Skip to main content
Top
Gepubliceerd in: Child Psychiatry & Human Development 5/2021

Open Access 19-09-2020 | Original Article

Prenatal and Postnatal Predictive Factors for Children’s Inattentive and Hyperactive Symptoms at 5 Years of Age: The Role of Early Family-related Factors

Auteurs: Hanna Huhdanpää, Isabel Morales-Muñoz, Eeva T. Aronen, Pirjo Pölkki, Outi Saarenpää-Heikkilä, Anneli Kylliäinen, E. Juulia Paavonen

Gepubliceerd in: Child Psychiatry & Human Development | Uitgave 5/2021

share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail
insite
ZOEKEN

Abstract

We examined several parent-reported prenatal and postnatal factors as potential risk factors for attention-deficit and hyperactivity disorder (ADHD) symptomatology in 5-year-old children. Our study is based on the CHILD-SLEEP birth cohort. Several parental questionnaires were collected prenatally (32nd pregnancy week) and postnatally (i.e. child aged 3, 8, and 24 months and at 5 years). At 5 years of age, ADHD symptoms were assessed using questionnaires. Our main results showed that being a boy, parental depressive symptoms, more negative family atmosphere or a child’s shorter sleep duration, and maternal authoritarian parenting style predicted inattentive/hyperactive symptoms. Maternal and paternal authoritative parenting style predicted less inattentive/hyperactive symptoms. Children with several risk factors together had the highest risk for inattentive/hyperactive symptoms. Our findings emphasise the need for early screening and treatment of parental mental health, and early evidence-based targeted parental support, to enable early intervention in those children at a risk of developing ADHD.
Opmerkingen

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Introduction

Attention-deficit and hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder in childhood and is reported to affect approximately 5% of the population, with male predominance [1]. The core psychopathologies of ADHD are attention difficulties, impulsivity, and hyperactivity [2]. Although it is well documented that ADHD is a highly heritable disorder [3, 4], it has been estimated that 10–40% of the variance associated with ADHD is accounted for by other than genetic factors [5]. More specifically, the development of ADHD is multifactorial, including a contribution of both genetic [3] and several prenatal, perinatal, and postnatal risk factors [412]. Taking into account that ADHD emerges early in life and is related to a wide variety of negative physical, psychosocial, and academic outcomes [13], identifying early causal risk factors for ADHD is of crucial relevance, as this would enable early intervention in children at risk of developing ADHD [14].
Several prenatal and postnatal maternal factors have been associated with children’s elevated risk of later diagnosis of ADHD, such as a family history of ADHD [3, 9, 15], lower maternal education [15, 16], single parenthood [12, 16], maternal younger age [7, 12], mother’s prenatal and/or postnatal depression [8, 12, 17, 18], unhealthy maternal behaviours during pregnancy, including smoking [5, 6, 12, 17, 19] or alcohol use [5, 20], and premature birth/low birth weight or delivery complications [6, 7, 9, 12]. Postnatal factors such as early exposure to severe adverse life events [19, 21], harsh-intrusive/hostile parenting style [9, 22, 23], and exposure to certain chemicals (such as lead, phthalates, and organophosphate pesticides) [19] have been also related to difficulties in symptoms of inattention and/or hyperactivity later in childhood. Finally, according to a previous meta-analysis, children’s sleeping difficulties, and especially shorter sleep duration, is associated with symptoms of inattention/hyperactivity [24], both in cross-sectional [25] and longitudinal studies [10, 26]. Shorter sleep duration during infancy has been linked to later ADHD-related symptoms [10, 26]. Most of the previous studies of early risk factors and ADHD have, however, typically focused on isolated risk factors, only considering a limited amount of the aforementioned potential risk factors. Previous reviews suggest a need for new studies that include a wider range of potential risk factors acting together during pregnancy, infancy, and early childhood, and provide a more comprehensive picture of the risk factors related to ADHD [4, 11].
The disruptive nature of a child’s ADHD symptoms can influence several aspects of family functioning. It has been well-documented that the presence of ADHD in children is associated with varying degrees of disturbances in marital functioning, more conflicted family environment, poorer parent–child relationships, more parenting stress, and increased parental psychopathology [27, 28]. Cross-sectional studies and a meta-analysis have demonstrated that parents of children with ADHD exhibit higher levels of depression, anxiety, and parenting stress compared to healthy children [2830]. Furthermore, the presence of parental psychopathology may negatively influence the parents’ ability to supportively respond to their child’s ADHD symptoms [30]. Moreover, parents of children with ADHD report more inconsistent and hostile parenting behaviours, and less parental warmth and sensitive behaviour toward their children compared to typically developing children [29, 3133]. Poorer parenting skills in these families may contribute to the development of additional behavioural problems that worsen ADHD outcomes [30, 31]. Most of the previous studies of parenting and ADHD are, however, cross-sectional in nature and focus on children who already have a diagnosis.
Surprisingly, little longitudinal research has been done on the family-related factors of early life, such as parental mental health, family atmosphere, and/or parenting behaviours, and their contribution to the developmental course of ADHD symptoms [34]. It has been suggested that a child’s ADHD symptoms negatively affect the mother–child relationship and increase the use of negative parenting strategies (e.g. mother–child hostility), rather than negative parenting having a causal role in ADHD [35, 36]. For instance, a large Canadian population-based birth cohort study (N = 2057 children) noted that parent-reported family dysfunction or poorer parenting strategies at the age of 5 months did not predict higher levels of inattentive/hyperactive symptoms in school-age children [12]. Furthermore, a longitudinal twin study with school-aged children and adolescents showed that associations between parent–child-hostility and ADHD symptoms appeared to largely be accounted for by genetic factors [35]. For instance, while boys’ ADHD symptoms had an impact on mother–child-hostility, there were no effects in the opposite direction.
Nevertheless, previous research on early parenting and later symptoms of inattention/hyperactivity have also reported contradictory findings [9, 22, 23, 3740]. These studies suggest that poorer parenting in early childhood may serve as a risk factor that moderates and exacerbates a child’s predisposition to present symptoms of inattention and hyperactivity. For instance, early intrusive (controlling/parent-agenda driven behaviours) and/or negative (hostile verbal and physical punishment) parenting when the child is 6-months-old has been associated with inattentive/hyperactive symptoms at preschool [9, 23] and school age [9, 22]. Furthermore, maternal sensitive parenting during infancy and early preschool age has been associated with the development of inhibitory [38] and attentional [40] control at preschool age and fewer ADHD or oppositional defiant disorder (ODD) symptoms at school age [37]. One longitudinal study has also found an indirect pathway in which parenting hostility mediated the relationship between maternal postnatal mental health problems and children’s ADHD symptoms at school age [39]. Most of the previous studies on the association between early parenting and later ADHD-symptoms have not, however, controlled for other well-known prenatal and postnatal risk factors, including for example low birth weight, smoking/alcohol use during pregnancy, socioeconomical factors, parental ADHD symptoms or parental prenatal/postnatal depressive symptoms.
Until recently, there has been a lack of longitudinal studies that consider a broad range of both parental and early childhood factors as moderating the risk for ADHD symptoms at preschool age [12]. Therefore, the aim of our study was to identify which prenatal and postnatal parent-reported risk factors predict inattentive and/or hyperactive symptoms at 5 years old. Based on previous studies [412, 17, 22], we hypothesised that maternal depression during and after pregnancy, children’s sleep duration, a hostile, punitive, and nonresponsive (authoritarian) parenting style, children’s low birth weight, low parental education, parental ADHD, low income, and maternal smoking and alcohol use during pregnancy would predict symptoms of inattention and hyperactivity at 5 years old. Furthermore, we hypothesised that a maternal consistent, supportive, and warm (authoritative) parenting style would predict less inattentive/hyperactive symptoms [37, 38, 40].

Methods

Participants

This study is based on the population-based CHILD-SLEEP birth cohort in Finland, with several measurement points from pregnancy until the children were 5 years old [41]. More specifically, the recruitment and baseline measurement occurred prenatally at the 32nd week, with the follow-up measurements taking place at childbirth and at the ages of 3, 8, 18, and 24 months and at 5 years. A total of 2,244 parents consented to receive the prenatal questionnaires during their visits to the maternity clinics, of which 1,679 (74.8%) families gave their consent to participate in the study and returned the baseline questionnaires. For this study, we used data from the parental questionnaires completed at pregnancy (week 32) and when the children reached the ages of 3, 8, and 24 months and 5 years. Prenatally, detailed information on parental sociodemographic and health factors was collected. Furthermore, parents estimated the family atmosphere and the duration of their child’s sleep at the age of 3 months, parenting style at 8 months, and the child’s inattentive and hyperactive symptoms at 5 years old.
The response rate at 5 years old was 42.5% (N = 714). Furthermore, we excluded cases with severe chronic illnesses or disabilities, such as Down’s syndrome or Hirschsprung disease (n = 7), and all twins (n = 8). Thereby, the final sample consisted of 699 children for whom either the Strengths and Difficulties Questionnaire (SDQ) or the Five-to-Fifteen (FTF) questionnaire was completed at 5 years old. The SDQ was available for 666 children and the FTF questionnaire for 671 children, while both SDQ and FTF questionnaires were available for 638 children. In a majority of these cases (n = 699), SDQ and FTF questionnaires were filled by mothers (n = 487). Some parents filled the questionnaire together (n = 170). Of the final sample (n = 699), prenatal questionnaires were available for 697 mothers and 670 fathers. At 3 months old, the parental responses regarding their child’s sleep duration were available for 654 families, and on family atmosphere for 671 mothers and 641 fathers. At 8 months old, the parental responses on parenting style were available for 674 mothers and 621 fathers, respectively. Finally, the parental depression trajectory, which was obtained from a depression questionnaire measured prenatally and again when the child was aged 3, 8, and 24 months, was available for 698 mothers and 674 fathers.
The respondents at 5 years old (n = 699) differed from the nonresponding parents in some demographic characteristics. For instance, the responding parents had a higher educational level (p < 0.05) and the number of children in the family during pregnancy was lower (0.71 compared with 0.80; p < 0.05). Furthermore, the responding mothers were slightly older (31.2 years compared with 30.3 years; p ≤ 0.001) and had fewer symptoms of ADHD (Adult ADHD Self-Report Scale ASRS total score 1.03 compared to 1.31; p ≤ 0.001). The responding fathers reported less current smoking during pregnancy (p < 0.01) and had more depressive symptoms (p < 0.05). There were, however, no differences in sex, birth weight, gestational age, maternal depressive symptoms, paternal ADHD symptoms or maternal smoking during pregnancy.
The ethics committee of Pirkanmaa Hospital District approved the study protocol (R11032) and all participants with a written informed consent were eligible for the study.

Measures

Outcome

Inattentive and hyperactive symptoms at 5 years of age were assessed using two different parent-reported questionnaires: the FTF [42], and the SDQ [43]. The FTF questionnaire comprises 181 statements with three response alternatives for 5–15-year-olds, related to behavioural or developmental problems. In this study, we used 18 items reflecting the same symptoms as found in the DSM-IV criteria for ADHD, comprising the 9-item inattention domain and the 9-item hyperactivity-impulsivity domain. The FTF inattention total score was the sum of the 9 inattention items, and the FTF hyperactivity-impulsivity total score was the sum of the 9 hyperactivity-impulsivity items. The cut-off points for both FTF inattention and hyperactivity-impulsivity domains were 6 points or more, corresponding to the 75th percentile in our 5-year-old sample (Table 1). Children scoring in the 75th percentile or over in FTF inattention and/or hyperactivity scales were considered to have inattentive and/or hyperactive symptoms. This specific 75th percentile cut off criteria was considered to allow sufficient sample size in each category.
Table 1
Means (SD) and frequencies (%) of the child’s variables of interest
 
Children (N = 699)
N (%)
Mean (SD)
Sex (male/female)
366 (52.4) / 333 (47.6)
Age at 5 years (months)
642
68.0 (5.1)
Birth weight (g)
658
3586 (451)
Gestational weeks
681
40.0 (1.2)
Apgar score
547
8.4 (1.1)
Apgar score < 7
23 (3.3)
Preterm birth (< 37 weeks)
11 (1.6)
Short sleep duration (< 13.0 h) at 3 months
171 (26.7)
SDQ Hyperactivity score at 5 years
666
3.1 (2.3)
FTF Inattention score at 5 years
668
3.8 (3.4)
FTF Hyperactivity-Impulsivity score at 5 years
670
4.0 (3.6)
SDQ Hyperactivity score > 75pc at 5 years
171 (25.7)
FTF Inattention score > 75pc at 5 years
174 (26.0)
FTF Hyperactivity-Impulsivity score > 75pc at 5 years
187 (27.9)
SDQ Strengths and Difficulties Questionnaire, FTF Five- to Fifteen Questionnaire, pc percentile
The SDQ is a brief child psychiatric screening questionnaire for 3–16-year-olds and includes 25 items. Parents rate the statement best describing their child’s behaviour on a 3-point scale. In this study, we only used the 5-item inattention-hyperactivity scale. The total scale score was the sum of 3 items and 2 reversed items. The cut-off point for inattentive/ hyperactive symptoms was 5 points or more, corresponding to the 75th percentile of the 5-year-old children in this study. Children scoring in the 75th percentile or over on the SDQ inattention-hyperactivity scale were considered to have inattentive/hyperactive symptoms.

Early Risk Factors

Background information including parental age, number of previous children, parental net income, and parental education was included on the prenatal questionnaires. Parental educational level was coded as 1 = “none or some vocational training”, 2 = “vocational training or some further education colleges, and 3 = “university”. Parental low income was defined as having a personal net income below 1,000 euros per month (no/yes). For mothers, smoking during pregnancy (no/yes) referred to having smoked at least once during the past six months. For fathers, smoking during pregnancy (no/yes) referred to current smoking. Maternal alcohol consumption during pregnancy was coded as 1 = yes, if alcohol was consumed at least once monthly, whereas for fathers, alcohol needed to have been consumed at least twice a week to be coded as 1 = yes.
Maternal and paternal depressive symptoms were measured prenatally and again when the child was aged 3, 8, and 24 months using the 10-item version of the Center for Epidemiological Studies Depression Scale (CES-D) [44, 45]. Caregivers were asked to rate how often over the past week they have experienced depressive symptoms, such as feeling lonely, feeling depressed, and restless sleep. The items were rated on a four-point scale and the total score was the sum of 8 items and 2 reversed items, with a higher score indicating more severe depressive symptoms (scale range 0–30 points). Latent profile analysis was used to construct a trajectory of maternal and paternal depressive symptoms from pregnancy to 2-years-old. For both parents, a solution with three stable depressive symptom trajectories (persistent low, moderate, or high levels of symptoms) was considered the best fitting and most informative. A detailed description of the parental trajectories is available elsewhere [46]. Finally, the maternal depressive symptom trajectory was dichotomized as 1 = persistent low levels of depressive symptoms and 2 = persistent moderate or high depressive symptoms (see Table 4a-b).
The maternal and paternal ADHD symptoms were measured prenatally using a six-item version of the Adult ADHD Self-Report Scale (ASRS) [47]. ASRS includes questions about the frequency of any recent DSM-IV criterion for adult ADHD. Parents evaluated how often they had hyperactive/inattentive symptoms on a five-point scale (i.e. 0 = “never”, 1 = “seldom”, 2 = “sometimes”, 3 = “often”, and 4 = “very often”). Items 1–3 were recoded as a dichotomous variable indicating a problem: 0 = “never/seldom”, and 1 = “sometimes to very often”. Items 4–6 were recoded as a variable indicating a problem: 0 = “never to sometimes”, and 1 = “often or very often”. The total score was the sum of the six dichotomous items. An ASRS total score of < 4 indicated “no ADHD symptoms” and an ASRS score of ≥ 4 indicated the presence of “ADHD symptoms”.
Mothers and fathers were asked to evaluate the social relationships and marital dissatisfaction in their family by using a family atmosphere scale [41] when the child was 3 months old. This scale includes seven items rated on a seven-point semantic differential scale (e.g., 1 = “approving”—7 = “disapproving”; 1 = “safe” – 7 = “unsafe”; “1 = “quarrelsome” – 7 = “harmonious”). Three of the items were reverse-coded and a summary score was calculated. All seven items loaded one factor indicating one-dimensionality of the measure. The Cronbach’s Alphas were 0.86 and 0.87 for maternal and paternal scales, respectively. For the purpose of this study, a good family atmosphere was defined using the 75th percentile of the summary score (sum score ≥ 46 for mothers; sum score ≥ 45 for fathers), while the families with more negative family atmosphere consisted of those having a summary score < 75th percentile.
Mothers and fathers were asked to assess their parenting style when their child was 8 months old by using a 38-item version of the Parenting Styles and Dimensions Questionnaire (PSDQ) [48]. The PSDQ includes three global parenting dimensions consistent with Baumrind’s authoritarian (i.e. marked by verbal hostility, punishment, punitive strategies, directiveness, and low levels of emotional support and responsiveness), authoritative (i.e. marked by high levels of emotional support and responsiveness, parental warmth and involvement, reasoning, democratic participation and patience with a child), and permissive (i.e. marked by lack of consistency, ignoring the child’s misbehaviour, and parental uncertainty about parenting abilities) parenting styles [49]. Parents were asked to evaluate how often they exhibit a behaviour on a five-point scale (i.e. 1 = “never”, 2 = “once in a while”, 3 = “about half of the time”, 4 = “very often” and 5 = “always”). For this study, 24 items were excluded from the original 62-item version, as the excluded items referred to significantly older (preschool/school-aged) children. Of the 38 remaining items, 13 reflected authoritative, 12 authoritarian, and 13 permissive parenting styles. Three of the permissive parenting items were reverse-scored. Summary scores for mothers and fathers were separately calculated for each parenting style. Cronbach’s Alphas were calculated for each summary score: (a) authoritarian parenting α = 0.74 for mothers, and α = 0.76 for fathers; (b) authoritative parenting α = 0.79 for mothers, and α = 0.83 for fathers; and (c) permissive parenting α = 0.53 for both parents. The cut-off points of each summary score, which corresponded to the 75th percentile, were: (a) authoritarian parenting style: sum score ≥ 22.0 for mothers and fathers; (b) authoritative parenting style: sum score ≥ 58.5 for mothers, and sum score ≥ 56.7 for fathers; and (c) permissive parenting style: sum score ≥ 29.3 for mothers, and sum score ≥ 27.1 for fathers. Scores over the 75th percentile indicated “authoritarian parenting”, “authoritative parenting”, and “permissive parenting”, respectively. Finally, to compare the prevalence of the elevated inattentive and/or hyperactive symptoms measured by SDQ and FTF between children with and without an authoritarian parent, a new variable including the following categories was created: 0 = “no maternal or paternal authoritarian parenting”, 1 = “maternal authoritarian parenting, no paternal authoritarian parenting”, 2 = “paternal authoritarian parenting, no maternal authoritarian parenting”, and 3 = “maternal and paternal authoritarian parenting”. A similar variable was created also for authoritative parenting.
The children’s sleep duration at the age of 3 months was measured using the Brief Infant Sleep Questionnaire [50]. For this study, we selected the items of night-time sleep and daytime sleep in hours. The total sleep duration was calculated as the sum of daytime and night-time sleep in hours per day. Extreme outliers (sleep duration < 7.0 h or 20.0 > hours) were excluded (n = 14). Short sleep duration (< 13.0 h per day) was defined using the 25th percentile, based on the sample of this study.

Missing Values

The missing answers in the subscales (Family atmosphere, PSDQ, SDQ, and FTF) were imputed by the individual mean if at least 60% of the answers were available. Otherwise, the subscale score was considered missing. The missing values were, however, infrequent in the data set. Approximately, 2–5% of answers per item in the family atmosphere or PSDQ subscales were missing. At the age of 5 years, approximately 2% of the answers were missing. Missing values in the background factors such as birth weight (N = 41), number of children prenatally (N = 58), mother’s (N = 9) or father’s (N = 84) age, educational level of mothers (N = 3) or fathers (N = 34), and mother’s (N = 14) or father’s (N = 40) net income per month were imputed by the item mean. The analyses were conducted with both the imputed and not-imputed datasets. Sensitivity analysis showed that the results remained similar in both regards. Thus, in this study, we only report the results of the imputed datasets.

Statistical Analysis

All analyses were performed using IBM SPSS Statistics 25. Firstly, the distribution of the variables of interest was described. Secondly, multinomial logistic regression analyses were used to assess whether several prenatal and postnatal factors predict a child’s inattentive/hyperactive symptoms at 5 years old. The outcome variables (FTF inattention, FTF hyperactivity-impulsivity, and SDQ inattention-hyperactivity scale scores) were dichotomous yes/no (children with inattentive/hyperactive symptoms, scale scores ≥ 75th percentile), and each outcome variable was examined in different models. The explanatory variables included continuous (child aged 5 years, birth weight, number of children in the family and parental age prenatally), categorical (parental education, and parental depressive symptoms), and dichotomous (gender, short sleep duration, low parental income, parental alcohol/tobacco use during pregnancy, parental prenatal ADHD symptoms, good family atmosphere, and PSDQ parenting styles) variables.
Univariate analyses were first done with one explanatory factor at a time in the model. Next, to find out the best combination of explanatory factors to predict the child’s inattentive/hyperactive symptoms at 5 years, multivariate analyses were performed using the backward stepwise selection method, which begins with all predictors in the initial (full) model and then eliminates variables in successive steps until no variables can be removed without statistically significant loss of model fit.
Third, the prevalence of inattentive/hyperactive symptoms at 5 years old (scoring over 75th percentile in SDQ/FTF inattentive/hyperactive scale score) in different parenting groups (authoritarian and authoritative parenting styles) were compared using χ2 tests.
Finally, to examine the cumulative effect of the three most significant risk factors in the predictive multivariate models, we studied the odds ratios (OR) related to different risk factor combinations relative to the no risk factors status (i.e. the children without any risk factors for inattentive/hyperactive symptoms measured by SDQ were separately compared to children with one or more risk factors). We reported the odds of developing inattentive/hyperactive symptoms given each combination of risk factors relative to the odds of developing inattentive/hyperactive symptoms given the non-exposure risk factor status. Next, the ORs for different risk factor combinations were summarised in Table 4a. Finally, in a separate analysis, we only selected all the boys from our sample at 5 years in order to examine the cumulative effect of these three risk factors in boys. This was done because we found that being a boy predicted ADHD symptoms in all our multinomial logistic regression models (Table 4b).

Results

Descriptive statistics on the children and their families are reported in Tables 12. Of the sample, 48.2% of the cases were females and the vast majority of the children were born full-term, with only 1.6% being born before the 37th gestational week (which was due to the inclusion criteria of the study). The mean 1 min Apgar score was 8.4, and 3.3% had Apgar score < 7, reflecting low levels of possible delivery complications.
Table 2
Means (SD) and frequencies of the parental variables of interest
 
Mothers (N = 697)
Fathers (N = 674)
 
Nc
Mean (SD) / N (%)
Nc
Mean (SD) / N (%)
Parental age during pregnancy
690
31.2 (4.59)
615
32.8 (5.11)
Number of children in the family during pregnancy
641
0.71 (0.88)
641
0.71 (0.88)
Low parental income < 1000 €/month during pregnancy
685
140 (20.4%)
659
45 (6.8%)
Parental Education during pregnancy
681
665
None or some vocational training
 
31 (4.6%)
 
63 (9.6%)
Vocational degree or further education colleges
 
401 (58.9%)
 
378 (57.6%)
University
 
249 (36.6%)
 
215 (32.8%)
Alcohol use during pregnancy (yes)a
690
102 (14.8%)
665
200 (30.1%)
Never drinking ≥ 6 doses per time
567
560 (98.8%)
658
92 (14.0%)
Tobacco use during the pregnancyb
694
33 (4.7%)
96
96 (14.4%)
Depressive symptoms (CES-D)
698
674
 No depression
 
453 (64.9%)
 
485 (72.0%)
 Moderate
 
193 (27.7%)
 
176 (26.1%)
 High
 
52 (7.4%)
 
13 (1.9%)
ADHD symptoms (ASRS > 4) during pregnancy
693
23 (3.3%)
664
48 (7.2%)
Parental ADHD diagnosis
628
3 (0.5%)
587
2 (0.3%)
Parental divorce during the past 5 years
 
55(7.9%)
 
22 (3.1%)
Good Family Atmosphere at 3 months > 75pc
669
149 (22.3%)
640
173 (27.0%)
Parenting style (PSDQ) at 8 months
    
 Authoritarian parenting > 75pc
672
166 (24.7%)
615
136 (22.1%)
 Authoritative parenting > 75pc
674
169 (25.1%)
621
160 (25.8%)
 Permissive parenting > 75pc
671
152 (22.7%)
617
177 (28.7%)
aFor mothers: having smoked at least once during the past six months; for fathers: current smoking
bFor mothers: alcohol use at least monthly during pregnancy; for fathers: at least twice a week
cn refer to available data for the specific measure
CES-D Center for Epidemiological Studies Depression Scale, ASRS Adult ADHD Self Report Scale, PSDQ Parenting Styles and Dimensions Questionnaire, pc percentile
Our results from the univariate and multinomial regression models are reported in Table 3. First, univariate analyses showed, that gender (being a boy) was associated with ADHD-related symptoms at 5 years of age. Further, moderate and high maternal depression levels and more negative family atmosphere at the age of 3 months were associated with more inattentive/hyperactive symptoms. Furthermore, a maternal authoritarian parenting style when the child was 8 months old was associated with ADHD-related symptoms, and authoritative parenting style was associated with less inattentive/hyperactive symptoms. Children’s shorter sleep duration at the age of 3 months was related to inattentive symptoms measured by FTF in 5-year-old children. Finally, maternal advanced age and paternal moderate depressive levels were related to hyperactive/impulsive symptoms.
Table 3
A-C Parent-reported prenatal and postnatal predictors of hyperactive and inattentive symptoms in 5-year-old children
A. SDQ Inattention-Hyperactivity > 75pc (N = 171)
Mothers (N = 583)a
Fathers (N = 528)a
 
Univariate
Multivariateb
Univariate
Multivariateb
 
OR
CI 95%
p
OR
CI 95%
p
OR
CI 95%
p
OR
CI 95%
p
Gender (being a boy)
1.82
1.27–2.61
0.001
1.87
1.25–2.79
0.002
1.82
1.27–2.61
0.001
1.75
1.17–2.64
0.007
Birth weight
1.00
0.97–1.04
0.894
   
1.00
1.00–1.00
0.965
   
Child’s age at 5 years old
1.01
0.97–1.04
0.726
   
1.01
0.97–1.04
0.726
   
Number of children in the family during pregnancy
1.18
0.97–1.44
0.105
   
1.18
0.97–1.44
0.105
   
Child’s short sleep duration at 3 months < 13 h
1.03
0.69–1.55
0.883
   
1.03
0.69–1.55
0.883
   
Parental age during pregnancy
1.00
0.96–1.04
0.835
   
1.02
0.98–1.06
0.358
   
Low parental income < 1000 €/month during pregnancy
1.09
0.71–1.67
0.689
   
2.35
0.98–5.66
0.056
3.01
1.03–8.78
0.044
Parental Education during pregnancy
  
0.128
  
0.070
  
0.612
   
None or some vocational training
            
 Vocational degree or further education colleges
0.64
0.30–1.40
0.264
0.90
0.38–2.12
0.805
1.03
0.56–1.91
0.917
   
 University
0.48
0.22–1.08
0.076
0.56
0.23–1.34
0.194
0.84
0.44–1.64
0.621
   
Alcohol use during pregnancy (yes/no)c
0.98
0.60–1.62
0.949
   
1.09
0.74–1.60
0.677
   
Tobacco use during the pregnancyd
1.79
0.86–3.74
0.123
   
1.49
0.93–2.40
0.099
   
Depressive symptoms (CES-D) No depression
  
0.001
  
0.046
  
0.282
   
 Moderate
1.49
1.01–2.20
0.046
1.30
0.83–2.02
0.247
1.27
0.85–1.89
0.245
   
 High
3.05
1.67–5.57
0.000
2.39
1.18–4.84
0.016
2.01
0.64–6.26
0.231
   
ADHD symptoms (ASRS > 4) during pregnancy
2.04
0.86–4.86
0.108
   
1.32
0.69–2.54
0.404
   
More negative family atmosphere at 3 monthse
2.22
1.35–3.63
0.002
1.81
1.05–3.13
0.034
1.74
1.12–2.72
0.015
1.51
0.93–2.46
0.097
Parenting style (PSDQ) at 8 months
            
 Authoritarian parenting at 8 months > 75pc
2.51
1.70–3.71
0.000
2.14
1.39–3.33
0.001
1.47
0.96–2.26
0.076
   
 Authoritative parenting at 8 months < 75pc
1.59
1.03–2.44
0.038
   
1.78
1.12–2.81
0.014
1.73
1.04–2.88
0.036
 Permissive parenting at 8 months > 75pc
1.19
0.79–1.81
0.402
   
1.21
0.81–1.81
0.362
   
B.FTF Inattention > 75pc (N = 174)
Mothers (N = 586)a
Fathers (N = 538)a
 
Univariate
Multivariateb
Univariate
Multivariateb
 
OR
CI 95%
p
OR
CI 95%
p
OR
CI 95%
P
OR
CI 95%
p
Gender (being a boy)
1.94
1.36–2.78
0.000
1.87
1.27–2.77
0.002
1.94
1.36–2.78
0.000
1.83
1.22–2.74
0.003
Birth weight
1.00
0.96–1.03
0.892
   
1.00
0.99–1.00
0.309
   
Child’s age at 5 years old
1.01
0.97–1.04
0.706
   
1.01
0.97–1.04
0.706
   
Number of children in the family during pregnancy
0.82
0.65–1.03
0.082
0.78
0.60–1.01
0.064
0.82
0.65–1.03
0.082
   
Child’s short sleep duration at 3 months < 13 h
1.91
1.30–2.82
0.001
1.87
1.23–2.84
0.003
1.91
1.30–2.82
0.001
1.87
1.22–2.87
0.004
Parental age during pregnancy
1.01
0.97–1.04
0.715
   
1.03
0.99–1.07
0.120
   
Low parental income < 1000 €/month during pregnancy
0.86
0.57–1.32
0.496
   
0.97
0.49–1.92
0.922
   
 Parental Education during pregnancy
 None or some vocational training
  
0.852
     
0.664
   
 Vocational degree or further education colleges
0.96
0.41–2.22
0.917
   
0.96
0.52–1.74
0.881
   
 University
0.87
0.36–2.06
0.743
   
0.81
0.43–1.54
0.518
   
Alcohol use during pregnancy (yes/no)c
0.97
0.60–1.59
0.915
   
0.87
0.59–1.29
0.498
   
Tobacco use during the pregnancyd
1.38
0.64–3.00
0.413
   
0.87
0.52–1.45
0.593
   
Depressive symptoms (CES-D)
  No depression
  
0.044
     
0.043
  
0.049
 Moderate
1.40
0.95–2.06
0.089
   
1.46
0.99–2.16
0.058
1.11
0.71–1.74
0.644
 High
1.98
1.06–3.69
0.033
   
2.82
0.93–8.56
0.068
5.13
1.38–19.0
0.015
ADHD symptoms (ASRS > 4) during pregnancy
1.64
0.67–3.97
0.277
   
1.24
0.64–2.38
0.515
   
More negative family atmosphere at 3 monthse
2.04
1.27–3.31
0.003
1.82
1.08–3.06
0.025
1.54
0.99–2.39
0.053
   
Parenting style (PSDQ) at 8 months
            
 Authoritarian parenting > 75pc (PSDQ)
1.41
0.95–2.10
0.087
1.64
1.04–2.59
0.034
0.99
0.63–1.54
0.949
   
 Authoritative parenting < 75pc (PSDQ)
1.48
0.96–2.26
0.073
   
1.50
0.96–2.34
0.075
1.54
0.95–2.51
0.079
 Permissive parenting > 75pc (PSDQ)
0.99
0.64–1.51
0.960
   
0.86
0.57–1.30
0.472
   
C. FTF Hyperactivity-Impulsivity > 75pc (N = 187)
Mothers (N = 588)a
Fathers (N = 540)a
 
Univariate
Multivariateb
Univariate
Multivariateb
 
OR
CI 95%
p
OR
CI 95%
p
OR
CI 95%
p
OR
CI 95%
p
Gender (being a boy)
1.76
1.24–2.49
0.001
1.82
1.23–2.68
0.003
1.76
1.24–2.49
0.001
1.70
1.12–2.56
0.012
Birth weight
1.01
0.98–1.04
0.599
   
1.00
0.99–1.00
0.305
   
Child’s age at 5 years old
1.01
0.98–1.04
0.414
   
1.01
0.98–1.04
0.414
   
Number of children in the family during pregnancy
1.01
0.82–1.24
0.904
   
1.01
0.82–1.24
0.904
   
Child’s short sleep duration at 3 months < 13 h
1.11
0.75–1.64
0.599
   
1.11
0.75–1.64
0.599
   
Parental age during pregnancy
1.04
1.00–1.08
0.034
1.06
1.02–1.10
0.007
1.12
0.98–1.05
0.327
   
Low parental income < 1000 €/month during pregnancy
0.90
0.59–1.36
0.618
   
2.20
0.96–5.00
0.062
9.30
2.12–40.8
0.003
Parental Education during pregnancy
  
0.241
     
0.944
   
None or some vocational training
            
 Vocational degree or further education colleges
1.77
0.66–4.74
0.260
   
1.09
0.59–2.00
0.787
   
 University
2.14
0.79–5.83
0.136
   
1.12
0.59–2.13
0.735
   
Alcohol use during pregnancy (yes/no)c
1.13
0.71–1.81
0.604
   
1.22
0.84–1.77
0.289
1.47
0.96–2.23
0.074
Tobacco use during the pregnancyd
0.60
0.24–1.49
0.271
   
0.82
0.50–1.36
0.446
   
Depressive symptoms (CES-D)
No depression
  
0.028
  
0.005
  
0.037
  
0.022
Moderate
1.36
0.93–2.00
0.110
1.48
0.97–2.24
0.066
1.51
1.03–2.22
0.033
1.27
0.82–1.98
0.288
High
2.14
1.16–3.94
0.015
2.95
1.45–6.00
0.003
2.54
0.84–7.74
0.099
7.31
1.66–32.2
0.009
ADHD symptoms (ASRS > 4) during pregnancy
2.19
0.93–5.17
0.072
   
0.87
0.44–1.72
0.689
   
More negative family atmosphere at 3 monthse
1.73
1.10–2.708
0.017
   
1.42
0.93–2.16
0.102
   
Parenting style (PSDQ) at 8 months
            
Authoritarian parenting > 75pc
1.73
1.18–2.54
0.005
   
0.94
0.61–1.45
0.779
   
Authoritative parenting < 75pc
1.93
1.25–2.99
0.003
1.84
1.14–2.94
0.012
2.17
1.37–3.44
0.001
2.47
1.49–4.10
0.000
Permissive Parenting > 75pc
0.98
0.64–1.47
0.903
   
1.12
0.75–1.66
0.581
   
Bold values denote statistical significance at the p < 0.05
TF Hyperactivity-Impulsivity domain was available for 670 children
Multivariate model shows the odds ratios (OR) from multinomial regression analyses
SDQ Inattention-Hyperactivity domain was available for 666 children
aPrenatal information for mothers (n = 697) and prenatal information for fathers (n = 674) was used as a base category
bUsing backward stepwise selection method
cFor mothers: having smoked at least once during the past six months; for fathers: current smoking
dFor mothers: alcohol use at least monthly during pregnancy; for fathers: at least two times a week
eFamily atmosphere summary score < 75th percentile
SDQ Strengths and Difficulties questionnaire, CES-D Center for Epidemiological Studies Depression Scale, ASRS Adult ADHD Self Report Scale, PSDQ Parenting Styles and Dimensions Questionnaire, pc percentile, FTF Five-To-Fifteen Questionnaire
Second, in multinomial regression models, high maternal and paternal depression levels were associated with more inattentive/hyperactive symptoms. Paternal low income was also associated with inattentive/hyperactive symptoms. Parental prenatal ADHD symptoms (ASRS score > 4) were not, however, related to the child’s inattentive/hyperactive symptoms. Children’s shorter sleep duration was associated with inattentive symptoms.
In addition, a maternal authoritarian parenting style was related to more inattentive/hyperactive symptoms. Furthermore, the maternal authoritative parenting style predicted less hyperactive symptoms measured by FTF, and good family atmosphere when the child was 3 months old reported by the mother was also associated with lower risk for inattentive/hyperactive symptoms. The paternal authoritative parenting style predicted less inattentive/hyperactive symptoms. The permissive parenting style was not related to any ADHD-related symptoms.
As Fig. 1 shows, the prevalence of inattentive and/or hyperactive symptoms in 5-year-old children was significantly related to parent-reported parenting styles (Fig. 1a-b). The highest percentage of children with elevated levels of inattention/hyperactivity symptoms appeared in families with both parents having an authoritarian parenting style while the maternal authoritarian parenting style was related to higher frequencies of hyperactivity symptoms, as measured by FTF (p < 0.05). Furthermore, 5-year-old children’s inattention/hyperactivity symptoms were less common in those families with authoritative compared to families with no authoritative parenting style (p < 0.05). Even having one parent (mother or father) with an authoritative parenting style appeared to decrease the risk of inattentive/hyperactive symptoms at 5 years of age.
Finally, when examining the cumulative effect of the most significant risk factors found in multivariate models, we observed that children with several risk factors (being a boy, maternal authoritarian parenting style, more negative family atmosphere, and persistent maternal depressive symptoms) had the highest risk (OR 8.40, CI 95% 3.17–22.30, p < 0.001) for having inattentive/hyperactive symptoms, as measured by SDQ at 5 years of age (Table 4a-b).
Table 4
a-b Odds Ratios (OR) for a all the children and b for boys having inattentive/hyperactive symptoms measured by SDQ (n = 666) in 5-year-old children, in terms of maternal authoritarian parenting style, family atmosphere, and maternal depressive symptoms. Table a shows the cumulative effect of three risk factors on a child’s risk for having inattentive/hyperactive symptoms at 5 years of age. Children with several risk factors (being a boy, mother’s authoritarian parenting style, more negative family atmosphere, and persistent maternal depressive symptoms) had the highest risk for having inattentive/hyperactive symptoms (Table b)
https://static-content.springer.com/image/art%3A10.1007%2Fs10578-020-01057-7/MediaObjects/10578_2020_1057_Tab4_HTML.png

Discussion

The purpose of this study was to evaluate which prenatal and postnatal parent-reported risk factors best predict inattentive/hyperactive symptoms in 5-year-old children. This study is one of the few studies considering a wide range of potential parental risk factors during and after pregnancy in the development of children’s ADHD-related symptoms. Our study adds to previous research by examining both maternal and paternal early factors. In particular, the role of fathers’ mental health and early parenting style on children’s later inattentive/hyperactive symptoms are highlighted. Furthermore, the role of both parents having a similar parenting style and the cumulative effect of several risk factors on children’s ADHD symptomatology are also described.
According to our initial hypotheses, we found that gender (i.e. being a boy), persistent maternal depression from pregnancy until the child was 24 months old, parent-reported child’s shorter sleep duration at 3 months old, maternal authoritarian parenting style when the child was 8 months old, and low paternal income increased the risk for children’s inattentive and/or hyperactive symptoms at 5 years old. Moreover, persistent paternal depressive symptoms and a more negative family atmosphere reported by mothers when the child was 3 months old predicted the child’s ADHD symptomatology. Nevertheless, and contrary to our expectations, the paternal authoritarian parenting style was not related to children’s ADHD symptomatology, although an authoritative parenting style was associated with fewer inattentive and/or hyperactive symptoms. In our study, maternal advanced age was associated with hyperactive-impulsive symptoms. Contrary to our hypothesis, low birth weight and several prenatal factors such as parental smoking or alcohol use during pregnancy, parental ADHD symptoms, or parental education were not associated with children’s ADHD symptomatology at 5 years of age in the predictive models. Finally, we found that risk factors display a cumulative effect on children’s ADHD symptoms. The highest risk for a child to have inattentive/hyperactive symptoms at 5 years of age occurred in children with several risk factors (persistent maternal depressive symptoms from pregnancy to 24 months postnatally, more negative family atmosphere when the child was 3 months old, mother’s authoritarian parenting style when the child was 8 months old, and being a boy). Our study supports the hypothesis regarding the multifactorial aetiology of ADHD and emphasises the relevance of several postnatal environmental factors such as parental mental health, family atmosphere, and parenting strategies, in affecting the development of a child’s inattentive/hyperactive symptoms during infancy and the preschool period.
In our study, both maternal and paternal high depressive symptom levels were associated with children’s inattentive/hyperactive symptoms at the age of 5 years. Our results are consistent with previous studies reporting associations between prenatal [8, 18] and postnatal [8, 12, 17] parental depression and children’s later ADHD symptoms. Previous studies have, however, also reported contradictory findings, with no association between paternal prenatal [18] or postnatal [12] depressive symptoms when controlling for several confounding factors. It has been suggested that maternal prenatal depression is associated with an infant’s later outcomes by altering the mother’s HPA-axis activity [51]. An elevated maternal cortisol level may influence glucocorticoid action in the placenta and thereby create an adverse foetal environment [52]. Nevertheless, all mechanisms involved in the association between maternal depressive symptoms during and after pregnancy, and a child’s later outcomes are not yet well understood [51]. Other maternal factors such as maternal physical health and lifestyle during pregnancy, a child’s inherited genetic susceptibility to psychopathology, and several postnatal factors may also account for this association [11, 51, 53]. For example, depressed woman during pregnancy may engage in more unhealthy behaviours such as smoking or substance use during the pregnancy period. Furthermore, a child’s genetic susceptibility to depression could manifest as behavioural problems during the preschool period. We found similar associations between maternal and paternal high depressive symptom trajectories and children’s ADHD-related symptoms, suggesting that the effect is not solely mediated by intrauterine mechanisms, but that familial, environmental, and possibly genetic factors are additionally driving this association [53]. In our sample, the maternal and paternal depressive symptoms during and after pregnancy were relatively stable [46], and 7.4% of the mothers and 1.9% of the fathers reported constantly (from pregnancy to two years postpartum) depressive symptoms above the clinical threshold. Persistent maternal and paternal depressive symptoms from pregnancy to the postnatal period were associated with children’s inattentive/hyperactive symptoms, suggesting that postnatal depression also affects the development of children’s attentional control [8, 18]. In line with our results, a population-based study with 1779 mother–child dyads demonstrated that persistent maternal depression during and after pregnancy was related to children’s ADHD symptoms at preschool-age [8]. It should be noted, however, that they showed postnatal maternal depression to have an additive effect on prenatal depression. Another study with two separate birth cohorts found that both maternal and paternal depressive symptoms during pregnancy predicted children’s attentional problems at preschool-age, whereas associations between prenatal paternal depression and children’s attentional problems were substantially weaker and were overridden by maternal anxiety/depressive symptoms when the child was 3 years old [18]. Finally, it has been suggested that parental depressive symptoms may influence children’s later ADHD symptoms via their effect on parenting and especially via hostile parenting strategies [39]. Our study showed, however, that persistent parental depressive symptoms were independently related to children’s later inattentive/hyperactive symptoms even when several prenatal and postnatal factors, including different parenting strategies, were taken into account.
Another relevant finding in our study was, indeed, related to the parenting styles when the child was 8 months old. The maternal authoritarian parenting style was associated with more inattentive/hyperactive symptoms in 5-year-old children. In turn, authoritative parenting styles in both parents was related to fewer ADHD symptoms. Furthermore, the highest percentage of children with elevated levels of inattention/hyperactivity symptoms appeared in families with both parents having an authoritarian parenting style. By contrast, the lowest risk for ADHD symptoms was found in those families with both parents having an authoritative parenting style.
To the best of our knowledge, this is the first longitudinal study to report significant associations of both maternal and paternal parenting styles during the first year of a child’s life on the child’s later ADHD symptoms. The majority of the previous studies on the relationship between parenting and children’s later inattentive/hyperactive symptoms have focused on mothers. Some of these studies have reported the association between maternal sensitive parenting during infancy and/or early preschool age and fewer inattentive/hyperactive symptoms at preschool and school-age [37, 38, 40]. For instance, high levels of maternal responsiveness/warm behaviour, as measured by videotaped tasks, when the child was 2 years old predicted a greater increase in sustained attention in a laboratory task completed between 2–4.5 years old compared to mothers with no such behaviour [40]. Our study extends these previous findings by providing similar results regarding paternal consistent, supportive, and warm parenting since paternal authoritative parenting during infancy is also related to a lower risk of ADHD related symptoms. Furthermore, the effect of authoritative parenting by both of a child’s parents seemed to be additive, as children with two such parents had the lowest risk for ADHD symptomatology. Similarly, a study with 200 children living in low-income families reported that 2-year-old children with two supportive parents scored highest in cognitive tests at 5 years old, while children with two unsupportive parents scored lowest [54].
Additionally, and consistent with our hypothesis [22, 23], we found that a maternal authoritarian parenting style is associated with children’s later inattentive/hyperactive symptoms. Some previous studies suggest that harsh and/or intrusive parenting may be related to the disrupted development of children’s attentional control [9, 22, 23]. It has been reported that maternal intrusiveness at 6 months old or maternal overstimulating behaviour at 3.5 years old, as measured by questionnaires, are associated with teachers reporting more ADHD symptoms at 11 years old. Furthermore, a longitudinal Family Life Project study with 1173 children reported that early harsh-intrusive caregiving behaviours, measured at the ages of 6, 15, 24, and 36 months by 10-min video recordings of parent–child interactions, constitute a general risk factor for elevated ADHD symptomatology in early (3–6 years) and middle childhood (7–12 years), as well as both timepoints together [9]. Therefore, this evidence suggests that children may be particularly vulnerable to the effect of hostile parenting during infancy. Contrary to our hypothesis, however, a paternal authoritarian style did not predict children’s later inattentive/hyperactive symptoms in our study. Previous cross-sectional studies with school-aged children have reported that fathers’ inconsistent discipline or authoritarian control is related to children’s ADHD symptoms [32, 33]. The lack of this association in our study may reflect fathers’ tendency to spend less time with a child during the first year of its life compared to mothers with access to longer parental leaves.
Opposite findings have also been reported with no association between parenting and later symptoms of inattention/hyperactivity [12, 35]. For instance, in the Quebec Longitudinal Study of Child Development birth cohort study, self-reported coercive parenting or overprotection when children were 5 months old was not significantly associated with ADHD symptomatology when they reached 8 years old [12]. The study suggested that the absence of this association may be partly related to the weakness in the measures of parenting. Moreover, in another longitudinal twin study including 886 twin pairs aged 11–17 years, most associations between parent–child hostility at school age and children’s ADHD symptoms were accounted for by genetic factors. Boys’ ADHD symptoms impacted upon mother–child hostility both within and across time and there were no effects in the opposite direction. It should be noted, however, that the children included in the study were significantly older than in our study and, thus, hostility in the parent–child relationship may have different associations during infancy and later in childhood.
Regarding the association between early parenting and children’s later inattentive/hyperactive symptoms, we were interested to study whether the early parenting style would be related to the emergence of inattentive/hyperactive symptoms at preschool-age. This hypothesis was partly strengthened as we found consistent associations between early parenting and later symptoms of inattention/hyperactivity. Another explanation for this association would, however, be the possibility that negative parenting during infancy is evoked by child’s challenging behaviours (i.e. excessive crying, early sleep difficulties, feeding problems) related to the later diagnosis of ADHD [55]. Furthermore, it is also possible that parental ADHD symptoms predispose to negative parenting strategies with less positive parenting and more harsh/inconsistent parenting [56] and, thus, negative parenting and children’s inattentive/hyperactive symptoms may have a shared genetic background. While genetic factors (i.e. multiple known risk gene variants) make an important contribution to the development of ADHD [4, 13], environmental factors (e.g. negative parenting, parental depression, and negative family atmosphere) and/or child-specific factors (e.g. sleep difficulties) may exert the strongest influence over individuals with a particular genetic vulnerability [19, 57, 58]. For example, a previous review and meta-analysis supported the idea that multiple factors (a certain genotype, exposure to chemicals, and traumatic life events) increased the probability for a child’s ADHD diagnosis [19].
In our study, several prenatal factors were not associated with children’s later inattentive/hyperactive symptoms, as would have been expected based on previous studies [57, 12, 1517]. For example, parental smoking or alcohol use during pregnancy was not significantly linked to the child’s later symptoms of inattention/hyperactivity. These results could be explained by a lack of power (i.e. the number of mothers smoking during pregnancy or using alcohol was rather small) or the genuine absence of an association. Among the prenatal factors, only paternal low income and the mother’s advanced age predicted the child’s later symptoms of inattention/hyperactivity. Contrary to previous studies [7, 12], we found maternal advanced age was a risk factor for children’s hyperactive symptoms, as measured by the FTF hyperactivity scale. Consistent findings have, however, been reported in a retrospective study with 58 children diagnosed with ADHD [15], where advanced maternal age was found to be associated with children’s ADHD symptoms at school age, possibly reflecting the sample characteristics (woman in the upper-middle socioeconomic class giving birth later in life). In addition, we found that a shorter sleep duration at 3 months was related to increased levels of inattention at 5 years old, which is in line with our previous report.[10].The specific role of sleep duration in the development of attentional control has been reported previously [10, 2426], which suggests that the development of attentional control may be particularly vulnerable to the effects of sleep deprivation during infancy and early childhood, due to its complex and prolonged course of maturation during the preschool period [59].
Finally, we found a cumulative effect of several risk factors (i.e. being a boy, maternal persistent moderate/high depressive symptoms, maternal authoritarian parenting style, and a more negative family atmosphere) on children’s inattentive/hyperactive symptoms at 5 years old. Odds ratios for those children with two or more risk factors were substantially higher compared to the children with no risk factors or only one risk factor alone. Our results highlight that it would be crucial to identify high-risk children with several risk factors that might lead to the development of ADHD symptoms in later childhood already during pregnancy and the first year of a child’s life. Indeed, early interventions such as evidence-based parenting programs [60], effective treatment of parental depression [61], and treatment of a child’s early sleep difficulties [62] could prevent later symptoms of inattention/hyperactivity. In future studies, further examination of this genetic-environment interaction and intervention studies would be of great importance [4, 13].
The strengths of this study include the use of a broad range of prenatal and postnatal potential risk factors gathered from both parents, several measurement time-points of parental depressive symptoms from pregnancy to 24 months postnatally, and the assessment of ADHD-related symptoms with two questionnaires. However, there are also some limitations to consider when interpreting the present results. Firstly, the response rate when the child was 5 years old was relatively low (42.5%) and may have affected these results. The responding parents had a higher educational level and mothers reported fewer ADHD symptoms during pregnancy compared to the nonresponding mothers. As there are studies suggesting that lower parental education is associated with children’s inattentive/hyperactive symptoms [15, 16, 63], the children in our responding families may have been at lower risk of ADHD symptoms than those in the general population. Therefore, this bias may weaken the results in this study as there may have been a lower prevalence of children at higher risk of ADHD. Secondly, the families in this study were recruited at the 32nd pregnancy week and, therefore, the sample consisted of a high prevalence of children with full-term births and normal birth weights. This may also have affected the results by weakening them, as there are studies reporting the association between prematurity/low birth weight and later ADHD symptoms [6, 7, 9, 12]. Thirdly, we relied on parental reports when assessing the children’s inattentive/hyperactive symptoms. As we lacked information from other sources (teacher ratings or performance-based assessment) we do not know whether these parent-reported behaviours at home also manifest at, for example, day-care. Further, many parents of children with inattentive/hyperactive symptoms may also find themselves experiencing these symptoms [3, 4] and they may find it difficult to evaluate their child’s behaviour [64]. Furthermore, as parents suffering from depressive symptoms might see the world more negatively than healthy parents, it is also possible that parents with depressive symptoms overestimate their child´s behaviour problems due to their own mental health issues. Future studies on the topic should aim to confirm these findings with a comprehensive evaluation of the children at school-age (teacher ratings, parent ratings, diagnostic evaluation). Fourthly, the majority of the risk factors were self-reported, and parents may have underreported their psychiatric symptoms and/or substance use during pregnancy, possibly leading to an underestimation of these effects. Finally, the Cronbach’s Alpha value for permissive parenting was rather low (α = 0.53) for both parents and may explain the lack of association between permissive parenting and inattentive/hyperactive symptoms or, alternatively, describe the inconsistency in the parenting style within the responders that belonged to this category.

Summary

The aim of our study was to evaluate which prenatal and postnatal parent-reported risk factors associated with inattentive/hyperactive symptoms in 5-year-old children. Our study adds to previous research by examining both maternal and paternal early factors. We found that persistent parental depressive symptoms during and after pregnancy, as well as maternal authoritarian parenting, more negative family atmosphere, and a child’s short sleep duration are related to the child’s later ADHD symptomatology. Furthermore, authoritative parenting styles in both parents were related to fewer ADHD symptoms. The results of this study highlight the importance of parental mental health and family atmosphere, and the role of early parenting strategies and a child’s sleep duration on the developmental course of the child’s later inattentive/hyperactive symptoms. As children’s early development is a critical period of vulnerability, we emphasise the need for early screening for several risk factors of ADHD-related symptoms, as preventive interventions for parental mental health and supportive parenting training programs may benefit not only parents but also their children’s development.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Onze productaanbevelingen

BSL Psychologie Totaal

Met BSL Psychologie Totaal blijf je als professional steeds op de hoogte van de nieuwste ontwikkelingen binnen jouw vak. Met het online abonnement heb je toegang tot een groot aantal boeken, protocollen, vaktijdschriften en e-learnings op het gebied van psychologie en psychiatrie. Zo kun je op je gemak en wanneer het jou het beste uitkomt verdiepen in jouw vakgebied.

BSL Academy Accare GGZ collective

Literatuur
1.
go back to reference Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA (2015) Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 56(3):345–365 PubMedCrossRef Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA (2015) Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 56(3):345–365 PubMedCrossRef
2.
go back to reference American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Association; 2013. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Association; 2013.
3.
go back to reference Faraone SV, Perlis RH, Doyle AE, Smoller JW, Goralnick JJ, Holmgren MA et al (2005) Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry 57(11):1313–1323 PubMedCrossRef Faraone SV, Perlis RH, Doyle AE, Smoller JW, Goralnick JJ, Holmgren MA et al (2005) Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry 57(11):1313–1323 PubMedCrossRef
5.
go back to reference Banerjee TD, Middleton F, Faraone SV (2007) Environmental risk factors for attention-deficit hyperactivity disorder. Acta Paediatr 96(9):1269–1274 PubMedCrossRef Banerjee TD, Middleton F, Faraone SV (2007) Environmental risk factors for attention-deficit hyperactivity disorder. Acta Paediatr 96(9):1269–1274 PubMedCrossRef
6.
go back to reference Silva D, Colvin L, Hagemann E, Bower C (2014) Environmental risk factors by gender associated with attention-deficit/hyperactivity disorder. Pediatrics 133(1):e14–22 PubMedCrossRef Silva D, Colvin L, Hagemann E, Bower C (2014) Environmental risk factors by gender associated with attention-deficit/hyperactivity disorder. Pediatrics 133(1):e14–22 PubMedCrossRef
7.
go back to reference Halmøy A, Klungsøyr K, Skjærven R, Haavik J (2012) Pre- and perinatal risk factors in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry 71(5):474–481 PubMedCrossRef Halmøy A, Klungsøyr K, Skjærven R, Haavik J (2012) Pre- and perinatal risk factors in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry 71(5):474–481 PubMedCrossRef
8.
go back to reference Wolford E, Lahti M, Tuovinen S, Lahti J, Lipsanen J, Savolainen K et al (2017 ) Maternal depressive symptoms during and after pregnancy are associated with attention-deficit/hyperactivity disorder symptoms in their 3- to 6-year-old children. PLoS ONE 12(12):e0190248 PubMedPubMedCentralCrossRef Wolford E, Lahti M, Tuovinen S, Lahti J, Lipsanen J, Savolainen K et al (2017 ) Maternal depressive symptoms during and after pregnancy are associated with attention-deficit/hyperactivity disorder symptoms in their 3- to 6-year-old children. PLoS ONE 12(12):e0190248 PubMedPubMedCentralCrossRef
9.
go back to reference Willoughby MT, Williams J, Mills-Koonce WR, Blair CB (2019) Early life predictors of attention deficit/hyperactivity disorder symptomatology profiles from early through middle childhood. Dev Psychopathol 23:1–12 Willoughby MT, Williams J, Mills-Koonce WR, Blair CB (2019) Early life predictors of attention deficit/hyperactivity disorder symptomatology profiles from early through middle childhood. Dev Psychopathol 23:1–12
10.
go back to reference Huhdanpää H, Morales-Muñoz I, Aronen ET, Pölkki P, Saarenpää-Heikkilä O, Paunio T et al (2019) Sleep Difficulties in Infancy Are Associated with Symptoms of Inattention and Hyperactivity at the Age of 5 Years: A Longitudinal Study. J Dev Behav Pediatr 40(6):432–440 PubMedPubMedCentralCrossRef Huhdanpää H, Morales-Muñoz I, Aronen ET, Pölkki P, Saarenpää-Heikkilä O, Paunio T et al (2019) Sleep Difficulties in Infancy Are Associated with Symptoms of Inattention and Hyperactivity at the Age of 5 Years: A Longitudinal Study. J Dev Behav Pediatr 40(6):432–440 PubMedPubMedCentralCrossRef
11.
go back to reference Sciberras E, Mulraney M, Silva D, Coghill D (2017) Prenatal Risk Factors and the Etiology of ADHD-Review of Existing Evidence. Curr Psychiatry Rep 19(1):1 PubMedCrossRef Sciberras E, Mulraney M, Silva D, Coghill D (2017) Prenatal Risk Factors and the Etiology of ADHD-Review of Existing Evidence. Curr Psychiatry Rep 19(1):1 PubMedCrossRef
12.
go back to reference Galéra C, Côté SM, Bouvard MP, Pingault J-B, Melchior M, Michel G et al (2011) Early risk factors for hyperactivity-impulsivity and inattention trajectories from age 17 months to 8 years. Arch Gen Psychiatry 68(12):1267–1275 PubMedCrossRef Galéra C, Côté SM, Bouvard MP, Pingault J-B, Melchior M, Michel G et al (2011) Early risk factors for hyperactivity-impulsivity and inattention trajectories from age 17 months to 8 years. Arch Gen Psychiatry 68(12):1267–1275 PubMedCrossRef
13.
14.
go back to reference Ohlsson H, Kendler KS. Applying causal inference methods in psychiatric epidemiology: A review. JAMA Psychiatry. 2019 Dec 11; Ohlsson H, Kendler KS. Applying causal inference methods in psychiatric epidemiology: A review. JAMA Psychiatry. 2019 Dec 11;
15.
go back to reference Gurevitz M, Geva R, Varon M, Leitner Y (2014) Early markers in infants and toddlers for development of ADHD. J Atten Disord 18(1):14–22 PubMedCrossRef Gurevitz M, Geva R, Varon M, Leitner Y (2014) Early markers in infants and toddlers for development of ADHD. J Atten Disord 18(1):14–22 PubMedCrossRef
16.
go back to reference Rodriguez A, Olsen J, Kotimaa AJ, Kaakinen M, Moilanen I, Henriksen TB et al (2009) Is prenatal alcohol exposure related to inattention and hyperactivity symptoms in children? Disentangling the effects of social adversity. J Child Psychol Psychiatry 50(9):1073–1083 PubMedCrossRef Rodriguez A, Olsen J, Kotimaa AJ, Kaakinen M, Moilanen I, Henriksen TB et al (2009) Is prenatal alcohol exposure related to inattention and hyperactivity symptoms in children? Disentangling the effects of social adversity. J Child Psychol Psychiatry 50(9):1073–1083 PubMedCrossRef
17.
go back to reference Sciberras E, Ukoumunne OC, Efron D (2011) Predictors of parent-reported attention-deficit/hyperactivity disorder in children aged 6–7 years: a national longitudinal study. J Abnorm Child Psychol 39(7):1025–1034 PubMedCrossRef Sciberras E, Ukoumunne OC, Efron D (2011) Predictors of parent-reported attention-deficit/hyperactivity disorder in children aged 6–7 years: a national longitudinal study. J Abnorm Child Psychol 39(7):1025–1034 PubMedCrossRef
18.
go back to reference Van Batenburg-Eddes T, Brion MJ, Henrichs J, Jaddoe VWV, Hofman A, Verhulst FC et al (2013) Parental depressive and anxiety symptoms during pregnancy and attention problems in children: a cross-cohort consistency study. J Child Psychol Psychiatry 54(5):591–600 PubMedCrossRef Van Batenburg-Eddes T, Brion MJ, Henrichs J, Jaddoe VWV, Hofman A, Verhulst FC et al (2013) Parental depressive and anxiety symptoms during pregnancy and attention problems in children: a cross-cohort consistency study. J Child Psychol Psychiatry 54(5):591–600 PubMedCrossRef
19.
go back to reference Nilsen FM, Tulve NS (2020) A systematic review and meta-analysis examining the interrelationships between chemical and non-chemical stressors and inherent characteristics in children with ADHD. Environ Res 180:108884 PubMedCrossRef Nilsen FM, Tulve NS (2020) A systematic review and meta-analysis examining the interrelationships between chemical and non-chemical stressors and inherent characteristics in children with ADHD. Environ Res 180:108884 PubMedCrossRef
20.
go back to reference Han J-Y, Kwon H-J, Ha M, Paik K-C, Lim M-H, Gyu Lee S et al (2015) The effects of prenatal exposure to alcohol and environmental tobacco smoke on risk for ADHD: a large population-based study. Psychiatry Res 225(1–2):164–168 PubMedCrossRef Han J-Y, Kwon H-J, Ha M, Paik K-C, Lim M-H, Gyu Lee S et al (2015) The effects of prenatal exposure to alcohol and environmental tobacco smoke on risk for ADHD: a large population-based study. Psychiatry Res 225(1–2):164–168 PubMedCrossRef
21.
go back to reference Stevens SE, Sonuga-Barke EJS, Kreppner JM, Beckett C, Castle J, Colvert E et al (2008) Inattention/overactivity following early severe institutional deprivation: presentation and associations in early adolescence. J Abnorm Child Psychol 36(3):385–398 PubMedCrossRef Stevens SE, Sonuga-Barke EJS, Kreppner JM, Beckett C, Castle J, Colvert E et al (2008) Inattention/overactivity following early severe institutional deprivation: presentation and associations in early adolescence. J Abnorm Child Psychol 36(3):385–398 PubMedCrossRef
22.
go back to reference Carlson EA, Jacobvitz D, Sroufe LA (1995) A developmental investigation of inattentiveness and hyperactivity. Child Dev 66(1):37–54 PubMedCrossRef Carlson EA, Jacobvitz D, Sroufe LA (1995) A developmental investigation of inattentiveness and hyperactivity. Child Dev 66(1):37–54 PubMedCrossRef
23.
go back to reference Jacobvitz D, Sroufe LA (1987) The early caregiver-child relationship and attention-deficit disorder with hyperactivity in kindergarten: a prospective study. Child Dev 58(6):1496–1504 PubMed Jacobvitz D, Sroufe LA (1987) The early caregiver-child relationship and attention-deficit disorder with hyperactivity in kindergarten: a prospective study. Child Dev 58(6):1496–1504 PubMed
24.
go back to reference Lee S-H, Kim H-B, Lee K-W (2019) Association between sleep duration and attention-deficit hyperactivity disorder: A systematic review and meta-analysis of observational studies✰. J Affect Disord 28(256):62–69 CrossRef Lee S-H, Kim H-B, Lee K-W (2019) Association between sleep duration and attention-deficit hyperactivity disorder: A systematic review and meta-analysis of observational studies✰. J Affect Disord 28(256):62–69 CrossRef
25.
go back to reference Paavonen EJ, Räikkönen K, Lahti J, Komsi N, Heinonen K, Pesonen A-K et al (2009) Short sleep duration and behavioral symptoms of attention-deficit/hyperactivity disorder in healthy 7- to 8-year-old children. Pediatrics 123(5):e857–e864 PubMedCrossRef Paavonen EJ, Räikkönen K, Lahti J, Komsi N, Heinonen K, Pesonen A-K et al (2009) Short sleep duration and behavioral symptoms of attention-deficit/hyperactivity disorder in healthy 7- to 8-year-old children. Pediatrics 123(5):e857–e864 PubMedCrossRef
26.
go back to reference Sivertsen B, Harvey AG, Reichborn-Kjennerud T, Torgersen L, Ystrom E, Hysing M (2015) Later emotional and behavioral problems associated with sleep problems in toddlers: a longitudinal study. JAMA Pediatr 169(6):575–582 PubMedCrossRef Sivertsen B, Harvey AG, Reichborn-Kjennerud T, Torgersen L, Ystrom E, Hysing M (2015) Later emotional and behavioral problems associated with sleep problems in toddlers: a longitudinal study. JAMA Pediatr 169(6):575–582 PubMedCrossRef
27.
go back to reference Johnston C, Mash EJ (2001) Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clin Child Fam Psychol Rev 4(3):183–207 PubMedCrossRef Johnston C, Mash EJ (2001) Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clin Child Fam Psychol Rev 4(3):183–207 PubMedCrossRef
28.
go back to reference Theule J, Wiener J, Tannock R, Jenkins JM (2013) Parenting stress in families of children with ADHD. J Emot Behav Disord 21(1):3–17 CrossRef Theule J, Wiener J, Tannock R, Jenkins JM (2013) Parenting stress in families of children with ADHD. J Emot Behav Disord 21(1):3–17 CrossRef
29.
go back to reference Cussen A, Sciberras E, Ukoumunne OC, Efron D (2012) Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning: a community-based study. Eur J Pediatr 171(2):271–280 PubMedCrossRef Cussen A, Sciberras E, Ukoumunne OC, Efron D (2012) Relationship between symptoms of attention-deficit/hyperactivity disorder and family functioning: a community-based study. Eur J Pediatr 171(2):271–280 PubMedCrossRef
30.
go back to reference Modesto-Lowe V, Danforth JS, Brooks D (2008) ADHD: does parenting style matter? Clin Pediatr (Phila) 47(9):865–872 CrossRef Modesto-Lowe V, Danforth JS, Brooks D (2008) ADHD: does parenting style matter? Clin Pediatr (Phila) 47(9):865–872 CrossRef
31.
go back to reference Bhide S, Sciberras E, Anderson V, Hazell P, Nicholson JM (2016) Association between parenting style and socio-emotional and academic functioning in children with and without adhd: a community-based study. J Atten Disord 23(5):463–474 PubMedCrossRef Bhide S, Sciberras E, Anderson V, Hazell P, Nicholson JM (2016) Association between parenting style and socio-emotional and academic functioning in children with and without adhd: a community-based study. J Atten Disord 23(5):463–474 PubMedCrossRef
32.
go back to reference Chang L-R, Chiu Y-N, Wu Y-Y, Gau SS-F (2013) Father’s parenting and father-child relationship among children and adolescents with attention-deficit/hyperactivity disorder. Compr Psychiatry 54(2):128–140 PubMedCrossRef Chang L-R, Chiu Y-N, Wu Y-Y, Gau SS-F (2013) Father’s parenting and father-child relationship among children and adolescents with attention-deficit/hyperactivity disorder. Compr Psychiatry 54(2):128–140 PubMedCrossRef
33.
go back to reference Ellis B, Nigg J (2009) Parenting practices and attention-deficit/hyperactivity disorder: new findings suggest partial specificity of effects. J Am Acad Child Adolesc Psychiatry 48(2):146–154 PubMedPubMedCentralCrossRef Ellis B, Nigg J (2009) Parenting practices and attention-deficit/hyperactivity disorder: new findings suggest partial specificity of effects. J Am Acad Child Adolesc Psychiatry 48(2):146–154 PubMedPubMedCentralCrossRef
34.
go back to reference Deault LC (2010) A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry Hum Dev 41(2):168–192 PubMedCrossRef Deault LC (2010) A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry Hum Dev 41(2):168–192 PubMedCrossRef
35.
go back to reference Lifford KJ, Harold GT, Thapar A (2009) Parent-child hostility and child ADHD symptoms: a genetically sensitive and longitudinal analysis. J Child Psychol Psychiatry 50(12):1468–1476 PubMedCrossRef Lifford KJ, Harold GT, Thapar A (2009) Parent-child hostility and child ADHD symptoms: a genetically sensitive and longitudinal analysis. J Child Psychol Psychiatry 50(12):1468–1476 PubMedCrossRef
36.
go back to reference Lifford KJ, Harold GT, Thapar A (2008) Parent-child relationships and ADHD symptoms: a longitudinal analysis. J Abnorm Child Psychol 36(2):285–296 PubMedCrossRef Lifford KJ, Harold GT, Thapar A (2008) Parent-child relationships and ADHD symptoms: a longitudinal analysis. J Abnorm Child Psychol 36(2):285–296 PubMedCrossRef
37.
go back to reference Choenni V, Lambregtse-van den Berg MP, Verhulst FC, Tiemeier H, Kok R (2019) The Longitudinal Relation between Observed Maternal Parenting in the Preschool Period and the Occurrence of Child ADHD Symptoms in Middle Childhood. J Abnorm Child Psychol. 47(5):755–764 PubMedCrossRef Choenni V, Lambregtse-van den Berg MP, Verhulst FC, Tiemeier H, Kok R (2019) The Longitudinal Relation between Observed Maternal Parenting in the Preschool Period and the Occurrence of Child ADHD Symptoms in Middle Childhood. J Abnorm Child Psychol. 47(5):755–764 PubMedCrossRef
38.
go back to reference Miller NV, Hane AA, Degnan KA, Fox NA, Chronis-Tuscano A (2019) Investigation of a developmental pathway from infant anger reactivity to childhood inhibitory control and ADHD symptoms: interactive effects of early maternal caregiving. J Child Psychol Psychiatry 60(7):762–772 PubMedPubMedCentralCrossRef Miller NV, Hane AA, Degnan KA, Fox NA, Chronis-Tuscano A (2019) Investigation of a developmental pathway from infant anger reactivity to childhood inhibitory control and ADHD symptoms: interactive effects of early maternal caregiving. J Child Psychol Psychiatry 60(7):762–772 PubMedPubMedCentralCrossRef
39.
go back to reference Mulraney M, Giallo R, Efron D, Brown S, Nicholson JM, Sciberras E (2019) Maternal postnatal mental health and offspring symptoms of ADHD at 8–9 years: pathways via parenting behavior. Eur Child Adolesc Psychiatry 28(7):923–932 PubMedCrossRef Mulraney M, Giallo R, Efron D, Brown S, Nicholson JM, Sciberras E (2019) Maternal postnatal mental health and offspring symptoms of ADHD at 8–9 years: pathways via parenting behavior. Eur Child Adolesc Psychiatry 28(7):923–932 PubMedCrossRef
40.
go back to reference Graziano PA, Calkins SD, Keane SP (2011) Sustained Attention Development during the Toddlerhood to Preschool Period: Associations with Toddlers’ Emotion Regulation Strategies and Maternal Behavior. Infant Child Dev 20(6):389–408 PubMedPubMedCentralCrossRef Graziano PA, Calkins SD, Keane SP (2011) Sustained Attention Development during the Toddlerhood to Preschool Period: Associations with Toddlers’ Emotion Regulation Strategies and Maternal Behavior. Infant Child Dev 20(6):389–408 PubMedPubMedCentralCrossRef
41.
go back to reference Juulia Paavonen E, Saarenpää-Heikkilä O, Pölkki P, Kylliäinen A, Porkka-Heiskanen T, Paunio T (2017) Maternal and paternal sleep during pregnancy in the Child-sleep birth cohort. Sleep Med 29:47–56 PubMedCrossRef Juulia Paavonen E, Saarenpää-Heikkilä O, Pölkki P, Kylliäinen A, Porkka-Heiskanen T, Paunio T (2017) Maternal and paternal sleep during pregnancy in the Child-sleep birth cohort. Sleep Med 29:47–56 PubMedCrossRef
42.
go back to reference Kadesjö B, Janols L-O, Korkman M, Mickelsson K, Strand G, Trillingsgaard A et al (2004) The FTF (Five to Fifteen): the development of a parent questionnaire for the assessment of ADHD and comorbid conditions. Eur Child Adolesc Psychiatry 13(Suppl 3):3–13 PubMed Kadesjö B, Janols L-O, Korkman M, Mickelsson K, Strand G, Trillingsgaard A et al (2004) The FTF (Five to Fifteen): the development of a parent questionnaire for the assessment of ADHD and comorbid conditions. Eur Child Adolesc Psychiatry 13(Suppl 3):3–13 PubMed
43.
go back to reference Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40(11):1337–1345 PubMedCrossRef Goodman R (2001) Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 40(11):1337–1345 PubMedCrossRef
44.
go back to reference Radloff LS (1977) The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401 CrossRef Radloff LS (1977) The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas 1(3):385–401 CrossRef
45.
go back to reference Irwin M, Artin KH, Oxman MN (1999) Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med 159(15):1701–1704 PubMedCrossRef Irwin M, Artin KH, Oxman MN (1999) Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med 159(15):1701–1704 PubMedCrossRef
46.
go back to reference Kiviruusu O, Pietikäinen JT, Kylliäinen A, Pölkki P, Saarenpää-Heikkilä O, Marttunen M et al (2019) Trajectories of mothers’ and fathers’ depressive symptoms from pregnancy to 24 months postpartum. J Affect Disord 10(260):629–637 Kiviruusu O, Pietikäinen JT, Kylliäinen A, Pölkki P, Saarenpää-Heikkilä O, Marttunen M et al (2019) Trajectories of mothers’ and fathers’ depressive symptoms from pregnancy to 24 months postpartum. J Affect Disord 10(260):629–637
47.
go back to reference Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E et al (2005) The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 35(2):245–256 PubMedCrossRef Kessler RC, Adler L, Ames M, Demler O, Faraone S, Hiripi E et al (2005) The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 35(2):245–256 PubMedCrossRef
48.
go back to reference Robinson CC, Mandleco B, Olsen SF, Hart CH (1995) Authoritative, authoritarian, and permissive parenting practices: development of a new measure. Psychol Rep 77(3):819–830 CrossRef Robinson CC, Mandleco B, Olsen SF, Hart CH (1995) Authoritative, authoritarian, and permissive parenting practices: development of a new measure. Psychol Rep 77(3):819–830 CrossRef
49.
go back to reference Baumrind D. Current patterns of parental authority. Dev Psychol. 1971;4(1, Pt.2):1–103. Baumrind D. Current patterns of parental authority. Dev Psychol. 1971;4(1, Pt.2):1–103.
50.
go back to reference Sadeh A (2004) A brief screening questionnaire for infant sleep problems: validation and findings for an Internet sample. Pediatrics 113(6):e570–e577 PubMedCrossRef Sadeh A (2004) A brief screening questionnaire for infant sleep problems: validation and findings for an Internet sample. Pediatrics 113(6):e570–e577 PubMedCrossRef
51.
go back to reference Talge NM, Neal C, Glover V (2007) Early Stress Translational Research and Prevention Science Network: Fetal and Neonatal Experience on Child and Adolescent Mental Health Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry. 48(3–4):245–261 PubMedCrossRef Talge NM, Neal C, Glover V (2007) Early Stress Translational Research and Prevention Science Network: Fetal and Neonatal Experience on Child and Adolescent Mental Health Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry. 48(3–4):245–261 PubMedCrossRef
52.
go back to reference Räikkönen K, Pesonen AK, O’Reilly JR, Tuovinen S, Lahti M, Kajantie E et al (2015) Maternal depressive symptoms during pregnancy, placental expression of genes regulating glucocorticoid and serotonin function and infant regulatory behaviors. Psychol Med 45(15):3217–3226 PubMedCrossRef Räikkönen K, Pesonen AK, O’Reilly JR, Tuovinen S, Lahti M, Kajantie E et al (2015) Maternal depressive symptoms during pregnancy, placental expression of genes regulating glucocorticoid and serotonin function and infant regulatory behaviors. Psychol Med 45(15):3217–3226 PubMedCrossRef
53.
go back to reference Smith GD (2008) Assessing intrauterine influences on offspring health outcomes: can epidemiological studies yield robust findings? Basic Clin Pharmacol Toxicol 102(2):245–256 PubMedCrossRef Smith GD (2008) Assessing intrauterine influences on offspring health outcomes: can epidemiological studies yield robust findings? Basic Clin Pharmacol Toxicol 102(2):245–256 PubMedCrossRef
54.
go back to reference Martin A, Ryan RM, Brooks-Gunn J (2007) The joint influence of mother and father parenting on child cognitive outcomes at age 5. Early Child Res Q 22(4):423–439 CrossRef Martin A, Ryan RM, Brooks-Gunn J (2007) The joint influence of mother and father parenting on child cognitive outcomes at age 5. Early Child Res Q 22(4):423–439 CrossRef
55.
go back to reference Hemmi MH, Wolke D, Schneider S (2011) Associations between problems with crying, sleeping and/or feeding in infancy and long-term behavioural outcomes in childhood: A meta-analysis. Arch Dis Child 96(7):622–629 PubMedCrossRef Hemmi MH, Wolke D, Schneider S (2011) Associations between problems with crying, sleeping and/or feeding in infancy and long-term behavioural outcomes in childhood: A meta-analysis. Arch Dis Child 96(7):622–629 PubMedCrossRef
56.
go back to reference Park JL, Hudec KL, Johnston C (2017) Parental ADHD symptoms and parenting behaviors: A meta-analytic review. Clin Psychol Rev 56:25–39 PubMedCrossRef Park JL, Hudec KL, Johnston C (2017) Parental ADHD symptoms and parenting behaviors: A meta-analytic review. Clin Psychol Rev 56:25–39 PubMedCrossRef
57.
go back to reference Nigg J, Nikolas M, Burt SA (2010) Measured gene-by-environment interaction in relation to attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 49(9):863–873 PubMedPubMedCentralCrossRef Nigg J, Nikolas M, Burt SA (2010) Measured gene-by-environment interaction in relation to attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 49(9):863–873 PubMedPubMedCentralCrossRef
58.
go back to reference Kendler KS, Eaves LJ (1986) Models for the joint effect of genotype and environment on liability to psychiatric illness. Am J Psychiatry 143(3):279–289 PubMedCrossRef Kendler KS, Eaves LJ (1986) Models for the joint effect of genotype and environment on liability to psychiatric illness. Am J Psychiatry 143(3):279–289 PubMedCrossRef
59.
go back to reference Turnbull K, Reid GJ, Morton JB (2013) Behavioral sleep problems and their potential impact on developing executive function in children. Sleep 36(7):1077–1084 PubMedPubMedCentralCrossRef Turnbull K, Reid GJ, Morton JB (2013) Behavioral sleep problems and their potential impact on developing executive function in children. Sleep 36(7):1077–1084 PubMedPubMedCentralCrossRef
60.
go back to reference Rimestad ML, Lambek R, Zacher Christiansen H, Hougaard E (2019) Short- and Long-Term Effects of Parent Training for Preschool Children With or at Risk of ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 23(5):423–434 PubMedCrossRef Rimestad ML, Lambek R, Zacher Christiansen H, Hougaard E (2019) Short- and Long-Term Effects of Parent Training for Preschool Children With or at Risk of ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 23(5):423–434 PubMedCrossRef
61.
go back to reference Letourneau NL, Dennis C-L, Cosic N, Linder J (2017) The effect of perinatal depression treatment for mothers on parenting and child development: A systematic review. Depress Anxiety 34(10):928–966 PubMedCrossRef Letourneau NL, Dennis C-L, Cosic N, Linder J (2017) The effect of perinatal depression treatment for mothers on parenting and child development: A systematic review. Depress Anxiety 34(10):928–966 PubMedCrossRef
62.
go back to reference Paul IM, Savage JS, Anzman-Frasca S, Marini ME, Beiler JS, Hess LB et al (2018) Effect of a responsive parenting educational intervention on childhood weight outcomes at 3 years of age: the INSIGHT randomized clinical trial. JAMA 320(5):461–468 PubMedPubMedCentralCrossRef Paul IM, Savage JS, Anzman-Frasca S, Marini ME, Beiler JS, Hess LB et al (2018) Effect of a responsive parenting educational intervention on childhood weight outcomes at 3 years of age: the INSIGHT randomized clinical trial. JAMA 320(5):461–468 PubMedPubMedCentralCrossRef
63.
go back to reference Klenberg L, Jämsä S, Häyrinen T, Lahti-Nuuttila P, Korkman M (2010) The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes. Scand J Psychol 51(5):439–448 PubMed Klenberg L, Jämsä S, Häyrinen T, Lahti-Nuuttila P, Korkman M (2010) The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes. Scand J Psychol 51(5):439–448 PubMed
64.
go back to reference Murray C, Johnston C (2006) Parenting in mothers with and without attention-deficit/hyperactivity disorder. J Abnorm Psychol 115(1):52–61 PubMedCrossRef Murray C, Johnston C (2006) Parenting in mothers with and without attention-deficit/hyperactivity disorder. J Abnorm Psychol 115(1):52–61 PubMedCrossRef
Metagegevens
Titel
Prenatal and Postnatal Predictive Factors for Children’s Inattentive and Hyperactive Symptoms at 5 Years of Age: The Role of Early Family-related Factors
Auteurs
Hanna Huhdanpää
Isabel Morales-Muñoz
Eeva T. Aronen
Pirjo Pölkki
Outi Saarenpää-Heikkilä
Anneli Kylliäinen
E. Juulia Paavonen
Publicatiedatum
19-09-2020
Uitgeverij
Springer US
Gepubliceerd in
Child Psychiatry & Human Development / Uitgave 5/2021
Print ISSN: 0009-398X
Elektronisch ISSN: 1573-3327
DOI
https://doi.org/10.1007/s10578-020-01057-7

Andere artikelen Uitgave 5/2021

Child Psychiatry & Human Development 5/2021 Naar de uitgave