COMT and DAT1 polymorphisms moderate the indirect effect of parenting behavior on youth ADHD symptoms through neurocognitive functioning

Although gene × environment interactions contribute to youth attention-deficit/hyperactivity disorder (ADHD) symptoms, the pathways mediating these influences are unknown. We tested genetic moderation of indirect effects from parenting behavior to youth ADHD symptoms through multiple neurocognitive factors. Two hundred and twenty-nine youth with and without ADHD were assessed at baseline (Wave 1; ages 5–10) and at a 2-year follow-up (Wave 2; ages 7–13). At Wave 1, youth completed a neurocognitive battery including measures of response inhibition, visuospatial working memory, and fluid reasoning, and a standardized parent–child interaction task yielding observational measures of positive and negative parenting. At Wave 2, youth psychopathology was rated by parents and teachers using multiple methods (i.e., structured interview, rating scale). We employed moderated multiple mediation and compared conditional indirect effects across youth genotypes at two biologically plausible genetic loci. Controlling for parent ADHD symptoms as well as youth demographic factors and co-occurring externalizing symptoms, these genetic factors moderated the indirect effect from Wave 1 parenting to multi-method/informant Wave 2 ADHD symptoms through Wave 1 neurocognitive functioning. This preliminary study is the first to identify genetic moderation of mediated effects underlying ADHD symptoms and suggests that specific gene × parenting interactions may underlie neurocognitive functioning deficits and subsequent ADHD.     

Mother-Child Relationship in Youths with Attention-Deficit Hyperactivity Disorder and their Siblings

Despite impaired mother-child interactions noted in youth with attention-deficit/hyperactivity disorder (ADHD), there is no such information for their siblings. This study aimed to test whether the affected and unaffected siblings, like youth with ADHD, also encountered impaired mothering and mother-child relationships as compared to typically developing youth (TD). The sample consisted of 122 probands (107 males, 87.7 %), aged 10–16, with DSM-IV ADHD, 44 affected (26 males, 59.1 %) and 78 unaffected (28 males, 35.9 %) siblings, and 122 TD youth. Both participants and their mothers received psychiatric interviews (K-SADS-E) about the participants and reported maternal parenting style, mother-child interactions and child behavioral problems at home. Based on both reports, probands with ADHD and affected siblings (only youth report) had more impaired relationships, more behavioral problems at home, and less perceived family support than unaffected siblings and TD youth. Probands with ADHD had higher maternal authoritarian control than unaffected siblings. The findings suggest that impaired mothering, mother-child interactions, and family support are related to the presence of ADHD diagnosis in both probands and their affected siblings.     

Emotion Regulation Mediates the Association Between ADHD and Depressive Symptoms in a Community Sample of Youth

The purpose of this study was to examine the longitudinal relationship between attention-deficit/hyperactivity disorder (ADHD) symptoms, emotion regulation (ER) ability, and depressive symptoms within a diverse community sample of 277 youth, ages 9–12 (56 % male). Participants were drawn from a larger study examining adolescent risk behaviors, and completed annual assessments over 3 years. Youth ADHD symptoms were assessed at Time 1 (T1) using the parent-reported Disruptive Behavior Disorders Rating Scale, ER was assessed with the parent-reported Emotion Regulation Checklist at Time 2 (T2), and youth depressive symptoms were assessed using the self-reported Revised Child Anxiety and Depression Scales at Time 3 (T3). Analyses examined T2 ER as a mediator between T1 ADHD symptoms (including the unique contributions of inattentive [IA] versus hyperactive/impulsive [HI] symptoms) and T3 depressive symptoms. Structural equation modeling (SEM) indicated the path model specified provided an excellent fit to the data. Tests of indirect effects suggested that T2 ER appears to be a significant mechanism that underlies the relationship between T1 ADHD and T3 depression, even when accounting for T1 oppositional defiant and depressive symptoms. Furthermore, while both T1 IA and HI symptoms had significant indirect effects on T3 depression through the mechanism T2 ER, HI proved a more robust predictor of T2 ER than IA. Results of this prospective study support cross-sectional findings pointing to ER as a potential mechanism linking ADHD and depressive symptoms in youth. Clinical implications and future directions are discussed.     

Siblings’ Perceptions of Differential Treatment,Fairness, and Jealousy and Adolescent Adjustment: A Moderated Indirect Effects Model

Youth’s perception of parents’ differential treatment (PDT) are associated with maladjustment during adolescence. Although the direct relations between PDT and youth’s maladjustment have been well established, the mechanisms underlying these associations remain unclear. We addressed this gap by examining whether sibling jealousy accounted for the links between PDT and youth’s depressive symptoms, self-worth, and risky behaviors. Additionally, we examined whether youth’s perceptions of fairness regarding their treatment as well as the gender constellation of the dyad moderated these indirect relations (i.e., moderated-indirect effects). Participants were first- and second-born adolescent siblings (M = 15.96, SD = .72 years for older siblings, M = 13.48, SD = 1.02 years for younger siblings) and their parents from 197 working and middle class European American families. Data were collected via home interviews. A series of Conditional Process Analyses revealed significant indirect effects of PDT through sibling jealousy to all three adjustment outcomes. Furthermore, perceptions of fairness moderated the relations between PDT and jealousy, such that the indirect effects were only significant at low (?1 SD) and average levels of fairness. At high levels of fairness (+1 SD) there was no association between PDT, jealousy, and youth adjustment. Taken together, results indicate that youth and parents would benefit from engaging in clear communication regarding the reasoning for the occurrence of differential treatment, likely maximizing youth and parent perceptions of that treatment as being fair and in turn mitigating sibling jealousy and maladjustment.     

Parent–Child Cultural Value Gaps and Depressive Symptoms Among Mexican American Youth

Cultural value gaps between Mexican American parents and their children are hypothesized to place youth at risk for poor mental health outcomes. While most studies examine these gaps on broad measures of acculturation, the present study examined value gaps in affiliative obedience, a cultural value that has at its core the belief that respect and deference must be shown to parents and adults. The present study hypothesized that adolescents would exhibit greater depressive symptoms when youth demonstrated lower levels of affiliative obedience than their mothers. Moreover, we examined whether gender, nativity status, and age predicted cultural value gaps and moderated the relationship between gaps and depressive symptoms. These questions were evaluated in a school-based sample of 159 Mexican American families whose children were either US born (n = 82) or foreign-born (n = 77). Twenty-five percent of the sample demonstrated a cultural value gap where youth endorsed lower levels of affiliative obedience than their parents, and this group reported the greatest depressive symptoms. Age moderated this relationship, and the greatest association between cultural value gaps and depression was found among the older group of early adolescents.     

Social Skills Mediate the Association of ADHD and Depression in Preadolescents

Childhood attention-deficit/hyperactivity disorder (ADHD) is a replicated risk factor for depression, but the explanatory factors underlying this association have not been reliably identified. Given that social skills (i.e., cooperation, assertion, responsibility, self-control) are sensitive to early ADHD and predict later depression, we tested whether individual differences in social skills individually and collectively mediated predictions of depressive symptoms from early ADHD symptoms. In an ethnically diverse (50 % non-Caucasian) sample of 232 children with (n = 124) and without ADHD (n = 108) followed prospectively for two years (aged 5–10 at Wave 1; 7–12 at Wave 2), we gathered multi-informant (i.e., parent, teacher) and multi-method (e.g., rating scale, structured interview) assessment of key constructs. Using a multiple mediation framework with bootstrapping and statistical control of sex, Wave 1 depression, Wave 1 oppositional defiant disorder (ODD), Wave 1 anxiety, and Wave 2 ADHD symptoms, an independent mediation effect emerged for parent-rated self-control in the prediction of Wave 2 depression (parent-rated) from Wave 1 ADHD symptoms (combined parent and teacher ratings). Teacher-rated social skills at Wave 1 also collectively mediated this association, with teacher-rated assertion emerging as a unique mediator. We discuss the role of social skills in emergent depression among youth with ADHD and consider implications for prevention and intervention.     

Externalizing Outcomes of Youth with and without ADHD: Time-Varying Prediction by Parental ADHD and Mediated Effects

Although parental attention-deficit/hyperactivity disorder (ADHD) is a risk factor for multiple negative youth outcomes, it is unknown how change in parental ADHD symptoms over time affects change in child ADHD symptoms; moreover, mediators of these predictions are largely unknown. Parents of 230 5–10 year-old children (68 % male) with (n = 120) and without ADHD (n = 110) were followed prospectively for 6–7 years across three separate waves. Parents self-reported their ADHD and depression symptoms and similarly rated offspring ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms; youth self-reported their substance use. Temporally-ordered mediators consisted of parental expressed emotion (EE), derived from the Five Minute Speech Sample, and self-reported positive and negative parenting behavior. Controlling for key demographics and parental depression symptoms, increasing parental ADHD symptoms were a time-varying predictor of worsening youth ADHD and ODD, although it was unrelated to change in CD and alcohol/substance use. Next, although EE facets (i.e., criticism, emotional over-involvement) did not mediate these predictions, negative parenting behavior significantly mediated predictions of youth ADHD (and marginally in predictions of ODD) from parental ADHD symptoms. These quasi-experimental findings suggest that parental ADHD symptoms are a potential unique causal risk factor for offspring ADHD and ODD; also, preventing negative parenting behavior secondary to parental ADHD symptoms is critical to improve trajectories of youth ADHD and ODD. We consider parental ADHD symptoms and family factors underlying emergent externalizing problems utilizing a developmental psychopathology framework, including implications for intervention and prevention.     

Friendship Intimacy Exchange Buffers the Relation between ADHD Symptoms and Later Social Problems among Children Attending an After-School Care Program

The friendships of children displaying symptoms of attention-deficit/hyperactivity disorder (ADHD) have been understudied, particularly in comparison to the domain of peer rejection. This study tested whether friendship intimacy exchange buffers the prospective relation between ADHD symptoms and social problems 1 year later in a sample of children attending a community-based after-school program. Children (N?=?131; 53 % boys; 66 % African American) ranging from 5 to 13 years of age participated in this study. At baseline, children reported on friendship intimacy exchange with their identified best friend, and program staff rated children on ADHD symptoms and social problems. Staff ratings of children’s social problems were collected again 1 year later. Multiple regression analyses indicated that, after controlling for demographic variables and baseline social problems, friendship intimacy exchange significantly moderated the association between ADHD symptoms and social problems at the one-year follow-up. Specifically, the relation between ADHD and social problems was no longer significant for children reporting high levels of friendship intimacy exchange. This moderation was not further qualified by either child age or sex, although boys were more likely than girls to report low rates of friendship intimacy exchange. These findings indicate the importance of friendship intimacy for children displaying ADHD symptoms, who often experience significant peer problems. Friendship quality may be a promising target for prevention and intervention efforts in mitigating some of the long-term social problems associated with ADHD symptomatology, and future research is needed to extend these findings to other domains of friendship quality and clinical samples of children with ADHD.     

The Contribution of Maternal ADHD Symptomatology,Maternal DAT1, and Home Atmosphere to Child ADHD Symptomatology at 7 Years of Age

Children of mothers with attention-deficit/hyperactivity disorder (ADHD) have an increased genetic and environmental risk for ADHD. The unique and interactive contributions of a maternal dopamine receptor gene (DAT1), maternal ADHD symptoms (hyperactive- impulsive, inattentive), and home atmosphere to the prediction of ADHD symptoms (hyperactive- impulsive, inattentive) in 7- year-old boys (N = 96) were examined using data from a longitudinal study of familial risk for ADHD. During the first 6 months of the study, mothers and their spouses completed a questionnaire about the mother’s ADHD symptoms. Home atmosphere questionnaire data were collected 4 years later. At the 7-year assessment, mothers reported on their child’s ADHD symptoms. Negative home atmosphere was significantly associated with child hyperactive-impulsive and inattentive symptoms. Maternal inattentive symptoms were significantly correlated with both child symptom dimensions. Regression models, with child genotype and maternal education controlled, showed main effects for maternal inattentive symptoms, maternal DAT1 10/10 genotype, and home atmosphere in the prediction of child inattentive symptoms. Only home atmosphere predicted child hyperactive-impulsive symptoms. There was a significant home atmosphere x maternal hyperactive-impulsive symptoms interaction in the prediction of child hyperactive-impulsive symptoms. Boys with higher levels of symptoms came from homes characterized by higher levels of negative atmosphere and had mothers with higher levels of hyperactive-impulsive symptoms. There was also a trend (p = 0.075) for a maternal DAT1 x home atmosphere interaction. Boys with higher levels of inattentive symptoms came from homes with higher levels of negative atmosphere and had mothers with the homozygous 10/10 genotype. The maternal heterozygous 9/10 genotype did not predict child symptoms.     

Longitudinal Associations of Parental Emotion Socialization and Children’s Emotion Regulation: The Moderating Role of ADHD Symptomatology

Theory and research suggest that parents’ reactions to children’s emotions play a critical role in teaching children effective emotion regulation (ER) skills, but no studies have directly examined the role that parent emotion socialization plays in the development of ER in children with ADHD. Gaining insight into the causes of impaired ER, particularly in youth with ADHD who are known to have poor ER, has important theoretical and translational significance. The present study is the first to longitudinally examine whether emotion socialization predicts later physiological and adult-reported measures of ER in children with and without ADHD. It also sought to determine if these relations are moderated by ADHD symptoms. Participants were 61 children (31 girls, 30 boys; M = 10.67 years, SD = 1.28) with and without clinically significant ADHD symptoms. At Time 1, parent reports of emotion socialization and parent- and teacher-report of child ADHD symptoms were collected. At Time 2, child ER measures were collected based on parent- and teacher-report and physiological reactivity during an impossible puzzle and a social rejection task. Physiological measures included respiratory sinus arrhythmia and skin conductance level (SCL). Supportive parenting practices were associated with better parent-rated emotion regulation skills for all children and greater SCL reactivity for children with high ADHD symptoms. Non-supportive parenting reactions were associated with greater adult-rated emotional lability for children with high ADHD symptoms. Results highlight the importance of considering multiple aspects of ER, including physiological manifestations. Findings suggest that parents’ use of adaptive emotion socialization practices may serve as a protective factor for children’s ER development and may be particularly critical for youth with ADHD. Our findings support the use of interventions addressing parent emotion socialization to help foster better ER in children.     

Mediators and Moderators of the Relation between Parental ADHD Symptomatology and the Early Development of Child ADHD and ODD Symptoms

The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children’s ADHD.     

Parent and Family Characteristics and Their Associates in a Follow-Up of Outpatient Children with ADHD

We examined associations between child symptoms, demographic variables, parent and family characteristics in a long-term follow-up study of 214 outpatient children with attention-deficit/hyperactivity disorder (ADHD). The children’s mean age was 12.6 (SD = 2.1) years, and the mean interval from diagnosis to follow-up was 3.7 (SD = 2.2) years. We compared the characteristics of the clinical group with a community group (n = 110) recruited from the same catchment area. Parents filled out questionnaires on child symptoms, parent characteristics, and family functioning. The results showed that parents of young boys (<13 years) experienced more parenting stressors than those of adolescent boys (≥13 years), but the opposite was true for parents of girls. Parents of children with both ADHD and oppositional defiant disorder symptoms in the clinical range experienced significantly more parent and family dysfunctions than those of children with ADHD only (even after controlling for levels of ADHD symptoms in the child). Parents of children in the community group experienced significantly less parent and family dysfunctions than those of children with ADHD. Partial correlations between parent characteristics and child symptoms showed that oppositional symptoms were most strongly associated with parent and family dysfunction. Fathers experienced significantly less parenting stress, parental efficacy, and child involvement than mothers. We conclude that parents of children with ADHD experienced considerable strain related to a broad range of parent and family characteristics. Assessment of such characteristics should be part of routine assessment procedures and a prerequisite for family-focused treatment of children with ADHD.     

Moderators of Parent Training for Disruptive Behaviors in Young Children with Autism Spectrum Disorder

We conducted a 6 month, randomized trial of parent training (PT) versus a parent education program (PEP) in 180 young children (158 boys, 22 girls), ages 3–7 years, with autism spectrum disorder (ASD). PT was superior to PEP in decreasing disruptive and noncompliant behaviors. In the current study, we assess moderators of treatment response in this trial. Thirteen clinical and demographic variables were evaluated as potential moderators of three outcome variables: the Aberrant Behavior Checklist-Irritability subscale (ABC-I), Home Situations Questionnaire (HSQ), and Clinical Global Impressions-Improvement Scale (CGI-I). We used an intent-to-treat model and random effects regression. Neither IQ nor ASD severity moderated outcome on the selected outcome measures. Severity of Attention Deficit Hyperactivity Disorder (ADHD) and anxiety moderated outcomes on the ABC-I and HSQ. For instance, there was a 6.6 point difference on the ABC-I between high and low ADHD groups (p?=?.05) and a 5.3 point difference between high and low Anxiety groups (p?=?.04). Oppositional defiant disorder symptoms and household income moderated outcomes on the HSQ. None of the baseline variables moderated outcome on the CGI-I. That IQ and ASD symptom severity did not moderate outcome suggests that PT is likely to benefit a wide range of children with ASD and disruptive behavior.     

Does Child Temperament Play a Role in the Association Between Parenting Practices and Child Attention Deficit/Hyperactivity Disorder?

Ineffective parenting practices may maintain or exacerbate attention deficit/hyperactivity disorder (ADHD) symptoms and shape subsequent development of disruptive behavior disorders (DBD’s) in youth with ADHD. Recent theoretical models have suggested that parenting may exert effects on ADHD via its role in child temperament. The current study aimed to evaluate the indirect effects of parenting dimensions on child ADHD symptoms via child temperament. Youth ages 6–17 years (N?=?498; 50.4 % ADHD, 55 % male) completed a multi-stage, multi-informant assessment that included parent, child, and teacher report measures of parenting practices, child temperament, and ADHD symptoms. Statistical models examined the direct and indirect effects of maternal and paternal involvement, poor supervision, and inconsistent discipline on inattention and hyperactivity-impulsivity via child temperament and personality traits. Results indicated differential patterns of effect for negative and positive parenting dimensions. First, inconsistent discipline exerted indirect effects on both ADHD symptom dimensions via child conscientiousness, such that higher levels of inconsistency predicted lower levels of conscientiousness, which in turn, predicted greater ADHD symptomatology. Similarly, poor supervision also exerted indirect effects on inattention via child conscientiousness as well as significant indirect effects on hyperactivity-impulsivity via its impact on both child reactive control and conscientiousness. In contrast, primarily direct effects of positive parenting (i.e., involvement) on ADHD emerged. Secondary checks revealed that similar pathways may also emerge for comorbid disruptive behavior disorders. Current findings extend upon past work by examining how parenting practices influence child ADHD via with-in child mechanisms and provide support for multi-pathway models accounting for heterogeneity in the disorder.     

Rapid automatized naming (RAN) in children with ADHD: An ex-Gaussian analysis

Children with ADHD demonstrate increased frequent “lapses” in performance on tasks in which the stimulus presentation rate is externally controlled, leading to increased variability in response times. It is less clear whether these lapses are also evident during performance on self-paced tasks, e.g., rapid automatized naming (RAN), or whether RAN inter-item pause time variability uniquely predicts reading performance. A total of 80 children aged 9 to 14 years—45 children with attention-deficit/hyperactivity disorder (ADHD) and 35 typically developing (TD) children—completed RAN and reading fluency measures. RAN responses were digitally recorded for analyses. Inter-stimulus pause time distributions (excluding between-row pauses) were analyzed using traditional (mean, standard deviation [SD], coefficient of variation [CV]) and ex-Gaussian (mu, sigma, tau) methods. Children with ADHD were found to be significantly slower than TD children (p < .05) on RAN letter naming mean response time as well as on oral and silent reading fluency. RAN response time distributions were also significantly more variable (SD, tau) in children with ADHD. Hierarchical regression revealed that the exponential component (tau) of the letter-naming response time distribution uniquely predicted reading fluency in children with ADHD (p < .001, ΔR² = .16), even after controlling for IQ, basic reading, ADHD symptom severity and age. The findings suggest that children with ADHD (without word-level reading difficulties) manifest slowed performance on tasks of reading fluency; however, this “slowing” may be due in part to lapses from ongoing performance that can be assessed directly using ex-Gaussian methods that capture excessively long response times.     

Institutional care and iron deficiency increase ADHD symptomology and lower IQ 2.5–5 years post‐adoption

Increased ADHD symptomology and lower IQ have been reported in internationally adopted (IA) children compared to non‐adopted peers (Hostinar, Stellern, Schaefer, Carlson & Gunnar, 2012; Kreppner, O'Connor & Rutter, 2001). However, it is unclear whether these outcomes are due to institutional deprivation specifically or to co‐occurring micronutrient deficiencies that disrupt brain development (Fuglestad, Rao & Georgieff, 2008b). In this study, IA children were compared to children raised in their biological families to examine differences in ADHD symptomology and IQ 2.5–5 years post‐adoption and to assess the contributions of iron deficiency (ID) and duration of deprivation to these cognitive outcomes. ADHD symptoms (parent‐ and experimenter‐reported) and IQ were evaluated in 88 IA (M = 62.1 months, SD = 2.4) and 35 non‐adopted children (M = 61.4 months, SD = 1.6). IA children were assessed 29–64 months post‐adoption (M = 41.9 months, SD = 10.2). ID was assessed during the initial post‐adoption medical visit in 69 children, and children were classified into four groups by iron status, ranging from normal to ID anemia (most severe). IA children had greater ADHD symptomology, p < .01, and lower IQ, p = .001, than non‐adopted children. Within the IA group, children with more severe ID at adoption had greater ADHD symptomology, r(69) = 0.40, p = .001, and lower IQ, r(68) = −0.28, p < .05. Duration of institutional care was positively correlated with ADHD symptoms, r(86) = .28, p < .01, but not IQ, r(85) = −.08, p = .52. Longitudinal results indicate improvement in IQ from 12 months post‐adoption to age 5 for children with greater ID severity at adoption and longer duration of institutional care but no improvement in ADHD symptoms. These results signify continuing effects of early deprivation and ID on ADHD symptoms and IQ years after adoption. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=vUFDAS3DD1c     

Adverse Effects of Childhood Emotional Maltreatment on Child Behavioral Outcomes

This study used a diverse community sample to test a moderated mediation model, investigating maternal depressive symptoms as a mediator of the relations between maternal emotional maltreatment and child behavior problems; we further tested the moderating effects of observed maternal hostility on these relations. Participants included 64 mother–child dyads (8–11 years old; 59.4% female), in which mothers completed self- and child-report measures and dyads completed a conflict resolution task. Results of a moderated mediation analysis (PROCESS; Hayes, 2013) indicated that the maternal history of emotional maltreatment was associated with increased maternal depressive symptoms, and subsequently with higher child externalizing problems. In addition, these relations were strongest at high levels of observed maternal hostility in the conflict task.     

Adolescent Conflict as a Developmental Process in the Prospective Pathway from Exposure to Interparental Violence to Dating Violence

Within a developmental psychopathology framework, the current study examined adolescent conflict (age 16) with families, best friends, and dating partners as mediators in the prospective pathway from exposure to interparental violence (EIPV) in early childhood (0–64 months) to dating violence perpetration and victimization in early adulthood (age 23). Adolescent conflict was predicted to partially mediate EIPV and dating violence with significant direct paths from EIPV to dating violence, given the extant literature on the salience of early childhood EIPV for later maladjustment. Participants (N?=?182; 99 males, 83 females; 67 % Caucasian, 11 % African-American, 18 % other, 4 % unreported) were drawn from a larger prospective study of high-risk mothers (aged 12–34 years) that followed their children from birth through adulthood. EIPV and adolescent conflict were rated from interviews with mothers and participants, and dating violence (physical perpetration and victimization) was assessed with the Conflict Tactics Scale. Path analyses showed that EIPV in early childhood (a) directly predicted dating violence perpetration in early adulthood and (b) predicted conflict with best friends, which in turn predicted dating violence perpetration. Although mediation of best friend conflict was not evident, indirect effects of EIPV to dating violence were found through externalizing behaviors in adolescence and life stress in early adulthood. Findings highlight that conflict with best friends is affected by EIPV and predicts dating violence, suggesting that it may be a promising target for relationship-based interventions for youth with EIPV histories. Furthermore, deleterious early experiences and contemporaneous risk factors are salient predictors of dating violence.     

Brain structure mediates the association between socioeconomic status and attention‐deficit/hyperactivity disorder

Low socioeconomic status (SES) is associated with greater risk for symptoms of attention‐deficit/hyperactivity disorder (ADHD). One mechanism through which SES may confer risk for ADHD is by influencing brain structure. Alterations to cortical thickness, surface area and subcortical volume have been associated with low SES and with the presence of ADHD across multiple studies. The current study examined whether cortical thickness, surface area or subcortical volume mediate the associations between SES and ADHD in youth 3–21 years old (N = 874) from the Pediatric Imaging, Neurocognition and Genetics Study. Freesurfer was used to estimate cortical thickness, surface area and subcortical volume from structural magnetic resonance imaging. Parents reported on demographics, family SES, ADHD diagnoses and the presence of child attention problems. Statistical mediation was assessed using a bootstrap resampling procedure. Controlling for parental ADHD, child age, gender, birth weight and scanner, children in low SES families were more likely to be in the ADHD group. Consistent with previous reports in this sample, low SES was associated with reduced surface area across the frontal lobe and reduced subcortical volume in the amygdala, cerebellum, hippocampus and basal ganglia. Of these regions, a significant indirect effect of SES on ADHD status through subcortical volume was observed for the left cerebellum (95% confidence interval: 0.004, 0.022), the right cerebellum (95% confidence interval: 0.006, 0.025), and the right caudate (95% confidence interval: 0.002, 0.022). Environmentally mediated changes in the cerebellum and the caudate may be neurodevelopmental mechanisms explaining elevated risk of ADHD in children in low SES families.     

Treating the Child or Syndrome: Does Context Matter for Treatment Decisions for Antisocially Behaving Youth?

Using a between-subject 3 × 3 design of an experimentally manipulated realistic case vignette of Black, White, and Hispanic youth in a survey mailed to 1540 experienced psychologists, psychiatrists, and social workers, the authors examined if clinicians alter their judgments about treatment for antisocially behaving youth based on the symptom’s social context (e.g., life circumstances) and the youth’s race or ethnicity, even among youth who are otherwise identical in terms of behavioral symptoms. Vignettes describe behaviors meeting DSM-IV criteria for conduct disorder, but contain contextual information suggesting either internal dysfunction (ID) or a normal response to a difficult environment [i.e., environmental-reaction (ER)]. Comparison was symptom-only (SO). Judgments of effectiveness of 14 treatments for youth exhibiting antisocial behavior were examined. Frequencies and median scores of perceived effectiveness level (1–9, Likert) were compared in bivariate analyses, stratifying context and youth’s race or ethnicity. The context of the behavior was associated significantly with differences in effectiveness judgments in 13 of 14 treatments. Within ID and ER contexts, clinicians judged three different treatments as effective (median ≥ 7 of 9). In the SO condition, clinicians were less selective, judging six as effective. In the ID context, psychiatric medications, systems oriented family therapy, and residential care were judged more effective for White than for Black or Hispanic youth. Evidence-based practice research may be hampered by inattention to the social context of behavioral symptoms. Context may activate implicit racial assumptions about treatment effectiveness. Implications are for clinical training to improve service delivery, and future clinical research.