title: Attention-deficit/hyperactivity disorder developmental trajectories related to parental expressed emotion.
abstract: In the transition from childhood to adolescence, attention-deficit/hyperactivity disorder (ADHD) developmental trajectories diverge. Family environment, as indexed by parental expressed emotion, may moderate these trajectories. 388 children with ADHD and 127 controls were assessed using multi-informant, multimethod diagnostic procedures at up to 3 time points 1 year apart in an accelerated longitudinal design spanning ages 7-13 years. Latent-class growth analysis was used to identify developmental trajectories for parent- and teacher-rated ADHD and oppositional-defiant disorder (ODD) symptoms within the ADHD sample. Parental expressed emotion, criticism, and emotional overinvolvement were coded from a 5-min speech sample at 2 time points, 1 year apart, for 208 of these children and compared among ADHD trajectory groups.
  
  
  RESULTS
  Parent-rated hyperactivity yielded a 4-class trajectory solution in latent-class growth analysis; teacher-rated inattention yielded a 3-trajectory solution. Teacher-rated ODD also yielded 3-trajectory solution. A parent-rated high persistent hyperactive group was more likely than the other ADHD groups to have parents with stable high criticism (34.6%, p < .001), with ODD symptoms controlled. A teacher-identified high ODD-worsening group was more likely to experience high criticism, particularly the initial time point; (87.5%, p < .001), with hyperactivity controlled. Parental criticism, an index of the family environment, is uniquely associated with divergent developmental trajectories among children with ADHD in addition to those associated with ODD symptoms. Lay summary: For many children, ADHD symptoms decrease as they transition to adolescence. Family environmental factors, such as parental criticism, may help explain for whom symptom remission is less likely.
authors: Department of Psychology, Florida International University.
authors: Erica D
authors: ED
authors: Musser
authors: Department of Psychiatry, Oregon Health & Science University.
authors: Sarah L
authors: SL
authors: Karalunas
authors: School of Nursing, Department of Psychiatry, Oregon Health & Science University.
authors: Nathan
authors: N
authors: Dieckmann
authors: Department of Psychiatry & Biobehavioral Science, Semel Institute, University of California, Los Angeles.
authors: Tara S
authors: TS
authors: Peris
authors: Departments of Behavioral Neuroscience and Psychiatry, Oregon Health & Science University.
authors: Joel T
authors: JT
authors: Nigg
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications; D002648:Child; D002657:Child Development; D019955:Conduct Disorder / Q000150:complications; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*