Clinical Assessment of Child and Adolescent Personality and ...

294 CHAPTER 12 assessing family contextimpact on the home environment andthe impact on parent and child interactions.Consistent with this view, parentalsubstance use has been linked to a host ofproblematic parent practices, includinghigher rates of abuse (Ondersma, 2007;Walsh, MacMillan, & Jamieson, 2003).Parental Antisocial BehaviorThe intergenerational link to antisocialbehavior is a consistent finding in researchand one that has long intrigued social scientistsand policy-makers alike (see Frick& Loney, 2002, for a review). Early studiestended to focus on the intergenerationallink to criminality. This research foundthat the link was independent of socioeconomicstatus, neighborhood, and intelligence(Glueck & Glueck, 1968). Morerecent studies have focused on psychiatricdefinitions of antisocial disorders. As instudies of criminality, children diagnosedwith antisocial disorders are significantlymore likely to have parents with antisocialdisorders than are children without conductproblems (Frick et al., 1992; Monuteaux,Faraone, Gross, & Biederman, 2007).An important methodological pointin the more recent family history studieswas the fact that each used clinic controlgroups and found that histories of antisocialdisorders in parents were specificto conduct problems in children. That is,children with conduct problems not onlyhad higher rates of parental antisocial disorder(APD) than normal controls, butthey also had higher rates of parental APDthan clinic-referred children with otherproblems in adjustment (Frick et al., 1992).Therefore, unlike parental depression andsubstance abuse, parent antisocial behaviorappears to have a more specific relationshipto a particular child problem (i.e., conductproblems).Frick and Loney (2002) reviewed datasupporting several potential mechanismsto explain this link including an inheriteddisposition passed from parent to child,parental modeling of antisocial behaviors,and disruptions in the family caused bythe parent’s antisocial behavior. In supportof at least some inherited predisposition,Tapscott, Frick, Wootton, and Kruh (1996)showed that a paternal history of antisocialpersonality disorder was associated with ahigher rate of Conduct Disorder in theirbiological offspring, even if the father hadno contact with the child since the firstyear of life.Parental ADHDThere is evidence that parents and otherbiological relatives of children with ADHDshow more attentional problems (Albert-Corush, Firestone, & Goodman, 1986) anda higher rate of ADHD (Faraone, Biederman,Keenan, & Tsuang, 1991). However,these studies may have underestimatedthe link between parent and child ADHDby studying the parents’ current adjustment.Given that 30–50% of children withADHD may not be diagnosed with thisdisorder as adults (Barkley, Fischer, Smallish,& Fletcher, 2002), it may be that manyof the parents of ADHD children exhibitedADHD as a child but are not currentlyshowing symptoms.To test this possibility, Frick et al. (1991)studied the childhood histories of parents ofclinic-referred children. A child’s biologicalparent reported on whether or not he or shehad problems associated with ADHD beforethe age of 18 and then completed a similarfamily history questionnaire for all firstdegreerelatives. Children with ADHD weremore likely to have mothers, fathers, andother biological relatives who also exhibitedADHD as children than were other clinicreferredchildren. In fact, approximately75% of the 103 children with ADHD hadone biological relative with a significant historyof ADHD (27% of mothers and 44% offathers) and 46% had two biological relativeswith a significant history of ADHD. This