PREDICTIVE ROLES OF STRESS, SELF-EFFICACY, ATTACHMENT, AND CHILD-ADHD SYMPTOM SEVERITY IN MOTHERS’ OPENNESS, AND MOTIVATION TO BE INVOLVED IN ADHD TREATMENT

Abstract

Attention-Deficit Hyperactivity Disorder (ADHD) is the most commonly diagnosed psychiatric condition of school-aged children, and is the number one presenting complaint of parents who seek psychological services for their kids in the United States (American Psychiatric Association [APA], 2013). Over the past decade, we have witnessed a drastic increase in the rate of ADHD diagnosis; from 2007 to 2012, there was a 42% increase in child populations, and this rate continues to rise (National Survey of Children’s Health, 2013). Given the rising rates, establishing and implementing effective treatment for these children is of paramount importance. Many options have been established as effective in the treatment of childhood ADHD, including behavioral interventions (Fabiano et al., 2009), medication management (Leggett & Hotham, 2011), and parent training/psychoeducation (Ferrin et al., 2014). Research suggests treatments that combine the aforementioned techniques, where parents are highly involved in the child’s care, produce the best treatment results (Leggett & Hotham, 2011). Furthermore, for children aged six and younger, behavior therapy is recommended as the first line of treatment (Center for Disease Control and Prevention [CDC], 2017). However, medication is still the primary means of treatment, which is used much more often than behavioral interventions, or a treatment that combines the two (National Institute of Mental Health [NIMH], 2011). To address this pattern, we need to understand parents’ experiences in their decision-making regarding treatment for their children’s ADHD. While research has been done exploring the impact of institutional factors (i.e., pharmaceutical companies) on this pattern, less research has been completed examining familial factors that may affect this trend. Therefore, this study was designed to examine several familial factors that may be associated with these decisions. Given that mothers are more likely to present for treatment services for their children and make decisions regarding treatment and subsequent implementation at home and beyond (Fabiano, 2007), factors which influence mothers’ decision-making are of particular importance. Based on the available literature and the author’s clinical observations, the current study identified maternal stress, maternal self-efficacy, the child-ADHD symptom severity, and a mother’s relationship with her child (attachment), as potential predictors of a mother’s motivation to be involved in treatment and her openness toward different treatment modalities. The study used a descriptive correlational design and collected data from 200 participants through MTurk, an online survey system. The results showed that there is a dynamic interplay of these factors in relation to a mother’s openness toward different ADHD treatments, her top choice of treatment for her child, and her level of motivation to be involved in that treatment. Specifically, mothers who reported higher levels of stress are more likely to be open to medication-only treatment, and prefer it if given the choice. In addition, older mothers who reported strong mother-child attachment, and also had a child whose symptoms are interpreted as severe, were more likely to be interested in behavior therapy for their child, and more likely to be motivated to be involved in general. Regarding openness to multimodal treatments, study variables were not significant predictors. Interestingly, results indicated that mothers overwhelmingly reported this treatment would be a good option for their child, but also ranked it as the least preferred option between the three, and it was not commonly used for participants’ children’s actual treatment. The meaning and implication of these findings were discussed in the context of the existing literature. Suggestions were made for future research in this area.