Psychology Theses and Dissertations
Permanent URI for this collectionhttp://hdl.handle.net/1903/2801
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Item Trajectories of Clinician Competence and Student Engagement During an Adolescent ADHD Intervention(2023) Sommer, Samantha Lynn; Teglasi, Hedwig; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)School-based organization, time management, and planning skills-related (OTMP) interventions have been developed to address academic and organizational difficulties students with Attention-Deficit/Hyperactivity Disorder face (ADHD), especially when entering secondary school (DuPaul et al., 2012; Evans et al., 2018; Villodas et al., 2014). For OTMP interventions to be reliably administered, interventionists must be appropriately trained to not only implement session procedures that adhere to intervention protocol, but to also adjust their responses to individual students to maintain quality interactions, which is referred to as competence (Goense et al., 2016; Perepletchikova et al., 2007). This study tested the hypothesis that the constructs, interventionist competence and student engagement, would significantly change over the course of a 16-session school-based intervention for adolescents with ADHD and academic challenges. Specific student characteristics were also expected to interact with initial levels or changes in competence and engagement over time. Using an archival dataset (N= 111) and latent growth modeling, findings revealed that neither competence nor engagement changed significantly over time. However, initial levels of both constructs significantly varied. Further conditional growth modeling found that greater ADHD symptom severity negatively contributed to competence and that internalizing symptoms contributed uniquely and positively to competence. Although interventionist competence and student engagement did not exhibit significant change over time, certain student factors were associated with the quality of interventionists responses to students and with the degree to which students remain engaged with intervention materials.Item Sleep, Alcohol, and Cannabis Use in College Student Drinkers with and without ADHD(2022) Marsh, Nicholas Patrick; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Background: Heavy drinking college students are at risk for experiencing poor sleep and negative alcohol-and cannabis-related consequences. College students with attention-deficit/hyperactivity disorder (ADHD) are uniquely vulnerable to both poor sleep and negative consequences from alcohol and cannabis use. Thus, it is critical to consider relations between ADHD, sleep and alcohol-related negative consequences together in a single study. In the present study, we examined: (1) the associations among ADHD status, sleep and alcohol- and cannabis-related consequences; (2) the independent and interactive effects of sleep and ADHD on negative alcohol-related consequences. Finally, we explored the independent and interactive effects of sleep and ADHD on negative cannabis-related consequences. Method: College student drinkers with (n=51) and without (n=50) ADHD completed a 2-hour assessment that included measures of sleep quality, alcohol and cannabis use, and alcohol/cannabis-related negative consequences. Analyses utilized a series of hierarchical linear regression models to examine study aims. Results: College student drinkers with ADHD reported significantly worse sleep quality relative to non-ADHD student drinkers. Students with ADHD also experienced more negative alcohol-related consequences, relative to student drinkers without ADHD. When ADHD and sleep quality were included in the model together, ADHD—but not sleep quality—was independently associated with negative alcohol consequences, but not negative cannabis consequences. There were no moderating effects of ADHD on the associations among sleep and negative consequences resulting from either alcohol or cannabis use. Conclusion: This is the first study to examine sleep quality in college students with and without ADHD engaging in heavy drinking, as well as the first to examine the independent and interactive effects of sleep and ADHD on alcohol- and cannabis-related consequences. Results demonstrated that college drinkers with ADHD are particularly vulnerable to experiencing poor sleep and negative consequences from their alcohol and cannabis use, compared to their heavy drinking peers without ADHD. Future, larger scale studies should consider longitudinal effects as well as underlying mechanisms of risk.Item Cortisol Reactivity and Observed Parenting among Mothers of Children with and without ADHD(2015) Thomas, Sharon Renee; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Parenting is a robust predictor of developmental outcomes among children with ADHD. Early parenting predicts the persistence and course of ADHD and comorbid problems above and beyond risk associated with shared genetic effects. Yet, on average, mothers of children with ADHD are less positive and more negative in their parent-child interactions compared to mothers of non-disordered children. Little is known about psychobiological markers which may be associated with individual variations in maternal parenting in families of children with ADHD. Neurobiological models of parenting suggest that maternal cortisol levels following a stressor may be positively associated with hostile and intrusive parenting; however, to date no studies have examined maternal cortisol reactivity and parenting in school-age, or clinical samples of, children. Mothers’ regulation of physiological stress responses may be particularly important for families of children with ADHD, as parenting a child with chronically challenging behaviors represents a persistent environmental stressor. The current study sought to extend the existing literature by providing an empirical examination of the relationship between maternal cortisol reactivity following two laboratory stressors and parenting among mothers of children with and without ADHD. It was hypothesized that child ADHD group would moderate the relationship between cortisol reactivity and self-reported and observed parenting. Greater total cortisol output and greater increase in cortisol during the TSST were associated with decreased positive parenting and increased negative and directive parenting, with the exception of parental involvement, which was associated with increased cortisol output during the TSST. Conversely, cortisol output during the PCI was associated with increased positive parenting, increased parental involvement, and decreased negative parenting. In contrast to the TSST, a greater decrease in cortisol during the PCI indicated more positive parenting and parental involvement. These associations were specific to mothers of children with ADHD, with the exception of maternal directiveness, which was specific to comparison mothers. Findings add to our understanding of physiological processes associated with maternal parenting and contribute to an integrative biological, psychological, and cognitive process model of parenting in families of children with ADHD.Item Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships(2015) LeMoine, Kaitlyn Ashley; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.Item PATERNAL ADHD, PARENTING, AND CHILD CONDUCT PROBLEMS: POTENTIAL MECHANISMS.(2012) Mintz, Abigail D.; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Parental factors, specifically psychopathology and parenting, robustly predict negative developmental outcomes among children with attention-deficit/hyperactivity disorder (ADHD). Indeed, emergent findings have linked maternal ADHD symptoms both with sub-optimal parenting and child conduct problems within families of children with ADHD. Despite considerable research supporting the important and unique contributions of fathers to their children's development, the role of fathers within families of children with ADHD has seldom been examined. In particular, little research has been conducted with regard to paternal ADHD symptoms and parenting, despite clear evidence for an association between maternal ADHD symptoms and maladaptive parenting. The current study examined psychopathology and parenting behavior among a sample of fathers (N=102) and their 5-12 year-old children with previously-diagnosed ADHD. Results indicated that paternal antisocial personality disorder (ASPD) symptoms (rather than ADHD symptoms) were robustly associated with child conduct problems, and paternal negative parenting mediated this relationship. Future research using prospective longitudinal designs should examine multiple forms of psychopathology and parenting behavior among fathers of children with ADHD in order to identify potential risk factors and associated mechanisms for the development of child conduct problems.Item Risky Sexual Behavior in College Students with and without Attention-Deficit/Hyperactivity Disorder: Is a Positive Parent-Child Relationship Protective?(2012) Huggins, Suzanne Lorraine; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)College presents a novel context with decreased parental supervision, increased rates of alcohol and illicit drug use, and increased access to potential sexual partners. It may be especially challenging for students with Attention-Deficit/Hyperactivity Disorder (ADHD). Research has shown that young adult males with ADHD engage in risky sexual behaviors (RSB); however, little to no research has been done on females or college students with ADHD, nor have prior studies examined environmental factors that may moderate risk. We examined whether ADHD is associated with RSB among college students and whether parent-child relationship quality moderated that relationship. Participants included 92 undergraduates, approximately half with ADHD and half without. Results indicated that the interaction between gender and ADHD status was associated with condom use frequency and age of first sexual experience. Further, the interaction between parent-child relationship and ADHD accounted for significant variance in number of sexual partners in the past year.Item Identifying Mechanisms Underlying the Association between Attention- Deficit/Hyperactivity Disorder and Problematic Alcohol Use in College Students(2011) Rooney, Mary; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Students with ADHD represent a significant population on college campuses who have been found to be at risk for problematic alcohol use. Yet little is known about mechanisms underlying the association between ADHD and alcohol-related problems. We examined patterns and consequences of alcohol use in college students with and without ADHD, as well as three possible mediators of the association between ADHD and alcohol-related impairment: (1) self-reported difficulty stopping a drinking session, (2) cue dependency on a behavioral task of response inhibition, and (3) self-reported trait disinhibition. Participants with ADHD reported higher rates of negative consequences of alcohol use relative to the non-ADHD group, despite equivalent rates of alcohol use. In addition, the ADHD group had higher rates of difficulty stopping a drinking session. Difficulty stopping a drinking session mediated the relationship between ADHD and negative consequences of alcohol use. Cue dependency and trait disinhibition did not mediate this relationship. These findings indicate that college students with ADHD are experiencing higher rates of negative consequences of alcohol use relative to their peers without ADHD. Difficulty stopping a drinking session may be one mechanism that explains the relationship between ADHD and alcohol-related problems.Item RISKY BEHAVIOR IN COLLEGE STUDENTS WITH ADHD(2008) Rooney, Mary; Chronis-Tuscano, Andrea M; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Individuals with attention-deficit/hyperactivity disorder (ADHD) are more likely to engage in risky behavior across the lifespan than those without ADHD. College represents an important developmental phase during which the initiation and escalation of heavy drinking set the stage for lifelong difficulties with alcohol and other drugs (Maggs, 1997). The present study examined patterns of alcohol use, illicit drug use, risky sexual behavior, and risky driving behaviors among 39 college students with ADHD and 60 college students without ADHD. Results suggested that among college students, ADHD, CD, and their comorbidity were differentially associated with patterns of risky behavior. Results from the present study largely support the overarching view that individuals with ADHD engage in higher rates of risky behavior; however, specific findings were at times inconsistent with the existing literature on young adults with ADHD. Further research is needed to examine moderators of the association between ADHD and risky behavior.Item Associations Between Paternal Psychopathology and Conduct Problems in Children with ADHD(2009) Mintz, Abigail D.; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Parental psychopathology has consistently emerged as an important risk factor for negative developmental outcomes in children with ADHD; yet, this literature has focused almost exclusively on mothers. The few studies that do focus on fathers have identified significant associations between paternal psychopathology and child conduct problems (CP). This study sought to replicate these findings among families of children with ADHD and to extend prior research by considering paternal involvement as a potential moderator. Direct relationships between paternal psychopathology and child CP were not found. However, paternal involvement moderated the relationship between paternal ADHD and child CP. For involved fathers, these two variables were positively correlated, which suggests that children whose fathers are both involved and display psychopathology may be at higher risk for concurrent CP.Item Executive Functions and Overt/Covert Patterns of Conduct Disorder Symptoms in Children With ADHD(2009) Clarke, Tana L.; Chronis-Tuscano, Andrea; Psychology; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)There are inconsistencies in findings exploring the relationship between executive functions (EF), attention-deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) symptoms in children in adolescents. In order to reconcile conflicting results in the existing literature, it is necessary to consider more carefully how these constructs are measured and the theory underlying any expected associations. The proposed study examined the EF correlates of overt and covert CD symptoms in a high-risk sample of 6-14 year old children with ADHD and varying levels of conduct problems. Several aspects of EF were examined, including shifting, working memory, behavioral inhibition, and interference control, to examine their relationship to both ADHD and overt and covert conduct problems. It was expected, after ADHD was accounted for, that deficits in behavioral inhibition and working memory would be related to both overt and covert CD symptoms, whereas deficits in shifting and interference control would be uniquely related to overt CD symptoms. Set shifting abilities were found to be significantly lower in children with co-occurring ADHD and CD in comparison to children with ADHD-only. Results failed to find consistent evidence for differential relationships between individual overt and covert behaviors and domains of EF, but an interaction between set shifting and interference control did significantly predict overt, but not covert symptoms. Potential reasons for these findings, as well as future directions for research are discussed.