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Budman JR, Fogel-Grinvald H, Maeir A. Psychological Health and Quality of Life among Ultra-orthodox Mothers of Children with Attention Deficit Hyperactivity Disorder: Impact of Occupational Experiences. Phys Occup Ther Pediatr 2023; 43:697-712. [PMID: 36922732 DOI: 10.1080/01942638.2023.2188077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Attention Deficit Hyperactivity Disorder (ADHD) is a common neuro-developmental health condition in children and adolescents. Parenting a child with ADHD can profoundly affect mothers' health. Research is limited regarding occupational experiences and their impact on health among mothers of children with ADHD (MoCwADHD). Ultra-orthodox MoCwADHD may have unique cultural circumstances that have not been studied. AIMS To broaden understanding of parental stress, psychological health, and quality of life (QoL) of ultra-orthodox MoCwADHD and explore a possible role of occupational experiences on these outcomes. METHODS Ultra-orthodox MoCwADHD (N = 114) completed a sociodemographic questionnaire and measurements to assess child ADHD symptomatology, mother's ADHD, parental stress, psychological health, QoL, and occupational experiences. RESULTS Participants displayed moderate parental stress, and 54.9 percent also showed psychological distress symptoms, similar to the literature on MoCwADHD in the general population. Frequency of engagement in health promoting occupations reflected patterns in line with cultural beliefs. Structure Equation Modeling showed that child ADHD negatively affected mothers' stress, psychological health and QoL. Importantly, occupational experiences directly and indirectly, via parental stress, impacted psychological health and QoL. CONCLUSIONS MoCwADHD impacts maternal health in the ultra-orthodox population and occupational experiences may be a modifiable target for promoting their health.
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Affiliation(s)
- Jennifer R Budman
- School of Occupational Therapy, Faculty of Medicine of the Hebrew University, Jerusalem, Israel
| | - Haya Fogel-Grinvald
- School of Occupational Therapy, Faculty of Medicine of the Hebrew University, Jerusalem, Israel
| | - Adina Maeir
- School of Occupational Therapy, Faculty of Medicine of the Hebrew University, Jerusalem, Israel
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2
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Piscitello J, Altszuler AR, Mazzant JR, Babinski DE, Gnagy EM, Page TF, Molina BSG, Pelham WE. The Impact of ADHD on Maternal Quality of Life. Res Child Adolesc Psychopathol 2022; 50:1275-1288. [PMID: 35648330 PMCID: PMC9613519 DOI: 10.1007/s10802-022-00935-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 11/24/2022]
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) is associated with substantial burden to caregiver quality of life (QoL). However, a paucity of work has focused on quantifying QoL among caregivers of adolescents with a history of ADHD. The purpose of the current study was (1) to quantify maternal QoL in a sample of mothers of adolescents with and without childhood ADHD; and (2) to examine predictors (i.e., parent and child characteristics and behavior) associated with maternal QoL. Participants included mothers of adolescents with (N = 110) and without ADHD (N = 90) ranging in age from 13 to 18 (M = 16.09, 92% male). The Quality Adjusted Life-Year (QALY) was used to calculate maternal QoL using two health domains (i.e., anxiety/depression and disruption in daily activities) commonly impacted by raising youth with ADHD. QALYs are valued monetarily to estimate disease burden. Mothers of adolescents with childhood ADHD experienced significantly worse QoL relative to mothers in the comparison group. Maternal depression, as well as adolescent age, ADHD status, and discipline problems significantly predicted lower levels of maternal QALY health status index, with ADHD being the strongest predictor. This is equal to a reduction in 1.96 QALYs when summed over the course of a child's lifetime and is associated with a loss of $98,000 to $196,000. Results of the investigation help to further elucidate the health impacts incurred by families of adolescents with ADHD and have important public health implications. Further, parental QoL should be considered when conceptualizing the financial and negative health impact of ADHD.
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Affiliation(s)
- Jennifer Piscitello
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US.
| | - Amy R Altszuler
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US
| | - Jessica Robb Mazzant
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US
| | - Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, US
| | - Elizabeth M Gnagy
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US
| | - Timothy F Page
- Department of Management, H. Wayne Huizenga College of College of Business and Entrepreneurship, Nova Southeastern University, Davie, FL, US
| | - Brooke S G Molina
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, US
| | - William E Pelham
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US
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3
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Babinski DE, Sibley MH. Family-based treatments for attention-deficit/hyperactivity disorder: A review of family functioning outcomes in randomized controlled trials from 2010 to 2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:83-106. [PMID: 34779516 DOI: 10.1111/jmft.12572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/31/2021] [Indexed: 06/13/2023]
Abstract
This review details advances in randomized controlled trials of family-based treatments for attention-deficit/hyperactivity disorder (ADHD) conducted in the United States from 2010 to 2019, and the impact of these treatments on the domain of family functioning. Twenty-two studies were included in the review and three types of family treatments, integrated parent-child treatments, parent-directed treatments, and youth treatments with adjunctive parent involvement, were identified for children and adolescents. Studies point to considerable advancements in consideration of understudied and diverse populations, and results of the review show all three types of family interventions for ADHD should be considered well-established interventions addressing family functioning. Practical guidelines are offered, and future directions for research are discussed.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Margaret H Sibley
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
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Tiwawatpakorn N, Worachotekamjorn J, Tassanakijpanich N. Effectiveness of Parenting Training on Emotional and Behavioral Problems in First through Fourth Grade Thai Children with ADHD: A Randomized Controlled Study. Psychol Rep 2021; 125:2470-2484. [PMID: 34154470 DOI: 10.1177/00332941211026846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of parenting training on emotional and behavioral problems of first through fourth grade Thai children with ADHD compared with routine clinical care in a university hospital in southern Thailand. MATERIAL AND METHODS Caregivers of the children were invited and assessed for eligibility. Eighty children with ADHD were randomly assigned to either a parenting training group or a routine clinical care group. The primary caregivers of the parenting training group participated in 6 120-minute weekly sessions in addition to routine clinical care. Caregiver and teacher ADHD ratings and oppositional-defiant disorder ratings were collected at the time of enrollment and after the 6 weeks of training in both groups. The differences in scores in both groups were analyzed using a mixed model ANOVA. RESULTS Each arm had 40 participants. The mean (SD) age of the children was 8.3 (1.1) years and their mean (SD) age at the first diagnosis of ADHD was 6.8 (1.3) years. Most of them were receiving methylphenidate for treatment of their ADHD. The mother was the primary caregiver for 83.5% of the children. The ADHD symptoms and oppositional-defiant symptoms showed significant improvement after receiving the treatment in both groups; however, no significant differences were found between groups. CONCLUSION Adding parenting training to the routine clinical care for children with uncomplicated ADHD who are being medicated was not more effective than the routine clinical care alone. However, the power of this study is limited, and follow-up is needed to evaluate the long-term effectiveness.
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Roigé-Castellví J, Morales-Hidalgo P, Voltas N, Hernández-Martínez C, van Ginkel G, Canals J. Prenatal and perinatal factors associated with ADHD risk in schoolchildren: EPINED epidemiological study. Eur Child Adolesc Psychiatry 2021; 30:347-358. [PMID: 32242248 DOI: 10.1007/s00787-020-01519-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/22/2020] [Indexed: 11/29/2022]
Abstract
The aim of this study is to assess the relationship between pre- and perinatal factors and ADHD in a sample of scholars exploring differences between ADHD presentations and spectrum of severity. A total of 6720 scholars (aged 3-4 and 10-11) participated in a double-phase epidemiologic cross-sectional study (Epidemiological Study of Neurodevelopmental Disorders, EPINED), and a sample of 646 scholars (ADHD risk, ASD risk and controls without risk) were individually assessed in the second phase of the study. The ADHD diagnosis, based on DSM-5 criteria, was performed with the Kiddie-Schedule for Affective Disorders & Schizophrenia, Present & Lifetime Version. Associations for the different ADHD presentations between prenatal, perinatal and postnatal factors and ADHD (n = 168), subclinical ADHD (n = 88) and non-ADHD (n = 310) were analysed. Logistic regression models showed that gestational diabetes (p = 0.012), instrumental delivery (p = 0.011), family history of psychopathology (p = 0.033) and maternal ADHD phenotype (p = 0.023) were associated with ADHD. These factors were related to the hyperactive-impulsive and combined presentations, but they were not related to the inattentive presentation. Maternal weight gain was associated with subclinical ADHD. In conclusion, metabolic disorder in the pregnancy, difficulties in childbirth and specific family phenotype were related to ADHD, specifically with hyperactive-impulsive presentation, but not in subclinical ADHD.
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Affiliation(s)
- Joana Roigé-Castellví
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Paula Morales-Hidalgo
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Núria Voltas
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Carmen Hernández-Martínez
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Georgette van Ginkel
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Josefa Canals
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain.
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A Qualitative Study of Impacts of the COVID-19 Pandemic on Lives in Adults with Attention Deficit Hyperactive Disorder in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042090. [PMID: 33669970 PMCID: PMC7924857 DOI: 10.3390/ijerph18042090] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/19/2022]
Abstract
(1) Background: COVID-19 may deteriorate some aspects among individuals with attention deficit hyperactivity disorder (ADHD). Although some positive aspects were reported during the pandemic, it remains unclear how COVID-19 qualitatively influences their living context; (2) Methods: this study employed interviews with four participants with ADHD during the declaration of emergency issued in Japan. The study was a part of ongoing coaching as a psychosocial intervention for ADHD, which was initiated long before the pandemic. The data were the answers to the question: “how are things going with participants during this pandemic?”. In a qualitative analysis, the researchers coded the data to identify different themes and sub-themes; (3) Results and Discussion: the qualitative data analysis yielded five themes: (1) Terrible feeling caused by frustration, stress, and anger; (2) Closeness due to the internal difficulties and conflict; (3) Deteriorating ADHD symptoms and executive function related matters; (4) Condition is the same as usual; and (5) Positive aspects associated with the self-lockdown. As a whole, these results show that the COVID-19 pandemic could be a factor in inducing psychological distress in the participants who adjust relatively better at work/school but did not do well at home before the pandemic; (4) Conclusions: this study indicates the need for special support for individuals with ADHD, especially those who originally had difficulties at home.
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Zaidman-Zait A, Shilo I. Parental ADHD Symptoms and Inhibitory Control in Relation to Parenting Among Mothers of Children With and Without ADHD. J Atten Disord 2021; 25:389-402. [PMID: 30442044 DOI: 10.1177/1087054718808063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: The study examined how the interplay between maternal ADHD symptoms and maternal inhibitory control and child ADHD is related to parenting behaviors. Method: The sample included 141 mothers and their 8- to 12-year-old children, 61 children with ADHD and 80 without. Parenting was measured using self-reports (i.e., overreactive and lax parenting) and observation (i.e., negative and supportive parenting). Maternal inhibitory control was measured using a neurocognitive task. Hierarchical multiple regressions were conducted to predict parenting, controlling for child sex, conduct behaviors, and parenting distress. Results: Interactions between maternal ADHD symptoms and maternal inhibitory control suggested that hyperactive-impulsive symptoms were linked to parenting negativity only when inhibitory control was low, and maternal inattention symptoms were related to lax parenting only when maternal inhibitory control was high or when children did not have ADHD. Conclusion: Results indicate the importance of maternal regulation processes in the mechanisms linking maternal ADHD with parenting.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel.,The University of British Columbia, Vancouver, Canada
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Does helping mothers in multigenerational ADHD also help children in the long run? 2-year follow-up from baseline of the AIMAC randomized controlled multicentre trial. Eur Child Adolesc Psychiatry 2020; 29:1425-1439. [PMID: 31807943 DOI: 10.1007/s00787-019-01451-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/24/2019] [Indexed: 01/23/2023]
Abstract
ADHD often affects multiple generations in a family. Previous studies suggested that children with ADHD benefit less from therapy if parents are also affected, since ADHD symptoms interfere with treatment implementation. This two-group randomised controlled trial examined whether targeting maternal ADHD boosts the efficacy of parent-child training (PCT) for the child's ADHD. Here, we report follow-up results 2 years from baseline. Mothers of 144 mother-child dyads (ADHD according to DSM-IV) were examined for eligibility (T1) and randomised to 12 weeks of intensive multimodal treatment comprising pharmacotherapy and DBT-based cognitive behavioural group psychotherapy (TG, n = 77) or clinical management comprising non-specific counselling (CG, n = 67) for Step 1 (concluded by T2). Subsequently, all dyads participated in 12 weekly PCT sessions for Step 2 (concluded by T3). In Step 3, participants received maintenance treatments for 6 months (concluded by T4). At 24 months after baseline (T5), we performed follow-up assessments. The primary endpoint was child ADHD/ODD score (observer blind rating). Outcomes at T5 were evaluated using ANCOVA. Assessments from 101 children and 95 mothers were available at T5. Adjusted means (m) of ADHD/ODD symptoms (range 0-26) in children did not differ between TG and CG (mean difference = 1.0; 95% CI 1.2-3.1). The maternal advantage of TG over CG on the CAARS-O:L ADHD index (range 0-36) disappeared at T5 (mean difference = 0.2; 95% CI - 2.3 to 2.6). Sensitivity analyses controlling for medication and significant predictors of follow-up participation showed unchanged outcomes. Within-group outcomes remained improved from baseline. At the 24-month follow-up, TG and CG converged. The superiority of intensive treatment regarding maternal symptoms disappeared. In general, cross-generational treatment seems to be effective in the long term. (BMBF grant 01GV0605; registration ISRCTN73911400).
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Brinksma DM, Dietrich A, de Bildt A, Buitelaar JK, van den Hoofdakker BJ, Hoekstra PJ, Hartman CA. ADHD symptoms across adolescence: the role of the family and school climate and the DRD4 and 5-HTTLPR genotype. Eur Child Adolesc Psychiatry 2020; 29:1049-1061. [PMID: 31628528 PMCID: PMC7369263 DOI: 10.1007/s00787-019-01424-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/12/2019] [Indexed: 12/30/2022]
Abstract
We examined bidirectional relations between attention-deficit/hyperactivity disorder (ADHD) symptoms and family and school climate, and the possible role of DRD4 and/or 5-HTTLPR genotypes herein. Three-wave longitudinal data of 1860 adolescents (mean ages 11, 13.5, and 16 years) from the general population and clinic-referred cohort of TRacking Adolescents' Individual Lives Survey were used. Using a multigroup Random Intercept Cross-Lagged Panel Model, we tested between-person (i.e., stable trait levels) and within-person (i.e., causal processes) associations across ADHD symptoms, family and school climate, and the extent to which these depended on genotype. Findings indicated no influence of genotype. Results did show significant between-person differences (ADHD symptoms with family climate r = .38; and school climate r = .23, p values < .001), indicating that higher stable levels of ADHD symptoms were associated with a less favorable family and school climate. Regarding within-person causal processes, ADHD symptoms predicted a less favorable family climate in early adolescence (β = .16, p < .01), while ADHD symptoms predicted a more favorable family climate in the later phase of adolescence (β = - .11, p < .01), a finding which we explain by normative developmental changes during adolescence. Overall, this study showed that negative associations between ADHD symptoms and both family and school climate are largely explained by stable between-person differences. We recommend applying the Random Intercept Cross-Lagged Path Model to developmental data to tease stable associations and change processes apart.
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Affiliation(s)
- Djûke M Brinksma
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, XA10, 9713 GZ, Groningen, The Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, XA10, 9713 GZ, Groningen, The Netherlands
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, XA10, 9713 GZ, Groningen, The Netherlands
- Accare Child and Adolescent Psychiatry, Groningen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, XA10, 9713 GZ, Groningen, The Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, XA10, 9713 GZ, Groningen, The Netherlands.
| | - Catharina A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Babinski DE, Mazzant JR, Merrill BM, Waschbusch DA, Sibley MH, Gnagy EM, Molina BSG, Pelham WE. Lifetime caregiver strain among mothers of adolescents and young adults with attention-deficit/hyperactivity disorder. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:342-352. [PMID: 31750692 PMCID: PMC7102920 DOI: 10.1037/fam0000609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The lifetime maternal caregiver strain (CS) associated with raising a child with attention-deficit/hyperactivity disorder (ADHD) into adolescence and young adulthood was examined in the Pittsburgh ADHD Longitudinal Study (PALS), a longitudinal study of individuals diagnosed with ADHD in childhood and recontacted in adolescence and young adulthood for yearly follow-up. Mothers of adolescents/young adults with (n = 364, 89.6% male; Mage = 19.79) and without childhood ADHD (n = 240, 88.8% male; Mage = 18.97) rated their lifetime maternal CS at Wave 3. Adolescent/young adult (AYA) ADHD and ODD severity measured at Wave 1, AYA delinquency measured at Wave 2, and school disciplinary actions combined from Waves 1 and 2 were explored as mediators of the association between childhood ADHD and lifetime maternal CS at Wave 3 using path analysis. AYA gender and age, parental marital status, maternal depression and ADHD, and highest parental education were included as covariates. Greater lifetime CS was reported among mothers of adolescents/young adults with versus without childhood ADHD. In the mediation model, direct effects of childhood ADHD on AYA ADHD and ODD severity, delinquency, and school discipline problems emerged, and direct effects of AYA ODD severity, delinquency, and school discipline problems on lifetime CS emerged. AYA ODD, delinquency, and school discipline mediated the association between childhood ADHD and lifetime maternal CS. These findings extend research on childhood ADHD to identify AYA sequelae contributing to maternal CS. Future research on the transaction between AYA functional impairment and maternal CS across the transition from adolescence into adulthood is needed to clarify opportunities for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Zaidman-Zait A. The contribution of maternal executive functions and active coping to dyadic affective dynamics: Children with autism spectrum disorder and their mothers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:645-657. [PMID: 31647318 DOI: 10.1177/1362361319854653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parenting is a cognitive, emotional, and behavioral endeavor, where parents' control capacities, including executive functions and active control coping, help parents to guide and regulate interactions with their children; yet limited research investigates how these capacities are associated with parent-child affective regulation processes during parent-child interactions. This study examined whether maternal executive functions (sustained attention, interference inhibitory control, working memory) and active engaged coping were related to dyadic affective flexibility and positive mutual affective interactions between mothers and their young children with autism spectrum disorders (N = 40). Dyadic flexibility and mutual positive affect were measured using dynamic systems-based modeling of second-by-second affective patterns during a mother-child interaction. The results showed that higher levels of maternal sustained attention and inhibitory control were related to increased dyadic affective flexibility. In addition, higher levels of maternal sustained attention and higher use of engaged coping were related to dyadic mutual positive affect. The findings highlight the importance of maternal cognitive control capacity in promoting adaptive parent-child dyadic regulatory processes.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel.,The University of British Columbia, Canada
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12
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Maternal breastfeeding and attention-deficit/hyperactivity disorder in children: a meta-analysis. Eur Child Adolesc Psychiatry 2019; 28:19-30. [PMID: 29907910 DOI: 10.1007/s00787-018-1182-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 06/09/2018] [Indexed: 10/28/2022]
Abstract
Previous studies have suggested environmental factors may contribute to the risk of attention-deficit/hyperactivity disorder (ADHD). The current meta-analysis examined (1) the difference in the duration of maternal breastfeeding between children with and without ADHD, and (2) the association between maternal breastfeeding and ADHD in children. The data of individual studies were synthesized with a random-effects model. Eleven articles were included in this meta-analysis. Children with ADHD had significantly less breastfeeding duration than controls (Hedges' g = - 0.36, 95% confidence intervals (CIs) = - 0.61 to - 0.11, p = 0.005; difference in means: - 2.44 months, 95% CIs = - 3.17 to - 1.71, p < 0.001). In addition, the rates of non-exclusive breastfeeding in children with ADHD is significantly higher in "under 3 months" (odds ratio (OR) = 1.90, 95% CIs = 1.45 to 2.48, p < 0.001) but lower in "6 to 12 months" (OR = 0.69, 95% CIs = 0.49 to 0.98, p = 0.039) and "over 12 months" (OR = 0.58, 95% CIs = 0.35 to 0.97, p = 0.038) than controls. Children with ADHD received significantly higher rate of exclusive breastfeeding duration "under 3 months" (OR = 1.51, 95% CIs = 1.20 to 1.89, p < 0.001) but lower in "over 3 months" (OR = 0.52, 95% CIs = 0.29 to 0.95, p = 0.033) than controls. Furthermore, an association was found between non-breastfeeding and ADHD children (adjusted OR = 3.71, 95% CI = 1.94 to 7.11, p < 0.001). Our results suggest maternal breastfeeding is associated with a lower risk of ADHD in children. Future longitudinal research is required to confirm/refute these findings and to explore possible mechanisms underlying this association.
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Hautmann C, Döpfner M, Katzmann J, Schürmann S, Wolff Metternich-Kaizman T, Jaite C, Kappel V, Geissler J, Warnke A, Jacob C, Hennighausen K, Haack-Dees B, Schneider-Momm K, Philipsen A, Matthies S, Rösler M, Retz W, von Gontard A, Sobanski E, Alm B, Hohmann S, Häge A, Poustka L, Colla M, Gentschow L, Freitag CM, Becker K, Jans T. Sequential treatment of ADHD in mother and child (AIMAC study): importance of the treatment phases for intervention success in a randomized trial. BMC Psychiatry 2018; 18:388. [PMID: 30545333 PMCID: PMC6293507 DOI: 10.1186/s12888-018-1963-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 11/23/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The efficacy of parent-child training (PCT) regarding child symptoms may be reduced if the mother has attention-deficit/hyperactivity disorder (ADHD). The AIMAC study (ADHD in Mothers and Children) aimed to compensate for the deteriorating effect of parental psychopathology by treating the mother (Step 1) before the beginning of PCT (Step 2). This secondary analysis was particularly concerned with the additional effect of the Step 2 PCT on child symptoms after the Step 1 treatment. METHODS The analysis included 143 mothers and children (aged 6-12 years) both diagnosed with ADHD. The study design was a two-stage, two-arm parallel group trial (Step 1 treatment group [TG]: intensive treatment of the mother including psychotherapy and pharmacotherapy; Step 1 control group [CG]: supportive counseling only for mother; Step 2 TG and CG: PCT). Single- and multi-group analyses with piecewise linear latent growth curve models were applied to test for the effects of group and phase. Child symptoms (e.g., ADHD symptoms, disruptive behavior) were rated by three informants (blinded clinician, mother, teacher). RESULTS Children in the TG showed a stronger improvement of their disruptive behavior as rated by mothers than those in the CG during Step 1 (Step 1: TG vs. CG). In the CG, according to reports of the blinded clinician and the mother, the reduction of children's disruptive behavior was stronger during Step 2 than during Step 1 (CG: Step 1 vs. Step 2). In the TG, improvement of child outcome did not differ across treatment steps (TG: Step 1 vs. Step 2). CONCLUSIONS Intensive treatment of the mother including pharmacotherapy and psychotherapy may have small positive effects on the child's disruptive behavior. PCT may be a valid treatment option for children with ADHD regarding disruptive behavior, even if mothers are not intensively treated beforehand. TRIAL REGISTRATION ISRCTN registry ISRCTN73911400 . Registered 29 March 2007.
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Affiliation(s)
- Christopher Hautmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavioral Therapy (AKiP), University Hospital Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavioral Therapy (AKiP), University Hospital Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Josepha Katzmann
- School of Child and Adolescent Cognitive Behavioral Therapy (AKiP), University Hospital Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Stephanie Schürmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavioral Therapy (AKiP), University Hospital Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Tanja Wolff Metternich-Kaizman
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavioral Therapy (AKiP), University Hospital Cologne, Pohligstraße 9, 50969 Cologne, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Viola Kappel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Julia Geissler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Andreas Warnke
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
| | - Christian Jacob
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, Medius Clinic, Kirchheim, Germany
| | - Klaus Hennighausen
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty and Medical Center – University of Freiburg, Freiburg, Germany
| | - Barbara Haack-Dees
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty and Medical Center – University of Freiburg, Freiburg, Germany
| | - Katja Schneider-Momm
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty and Medical Center – University of Freiburg, Freiburg, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Swantje Matthies
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Rösler
- Institute for Forensic Psychology and Psychiatry, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Wolfgang Retz
- Institute for Forensic Psychology and Psychiatry, Saarland University Faculty of Medicine, Homburg/Saar, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Alexander von Gontard
- Saarland University Hospital: Department of Child and Adolescent Psychiatry and Psychotherapy, Saarland University Faculty of Medicine, Homburg/Saar, Germany
| | - Esther Sobanski
- Clinic for Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Barbara Alm
- Clinic for Psychiatry and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alexander Häge
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Child and Adolescent Psychiatry, University Medicine Göttingen, Göttingen, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Michael Colla
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry, University Medical Center Rostock, Rostock, Germany
| | - Laura Gentschow
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Christine M. Freitag
- Saarland University Hospital: Department of Child and Adolescent Psychiatry and Psychotherapy, Saarland University Faculty of Medicine, Homburg/Saar, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Frankfurt University Hospital, Frankfurt, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Thomas Jans
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center for Mental Health, University Hospital of Würzburg, Würzburg, Germany
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Crandall A, Ghazarian SR, Deater-Deckard K, Bell MA, Riley AW. The Interface of Maternal Cognitions and Executive Function in Parenting and Child Conduct Problems. FAMILY RELATIONS 2018; 67:339-353. [PMID: 30364561 PMCID: PMC6197061 DOI: 10.1111/fare.12318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/21/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore the direct and indirect associations of maternal emotion control, executive functioning, and social cognitions maternal with harsh verbal parenting and child behavior and to do so guided by social information processing theory. BACKGROUND Studies have demonstrated a relationship between maternal harsh parenting and increased child conduct problems. However, less is known about how maternal emotion and cognitive control capacities and social cognitions intersect with harsh parenting and child behavior. METHOD Structural equation modeling was used with a convenience sample of 152 mothers from Appalachia who had a child between 3 and 7 years of age. RESULTS Maternal emotion control and executive functioning were both inversely associated with child conduct problems. That is, stronger maternal emotion control was associated with less harsh verbal parenting and lower hostile attribution bias, and higher maternal executive functioning was related to less controlling parenting attitudes. CONCLUSION The results suggest maternal emotion and cognitive control capacities affect how mothers interact with their children and ultimately child conduct problems. IMPLICATIONS To more effectively reduce harsh verbal parenting and child conduct problems, interventions should help mothers to improve their emotion and cognitive control capacities.
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15
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Parental ADHD symptoms and parenting behaviors: A meta-analytic review. Clin Psychol Rev 2017; 56:25-39. [PMID: 28601690 DOI: 10.1016/j.cpr.2017.05.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/13/2017] [Accepted: 05/27/2017] [Indexed: 12/31/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) persists throughout the lifespan, and there are known impairments associated with adult ADHD. Understanding ADHD-related impairments in the parenting domain is particularly important given that the children of adults with ADHD also are likely to have ADHD, and there is potential for parenting to alter the developmental outcomes of these children. The present study quantitatively synthesizes evidence regarding the associations between parental ADHD symptoms and parenting behaviors. Across 32 studies, this meta-analysis found that parental ADHD symptoms accounted for 2.9%, 3.2%, and 0.5% of the variance of harsh, lax, and positive parenting, respectively. Greater parental ADHD symptoms were associated with less positive and more harsh and lax parenting behaviors. Variables, such as the proportion of children in the sample diagnosed with ADHD, child gender, and method/rater variance, moderated the strength of these relations. Results also suggest more similarities than differences in the associations between parenting behaviors and the two dimensions of inattention and hyperactivity/impulsivity symptoms. Overall, parental ADHD symptoms are significantly associated with parenting behaviors with effect sizes similar to the associations found between other parental psychopathologies and parenting, although the associations remain relatively small. The paper concludes with comments regarding remaining gaps in the literature that warrant further research and the clinical implications of the associations between parental ADHD symptoms and parenting.
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16
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Friedrich A, Moning J, Weiss J, Schlarb AA. The Effects of Parental ADHD Symptoms on Parenting Behaviors. Health (London) 2017. [DOI: 10.4236/health.2017.97077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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17
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Crandall A, Deater-Deckard K, Riley AW. Maternal emotion and cognitive control capacities and parenting: A conceptual framework. DEVELOPMENTAL REVIEW 2015; 36:105-126. [PMID: 26028796 PMCID: PMC4445866 DOI: 10.1016/j.dr.2015.01.004] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE Emerging evidence suggests that maternal emotion and cognitive control capacities are critical to the development and maintenance of parenting practices and may be related to parents' ability to seek and use parenting help. The purpose of this paper is to present a cohesive conceptual framework on the intersection of maternal emotion and cognitive control capacities and parenting based on a review of literature. METHODS We conducted a comprehensive literature review of articles published between 2000 and February 2014 that addressed maternal emotion and cognitive control and parenting. The 35 articles identified were assigned a methodological quality score. RESULTS Low maternal emotion and cognitive control capacity is associated with increased risk of engaging in child maltreatment, whereas higher maternal emotion and cognitive regulation is associated with sensitive, involved parenting. Contextual factors, such as SES and household organization, play a complex and not clearly understood role on the association between maternal cognitive control and parenting. A conceptual framework was developed based on the results of the literature review. CONCLUSIONS The conceptual framework developed can be used to inform future research and practice. Longitudinal studies that assess the temporal relationship of maternal emotion and cognitive control and parenting are necessary to establish causality. Research that addresses how maternal emotion regulation and cognitive control capacities are related to mothers' enrollment and participation in parenting and early intervention programs is an important next step to strengthening policy and intervention work.
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Affiliation(s)
- AliceAnn Crandall
- Department of Population, Family and Reproductive Health, Johns Hopkins University School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
| | - Kirby Deater-Deckard
- Department of Psychology, Virginia Tech, Blacksburg, VA 24061, USA
- Department of Psychiatry, Virginia Tech – Carilion School of Medicine, Roanoke, VA 24061, USA
| | - Anne W. Riley
- Department of Population, Family and Reproductive Health, Johns Hopkins University School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA
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18
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Estévez N, Eich-Höchli D, Dey M, Gmel G, Studer J, Mohler-Kuo M. Prevalence of and associated factors for adult attention deficit hyperactivity disorder in young Swiss men. PLoS One 2014; 9:e89298. [PMID: 24586672 PMCID: PMC3930697 DOI: 10.1371/journal.pone.0089298] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 01/19/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The present study aimed to measure the prevalence of adult attention deficit hyperactivity disorder (ADHD) in a large, representative sample of young Swiss men and to assess factors associated with this disorder. METHODS Our sample consisted of 5656 Swiss men (mean age 20 years) who participated in the Cohort Study on Substance Use Risk Factors (C-SURF). ADHD was assessed with the World Health Organization (WHO) adult ADHD Self Report Screener (ASRS). Logistic regression analyses were conducted to assess the association between ADHD and several socio-demographic, clinical and familial factors. RESULTS The prevalence of ADHD was 4.0%, being higher in older and French-speaking conscripts. A higher prevalence also was identified among men whose mothers had completed primary or high school/university and those with a family history of alcohol or psychiatric problems. Additionally, adults with ADHD demonstrated impairment in their professional life, as well as considerable mental health impairment. CONCLUSION Our results demonstrate that ADHD is common among young Swiss men. The impairments in function and mental health we observed highlight the need for further support and interventions to reduce burden in affected individuals. Interventions that incorporate the whole family also seem crucial.
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Affiliation(s)
- Natalia Estévez
- Institute of Social and Preventive Medicine, Zurich, Switzerland
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
- * E-mail:
| | | | - Michelle Dey
- Institute of Social and Preventive Medicine, Zurich, Switzerland
| | - Gerhard Gmel
- Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - Joseph Studer
- Alcohol Treatment Centre, Lausanne University Hospital CHUV, Lausanne, Switzerland
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