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Review

  1. 1. The Impact of ADHD on theChild’s Family<br />Julie Lewis<br />PSY492: Advanced General Psychology<br />August 15, 2011<br />
  2. 2. Overview<br /><ul><li>Research question: What is the impact on the family when there is a child with ADHD in the household?
  3. 3. Objective: To gain insight into how a child’s ADHD affects the family
  4. 4. Hypothesis: There is an impact on the family when there is a child with ADHD
  5. 5. Literature review findings</li></li></ul><li>Brannon and Heflinger (2006): Caregiver, child, family, and service system contributors to caregiver strain in two child mental health service systems <br /><ul><li>Financial strain
  6. 6. Disruption of family relationships and social life
  7. 7. Interruptions at work
  8. 8. Limits on personal freedom and time
  9. 9. Feelings of sadness, guilt, anger, frustration
  10. 10. Fatigue and depression
  11. 11. Severity of child problems was the most consistent predictor of caregiver strain.
  12. 12. Strength – compared Medicaid and fee-for-service patients
  13. 13. Limitation – small sample</li></li></ul><li>Brown, Howcroft, and Muthen (2010): Resilience in families living with a child diagnosed with hyperactivity/attention deficit disorder <br /><ul><li>Increase in separation and divorce rate
  14. 14. Increased interpersonal conflict
  15. 15. Increased marital conflict, separation and divorce
  16. 16. Less contact with extended families
  17. 17. Fewer positive family experiences
  18. 18. Personal and relational transformation forged from adversity is possible
  19. 19. Family resilience can be a powerful asset in dealing with the stress and strain
  20. 20. Strength – provided research on family resilience – no previous research
  21. 21. Limitation – used a small sample</li></li></ul><li>(Deault, 2010): A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). <br /><ul><li>Comorbid oppositional defiant disorder and conduct disorder exacerbate parental stress and strain
  22. 22. Stress and strain from having a child with ADHD can worsen parent’s psychopathology, which can negatively affect ADHD symptoms
  23. 23. Parental stress and strain negatively affects parenting skills
  24. 24. Increased maternal anxiety and depression leading to less consistent parenting
  25. 25. Strength – highlights gap in research regarding effect of comorbities on parental stress
  26. 26. Limitation – all research subjects were boys</li></li></ul><li>Hurt, Hoza, & Pelham (2007): Parenting, family loneliness, and peer functioning in boys with attention-deficit/hyperactivity disorder <br /><ul><li>Parental stress can interfere with emotional warmth, assertive discipline, and parent-child attachment
  27. 27. Parental stress can lead to use of physical punishment, verbal reprimands, harsh commands, and threats
  28. 28. Stress and strain can lead to dysfunctional parenting, which can lead to aggressive behavior from child toward peers and parents, which leads to more stress. . .
  29. 29. Strength – used information from children and parents
  30. 30. Limitation – only boys were included in sample</li></li></ul><li>Lifford, Harold, & Thapar, (2009): Parent-child hostility and child ADHD symptoms: a genetically sensitive and longitudinal analysis <br /><ul><li>Genetics and environment contribute to mother-son hostility
  31. 31. Less parental stress when child is properly medicated
  32. 32. High conflict and stress contributes to parent psychopathology
  33. 33. Mothers more responsive to ADHD symptoms than fathers
  34. 34. Parents often see boys ADHD symptoms as being more deliberate, which increases the stress reaction
  35. 35. Strength – longitudinal study
  36. 36. Limitation – children’s report on relationships could be affected by ADHD</li></li></ul><li>Pelham & Lang (1999): Can your children drive you to drink? <br /><ul><li>Increased parental stress associated with increased alcohol intake
  37. 37. Increased alcohol intake exacerbates ADHD symptoms, which increases stress and alcohol intake.
  38. 38. Family history of alcoholism associated with effects stress has on behavior
  39. 39. Strength – contributes to sparse literature on subject, used single and married parents
  40. 40. Limitation – self reports on drinking, possibility of dishonesty</li></li></ul><li>(Van DerOord, et al., 2006):The association between parenting stress, depressed mood and informant agreement in ADHD and ODD<br /><ul><li>The higher the stress level the more negative the reported symptoms are
  41. 41. The higher the parental stress the more disparity there is between teacher reports and parent reports.
  42. 42. Parental stress affects perception of conflict and family disruption
  43. 43. Strength – study stresses the importance of considering parental stress when reporting ADHD symptoms
  44. 44. Limitation – children with ADHD tend to behave differently in school than they do at home so difference in reporting may be due to difference in behavior</li></li></ul><li>(Whalen, Henker, Jamner, Ishikawa, Joshua, et. al., 2006): Toward mapping daily challenges of living with ADHD: Maternal and child perspectives using electronic diaries <br /><ul><li>Increased feeling that there is no choice to change the situation
  45. 45. Parents tend to be more critical, negative, and disapproving when they feel there is no end to the stress from their child’s ADHD symptoms
  46. 46. Increased conflict and discord when parents have less esteem and satisfaction
  47. 47. Increased anger with child’s noncompliance
  48. 48. Strength – study used electronic mapping, which is an effective way of reporting symptoms as they are happening
  49. 49. Limitation – small sample size, families in chaos less likely to volunteer</li></li></ul><li>Conclusion<br /><ul><li>Parents who have a child with ADHD experience a great deal of stress due to a variety of reasons
  50. 50. Family stress can decrease overall functioning of the child with ADHD and his/her family
  51. 51. Parents often have increased anxiety, depression, marital discord, divorce, and substance abuse
  52. 52. Further research could evaluate what effect treating parental stress has on ADHD symptoms and family functioning</li></li></ul><li>References<br /> Brannan, A.M., & Heflinger, C.A., (2006). Caregiver, child, family, and service system contributors to caregiver strain in two child mental health service systems. Journal of Behavioral Health Services & Research,33(4), 408-422. <br />Brown, O., Howcroft, G., & Muthen, T. (2010). Resilience in families living with a child diagnosed with hyperactivity/attention deficit disorder. South African Journal of Psychology.330(13), 338-350.<br />Deault, L.C. (2010). A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry & Human Development. 168(25), 168-192.<br />Hurt, E.A., Hoza, G., & Pelham Jr., W.E. (2007). Parenting, family loneliness, and peer functioning in boys with attention-deficit/hyperactivity disorder. Journal of Abnormal Child Psychology.35(4), 543-555. <br />Lifford, K.J., Harold, G.T., & Thapar, A. (2009). Parent-child hostility and child ADHD symptoms: a genetically sensitive and longitudinal analysis. Journal of Child Psychology & Psychiatry. 50(12), 1468-1476.<br />Pelham Jr., W.E., & Lang, A.R., (1999). Can your children drive you to drink? Alcohol Research and Health. 23(4). <br />Singh, N.N., Singh, A.N., Lancioni, G.E., Singh, J., Winton, A.S., & Adkins, A.D. (2010). Mindfulness training for parents and their children with ADHD increases the children’s compliance. Journal of Child and Family Studies.19(2), 157-166. <br />
  53. 53. References cont.<br />Van DerOord, S., Prins, P.J.M., Oosterlaan, J. & Emmelkamp, P.M.G. (2006). The association between parenting stress, depressed mood and informant agreement in ADHD and ODD.BehaviourResearch and Therapy. 44(11). 1585-1595.<br />Whalen, C.K., Henker, B., Jamner, L.D. Ishikawa, S.S. Joshua, N., et al. (2006). Toward mapping daily challenges of living with ADHD: Maternal and child perspectives using electronic diaries. Journal of Abnormal Child Psychology.34(1), 115-130. <br />Withrow, L.M., Has, P.A.K., & Holten, K.B. (2011). Managing ADHD in children: Are you doing enough? Journal of Family Practice.60(4), E1-E3. <br /> <br /> <br /> <br />

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