Investigation of parental expressed emotion in adolescent with attention deficit hyperactivity disorder and evaluation of the relationship between expressed emotion and empathy skills, conduct problems, peer bullying

Aim: In our study, it is aimed to investigate whether there is a significant difference in parental expressed emotion and perceived expressed emotion in adolescents with ADHD compared to adolescents in the healthy control group; also to examine the relationship between expressed emotion and empathy tendency, ADHD symptoms, conduct problems, peer bullying. Method: Our study included 52 ADHD and 50 control group adolescents who were 12-16 years old and their mothers and fathers, according to the K-SADS-PL interview and DSM-V diagnostic criteria. In the clinical evaluation, participants were not included in the study in cases the adolescent's psychiatric diagnosis other than ADHD, any major psychiatric disease in the parents, at least one of the adolescent or parents has clinical intellectual disability, neurological disease or a chronic medical condition that may directly affect their cognitive functions, a history of psychostimulant drug or atomoxetine use in the last 6 months, a life long history of antidepressant or antipsychotic drug use or where the adolescent does not reside with his/her parents. Clinical interviews were made with all participants and after sociodemographic information was obtained; parents were asked to fill in the Symptom Checklist (SCL-90-R) and about their children Expressed Emotion Scale (EE), Turgay Disruptive Behavior Rating Scale (T-DSM-IV-S), The Strengths and Difficulties Questionnaire (SDQ). Adolescents were asked to fill in the Shortened Level of Expressed Emotion Scale in Adolescents and about themselves KASI Empathic Tendency Scale-Adolescent Form, Olweus Bullying Questionnaire for Students. Results: In the study, the EE total score and subscale scores reported by the parents were found to be significantly higher in the case group than in the control group. Similarly, the perceived EE total score and subscale scores reported by the adolescents were found to be significantly higher in the case group than in the control group. A negative and significant correlation was found between the empathy tendency and the perceived EE total score and the Lack of Emotional Support subscale score in the adolescents in the case group. In the case group, there was a positive significant correlation was found between the AD/HA problem scores reported by the parents and the maternal EE total score, the maternal EE criticism-hostility subscale score, the paternal EE total score, the paternal EE criticism-hostility subscale score, the adolescent's perceived EE total score, the adolescent's Lack of Emotional Support and Irritability subscale scores. In the case group, a statistically significant positive correlation was found between the conduct problems scores reported by the parents and the maternal EE total score, the maternal EE criticism-hostility subscale score, and the perceived EE total score reported by the adolescent. In our study, when the EE scores reported by the participants in the case group and the roles of peer bullying were examined together, maternal EE total and maternal EE criticism-hostility subscale scores were found to be statistically significantly higher in students involved in bullying. Conclusion: In our study, it was found that both parental emotional expression and perceived emotional expression in adolescents were reported higher in the ADHD group than in the control group. The Inattention/Hyperactivity scores of the adolescents in the case group were determined by the EE-total and EE criticism-hostility subscale scores of both parents, the perceived Lack of Emotional Support and Irritability subscale scores in the adolescent; on the other hand, it was determined that the conduct problems score was only related to them other's EE-total and EE criticism-hostility subscale scores. Inaddition, maternal EE total and maternal EE criticism-hostility subscale scores were found to be high in adolescents involved in peer bullying in the case group. As far as we know, we think that our study will contribute to the literature as it is the first study to examine parental expressed emotion and perceived expressed emotion in terms of the relationship between empathy tendency, conduct problems and peer bullying in adolescents diagnosed with ADHD. Keywords: attention deficit hyperactivity disorder, expressed emotion, empathy, conduct problems, peer bullying