Childhood Attention Deficit/Hyperactivity Disorder Symptomatology in Parents: A Risk Factor for Children with ADHD? Presented at the UCI Undergraduate Research Symposium by David A. Hallowell May 15, 2004

Acknowledgments: Professor Carol Whalen Professor Valerie Jenness Dr. Sharon Ishikawa Project Coordinators Tina Merrilees and Cara Kiff This ongoing study is being supported by funding from Eli Lilly and Company The Parents and Children from the Community who Participated in Week-Long, Labor Intensive Study

Attention/Deficit Hyperactivity Disorder (ADHD) Difficulty paying attention, following directions, or being quiet from time to time are features intrinsic to childhood Children with ADHD display these problems more frequently, causing significant disruptions for those in their social environment According to the DSM-IV, the diagnostic criteria are: a) Displaying at least 6 of the 9 symptoms for either the inattentive, the hyperactive/impulsive, or combined subtype features of the disorder b) Problematic behaviors must surface prior to age 7 and have persisted for at least 6 months c) The symptoms must be negatively affecting the child across at least two settings

Constructs Perceptions of Parenting Efficacy- An individual’s beliefs about their level of ability to function in the role of parent Attributions- Perceived causes that people assign to events that occur in their environment Learned Helplessness- Attribution style that assigns stable, internal, uncontrollable causes to negative events associated with an individual Dyad- A group of two units that are related to each other in some way Affect- Emotional State

Parenting Efficacy Socio-Economic Status Depression Perceptions of Infant Temperament Ratings of Actual Parenting Competence Perceptions of Parenting Efficacy Teti & Gelfand, 1991

Efficacy and Mood Learned Helplessness Negative Event UncontrollableStableInternal ControllabilityStabilityLocus Negative Affect Assign Causation Possible Attribution Style

Efficacy and Mood (Continued) 1 Mash & Johnston, 1983, Coleman and Karraker, 1997; 2 Bugental & Johnston, 2000; 3 Rucklidge & Kaplan, 2000 Past Research: Relationships found Between Learned Helplessness Attribution Style for Child Behaviors 1 Low Perceptions of Parenting Efficacy and Child Attributions for Child Behaviors 2 Parent Attributions for Child Behaviors and Adult Learned Helplessness 3 Childhood ADHD and Major Depressive Disorder 3 Learned Helplessness and

Research: Negative Affect Bandura, 1989 AttributionsEmotions Bidirectional Priming Effect

Psychological Symptoms Childhood Hyperactivity ADHD Major Depressive Disorder Personality Disorders Adulthood 13-Year Follow-Up Study (Fischer et al., 2002)

Methodology Convenience sample of 24 parent-child dyads recruited from local area schools and from physician practices Children’s ages between 8 and 12 years old All children diagnosed with ADHD and being treated with a long-acting stimulant medication, taken once daily during the study NMean AgeGender Parents2443.6M=1, F=23 Children2410.6M=14, F=10 All but one dyad white, non-hispanic ethnicity. Participants mostly well-educated, upper-middle class.

Methodology (Continued) Measures Assessment of Hyperactivity (AHA) Mehringer et al., 2002 Childhood ADHD Characteristics Brief Symptom Inventory (BSI) Derogatis, 1983 The Mood Disorder Questionnaire (MDQ), Hirschfeld, 2000 Psychological Symptoms

Methodology (Continued) Rationale: Observe the daily lives of children and parents in their natural environment Child Moods: Diary Programs on PalmPilots Parental Perceptions of Their Own Parenting Efficacy: Morning and evening summary diaries completed daily

Palm Pilot Child Diary Screenshots Positive MoodNegative Mood

Hypothesis One 1) Among parents of children with ADHD, parents whose self-reported childhood ADHD characteristics meet DSM-IV criteria will exhibit more adult psychological symptoms than parents whose self-reported ADHD characteristics do not meet diagnostic criteria

Hypothesis Two 2) Among parents of children with ADHD, parents whose self-reported childhood ADHD characteristics meet DSM-IV criteria will report lower perceptions of parenting efficacy than parents whose self- reported ADHD characteristics do not meet diagnostic criteria

Hypothesis Three 3) Among children with ADHD, those whose parents’ self-reported childhood ADHD characteristics meet DSM-IV criteria will report more negative moods and fewer positive moods than children whose parents’ self-reported ADHD characteristics do not meet DSM-IV criteria

Results: Psychological Symptoms * Results significant for  < Results significant for  < 0.01 Brief Symptom InventoryMood Disorder Questionnaire

Results: Perceptions of Parenting Efficacy * Results approached significance (p =.106). Tendency not present for evening summary diaries Parenting Efficacy for Morning Summary Diaries

Results: Child Moods Composite Child Mood Profiles No Significant Differences

Discussion: Psychological Symptoms Parents exhibiting a childhood history of high childhood ADHD characteristics may be at greater risk for psychological symptoms than their low childhood ADHD counterparts

Discussion: Parenting Efficacy Group differences in perceptions of parenting efficacy during morning times approached significance Perhaps interactions before school are particularly stressful and parents with a history of high childhood ADHD characteristics come away from challenging interactions feeling less capable than those without such a history We are continuing to enroll participants in this study so that we will be able to repeat these analyses with an adequate sample size

Discussion: Mood Profiles The lack of group differences may have been related to methodological limitations: - Emotions were reported on a three-point scale - Positive response bias may have operated Pharmacology treatment in children linked to reversal of the learned helplessness attribution style in parents (Johnston et al, 2000)

Limitations Non-representative Convenience Sample Small Sample Size Self-Selection Process May Have Precluded the Most Severely Affected Families (Whalen et al, 2002) Retrospective Self-Diagnosis of Parental ADHD in Childhood Efficacy measures were pen-and-paper surveys Primarily Mother-Child Dyad Characteristics

Implications These findings suggest that parents with childhood histories of ADHD may benefit from special resources and training aimed at: - Helping them manage their own children with ADHD - Improving their perceived parenting efficacy

David Hallowell Dept. of Psychology and Social Behavior University of California, Irvine For further information I can be reached at: