PATERNAL ADHD, PARENTING, AND CHILD CONDUCT PROBLEMS

159 Pages·2012·0.58 MB·English

by  Abigail Romirowsky

ABSTRACT

Title of Dissertation: PATERNAL ADHD, PARENTING, AND
CHILD CONDUCT PROBLEMS:
POTENTIAL MECHANISMS.

Abigail D. Mintz, Doctor of Philosophy, 2012

Dissertation Directed By: Professor Andrea Chronis-Tuscano
Department of Psychology

Parental factors, specifically psychopathology and parenting, robustly
predict negative developmental outcomes among children with attention-
deficit/hyperactivity disorder (ADHD). Indeed, emergent findings have linked
maternal ADHD symptoms both with sub-optimal parenting and child conduct
problems within families of children with ADHD. Despite considerable research
supporting the important and unique contributions of fathers to their children’s
development, the role of fathers within families of children with ADHD has
seldom been examined. In particular, little research has been conducted with
regard to paternal ADHD symptoms and parenting, despite clear evidence for an
association between maternal ADHD symptoms and maladaptive parenting. The
current study examined psychopathology and parenting behavior among a sample
of fathers (N=102) and their 5-12 year-old children with previously-diagnosed
ADHD. Results indicated that paternal antisocial personality disorder (ASPD)
symptoms (rather than ADHD symptoms) were robustly associated with child
conduct problems, and paternal negative parenting mediated this relationship.
Future research using prospective longitudinal designs should examine multiple
forms of psychopathology and parenting behavior among fathers of children with
ADHD in order to identify potential risk factors and associated mechanisms for
the development of child conduct problems.
PATERNAL ADHD, PARENTING, AND CHILD CONDUCT PROBLEMS:
POTENTIAL MECHANISMS.

By

Abigail D. Mintz

Dissertation submitted to the Faculty of the Graduate School of the
University of Maryland, College Park, in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy
2012

Advisory Committee:
Professor Andrea Chronis-Tuscano, Chair
Professor Natasha J. Cabrera
Professor Andres De Los Reyes
Professor Lea R. Dougherty
Professor Karen M. O’Brien
© Copyright by
Abigail D. Mintz
2012
ii

Dedication
To my parents for their unending support and encouragement. To my husband for
riding alongside me on the long and winding road toward my degree. To my
teachers in all aspects of my training: instructional, research, and clinical. Finally,
to the tireless efforts of all parents, both mothers and fathers, who are raising a
child with any type of special need.
iii

Acknowledgements
The author wishes to thank those undergraduate students who aided in data
collection and organization for this study: Robert Beck, B.A. and Katie Harrelson,
B.A. A special thanks to the Institute for Challenging Disorganization (ICD) for
their assistance in recruitment for this study. The author also wishes to thank the
following dissertation committee members for their input regarding this study:
Andrea Chronis-Tuscano, Ph.D. (Chair), Natasha Cabrera, Ph.D., Karen O’Brien,
Ph.D., Lea Dougherty, Ph.D., and Andres De Los Reyes, Ph.D.
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Table of Contents

Dedication................................................................................................................ii

Acknowledgments..................................................................................................iii

Table of Contents....................................................................................................iv
List of Tables...........................................................................................................v
List of Figures.........................................................................................................vi
Introduction..............................................................................................................1
Aims.......................................................................................................................25
Method...................................................................................................................29
Results....................................................................................................................38
Discussion..............................................................................................................60
Figures....................................................................................................................75
Tables.....................................................................................................................80
Appendices.............................................................................................................89
References............................................................................................................123
v

List of Tables
Table 1. Aim 1: Paternal Sample Demographic and Diagnostic Characteristics
Table 2. Aim 1: Child Sample Demographic and Diagnostic Characteristics
Table 3. Correlation Matrix of Independent, Dependent, Mediator and
Demographic Variables
Table 4. Aim 2a: Total, direct, indirect, and partial effects of the mediation model
Table 5. Aim 2b: Total, direct, indirect, and partial effects of the mediation model
Table 6. Aim 3a: Total, direct, indirect, and partial effects of the mediation model
Table 7. Aim 3b: Total, direct, indirect, and partial effects of the mediation model
Table 8. Exploratory Aim 1a: Total, direct, indirect, and partial effects of the
mediation model
Table 9. Exploratory Aim 1b: Total, direct, indirect, and partial effects of the
mediation model
Table 10. Exploratory Aim 2a: Paternal ADHD and ASPD symptoms predicting
child CP
Table 11. Exploratory Aim 2b: Paternal ADHD and ASPD symptoms predicting
paternal PP
Table 12. Exploratory Aim 2c: Paternal ADHD and ASPD symptoms predicting
paternal NP
Table 13. Aim 2c: Total, direct, indirect, and partial effects of the moderated
mediation model
Table 14. Aim 3c: Total, direct, indirect, and partial effects of the moderated
mediation model
Table 15. Exploratory Aim 1c: Total, direct, indirect, and partial effects of the
moderated mediation model
Table 16. Exploratory Aim 1c: Total, direct, indirect, and partial effects of the
moderated mediation model
vi

List of Figures

Figure 1. Disposition of participants
Figure 2. Model of direct effects (A) and simple mediation (B): Aims 2a and 2b
Figure 3. Model of direct effects (A) and simple mediation (B): Aims 3a and 3b
Figure 4. Model of direct effects (A) and simple mediation (B): Exploratory
Analysis 1a
Figure 5. Model of direct effects (A) and simple mediation (B): Exploratory
Analysis 1b
Figure 6. Model of direct effects (A) and moderated mediation (B): Aim 2c
Figure 7. Model of direct effects (A) and moderated mediation (B): Aim 3c
Figure 8. Models of direct effects (A) and moderated mediation (B): Exploratory
analysis 1c
1

Introduction
Children with ADHD and Comorbid Conduct Problems
ADHD is present in 3-7% of school-age children in the United States
(American Psychiatric Association, 2000). Characterized by symptoms of
hyperactivity, impulsivity, and inattention, children with ADHD experience
significant functional impairment across important life areas (APA, 2000). For
instance, they often have more conflict with parents and siblings, have trouble
succeeding in the classroom both academically and socially, and face unique
challenges in maintaining peer relationships (Coie & Dodge, 1998; Fischer, 1990;
Mikami & Pfiffner, 2008; Zentall, 2007). Additionally, these children are at
substantially higher risk for maladaptive outcomes later in development, such as
early initiation and abuse of substances, depression, suicidal behavior, and
delinquency (Burke, Loeber, & Lahey, 2001; Chronis-Tuscano et al., 2010; Elkins
et al., 2007).
Conduct Disorder (CD) and Oppositional Defiant Disorder (ODD) are
both highly comorbid with ADHD. CD is characterized by consistent behaviors in
any of the following categories: aggression to people and animals, destruction of
property, deceitfulness or theft, and serious violations of rules (APA, 2000). In
community samples, CD co-occurs with ADHD at rates between 2.6 percent
(Romano, Tremblay, Vitarro, Zoccolillo, Pagani, 2005) and 17.1 percent (Bird,
Gould, & Staghezza-Jaramillo, 1994). Moreover, some clinical samples have
found comorbidity rates between ADHD and CD as high as 52.4 percent (Jensen,
Martin & Cantwell, 1997). ODD is characterized by a recurrent pattern of