(PS6-83) Maternal Self-efficacy Predicts Treatment Attendance in Parenting Interventions for Youth with ADHD

 Behavioral parenting training (BPT) is an efficacious psychosocial intervention to improve outcomes for children with ADHD (Evans et al., 2018). However, almost 50% of families drop out of BPT before completion (Chacko et al., 2016). Engagement in BPT is often predicted by the severity of child behavior difficulties, family SES, maternal age, maternal education, and maternal mental health (Chacko et al., 2016; Reyno & McGrath, 2006 ). In addition, parents of children with ADHD report lower parenting efficacy compared to parents of children without ADHD, which predicts worse externalizing outcomes in children after BPT (Primack et al., 2012; Van den Hoofdakker et al., 2010). More broadly, personality traits are associated with mental health treatment attendance and outcomes (Bucher et al., 2019). Despite these findings, little is known about predictors of treatment engagement in parenting interventions when elevated levels of parenting psychopathology are present, although up to half of mothers of children with ADHD have a history of major depressive disorder (MDD; Johnson & Chronis-Tuscano, 2015).

To address this gap, we conducted a secondary analysis of an efficacy trial examining predictors of treatment attendance for two parenting interventions (Integrated Parenting Intervention for ADHD (IPI-A) and standard BPT; Chronis-Tuscano et al., 2013) for mothers with elevated depression symptoms seeking treatment for their child with ADHD. We hypothesized that maternal age and education, maternal depression, baseline child behavior problems, parenting self-efficacy, maternal conscientiousness, and maternal neuroticism would be significant predictors of treatment engagement for these parenting interventions.

Participants included 98 mothers who met or exceeded a minimal level of depression

( >=9) on the Beck Depression Inventory-II (BDI-II; Beck et al., 1996) and their children with

ADHD. Parenting self-efficacy was assessed using the efficacy subscale from the Being a Parent Questionnaire (BAP; Mash & Johnston, 1989). Parental personality traits were measured using the NEO Personality Inventory (NEO-PI; Costa & McCrae, 1985). Parent age, education level, and baseline child disruptive behavior problems were measured through parent reports. Treatment attendance (Range = 0-14 sessions attended, M = 8.47, SD = 4.67) did not differ between parenting interventions, so the two BPT groups were examined together. First, we conducted bivariate correlations between hypothesized predictors and treatment attendance. Maternal education, neuroticism, and parenting self-efficacy demonstrated significant positive correlations with treatment attendance. These variables were entered into a hierarchical regression equation (Step 1: maternal education; Step 2: parenting self-efficacy and neuroticism). In the overall model, both parent education (B=0.22, t= 2.24, p=.03) and parenting self-efficacy (B=0.34, t= 3.36, p=.001) were significant positive predictors of treatment attendance, F(3,85) = 8.58, p< .001, R2=0.23. Neuroticism was a nonsignificant predictor.
Results suggest that parenting self-efficacy and parent education may be key treatment engagement indicators for mothers with elevated depressive symptoms.