Arthur D. Anastopoulos

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 childs 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 childs oppositional-defiant behavior and maternal psychopathology were especially potent predictors. The severity of the childs ADHD, the childs 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.

Parent ratings of attention-deficit/hyperactivity disorder symptoms: Factor structure and normative data.

Changes in the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) have necessitated the creation of new measures for clinical assessment. The factor structure of a parent rating scale containing the 18 symptoms of ADHD was examined in this study. Factor analyses and assessment of differences in ADHD ratings across sex, age, and ethnic group were conducted using a sample of 4666 participants ranging in age from 4 to 20 years old who attended kindergarten through 12th grade in 22 school districts across the United States. Two factors (Inattention and Hyperactivity–Impulsivity) were derived and normative data for a nationally representative sample are presented. A higher frequency of ADHD symptoms was found for boys, younger children, and African-American participants. Potential uses of this scale in clinical practice and research are discussed.

Parent training for Attention Deficit Hyperactivity Disorder: Its impact on parent functioning

This study examined changes in parent functioning resulting from parental participation in a behavioral parent training (PT) program specifically designed for school-aged children with attention-deficit hyperactivity disorder (ADHD). Relative to wait list controls, subjects who completed the nine-session PT program showed significant posttreatment gains in both child and parent functioning, which were maintained 2 months after treatment. In particular, there were PT-induced reductions in parenting stress and increases in parenting self-esteem, which accompanied parent-reported improvements in the overall severity of their childs ADHD symptoms. In addition to their statistical importance, these findings are discussed in terms of their clinical significance, utilizing methods developed by Jacobson and Truax (1991).

Adolescents with ADHD : patterns of behavioral adjustment, academic functioning, and treatment utilization

Adolescents with attention deficit hyperactivity disorder (ADHD) were compared with a control group on a comprehensive assessment battery. More ADHD teenagers had oppositional defiant disorder (68%) and conduct disorder (39%) and were rated as more impaired in social competence, behavioral and emotional adjustment, and school performance by parents and teachers than control teens. The ADHD youths, however, rated themselves as better adjusted than did their parents and teachers, differing only from controls in depressive symptoms and antisocial acts. Poorer performances in verbal learning and vigilance and greater ADHD behaviors during a math task also distinguished the ADHD from control teenagers.

Regulatory Contributors to Children’s Kindergarten Achievement.

The present study sought to examine whether preschool childrens emotion regulation, problem behaviors, and kindergarten behavioral self-regulation in the classroom were predictors of kindergarten achievement scores. The children (N = 122, 47% male and 63% European American) who were participating in an ongoing longitudinal study, were seen at both a preschool and kindergarten assessment. The present study examined the relation between parent report, teacher report, and laboratory measures of regulation and childrens achievement test scores. Childrens emotion regulation and behavioral self-regulation in the classroom were related to all measures of achievement. The relation between preschool emotion regulation and kindergarten achievement was mediated by behavioral self-regulation in the kindergarten classroom. In addition, all measures of regulation were correlated, suggesting that some children who have difficulty regulating their behavior in one setting (such as home) may also have difficulty with regulation in other settings (such as school).

Teacher ratings of Attention-Deficit/Hyperactivity Disorder symptoms: Factor structure and normative data.

Comprehensive assessment of attention-deficit/hyperactivity disorder (ADHD) symptoms includes parent and teacher questionnaires. The ADHD Rating Scale-5 was developed to incorporate changes for the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013). This study examined the fit of a correlated, 2-factor structure of ADHD (i.e., DSM-5 conceptual model) and alternative models; determined whether ADHD symptom ratings varied across teacher and child demographic characteristics; and presented normative data. Two samples were included: (a) 2,079 parents and guardians (1,131 female, 948 male) completed ADHD symptom ratings for children (N = 2,079; 1,037 males, 1,042 females) between 5 and 17 years old (M = 10.68; SD = 3.75) and (b) 1,070 teachers (766 female, 304 male) completed ADHD symptom ratings for students (N = 2,140; 1,070 males, 1,070 females) between 5 and 17 years old (M = 11.53; SD = 3.54) who attended kindergarten through 12th grade. The 2-factor structure was confirmed for both parent and teacher ratings and was invariant across child gender, age, informant, informant gender, and language. In general, boys were higher in symptom frequency than girls; older children were rated lower than younger children, especially for hyperactivity-impulsivity; and non-Hispanic children were rated higher than Hispanic children. Teachers also rated non-Hispanic African American children higher than non-Hispanic White, Asian, and Hispanic children. Non-Hispanic White teachers provided lower hyperactivity-impulsivity ratings than non-Hispanic, African American, and Hispanic teachers. Normative data are reported separately for parent and teacher ratings by child gender and age. The merits of using the ADHD Rating Scale-5 in a multimodal assessment protocol are discussed. (PsycINFO Database Record

Assessing culturally different students for attention deficit hyperactivity disorder using behavior rating scales.

Behavior rating scales are commonly used in the assessment of attention deficit-hyperactivity disorder (ADHD). However, there is little information available concerning the extent to which scales are valid with culturally different students. This study explored the use of the ADHD-IV Rating Scale School Version with male Caucasian (CA) and African American (AA) students from ages 5 to 18 years. Teachers rated AA students higher on all symptoms across all age groups. LISREL analysis indicated that scale does not perform identically across groups. This was supported by the results of multidimensional scaling with suggested that there is a different relation between items across groups. Implications for research and practice are discussed.

Motives and Perceived Consequences of Nonmedical ADHD Medication Use by College Students Are Students Treating Themselves for Attention Problems

Objective: This study examines why college students without a prescription take ADHD medication, what they perceive the consequences of this to be, and whether attention problems are associated with this behavior. Method: More than 3,400 undergraduates attending one public and one private university in the southeastern United States completed a Web-based survey. Results: Nonmedical ADHD medication use in the prior 6 months was reported by 5.4% of respondents and was positively associated with self-reported attention difficulties. Enhancing the ability to study was the most frequent motive reported; nonacademic motives were less common. Students perceived nonmedical use to be beneficial despite frequent reports of adverse reactions. Conclusion: Students without prescriptions use ADHD medication primarily to enhance academic performance and may do so to ameliorate attention problems that they experience as undermining their academic success. The academic, social, and biomedical consequences of illicit ADHD medication use among college students should be researched further. (J. of Att. Dis. 2009; 13(3) 259-270)

Reliability and validity of parent and teacher ratings of Attention-Deficit/Hyperactivity Disorder symptoms.

The reliability and criterion-related validity of the Home and School versions of the AD/HD Rating Scale-IV were evaluated in a nonreferred sample of 71 students. Parent and teacher ratings were obtained 4 weeks apart at a time contemporaneous with observations of classroom behavior and academic productivity. Results indicated adequate levels of internal consistency, test-retest reliability, and cross-informant agreement for both parent and teacher ratings. Teacher ratings were significantly correlated with classroom observational data, and parent ratings were primarily related to behavior ratings. The discriminant validity of these scales also was examined in a sample of 92 clinic-referred children. Both the Home and School versions of the AD/HD Rating Scale-IV were found to discriminate significantly between children with and without AD/HD. The AD/HD Rating Scale-IV appears to have adequate psychometric properties for the screening and assessment of AD/HD.

Predicting Stability and Change in Toddler Behavior Problems: Contributions of Maternal Behavior and Child Gender

This study examined the stability and continuity of early-identified behavior problems and the factors associated with this stability. Children and their mothers (N=125) were seen when the children were 2 and 4 years of age. Maternal reports of child externalizing behavior and laboratory observations of child noncompliance were stable from age 2 to age 4. Early externalizing behaviors decreased over time; however, child noncompliance in the laboratory did not. Although few associations were found between maternal positive behavior and child behavior problems, maternal controlling behavior was related to increases in child behavior problems, particularly at high levels of both prior noncompliance and prior maternal control. Child noncompliance was predictive of increases in maternal controlling behavior over time.