Brief report: The impact of attention deficit hyperactivity disorder (ADHD) symptoms on academic performance in an adolescent community sample.

Less is understood about the relationship between ADHD symptoms and academic performance in adolescents than the relationship in younger children. As such, the aim of the present study was to investigate the prospective relationship between ADHD symptoms and academic performance in a community adolescent sample. Three hundred and twenty-four participants, aged 15 and 16, in their final year of compulsory education, completed measures of ADHD, anxiety, depression, and motivation, and a test of general cognitive ability. Participants were also asked for permission for their academic grades to be viewed on a later occasion (approximately 6 months later). In regression analyses, ADHD symptoms were the most significant independent psychopathological predictor of academic performance, and were almost as significant as motivation and cognitive ability. The results suggest that adolescents with more ADHD symptoms are likely to encounter greater academic difficulties.

Assessing expressed emotion in mothers of children with autism: the Autism-Specific Five Minute Speech Sample.

BACKGROUND: Expressed emotion (EE) is a measure of family emotional climate found to be predictive of symptom levels in a range of psychiatric, medical, and developmental disorders, including autism. METHOD: Employing data from 104 mothers of children with autism, this study examines the Autism-Specific Five Minute Speech Sample (AFMSS), a modified EE coding system based on the widely used Five Minute Speech Sample (Magana et al., 1986). FINDINGS: With the exception of one EE component, emotional over-involvement, the revised coding system demonstrated adequate internal consistency and good to excellent inter-rater and code-recode reliability. It also demonstrated acceptable validity, based on its significant correlations with factors linked to EE in previous research. Regression analyses also indicated AFMSS-EE to be a significant predictor of child social competence, but not child problem behaviors. DISCUSSION: While further testing is required, the AFMSS appears to be a useful method of assessing EE within the context of parenting children with autism and related disorders.

Do maternal attention-deficit/hyperactivity disorder symptoms exacerbate or ameliorate the negative effect of child attention-deficit/hyperactivity disorder symptoms on parenting?

The impact of similarity in parent and child characteristics on the quality of parenting is underresearched. The current study examined the interaction between mother and child attention-deficit/hyperactivity disorder (ADHD) symptoms on parenting. Two hypotheses were tested: the similarity-fit hypothesis, which predicted that parent and child similarity will improve parenting, and the similarity-misfit hypothesis, which predicted the opposite. Study 1 examined the associations between maternal and child ADHD symptoms and child-specific rearing attitudes of 95 mothers with school-aged children. In Study 2 this analysis was extended to more objective observer-rated mother-child interaction and maternal expressed emotion in 192 mothers of preschool children. Child ADHD symptoms were associated with negative maternal comments and maternal ADHD symptoms with negative expressed emotion. In both studies maternal ADHD symptoms appeared to ameliorate the effects of child ADHD symptoms on negative parenting. Parental response to children with high ADHD symptoms was more positive and affectionate when the mother also had high ADHD symptoms. The results support the similarity-fit hypothesis and highlight the importance of considering both child and maternal ADHD symptoms in studies of parenting.

Mothers' expressed emotion toward their school-aged sons. Associations with child and maternal symptoms of psychopathology.

INTRODUCTION: Evidence suggests that mothers are negative and critical when talking about their children with behaviour problems. However the association with specific types of behaviour problems and the influence of both child and adult psychopathology on these relationships require further clarification. METHODS: Speech samples were gathered from mothers of 100 school-aged boys and coded using standard Expressed Emotion (EE) categories. Levels of maternal and child psychopathology were ascertained using standardised questionnaires completed by the mother. RESULTS: There were significant and positive correlations between criticism and child ADHD, conduct and emotional symptoms respectively. There were also significant and negative correlations between EOI and child ADHD and conduct problems. CONCLUSIONS: The findings of the current study suggest that when considered together EE is driven more by the child rather than by maternal characteristics and these effects are specific to conduct and emotional problems. The implications of the findings are discussed.

Parenting intervention in Sure Start services for children at risk of developing conduct disorder: pragmatic randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of a parenting programme as a preventive intervention with parents of preschool children considered to be at risk of developing conduct disorder. DESIGN: Pragmatic randomised controlled trial using a block design with allocation by area. SETTING: Eleven Sure Start areas in north and mid-Wales. PARTICIPANTS: 153 parents from socially disadvantaged areas, with children aged 36-59 months at risk of conduct disorder defined by scoring over the clinical cut off on the Eyberg child behaviour inventory. Participants were randomised on a 2:1 basis, 104 to intervention and 49 to remaining on the wait listing (control). Twenty (13%) were lost to follow-up six months later, 18 from the intervention group. INTERVENTION: The Webster-Stratton Incredible Years basic parenting programme, a 12 week group based intervention. MAIN OUTCOME MEASURES: Problem behaviour in children and parenting skills assessed by self reports from parents and by direct observation in the home. Parents' self reported parenting competence, stress, and depression. Standardised and well validated instruments were used throughout. RESULTS: At follow-up, most of the measures of parenting and problem behaviour in children showed significant improvement in the intervention group. The intention to treat analysis for the primary outcome measure, the Eyberg child behaviour inventory, showed a mean difference between groups of 4.4 points (95% confidence interval 2.0 to 6.9, P<0.001) on the problem scale with an effect size of 0.63, and a mean difference of 25.1 (14.9 to 35.2, P<0.001) on the intensity scale with an effect size of 0.89. CONCLUSION: This community based study showed the effectiveness of an evidence based parenting intervention delivered with fidelity by regular Sure Start staff. It has influenced policy within Wales and provides lessons for England where, to date, Sure Start programmes have not been effective. TRIAL REGISTRATION: ISRCTN46984318.

Maternal distress and expressed emotion: cross-sectional and longitudinal relationships with behavior problems of children with intellectual disabilities.

Mothers of children with intellectual disability were assessed at two time points, 2 years apart (n = 75 at Time 1, n = 56 at Time 2). Data were gathered on maternal distress, mental health, expressed emotion, and the child's internalizing and externalizing behavior problems. Consistent with previous research with families of children who have intellectual disability, maternal distress and children's behavior problems entered into a bidirectional relationship over time. This relationship was found to be specific to externalizing problems. Exploratory analyses also suggest that maternal distress and depression had a bidirectional longitudinal relationship. In terms of maternal expressed emotion, criticism and not emotional over-involvement was cross-sectionally but not longitudinally related to children's externalizing behavior problems and to maternal distress.

Symptoms of ADHD and their correlates in children with intellectual disabilities.

Existing research suggests that children with intellectual disabilities are at increased risk for ADHD, and that the symptoms of the disorder might successfully be treated with stimulant drugs. However, there has been little exploration of ADHD symptoms and their correlates in children with intellectual disabilities. Analyses of three samples of children with intellectual disabilities are presented (total N=338). Correlational analyses showed that younger children, and those with a diagnosis of Autism were rated as having more ADHD/hyperactivity symptoms. There was little evidence of a sex difference, and no strong associations with domains of adaptive behavior (socialization, communication, and daily living skills). However, there was a small but significant negative association between mental age and ratings of symptoms. Finally, an increased prevalence of ADHD/hyperactivity symptoms was confirmed in the children with intellectual disabilities compared to their siblings. This effect remained after controlling for chronological and mental age differences between the siblings. These findings support those from previous research and suggest that ADHD/Hyperkinesis may be a valid psychiatric diagnosis for children with intellectual disabilities. However, a great deal more research is needed to explore the phenomenology of ADHD in intellectual disability and to develop an evidence base for psychosocial intervention.

Spirituality and well-being in frail and nonfrail older adults.

Previous studies have identified that spiritual beliefs contribute to psychological well-being (PWB) in older people, but limited research has considered the effects of spirituality on PWB when physical health deteriorates and people become frail. We recruited 233 British participants from warden-controlled retirement housing to complete interviewer-administered questionnaires. Results showed that, after we controlled for marital status, age, education, other health problems, and gender, degree of frailty had a negative effect on PWB. Spirituality was also a significant predictor of PWB and moderated the negative effects of frailty on PWB. Therefore, this study suggests that spirituality is a resource in maintaining PWB, and that the use of this resource is more significant for individuals with greater levels of frailty.

The influence of children's self-report trait anxiety and depression on visual search for emotional faces.

BACKGROUND: This study presents two experiments that investigated the relationship between 7- and 10-year-olds' levels of self-report trait anxiety and depression and their visual search for threatening (angry faces) and non-threatening (happy and neutral faces) stimuli. METHOD: In both experiments a visual search paradigm was used to measure participants' reaction times to detect the presence or absence of angry, happy or neutral schematic faces (Experiment 1) or cartoon drawings (Experiment 2). On target present trials, a target face was displayed alongside three, five or seven distractor items. On target absent trials all items were distractors. RESULTS: Both experiments demonstrated that on target absent (but not present) trials, increased levels of anxiety produced significantly faster search times in the angry face condition, but not in the neutral condition. In Experiment 2 there was some trend towards significance between anxiety and searches for happy faces in absent trials. There were no effects of depression on search times in any condition. CONCLUSION: The results support previous work highlighting a specific link between anxiety and attention to threat in childhood.

Are planning, working memory, and inhibition associated with individual differences in preschool ADHD symptoms?

The association between executive function (EF; planning, working memory, and inhibition) and individual differences in symptoms of attention deficit hyperactivity disorder (ADHD) was explored in a sample of preschool children. One hundred sixty children (between the ages of 3 years, 0 months and 5 years, 6 months), selected so as to oversample high ADHD scorers, performed 3 tasks previously shown to measure planning (Tower of London), working memory (Noisy Book) and inhibition ("Puppet Says..."). EF measures were reliable (kappa > .77) and were correlated with IQ (rs > .38) and age (rs > .59). Once IQ and age were controlled, planning and working memory (r = .41) were correlated. Planning and working memory were not correlated with inhibition (rs < .20). There was no association between ADHD and working memory or planning (rs < .12). There was a significant negative association between ADHD and conduct problems and inhibition (r = -.30 and r = -.25, respectively). Only the link with ADHD persisted after the effects of other factors were controlled for in a multiple regression. Specific deficits in inhibitory control rather than general EF deficits are associated with ADHD in the preschool period. This association is linear in nature, supporting the idea that ADHD is better seen as a continuum rather than a discrete category. This association provides evidence for Barkley's (1997) view that ADHD is underpinned by inhibitory deficits in the preschool period.