Rosanna P. Breaux

The Role of Parent Psychopathology in the Development of Preschool Children with Behavior Problems

The present study examined associations between early parental self-reported psychopathology symptoms and the later behavioral, emotional, and social functioning of preschool children with behavior problems. Mothers and fathers of preschoolers with behavior problems (N = 132; 55 girls, 77 boys) completed parent psychopathology questionnaires when children were 3 years old and completed measures of childrens externalizing, internalizing, and social problems annually from age 3 to age 6. The sample included 61% European American, 16% Latino (predominantly Puerto Rican), 10% African American, and 13% multiethnic children. Every dimension of mothers’ and fathers’ psychopathology symptoms when children were 3 years old was associated with their own reports of childrens externalizing and internalizing problems 3 years later. Several dimensions of maternal psychopathology symptoms at age 3 were associated with mother-reported social skills 3 years later. However, the relation between many dimensions of psychopathology symptoms and child outcome appears to be accounted for by co-occurring psychopathology symptoms. Only maternal attention-deficit hyperactivity disorder (ADHD) and Cluster A symptoms, and paternal ADHD and depression/anxiety symptoms emerged as unique predictors of child functioning. These findings suggest that most types of mothers’ and fathers’ self-reported psychopathology symptoms may play a role in the prognosis of behavioral, social, and emotional outcomes of preschoolers with behavior problems, but that co-occurring symptoms need to be considered.

Early development of comorbidity between symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).

Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are among the most common childhood disorders and frequently co-occur. The present study sought to advance our understanding of how comorbidity between ADHD and ODD develops during the preschool years by testing a cross-lagged model that integrates 2 prominent models: the developmental precursor model and the correlated risk factors model. Participants were 199 children (107 boys) who took part in a longitudinal study of preschoolers with behavior problems. Parent reports of ADHD and ODD symptoms were collected annually from ages 3 to 6 and a family history interview was administered at age 3. In support of the developmental precursors model, ADHD symptoms predicted later argumentative/defiant symptoms. In support of the correlated risk factors model, family histories of ADHD and ODD/CD symptoms were correlated risk factors that uniquely predicted ADHD and anger/irritable symptoms in children. Results suggest that the correlated risk factors model may best explain the development of comorbidity between symptoms of ADHD and anger/irritability, whereas the developmental precursors model may better explain the development of comorbidity between symptoms of ADHD and argumentative/defiance.

Longitudinal Changes in Individual Symptoms Across the Preschool Years in Children with ADHD

The present study examined trajectories of individual Diagnostic and Statistical Manual of Mental Disorders (4th ed.) symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) across the preschool years in children with ADHD. It also evaluated whether preschool symptoms vary in their ability to discriminate children who later meet criteria for ADHD from typically developing children. ADHD and ODD symptoms were assessed annually in 75 ethnically diverse children (46 boys) who presented with behavior problems at age 3 and met criteria for ADHD 3 years later, and in 51 typically developing children (26 boys). Children with ADHD generally exhibited stable levels of hyperactivity/impulsivity but increases in several symptoms of inattention. Most ADHD symptoms showed at least fair utility in discriminating children with and without ADHD; however, 3 symptoms of inattention (carelessness, losing things, and forgetfulness) and 1 symptom of hyperactivity/impulsivity (blurting out answers) had relatively poor utility. These symptoms demonstrated only somewhat greater utility at age 4, but by the age of 5 were better able to classify children. Children with ADHD exhibited increases in several ODD symptoms, including symptoms related to negative affect. Although most symptoms of hyperactivity/impulsivity appear to extend well down to age 3, more developmentally appropriate symptoms of inattention may be required to develop more sensitive assessments for 3- and 4-year-old children.

Emotion Socialization Practices in Latina and European American Mothers of Preschoolers with Behavior Problems.

The present study examined mothers’ emotion socialization of three-year-old children with behavior problems to determine whether emotion socialization practices, as well as the relation between these practices and child functioning, varied across ethnicities. Participants were 134 preschoolers with behavior problems. Mothers were European-American (n = 96) and Latina (n = 38; predominantly Puerto Rican). Audiotaped mother-child interactions were coded for emotion socialization behaviors. Latina and European-American mothers used similar emotion socialization practices on most dimensions. Latina mothers were more likely to minimize or not respond to their childrens negative affect. However, this difference did not appear to have ramifications for children. This study provided evidence for both differences and similarities across ethnicities on emotion socialization practices.

Reactive attachment/disinhibited social engagement disorders: Callous-unemotional traits and comorbid disorders

BACKGROUND DSM-5 Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) are rare, understudied, and controversial disorders. METHODS Comorbidity in children diagnosed with RAD or DSED was compared with comorbidity in ADHD and autism to determine if RAD/DSED comorbidity differed from that for the two most common disorders in child psychiatric clinics. Samples included 4-17-year-olds, 20 with RAD and/or DSED, 933 with autism, and 895 with ADHD. Children with RAD/DSED were removed from their neglectful environments at a mean of 4 years and were a mean 10 years when studied. Mothers rated the children on the Pediatric Behavior Scale assessing oppositional behavior, conduct problems, ADHD, anxiety, depression, and other symptoms. RESULTS Five of the 20 children with RAD/DSED had DSED without RAD, 15 had RAD with DSED, and none had RAD without DSED. All children with RAD had callous-unemotional traits (CU) and 73% had conduct disorder (CD). No children with DSED-no RAD had CU or CD. Children with RAD+DSED were considerably more impaired than children with DSED-no RAD, autism, and ADHD. CONCLUSIONS Findings are consistent with other studies indicating high CD/CU comorbidity in RAD and extreme rarity of RAD without DSED, findings which are not noted in the DSM-5.

High Prevalence of Dysgraphia in Elementary Through High School Students With ADHD and Autism

Objective:Prevalence of dysgraphia by age across all grade levels was determined in students with ADHD or autism. Method: Referred children with normal intelligence and ADHD–Combined, ADHD–Inattentive, or autism (N = 1,034) were administered the Developmental Test of Visual-Motor Integration (VMI) and Wechsler Intelligence Scale for Children (WISC). Results: VMI and WISC Coding scores were significantly lower than IQ and the normal mean of 100 for all diagnoses. More than half (59%) had dysgraphia, and 92% had a weakness in graphomotor ability relative to other abilities. Dysgraphia prevalence did not differ between diagnostic or age groups (6-7 years, 56%; 8-10 years, 60%; and 11-16 years, 61%). Conclusion: Dysgraphia is common at all ages in children and adolescents with ADHD and autism. Accommodations and strategies for addressing this problem are discussed.

A Longitudinal Study of the Relation Between Family Functioning and Preschool ADHD Symptoms

The present study examined the bidirectional relation between family functioning and attention-deficit/hyperactivity disorder (ADHD) symptoms across the preschool years. Participants included 197 (110 boys) 3-year-old children (M = 44.14 months, SD = 3.43; 60% White) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Parenting, parent psychopathology, life stress, and child symptoms were assessed annually from ages 3 to 6. Cross-lagged models provided evidence for both parent and child effects for mothers. In particular, greater maternal overreactive parenting and life stress were predictive of more child ADHD symptoms, and greater child ADHD symptoms significantly predicted greater maternal life stress and depressive symptoms and lower warmth, controlling for child oppositional defiant disorder and parent ADHD symtoms. Child effects were evident for fathers’ depression and life stress, but these did not remain controlling for paternal ADHD symptoms. Findings suggest that targeting child ADHD symptoms, maternal overreactive parenting, and maternal stress each hold promise for attenuating the negative mutual influence of child ADHD symptoms and family functioning over time.