Parent–Adolescent Conflict in Teenagers with ADHD and ODD

Eighty-seven male teens (ages 12–18 years) with ADHD/ODD and their parents were compared to 32 male teens and their parents in a community control (CC) group on mother, father, and teen ratings of parent–teen conflict and communication quality, parental self-reports of psychological adjustment, and direct observations of parent–teen problem-solving interactions during a neutral and conflict discussion. Parents and teens in the ADHD/ODD group rated themselves as having significantly more issues involving parent–teen conflict, more anger during these conflict discussions, and more negative communication generally, and used more aggressive conflict tactics with each other than did parents and teens in the CC group. During a neutral discussion, only the ADHD/ODD teens demonstrated more negative behavior. During the conflict discussion, however, the mothers, fathers, and teens in the ADHD/ODD group displayed more negative behavior, and the mothers and teens showed less positive behavior than did participants in the CC group. Differences in conflicts related to sex of parent were evident on only a few measures. Both mother and father self-rated hostility contributed to the level of mother–teen conflict whereas father self-rated hostility and anxiety contributed to father–teen conflict beyond the contribution made by level of teen ODD and ADHD symptoms. Results replicated past studies of mother–child interactions in ADHD/ODD children, extended these results to teens with these disorders, showed that greater conflict also occurs in father–teen interactions, and found that degree of parental hostility, but not ADHD symptoms, further contributed to levels of parent–teen conflict beyond the contribution made by severity of teen ADHD and ODD symptoms.     

A sequential analysis of the mother-adolescent interactions of ADHD,ADHD/ODD,and normal teenagers during neutral and conflict discussions

The sequential interactions of three groups of teenagers conversing with their mothers during both neutral and conflict discussion situations were evaluated. Groups consisted of (1) attention deficit hyperactivity disorder (ADHD) alone (n =21), (2) ADHD with comorbid oppositional defiant disorder (ADHD/ODD; n =40), and (3) a community control group of adolescents (n =49). All groups had been followed concurrently for the past 8 to 10 years before being reevaluated in this study. Results indicated that (1) teens and parents in all groups interacted in a tightly linked manner, with the behavior of each member being significantly related only to the immediate antecedent behavior of the other; (2) mothers in all groups were more likely than teens to initiate positive behaviors; (3) teen interactions could be characterized as tit-for-tat while mothers could be typified as be-nice-and-forgive; (4) mother-teen dyads in the ADHD/ODD group displayed significantly higher rates of conflict behaviors than dyads in the other two groups, who did not differ significantly from each other on most measures; and (5) mothers in the ADHD/ODD group responded in a manner similar to their teens (greater negativity) and less like that of mothers in the other groups. The majority of conflict between ADHD children and their parents seemed due to comorbid ODD and such ODD is a family, not just a teen, characteristic.     

Interparental conflict and risk behaviors among Mexican American adolescents: a cognitive-emotional model

This study used a cognitive-emotional model to examine the relations between multiple dimensions of interparental conflict and health risk behaviors among young adolescents. Participants were 151 Mexican American adolescents and their parents. At initial individual interviews, parents reported on conflict with their spouses, and adolescents reported on their parents' conflict, their appraisals of the conflict, their emotional distress, and their acculturation level. At 6-month follow-ups, adolescents reported on their risk behaviors, including substance use and sexual activity. In general, adolescents' acculturation level was not related to their risk behaviors. More frequent conflict, more conflict about the adolescent, more adolescent involvement in the conflict, and poor conflict resolution were related to greater emotional distress. More conflict about the adolescent, mothers being more demanding/dominating during conflict, and more adolescent involvement in the conflict were related to greater risk behaviors. Adolescents' cognitions mediated the link between two dimensions of parental conflict, frequency and resolution, and emotional distress. Adolescents' emotional distress mediated the association between adolescent involvement in parental conflict and adolescents' risk behaviors.     

Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: family,parenting, and behavioral correlates

This community study assigned 129 4-year-olds to groups at risk for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), both ADHD and ODD, or no problems. Mothers of children at risk for ODD reported more family dysfunction, felt less competent as parents, suggested fewer solutions to child behavior problems, demonstrated a less assertive approach to child management, and reported more child internalizing problems than did mothers of children not elevated on ODD symptoms. Mothers of children at risk for ADHD reported higher personal depression scores than did those of the non-ADHD subgroup. Children at risk for ADHD evidenced the most difficulties in school where teachers reported more social behavior, classroom management, and internalizing problems relative to other children not at risk for ADHD. When solving child management problems, mothers of children in all groups suggested twice as many controlling/negative management strategies as positive/preventive strategies. In addition, faced with oppositional and conduct problems, mothers of children in all groups increased controlling/negative suggestions and decreased positive/preventive suggestions. Mothers of girls at risk for ADHD, ODD, and ADHD/ODD gave more rewards per positive behavior than did mothers of boys.     

The role of a lifetime history of oppositional defiant and conduct disorders in adults with ADHD: implications for clinical practice

IntroductionAttention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) are frequently co-occurring disorders in children and adolescents. However, their clinical status among adults is still under discussion. This study analyzes how the current clinical presentation of adult ADHD might be influenced by a lifetime history of CD and ODD. METHODS: We compared three groups of patients: ADHD without history of CD/ODD (n = 178), ADHD + history of ODD (n = 184), and ADHD + history of CD (n = 96). RESULTS: A history of CD (and to a lower extent ODD) is associated with a more severe and externalizing profile.ConclusionPast CD and ODD entail a significant negative mental health impact on persistent ADHD, reinforcing the importance of actively assessing the developmental history of adult ADHD patients.     

青少年和母亲知觉的差异及其与青少年问题行为的关系

从辽宁辽阳市选取605名小学五年级至初中二年级、高中一年级至高中三年级学生及其母亲为被试,探讨青少年与其母亲对父母冲突知觉的差异,以及这种知觉差异与青少年问题行为的关系。要求青少年和其母亲分别报告父母过去一年中在10个方面的冲突频率,同时要求青少年报告自己在过去一年中20种问题行为的发生频率。研究发现：青少年对父母冲突的知觉明显比母亲消极,但是到了高中．两者知觉的差异不再明显;青少年与母亲在指向父母自身冲突方面的知觉差异大于指向孩子的父母冲突方面两者的知觉差异;青少年知觉到的父母冲突多于母亲知觉到的父母冲突的人数比例高于青少年知觉到的父母冲突少于母亲知觉到的父母冲突的人数比例;青少年与母亲对父母冲突知觉的差异会增加青少年出现问题行为的可能性。     

What is the Social Impact of ADHD in Girls? A Multi-Method Assessment

This study explores the social impact of ADHD, with and without opposition-defiant behaviour (ADHD+ODD (n= 22) and ADHD-only (n= 18)), in 9- to 12- year old girls compared to girls without ADHD (n= 40). Girls played a computer game involving simulated players, and mothers and teachers completed rating scales. In general, mothers and teachers saw girls with ADHD+ODD as more overtly and relationally aggressive and less prosocial than girls with ADHD-only, who were seen as more overtly and relationally aggressive and less prosocial than control girls. On the computer game, girls with ADHD+ODD were more overtly aggressive, more directly relationally aggressive, and showed less skilled behaviour than the other groups. Girls with ADHD-only showed less covert, indirect relational aggression and more socially awkward interactions than girls in the control group on the computer game. In all, the results indicate that girls with ADHD, with and without ODD behaviour, engage in socially detrimental behaviours.     

Interparental Interactions and Adolescent Mood: A Daily Diary Approach

The literature assessing relations between interparental functioning and youth adjustment is extensive. Most of this literature used a between subjects approach and examines youth responses to conflict reported by parents. The current study used a daily diary approach to complement the existing literature by assessing relations between aspects of marital interactions and adolescent reported daily mood using a within-family approach. We hypothesized that parents’ emotionality during interactions, the severity of their marital conflicts, and the degree to which their conflicts were resolved would be associated with their adolescents’ daily moods. To test these hypotheses a diverse sample (N?=?86; 27% Black, 33% White, 26% Hispanic, and 14% another race or families members differed in race) of mothers, fathers, and adolescents drawn from the Supporting Healthy Marriage project completed 15 days of daily diaries. Multilevel modeling results suggested differential associations between mother and father reports of their own emotions during interactions, conflict severity, and conflict resolution and adolescents’ daily moods. Overall, there were more significant results indicating fathers’ compared to mothers’ associations with adolescents’ daily moods, providing support for the need to continue efforts to engage fathers in family strengthening programs.     

Risk Taking and Sensitivity to Punishment in Children with ADHD,ODD, ADHD+ODD,and Controls

We used the Balloon Analog Risk Task (BART) to examine risk taking and sensitivity to punishment, two relevant aspects of behavioral inhibition, in 203 school-age children with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), ADHD+ODD, and controls. Participants earned points on the BART by pumping 30 separate balloons that exploded at variable intervals. No points were earned on a trial when a balloon exploded. The number of pumps across all balloons estimated risk taking and the reduction in pumps following balloon explosions was interpreted as an indicator of sensitivity to negative punishment. We found that all groups significantly differed from one another on risk taking. The ADHD+ODD group pumped the most, followed by the ODD, ADHD, and the control group, respectively. For sensitivity to negative punishment, all groups performed differently, with the ODD group showing the least sensitivity to an exploded balloon, followed by the ADHD, control, and ADHD+ODD groups, respectively. Children with ADHD+ODD demonstrated significantly different patterns of risk taking and sensitivity to negative punishment than children with either ADHD-only or ODD-only. ADHD youth with comorbid ODD had the greatest levels of risk taking, but they were also the most sensitive to negative punishment. The relationship between ADHD and ODD, as well as the nature of comorbidity in constructs related to risk taking and related behaviors, are discussed.     

Do Executive Function Deficits Differentiate Between Adolescents with ADHD and Oppositional Defiant/Conduct Disorder? A Neuropsychological Study Using the Six Elements Test and Hayling Sentence Completion Test

Two neuropsychological measures of executive functions—Six Elements Tests (SET) and Hayling Sentence Completion Test (HSCT)—were administered to 110 adolescents, aged 12–15 years. Participants comprised four groups: Attention Deficit Hyperactivity Disorder (ADHD) only (n = 35), ADHD and Oppositional Defiant Disorder/Conduct Disorder (ODD/CD) (n = 38), ODD/CD only (n = 11), and a normal community control group (n = 26). Results indicated that adolescents with ADHD performed significantly worse on both the SET and HSCT than those without ADHD, whether or not they also had ODD/CD. The adolescents with ADHD and with comorbid ADHD and ODD/CD were significantly more impaired in their ability to generate strategies and to monitor their ongoing behavior compared with age-matched controls and adolescents with ODD/CD only. It is argued that among adolescents with clinically significant levels of externalizing behavior problems, executive function deficits are specific to those with ADHD. The findings support the sensitivity of these two relatively new tests of executive functions and their ecological validity in tapping into everyday situations, which are potentially problematic for individuals with ADHD.     

Identification of Oppositional Defiant Disorder in Young Adult College Students

Long-considered a disorder restricted to children and adolescents, more research is needed to understand how oppositional defiant disorder (ODD) affects adults. Recent research suggests that symptoms of ODD persist into adulthood and are associated with specific negative functional outcomes. This current study seeks to investigate the prevalence and associated impairments of ODD symptoms in young adults. Two large samples of college students between the ages of 18–24 years old (N =?1792; N =?1497) completed self-report measures of ODD symptoms, ADHD symptoms, psychiatric diagnoses, and functional impairments. Rates and internal consistency of ODD symptoms were calculated, and multiple regression was used to estimate the association between high levels of ODD severity scores and social and authority-related impairments, as well as online antagonistic behavior. In the two samples, the proportion of individuals reporting four or more symptoms of ODD was estimated to be 3.39 and 4.12% respectively, and did not vary significantly by gender. Higher ODD severity was associated with social impairment, online antagonistic behavior, and greater conflict with authority figures, even after controlling for ADHD symptoms and self-reported depression or anxiety diagnoses. ODD symptoms measured in college students demonstrate acceptable reliability and are uniquely associated with specific impairments. The findings from this study support greater consideration of ODD symptoms in adult populations.     

Roman Catholic couples: wrath and religion.

Qualitative methods were used to research the effects of the religious beliefs and practices of ten Roman Catholic couples on the ways in which they managed anger and conflict in their marital relationship. The couples were interviewed separately, twice each, using Grounded Theory techniques in the first, semi-structured interview, and Repertory Grids in the second. Religious beliefs supported a broad range of positions on anger management from self-control through to the thoughtful expression of anger. It is suggested that religious beliefs and practices can be thought of as expanding or restricting "space" by reducing the intensity of anger experienced and by providing an opportunity for reflection which enabled participants to take greater responsibility for their part in conflicts. The relationship with God affected the "space" in the couple relationship by meeting some of the unmet needs of individuals and by detouring anger away from the spouse to God where it was felt to be safely contained. This procedure was used more by wives; their husbands seemed more often to fear and avoid conflicts and the expression of anger. Links were made between the marital relationship and the relationship with God. It was proposed that these systems are both evolving interactively with changes in one resulting in changes in the other. However, there can be a delay before changes in one system can be integrated with conflicting beliefs or practices in the reciprocal system, which may result in ambivalent attitudes toward anger and conflict. Clinical implications and directions for future research were suggested.     

Marital Conflict as a Mediator of the Longitudinal Connections between Maternal Emotional Distress and Early Adolescent Maladjustment

In this study, we examined the longitudinal relations among maternal emotional distress, marital conflict, and early adolescent externalizing behaviors and internalizing symptoms during the transition to adolescence. 3 years of self-report data were collected from 136 married mothers and their children, beginning when the children were in 5th grade. Structural equations modeling with latent variables were conducted to examine the nature and directionality of paths between constructs. For mothers, results indicated that marital conflict mediated the relation between prior maternal emotional distress and subsequent early adolescent externalizing behaviors and internalizing symptoms. For early adolescents, a mediating pattern was seen only for externalizing behaviors. In testing the reverse pattern of effects for mothers, marital conflict mediated the relation between prior early adolescent externalizing behaviors and subsequent maternal emotional distress whereas only an indirect pattern of effects existed for internalizing symptoms. Thus, we identified dynamic patterns of familial relations that accounted for the diminished well-being of both early adolescents and their mothers, suggesting that prevention and intervention work during the transition to adolescence should focus on multiple components of family functioning.     

Examining Anxiety and Depression as Moderators of the Associations Between ADHD Symptoms and Academic and Social Problems in Hispanic Adolescents

The effects of attention-deficit/hyperactivity disorder (ADHD) symptoms on the psychosocial functioning of Hispanic youth have been understudied. It also remains unclear if the well-established associations between ADHD symptoms and academic and social impairment are exacerbated by co-occurring internalizing symptoms. The purposes of the present study were to (1) examine whether ADHD symptoms would be associated with academic and social problems while also controlling for oppositional defiant disorder (ODD) symptoms, and (2) test the hypothesis that anxious and depressive symptoms would moderate the relations between ADHD symptoms and academic and social problems. Participants were 142 at-risk Hispanic adolescents (54 % male, ages 14–19) who reported on their anxious and depressive symptoms, as well as their teachers who reported on adolescents’ ADHD symptoms, ODD symptoms, academic problems, and social problems. When the psychopathology variables were included simultaneously in a path model, ADHD was the only domain significantly positively associated with academic problems. In contrast, ODD and depressive symptoms were the only domains significantly positively associated with social problems when all of the psychopathology variables were included in the path model. No moderation effects were found in relation to academic problems, although a significant ADHD × depression interaction was found in relation to social problems. Specifically, ADHD symptoms were not associated with social problems among adolescents who reported low levels of depressive symptoms, but the association between ADHD symptoms and social problems was significant at higher levels of depression. In addition to targeting oppositionality, attending to the combined presence of ADHD and depressive symptoms will be important for reducing the social impairments among Hispanic adolescents.     

Diversity in Pathways to Common Childhood Disruptive Behavior Disorders

Oppositional-Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are highly comorbid, a phenomenon thought to be due to shared etiological factors and mechanisms. Little work has attempted to chart multiple-level-of-analysis pathways (i.e., simultaneously including biological, environmental, and trait influences) to ODD and ADHD, the goal of the present investigation. 559 children/adolescents (325 boys) between the ages of 6 and 18 participated in a multi-stage, comprehensive diagnostic procedure. 148 were classified as ODD; 309 were classified as ADHD, based on parent, teacher, and clinician ratings. Children provided buccal or salivary samples of DNA, assayed for select markers in DRD4 and 5HTT. Parents completed the Alabama Parenting Questionnaire and the California Q-Sort. Children completed the Child Perception of Interparental Conflict Scale. Correlational associations consistent with multiple-level-of-analysis pathways to ODD and ADHD emerged. For ODD, children with the short allele of the 5HTT promoter polymorphism had higher neuroticism and ODD symptoms regardless of level of self-blame in relation to inter-parental conflict, whereas children without this allele had more ODD symptoms only in the context of more self-blame for inter-parental conflict. For ADHD (and ODD), children homozygous for the long allele of DRD4 120?bp insertion polymorphism had lower conscientiousness when exposed to inconsistent parenting, whereas children without this genotype were more resilient to effects of inconsistent discipline on conscientiousness. Thus, ODD and ADHD appear to demonstrate somewhat distinct correlational associations between etiological factors and mechanisms consistent with pathway models using a multiple-level-of-analysis approach.     

Toward Mapping Daily Challenges of Living with ADHD: Maternal and Child Perspectives Using Electronic Diaries

Attention-deficit/hyperactivity disorder (ADHD) has an impact on the family as well as the affected child. This study developed and tested an electronic diary for mapping the challenges of everyday family life in a sample of children with ADHD being treated with pharmacotherapy. Across 7 days, mothers and children (27 ADHD; 25 non-ADHD) independently reported their moods, behaviors, and social contexts every 30 min during nonschool hours. Symptomatic behaviors and negative moods were elevated in the ADHD group, combined with maternal perceptions of lower parenting effectiveness and quality of life. Differences in the contexts of maternal anger were salient, with mothers in the ADHD group more often angry when with their children and comparison mothers more often angry when not. Although mothers' diaries were more informative, children's diaries also distinguished the two groups, especially during mornings and weekends. The need for family-wide interventions, the utility of child self-reports, and the promise of electronic diaries are discussed.     

An Intensive Summer Treatment Program for ADHD Reduces Parent–Adolescent Conflict

There are currently almost no treatment efforts to reduce parent–adolescent conflict in adolescents with ADHD. As such, this study investigated the effect of an intensive Summer Treatment Program for Adolescents with ADHD (STP-A) on parent–adolescent conflict. Twenty adolescents and their parents completed the 8 week behavioral treatment program, which included 320 hours of adolescent-directed treatment, 15 hours of parent behavior management training, and daily feedback from staff on parent implementation of a home-based behavioral contract. Results indicated that 70–85 % of adolescents who attended the STP-A demonstrated reliable improvement in parent–adolescent conflict from baseline to post-treatment. Treatment response was associated with higher levels of conflict at baseline, but not adolescent ODD severity or parent ADHD severity. Several patterns of treatment non-response were detected through visual examination of weekly conflict scores during the STP-A. Discussion suggests that intensive, parent-involved treatment programs may be necessary to improve home-conflict in adolescents with ADHD.     

Exoneration reduces adult conflict's effects on preschoolers' cognitions, behavioral distress, and physiology

In this experiment, the authors investigated the influence of exoneration from blame on children's overt behavioral distress and physiological reactivity following the presentation of overheard adult conflict. The participants were 48 children (48-71 months of age) and their mothers. Through random assignment, the authors presented 16 children with statements that exonerated them from an overheard disagreement between two adults, did not address 16 during a similar disagreement, and presented 16 with a neutral discussion of difficulties. Exonerated children responded with less distress than did nonaddressed children, but did not differ from children presented the neutral discussion, except for overt behavioral distress. Nonaddressed children most often blamed themselves for the argument. Exonerating statements may protect children from attributional error and resultant physiological arousal during adult conflict.     

Inhibition,Reinforcement Sensitivity and Temporal Information Processing in ADHD and ADHD+ODD: Evidence of a Separate Entity?

This study compared children with ADHD-only, ADHD+ODD and normal controls (age 8–12) on three key neurocognitive functions: response inhibition, reinforcement sensitivity, and temporal information processing. The goal was twofold: (a) to investigate neurocognitive impairments in children with ADHD-only and children with ADHD+ODD, and (b) to test whether ADHD+ODD is a more severe from of ADHD in terms of neurocognitive performance. In Experiment 1, inhibition abilities were measured using the Stop Task. In Experiment 2, reinforcement sensitivity and temporal information processing abilities were measured using a Timing Task with both a reward and penalty condition. Compared to controls, children with ADHD-only demonstrated impaired inhibitory control, showed more time underestimations, and showed performance deterioration in the face of reward and penalty. Children with ADHD+ODD performed in-between children with ADHD-only and controls in terms of inhibitory controls and the tendency to underestimate time, but were more impaired than controls and children with ADHD-only in terms of timing variability. In the face of reward and penalty children with ADHD+ODD improved their performance compared to a neutral condition, in contrast to children with ADHD-only. In the face of reward, the performance improvement in the ADHD+ODD group was disproportionally larger than that of controls. Taken together the findings suggest that, in terms of neurocognitive functioning, comorbid ADHD+ODD is a substantial different entity than ADHD-only.