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Structural Equation Modeling (SEM): Childhood Aggression and Irritable ADHD Associated with Parental Psychiatric Symptoms

Author

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  • Ruu-Fen Tzang

    (Department of Psychiatry, Mackay Memorial Hospital, Taipei 104, Taiwan
    Department of Childhood Care and Education, Mackay Junior College of Medicine, Nursing and Management, Taipei 112, Taiwan
    Mackay Medical College, New Taipei City 252, Taiwan)

  • Yue-Cune Chang

    (Department of Mathematics, Tamkang University, New Taipei City 251, Taiwan)

  • Chuan-Hsin Chang

    (Agricultural Biotechnology Research Center, Academia Sinica, Taipei 115, Taiwan)

Abstract

Background: Children with attention deficit hyperactivity disorder (ADHD) co-occurring with Oppositional Defiant Disorder (ODD) further present aggressive behavior and may have a depressive parent. A child with co-occurring ADHD and ODD has differentially higher levels of behavioral and emotional difficulties. Little is known about how the irritable subtype of ADHD in children mediates the development of parental symptomatology. This study aims to elucidate the direct or indirect influence of childhood disruptive ADHD with aggressive behavior on their parental symptom using Structural Equation Modeling (SEM). Methods: A total of 231 ADHD children and their parents completed the Swanson, Nolan, and Pelham Version IV questionnaire for symptoms of ADHD, Oppositional Defiant Disorder (ODD) scale for irritable symptoms, Child Behavior Check List (CBCL) for aggression, and Symptom Checklist (SCL) for parental symptom. Results: The three-factor confirmatory factor analysis (CFA) model found symptoms of inattention, hyperactivity/impulsivity, irritable ODD, and aggression were inter-related. Mediational analyses demonstrated ODD mediates symptoms directly predicting the risk of increasing ADHD severity. Disruptive child symptoms (ADHD + ODD + aggression) may increase the risk of depression-related symptoms in the parent. When the child’s aggression increases by one standard deviation (SD), parental psychiatric symptoms increase by 0.235 SD ( p < 0.001). Conclusions: By this SEM pathway analysis, there is the correlation between the disruptive, more aggressive subtype of ADHD in children/adolescents and the existence of psychopathological symptomatology of their parents. ADHD + ODD + aggression in children should be classified as an irritable subtype of ADHD, warranting early diagnosis and intensive treatment.

Suggested Citation

  • Ruu-Fen Tzang & Yue-Cune Chang & Chuan-Hsin Chang, 2021. "Structural Equation Modeling (SEM): Childhood Aggression and Irritable ADHD Associated with Parental Psychiatric Symptoms," IJERPH, MDPI, vol. 18(19), pages 1-11, September.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10068-:d:642742
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    1. Lenka Štofejová & Štefan Kráľ & Richard Fedorko & Radovan Bačík & Mária Tomášová, 2023. "Sustainability and Consumer Behavior in Electronic Commerce," Sustainability, MDPI, vol. 15(22), pages 1-16, November.

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