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Page 1: Negative parenting behavior and childhood oppositional defiant disorder: Differential moderation by positive and negative peer regard

Negative Parenting Behavior and Childhood OppositionalDefiant Disorder: Differential Moderation by Positive andNegative Peer RegardIrene Tung and Steve S. Lee*

Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, California

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Although negative parenting behavior and peer status are independently associated with childhood conduct problems (e.g.,oppositional defiant disorder (ODD)), relatively little is known about their interplay, particularly in relation to differentiatedmeasures of positive and negative peer regard. To improve the specificity of the association of negative parenting behavior andpeer factors with ODD, we explored the potential interaction of parenting and peer status in a sample of 169 five‐to ten‐year‐oldethnically diverse children with and without attention‐deficit/hyperactivity disorder (ADHD) assessed using multiple measures(i.e., rating scales, interview) and informants (i.e., parents, teachers). Controlling for children’s age, sex, number of ADHDsymptoms, and parents’ race‐ethnicity, peer acceptance inversely predicted and inconsistent discipline, harsh punishment, andpeer rejection were each positively associated with ODD symptom severity. Interactive influences were also evident such thatinconsistent discipline and harsh punishment each predicted elevated ODD but only among children experiencing low peeracceptance or high peer rejection. These findings suggest that supportive environments, including peer acceptance, may protectchildren from negative outcomes associated with inconsistent discipline and harsh punishment. Findings are integrated withtheories of social support, and we additionally consider implications for intervention and prevention. Aggr. Behav. 40:79–90,2014. © 2013 Wiley Periodicals, Inc.

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Keywords: parenting; peers; conduct problems

INTRODUCTION

Child conduct problems (CP) (e.g., aggression,delinquency) are the most common referral for mentalhealth services (Kazdin, 1995) and they disrupt children’ssocio‐emotional, behavioral, and academic development(Colman et al., 2009; Fergusson, Horwood, & Ridder,2005). Oppositional defiant disorder (ODD), particularlywhen it presents with attention‐deficit/hyperactivitydisorder (ADHD), predicts future conduct disorder(CD), and antisocial personality disorder (Burke, Loeber,& Birmaher, 2002; Hinshaw, Lahey, & Hart, 1993;Maughan, Rowe, Messer, Goodman, & Meltzer, 2004).That is, because ADHD is critical in fueling an earlyonset of ODD, studies of ODD in children with ADHDare well‐positioned to identify early risk factors for ODD,a crucial consideration given that this group is moreaggressive, delinquent, and treatment resistant thanchildren with ADHD or ODD only (Biederman et al.,2008; Kuhne, Schachar, & Tannock, 1997). Identifyingpotential factors for modification early in development iscrucial to facilitate innovations in the development of

interventions that may alleviate the significant clinicaland public health burden associated with these behaviors.

Harsh and Inconsistent Discipline

Theories of CP suggest that negative parentingbehavior, including inconsistent discipline (i.e., notfollowing through with proposed punishments) and harshpunishment (i.e., frequent hitting, spanking, grabbing),positively predicts child and adolescent CP (Burkeet al., 2002). Chronic harsh and inconsistent disciplinelikely contributes to ODD and aggression through acoercive cycle of negative parent–child interactions.Specifically, children respond to harsh punishment with

�Correspondence to: Steve S. Lee, Department of Psychology, UCLA,1285 Franz Hall, Box 951563, Los Angeles, CA 90095‐1563.E‐mail: [email protected]

Received 15 November 2012; Accepted 17 June 2013

DOI: 10.1002/ab.21497Published online 5 August 2013 in Wiley Online Library(wileyonlinelibrary.com).

AGGRESSIVE BEHAVIORVolume 40, pages 79–90 (2014)

© 2013 Wiley Periodicals, Inc.

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elevated noncompliance and aggression; in an effort toavoid these aversive interactions, parents become moreinconsistent in their discipline strategies over time, whichultimately exacerbates this coercive cycle by reinforcingthe child’s oppositional and aggressive behaviors(Patterson, Reid, & Dishion, 1992). In a cross‐sectionalstudy of 399 youth aged 6–18, inconsistent disciplinepositively predicted oppositional, rule‐breaking, andaggressive behavior, even after controlling for child’sage, gender, and race‐ethnicity (Stanger, Dumenci,Kamon, & Burstein, 2004). Similarly, in a study of 500boys, harsh physical punishment and timid parenting(i.e., reluctance to enforce rules) at age 6 predicted higherincrease in parent‐ and teacher‐reported ODD and CDsymptoms from age 6 to 16, controlling initial CP as wellas age and race‐ethnicity (Pardini, Fite, & Burke, 2008).Importantly, however, exposure to harsh and inconsistentparenting behavior does not universally predict CP, giventhat many children exposed to these behaviors exhibitminimal CP. Given that parenting behavior accounted for11% of the variance in CP in a meta‐analysis of 161studies (Hoeve et al., 2009), other childhood factors alsoinfluence the predictive strength of harsh/inconsistentdiscipline and CP, including school factors as well associo‐emotional and biological traits (Loeber, Burke, &Pardini, 2009). Despite the plausibility of interactiveinfluences underlying the development of CP and theirincremental value to understanding the etiology of CP(Maughan & Gardner, 2010), few studies have simulta-neously modeled influences that are crucial to children’sdevelopment across multiple settings and domains (e.g.,peer influences at school and parenting behavior athome).

Peer Status and ODD

Peer relationships represent a major milestone inchildren’s development, and they constitute a significantsource of socialization (Vandell, 2000). Factors such aspeer status (i.e., peer rejection and acceptance), deviantpeer affiliation, and dyadic friendships are evident asearly as preschool (Haun & Tomasello, 2011), and theyshow strong prospective associations with importantoutcomes. For example, age 5 peer rejection robustly andindependently predicted child and adolescent CP aboveand beyond the child’s sex and prior aggression, althoughthis effect attenuated somewhat later in development(e.g., age 12) (Ladd, 2006). The association of peerrejection and CP may reflect a reciprocal socialtransactional model where children respond to peerrejection with verbal and physical aggression that furthercontributes to social rejection (Dodge, Coie, Pettit, &Price, 1990). In a longitudinal study of 269 children,kindergarten aggression predicted CP in first grade, andpeer rejection significantly incremented predictions of

later CP (McEachern & Snyder, 2012). In the same study,peer rejection mediated predictions of CP from earlyaggression, suggesting that the experience of peerrejection is a crucial conduit to later CP for young,aggressive children. Similarly, among 259 children, peerrejected children exhibited twice the level of aggression4 years later than non‐rejected youth (Dodge et al., 2003),independent of previous CP, school performance, andinternalizing problems. Finally, peer rejection (notincluding externalizing best friends) among 740 kinder-garten children positively predicted oppositional andaggressive behavior 3 years later, independent of initialproblem behavior (Sturaro, van Lier, Cuijpers, &Koot, 2011). Thus, peer rejection may significantlyincrement predictions of CP beyond other well‐estab-lished correlates, suggesting a potentially independentrole in the development of CP.Whereas peer rejection may contribute to CP, peer

acceptance, a critical source of interpersonal support(Parker & Asher, 1993), may protect against thesenegative outcomes. Although peer acceptance is partiallyindependent from peer rejection (Sentse, Lindenberg,Omvlee, Ormel, & Veenstra, 2010), few studies havedifferentially tested peer acceptance versus peer rejectionfor child CP. In one study of 148 girls, peer rejection ingrades 4–6 positively predicted later aggression, sub-stance use, and risky sexual behaviors in grades 10–12,but peer acceptance significantly buffered this associa-tion (Prinstein & La Greca, 2004). The empiricaldistinction between peer acceptance and peer rejectionis also reflected in peer sociometrics, where children areasked to differentially nominate which peers they likebest (i.e., accept) and which peers they like least (i.e.,reject) (Coie, Dodge, & Coppotelli, 1982). Given thatsome children experience low peer acceptance and lowpeer rejection (i.e., “ignored” children) as well as highpeer acceptance and high peer rejection (i.e., “controversial”children) (Newcomb, Bukowski, & Pattee, 1993), peeracceptance and rejection are not opposite ends of thesame continuum. Although few studies have investigatedthe independent role of peer acceptance on childhood CP,previous studies of related, although separate, factors ofpeer support, support the potential buffering effect ofpeer acceptance on child CP. For example, friendshipquality moderated the association between CP andbullying behavior, such that children with CP but atleast one high‐quality friendship were significantly lesslikely to bully than children with only low‐qualityfriendships (Bollmer, Milich, Harris, & Maras, 2005).Thus, despite the dearth of evidence on the specificassociation of peer acceptance and CP, existing researchon related factors of peer support indicate the potentialvalue afforded by the dissociation of peer acceptancefrom peer rejection in predictions of CP.

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Parenting and Peer Interactions

Although parenting behavior and peer factors inde-pendently predict CP, few studies have examined theirpotential interaction, particularly with differentiatedmeasures of peer rejection versus peer acceptance. Giventheir centrality to models of risk and resilience for CP,including both parenting and peer factors will incrementcurrent predictive models of CP (Maughan & Gardner,2010). Security and connectedness with others areessential to adaptive development (Cohen & Wills,1985), and thus supportive interpersonal experiences,such as peer acceptance, may counteract exposure to risk,whereas peer rejection may exacerbate risk associatedwith exposure to harsh/inconsistent parenting behavior(Criss, Pettit, Bates, Dodge, & Lapp, 2002). For example,peer acceptance moderated the negative effects of lowcloseness with parents on adolescents’ global self‐esteem, demonstrating the inter‐dependence of parentand peer contexts (Birkeland, Breivik, & Wold, 2013).Similarly, adolescent peer acceptance buffered theassociation between parental rejection and externalizingand internalizing problems (Sentse et al., 2010). Finally,early peer acceptance buffered the prospective associa-tion of family adversity (e.g., harsh discipline, low SES)and CP, controlling for child temperament and social‐cognitive patterns (Criss et al., 2002). Negative peerrelations also moderated the association of negativeparenting and offspring CP: children who experiencedharsh, punitive, and hostile family environments and hadfew friends were significantly more likely to experiencepeer victimization (Schwartz, Dodge, Pettit, & Bates,2000). Thus, positive and negative peer status maydifferentiallymoderate the association between harsh andinconsistent discipline and CP.

The Present Study

Although harsh punishment and inconsistent disciplineand peer status are associated with CP (e.g., ODDsymptom severity), relatively little is known about theirinterplay with separate measures of negative and positivepeer regard. The purpose of this study was to (1) test theunique association of inconsistent discipline, harshpunishment, peer acceptance, and peer rejection withchildren’s ODD symptom severity, and (2) exploreseparate interactions of peer acceptance and peerrejection with inconsistent discipline and harsh punish-ment. Using a large and well‐characterized sample ofschool‐age children ascertained with multiple measuresand informants for parenting, peer status, and ODD, wehypothesized that inconsistent discipline, harsh punish-ment, and peer rejectionwould each positively predict theseverity of ODD symptoms whereas peer acceptancewould negatively predict ODD. We also hypothesized

that negative parenting behavior dimensions wouldpredict ODD more robustly for children with low peeracceptance and high peer rejection relative to childrenwith high peer acceptance and low peer rejection.

METHOD

Participants

Participants were 162 (72% male) 5‐ to 10‐year‐oldchildren (mean age ¼ 7.3, SD ¼ 1.1) with (n ¼ 81) andwithout ADHD (n ¼ 81); 58% were Caucasian, 7%African‐American, 9% Hispanic, 3% Asian, and 25%Mixed/Other. Families were recruited through presenta-tions to self‐help groups, advertisements mailed to localelementary schools, and referrals from pediatric officesand mental health clinics. All children were requiredto have a Full Scale IQ of at least 70, live with onebiological parent at least half time, and be fluent inEnglish. Participants were excluded if they had a current/previous diagnosis of an autism spectrum, seizure, orneurological disorder that prevented full participation inthe study. ADHD symptoms and diagnostic status wereascertained from the Diagnostic Interview Schedule forChildren, 4th edition (DISC‐IV‐P; Shaffer, Fisher, Lucas,Dulcan, & Schwab‐Stone, 2000), a fully structuredinterview with the parent keyed to DSM‐IV criteria (e.g.,age of onset, symptom persistence, cross‐situational).

Procedures

After completing a telephone screening, eligiblefamilies (n ¼ 230) were mailed rating scales (218families (95%) returned completed or partially completedrating scales). Of these families, 162 participants hadcomplete data for all primary variables. Followingparental consent, we mailed the child’s primary teacherparallel rating scales (113 teachers (63%) returned therating scales). Parents and teachers were asked tocomplete rating scales based on the child’s unmedicatedbehavior. Families were invited to our laboratory for in‐person assessments where 85% of the children wereunmedicated. After obtaining parental consent and childassent, parents completed a structured diagnostic inter-view of child psychopathology and an interview aboutparenting. All interviewers were initially blind to thechild’s diagnostic status, although blindness was difficultto maintain following the completion of the DISC‐IV.The IRB approved all study procedures.

MeasuresAlabamaparentingquestionnaire (APQ; Shelton,

Frick, &Wootton, 1996). The APQ is a widely usedself‐report measure consisting of 42 items and six factors:Involvement, Positive Parenting, Poor Monitoring,Inconsistent Punishment, Corporal Punishment, and

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Other Discipline (Shelton et al., 1996). Parents rated thetypical frequency of each item on a five point Likertscale from 1 ¼ “Never,” to 5 ¼ “Always.” We used theInconsistent Discipline factor which consisted of 6 items(Cronbach’s a ¼ .66) such as “You threaten to punishyour child and then do not actually punish him/her” and“You let your child out of a punishment early (like liftrestrictions earlier than you originally said).” Thisinternal consistency approximates previous studies thatreported slightly lower reliability for inconsistentdiscipline relative to other parenting dimensions (e.g.,Ellis & Nigg, 2009).Semi‐structured interview of parenting behavior.

Harsh punishment was assessed using a semi‐structuredparent interview adapted from previous interviews(Dodge, Bates, & Pettit, 1990) and with select itemsfrom the National Longitudinal Study of AdolescentHealth (Harris et al., 2008). Items reflected the type,frequency, and intensity of corporal punishment. First,parents responded “yes,” “maybe,” or “no” to two items(i.e., “Do you slap, spank, or hit your child?” and “Doyou grab or shake your child?”), followed by a singleopen‐ended inquiry about the frequency of its use (i.e.,“How often do you or your spouse have to physicallypunish your child?”). Finally, parents were asked toanswer “yes” or “no” to three questions regardingthe intensity of physical punishment (e.g., “Did you giveyour child several swats or use an object over bareskin?”). Severity was coded as 0 ¼ “low/no history ofcorporal punishment,” 1 ¼ “moderate severity,” and2 ¼ “high severity.” For example, parents that responded“no” or “maybe” to the first two questions but endorsedengaging in physical punishment less than once a monthwere coded as “low/no history of corporal punishment.”Parents who responded “yes” to either first two questions,endorsed engaging in these behaviors over once a month,and responded “yes” to at least one out of three intensityquestions were coded as high severity. Parents withresponses between low and high severity were coded asmoderate severity. (Detailed coding guidelines withspecific items are available from authors upon request.) Ahighly similar interview demonstrated convergent valid-ity with a validated measure of physical abuse (i.e.,Conflict Tactics Scale; CTS) (Dodge, Bates, et al., 1990).In the present sample, harsh punishment correlated withthe number of ADHD (r ¼ .24, P < .01) and ODDsymptoms (r ¼ .17, P ¼ .04) in the expected directions,demonstrating the scale’s convergent validity.Dishion social preference scale (DSPS)

(Dishion, 1990). A three‐item measure of theproportion of peers who accept/like, reject/dislike, andignore the target child, teachers rated each item on a fivepoint scale, where 1 ¼ “None or 0% of peers,” 2 ¼ “

Some or 25%,” 3 ¼ “Half or 50%,” 4 ¼ “Most or 75%,”

and 5 ¼ “Almost all or 100%.” The Dishion has shownmoderate to strong correlations with peer sociometricdata (Dishion & Kavanagh, 2003) and validity withschool‐aged youth (Lahey et al., 2004). In this sample,peer acceptancewas inversely correlatedwith the numberof parent‐reported ADHD (r ¼ �.22, P < .01) andteacher‐reported ODD symptoms (r ¼ �.40, P < .01)whereas peer rejection was positively associated with thenumber of ADHD and ODD symptoms (r ¼ .18,P < .01 and r ¼ .41, P < .01, respectively).Diagnostic interview schedule for children‐

fourth edition (DISC‐IV‐P) (Shaffer et al.,2000). The DISC‐IV‐P is a computer‐assisted, fullystructured diagnostic interview that was administered toeach parent to assess child ADHD. The DISC‐IV‐P hasexcellent psychometrics, including high test–retestreliability (r ¼ .79 after 1 year) and internal consistency(ICC ¼ .84 for symptoms and ICC ¼ .77 for criterion)for parent ratings in a large community sample (seeShaffer et al., 2000). We controlled for the total numberof ADHD symptoms to account for the case–controldesign and to ensure that the association of parentingbehavior and ODD was independent of their correlationwith ADHD.Disruptive behavior disorder rating scale

(DBDRS) (Pelham, Gnagy, Greenslade, &Milich, 1992). The DBD is a 45‐item rating scaleadapted fromDSM‐III‐R andDSM‐IV for ADHD,ODD,and CD. Parents and teachers completed identicalversions rating each symptom as “Not at All” (0),“Just a Little” (1), “PrettyMuch” (2), or “VeryMuch” (3).Confirmatory factor analyses show strong support forseparate but correlated factors underlying ADHD, ODDand CD (Molina, Smith, & Pelham, 2001). We separatelyanalyzed the total symptom severity score of parent‐ andteacher‐rated DSM‐IV ODD symptoms on a 0–3 scale (8items; a ¼ .89 and .93, respectively), which has shownhigh predictive power (Pelham et al., 1992).

Data Analyses

Given that parenting behavior varies with offspring ageandADHD (Ellis &Nigg, 2009; Straus&Stewart, 1999),as well as parent race‐ethnicity (Maker, Shah, &Agha, 2005), these three variables were entered ascovariates. To construct robust models for testinginteractions and reducing multicollinearity (Table I), allcontinuous predictor variables were centered (Cronbach,1987). Additionally, because teacher ratings of peerstatus (i.e., Dishion) were only available for 69% offamilies, we conducted multiple imputation using teniterations of Markov Chain Monte Carlo in SAS PROCMI (Yuan, 2002). Analyses were conducted using themean of the ten iterations. There were no significantdifference between imputed versus non‐imputed groups

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for parent‐ or teacher‐rated ODD [t(160) ¼ �.89,P ¼ .37 and t(109) ¼ �1.11, P ¼ .27, respectively].We fit a generalized linear model (GLM) specifyingPoisson distributions to account for the skeweddistributions associated with ODD symptom severity.Although peer acceptance and peer rejection weresignificantly correlated (r ¼ .67, P < .01), there wasminimal evidence of multicollinearity (VIFs ranged from1.67 to 1.84). Thus, these variables were enteredsimultaneously in each model to control for theirpotential overlap and to estimate their independentassociation with outcome (Belsley, Kuh, & Welsch,1980).Two sets of complementary GLMs were constructed,

one set with inconsistent discipline and the next withharsh punishment as predictors of ODD outcomes.Specifically, the first model consisted of inconsistentdiscipline, peer acceptance, and peer rejection aspredictors of parent‐rated ODD, followed by anothermodel predicting teacher‐rated ODD. These two modelswere then reproduced replacing inconsistent disciplinewith harsh punishment. To evaluate interactive effects,we simultaneously included separate interactions be-tween inconsistent discipline � peer acceptance andinconsistent discipline � peer rejection; for modelsbased on harsh punishment, we evaluated harsh punish-ment � peer acceptance and harsh punishment � peerrejection to separately predict parent‐ and then teacher‐rated ODD. The distributional properties of our parentingand peer predictors made probing interactions at þ1 SD,grand mean, and �1 SD prohibitive (West & Aiken,1991). Thus, significant interactions were deconstructedin post hoc analyses by using amedian split to analyze themodels separately for children with “low” versus “high”peer acceptance and rejection. Finally, correlationsamong covariates and key variables are summarized inTable I.

RESULTS

Inconsistent Discipline, Peer Acceptance, andPeer RejectionMain effects. Controlling for parent race‐ethnicity,

child’s age, sex, and the number of ADHD symptoms,inconsistent discipline was positively associated withparent‐reported ODD and teacher‐reported ODD(B ¼ .17, SE ¼ 0.06, Wald x2 ¼ 7.16, P < .01 andB ¼ .19, SE ¼ 0.08, Wald x2 ¼ 5.20, P ¼ .02, respec-tively: Step 2, Table II). Peer acceptance was negativelyassociated with teacher‐reported ODD (B ¼ �.27, SE¼ 0.04, Wald x2 ¼ 44.26, P < .01) whereas peerrejection was positively associated with teacher‐reportedODD (B ¼ .16, SE ¼ 0.04, Wald x2 ¼ 15.23, P < .01).Inconsistent discipline � peer status interac-

tions. In the fully saturated models (Step 3, Table II),including covariates and main effects, the inconsistentdiscipline � peer acceptance interaction significantlyand separately predicted parent‐ and teacher‐reportedODD symptom severity (B ¼ �.11, SE ¼ 0.05, Waldx2 ¼ 4.64, P ¼ .03 and B ¼ .44, SE ¼ 0.09, Waldx2 ¼ 21.82, P < .01, respectively). Post hoc analysesrevealed that inconsistent discipline positively predictedparent‐rated ODD for children with low peer acceptance(B ¼ .22, SE ¼ 0.08,Wald x2 ¼ 8.47, P < .01), but notfor children with high peer acceptance (B � .01,SE ¼ 0.11, Wald x2 < .01, P ¼ .99) (Fig. 1). However,post hoc probing with teacher‐reported ODD indicatedthat the association between inconsistent discipline andteacher‐rated ODD was marginal for children with lowpeer acceptance (B ¼ .11, SE ¼ 0.09, Wald x2 ¼ 1.78,P ¼ .18) and high peer acceptance (B ¼ .61, SE ¼ 0.31,Wald x2 ¼ 3.83, P ¼ .05; Fig. 2).The inconsistent discipline � peer rejection interac-

tion significantly predicted teacher‐reported ODD, butnot parent‐reported ODD (B ¼ .36, SE ¼ 0.09, Wald

TABLE I. Correlations Between Child Demographic, ODD, Parenting, and Peer Variables

1 2 3 4 5 6 7 8 9 10

1. Child’s age —

2. Child’s sex .04 —

3. Parent’s race‐ethnicity .04 .04 —

4. ADHD (DISC‐IV‐P) �.08 �.17�� .01 —

5. ODD (P‐DBD) .06 �.19� �.16 .29�� —

6. ODD (T‐DBD) �.10 �.13 .01 .30�� .23� —

7. Inconsistent discipline (APQ) .13 .03 �.11 .23�� .17� .14 —

8. Harsh punishment (PBI) �.12 �.10 .11 .22�� .17� .11 .19�� —

9. Peer acceptance (DSPS) �.14� .05 �.05 �.20�� �.11 �.43�� �.01 �.06 —

10. Peer rejection (DSPS) .03 �.10 .08 .19�� .11 .48�� .05 .06 �.67�� —

DISC‐IV‐P, diagnostic interview schedule for children‐fourth edition; P‐DBD, parent disruptive behavior disorder rating scale; T‐DBD, teacher disruptivebehavior disorder rating scale; APQ,Alabama parenting questionnaire; PBI, semi‐structured interview of parenting behavior; DSPS, Dishion social preferencescale.�P < .05.��P < .01.

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x2 ¼ 16.01, P < .01 and B ¼ �.01, SE ¼ 0.06, Waldx2 ¼ .05, P ¼ .82, respectively). Consistent with hy-potheses, inconsistent discipline positively predictedteacher‐reported ODD for children with high peerrejection (B ¼ .21, SE ¼ 0.10, Wald x2 ¼ 4.19,P ¼ .04), but not for children with low peer rejection(B ¼ .18, SE ¼ 0.14, Wald x2 ¼ 1.62, P ¼ .20; Fig. 2).

Harsh Punishment, Peer Acceptance, and PeerRejectionMain effects. Controlling for child’s age, sex,

ADHD symptoms, and parent race‐ethnicity, harshpunishment was positively associated with parent‐reported ODD (B ¼ .25, SE ¼ 0.06, Wald x2 ¼ 20.24,P < .01; Step 2, Table III). Peer acceptancewas inversely

TABLE II. Inconsistent Discipline, Peer Acceptance, and Peer Rejection for Parent‐ and Teacher‐Rated ODD

Dependent variable Predictors B SE Wald x2 P‐value

Parent‐rated ODD Step 1Age .03 0.03 1.33 .25Sex �.25 0.08 9.16 <.01Race‐ethnicity �.25 0.07 13.72 <.01ADHD symptoms .03 0.01 33.53 <.01

Step 2Inconsistent discipline .17 0.06 7.16 <.01Peer acceptance �.01 0.02 .27 .61Peer rejection .02 0.03 .54 .47

Step 3Inconsistent � acceptance �.11 0.05 4.64 .03Inconsistent � rejection �.01 0.06 .05 .82

Teacher‐rated ODDStep 1Age �.11 0.04 7.78 <.01Sex �.28 0.10 8.44 <.01Race‐ethnicity .04 0.08 .27 .61ADHD symptoms .08 0.01 100.53 <.01

Step 2Inconsistent discipline .19 0.08 5.20 .02Peer acceptance �.27 0.04 44.26 <.01Peer rejection .16 0.04 15.23 <.01

Step 3Inconsistent � acceptance .44 0.09 21.82 <.01Inconsistent � rejection .36 0.09 16.01 <.01

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Fig. 1. Association between inconsistent discipline and parent‐ratedODD symptoms for children low versus high in peer acceptance.

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Fig. 2. Association between inconsistent discipline and teacher‐ratedODD Symptoms for children low versus high in peer acceptance andpeer rejection.

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associated with teacher‐reported ODD, whereas peerrejection was positively associated with teacher‐reportedODD (B ¼ �.29, SE ¼ 0.04,Wald x2 ¼ 48.18,P < .01and B ¼ .15, SE ¼ 0.04, Wald x2 ¼ 13.10, P < .01,respectively).Harsh punishment � peer status interactions.

In the fully saturated models (Step 3, Table III), includingall covariates and main effects, the harsh punishment �peer acceptance interaction significantly predicted par-ent‐ and teacher‐reported ODD (B ¼ �.10, SE ¼ 0.04,Wald x2 ¼ 8.02, P ¼ .01 and B ¼ .11, SE ¼ 0.06,Waldx2 ¼ 4.65, P ¼ .07, respectively). Post hoc analysesrevealed that harsh punishment was positively associatedwith parent‐rated ODD for children with low peeracceptance (B ¼ .33, SE ¼ 0.07, Wald x2 ¼ 25.43,P < .01), but not for children with high peer acceptance(B ¼ .08, SE ¼ 0.11, Wald x2 ¼ .48, P ¼ .49; Fig. 3).For teacher‐rated ODD, harsh punishment was signifi-cantly and inversely associated with ODD for childrenexperiencing high peer acceptance (B ¼ �.97, SE¼ 0.30, Wald x2 ¼ 10.51, P < .01), but not for childrenwith low peer acceptance (B ¼ .10, SE ¼ 0.07, Waldx2 ¼ 2.09, P ¼ .15; Fig. 4).Similarly, the harsh punishment � peer rejection

interaction significantly predicted parent‐ and teacher‐reported ODD (B ¼ .03, SE ¼ 0.05, Wald x2 ¼ 5.46,P ¼ .58 and B ¼ �.03, SE ¼ 0.06, Wald x2 ¼ 4.17,P ¼ .63, respectively). Post hoc analyses indicatedthat harsh punishment was positively associated with

parent‐reported ODD both for children experiencinghigh peer rejection and low peer rejection (B ¼ .24,SE ¼ 0.08, Wald x2 ¼ 8.89, P < .01 and B ¼ .34,SE ¼ 0.08, Wald x2 ¼ 16.62, P < .01, respectively;Fig. 3). In contrast, for teacher‐rated ODD, theassociation between harsh punishment and ODD wasneither significant for children experiencing high peerrejection, nor for children with low peer rejection(B ¼ .05, SE ¼ 0.09, Wald x2 ¼ .27, p ¼ .60 andB ¼ .02, SE ¼ 0.13, Wald x2 ¼ .02, P ¼ .90, respec-tively; Fig. 4).

TABLE III. Harsh Punishment, Peer Acceptance, and Peer Rejection for Parent‐ and Teacher‐Rated ODD

Dependent variable Predictors B SE Wald x2 P‐value

Parent‐rated ODD Step 1Age .03 0.03 1.33 .25Sex � .25 0.08 9.16 <.01Race‐ethnicity �.25 0.07 13.72 <.01ADHD symptoms .03 0.01 33.53 <.01

Step 2Harsh punishment .25 0.06 20.24 <.01Peer acceptance �.02 0.02 .51 .48Peer rejection .01 0.03 .04 .84

Step 3Harsh � acceptance �.14 0.05 8.02 <.01Harsh � rejection �.14 0.06 5.46 .02

Teacher‐rated ODD Step 1Age �.11 0.04 7.78 <.01Sex �.28 0.10 8.44 <.01Race‐ethnicity .04 0.08 .27 .61ADHD symptoms .08 0.01 100.53 <.01

Step 2Harsh punishment .03 0.07 .15 .70Peer acceptance �.29 0.04 48.18 <.01Peer rejection .15 0.04 13.10 <.01

Step 3Harsh � acceptance .17 0.08 4.65 .03Harsh � rejection .15 0.07 4.17 .04

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Fig. 3. Association between harsh punishment and parent‐rated ODDSymptoms for children low versus high in peer acceptance and peerrejection.

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DISCUSSION

In a well‐characterized sample of 5‐ to 10‐year‐oldchildren with and without ADHD, we observed severalkey findings: (1) inconsistent discipline was positivelyassociated with parent‐ and teacher‐reported ODDwhereas harsh punishment was positively associatedwith parent‐reported ODD only; (2) peer rejection andpeer acceptance were positively and inversely associatedwith teacher‐reported ODD, respectively; (3) the inde-pendent associations of harsh punishment and inconsis-tent discipline with ODD symptom severity differedbased on children’s exposure to high versus low peeracceptance and peer rejection. Overall, inconsistentdiscipline and harsh punishment each predicted elevatedODD only among children experiencing low peeracceptance or high peer rejection. This study extendedthe literature by using a specific measure of CP (i.e.,ODD symptom severity) separately gathered fromparents and teachers as well as parenting behavior datagathered from self‐report as well as semi‐structuredinterview, a method shown to yield more valid estimatesof harsh parenting (Jaffee, Caspi, Moffitt, & Taylor,2004).The associations between harsh and inconsistent

discipline and peer status (i.e., acceptance and rejection)with ODD symptoms are consistent with the prevailingliterature (Burke et al., 2002; Dodge et al., 2003). Theobserved associations resonate with theories of socialsupport and attachment, and they collectively reinforcethe centrality of parenting and peer relations to CP. Thepresence of sensitive and responsive primary relation-ships (e.g., peer acceptance) promote the child’s ability toform mental representations of the environment asreliable and trustworthy (Bretherton, 1992). Accordingly,

the lack of supportive interpersonal interactions (e.g.,harsh and inconsistent discipline or peer rejection) maylead a child to respond to social interactions withoppositional, aggressive, or hostile behavior (Crick &Dodge, 1994; Tone & Davis, 2012). These findings arerobust given that harsh punishment and inconsistentdiscipline incremented predictions of ODD beyond thechild’s age, sex, ADHD symptoms, and parent’s race‐ethnicity. Moreover, when parenting and peer influenceson CP were examined simultaneously, the independentcontributions of harsh/inconsistent discipline and peerstatus to ODD varied based on parent or teacher‐reportedODD,which highlights the value afforded by consideringmultiple relationship contexts and informants in studiesof CP.Harsh/inconsistent parenting behavior and peer status

also showed interactive effects, such that inconsistentdiscipline and harsh punishment were each positivelyassociated with ODD but only among children with lowpeer acceptance or high peer rejection. These findingssuggest that positive peer relationships may mitigate thesequelae associated with exposure across two centraldimensions of negative parenting (i.e., harsh andinconsistent parenting). Particularly, positive parentand peer relationships, through the provision of affectionand support (Furman & Buhrmester, 1992), may createcross‐contextual influence that relates to socio‐emotionaland behavioral development. For example, drawing fromthe friendship literature, having at least one high qualityfriendship buffered the association of a low cohesivefamily environment with respect to adolescents’ per-ceived social competence and self‐worth (Gauze,Bukowski, Aquan‐Assee, & Sippola, 1996). Similarly,in a sample of 5th and 6th grade children, the presence ofa best friend during daily negative experiences (e.g. beingbullied during recess) significantly buffered the effect ofthe negative experience on cortisol level changes andglobal self‐worth (Adams, Santo, & Bukowski, 2011).That is, the support from a close friend may mitigatebroader psychological and physiological effects associ-ated with early adversity, such that feelings of support inone relationship context may help children interpret otherstressful experiences in adaptive ways (Adams et al.,2011). Thus, one potential mechanism underlying ourfindings is that experiencing acceptance and support frompeers may diminish the development of biases in socialcognition, including hostile attribution biases (HAB) ofothers’ behaviors, which may otherwise propel childrento further oppositional, aggressive, or hostile behavior(Dodge, Pettit, Bates, & Valente, 1995; Tone & Davis,2012). An experimental study of HAB assigned 134adolescents to one of two manipulated “chat‐room”

conditions where adolescents communicated with online“peers” (e‐confederates) who endorsed either hostile or

0

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-0.25 0.25 0.75 1.25 1.75 2.25

Teac

her-

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erity

Harsh punishment

Fig. 4. Association between harsh punishment and teacher‐ratedODDsymptoms for children low versus high in peer acceptance and peerrejection.

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benign intent attributions to ambiguous scenarios(Freeman, Hadwin, & Halligan, 2011). Controlling forbaseline HAB, adolescents exposed to hostile e‐confederates increased their own HAB whereas adoles-cents exposed to benign e‐confederates decreased theirHAB. These findings reinforce the powerful influence ofpeer relations in shaping children’s social cognition andrelated behavioral responses. In another study, harshparental punishment in kindergarten predicted maladap-tive social information processing (e.g., HAB) in children6 months later, which then predicted the development ofaggressive behavior at school, controlling for harshpunishment and earlier aggression (Weiss & Dodge,1992). These findings support the potential mediatingrole of HAB between parenting and peer relations andchild CP. Given that measures of social informationprocessing, such as HAB, were not available in thepresent study, future studies should explicitly test thepotential mediational role of HAB in the context ofparenting � peer interactions and CP.In addition to the potential buffering effects of peer

acceptance on the association between harsh andinconsistent discipline on ODD, the interaction of highpeer rejection and elevated harsh or inconsistentparenting also predicted more ODD symptoms. Thesefindings are consistent with the cumulative risk hypothe-sis, in which the accumulation of stressors acrossmultiple contexts, rather than the presence or absenceof any specific risk factor, accounts for the most variationin the development of maladaptive behaviors (Apple-yard, Egeland, van Dulmen, & Sroufe, 2005). Althoughpeer rejection at school has been portrayed as an indicatorof CP (Bierman, Smoot, & Aumiller, 1993), it may alsoact as a chronically negative experience for children(Dodge et al., 2003), much like daily experience of harshor inconsistent discipline at home. As a chronic stressor,peer rejection may be a particularly serious risk factor forchildren who simultaneously experience stressors inother contexts (e.g., at home). These findings suggest thatstressors from different contexts (i.e., harsh/inconsistentparenting at home and peer rejection at school) mayindependently exert unique influences on child ODD aswell as cumulatively increase these problems. Moreover,although these findings support the cumulative influenceof multiple risk factors on child CP, it is unclear howthese specific factors interact across contexts anddevelopment. Whereas some studies propose thatcumulative risk and child maladjustment follows a linearmodel (Appleyard et al., 2005; Evans & English, 2002),other studies suggest a quadratic model of risk wherecumulative risk becomes particularly aversive after aspecific “threshold” (Forehand, Biggar, & Kotchick,1998). Given that previous research has largely examinedseparate risk factors for CP, these findings highlight the

need to simultaneously test multiple risk factors in thedevelopment of CP. Moreover, given that the relationbetween ODD and peer status is likely to be reciprocaland transactional (McEachern & Snyder, 2012), pro-spective studies are necessary to directly investigatepotential mechanisms underlying these predictive asso-ciations (i.e., mediators).These findings also highlight the importance of

including multiple informants (i.e., parents and teachers)in studies of CP. We found that inconsistent disciplinepredicted both parent‐ and teacher‐rated ODD severity,whereas harsh punishment was specific to parent‐ratedODD and measures of peer status were specific toteacher‐rated ODD symptoms. These findings areconsistent with informant discrepancies with respect tochild and adolescent CP (Salbach‐Andrae, Lenz, &Lehmkuhl, 2009; Youngstrom, Loeber, & Stouthamer‐Loeber, 2000) that may reflect potential contextualeffects on children’s CP (i.e., parent‐ vs. teacher‐reportedODD as proxies for home vs. school) (Nolan, Gadow, &Sprafkin, 2001). For example, children may exhibitoppositional and aggressive behavior at home whensurrounded by siblings, but may behave less so under theincreased structure of the classroom setting (Biglan,1995). In a randomized controlled trial featuring parenttraining, increased positive parenting behavior (e.g.,positive reinforcement, praise) and decreased negativeparenting behavior (e.g., inconsistent discipline, harshpunishment, criticism) predicted significant reductions inparent‐rated CP, but not teacher‐rated CP (Scott et al.,2010). Such findings underline the need to developeffective interventions with effects that generalize acrosssettings, given the salience of contextual effects on CP(Nolan et al., 2001). Notably, current criteria for ODD donot require that symptoms be present cross‐situationally(unlike ADHD), meaning that ODD can be presentexclusively at home or at school. In a secondary dataanalysis of 292 youth between ages 5 and 18, the numberof contexts (i.e., home, school, with peers) in whichODDsymptoms were present was a significant predictor ofproblems in later adjustment, even after controlling forthe total number of ODD symptoms (Youngstrom, 2011).These findings suggest that cross‐situational ODD isempirically distinct and may indicate a more severeclinical presentation of ODD. Importantly, although themain effects of parenting and peer factors may be affectedby context, the present findings suggest that peeracceptance may protect against the association ofparenting and ODD across contexts, given that themoderating effects were evident according to bothparents and teachers. Given that most studies of CPcontinue to rely on single‐informant data, our findingsunderscore the importance of considering multipleinformants and contexts in future investigations of CP.

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We note at least four important limitations of this study.First, ODD symptom severity is a specific type of CP, butother dimensions are salient (e.g., proactive vs. reactiveaggression, physical vs. relational aggression, and overtvs. covert antisocial behavior) and may show differentassociations with peer and parenting factors. Second, thecross‐sectional design precluded inferences about direc-tionality of effects between parenting, peer status, andchild ODD. Although these findings are consistent withseveral longitudinal studies of CP (e.g., Dodge et al.,1995), the associations between parenting and peerfactors and child ODD are likely to be reciprocal (Burke,Pardini, & Loeber, 2008; McEachern & Snyder, 2012).Given evidence that child ODD predicts increased harshand inconsistent discipline, increased peer rejection, anddecreased peer acceptance over time (Burke et al., 2008),future research must employ prospective designs todetangle the reciprocal and transactional relationshipsamong parenting, peer factors, and the development ofODD. Third, although this study focused on moderatorsof harsh/inconsistent parenting behaviors, positiveaspects of parenting (e.g., warmth, involvement) canalso play an important role in protecting children fromnegative outcomes (Chronis et al., 2007). Future studiesthat examine the potential protective effects of positiveparenting may further uncover how positive and negativeaspects of parenting and peer factors influence thedevelopment of CP. Finally, due to the sample specificdistributions (i.e., cell sizes) of the peer predictors,significant interactions were deconstructed using amedian split of peer variables rather than by recom-mended approaches (e.g., þ1 SD, grand mean, and �1SD; West & Aiken, 1991). Because the post hoc groupswere derived from our specific sample, rather thantheoretically‐ or empirically‐derived from normativedata, the groups created herein may not generalize toother samples. Future studies must consider thesefindings based on larger samples and also prioritize thegeneration of normative data within these domains.This study found preliminary evidence that peer

acceptance buffered and peer rejection exacerbated theassociation between both inconsistent discipline andharsh punishment with ODD symptom severity, which isconsistent with previous reports that peer factors, such asacceptance and rejection, can differentially protectchildren from or exacerbate the negative outcomesrelated to environmental adversity (Bolger & Patterson,2001; Criss et al., 2002; Lansford, Criss, Pettit, Dodge, &Bates, 2003). However, whereas previous studiesinvestigated broad measures of psychopathology (e.g.,“externalizing behavior”) and environmental adversity(e.g., “ecological disadvantage”) (Criss et al., 2002;Lansford et al., 2003), this study demonstrated that peeracceptance and peer rejection moderated the influence of

specific negative parenting behaviors (i.e., inconsistentdiscipline and harsh physical punishment) on a clinicaldiagnostic measure of CP (i.e., ODD symptom severity).Thus, the specificity of our findings allows directimplications for intervention and prevention researchfor ODD. Prevailing interventions currently featureparent behavior training, where parents learn to decreasespecific negative parenting behaviors related to child CP,including harsh and inconsistent discipline. In addition todemonstrating the value of examining CP cross‐contextually, our findings suggest that intervention andprevention efforts for childhood CP would benefit fromexpanding beyond parent‐training to include classroomand peer settings.

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