WP: Married, With ADHD (relationships suffer under stress of raising ADHD child

[Guest guest]

This subject has been discussed here - I'd bet the rates for ASD parents (more

stress!) is higher ...

Married, With ADHD

Relationships Suffer Under Stress of Raising Child With Disorder, Study Finds

By Shankar Vedantam

Washington Post Staff Writer

Tuesday, March 3, 2009; HE01

http://www.washingtonpost.com/wp-dyn/content/article/2009/03/02/AR2009030201787_\

pf.html

For many years, scientists have explored how parental conflicts and other

marital problems can affect the well-being of children. Far less attention has

been paid to the opposite question: How do children, especially difficult

children, influence the quality of married life?

Couples who have a child with attention deficit hyperactivity disorder are

nearly twice as likely to divorce or separate as couples who do not have

children with the psychiatric disorder, according to a definitive new study that

is the first to explicitly explore the question. The reason appears simple:

Having a child who is inattentive or hyperactive can be extremely stressful for

caregivers and can exacerbate conflicts, tensions and arguments between parents.

The research topic is sensitive because it can be easily misinterpreted to mean

that scientists are blaming kids for the marital woes of their parents; that may

be one reason researchers have generally avoided the topic and limited their

investigations to how parental conflicts affect children. But increasingly, the

evidence suggests that the lines of influence run in both directions.

The study, led by psychologists Wymbs and Pelham and published

last year in the Journal of Consulting and Clinical Psychology, longitudinally

tracked a large number of families with and without children diagnosed with

ADHD, a disorder characterized by inattention and hyperactivity and often

accompanied by conduct problems and oppositional behavior.

While 12.6 percent of the parents of children without ADHD were divorced by the

time the children were 8 years old, the figure was 22.7 percent for parents of

kids with ADHD. Couples with ADHD kids also tended to reach the point of divorce

or separation faster.

" We have known for a long time that kids can be stressful for their parents.

What we show is they can be really stressful and can lead to marital

dissatisfaction and divorce, " said Pelham, who works at the State University of

New York at Buffalo. " What it means is ADHD should not be treated without

involving the parents in the treatment. "

Pelham said his interest in the topic was piqued after he conducted a study that

looked into how children's behavior influenced the propensity of their parents

to consume alcohol. Pelham had a large number of parents interact with children

who were not their own. Some of the kids were trained to act cooperatively,

while others were trained to act as though they had ADHD. The parents were given

a break midway through the session, when they could consume alcohol, and then

sent back in for a second period with the same child.

The parents thought the experiment was measuring how parent-child interactions

changed depending on alcohol use; in reality, Pelham wanted to know how dealing

with easy and difficult children influenced the propensity of caregivers to

drink. The psychologist found that parents randomly assigned to interact with

the difficult children drank a whopping 40 percent more alcohol during the break

than parents who were assigned manageable kids.

Several previous studies have hinted at connections between marital health and

children's behavior.

" Parents of children with ADHD report less marital satisfaction, fight more

often, and use fewer positive and more negative verbalizations during

child-rearing discussions than do parents of children without ADHD especially if

the child also has conduct or oppositional problems, " Pelham and Wymbs noted in

their paper.

Many other factors influence whether couples stay together. Communication

problems, substance abuse, financial difficulties and mental health problems

among partners all play a role in the health of intimate relationships. The

difference between those other factors and the role that children play is that

the other factors have been widely documented and discussed.

Wymbs said that in a separate study, he brought parents with and without ADHD

kids into a laboratory. As before, he assigned them to interact with children

who were not their own; some had been trained to act cooperatively, and others

had been trained to act difficult. (The " difficult " kids in the study were

nowhere as difficult as many kids with ADHD in real life; ethical guidelines

forbade researchers from training child actors to hit or scream.)

Wymbs had the parents and kids perform four exercises: The first involved

playing the game Jenga, which requires strategic thinking and planning. Kids

trained to be helpful worked cooperatively with the parents; the kids trained to

act difficult undermined the parents at every turn.

A second exercise called for parents to monitor the kids solving math problems

while they themselves had to fill out a checkbook, the kind of parallel

processing that induces stress. The easy kids attended to their homework; the

difficult kids refused to do their homework, scribbling on their papers or

erasing their answers and blowing the shavings on the parents.

In the third task, the kids directed play. The child actors always chose to play

mini-bowling and mini-basketball. The cooperative children took turns and helped

set up the games, and the difficult children played out of turn and were

disruptive.

The fourth task involved cleanup where, as you might imagine, the children were

trained to be either helpful or unhelpful.

Wymbs videotaped the interactions. What he was on the lookout for was not how

the parents interacted with the children, but how the children's behavior

affected the way the parents worked with each other. Regardless of whether they

had children with ADHD, Wymbs found, the parents asked to work with difficult

children were four times as likely to exchange negative criticism and questions,

or to ignore each other and trade nonverbal barbs, than the parents in the other

group.

And regardless of whether they were dealing with easy or difficult children,

parents who had ADHD children at home were three times as likely to be negative

toward each other as parents who did not. Put another way, the parents of

children with ADHD simply had less ability to respond to challenges with

equanimity; they appeared to be psychologically worn thin.

Pelham said that although medications are effective in addressing ADHD symptoms,

they often prove unhelpful when it comes to parent-child interactions because

ADHD drugs are stimulants, usually given to the kids in the morning before they

head to school. The medication is wearing off by the time kids get home and have

most of their interactions with their parents. It isn't advisable to give

children more medication because it would keep them up at night.

Several researchers said parents need to develop behavioral techniques to

improve coping skills.

" When you sit back, you can laugh at it, but in the moment it is phenomenally

stressful for the family, " said Charlotte ston, a psychology professor at

the University of British Columbia, referring to the daily challenges that

parents of kids with ADHD face. " Often the parents have different tolerances for

tantrums. One wants to stand firm, but the other is willing to give in. Now the

parents are set up to fight, [saying,] 'You let him do that?' or 'You are too

strict with him!' "

ston teaches parents to get on the same page and follow three rules: The

first is to pare down their expectations and to focus on only one or two problem

behaviors in their ADHD child. The second rule is the familiar parental

technique of rewarding all positive behavior and discouraging negative behavior,

often by ignoring it. The third rule is to consistently stick with the technique

long enough to see it work.

Other experts said it is also important to teach parents to take time to pamper

themselves and put themselves back together psychologically.

" Many parents do not take care of themselves. We encourage them to do that even

though they may feel they have no time because of all their commitments to their

families, " said Chronis-Tuscano, a psychologist who directs the

University of land's ADHD Program. " One of our mantras is, 'If you don't

take care of yourself, you can't do your best as a parent.' "

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