Parental ADHD and Depression: Time-Varying Prediction of Offspring Externalizing Psychopathology

Abstract

Parental attention deficit/hyperactivity disorder (ADHD) and depression are risk factors for negative child outcomes, but given their frequent co-occurrence and variability over time, developmentally sensitive studies are needed. To characterize change in parental ADHD and depression as predictors of change in child ADHD and oppositional defiant disorder (ODD), 230 five- to ten-year-old children with (n = 110) and without (n = 120) ADHD were followed prospectively for 2 years with 90% retention. At baseline and again 2 years later (i.e., Wave 2), parents self-reported their ADHD and depression; parents and teachers also separately rated child ADHD and ODD, as well as broader attention and externalizing problems. Controlling for child sex, race-ethnicity, age, and parental depression, generalized estimating equations revealed that 2-year decreases in parental ADHD significantly predicted reduced child ADHD symptoms, but only among non-ADHD youth. Alternatively, increasing parental depression positively predicted change in teacher-rated ODD symptoms. These findings provide quasi-experimental evidence that parental ADHD and depression may be time-varying risk factors with respect to key dimensions of child externalizing behavior problems. We consider the potential dynamic and reciprocal interrelations among parental ADHD and depression with developmental change in offspring ADHD and ODD. We also discuss implications of parent psychopathology in the development of interventions to reduce the burden of youth ADHD and associated externalizing behavior.

Notes

¹ Given gender differences in ADHD and depression, we reanalyzed models exclusively among mothers (86% of the total Wave 1 sample). Results were nearly identical, with the exception that change in parental ADHD (B = 0.002, z = 2.14, p = .03) positively predicted change in TRF Externalizing Behavior, with control of child sex, age, race-ethnicity, age, change in parental depression, and Wave 1 ADHD diagnostic status.

² We also evaluated whether time-varying parental depression and ADHD independently (i.e., without controlling for the other) predicted time-varying child ADHD and ODD, controlling for sex, race-ethnicity, and age (as well as Wave 1 child ADHD diagnostic status in predictions of ODD and CBCL/TRF Externalizing Behavior). Decreased parental ADHD significantly predicted decreased parent-rated ADHD symptoms (via the DISC-IV) and CBCL Attention Problems; it marginally predicted decreased CBCL Externalizing Behavior as well. Alternatively, decreased parental depression was significantly associated with decreased DISC-IV ADHD symptoms, CBCL Attention Problems, and CBCL Externalizing Behavior; it was also marginally associated with decreases in DISC-IV ODD symptoms and teacher-rated ODD symptoms (via the teacher DBD). Additional details regarding these results are available upon request.