Presented at the UCI Undergraduate Research Symposium by David A. Hallowell

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

2. 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

4. 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

5. 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

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

7. Negative Event Negative Affect Locus Stability Controllability Internal Stable Uncontrollable Efficacy and Mood Learned Helplessness Assign Causation Possible Attribution Style

8. Past Research: Relationships found Between Low Perceptions of Parenting Efficacy and Learned Helplessness Attribution Style for Child Behaviors1 Parent Attributions for Child Behaviorsand Child Attributions for Child Behaviors2 Childhood ADHDand Adult Learned Helplessness3 Learned Helplessnessand Major Depressive Disorder3 Efficacy and Mood (Continued) 1 Mash & Johnston, 1983, Coleman and Karraker, 1997; 2 Bugental & Johnston, 2000; 3 Rucklidge & Kaplan, 2000

9. Attributions Emotions Bidirectional Priming Effect Research: Negative Affect Bandura, 1989

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

11. 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 • All but one dyad white, non-hispanic ethnicity. Participants mostly • well-educated, upper-middle class.

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

13. 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

14. Palm Pilot Child Diary Screenshots Positive Mood Negative Mood

15. Hypothesis One 1)Amongparents 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

16. Hypothesis Two 2) Amongparents 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

17. 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

18. * Results significant for  < 0.05 + Results significant for  < 0.01 Results: Psychological Symptoms Brief Symptom Inventory Mood Disorder Questionnaire

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

20. No Significant Differences Results: Child Moods Composite Child Mood Profiles

21. 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

22. 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

23. 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)

24. 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

25. 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

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