Parental Responses to Temper Outbursts in Children With ADHD: The Role of Psychological Factors

Objective: Children with ADHD frequently exhibit temper outbursts (TO). One related factor may be parental responses, such as harsh discipline and accommodation. This study tests the hypotheses that these responses will be associated with greater TO, and parental characteristics of higher anger and lower sense of competence, in children with ADHD. Method: Participants included 79 5- to 9-year-old children with ADHD (77.22% boys). Regressions were used to determine the association between parental psychological factors and responses to TO while covarying for TO frequency, severity, and duration. Results: Parental anger and sense of competence were not significantly related to any discipline responses after covarying for TO characteristics, although sense of competence predicted spanking at trend-level significance. Both parental anger and sense of competence significantly predicted accommodation over and above TO characteristics. Conclusion: Results underscore the importance of parental anger and sense of competency in predicting parental behavior, specifically parental accommodation.

Prediction of externalizing behavior problems from early to middle childhood: The role of parental socialization and emotion expression

Parental emotions and behaviors that contribute to continuity and change in preschool children's externalizing problems were examined. Mothers and fathers were observed interacting with their children, and child-rearing styles were reported. Teachers, mothers, and children reported children's antisocial, oppositional behavior. Externalizing problems showed strong continuity 2 and 4 years later. Proactive parenting (i.e., supportive presence, clear instruction, and limit setting) predicted fewer behavior problems over time, after controlling for initial problems; the converse was true for parental anger. In contrast, the hypothesized ameliorative contribution of parents' positive emotion was not found. Parental contributions were most influential for children whose initial problems were in the clinical range. In particular, parental anger predicted continuation of problems over time. Paternal, as well as maternal, influences were identified. Examination of parental emotions and inclusion of fathers is important to research and intervention with young antisocial children.

New Concepts in the Management of Encopresis

Persistent fecal incontinence without anatomic abnormality, otherwise known as soiling or encopresis, frequently brings ridicule and shame to the affected child. The disability that it imposes is accentuated by the parental anger, guilt, and helplessness it engenders; by the peer hostility and rejection it promotes; and by the disgust with which it may be greeted by teachers. Home-based pediatric therapy is safe, generally very effective, and rewarding to patient, family, and physician. However, it requires a comprehensive understanding of both the underlying pathophysiology and the integrated therapeutic program of counseling, pharmacotherapy, and behavior modification.