Examining Maternal Emotion Regulation in Children with and without ADHD: A Multimodal Approach

Abstract

Objectives: Our study utilized a multimodal approach to explore profiles of emotion regulation (ER) in mothers of young children with and without attention-deficit/hyperactivity disorder (ADHD). We also sought to understand how parent factors (i.e., skills, stress, ADHD symptoms) as well as child factors were associated with membership to these profiles. Methods: The final sample consisted of 182 parent-child dyads. Sixty-six children were in the typically developing group (Mean age = 5.47, SD = .90, 74.2% males), and there were 116 children in the ADHD group (Mean child age = 5.41, SD = .75, 80.2% males). Dyads completed a stress-inducing task (clean up) during which mothers’ heart rate variability (HRV), specifically, respiratory sinus arrhythmia and pre-ejection period, was collected. Maternal ER strategies and parenting behaviors (DO and DON’T skills) were coded during the same clean up task. Mothers also completed self-reports of their ER strategies, parenting stress, parenting behaviors, and ADHD symptoms. Parent/teachers completed questionnaires on child ER and ADHD symptoms. Children completed two frustration tasks to assess domains of emotion dysregulation. Results: Latent profile analysis included maternal ER as indicators (HRV, self report, coding) and yielded 4 distinct profiles: mixed (n = 64), moderate (n = 49), low (n = 12), and high (n = 57) ER. Mothers in the low ER profile demonstrated the highest levels of observed ER difficulties. The moderate ER profile demonstrated some co-activation of the autonomic nervous system (ANS), yet were more behaviorally regulated than mothers in the low ER group. There were no differences between mixed and high ER profile on behavioral measures of ER but there was evidence of co-activation of the ANS for the mixed ER profile. Lastly, DON’T skills were associated with the probability of membership to each profile. Parenting stress was uniquely associated with membership to the mixed ER profile while child hyperactivity/impulsivity symptoms was predictive of membership to high ER profile. There was a significant difference between diagnostic groups and membership to profiles, Pearson χ2(3) = 8.39, pConclusions: Four distinct profiles of maternal ER emerged, highlighting the heterogeneity in maternal ER. Negative parenting behaviors, parenting stress, and child symptomology may also play a significant role in the development and maintenance of these maternal ER strategies. Future clinical trials should examine maternal ER as a potential therapeutic target.