Parental positive regard and expressed emotion\u2014prediction of developing attention deficit, oppositional and callous unemotional problems between preschool and school age

Ursula Pauli-Pott,Susan Schloß,Katja Becker,Viola Müller,Lotte Bauer,Christopher Mann

doi:10.1007/s00787-020-01625-1

Abstract

Parental expressed emotion and positive reinforcement are assumed to affect the development of oppositional and callous-unemotional behaviors in children at risk of attention deficit hyperactivity disorder (ADHD). As longitudinal research on this issue is scarce, we analyzed the respective links between preschool and school age. 138 five-year-old (m = 58.2, s = 6.2 months) children (59% boys) with elevated ADHD symptoms (according to screening) were assessed at the ages of five and eight years. At 5 years, maternal expressed emotion (using the Five Minute Speech Sample) and positive regard of child (using a standardized at-home observation procedure) were assessed. At 5 and 8 years, symptoms of ADHD, oppositional defiant disorder (ODD), and callous-unemotional (CU) behaviors were measured using a multi-informant approach. Multiple linear regression analyses revealed that positive regard specifically predicted a decrease in ODD symptoms between preschool and school age. The expression of high negative emotion specifically predicted an increase in CU behaviors. The development of ADHD symptoms was not predicted by parenting. Knowledge on these specific links can help to elaborate diagnostic and counseling processes in preschoolers with high ADHD symptoms. Underlying mechanisms and the role of neurocognitive deficits of the preschool child should be further analyzed.

Highlights

There is broad evidence on an association between behavior problems in childhood and coercive, harsh parenting as well as low positive parental regard/reinforcement, and there is consensus on the notion that these parenting characteristics play an important role in the development of problem behaviors in childhood
Low maternal positive regard in the mother–child interaction was significantly associated with concurrent attention deficit hyperactivity disorder (ADHD) symptoms and 8-years oppositional defiant disorder (ODD) symptoms (ODD: teacher and composite score)
With the exception of ODD symptoms reported by the teacher at 8 years, maternal critical comments (EE-critical comments) were associated with ADHD, ODD, and CU symptom scores (CU: teacher, parent, and composite score)

Summary

Introduction

There is broad evidence on an association between behavior problems in childhood and coercive, harsh parenting as well as low positive parental regard/reinforcement, and there is consensus on the notion that these parenting characteristics play an important role in the development of problem behaviors in childhood. We focus on the developmental pathway from parenting to child behavior problems as one component of a more complex transactional process model in parent and child behavior development [1]. Research focused on attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD), and the development of co-morbid ODD/CD in ADHD. -called callous-unemotional (CU) traits have been distinguished within the ODD/CD spectrum, and regarded as a sub-dimension with specific etiology and developmental precursors. The three psychopathological dimensions, i.e. attention deficit/hyperactivity, oppositional, and CU symptoms are correlated and occur co-morbidly. The attention deficit problems might contribute to the development of the difficulties in emotion recognition and regulation in ODD/ CD/CU [2, 6]

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