Research review: mechanisms of change and between‐family differences in parenting interventions for children with ADHD – an individual participant data meta‐analysis

Psyllou, C, Luman, M, van den Hoofdakker, BJ, Van der Oord, S, Aghebati, A, Boyer, B, Buitelaar, J, Chronis‐Tuscano, A, Daley, D ORCID: https://orcid.org/0000-0002-3597-0408, Dekkers, TJ, DuPaul, GJ, Fabiano, GA, Ferrin, M, Franke, N, Gershy Tsahor, N, Harvey, E, Hennig, T, Herbert, S, Hoekstra, PJ, Kern, L, Mautone, JA, Mikami, AY, Normand, S, Pfiffner, LJ, Shimabukuro, S, Schramm, SA, Schweitzer, JB, Sibley, MH, Sonuga‐Barke, E, Thompson, C, Thompson, MJ, Tripp, G, Webster‐Stratton, C, Xie, Y, Leijten, P and Groenman, AP, 2025. Research review: mechanisms of change and between‐family differences in parenting interventions for children with ADHD – an individual participant data meta‐analysis. Journal of Child Psychology and Psychiatry. ISSN 0021-9630

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Abstract

Background: Behavioural parenting interventions are evidence-based programmes for children with attention-deficit/hyperactivity disorder (ADHD). However, our understanding of the precise pathways leading to treatment effects remains limited. Understanding how such interventions work and for whom may help personalise interventions. Therefore, we examined whether intervention-related improvements in parenting are related to improvements in child behaviour and functional outcomes, and if these relations vary according to parents’ baseline levels of parenting.

Methods: We conducted moderated mediation analysis using individual participant data from 19 randomised controlled trials focusing on children with ADHD (n = 1,720). Immediate post-intervention measures of child ADHD and oppositional behaviour severity, reported by parents, and functional impairment reported by either the parent or probably masked clinicians, were treated as outcomes. We estimated pathways from intervention (versus control) to each child outcome, via immediate post-intervention parent reports of constructive parenting (e.g., praise), non-constructive parenting (e.g., physical punishment), and parent-child affection (e.g., warmth), while controlling for baseline values of both child outcomes and parenting levels. Baseline values of each parenting variable were used as moderators of the mediated pathways.

Results: Improvements in parenting behaviours and parent-child affection, immediately following the intervention were found to jointly explain improvements in children’s ADHD severity, oppositional behaviour, and functional impairment immediately following the intervention. Improvements in non-constructive parenting and parent-child affection uniquely accounted for intervention effects on functional impairment, especially for families with higher baseline levels of non-constructive parenting.

Conclusions: Our findings suggest that improvements in both the behavioural and affective aspects of parenting are associated with simultaneous reductions in child ADHD severity, oppositional behaviour, and functional impairment. Supporting families with poorer parenting skills is of particular importance, as reductions in non-constructive parenting in these families are linked to stronger treatment effects on child functional impairment.

Item Type:	Journal article
Publication Title:	Journal of Child Psychology and Psychiatry
Creators:	Psyllou, C., Luman, M., van den Hoofdakker, B.J., Van der Oord, S., Aghebati, A., Boyer, B., Buitelaar, J., Chronis‐Tuscano, A., Daley, D., Dekkers, T.J., DuPaul, G.J., Fabiano, G.A., Ferrin, M., Franke, N., Gershy Tsahor, N., Harvey, E., Hennig, T., Herbert, S., Hoekstra, P.J., Kern, L., Mautone, J.A., Mikami, A.Y., Normand, S., Pfiffner, L.J., Shimabukuro, S., Schramm, S.A., Schweitzer, J.B., Sibley, M.H., Sonuga‐Barke, E., Thompson, C., Thompson, M.J., Tripp, G., Webster‐Stratton, C., Xie, Y., Leijten, P. and Groenman, A.P.
Publisher:	Wiley
Date:	5 February 2025
ISSN:	0021-9630
Identifiers:	Number Type 10.1111/jcpp.14120 DOI 2390890 Other
Rights:	© 2025 The Author(s). Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Divisions:	Schools > School of Social Sciences
Record created by:	Laura Borcherds
Date Added:	03 Mar 2025 13:24
Last Modified:	24 Mar 2025 11:02
URI:	https://irep.ntu.ac.uk/id/eprint/53162

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