Parenting Styles and ADHD Symptoms

 

In my continued effort to beat a dead horse, this post concerns yet another not-so-science-based characteristic of authors of the literature on ADHD: their refusal to consider any alternate interpretations of their data other than that they are studying some sort of brain disease. In this case, they do not consider the possibility that the symptoms of their subjects come as a result of environmental issues, such as a chaotic home environment and/or sleep deprivation.

One well-publicized study (Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD | American Journal of Psychiatry (psychiatryonline.org) purports to show that up to 90% of children who have attention-deficit/hyperactivity disorder (ADHD) may continue to experience residual symptoms of the disorder into young adulthood. Amazingly, the authors add that they may also have periods of remission along the way. In other words, ADHD is a disease with waxing and waning symptoms. Could it not be that other, environmental issues that create their symptoms are what is doing the waxing and waning???

In another publication, Greg Mattingly, MD, of the Midwest Research Group, tells us that, “Instead of resorting to positive parenting, many of them [parents of kids diagnosed with ADHD] have fallen back on what we call negative parenting: scolding, discipline, getting frustrated. As we shift into next year, we need to shift into how we shift into a positive parenting model. I want you to talk to your kids with encouragement about the school year. Share something each day that was something cool they learned in a positive way, and then complement them for sharing that fact back with you."

So the symptoms get better with positive changes in parenting style? The author doesn’t seem to consider the possibility that negative parenting styles were perhaps a big cause of the so-called disease in the first place. 

This reminds me of TARA, a support group for parents of people with BPD (at least those that weren’t physically or sexually abusive, since those relatively common parents-of-kids-with-the-disorder would never join a parent support group —other than perhaps the False Memory Syndrome Foundation). They teach parents how not to invalidate their kids but somehow don’t mention the DBT theory that an invalidating environment is a major cause of the disorder in the first place. In TARA's case, this isn’t a bad thing because if they did that, a lot of these parents wouldn’t attend their seminars. But researchers in the field ignores this issue as well.

Measuring the Nature of Parenting Practices in Studies

A "scientific" journal article entitled, “Which dimension of parenting predicts the change of callous unemotional traits in children with disruptive behavior disorder?” By Muratori and others in the August 2016 issue of Comprehensive Psychiatry attempted to determine whether parenting practices influenced the development of so called callous and unemotional (CU) character traits in children. Alternatively, are those traits – which are common in children with disruptive behavior –more genetic in origin? 

In the study, no significant relationship was found between "negative" parenting and CU traits; these two variables were also unrelated when "positive" parenting was considered in the same model. However, using a slightly different model, higher levels of positive parenting predicted lower levels of CU traits.

Although I would like to believe and tend to agree that “positivity” in parent-child relationships helps decrease acting out behavior in children, a huge problem with this type of study is how the hell can you precisely measure the nature of the relationship between parents and children? The biggest problems with that include the fact that these relationships are not constants but vary across time and situational contexts. Parents might be good disciplinarians when it comes to providing children with adequate curfews, for example, but terrible at allowing them to stay up all hours of the night. Furthermore, the disciplinary practices certainly change over time as the children get older.

Second, how does a study even attempt to measure the tone of parenting practices? This study used a measure called The Alabama Parenting Questionnaire (APQ) [40] – mother report. This parent report measure has five subscales: parental involvement, positive parenting, poor monitoring/supervision, inconsistent discipline, and corporal punishment. Items are rated on a 5-point Likert scale, ranging from 1 (never) to 5 (always).

They used the mother’s own report of her own disciplinary practices! If a mother were abusive or inconsistent, how likely do these authors think she would admit to it, even if she were very self-aware, which obviously many people are not. There is no way to be sure, of course, but the odds are very good that the amount of “negative” parenting is  higher than their study results would indicate, while the amount of “positive” parenting could be overestimated. 

And which particular types of those parental behaviors listed in the instrument were the most relevant to the question at hand? There is no way to know!

When it comes to assessing the effects of family interactions, details make a huge difference. And as I have maintained over and over again, in order to get these details, you would need a camera on both the parents and the children 24 hours a day over a significant time period. This type of study using absolutely no direct observation of what is purportedly being measured is a complete waste of time.

When and How Can a Parent Stop Parenting?

In her column of 9/13/09, a letter writer asked Dear Abby:  “At what point does a parent stop giving unsolicited advice? It is painful to watch my "child" repeatedly make choices that aren't in her best interest.”  The writer's daughter was 43. 

After describing some self-destructive behavior by her daughter, the writer added, “Although I am trying to keep my mouth shut, she tells me she "feels" my disapproval… Must I duct tape my mouth shut?

The relationship between parents and adult children is by its very nature a bit of a mine field. In order to rear their children properly, parents have to discipline them. Parents have to tell children what to do, what not to do, and how to behave in various social situations. Parents have to find ways to make their children follow these parental directives. Good parents continually set limits with their children.

The difficulty is, when is this supposed to stop?

Does the child suddenly become capable of making his own enlightened choices by virtue of having lived eighteen years? Should parents ignore the wisdom of their added years and never advise their adult children about anything? If the parents do persist in giving counsel, how upset are they going to be if the child chooses not to follow their sage advice? If a parent suggests a course of action over a particular issue, will the adult children feel infantilized?

Even with peers who are not relatives, the issue of when and when not to give advice can get to be problematic.  In Eric Berne’s psychotherapy model, transactional analysis, he shows how asking for and giving advice can become a “game.”  On the surface, two people may seem to be engaged in an “adult to adult” conversation, but the subtext may be entirely different.  One member of the dyad may be acting like, say, a helpless yet petulant child trying to frustrate the other member, who may be acting out the role of an exasperated parent who thinks he or she knows what is best for the other person.

A game people play

When the two parties actually are parent and child, the question of whether or not there is a hidden agenda being acted out becomes that much more complicated.  The parents may claim that they are “just expressing their opinion,” while the adult children feel like they are being told what to do as if they had no valid opinions on the subject themselves.  Is the parent’s advice merely an opinion, or is it a directive (a command telling the child how to behave)?

 

Unless parents and adult children are adept at metacommunicating about this issue (talking about the way they talk to one another), tension is bound to develop.

This situation becomes compounded exponentially in those situations where the parents themselves are highly conflicted about the advice they give.  They may be unsure of and unhappy with their own choices in life, but cannot admit that even to themselves - let alone to their adult children.

In such a case, two events frequently transpire: the parents bring up the issue involved rather often — because they are themselves preoccupied with it — and they give out a double message.  The offspring often interpret the advice to mean “Do it because I did,” but almost simultaneously, the way the advice is given may also have elements suggestive of “I hope you don’t have to do what I did and become miserable like me.” Whenever this chain of events takes place, a question about the motivation behind the parental advice giving is invariably created for the child.

The child must choose between two possible presuppositions. As mentioned, either the advice is meant as a directive or is merely the parent's opinion about a controversial issue. The frequency of the advice giving will most usually indicate to the child that how he or she behaves is a matter of grave concern to the parent. Therefore, the younger family member will presuppose that the parent's statements about the issue are directives or instructions.

But which part of the double message should the children heed? In situations where the advice is given ambivalently or is part of a double message, they will then make an effort to determine, using principles of ordering environmental cues that I describe in my book, Deciphering Motivation in Psychotherapy, which side of the double message to follow.

  

Consider the example from that book of a woman I will call Trudy and her mother. Trudy was having all kinds of anxiety symptoms over making a decision to really commit to her boyfriend.  Her mother had said on numerous occasions that "marriage is a mixed blessing: one has to take the bitter with the sweet."

One could interpret this as sage advice on the wisdom of not expecting perfection and retaining one's equanimity in the face of unavoidable adversity. Nothing in the lexical content of the statement indicates that Trudy's mother was commanding her to behave in any particular fashion or make any particular choices regarding marriage or spouse selection. The statement can be viewed as an expression of the mother's opinions about life and as good advice - nothing more.

  

On the other hand, the fact that the mother seemed compelled to drive this point home by repeating it over and over again suggested otherwise. The statement began to sound like a warning: "You'd better watch out! If you get married, you'd better be prepared for all the bitter you're going to get along with any sweet!" Every time the mother would talk about the good points of relationships, she seemed to be throwing in a warning about it.

Not only that, but her frequent repetitions indicated to the daughter that the mother was very concerned about whether the message had been heard loud and clear by Trudy. Perhaps she was worried that Trudy had not understood it the first twenty times it was said.

  

Naturally, Trudy began to worry about the consequences of getting involved with men. She became concerned not only that she might be in for a rough time, but also, for some reason, that her mother might become very upset about it. What Trudy did not realize was that the mother's repetitions indicated that she was trying to convince herself, not Trudy. In any event, the motivation presupposed by the mother's statement was in question, and the patient had been forced to guess what was correct. A good therapist would be alert to the possibility that Trudy may have guessed wrong.

Guest Post: What Parents Can Do If They Do Not Like Their Child's Romantic Partner

The first guest post on my blog is contributed by Kitty Holman, a freelance writer, pursuing her online Journalism course. She loves to write on health, parenting, environment, and education-related topics. She regularly writes on the topics of nursing colleges. She welcomes your comments at: kitty.holman20@gmail.com.  In this post she discusses how parents can respect their adult children's autonomy in a difficult situation.

What Parents Can Do If They Do Not Like Their Child's Romantic Partner

Sooner or later, parents have to face the prospect of their son or daughter's eventually entering a romantic relationship. Of course, each set of parents will have their own way of handling this process: at what point their children can start dating, whom they can date, what curfews they'll face, and so on. However, there will come a day when your child is on his or her own, dating and seeing other people, and there just might be that one romantic partner whom you absolutely cannot stand.

How will you handle it? What do you take into consideration when deciding how to act regarding this new development? After all, you are the parent, and your parental instincts might tell you that this relationship is bad for your child, but you also have to respect your child's wishes, especially since he or she is a grown adult now, for if you overstep your bounds, you risk not only damaging your child's relationship with a potential partner, but also your relationship with your child.

Observe

Your first step, the first action you can take in this situation, is one of non-action. Simply observe. Do your best to observe your child in this new relationship. Watch how he or she interacts with the partner. Listen to how they speak to one another. Listen also to how your child speaks about this new partner. You want to gather as much information as possible before making any judgments.

Invite

Next, if you get a bad feeling about your child's partner, one thing you can do is invite everyone to hang out together. This way you can also interact with the partner on your own. Get a feel for how your child's partner treats you and your family. How they initially treat you will give you some insight into how they will treat you and your family later on, as well as how they treat your son or daughter. If this phase confirms your suspicions, then you'll want to take some action.

Talk

This is perhaps the trickiest part of the process, as how you approach your child about his or her partner will determine the tone of the rest of the discussion and perhaps the rest of the time your child is dating that person. Try to find a time to talk to your child about the relationship. Preface your remarks by saying that you only wish to offer your opinion and a little advice, and that you respect your child's decisions. If you can approach the situation gently, then you can save you and your child a lot of heartache later on. You have to trust your child at this point to understand your concern, but you have to also realize that your child is an adult who can make his or her own decisions. Think of yourself as an advisor at this point.

Intervene

However, should you find that your child is in danger, either mentally or physically, then you just might have to take steps to intervene on his or her behalf. This should be an action of last resort, as the consequences of your intervention can be drastic if you misjudge the situation. But, you are the parent, and ultimately, your experience in the world gives you the tools to be the most helpful, caring parent possible for your child. That's something that no professional can really lay claim too.

The question, then, is how exactly do you intervene? The simplest, perhaps less confrontational method would be to ask to speak with both your child and his or her romantic partner. This method requires that you take an extra step in your discussion. Simply giving advice is not an option. You might request that your child and partner go to family or relationship counseling; you could offer to help pay for it as encouragement. You could offer to even join them. However, if this intervention does not work, then you may need to seek help from the justice system. Unfortunately, you cannot take out a restraining order on a third party, so you will need to talk to your child about this option. Ultimately, if your child resists, your best bet is to encourage him or her to be careful in the relationship. Be as supportive as possible, but understand that your child is an adult who can act on his or her own.

A Great Post About Affect Regulation in Children from Dr. Claudia Gold

http://claudiamgoldmd.blogspot.com/2010/12/how-parents-and-children-regulateand.html