Are ADHD trajectories shaped by the social environment? A longitudinal study of maternal influences on the preschool origins of delay aversion

TY - JOUR

T1 - Are ADHD trajectories shaped by the social environment? A longitudinal study of maternal influences on the preschool origins of delay aversion

AU - Chan, Wendy W.Y.

AU - Shum, Kathy Kar man

AU - Downs, Johnny

AU - Sonuga-Barke, Edmund J.S.

N1 - Publisher Copyright: © 2024 The Author(s). Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

PY - 2024

Y1 - 2024

N2 - Background: Attention-deficit/hyperactivity disorder (ADHD) is commonly attributed to neuro-cognitive deficits of genetic and/or prenatal/perinatal environmental origins. Sonuga-Barke proposed an alternative formulation, suggesting that ADHD behaviors are functional expressions of delay aversion—a strong motivational disposition to avoid or escape negative affective states evoked by delay. It is hypothesized that the strength of this disposition, though neuro-biologically rooted, is exacerbated by early negative social interactions during waiting-related encounters. This paper reports findings from an initial proof-of-concept study that specifically tests this hypothesis in a nonclinical sample. Methods: Preschoolers (n = 112; mean age = 46.2 months) and their parents from London, UK, and Hong Kong participated in a longitudinal study. The Parent–Child Delay Frustration Task (PC-DeFT) and two nonwaiting control tasks were administered at baseline. Children's performance, behavioral and emotional responses, and parents' reactions were observed. Teachers rated children's ADHD behaviors and delay aversion at baseline and follow-up (12–18 months later). Results: At baseline, children's maladaptive performance and parental negative reactions during the PC-DeFT were correlated with each other and with teacher ratings of ADHD and delay aversion. Negative parental reactions during the PC-DeFT at baseline predicted an increase in teacher-rated ADHD behaviors at follow-up, but similar associations were not observed for baseline parental responses in the nonwaiting tasks. The increase in child ADHD symptoms associated with negative parental reactions at baseline was statistically mediated by delay aversion. These longitudinal effects were consistent across the UK and HK samples. Conclusions: The findings provide the first evidence that parent's negative reactions to preschooler's attempts to manage delay are associated with increases in ADHD behaviors overtime, and linked to delay aversion increases. They underscore the potential significance of the early social environment as a contributor to developmental trajectory of ADHD behaviors. Future studies with clinical samples over an extended time-frame using a range of different aversive environments (i.e. difficult tasks to complete) are indicated.

AB - Background: Attention-deficit/hyperactivity disorder (ADHD) is commonly attributed to neuro-cognitive deficits of genetic and/or prenatal/perinatal environmental origins. Sonuga-Barke proposed an alternative formulation, suggesting that ADHD behaviors are functional expressions of delay aversion—a strong motivational disposition to avoid or escape negative affective states evoked by delay. It is hypothesized that the strength of this disposition, though neuro-biologically rooted, is exacerbated by early negative social interactions during waiting-related encounters. This paper reports findings from an initial proof-of-concept study that specifically tests this hypothesis in a nonclinical sample. Methods: Preschoolers (n = 112; mean age = 46.2 months) and their parents from London, UK, and Hong Kong participated in a longitudinal study. The Parent–Child Delay Frustration Task (PC-DeFT) and two nonwaiting control tasks were administered at baseline. Children's performance, behavioral and emotional responses, and parents' reactions were observed. Teachers rated children's ADHD behaviors and delay aversion at baseline and follow-up (12–18 months later). Results: At baseline, children's maladaptive performance and parental negative reactions during the PC-DeFT were correlated with each other and with teacher ratings of ADHD and delay aversion. Negative parental reactions during the PC-DeFT at baseline predicted an increase in teacher-rated ADHD behaviors at follow-up, but similar associations were not observed for baseline parental responses in the nonwaiting tasks. The increase in child ADHD symptoms associated with negative parental reactions at baseline was statistically mediated by delay aversion. These longitudinal effects were consistent across the UK and HK samples. Conclusions: The findings provide the first evidence that parent's negative reactions to preschooler's attempts to manage delay are associated with increases in ADHD behaviors overtime, and linked to delay aversion increases. They underscore the potential significance of the early social environment as a contributor to developmental trajectory of ADHD behaviors. Future studies with clinical samples over an extended time-frame using a range of different aversive environments (i.e. difficult tasks to complete) are indicated.

KW - ADHD

KW - delay aversion

KW - development

KW - parenting

KW - preschoolers

KW - social factors

UR - http://www.scopus.com/inward/record.url?scp=85212701563&partnerID=8YFLogxK

U2 - 10.1111/jcpp.14103

DO - 10.1111/jcpp.14103

M3 - Article

AN - SCOPUS:85212701563

SN - 0021-9630

JO - Journal of Child Psychology and Psychiatry and Allied Disciplines

JF - Journal of Child Psychology and Psychiatry and Allied Disciplines

ER -