S., Abikoff, H., Arnold, L. E., Cantwell, D. P., Conners, C. K., et al. (1997). Comprehensive assessment of childhood attention-deficit hyperactivity disorder in the context of a multisite, multimodal clinical trial. Journal of Attention Disorders, 1, 217-234.Google Scholar
  26. Hinshaw, S. P., Owens, E. B., Wells, K. C., Kraemer, H. C., Abikoff, H. B., Arnold, L. E., et al. (2000). Family processes and treatment outcome in the MTA: Negative/ineffective parenting practices in relation to multimodal treatment. Journal of Abnormal Child Psychology, 28, 555-568.Google Scholar
  27. Holmbeck, G. N. (1997). Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures. Journal of Consulting and Clinical Psychology, 65, 599-610.Google Scholar
  28. Jensen, P. S., Martin, D., & Cantwell, D. P. (1997). Comorbidity in ADHD: Implications for research practice, and DSM-IV. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1065-1079.Google Scholar
  29. Jensen, P. S., Shervette, R. E., Xenakis, S. N., & Richters, J. E. (1993). Anxiety and depressive disorders in attention deficit disorder with hyperactivity: New findings. American Journal of Psychiatry, 150, 1203-1209.Google Scholar
  30. Johnston, C., (1996). Parent characteristics and parent-child interactions in families of nonproblem children and ADHD children with higher and lower levels of oppositional-defiant behavior. Journal of Abnormal Child Psychology, 24, 85-104.Google Scholar
  31. Johnston, C., & Mash, E. (2001). Families of children with Attention-deficit/hyperactivity disorder: Review and recommendations for future research. Clinical Child and Family Psychology Review, 4, 183-207.Google Scholar
  32. Kenny, D. A. (2001, February). Mediation. Retrieved from http://users. rcn.com/dakenny/mediate.htm.Google Scholar
  33. Landis, J., & Koch, G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159-174.Google Scholar
  34. Laufer, M., & Denhoff, E. (1957). Hyperkinetic behavior syndrome in children. Journal of Pediatrics, 50, 463-474.Google Scholar
  35. Lovejoy, M.C. (1991). Maternal depression: Effects on social cognition and behavior in parent-child interactions. Journal of Abnormal Child Psychology, 19, 693-706.Google Scholar
  36. Maccoby, E. E. (2000). Parenting and its effects on children: On reading and misreading behavior genetics. Annual Review of Psychology, 51, 1-27.Google Scholar
  37. Mannuzza, S., & Klein, R. G. (1999). Adolescent and adult outcomes in attention-deficit/hyperactivity disorder. In H. C. Quay & A. E. Hogan (Eds.), Handbook of disruptive behavior disorders (pp. 279-294). New York: Kluwer Academic/Plenum.Google Scholar
  38. McDermut, J. F., Haaga, D. A. F., & Bilek, L. A. (1997). Cognitive bias and irrational beliefs in major depression and dysphoria. Cognitive Therapy and Research, 21, 459-476.Google Scholar
  39. MTA Cooperative Group. (1999a). A 14-month randomized clinical trial of treatment strategies for attention deficit hyperactivity disorder. Archives of General Psychiatry, 56, 1073-1086.Google Scholar
  40. MTA Cooperative Group. (1999b). Effects of co-morbid anxiety disorder, family poverty, session attendance, and community medication on treatment outcome for attention deficit hyperactivity disorder. Archives of General Psychiatry, 56, 1088-1096.Google Scholar
  41. Najman, J. M., Williams, G. M., Nikles, J., Spence, S., Bor, W., O'Callaghan, M., et al. (2000). Mothers mental illness and child behavior problems: Cause-effect association or observation bias? Journal of the American Academy of Child and Adolescent Psychiatry, 39, 592-602.Google Scholar
  42. Nigg, J. T., & Hinshaw, S. P. (1998). Parent personality traits and psychopathology associated with antisocial behaviors in childhood attention-deficit hyperactivity disorder. Journal of Child Psychology, Psychiatry and Allied Disciplines, 39, 145-159.Google Scholar
  43. Patterson, G. R. (1995). Coercion as a basis for early age of onset for arrest. In J. McCord (Ed.), Coercion and punishment in long-term perspectives (pp. 81-105). New York: Cambridge University Press.Google Scholar
  44. Pelton, J., & Forehand, R. (2001). Discrepancy between mother and child perceptions of their relationship: I. Consequences for adolescents considered within the context of parental divorce. Journal of Family Violence, 16, 1-15.Google Scholar
  45. Pelton, J., Steele, R. G., Chance, M. W., & Forehand, R. (2001). Discrepancy between mother and child perceptions of their relationship: II. Consequences for children considered within the context of maternal physical illness. Journal of Family Violence, 16, 17-35.Google Scholar
  46. Pliszka, S. R., Carlson, C. L., & Swanson, J. M. (1999). ADHD with comorbid disorders: Clinical assessment and management. New York: Guilford.Google Scholar
  47. Preacher, K. J., & Leonardelli, G. J. (2001, April). Calculation for the Sobel test: An interactive calculation tool for mediation tests. Retrieved from http://quantrm2.psy.ohio-state.edu/kris/sobel/sobel.htm.Google Scholar
  48. Reiss, D., Hetherington, M., Plomin, R., & Howe, G. W. (1995). Genetic questions for environmental studies: Differential parenting and psychopathology in adolescence. Archives of General Psychiatry, 52, 925-936.Google Scholar
  49. Richters, J. E. (1992). Depressed mothers as informants about their children: A critical review of the evidence for distortion. Psychological Bulletin, 112, 485-499.Google Scholar
  50. Sawyer, M. G., Streiner, D. L., & Baghurst, P. (1998). The influence of distress on mothers' and fathers' reports of childhood emotional and behavioral problems. Journal of Abnormal Child Psychology, 26, 407-414.Google Scholar
  51. Shelton, K. K., Frick, P. J., & Wootton, J. (1996). Assessment of parenting practices in families of elementary school-age children. Journal of Clinical Child Psychology, 25, 317-329.Google Scholar
  52. Sobel, M. E. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. In S. Leinhardt (Ed.), Sociological methodology 1982. (pp. 290-312). Washington, DC: American Sociological Association.Google Scholar
  53. Stark, K. D., Schmidt, K. L., & Joiner, T. E. (1996). Cognitive triad: Relationship to depressive symptoms, parents' cognitive triad, and perceived parental messages. Journal of Abnormal Child Psychology, 24, 615-631.Google Scholar
  54. Stormshak, E. A., Speltz, M. L., DeKlyen, M., & Greenberg, M. T. (1997). Observed family interactions during clinical interviews: A comparison of families containing preschool boys with and without disruptive behavior. Journal of Abnormal Child Psychology, 25, 345-358.Google Scholar
  55. Tannock, R. (1998). Attention deficit hyperactivity disorder: Advances in cognitive, neurobiological, and genetic research. Journal of Child Psychology, Psychiatry, and Allied Disciplines, 39, 65-99.Google Scholar
  56. Youngstrom, E., Izard, C., & Ackerman, B. (1999). Dysphoria-related bias in maternal ratings of children. Journal of Consulting and Clinical Psychology, 67, 905-916.Google Scholar
  57. Youngstrom, E., Loeber, R., & Stouthamer-Loeber, M. (2000). Patterns and correlates of agreement between parent, teacher, and male adolescent ratings of externalizing and internalizing problems. Journal of Consulting and Clinical Psychology, 68, 1038-1050.Google Scholar
  58. Wechsler, D. (1991). Wechsler intelligence scale for children (3rd ed.). New York: Psychological Corporation.Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Terry C. Chi
    • 1
  • Stephen P. Hinshaw
  1. 1.University of CaliforniaBerkeleyCalifornia

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