It’s a Blessing that I Have ADHD: Single Mothers Raising Children with ADHD

In this article I explore the emotional resources activated by single mothers to support their adolescent children’s educational journeys. Mothers’ emotional work is often regarded as something that mothers must do (Gillies, 2006). However, this view does not recognise the power and influence that mothers exert to create opportunities for educational success. By centring the mother as the head of her family and drawing on the concept of emotional capital as a legitimate and valuable resource within single-mother families, it becomes possible to show how mothers in a low socio-economic community invest in their children’s schooling. This article is based on a qualitative case study of single mother families from a South African community. The findings show that the single mothers maintained strong bonds with their children, which enhanced perceived support and contributed positively to their education. Maintaining open communication channels, demonstrating authoritative parenting, and communicating pride in non-academic qualities were significant emotional practices that served to maintain these strong bonds. By engaging in these practices, these single mothers from low-income contexts activated their emotions strategically to support their adolescent child’s education.

Background: Attention-Deficit Hyperactivity Disorder (ADHD) is a common disorder, affecting 4% to 5% of South African children. Recent studies reveal that 30% to 70% of children continue to experience problems related to ADHD in adulthood. Adults are becoming increasingly aware of adult ADHD as a result of public awareness campaigns in the media. Their first line of action is to visit their family physician (GP), but the question that arises is whether these practitioners are ready to take on patients with ADHD. The aims of this study were to determine the familiarity, attitudes and practices of general practitioners (GPs) in South Africa with regard to ADHD in both children and adults, and whether there are differences in children and adults with regard to depression and generalised anxiety disorders as comorbid disorders. The study also briefly explored the training models of GPs in South Africa. Methods: The research questions were addressed by means of a survey approach, using quantitative measures. An e-mail message with a covering letter, explaining the purpose of the research project, provided a link to a web-based questionnaire. It was relayed to 6 704 GPs on the database of the company MEDpages, which managed the distribution. A questionnaire attached to an e-mail message was sent to all departments of Family Health at universities in the country to obtain information with regard to the training models of GPs. The questionnaire was completed by 229 respondents. The data were statistically analysed using Statistica Version 7.0. Results: The most significant outcome of the study revealed a considerable need among GPs to increase their knowledge base with regard to ADHD (87% with regard to children and 89% with regard to adults). As they were of the opinion that they should be able to diagnose and manage ADHD in both children (90%) and adults (85%) a significant need for a screening tool (83%) was also found. The GPs’ knowledge and training with regard to depression and generalised anxiety disorders were significantly more extensive with regard to adults than to children. Training with regard to ADHD in adults was almost non-existent. With regard to children the most important barriers were uninformed parents (70%), limited funds (61%), uninformed teachers (58%), and with regard to adults these barriers were uninformed patients (64%), lack of knowledge on ADHD in adults on the part of the GPs (63%), and consultation time (58%). Although GPs did seem to have an awareness of the important role of the psychologist in the diagnosis and effective management of patients with ADHD, their referral practices generally involved a limited interdisciplinary approach. Conclusion: It is recommended that the limited knowledge base of GPs with regard to ADHD should be addressed by adapting the curriculum of undergraduate medical students and providing opportunities for continued medical education that focuses on the diagnosis and management of ADHD, in both children and adults. GPs should acknowledge the educational psychologist as an equal partner within a multidisciplinary team.

The World Health Organization (WHO) reported various pneumonia cases (‘Coronavirus Disease 2019’ [COVID-19]) on 31 December 2019 in Wuhan City, China, which has spread to many countries, including South Africa. In response to this, the President of South Africa declared a state of national disaster on 15th March 2020, followed by introducing various COVID-19 containment measures to minimize the spread of the virus. This paper examines the negative impacts that COVID-19 containment measures may have had on the family as a unit of society and furthermore provides recommendations to mitigate the impacts of these measures. It can be concluded that COVID-19 containment measures, specifically the lockdown restrictions, would yield both short-term and long-term impacts on proper family functioning. Several families in South Africa have been impacted financially due to the closure of business which led to the temporary/ permanent unemployment of some breadwinners in the families. This also has had a cascading impact on the food security of families and their ability to afford other basic necessities. Distress as a result of financial challenges or failure to provide for the family alongside spending much time locked down together as a family has also led to violence in the family. This was further exacerbated by the fact that the victims were stuck with the abusers and some could not report or find help due to the restricted movements. Furthermore, since most institutions predominantly moved learning online, results indicated that the lockdown restrictions affected the ability of some individuals especially those from poor families to access formal education during the period due to the lack of digital devices and internet facilities. In order to mitigate the impacts of the COVID-19 containment measures on the family, there is a need for collaborative efforts at intrapersonal, interpersonal, institutional, community and policy levels using the ecological framework.

Objectives The present study examined the associations between raising a child with autism spectrum disorder (ASD), guilt, and depression in single and married mothers. Raising children with ASD presents unique challenges for parents, especially mothers, who often experience heightened levels of depression. For single mothers, raising a child with ASD may result in additional demands, but for married mothers it may result in more tension and marital conflict. We explored the role of interpersonal guilt in explaining maternal depression of single and married mothers raising a typically developing (TD) child with ASD as compared to mothers raising a TD (Typically developing) child. Methods The study included 85 mothers (54 married, 31 single) of 3–18 years old children (28 diagnosed with ASD and 57 TD children), who completed measures of depression (DASS-21) and interpersonal guilt (a subscale of Loneliness in Intimate Relationships Scale). Multivariate regression was conducted to test the main effects of child diagnosis, maternal marital status and maternal interpersonal guilt on maternal depression. A moderated moderation model was tested, examining how interpersonal guilt and marital status influence maternal depression in mothers of children with ASD compared to mothers of typically developing children. Results: Our results indicated higher levels of depression and interpersonal guilt for both single and married mothers of children with ASD than among mothers of TD children. Depression levels were correlated to higher levels of interpersonal guilt. Although Maternal depression was significantly higher for mothers of children with ASD it was not explained by marital status alone. However, the presence of interpersonal guilt significantly exacerbated depression for married mothers of children with ASD, but not for single mothers, highlighting the importance of blameless and emotional support in marital relationships. Conclusions This study underscores the need for targeted interventions that address emotional distress and guilt among mothers raising children with ASD, and describes the interpersonal guilt affecting married and single mothers raising children with ASD.

Objective: Temperament and personality in bipolar I patients have been studied but temperament and personality in bipolar I patients comorbid with adult ADHD have not been studied. The aim of this study was to determine the effect of ADHD on the temperament and personality of bipolar I patients in remission. Materials and Method: Patients with a bipolar I disorder diagnosis (n=121) (female 71, male 50) were matched with control group with no known psychiatric illness (n=100 female 55 male 45) according to age, sex, education were recruited from consecutive admissions. Information about the characteristics of patients and control group were obtained from sociodemographic form, SCID-I, SCID-II. All patients were interviewed for the presence and history of current adult and childhood ADHD diagnosis. The subjects also completed the Adult ADD/ADHD DSM-IV Based Diagnostic and Screening Rating Scale Turkish version and the Turkish version of TEMPS-A scale. Results: Adult ADHD diagnosis were observed in bipolar I patients with 22.3% (n=27) and in control group with 8% (n=8). The mild depressive and anxious temperaments were observed in bipolar I patients. The bipolar patients comorbid with adult ADHD were observed to have moderate/severe episodes, earlier and longer maintenance treatment periods. Both groups didnot differ in terms of temperament. Antisocial personality disorder were observed only in bipolar I patients comorbid with adult ADHD. Conclusion: Bipolar I disorder comorbid with adult ADHD has significant clinical implications which may relate to a personality disorder. This may be due to the influence of ADHD on bipolar I disorder.

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT REQUEST OF AUTHOR.] African American families comprise an estimated 9,808,000 households across the nation, 37% of which are led by single mothers raising their own children (U.S. Census Bureau, 2016). This means that almost 4 million single African America mothers are the heads of families. The purpose of this study is to showcase strength-based narratives of single Black mothers and their views on interactions with the school system and how they help their children through schooling. The overarching research question this study explores is: How do single Black mothers work to support their children's educational journeys through PK-5 school? It is an important question to study for answers because those answers can affect how these mothers and children can thrive in our 21st century academic culture. Data collection included interviews with 10 single Black mothers. The findings of this study described the barriers, resources, and the motherwork of single Black mothers educating their children. Through these narratives, participant Black single mothers revealed what they considered most important in their motherwork: 1) to have high expectations for their children 2) to communicate effectively with their children, and 3) to communicate effectively with their children's schools. Thus, one main purpose of this study was to share how Black mothers support their children's education. Fulfilling that purpose will go far in informing educators and school leaders what is necessary to fully include this segment of our population when deciding educational matters.

The present study set out to examine the relationship between marital status, poverty and depression in a sample of inner-city women. Single and married mothers were followed up over a 2-year period during which time rates of psychosocial risk factors, onset of depression and experience of chronic episodes were measured. Risk of onset was double among single mothers. Single mothers were twice as likely as their married counterparts to be in financial hardship, despite being twice as likely to be in full-time employment. Both of these factors were independently associated with onset in single mothers. The link between them and onset was via their association with humiliating or entrapping severe life events. Single parents were at a much raised risk of experiencing these events. Onset was also more likely to follow such an event when women had poor self-esteem and lack of support, both of which were more common among single mothers. These risk factors were more frequently found among those in financial hardship. Financial hardship was also related to risk of having a chronic episode (lasting at least a year), of which single parents were also at greater risk. The majority of chronic episodes among single mothers had their origins in prior marital difficulties or widowhood and rates of chronicity reduced with length of time spent in single parenthood. Results are discussed in terms of an aetiological model of onset in which financial hardship probably influences outcome at a wide variety of points.

Objective: To evaluate the psychological impact of receiving a diagnosis of ADHD in adulthood and treatment with medication and to examine how diagnosis and treatment with medication changes an individual's self-perception and view of the future. Method: Participants were eight individuals diagnosed with ADHD at a tertiary service. Semistructured interviews were conducted and the data were analyzed according to the principles of Interpretative Phenomenological Analysis. Results: Three master themes emerge from the analysis: Participants engage in a (a) review of the past, particularly how they feel different from others, (b) the emotional impact of the diagnosis, and (c) consideration of the future. These themes suggest a six-stage model of psychological acceptance of a diagnosis of ADHD: (a) relief and elation, (b) confusion and emotional turmoil, (c) anger, (d) sadness and grief, (e) anxiety, and (f) accommodation and acceptance. Conclusion: The model indicates an important role for psychological treatment, which should begin at the point of diagnosis. Cognitive behavioral techniques will help clients diagnosed with ADHD in adulthood cope with the adjustment process. Adults should be taught skills to anticipate future hurdles and challenges and apply appropriate coping strategies. (J. of Att. Dis. 2008; 11(4) 493-503)

We examine the relationships among early family adversities, depression, and family status using a sample of single and married mothers. Regardless of whether they are never-married or separated or divorced, single mothers report higher lifetime and 1-year prevalence rates of depression than married mothers. By examining the connections among adversities, depressive episodes, and family status, we demonstrate the importance of early adversities in childhood and adolescence in explaining these differences in depression according to marital status. Specifically, higher rates of depression among single mothers are due, in part, to a greater likelihood of early childhood adversities, which then increase the risk for early onset of depression. Interestingly, women whose childhoods have been relatively free of adversities are more likely either to report no depressive episodes or to have a later onset of depression. These latter trajectories are more common among married than among single mothers. We discuss the relevance of these findings for understanding the interplay of stressful experience, depressive illness, and family status. Key Words: childhood adversities, depression, family structure, single mothers, stress. Recent increases in the number of divorces and births out of marriage have led to a rise in the number of single-parent families in North America, the majority of which are headed by women. These changes have broad implications for the psychological well-being of family members, particularly mothers and their children. As numerous researchers have documented, the economic and social conditions associated with single parenthood frequently result in a variety of stressors and chronic strains that lead to elevated levels of psychological distress and clinical depression (Doherty, Su, & Needle, 1991; Hetherington, Cox, & Cox, 1981; McLanahan, 1983, 1985). These observations are consistent with the well-known stress process formulation (Pearlin, 1989; Pearlin, Lieberman, Menaghan, & Mullan, 1981) that postulates that individuals' locations in the social structure expose them to various types of stresses and strains that ultimately manifest themselves in feelings of distress (cf. Avison & Gotlib, 1994, for an overview). Within this theoretical context, many researchers argue that the stress often accompanying the experience of being a single parent and the absence of protective resources such as high self-esteem, mastery, or social support adversely affect mental health. This research does much to inform us about the challenges these women face; however, a focus on current circumstances provides only a partial picture of why marital and parental statuses affect mental health. Although current statuses may be proximal determinants of depression, they obviously cannot shed much light on the distal determinants or origins of depression. In our view, a more complete understanding of the link between single parenthood and mental health requires consideration of these women's backgrounds. It seems important to appreciate that the relationship between single parenthood and mental health is, in part, a reflection of earlier social experiences. Indeed, various research findings are consistent with this premise. For example, research indicates that the onset of depressive disorder frequently occurs in early adulthood (Robins & Regier, 1991), with a significant proportion occurring in childhood and adolescence (Sorenson, Rutter, & Aneshensel, 1991). Moreover, most current cases of major depression among adults are recurrences rather than first episodes (Kessler & Magee, 1993, 1994a, 1994b). These observations strongly suggest that some of the important precursors of depression are to be found in childhood or adolescence. Therefore, to focus only on the circumstances associated with single parenthood neglects the prior experiences that these women bring into their adult marital and parenting roles-that is, life histories that may either exacerbate or diminish their risk of depression. …

Duplicated Enhancer Region Increases Expression of CTSB and Segregates with Keratolytic Winter Erythema in South African and Norwegian Families

This case study explores the effectiveness of psychosocial support interventions in strengthening family bonds and enhancing mother-child interactions within South African foster care environments. The study examines the impact of targeted interventions on caregivers' emotional well-being, parenting efficacy, and overall family cohesion. Using a qualitative research approach, the study employed semi-structured interviews, focus groups, and purposive sampling to collect data from 12 caregivers affiliated with SOS Children's Villages South Africa. Findings, analysed through the lens of attachment theory and the resilience framework, reveal that psychosocial interventions significantly enhance caregivers' coping mechanisms, improve communication dynamics, foster secure attachment relationships, and provide essential emotional support. As a result, foster families exhibit greater resilience, stability, and improved child-caregiver relationships. The study highlights the critical role of psychosocial interventions in addressing the emotional and psychological needs of both caregivers and foster children, emphasising the importance of structured support programs. By shedding light on the transformative impact of these interventions, the findings contribute to the development of more effective policies and tailored support programs that address the unique challenges faced by foster families in South Africa. The study underscores the necessity of ongoing psychosocial support to promote sustainable and healthy foster care environments in various countries and globally.

Adults with ADHD have been found in prior studies to have a greater risk for various psychiatric disorders. Chief among these are oppositional defiant disorder (ODD) and conduct disorder (CD). Approximately 24–35% of clinic–referred adults diagnosed with ADHD have ODD and 17–25% have CD, either currently or over the course of their earlier development (Barkley, Murphy, & Kwasnik, 1996; Biederman, et al., 1993; Murphy & Barkley, 1996; Murphy, Barkley, & Bush, 2002; Spencer, 2004). These figures for clinic–referred adults are below those reported in studies of ADHD children, particularly studies of hyperactive children followed to adulthood, where levels of ODD and CD may be double or triple these rates reported for adults diagnosed with ADHD (see Barkley, 2006, for a review; Barkley, Fischer, Edelbrock, & Smallish, 1990; Fischer, Barkley, Smallish, & Fletcher, 2002; Weiss & Hechtman, 1993). Among parents of children having ADHD who also meet criteria for ADHD, disruptive behavior disorders are also significantly more common (McGough et al., 2005; Minde, et al., 2003). For instance, one study found that 53% have had ODD and 33% have had CD sometime in their lives (Biederman et al., 1993), figures closer to those seen in follow–up studies of hyperactive or ADHD children. Antisocial Personality Disorder is often an associated adult outcome in a large minority of those children or adolescents who have both ADHD and CD; thus it is not surprising to find that 7–44% of clinic–referred adults diagnosed with ADHD also qualify for a diagnosis of this personality disorder (Biederman et al., 1993; Shekim, Asarnow, Hess, Zaucha, & Wheeler, 1990; Torgersen, Gjervab, & Rasmussen, 2006). Even among those who do not qualify for this diagnosis, many receive higher than normal ratings on those personality traits associated with this personality disorder (Tzelepis, Schubiner, & Warbase, 1995). Substance dependence and abuse are known to occur to a more frequent degree among hyperactive or ADHD children who develop CD by adolescence or Antisocial Personality Disorder by adulthood (Barkley, 2006; Tercyak, Peshkin, Walker, & Stein, 2002). Arecent study of a large general population sample likewise found an association between ADHD and antisocial disorder (Kessler, et al., 2006). Adults clinically diagnosed with ADHD seem to be no exception to this rule linking ADHD, antisocial activities, and drug use disorders. Studies have found lifetime rates of alcohol dependence or abuse disorders ranging between 21% and 53% of adults diagnosed with ADHD, whereas 8–32% may manifest some other form of substance dependence or abuse disorder (Barkley,

Utilizing the 2003 and 2004 American Time Use Survey (ATUS), this study examines the relationship between family structure and maternal time with children among 4,309 married mothers and 1,821 single mothers with children less than 13 years of age. Single mothers spend less time with their children than married mothers, though the differences are not large. Marital status and living arrangement differences in time with children largely disappear or single mothers engage in more child care than married mothers after controls for socioeconomic status and other characteristics are introduced. Thus, less maternal time with children appears to be mainly attributable to the disadvantaged social structural location of single mothers rather than different proclivities toward mothering between married and single mothers.

The COVID-19 pandemic affected families globally. Empirical research has been explored to understand the impact of COVID-19 on families across countries, however, there are limited findings of how COVID-19 has affected the daily realities of families in South Africa. This study used an exploratory qualitative research approach to explore the experiences of COVID-19 for South African families. Findings suggest that the negative outcomes of COVID-19 experienced by South African families included a shift in the daily routines, restrictions on family events, lack of socialization and loss of connections, family conflicts, financial constraints as well as psychological impacts. On the contrary, the positive outcomes included increased family time and communication, cleanliness, and good health status, and improved financial management. Implications for future research should include research focused on the health impacts of COVID-19 on diverse family structures, family compositions, and family dynamics. In-depth research and findings can assist in developing policies and interventions for families.

Background: Adult attention-deficit hyperactivity disorder (ADHD) is a chronic, costly and debilitating disorder. In South Africa (SA), access to funding for care and treatment of ADHD is limited, and research is lacking.Aim: This study aimed to establish the current situation with regard to the psychiatric management of and funding for treatment of adult ADHD in the private sector in SA.Methods: A diagnostically refined retrospective claims database analysis was conducted. We examined the prevalence, costs and funding profile of claims over a 2-year period for adult beneficiaries with possible ADHD of a large medical administrator in SA.Results: The prevalence of adult ADHD was lower than published international rates. The presence of adult ADHD increased the prevalence of comorbidity and doubled the health care costs of beneficiaries. Contrary to public belief, comorbidities (including their medicine costs) rather than psychiatric services or medicines were the main cost drivers.Conclusion: The current private health insurance funding model for ADHD limits access to funding. This affects early diagnosis and optimal treatment, thereby escalating long-term costs. Improved outcomes are possible if patients suffering from ADHD receive timely and accurate diagnosis, and receive chronic and comprehensive care. Balanced regulation is proposed to minimise the risk to both medical schemes and patients. A collaborative approach between stakeholders is needed to develop an alternative cost-effective funding model to improve access to treatment and quality of life for adults with ADHD in SA.