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Stewart CM, Master A, Mire SS, Hassett KS, Smith BH. Perceptions of Academic Performance, Impairment, and Mental Health in University Students With and Without ADHD. J Atten Disord 2024; 28:1746-1759. [PMID: 39342442 DOI: 10.1177/10870547241285237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
OBJECTIVE This study aims to investigate the impact of positive illusory bias (PIB) on the relationship between ADHD symptoms and functioning in college students, with a focus on gender differences. METHOD The sample consisted of 195 college students, including 148 with ADHD and 47 without ADHD. Measures of ADHD symptomatology, life satisfaction, affect, gender identity, and impairment were collected, along with cumulative grade point average. RESULTS ADHD symptomatology was inversely linked to subjective well-being, with PIB acting as a significant moderator. Functional impairment was predicted by ADHD symptoms and subjective well-being, while social impairment and academic functioning were predicted by PIB and well-being. Significant gender differences were found, particularly in the interaction between PIB and ADHD symptoms for non-binary individuals. CONCLUSION This study suggests that PIB is relevant for emerging adults with ADHD enrolled in higher education. Subjective well-being and PIB act as buffers against the detrimental functional and social effects of ADHD symptoms in emerging adult college students. The study highlights the importance of considering gender-specific approaches in understanding and supporting the mental health of this population.
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Affiliation(s)
- Christian M Stewart
- University of Houston, TX, USA
- Center for Behavioral Health, Boys Town, Nebraska
| | | | - Sarah S Mire
- University of Houston, TX, USA
- Baylor University, Waco, TX, USA
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2
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Betancourt JL, Alderson RM, Roberts DK, Bullard CC. Self-esteem in children and adolescents with and without attention-deficit/hyperactivity disorder: A meta-analytic review. Clin Psychol Rev 2024; 108:102394. [PMID: 38286088 DOI: 10.1016/j.cpr.2024.102394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/18/2024] [Indexed: 01/31/2024]
Abstract
Meta-analytic methods were used to examine global and domain-specific (i.e., academic, social, behavioral) self-esteem in children and adolescents with and without ADHD. Potential moderators of effect size heterogeneity were also examined via meta-regressions within a three-level approach. Findings from 49 aggregated global self-esteem effect sizes (ADHDN = 2500, TDN = 9448), 12 academic self-esteem effect sizes (ADHDN = 386, TDN = 315), 11 social self-esteem effect sizes (ADHDN = 258, TDN = 254), and 8 behavioral self-esteem effect sizes (ADHDN = 231, TDN = 211) suggest that children and adolescents with ADHD experience moderate global (ES = 0.46, p < .001), academic (ES = 0.60, p = .009), and social (ES = 0.67, p = .001) self-esteem impairments compared to children and adolescents without the disorder. The aggregated behavioral self-esteem effect size (ES = 0.20, p = .54), however, was not significant, and the global self-esteem effect size was markedly smaller compared to effect sizes for the academic and social domains. Further, examination of potential moderators of effect size heterogeneity indicated null effects for medication status, diagnostic complexity, informant, age, sex, comorbid psychopathology, and self-esteem dimension. Collectively, findings suggest that children and adolescents with ADHD do not hold a ubiquitous negative self-perception of difficulties across academic, social, and behavioral domains of functioning, and unexamined domains that are distal to ADHD may serve to bolster global self-esteem.
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Affiliation(s)
| | - R Matt Alderson
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Delanie K Roberts
- Department of Psychology, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Caitlin C Bullard
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
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3
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Norvilitis JM, Liu M, Zhang J. Self-perception of academic ability and ADHD symptoms in college students in China and the United States: A preliminary study. Bull Menninger Clin 2023; 87:250-265. [PMID: 37695884 DOI: 10.1521/bumc.2023.87.3.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Children with ADHD are frequently reported to demonstrate a positive illusory bias in multiple domains. Less is known about such a bias in college students. This study examined academic positive illusory bias in college students and whether cultural factors play a role in its expression. A total of 633 college students from China and the United States completed measures designed to assess biased self-perception of academics. Among other measures, the nonclinical sample completed a math task and then estimated their own achievement and completed measures of intellectual and scholastic self-competence. Symptoms of ADHD were unrelated to overconfidence on the math task and were negatively related to reports of self-competence. However, individualism and collectivism were related to overconfidence and self-competence. In contrast to results from research in other domains, academic positive illusory bias among those with more symptoms of ADHD does not appear to persist into college.
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Affiliation(s)
| | - Mingli Liu
- Associate professor of psychology at Hunan University of Science and Technology, Hunan, China
| | - Jie Zhang
- Distinguished professor of sociology at SUNY Buffalo State, Buffalo, New York
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4
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Crisci G, Cardillo R, Mammarella IC. The Processes Underlying Positive Illusory Bias in ADHD: The Role of Executive Functions and Pragmatic Language Skills. J Atten Disord 2022; 26:1245-1256. [PMID: 34937413 DOI: 10.1177/10870547211063646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Children with ADHD often show a positive illusory bias (PIB), reporting an extremely positive idea of their own competence, despite their difficulties. The mechanisms underlying this phenomenon are still poorly understood. In the present study, we examined social PIB and investigated the role of executive functions (EFs) and pragmatic language (PL). METHOD Forty-one children with ADHD and 42 typically-developing children matched on age, IQ, and receptive language were administered measures of social competence, EFs and PL. The parents were also asked to estimate their child's social competence. RESULTS There was evidence of social difficulties and PIB in children with ADHD. Only PL, not EFs, seemed to mediate the association between ADHD and PIB. CONCLUSION Our findings suggest that PL abilities should be considered in efforts to improve self-perception in children with ADHD.
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Slobodin O, Davidovitch M. Primary School Children’s Self-Reports of Attention Deficit Hyperactivity Disorder-Related Symptoms and Their Associations With Subjective and Objective Measures of Attention Deficit Hyperactivity Disorder. Front Hum Neurosci 2022; 16:806047. [PMID: 35250516 PMCID: PMC8888855 DOI: 10.3389/fnhum.2022.806047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe diagnosis of Attention deficit hyperactivity disorder (ADHD) is primarily dependent on parents’ and teachers’ reports, while children’s own perspectives on their difficulties and strengths are often overlooked.GoalTo further increase our insight into children’s ability to reliably report about their ADHD-related symptoms, the current study examined the associations between children’s self-reports, parents’ and teachers’ reports, and standardized continuous performance test (CPT) data. We also examined whether the addition of children’s perceptions of ADHD-symptoms to parents’ and teachers’ reports would be reflected by objective and standardized data.MethodsThe study included 190 children with ADHD, aged 7–10 years, who were referred to a pediatric neurologic clinic. A retrospective analysis was conducted using records of a clinical database. Obtained data included children’s self-reports of their attention level and ADHD-related symptoms, parent, and teacher forms of the Conners ADHD rating scales, Child Behavior Checklist (CBCL), Teacher’s Report Form (TRF), and CPT scores.ResultsChildren’s self-evaluations of their functioning were globally associated with their teachers’ and parents’ evaluations, but not uniquely. Children’s self-reports of ADHD symptoms were not uniquely linked to a specific CPT impairment index, but to a general likelihood of having an impaired CPT. The CPT performance successfully distinguished between the group of children who defined themselves as inattentive and those who did not.ConclusionPrimary school children with ADHD are able to identify their limitations and needs difficulties and that their perspectives should inform clinical practice and research. The clinical and ethical imperative of taking children’s perspectives into account during ADHD diagnosis and treatment is highlighted.
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Affiliation(s)
- Ortal Slobodin
- The Department of Education, Ben-Gurion University, Be’er Sheva, Israel
- *Correspondence: Ortal Slobodin,
| | - Michael Davidovitch
- Child Development North District, Maccabi Healthcare Services, Tel Aviv-Yafo, Israel
- Kahn-Sagol-Maccabi Research and Innovation Institute, Maccabi Healthcare Services, Tel Aviv-Yafo, Israel
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Basile A, Toplak ME, Andrade BF. Using Metacognitive Methods to Examine Emotion Recognition in Children With ADHD. J Atten Disord 2021; 25:245-257. [PMID: 30442038 DOI: 10.1177/1087054718808602] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: This study investigated confidence accuracy associations for emotion recognition (ER) in children with ADHD and typically developing children (TD). Method: Thirty-nine children with ADHD and 42 TD (M = 9 years, 11 months, SD = 14.92 months, 26 females) completed an ER task. Intelligence and executive function task performance were also measured. Results: The ADHD group was more confident on ER compared with TD, but no group differences were found on their overall accuracy. Specifically, the ADHD group was more confident in its recognition of sad and angry faces compared with the TD group. On a metacognitive index, the ADHD group displayed lower resolution, suggesting that the TD group was better at discriminating correct from incorrect responses. Higher resolution was associated with lower ADHD symptoms. Conclusion: Confidence ratings with reference to performance on a specific task can provide an index of social-cognition in children with ADHD.
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Affiliation(s)
| | | | - Brendan F Andrade
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,University of Toronto, Ontario, Canada
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Capodieci A, Crisci G, Mammarella IC. Does Positive Illusory Bias Affect Self-Concept and Loneliness in Children With Symptoms of ADHD? J Atten Disord 2019; 23:1274-1283. [PMID: 29562849 DOI: 10.1177/1087054718763735] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Positive illusory bias (PIB) has been amply studied in children with ADHD, but its function is still limited understanding. Method: In a sample of 21 children with symptoms of ADHD, this study investigated whether they were more likely to be rejected by peers and examined PIB, and its influence on self-concept and loneliness, comparing the children with symptoms of ADHD with children who had weak social skills, but no ADHD. The children's and teachers' perception of social difficulties were compared, and self-concept and loneliness were analyzed in the two groups, which were also compared with typically developing (TD) children. Results: The results showed the presence of PIB on social skills in children with symptoms of ADHD, but this phenomenon did not give them a higher self-concept, which was similar to that of children with weak social skills and lower than in TD children. Conclusion: The implications of these findings are discussed.
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Tu JW, Owens EB, Hinshaw SP. Positive Illusory Bias Still Illusory? Investigating Discrepant Self-Perceptions in Girls with ADHD. J Pediatr Psychol 2019; 44:576-588. [PMID: 30649391 PMCID: PMC7967872 DOI: 10.1093/jpepsy/jsy109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine whether girls with attention deficit/hyperactivity disorder (ADHD) demonstrate positive illusory self-perceptions during adolescence and young adulthood. METHODS We tested, across a 5-year longitudinal span, whether self-perceptions versus external-source ratings were more strongly predictive of young adulthood impairment and depressive symptoms. Participants included an ethnically diverse sample of 140 girls with ADHD and 88 comparison girls, aged 11-18 years (M = 14.2) at adolescent and 19-24 years (M = 19.6) at young adult assessment. RESULTS Although girls with ADHD rated themselves more positively than indicated by external ratings, their self-reports still did not differ significantly from external ratings in both scholastic competence and social adjustment domains. Comparison girls, on the other hand, rated themselves significantly less positively than indicated by external ratings in social adjustment. Positive discrepancy scores in adolescence did not significantly predict depressive symptoms in young adulthood and vice versa. Crucially, measures of actual competence in adolescence were more strongly associated with young adulthood impairments than were inaccurate self-perceptions for girls with ADHD. CONCLUSIONS Our findings continue to challenge the existence of a positive illusory bias among girls with ADHD, including any association of such bias with key indicators of impairment.
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Affiliation(s)
| | - Elizabeth B Owens
- Institute of Human Development, University of California, Berkeley and
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9
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Thorell LB, Chistiansen H, Hammar M, Berggren S, Zander E, Bölte S. Standardization and cross-cultural comparisons of the Swedish Conners 3 ® rating scales. Nord J Psychiatry 2018; 72:613-620. [PMID: 30269665 DOI: 10.1080/08039488.2018.1513067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE The Conners Rating Scales are widely used in research and clinical practice for measuring attention deficit/hyperactivity disorder (ADHD) and associated problem behaviors, but country-specific norms are seldom collected. The current study presents the standardization of the Swedish Conners 3® Rating Scales. In addition, we compared the Swedish norms to those collected in the U.S. and Germany. MATERIAL AND METHODS The study included altogether 3496 ratings of children and adolescents aged 6-18 years from population-based samples. RESULTS The scores obtained for the Swedish Conners 3® showed satisfactory to excellent internal consistency for most subscales and excellent test-retest reliability. Across-informant correlations were modest. Cross-country comparisons revealed that aggression symptoms rated by teachers and ADHD symptoms rated by parents differed between Sweden, Germany and the U.S. Executive functioning deficits also varied as a function of rater and country, with German and Swedish teachers reporting increasing behavior problems with age, whereas a decrease was observed in the U.S. For some subscales, the observed cross-cultural differences were large enough for a child to be classified as being within the normal range (t-score <60) in one country and within the clinical range (t-score > 70) in another country. CONCLUSION The present study shows that the Swedish adaptation of the Conners 3® provides consistent and reproducible scores. However, across-informant ratings were only modest and significant cross-cultural differences in scoring were observed. This emphasizes the need for multi-informant assessment as well as for national norms for rating instruments commonly used within child and adolescent psychiatry research and clinical settings.
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Affiliation(s)
- Lisa B Thorell
- a Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Hanna Chistiansen
- b Clinical Child and Adolescent Psychology, Department of Psychology , Philipps University Marburg , Marburg, Germany
| | - Martin Hammar
- c Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden.,d Center for Psychiatry Research , Stockholm County Council , Stockholm , Sweden.,e Child and Adolescent Psychiatry , Stockholm County Council , Stockholm , Sweden
| | - Steve Berggren
- c Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden.,d Center for Psychiatry Research , Stockholm County Council , Stockholm , Sweden.,e Child and Adolescent Psychiatry , Stockholm County Council , Stockholm , Sweden
| | - Eric Zander
- c Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden.,d Center for Psychiatry Research , Stockholm County Council , Stockholm , Sweden.,e Child and Adolescent Psychiatry , Stockholm County Council , Stockholm , Sweden
| | - Sven Bölte
- c Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden.,d Center for Psychiatry Research , Stockholm County Council , Stockholm , Sweden.,e Child and Adolescent Psychiatry , Stockholm County Council , Stockholm , Sweden
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10
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Mastoras SM, Saklofske DH, Schwean VL, Climie EA. Social Support in Children With ADHD: An Exploration of Resilience. J Atten Disord 2018; 22:712-723. [PMID: 26515891 DOI: 10.1177/1087054715611491] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study investigated the role of perceived social support in promoting emotional well-being among children with ADHD. Specifically, it examined how children with ADHD perceive support from key individuals in their lives and the relationships between this support and aspects of emotional well-being. Main versus buffering models of social support in the context of social preference status were also explored. METHOD Participants were 55 school-age children with ADHD-combined or hyperactive/impulsive (ADHD-C/HI). Parent and child ratings evaluated source-specific social support, social status, and aspects of self-concept, anxiety, and depression. RESULTS Children with ADHD reported lower social support than normative samples. Social support had moderate positive associations with self-concept, with source-specific differences, but was not associated with internalizing symptoms. Regression models with social preference status supported a main effect model of perceived social support. CONCLUSION Social support may provide a target for resilience-based interventions among children with ADHD in promoting their self-concept and well-being.
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11
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Grygiel P, Humenny G, Rębisz S, Bajcar E, Świtaj P. Peer Rejection and Perceived Quality of Relations With Schoolmates Among Children With ADHD. J Atten Disord 2018; 22:738-751. [PMID: 25526905 DOI: 10.1177/1087054714563791] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The main aim of the current study was to investigate the links between ADHD diagnosis and the objective and subjective dimensions of social relationships among children from primary schools. METHOD We used the data from 36 regular classrooms, consisting of 718 students, with each containing at least one child with an established clinical diagnosis of ADHD (38 children). RESULTS For children with ADHD, the level of the perceived quality of social relations was lower than that of children without such a diagnosis. After controlling for sociometric status, the impact of ADHD on perceived status proved to be statistically nonsignificant but the indirect impact of ADHD on this status through sociometric status was statistically significant. CONCLUSION Children diagnosed with ADHD are more often rejected by their peers and have a more pessimistic view of their social world. Moreover, ADHD diagnosis does not have a direct influence on the perceived quality of social relations otherwise than through sociometric status.
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Affiliation(s)
| | | | | | | | - Piotr Świtaj
- 4 Institute of Psychiatry and Neurology, Warsaw, Poland
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12
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Vacaru VS, Sterkenburg PS, Schuengel C. Self-concept in institutionalized children with disturbed attachment: The mediating role of exploratory behaviours. Child Care Health Dev 2018; 44:476-484. [PMID: 28895183 DOI: 10.1111/cch.12521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 08/07/2017] [Accepted: 08/19/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Self-concept is seen as both an outcome of sociocognitive and emotional development, and a factor in social and mental health outcomes. Although the contribution of attachment experiences to self-concept has been limited to quality of primary attachment relationships, little is known of the effects of disturbed attachment on self-concept in institutionalized children. Thus, the current study examined associations between disturbed attachment behaviours in institutionalized children and self-concept, testing limited exploration as an explanatory factor. METHODS Thirty-three institutionalized children, aged 4-12, participated in a multimethod and multi-informant assessment of disturbed attachment behaviours (i.e., Disturbances of Attachment Interview and Behavioral Signs of Disturbed Attachment in Young Children), self-concept (i.e., Pictorial Scale of Perceived Competence and Social Acceptance for Young Children), and exploratory behaviours (i.e., Student Exploratory Behaviours Observation Scale). Analyses were conducted using bootstrapping techniques. RESULTS Global self-concept converged with teacher-rated children's self-concept, except for physical competence domain. Disturbed attachment behaviours were identified in 62.5% of the children, and this was associated with lower levels of exploration and lower scores on self-concept, compared with children without disturbed attachment behaviours. Furthermore, exploratory behaviours mediated the effects of disturbed attachment behaviours on self-concept. CONCLUSIONS Institution-reared children with disturbed attachment behaviours were likely to have a negative perception of self and one's own competences. Limited exploratory behaviours explained this linkage. Targeting disordered attachment in children reared in institutions and their caregivers should become a high priority as a means for preventing socioemotional development issues.
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Affiliation(s)
- V S Vacaru
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - P S Sterkenburg
- Department of Clinical Child and Family Studies, VU University, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.,Bartiméus, Doorn, The Netherlands
| | - C Schuengel
- Department of Clinical Child and Family Studies, VU University, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
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Controlled Social Interaction Tasks to Measure Self-Perceptions: No Evidence of Positive Illusions in Boys with ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:1051-1062. [PMID: 27841009 DOI: 10.1007/s10802-016-0232-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Studies have suggested that children with Attention-Deficit/Hyperactivity Disorder (ADHD) possess a Positive Illusory Bias (PIB) where they have higher self-perceptions of competence than more objective measures of their competence. However, recent research calls into question the primary methodology of these studies, that is, difference scores. This study investigated the PIB in boys with ADHD within the social domain using a novel methodology that refrains from using difference scores. Eighty-one 8- to 12-year-old boys with and without ADHD completed social interaction tasks where their actual social performance was made comparable, allowing for tests of between-group differences in self-perceptions that do not rely on difference scores. In addition, to examine whether clarity of social feedback moderates the presence of the PIB, the social tasks presented unclear, clear positive, or clear negative feedback. Boys rated how well they performed in each social interaction task, and these ratings were compared between ADHD and non-ADHD groups. Compared to the non-ADHD group, boys with ADHD did not show a PIB in their ratings of performance on the social tasks. There also was no moderation of boys' ratings by type of feedback received. In contrast, when the PIB was calculated using difference scores based on child and parent ratings of child competence, boys with ADHD showed a PIB compared to boys without ADHD. These findings call attention to the need to re-examine the phenomenon of the PIB using methodologies outside of difference scores.
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Bourchtein E, Langberg JM, Owens JS, Evans SW, Perera RA. Is the Positive Illusory Bias Common in Young Adolescents with ADHD? A Fresh Look at Prevalence and Stability Using Latent Profile and Transition Analyses. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:1063-1075. [PMID: 28004285 DOI: 10.1007/s10802-016-0248-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The goal of this study was to use novel approaches that do not require the use of arbitrary cut-points (i.e., latent profile/transition analysis) to evaluate the prevalence and stability of the positive illusory bias (PIB) in young adolescents with attention-deficit/hyperactivity disorder (ADHD). Participants were 326 middle-school students diagnosed with ADHD (Mage = 12.26 years, 71% male, 77% Caucasian). The Self-Perception Profile for Children (SPPC) was completed by participants and their parents at baseline and again 12 and 18 months later. Cross-sectional results revealed four subgroups based on SPPC responses. Only a small subset (18.4%) of youth with ADHD exhibited a global PIB, across the behavioral, scholastic, and social domains, with an additional 29% displaying a PIB in the scholastic domain only. Additionally, average parent/adolescent-rated competence within each subgroup was in line with an objective measure of scholastic competence (i.e., grades). When examined longitudinally, only a PIB in the social domain was stable across the 18-month study period and only for half of the sample. These findings suggest that the PIB is not ubiquitous in youth with ADHD, with many young adolescents rating themselves accurately relative to their parents and their grades. Further, when stability across time is considered, the PIB may be specific to social functioning, as opposed to a global, cross-domain phenomenon. Implications for the future measurement of the PIB are discussed.
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Affiliation(s)
- Elizaveta Bourchtein
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, 23284-2018, USA.
| | - Joshua M Langberg
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, 23284-2018, USA
| | - Julie S Owens
- Ohio University, 200 Porter Hall, Athens, OH, 45701, USA
| | - Steven W Evans
- Ohio University, 200 Porter Hall, Athens, OH, 45701, USA
| | - Robert A Perera
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, 23284-2018, USA
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Fogleman ND, Leaberry KD, Rosen PJ, Walerius DM, Slaughter K. How do children with and without ADHD talk about frustration?: Use of a novel emotion narrative recall task. ACTA ACUST UNITED AC 2018; 10:297-307. [DOI: 10.1007/s12402-018-0255-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
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Is the Positive Bias an ADHD Phenomenon? Reexamining the Positive Bias and its Correlates in a Heterogeneous Sample of Children. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 46:1395-1408. [PMID: 29177721 DOI: 10.1007/s10802-017-0369-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The goals of this study were to (a) evaluate the presence of the positive bias (PB) in elementary-school-aged children with and without ADHD when PB is defined at the individual level through latent profile analysis and (b) examine the extent to which several correlates (i.e., social functioning, aggression, depression, and anxiety) are associated with the PB. Participants were 233 youth (30% female; 8 to 10 years of age), 51% of whom met criteria for ADHD. During an individual evaluation, children and parents completed a battery of questionnaires to assess child competence, depression, anxiety, and aggression. Children also participated in a novel group session with same-sex unfamiliar peers (half of the group was comprised of children with ADHD) to engage in group problem-solving tasks and free play activities. After the group session, peers and staff completed ratings of each child's behavior (e.g., likeability, rule following). The best fitting LPA model for parent and self-ratings of competence revealed four profiles: High Competence/Self-Aware; Variable Competence/Self-Aware; Low Competence/Self-Aware; and Low Competence/PB, in which the PB was present across domains. Only 10% of youth showed a PB and youth with ADHD were no more likely to display the PB than their non-ADHD peers with similar levels of low competence. Lastly, the Low Competence/Self-Aware profile demonstrated higher levels of anxiety and depression than the Low Competence/PB profile; the profiles did not differ on aggression or peer or staff ratings of social/behavioral functioning. Implications for understanding the PB in children with and without ADHD are discussed.
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King KM, Pedersen SL, Louie KT, Pelham WE, Molina BS. Between- and within-person associations between negative life events and alcohol outcomes in adolescents with ADHD. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:699-711. [PMID: 28703610 PMCID: PMC5593772 DOI: 10.1037/adb0000295] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Escalations in alcohol use during adolescence may be linked with exposure to negative life events, but most of this research has focused on between-person associations. Moreover, adolescents with attention-deficit hyperactivity disorder (ADHD) may be an especially vulnerable population, reporting more life events and alcohol involvement and may even be more sensitive to the effects of life events on alcohol outcomes compared with those without ADHD. We tested the between- and within-person effects of the number and perceptions of negative life events on the development of alcohol use outcomes from age 14 to 17 years in 259 adolescents with and without ADHD using generalized estimating equations. Between-person differences in exposure to negative life events across adolescence, but not the perception of those events, were associated with a higher likelihood of alcohol use and drunkenness at age 17 years. Within-person differences in life events were associated with alcohol use above and beyond that predicted by an adolescents' typical trajectory over time. Parent- and teacher-reported ADHD symptoms were associated with more negative perceptions of life events and with greater alcohol use and drunkenness at age 17 years, but symptoms did not moderate the life event-alcohol association. Interventions should consider the variables that produce vulnerability to life events as well as the immediate impact of life events. That the accumulation of life events, rather than their perceived negativity, was associated with alcohol outcomes indicates that interventions targeting the reduction of negative events, rather than emotional response, may be more protective against alcohol use in adolescence. (PsycINFO Database Record
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Steward KA, Tan A, Delgaty L, Gonzales MM, Bunner M. Self-Awareness of Executive Functioning Deficits in Adolescents With ADHD. J Atten Disord 2017; 21:316-322. [PMID: 24799318 DOI: 10.1177/1087054714530782] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Children with ADHD lack self-awareness of their social and academic deficits, frequently rating themselves more favorably than external sources. The purpose of the current study was to assess whether adolescents with ADHD also hold a positive bias toward their executive functioning (EF). METHOD Participants include 22 control and 35 ADHD subjects, aged 11 to 16. Participants and their parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF) Self and Parent forms, respectively. Discrepancy scores were calculated for each domain by subtracting the adolescents' T-score from the parents' T-score. RESULTS Discrepancy scores were significantly higher in the ADHD group than controls within the Inhibit, Shift, Monitor, Emotional Control, Working Memory, and Plan/Organization domains (all p < .05). CONCLUSION As compared with controls, adolescents with ADHD tend to endorse fewer EF difficulties than what parents report. This is the first study to demonstrate that those with ADHD may overestimate their EF ability.
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Affiliation(s)
- Kayla A Steward
- 1 Austin Neuropsychology, PLLC, TX, USA.,2 University of Texas at Austin, TX, USA
| | - Alexander Tan
- 1 Austin Neuropsychology, PLLC, TX, USA.,2 University of Texas at Austin, TX, USA
| | | | | | - Melissa Bunner
- 1 Austin Neuropsychology, PLLC, TX, USA.,2 University of Texas at Austin, TX, USA
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Ros R, Graziano PA. Social Functioning in Children With or At Risk for Attention Deficit/Hyperactivity Disorder: A Meta-Analytic Review. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 47:213-235. [PMID: 28128989 DOI: 10.1080/15374416.2016.1266644] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Considerable work has demonstrated significant impairment in social functioning for children with attention deficit/hyperactivity disorder (ADHD). The social functioning profiles of children with ADHD are marked by impairments across diverse domains as they tend to experience greater rates of peer rejection, have lower levels of social skills, and have impaired social cognitions. The purpose of this study was to (a) quantitatively examine the association between ADHD and deficits across several domains of social functioning (peer functioning, social skills, social information processing), (b) examine differences in the magnitude of such associations, and (c) examine the effect of potential moderators. A meta-analysis of 109 studies (n = 104,813) revealed that children with ADHD have the most impairment within the peer functioning domain (weighted effect size [ES] r = .33) followed by significantly smaller effects within the social skills (weighted ES r = .27) and social information-processing domains (weighted ES r = .27). When examining potential moderators, results revealed that the association between ADHD and deficits within the social skills domain was weaker among studies that controlled for co-occurring conduct problems (CP). Studies that utilized sociometric and teacher reports of peer status reported the largest effects within the peer functioning domain. In addition, studies that utilized the "gold standard" approach to diagnosing ADHD documented the largest effects within both the social skills and peer functioning domains. Last, studies utilizing younger samples revealed the largest effects for deficits within the peer functioning domain. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Rosmary Ros
- a Department of Psychology , Florida International University
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Giannotta F, Rydell AM. The Prospective Links Between Hyperactive/Impulsive, Inattentive, and Oppositional-Defiant Behaviors in Childhood and Antisocial Behavior in Adolescence: The Moderating Influence of Gender and the Parent-Child Relationship Quality. Child Psychiatry Hum Dev 2016; 47:857-870. [PMID: 26680210 DOI: 10.1007/s10578-015-0617-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We prospectively investigated the effect of child hyperactive/impulsive, inattentive, and oppositional/defiant behaviors on the development of youth antisocial behaviors, and the moderating influence of gender and the parent-child relationship quality in a normative sample. Participants (N = 673, 50 % girls) were assessed at 10 years of age (parent reports) and at age 15 (parent and adolescent reports). Using latent change models, we found that initial levels of, as well as increases in, hyperactivity/impulsivity and oppositional behaviors and initial levels of inattention behaviors predicted youth antisocial behaviors. The increase in oppositional behaviors was predictive of youth antisocial behaviors in girls only. Child hyperactive/impulsive behaviors predicted youth antisocial behaviors only in children for whom the quality of the parent-child relationship deteriorated from childhood to adolescence. Thus, both initial levels of and increases in disruptive behaviors as well as gender are important for understanding the development of antisocial behaviors in adolescence. We received partial support for the hypothesized, moderating role of a high-quality parent-child relationship.
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Affiliation(s)
- Fabrizia Giannotta
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden.
| | - Ann-Margret Rydell
- Uppsala Child and Baby Lab, Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
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Aguirre-Raya KA, Castilla-Peón MF, Barajas-Nava LA, Torres-Rodríguez V, Muñoz-Hernández O, Garduño-Espinosa J. Self-perception and knowledge of evidence based medicine by physicians. BMC MEDICAL EDUCATION 2016; 16:166. [PMID: 27357211 PMCID: PMC4928273 DOI: 10.1186/s12909-016-0681-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 06/01/2016] [Indexed: 05/26/2023]
Abstract
BACKGROUND The influence, legitimacy and application of Evidence Based Medicine (EBM) in the world is growing as a tool that integrates, the best available evidence to decision making in patient care. Our goal was to identify the relationship between self-perception about the relevance of Evidence Based Medicine (EBM) and the degree of basic knowledge of this discipline in a group of physicians. METHODS A survey was carried out in a third level public hospital in Mexico City. Self-perception was measured by means of a structured scale, and the degree of knowledge through parameter or "rubrics" methodology. RESULTS A total of 320 questionnaires were given to 55 medical students (17 %); 45 pre-graduate medical interns (14 %); 118 medical residents (37 %) and 102 appointed physicians of different specialties (32 %). Self-perception of EBM: The majority of those surveyed (n = 274, 86 %) declared that they were very or moderately familiar with EBM. The great majority (n = 270, 84 %) believe that EBM is very important in clinical practice and 197 physicians (61 %) said that they implement it always or usually. The global index of self-perception was 75 %. Knowledge of EBM: Definition of EBM; Seven of those surveyed (2 %) included 3 of the 4 characteristics of the definition, 82 (26 %) mentioned only two characteristics of the definition, 152 (48 %) mentioned only one characteristic and 79 (25 %) did not include any characteristic of EBM. Phases of the EBM process: The majority of those surveyed (n = 218, 68 %) did not include the steps that characterize the practice of EBM, of which 79 participants (25 %) mentioned elements not related to it. The global index of knowledge was 19 %. CONCLUSIONS The majority of the surveyed physicians have a high self-perception of the relevance of EBM. In spite of this, the majority of them did not know the characteristics that define the EBM and phases of the process for its practice. A major discrepancy was found between self-perception and the level of basic knowledge of EBM among the surveyed physicians.
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Affiliation(s)
| | - María F Castilla-Peón
- Department of Medical Publications, Hospital Infantil de México Federico Gómez (HIMFG), National Health Institute, México City, Mexico
| | - Leticia A Barajas-Nava
- Evidence-Based Medicine Research Unit, Hospital Infantil de México Federico Gómez (HIMFG), National Health Institute, México City, Mexico
| | - Violeta Torres-Rodríguez
- Evidence-Based Medicine Research Unit, Hospital Infantil de México Federico Gómez (HIMFG), National Health Institute, México City, Mexico
| | - Onofre Muñoz-Hernández
- Direction of Research, Hospital Infantil de México Federico Gómez (HIMFG), National Health Institute, México City, Mexico
| | - Juan Garduño-Espinosa
- Direction of Research, Hospital Infantil de México Federico Gómez (HIMFG), Torre de Hemato-Oncología e Investigación, National Health Institute, Dr. Márquez, No. 162, Col. Doctores, Del. Cuauhtémoc, C.P. 06720, México, DF, Mexico.
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Helseth SA, Bruce BS, Waschbusch DA. Overestimation of Physical Abilities Among Boys With and Without ADHD. J Atten Disord 2016; 20:163-7. [PMID: 23881557 DOI: 10.1177/1087054713496463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Children with ADHD have been widely reported to overestimate their abilities in social and academic domains, but a similar overestimation of physical abilities has not been examined. METHOD Twenty-four elementary school-age boys with ADHD and fifteen boys without ADHD were compared on their ability to accurately estimate their ability to complete four lab-based physical tasks, varying on three levels of difficulty: (a) within their ability, (b) 8% beyond their ability, and (c) 13% beyond their ability. RESULTS Children with ADHD were significantly more likely than controls to overestimate their physical ability at difficult levels of the task. CONCLUSION Implications of these results for preventing risky behaviors in children with ADHD are discussed.
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Affiliation(s)
| | - Beth S Bruce
- Dalhousie University, Halifax, Nova Scotia, Canada
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Elmaadawi AZ, Jensen PS, Arnold LE, Molina BSG, Hechtman L, Abikoff HB, Hinshaw SP, Newcorn JH, Greenhill LL, Swanson JM, Galanter CA. Risk for emerging bipolar disorder, variants, and symptoms in children with attention deficit hyperactivity disorder, now grown up. World J Psychiatry 2015; 5:412-424. [PMID: 26740933 PMCID: PMC4694555 DOI: 10.5498/wjp.v5.i4.412] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/18/2015] [Accepted: 10/13/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the prevalence of bipolar disorder (BD) and sub-threshold symptoms in children with attention deficit hyperactivity disorder (ADHD) through 14 years’ follow-up, when participants were between 21-24 years old.
METHODS: First, we examined rates of BD type I and II diagnoses in youth participating in the NIMH-funded Multimodal Treatment Study of ADHD (MTA). We used the diagnostic interview schedule for children (DISC), administered to both parents (DISC-P) and youth (DISCY). We compared the MTA study subjects with ADHD (n = 579) to a local normative comparison group (LNCG, n = 289) at 4 different assessment points: 6, 8, 12, and 14 years of follow-ups. To evaluate the bipolar variants, we compared total symptom counts (TSC) of DSM manic and hypomanic symptoms that were generated by DISC in ADHD and LNCG subjects. Then we sub-divided the TSC into pathognomonic manic (PM) and non-specific manic (NSM) symptoms. We compared the PM and NSM in ADHD and LNCG at each assessment point and over time. We also evaluated the irritability as category A2 manic symptom in both groups and over time. Finally, we studied the irritability symptom in correlation with PM and NSM in ADHD and LNCG subjects.
RESULTS: DISC-generated BD diagnosis did not differ significantly in rates between ADHD (1.89%) and LNCG 1.38%). Interestingly, no participant met BD diagnosis more than once in the 4 assessment points in 14 years. However, on the symptom level, ADHD subjects reported significantly higher mean TSC scores: ADHD 3.0; LNCG 1.7; P < 0.001. ADHD status was associated with higher mean NSM: ADHD 2.0 vs LNCG 1.1; P < 0.0001. Also, ADHD subjects had higher PM symptoms than LNCG, with PM means over all time points of 1.3 ADHD; 0.9 LNCG; P = 0.0001. Examining both NSM and PM, ADHD status associated with greater NSM than PM. However, Over 14 years, the NSM symptoms declined and changed to PM over time (df 3, 2523; F = 20.1; P < 0.0001). Finally, Irritability (BD DSM criterion-A2) rates were significantly higher in ADHD than LNCG (χ2 = 122.2, P < 0.0001), but irritability was associated more strongly with NSM than PM (df 3, 2538; F = 43.2; P < 0.0001).
CONCLUSION: Individuals with ADHD do not appear to be at significantly greater risk for developing BD, but do show higher rates of BD symptoms, especially NSM. The greater linkage of irritability to NSM than to PM suggests caution when making BD diagnoses based on irritability alone as one of 2 (A-level) symptoms for BD diagnosis, particularly in view of its frequent presentation with other psychopathologies.
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Positively Biased Self-Perceptions in Children with ADHD: Unique Predictor of Future Maladjustment. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015. [DOI: 10.1007/s10802-015-0056-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Canu WH, Tabor LS, Michael KD, Bazzini DG, Elmore AL. Young adult romantic couples' conflict resolution and satisfaction varies with partner's attention-deficit/hyperactivity disorder type. JOURNAL OF MARITAL AND FAMILY THERAPY 2014; 40:509-524. [PMID: 24749971 DOI: 10.1111/jmft.12018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has previously been associated with less satisfaction and success in romantic relationships. This study compares conflict resolution and problem-solving behaviors in young adult romantic couples either having one partner with ADHD combined type (C-couples), having one partner identified with ADHD inattentive type (IA-couples), or in which neither partner has an ADHD diagnosis (nondiagnosed [ND] couples). Self-reports of current and childhood ADHD symptoms corroborated diagnostic status and speaker and listener behaviors, coded via the Rapid Couples Interaction Scoring System (Gottman, 1996), were the primary dependent variables. Analyses revealed greater negativity and less positivity in C-couples' behavior during a conflict resolution task, relative to IA and ND couples, and this corresponded with couples' relational satisfaction. IA-couples emitted relational behavior that was largely similar to ND couples. Findings support that relational impairment exists in C-couples, and to some degree, contrast with previous research suggesting that individuals with predominant inattention experience greater social impairment in adulthood than those with other types of ADHD.
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Abstract
OBJECTIVE To explore the relationship between parental feedback and the accuracy of children's self-perceptions. Children with ADHD have been demonstrated to overestimate their own competence, a phenomenon known as positive illusory bias (PIB). METHOD Participants were families of 56 children (41 male) ages 7 to 10, half of whom had clinical diagnoses of ADHD. PIB was assessed by comparing children's self-ratings of their competence relative to teachers' ratings. Laboratory interactions were observed where parental feedback to children was coded. RESULTS Parental warmth was associated with lower PIB about social competence in children with ADHD, but greater PIB in comparison children. Parent criticism was positively correlated with greater PIB about social competence in children with ADHD, but the relationship was nonsignificant for comparison children. Parent praise was associated with lower PIB about behavioral conduct in comparison children. CONCLUSION Results support the self-protective hypothesis of PIB, and implications for interventions are discussed.
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Cook J, Knight E, Hume I, Qureshi A. The self-esteem of adults diagnosed with attention-deficit/hyperactivity disorder (ADHD): a systematic review of the literature. ACTA ACUST UNITED AC 2014; 6:249-68. [PMID: 24668198 DOI: 10.1007/s12402-014-0133-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 03/11/2014] [Indexed: 10/25/2022]
Abstract
Individuals with attention-deficit/hyperactivity disorder (ADHD) often grow up with negative messages surrounding their abilities and may experience adverse outcomes throughout their lives. Despite this, by adulthood, those with ADHD often find that they are left without adequate support from services. This review explores the relationship between self-esteem and ADHD in adulthood with a view to outlining needs and potential opportunities in terms of service provision. Twelve databases were searched for relevant literature published between 1980 and 2013 using terms relating to self-esteem, ADHD and adulthood. The resulting 13 articles comprised both cross-sectional and intervention studies. Despite a limited number of studies and methodological concerns, there is evidence to suggest that ADHD is associated with lower self-esteem in adulthood and that self-esteem difficulties can be remedied, to at least some extent, by psychotherapeutic work. It is recommended that future research focuses on the evaluation of therapy that specifically targets difficulties in self-esteem in this population.
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Affiliation(s)
- Julia Cook
- Faculty of Health and Life Sciences, Clinical Psychology Doctorate Programme, Coventry and Warwick Universities, Coventry University, James Starley Building, Priory Street, Coventry, CV1 5FB, UK,
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Duric NS, Aßmus J, Elgen IB. Self-reported efficacy of neurofeedback treatment in a clinical randomized controlled study of ADHD children and adolescents. Neuropsychiatr Dis Treat 2014; 10:1645-54. [PMID: 25214789 PMCID: PMC4159126 DOI: 10.2147/ndt.s66466] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many non-pharmacological treatments for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) have been attempted, but reports indicate that most are ineffective. Although neurofeedback (NF) is a treatment approach for children with ADHD that remains promising, a variety of appropriate measures have been used in reporting and evaluating its effect. OBJECTIVE To report the self-evaluations of NF treatment by children and adolescents with ADHD. METHODS Randomized controlled trial in 91 children and adolescents with ADHD, aged less than 18 years (mean, 11.2 years) participated in a 30-session program of intensive NF treatment. Participants were randomized and allocated by sequentially numbered sealed envelopes into three groups: methylphenidate (MPH) as an active control group, and two trial groups NF with MPH, and NF alone. ADHD core symptoms and school performance were given on a scale of 1 to 10 using a self-reporting questionnaire, and the changes in these scores after treatment were used as the self-reported evaluation. Basic statistical methods (descriptive, analyses of variance, exact χ (2) test, and paired t-test) were used to investigate the baseline data. Changes in ADHD core symptoms and treatment effects were investigated using a general linear model for repeated measures. RESULTS Eighty participants completed the treatment study and 73 (91%) responded sufficiently on the self-reporting questionnaires. The treatment groups were comparable in age, sex, and cognition as well as in the baseline levels of core ADHD symptoms. All treatments resulted in significant improvements regarding attention and hyperactivity (P<0.001), and did not differ from each other in effectiveness. However, a significant treatment effect in school performance was observed (P=0.042), in which only the NF group showed a significant improvement. CONCLUSION The self-reported improvements in ADHD core symptoms and school performance shortly after treatment indicate NF treatment being promising in comparison with medication, suggesting NF as an alternative treatment for children and adolescents who do not respond to MPH, or who suffer side effects. Further long-term follow-up is needed.
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Affiliation(s)
- Nezla S Duric
- Department of Clinical Medicine, University of Bergen, Bergen, Norway ; Center for Child and Adolescent Mental Health, University of Bergen, Bergen, Norway ; Department of Child and Adolescent Psychiatry, Helse Fonna Haugesund Hospital, Haugesund, Norway
| | - Jörg Aßmus
- Center for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Irene B Elgen
- Department of Clinical Medicine, University of Bergen, Bergen, Norway ; Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway
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Co-occurring aggressive and depressive symptoms as related to overestimations of competence in children with attention-deficit/hyperactivity disorder. Clin Child Fam Psychol Rev 2013; 17:157-72. [PMID: 24197937 DOI: 10.1007/s10567-013-0158-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Research indicates that on average, children with attention-deficit/hyperactivity disorder (ADHD) overestimate their competence in various domains. ADHD also frequently co-occurs with disorders involving aggressive and depressive symptoms, which themselves seem to influence estimations of self-competence in social, academic, and behavioral domains. In particular, high levels of aggressive behavior are generally associated with overestimations of competence, and high levels of depressive symptoms are related to underestimations of competence. This paper reviews studies of overestimations of competence among children with ADHD and examines the extent to which comorbid aggressive or depressive symptoms may be influencing these estimates. Although significant challenges arise due to limited information regarding comorbidities and problematic methods used to assess overestimations of competence, existing evidence suggests that ADHD may be associated with overestimations of competence over and above co-occurring aggression. As well, studies suggest that comorbid depression may reduce the appearance of overestimations of competence in children with ADHD. Underlying mechanisms (e.g., neuropsychological deficits or self-protection) of overestimations in children with ADHD are discussed, each with particular clinical implications for the assessment and treatment of ADHD. Future research would do well to carefully consider and explicitly describe the comorbid aggressive and depressive characteristics among individuals with ADHD when overestimations of competence are examined.
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Heath N, Roberts E, Toste JR. Perceptions of academic performance: positive illusions in adolescents with and without learning disabilities. JOURNAL OF LEARNING DISABILITIES 2013; 46:402-412. [PMID: 22183191 DOI: 10.1177/0022219411428807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Children with academic and behavioral difficulties have been found to report overly positive self-perceptions of performance in their areas of specific deficit. Researchers typically investigate self-perceptions in reference to both actual performance and ratings by teachers, peers, and parents. However, few studies have investigated whether or not adolescents with difficulty report overly positive self-perceptions. The present study sought to investigate self-perceptions of performance in the domains of spelling and math among a sample of adolescents with and without learning disabilities (LD). A total of 58 adolescents with and without LD participated. Adolescents with LD significantly overestimated their performance in math relative to their actual performance, but not in spelling, reflecting the predominant difficulty of the sample in the area of math rather than spelling. In addition, the magnitude of the gap between math predictions and actual performance was significantly greater for the group with LD than the group without LD. Findings support the existence of positive illusions in specific areas of deficit.
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Watabe Y, Owens JS, Evans SW, Brandt NE. The Relationship Between Sluggish Cognitive Tempo and Impairment in Children With and Without ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2013; 42:105-15. [DOI: 10.1007/s10802-013-9767-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nigg JT. Attention-deficit/hyperactivity disorder and adverse health outcomes. Clin Psychol Rev 2012; 33:215-28. [PMID: 23298633 DOI: 10.1016/j.cpr.2012.11.005] [Citation(s) in RCA: 243] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Revised: 11/02/2012] [Accepted: 11/22/2012] [Indexed: 12/13/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is defined by extreme levels of inattention-disorganization and/or hyperactivity-impulsivity. In DSM-IV, the diagnostic criteria required impairment in social, academic, or occupational functioning. With DSM-5 publication imminent in 2013, further evaluation of impairment in ADHD is timely. This article reviews the current state of knowledge on health-related impairments of ADHD, including smoking, drug abuse, accidental injury, sleep, obesity, hypertension, diabetes, and suicidal behavior. It concludes by suggesting the need for new avenues of research on mechanisms of association and the potential for ADHD to be an early warning sign for secondary prevention of some poor health outcomes.
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Affiliation(s)
- Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, United States.
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Knouse LE, Anastopoulos AD, Dunlosky J. Isolating metamemory deficits in the self-regulated learning of adults with ADHD. J Atten Disord 2012; 16:650-60. [PMID: 22094857 DOI: 10.1177/1087054711417231] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED ADHD in adulthood is associated with chronic academic impairments and problems with strategic memory encoding on standardized memory assessments, but little is known about self-regulated learning that might guide intervention. OBJECTIVE Examine the contribution of metamemory judgment accuracy and use of learning strategies to self-regulated learning in adults with ADHD, focusing on the use of self-testing. METHOD A total of 34 adults with ADHD and 34 matched controls predicted their memory performance and regulated their learning of paired associates. RESULTS Adults with ADHD were as accurate as controls at predicting memory performance, despite remembering fewer words. By observation and self-report, they were less likely to use self-testing to learn the pairs. CONCLUSION Across groups, self-testing was associated with significantly better recall and largely accounted for differences between diagnostic groups. Adults with ADHD often failed to employ a strategy that was associated with improved memory, identifying an intervention target that may improve self-regulated learning.
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Affiliation(s)
- Laura E Knouse
- Department of Psychology, University of Richmond, Richmond Hall, 28 Westhampton Way, VA 23173, USA.
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Scholtens S, Diamantopoulou S, Tillman CM, Rydell AM. Effects of symptoms of ADHD, ODD, and cognitive functioning on social acceptance and the positive illusory bias in children. J Atten Disord 2012; 16:685-96. [PMID: 21868588 DOI: 10.1177/1087054711417398] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the effects of symptoms of ADHD and ODD and cognitive functioning on social acceptance and positive bias in children. METHOD The sample consisted of 86 children (49 girls) between 7 and 13 years old, recruited to reflect a wide range of ADHD symptoms. Parents and teachers reported on ADHD and ODD symptoms and social acceptance. Children reported on social acceptance and were given tasks measuring working memory, inhibition and reaction-time variability. A discrepancy score between child and adult reports of social acceptance was used as a measure of positive bias. RESULTS Inattention independently explained variance in social acceptance. The cognitive factors were related to social acceptance and the positive bias, but not beyond the ADHD and ODD symptoms. CONCLUSION It is primarily disruptive behavior that contributes to external reports of children's social acceptance.
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Affiliation(s)
- Sara Scholtens
- Department of Psychology, Uppsala University, Box 1225, SE-751 42 Uppsala, Sweden.
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Is the positive illusory bias illusory? Examining discrepant self-perceptions of competence in girls with ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:987-98. [PMID: 22391774 DOI: 10.1007/s10802-012-9615-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
It has been claimed that excessively positive self-perceptions of competence are a key risk factor for concurrent and subsequent impairments in youth with attention-deficit/ hyperactivity disorder (ADHD). We examined whether girls with ADHD demonstrate positive illusory self-perceptions in scholastic competence, social acceptance, and behavioral conduct domains. We then tested, across a five-year longitudinal span, whether (a) such self-perceptions versus (b) the constituent informant ratings or test scores were more strongly predictive of adolescent impairment and positive adjustment. Participants included an ethnically diverse sample of 140 girls with ADHD and 88 comparison girls, aged 6-12 at baseline (M = 9.0, SD = 1.7). Girls with ADHD rated themselves as more positive than indicated by external ratings, but these self-reports were still in a negative direction (comparison girls rated themselves as less positive than these indicators). ADHD subtypes were not related to discrepancy scores. Higher rates of depression symptoms were associated with attenuated discrepancy scores. Crucially, measures of actual competence were more strongly associated with adolescent impairment and positive adjustment than were "illusory" self-perceptions for girls with ADHD. Our findings challenge the view that, at least in girls with ADHD, overly positive and "illusory" appraisals of competence are strongly associated with future impairment and adjustment. The key psychometric point is that, in difference or discrepancy scores, the individual components of such scores should be separately examined.
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Wiener J, Malone M, Varma A, Markel C, Biondic D, Tannock R, Humphries T. Children’s Perceptions of Their ADHD Symptoms. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2012. [DOI: 10.1177/0829573512451972] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated the perceptions of children with Attention-Deficit/Hyperactivity Disorder (ADHD) of their ADHD symptoms in terms of the positive illusory bias (PIB), their attributions for their problem behaviors, and their beliefs about whether their problem behaviors and disorder are stigmatizing. Participants were 152 9- to 14-year-old children (86 ADHD). Children with ADHD demonstrated a PIB for their ADHD symptoms; the discrepancy between their self-reports and parent reports was greater than for children without ADHD. They also viewed their self-identified most problematic behavior as more uncontrollable and stigmatizing (i.e., bothersome to others, leading to differential treatment, and embarrassing) than comparison children. Their perception that their problem behaviors and their disorder were stigmatizing was negatively associated with behavioral self-concept and self-esteem. These results suggest that school psychologists should interpret the self-reports of problem behaviors of children with ADHD with caution while being aware of the vulnerability of these children to feelings of stigma.
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Affiliation(s)
- Judith Wiener
- Department of Human Development and Applied Psychology, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Molly Malone
- Child Development Program, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Angela Varma
- Department of Human Development and Applied Psychology, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Clarisa Markel
- Department of Human Development and Applied Psychology, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Daniella Biondic
- Department of Human Development and Applied Psychology, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Rosemary Tannock
- Department of Human Development and Applied Psychology, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Tom Humphries
- Department of Human Development and Applied Psychology, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
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Prevatt F, Proctor B, Best L, Baker L, Van Walker J, Taylor NW. The positive illusory bias: does it explain self-evaluations in college students with ADHD? J Atten Disord 2012; 16:235-43. [PMID: 21289235 DOI: 10.1177/1087054710392538] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate whether the positive illusory bias explains the self-evaluations of driving and work behaviors in college students with ADHD. METHOD A total of 103 students with ADHD were compared to a sample of 94 students without ADHD. Both groups completed self-reports of their specific driving and work behaviors and then rated their overall, global performance in each area. Three specific-to-global change scores were obtained (one measuring work and two measuring driving) that were thought to be measures of the positive illusory bias. These specific-to-global change scores were analyzed using chi-square to evaluate differences between participants with and without ADHD. RESULTS The participants with ADHD were significantly more likely than the participants without ADHD to engage in the positive illusory bias on two of the three work and driving ratings. CONCLUSION College students with ADHD demonstrate self-evaluations that appear to reflect the positive illusory bias and that may be related to their academic functioning in the college setting and willingness to receive treatment.
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Ohan JL, Johnston C. Positive illusions of social competence in girls with and without ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2011; 39:527-39. [PMID: 21264503 DOI: 10.1007/s10802-010-9484-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We compared social self-competence ratings in 9-12 year old girls with (n = 42) versus without (n = 40) ADHD, relative to ratings of the girls' social competence made by mothers, teachers, and blind raters during a social laboratory task. Relative to scores from mothers, teachers, and the lab-task, girls with ADHD over-estimated their competence significantly more than control girls. Over-estimates were greater for girls with ADHD who also had heightened oppositional-defiant symptoms, or lower depressive symptoms. Over-estimates were positively related to a socially desirable reporting bias for girls with ADHD, but not for control girls, suggesting that girls with ADHD attempt to present themselves in an unduly positive, self-protective light. For girls with ADHD, over-estimates also were positively related to maladjustment and negatively related to adjustment. However, for girls without ADHD, over-estimates were positively related to adjustment. Overall, over-estimates of competence function differently in girls with and without ADHD.
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Affiliation(s)
- Jeneva L Ohan
- School of Psychology & Counselling, Queensland University of Technology, Kelvin Grove, Brisbane, QLD 4059, Australia.
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Ekornås B, Heimann M, Tjus T, Heyerdahl S, Lundervold AJ. Primary School Children's Peer Relationships: Discrepancies in Self-Perceived Social Acceptance in Children with Emotional or Behavioral Disorders. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2011. [DOI: 10.1521/jscp.2011.30.6.570] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Krueger CE, Rosen HJ, Taylor HG, Espy KA, Schatz J, Rey-Casserly C, Kramer JH. Know thyself: real-world behavioral correlates of self-appraisal accuracy. Clin Neuropsychol 2011; 25:741-56. [PMID: 21547852 DOI: 10.1080/13854046.2011.569759] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Accurate appraisal of one's own abilities is one metacognitive skill considered to be an important factor affecting learning and behavior in childhood. The present study measured self-appraisal accuracy in children using tasks of executive function, and investigated relations between self-appraisal and informant ratings of real-world behaviors measured by the BRIEF. We examined self-appraisal accuracy on fluency tasks in 91 children ages 10-17. More accurate self-appraisal was correlated with fewer informant ratings of real-world behavior problems in inhibition and shifting, independent of actual performance. Findings suggest that self-appraisal represents cognitive processes that are at least partially independent of other functions putatively dependent on the frontal lobes, and these self-appraisal-specific processes have unique implications for optimal daily function.
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Affiliation(s)
- Casey E Krueger
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
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Rizzo P, Steinhausen HC, Drechsler R. Self-perception of self-regulatory skills in children with attention-deficit/hyperactivity disorder aged 8-10 years. ACTA ACUST UNITED AC 2010; 2:171-83. [PMID: 21432604 DOI: 10.1007/s12402-010-0043-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 10/24/2010] [Indexed: 11/29/2022]
Abstract
Several studies have reported a characteristic "positive illusory bias" in the self-evaluation of children with ADHD. However, results are controversial. The aim of the present study was to investigate whether children with ADHD aged 8 to 10 years can rate their self-regulatory skills accurately when assessed with an age appropriate instrument. Twenty-seven children with ADHD and 27 matched normal control children completed the Self-rating Scale of Self-regulatory Function (SelfReg), a new rating scale that has been specifically designed for this age group. As expected, children with ADHD rated themselves significantly more dysfunctional than control children. In most domains, self-ratings of children with ADHD did not diverge from parent and teacher ratings to a greater extent than self-ratings of control children, although overall results indicated a moderate tendency toward a positive bias. When a cluster analysis based on discrepancies between children's and adults' evaluations was carried out, three groups with different self-rating patterns emerged: A "positive bias" group containing exclusively children with ADHD, a "negative bias" group containing both children with ADHD and control children, and the largest group of accurate self-raters which also included children from both diagnostic groups. It is concluded that overly positive self-judgments are not a ubiquitous finding in ADHD, but may be confined to a specific subgroup of children whose specific characteristics remain to be determined.
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Affiliation(s)
- Patrizia Rizzo
- Department of Child and Adolescent Psychiatry, University of Zurich, Switzerland
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Mikami AY, Calhoun CD, Abikoff HB. Positive illusory bias and response to behavioral treatment among children with attention-deficit/hyperactivity disorder. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2010; 39:373-85. [PMID: 20419578 DOI: 10.1080/15374411003691735] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The current study investigates the accuracy of self-perceptions of competence among 43 children with attention-deficit/hyperactivity disorder (ages 6.9-11.9; 37 boys) attending an 8-week empirically supported behavioral summer treatment program. Having inflated self-perceptions about one's competence at the beginning of the summer predicted poorer response to the intervention administered in the program as assessed by changes in observed conduct problems, peer-nominated social preference, and friendship. However, inflated self-perceptions at the start of the summer predicted reductions in self-reported depressive symptoms during the treatment period. Despite participating in an intensive intervention, there was high stability of children's biased self-perceptions regarding their performance.
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Affiliation(s)
- Amori Yee Mikami
- Department of Psychology, University of Virginia, Charlottesville, VA 22904-4400, USA.
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Saylor K, Williams DW, Schuh KJ, Wietecha L, Greenbaum M. Effects of atomoxetine on self-reported high-risk behaviors and health-related quality of life in adolescents with ADHD. Curr Med Res Opin 2010; 26:2087-95. [PMID: 20642391 DOI: 10.1185/03007995.2010.493747] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This study measured the effects of atomoxetine HCl on high-risk behaviors and health-related quality of life in adolescents with attention-deficit/hyperactivity disorder (ADHD), using a subgroup analysis of data from a previous clinical trial. RESEARCH DESIGN AND METHODS In the base study, which was conducted at 26 sites in the United States, patients ages 13-16 years were randomized in a double-blind manner to atomoxetine treatment by one of two dose titration schedules for 8 weeks. Patients who responded to treatment were rerandomized to atomoxetine at a daily dose of 0.8 or 1.4 mg/kg for 40 weeks. Patients in the highest-risk quartile for each category of behavior or domain were included and the dosing groups combined. MAIN OUTCOME MEASURES Efficacy measures included the Youth Risk Behavior Surveillance (YRBS) and Child Health and Illness Profile - Adolescent Edition (CHIP-AE). The YRBS has six categories of behavior, and the CHIP-AE has six domains. Data for mean change from baseline were analyzed using a last-observation-carried-forward analysis. RESULTS A total of 267 patients were randomized, but the high-risk subgroup analyzed in the present study was much smaller (range of n = 5-68 per group). YRBS scores for tobacco use, unhealthful dietary behaviors, inadequate physical activity, and behaviors contributing to unintentional injuries showed statistically significant improvements (p < 0.05) by atomoxetine treatment at Week 8. At the end of the 40-week maintenance period, unhealthful dietary behaviors, inadequate physical activity, and behaviors contributing to unintentional injuries continued to show statistically significant improvements (p < 0.001). When the highest-risk quartile of the CHIP-AE data was analyzed, there were statistically significant improvements on all six domains after atomoxetine treatment at 8 weeks (p < 0.001) and on five of the six domains at 40 weeks (p < or = 0.01). CONCLUSIONS Atomoxetine improved self-reported high-risk behaviors and overall health-related quality of life in adolescents with ADHD. Potential limitations of this study include small sample sizes and the fact that it involved a subgroup analysis, which is by nature hypothesis-generating. Further, well-controlled, prospective studies in larger and more heterogeneous ADHD populations, including older patients, are warranted to confirm or reject these findings.
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Drechsler R, Rizzo P, Steinhausen HC. The impact of instruction and response cost on the modulation of response-style in children with ADHD. Behav Brain Funct 2010; 6:31. [PMID: 20525316 PMCID: PMC2901315 DOI: 10.1186/1744-9081-6-31] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Accepted: 06/04/2010] [Indexed: 11/10/2022] Open
Abstract
Background The present study investigated the impact of divergent instructions and response cost on strategic cognitive control in children with ADHD. Methods Children with ADHD (N = 34), combined subtype, and control children (N = 34) performed a series of self-paced computerized visual search tasks. The tasks varied by verbal instructions: after a baseline task, children were either instructed to work as fast as possible (speed instruction) or as accurately as possible (accuracy instruction). In addition, tasks were performed with and without response cost. Results Both groups modulated latencies and errors according to instructions in a comparable way, except for latency in the accuracy - instruction without response cost, where control children showed a larger increase of response time. Response cost did not affect the modulation of response style in children with ADHD to a larger extent than in controls. However, with instructions group differences related to target criteria became clearly more accentuated compared to baseline but disappeared when response cost was added. Conclusions Delay aversion theory and motivational or state regulation models may account for different aspects of the results. Modifications related to task presentation, such as the emphasis put on different details in the verbal instruction, may lead to divergent results when comparing performances of children with ADHD and control children on a self-paced task.
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Affiliation(s)
- Renate Drechsler
- Department of Child and Adolescent Psychiatry, University of Zurich, Neumuensterallee 9, 8032 Zurich, Switzerland.
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Wehmeier PM, Schacht A, Dittmann RW, Banaschewski T. Minor differences in ADHD-related difficulties between boys and girls treated with atomoxetine for attention-deficit/hyperactivity disorder. ACTA ACUST UNITED AC 2010; 2:73-85. [DOI: 10.1007/s12402-010-0022-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Accepted: 03/12/2010] [Indexed: 11/28/2022]
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Bjorklund DF, Periss V, Causey K. Elucidating the mechanisms of human development: A reply to Dubas. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2009. [DOI: 10.1080/17405620802602417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Owens JS, Goldfine ME, Evangelista NM, Hoza B, Kaiser NM. A Critical Review of Self-perceptions and the Positive Illusory Bias in Children with ADHD. Clin Child Fam Psychol Rev 2007; 10:335-51. [PMID: 17902055 DOI: 10.1007/s10567-007-0027-3] [Citation(s) in RCA: 320] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite significant functional problems in multiple domains, children with Attention-Deficit/Hyperactivity Disorder (ADHD) unexpectedly provide extremely positive reports of their own competence in comparison to other criteria reflecting actual competence. This counterintuitive phenomenon is known as the positive illusory bias (PIB). This article provides a comprehensive and critical review of the literature examining the self-perceptions of children with ADHD and the PIB. Specifically, we analyze methodological and statistical challenges associated with the investigation of the phenomenon, the theoretical basis for the PIB, and the effects of sample heterogeneity on self-perception patterns. We conclude by discussing the implications of this work and providing recommendations for advancing research in this area.
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