Parenting stress among families of children with attention deficit hyperactivity disorder

Prior research has shown that parenting stress levels can be quite high among families of children with attention deficit hyperactivity disorder (ADHD). This study investigated the degree to which such stress was related not only to the child's ADHD, but also to various other child, parent, and family-environment circumstances. Multimethod assessments were conducted on 104 clinic-referred children with ADHD. Data collected from these subjects were entered into hierarchical multiple-regression analyses, utilizing the Parenting Stress Index as the criterion. The results showed that child and parent characteristics accounted for a substantial portion of the variance in overall parenting stress. The child's oppositional-defiant behavior and maternal psychopathology were especially potent predictors. The severity of the child's ADHD, the child's health status, and maternal health status also emerged as significant predictors. These findings are discussed in terms of their impact upon the clinical management of children with ADHD.The authors are grateful to Mary Maher and Paula Nevins for their assistance in collecting and coding the data. The authors would also like to thank Dr. Kenneth Fletcher for his helpful comments regarding the statistical analyses.     

A short-term longitudinal study of the early development of self-regulation

A short-term longitudinal study was conducted to determine whether self-regulation at 4 years could be predicted from child and maternal measures obtained when the children were age 24 months. The subjects were 69 children and their mothers drawn from the general community. Criterion behaviors assessed at 4 years were those suggestive of attention-deficit hyperactivity disorder. Of the 24-month child measures, maternal ratings of the child's impulsivity and attention span, plus an objective measure of delay ability, were the most effective predictors. Maternal negativity, as assessed in mother-child interaction, predicted the criterion behaviors, even after the child's behavior as an elicitor of maternal behavior was controlled. Maternal child-rearing attitudes on the dimensions of warmth and aggravation were also effective predictors, even after controlling for the child's emotionality as a possible determinant of maternal attitudes. It is argued that the results with the maternal attitude measures provide support for the hypothesis that maternal behavior is a contributor to the development of self-regulation.This research was supported by a State of Ohio Academic Challenge Grant to the Bowling Green State University Clinical Psychology Program, and by a Basic Grant awarded to the first author by the Bowling Green State University Faculty Research Committee. The authors are grateful to Eric Dubow, Douglas Ullman, and two anonymous reviewers for their helpful comments and criticisms on previous versions of this article.     

Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder

Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a regular classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.The authors gratefully acknowledge the assistance of Patricia Donovan, Michelle Berry, Mary Ingram, Patricia Wells, Beth Gnagy, Karen Greenslade, Mary Hamilton, and the entire staff of the Western Psychiatric Institute and Clinic ADHD Summer Treatment Program.     

Effects of protein malnutrition and the administration of cortisol on the reflexologic development in rats.

The use of neurological tests in various states of undernutrition has confirmed the presence of delays in reflex ontogeny. Glucocorticoid administration in conditions of normal nutrition produces diminished growth and alterations in brain development similar to those observed in malnutrition, but there is not enough evidence about its effect on reflex development. In addition, some facts lead us to think that the use of permissive doses of these hormones during gestation could alleviate some of the effects of protein malnutrition on the development of pups. In the present study the ages at which certain reflexes appeared in the offspring of Wistar rats (Rattus norvegicus) fed a 20% (N) or 10% (M) protein diet from a week before conception to the end of lactation were observed. Each dietary group was subdivided into two: mothers receiving a daily injection during gestation either of a 0.9% NaCl (S) solution or of a 0.5 mg/100 g weight hydrocortisone acetate (C) solution. Results showed that the NS group of pups generally presented earlier ages of appearance of the variables under study than the remaining groups. Pups of the NC group presented delays in the age of appearance of reflexes. Finally, protein malnutrition delayed the appearance of reflexes and this effect seemed to be attenuated by treatment with hydrocortisone. Thus, hydrocortisone administration in protein malnutrition conditions seems to be beneficial although the results are harmful when administered under normal nutritional conditions.     

Does a cognitive map guide choices in the radial-arm maze?

Fifteen rats performed in a standard radial-arm maze task (Experiment 1) and in a modified task with a set of forced choices and a 15-min retention interval prior to completion of the maze (Experiment 2). In addition to the standard measure of choice in the radial-arm maze, orientation toward arms was measured and considered to constitute go-no-go "microchoice" decisions. Rats investigated but rejected many arms. A model of choice was developed in which it was assumed that choice decisions about arms were made independently and that microchoices were not selectively guided toward baited arms. The model performed nearly as well as the rats. These results place important limitations on the theory that choice behavior in the radial-arm maze is guided by a cognitive map.     

Multivariate genetic analysis of specific cognitive abilities in the Colorado adoption project at age 7

A multivariate hierarchical model of specific cognitive abilities was fitted to data from 7-year-old adopted and nonadopted sibling pairs in the Colorado Adoption Project in order to assess differential genetic influence on specific mental abilities. Model fitting results and Schmid-Leiman (Schmid & Leiman, 1957) transformations reveal significant heritable variation for verbal, spatial, and memory factors independent of general cognitive ability for the eight ability tests examined. In contrast, environmental influences are primarily measure-specific. The results suggest genetic effects in middle childhood that differentially influence mental ability scores.     

Soul Healing: A Model of Feminist Therapy

A feminist psychospiritual model of therapy that can be used in working with clients who value the spiritual dimension in their lives is offered. The history, philosophy, and work of Women for a New World, a multidisciplinary team of women representing the areas of psychology, religious education, and the arts is presented. Using examples drawn from the developmental history of our retreat-workshop paradigm and from some of our programs, including a weekend retreat for women and a day of reflection for persons affected by AIDS (including family and friends of those with AIDS), the metaphor of therapy as soul healing is developed.     

The Pinocchio Syndrome: Lying and Its Impact on the Counseling Process

Surprisingly little has been written in the counseling journals on the topic of lying: that is, why some clients consciously choose to be either dishonest with their counselors or deliberately hold back (i.e., keep secrets) important information from their counselors. This article discusses the dynamics of lying and offers suggestions to counselors on how to work with clients who lie.