Chan Elizabeth S M, Macias Mariafernanda, Kofler Michael J
Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306-4301 USA.
J Psychopathol Behav Assess. 2022;44(4):924-936. doi: 10.1007/s10862-021-09922-y. Epub 2022 Aug 9.
Pediatric ADHD is associated with parent-child relationship difficulties. However, the extent to which these relations are attributable to specific ADHD symptom clusters (i.e., inattentive vs. hyperactive/impulsive), and the extent to which child anxiety symptoms may exacerbate or protect against these difficulties, remains unclear. To address these gaps in the literature, the current study combined multi-informant measures (parent, teacher, child) with a clinically-evaluated and carefully-phenotyped sample of 188 children with and without ADHD and anxiety (ages 8-13; 63 girls). Results indicated that child-reported anxiety (β = .46) and teacher-reported inattentive (β = .71) symptoms, and their interaction (β = -1.06), along with child age and IQ (β = -.14 to -.15), predict the extent to which parents perceive themselves as confident and competent parents (all < .05). In contrast, only comorbid oppositional-defiant disorder conferred risk for increased parent-reported relational frustration, and we were unable to detect any reliable child-level demographic, diagnostic, or behavioral predictors of parent-reported discipline practices. These findings were robust to control for child demographic characteristics, clinical diagnoses, and intellectual functioning, with sensitivity analyses highlighting the importance of assessing ADHD inattentive vs. hyperactive/impulsive symptoms separately for understanding parenting outcomes. Taken together, the current findings suggest that child ADHD and anxiety symptoms may influence specific rather than broad-based aspects of the parent-child relationship, and produce differently valenced outcomes in the presence vs. absence of the other condition. Interestingly, it appears that the combination of greater child inattention and anxiety, rather than elevations in either symptom domain independently, predict adverse parenting outcomes in terms of reduced parental confidence.
小儿多动症与亲子关系困难有关。然而，这些关系在多大程度上可归因于特定的多动症症状群（即注意力不集中与多动/冲动），以及儿童焦虑症状在多大程度上可能加剧或预防这些困难，目前尚不清楚。为了填补文献中的这些空白，本研究将多 informant 测量方法（父母、教师、儿童）与一个经过临床评估且仔细分型的样本相结合，该样本包含 188 名患有和未患有多动症及焦虑症的儿童（年龄 8 - 13 岁；63 名女孩）。结果表明，儿童报告的焦虑症状（β = 0.46）、教师报告的注意力不集中症状（β = 0.71）及其相互作用（β = -1.06），以及儿童年龄和智商（β = -0.14 至 -0.15），可预测父母认为自己是自信且称职父母的程度（所有 p < 0.05）。相比之下，只有共病的对立违抗障碍会增加父母报告的关系挫折风险，并且我们无法检测到任何可靠的儿童层面人口统计学、诊断或行为预测因素来预测父母报告的管教方式。这些发现对于控制儿童人口统计学特征、临床诊断和智力功能具有稳健性，敏感性分析强调了分别评估多动症注意力不集中与多动/冲动症状对于理解养育结果的重要性。综上所述，当前研究结果表明，儿童多动症和焦虑症状可能会影响亲子关系的特定而非广泛方面，并且在存在或不存在另一种情况时会产生不同效价的结果。有趣的是，似乎儿童注意力不集中和焦虑的组合，而非任一症状领域单独升高，可预测在父母信心降低方面的不良养育结果。
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