THE ROLE OF CHILD SOCIAL COGNITIVE BIASES ON CHILD SOCIAL FUNCTIONING DIFFICULTIES WITHIN A MOTHER-CHILD INTERACTION
by
Natalie Viola Miller
B.Sc. The University of Calgary, 2008
A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF ARTS
in
The Faculty of Graduate Studies
(Psychology)
THE UNIVERSITY OF BRITISH COLUMBIA
(Vancouver)
August 2011
© Natalie Viola Miller, 2011 Abstract
Children with high levels of ADHD symptoms and conduct problems have difficulties developing social relationships with their peers, and these difficulties have been linked to certain social cognitive biases. The study examined the role of social cognitive biases for these children’s social behaviour within mother-child interactions. 38 children (9-12 years, 63% male) and their mothers participated. Severity of ADHD symptoms and conduct problems varied across children. Social cognitive bias measures included assessment of hostile attribution bias and positive illusory bias. Child social functioning difficulties were observed during mother-child play session. Hierarchical regression models indicated only the positive illusory bias was related to social functioning difficulties among children with high levels of ADHD symptoms and conduct problems (ps < .05). This study extends previous research by demonstrating that the positive illusory bias contributes to child social functioning difficulties within the family among children with high levels of ADHD symptoms and conduct problems.
ii Preface
This project was approved by the UBC Behavioural Research Ethics Board.
Certificate number: H10-025333
iii Table of Contents
Abstract ...... ii
Preface ...... iii
Table of Contents ...... iv
List of Tables ...... viii
List of Figures...... ix
Acknowledgements ...... x
Dedication ...... xi
1 Introduction ...... 1
1.1 Child social functioning and social cognitive biases ...... 1
1.2 The hostile attribution bias...... 6
1.2.1 Social information processing and peer interactions ...... 6
1.2.2 Hostile attribution bias and family interactions ...... 8
1.3 Positive illusory bias ...... 11
1.3.1 Positive illusory bias and peer social functioning ...... 13
1.3.2 Positive illusory bias and family interactions ...... 16
1.4 Hostile attribution bias and positive illusory bias...... 18
1.5 Other factors associated with social-cognitive biases and social functioning...... 21
1.5.1 Comorbid internalizing symptomatology ...... 21
1.5.2 Maternal psychopathology...... 21
1.5.3 Maternal parenting behaviours ...... 22
1.5.4 Demographic considerations...... 22
1.6 Hypotheses ...... 23
iv 2 Method...... 25
2.1 Participants...... 25
2.2 Measures ...... 27
2.2.1 Demographic and treatment information ...... 27
2.2.2 Assessment of ADHD symptoms and conduct problems ...... 27
2.2.3 Social-cognitive biases: Hostile attribution bias...... 28
2.2.4 Social-cognitive biases: Positive illusory bias ...... 29
2.2.5 Child social functioning within mother-child interaction ...... 32
2.2.6 Potential covariates ...... 35
2.3 Procedure...... 36
3 Results ...... 40
3.1 Demographic characteristics ...... 41
3.2 Child ADHD symptoms and conduct problems...... 41
3.3 Social cognitive biases ...... 42
3.4 Observed child social functioning difficulties ...... 43
3.5 Child internalizing symptoms ...... 44
3.6 Maternal behaviour and psychopathology...... 44
3.7 Main analyses...... 45
3.7.1 Hypothesis (1) ...... 47
3.7.2 Hypothesis (2) ...... 48
3.7.3 Hypothesis (3) ...... 50
3.7.4 Hypothesis (4) ...... 53
3.7.5 Hypothesis (5) ...... 59
4 Discussion...... 63
v 4.1 ADHD symptoms, conduct problems, and child social functioning difficulties ...... 63
4.2 ADHD symptoms and conduct problems and the hostile attribution bias ...... 64
4.3 ADHD symptoms, conduct problems, and the positive illusory bias ...... 65
4.4 Social cognitive biases and child social functioning difficulties ...... 66
4.4.1 Hostile attribution bias and child social functioning difficulties ...... 67
4.4.2 Positive illusory bias and child social functioning difficulties ...... 68
4.4.3 Hostile attribution bias and positive illusory bias...... 71
4.5 Social cognitive biases as mediators between ADHD symptoms, conduct problems, and child social functioning difficulties...... 71
4.6 Limitations ...... 73
4.7 Future directions ...... 77
Bibliography ...... 79
Appendices...... 93
Appendix A: Recruitment flyer...... 93
Appendix B: Family information questionnaire ...... 94
Appendix C: ADHD Rating Scale-IV ...... 98
Appendix D: Oppositional Defiant Disorder Rating Scale ...... 99
Appendix E: Child Attribution Measure and coding manual...... 100
Appendix F: Modified Social Skills subscales of the Social Skills Improvement System - Rating Scale ...... 104
Appendix G: MESSY Aggressive/Antisocial Behaviour...... 105
Appendix H: Instructions for mothers during parent-child interaction...... 106
Appendix I: Dyadic Parent-Child Interaction Coding System - Child categories ...... 110
Appendix J: Dyadic Parent-Child Interaction Coding System - Parent categories ...... 111
Appendix K: Dyadic Parent-Child Interaction Coding System - Composite variables...... 112
vi Appendix L: Brief Symptom Inventory - Anxiety, Depression, and Hostility ...... 113
Appendix M: Children’s Depression Inventory Short Form...... 114
Appendix N: Multidimensional Anxiety Scale for Children ...... 115
Appendix O: Telephone script ...... 116
Appendix P: Consent form for mothers ...... 124
Appendix Q: Assent form for children...... 129
vii List of Tables Table 2.1 Demographic Characteristics of the Sample...... 26 Table 3.1 Descriptive Statistics for the Variables of Interest...... 46 Table 3.2 Pearson Correlations among the Variables of Interest...... 47 Table 3.3 Summary of Regression Analysis for ADHD Symptoms and Conduct Problems Predicting Child Social Functioning Difficulties within Mother- Child Interactions Controlling for Child Medication Status, Mother Age, and Maternal Depression...... 48 Table 3.4 Summary of Regression Analysis for ADHD Symptoms and Conduct Problems Predicting Hostile Attribution Bias Controlling for Child Medication Status, Mother Age and BSI-II Maternal Depression...... 49 Table 3.5 Summary of Regression Analysis for ADHD Symptoms and Conduct Problems Predicting Child Positive Illusory Bias for Prosocial Behaviour Controlling for Child Medication Status, Mother Age, Marital Status, Maternal Depression, and Family Income...... 51 Table 3.6 Summary of Regression Analysis for ADHD Symptoms and Conduct Problems Predicting Child Positive Illusory Bias for Aggressive/Antisocial Behaviour Controlling for Child Medication Status, Mother Age, Marital Status, Family Income, and Maternal Depression...... 53 Table 3.7 Summary of Regression Analysis for Hostile Attribution Bias and Positive Illusory Bias for Prosocial Behaviour Predicting Child Social Functioning Difficulties Controlling for Mother Age, Marital Status, and Family Income...... 55 Table 3.8 Summary of Regression Analysis for Hostile Attribution Bias and Aggressive/Antisocial Behaviour Positive Illusory Bias Scores Predicting Child Social Functioning Difficulties Controlling for Marital Status and Family Income...... 57 Table 3.9 Summary of Regression Analysis for the Aggressive/Antisocial Behaviour Positive Illusory Bias Scores Predicting Child Social Functioning Difficulties Controlling for Marital Status and Family Income...... 58 Table 3.10 Mediation of the Effect of Conduct Problems on Child Social Functioning Difficulties Through the Aggressive/Antisocial Behaviour Positive Illusory Bias Controlling for Marital Status, Mother Age, Family Income, Child Medication Status, and Maternal Depression...... 61 Table 3.11 Direct, Total, and Partial Effects...... 61
viii List of Figures
Figure 3.1 Mediation of the Effect of Conduct Problems on Child Social Functioning Difficulties Through Aggressive/Antisocial Behaviour Positive Illusory Bias Controlling for Marital Status, Mother Age, Family Income, Child Medication Status, and Maternal Depression...... 62
ix Acknowledgements
I would like to thank my supervisor, Dr. Charlotte Johnston, for her support, encouragement, and guidance over the past two years, without which this project would have been a fleeting idea.
Thank-you to all members of the Parenting Lab for sticking with me as we muddled through the details and logistics of this project. It has been an inspiration to work with such a dedicated and heart-filled group.
I would like to acknowledge the members of my committee, Dr. Andrew Baron, Dr. Scott
Carlson, and Dr. Sheila Woody, for their excitement and insight into this project.
I would also like to acknowledge the Social Science and Humanities Research Council for providing the financial resources to fund this project.
Finally, I wish to thank my parents for their steadfast belief in me.
x Dedication
In loving memory of my grandfather, Giant.
xi 1 Introduction
1.1 Child social functioning and social cognitive biases
Social functioning describes a spectrum of interpersonal skills that are involved in developing and maintaining relationships. Social functioning abilities are established in childhood, first as children learn how to interact with their parents and siblings, and later as children begin forming peer relationships (Attili, Vermigli, & Roazzi, 2010; Elicker, Englund, & Sroufe, 1992;
McDowell & Parke, 2009). Children vary in their social functioning abilities; some children easily develop positive relationships with their peers, whereas others struggle to find friendship
(Hoza et al., 2005; Milich & Landau, 1982). Emerging even earlier in life, family relationships form the foundation of peer social functioning (Attili et al., 2010; Elicker et al., 1992; McDowell
& Parke, 2000), and as such, may hold clues to the origins of children’s social problems with peers. Thus, the current study seeks to understand factors related to difficulties in children’s social functioning within the family context.
Children with high levels of inattention, hyperactivity, and impulsivity (Attention-Deficit/
Hyperactivity (ADHD) symptoms) have difficulties with social functioning across peer and family contexts, and these difficulties are exacerbated when these children also demonstrate age- inappropriate aggressive and oppositional behaviours (i.e., conduct problems; Bagwell, Molina,
Pelham, & Hoza, 2001; Mash & Barkley, 2007; Waschbusch, 2002). Many children with higher levels of ADHD symptoms and conduct problems have difficulties developing and maintaining relationships with their peers, (Hinshaw, Zupan, Simmel, Nigg, & Melnick, 1997; Hodgens,
Cole, & Boldizar, 2000) and their interactions with their peers are characterized by higher levels of intrusiveness, disorganization, impulsivity, hostility, and disruptiveness compared to their
1 typically developing peers (Bloomquist, August, Cohen, Doyle, & Everhart, 1997; Erhardt &
Hinshaw, 1994; Frankel & Feinberg, 2002; Hinshaw & Melnick, 1995; Matthews, 1992;
Matthys, Cuperus, & Van England, 1999; Milich & Landau, 1982; Pelham & Bender, 1982;
Whalen & Henker, 1985). Approximately 50% of children with high levels of ADHD symptoms and conduct problems experience rejection and poor peer relationships (Hoza et al., 2005; Milich
& Landau, 1982). Thus, a strong body of research indicates that high levels of both ADHD and conduct problems are related to children’s difficulties with social functioning within their peer groups. However, in order to begin understanding the mechanisms underlying these difficulties, one must turn to the family, where children first develop their social functioning abilities
(Maccoby & Martin, 1983).
ADHD symptoms and conduct problems are related to family relationships; parent-child relationships for children with higher levels of ADHD symptoms and conduct problems are characterized by higher levels of conflict and negativity compared to children with lower levels of these symptoms (Johnston & Mash, 2001). Previous research has found that these children are less compliant, less responsive, and more negative when interacting with their parents compared to either children with low levels of ADHD symptoms and conduct problems or children with high levels of ADHD symptoms only (Gomez & Sanson, 1994; Johnston, 1996; Johnston &
Mash, 2001; Lindahl, 1998). Children’s social functioning contributes to and is developed through family interactions (e.g., Finnie & Russell, 1988; Maccoby & Martin, 1983). Positive and supportive parent-child interactions aid in the development of the child’s social functioning competence, resulting in, not only further positive family interactions, but also skills that transfer to positive interactions with peers (Lindsey, Colwel, Frabutt, Chambers, & MacKinnon-Lewis,
2 2008; Mize, Pettit, & Meece, 2000; Pettit, Brown, Mize, & Lindsey, 1998). When families demonstrate prosocial behaviours, children are more likely to incorporate these behaviours into other social situations (Black & Logan, 1995). On the other hand, negative, conflicted family interactions reinforce poor social functioning skills for children, which contribute to further problematic interactions (Reid, Patterson, & Snyder, 2002; Vuchinich, Bank, & Patterson, 1992).
Previous research has found that children with high levels of ADHD symptoms and conduct problems demonstrate high levels of negative behaviours and noncompliance with their mothers
(Johnston & Mash, 2001), which are thought to be important components of children’s social functioning difficulties within the family (Attili et al., 2010; Chen, Wang, Chen, & Liu, 2002;
Dodge, 1985; Eyberg, Nelson, Duke, & Boggs, 2005; Rose-Krasnor, 1997; Rubin & Rose-
Krasnor, 1992). Therefore the current study operationalized children’s social functioning difficulties through measures of noncompliance and negative behaviours within mother-child interactions.
In looking for potential mechanisms that may underlie children’s social functioning difficulties, various cognitive biases in the processing of social information have been proposed
(e.g., Brendgen, Vitaro, Turgeon, & Poulin, 2002; David & Kistner, 2000; Dodge et al., 2003;
Hancock, 2008; Hoza, Waschbusch, Pelham, Molina, & Milich, 2000; Hymel, Bowker, &
Woody, 1993; Milich & Dodge, 1984; Schwartz et al., 1998). For the purposes of the current study, two social cognitive biases were examined: the hostile attribution bias and the positive illusory bias.
The hostile attribution bias describes the tendency to perceive hostile intent in others’ actions under ambiguous conditions (e.g., did someone step on your foot on purpose or by
3 accident?; Dodge, Pettit, McClaskey, & Brown, 1986). Theoretically, the hostile attribution bias is thought to underlie the social functioning difficulties of certain children within peer interactions (Crick & Dodge, 1994); a proposition that has received considerable empirical support (e.g., Orobio de Castro, Veerman, Koops, Bosch, & Monshouwer, 2002). Children with high levels of conduct problems have been the main focus of the hostile attribution literature, however there also is evidence that children with high levels of ADHD symptoms and conduct problems show the hostile attribution bias within peer interactions and that this bias contributes to their social difficulties (Andrade, 2007; Milich & Dodge, 1984; Murphy, Pelham, & Lang,
1992). Despite this, there is a paucity of research examining the role of the hostile attribution bias within family interactions (i.e., MacKinnon-Lewis, Lamb, Hattie, & Baradaran, 2001), and a complete lack of research in this area including children with high levels of ADHD symptoms and conduct problems, a population at risk for family-related social functioning difficulties
(Johnston & Mash, 2001).
The second social cognitive bias, the positive illusory bias, defines the psychological phenomenon that some children greatly overestimate their social functioning abilities relative to others. Although this overestimation has been found in children’s assessment of their social, academic, and behavioural functioning (Gresham, MacMillan, Bocian, Ward, & Forness, 1998;
Hoza, Pelham, Dobbs, Owens, & Pillow, 2002; Hoza, Pelham, Milich, & Pillow, 1993), the current study focused on children’s evaluations of their social functioning only. Similar to the hostile attribution bias, the positive illusory bias is thought to underlie some of the social functioning difficulties children with high levels of ADHD symptoms and conduct problems encounter within their peer groups (e.g., Hoza et al., 2000; Kaiser, Hoza, Pelham, Gnagy, &
4 Greiner, 2008). However, and again parallel to the hostile attribution bias literature, little research has examined how this bias may contribute to the social functioning difficulties these children face within their families (Gerdes et al., 2007; Gerdes, Hoza, & Pelham, 2003).
Given these gaps in the literature, the primary objective of the current study was to replicate and extend previous research of the social-cognitive biases within the family context.
First, I aimed to replicate previous research reporting that higher levels of ADHD symptoms and conduct problems were related to: a) each of the social cognitive biases, and b) social functioning difficulties within the mother-child interaction. Second, extending previous research, I aimed to study the relationship between each of these biases and children’s social functioning difficulties within the mother-child interaction. Given that social-cognitive biases may have their origins within family relationships (Bandura, 1977; Bugental & Johnston, 2000; MacBrayer, Milich, &
Hundley, 2003; MacKinnon-Lewis, Castellino, Brody, & Fincham, 2001; MacKinnon-Lewis,
Lamb et al., 2001; Nelson, Mitchell, & Yang, 2008), it is an interesting question whether these biases co-occur within the family context, and how they may be related to child social functioning difficulties at home. Therefore, a secondary objective of the current study was to explore the hostile attribution bias and the positive illusory bias together. First, to see how these biases are related to one another. Second, to consider how these biases may operate together in relation to children’s social functioning difficulties within the mother-child relationship. The current study is unique in that no previous study has examined these research questions.
The following sections describe each of the social-cognitive biases, outline their individual relationship to child social functioning difficulties within peer and family contexts,
5 and discuss how the combination of these biases may be associated with child social functioning difficulties within the family.
1.2 The hostile attribution bias
The hostile attribution bias describes the tendency to perceive hostility in the ambiguous actions of others when these actions result in negative outcomes (Dodge, 1980). Literature concerning the hostile attribution bias has typically conceptualized it within the social-cognitive model of social information processing (e.g., Crick & Dodge, 1996; Orobio de Castro et al., 2002). Dodge and his colleagues (Crick & Dodge, 1994; Dodge, 1986) developed the social information processing model to describe the mental processes involved when an individual interacts with others. The model outlines six interdependent stages of processing occurring in the time between when individuals receive a social stimulus and when they behaviourally respond. According to the model, the hostile attribution bias interferes with social processing at the interpretation stage, where meaning is ascribed to social information (Crick & Dodge, 1994).
1.2.1 Social information processing and peer interactions
The social information processing model has been applied to understanding the development of aggression or social functioning difficulties among certain children (e.g., Dodge & Pettit, 2003;
Orobio de Castro et al., 2002; Yoon, Hughes, Gaur, & Thompson, 1999). In particular, research on social information processing indicates that, compared to their typically developing peers, children with conduct problems interpret the intention of peer’s actions as hostile when actions are ambiguous (i.e., the hostile attribution bias; Orobio de Castro et al., 2002). A smaller body of research has reported similar patterns of processing among children with high levels of ADHD
6 symptoms and conduct problems (Andrade, 2007; MacBrayer et al., 2003; Milich & Dodge,
1984).
In their study of social information processing, including the hostile attribution bias,
Milich and Dodge (1984) compared children, aged 6 to 12 years, with ADHD symptoms alone, conduct problems alone, or both ADHD symptoms and conduct problems, to controls. Children in the clinical groups were categorized based on a compendium of information including mother and teacher ratings of ADHD symptoms and conduct problems (refer to Milich, Loney, &
Landau, 1982 for complete procedure). The control sample was randomly selected classmates of the clinical sample participants. Children were presented with a series of hypothetical scenarios depicting interactions between the participant and a peer antagonist. These interactions involved ambiguous events with negative outcomes (e.g., Johnny steps on your foot while you both wait in line). Following presentation, the children were asked to discuss the degree of intentionality behind the antagonist’s behaviours. Results indicated that children with high levels of both
ADHD symptoms and conduct problems attributed the greatest hostile intent to the antagonist’s behaviour, followed by children with ADHD symptoms, and then controls. Interestingly, however, children with only conduct problems showed less hostile attribution bias compared to controls. It is possible that the children with only conduct problems differed qualitatively from children with ADHD symptoms or both ADHD symptoms and conduct problems. For instance, the children with only conduct problems may have had a more proactive quality to their aggression compared to children in the other two clinical samples. This study highlights the importance of considering both ADHD symptoms and conduct problems when assessing the hostile attribution bias.
7 In summary, previous research has found that levels of ADHD symptoms and conduct problems are related to the hostile attribution bias when children evaluate ambiguous behaviours of their peers. Given that children with high levels of both types of symptomatologies often
(although not always) demonstrate social functioning difficulties across both peer and family contexts, an important step in understanding the relationship between the hostile attribution bias and child social functioning for these children is to determine whether child ADHD and conduct problem symptoms are related to this bias within the family context.
1.2.2 Hostile attribution bias and family interactions
It is likely that if children show the hostile attribution bias for their peers’ behaviours, they also will demonstrate it when evaluating their parents’ behaviours. This conclusion follows from the theoretical position that children’s hostile attribution biases for their peers are developed within the family, through modeling of parent attributions (Bandura, 1977; Bugental & Johnston, 2000;
MacBrayer et al., 2003; MacKinnon-Lewis, Castellino et al., 2001; MacKinnon-Lewis, Lamb et al., 2001; Nelson et al., 2008; Snarr, Slep, & Grande, 2009). In support of this position, a few studies have investigated the development of the hostile attribution bias among children by looking at the cognitions and behaviours of their parents. With respect to parental cognitions, this work has found that children attribute a greater degree of hostility to the ambiguous actions of their peers when their mothers also show the hostile attribution bias toward their adult peers, indicating that children may model the social cognitions of their mothers (MacBrayer et al.,
2003; Nelson et al., 2008). Other research has found that children’s hostile attributions for their peers were related to their perceptions of maternal parenting behaviour. Specifically, children’s hostile attribution bias was negatively correlated with their perceptions of maternal support and
8 positively related their perceptions of maternal control (Gomez, Gomez, DeMello, & Tallent,
2001). This study demonstrated the relationship between the hostile attribution bias for peers and the family environment, and these authors argued that this relationship provides evidence of the origins of the hostile attribution bias within the family. Therefore, it is expected that if children hold the hostile attribution bias at all, they should readily demonstrate this bias within family relationships where it may have originated.
As previously noted, although the hostile attribution bias has been widely applied to understanding peer relationships, a dearth of research has examined how this bias of children operates within family interactions. This is surprising given that, as also mentioned earlier, family interactions provide children with their first social experiences and serve as the template to guide much of their thoughts and behaviours in future social interactions outside the family
(Maccoby & Martin, 1983).
An important exception to the lack of research in this area is work by MacKinnon-Lewis and her colleagues, which has extended the social information processing framework into family interactions by investigating child and parent attributions for each other’s behaviours. In longitudinal studies, MacKinnon-Lewis and her colleagues demonstrated that the hostile attribution bias in children was predictive of later aggressive behaviours directed towards the parent (MacKinnon-Lewis, Castellino et al., 2001; MacKinnon-Lewis, Lamb et al., 2001).
Specifically, in a study of a normative sample of mothers and sons, aged 7 to 9 years,
MacKinnon-Lewis and her colleagues (MacKinnon-Lewis, Lamb et al., 2001) assessed the attributions and behaviour of mothers and sons on two occasions over a period of 15 months.
Hostile attributions were assessed using hypothetical scenarios with ambiguous conditions and
9 negative outcomes. Children were presented a series of scenarios involving their mother as the antagonist, and mothers were given scenarios with their child as the antagonist. Children and their mothers were asked open-ended questions regarding the intentionality behind the antagonist’s actions in each scenario. To assess maternal and child social functioning, mothers and sons were observed participating in a competitive game and a collaborative task. The frequencies of negative and positive behaviours were rated by trained coders. Attributional and observational assessments were conducted at both time periods. The results of this study revealed that children’s hostile attribution bias for their mothers’ behaviour at time one was predictive of children’s aggressive behaviour within mother-child interactions at time two, after controlling for child aggression at time one (MacKinnon-Lewis, Lamb et al., 2001).
In summary, preliminary evidence indicates that the child-held hostile attribution bias is related to children’s social functioning difficulties, not only in peer contexts, but also within the family. The current study will assess whether children’s levels of ADHD and conduct problem symptoms are related to the hostile attribution bias when evaluating the ambiguous behaviours of their mothers, and it is predicted that higher levels of ADHD symptoms and conduct problems will be positive correlated with the hostile attribution bias. Furthermore, the current study will examine the relationship between the hostile attribution bias for maternal behaviour and children’s social functioning within mother-child interactions. It is predicted that the hostile attribution bias will be positively related to child social functioning difficulties within this interaction.
10 1.3 Positive illusory bias
In contrast to the hostile attribution bias, which influences children’s views of others, the positive illusory bias operates on children’s view of themselves. Children with high levels of ADHD symptoms and conduct problems overestimate their functioning in various domains, particularly their social functioning abilities. That is, these children believe they are more socially competent than they actually are and this over-estimation is greater than that seen in typically developing children (Diener & Milich, 1997; Hinshaw & Melnick, 1995). This discrepancy between self- evaluations and criterion performance has been found across studies comparing children’s self- reports of performance to objective coder ratings, peer reports, parent reports, and teacher reports of the child’s performance (e.g., Gerdes et al., 2003; Hinshaw & Melnick, 1995; Hoza et al.,
2004; Hoza et al., 2002; Hoza et al., 2000). Furthermore, recent research has found that this bias is independent of children’s actual competency (i.e., children with severe social difficulties are not overestimating their abilities simply because their actual level of low competence allows more room for overestimation; Ohan & Johnston, 2011).
A recent study indicates that the positive illusory bias is specific to self-evaluation, reporting that children with high levels of ADHD symptoms and conduct problems had no difficulties accurately assessing the social functioning abilities of their peers despite inflated self- perceptions (Evangelista, Owens, Golden, & Pelham, 2008). This finding poses an interesting paradox whereby children with high levels of ADHD symptoms and conduct problems accurately evaluate the social functioning abilities of their peers, but at the same time misinterpret their ambiguous actions (i.e., hostile attribution bias; Milich & Dodge, 1984). One possible explanation is that children’s social assessments depend on whether they are involved in
11 the situation or merely observing. Evangelista and her colleagues (2008) had children with high levels of ADHD symptoms and conduct problems observe video recordings of other children interacting and assess the social competence of the children on the videos. However, studies demonstrating the hostile attribution bias are more likely to use scenarios where children with high levels of ADHD symptoms and conduct problems are asked to imagine themselves actually involved in the interaction with the other child (Milich & Dodge, 1984).
Perhaps the most convincing evidence of the positive illusory bias among children with high levels of ADHD symptoms and conduct problems comes from laboratory studies, where social interactions are controlled and children’s reports are compared to objective observer ratings, thus avoiding any biases that teacher, peer, or parent reports might contain. For example,
Hoza and her colleagues (2000) had children interact with child confederates during a get- acquainted task, where the children were told to convince the confederates to attend camp with them. Using child confederates allowed the researchers to control for partner variability within peer interactions. The child confederates acted in either a clearly positive or clearly negative fashion toward the child participants. Following the task, children were asked questions about their social functioning within the task (e.g., “How well do you think you did getting him (the confederate) to like you?”). Objective observers rated the participants’ social functioning in the interactions. The degree of positive illusory bias shown by the children was calculated as the discrepancy between the child-report and objective ratings of social functioning. The authors found evidence of the positive illusory bias, reporting that children with high levels of ADHD and conduct problems evaluated their own social functioning within the interaction more positively than did children with lower levels of these symptomatologies, despite objective
12 ratings indicating more impaired social functioning among the children with high levels of
ADHD symptoms and conduct problems.
According to the self-protection hypothesis, children use the positive illusory bias as a means of coping with threats or failure in order to protect their self-esteem (Diener & Milich,
1997). As noted, children with high levels of ADHD symptoms and conduct problems demonstrate a greater positive illusory bias when evaluating their own social functioning compared to children with high levels of ADHD symptoms alone, or controls (Hoza et al., 2002).
It has been argued that children with high levels of ADHD symptoms and conduct problems use this positive illusory bias to cope with their difficulties in social functioning (i.e., these children demonstrate the greatest positive illusory bias in their most deficient area; Diener & Milich,
1997; Owens, Goldfine, Evangelista, Hoza, & Kaiser, 2007). Although the positive illusory bias may be adaptive in protecting these children’s self-esteem, researchers have suggested that the positive illusory bias may be maladaptive for children’s actual social functioning (McQuade &
Hoza, 2008; Mikami, Calhoun, & Abikoff, 2010).
1.3.1 Positive illusory bias and peer social functioning
We know that the positive illusory bias is prevalent among children with high levels of ADHD symptoms and conduct problems and these children have difficulties with social functioning
(Hinshaw & Melnick, 1995; Hoza et al., 2002; Matthews, 1992). Although the relationship between the positive illusory bias and peer social functioning has not been thoroughly investigated among children with high levels of ADHD symptoms and conduct problems
(McQuade & Hoza, 2008), research in normative child samples and with children with conduct problems suggests a positive relationship between the positive illusory bias and social
13 functioning difficulties, such as aggression, peer rejection, and poor social skills (David &
Kistner, 2000; Gresham, Lane, MacMillan, Bocian, & Ward, 2000; Hughes, Cavell, & Grossman,
1997; Kupersmidt, Burchinal, & Patterson, 1995). For example, a longitudinal study of second- and third-grade children with conduct problems found that these children’s inflated positive perceptions of their peer acceptance at time one (i.e., positive illusory bias about peer social functioning) were predictive of peer rejection 30 months later (Hughes et al., 1997). A similar relationship between the positive illusory bias and difficulties with peer social functioning has been found in a large normative sample of children (n = 961; David & Kistner, 2000). These authors reported that children who overestimated their peer acceptance (i.e., positive illusory bias about peer social functioning) were more likely to be rated as aggressive by their peers. In contrast, another large-scale longitudinal study of children (n = 670) from both normative and peer-rejected samples found a positive relationship between time one inflated positive perceptions of peer acceptance (i.e., positive illusory bias) and time two peer acceptance ratings
(6 months later) for the normative sample, although no relationship was found between these variables for the peer-rejected sample (Kistner, David, & Repper, 2007). Taken together, these studies generally suggest that for children with behavioural difficulties (i.e., conduct problems or peer rejection), the positive illusory bias exacerbates their social functioning difficulties, whereas among typically developing children the positive illusory bias may be helpful in gaining peer acceptance. Indeed, in a recent longitudinal study comparing children with high levels of ADHD symptoms and conduct problems to controls, increases in children’s self-perceived social functioning relative to teacher-reports (i.e., positive illusory bias) were predictive of parent- reports of child aggression for children with high levels of ADHD symptoms and conduct
14 problems but not controls (Hoza, Murray-Close, Arnold, Hinshaw, & Hechtman, 2010). These results raise the question of how the positive illusory bias might contribute to the social functioning difficulties of children with high levels of ADHD symptoms and conduct problems.
The positive illusory bias may contribute to children’s difficulties in social functioning in several ways. First, it may reduce children’s willingness to change their social functioning patterns, despite evidence of their considerable difficulties. Previous research has found that awareness of one’s deficits provides motivation to change (Hoza et al., 1993; Mikami et al.,
2010), therefore children who believe they are more socially capable than they actually are may be less willing to adjust their behaviour. Second, it may be that the positive illusory bias encourages children to engage in social interactions in ways that are beyond their social abilities.
For example, making friends is challenging even for typically developing children, but children with high levels of ADHD symptoms and conduct problems are more quickly rejected by new peer groups, even compared to children with other externalizing or internalizing symptomatology
(Erhardt & Hinshaw, 1994; Gresham et al., 1998). Perhaps these findings reflect that the positive illusory bias encourages children to rush attempts at friendships, which are perceived by peers as intrusive and negative. When these children overlook their social functioning difficulties it likely contributes to further social functioning difficulties, possibly because they may not adjust their behaviour to situational demands (e.g., Johnny continues to interrupt his friend in part because he believes he is positively contributing to their interaction).
In summary, high levels of ADHD symptoms and conduct problems are positive correlated with a positive illusory bias in children’s assessments of their social functioning abilities among peers, and research suggests that this bias is associated with children’s social
15 functioning difficulties in the peer context. Parallel to my review of the hostile attribution bias, the next step in understanding the positive illusory bias is to examine the role of this bias within the family context among children with high levels of ADHD symptoms and conduct problems.
1.3.2 Positive illusory bias and family interactions
As with the hostile attribution bias, the preponderance of research about the positive illusory bias with regards to social functioning has focused on the peer context (e.g., Owens et al., 2007).
Theoretically, it has been argued that overly positive self-perceptions (i.e., positive illusory bias) may originate within the family, as means of coping with stressful family situations that threaten children’s developing sense of self (Diener & Milich, 1997; Hughes et al., 1997). Given that many families of children with high levels of ADHD symptoms and conduct problems have conflicted and negative family relationships (Johnston & Mash, 2001), it is possible that children with high levels of ADHD symptoms and conduct problems develop a positive illusory bias at home. Therefore, children with high levels of ADHD symptoms and conduct problems should demonstrate a positive illusory bias about their own social functioning abilities within the family.
However, only two studies have explored the positive illusory bias of children with high levels of
ADHD symptoms and conduct problems within family relationships (Gerdes et al., 2007; Gerdes et al., 2003). These studies compared child ratings and parent ratings of the parent-child relationship quality (e.g., parental power assertion and warmth). Both studies reported that children with high levels of ADHD symptoms more favorably evaluated the relationship quality compared to their mothers; and this discrepancy did not exist for control dyads. Thus, these studies offer preliminary evidence of a positive illusory bias among children with high levels of
ADHD symptoms and conduct problems within a family context. However, they focused on
16 perceptions of the parent-child relationships and did not specifically examine the children’s perceptions of their own social functioning within family interactions.
Similar to the literature on family social functioning difficulties and the hostile attribution bias, there is a lack of research examining the relationship between the positive illusory bias and children’s social functioning within the family. Theoretically, it is reasonable to believe that children who overestimate their social functioning abilities within the home may be disadvantaged in family interactions. Although parents are more likely than peers to adjust their social style to compensate for their children’s difficulties, this pattern may not be sustainable with persistent child social functioning difficulties (e.g., Johnny’s mother allows him to win a board game, but when Johnny incessantly parades his win around the house, his mother breaks the news that she let him win). Given that social functioning difficulties have been observed as correlated with child ADHD symptoms and conduct problems within mother-child interactions
(Gomez & Sanson, 1994; Johnston, 1996), children who overlook these difficulties, due to a positive illusory bias, may be less motivated to change and may persist with the same maladaptive behaviours within family interactions, losing the opportunity to further develop adaptive social functioning abilities (Banks, 2005; Gresham, 1988).
As the majority of the literature on the positive illusory bias primarily focuses upon self- perceptions of competency within peer interactions, exploring how self-perceptions of social functioning abilities are manifested within family interactions will aid in understanding the scope of the positive illusory bias. It is predicted that high levels of both ADHD and conduct problem symptoms will be associated with the positive illusory bias concerning child social functioning
17 within the family. Moreover, it is expected that this bias will be positively related to children’s social functioning difficulties within mother-child interactions.
To summarize the preceding sections: The hostile attribution bias and the positive illusory bias are related to children’s levels of ADHD symptoms and conduct problems, and these biases are each individually related to children’s social functioning difficulties across peer and family contexts. The final objective of the current study is to investigate how these biases operate simultaneously upon child social functioning within the family.
1.4 Hostile attribution bias and positive illusory bias
Although the hostile attribution bias and positive illusory bias have developed from separate literatures, it is likely that they are closely related because they offer children compatible information about their social world. For instance, the hostile attribution bias describes children’s social-cognition about others’ ambiguous actions, thus providing social information about the negative other. Whereas the positive illusory bias involves children’s distorted self-perceptions that describe information about the positive self.
Hypothetically, the positive illusory bias and the hostile attribution bias may mutually reinforce one another and the two biases may operate synergistically upon child social functioning. First, the positive illusory bias may reinforce the hostile attribution bias. For example, children who approach a social interaction, underestimating their own social deficits, and who then encounter an ambiguous slight from another person, may be more likely to attribute hostile intent towards the other’s actions than children who understand their own social deficits. Because these children may not adequately consider the role of their own behaviours in unfortunate social situations (e.g., Johnny impulsively gets out of his kitchen seat just as his
18 mother walks by with coffee, the coffee is spilt on Johnny, he believes his mother did it on purpose rather than acknowledging the role of his impulsive behaviour), they may attribute more responsibility to others for negative events (i.e., a stronger hostile attribution bias).
Second, the hostile attribution bias may reinforce the positive illusory bias. As children who show the hostile attribution bias may feel they are under threat more often than other children, it is conceivable that these children amplify their positive views of self as means of protecting themselves from perceived threats in their social world. This is consistent with other research arguing that the positive illusory bias serves a protective function for children (Diener &
Milich, 1997). Alternatively, when children judge another’s ambiguous action as hostile and intentional they are placing responsibility for the negative outcome upon the other and rejecting any personal onus. By denying their role in precipitating negative social situations, children may enhance their own exaggerated beliefs about their social functioning abilities.
Finally, the combination of the social-cognitive biases may operate synergistically upon child social functioning. First, the positive illusory bias may enhance the relationship between the hostile attribution bias and aggressive behaviour. Within the literature on child aggression and the positive illusory bias, some researchers have posited that children with highly inflated sense of self-competency may react with aggression to perceived threats to their sense of self
(i.e., threatened egotism; Baumeister, Smart, & Boden, 1996). The hostile attribution bias may hyper-sensitize these children to possible threats against themselves, consequently these children may react with aggression across many situations. Although an inflated sense of self-competency reflects particularly high self-esteem and not the positive illusory bias per se, these arguments are informative for speculating how the social-cognitive biases operate together in relation to child
19 social functioning difficulties. Second, the hostile attribution bias may strengthen the relationship between the positive illusory bias and difficulties with social functioning. As argued in the positive illusory bias sections, children with this positive bias may be less motivated to change their maladaptive behaviour and also may precipitate more negative outcomes from their environment than children with more accurate self-understanding. For example, Johnny frequently promises he will help his mother with many household chores, however his inattention and impulsivity preclude him from accomplishing these tasks, and when he fails to keep his promises, his mother becomes frustrated and takes away his toys. If the hostile attribution bias reinforces the positive illusory bias, children demonstrating both biases may be even less motivated to change and may enter into more challenging social situations, thereby contributing to further social functioning difficulties.
Although there are theoretical arguments for why the hostile attribution bias and positive illusory bias should be synergistically related to child social functioning difficulties, research is needed to identify how these social-cognitive biases operate within one model when predicting children’s social functioning within the family. Within the current study, it is expected that both the positive illusory bias and hostile attribution bias will be associated with child social functioning difficulties within the mother-child interaction. It is predicted that these social- cognitive biases operate together to synergistically predict child social functioning within the mother-child interaction.
20 1.5 Other factors associated with social-cognitive biases and social functioning
1.5.1 Comorbid internalizing symptomatology
Both anxiety and depression are relatively common comorbidities to ADHD symptoms and conduct problems (Biederman, Faraone, Keenan, & Steingard, 1991; Biederman, Mick, &
Faraone, 1998). With regards to the social-cognitive biases, it is known that symptoms of anxiety and depression attenuate the positive illusory bias among children with high levels ADHD symptoms and conduct problems (Hoza et al., 1993; Owens, 2002). On the other hand, previous research indicates that the hostile attribution bias is not related to internalizing symptoms
(Hoglund & Leadbeater, 2007). But, anxiety and depression symptoms are related to conflicted, parent-dominated, and disengaged family interactions (Katz & Low, 2004). Because of the various associations among internalizing symptoms and both social-cognitive biases and social functioning, the current study will assess for these symptoms in order to control for their possible influence in assessing the relationship between children’s social-cognitive biases and the mother- child interaction.
1.5.2 Maternal psychopathology
Previous research has found that maternal psychopathology is related to parenting behaviours that negatively impact the quality of the mother-child interaction (Goodman & Gotlib, 1999;
Granger et al., 1998; Whaley, Pinto, & Sigman, 1999). In particular, maternal anxiety, depression, and hostility are associated with maladaptive parenting behaviours and have been identified as disruptive to the mother-child interaction (e.g., Kim-Cohen, Caspi, Rutter, Tomas, &
Moffitt, 2006; Lovejoy, Graczyk, O'Hare, & Neuman, 2000; Whaley et al., 1999; Wheatcroft &
21 Creswell, 2007). In the current study, these aspects of maternal psychopathology will be measured so that variation in the dependent variable, child social functioning within mother-child interaction, due to these symptoms can be controlled.
1.5.3 Maternal parenting behaviours
Maternal parenting behaviours contribute to child behaviours within mother-child interactions
(Baumrind, 1971). For instance, maternal prosocial behaviours, such as sensitivity, are negatively related to child aggressive behaviours and positively related to child prosocial behaviours (Alink et al., 2009), whereas maternal negativity contributes to child aggression (Patterson, Reid, &
Dishion, 1992). Finally, if mothers make many demands of their children, these children will have more opportunities to demonstrate compliance or noncompliance compared to children of mothers who are more lax. In the current study, maternal parenting behaviours (i.e., negative talk and opportunities for child compliance) occurring in the mother-child interaction will be assessed so that variation in the dependent variable, child social functioning within mother-child interaction, due to these behaviours can be controlled.
1.5.4 Demographic considerations
Although there is a higher prevalence of both ADHD symptoms and conduct problems among boys (Hinshaw & Lee, 2003; American Psychiatric Association, 2000; Keenan, Loeber, & Green,
1999), a meta-analysis of the relationship between the hostile attribution bias and conduct problems found no consistent gender differences (Orobio de Castro et al., 2002). With respect to age, the same meta-analysis reported a positive relationship between the hostile attribution bias and conduct problems across a range of studies, which included children aged 4 year to over 12 years (Orobio de Castro et al., 2002). The manifestation of the positive illusory bias is presumed
22 to be contingent on children reaching certain cognitive developmental milestones. Younger children’s self-evaluations are unidimensional, concrete, and influenced by immediate environmental factors (Cicchetti & Toth, 1995), therefore previous research has focused on children nine years and older, as typically developing children of this age have the ability to critically and reliably evaluate their own performance (Mezulis, Abramson, Hyde, & Hankin,
2004). Although few studies exploring this bias have investigated both girls and boys, no robust gender effect has been reported (Evangelista et al., 2008; Owens et al., 2007). Based on these findings, the current study will include both boys and girls, aged 9 to 12 years.
Mothers are typically the primary caregiver and provide a main source of socialization for their children (e.g., Kim & Cicchetti, 2004). Therefore, studying the mother-child relationship will provide valuable information for understanding child social functioning.
Furthermore, many families are single-parent families headed by mothers. By studying the mother-child relationship we will maximize the generalizability of the current study’s findings to include both single and two-parent families.
1.6 Hypotheses
The hostile attribution bias and the positive illusory bias are commonly associated with social functioning difficulties within peer interactions (Hoza et al., 2000; Hughes et al., 1997; Orobio de Castro et al., 2002). However, limited research has investigated these social-cognitive biases within family relationships, or their relation to children’s social functioning within the family context, and no study has examined how these biases operate together as a potential mechanism underlying children’s social functioning difficulties. The goal of this study was to investigate these social-cognitive biases and to test whether they serve as a mechanism to explain the
23 relationship between children’s social functioning difficulties in mother-child interactions and their levels of ADHD symptoms and conduct problems. The current study tested the following hypotheses:
(1) Children’s levels of ADHD symptoms and conduct problems would each be positively
correlated with social functioning difficulties in an interaction.
(2) Children’s levels of ADHD symptoms and conduct problems would each be positively
correlated with children’s hostile attribution bias when evaluating the intentions of their
mothers.
(3) Children’s levels of ADHD symptoms and conduct problems would each be positively
correlated with children’s positive illusory bias when evaluating their own social functioning
abilities within the family.
(4) The hostile attribution bias and positive illusory bias would interactively predict children’s
social functioning difficulties within the mother-child interaction.
(5) The relationships between children’s ADHD symptoms, conduct problems, and their social
functioning difficulties in the family would be at least partially mediated by the hostile
attribution bias and the positive illusory bias.
24 2 Method
2.1 Participants
Thirty-eight mother-child dyads were recruited from the community, elementary schools, the
ADHD Clinic at a children’s hospital, and from the UBC Parenting Lab’s past participant registry. The registry is a list of families who have previously participated in studies and agreed to be contacted by the UBC Parenting Lab about future studies. Participants were recruited from both community and clinical sites to ensure the variability in children’s ADHD symptom and conduct problem severity across the sample. Over the course of 6 months, flyers were distributed to elementary schools (approximately 1,800 flyers) and community centres (approximately 25 flyers) within the Lower Mainland (see Appendix A for flyer). Thirteen participating families were recruited through flyers sent to community centres or schools. Flyers were also given to the
ADHD Clinic (approximately 50 flyers) and 2 families were recruited this way. Of the 60 families contacted through the UBC Parenting Lab’s volunteer registry, 20 families participated.
Finally, five families participated after learning about the study in the Parenting Lab’s semi- annual newsletter. Demographic characteristics of the sample are described in Table 2.1.
Children with mental retardation, autism, tic disorders, or difficulties speaking and comprehending English (as reported by mothers) were excluded from the sample. According to mother-report, 15 children in the sample had been diagnosed with ADHD. Of these children, three had a co-morbid learning disability, one had co-morbid fetal alcohol syndrome, and one had a co-morbid anxiety disorder. One child had been diagnosed with ADHD, Oppositional
Defiant Disorder, and an anxiety disorder. Two children, without ADHD diagnoses, had anxiety disorders.
25 Table 2.1 Demographic Characteristics of the Sample
Mean (SD) Frequency
Child age 10.7 (1.2) 9 years 36.8% 10 years 26.3% 11 years 18.4% 12 years 18.4%
Child gender male 63.2%
Child ethnicity1 European-Caucasian 44.7% Asian 26.3%
Mother-child relationship biological 97.4% adopted 2.6%
Number of siblings none 36.8% one 34.2% two 21.1% ≥ three 7.9%
Birth order youngest 23.7% middle 10.5% oldest 28.9% only child 36.8%
Mother age 43.9 (5.7) 30 - 39 years 13.2% 40 - 49 years 71.1% ≥ 50 years 15.7%
Marital status married 65.8% divorced/separated 21.1% single 13.2%
Mother education partial high school 2.6% high school graduate 5.3% partial college/university 23.7% standard college/university graduate 50.0% graduate/professional training 18.4%
Mother employed yes 55.3%
Family income < $5,000 7.9% $5,000 - $19,999 15.8% $20,000 - $34,999 13.2% $35,000 - $49,999 5.3% $50,000 - $74,999 18.4% $75,000 - $99,999 18.4% $100,000 - $149,999 15.8% ≥ $200,000 5.3% 1Other child ethnicities included: Mixed-ethnic background (n = 5), Native Canadian (n = 1), South Asian (n = 2), Latin American (n = 1), Azerbaijani (n = 1), and Albanian (n = 1)
26 2.2 Measures
2.2.1 Demographic and treatment information
The family information questionnaire (Appendix B) was developed by the UBC Parenting Lab and was used to collect information about family background, including family income, child age, mother age, and maternal education level. The questionnaire also asked about child psychiatric diagnoses and any medications the child might have been taking for a psychiatric condition.
2.2.2 Assessment of ADHD symptoms and conduct problems
Child ADHD symptoms were measured using the ADHD Rating Scale-IV (ADHD-IV; DuPaul,
Power, Anastopoulos, & Reid, 1998). Typically the ADHD-IV is completed by parents and teachers to aid in the diagnosis of ADHD (DuPaul et al., 1998), however for the purposes of this study, only the mother-report on the ADHD-IV was used to quantify levels of child ADHD symptoms as my focus was on symptoms of ADHD rather than ADHD diagnoses per se.
Furthermore, the current study focused on the family context, so mother reports of child ADHD symptoms were better suited than teacher-reported symptoms.
The ADHD-IV is an 18-item questionnaire corresponding with DSM-IV criteria for
ADHD. Each item assesses the frequency of a symptom and is rated on a 4-point Likert scale (0
= never; 3 = very often). The internal consistency coefficient for this scale has been reported to be .92 (Cronbach alpha) (DuPaul et al., 1998). The ADHD-IV also has demonstrated construct and predictive validity (DuPaul et al., 1998). Levels of ADHD symptoms across the children were reflected by the average of frequency ratings across all symptoms. The ADHD-IV is
27 presented in Appendix C. The internal consistency for the ADHD-IV was good within the current sample (Cronbach alpha = .95).
The Oppositional Defiant Disorder Rating Scale (ODDRS; Hommersen, Murray, Ohan,
& Johnston, 2006) was used to assess levels of conduct problems among the children. The
ODDRS is an 8-item parent-report questionnaire based on the DSM-IV criteria for Oppositional
Defiant Disorder. Items are rated on a four-point Likert scale for frequency of behaviours (0 = not at all; 3 = very much). The ODDRS has demonstrated good reliability and validity
(Hommersen et al., 2006). The average score on this measure represented children’s levels of conduct problems. The internal consistency for the mothers’ reports on the ODDRS within the current sample was .92 (Cronbach alpha). Appendix D contains the ODDRS.
2.2.3 Social-cognitive biases: Hostile attribution bias
The Child Attribution Measure (CAM; MacKinnon-Lewis, Lamb, Arbuckle, & Baradaran, 1992) was used to assess the hostile attribution bias of children for their mothers’ actions. The CAM consists of five stories about a mother and child. The children were read these stories by a research assistant and asked to pretend the stories were about their interactions with their mothers. In all of the stories, the mothers’ intentions were ambiguous, but the outcomes for the child were always negative. Children were asked questions about their mothers’ intent (i.e.,
“Why do you think your mother would do this?”). Responses were audio recorded and transcribed for coding. In accordance with MacKinnon-Lewis et al. (1992; 2001), raters coded the children’s responses as either 0 = accidental or positive intent or 1 = negative intent. The average score was calculated by adding the ratings for each of the five intent questions, and
28 dividing by the number of answered questions, with higher scores indicating higher levels of hostile attribution. Appendix E contains the CAM stories and coding manual.
Child responses to the CAM were coded by the primary researcher, and two other coders, who were blind to the children’s levels of ADHD symptoms and conduct problems. Participant responses were randomly assigned across the three coders, and each coder rated child responses for one third of the sample. Additionally, one third of the children’s responses were blindly double-coded. To avoid rater drift and maintain reliability, weekly meetings were held to review coding procedures. Inter-rater reliability for the CAM stories was moderate (ICC = .63; LeBreton
& Senter, 2008).
2.2.4 Social-cognitive biases: Positive illusory bias
A modified version of the Social Skills Improvement System - Rating Scale (SSIS-RS; Gresham
& Elliot, 2008) was used to assess the positive illusory bias of children when evaluating their own social functioning within the family. The SSIS-RS is a questionnaire with parallel child- report and parent-report forms. The SSIS-RS includes three factors: Social Skills, Problem
Behaviours, and Academic Competence. The original Social Skills scale focuses primarily on children’s social functioning among peers and was modified for this study to assess children’s social functioning within the family. Appendix F describes the modified Social Skills scale and provides example items. The parent and child modified Social Skills scales contained 46 items.
Mothers rated items on a 4-point Likert scale (0 = never; 3 = almost always) for the frequency the child demonstrated each social skill within the family. Children rated how true each statement was about them on a similar 4-point Likert scale (0 = not true; 3 = very true). The original parent-report and child-report Social Skills scales have good reliability (test-retest = .84
29 and .81 respectively; over 8 week interval; Gresham & Elliot, 2008). With regards to construct validity, the SSIS-RS, for assessing peer social functioning, shows moderate to high correlations with the Behavioural Assessment System (Reynolds & Kamphaus, 1992)), the Social Skills
Rating System (Gresham & Elliott, 1990), and the Vineland Adaptive Behaviour Scale (Sparrow,
Balla, & Cicchetti, 1984). The internal consistencies for the modified forms of the SSIS-RS were .94 and .92 (Cronbach alpha) for mother and child versions used in this study.
In addition to the SSIS-RS, which focuses on prosocial behaviour, another measure of child social functioning was used to capture each participant’s perspective on child negative social behaviour. A modified version of the Matson Evaluation of Social Skills for Youngsters
(MESSY; Matson, Rotatori, & Helsel, 1983) was used to assess the positive illusory bias of children when evaluating aggressive or antisocial behaviour they may demonstrate within their families. Similar to the SSIS, the MESSY is a questionnaire with parallel child and parent forms.
The current study selected items from the Aggressive/Antisocial Behaviour scale, identified in a recent factor analysis of the MESSY (Teodoro, Käppler, Rodrigues, de Freitas, & Haase, 2005).
Exploratory and confirmatory factor analytic methods were used to derive the Aggressive/
Antisocial Behaviour scale (n = 382). The authors reported the scale to have good reliability
(Cronbach alpha = .87) and strong correlations with other measures of social functioning
(Teodoro et al., 2005). This scale was selected instead of the Inappropriate Assertiveness scale developed by Matson and colleagues (1983) because of its broader range of items reflecting problematic social behaviour and its psychometric profile. Some items were excluded if they did not appear on both parent and child forms or if they described inappropriate social behaviour with other children were excluded (e.g., “I/My child pick(s) out other children’s faults”). The
30 modified parent and child versions of the Aggressive/Antisocial Behaviour scale contained 20 items. Mothers and children rated items on a 5-point Likert scale (0 = not at all; 5 = very much) for the frequency the child demonstrated each behaviour. For ease of interpretation, items on the
Aggressive/Antisocial Behaviour scale were reversed scored to parallel the SSIS (i.e., higher scores indicated better social functioning, or fewer aggressive/antisocial behaviours, relative to lower scores). Internal consistency for the modified Aggressive/Antisocial Behaviour scale as used in this study were good for both the child and mother versions (child version Cronbach alpha = .83; mother version Cronbach alpha = .92). Appendix G contains the modified version of the MESSY Aggressive/Antisocial Behaviour scale.
The positive illusory bias was determined by the degree of discrepancy between the child-report and parent-report scores on the modified Social Skills scale and on the modified
Aggressive/Antisocial Behaviour scale. The raw scores for the total Social Skills scale and for the Aggressive/Antisocial Behaviour scale were standardized for both child and parent versions to control for possible differences in the variances of the child and parent scores (see De Los
Reyes & Kazdin, 2004; Owens et al., 2007). Then, the difference between the standardized child- report scores and standardized parent-report scores was taken (i.e., child-report - parent-report) for each measure, and these difference variables were used as indices of the positive illusory bias. Standardized discrepancy scores are the preferred method of determining the difference in scores between raters because they are more strongly and equally correlated with the scores they are derived from (i.e., standardized scores) than raw score differences or residual differences (De
Los Reyes & Kazdin, 2004). Higher scores on both positive illusory bias measures indicated larger discrepancies between child and mother reports (i.e., child overestimating social
31 functioning to a greater degree). Two measures of social functioning, one assessing positive prosocial aspects of functioning and the other assessing negative or aggressive functioning, were used for a comprehensive assessment of the positive illusory bias.
2.2.5 Child social functioning within mother-child interaction
The current study assessed child social functioning difficulties within the mother-child interaction using behavioural indicators of prosocial behaviour, negative behaviour, and noncompliance. Additionally, maternal commands were assessed to control for opportunities for child compliance, and maternal negative talk was assessed to control for variation in mothers’ behaviours toward their children.
Children’s social behaviour was assessed through observations of child behaviour within a mother-child interaction conducted in the play-room of the UBC Parenting Lab. The interaction involved the mother directing the child through a series of eight tasks. These tasks, in order of presentation, were: 1) lacing a pair of shoes, 2) handwriting, 3) sorting a mixture of toy animals and cars into separate containers, 4) solving math problems, 5) folding and sorting laundry, 6) sorting a mixture of black and green dots into separate containers, 7) not interrupting the mother while she completed a questionnaire, and 8) capturing balls from a toy that spits out balls (i.e.,
Mr. Bucket).
Each task was timed for 1 minute from when the mother started to explain the task.
Mother-directed play was video-recorded through a one-way mirror. Mothers wore audio receivers, similar to hearing aids, from which they received instructions about each task. These instructions are adapted from a similar study of mother-child interactions (Deskins, 2005) and can be found in Appendix H. In addition to the materials used for the mother-directed play, the
32 play room contained a standard set of age-appropriate toys including: legos, picture books, colouring materials, stuffed animals, games (e.g., Hungry Hungry Hippos, Jenga, Battleship,
Chinese Checkers), dolls, dollhouse, puzzles, building blocks, a marble tower, and a ball. These types of toys have been successfully used in a similar study of school-aged children (Deskins,
2005). Prior to the mother-directed play, the mother and child participated in 10 minutes of child- directed play. During this time the child was in charge of the play, and the mother was instructed to follow the child’s lead. Following the mother-directed play, the mother was instructed to have the child clean-up all the toys for 5 minutes. Neither child-directed play nor the clean-up period were used for the purposes of this study.
Mother-directed play was coded using the Dyadic Parent-Child Interaction Coding
System 3rd edition (DPICS; Eyberg et al., 2005). The DPICS is a behavioural observation system used to code parent-child social interactions, and has been used in previous research with children aged 2 to 12 (Deskins, 2005; Eyberg et al., 2005). It assesses micro-level behaviours, which are combined into larger categories of child social functioning and maternal parenting behaviours. For the purposes of the current study, the categories of verbalizations (i.e., neutral/ prosocial talk and negative talk) and response to commands (i.e., compliance, noncompliance, and no opportunity for compliance) were used to indicate child social functioning. Child responses to maternal commands were coded considering both child and mother behaviour during and immediately proceeding commands. If the child did not have an opportunity to begin to comply with a command within 5 seconds of the mother issuing it, the child’s response was coded as ‘no opportunity for compliance.’ Additionally, the frequency of maternal negative talk was assessed to control for mother behaviour. Appendix I contains a summary of the micro-level
33 coding categories for children and Appendix J contains a summary of the mother coding categories.
Using the total frequency for each child micro-level behavioural category within mother- led play, two ratio scores were calculated: 1) instances of child noncompliance/total number of maternal commands, and 2) instances of child negative talk/total amount of child talk. The dependent variable, child social functioning difficulties, was represented by the average of these ratio scores. Higher scores on this variable reflected a greater degree of difficulties with social functioning within the mother-child interaction. Appendix K contains the equations for deriving the ratio and social functioning difficulties scores. Finally, mother negative talk was represented by the frequency of negative verbalizations during the 10 minute mother-directed play session.
The primary researcher and two other coders, who were blind to the study’s main hypotheses, independently evaluated child and mother behaviour using the DPICS system. One third of the mother-child interactions were randomly assigned to each coder. Additionally, one third of the mother-child interactions were blindly double-coded. Using criteria specified by
LeBreton and Sentor (2008), inter-rater reliability for the dependent variable, child social functioning difficulties, was strong (ICC = .87). The inter-rater reliability for the constituents of child social functioning difficulties were also strong (Noncompliance Ratio ICC = .81, Negative
Talk Ratio ICC = .78). However, inter-rater reliability for the frequency of mother negative talk was weak (ICC = .30). Coders were partially blind to levels of ADHD symptoms and conduct problems of the children (i.e., coders sometimes were involved in gathering data from families and were in contact with information about child ADHD symptoms and conduct problems).
34 During coding of the study’s tapes, coders met weekly to discuss discrepancies, coding issues, and review the coding manual (i.e., 8 weeks of 1 to 2 hour meetings).
2.2.6 Potential covariates
As previously noted, maternal parenting behaviours occurring during the mother-child interaction were assessed using the DPICS.
Maternal psychopathology symptoms were assessed using an abbreviated form of the
Brief Symptom Inventory (Derogatis & Melisaratos, 1983). The abbreviated form contains the subscales of Anxiety, Depression, and Hostility. The Anxiety subscale measures symptoms associated with anxiety disorders, ranging from feelings of nervousness to panic attacks. The
Depression subscale assesses affective and physical correlates of depression (e.g., hopelessness, loss of interest, and sadness). The Hostility subscale measures feelings and behaviours associated with anger. Items are rated on a five-point Likert scale (0 = not at all; 4 = extremely). The reliability of these three subscales is good (Derogatis, 1993), and scores on these subscales correlate moderately with respective measures on the Minnesota Multiphasic Personality
Inventory-2 (rs > .40) (Rielly, 1998). Appendix L contains example items for these BSI subscales. The internal consistencies within this sample were .85 for anxiety, .76 for depression, and .62 for hostility (Cronbach alpha).
The Children’s Depression Inventory Short Form (CDI-S; Kovacs, 1992) was used to assess child depressive symptoms. The CDI-S is a 10 item self-report questionnaire, which asks children to rate statements about their feelings over the past 2 weeks. The CDI-S is appropriate to use for children aged 7 to 17 years. Items are rated on a three-point Likert scale ranging from 0 to 2, with higher scores indicating more severe symptoms. T-scores can be calculated from the
35 total score, allowing comparison to age and gender specific norms. The CDI-S is strongly correlated with the full CDI (r = .89) which has demonstrated good reliability; internal consistency coefficients ranging from .71 to .83; test-retest coefficients ranging from .74 to .83 over a 3 week period (Kovacs, 1992). Previous research supports the CDI’s validity and the CDI has been used successfully as a screen for depression symptoms among children
(Giannakopoulos et al., 2009). Internal consistency for the CDI-S within the current sample was poor (Cronbach alpha = .57). Appendix M contains example items for the CDI-S.
The Multidimensional Anxiety Scale for Children (MASC; March, Parker, Sullivan, &
Stallings, 1997) was used to assess child anxiety symptoms. The MASC is a thirty-nine item self-report questionnaire asking children to report how true statements are of them on a four- point Likert scale (0 = never true about me; 3 = very true about me). The mean of the total
MASC score was calculated for analyses, with higher scores indicating higher levels of anxiety.
T-scores can be calculated from the total score, allowing comparison to age and gender specific norms. The MASC has been demonstrated to have good internal consistency, test-retest reliability and criterion validity (March, Parker, Sullivan, & Stallings, 1997; March, Sullivan, &
Parker, 1999). The internal consistency within the current sample for the MASC’s thirty-nine items was good (Cronbach alpha = .91). Appendix N contains sample items for this scale.
2.3 Procedure
Upon seeing a notice of the study, interested mothers were instructed to telephone the UBC
Parenting Lab. A research assistant conducted a screening interview with the mother to determine her own and her child’s eligibility for the study. Mothers on the UBC Parenting Lab’s participant registry were contacted by telephone and given a brief description of the study. If these mothers
36 expressed interest in the study, they also were interviewed to determine their own and their children’s eligibility for the study.
The eligibility telephone interview included: a description of the study, a screen for pervasive developmental disorders, tic disorders, or mental retardation, screens for child ADHD symptoms and conduct problems, an informal assessment of the spoken English skills of the mother, and questions about the child’s spoken, written, and comprehension English abilities.
Appendix O contains the telephone script. When prospective families met eligibility criteria and the mother provided verbal consent for herself and her child’s participation, a session at the UBC
Parenting Lab was scheduled.
The current study was part of a larger ongoing study. Mothers and their children completed tasks and measures for both studies during their 2.5 hour visits to the Parenting Lab.
At the beginning of the lab visit, the consent and assent form (Appendices P and Q) were reviewed with mothers and children respectively. As part of informed consent, families were told they were free to withdraw from participation at any point and that all information collected would be kept confidential.
As part of the current study, mothers completed four questionnaires: the family information questionnaire, the BSI-II, the parent version of the modified Social Skills Scales of the SSIS-RS, and the parent version of the MESSY, which included the Aggressive/Antisocial
Behaviour scale. Mothers also completed 10 additional questionnaires, including one interview- format measure, for the larger study. The family information questionnaire was completed by mothers at the beginning of their visit. The remaining 14 questionnaires were divided into three
37 sections and randomized within each section. The first section included the SSIS-RS and the third section contained the BSI-II and MESSY.
During the lab visit, children completed 10 questionnaires. As part of the current study, children completed five questionnaires: the CDI-S, the MASC, the CAM, and the child version of the modified Social Skills scale of the SSIS-RS, and the child version of the MESSY, which included the Aggressive/Antisocial Behaviour scale. The five CAM stories were presented within two audio-recorded interviews. The interviews contained stories for both the larger study and the current study, and the order of presentation for the stories was randomized across children. A research assistant helped children complete the other questionnaires (e.g., reading the items, using pictures of the rating scales). Similar to the mother questionnaires, the measures were divided into three sections. Sections one and two contained the primary measures for both studies, and section three contained covariate measures. As in the mothers’ case, the order of questionnaires within each section was randomized for each child.
Children and mothers completed four interactive tasks together, which were video- recorded from behind a one-way mirror. These four tasks included: a child-directed play period
(10 minutes), a mother-directed play period (approximately 10 minutes), a clean-up period (five minutes), and a discussion of four hypothetical situations involving the child (12 minutes). Only the mother-directed play period was used for the current study. The play periods were always presented in the order of child-directed, mother-directed, and clean-up. However, the order of the discussion and the play periods was counter-balanced across participants.
After 11 children with diagnosed ADHD had participated, it was observed that these children had difficulty completing all the questionnaires during the lab visit. Because the larger
38 study excluded children with ADHD diagnoses, the protocol was amended to prioritize the current study’s questionnaires over the larger study’s measures. The larger study’s measures, originally incorporated into sections one and two, were added to the end of section three.
However, children without ADHD continued to complete questionnaires in the order that was originally intended. Four children with ADHD completed questionnaires with the amended protocol, and 11 children with ADHD completed questionnaires with the original protocol.
At the end of the lab session, mothers were given $35 and children were given a UBC
Parenting Lab t-shirt for their participation. Sixteen mothers did not complete all the questionnaires within the 2.5 hours, and were provided with self-addressed stamped envelopes to mail the completed questionnaires back to the lab. Of these mothers, 14 returned the questionnaires. Only covariate measures, such as the BSI-II, were completed by mothers after the lab visit.
39 3 Results
All data analyses were performed using SPSS 17.0. Pearson correlations were conducted to investigate the relationships among the primary variables (i.e., ADHD symptoms, conduct problems, hostile attribution bias, positive illusory bias, or child social functioning difficulties) and potential covariates (i.e., demographic characteristics, child internalizing symptoms, and maternal psychopathology). Additionally, independent samples t-tests or univariate ANOVAs were conducted in lieu of Pearson correlations when potential covariate variables were categorical (e.g., child gender, child ethnicity). Covariate variables that were significantly related to the primary variables (p < .05) were controlled in subsequent analyses. The study’s main hypotheses were examined in a series of hierarchical regression models.
Missing data for the primary and covariate variables were replaced with the mean for the respective measure. There were no missing data for either the ADHD-IV or ODDRS. In terms of the positive illusory bias, one child did not complete the SSIS Social Skills scale, and four children and two mothers did not complete the MESSY Aggressive/Antisocial Behaviour scale.
Missing values were replaced with the mean scores for each of these scales, and the positive illusory bias scores for children based on each of these measures were subsequently calculated.
Only one child did not complete the CAM. Finally, there were no missing data for the observational measure of child social functioning difficulties. There were missing data for income (n = 1), BSI-II measures of anxiety, depression, and hostility (n = 1), and on the child measures of depression (CDI-S; n = 2) and anxiety (MASC; n = 2).
40 3.1 Demographic characteristics
The demographic characteristics of the sample are summarized in a previous section. In terms of the predictor variables, child ADHD symptoms and conduct problems, mother age was negatively correlated with maternal reports of child conduct problems, r(36) = -.46, p = .004.
Child age, family income, maternal education, number of siblings, and child birth order were not significantly correlated with either ADHD symptoms or conduct problems (ps >.05). Although male children tended to have higher levels of ADHD symptoms and conduct problems compared to female children, these differences were not significant (ps > .05). Similarly, there were no significant group differences in either ADHD symptoms or conduct problems with respect to child ethnicity, maternal work status, or marital status (ps > .05).
With respect to the social cognitive biases, the prosocial positive illusory bias was correlated with mother age, r(36) = -.33, p = .040, and family income, r(36) = -.39, p = .016. The aggressive/antisocial positive illusory bias was related to family income, r(36) = .40, p = .012, and marital status, t(36) = 3.00, p = .005. Children of married mothers (M = -.35, SD = .95) showed less overestimation of their social abilities with respect to aggressive/antisocial behaviour compared to children of non-married mothers (M = .67, SD = 1.09). The hostile attribution bias was not related to any of the demographic variables (ps > .05). The dependent variable, observed child social functioning difficulties in the mother-child interaction, also was not related to any of the demographic variables (ps > .05).
3.2 Child ADHD symptoms and conduct problems
Table 1 contains the descriptive statistics for measures of children’s levels of ADHD symptoms and conduct problems. As seen in Table 1, both measures were approximately normally
41 distributed with scores covering the full ranges of the measures. Thirty-seven percent of mothers rated their children’s ADHD symptoms, as assessed on the ADHD-IV, above the 84th percentile.
The mean percentile score was 68.1 (SD = 24.9, Range = 1 to 99). Fifty percent of mothers endorsed six or more child ADHD symptoms at levels of often or very often, which coincides with the clinical range of ADHD symptoms defined by the DSM-IV-TR (American Psychiatric
Association, 2004). The ODDRS does not have community or clinical norms, but 21.1% of mothers rated their children’s conduct problems within the DSM-IV-TR defined clinical range for Oppositional Defiant Disorder (i.e., four or more items rated pretty much or very much;
American Psychiatric Association, 2000).
Fifteen mothers reported their child had been diagnosed with ADHD by a professional.
Of these children, 10 children were taking medication for ADHD symptoms and of these three were removed from their medication prior to their visit to the UBC Parenting Lab. A dummy variable contrasting children on medication with the remainder of the sample was generated to control for medication status in the main analyses (0 = not on medication or removed from medication; 1 = on medication during lab visit). ADHD symptoms, as assessed using the ADHD-
IV, were significantly related to medication status, r(36) = .64, p < .001. Similarly, conduct problems, assessed using the ODDRS, were significantly related to medication status, r (36) = .
60, p < .001. Medication status was not related to any of the other primary variables.
3.3 Social cognitive biases
As seen in Table 1, children’s scores on the measure of a mother-targeted hostile attribution bias were approximately normally distributed, and covered nearly the full range of the measure, although no child reported maternal hostile intent across all five scenarios. Similarly, scores on
42 the positive illusory bias measure of children’s prosocial behaviour were approximately normally distributed. The constituent components of the positive illusory bias measure for prosocial behaviour (i.e., child- and mother-reports on the SSIS Social Skills scale) also were normally distributed. Finally, scores on the positive illusory bias measure of children’s aggressive/ antisocial behaviour also were approximately normally distributed. Child- and mother-reports on the MESSY Aggressive/Antisocial Behaviour scale also were normally distributed.
With respect to the measures of social functioning, children tended to rate themselves more favorably than did their mothers. On average, children reported that acting in a prosocial manner at home was somewhat true of them, and mothers rated prosocial child behaviour occurring some of the time. A larger discrepancy between child and mother reports was noted on the measure of aggressive/antisocial behaviour. Children reported engaging in aggressive/ antisocial behaviours not at all or a little. In contrast, mothers reported an average frequency of some of the time for these child behaviours.
3.4 Observed child social functioning difficulties
As shown in Table 1, the measure of child social functioning difficulties derived from observations of child and mother behaviour during the mother-child interaction was positively skewed. Most children behaved very well with their mothers, therefore the majority of observational scores of children’s social functioning difficulties were close to zero.
Transformations of data can be used to mitigate skewness, however a transformation was not applied to this data because many of the scores were zero (n = 12) or very close to zero (i.e., > .
10; n = 15) and these cannot be transformed effectively (Tabachnick & Fidell, 2007).
43 3.5 Child internalizing symptoms
According to child reports on the MASC, two children scored within the very much above average range (T score > 70) and 12 children scored within the slightly above average range (T score of 56-60) for anxiety problems. With respect to depression, one child scored within the much above average range (T score of 66-70) and one child scored within the slightly above average range (T score of 56-60) on the CDI-S. Mean T scores for the overall sample were 51.9
(SD = 14.9) for the MASC and 45.9 (SD = 6.5) for the CDI-S. Mean rating-scale scores for the overall sample were 1.29 (SD = .48) for the MASC and .18 (SD = .20) for the CDI-S. Child reports of anxiety and depression were not related to any of the variables of interest (ps > .05).
3.6 Maternal behaviour and psychopathology
Mothers verbalized an average of 1.71 negative statements during the 10 minute mother-directed play session (SD = 2.60; Range = 0 to 10). The frequency of mother negative talk was not correlated with any of the primary variables (ps > .05).
On the BSI-II, 14 mothers scored above the clinical cut-off (T ≥ 63) on the depression scale, eight mothers scored above the clinical cut-off on the anxiety scale, and six mothers scored above the clinical cut-off on the hostility scale. Mean T scores for the overall sample were 59.7
(SD = 8.4) for depression, 57.8 (SD = 6.7) for anxiety, 58.1 (SD = 8.3) for hostility. Mean rating- scale scores for the overall sample were .93 (SD = .78) for depression, .81 (SD = .67) for anxiety, .65 (SD = .45) for hostility.
Only mother rating-scale reports of depressive symptoms were significantly correlated with the variables of interest. Unexpectedly, mother depression was negatively correlated with
44 both child ADHD symptoms, as assessed using the ADHD-IV, r (36) = -.40, p = .013, and conduct problems, as assessed using the ODDRS, r (36) = -.35, p = .032.
3.7 Main analyses
Based on preliminary analyses, it was determined that mother age, family income, marital status, mother depression, and child medication status at time of lab visit should be controlled in the main analyses. However, these covariates were only included when they were related to primary variables contained within a particular analysis. Mother age and depression were included in regression models that contained child ADHD symptoms or conduct problems, whereas mother age and family income were included in analyses that involved child positive illusory bias scores. Child medication status was included in analyses involving the dependent variable, child social functioning difficulties. Table 3.1 provides descriptive statistics for each primary variable, and Table 3.2 presents the bivariate correlations among the primary variables.
A series of hierarchical regression models were developed to test hypotheses (1) thru (4).
Step one of each model contained significant demographic or psychological correlates of either the predictor or dependent variables. Predictor variables were then entered into step two of the models to examine their contributions above and beyond that of the control variables. Hypothesis
(4) tested the interaction between the hostile attribution bias and positive illusory bias as a predictor of child social functioning difficulties. In this case the interaction term was entered in step three. Hypothesis (5) was tested using indirect effects testing with a bootstrapping procedure. Although many regression models were tested, significance levels were set at α = .05 due to the study’s small sample size and low power.
45 Table 3.1 Descriptive Statistics for the Variables of Interest
Mean SD Range Skewness (SE) Kurtosis (SE)
ADHD Symptoms 1.30 .78 0 to 3.00 .61 (.38) -.58 (.75)
Conduct Problems 1.10 .74 0 to 2.75 .95 (.38) .29 (.75)
Hostile Attribution Bias for Mother Behaviour1 .31 .21 0 to .80 .32 (.38) -.52 (.75)
Positive Illusory Bias - Prosocial Behaviour2 0 1.17 -2.66 to 2.57 -.36 (.38) -.13 (.75)
Child Social Skills - Child Report 2.12 .37 1.47 to 2.72 -.10 (.38) -.93 (.75)
Child Social Skills - Mother Report 1.70 .51 .33 to 2.60 -1.00 (.38) 1.00 (.75)
Positive Illusory Bias - 0 1.17 -2.68 to 2.07 -.36 (.38) -.35 (.75) Aggressive/Antisocial Behaviour3 Aggressive/Antisocial - Child 4.29 .38 3.30 to 4.89 -.74 (.38) .18 (.75) (reverse scored) Aggressive/Antisocial - Mother 2.95 .71 1.22 to 5.00 -.07 (.38) 1.35 (.75) (reverse scored) Observed Child Social Functioning Difficulties .10 .17 0 to .75 2.70 (.38) 7.50 (.75)
Negative Talk Ratio .07 .13 0 to .62 2.96 (.38) 8.91 (.75)
Noncompliance Ratio .13 .22 0 to .89 2.58 (.38) 6.62 (.75)
1 Assessed using the CAM 2 (Standardized scores of SSIS Social Skills Child Report) - (Standardized scores of SSIS Social Skills Mother Report) 3 (Standardized scores of reversed scored MESSY Aggressive/Antisocial Behaviour Child Report) - (Standardized scores of reversed scored MESSY Aggressive/Antisocial Behaviour Mother Report)
46 Table 3.2 Pearson Correlations among the Variables of Interest
2. 3. 4. 5. 6.
1. Observed Child Social Functioning Difficulties .37* .42** < .01 -.08 .44**
2. ADHD Symptoms .69** -.16 < .01 -.02
3. Conduct Problems -.12 .36* .24
4. Hostile Attribution Bias for Mother Behaviour -.06 .08
5. Positive Illusory Bias - Prosocial Behaviour .51**
6. Positive Illusory Bias - Aggressive/Antisocial Behaviour
* Correlation significant at p < .05 ** Correlations significant at p < .01
3.7.1 Hypothesis (1)
A hierarchical regression model tested the hypothesis that ADHD symptoms and conduct problems would be positively related child social functioning difficulties within the mother-child interaction (Table 3.3). At step one, the covariates of child medication status at time of lab visit, mother age, and maternal depression did not account for significant variance in child social functioning difficulties, F(3, 34) < 1. At step two, as hypothesized, ADHD symptoms and conduct problems, assessed by the ADHD-IV and ODDRS respectively, accounted for an additional 43% of the variance in child social functioning difficulties, Fchange(2, 32) = 12.00, p < .
001. Inspection of the standardized regression coefficients for ADHD symptoms and conduct problems revealed that within the model, ADHD symptoms were related to child social functioning difficulties at a marginally significant level. However, conduct problems were significantly associated with child social functioning difficulties. Overall the model accounted for a significant amount of variance in child social functioning difficulties, F(5, 32) = 4.88, p = .
002. Assumption testing of this model revealed that assumptions of linearity and homoscedasticity had been violated. Violations of linearity tend to result in regression models
47 that underestimate the relationships among independent and dependent variables, however the effects of violations of homoscedasticity in regression are less predictable. Therefore, the results of this model should be interpreted in light of these violations.
Table 3.3 Summary of Regression Analysis for ADHD Symptoms and Conduct Problems
Predicting Child Social Functioning Difficulties within Mother-Child Interactions
Controlling for Child Medication Status, Mother Age, and Maternal Depression (N = 38)
Variable B SE B ϐ p Step 1 Child medication status (1 = on medication at lab) .01 .08 .03 .878 Mother Age < .01 .01 .10 .613 Maternal depression < .01 .04 -.02 .928
Step 2 Child medication status (1 = on medication at lab) -.23 .08 -.55 .009 Mother age .01 .01 .16 .330 Maternal depression .06 .03 .27 .090 ADHD symptoms .09 .05 .44 .058 Conduct problems .14 .05 .61 .006 Note: R2 = .01 for Step 1 (p = .966), ΔR2 = .43 for Step 2 (p < .001)
3.7.2 Hypothesis (2)
The hypothesis that ADHD symptoms and conduct problems would be positively related to the hostile attribution bias for mother behaviour was tested with a hierarchical regression model
(Table 3.4). At step one, child medication status, mother age, and maternal depression were entered and did not account for a significant amount of variance in children’s hostile attribution scores, F(3, 34) = 1.41, p = .258. In step two, contrary to prediction, neither ADHD symptoms nor conduct problems added significantly to the prediction of children’s hostile attribution bias
48 scores, as assessed using the CAM, Fchange(2, 32) < 1. Indeed, as evidenced by the standardized regression coefficients, neither ADHD symptoms nor conduct problems were significantly related to the hostile attribution bias. Overall the model did not account for a significant amount of variance in children’s hostile attribution scores, F(5, 32) < 1. No assumptions of this model were violated.
Table 3.4 Summary of Regression Analysis for ADHD Symptoms and Conduct Problems
Predicting Hostile Attribution Bias Controlling for Child Medication Status, Mother Age and BSI-II Maternal Depression (N = 38)
Variable B SE B β p Step 1 Child medication status (1 = on medication at lab) -.16 .09 -.30 .103 Mother age -.01 .01 -.27 .153 Maternal depression .04 .05 .15 .386
Step 2 Child medication status (1 = on medication at lab) -.18 .13 -.34 .178 Mother age -.01 .01 -.29 .156 Maternal depression .05 .05 .17 .387 ADHD symptoms .03 .07 .11 .700 Conduct problems -.02 .07 -.07 .793 Note: R2 = .11 for Step 1 (p = .258), ΔR2 < .01 for Step 2 (p = .924)
49 3.7.3 Hypothesis (3)
The hypothesis that ADHD symptoms and conduct problems would be positively related to the positive illusory bias was evaluated in two hierarchical regression models. The first model tested the relationship between children’s behavioural difficulties and the positive illusory bias for prosocial behaviour (Table 3.5), and the second model tested the relationship between children’s behavioural difficulties and the aggressive/antisocial behaviour positive illusory bias (Table 3.6).
As described in Table 3.5, step one of the prosocial behaviour positive illusory bias model, which included child medication status, mother age, marital status, maternal BSI-II depression scores, and family income, accounted for 26% of the variance in positive illusory bias scores with marginal significance, F(5, 32) = 2.23, p = .076. In step two, child ADHD symptoms and conduct problems accounted for an additional 12% of the variance in child positive illusory bias scores derived from the SSIS Social Skills scale with marginal significance, Fchange(2, 30) =
2.77, p = .079. ADHD symptoms were marginally significantly related to the prosocial behaviour positive illusory bias, whereas conduct problems were significantly related to the prosocial behaviour positive illusory bias. The overall model significantly predicted positive illusory bias scores, F(7, 30) = 2.56, p = .034. No assumptions of this model were violated.
50 Table 3.5 Summary of Regression Analysis for ADHD Symptoms and Conduct Problems
Predicting Child Positive Illusory Bias for Prosocial Behaviour Controlling for Child
Medication Status, Mother Age, Marital Status, Maternal Depression, and Family Income
(N = 38)
Variable B SE B β p Step 1 Child medication status (1 = on medication at lab) -.28 .50 -.09 .583 Mother age -.07 .04 -.33 .071 Marital status (1 = married) -.47 .54 -.19 .394 Family income -.11 .12 -.20 .379 Maternal depression -.10 .24 -.07 .691
Step 2 Child medication status (1 = on medication at lab) -.13 .66 -.05 .843 Mother age -.04 .04 -.18 .336 Marital status (1 = married) -.52 .52 -.21 .330 Family income -.09 .12 -.16 .470 Maternal depression -.14 .26 -.09 .602 ADHD symptoms -.66 .37 -.44 .085 Conduct problems .78 .37 .50 .040 Note: R2 = .26 for Step 1 (p = .076), ΔR2 = .12 for Step 2 (p = .079)
A similar model was developed to examine the relationship between ADHD symptoms and conduct problems as predictors of the children’s levels of the positive illusory bias for aggressive/antisocial behaviour (Table 3.6). In step one, child mediation status during lab visit, mother age, marital status, family income, and maternal depression accounted for 42% of the variance in positive illusory bias scores for aggressive/antisocial behaviour, F(5, 32) = 4.64, p = .
003. In step two, ADHD symptoms and conduct problems accounted for an additional 8% of
51 variance in aggressive/antisocial behaviour positive illusory bias scores, Fchange(2, 30) = 2.51, p
= .099. Inspection of the standardized coefficients revealed that the aggressive/antisocial behaviour positive illusory bias was significantly related to conduct problems but not ADHD symptoms within the model. The overall model significantly predicted positive illusory bias scores, F(7, 30) = 4.35, p = .002. No assumptions of this model were violated. In summary, these models provided limited support for hypothesis (3) that ADHD symptoms and conduct problems would be significantly related to the positive illusory bias.
52 Table 3.6 Summary of Regression Analysis for ADHD Symptoms and Conduct Problems
Predicting Child Positive Illusory Bias for Aggressive/Antisocial Behaviour Controlling for
Child Medication Status, Mother Age, Marital Status, Family Income, and Maternal
Depression (N = 38)
Variable B SE B β p Step 1 Child medication status (1 = on medication at lab) -1.21 .42 -.43 .007 Mother age -.05 .03 -.27 .090 Marital status (1 = married) -.69 .45 -.30 .132 Family income -.09 .10 -.19 .366 Maternal depression -.30 .20 -.21 .144
Step 2 Child medication status (1 = on medication at lab) -1.61 .56 -.57 .007 Mother age -.04 .03 -.18 .274 Marital status (1 = married) -.62 .44 -.27 .168 Family income -.06 .10 -.13 .527 Maternal depression -.20 .22 -.14 .376 ADHD symptoms -.17 .31 -.12 .584 Conduct problems .67 .31 .45 .036 Note: R2 = .42 for Step 1 (p = .003), ΔR2 = .08 for Step 2 (p = .099)
3.7.4 Hypothesis (4)
Two hierarchical regression models were developed to investigate the relationship between the social cognitive biases and child social functioning difficulties. Each model included the hostile attribution bias and one measure of the positive illusory bias (i.e., either prosocial behaviour or aggressive/antisocial behaviour). For each model, potential covariates were entered into step one, measures of the social cognitive biases were entered into step two, and step three contained an
53 interaction term between the hostile attribution bias and positive illusory bias measures. The scores of the hostile attribution bias and positive illusory bias measures were centered, and the interaction term was created by multiplying the scores of the centered measures.
The first regression model tested the relationship between the hostile attribution bias and positive illusory bias for prosocial behaviour, and child social functioning difficulties (Table 3.7).
In step one of the model mother age, marital status, and family income did not account for any variance in child social functioning difficulties, F(3, 34) < 1. Step two of the model revealed that the hostile attribution bias and prosocial behaviour positive illusory bias did not significantly predict variance in child social functioning difficulties, Fchange(2, 32) < 1. The interaction between the hostile attribution bias and the prosocial behaviour positive illusory bias was entered in step three, and also did not account for a significant amount of variance in child social functioning difficulties, Fchange(1, 31) < 1. Overall this model did not account for a significant amount of variance in child social functioning difficulties, F(6, 31) < 1. This model violated assumptions of normality and homoscedasticity, therefore these results should be interpreted with consideration to these violations.
54 Table 3.7 Summary of Regression Analysis for Hostile Attribution Bias and Positive
Illusory Bias for Prosocial Behaviour (PIB-Prosocial Behaviour) Predicting Child Social
Functioning Difficulties Controlling for Mother Age, Marital Status, and Family Income (N
= 38)
Variable B SE B β p Step 1 Mother age < .01 .01 .06 .714 Marital status (1 = married) -0.1 .09 -.30 .226 Family income .01 .02 .10 .698
Step 2
Mother age < .01 .01 .01 .057 Marital status (1 = married) -.12 .09 -.33 .191 Family income .01 .02 .07 .794 Hostile attribution bias1 -.01 .14 -.01 .943 PIB-Prosocial behaviour1 -.02 .03 -.17 .390 Step 3
Mother age < .01 .01 .01 .949 Marital status (1 = married) -.11 .09 -.32 .216 Family income < .01 .02 .06 .822 Hostile attribution bias1 .01 .15 .02 .924 PIB-Prosocial behaviour1 -.02 .03 -.15 .459 Hostile attribution bias x PIB-Prosocial behaviour2 -.10 .16 -.12 .517 Note: R2 = .063 for Step 1 (p = .527), ΔR2 = .022 for Step 2 (p = .687), ΔR2 = .013 for Step 3 (p = .517) 1 The values on these scales have been centered around the means 2 Interaction term using product of centered hostile attribution bias and positive illusory bias measures
55 A second hierarchical regression model was constructed to examine the relationship between the aggressive/antisocial behaviour positive illusory bias and the hostile attribution bias scores as predictors of child social functioning difficulties (Table 3.8). Marital status and family income, entered in step one, did not account for a significant amount of variance in the dependent variable, F(2, 35) = 1.09, p = .347. In step two, the social cognitive biases accounted for an additional 16% of the variance in child social functioning difficulties, Fchange(2, 33) = 3.28, p = .050. In step three, the interaction between the positive illusory bias and the hostile attribution bias scores did not account for significant variance in child social functioning difficulties, F(1, 31) = 1.21, p = .280. Overall, this model did not significantly predict variance in child social functioning difficulties, F(5, 32) = 2.06, p = .097. This model demonstrated heteroscedasticity, and these results should be interpreted in consideration of this assumption violation. In summary, these models did not provide support for the hypothesis that the social cognitive biases would be significantly related to children’s social functioning difficulties within mother-child interactions.
56 Table 3.8 Summary of Regression Analysis for Hostile Attribution Bias and Aggressive/
Antisocial Behaviour Positive Illusory Bias Scores (PIB-Aggressive/Antisocial Behaviour)
Predicting Child Social Functioning Difficulties Controlling for Marital Status and Family
Income (N = 38)
Variable B SE B β p Step 1 Marital status (1 = married) -.11 .08 -.31 .189 Family income .01 .02 .12 .614
Step 2 Marital status (1 = married) -.06 .08 -.17 .449 Family income .02 .02 .21 .359 Hostile attribution bias1 -.05 .13 -.06 .723 PIB-Aggressive/antisocial behaviour1 .07 .03 .45 .015 Step 3 Marital status (1 = married) -.07 .08 -.19 .408 Family income .02 .02 .21 .355 Hostile attribution bias1 -.07 .13 -.09 .571 PIB-Aggressive/antisocial behaviour1 .07 .03 .48 .011 Hostile attribution bias x PIB-Aggressive/antisocial -.15 .14 -.18 .280 behaviour2 Note: R2 = .059 for Step 1 (p = .347), ΔR2 = .156 for Step 2 (p = .050), ΔR2 = .029 for Step 3 (p = .280) 1 The values on these scales have been centered around the means 2 Interaction term using product of centered hostile attribution bias and positive illusory bias measures
In the previous regression model, examination of the standardized coefficients revealed that the positive illusory bias for aggressive/antisocial behaviour was significantly related to the dependent variable, whereas the standardized coefficient for the hostile attribution bias was not.
Consequently, a hierarchical regression model was developed to explore only the relationship
57 between the Aggressive/Antisocial Behaviour positive illusory bias and child social functioning difficulties (Table 3.9). Marital status and family income, entered in step one, were not significant predictors of child social functioning difficulties, F(2, 35) = 1.09, p = .347. However, in step two, the Aggressive/Antisocial Behaviour positive illusory bias scores accounted for an additional 15% of variance in child social functioning difficulties after controlling for marital status and family income, F (1, 34) = 6.60, p = .015. Overall, this model significantly accounted for variance in child social functioning difficulties, F(3, 24) = 3.04, p = .042. This model demonstrated heteroscedasticity, and results should be interpreted in consideration of this assumption violation. Although the models including both the hostile attribution bias and positive illusory bias did not provide support for hypothesis (4), this restricted model demonstrated that the aggressive/antisocial behaviour positive illusory bias was significantly related to children’s social functioning difficulties within mother-child interactions, thus providing some evidence in support of hypothesis (4).
Table 3.9 Summary of Regression Analysis for the Aggressive/Antisocial Behaviour
Positive Illusory Bias Scores (PIB-Aggressive/Antisocial Behaviour) Predicting Child Social
Functioning Difficulties Controlling for Marital Status and Family Income (N = 38)
Variable B SE B β p Step 1 Marital status (1 = married) -.11 .08 -.31 .189 Family income .01 .02 .12 .614
Step 2 Marital status (1 = married) -.06 .08 -.17 .454 Family income .02 .02 .20 .375 PIB-Aggressive/antisocial behaviour .07 .03 .44 .015 Note: R2 = .06 for Step 1 (p = .347), ΔR2 = .15 for Step 2 (p = .015)
58 3.7.5 Hypothesis (5)
Statistical models were developed to test the hypothesis that social cognitive biases might mediate the relationship between children’s behavioural difficulties (i.e., ADHD symptoms, conduct problems) and their social functioning difficulties within mother-child interactions.
However, for mediation to occur, the predictor, dependent, and mediating variables must be correlated (Baron & Kenny, 1986). As seen in Table 3.2, the hostile attribution bias was not related to any of the other primary variables. Similarly, the positive illusory bias for prosocial behaviour was not correlated with the dependent variable, children’s social functioning difficulties, and was only correlated with one of the predictor variables, conduct problems.
Finally, ADHD symptoms, although significantly associated with the dependent variable, were not related to any of the possible mediators (i.e., the social cognitive biases). For these reasons, mediation models including the hostile attribution bias or prosocial behaviour positive illusory bias scores as mediators or ADHD symptoms as a predictor variable were excluded. For the final set of analyses, the extent to which the aggressive/antisocial behaviour positive illusory bias mediated the relationship between conduct problems scores and child social functioning difficulties within mother-child interactions was evaluated.
Mediation was assessed using a nonparametric bootstrapping procedure developed by
Preacher and Hayes (2004), with 1,000 bootstrap resamples. The relationship between an independent variable and dependent variable is composed of a direct effect and indirect effect
(i.e., relationship between these variables thru a mediating variable). The bootstrapping technique tests the significance of the indirect effect by comparing the strength of the direct effect of the independent on the dependent variable before and after the mediator is introduced.
59 This approach has several advantages over the traditional mediation effects testing of Baron and
Kenny (1986). First, bootstrapping techniques do not assume normality of the sampling distribution of the indirect effects. This means that indirect effects testing using bootstrapping methods does not require a large sample size, which accommodates the current study’s smaller sample. Second, indirect effects testing does not requires a series of regression models testing the significance of paths a, b, and c independently of one another, and is, therefore, less vulnerable to Type II error compared to the method described by Baron and Kenny (MacKinnon,
Lockwood, Hoffman, West, & Sheets, 2002).
As illustrated in Tables 3.10 and 3.11, and Figure 3.1, the Aggressive/Antisocial
Behaviour positive illusory bias scores partially mediated the relationship between child conduct problems, as assessed by the ODDRS, and observed child social functioning difficulties in the interaction with their mother. The indirect effects of the positive illusory bias scores were significant using bias corrected, and bias correct and accelerated confidence intervals, but not significant using percentile confidence intervals. Several authors have argued that bias corrected and accelerated confidence intervals offer a more powerful test of significance compared to the traditional percentile confidence intervals (Briggs, 2006; Efron & Tibshirani, 1993; Preacher &
Hayes, 2008). Therefore, these results are interpreted as evidence for the positive illusory bias of aggressive/antisocial behaviour as a partial mediator in the relationship between conduct problems and children’s social functioning difficulties within mother-child interactions.
60 Table 3.10 Mediation of the Effect of Conduct Problems on Child Social Functioning
Difficulties Through the Aggressive/Antisocial Behaviour Positive Illusory Bias (PIB-
Aggressive/Antisocial Behaviour) Controlling for Marital Status, Mother Age, Family
Income, Child Medication Status, and Maternal Depression
Bootstrapping
Percentile 95% CI BC 95% CI BCa 95% CI
Point Estimate Lower Upper Lower Upper Lower Upper
PIB-Aggressive/Antisocial Behaviour .04 -.006 .092 .001 .135 .001 .132
Note - BC, bias corrected; BCa, bias corrected and accelerated; 1,000 bootstrap samples.
Table 3.11 Direct, Total, and Partial Effects
B SE B β p Direct Effects
Conduct problems to PIB-Aggressive/antisocial behaviour .60 .27 .40 .036
PIB-Aggressive/antisocial behaviour to social functioning difficulties .06 .03 .42 .031
Conduct problems to social functioning difficulties .15 .05 .65 .004
Total Effects
Conduct problems to social functioning difficulties .19 .05 .82 < .001
Partial Effects
Marital status (1 = married) -.03 .07 -.09 .661
Mother age .01 < .01 .31 .065
Family income .02 .02 .27 .192
Maternal depression .05 .03 .24 .113
Child medication status (1 = on medication at lab) -.04 .09 -.09 .667
61 Figure 3.1 Mediation of the Effect of Conduct Problems on Child Social Functioning
Difficulties Through Aggressive/Antisocial Behaviour Positive Illusory Bias Controlling for
Marital Status, Mother Age, Family Income, Child Medication Status, and Maternal
Depression
Aggressive/Antisocial Behaviour Positive Illusory Bias
.40* .42*
Social Functioning Conduct Problems Difficulties .82** (.65**) *p < .05; **p < .01
62 4 Discussion
This study examined the relationships among ADHD symptoms and conduct problems, child social cognitive biases, and child social functioning difficulties within the family. Although previous studies have examined the hostile attribution bias or the positive illusory bias in relation child social functioning within the family (e.g., Gerdes et al., 2007; MacKinnon-Lewis, Lamb et al., 2001), this is the first study to include both social cognitive biases to examine their joint influence. Furthermore, the current study extended previous research by evaluating these social cognitive biases as possible mechanisms underlying the relationships between ADHD symptoms and conduct problems and children’s social functioning difficulties within the family.
4.1 ADHD symptoms, conduct problems, and child social functioning difficulties
As predicted, at the bivariate level child ADHD symptoms and conduct problems were each significantly related to observations of child social functioning difficulties within a mother-child interaction. This finding is congruent with previous observational research, indicating that both of these type of difficulties are associated with more conflicted mother-child interactions (Gomez
& Sanson, 1994; Johnston, 1996; Lindahl, 1998). However, there also is a growing consensus among researchers that conduct problems more strongly contribute to children’s social functioning difficulties within parent-child interactions than ADHD symptoms (Deault, 2010;
Johnston & Mash, 2001). Within the current study, when both ADHD symptoms and conduct problems were included in the same regression model, child social functioning difficulties remained significantly related to conduct problems, but only marginally significantly related to
63 ADHD symptoms. This result, consistent with previous research, highlights the importance of examining both dimensions of symptoms as they relate to the social functioning of children.
4.2 ADHD symptoms and conduct problems and the hostile attribution bias
This is the first study to examine children’s hostile attribution bias for their mothers’ behaviour in relation to children’s levels of ADHD symptoms and conduct problems. Unexpectedly, neither
ADHD symptoms nor conduct problems were related children’s levels of hostile attribution bias for their mothers’ behaviour. This result is inconsistent with the previous studies by MacKinnon-
Lewis in this area (1992; 2001), and with my predictions. Several explanations for the nonsignificant findings can be entertained. Although possible, it is unlikely that the scenarios used in the current study to assess the hostile attribution bias failed to adequately measure this construct because the same scenarios have been used successfully in previous research with typically developing children (MacKinnon-Lewis, Lamb et al., 2001). However, the assessment of the hostile attribution bias was limited in other ways. Specifically, the coding of children’s responses to the CAM had only moderate inter-rater reliability, leaving the possibility that error in measurement obscured any relationship between ADHD symptoms, conduct problems, and mother-targeted hostile attribution bias. In addition, it is likely that the current study was underpowered given the relatively small effect sizes found in previous studies of the hostile attribution bias in peer relations (Andrade, 2007; MacBrayer et al., 2003; Milich & Dodge,
1984). It should be noted that other studies of social information processing among children with high levels of ADHD symptoms and conduct problems also have failed to find a consistent relationship between these behavioural difficulties and the hostile attribution bias even within peer relations, leading some authors to question the robustness of this bias within this population
64 (Matthys et al., 1999; Murphy et al., 1992; Sibley, Evans, & Serpell, 2010). Finally, these null results may indicate that children with high levels of ADHD symptoms and conduct problems do not demonstrate the hostile attribution bias when evaluating their mothers’ behaviours. It could be instead that the positive illusory bias extends to children’s understanding of their mothers’ behaviour within the mother-child relationship, thus over-riding the possibility for children to attribute hostility to their mothers’ actions (i.e., Johnny believes his mother always acts kindly towards him). In support of this argument, it has been found that children with high levels of
ADHD symptoms and conduct problems overestimate the quality of the parent-child relationship relative to parent-reports compared to controls, suggesting that these children may extend the positive illusory bias to their relationships with their parents (Gerdes et al., 2007; Gerdes et al.,
2003). However, following from this interpretation one would expect the hostile attribution bias to be negatively correlated with ADHD symptoms and conduct problems, a hypothesis also not supported by this study. In sum, there are both theoretical and methodological reasons that might have contributed to these null results. Future research addressing these methodological concerns is needed to better understand the relationship between ADHD symptoms, conduct problems, and the mother-targeted hostile attribution bias.
4.3 ADHD symptoms, conduct problems, and the positive illusory bias
As predicted, conduct problems were related to both the prosocial and aggressive/antisocial behaviour positive illusory biases. However, ADHD symptoms were not significantly related to either the prosocial or aggressive positive illusory bias (in fact, within the model predicting the prosocial positive illusory bias, ADHD symptoms were marginally related, but in a negative direction, likely due to the colinearity of ADHD symptoms and conduct problems). These
65 findings were consistent with previous studies showing a link between conduct problems and the positive illusory bias (McQuade, personal communication, April 13, 2011; Gresham, Lane, &
Beebe-Frankenberger, 2005; Hoza et al., 2010). However, the nonsignificant findings for ADHD symptoms were in contrast to research that has consistently found that children with high levels of ADHD symptoms overestimate their social functioning abilities within peer groups relative to other raters (i.e., teachers, parents, or laboratory observations; Diener & Milich, 1997; Hoza et al., 2004; Hoza et al., 2010; Hoza et al., 2002; Mikami et al., 2010; Ohan & Johnston, 2002;
Owens et al., 2007). Interestingly, in studies of children with high levels of ADHD, when conduct problems were assessed, it appears that children with the combination of high levels of both ADHD symptoms and conduct problems demonstrated the largest positive illusory bias within the social domain compared to children with high levels of ADHD symptoms alone (Hoza et al., 2002). Thus, it remains an open question the extent to which both ADHD and conduct problems contribute to the positive illusory bias (Hoza et al., 2002), but the findings of my study do highlight the importance of considering ADHD symptoms and conduct problems separately in relation to the positive illusory bias.
4.4 Social cognitive biases and child social functioning difficulties
The hypothesis that both types of social cognitive bias would be related to child social functioning difficulties was only partially supported. First, the hostile attribution bias was not related to child social functioning difficulties within mother-child interactions. However, as predicted, children who demonstrated higher levels of the positive illusory bias for their own antisocial or aggressive behaviour also demonstrated higher levels of negative behaviour with their mothers. Specifically, these children were less likely to comply with their mothers’
66 commands, and more likely to speak negatively to their mothers (e.g., rudeness, sassy comments, refusing to cooperate). On the other hand, there was no relationship between the positive illusory bias for prosocial behaviour and child social functioning difficulties. Finally, the interaction between the positive illusory bias (aggressive/antisocial behaviour or prosocial behaviour) and the hostile attribution bias was not significant.
4.4.1 Hostile attribution bias and child social functioning difficulties
As noted, the mother-targeted hostile attribution bias was not associated with observations of child social functioning difficulties during a mother-child interaction. This result was inconsistent with other studies, which reported a positive relationship between the hostile attribution bias and aggressive or noncompliant behaviours within mother-child interactions
(MacKinnon-Lewis et al., 1992; MacKinnon-Lewis, Lamb et al., 2001). When comparing the results of the current study to the work of MacKinnon-Lewis and her colleagues (2001), a few methodological differences should be considered. First, MacKinnon-Lewis and colleagues studied a large sample of typically developing boys, aged 7 to 9 years. In contrast to the current study, which was constituted primarily by European-Caucasian and Asian children, their sample consisted of European-Caucasian (n = 139) and African American (n = 107) children. Although they did not report an effect of ethnicity on children’s attributions or social functioning, it is possible that child ethnicity plays a role in the manifestation of the hostile attribution bias, given both the inconsistency of results and the ethnic diversity across studies.
Second, in comparison to MacKinnon-Lewis et al. (2001), the current study included both boys and girls. The hostile attribution bias has predominantly been studied with boys, and one meta-analysis suggested a stronger hostile attribution bias is found in clinic-referred samples
67 of boys compared to mixed samples (Orobio de Castro et al., 2002). However, the same meta- analysis reported no effect size differences between studies using either male or mixed gender community samples. Further, the one study that examined the hostile attribution bias within a female sample reported a strong positive relationship between externalizing behaviours (i.e.,
ADHD symptoms, conduct problems) and the hostile attribution bias (White, 1984). Therefore, it is unlikely that the current study’s mixed-gender community sample contributed to the null effects of the hostile attribution bias.
Although the CAM was used in both studies, MacKinnon-Lewis et al. (2001) supplemented the measure with cartoon depictions of each scenario and this may have aided children’s interpretations by making the scenarios more concrete. The children in the current study were older and comprehension ratings taken by research assistants following administration of the CAM indicated that all children adequately understood the scenarios.
Nonetheless, pictures may have made scenarios more salient and relatable to the children.
Finally, as previously discussed, the coding of children’s responses to the CAM had only moderate inter-rater reliability, leaving the possibility that error in measurement obscured any relationship between the mother-targeted hostile attribution bias and child social functioning difficulties. In sum, although the current study found no evidence that the mother-targeted hostile attribution bias was related to child social functioning difficulties within mother-child interactions, there were methodological reasons to doubt these findings.
4.4.2 Positive illusory bias and child social functioning difficulties
This was the first study to investigate the relationship between the positive illusory bias and children’s social functioning difficulties within mother-child interactions. Although many studies
68 have examined group differences in the positive illusory bias between controls and children with high levels of ADHD symptoms and conduct problems (see Owens et al., 2007 for a review), only a handful of studies have explored the relationship between this positive illusory bias and peer social functioning difficulties (Hoza et al., 2010; Kaiser et al., 2008; Mikami et al., 2010).
Encouragingly, these studies report results consistent with the current study’s findings, that is, the positive illusory bias was related to child social functioning difficulties. However, the discrepancy of results between the antisocial/aggressive positive illusory bias and the prosocial positive illusory bias should be considered.
The positive illusory bias for prosocial behaviour was not significantly related to child social functioning difficulties, whereas the positive illusory bias for aggressive/antisocial behaviour was. I had expected that a discrepancy between mother and child ratings of social behaviour would present consistently across domains of functioning. Indeed, the positive illusory bias measures were strongly positively correlated with one another, r(36) = .51, suggesting that, to some degree, this was the case. However, due to the inconsistency of results with respect to child social functioning difficulties across the two PIB measures, it appears that there were differences either between the measures (SSIS vs. MESSY) or the constructs (overestimation of prosocial behaviour vs. underestimation of aggressive/antisocial behaviour) of the positive illusory bias.
There were several differences between the SSIS Social Skills and the MESSY
Aggressive/Antisocial Behaviour measures. Most obviously, the SSIS items described instances of prosocial behaviour, whereas the MESSY contained items describing aggressive or antisocial behaviour. Most of the time, these questionnaires were administered orally to children by a
69 research assistant. Therefore, social desirability may have influenced children’s ratings differentially across the measures. For instance, it may be easier for children to accurately acknowledge lower levels of prosocial behaviour (e.g., endorsing I complete my chores on time at never) compared to admitting higher levels of aggressive/antisocial behaviour (e.g., endorsing
I hurt others when teasing them at much of the time). In this case, children’s MESSY scores may be influenced by social desirability to a greater degree than the SSIS. That is, children may have underestimated their levels of aggressive/antisocial behaviour to a greater degree than they overestimated their levels of prosocial behaviour because of the social desirability bias.
Therefore, the measure of positive illusory bias for aggressive/antisocial behaviour may have been more exaggerated than the prosocial behaviour positive illusory bias.
Second, the SSIS was focused on home and family situations, which may have limited its assessment of social functioning. In contrast, the MESSY did not specify only ‘at home’ or ‘with family members’ in any of its items, allowing for a broader conceptualization of social functioning. Parents are privy to children’s social functioning across many contexts, not defined specifically by the home or family members. Therefore, the MESSY may have captured the construct of social functioning more comprehensively than the SSIS, and this might explain the inconsistency in current study’s results.
Alternatively, it may be that the constructs derived from these measures are qualitatively different. Past research suggests that children demonstrate the positive illusory bias for the areas of their greatest deficit (Hoza et al., 2004; Hoza et al., 2010; Hoza et al., 2002). As discussed in the Introduction, it has been posited by many researchers that the positive illusory bias may serve a self-protective function, and therefore children with social difficulties would be expected to
70 manifest the positive illusory bias to protect themselves from acknowledging this deficit (Diener
& Milich, 1997; Hoza et al., 2010; Ohan & Johnston, 2002). It could be argued that these social functioning difficulties derive from these children’s propensity to engage in maladaptive or disruptive behaviour, rather than a paucity of prosocial behaviour. With this in mind, it is understandable that children’s social functioning difficulties within mother-child interactions were related to the positive illusory bias for aggressive/antisocial behaviour, reflecting behaviours that these children struggle with, rather than the prosocial behaviour positive illusory bias.
4.4.3 Hostile attribution bias and positive illusory bias
Contrary to prediction, the interaction term between the hostile attribution bias and positive illusory bias (neither prosocial or aggressive/antisocial behaviour) was not significantly related to child social functioning difficulties within mother-child interactions. That is, the hostile attribution bias did not moderate the relationship between the positive illusory bias and child social functioning difficulties. Again, methodological limitations may have contributed to these results. As previously mentioned, this study was probably underpowered to detect either the hostile attribution bias or an interaction.
4.5 Social cognitive biases as mediators between ADHD symptoms, conduct problems, and child social functioning difficulties
To test the final hypothesis, that the social cognitive biases would mediate the relationship between ADHD symptoms or conduct problems and child social functioning difficulties, mediation models were developed. As a first step, the relationships among the primary variables were examined. These results are summarized in the previous sections. Only variables that were
71 significantly related to one another in the preceding regression models were selected for the mediation models. Thus, only the aggressive/antisocial behaviour positive illusory bias was evaluated as a potential mediator in the relationship between conduct problems and child social functioning difficulties. A few previous studies have found that the positive illusory bias mediates the relationship between ADHD symptoms and peer behavioural problems (Hoza et al.,
2010; Kaiser et al., 2008). Nonetheless, this was the first study to investigate the positive illusory bias as a potential mechanism underlying the relationship between conduct problems and child social functioning difficulties within the family context. As hypothesized, the relationship between child conduct problems and social functioning difficulties was mediated by the positive illusory bias for antisocial or aggressive behaviour.
However, this study used a cross-sectional design, so it is impossible to determine whether the positive illusory bias causes children with high levels of conduct problems to behave poorly with their mothers. Longitudinally designed studies would offer stronger evidence because links between the positive illusory bias and social functioning difficulties could be drawn across time. Indeed, a recent longitudinal study of children’s positive illusory bias and social functioning difficulties within peer groups reported that increases in children’s biased self- perceptions over time were predictive of increases in aggressive behaviour, even after controlling for previous levels of aggressive behaviour (Hoza et al., 2010). However, the current study strengthened preliminary evidence suggesting that the positive illusory bias contributes to social functioning difficulties among children with high levels of conduct problems by including observations of child behaviour and extending into the family context (Hoza et al., 2010; Kaiser et al., 2008; Mikami et al., 2010).
72 Contrary to prediction and in contrast to previous studies (i.e., Hoza et al., 2010; Kaiser et al., 2008), the relationship between ADHD symptoms and social functioning difficulties was not mediated by the positive illusory bias because neither measure of the positive illusory bias was related to ADHD symptoms. This result was discussed in a previous section. Given that larger, longitudinal studies have found the positive illusory bias to partially mediate the relationship between ADHD symptoms and peer social functioning difficulties (i.e., Hoza et al., 2010; Kaiser et al., 2008), it is possible this null finding reflects methodological limitations rather than theoretical divergence between the peer and family contexts. Finally, conclusions regarding the positive illusory bias as a partial mediator in the relationship between conduct problems and social functioning difficulties should be interpreted with care. That is, of the six possible simple mediation models (i.e., ADHD symptoms or conduct problems as predictors and the three social cognitive bias measures as potential mediators), only one resulted in a significant mediation effect, leaving these analyses vulnerable to Type I error.
4.6 Limitations
The current study was limited by its small sample size, both in terms of statistical power as already noted, and in terms of the representative of the sample. With such a small sample size, only a few outlying scores can alter results substantially. For instance, the bivariate correlations indicated that maternal depression was negatively related to both ADHD symptoms and conduct problems, which is in contrast to most previous studies that report a positive relationship maternal depression and either ADHD symptoms or conduct problems (e.g., Brennan et al.,
2000; Hay, Pawlby, Angold, Harold, & Sharp, 2003; Kim-Cohen et al., 2006). The current study’s unexpected results were likely driven by bivariate outliers. That is, of the 14 mothers
73 who reported levels of depression within the clinical range, only four also reported high levels of
ADHD symptoms for their child. Nonetheless, maternal depression was statistically controlled in the main analyses and maternal behaviour that may be related to depression (e.g., less engaged with child - issuing fewer commands) was assessed and controlled in determining child social functioning difficulties from observations of mother-child interactions.
Second, as previously discussed, the current study was likely underpowered to test the hypotheses pertaining to the hostile attribution bias. It is also possible that mediation analyses were hampered by the small sample size, although the bootstrapping procedure would offer some compensation for low power .
Although symptoms of ADHD and conduct problems were well represented within the sample, very few children demonstrated extreme social functioning difficulties within the mother-child interactions. This may be a function of the small sample size or characteristics of the observation period. Although observational data offer objective evaluations of child behaviour, these data obviously may not be representative of children’s overall levels of social functioning difficulties with their mothers. First, children were observed within a novel environment, and previous research has found that children with high levels of ADHD symptoms are most likely to attend to and engage with novel, interesting stimuli (Sagvolden, Aase,
Johansen, & Russell, 2005). Although attempts were made to mitigate this effect (i.e., having children complete tedious tasks), the limited variability of child social functioning difficulties suggests these attempts were not completely successful. Second, the current study treated children’s behaviour within the 10 minute observation as representative of their day-to-day interactions with their mothers. Clearly, observations from a 10 minute play period offer a
74 narrow, and possibly biased, window into child social functioning difficulties. Despite these concerns, child social functioning difficulties were positively related to both ADHD symptoms and conduct problems in the current study, suggesting some confidence in this assessment of child social functioning difficulties . However, it is likely that the limited variability of child social functioning difficulties reduced the sensitivity of this measure to show relations with other variables. Encouragingly, the inter-rater reliability was strong for the observational measure of child social functioning difficulties. However the inter-rater reliability for the maternal negative talk measure was poor. Therefore, mothers’ negative behaviour, such as insulting the child, was not optimally assessed and consequently not adequately controlled for in the main analyses. It is possible that inclusion of a better measure of maternal negative behaviour might have altered the results. On the other hand, the quality of maternal commands was incorporated in the measure of child social functioning difficulties, so at least some maternal behaviour was accounted for in the analyses.
Finally, the measurement of the positive illusory bias (i.e., comparison of mother ratings to child ratings) has inherent difficulties. Consistent with previous research, the current study considered mother ratings as the criterion of child social functioning. However, it is known that adult ratings of children, especially of children with high levels of ADHD symptoms and conduct problems, are not free from bias. Specifically, adults tend overestimate children’s ADHD symptoms when the child also demonstrates conduct problems, and this is known as a negative halo effect (Abikoff, Courtney, Pelham, & Koplewicz, 1993; Schachar, Sandberg, & Rutter,
1986; Stevens, Quittner, & Abikoff, 1998). It is likely that mothers of children with high levels of
ADHD symptoms and conduct problems also demonstrate such a negative halo effect and this
75 may extend to assessments of their own child’s social functioning (Johnston, Weiss, Murray, &
Miller, Revise and resubmit). Given this possibility, it is difficult to discern whether children are overestimating or mothers are underestimating the degree of child social functioning ability, and this is a challenge to all studies of the positive illusory bias which rely other raters as the criterion (see Owens et al., 2007). Conversely, children with high levels of ADHD symptoms and conduct problems have been shown to overestimate their social functioning abilities relative to a variety of other indicators, such as teacher-ratings and objective ratings of task performance, lending support to the positive illusory bias as an indicator that these children have biased perceptions of their abilities (e.g., Diener & Milich, 1997; Hinshaw et al., 2000; Mikami et al.,
2010; Ohan & Johnston, 2011). Recent evidence indicates that executive functioning deficits may underlie the positive illusory bias among children with high levels of ADHD symptoms and conduct problems. Specifically, one study found the relationship between ADHD symptoms and the positive illusory bias was mediated by deficits in executive functioning (e.g., poorer working memory; McQuade et al., 2011). Taken together, these findings suggest the validity of the positive illusory bias among children with high levels of ADHD symptoms and conduct problems, but future research using parent-reports of child functioning should attempt to control for the possibility of negative halo effects in the parent ratings. Nonetheless, this discrepancy appears to underlie some of the social functioning difficulties children with high levels of ADHD symptoms and conduct problems demonstrate with their mothers. Perhaps it is both mothers’ high expectations for problematic behaviour and children’s lack of awareness of their own problematic behaviour that are associated with children’s social functioning difficulties.
76 4.7 Future directions
As previously discussed, past studies of the hostile attribution bias have used samples of
European-Caucasian and African American boys (e.g., MacKinnon-Lewis, Lamb et al., 2001;
Milich & Dodge, 1984). In contrast, the current study included boys and girls from a diverse range of ethnic backgrounds, including European-Caucasian and Asian. It is possible that the demographic heterogeneity across samples contributed to the disparate results between the current study and previous research. Therefore, future research should examine the roles of gender and ethnicity as potential moderators of the relationship between the hostile attribution bias and ADHD symptoms, conduct problems, or child social functioning difficulties.
In addition to addressing the methodological concerns discussed in previous sections, in future research it would be interesting to see how social cognitive biases translate from family into peer groups, or vice versa. Preliminary research with typically developing children has found that children’s interpretations of their parents’ behaviour are related to their interpretations of peer behaviour and the degree that they are liked by their peers (Rah & Parke, 2008).
However, longitudinally-designed research is needed to understand how social cognitive biases of children with high levels of ADHD symptoms and conduct problems might influence their behaviour within the family and within peer groups.
In conclusion, the current study offered preliminary evidence that the positive illusory bias may underlie some of the social functioning difficulties children with conduct problems encounter within their families. This evidence would be strengthened by a longitudinal study demonstrating a relationship between the positive illusory bias and social functioning difficulties over time, controlling for children’s previous levels of social functioning difficulties. This type of
77 research could inform family-based interventions targeting children with high levels of conduct problems, as peer-based interventions for these children have benefited from studies of social cognitive biases (e.g., Kazdin, Siegel, & Bass, 1992; Lochman & Lenhart, 1993).
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92 Appendices
Appendix A: Recruitment flyer
Hey Parents! We need families of 9 to 12 children with or without attentional and behaviour problems to participate in a study of parents and children! WHO? Mothers, fathers, and their 9 to 12 year old children (with or without ADHD)
93 Appendix B: Family information questionnaire
Part I: General Family Information First name of child: ______
1. What is your child’s date of birth? ______(dd/mm/yyyy)
2. Gender? M / F
3. What grade is your child in? ______
4. Was your child adopted? Yes. Age at adoption: ______
No, my child is not adopted.
5. Do you have any other children? Yes. Please write their age(s) and gender(s) below.
______
No, I do not have any other children.
6a. Has your child been diagnosed with any disorders, behaviour problems, or learning, developmental, or neurological problems? Yes. Please describe: ______
No.
6b. Is your child currently taking any medication for a psychological condition (e.g., ADHD)? Yes. What kind of medication? ______
7. Did your child take this medication today? Yes, my child took this medication today.
No, my child did not take this medication today.
No, my child is not taking any medication for a psychological condition.
(Note: Questions 6b and 7 were administered to mothers of children with ADHD diagnoses only)
94 For questions 8-10, please do not count the time your child is asleep or at school. 8. On average, how many hours per week do you work outside the home? (If applicable)
______hours/week 9. On days when you work outside the home, how much time do you spend taking care and doing things with your child? (If applicable) ______hours/day 10. On days when you do not work outside the home, how much time do you spend taking care and doing things with your child? (If applicable)
______hours/day
Part II: Mother Information
11. What is your relationship to ______? Biological mother
Step-mother
Adoptive mother
Other, please explain: ______
12. How old are you? ______(years)
13. How would you describe your ethnicity? ______
14. On a scale of 1 to 10, where 1 is not at all, and 10 is completely, how much do you identify yourself as Canadian? (circle one) 1 ------2 ------3 ------4 ------5 ------6 ------7 ------8 ------9 ------10 Not at all Completely
15. What is your level of education? Less than grade 7 Junior high school Partial high school (grade 10 or 11) High school graduate Partial college/university (min. 1 year) or special training Standard college or university graduate (i.e.: B.A., B.Ed.) Graduate or professional training (i.e.: M.A., PhD)
95 16. Are you currently employed? Yes. Please briefly describe your occupation: ______ No, I am not currently employed.
17. Please check your household income category (before taxes) for this past year: Less than $5000 $75 000 - $99 999 $5000 - $19 999 $100 000 - $149 999 $20 000 - $34 999 $150 000 - $199 999 $35 000 - $49 999 $200 000 and higher $50 000 - $74 999
18. What is your marital status? Married or common law. How many years? ______ Divorced or separated Widowed Single
Part III: Father Information
If applicable, please answer the following questions about your partner: 19. What is your partner’s relationship to ______? Biological father
Step-father
Adoptive father
Other, please explain: ______
20. How old is your partner? ______(years)
21. How would you describe your partner’s ethnicity? ______
22. On a scale of 1 to 10, where 1 is not at all, and 10 is completely, how much does your partner identify themselves as Canadian? (circle one) 1 ------2 ------3 ------4 ------5 ------6 ------7 ------8 ------9 ------10 Not at all Completely
23. What is your partner’s level of education? Less than grade 7
96 Junior high school Partial high school (grade 10 or 11) High school graduate Partial college/university (min. 1 year) or special training Standard college or university graduate (i.e.: B.A., B.Ed.) Graduate or professional training (i.e.: M.A., PhD)
24. Is your partner currently employed? Yes. Please briefly describe your partner’s occupation: ______ No, they are not currently employed.
For questions 25-27, please do not count the time your child is asleep or at school.
25. Thinking of the past month, on average, how many hours per week does your partner work outside the home? (If applicable) ______hours/week
26. Thinking of the past month, on days when your partner is working outside the home, how much time do they spend taking care and doing things with your child? (If applicable)
______hours/day
27. Thinking of the past month, on days when your partner does not work outside the home, how much time do they spend taking care and doing things with your child? (If applicable)
______hours/day
97 Appendix C: ADHD Rating Scale-IV
Developed by DuPaul et al., 1998 Circle the number that best describes your child’s home behaviour over the past 6 months. If your child is taking medication to treat ADHD, please rate his/her behaviour as it would be OFF of the medication.
Never Some- Often Very or times Often rarely 1. Fails to give close attention to details or makes careless 0 1 2 3 mistakes in schoolwork or other activities. 2. Fidgets with hands or feet or squirms in seat. 0 1 2 3 3. Has difficulty sustaining attention in tasks or play 0 1 2 3 activities. 4. Leaves seat in classroom or in other situations in which 0 1 2 3 remaining seated is expected. 5. Does not seem to listen when spoken to directly. 0 1 2 3 6. Runs about or climbs excessively in situations in which 0 1 2 3 it is inappropriate. 7. Does not follow through on instructions and fails to 0 1 2 3 finish work. 8. Has difficulty playing or engaging in leisure activities 0 1 2 3 quietly. 9. Has difficulty organizing tasks and activities. 0 1 2 3 10. Is “on the go” or acts as if “driven by a motor.” 0 1 2 3 11. Avoids tasks (e.g., schoolwork, homework) that 0 1 2 3 require sustained mental effort. 12. Talks excessively. 0 1 2 3 13. Loses things necessary for tasks or activities. 0 1 2 3 14. Blurts out answers before questions have been 0 1 2 3 completed. 15. Is easily distracted. 0 1 2 3 16. Has difficulty awaiting turn. 0 1 2 3 17. Is forgetful in daily activities. 0 1 2 3 18. Interrupts or intrudes on others. 0 1 2 3
How much do your child’s problems with inattention, 0 1 2 3 hyperactivity, and/or impulsivity impair or interfere with his ability function at home or at school.
98 Appendix D: Oppositional Defiant Disorder Rating Scale
Developed by Hommersen et al., 2006
Please use the following scale to rate your child’s behaviour over the last 6 months.
0= Not at All 1= Just a Little 2= Pretty Much 3= Very Much
Not Just a Pretty Very at all little much Much
1. Often loses temper 0 1 2 3 2. Often argues with adults 0 1 2 3 3. Often actively defies or refuses to comply with adults’ requests or rules 0 1 2 3 4. Often deliberately annoys people 0 1 2 3 5. Often blames others for his or her mistakes or 0 1 2 3 misbehaviour
6. Often touchy or easily annoyed by others 0 1 2 3 7. Often angry and resentful 0 1 2 3 8. Is spiteful or vindictive 0 1 2 3
99 Appendix E: Child Attribution Measure and coding manual
Adapted from MacKinnon-Lewis et al., 1992
The child is presented with five hypothetical stories that depict the child and his/her mother interacting around a potentially conflictual situation. In all of the stories the outcome for the child is negative but the intent of the mother is ambiguous. The child is asked why his/her mother acted the way she did in each story (i.e., child attributions).
The child's attribution is coded as a (0) for a non-negative response or a (1) for a negative response. Examples of non-negative and negative responses for questions are given below.
NOTE: If a negative response is given followed by a non-negative response (or vice versa), always code the first response and ignore the last.
Example: MOM #3 response - “It was an accident or maybe she did not want me to win” Score “It was an accident” as (0) for non-negative and do not consider the second portion of the response in giving your score (i.e., ignore “or maybe she did not want me to win”)
MOM #1 You and your mom are shopping at a grocery store and that you reach for a snack that you want to look at. Your mother tells you that you cannot have it.
Why do you think your mother told you that you could not have the snack?
0 = NON-NEGATIVE Because it wasn't good for me Because she didn't have enough money Because she only had enough money for what we needed Probably thinks it costs too much She thinks you don't need it and you can get it later It might spoil my appetite I could be on a diet and couldn't have it Just didn't want me to have it Because it was too expensive Because it had too much fat Because I already had a snack or I had already gotten a snack that I wanted Because she is trying to stay on a budget She was in a hurry It wasn't healthy We already had it at home
100 Because we were having something special for dinner that night Because I don't need to eat junk food Because it was bad for my teeth Because I didn't like the taste of it Because it might be too sweet Because I didn't need it Because she is trying to not make me spoiled and think I can have everything I want
1 = NEGATIVE
Because she is mean Because she didn't want to have to pay for it and wanted to use the money for herself
MOM #2 You are working on your school work. You have a problem that you can’t figure out. You ask your mother if she will help you. She says “I can’t.”
Why do you think your mother can't help you with your homework?
0 = NON-NEGATIVE Because she has to do so many things for us She might be busy with my sister/brother She is busy cooking dinner for us Because if she told me the answer it would be cheating She wants me to learn it myself She wants me to do it on my own so I learn something new She is busy doing something for me/or my family
1 = NEGATIVE She is too busy doing something for herself She doesn't know how to do it She was busy She has to do her own homework
MOM #3 You and your mother are playing a board game. You are almost to the finish line and you are winning. Your mother knocks the pieces off the board onto the floor.
Why did your mother knock the pieces to the floor?
0 = NON-NEGATIVE It was an accident We were horsing around and knocked it over
101 She was going to help brother/sister She was teaching me not to brag
1 = NEGATIVE She is mad because she is losing She is a poor sport Because she didn't want me to win She is jealous that I am winning She is jealous of me She wanted to mess me up
MOM #4 It is your birthday. There is something that you have been wanting for a long time. All of your friends already have it. Your mother told you to wait until your birthday to get it. The day before your birthday she says "You are not going to get the thing you wanted."
Why do you think your mother said that you were not going to get what you wanted?
0 = NON-NEGATIVE She couldn't find it anywhere Because she didn't have enough money Maybe she felt it was dangerous or not a good thing for me to have She wanted to surprise me
1 = NEGATIVE She was being mean Because I did something bad (broke rule, did bad school work) Because I got too many other presents Because I was going to get other toys Because she thinks I don’t really need it Because I beg too much
MOM #5 It is a special event at school. Moms are invited and there is going to be refreshments. When you left for school in the morning you thought your mom would be coming for the special event. She didn’t come.
Why do you think your mother didn't show up at school?
0 = NON-NEGATIVE She couldn't find a babysitter Because she had to take care of my brother She got stuck in traffic
102 She might have been sick She had to earn many so that she could buy me and our family things She was busy at work
1 = NEGATIVE She forgot She had to do something else that was more important Because she never remembers to come to things at my school Because she always forgets about me Because she was stupid enough not to know where my school was and couldn't find it
103 Appendix F: Modified Social Skills subscales of the Social Skills Improvement
System - Rating Scale
Adapted from Gresham & Elliot, 2008 Subscale Description Examples Communication Taking turns and making eye Your child says “please” contact during a You say “please” conversation, using appropriate tone of voice and gestures, and being polite by saying “thank-you” and “please”
Cooperation Helping others, sharing Your child pays attention to your instructions materials, and complying You pay attention to your mom’s instructions with rules and directions
Assertion Initiating behaviours, such as Your child asks for your help asking others for information, You ask for your mom’s help introducing oneself, and responding to the actions of others
Responsibility Showing regard for property Your child does what he/she promised or work You do what you promised
Empathy Showing concern and respect Your child tries to understand how you feel for others’ feelings and You try to understand how your mom feels viewpoints
Engagement Joining activities in progress Your child invites you to join activities and inviting others to join, You invite your mom to join activities initiating conversations, and interacting well with others
Self-Control Responding appropriately in Your child stays calm when you point out conflict (e.g., disagreeing his/her mistakes with parent) and nonconflict You stay calm when your mom points out situations (taking turns and your mistakes compromising)
104 Appendix G: MESSY Aggressive/Antisocial Behaviour
Adapted from Matson et al., 1983 and Teodoro et al., 2005
Scale Description Examples Aggressive/ Items assess instances of My child gets into fights a lot/I get into Antisocial inappropriate social behaviour fights a lot Behaviour My child makes fun of others/I make fun of others
105 Appendix H: Instructions for mothers during parent-child interaction
WALKIE-TALKIE SET UP:
For the next task you will play with your child in this room.
You will be wearing this ear phone and walkie talkie so that I can give you instructions from outside the room.
Here is a fanny pack, it is to hold the walkie talkie.
Please try it on and we will make sure you can hear me okay. You can adjust the volume by twisting this knob on the radio.
I am going to leave the room and go into the hallway to test the walkie talkie. When I come back let me know if you heard me well enough.
Now that we have finished that section I am going to buzz [Child RA name] to let them know to come back. While they are making their way here I will be setting up the room for the next task.
1. Child-Led Play
Move table to the back of the room (see setup booklet)
To Child: You and your mom are going to play in this room now.
Your mom is wearing a special ear phone so that we can talk to her outside of the room.
We will be watching you and your mom play from behind this one-way mirror. (leave room)
I’ll let you know when you can start.
Over the walkie talkie:
In this situation, tell [Child’s name] that he/she may play with whatever he/she chooses. Let him/her choose any activity he/she wishes. You just follow his/ her lead and play along with him/her.
After five minute warm up period, tell Mom:
You’re doing a nice job of allowing [Child’s name] to lead the play. Please continue to let him/her lead.
Mom RA and Child RA enter room at end of the child-directed play. Mom RA takes Mom into hallway to explain the tasks involved with mother-directed play. Child RA plays tic-tac-toe with Child in the Small Lab. Take Mom down the hall away from the door to the Small Lab, speak to Mom is lower voice to
106 prevent Child from hearing exactly what you are saying to Mom. Unlock the door to the Small Lab to make your return to the Small Lab from the hallway easier.
2. Mother-Led Play
Move table back to centre of room with the help of ChildRA (see duct tape)
We are going to do something a little different now. [Child RA name] will stay here with [Child’s name] and I will give you instructions about the next task in the hallway. Please follow me.
To Mom in the hallway:
Now we’ll switch to another situation.
You will instruct your child through a series of tasks.
There are eight tasks, which will take 10 minutes total to complete.
I will give you specific instructions over the walkie talkie, and after each task tell by radio that the task is over, and that I am going to provide you instructions for the next task.
I just want you to be familiar with the equipment you will use for each task first.
Now I will briefly describe each task and show you where you can find it in here.
Some of the tasks will make a mess. Your child will be given a clean-up time at the very end, so please do not clean up after each task. It is better if the room is messier.
------
In the first task you will have your child re-lace this pair of shoes.
In the second task, your child will complete a sentence worksheet. Here is the sentence worksheet and pens.
In the third task, your child will sort animals and cars in to separate containers.
In the fourth task, your child will complete a series of math problems, tell (child) that they only have one minute to complete the worksheet.
In the fifth task, you will instruct your child to sort a basket of laundry. Dump out all the laundry onto the coach.
In the sixth task, your child will sort these two colored dots.
In the seventh task, you will complete this questionnaire and ask your child not to bother you.
107 In the final task, you will use Mr. Bucket. Mr. Bucket spits out balls. Instruct your child to stand up and to pick up the balls that Mr. Bucket spits out and return them to the bucket using this shovel. The switch is on the back.
Keep him/her playing with you according to the rules.
If your child goes off task, try to get him/her re-engaged with the task.
Knock on Small Lab door before returning to the Small Lab with Mom. Put mother-directed play bin in the Small Lab. Child RA and Mom RA leave the Small Lab. Give Mom the first set of instructions and begin recording. Have camera set up so the entire Small Lab is captured on the screen. TIMING: The minute you time mom does not include the time it takes you to give mom instructions. The minute timed includes mom giving directions to child and child attempting task.
1) Child re-laces shoe laces
In the bin is a pair of shoes. These shoes are half laced up. Instruct your child to lace up these shoes.
After approximately 1 minute Well done (unless it’s not), I am going to get you and your child to do something new now.
2) Child completes sentence task
On the clipboard there is a sentence worksheet. Please instruct your child to complete the sentence worksheet without making any mistakes. Correct your child if he/she makes any mistakes.
After approximately 1 minute Good job, let’s move onto the next task.
3) Sorting animals and cars, putting cars into container first
There is a bin labeled animals and cars. Dump this bin onto the table. Instruct your child to pick up only the animals and put them back into the animal bin.
After approximately 1 minute Well done, I am going to get you and your child to do something new now.
4) Child completes math problems
Take the math question sheet from the clipboard and tell (child) that they have only one minute to complete the whole worksheet.
After approximately 1 minute Good job, let’s move onto the next task.
5) Sorting and hanging up laundry
Dump the laundry onto the couch. Instruct your child to sort and fold the laundry back into the basket.
108 After approximately 1 minute We are going to move onto the next task now.
6) Sorting colored dots into separate colors
In the bin, there is a mixture of colored dots. Instruct your child to separate the two dot colors into two separate containers.
After approximately 1 minute Good job, let’s move onto the next task.
7) Mom completes questionnaire, child not to interrupt
On the clipboard, there is a questionnaire for you to complete. Instruct your child not to interrupt you while you complete this questionnaire.
After approximately 1 minute We are going to move onto the next task now.
8) Child picks up Mr. Bucket balls
In the next task you will use Mr. Bucket. Mr. Bucket is a toy that spits out balls. Take Mr. Bucket out of the bin and put him on the table. Instruct your child to pick up the balls that Mr. Bucket spits out and return them to the bucket. Your child may only use the shovel to pick up the balls. Turn Mr. Bucket on once you have explained the instructions to your child. Remember to make your child stand up away from the table.
3. Clean-Up (stop camera and play again to keep video segments separate)
Walkie Talkie:That was great. Now I’d like you to tell [Child’s name] that the play session is over and the toys must be put away. Make sure you have him/her put the toys away by him/herself. Have him/her put all the toys in their proper containers and all the containers on the shelf including toys he/she did not play with at the beginning. Each shelf is labeled with the toys that are supposed to be stored there. Have [Child’s name] put the toys in their proper spot on the shelf.
After five minutes of clean-up the research assistant will enter the room and thank Mom and Child for their participation in the task.
Child RA takes Child back to Clinic Room. Child RA takes radio for communication.
Mom RA quickly cleans the Small Lab. Use the screen to cover the shelves.
109 Appendix I: Dyadic Parent-Child Interaction Coding System - Child categories
Developed by Eyberg et al., 2005
Verbalizations Description
Negative Talk Verbal expression of disapproval of the child or the child’s attributes, activities, products, or choices. Negative talk includes sassy, sarcastic, rude, or imprudent speech.
Prosocial Talk All statements that positively evaluate an attribute, product, or behaviour of the mother; describe the mother’s behaviour; provide neutral information; reflect the mother’s verbalizations; or acknowledge the mother.
Responses to Commands Description
Compliance When the child performs, begins to perform, or attempts to perform a behaviour requested by the mother within a 5- second interval following the command.
Noncompliance When the child does not perform, attempts to perform, or stops attempting to perform a requested behaviour by the mother within a 5-second interval following the command.
No Opportunity for Compliance When the child is not given an adequate chance to comply with the command.
110 Appendix J: Dyadic Parent-Child Interaction Coding System - Parent categories
Developed by Eyberg et al., 2005
Verbalizations Description
Command Declarative statements that contain an order or direction for a vocal or motor behaviour to be performed and indicate that the child is to perform this behaviour. OR A suggestion for a vocal or motor behaviour to be performed that is implied or stated in question form. Negative Talk Verbal expression of disapproval of the child or the child’s attributes, activities, products, or choices. Also includes sassy, sarcastic, rude, or impudent speech.
111 Appendix K: Dyadic Parent-Child Interaction Coding System - Composite variables
Developed by Eyberg et al., 2005
Child Categories Equation
Noncompliance Ratio Noncompliance ÷ [(Command) - No Opportunity for Compliance]
Negative Talk Ratio Negative Talk/[Negative Talk + Prosocial Talk]
Social Functioning [Noncompliance Ratio + Negative Talk Ratio]/2 Difficulties
112 Appendix L: Brief Symptom Inventory - Anxiety, Depression, and Hostility
Developed by Derogatis & Melisaratos, 1983
Subscale Description Examples Anxiety Items reflect nervousness, Nervousness or shakiness inside tension, panic attacks, and terror Feeling tense or keyed up
Depression Describes symptoms of clinical Feeling hopeless about the future depression, including dysphoric Feeling no interest in things mood and withdrawal
Hostility Items describe feelings, thoughts, Feeling easily annoyed or irritated or actions related to negative Getting into frequent arguments affect state of anger
113 Appendix M: Children’s Depression Inventory Short Form
Developed by Kovacs, 1992
Scale Description Examples Depression Items assess symptoms of I feel like crying depression, including negative mood, ineffectiveness, anhedonia, and negative self esteem.
114 Appendix N: Multidimensional Anxiety Scale for Children
Developed by March et al., 1997
Scale Description Examples Anxiety Items assess symptoms of anxiety I check to make sure things are safe including physical symptoms, I try to stay near my mom or dad harm avoidance, separation/panic, and social anxiety)
115 Appendix O: Telephone script
INTRODUCTION
If research assistant answers mother’s call directly.
Thank-you for contacting Dr. Johnston’s lab and taking an interest in our study. My name is ______and I will give you some more information about the study. Is now a good time to talk?
We are investigating parents’ and children’s thoughts about their own and each other’s behaviours. Specifically we are interested in how these thoughts are related and how these thoughts are associated with behaviour in the family.
GO TO PAGE TWO ------If research assistant is returning mother’s call.
Hello, my name is ______and I work at Dr. Johnston’s lab. You contacted us regarding the family thoughts and behaviour study and I am calling to provide you with some more information about this study. Is now a good time to talk?
We are investigating parents’ and children’s thoughts about their own and each other’s behaviours. Specifically we are interested in how these thoughts are related and how these thoughts are associated with behaviour in the family.
GO TO PAGE TWO ------If calling mother from volunteer participant registry.
Hello, my name is ______and I work at Dr. Johnston’s lab at UBC. You have previously agreed to be contacted about future studies happening in our lab. I am calling to provide you with some information about a new study and to see if you are interested in participating. Is now a good time to talk?
The new study investigates parents’ and children’s thoughts about their own and each other’s behaviours. Specifically we are interested in how these thoughts are related and how these thoughts are associated with behaviour in the family.
GO TO PAGE TWO ------
116 Continue with script for direct and returning calls.
If you choose to participate in this study I will conduct a 15 minute telephone interview with you mainly about (your child’s) behaviour. The second part of the study involves you and (your child) visiting Dr. Johnston’s lab at UBC. The lab visit will take about two-and-a-half hours. It will consist of you and (your child) completing questionnaires and interviews, and participating in observed discussions and play with (your child.)
If you decide to participate in the study, at the end of this phone call we will arrange a convenient time to complete the lab visit portion of the study. Your participation is completely voluntary and you are free to withdraw at any time. If you decide to participate, all identifying information on the interview and questionnaires will be kept strictly confidential. Should you chose to participate we will give you $35 for your help, we also have a UBC lab t-shirt we will give to (your child).
Do you have any questions regarding the study that I may clarify? Would you like to participate in this study?
If NO Go to exclusionary script.
If YES Great! Would you like to proceed with the telephone interview now, it will take about another 10 minutes, or would you rather arrange a more convenient time?
At time of telephone interview (whether now or rescheduled):
Let me start off by getting some contact info. What is your name? What is your phone number? (If applicable) Best time to call this number? What is the best email address to reach you at? How did you hear about the study?(if the family called lab) What is your child’s name? What is your child’s gender? How old is your child? Go to exclusionary script if not between 9 and 12 years. Birthdate?
Proceed with Eligibility Questions.
ELIGIBILITY QUESTIONS
When is your child’s birthdate? Use to make sure child will be within age range on lab visit
117 Have you lived with your child during the past year? If NO go to exclusionary script.
Are you the child’s legal guardian? If NO go to exclusionary script.
Has your child ever been diagnosed with autism, a developmental disorder, or a tic disorder? If YES go to exclusionary script.
Has your child ever been diagnosed with Attention-Deficit/Hyperactivity Disorder? If YES Who was this diagnosed by? Age of diagnosis? Is your child on medications for ADHD? What kind of medication? Is this short or long acting? How often is this medication usually administered? When? Is your child usually ON or OFF medication when interacting with you?
Can your child speak and understand English? If NO go to exclusionary script. Determine mother’s ability to speak and understand English from phone conversation If difficult to communicate with her go to exclusionary script.
Do you have any questions? If NO, proceed to Child ADHD Symptoms If YES, answer questions and proceed to Child ADHD Symptoms
CHILD ADHD SYMPTOMS
It looks like we can move on to the next part of this phone interview. Now I will ask you some questions about ___(child’s name)____.
Some children have higher levels of inattention, impulsivity, and hyperactivity than other children. Now I am going to ask you some questions about [Child’s Name]’s levels of inattention, impulsivity, and hyperactivity. I will ask you to rate each item thinking about [Child’s Name]’s behaviour in the past 6 months.
If child is on medication of ADHD If your child is taking medication for ADHD please rate his/her behaviour when he/she is off medication.
Do you have a pen and paper to write down the answer choices? That might be easier than remembering the numbers. You will be asked to rate each item using a four point scale, 0 = never or rarely, 1 = sometimes, 2 = often, 3 = very often. Do you have any questions?
118 Let’s get started. Remember to think of [Child’s Name] over the last 6 months.
Administer ADHD-IV Rating Scale. Three quarters of the way through encourage Mom. Thanks for answering these questions were are almost finished this questionnaire.
Thank you for completing that questionnaire, I have a few more questions I would like to ask you about your child.
CHILD CONDUCT PROBLEMS
Okay, now I am going to ask you some questions about your child, [Child’s Name], and aggressive behaviours some children demonstrate. I will ask you to rate each item thinking about [Child’s Name]’s behaviour in the past 6 months. As with the last questionnaire I will be giving you a rating scale and asking you to rate various statements about your child on a scale. You may want to write this scale down too to make it easier to remember the numbers. You will be asked to rate each item using a four point scale, 0 = not at all, 1 = just a little, 2 = pretty much, 3 = very much. Do you have any questions?
If YES, answer questions. If NO, proceed. Let’s get started. Remember to think of [Child’s Name] over the last 6 months. Administer ODDRS.
Thank you for answering those questions.
LAB VISIT
The second last thing we need to do is schedule a lab visit. Remember the lab visit should take about two-and-a-half hours to complete. Ideally this will be at a time when you and your child can come in alone, however if you have other children we can organize for a research assistant to look after at the lab during your visit. Do you have any questions?
If YES, answer questions. If NO, proceed.
Schedule the lab visit Which would be a more convenient time for you and your child to come to our lab - weekdays, evenings, or weekends?
Check google calendar for availability of research assistants.
119 We have time available from [time] to [time] on [day] or from [time] to [time] on [day]. Would either of these times work for you?
If child is taking medication for ADHD We would like your child to be in the medication state he/she normally is when interacting with you. For example, if your child takes short-acting medication during school hours, but not in the evening or on weekends when your child sees you, your child should be off medication for the visit. We can schedule your lab visit for a time when your child would normally be in this state, including evenings and weekends. Please do not take your child off his/her medications unless you know it is medically safe to do so. CHILDCARE If necessary, we can provide child care for other children during your lab visit, but we must know ahead of time to make these arrangements. Will you require child care for other children during your lab visit?
If YES, note on contact sheet need for child care and schedule time when three RAs are available. What is the name, age, and gender of this child? Proceed to next question.
Before I let you go I will let you know how to find us. [Give directions to lab]
ABOUT FATHERS Note: fathers were recruited for the larger study
Finally, we are also interested in having fathers participate in this study. If your child’s father would be interested in participating, he can contact us and I will describe what is involved in the study. Basically, when you come to the lab, if your child’s father would be interested in participating we would provide you with questionnaires for him to complete at home. These questionnaires are identical to the questionnaires you will complete in the lab. Fathers will receive $25 for completing the questionnaires.
Does a second parent live with (your child)?
If NO Thank-you for your participation, we look forward to seeing you and (your child) on [date and time].
If YES What is their relationship with the child?
If biological father go to Father Interest Questions
120 If other type of relationship:
How long has he been living with you?
A) If more than 3 years, father is eligible. If less than 3 years B) Unfortunately he does not meet criteria for the study.
However we look forward to seeing you and [Child’s Name] on [date and time].
Does your child consider him to be his/her parent?
A) If YES continue to Father Interest Questions
B) If NO Unfortunately he does not meet criteria for the study.
However we look forward to seeing you and [Child’s Name] on [date and time].
FATHER INTEREST QUESTIONS
May I speak with him about this study? If YES go to father script. Ask for his name. If NO If he is interested in the study he can also call or email the lab
We can also try to call him or e-mail him when he is available. Do you know what number and email we should use to contact him, and what hours would work best for him?
Thank-you for your participation, we look forward to seeing you and (your child) on [date and time].
FATHER SCRIPT
Hello, my name is ______and I work at Dr. Johnston’s lab. I have spoken with [Mom’s name] about a study we are conducting at the lab. I would like to provide you with some information about a new study and to see if you are interested in participating. Is now a good time to talk?
The new study investigates parents’ and children’s thoughts about their own and each other’s behaviours. Specifically, we are interested in how these thoughts are related and how these thoughts are associated with behaviour in the family.
121 The questionnaires you would complete ask for some descriptive information about yourself and (your child), about difficulties you or (your child) may have with feelings or behaviours such as sadness or aggression, questions about how you get along with (your child), questions about how both you and (your child) gets along with others, and questions about how you and (your child) interpret the actions of others.
To thank-you for your participation we will give you a $25 cheque, which will be mailed to you upon receipt of your questionnaires.
Do you have any questions regarding the study that I may clarify? Would you like to participate in this study?
If NO go to exclusionary script If YES Great! We will give the questionnaires to [Mom’s name] when she visits our lab on [date of visit]. We will provide you with a self-addressed stamped envelope to return the questionnaires to us. In order to mail you the cheque we will need your address. Please write down your address on the envelop, as well as on the application form that will be in the package.
Thank-you for your interest in our research.
Goodbye.
EXCLUSIONARY SCRIPT
If mother/father indicated s/he did not want to participate in the study: Thank-you for your interest and time. Goodbye.
If mother/child did not meet study criteria: Thank-you for your interest in this study. Unfortunately, your family does not match with the criteria we are looking for. If you are interested in participating or learning more about future research at the UBC Parenting Lab we can add you to our participant registry. Is this something you would be interested in?
FREQUENTLY ASKED QUESTIONS
What do the questionnaires/interviews ask?
The questionnaires and interviews you and (your child) would complete ask for some descriptive information about yourself and (your child), about difficulties you or (your child) may have with feelings or behaviours such as sadness or aggression, questions about how you get along with
122 (your child), questions about how both you and (your child) get along with others, and questions about how you and (your child) interpret the actions of others.
What does the play session involve?
The play session for you and (your child) will include time when (your child) will be in charge of the play session, time when you will be in charge of the session and will direct (your child) through a series of tasks.
What does the discussion session involve?
Finally, the discussion between you and (your child) will last 10 minutes. You and your child will discuss two hypothetical scenarios in which something bad happens (e.g., your child keeps watching TV when you tell him to turn it off) and you are to decide why the event happens. Both the interaction session and the discussion will be video-recorded from behind a one-way mirror.
Will I get to find out the results of the study?
If you are interested in the outcome of this study, you can also request a summary of the group results, which will be sent once the study is complete.
123 Appendix P: Consent form for mothers
THE UNIVERSITY OF BRITISH COLUMBIA
Mother Consent Form Children's attributions: Relations to parents' attributions Principal Investigator: Dr. Charlotte Johnston, Ph.D. Co-Investigator: Ms. Natalie Miller, B.Sc. Department of Psychology
This study is funded by the Social Sciences and Humanities Research Council of Canada.
This consent form is only part of the process of informed consent. It should give you the basic idea of what the research is about and what your participation will involve. If you would like more detail about something mentioned here, or information not included here, please ask. Take the time to read this carefully.
Purpose:
This study looks at the relations between children’s thoughts about their own and others’ behaviours (e.g., their parents or their peers) and parents’ thoughts about their own behaviours and others’ behaviours (e.g., their children, their adult peers). We also are interested in how these thoughts of both parents and children are related to how children and parents get along together. The first objective of the study is to examine relations between boys and girls thoughts about themselves and other people with similar thought patterns in their mothers and/or fathers to see to what extent parents and children show the same or diferent ways of thinking, and whether this varies depending on the sex of the parent and/or child.
In order to assess a range of children’s thoughts about their own and others’ behaviours, this study will recruit children with varying levels of attentional and conduct problems. Children with these problems tend to have diferent thoughts about their own and others’ behaviours compared to children without
124 these problems. One objective of the study is to compare the thoughts and behaviours of children with high levels of attentional and conduct problems to children with low levels of attentional and conduct problems.
Study Procedures:
Your participation will involve visiting the Dr. Johnston’s lab with your child. During this visit, you and your child will complete questionnaires and an audio- taped interview, participate in a video-recorded interaction session, and in a video-recorded discussion.
The questionnaires will take approximately 1.5 hours to complete and include the following: • a questionnaire asking for general information about your family (e.g., your child’s age, your occupation, education, income, and ethnicity) • questionnaires about how both you and your child get along with other people • a questionnaire about difculties your child may have with nervousness, sadness, aggression, inattention, impulsivity, or hyperactivity • questionnaires about your own experience with anxiety, depression, and hostility • questionnaires about how you get along with your child • a questionnaire about the reasons that negative events sometimes happen in people’s lives •a questionnaire about negative events that have recently happened to your family • a questionnaire about your interpretation of the reasons for the actions of others (i.e., peers, your child, your child’s peers) in negative situations (e.g., someone spills milk on you in a restaurant)
The audio-taped interview also will include questions about your interpretation about the actions of others (i.e., peers, your child, and your child’s peers) in negative situations. It will take about 10 minutes to complete and your responses will later be coded by research assistants in Dr. Johnston’s lab.
The questionnaires your child will complete take about 1.5 hours and include: • questionnaires about how he/she gets along with his family and his friends •questionnaires about feelings and behaviours such as nervousness, sadness, aggression, or anger • questionnaires about his/her interpretation of the actions of others (e.g., family members, peers) in negative situations (e.g., not being invited to another child’s birthday party)
125 Your child also will complete an audio-taped interview, which will include questions about his/her interpretation of the actions of others (e.g., family members, peers) in negative situations. It will take about 15 minutes to complete and his responses will later be coded by research assistants in Dr. Johnston’s lab.
The interaction session for you and your child will take 25 minutes; 10 minutes of play, 10 minutes of tasks, and 5 minutes of clean-up. For the 10 minutes of play, your child will be in charge of choosing the activities or toys with which you both play. For the 10 minutes of tasks, you will lead the interaction. You will be provided with a list of tasks to instruct your child to complete during this time. For example, getting your child to write out a sentence or sort toys into diferent boxes. The final 5 minutes will involve having your child clean up the room. The entire session will be video recorded behind a one way mirror. The recording will later be coded by research assistants in Dr. Johnston’s lab.
The discussion portion of the lab visit will take 10 minutes during which you and your child will discuss two hypothetical scenarios. In one scenario a negative event happens to your child (e.g., your child’s best friend doesn’t speak to him/her one day). In the other scenario your child causes a negative event (e.g., your child breaks a vase at home). The discussion will be video recorded and coded later by research assistants.
Potential Risks:
Both your and your child’s responses to questionnaire items are voluntary and you may skip questions you do not feel comfortable answering. Some of the questionnaires ask about personal information such as feelings of distress or negative life events. Some parents and children may become upset when thinking about such items. If you or your child are upset and do not wish to continue or to complete certain items, please indicate this to the research assistants. At the completion of the study, you will be provided with a list of resources that may be helpful to you and/or your child should you be dealing with stressful or difcult circumstances.
Potential Benefits:
You will not receive any direct benefit from participating in the study, but your answers will help us understand how parents and children’s thoughts about each other are related, and how these thoughts may contribute to children’s social development.
126 Once this study is completed, we will report the aggregated results in our lab’s semi-annual newsletter. If you would like to learn about the results of this research we can send you a copy of the newsletter.
Confidentiality:
Your and your child’s identity will be kept strictly confidential. Your questionnaires, your child’s questionnaires, the audio-recordings of your interview responses, the interaction session video recording, and the discussion video recording will not have your names on them, and will be identified only by code number and kept in a locked file cabinet. Your contact information, including your name and address, will be kept in a separate locked filing cabinet in Dr. Johnston’s lab and this information will be destroyed after your participation in the study is complete. All of the information we gather from you and your child will be kept on a computer hard disk, will be identified only by code number and will be password protected so that only Natalie Miller, Dr. Johnston, and authorized research assistants will have access to it. Following the completion of the study, the data will be transferred to a CD and stored in a locked filing cabinet. The results of this study will be used to write a scientific report but individual participants will not be identified. Responses to questionnaires and recorded interactions will be destroyed seven years after the data has been published.
Should the researcher suspect or have information disclosed to them about possible child abuse or neglect, they are required by law to report that information to the proper authorities.
This research will be used for Ms. Miller’s Master’s thesis. Individual participants will not be identified in Ms. Miller’s thesis. The results will be aggregated across all of the participating families and these will be included in the thesis which is a public document.
Compensation
At the end of your visit we will give you $35 and your child a t-shirt for your participation in this research.
Contact for Information about the Study:
Please feel free to contact Dr. Johnston’s lab if you have any questions about the research.
127 Contact for Concerns about the Rights of Research Subjects:
If you have any concerns about your treatment or rights as a research subject, please contact the Research Subject Information Line in the Ofce of Research Services at the University of British Columbia.
Consent:
Your and your child’s participation in this study is entirely voluntary and you may refuse to participate or withdraw from the study at any time before publication of the study.
Signing this form indicates that you have read, understood, and consented to participate in the following research. Signing this form also indicates that you have received a copy of this consent form for your own records.
I do/do not consent (circle one) to allow my child to participate in the project.
Mother’s Name Mother’s Signature Date As Participant and Legal Guardian
Child’s Name
128 Appendix Q: Assent form for children
THE UNIVERSITY OF BRITISH COLUMBIA
Child Assent Form Children's attributions: Relations to parents' attributions Principal Investigator: Dr. Charlotte Johnston, Ph.D., R.Psych. Co-Investigator: Ms. Natalie Miller, B.Sc. Department of Psychology
We want to tell you about a research study we are doing. A research study is a way to learn more about something. We are studying how mothers and children get along together. We are also looking at what children think about how they get along with their mothers.
If you agree to join this study, you will be asked to do five things. First, you will listen to or read some stories about events that happen in children’s lives. You will be asked to answer some questions about these stories. Second, you will be given questions about feelings of sadness or nervousness that children sometimes have. Third, you will also answer some questions about how you usually act at home and with your friends. Fourth, you and your mom will play with some toys. We will videotape you and your mom playing with toys from behind a one-way mirror. Finally, you and your mom will have a talk about some bad things that sometimes happen to children. For example, sometimes children get in fights with their friends or break things at home. We will also videotape you and your mom having a talk from behind a one-way mirror. The entire visit to our lab will take 2.5 hours.
Some of the questions you’ll fill in ask about bad things like feeling angry, sad, or bad things that have happened to you. Some kids get upset when they think about these types of things. If you get upset and don’t want to keep going, just let the research assistant know.
129 If you have any questions, or want to take a break from the study, you can ask the research assistant.
I am willing to be in this study
Child’s Signature
Date
Investigator/Delegate’s Name
130