Limited but growing evidence implicates toxic

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at least some cases of ADHD. Limited but growing evidence implicates toxic chemical exposuresfrom pesticides or phthalates in ADHD (Marks et al. 2010); again, the most salient effects mayappear in individuals with high genetic vulnerability. Even extremes of psychosocial deprivationcan result in severe levels of inattention and overactivity, as shown by investigations of EasternEuropean orphans who spent early years in horribly deprived settings (for an early overview, seeRutter 1998). In such cases, however, ADHD-linked symptoms are typically embedded in a clinicalpicture of highly maladaptive attachments (e.g., displays of indiscriminant friendliness), signifyingthe complex pathways that can eventuate in clinically significant levels of the core symptoms.A common stereotype is that ADHD results from overly permissive or other kinds of mal-adaptive parenting styles. Except in cases of clear neglect or other forms of maltreatment, littleevidence supports this contention. At the same time, bidirectional and reciprocal effects are clearlyoperative (see Bell 1968). Thus, parents of children with difficult temperaments and/or early signsof impulsive, irritable behavior tend to respond with unsuccessful attempts to manage such be-havior patterns (Beauchaine & McNulty 2013). The development of coercive parenting styles(Patterson 1982) is highly likely to increase the child’s initial behavioral propensities and promoteantisocial activity (or, more often in girls, self-harm). Thus, socialization influences, though re-active or maintaining, are still highly important. In addition, given the strongly heritable natureof ADHD-related symptoms, it is likely that the biological parents of a diagnosed child will sharepropensities for problems in attentional and impulse control, planning and judgment, and emotionregulation. The result, too often, can be a fully transactional cycle of genetic vulnerability fueledby discordant, even explosive, family interactions.Can positive parenting styles protect children with ADHD? Hinshaw et al. (1997) found thatboys with ADHD whose parents showed a strongly authoritative parenting style, incorporatinghigh warmth plus strong limits, had unexpectedly high rates of social competence in terms ofpositive peer sociometric appraisals. Intriguingly, the typically developing comparison boys inthis research program showed no such protective effect (for an additional example of positiveparenting practices related to outcomes of young children with ADHD, see Healey et al. 2011).Of course, as with all family studies lacking genetically informative designs, it could be arguedthat shared genes comprise the third variable driving both positive parenting practices and thechild’s social competence. Yet landmark investigations by Harold et al. (2013a,b) utilizing adoptivefamilies, in which passive gene–environment correlation was removed from the picture, revealedthat (a) early ADHD-related child behaviors induced hostile parenting responses, and (b) suchparenting practices independently predicted the maintenance of the children’s behavior patterns

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