Research in Developmental Disabilities 35 (2014) 87–98

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Research in Developmental Disabilities

The negative attribution processes of mothers of children with

attention deficit/hyperactivity disorder
Huei Lin Huang a,*, Syu Sin Li a, Chung Ping Cheng b, Chun Yu Lin b,
Yen Kuang Yang c, June Hui Huang d
a
Institute of Behavioral Medicine, National ChengKung University, No. 1, University Road, Tainan City 70101, Taiwan
b
Department of Psychology, National ChengKung University, No. 1, University Road, Tainan City 70101, Taiwan
c
Department of Psychiatry, National Cheng Kung Hospital, Medical College, National Cheng Kung University, No. 138, Sheng Li Road,
Tainan City 70403, Taiwan
d
Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan

A R T I C L E I N F O A B S T R A C T

Article history: The objective of this study was to investigate the attribution processes of mothers
Received 13 August 2013 regarding children’s prosocial behaviors, inattention, and hyperactivity/impulsivity
Accepted 20 September 2013 (symptoms of attention deficit/hyperactivity disorder, ADHD) using two paradigms.
Available online 15 November 2013 The first paradigm involved multidimensional attributions. The second paradigm
concerned making attributions of children’s identical behaviors based on information
Keywords: such as consensus, distinctiveness, and consistency. The participants were 64 mothers of
Attention deficit-hyperactivity disorder children with ADHD (7–13 years old) and 64 mothers with typical/normal children (7–12
(ADHD)
years old). The results showed that mothers of typical children exhibited positive
Attribution
attribution styles or person attributions whereas mothers of children with ADHD
Prosocial behavior
Sentence analogy questionnaire (SAQ)
exhibited negative attribution styles. Mothers of children with ADHD tended to make
Person attribution personal attributions of children’s negative behaviors (e.g., inattention and hyperactivity/
impulsivity; HI) but made situational attributions of prosocial behaviors. The results of
this study can be used in future studies of the effects of intervention on children with
ADHD or in studies related to neurophysiology.
ß 2013 Elsevier Ltd. All rights reserved.

1. Introduction

Parenting experiences determine parents’ attributions of their children’s behavior (Dix & Lochman, 1990; Johnston &
Ohan, 2005; Strassberg, 1995). Therefore, this study explored the essence of the attributions made by mothers of children
with attention deficit-hyperactivity disorder (ADHD) regarding children’s behaviors. ADHD is a neurodevelopmental
disorder with symptoms of inattention and hyperactivity/impulsivity (American Psychiatric Association, 2013). Parents of
children with ADHD often experience negative interactions and parenting difficulties, which affects their attributions of their
children’s behaviors.
Previous studies have suggested that parental attributions mediate children’s and parents’ behaviors. Parental attribution
acts as a filter to interpret children’s behaviors and affects parents’ responses to those behaviors (Dix, Ruble, Grusec, & Nixon,
1986; Weiner, 1990). Parenting behaviors may also affect children’s behaviors; therefore, parental attribution was found to
be crucial in parent–child interactions. It was found that parents of typical/control children tended to attribute children’s

* Corresponding author. Tel.: +886 6 2353535x5107/919607776; fax: +886 6 2095616.

E-mail address: hueilinh@mail.ncku.edu.tw (H.L. Huang).

0891-4222/$ – see front matter ß 2013 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.ridd.2013.09.037
88 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98

positive behaviors to internal, controllable, and stable causes (i.e., person attribution) and to attribute children’s negative
behaviors to external, uncontrollable, or temporary causes (i.e., situational attribution). Conversely, parents of children with
ADHD tended to attribute children’s negative behaviors to internal and stable causes and attribute children’s positive
behaviors to external, uncontrollable, and unstable causes (Johnston & Freeman, 1997; Maniadaki, Sonuga-Barke, &
Kakouros, 2005).
To explore parental attribution, relevant conceptual and methodological issues had to be clarified first (Johnston & Ohan,
2005). Attribution theories had developed since the 1950s, and numerous scholars had provided their insights. First, in the
1960s, Heider (1958) proposed that people believe human behavior results from specific causes and that people wish to
identify the behavioral causes when certain behaviors are observed. Kelley (1967) later developed attribution theory, which
indicates that attribution is a process of deducing the causes of behavior (Kelley, 1973; McArthur, 1972; Seidel et al., 2010).
Kelley (1967) argued that internal and external attributions were made based on the following three pieces of information:
(a) consensus, which refers to whether the same reactions would be produced in other people; (b) distinctiveness, which
refers to whether a specific person has identical reactions when encountering different stimuli; and (c) consistency, which
refers to whether a specific person has identical reactions in response to identical stimuli at different times and in various
situations. People made attributions concurrently based on all three pieces when sufficient information was available
(Kelley, 1973). However, when information is insufficient, people might have only one observation opportunity before
drawing a conclusion. In these situations, mothers might attribute children’s behaviors to additional potential causes (e.g.,
the parental experiences of mothers, children with or without ADHD and behavior categories). Finally, Weiner (1985)
subdivided the internal–external distinctions into multiple dimensions: (a) locus, which relates to whether behavioral
causes are internal or external; (b) control, which relates to whether behaviour is controllable (e.g., with effort) or
uncontrollable (e.g., because of mental illness); and (c) stability, which refers to whether a specific behavior will reoccur in
the future. Johnston and his colleagues (Bugental & Johnston, 2000; Johnston, Chen, & Ohan, 2006) have applied the
multidimensional attribution model to explore the association between parental attribution and children with and without
ADHD or oppositional defiant behaviors.
The primary objective of this study was to use two attribution paradigms to examine the parental experiences of
mothers that might affect their attributions of negative behaviors (inattention and HI) and prosocial behaviors of children
with ADHD. The first attribution paradigm was the questionnaire used by McArthur (1972) that was based on the
attribution theory proposed by Kelley (1973). McArthur (1972) systematically examined the attributions triggered by
combinations of information on distinctiveness, consistency, and consensus. The results provided empirical support for
the claim that low consensus, low distinctiveness, and high consistency contribute to a high proportion of person
attributions (Ferguson & Wells, 1980; McArthur, 1972; Orvis, Cunningham, & Kelley, 1975; Pruitt & Insko, 1980;
Zuckerman, 1978). However, the attribution behaviors (Bugental, Johnston, New, & Silvester, 1998) in the paradigm
developed by McArthur (1972) were only adult behaviors. The results of attributing children’s behaviors, such as
prosocial behaviors, inattention and hyperactivity/impulsivity (HI), were further studied. Therefore, the second objective
of this study was to investigate whether mothers make rational attributions of children’s behaviors when sufficient
information is available.
The second attribution paradigm used in this study used multiple dimensions to attribute children’s behaviors (Johnston
& Freeman, 1997; Johnston et al., 2006). Johnston and his colleagues developed a written analog questionnaire (WAQ) to
investigate the mothers’ multidimensional attributions of children’s behaviors (Johnston & Freeman, 1997; Johnston &
Leung, 2001). The WAQ consists of analogs that resemble typical parent–child interactions. In these studies, parents were
instructed to imagine the children in all of the analog scenarios as their own children and to attribute the children’s behaviors
on multiple dimensions, including locus, control, globality, and stability. This study changed the WAQ scenarios into
sentences and discarded the imagination portion of the instructions. The questionnaire items, which consisted of sentences
about the behaviors of children with and without ADHD, asked mothers to attribute on multiple dimensions without
imagining the children in the sentences as their own children. Thus, this questionnaire was termed a sentence analogy
questionnaire (SAQ). In summary, the third objective of this study was to use a multidimensional assessment to examine
mothers’ attributions of children’s behaviors with insufficient information.

2. Methods

2.1. Participants

The participants were mothers who had one or more schoolchildren. Sixty-four mothers were recruited through the
assistance of various Taiwanese hospitals, clinics, and associations for ADHD. The children of these mothers were receiving
outpatient stimulant treatment for ADHD. The other 64 mothers were recruited from various Taiwanese regions and
communities, and the children of these mothers were never diagnosed as having ADHD. The mothers were all born in and
grew up in Taiwan; therefore, the influence of cultural differences can be excluded (Zhou & Cacioppo, 2010). All mothers had
received a minimum of nine years of education, which enabled them to read and comprehend the questionnaires, and their
children had not been diagnosed as having other severe mental disorders (e.g., intellectual disability or autistic spectrum
disorder). The two groups were matched by their and their children’s genders and ages. Informed consent was obtained from
all mothers.
 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98 89

2.2. Instruments

2.2.1. Attribution questionnaires

One of the attribution questionnaires was developed from the McArthur paradigm (Harris, Todorov, & Fiske, 2005) and
the other questionnaire, the SAQ, was developed from the WAQ (Johnston & Freeman, 1997; Johnston & Leung, 2001). The
items consisted of the same children’s behaviors on both questionnaires. Children’s behaviors had three categories: (a)
prosocial behaviors, such as obeying mothers’ orders, appreciating mothers, and assisting mothers in household chores; (b)
inattentive behaviors, such as carelessness in solving math problems, frequently losing erasers, and being easily distracted
from homework; and (c) HI (hyperactivity/impulsivity) behaviors, such as leaving their seats during classes, interrupting
their mothers’ conversations, and answering their mothers’ questions without waiting for the mothers to finish their
sentences. Nine sentences (3  3) were written to describe these behaviors, and nine popular children’s names were
assigned to the children in the sentences. Every mother completed both questionnaires, which were presented in
counterbalance.
The instructions had two forms: (a) one instruction asked mothers to attribute the behaviors of children with ADHD (the
attribution object was children with ADHD), and (b) the other instruction asked mothers to attribute the behaviors of
children with typical development (the attribution object was typical children). Each mother was assigned only one form of
instruction; in other words, each mother only made attributions regarding either the behaviors of typical children or the
behaviors of children with ADHD.
Consequently, half of the mothers of children with ADHD completed questionnaires on which the attribution object was
children with ADHD and the other half completed questionnaires on which the attribution object was typical children.
Similarly, half of the mothers of typical children were instructed to complete questionnaires on which the attribution object
was children with ADHD, and the other half were instructed to complete questionnaires on which the attribution object was
typical children.
In summary, there were two groups of mothers (mothers of children with ADHD and mothers of typical children). Every
mother was asked to complete questionnaires from two paradigms (the MacArthur paradigm and the SAQ paradigm). In the
instructions for each questionnaire, one half of the mothers were asked to complete the questionnaire with children with
ADHD as the attribution object and the other half of the mothers were asked to complete the questionnaire with typical
children as the attribution object.

2.2.1.1. The sentence analogy questionnaire (SAQ). The SAQ, developed from the WAQ (Johnston & Freeman, 1997), used
sentences to replace the original scenarios as stimuli. A 10-point Likert scale was used on the four dimensions, and the
mothers were instructed to rate the nine sentences as the causal attributions of specific children’s behaviors.
Considering the semantic meaning of the Chinese language, the items related to internal locus, strong control, globality,
and stability were rated as high scores. The four dimensions were (a) locus, with ‘1’ representing factors related to other
people and situations (i.e., situational or external attribution) and ‘10’ representing factors related to the children
themselves (i.e., personal or internal attribution); (b) control, with ‘1’ representing no control and ‘10’ representing
complete self-control; (c) globality, with ‘1’ meaning the situation is scenario-specific and ‘10’ meaning the situation
occurs in all scenarios; and (d) stability, with ‘1’ meaning the situation occurred only once and ‘10’ meaning the situation
is recurring. The instructions were as follows for the questionnaire with typical children as the attribution object: ‘‘This
questionnaire consists of sentences describing the daily behaviors of typical children (or of children with ADHD on the
questionnaire with them as the attribution object). For each sentence, please select a number between 1 and 10 for
representativeness of behavior on the following four dimensions: (a) the degree to which the behaviors are internal or
external, (b) the level of each behavior’s controllability, (c) the level of each behavior’s globality, and (d) the level of each
behavior’s stability’’.

2.2.1.2. Attribution questionnaire from the McArthur paradigm. This study used the McArthur paradigm (McArthur, 1972)
that was developed based on the attribution theory proposed by Kelley (1967), which stated that people interpret human
behavior through the combination of three pieces of information (i.e., consensus, distinctiveness, and consistency). In
addition, every piece of information consisted of a high and a low level. Thus, every information combination had two
levels, with H representing a high level and L representing a low level (i.e., HHH represented high consensus, high
distinctiveness and high consistency; LHH represented low consensus, high distinctiveness and high consistency; and so
on). The mothers were asked to make attributions from nine sentences that described children’s behaviors in eight
information combinations. The questionnaire consists of 72 items (9 sentences  8 combinations), and the partial Latin
square design was used to arrange the 8 information combinations. Four alternatives were provided for each sentence (i.e.,
person attribution, stimulus attribution, circumstance attribution, and a combination of the three attributions). During
data analysis, the three choices other than person attribution were combined into situational attribution. The
questionnaire instructions were as follows: ‘‘This questionnaire contains a number of sentences that report the occurrence
of typical children’s (or those of children with ADHD) daily events. Following each sentence, you will find three items of
information, all of which apply to the reported event. Your task is to decide, on the basis of the information given, what
probably caused the event to occur. Please indicate your choice by circling the most likely cause among the four alternative
causes’’.
90 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98

2.2.2. Disruptive behavior rating scale: parent form (DBRS, Barkley & Murphy, 1998)
This scale was developed using the symptomatic behaviors listed in the diagnostic criteria of the Diagnostic and Statistical
Manual of Mental Disorders (4th Edition) for the items. Thus, the scale consisted of 18 items related to ADHD symptoms (9
items for inattention and 9 items for HI), 8 items related to oppositional defiant disorder (ODD), 15 items related to conduct
disorder, and 8 items related to transient situational disturbance (Barkley & Murphy, 1998). Based on their children’s
behavior in the previous 6 months, the parents completed the questionnaire and rated the items depending on the frequency
of the behavior. The 18 items about ADHD symptoms have fair reliability and validity (DuPaul, Thomas, & Anastopoulos,
1998) and are able to differentiate inattention, HI, oppositional defiant disorder, and conduct disorder (Erford, 1993).
Previous studies (Chhabildas, Pennington, & Willcutt, 2001; DuPau et al., 1998) have indicated that the internal consistency
of the DBRS can reach a = .92–.96 and the test–retest reliability can reach r = .59–.89. In this study, 26 items relating to ADHD
and ODD symptoms were used.

2.2.3. Home situations questionnaire: parent form (HSQ, Barkley & Edelbrock, 1987)
Parents rated the universality and severity of their children’s disturbing behaviors in 16 home or public situations
(Barkley & Murphy, 1998). First, parents answered whether their children behaved inappropriately and disturbed them in
particular situations. If the answer was ‘‘yes’’, the parents further rated how disruptive the behaviors were to them using a 9-
point Likert scale, with increasing severity from 1 to 9. Altepeter and Breen (1989) confirmed that this scale had good test–
retest reliability (.89), internal consistency (.85), rater reliability, and construct validity (Dupaul & Barkley, 1992). The
Chinese version of the Home Situations Questionnaire (HSQ) also had good internal consistency (.89) and test–retest
reliability (number of situation items: r = .47; total score for disturbance: r = .70; average severity: r = .57; Huang, Chao, Tu,
Kuo, & Yang, 2004).

2.2.4. Beck depression inventory (BDI-II, Beck, Steer, & Brown, 1996)
This scale assesses the severity of depression using a 4-point (0–3) Likert scale with 21 items. Regarding reliability and
validity, the internal consistency of the Chinese version was .93, and the internal consistency of the retest (1 week) was .93.
The construct validity, content validity, and factor analysis were all fair.

2.2.5. Beck anxiety inventory (BAI, Beck & Steer, 1993)

This scale assesses levels of anxiety using a 4-point (0–3) Likert scale with 21 items. Regarding reliability and validity, the
internal consistency of the Chinese version was .92, and that of the retest (1 week) was .75. The concurrent validity with
other tools ranged between .22 and .61.

3. Results

3.1. Demographics and relevant factors

The demographic variables (i.e., the ages of the mothers and children, the sex of the children, and the education levels of
the mothers) were not significantly different between the group of mothers of children with ADHD and the group of mothers
of typical children (Table 1). However, the children with ADHD had significantly higher scores than did the typical children
on the indexes for inattention, HI, opposition/defiance, number of situations, severity, and average severity (Table 1).
Regarding relevant factors, the mothers of children with ADHD had significantly higher scores for anxiety than did the
mothers of typical children (p < .05; Table 1) but non-significantly different scores for depression (p > .05).

3.2. Person attribution in the Kelly theory: the MacArthur paradigm

External attribution is made when evidence exists as to the high distinctiveness, consistency, and consensus of the
appropriate effects (Kelley, 1967). Furthermore, person attributions will be more frequent when a response is characterized
by low consensus, low distinctiveness, or high consistency (McArthur, 1972).

3.2.1. Person attribution in children with and without ADHD

The proportions of personal attribution in the MacArthur paradigm were analyzed by analyses of variance of repeated
measurements for group effect (mothers of children with or without ADHD or typical children), object effect (behaviors of
children with or without ADHD) and combination effect in three behavior categories (Table 2). The main effects of
combination were significant for prosocial behaviors (F (7,868) = 31.649, p = 00, h2 = .203), inattention behaviors (F
(7,868) = 27.502, p = .00, h2 = .182), and HI behaviors (F (7,868) = 31.733, p = .00, h2 = .204). However, there were no
significant differences among all group effects, object effects and the interaction effects of both two factors and three factors.

3.2.2. Combinations in which the proportions of person attribution were significantly higher than chance level (25%)
The mothers were asked to make attributions of the behavior described in each sentence. The cause was one or a
combination of the following three factors: the actor, the stimulus, and the circumstance (Kelley, 1973). ‘‘Personal
attribution’’ was represented as being caused by the actor, and ‘‘situational attribution’’ was represented as being caused by
 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98 91

Table 1
Demographic characteristics of the ADHD and control groups.

Variables ADHD group (n = 64) Control group (n = 64) x2 or t p

Age (years): mean (SD) and range

Children 10.09 (1.91) 7–13 9.91 (1.76) 7–12 0.58 .565
Mother 39.25 (4.41) 26–49 39.63 (4.89) 26–49 0.46 .650
Sex: number of boys (girls) 53 (11) 53 (11) – –
Education level of mother 2.53 (0.64) 2.72 (0.49) 1.86 .065

DBRS – parent form

Inattention 15.27 (6.13) 6.81 (4.67) 8.77** .000
Hyperactivity/impulsivity 12.39 (6.45) 4.17 (4.27) 8.50** .000
Opposition/defiant 12.11 (5.27) 4.70 (3.55) 9.26** .000

HSQ
Number of situations 10.03 (4.02) 5.45 (4.04) 6.42** .000
Severity 44.91 (27.24) 14.06 (16.79) 7.71** .000
Average severity 4.27 (1.65) 1.97 (1.36) 8.60** .000
Anxiety of mother (BAI) 10.72 (10.94) 5.95 (7.26) 2.90** .004
Depression of mother (BDI) 10.08 (8.58) 7.35 (7.42) 1.90 .060

Note: DBRS = disruptive behavior rating scale; HSQ = home situation questionnaire; BAI = beck anxiety inventory; BDI = beck depression inventory.
Note: *p < .05, **p < .01.

Table 2
Summary table of ANOVAs for the proportions of person attributions.

Source Prosocial behaviors Inattention behaviors HI behaviors

F p h2 F p h2 F p h2
a
Group 0.330 .57 .003 0.043 .84 .000 1.915 .17 .015
Objecta 2.180 .14 .017 0.313 .58 .003 1.539 .22 .012
Combinationb 31.649 .00** .203 27.502 .00** .182 31.733 .00** .204
G  Oa 0.127 .72 .001 3.790 .054 .030 1.902 .17 .015
G  Cb 0.502 .83 .004 0.847 .55 .007 0.479 .85 .004
O  Cb 0.464 .86 .004 0.477 .77 .004 0.359 .93 .003
G  O  Cb 0.772 .61 .006 1.927 .10 .015 0.901 .51 .007

Note: HI = hyperactivity/impulsivity; group = mothers of children with ADHD vs. mothers with non-ADHD children; object = children with ADHD as the
attribution objects vs. typical children as the attribution objects; combination = eight combinations of additional information (HHH, HHL, HLH, HLL, LHH,
LHL, LLH and LLL); G  O = interaction effects of groups and objects; G  C = interaction effects of groups and combinations; O  C = interaction effects of
objects and combinations; G  O  C = interaction effects of groups, objects, and combinations.
Note: adf1 = 1, df2 = 124; bdf1 = 7, df2 = 868. *p < .05, **p < .01.

one of the other factors or by combinations of these factors. Consequently, the chance level of person attribution was 25%. In
this study, proportions of person attribution were compared with 25% by t test.
It was significantly higher than chance level that mothers in both groups made person attributions of the prosocial,
inattention and HI behaviors of typical children and of children with and without ADHD under the LLH combinations (Fig. 1).
The proportion of mothers of children with ADHD who made personal attributions of the prosocial behaviors of children with
ADHD was not significantly higher than 25%, whereas the other proportions under the HLH combination were significantly
higher than those at the chance level under the HLH combination.
In Fig. 1(a), under the HLL and LHH combinations, the proportion of mothers of typical children who attributed the
inattention behaviors of typical children was significantly higher than chance level. Furthermore, in Fig. 1(d), under the LHL
combination, the proportion of mothers of children with ADHD who attributed the inattention behaviors to children with
ADHD was significantly higher than chance level.

3.3. Multiple attribution dimensions (the SAQ paradigm)

Johnston et al. (2006) found a high correlation between the dimensions of globality and stability; therefore, the mean of
these two dimensions was computed as the index of the globality/stability dimension. In this study, the correlations of
globality and stability were significantly (p < .05) high for prosocial behaviors (.59), inattention (.62), and HI (.74).
Consequently, the mean of these two dimensions was computed as the index of the globality/stability dimension in this
study.

3.3.1. Mothers of children with ADHD or typical children and their attributions of the behaviors of children with and without ADHD
The attribution ratings were analyzed by analysis of variance for group effect (mothers of children with ADHD or typical
children) and object effect (behaviors of children with and without ADHD) on three attribution dimensions with three
92 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98

Fig. 1. In the HLH and LLH combinations, the mothers of typical children consistently made person attributions at significantly higher than chance level
(25%) for positive (prosocial) and negative (inattention and HI) behaviors and for both the typical children and the children with ADHD (a and b). The
mothers of children with ADHD made person attributions at significantly higher than chance level (25%) for negative (inattention and HI) behaviors and for
both the typical children and the children with ADHD (c and d). However, the mothers of children with ADHD made person attributions of the prosocial
behaviors of typical children at significantly higher than chance level (c) and of the behaviors of children with ADHD at not significantly higher than chance
level (d). Therefore, the mothers of children with ADHD made negative attributions of children’s behaviors, and mothers of typical children made positive
attributions.

behavior categories (Table 3). On the locus dimension, the group effect (F (1,124) = 6.633, p = .01, h2 = .051) and object effect
(F (1,124) = 8.566, p = .00, h2 = .065) both had significance with prosocial behaviors. In the control dimension, the object effect
with prosocial behaviors (F (1,124) = 22.945, p = .00, h2 = .156), inattention behaviors (F (1,124) = 14.604, p = .00, h2 = .105),
and HI behaviors (F (1,124) = 32.654, p = .00; h2 = .208) all had significance. Moreover, on the globality/stability dimension,
the object effects with inattention behaviors (F (1,124) = 4.062, p = .046, h2 = .032) and HI behaviors (F (1,124) = 5.538, p = .05,
h2 = .043) both had significance. Otherwise, none of the interaction effects between group and object were significant.

3.3.2. Different attribution styles exhibited by mothers of children with or without ADHD
With regard to prosocial behaviors, the result of this study showed that mothers of typical children had a
greater tendency to make person attributions than did mothers of children with ADHD (Table 3). However, in other
dimensions or behavior categories, there was no significant difference between the attributions made by the two
groups. Mothers in both groups attributed the prosocial behaviors of typical children as having greater locus and control
than children with ADHD had. Regarding inattention and HI behaviors, mothers of both groups believed that typical
children had higher control over their inattention behaviors and that children with ADHD had higher globality/
stability.
The results of this study are shown in Fig. 2. When comparing attributors, (mothers of children with or without ADHD)
on the locus dimension, the mothers of typical children had a greater tendency to make person attributions of prosocial
behaviors than did the mothers of children with ADHD, whereas there was no significant difference between the two
 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98 93

Table 3
Summary table of ANOVAs for the multiple dimensions of attribution (SAQ).

Attribution dimension Sources of variance Prosocial behaviors Inattention behaviors HI behaviors

2 2
F p h F p h F p h2
Locus Group 6.633 .01* .051 0.089 .77 .001 0.227 .63 .002
Object 8.566 .00** .065 0.004 .95 .000 0.277 .60 .002
GO 0.065 .80 .001 0.276 .60 .002 0.160 .69 .001

Control Group 0.812 .37 .007 1.769 .19 .014 0.807 .37 .006
Object 22.945 .00** .156 14.604 .00** .105 32.654 .00** .208
GO 1.265 .26 .010 .436 .51 .004 2.641 .11 .021

Globality/stability Group 0.034 .86 .000 2.507 .12 .020 .001 .98 .000
Object 3.537 .06 .028 4.062 .046* .032 5.538 .02* .043
G O 1.975 .16 .016 2.119 .15 .017 1.566 .21 .012

Note: HI = hyperactivity/impulsivity; group = mothers of non-ADHD children vs. mothers of children with ADHD; object = typical children as the attribution
object vs. children with ADHD as the attribution object; G  O = interaction effects of group and attribution object.
Note: df1 = 1, df2 = 124. *p < .05, **p < .01.

groups regarding attributions of inattention behaviors or HI behaviors. When comparing children with or without
ADHD as the attribution objects on the locus and control dimensions, the prosocial behaviors of typical children as the
objects were rated significantly higher than were the prosocial behaviors of the children with ADHD as the object. On the
control dimension, attributors rated typical children as the object significantly higher. On the globality/stability
dimension, the ratings for children with ADHD as the object were significantly higher than were those for typical children
as the object.

4. Discussion

The purpose of this study was to investigate the attribution processes that mothers of children with ADHD make of
positive and negative behaviors in children using two paradigms.

Fig. 2. Attribution ratings on multiple dimensions of the three categories of behavior (*p < .05).
94 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98

4.1. Information and attribution

When information is sufficient, mothers are more capable of making rational attributions of the causes of their children’s
behaviors (Bugental & Johnston, 2000).
This study found that with the MacArthur paradigm, there was no effect on person attribution whether the attributors were
mothers of children with ADHD and whether the objects were children with typical development. After further comparison
with the chance level (25%), it was found that under the LLH combination, the proportions of mothers who made person
attributions were significantly higher than chance level regardless of the behavior categories, whether the mothers had children
with or without ADHD, and whether the object was children with or without ADHD. These results were similar to those of Kelley
(1967) and the MacArthur paradigm. In other words, when mothers of children with ADHD received the information
combination of low consensus (most children would not perform the behavior), low distinctiveness (children would perform
the behavior with most people), and high consistency (children with ADHD would perform the behavior under many
circumstances), known as the LLH combination, both groups of mothers made person attributions for the prosocial, inattention,
and HI behaviors of children with and without ADHD. This result is also consistent with those of previous studies regarding
behavioral data; that is, people do not use consensus information as much as predicted (Fiske, 2004).
Studies on fMRI (Harris et al., 2005; Lieberman, Gaunt, Gilbert, & Trope, 2002) found that the superior temporal sulcus
(STS) and left medial prefrontal cortex (left MPFC) are activated under the LLH combination. The function of the STS is known
as inferring intention, and the functions of the MPFC are propositional thought and internally generated inferences.
In comparison with chance level (25%), it was found that mothers of children with ADHD tended to attribute the prosocial
behaviors of children with ADHD externally under the HLH combination. However, there were person attributions in the rest
of the conditions, including that mothers of typical children attributed the prosocial behaviors of typical children and
mothers of children with and without ADHD attributed inattention and HI behaviors to children with and without ADHD.
Only the STS (for the inferring intention function) was activated under the HLH combination; by contrast, the left MPFC was
not activated (Harris et al., 2005). Therefore, when mothers of children with ADHD received the information combination of
high consensus (the behavior would be performed by most children), low distinctiveness (the behavior would not be
performed in front of most people), and high consistency, known as the HLH combination, the STS was activated but the left
MPFC was not activated. Based on the previous research, we assumed that mothers only inferred intentions to make
attributions in the absence of rational propositional thought and internally generated inferences. Consequently, mothers of
children with ADHD would tend to attribute the good traits of children with ADHD to external causes (i.e., the mother or
circumstance factor). Mothers of typical children made person attributions of the prosocial behaviors of typical children by
inferring intention. In addition, mothers of children with and without ADHD made person attributions for inattention and HI
behaviors.
According to the previously mentioned study, under the LLH combination, mothers made person attributions by inferring
intention (with the STS activated or with positive signal changes), propositional thought and internally generated inference
(with the left MPFC activated). However, under the HLH combination, mothers made person attributions by propositional
thought and internally generated inferences (with the left MPFC activated or with positive signal changes) but suppressed
inferring intention (with the STS inactivated or with negative signal changes) (Harris et al., 2005). This study further
compared the HLH combination and the LLH combination and examined the differences. It was found that mothers of
children with ADHD did not make significantly higher person attributions of the prosocial behaviors of children with ADHD.
The first possible explanation is that the left MPFC was not activated but the STS was activated and hence the related brain
functions (propositional thought and internally generated inferences) were not activated, whereas the mothers of children
with ADHD attributed the prosocial behaviors of children with ADHD. Because the HLH combination did not activate the left
MPFC, the STS could not be suppressed, which led to making external attributions for prosocial behaviors with irrational
inferring intention. The other possible explanation is that neither the STS nor the left MPFC was activated. Therefore, mothers
of children with ADHD would tend to make external attributions. Based on a previous study (Harris et al., 2005), the second
possible explanation was thought to be more reliable, and it was confirmed that the prosocial behaviors of children with
ADHD were neglect because of an inactivated left MPFC when the mothers of children with ADHD attributed the prosocial
behaviors of children with ADHD. It is important to seek advanced assistance for parents of children with ADHD, including
cognitive behavioral treatment or medication. However, the first priority is to clarify the exact cause through future fMRI
research.
In addition to the above, this study found that inattention behaviors received person attributions more frequently than
did prosocial behaviors and HI behaviors (11/32 for inattention, 7/32 for prosocial, and 8/32 for HI). The previous studies
(Harris et al., 2005; McArthur, 1972) suggested that behavior categories had no effect on locus attribution. However,
although this study manipulated the traits of attributor and object, the results differed. Further fMRI studies in the future are
very important for clarifying this difference.

4.2. Attribution in multiple dimensions

Johnston and his colleagues (2006) found, using the WAQ paradigm, that mothers of children with ADHD attributed
oppositional and inattentive–impulsive child behaviors as being more stable and global than did mothers of typical children.
This study slightly modified the WAQ paradigm into the SAQ paradigm by differentiating the mothers’ traits (the mothers
 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98 95

had children with and without ADHD) and the children’s traits (they had or did not have ADHD). The results were consistent
with those of Johnston’s study in that mothers tended to attribute the inattention and HI behaviors of children with ADHD as
being more global and stable. A comparison between the SAQ and the WAQ indicated that the mothers of children with
ADHD made the same attributions of the behaviors of children with ADHD on the SAQ as they did on the WAQ and that the
mothers of typical children made the same attributions of typical children’s behaviors as did the control group in
the Johnston studies. This study found that the mother’s traits did not affect their ratings of inattention and HI behaviors on
the globality and stability dimensions. In addition, by differentiating variables more meticulously, it was confirmed that the
inattention and HI behaviors of children with ADHD were attributed as global and stable by not only the mothers of children
with ADHD but also the mothers of typical children.
This study also found that mothers of typical children tended to make more person attributions than did mothers of
children with ADHD and that the prosocial behaviors of typical children as the object were more often attributed to the
person than were those of children with ADHD on the locus dimension. The controllability ratings of typical children in all
behavior categories were also significantly higher than were those of children with ADHD.
Parents of typical children attribute children’s positive behaviors to internal, controllable, and stable causes but attribute
undesirable or problematic behaviors to external, uncontrollable, and unstable causes (Joiner & Wagner, 1996). However,
parents of children with ADHD tend to attribute children’s positive behaviors to external, uncontrollable, and unstable
causes but to attribute undesirable or problematic behaviors to internal, controllable, and stable causes. This study also
found that mothers of typical children tended to attribute prosocial behaviors (positive behavior) to being of internal locus.
On the contrary, mothers of children with ADHD were more likely to make external attributions of prosocial behaviors. This
result was consistent with those from previous research, yet this study did not obtain the same results on the control and
globality dimensions. In this study, there was no significant difference between mothers of typical children and mothers of
children with ADHD, including their attribution ratings in three behavior categories (prosocial, inattention and HI
behaviors), on the control and globality/stability dimensions. The dissimilarity might result from the different
measurements. The past study requested that attributors make attributions of their own children’s behaviors. Therefore,
only two conditions were available to study. One of the conditions was that the mothers of children with ADHD attributed
the behaviors of their own children with ADHD. The other condition was that the mothers of typical children attributed the
behaviors of their own typical children. Consequently, attribution ratings were limited to the experience of the mothers’
personal interactions with their own children. Instead, this study used a modified paradigm (the SAQ) that asked mothers to
attribute using the analogy of their personal parenting experience. One possible confounding variable was that mothers of
typical children might have been unable to attribute well because they were unfamiliar with children with ADHD. Even so,
the effect size of this confounding variable was likely very small because in past research on the MacArthur paradigm,
mothers of children with ADHD had significantly different attributions from those of other groups and the effect size did not
disappear because of the presence of data from mothers of typical children. In addition, we recruited not only all mothers but
also roughly 200 college students to complete a knowledge questionnaire about ADHD. The analysis of the knowledge
questionnaire suggested that all of the mothers and the college students were clearly aware of ADHD symptoms, including
inattention, hyperactivity and impulsivity. The uniqueness of measurement in this study was to differentiate the object trait
of having or not having ADHD. This study found that the prosocial behaviors of children with ADHD tended to be attributed
to external loci; in other words, good traits were not considered person traits but as being of external locus or the result of
promotion by mothers. Additionally, the inattention and HI behaviors of children with ADHD were found to be global and
stable in this study; in other words, bad traits were considered to exhibit stability. These results were consistent with those
of previous studies (Johnston & Freeman, 1997; Johnston et al., 2006; Joiner & Wagner, 1996). Nevertheless, the three
behavior categories of children with ADHD were attributed to uncontrollable causes whereas the three behavior categories
of typical children were attributed to controllable causes. This finding was different from that of Joiner and Wagner’s study.
In conclusion, this study found that except for the person attributions of prosocial behaviors, there was no significant
difference between the attributions of mothers of children with or without ADHD. The children’s trait (having or not having
ADHD) was the main factor of attribution. In general, children with ADHD received negative attributions. For example, the
prosocial behaviors of children with ADHD were considered to have an external locus, positive and negative behaviors were
uncontrollable, and negative behavior was stable.

4.3. The comparison of the two paradigms’ results

This study used the same nine sentences in the different paradigms to investigate mothers’ attributions of children’s
behaviors. The difference between the two paradigms was whether information was provided or not. The MacArthur
paradigm provided additional information and emphasized the reasoning process while giving attributors access to
information. The SAQ paradigm did not provide any additional information to reduce the reasoning process of the attributor.
Both of the paradigms found that mothers of children with ADHD tend to make external attributions of the prosocial
behaviors of children with ADHD. This finding might result from an inactive left MPFC. The difference between the two
paradigms was that the inattention and HI behaviors of children with ADHD were attributed as having global and stable
causes in the SAQ paradigm, whereas the inattention behaviors of children with ADHD were attributed as being person-
caused in the MacArthur paradigm. The MacArthur paradigm used one dimension and dichotomy (person attribution vs.
stimulus/circumstance attribution) and was available to the neural substrate or brain area through fMRI research (Harris
96 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98

et al., 2005). However, the SAQ paradigm used multiple dimensions and a 10-point Likert-type assessment that was
unavailable to the neural substrate or brain area through present fMRI studies.
After the WAQ paradigm was modified, the SAQ paradigm was a psychometric scale. Dimoka’s fMRI research (2011)
found that each construct measured by psychometric scale could be related to a relevant brain area. For example, fMRI
research confirmed the neural correlation between trust and the caudate nucleus, putamen, anterior paracingulate cortex,
and orbitofrontal cortex and between distrust and the amygdala and the insular cortex. Therefore, it is important to use the
SAQ paradigm with fMRI for further research in the future. Additionally, association analysis of the MacArthur paradigm and
the WAQ paradigm is an important issue.

4.4. Anxiety, depression and attribution

Parents’ anxiety and depression affect parent–child interactions (Kashdan et al., 2004). For example, parental anxiety was
negatively related to parental warmth and positive involvement, intrusiveness and negative discipline, and social distress,
whereas parental depression was only negatively related to social distress. Margari et al. (2013) found that anxiety and
depression in mothers of children with ADHD were significantly higher than they were in mothers of typical children. This
study result indicated that the anxiety scores of mothers of children with ADHD were significantly higher than they were for
mothers of typical children but there was no significant difference in their depression scores. Consequently, to study the
attribution process in mothers of children with ADHD and mothers of typical children, anxiety and depression disorders
should be group variables for mothers and further attribution research between the four groups should be conducted.

4.5. From parent–child interactions

ADHD is a neurodevelopmental disorder that is associated with cognitive and behavioral defects (Pimentel, Vieira-Santos,
Santos, & Vale, 2011), and the symptoms of ADHD adversely affect parent–child interactions (Johnston, 1996). In disturbed
family relationships, children with ADHD are likely to experience negative family interactions, such as excessively strict
parental instructions and rules and sibling rivalry (Mash & Johnston, 1982). This phenomenon indicates that ADHD
symptoms affect children’s lives and cause problematic family functioning and conflicted parent–child relationships
(Barkley, 2006; Deault, 2010). In particular, the disruptive behavior of children with ADHD can trigger negative responses
from family members, thereby damaging family relationships and the psychological functioning of parents (Fischer, 1990;
Johnston & Mash, 2001; McLaughlin & Harrison, 2006). Therefore, parents of children with ADHD are likely to have negative
interactions with their children and difficult parenting experiences; consequently, such experiences affect parents’
processes of attribution of their children’s behaviors.
Attributor and attribution objects moderate the attribution process, causing mothers of children with ADHD to exhibit
negative parenting practices. Scholars (Dix et al., 1986) have proposed a social-cognitive model to demonstrate the
attribution process, maintaining that numerous moderators affect the attribution process: child’s behavior ! parental
attribution ! parental responses. The moderators include attributor, attribution object, and the relationship between the
attributors and the attribution objects. These moderators can be preliminarily divided into parent-driven effects and child-
driven effects: Parent-driven effects means that parents of children with behavioral problems exhibit negative attribution
styles (MacBrayer, Milich, & Hundley, 2003); child-driven effects indicates that children’s constant behavioral problems
provide evidence for parents’ attribution biases, and constant frustrating interactions with children cause parents to produce
negative attributions. The results of this study confirm that parent- and child-driven effects both cause mothers of children
with ADHD to make negative attributions of the behaviors of children with ADHD. In addition, in various behavior categories
and on various attribution dimensions, attribution objects (children with or without ADHD) often affect mothers’ attribution
cognition, and the attributor (i.e., mothers of children with or without ADHD) primarily affects the internal and external
attributions that mothers make regarding prosocial behaviors. Furthermore, we found that objective information can
eliminate the effects of attribution objects on attribution perceptions.
The results of this study can be used in parenting training for mothers of children with ADHD. Recent studies have
focused primarily on parents’ attribution cognition processes, but parental attributions affect parent emotional responses,
self-efficacy, parenting behaviors, and child treatment effectiveness. Relevant studies have indicated that parents’
attributions of children’s behaviors is vital. For example, when parents attribute the behavior of children with ADHD to
internal and stable factors, these parents tend not to consider behavioral treatment an effective intervention method.
Another study (Finzi-Dottan, Triwitz, & Golubchik, 2011) has further indicated that personal characteristics (e.g.,
emotional intelligence) and environmental influence (e.g., social support) motivate parents to engage in constructive
cognitive processing. Therefore, this study investigated the cognitive processes of mothers in parent–child interactions to
provide information for developing appropriate intervention proposals and plans based on the parenting cognition of
mothers of children with ADHD.

Acknowledgments

This study was funded by the National Science Council (Taiwan; NSC-99-2410-H-006-131, NSC-100-2410-H-006-026-
MY3) and a research grant from National Cheng Kung University (D100-35B22; D100-35A04). We thank Pei-Tzu Huang,
 H.L. Huang et al. / Research in Developmental Disabilities 35 (2014) 87–98 97

Jou-Han Liao, Ting-Hsuan Jao, and Pin-Fang Cheng for their assistance in data collection. In addition, we are grateful to Dr.
Shin-Jaw Chen, Prof. Horng-Yih Lee, and the Kaohsiung Association of Hyperactive Children for providing recommendations
regarding participant recruitment. Finally, we appreciate the participation of the mothers in this study.

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