Parents of children with attention-deficit/hyperactivity disorder (ADHD) experience a great deal of parenting stress and are far more likely than parents of non-disordered children to experience psychopathology themselves. It has been theorized that such parental problems may negatively impact parenting, which then exacerbates child behavior problems, creating a reciprocal pattern of negative parent-child interactions within the families of children with ADHD. There are also important implications of parental psychopathology on child treatment. Given that both behavioral and pharmacological treatments for childhood ADHD rely on parents (particularly mothers) to obtain and consistently administer treatment, it is no surprise that parental psychopathology (particularly maternal depression) predicts poorer child treatment response. Yet, existing ADHD treatments largely fail to directly address parental problems. The objective of the proposed project is to develop and evaluate a novel, integrated approach to behavioral parent training for mothers of children with ADHD with elevated depressive symptoms in order to facilitate successful outcomes following treatment. In Phase 1, we will complete the development and refinement of a manualized treatment, integrating the two empirically validated treatments: cognitive-behavioral depression intervention (specifically, the Coping with Depression Course) and behavioral parent training for ADHD. In Phase 2, 88 mothers with children with ADHD and elevated depressive symptoms will be recruited and randomly assigned to either: 1) standard behavioral parent training or 2) integrated parent intervention (IPI-A). Outcome measures include maternal self-reports of depressed mood (primary), parenting stress, self-esteem, expectations and attributions for child behavior, parenting sense of competence, self-reported and observed parenting behavior and parental reports of child behavior and associated family impairment. Based on the outcome of this preliminary trial the IPI-A protocol will be further refined and prepared for larger-scale clinical trials.
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