2 - (SYM 2) Examining Associations Between Parent and Adolescent EMA Ratings and Treatment Outcomes for Adolescents with ADHD

Parent emotion socialization (ES) is a strong predictor of adolescent social-emotional outcomes (Brand et al., 2010; Klimes-Dougan et al., 2007), including emotion dysregulation (ED). The majority of the ES research has relied on global retrospective report or lab-based paradigm tasks. This study sought to utilize ecological momentary assessment (EMA) to examine how pre-treatment parent ES and adolescent ED and affectivity ratings relate to treatment outcomes following participation in the RELAX (Regulating Emotions Like An eXpert) intervention (Breaux & Langberg, 2020; Breaux et al., 2021), which targets ED and interpersonal conflict among families of adolescents with ADHD.

Participants were 20 adolescents (14 males; 85% White; 10% Hispanic/Latine) and a primary caregiver (Mage = 45.35 years; 75% mothers) who participated in the RELAX intervention telehealth pilot study. Participants were asked to complete online daily ratings for two weeks pre-treatment; parents reported on their ES practices and adolescents reported on their emotion regulation strategies and positive and negative affectivity. Parents completed an average of 11.40 ratings (range=5-14) and adolescents completed an average of 9.38 ratings (range=0-14). Treatment outcomes included adolescent ED and family conflict. 

Parent pre-RELAX daily supportive ES practices predicted improvements in adolescent ED and family conflict, such that families who had higher pre-treatment supportive practices had better treatment outcomes. Similarly, parent pre-RELAX daily non-supportive ES practices predicted improvements in family conflict, such that families who had less pre-treatment non-supportive practices had better treatment outcomes.

Adolescent pre-RELAX daily use of cognitive reappraisal and expressive suppression strategies predicted improvements in family conflict, such that adolescents who used more cognitive reappraisal and less expressive suppression had better treatment outcomes. Adolescent pre-RELAX daily positive affect was associated with improvements in family conflict and negative affect was associated with reductions of ED, such that adolescents with higher positive affectivity and lower negative affectivity had better treatment outcomes.

These findings and their clinical implications regarding identifying potential treatment non-responders and points of intervention at the parent and adolescent-level based on pre-treatment EMA data will be discussed.