Parent-adolescent conflict in
teenagers with ADHD and ODD
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Diagnostic Criteria for 314.01 ADHD –
Inattention (Cognitive Component)
 Often fails to give close attention to details or makes careless
mistakes in schoolwork, work, or other activities
 Often has difficulty sustaining attention in tasks or play
activities
 Often does not seem to listen when spoken to directly
 Often does not follow through on instructions and fails to
finish schoolwork, chores, or duties in the workplace (not due
to oppositional behaviour or failure to understand
instructions)
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Diagnostic Criteria for 314.01 ADHD –
Inattention (continued)
 Often has difficulty organizing tasks and activities
 Often avoids, dislikes, or is reluctant to engage in tasks that
require sustained mental effort (such as schoolwork or
homework)
 Often loses things necessary for tasks or activities (e.g., toys,
school assignments, pencils, books, or tools)
 Is often easily distracted by extraneous stimuli
 Is often forgetful in daily activities
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Diagnostic Criteria for 314.01 ADHD –
Hyperactivity (Motor Component)
 Often fidgets with hands or feet or squirms in seat
 Often leaves seat in classroom or in other situations in which
remaining seated is expected
 Often runs about or climbs excessively in situations in which it
is inappropriate (in adolescents or adults, may be limited to
subjective feelings of restlessness)
 Often has difficulty playing or engaging in leisure activities
quietly
 Is often "on the go" or often acts as if "driven by a motor“
 Often talks excessively
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Diagnostic Criteria for 314.01 ADHD –
Impulsivity (Social Component)
 Often blurts out answers before questions have been
completed
 Often has difficulty awaiting turn
 Often interrupts or intrudes on others (e.g., butts into
conversations or games)
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Diagnostic Criteria for 313.81 ODD
 Often loses temper
 Often argues with adults
 Often actively defies or refuses to comply with adults' requests or
rules
 Often deliberately annoys people
 Often blames others for his or her mistakes or misbehaviour
 Is often touchy or easily annoyed by others
 Is often angry and resentful
 Is often spiteful or vindictive
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Participants
 N = 302
 ADHD/ODD group, n = 225
 Community Control group, n = 77
 Adolescents: aged between 12 and 18
 Biological child or adopted at birth
 IQ >= 80
 Exclusions = deafness, blindness, severe language delay,
cerebral palsy, epilepsy, autism, and/or psychosis
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Selection Measures – Nil
Methylphenidate/Risperidone
 Parental Interview
 Child Behaviour Checklist – Parent form (CBCL: Achenbach,
1991)
 Ratings of ADHD/ODD Symptoms
 Kaufmann Brief Intelligence Test (KBIT; Kaufmann &
Kaufmann, 1990)
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Dependent Measures – Parental
Adjustment
 Beck Depression Inventory (BDI; Beck, Steer, & Garbin, 1988)
 Symptom Checklist 90 – Revised (SCL-90-R; Derogatis, 1992)
 Locke-Wallace Marital Adjustment Test (LW-MAT; Locke &
Wallace, 1959)
 Adult ADHD Rating Scale (Barkley & Murphy, 1998)
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Dependent Measures - Ratings of
Parent/Teen Conflict
 Conflict Behaviour Questionnaire (CBQ; Prinz, Foster, Kent, &
O’Leary, 1979)
 Issues Checklist (Prinz et al., 1979)
 Conflict Tactics Scale – Parent-Teen Version (CTSPT)
 Direction Behaviour Observations of Parent-Teen Interactions
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Ratings of Parent-teen conflict
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Observed/video recorded interactions
 Teens in the ADHD/ODD group had significantly
higher levels of negative behaviour during
neutral discussions compared to the control
group.
 Differences in dyadic and triadic interactions?
- Yes, but only in the control group.
 However, mothers and teens in the ADHD/ODD
group rated the neutral discussions as
significantly less similar compared to the
mothers and teens ratings in the control group.
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Parents Psychological Adjustment
Factors contributing to the level of conflict
beyond ADHD and ODD.
- For mother-teen interactions
- For father-teen interactions
Worst tactic used
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Family Coercion Theory
 Patterson (1982) hypothesised that aggressive behavior is
performed insofar as it forces other people to give in to the
aversive demands that make up that behaviour
 A child does not learn about cause and consequence in
relation to his/her actions
 Parents of ADHD/ODD children are excessively intrusive,
demanding, argumentative and provide little in terms of
positive reinforcement
 A child quickly learns about the power of coercion
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A summary of the major significant
differences regarding parent-adolescent
conflict comparing experimental and
control families.
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Discussion
What implications does this study have for
interventions to reduce parent adolescent
conflict?
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Pharmacological Treatment
 Medication: Ritalin (ADHD) and Risperdal (ODD)
 Ritalin: amphetamine and CNS stimulant
 Giving a stimulant to a hyperactive child would appear to be
counter-intuitive, however researchers believe it increases
concentration and attention span, thus improving one’s alertness
 Studies indicate a 60-90% improvement in terms of disruptive
behaviour
 Psychoactive medication does NOT permanently change behaviour
and has both physiological and psychological side effects – Ritalin
recommended for =< six months
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Parenting Programs
 Systematic training for effective parenting (STEP) - change
parental attitude to change parental behaviour to change child
behaviour i.e., identify what it is that the child is trying to
achieve
 Parent effective training (PET) – change family attitude to
change parental behaviour to change child behaviour i.e., the
recognition and understanding of others by encouraging free
expression of one’s feelings
 Positive parenting programme (PPP) – change parenting skills
to change child skills leading to a change in family attitudes
i.e., an emphasis on parenting skills to teach child self-control,
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leading to behavioural change