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Child ADHD and ODD Behavior Interacts with Parent
ADHD Symptoms to Worsen Parenting and Interparental
Communication
Brian T. Wymbs &Frances A. Wymbs &Anne E. Dawson
Published online: 3 June 2014
#Springer Science+Business Media New York 2014
Abstract Attention-deficit hyperactivity disorder (ADHD) in
children and adults increases risk of parenting difficulties and
interparental discord. However, little is known about whether
disruptive child behavior and adult ADHD operate additively
or synergistically to predict parenting and interparental rela-
tionship quality. As part of a larger study, 90 parent couples
were randomly assigned to interact with a 9–12 year-old
confederate child exhibiting eitherADHD/ODD-like behavior
or typical behavior. Before these interactions, parents reported
their own ADHD symptoms. Afterwards, parents reported on
their partner’s parenting and interparental communication be-
havior. Observers coded the parenting and communication
behavior of both partners during the tasks. Child
ADHD/ODD-like behavior was found to predict less positive
and more negative parenting and communication reported by
partners and observers beyond adult ADHD symptoms and
other covariates. Elevated adult ADHD symptoms only
uniquely increased risk of observer-coded negative parenting.
Child and adult ADHD behavior interacted synergistically to
predict partner-reported negative parenting and interparental
communication, such that parents reporting greater ADHD
symptoms—especially inattentiveness—were rated by their
partners as parenting and communicating more negatively
when managing child ADHD/ODD-like behavior than parents
with fewer ADHD symptoms or those managing typical child
behavior. Child and adult ADHD behavior did not interact to
predict observer-coded parenting or interparental communica-
tion, and patterns did not differ for mothers or fathers. Our
results underscore the potential risk of parents with elevated
ADHD symptoms parenting and communicating negatively,
at least as perceived by their partners, during interactions with
children exhibiting ADHD/ODD behavior.
Keywords ADHD .Parenting .Interparental relations .
Familial dysfunction
Being a parent is not easy, but it is especially difficult when
raising a child with attention-deficit hyperactivity disorder and
oppositional defiant disorder (ADHD/ODD). Parents of chil-
dren with ADHD/ODD often become aggravated to a point at
which some rely on aversive parenting practices, including
underusing positive reinforcement of appropriate behavior
and overusing commands and critical feedback (Johnston
and Lee-Flynn 2011). Due at least in part to managing disrup-
tive child behavior (Wymbs 2011), parent couples of children
with ADHD/ODD are more likely than parents of children
without ADHD/ODD to report frequent and unresolved con-
flicts, and to ultimately divorce (Wymbs et al. 2008a,b).
However, disruptive child behavior is not the only stressor
contributing to adversity in these families. For example, ap-
proximately 40–55 % of children with ADHD have at least
one parent with ADHD (Smalley et al. 2000; Takeda et al.
2010). The elevated prevalence of ADHD among parents of
children with ADHD/ODD is concerning because adults with
ADHD often use inconsistent and punitive parenting strate-
gies (Johnston et al. 2012) and spark marital conflict (Barkley
et al. 2008). Although evidence indicates that ADHD in both
children and parents exacerbates aversive parenting and
interparental discord, few studies have investigated the addi-
tive and synergistic contributions of child and adult ADHD to
parenting and marital difficulties. Given the implications of
this line of research for treating children with ADHD/ODD
who have parents with ADHD, the present study was con-
ducted to evaluate the comparative and combined effects of
B. T. Wymbs (*):F. A. Wymbs:A. E. Dawson
Department of Psychology, Ohio University, Porter Hall, Athens,
OH 45701, USA
e-mail: wymbs@ohio.edu
J Abnorm Child Psychol (2015) 43:107–119
DOI 10.1007/s10802-014-9887-4
child and parent ADHD on parenting and interparental rela-
tionship quality.
Effects of Child ADHD on Parenting and Interparental
Relations
Children’s influence on adult behavior is a well-documented
phenomenon. Following Bell’s(1968) seminal review, which
called into question the widely held notion that parents influ-
ence children and not vice versa, science has repeatedly
shown that children play a significant role in shaping the
behavior of their parents. In these studies, child behavior has
been manipulated most often through the use of confederate
children (for reviews, see Bell and Chapman 1986; Lytton
1990). For example, Pelham, Lang, and colleagues conducted
a series of studies where they trained child confederates to
reliably enact “deviant,”ADHD/ODD-like child behavior in
order to examine its impact on adult parenting behavior,
affective distress, and alcohol use. In brief, they found that
parents who interacted with deviant confederates (aged 9–
12 years-old) used more restrictive (e.g., commands) and less
positive (e.g., laughing, playing) parenting behaviors, report-
ed greater negative affect, and consumed more alcohol in a
laboratory setting than did individual parents interacting with
“normal,”non-deviant confederates (Lang et al. 1999;Pelham
et al. 1997,1998). Adapting the confederate child behavior
manipulation employed by Pelham, Lang and colleagues for
use with parent couples, Wymbs and Pelham (2010)found
that mothers and fathers communicate less positively and
more negatively with each other during interactions with 9–
12 year-old confederates displaying “disruptive,”
ADHD/ODD-like behavior than those exhibiting “typical,”
developmentally-appropriate behavior. In light of these stud-
ies highlighting that child ADHD/ODD behavior has an ob-
servable adverse effect on parenting and interparental com-
munication, it makes sense that evidence-based treatments for
children with ADHD/ODD (e.g., Evans et al. 2013)includea
review of coping skills for parents to handle child-induced
stress. However, less is known about whether risk variables
common in families of children with ADHD/ODD, such as
the presence of ADHD in parents, magnify the chances of
parents responding ineffectively or adversely to managing
child ADHD/ODD behavior.
Parenting and Interparental Relations of Adults
with ADHD
Many children with ADHD have parents with ADHD
(Smalley et al. 2000; Takeda et al. 2010). One of the most
common areas of impairment for adults with ADHD is inter-
personal relationships (Barkley et al. 2008), including
relations with their children. For example, studies have shown
that elevated ADHD symptoms in parents increases the risk
that they will use ineffective parenting strategies, such as
being uninvolved, giving infrequent praise, being impatient
and over-reactive, and monitoring or disciplining misbehavior
inconsistently (e.g., Chronis-Tuscano et al. 2008; Griggs and
Mikami 2011;Harveyetal.2003; Mokrova et al. 2010;Zisser
and Eyberg 2012). Narrowing the focus to the symptom-level,
preliminary evidence indicates that parents with elevated in-
attentive symptoms, but not hyperactive/impulsive symptoms,
are prone to parenting difficulties (Harvey et al. 2003;Zisser
and Eyberg 2012), though this may only be the case for
parents of children with ADHD (Griggs and Mikami 2011).
One limitation of research on the association between ADHD
symptoms and parenting behavior is that very few studies had
samples including mothers and fathers, and of these studies,
none assessed the quality of parenting behavior in mother-
father-child triads. Given that evidence-based psychosocial
treatments for child ADHD/ODD (i.e., behavioral parent
training; BPT) focus on dyadic processes between children
and, most typically, their mothers (Evans et al. 2013), exam-
ining associations between parent ADHD symptoms and one-
on-one interactions with their child is logical. That said,
children in two-parent households spend more time with both
of their parents than they did in the past (Sandberg and
Hofferth 2001), suggesting that children are increasingly like-
ly to engage in triadic (mother-father-child) interactions.
Moreover, research has also found important differences in
parenting quality between dyadic and triadic interactions (e.g.,
Buhrmester et al. 1992). Thus, studies are needed to better
understand the contribution of parent ADHD symptoms to the
quality of triadic parenting contexts as doing so may inform
treatment with families headed by more than one parent.
In addition to parenting difficulties, adults with ADHD
often report lower romantic relationship satisfaction (e.g.,
Eakin et al. 2004; Minde et al. 2003) and higher rates of
separation/divorce (e.g., Kessler et al. 2006) than adults with-
out ADHD. Partners of adults with elevated ADHD symp-
toms also indicate significant impairment in their relationships
(Eakin et al. 2004; Robin and Payson 2002). Interestingly,
Eakin and colleagues (2004) as well as Robin and Payson
(2002) found that romantic relationship difficulties were
sparked primarily by inattentive behaviors (e.g., task comple-
tion and time management) and not hyperactive/impulsive
behavior. However, the literature is limited in its coverage of
whether adult ADHD differentially affects relationship quality
in men and women. The few evaluations of gender effects
found statistical trends indicating that non-ADHD male part-
ners of women with ADHD were more distressed by, and
ultimately more willing to divorce, their spouse than non-
ADHD female partners of men with ADHD (Minde et al.
2003; Robin and Payson 2002). Research examining whether
adult ADHD symptoms and interparental relationship quality
108 J Abnorm Child Psychol (2015) 43:107–119
differs between men and women may help inform the need to
develop gender-specific treatment plans to address relation-
ship issues in adults with ADHD.
Unique Effects of Child and Parent ADHD on Parenting
and Interparental Relations
Despite evidence linking child ADHD/ODD and adult ADHD
to ineffective parenting and interparental discord, few studies
have examined the unique contribution of each to parenting or
interparental relationship quality. Findings from those studies
that have examined child and parent behavior as unique risk
factors indicate that child ADHD/ODD behavior is a stronger
risk factor for aversive parenting than parent ADHD symp-
toms. For example, Psychogiou et al. (2007) found that child
ADHD symptoms explained unique variance in maternal and
paternal negative parenting beyond that accounted for by
parent ADHD symptoms (which were non-significant predic-
tors). Chronis-Tuscano and colleagues (2008)reportedthat
parent ADHD symptoms were not uniquely associated with
observed positive parenting beyond child ODD diagnoses or
with the number of commands they issued beyond disruptive
child behavior. Similarly, Williamson and Johnston (2013)
showed that child ADHD diagnosis predicted lower mother-
rated collaborative parenting alliance independent of mother
and father ADHD symptoms, though this unique child effect
was reduced to non-significance when covariates (i.e., paren-
tal depression, hostility, child ODD) were included in the
analysis. The same study also found that elevated paternal
ADHD symptoms predicted more negative interparental rela-
tionship attributions beyond child- and mother- ADHD symp-
toms, but this effect was also attenuated when the same
covariates were included in the model. In brief, these results
suggest that child ADHD/ODD behavior is more strongly
associated with aversive parenting and interparental discord
than parent ADHD symptoms, and that it may be important to
control for parent factors beyond ADHD symptoms when
testing whether child and parent ADHD are uniquely associ-
ated with parenting and interparental relationship quality.
Interestingly, there is emerging evidence suggesting that
child and adult ADHD operate synergistically in prediction of
parenting behavior. Psychogiou and colleagues (2007)found
that the Child x Maternal ADHD symptoms interactions
significantly predicted negative parenting in an unexpected
pattern. Namely, when child and maternal ADHD symptoms
were both low, mothers exhibited the lowest levels of negative
parenting; when child ADHD symptoms were high and
maternal ADHD symptoms were low, mothers exhibited the
highest levels of negative parenting. Psychogiou et al. (2008)
found a similar pattern with positive parenting, such that it
peaked when levels of child- and maternal- ADHD symptoms
were both high, but it was at its lowest levels among mothers
with high ADHD symptoms parenting children with low
ADHD symptoms. The authors suggested that these findings
supported a “similarity-fit”hypothesis for mothers, whereby
those with elevated ADHD symptoms, perhaps owing to
greater degree of tolerance or empathy resulting from their
own experience with ADHD symptoms, are more positive and
less negative when parenting children with elevated ADHD
symptoms.
It is important to note that Psychogiou and colleagues
(2007) found a different synergistic pattern for fathers: nega-
tive parenting was greatest when child and father ADHD
symptoms were both elevated. In contrast to the similarity-fit
hypothesis for mothers, the authors suggest that these data are
consistent with “similarity-misfit”for fathers, such that those
with elevated ADHD symptoms may use more aversive
strategies when managing children with ADHD due to
having poor regulation of negative affect and being easily
annoyed or overwhelmed by disruptive child behavior.
Griggs and Mikami (2011) found evidence in support of the
similarity-misfit hypothesis—but for mothers, such that ma-
ternal inattention was associated with providing less correc-
tive feedback for, and being less irritable with, children with
ADHD while no associations were found between maternal
inattentiveness and feedback/irritability for children without
ADHD. Thus, regardless of their gender, some parents with
elevated ADHD symptoms may be more susceptible to neg-
ative parenting when managing children with elevated ADHD
symptoms than others.
That said, the studies examining disruptive child behavior
and parent ADHD symptoms as additive and synergistic risk
factors for parenting and interparental relationship difficulties
have several limitations. First, only one of the five studies
included mothers and fathers in their sample and tested for
unique effects of parent ADHD symptoms by parent gender in
the same analysis (Williamson and Johnston 2013).
Psychogiou and colleagues (2007) suggested that similarity-
fit/misfit patterns differed for mothers and fathers, yet did not
examine whether gender moderated associations between the
Child x Adult ADHD interaction and parenting behavior.
Second, none of the studies assessed for the contribution of
child ADHD/ODD and parent ADHD to the quality of par-
enting during triadic interactions. As such, it is unclear wheth-
er the gender-specific similarity-fit/misfit patterns presented
by Psychogiou and colleagues would manifest the same in
triadic interactions as in dyadic interactions. Third, no studies
examined whether disruptive child behavior and adult ADHD
symptoms operated synergistically in the prediction of out-
comes other than parenting behavior, such as interparental
communication. Lastly, studies have yet to explore whether
parental inattention and hyperactivity/impulsivity symptoms
interact differentially with child ADHD/ODD symptoms in
the prediction of parenting or interparental relations. Parents
with elevated inattentiveness, versus those reporting elevated
J Abnorm Child Psychol (2015) 43:107–119 109
hyperactivity/impulsivity, may be especially prone to aversive
parenting and interparental communication when interacting
with children behaving disruptively because inattention is
more strongly associated with variables that are often corre-
lated with parenting and marital difficulties (e.g., general
distress, less positive and more negative mood; Knouse et al.
2008). Moreover, one study has shown that parents with
elevated inattentiveness, but not necessarily hyperactivity/
impulsivity, were especially likely to parent aversively during
interactions with children with ADHD (Griggs and Mikami
2011). Taken together, addressing each of these gaps in the
literaturemay have implications for tailoring BPTprograms to
best serve two-parent households including children and par-
ents with ADHD.
Current Study
We conducted a study evaluating whether ADHD/ODD-like
child behavior and parent ADHD symptoms operate additive-
ly or synergistically in the prediction of parenting behavior
and interparental communication during the course of triadic
interactions. As part of a larger study (Wymbs and Pelham
2010), 90 parent couples were randomly assigned to interact
briefly with a child confederate exhibiting either
ADHD/ODD-like or typical, developmentally-appropriate be-
havior.
1
Beforehand, parents reported on their own ADHD
symptoms and immediately afterward, they reported on the
quality of their partner’s parenting and interparental commu-
nication during the interaction. Trained observers also coded
parenting and communication behavior. We hypothesized that
(1) relative to parent ADHD symptoms, child ADHD/ODD-
like behavior would be more strongly associated with parent-
ing and interparental communication quality as rated by part-
ners and observers; and (2) confederate child behavior and
parent ADHD symptoms would interact synergistically to
predict parenting and interparental relationship quality.
Given the conflicting results reported by Psychogiou and
colleagues (2007,2008) and by Griggs and Mikami (2011)
when probing similar interactions, we did not hypothesize
whether our results would support similarity-fit or similarity-
misfit patterns; (3) Parent inattention, but not hyperactivity/
impulsivity, would interact synergistically with child
ADHD/ODD-like behavior in the prediction of parenting
and interparental communication; and (4) Parent gender
would moderate synergistic associations between risk factors
and outcomes, such that fathers reporting elevated ADHD
symptoms would manage ADHD/ODD-like children, and
communicate with their partner during these interactions, with
lower levels of positivity and higher levels of negativity than
mothers, who would exhibit higher levels of positivity and
lower levels of negativity when interacting with
ADHD/ODD-like children and their partners.
Method
Participants
Ninety parent couples were recruited to participate in a larger
study examining whether disruptive child behavior caused
interparental conflict (for complete description of methods,
see Wymbs and Pelham 2010). Couples were required to have
lived together for at least 2 years and both partners were
required to play an active role in parenting their children. Of
these couples, 51 had children meeting Diagnostic and
Statistical Manual of Mental Disorders (4th ed.) criteria
(American Psychiatric Association 1994) for ADHD and 39
had children without ADHD. Demographic characteristics of
both parents and their children were consistent across families
including children with and without ADHD.
2
Overall, this
sample was comprised primarily of middle-aged (mean ma-
ternal and paternal age = 40 and 42, respectively), Caucasian
(sample comprised of 5.0 % minorities), married (5.6 % non-
married, cohabitating), and middle to upper-middle class par-
ents (mean household income = $75 K) who had boys
(84.40 % male) in middle childhood (mean age = 10.77, range
8.50–12.92 years-old).
Procedures
Study procedures were approved by a university institutional
review board. After providing informed consent, parents were
asked to complete several questionnaires (see below). Next,
parent couples were given an overview of the child interaction
task sequence. Parents were told that they would interact with
an unfamiliar child selected at random from a local elementary
1
Confederate child behavior, and not the behavior of the couples’own
children, was used as the main effect of child ADHD/ODD in the present
study. The primary aim of the larger study (Wymbs and Pelham 2010)
from which data was gathered to conduct this study was to examine
whether disruptive, ADHD/ODD-like child behavior caused interparental
discord. Utilizing confederate children to enact ADHD/ODD-like or
typical child behavior was the most appropriate strategy to conduct an
initial examination of child effects on marital quality. Regarding the
present study, relying on confederate behavior as the child behavior main
effect allowed for us to test directly how parents respond in-the-moment
to ADHD/ODD-like or typical child behavior.
2
As described previously (Wymbs and Pelham 2010), maternal and
paternal age, race, marital status, and household income did not differ
between parents of children with and without ADHD. Furthermore, the
age, gender, and race of their children also did not differ statistically
between groups. Notably, the ADHD status of parents’own children was
not a risk factor of interest in the present study. ADHD/ODD behavior as
exhibited by confederate childrenduring interactions with parents was the
primary child effect measured in this study. Nonetheless, given its prom-
inent role in sample selection, ADHD status of the parents’own children
was included as a covariate in all analyses.
110 J Abnorm Child Psychol (2015) 43:107–119
school who was the same gender and race and approximately
the same age as their own child. Couples were encouraged to
act naturally with the child during the interaction. Parent
couples were also reminded that the goal of this study was
to learn more about co-parenting. As such, they were asked to
problem solve with each other as needed to resolve child
behavior management issues, if applicable. After this intro-
duction, the co-parent dyads interacted with the child in four
structured-task activities, including a cooperative task (i.e.,
build tower with Jenga blocks; 8 min), a parallel task (i.e.,
parents balanced checkbook while child completed math as-
signment; 7 min), a free-play task (i.e., played Nerf basketball
together; 7 min), and a clean-up task (i.e., parents instructed
child to clean up the toys; 3 min). Structured interactions such
as these are evidence-based (Roberts 2001) and are often used
to study parent–child relationship quality in families of youth
with ADHD (e.g., Chronis-Tuscano et al. 2008).
Unbeknownst to the parents, the child with whom they
interacted was a confederate. Seven 9- to 12-year-old children
were trained extensively to enact two scripted behavioral
roles: one dictating that they behave like children with
ADHD/ODD and another requiring they behave like children
without ADHD/ODD. Scripts for both roles were adapted
from an experimental paradigm devised and validated in a
series of studies with individual parents (Lang et al. 1999;
Pelham et al. 1997,1998) to allow for interactions with
couples. Every confederate was trained to enact both
ADHD/ODD-like and typical behavior roles, and then ran-
domly assigned to enact only one role with each couple for the
duration of the interaction. Trained observers, who were not
briefed on study hypotheses or any details regarding the parent
couples, used checklists to track the behavior of the confed-
erates during every interaction, recording whether or not spe-
cific behaviors were exhibited or omitted correctly according
to the scripts for each role. Behavior tracking confirmed
the reliability of the confederates in typical (M=93 %,
SD=5, Range = 82–99 %) and ADHD/ODD-like roles
(M=88 %, SD=4, Range=78–98 %). To determine
whether the confederate manipulation was successful,
we analyzed parent reports of confederate child behavior
on the IOWA Conners Rating Scale (ICRS; Waschbusch
and Willoughby 2008). The 10-item ICRS is a widely
used and validated behavior rating scale assessing per-
ceptions of how often children exhibit inattention over-
activity (IO) and oppositional defiance (OD) behavior.
As reported in (Wymbs and Pelham 2010), parents
interacting with ADHD/ODD-like confederates endorsed
significantly greater child IO (F[1, 169]=379.58, p=
0.01) and OD (F[1, 169]= 124.52, p= 0.01) than did
parents interacting with typical confederates. Effect sizes
calculated using Cohen’sd(i.e., M1-M2/α
pooled
;
Cohen 1988) revealed very large effects for both com-
parisons (d=3.10 and 1.79, respectively).
Predictor Variables
Confederate Child Behavior Confederate behavior was coded
dichotomously, such that typical child behavior = 0 and child
ADHD/ODD-like behavior = 1.
Parent ADHD Symptoms Prior to interacting with the confed-
erate child, parents reported on their own ADHD symptoms
using the Current Symptoms Scale (CSS; Barkley and
Murphy 1998). The CSS asks for respondents to endorse
how frequently they exhibit the 18 DSM-IVADHD symptoms
in the past 6 months (0 = Never or rarely,1=Sometimes,2=
Often,3=Very often). Validity of the CSS has been demon-
strated through past findings of significant group differences
between ADHD and control adults (Barkley et al. 2008).
Summary scores were created for total ADHD symptoms
(α=0.89) as well as for inattention (α=0.86) and
hyperactivity/impulsivity symptoms (α=0.77). Average sum-
mary scores for inattention (M=4.41, SD=4.14), and
hyperactivity/impulsivity symptoms (M=4.54, SD=3.69)
were somewhat lower than normative scores reported by
Barkley and Murphy (1998)for30–49 year-old adults. Nine
study participants exceeded the + 1.5 SD clinical cutoff score
for total ADHD symptoms recommended by Barkley and
Murphy.
Covariates Given the nature of the sample recruited for the
original study (Wymbs and Pelham 2010), we controlled for
ADHD status of the couples’own child. We covaried confed-
erate gender to address concerns that associations between
child behavior, parenting, and interparental communication
may differ depending on whether parent couples interacted
with boys or girls (Cox et al. 2001;DaviesandLindsay2001).
Parent gender was also included as a covariate in all analyses
and later tested as a potential moderator of associations be-
tween the Confederate child behavior x Parent ADHD symp-
toms interaction and outcomes. In light of well-established
associations between depression and both parenting and mar-
ital quality (Cummings et al. 2001), we covaried self-reported
depressive symptoms as measured by the Beck Depression
Inventory-Second Edition (BDI-II; Beck et al. 1996;α=0.88).
To control for pre-interaction perceptions of parenting and
relationship quality, we covaried self-reported parenting and
marital satisfaction using the 9-item satisfaction subscale of
the Parenting Sense of Competence Scale (PSOC-S; Johnston
and Mash 1989;α=0.80) and the 9-item satisfaction subscale
of the Dyadic Adjustment Scale (DAS-S; Spanier 1976;
Kurdek 1992;α=0.86), respectively.
Outcome Variables
Observer-Coded Parenting and Interparental
Communication Parenting and interparental communication
J Abnorm Child Psychol (2015) 43:107–119 111
behaviors were coded using the Family Observation Schedule
(FOS; Dadds and Sanders 1992; see also Dadds et al. 1987).
The FOS is a simplified version of the Family Interaction
Coding System (Patterson 1982) and is well-suited for studies
seeking to capture parenting and communication behaviors
exhibited by parents during interactions with disruptive chil-
dren (Dadds et al. 1987). Trained coders, who were not made
aware of study hypotheses or details about parent couples but
were aware of the nature of child confederate manipulation,
evaluated parents’use of positive (i.e., praise, polite questions,
positive instructions, positive nonverbal attention) or negative
parenting behaviors (i.e., impolite questions, negative instruc-
tion, criticism, threats of punishment, negative nonverbal at-
tention). They also coded the same positive behaviors used
when parents were communicating with each other, and coded
a similar set of negative interparental communication behav-
iors (i.e., aversive questions, negative instructions, criticism,
ignoring, negative nonverbal attention). Total frequencies of
positive parenting and interparental communication behaviors
were dependent measures. Owing to positively skewed data
for negative parenting and interparental communication, di-
chotomous variables were used to indicate the absence (0) or
presence (1) of either behavior. Interactions were coded by
pairs of observers in order to calculate inter-observer agree-
ment for positive (ICC = 0.98) and negative (ICC = 0.99)
parenting as well as positive (ICC = 0.98) and negative (ICC =
0.81) interparental communication.
Partner-Reported Parenting and Interparental
Communication Immediately following the child interaction,
each parent independently answered two questions regarding
how their partner parented the confederate child: 1) “Ignoring
their negative parenting, how positively did your partner
parent the child (1 = Not at all positive to 10 = Completely
positive)?”and 2) “Ignoring their positive parenting, how
negatively did your partner parent the child (1 = Not at all
negative to 10 = Completely negative)?”Similarly, on the
same response scales, parents also independently rated how
their partner communicated with them during the interaction:
1) “Ignoring their negative communication, how positively
did your partner communicate with you?”and 2) “Ignoring
their positive communication, how negatively did your part-
ner communicate with you?”The format and scale of the
partner ratings was adapted from Fincham and Linfield’s
(1997) Positive and Negative Quality in Marriage Scale, an
empirically validated measure of positivity and negativity in
romantic relationships. Observer and partner ratings of posi-
tive parenting were not significantly associated (r=0.14, p=
0.06), but observer and partner ratings of negative parenting
(r=0.25, p< 0.01) as well as positive (r=0.21, p<0.01) and
negative (r<0.22, p=0.01) communication were significantly
correlated. The strength of these associations is consistent
with cross-informant correlations for measures of parenting
(e.g., Coffman et al. 2006) and interpersonal behavior (e.g.,
Foltz et al. 1999).
Analytical Plan
Multiple regression analyses were conducted in Mplus 7.0
(Muthén and Muthén 2012). The maximum likelihood esti-
mator robust to data non-normality (MLR) was used for all
regression analyses including those with dichotomous out-
comes (observer-coded negative parenting and interparental
communication), which were tested using logistic regression.
Given the hierarchical nature of the data, the “cluster”com-
mand was used to account for individual parents nested within
couples. To test whether child and parent ADHD contribute
additively to predict the quality of parenting and interparental
communication, confederate child behavior and parent-
reported ADHD symptoms were entered simultaneously into
the equation alongside the covariates. The main effects of
confederate child behavior and parent ADHD symptoms were
entered simultaneously. Next, to test whether child
ADHD/ODD-like behavior and parent ADHD symptoms
interacted synergistically to predict parenting and interparental
communication outcomes, the Confederate behavior x Parent
ADHD interaction was entered into the equation after the
covariates and main effects. In the presence of a significant
interaction, analyses would be conducted to examine (1)
whether confederate behavior interacted with parent inatten-
tion and/or hyperactivity/impulsivity to predict the same out-
come and (2) whether parent gender moderated the effect of
the Confederate behavior x Parent ADHD interaction on the
same outcome. Partner-rated and observer-coded parenting
and communication outcomes were tested separately, and
not combined to form a composite or latent variable, owing
to the weak associations of these constructs across informants.
Results
Preliminary Analyses
Descriptive statistics and intercorrelations for all covariates,
predictor and outcome variables are shown in Table 1.
Confederate child behavior was significantly correlated with
all eight outcome variables, such that disruptive child behav-
ior was mainly associated with lower levels of positive par-
enting and interparental communication, and with greater
levels of negative parenting and interparental communication.
The lone exception was finding that disruptive child behavior
waspositivelyassociatedwithobserver-codedpositivepar-
enting. Parent-reported ADHD symptoms were only associat-
ed with one of the eight outcome variables, such that parents
with elevated ADHD symptoms were more likely to exhibit
112 J Abnorm Child Psychol (2015) 43:107–119
negative interparental communication according to observers.
Parental depression was not significantly correlated with any
outcome measures, so it was not included as a covariate in
subsequent analyses.
Prediction of Parenting
Results of multiple regression analyses predicting parent-rated
and observer-coded parenting are presented in Table 2.
Testing our first hypothesis, we found that ADHD/ODD-like
behavior exhibited by the confederates was uniquely associ-
ated with every parent- and observer-rated measure of parent-
ing during the triadic interaction, but elevated parent ADHD
symptoms was only uniquely associated with one outcome
(observer-coded negative parenting) beyond confederate be-
havior. With regards to our second hypothesis, the
Confederate behavior x Parent ADHD interaction did not
predict either positive parenting variable or observer-coded
negative parenting during the tasks. However, it did predict
partner-rated negative parenting, such that parents who
interacted with ADHD/ODD-like children, especially parents
who self-reported elevated ADHD symptoms, were rated by
their partners as parenting more negatively than those who
interacted with typical confederates (Fig. 1). Follow-up anal-
yses conducted to evaluate our third hypothesis revealed that
confederate behavior interacted with parent inattention symp-
toms (b=0.90, SE = 0.36, p= 0.01), but not parent
hyperactivity/impulsivity symptoms (b=0.60, SE=0.50, p=
0.23), in the prediction of partner-rated negative parenting
during the tasks. Identical to the pattern presented in Fig. 1,
parents with elevated inattention symptoms who interacted
with ADHD/ODD-like children were rated by their partners
as parenting more negatively than parents with low levels of
inattention and those who did not interact with ADHD/ODD-
like children. Finally, tests of our fourth hypothesis revealed
that the 3-way interaction between confederate behavior, par-
ent ADHD symptoms, and parent gender did not predict
partner-rated negative parenting during the tasks.
Prediction of Interparental Communication
Results of multiple regression analyses predicting parent-rated
and observer-coded interparental communication are present-
ed in Table 3. As above, testing our first hypothesis indicated
that ADHD/ODD-like behavior exhibited by the confederates
was uniquely associated with every parent- and observer-rated
measure of interparental communication during the triadic
interaction. Parent-reported ADHD symptoms were not
uniquely associated with any interparental communication
outcome during the tasks beyond confederate behavior.
Addressing our second hypothesis, the Confederate behavior
x Parent ADHD interaction did not predict either positive
interparental communication variable or observer-coded neg-
ative interparental communication during the tasks. However,
Tabl e 1 Descriptive statistics and intercorrelations among covariates, predictors and outcomes
M(SD)or%12345678
1. Child ADHD status 56.67 ADHD –
2. Child sex 15.56 % fem −0.06 –
3. Parent MDD symptoms 7.63 (6.53) 0.26** 0.06 –
4. Relationship satisfaction 42.09 (5.45) −0.25** 0.00 −0.55** –
5. Parenting satisfaction 38.61 (7.03) −0.45** −0.02 −0.49** 0.47** –
6. Parent sex 50.00 % fem 0.00 0.00 −0.03 0.04 −0.12 –
7. Confederate status 47.78 % typ 0.02 −0.02 −0.08 −0.08 −0.10 0.00 –
8. Parent ADHD symptoms 8.95 (7.09) 0.17* 0.01 0.19* −0.26** −0.11 −0.08 −0.03 –
9. Observer-coded positive parenting 98.16 (47.88) 0.03 −0.02 −0.03 0.08 −0.20** 0.26** 0.31** −0.01
10. Any observer-coded negative parenting? 35.00 0.03 0.07 0.03 −0.13 −0.15* 0.06 0.66** 0.09
11. Observer-coded positive communication 26.53 (12.31) −0.11 0.03 0.08 −0.13 0.13 0.09 −0.23** 0.04
12. Any observer-coded negative communication? 23.89 0.23** −0.24** 0.09 −0.16* −0.20** −0.01 0.33** −0.09
13. Partner-rated positive parenting 8.69 (1.53) −0.20** 0.01 −0.10 0.13 0.23** 0.08 −0.48** −0.07
14. Partner-rated negative parenting 1.78 (1.30) 0.14 0.05 −0.01 −0.03 −0.11 −0.08 0.42** 0.11
15. Partner-rated positive communication 8.49 (2.04) −0.25** 0.05 −0.05 0.12 0.19** 0.07 −0.40** −0.02
16. Partner-rated negative communication 1.81 (1.56) 0.11 −0.12 0.02 −0.13 −0.09 −0.04 0.38** 0.15*
Child ADHD Status = ADHD diagnostic status of parents’own child (0 = NonADHD,1=ADHD); Child Sex = Sex of parents’own child and
confederate with whom they interacted (1 = male; 2 = female); Parent MDD symptoms = Depression symptoms reported on BDI-II; Relationship
Satisfaction = Relationship satisfaction reported on DAS-S; Parenting Satisfaction = Satisfaction with parenting reported on satisfaction subscale of the
PSOC; Parent Sex = female (0), male (1); Confederate Status = Typical (0) or ADHD/ODD-like (1); Parent ADHD symptoms = Self-reported ADHD
symptom measured by the CSS; Observer-coded positive parenting/communication = Total frequencies of positive parenting/communication behaviors
coded by observers during interactions; Any observer-coded negative parenting/communication? = Absence of negative parenting/communication (0),
presence of negative parenting/communication (1); Partner-rated positive parenting/communication (1 = Not at all positive to 10 = Completely positive);
Partner-rated negative parenting/communication (1 = Not at all negative to 10 = Completely negative)
J Abnorm Child Psychol (2015) 43:107–119 113
it did predict partner-rated negative interparental communica-
tion, such that parents who interacted with ADHD/ODD-like
children, especially those who self-reported elevated ADHD
symptoms, were rated by their partners as communicating
more negatively than those who interacted with typically-
behaving children (Fig. 2). Once more, follow-up analyses
conducted to evaluate our third hypothesis revealed that con-
federate behavior interacted with parent inattention (b=1.20,
SE=0.48, p= 0.01), but not parent hyperactivity/impulsivity
(b=0.60, SE =0.45, p=0.18), in the prediction of partner-rated
negative parenting during the tasks. As shown in Fig. 2,
parents with elevated inattention symptoms who interacted
with ADHD/ODD-like children were rated by their partners
as communicating more negatively, relative to parents without
inattentive symptoms and those who did not interact with
ADHD/ODD-like children. Again, testing our fourth hypoth-
esis indicated that Parent gender x Confederate behavior x
Parent ADHD interaction did not significantly predict partner-
rated negative interparental communication during the tasks.
Discussion
In the present study, we examined whether child ADHD/ODD
behavior and parent ADHD symptoms contribute additively
and synergistically to parenting and interparental communica-
tion dysfunction. Our results indicated that ADHD/ODD-like
behavior exhibited by confederate children increased risk for
every parenting and interparental communication outcome
beyond the contribution of parent-reported ADHD symptoms
and other covariates (including parent depressive symptoms,
ADHD status of the couples’own child, parent gender, par-
enting and marital satisfaction). Conversely, parent ADHD
symptoms contributed uniquely to prediction of only one
outcome (observer-coded negative parenting) independent of
confederate child behavior and the same covariates. Next, we
Tab l e 2 Results of multiple regressions predicting partner-rated and observer-coded parenting
Positive parenting Negative parenting
Parent-Rated Observer-Coded Parent-Rated Observer-Coded
Step 1 Step 2 Step 1 Step 2 Step 1 Step 2 Step 1 Step 2
b(SE) b(SE) b(SE) b(SE) b(SE) b(SE) O.R.(95 %CI) O.R.(95%CI)
Child ADHD status −0.37 (0.20) −0.37 (0.20) −0.53 (0.56) −0.54 (0.54) 0.28 (0.18) 0.29 (0.18) 0.90 (0.33, 2.44) 0.88 (0.33, 2.43)
Child sex −0.03 (0.24) −0.03 (0.24) −0.33 (0.71) −0.38 (0.75) 0.22 (0.21) 0.24 (0.20) 2.76 (0.98, 7.76) 2.71 (0.93, 7.89)
Relationship satisfaction −0.01 (0.03) −0.01 (0.03) 0.19 (0.06)** 0.19 (0.06)** 0.24 (0.19) 0.25 (0.20) 0.99 (0.92, 1.06) 0.98 (0.92, 1.06)
Parenting satisfaction 0.03 (0.02) 0.03 (0.02) −0.18 (0.06)** −0.18 (0.06)** −0.12 (0.14) −0.13 (0.14) 0.97 (0.91, 1.03) 0.97 (0.92, 1.03)
Parent sex 0.28 (0.19) 0.28 (0.19) 2.12 (0.72)** 2.09 (0.71)** −0.21 (0.16) −0.20 (0.16) 1.64 (0.67, 4.04) 1.62 (0.67, 3.95)
Confederate status −1.43 (0.19)** −1.43 (0.19)** 2.90 (0.55)** 2.90 (0.55)** 1.10 (0.18)** 1.10 (0.18)** 121.10 (24.06, 609.58)** 201.01 (11.92, 3,390.08)**
Parent ADHD symptoms −0.09 (0.13) −0.10 (0.16) 0.35 (0.48) 0.98 (0.62) 0.20 (0.13) −0.03 (0.06) 1.95 (1.08, 3.50)* 3.35 (0.72, 15.64)
Confederate × Parent ADHD –0.02 (0.27) –−1.37 (0.87) –0.49 (0.23)* –0.50 (0.10, 2.44)
R
2
=0.29 R
2
=0.29 R
2
=0.22 R
2
=0.23 R
2
=0.22 R
2
=0.24 R
2
=0.66 R
2
=0.70
Child ADHD Status = ADHD diagnostic status of parents’own child (0 = NonADHD,1=ADHD); Child Sex = Sex of parents’own child and confederate with whom they interacted (1 = male; 2 = female);
Relationship Satisfaction = Relationship satisfaction reported on DAS-S; Parenting Satisfaction= Satisfaction with parenting reported on satisfaction subscale of the PSOC; Parent Sex = female (0), male
(1); Confederate Status = Typical (0) or ADHD/ODD-like (1); Parent ADHD symptoms = Self-reported ADHD symptom measured by the CSS. With exception of dichotomous variables, all predictors
were centered for each analysis. Unstandardized betas and standard errors are reported for prediction of continuous outcome measures while odds ratios and 95 % confidence intervals are reported for
prediction of dichotomous outcomes measures
1
1.2
1.4
1.6
1.8
2
2.2
2.4
2.6
2.8
Low High
Partner-
Rated
Negative
Parenting
Parent ADHD Symptoms
"Typical"
Confederate
"ADHD/ODD
-Like"
Confederate
Fig. 1 Confederate child behavior and parent ADHD symptoms interact
to predict partner-rated negative parenting. Low parent ADHD symptoms
= 1 standard deviation below mean; High parent ADHD symptoms = 1
standard deviation above mean
114 J Abnorm Child Psychol (2015) 43:107–119
found that disruptive child behavior and parent ADHD symp-
toms operated synergistically towards prediction of partner-
rated negative parenting and interparental communication.
Probing Confederate behavior x Parent ADHD interactions
revealed that parents reporting elevated ADHD symptoms
were most likely to be perceived by their partners as parenting
and communicating negatively when managing
ADHD/ODD-like confederates. Additional follow-up analy-
ses indicated that parents reporting elevated inattentiveness,
but not hyperactivity/impulsivity, were especially at risk of
being perceived by their partners as parenting and communi-
cating negatively during interactions with ADHD/ODD-like
children. Lastly, child ADHD/ODD and parent ADHD symp-
toms did not operate synergistically to predict observer-coded
parenting or communication during the triadic interactions
nor did gender moderate synergistic associations between
child ADHD/ODD behavior, parent ADHD symptoms and
partner-rated negative parenting and communication.
Consistent with previous research (Chronis-Tuscano et al.
2008; Psychogiou et al. 2007), our results highlight unique
child effects on positive and negative parenting. Child effects
on interparental communication uncovered in this study were
also stronger and/or more pervasive than indicated previously
(Williamson and Johnston 2013). Furthermore, our results
indicating that elevated parent ADHD symptoms failed to
predict most parenting or any interparental communication
outcomes independent of child ADHD/ODD behavior are in
line with prior studies (Chronis-Tuscano et al. 2008;
Psychogiou et al. 2007). Although our findings and those of
prior studies suggest that the child effect on parenting and
interparental communication is more pronounced than the
effect of parental ADHD symptoms, it may be that the
strength of parent effects would be greater if our sample and
the samples of previous investigations included more adults
with clinically-significant ADHD symptoms. Studies includ-
ing parents with more pronounced ADHD symptoms may
Tab l e 3 Results of multiple regressions predicting partner-rated and observer-coded interparental communication
Positive communication Negative communication
Parent-Rated Observer-Coded Parent-Rated Observer-Coded
Step 1 Step 2 Step 1 Step 2 Step 1 Step 2 Step 1 Step 2
b(SE) b(SE) b(SE) b(SE) b(SE) b(SE) O.R.(95%CI) O.R.(95%CI)
Child ADHD status −0.89 (0.30)** −0.89 (0.30)** −2.00 (2.37) −1.97 (2.36) 0.21 (0.29) −0.21 (0.29) 2.81 (0.92, 8.61) 2.83 (0.94, 8.47)
Child sex 0.16 (0.34) 0.17 (0.34) 0.78 (2.79) 0.88 (2.76) −0.45 (0.19)* −0.43 (0.19)* 0.00 (0.00, 0.00) 0.00 (0.00, 0.00)
Relationship satisfaction 0.00 (0.03) 0.00 (0.03) −0.60 (0.19)** −0.60 (0.19)** −0.01 (0.02) −0.01 (0.02) 0.96 (0.87, 1.06) 0.96 (0.87, 1.06)
Parenting satisfaction 0.02 (0.02) 0.02 (0.02) 0.38 (0.15)* 0.36 (0.16)* 0.00 (0.02) 0.00 (0.02) 0.97 (0.90, 1.04) 0.97 (0.90, 1.04)
Parent sex 0.33 (0.24) 0.33 (0.24) 3.19 (0.74)** 3.24 (0.76)** −0.07 (0.18) −0.06 (0.18) 0.84 (0.42, 1.68) 0.82 (0.41, 1.65)
Confederate status −1.60 (0.29)** −1.60 (0.29)** −5.67 (2.39)* −5.68 (2.37)* 1.17 (0.23)** 1.17 (0.23)** 6.35 (2.15, 18.77)** 7.18 (2.41, 21.45)**
Parent ADHD symptoms 0.05 (0.18) 0.00 (0.20) 0.15 (0.99) −1.30 (1.36) 0.27 (0.14) 0.00 (0.07) 0.59 (0.32, 1.12) 0.35 (0.09, 1.40)
Confederate × parent ADHD –0.10 (0.35) –3.16 (1.95) –0.58 (0.27)* –2.05 (0.46, 9.07)
R
2
=0.23 R
2
=0.23 R
2
=0.14 R
2
=0.15 R
2
=0.19 R
2
=0.21 R
2
=0.89 R
2
=0.89
Child ADHD Status = ADHD diagnostic status of parents’own child (0 = NonADHD,1=ADHD); Child Sex = Sex of parents’own child and confederate with whom they interacted (1 = male; 2 = female);
Relationship Satisfaction = Relationship satisfaction reported on DAS-S; Parenting Satisfaction= Satisfaction with parenting reported on satisfaction subscale of the PSOC; Parent Sex = female (0), male
(1); Confederate Status = Typical (0) or ADHD/ODD-like (1); Parent ADHD symptoms = Self-reported ADHD symptom measured by the CSS. With exception of dichotomous variables, all predictors
were centered for each analysis. Unstandardized betas and standard errors are reported for prediction of continuous outcome measures while odds ratios and 95 % confidence intervals are reported for
prediction of dichotomous outcomes measures
1
1.2
1.4
1.6
1.8
2
2.2
2.4
2.6
2.8
Low High
Partner-
Rated
Negative
Comm.
Parent ADHD Symptoms
"Typical"
Confederate
"ADHD/ODD-
Like"
Confederate
Fig. 2 Confederate child behavior and parent ADHD symptoms interact
to predict partner-rated negative interparental communication. Low par-
ent ADHD symptoms = 1 standard deviation below mean; High parent
ADHD symptoms = 1 standard deviation above mean
J Abnorm Child Psychol (2015) 43:107–119 115
provide a more balanced comparison of child and parent
effects on parenting and interparental communication.
Similar to previous research (Griggs and Mikami 2011;
Psychogiou et al. 2007,2008), we also found that disruptive
child behavior and parent ADHD symptoms interacted syner-
gistically to increase risk of partner-reported negative parent-
ing. However, unlike Psychogiou and colleagues (2008), we
did not find that disruptive child behavior and parent ADHD
symptoms operated synergistically in prediction of positive
parenting. We also did not replicate the findings of
Psychogiou and colleagues (2007) suggesting that synergistic
effects on negative parenting may vary between mothers and
fathers; instead, we found that parent gender did not moderate
the significant predictive association between the Confederate
behavior x Parent ADHD interaction and partner-reported
negative parenting. That is, parents, regardless of gender,
exhibited a “similarity-misfit”pattern of behavior
(Psychogiou et al. 2007): mothers and fathers with elevated
ADHD symptoms were equally at risk of using negative
parenting strategies when managing children exhibiting
ADHD/ODD-like behavior.
There are at least two reasons why our findings might
contrast with those of Psychogiou and colleagues (2007,
2008). First, we assessed for synergistic effects between dis-
ruptive child behavior and parent ADHD symptoms during
the course of triadic (mother-father-child) interactions;
Psychogiou and colleagues assessed for synergy during dyad-
ic (mother-child/father-child) interactions. Research has
shown that parents behave differently during triadic versus
dyadic interactions. For example, Buhrmester and colleagues
(1992) found that fathers, relative to mothers, exhibited lower
levels of demanding and aversive parenting when parenting
individually, regardless of the ADHD status of the child with
whom they interacted. However, when parenting collabora-
tively, fathers and mothers were both more demanding and
aversive when managing children with ADHD, with fathers
parenting more negatively than mothers. When co-parenting
disruptive children, it may be that mothers and fathers feel
more pressure to be an effective parent in the presence of their
partner. But instead, possibly due to poor coping under in-
creased stress, they manage child misbehavior in a way that
they may not typically do (e.g., relying on negative parenting
techniques). Parents with elevated ADHD symptoms may be
especially vulnerable to this tendency. Accordingly, the “sim-
ilarity-fit”observed by Psychogiou et al. (2007,2008)in
dyadic interactions may not apply in triadic interactions,
where co-parenting and partner alignment might disrupt such
phenomenon.
Second, our findings may have deviated from Psychogiou
and colleagues (2007) because we did not use parents’self-
report of their own parenting practices. Rather, our outcome
measures were partner- and observer- ratings of parenting
behavior collected during live structured-task interactions.
Using these measures reduced the likelihood that inaccurate
self-appraisals (e.g., Lui et al. 2013) or self-report bias ex-
plained associations between adult ADHD and parenting be-
havior. Moreover, our use of structured-task interactions
allowed for real-time judgments of parenting behavior, which
may be more accurate than the retrospective reports collected
by Psychogiou et al. (2007,2008). Indeed, the use of retro-
spective reports is a notable concern for adults with elevated
ADHD symptoms (Miller et al. 2010;Sibleyetal.2012).
With regard to our use of informant ratings of parenting
behavior, it was interesting that child ADHD/ODD and parent
ADHD symptoms interacted synergistically to predict nega-
tive parenting as rated by partners, but not by observers.
Relatedly, and consistent with results of a prior study
employing a confederate child behavior manipulation (Lang
et al. 1999), interacting with a ADHD/ODD-like child was
associated with greater use of positive parenting per observer
but not partner report; instead partners indicated lower levels
of positive parenting when interacting with an ADHD/ODD-
like child. It may be that partners, especially those of parents
with elevated ADHD symptoms, are more sensitive to their
co-parent’s negative parenting and are less attuned to positive
behaviors in response to disruptive child behavior than are
objective observers. For example, parents might observe more
readily micro-level negative behaviors in their co-parent be-
cause, through an experience unshared by observers, they are
primed to notice behaviors that are problematic. Partners
might also miss positive, effective parenting strategies of their
partner if they are hypervigilant for, or expectant of, negative
parenting behaviors. Alternatively, differences in results be-
tween reporters may be due to parents and observers rating
outcomes on two different scales. Regardless of the explana-
tion, finding that parents were more likely to perceive that
partners with elevated ADHD symptoms managed
ADHD/ODD-like children in a negative and less positive
way is a concern. These perceptions may spillover to impact
other areas of their relationship.
To this end, we also found that Confederate Behavior x
Parent ADHD interaction significantly predicted negative
interparental communication. Specifically, parents reporting
elevated ADHD symptoms were perceived by their partners as
communicating with them most negatively during interactions
with ADHD/ODD-like children. These findings extend prior
research (Griggs and Mikami 2011; Psychogiou et al. 2007,
2008) by highlighting that disruptive child behavior and par-
ent ADHD symptoms operate synergistically in prediction of
family functioning variables beyond parenting. In light of
findings from another study using this data set (Wymbs and
Pelham 2010), which found that negative parenting mediates
the association between disruptive child behavior and nega-
tive interparental communication, it may be that child
ADHD/ODD and parent ADHD operate synergistically to
predict negative interparental communication through their
116 J Abnorm Child Psychol (2015) 43:107–119
effects on negative parenting. That is, parents who witness
their partners with elevated ADHD symptoms managing dis-
ruptive child behavior in an aversive manner may voice their
concern or withhold support for their partner’s parenting,
which may result in a negative verbal/nonverbal reaction from
their partners. Researchers should conduct sequential analyses
to assess for specific behavioral antecedents (e.g., adult
ADHD symptoms, disruptive child behaviors) and conse-
quences of negative parenting (e.g., discordant interparental
communication, worsening child behavior) that escalate dys-
function between disruptive children and parents with ADHD.
Another unique finding of this study was that only parent
inattention, and not hyperactivity/impulsivity, interacted syner-
gistically with child ADHD/ODD behavior to predict partner-
rated negative parenting and interparental communication. Prior
research has shown that parent inattentiveness is more strongly
associated with aversive parenting (Griggs and Mikami 2011;
Harvey et al. 2003;ZisserandEyberg2012) and romantic
relationship discord (Eakin et al. 2004; Robin and Payson
2002) than is difficulties with behavioral regulation. However,
this was the first study to highlight that elevated inattention
increases the risk of parenting and communicating negatively
during interactions with ADHD/ODD-like children. Being dis-
organized or not listening when managing disruptive children
may cause parents to miss important behaviors that the child is
exhibiting, to fail to predict, plan ahead for, and prevent misbe-
havior, or to overlook relevant contextual details (e.g., when to
support their partner’s parenting efforts), which may result in
their partners believing that they are not parenting and commu-
nicating effectively. Alternatively, parents who are inattentive
may apply discipline tactics more inconsistently, and partners
maybesensitivetothispattern.Studiesareneededtoidentify
specific behavioral manifestations of inattention that exacerbate
difficulties during triadic interactions between parents with
ADHD and their children.
Although this study had several strengths (e.g., triadic
interactions, informant-rated outcome measures), there were
several limitations. Most notably, the generalizability of our
findings is questionable given our use of an experimental
child-behavior manipulation paradigm, which included stag-
ing interactions in a university laboratory and having couples
interact with unfamiliar children enacting scripted behaviors.
Indeed, as reported elsewhere (Wymbs and Pelham 2010),
parents reported that their partners parented and communicat-
ed less negatively and more positively during the child inter-
actions than they would in similar situations at home with their
own child. These methodological issues likely reduced the
effect of disruptive child behavior on interparental communi-
cation observed in this study. Yet, the confederate manipula-
tion still produced large effects on parenting and communica-
tion behavior. As such, these data underscore the impressive
strength of the manipulation and, presumably, child effects on
parent behavior. Nonetheless, researchers should conduct
similar investigations in more naturalistic environments and
explore relations between parents and their own child(ren).
The generalizability of this study is limited in other ways as
well. First, although evidence suggests that the accuracy of self-
reported ADHD symptoms may increase with age (Barkley et al.
2008), there is reason to suspect that adults in our study may have
underestimated their symptoms (Barkley et al. 2002;Sibleyetal.
2012). Low levels of parent-rated ADHD symptoms in this study
may have also been a result of our sample being comprised
mostly (94 %) of married couples. Future studies exploring adult
ADHD as a risk factor should consider using ratings from other
informants who know them well (e.g., spouse/partner) and in-
cluding more unmarried co-parenting couples, who may include
adults with more severe ADHD profiles. Second, due to the
limited number of couples including two adults with elevated
ADHD symptoms in our sample, we did not have adequate
power to test whether parent and partner ADHD symptoms
interacted to predict response to managing disruptive child be-
havior. We recommend that other researchers examine whether
risks to child and family functioning are most pronounced in
families headed by two parents with elevated ADHD symptoms.
Third, we did not differentially examine child inattention,
hyperactivity/impulsivity or ODD symptoms exhibited by con-
federate children and their impact on parenting and interparental
communication behaviors in this study. We are planning to
explore this in a future study. Fourth, observers were not blind
to the child's confederate behavior status (ADHD/ODD or typi-
cal) –they coded interactions with children behaving in both
ways. It is possible this may have biased their ratings. Fifth,
participants were mostly Caucasian, middle- to upper-class, mar-
ried parents of 9- to 12-year-old boys. It is possible that responses
to the experimental manipulation by our sample of parents may
have been meaningfully different than the reaction of parents
with more racial, socioeconomic, and marital status diversity. For
example, socioeconomic disadvantage, especially low parent
education or family income, is linked with poorer parenting
(Lundahl et al. 2006; Reyno and McGrath 2006). It is feasible
that parents with more socioeconomic resources would remain
calmer and would be less harsh when managing a child
displaying ADHD/ODD. Lastly, because we did not assess for
current or past history of ADHD treatment for parents or their
children, we cannot rule out the possibility that our results may
differ between families with and without treatment histories.
In brief, this study sheds light on the unique and synergistic
contributions of disruptive child behavior and parent ADHD
symptoms to parenting and interparental communication qual-
ity during triadic interactions. It is not surprising that children
exhibiting ADHD/ODD behavior make it harder to be an
effective parent or that adults with elevated ADHD symptoms
are more likely to have difficulties communicating with their
partners, particularly under times of distress (e.g., when par-
enting misbehaving children). At the sametime, little attention
has been paid to examining the difficulties faced by parents
J Abnorm Child Psychol (2015) 43:107–119 117
with elevated ADHD symptoms tasked with raising children
with ADHD/ODD. Mindful of this gap in the literature, we are
hopeful that this study will encourage research on ways to
reduce or prevent the risk of dysfunction in these families. For
example, researchers could investigate ways to adapt
evidence-based treatments for children with ADHD/ODD,
such as BPT (Evans et al. 2013), for use when their parents
have elevated (even subclinical) symptoms of ADHD to ad-
dress risk for negativity in parenting and interparental rela-
tions. To this end, clinicians could emphasize alternatives to
negative parenting strategies for parents to use when manag-
ing child misbehavior, particularly when co-parenting with
their partner. Improving in-the-moment interparental commu-
nication and problem-solving strategies of parents with ele-
vated ADHD symptoms may also help them cope better with
child ADHD behavior in co-parenting situations. Lastly, re-
sults of this study are concerning for the long-term develop-
ment of roughly 40–55 % of children with ADHD who are
being raised by a parent with elevated ADHD symptoms
(Smalley et al. 2000; Takeda et al. 2010). These children are
more likely to be exposed to negative parenting and may be
less likely to develop appropriate self-regulation strategies
(Johnston et al. 2012). Moreover, because children with
chronic behavior problems often react poorly to marital diffi-
culties (Hetherington and Stanley-Hagan 1999), the potential
for children with ADHD/ODD to witness more overt
interparental discord is concerning. It is time for researchers
and clinicians to devote resources to resolving the unique
functional difficulties of families including children and par-
ents with ADHD.
Acknowledgments This study was conducted using data collected by
Dr. Brian T. Wymbs as part of his dissertation project, chaired by William
E. Pelham Jr. at the University of Buffalo, State University of New York.
Dr. Wymbs’s dissertation was funded by an Elizabeth Munsterberg
Koppitz Fellowship from the American Psychological Foundation, as
well as grants from the University at Buffalo; research societies (Amer-
ican Psychological Association, Association for Psychological Science,
Society for a Scientific Clinical Psychology, and Society for Clinical
Child and Adolescent Psychology); and advocacy organizations (Chil-
dren and Adults With ADHD and Melissa Institute for Violence Preven-
tion and Treatment). Portions of this study were presented at the 2013
convention of the International Society for Research on Child and Ado-
lescent Psychopathology in Leuven, Belgium.
Conflict of Interest The authors declare that they have no conflict of
interest.
References
American Psychiatric Association. (1994). Diagnostic and statistical
manual of mental disorders (4th ed.). Washington: Author.
Barkley, R. A., & Murphy, K. R. (1998). Attention-deficit hyperactivity
disorder: A clinical workbook (2nd ed.). New York: The Guilford
Press.
Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2002). The
persistence of attention-deficit/hyperactivity disorder into young
adulthood as a function of reporting source and definition of disor-
der. Journal of Abnormal Psychology, 111,279–289.
Barkley, R. A., Murphy, K. R., & Fischer, M. (2008). ADHD in adults:
What the science says. New York: The Guilford Press.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck
depression inventory-II. San Antonio: Psychological Corporation.
Bell, R. Q. (1968). A reinterpretation of the direction of effects in studies
of socialization. Psychological Review, 75,81–95.
Bell, R. Q., & Chapman, M. (1986). Child effects in studies using
experimental or brief longitudinal approaches to socialization.
Developmental Psychology, 22,595–603.
Buhrmester, D., Camparo, L., Christensen, A., Gonzalez, L. S., &
Hinshaw, S. P. (1992). Mothers and fathers interacting in dyads
and triads with normal and hyperactive sons. Developmental
Psychology, 28,500–509.
Chronis-Tuscano, A. M., Raggi, V. L., Clarke, T. L., Rooney, M. E., Diaz,
Y., & Pian, J. (2008). Associations between maternal attention-
deficit/hyperactivity disorder symptoms and parenting. Journal of
Abnormal Child Psychology, 36, 1237–1250.
Coffman, J. K., Guerin, D.W., & Gottfried, A. W. (2006). Reliability and
validity of the Parent–Child Relationship Inventory (PCRI): evi-
dence from a longitudinal cross-informant investigation.
Psychological Assessment, 18,209–214.
Cohen, J. (1988). Statistical power analyses for the behavioral sciences
(2nd ed.). Hillsdale: Lawrence Erlbaum Associates.
Cox, M. J., Paley, B., & Harter, K. (2001). Interparental conflict and
parent–child relationships. In J. H. Grych & F. D. Fincham (Eds.),
Interparental conflict and child development: Theory, research and
application. UK: Cambridge University Press.
Cummings, E. M., DeArth-Pendley, G., Du Rocher Schudlich, T., &
Smith, D. A. (2001). Parental depression and family functioning:
Toward a process-oriented model of children’s adjustment. In S. R.
H. Beach (Ed.), Marital and family processes in depression: A
scientific foundation for clinical practice. Washington: American
Psychological Association.
Dadds, M. R., & Sanders, M. R. (1992). Behavioural Observation
Coding System: FOS-V. Unpublished manual.
Dadds, M. R., Sanders, M. R., Behrens, B. C., & James, J. E. (1987).
Marital discord and child behavior problems: a description of family
interactions during treatment. Journal of Clinical Child Psychology,
16,192–203.
Davies, P. T., & Lindsay, L. L. (2001). Does gender moderate the effects
of marital conflict on children? In J. H. Grych & F. D. Fincham
(Eds.), Interparental conflict and child development: Theory, re-
search and application. UK: Cambridge University Press.
Eakin,L.,Minde,K.,Hechtman,L.,Ochs,E.,Krane,E.,
Bouffard, R., et al. (2004). The marital and family function-
ing of adults with ADHD und their spouses. Journal of
Attention Disorders, 8,1–10.
Evans, S.W., Owens, J.S., & Bunford, N. (2013). Evidence-based psy-
chosocial treatments for children and adolescents with attention-
deficit/hyperactivity disorder. Journal of Clinical Child and
Adolescent Psychology. Advance online publication.
Fincham, F. D., & Linfield, K. J. (1997). A new look at marital quality:
can spouses feel positive and negative about their marriage? Journal
of Family Psychology, 11,489–502.
Foltz, C., Morse, J. Q., & Barber, J. P. (1999). Self and observer reports of
interpersonal problems in couples. Journal of Clinical Psychology,
55,27–37.
Griggs, M. S., & Mikami, A. (2011). The role of maternal and child
ADHD symptoms in shaping interpersonal relationships. Journal of
Abnormal Child Psychology, 39,437–449.
Harvey, E., Danforth, J. S., Eberhardt McKee, T., Ulaszek, W. R., &
Friedman, J. L. (2003). Parenting of children with Attention-Deficit/
118 J Abnorm Child Psychol (2015) 43:107–119
Hyperactivity Disorder (ADHD): the role of parental ADHD symp-
tomatology. Journal of Attention Disorders, 7,31–41.
Hetherington, E. M., & Stanley-Hagan, M. (1999). The adjustment of
children with divorced parents: a risk and resiliency perspective.
Journal of Child Psychology and Psychiatry, 40,129–140.
Johnston, C., & Lee-Flynn, S. C. (2011). Family functioning. In S. W.
Evans & B. Hoza (Eds.), Attention deficit hyperactivity disorder:
State of the science & best practices (Vol. 2). New York: Civic
Research Institute.
Johnston, C., & Mash, E. J. (1989). A measure of parenting satisfaction
and efficacy. Journal of Clinical Child Psychology, 18,167–175.
Johnston, C., Mash, E. J.,Miller, N., & Ninowski, J. E. (2012). Parenting
in adults with Attention-Deficit/Hyperactivity Disorder (ADHD).
Clinical Psychology Review, 32,215–228.
Kessler, R., Adler, L., Barkley, R., Biederman, J., Conners, C., Demler,
O., et al. (2006). Prevalence and correlates of adult ADHD in the
United States: results from the national comorbidity survey replica-
tion. American Journal of Psychiatry, 163,716–723.
Knouse, L. E., Mitchell, J. T., Brown, L., Silvia, P. J., Kane, M. J., Myin-
Germeys, I., et al. (2008). The expression of adult ADHD symptoms
in daily life: an application of experience sampling methodology.
Journal of Attention Disorders, 11,652–663.
Kurdek, L. A. (1992). Dimensionality of the dyadic adjustment scale:
evidence from heterosexual and homosexual couples. Journal of
Family Psychology, 6,22–35.
Lang, A. R., Pelham, W. E., Atkeson, B. M., & Murphy, D. A. (1999).
Effects of alcohol intoxication on parenting behavior interactions
with child confederates exhibiting normal or deviant behaviors.
Journal of Abnormal Child Psychology, 27,177–189.
Lui, J. H., Johnston, C., Lee, C. M., & Lee-Flynn, S. C. (2013). Parental
ADHD symptoms and self-reports of positive parenting. Journal of
Consulting and Clinical Psychology, 81,988–998.
Lundahl, B., Risser, H. J., & Lovejoy, M. C. (2006). A meta-analysis of
parent training: moderators and follow-up effects. Clinical
Psychology Review, 26,86–104.
Lytton, H. (1990). Child and parent effects in boys’conduct disorder: a
reinterpretation. Developmental Psychology, 26,683–697.
Miller, C. J., Newcorn, J. H., & Halperin, J. M. (2010). Fadingmemories:
retrospective recall inaccuracies in ADHD. Journal of Attention
Disorders, 4,7–14.
Minde, K., Eakin, L., Hechtman, L., Ochs, E., Bouffard, R., Greenfield,
B., et al. (2003). The psychosocial functioning of children and
spouses of adults with ADHD. Journal of Child Psychology and
Psychiatry, 44,637–646.
Mokrova, I., O’Brien, M., Calkins, S., & Keane, S. (2010). Parental
ADHD symptomatology and ineffective parenting: the connecting
link of home chaos. Parenting Science and Practice, 10,119–135.
Muthén, L. K., & Muthén, B. O. (2012). Mplus user’s guide (7th ed.). Los
Angeles: Muthén& Muthén.
Patterson, G. R. (1982). Coercive family process. Eugene: Castalia
Publishing Co.
Pelham, W. E., Lang, A. R., Atkeson, B., Murphy, D. A., Gnagy, E. M.,
Greiner, A. R., et al. (1997). Effects of deviant child behavior on
parental distress and alcohol consumption in laboratory interactions.
Journal of Abnormal Child Psychology, 25,413–424.
Pelham, W. E., Lang, A. R., Atkeson, B., Murphy, D. A., Gnagy, E. M.,
Greiner, A. R., et al. (1998). Effects of deviant child behavior on
parental alcohol consumption: stress-induced drinking in parents of
ADHD children. The American Journal on Addictions, 7,103–114.
Psychogiou, L., Daley, D., Thompson, M., & Sonuga-Barke, E. (2007).
Testing the interactive effect of parent and child ADHD on parenting
in mothers and fathers: a further test of the similarity-fit hypothesis.
British Journal of Developmental Psychology, 25,419–433.
Psychogiou, L., Daley, D. M., Thompson, M. J., & Sonuga-Barke, E. J. S.
(2008). Do maternal attention-deficit/hyperactivity disorder symp-
toms exacerbate or ameliorate the negative effect of child attention-
deficit/hyperactivity disorder symptoms on parenting? Development
and Psychopathology, 20,121–137.
Reyno, S. M., & McGrath, P. J. (2006). Predictors of parent training
efficacy for child externalizing behavior problem–a meta-analytic
review. Journal of Child Psychology and Psychiatry, 47,99–111.
Roberts, M. W. (2001). Clinic observations of structured parent–child
interactions designed to evaluate externalizing disorders.
Psychological Assessment, 13,46–58.
Robin, A., & Payson, E. (2002). The impact of ADHD on marriage. The
ADHD Report, 10,9–13.
Sandberg,J. F., & Hofferth, S. L. (2001). Changes in children’s time with
parents: United States, 1981–1997. Demography, 38,423–436.
Sibley, M., Pelham, W., Molina, B., Gnagy, E., Waxmonsky, J.,
Waschbusch, D., et al. (2012). When diagnosing ADHD in adults
emphasize informant reports, DSM items, and impairment. Journal
of Consulting and Clinical Psychology, 80,1052–1062.
Smalley, S. L., McGough, J. J., Del’Homme, M., NewDelman, J.,
Gordon, E., Kim, T., et al. (2000). Familial clustering of symptoms
and disruptive behaviors in multiplex families with attention-deficit/
hyperactivity disorder. Journal of the American Academy of Child
and Adolescent Psychiatry, 39, 1135–1143.
Spanier, G. B. (1976). Measuring dyadic adjustment: new scales for
assessing the quality of marriage and similar dyads. Journal of
Marriage and Family, 38,15–28.
Takeda, T., Stotesbery, K., Power, T., Ambrosini, P. J., Berrettini, W.,
Hakonarson, H., et al. (2010). Parental ADHD status and it associ-
ation with proband ADHD subtype and severity. Journal of
Pediatrics, 157,995–1000.
Waschbusch, D. A., & Willoughby, M. T. (2008). Parent and teacher
ratings on the IOWA Conners rating scale. Journal of
Psychopathology and Behavioral Assessment, 30,180–192.
Williamson, D., & Johnston, C. (2013). Marital and coparenting relation-
ships: Associations with parent and child symptoms of ADHD.
Journal of Attention Disorders. Advance online publication.
Wymbs, B. T. (2011). Mechanisms underlying the impact of disruptive
child behavior on interparental communication. Journal of Family
Psychology, 25,873–884.
Wymbs, B. T., & Pelham, W. E. (2010). Child effects on communication
between parents of youth with and without ADHD. Journal of
Abnormal Psychology, 119,366–375.
Wymbs, B. T., Pelham, W. E., Gnagy, E. M.,& Molina, B. S. G.(2008a).
Mother and adolescent reports of interparental discord among fam-
ilies of adolescents with and without attention-deficit hyperactivity
disorder. Journal of Emotional and Behavioral Disorders, 16,29–
41.
Wymbs, B. T., Pelham, W. E., Molina, B.S. G., Gnagy, E. M., Wilson, T.,
& Greenhouse, J. B. (2008b). Rate and predictors of divorce among
parents of youth with attention-deficit hyperactivity disorder.
Journal of Consulting and Clinical Psychology, 76,735–744.
Zisser, A. R., & Eyberg, S. M. (2012). Maternal ADHD: parent–child
interactions and relations with child disruptive behavior. Child &
Family Behavior Therapy, 34,33–52.
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