Relationship Among Peer Relations, Parental Attachment Styles, and Level of Tendency to Violence in Adolescents Diagnosed with Attention Deficit and Hyperactivity Disorder

Year 2023, Volume: 45 Issue: 1, 101 - 109, 23.01.2023

Barış Güller Didem Ayyıldız Ferhat Yaylacı

https://doi.org/10.20515/otd.1173865

Abstract

In recent years, parental factors have been emphasized among the factors that predict violent behavior, which is observed more frequently in adolescents with Attention Deficit and Hyperactivity Disorder (ADHD) compared to healthy controls. However, the relationship between parental attachment styles and violent behaviors of ADHD patients remains unclear. In the present study, it was aimed to investigate the effects of parental attachment styles and other related factors such as peer relations or psychosocial factors on the tendency to violence in adolescents followed up with the diagnosis of ADHD. Adolescents aged 12-18 years (n=115) who were newly diagnosed or being followed up with the diagnosis of attention deficit hyperactivity disorder (ADHD) between August 2021 and April 2022 in a Child and Adolescent Psychiatry Outpatient Clinic were included in the study. The parents of the participants were asked to fill out a detailed researcher form and the “Strengths and Difficulties Questionnaire-parent form” (SDQ). "Peer Relationship Scale", the "Violence Tendency Scale" and the Parent and Peer Attachment Inventory- brief form (IPPA-R) were given to the adolescents to fill out. Hierarchical linear regression analyses indicated that peer relationship problems (PRS-loyalty subscale) (B= .926, p= .001), psychiatric difficulties (the SDQ-total) (B= .547, p=.001) and the parental alienation (mother) (B=.430, p=.015) variables were statistically significantly associated with violence tendency. Identifying environmental factors that predict violence in youth with ADHD without co-morbid conduct disorder is crucial for the development of preventive interventions.

Keywords

ADHD, violence, attachment, peer groups, alienation, adolescent psychiatry.

Dikkat Eksikliği ve Hiperaktivite Bozukluğu Tanısı olan Ergenlerde Akran İlişkileri, Ebeveyne Bağlanma Stilleri ve Şiddet Eğilimi Düzeyleri Arasındaki İlişki

Abstract

Dikkat Eksikliği ve Hiperaktivite Bozukluğu (DEHB) olan ergenlerde sağlıklı kontrollere göre daha sık görülen şiddet davranışını yordayan faktörler arasında son yıllarda ebeveyn faktörlerinin üzerinde durulmaktadır. Ancak DEHB hastalarının ebeveyn bağlanma stilleri ile şiddet davranışları arasındaki ilişki belirsizliğini korumaktadır. Bu çalışmada, DEHB tanısı ile izlenen ergenlerde, ebeveyn bağlanma biçimleri ile akran ilişkileri ya da psikososyal faktörler gibi ilişkili diğer faktörlerin şiddet eğilimine etkisinin araştırılması amaçlanmıştır. Bir Çocuk ve ergen psikiyatrisi polikliniğinde Ağustos 2021-Nisan 2022 tarihleri arasında Dikkat Eksikliği ve Hiperaktivite Bozukluğu (DEHB) tanısı ile takip edilmekte olan veya yeni tanı alan 12-18 yaş arası ergenler (n=115) çalışmaya alınmıştır. Katılımcıların ailelerinden detaylı bir araştırmacı formu ve “Güçler ve Güçlükler Anketi-ebeveyn formu” (SDQ) doldurmaları istenmiştir. Ergenlere doldurmaları üzere "Akran İlişkileri Ölçeği", "Şiddete Eğilim Ölçeği” ve Ebeveyn ve Akrana Bağlanma Envanteri kısa formu verilmiştir. Hiyerarşik doğrusal regresyon analizleri, akran ilişkileri sorunları (PRS-sadakat alt ölçeği) (B= .926, p= .001), psikiyatrik güçlük düzeyleri (SDQ-toplam) (B= .547, p=.001) ve ebeveyne yabancılaşmanın (B=.430, p=.015) şiddet eğilimi ile istatistiksel olarak anlamlı düzeyde ilişkili değişkenler olduğunu göstermektedir. Davranım bozukluğu eş tanısı olmayan DEHB’li gençlerde şiddeti ön gördüren çevresel etmenlerin belirlenmesi önleyici müdahalelerin geliştirilmesi açısından önem arz etmektedir.

Keywords

DEHB, şiddet eğilimi, bağlanma, akran grupları, ebeveyne yabancılaşma, ergen, psikiyatri.

References

• Polanczyk G, De Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942-48.
• Moriyama TS, Cho, AJ M, et al. Attention deficit hyperactivity disorder In Rey JM (ed), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions, 2012.
• Thapar A, Van den Bree M, Fowler T, et al. Predictors of antisocial behaviour in children with attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry.2006;15(2):118-5.
• Wymbs B, Molina B, Pelham W, et al. Risk of intimate partner violence among young adult males with childhood ADHD. J Atten Disord. 2012;16(5):373-83.
• Miura, H. Differences in frontal lobe function between violent and nonviolent conduct disorder in male adolescents. Psychiatry Clin Neurosci. 2009;63(2):161-66.
• Barker ED, Tremblay RE, van Lier PA, et al. The neurocognition of conduct disorder behaviors: Specificity to physical aggression and theft after controlling for ADHD symptoms. Aggress Behav.2011;37(1):63-72.
• Çelik S, Gençoğlu C, Kumcağız H. Emotional intelligence as a predictor of violence tendency in adolescents. Journal of Kırşehir Ahi Evran University Education Faculty.2016;17(3):121-34.
• Bernat DH, Oakes JM, Pettingell SL, et al. Risk and direct protective factors for youth violence: results from the National Longitudinal Study of Adolescent Health. Am J Prev Med.2012;43(2):57-6.
• Hoza B, Gerdes AC, Mrug S, et al. Peer-assessed outcomes in the multimodal treatment study of children with attention deficit hyperactivity disorder. J Clin Child Adolesc Psychol. 2005;34(1):74-86.
• Aduen PA, Day TN, Kofler MJ, et al. Social problems in ADHD: Is it a skills acquisition or performance problem? J Psychopathol Behav Assess. 2018;40(3):440-51.
• Ayaz AB, Erol Güler E, Yildirim B, et al. Predictors of aggressive behavior in children diagnosed with attention deficit hyperactivity disorder. Anatolian Journal of Psychiatry.2016;17(3).
• Johnston C, Jassy JS. Attention-deficit/hyperactivity disorder and oppositional/conduct problems: Links to parent-child interactions. J Can Acad Child Adolesc Psychiatry. 2007;16(2):74.
• Özcan C, Oflaz F, Türkbay T. Comparison of empathy in parents of children with attention deficit hyperactivity disorder and co-occurence of oppositional defiant disorder. Turk J Child Ment Health. 2003; 3:108-14.
• Csibi S, Csibi M. Study of aggression related to coping, self-appreciation and social support among adolescents. Nordic Psychology. 2011;63(4):35.
• Avcı ÖH, Yildirim İ. Ergenlerde şiddet eğilimi, yalnızlık ve sosyal destek. Journal of Hacettepe University Education Faculty. 2014;29(29-1):157-68.
• Çengel Kültür SE. Parenting Skills in the Treatment of Attention Deficit/Hyperactivity Disorder and Disruptive Behavior Problems. Turkiye Klinikleri J Child Psychiatry-Special Topics. 2017;3(2):106-14.
• Mroczkowski MM, Walkup JT, Appelbaum PS. Assessing violence risk in adolescents in the pediatric emergency department: systematic review and clinical guidance. West J of Emerg Med. 2021;22(3):533.
• Molina MF, Musich FM. Perception of parenting style by children with ADHD and its relation with inattention, hyperactivity/impulsivity and externalizing symptoms. J Child Fam Stud. 2016;25(5):1656-671.
• Cop E, Cengel Kultur SE, Senses Dinc G. Anababalık tutumları ile dikkat eksikliği ve hiperaktivite bozukluğu belirtileri arasındaki ilişki. Türk Psikiyatri Dergisi.2017; 28(1),:25-2.
• Kaiser NM, McBurnett K, Pfiffner LJ. Child ADHD severity and positive and negative parenting as predictors of child social functioning: Evaluation of three theoretical models. J Atten Disord.2011;15(3):193-03.
• Al-Yagon M, Lachmi M, Shalev L. Coping strategies among adults with ADHD: The mediational role of attachment relationship patterns. Res Dev Disabil. 2020;102:103657.
• Wylock JF, Borghini A, Slama H, et al. Child attachment and ADHD: a systematic review. Eur Child Adolesc Psychiatry.2021;1-12.
• Kissgen R, Franke S, Susewind M, et al. Attachment Representation and Emotion Recognition Ability in Children with ADHD and Their Parents: A Study Protocol. Int J Environ Res Public Health. 2021;18(5): 2277.
• Storebø OJ, Rasmussen PD, Simonsen E. Association between insecure attachment and ADHD: environmental mediating factors. J Atten Disord. 2016;20(2):187-96.
• Rampp G, Roesler C, Peter J. Attachment Representations, Critical Life Events and ADHD in Boys at 6 to 10 Years of Age. Prax Kinderpsychol Kinderpsychiatr. 2020;69(1):40-60.
• Dekkers TJ, Hornstra R, van den Hoofdakker BJ, et al. S. Attachment representations in children with and without Attention-Deficit/Hyperactivity Disorder (ADHD). Brain Sci. 2021; 11(11):1516.
• Kaner S. Peer relationship scale and peer divergence scale development study. Ankara University Journal of Faculty of Educational Sciences.2000;33(1).
• Günaydın G, Selçuk E, Sümer N, et al. The psychometric evaluation of a short form of Inventory of Parent and Peer Attachment. 2005.
• Güvenir T, Özbek A, Baykara B, et al. Psychometric Properties of The Turkish Version of The Strengths and Difficulties Questionnaire (SDQ). Turkish Journal of Child and Adolescent Mental Health. 2008;15:65-4.
• Young S, Thome J. ADHD and offenders. World J Biol Psychiatry. 2011;12(1):124-28.
• Carpenter DO, Nevin R. Environmental causes of violence. Physiol Behav. 2010;99(2):260-68.
• Murray AL, Obsuth I, Zirk-Sadowski J,et al. Developmental relations between ADHD symptoms and reactive versus proactive aggression across childhood and adolescence. J Atten Disord. 2020;24(12),1701-710.
• Lambie I, Ioane J, Randell I, et al. Offending behaviours of child and adolescent firesetters over a 10‐year follow‐up. J Child Psychol Psychiatry.2013;54(12):1295-307.
• McQuade JD. Peer functioning in adolescents with ADHD. 2020
• Rabiner DL, Coie JD, Miller-Johnson S, et al. Predicting the persistence of aggressive offending of African American males from adolescence into young adulthood: The importance of peer relations, aggressive behavior, and ADHD symptoms. J Emot Behav Disord. 2005;13(3):131-40.
• Gudjonsson GH, Sigurdsson JF, Sigfusdottir ID, et al. A national epidemiological study of offending and its relationship with ADHD symptoms and associated risk factors. J Atten Disord. 2014;18(1):3-13.
• Ercan EU. Aggression and Attention Deficit Hyperactivity Disorder in Children and Adolescents. Journal of Sinop University Social Sciences. 2018;2(2):149-64.
• Laporta-Herrero I, Jáuregui-Lobera I, Barajas-Iglesias B, et al. Attachment to parents and friends and body dissatisfaction in adolescents with eating disorders. Clin Child Psychol Psychiatry. 2021;26(1):154-66.
• Qin X, Sun X, Zhang M, et al. Life-Events Mediate the Prediction of Parental Alienation on Depression in Rural Left-Behind Children: A Longitudinal Study. Front Psychiatry. 2022;13:864751.
• Baker AJ, Ben-Ami N. To turn a child against a parent is to turn a child against himself: The direct and indirect effects of exposure to parental alienation strategies on self-esteem and well-being. Journal of Divorce & Remarriage.2011;52(7):472-89.
• Viana AG, Rabian B. Perceived attachment: Relations to anxiety sensitivity, worry, and GAD symptoms. Behav Res Therapy. 2008;46(6):737-47.
• Lei L, Wu Y. Adolescents' paternal attachment and Internet use. CyberPsychol Behav. 2007;10(5):633-39.
• Kaźmierczak-Mytkowska A, Butwicka A, Lucci KD, et al. Attachment in adolescents with attention deficit hyperactivity disorder and oppositional defiant disorder. Psychiatria Polska. 2022;56(3):535-49.
• Nikiforou M, Georgiou SN, Stavrinides P. Attachment to parents and peers as a parameter of bullying and victimization. Journal of criminology.2013.
• Ooi YP, Ang RP, Fung DS, et al. The impact of parent–child attachment on aggression, social stress and self-esteem. School Psychology International.2006;27(5):552-66.