Category: Child / Adolescent - Externalizing
Family accommodation describes changes that family members make to their own behaviors to avoid or alleviate the distress that their relative is experiencing due to behavioral or emotional concerns. Parents typically engage in accommodation because it is an effective way to reduce child distress in the short term. However, over time, these accommodations may maintain children’s maladaptive behaviors through negative reinforcement processes. Research has demonstrated an association between parent accommodation and increased symptomatology, functional impairment and a poorer treatment response in children with obsessive-compulsive disorder (OCD). Moreover, temper outbursts and other disruptive behaviors associated with OCD uniquely predict parent accommodation. Research examining parent accommodation in a range of anxiety disorders as well as tic and eating disorders shows similar findings. As such, accommodation is a transdiagnostic phenomenon that may be impacting the successful treatment of children with psychopathology. To date, no studies have examined parent accommodation of children with severe emotional dysregulation, characterized by severe temper outbursts (STO), or in children with behavioral dysregulation, characterized by Attention Deficit Hyperactivity Disorder (ADHD). Anecdotally, in our own work, we have found that parents of these children accommodate in many ways, such as changing daily routines and avoiding shopping trips and outings. However, no measure exists to systematically assess this. Thus, the aim of this study is to develop a measure designed to investigate the characteristics and clinical correlates of parent accommodation in these populations.
This measure is currently being developed in a sample of 6-9-year-old children across three groups: children with STO, children with ADHD without STO, and typically developing children. All participants receive comprehensive systematic diagnostic assessments and participate in a variety of behavioral and neuropsychological tasks. Data collection will not be complete until the fall, at which time, analyses will be conducted.
We will present analyses of psychometric properties of the new measure including internal consistency and construct validity. Convergent validity with the Family Impact Questionnaire – Revised and discriminant validity will be investigated. We will also describe the nature, incidence and clinical correlates of accommodation in these populations. We hypothesize that parent accommodation will be prevalent and pervasive throughout both clinical populations, but will be higher in children with STO than in those with only ADHD.
Treatment implications of this measure will be discussed.
Emily Hirsch– Doctoral Student, Fordham University, New York, New York
Amy Roy– Associate Professor of Psychology, Fordham University, Bronx, New York
Jonathan Comer– Director of the Mental Health Interventions and Technology (MINT) Program; Professor of Psychology and Psychiatry, Florida International University, Florida