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Children's Inattention and Hyperactivity, Mother's Parenting, and Risk Behaviors in Adolescence

A 10-Year Longitudinal Study of Chilean Children

Nelson, Theodora, MD*; East, Patricia, PhD*; Delva, Jorge, PhD; Lozoff, Betsy, MD; Gahagan, Sheila, MD*,‡

Journal of Developmental & Behavioral Pediatrics: May 2019 - Volume 40 - Issue 4 - p 249–256
doi: 10.1097/DBP.0000000000000661
Original Article

Objective: To examine how mothers' nurturant and, separately, hostile parenting mediate the effects of young children's inattentiveness and hyperactivity on risk behaviors in adolescence.

Method: Data were analyzed from 920 healthy Chilean children, studied at 5.5, 10 years, and adolescence. Children's hyperactivity and inattentiveness at 5.5 years were assessed by mother ratings on the Children's Adaptive Behavior Inventory. Mothers' nurturance and hostility toward the child at 10 years were assessed by maternal interview on the Home Observation for Measurement of the Environment. Youth's delinquent and aggressive behaviors in adolescence were compiled from the Youth Self-Report questionnaire, and youth's substance use in adolescence was assessed by an extensive self-report substance use inventory. Structural equation modeling was used to identify direct and indirect effects.

Results: Findings supported a mediating effect, with more severe child hyperactivity at 5.5 years leading to mothers' greater hostility toward her child at age 10, which, in turn, led to greater delinquency and aggression in adolescence. Marginal mediating effects were also found from child hyperactivity and inattention at 5.5 years to mothers' lower nurturance at 10 years to youth substance use in adolescence.

Conclusion: Mothers' hostile treatment of children with hyperactive or inattentive behaviors contributed to adolescent risk behaviors and is an area of intervention.

*Division of Academic General Pediatrics, Department of Pediatrics, University of California, San Diego, La Jolla, CA;

School of Social Work, Boston University, Boston, MA;

Center for Human Growth and Development, University of Michigan, Ann Arbor, MI.

Address for reprints: Theodora Nelson, MD, Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, Mail Code 0927, La Jolla, CA 92093-0927; e-mail:

Supported by grants from the National Institutes of Health R01-HL-088530 (PI: S. Gahagan), R01-HD-033487 (PIs: S. Gahagan and B. Lozoff), R01-DA-021181 (PI: J. Delva), and T-77-MC-25734 from the Health Resources and Services Administration Maternal and Child Health Bureau.

Disclosure: The authors declare no conflict of interest.

See the Video Abstract at

Received September 28, 2018

Accepted January 16, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.