Attention-deficit/hyperactivity disorder developmental trajectories related to parental expressed emotion.

Abstract

Background In the transition from childhood to adolescence, attention-deficit/hyperactivity disorder (ADHD) developmental trajectories diverge. Family environment, as indexed by parental expressed emotion, may moderate these trajectories. Methods 388 children with ADHD and 127 control children were assessed using a multi-informant, multi-method diagnostic procedure at up to three time points one year apart in an accelerated longitudinal design spanning ages 7-13 years. Latent-class growth analysis (LCGA) was used to identify developmental trajectories for both parent- and teacher-rated ADHD and ODD symptoms within the ADHD sample. Parental expressed emotion, criticism, and emotional over-involvement were coded from a 5-minute speech sample at two time points, one year apart, for 208 of these children and compared to the non-ADHD sample and among the ADHD trajectory groups. Results Parent-rated hyperactivity yielded a four class trajectory solution in LCGA; teacher-rated inattention yielded a three-trajectory solution. Teacher-rated ODD also yielded three-trajectory solution. A parent-rated high persistent hyperactive group was more likely than the other ADHD groups to have parents with stable high criticism (34.6%, p<.001), with ODD symptoms controlled. A teacher-identified high ODD-worsening group was more likely to experience high criticism at either time point, particularly the initial time point; (87.5%, p<.001), with hyperactivity controlled. Conclusion Parental criticism, an index of the family environment, is uniquely associated with divergent developmental trajectories among children with ADHD in addition to those associated with ODD symptoms.

Evidence of concurrent and prospective associations between early maltreatment and ADHD through childhood and adolescence

“…These associations were robust for the total sample, but particularly amongst boys. The measure used specifically captures negative evaluations from their parents, demeaning attitudes and perceived threat, which is consistent with recent findings in which parents' negative expressed emotion about their children predicted a persistent ADHD trajectory [44]. Nevertheless, findings on parental expressed emotion and hostility in relation with ADHD are mixed, with reports of negative findings [45]; others have found that children's ADHD may precede [46] or evoke [47] parental hostility.…”

“…Further, both parental behaviours [52] and physical abuse [53] have been shown to moderate genetic vulnerability for ADHD. Meanwhile, low maternal warmth [54] and frequent parental criticism [44] have been recently related with a worse ADHD symptom trajectory.…”

Trait Impulsivity and the Externalizing Spectrum

“…Hyperactive children who experienced effective parenting did not progress to more severe externalizing outcomes, whereas those who experienced explosive, coercive, and nattering parenting did. High rates of parental criticism also mediate associations between ADHD and growth in ODD among 7-13-year-olds (Musser et al 2016). Similar to research on temperament referred to above, disruptions in parenting that are common to maternal depression mediate longitudinal associations between ADHD in early childhood and conduct problems 2-8 years later, whereas positive parenting offers protection (Chronis et al 2007).…”

ADHD and Present Hedonism: time perspective as a potential diagnostic and therapeutic tool

“…High emotional expression in parenting (particularly negative-reactive instead of positive parenting strategies) was associated with ADHD54 as well as higher rates of aggressive behavior, fighting, and later impulsivity 55. Similarly, research has found a direct correlation with the behaviors and parenting roles in time perspective studies.…”