Tammy D. Barry

Does Attention-Deficit/Hyperactivity Disorder Have a Dimensional Latent Structure? A Taxometric Analysis

An understanding of the latent structure of attention-deficit/hyperactivity disorder (ADHD) is essential for developing causal models of this disorder. Although some researchers have presumed that ADHD is dimensional and others have assumed that it is taxonic, there has been relatively little research directly examining the latent structure of ADHD. The authors conducted a set of taxometric analyses using data from the NICHD Study of Early Child Care and Youth Development (ns between 667 and 1,078). The results revealed a dimensional latent structure across a variety of different analyses and sets of indicators for inattention, hyperactivity/impulsivity, and ADHD. Furthermore, analyses of correlations with associated features indicated that dimensional models demonstrated stronger validity coefficients with these criterion measures than dichotomous models. These findings jibe with recent research on the genetic basis of ADHD and with contemporary models of ADHD.

STABILITY OF PSYCHOPATHIC CHARACTERISTICS IN CHILDHOOD The Influence of Social Relationships

The current study is a preliminary longitudinal investigation of the stability of psychopathic characteristics, including social relationships as a moderator, within a group of aggressive children (N = 80). Data were collected from the children, their parents, teachers, and peers. Results indicated that the psychopathic characteristics (callous—unemotional traits, impulsive conduct problems, and narcissism) were relatively stable across three time points. Social relationship variables (child self-report of social competence, teacher-rated social competence, and peer-rated social preference) were generally correlated with psychopathic characteristics. Self-report of social competence moderated change from Time 1 to Time 2 narcissism based on parent report. Both peer-rated social preference and teacher-rated social competence moderated change from Time 1 to Time 3 impulsive conduct problems. These results provide preliminary support that psychopathic characteristics are generally stable in aggressive children and that social relationships are a potentially valuable point of intervention when children present with these characteristics.

Anger and Aggression

Problems with anger and aggression represent two of the most common causes for referral for mental health treatment, often because of the implications these problems have on social relationships. In some cases the aggressive and antisocial behavior leads to social rejection by the people around them; in some cases the social rejection from others triggers escalating anger and aggression, and in many cases the relation between aggression and social rejection is bidirectional. Because of their difficulties with social relationships, it is critically important to understand the nature of the social skills of angry and aggressive individuals. In this chapter we will discuss normal and problematic development of anger and aggression in youth and adults and will review the types of social-cognitive and social skill deficits that are apparent for aggressive individuals. The chapter will then review assessment and treatment issues with this population, with a particular emphasis on measures specifically tailored to provide information that can be useful in intervention.

Birth order rank as a moderator of the relation between behavior problems among children with an autism spectrum disorder and their siblings

Variability within the literature investigating typically-developing siblings of children with an autism spectrum disorder suggests that the quality of sibling outcomes may depend on specific factors. For this study, 42 parents of a child with an autism spectrum disorder and a typically- developing sibling provided data via online questionnaires. Birth order rank of the child with an autism spectrum disorder significantly moderated the relation between externalizing behaviors in children with an autism spectrum disorder and externalizing behaviors in their typically-developing siblings. Children with an autism spectrum disorder and higher levels of behavior problems had typically-developing siblings with higher levels of behavior problems only when the child with an autism spectrum disorder was older. These results provide a hint of clarification about the complex nature of sibling relations, but a great deal more research is needed to further examine outcomes of typically-developing siblings of children with an autism spectrum disorder.

A Longitudinal Examination of the Relation Between Parental Expressed Emotion and Externalizing Behaviors in Children and Adolescents with Autism Spectrum Disorder

The current study explored the longitudinal relation between parental expressed emotion, a well-established predictor of symptom relapse in various other disorders (e.g., schizophrenia) with externalizing behaviors in 84 children, ages 8–18 (at Time 2), with autism spectrum disorder (ASD). It was found that parental expressed emotion, specifically criticism/hostility at Time 1, significantly related to a change in externalizing behaviors from Time 1 to Time 2, even after controlling for Time 1 family income, ASD symptom severity, parental distress, and parenting practices. That is, higher levels of parental criticism/hostility at Time 1 predicted higher levels of child externalizing behaviors at Time 2. However, the reverse was not found. This finding of a unidirectional relation has important clinical implications.

The latent structure of oppositional defiant disorder in children and adults

An understanding of the latent structure of oppositional defiant disorder (ODD) is essential for better developing causal models, improving diagnostic and assessment procedures, and enhancing treatments for the disorder. Although much research has focused on ODD-including recent studies informing the diagnostic criteria for DSM-5-research examining the latent structure of ODD is sparse, and no known study has specifically undertaken a taxometric analysis to address the issue of whether ODD is a categorical or dimensional construct. To address this gap, the authors conducted two separate studies using a set of taxometric analyses with data from the NICHD Study of Early Child Care and Youth Development (child study; n = 969) and with data from a large mixed sample of adults, which included participants reporting psychiatric difficulties as well as healthy controls (adult study; n = 600). The results of a variety of non-redundant analyses across both studies revealed a dimensional latent structure for ODD symptoms among both children and adults. These findings are consistent with previous studies that have examined latent structure of related constructs (e.g., aggression, antisocial behavior) as well as studies that have examined the dimensional versus categorical structure of ODD using methods other than taxometric analysis.

Sibling relationship quality and psychosocial outcomes among adult siblings of individuals with autism spectrum disorder and individuals with intellectual disability without autism

Research on adult typically-developing (TD) siblings of individuals with developmental disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual disability (ID) completed questionnaires about themselves and their affected sibling. Results of this study suggest that the attitudes possessed by adult TD siblings are important to consider when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of positive sibling relationship attitudes are related to TD siblings providing more aid/support to their sibling with a disability, along with having higher levels of general life satisfaction, and negatively related to levels of stress and depressive symptoms among TD siblings. Consistent with previous child research, siblings of individuals with ASD reported fewer positive sibling relationship attitudes compared to siblings of individuals with ID. Finally, group membership related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling relationship attitudes. Overall, results indicate that sibling relationship attitudes may be particularly important to consider when conceptualizing sibling relationships when one sibling has an intellectual or developmental disability.

The Relation Between Parental Expressed Emotion and Externalizing Behaviors in Children and Adolescents With an Autism Spectrum Disorder

The current study examined the relation between parental expressed emotion, a construct of the quality and amount of emotion expressed within the family environment that is a well-established predictor of symptom relapse in various psychological disorders, with externalizing behaviors in children and adolescents with an autism spectrum disorder (ASD). Participants were 111 parents of 6- to 18-year-old children and adolescents with an ASD who completed questionnaires measuring family environment variables (including parental expressed emotion, parental distress, and parenting practices), as well as assessing their child’s autism symptoms and emotional and behavioral functioning. Results of regression analyses indicated that parental expressed emotion, specifically criticism/hostility, accounted for 18.7% of the variance in child externalizing behaviors beyond that accounted for by demographic control variables, overinvolvement, parental distress, and parenting practices. Findings highlight a possible point of intervention for parents of children and adolescents with an ASD with concomitant externalizing behaviors.

Parents’ Goals for ADHD Care in a Clinical Pediatric Sample

Objective. This report describes goals parents have for their children with attention deficit/hyperactivity disorder (ADHD) when coming for a pediatric visit. Method. Data were collected from 441 parents of children presenting to either a primary care pediatric practice or a developmental behavioral pediatric practice. Parents were asked to report their top 1 or 2 goals for improvement for their children, and responses were coded into 17 categories. These categories were further grouped into 7 goal composites and examined in relation to demographic characteristics of the families, office type, and symptomology. Results. Goals related to reducing symptoms of inattention were most common, but goals were heterogeneous in nature. Goals were meaningfully, but modestly, related to symptomology. In several instances, symptoms of comorbid conditions interacted with symptoms of ADHD in relation to specific goals being reported. Conclusions. Parents’ goals extended beyond ADHD symptoms. Pediatricians need an array of resources to address parents’ goals.

Parentification of adult siblings of individuals with autism spectrum disorder: Distress, sibling relationship attitudes, and the role of social support

ABSTRACT Background Typically developing (TD) siblings of individuals with autism spectrum disorder (ASD) often fulfil caregiving roles as children or adults (i.e., parentification, which can be either parent-focused or sibling-focused). Method This study examines how parentification interacts with social support when predicting distress and sibling relationship attitudes in 60 TD adult siblings of individuals with ASD. Results Perceived social support served as a moderator. Specifically, TD adult siblings who experienced high parent-focused parentification during childhood and low current social support were most likely to report high distress. TD siblings who reported low sibling-focused parentification during childhood and low current social support were most likely to report less positive attitudes about their relationships with their siblings with ASD. Conclusions Current findings suggest that perceived social support may serve as a potential point of intervention for reducing distress and improving sibling relationship attitudes among adult TD siblings of those with ASD.