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Parent-adolescent conflict in teenagers with ADHD and ODD


Parent-adolescent conflict in teenagers with ADHD and ODD – PowerPoint PPT presentation

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Title: Parent-adolescent conflict in teenagers with ADHD and ODD

Parent-adolescent conflict in teenagers with ADHD
and ODD
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
  • 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)

Diagnostic Criteria for 314.01 ADHD Inattention
  • Often has difficulty organizing tasks and
  • 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

Diagnostic Criteria for 314.01 ADHD
Hyperactivity (Motor Component)
  • Often fidgets with hands or feet or squirms in
  • 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

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)

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
  • Is often touchy or easily annoyed by others
  • Is often angry and resentful
  • Is often spiteful or vindictive

  • 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 gt 80
  • Exclusions deafness, blindness, severe language
    delay, cerebral palsy, epilepsy, autism, and/or

Selection Measures Nil Methylphenidate/Risperido
  • Parental Interview
  • Child Behaviour Checklist Parent form (CBCL
    Achenbach, 1991)
  • Ratings of ADHD/ODD Symptoms
  • Kaufmann Brief Intelligence Test (KBIT Kaufmann
    Kaufmann, 1990)

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)

Dependent Measures - Ratings of Parent/Teen
  • Conflict Behaviour Questionnaire (CBQ Prinz,
    Foster, Kent, OLeary, 1979)
  • Issues Checklist (Prinz et al., 1979)
  • Conflict Tactics Scale Parent-Teen Version
  • Direction Behaviour Observations of Parent-Teen

Ratings of Parent-teen conflict
Observed/video recorded interactions
  • Teens in the ADHD/ODD group had significantly
    higher levels of negative behaviour during
    neutral discussions compared to the control
  • 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.

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

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

A summary of the major significant differences
regarding parent-adolescent conflict comparing
experimental and control families.
  • What implications does this study have for
    interventions to reduce parent adolescent

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 ones
  • 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 lt six months

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 ones 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,
    leading to behavioural change
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