Social problems associated with ADHD vs. ODD in children referred for friendship problems

Altered somatosensory processing in adult attention deficit hyperactivity disorder

BACKGROUND

Tactile sensitivity and sensory overload in ADHD are well-documented in clinical-, self-, and parent- reports, but empirical evidence is scarce and ambiguous and focuses primarily on children. Here, we compare both empirical and self-report tactile sensitivity and ADHD symptomatology in adults with ADHD and neurotypical controls. We evaluate whether tactile sensitivity and integration is more prevalent in ADHD and whether it is related to ADHD symptom severity.

METHODS

Somatosensory evoked potential (SEP) amplitudes were measured in 27 adults with ADHD and 24 controls during four conditions (rest, stroking of the own arm, stroking of the arm by a researcher, and stroking of an object). Participants also filled out questionnaires on tactile sensitivity and ADHD symptoms and performed a Qb-test as an objective measure of ADHD symptom severity.

RESULTS

Participants with ADHD self-reported greater tactile sensitivity and ADHD symptom severity than controls and received higher scores on the Qb-test. These values correlated with one another. ADHD participants showed lower tolerable threshold for electrical radial nerve stimulus, and greater reduction in cortical SEP amplitudes during additional tactile stimuli which was correlated with ADHD symptoms.

CONCLUSIONS

We find that ADHD symptomatology and touch sensitivity are directly linked, using both self-reports and experimental measures. We also find evidence of tactile sensory overload in ADHD, and an indication that this is linked to inattention specifically. Tactile sensitivity and sensory overload impact the functioning and life quality of many people with ADHD, and clinicians should consider this when treating their patients.

Impulsivity as key bridge symptoms in cross-sectional and longitudinal networks of ADHD and ODD

BACKGROUND

Impulsivity is viewed as key to attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders (DBD). Yet, to date, no work has provided an item-level analysis in longitudinal samples across the critical developmental period from childhood into adolescence, despite prior work suggesting items exhibit differential relevance with respect to various types of impairment. The current study conducted a novel longitudinal network analysis of ADHD and oppositional defiant disorder (ODD) symptoms between childhood and adolescence, with the important applied prediction of social skills in adolescence.

METHODS

Participants were 310 children over-recruited for clinical ADHD issues followed longitudinally for six years in total with gold standard diagnostic procedures and parent and teacher ratings of symptoms and social outcomes.

RESULTS

Findings from baseline, Year 3, and Year 6 suggested Difficulty waiting turn, Blurts, and Interrupts/intrudes were key bridge items across cross-sectional and longitudinal parent-reported DBD networks. Furthermore, shortened symptom lists incorporating these symptoms were stronger predictors of teacher-rated social skills 5 years later compared to total DBD scores.

CONCLUSIONS

Such findings are consistent with the trait impulsivity theory of DBD and ADHD and may inform useful screening tools and personalized intervention targets for children at risk for DBD during adolescence.

Differences in Offending Behaviors, Aggression, Substance Use, and Mental Health Problems between Male Drug Dealers and Non-Drug Dealers in Belgian Youth Detention Centers

This study investigated whether drug dealing juvenile offenders in Belgium differ from non-drug dealers in levels of violent and non-violent offending behaviors, aggression, substance use, and mental health needs. The current study examined data from 226 16- to 17-year-old male juvenile offenders. Information relating to drug dealing, substance use, and mental health needs were collected through self-report questionnaires. A structured diagnostic interview was used to collect information about past violent and non-violent behaviors. Chi-square tests and multivariate analysis of variance compared non-dealers and dealers and explored if hard-drug dealers and soft-drug dealers differed from each other. Relative to non-drug dealers, drug dealers engaged in more violent offending behaviors, exhibited higher levels of aggression, substance use and oppositional defiant problems, and displayed lower levels of anxiety. Soft- and hard-drug dealers did not differ from each other. To conclude, detained drug dealers are characterized by severe antisocial behavior.

Characterizing Youth-Caregiver Concordance and Discrepancies in Psychopathology Symptoms in a US Community Sample

Evidence shows that reports of psychopathology symptoms by youth and their caregiver informants differ. To quantify youth-caregiver discrepancies in psychopathology symptoms and factors associated with such discrepancies, we investigated differences in how youth and their caregivers rated psychopathology symptoms. The sample (N = 5094) was extracted from the Philadelphia Neurodevelopmental Cohort, a community-based sample of youth and included participants ages 11-17 years old with both youth and caregiver reported symptom scores. Across psychopathology symptoms, youth-caregiver concordance was poor to fair (Cohens kappa for symptom items ranged between 0.03-0.41). Psychosis symptoms had the lowest concordance-Cohen's kappa ranged from 0.03 to 0.17 across psychosis symptoms. Discrepancies between youth and caregiver symptom reports were greater than average for Black youth and for youth of low socioeconomic status; discrepancies were also higher than average in youth with any psychiatric disorder when compared to typically developing youth. Network analysis of difference scores obtained by subtracting youth symptom scores from caregiver reported symptom scores showed that network connectivity (i.e., correlated difference scores) was sparsest for psychosis spectrum compared to other psychiatric disorders. Using a large sample, we show that youth and their caregiver informants tend to report psychopathology symptoms differently. Youth-caregiver discrepancies were the most pronounced for Black youth and youth of low socio-economic status. Race and socioeconomic status contribute to significant differences in how youth and their caregivers report such symptoms and are important factors that should be accounted for to facilitate accurate mental health symptom assessment and evaluation.

ASD symptoms in adults with ADHD: a preliminary study using the ADOS-2

Attention-deficit/hyperactivity disorder (ADHD) has long been regarded as disparate and mutually exclusive to autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R and DSM-IV. However, this idea has become obsolete due to a growing body of evidence suggesting numerous phenotypic and genetic similarities between ADHD and ASD. ASD symptoms or autistic traits in individuals with ADHD have been examined; however, most studies were conducted on children and relied on self- or parent- reports. ASD symptoms assessed with more direct, objective measures, such as the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in adults with ADHD, remain understudied. In the present study, we used the ADOS-2 to evaluate ASD symptoms in adults with ADHD who were not clinically diagnosed with ASD. Fifty-six adults (mean age 33.9 years, 35 males, intelligence quotient ≥ 85), who were diagnosed with ADHD based on the DSM-5 criteria, completed Module 4 of the ADOS-2. Autism Spectrum Quotient (AQ), Conners' Adult ADHD Rating Scale (CAARS), and Wechsler Adult Intelligence Scale (WAIS)-III were also administered to assess self-rated ASD symptoms, ADHD symptoms, and intelligence, respectively. Overall, 23.3% of participants met the ASD diagnostic classification on the ADOS-2. Social reciprocal interaction scores tended to be higher, while restricted and repetitive behavior scores were low. The scoring patterns and possible overlapping and differing phenotypic characteristics of ADHD and ASD are discussed.

Interpersonal Negotiation Skills in ADHD

Social interaction difficulties are amongst the most prevalent and pervasive adverse outcomes for children and adolescents with ADHD. Problem-solving strategies are impaired in affected individuals, according to the literature. This study aimed to investigate the social problem-solving skills of children and adolescents with and without ADHD, using objective quantitative measures provided by the Interpersonal Negotiation Strategies Interview (INSI). Because verbal communication skills and working memory may be impaired in ADHD, we investigated their contribution to the performance. Forty-three children and adolescents with ADHD and 27 clinical controls with clinical diagnoses other than ADHD completed the INSI along with measures of verbal communication skills (Verbal Comprehension Index [VCI]): Similarities, Vocabulary and Comprehension subtests from the Wechsler Battery, visual (Corsi Blocks) and verbal (Digit Span) working memory tasks. Groups performed similarly on measures of intellectual functioning, working memory, and verbal communication. For the entire sample, VCI scores were positively correlated with INSI performance scores. The ADHD group performed worse on the INSI than the clinical control group. Linear regression analysis showed that inattention and hyperactivity/impulsivity levels and Similarities predicted INSI's performance. Our findings indicate that interpersonal negotiation difficulties in ADHD are related to DSM-5 defining symptoms of the disorder.

Peer victimization and the association with hippocampal development and working memory in children with ADHD and typically-developing children

The symptoms of hyperactivity-impulsivity and inattention displayed by children with ADHD put them at risk of experiencing peer victimization. Hippocampal maturation, may reduce a child's vulnerability to the experience of peer victimization, as it has been associated with decreased ADHD symptomatology. Working memory is an important executive function in the formation and maintenance of social relationships, which is often impaired in ADHD. We aimed to evaluate the relationship between problem behaviours, peer victimization, hippocampal morphology, and working memory in children with and without ADHD. 218 typically-developing participants (50.5% male) and 232 participants diagnosed with ADHD (77.6% male) were recruited. The ADHD group was subdivided into inattentive (ADHD-I) or combined (ADHD-C) types. The Child Behavior Checklist measured problem behaviours and peer victimization. Children underwent Magnetic Resonance Imaging (MRI). Hippocampal subfield volumes were obtained using FreeSurfer. The Wechsler Intelligence Scale for Children-fifth edition measured working memory (WM). The ADHD-C group displayed significantly higher levels of problem behaviours and peer victimization (all, p < 0.001), compared to the other groups. Left Cornu Ammonis 3 (CA3) volume was a positive predictor of peer victimization (all, p < 0.013). Left CA3 volume was a positive predictor of WM and left Cornu Ammonis 4 (CA4) volume negatively predicted WM (all, p < 0.025). A cluster analysis revealed that children displaying symptoms of hyperactivity-impulsivity are the most at risk for peer victimization. Interventions focusing on minimizing peer victimization may aid in mitigating adverse downstream effects, and assist in promoting brain health and cognitive function.

Unique Associations Between Specific Attention-Deficit Hyperactivity Disorder Symptoms and Related Functional Impairments

OBJECTIVE

The purpose of this study was to explore the unique relationships between specific attention-deficit hyperactivity disorder (ADHD) symptoms and functional impairment in school-age children using parent and teacher ratings.

METHODS

Parents and teachers rated ADHD symptoms and comorbidities (internalizing and oppositional behaviors) as well as impairments (academic, relationship, and classroom behavior) for 8689 children using the Vanderbilt ADHD Diagnostic Rating Scales. Stepwise regression was used to determine which of the 18 ADHD symptom items were most associated with specific domains of impairment with relevant demographic and clinical characteristics used as covariates (e.g., sex, comorbidities, medication status, and age).

RESULTS

"Careless mistakes" and "avoids tasks" significantly predicted academic impairment across content areas and across parent- and teacher-rating models. ADHD symptoms accounted for limited variance in impairment in the family and peer relationship domains or in organized activities when oppositional symptoms were entered as a covariate. Regarding teacher-rated classroom behavior, the strongest predictor of impairment was "talks too much."

CONCLUSION

The findings indicate that the symptoms that were most predictive of impairment varied by domain of impairment.

Bivariate latent change score analysis of peer relations from early childhood to adolescence: Leading or lagging indicators of psychopathology

Understanding longitudinal associations between problematic peer relations and psychopathology are needed to inform public health. Three models have been proposed: poor peer relations i) lead or are a risk factor for psychopathology; ii) lag or are a consequence of psychopathology; iii) both lead and lag psychopathology. Another model is that poor peer relations lead or lag psychopathology depending upon the developmental period. To test these models, youth's peer relations and clinical symptoms were assessed up to 6 times between ages 3-11 in 306 children. Bivariate latent change score models tested leading/lagging longitudinal relationships between children's peer relations (peer victimization/rejection, peer-directed aggression, social withdrawal, prosocial behavior) and psychopathology (depression, anxiety, and externalizing symptoms). Peer victimization/rejection was a leading indicator of depression from early childhood into preadolescence. Peer-directed aggression was a leading indicator of externalizing symptoms (in late childhood).

Friendship and social functioning following early institutional rearing: The role of ADHD symptoms

Early institutional rearing is associated with increased risk for subsequent peer relationship difficulties, but the underlying mechanisms have not been identified. Friendship characteristics, social behaviors with peers, normed assessments of social problems, and social cue use were assessed in 142 children (mean age = 10.06, SD = 2.02; range 7-13 years), of whom 67 were previously institutionalized (PI), and 75 were raised by their biological families. Anxiety and attention-deficit/hyperactivity disorder (ADHD) symptoms, often elevated among PI children, were examined as potential mediators of PI status and baseline social functioning and longitudinal follow-ups (2 and 4 years later). Twenty-seven percent of PI children fell above the Child Behavior Checklist Social Problems cutoff. An examination of specific social behaviors with peers indicated that PI and comparison children did not differ in empathic concern or peer social approach, though parents were more likely to endorse aggression/overarousal as a reason that PI children might struggle with friendships. Comparison children outperformed PI children in computerized testing of social cue use learning. Finally, across these measures, social difficulties exhibited in the PI group were mediated by ADHD symptoms with predicted social problems assessed 4 years later. These findings show that, when PI children struggle with friendships, mechanisms involving attention and behavior regulation are likely contributors.

Longitudinal Associations between Oppositional Defiant Symptoms and Interpersonal Relationships among Chinese Children

Children with oppositional defiant disorder (ODD) are at increased risk for developing poor relationships with people around them, but the longitudinal links between ODD symptoms and subsequent interpersonal functioning remain unclear. In the current study, we examined the bidirectional associations between ODD symptoms and children's relationships with parents, peers, and teachers. We included separate analyses for parent vs. teacher reports of ODD symptoms, with regard to subsequent interpersonal relationships. Participants included 256 children with ODD, recruited in China, along with their parents and teachers, assessed at three time points roughly two years apart. Parents and teachers reported child ODD symptoms at each time point, and children reported their perceptions of father- and mother-child attachment, peer relationships, and teacher-student relationships across the three time points. ODD symptoms reported either by parents or teachers predicted impairments in interpersonal functioning. Meanwhile, child interpersonal impairments with peers and teachers predicted subsequent increase in teacher-reported ODD symptoms. These findings highlight the importance of transactional models of influence-and of considering early intervention for ODD in protecting children from developing further deficits and impairments. Additionally, we discuss the perspectives of multiple informants on ODD symptoms, including their different patterns of association with subsequent interpersonal relationships.

Peer relationships and prosocial behaviour differences across disruptive behaviours

It is unclear if impairments in social functioning and peer relationships significantly differ across common developmental conditions such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and associated callous-unemotional traits (CU traits). The current study explored sex differences and symptoms of parent- and teacher-reported psychopathology on peer relationships and prosocial behaviour in a sample of 147 referred children and adolescents (aged 5-17 years; 120 m). The results showed that increases in parent-reported ADHD Inattentive symptoms and teacher-reported ADHD Hyperactive-Impulsive symptoms, CD, ODD, and CU traits were significantly associated with peer relationship problems across sex. At the same time, teacher-reported symptoms of ODD and both parent- and teacher-reported CU traits were related to difficulties with prosocial behaviour, for both boys and girls, with sex explaining additional variance. Overall, our findings show a differential association of the most common disruptive behaviours to deficits in peer relationships and prosocial behaviour. Moreover, they highlight that different perspectives of behaviour from parents and teachers should be taken into account when assessing social outcomes in disruptive behaviours. Given the questionable separation of conduct problem-related constructs, our findings not only point out the different contribution of those aspects in explaining peer relationships and prosocial behaviour, but furthermore the variance from different informants about those aspects of conduct problems.

Dimensions and subtypes of oppositionality and their relation to comorbidity and psychosocial characteristics

The symptoms of oppositional defiant disorder (ODD), or oppositionality, seem to constitute a three-dimensional structure of angry/irritable, vindictiveness and argumentative behavior dimensions. Also, subjects with oppositionality are characterized by different comorbidity and longitudinal trajectories, suggesting that they could be divided into subtypes. This study is the first to examine the dimensions and subtypes of oppositionality in Nordic children. Study participants included 3435 children aged 7-10 years from the Danish National Birth Cohort. Information was collected using the Development and Well-Being Assessment (DAWBA) online version. A three-factor ODD model was identified. The angry/irritable dimension was associated with emotional problems and disorders, fewer social skills and fewer personal positive attributes. The argumentative behavior dimension was associated with hyperactivity/conduct problems, reduced social skills and positive attributes. The vindictiveness dimension was associated with externalizing, internalizing and prosocial problems. Four ODD subtypes were identified. The subtypes with many or mainly angry/irritable symptoms were characterized by comorbid psychopathology, increased functional impairment and psychosocial problems. Children with ODD had fewer positive attributes, more friendship/school problems and higher functional impairment than children with emotional disorders and control group children. Oppositionality consists of three dimensions differently associated with comorbidity and psychosocial characteristics, and the same pattern is seen for the four ODD subtypes identified in this study. Children with ODD experience more adversities and functional impairment than children with emotional disorders. Our results indicate that treatment of children with ODD would improve from extended knowledge on individual ODD dimensions and subtypes and the related child psychosocial characteristics.

Response Patterns to Emotional Faces Among Adolescents Diagnosed With ADHD

OBJECTIVE

The present study investigated differences in emotional face processing between adolescents (age 15-18) with ADHD-Combined type (ADHD-CT) and typically developing controls.

METHOD

Participants completed a visual emotional task in which they were asked to rate the degree of negativity/positivity of four facial expressions (taken from the NimStim face stimulus set).

RESULTS

Participants' ratings, ratings' variability, response times (RTs), and RTs' variability were analyzed. Results showed a significant interaction between group and the type of presented stimuli. Adolescents with ADHD-CT discriminated less between positive and negative emotional expressions compared with those without ADHD. In addition, adolescents with ADHD-CT exhibited greater variability in their RTs and in their ratings of facial expressions when compared with controls.

CONCLUSION

The present results lend further support to the existence of a specific deficit or alteration in the processing of emotional face stimuli among adolescents with ADHD-CT.

Auch Du Hast Sommerferien

Zusammenfassung. Das Sommertherapiecamp (STC) ist ein multimodaler kognitiv-verhaltenstherapeutischer Intensivbehandlungsansatz für die Aufmerksamkeitsdefizit-/ Hyperaktivitätsstörung (ADHS). Der Artikel berichtet über Befunde einer Wirksamkeitsstudie für das STC mit Prä-Post-Design und Kontrollgruppenvergleich. Die Eltern von N = 31 Kindern (7 – 11 Jahre) mit einer ADHS-Diagnose füllten vor und nach dem dreiwöchigen STC folgende Symptom-Fragebögen aus: CBCL/4 – 18, DISYPS-II FBB-ADHS und FBB-SSV. N = 13 weitere Kinder der gleichen Grundgesamtheit, die in der selben Zeit unbehandelt blieben oder „treatment as usual“ erhielten, dienten als Kontrollgruppe. Die STC-Gruppe zeigte eine Verbesserung der ADHS-Symptomatik sowie eine Reduktion weiterer Verhaltensauffälligkeiten, während vergleichbare Effekte für die Kontrollgruppe nicht nachweisbar waren. Angesichts kleiner Stichproben sind diese Befunde vorerst vorsichtig zu interpretieren, liefern jedoch erste ermutigende Hinweise auf die Brauchbarkeit des STC.

Being on Your Own or Feeling Lonely? Loneliness and Other Social Variables in Youths with Autism Spectrum Disorders

A cross-sectional study was conducted to examine loneliness and its correlates in children (7 to 11 years) and adolescents (12 to 18 years) with autism spectrum disorders (ASD, n = 73) and control groups of clinically referred (ADHD, n = 76) and non-clinical (n = 106) youths. Youths completed questionnaires on loneliness and desire for social interaction, while parents and teachers filled out scales on other aspects of children's social functioning. Results indicated that only at an adolescent age, the ASD group reported higher levels of loneliness than the control groups. Further, the ASD group generally expressed relatively low levels of desire for social interaction, although these youths displayed a similar increase in the wish to belong during adolescence as participants in the control groups. Finally, the ASD group exhibited lower levels of social competence and social skills and higher levels of social problems and social anxiety than the control groups, and in all groups these social variables correlated in a theoretically meaningful with loneliness.

ADHD Symptomology and Social Functioning in College Students

OBJECTIVE

ADHD is no longer considered a disorder that children simply outgrow. Adults experience ADHD at high rates (2.5%-5%) and are impaired in multiple life domains, including social impairment. The purpose of this study was to examine emerging adults with varying degrees of ADHD symptomology in respect to social impairment, state and trait anger, romantic relationship satisfaction, and intimate partner violence (IPV).

METHOD

College students, a subset of emerging adults, were recruited to complete measures online.

RESULTS

Data were analyzed using a series of multiple regressions. Higher levels of ADHD symptomology in college students were related to increased social impairment and higher levels of state and trait anger, but not romantic relationship satisfaction or rates of IPV.

CONCLUSION

Anger management and social skills training may be beneficial treatment components for this group.

The Association between Sleep and Theory of Mind in School Aged Children with ADHD

Theory of Mind (ToM) is defined as the ability to infer a range of internal mental states of others, including beliefs, intentions, desires, and emotions. These abilities are associated with children’s ability to socialize effectively with peers. ToM impairments are associated with peer rejection and psychiatric disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD). Previous studies have found poor sleep negatively impacts executive functioning (EF) and emotional information processing, which are essential for the effective use of ToM. Youth with ADHD have EF deficits and sleep problems. However, the relationship between sleep, executive functioning, and ToM in children with ADHD has not been studied. In this review, we propose that the poor social and interpersonal skills characterizing individuals with ADHD could be explained by the impact of poor sleep on the emotional and cognitive mechanisms underlying ToM.

Reliability and Validity of a Spanish Version of the Social Skills Rating System–Teacher Form

The aim of this study was to examine the psychometric properties of a Spanish version of the Social Skills Scale of the Social Skills Rating System–Teacher Form (SSRS-T) with a sample of children attending elementary schools in Puerto Rico ( N = 357). The SSRS-T was developed for use with English-speaking children. Although translated, adapted, and administered in Spanish, little was known about its psychometric properties. The authors evaluated the applicability of the Spanish SSRS-T by examining specifically its internal consistency, test-retest reliability, parent-teacher cross-informant correlations, and construct validity. Findings suggest that the Spanish SSRS-T is a valid and reliable instrument and support its potential utility in the early identification of social difficulties that may hinder the social, emotional, and academic adjustment of Latino children.

Impaired Social Decision-Making Mediates the Association Between ADHD and Social Problems

Attention-deficit/hyperactivity disorder (ADHD) reliably predicts social dysfunction, ranging from poor social competence and elevated peer rejection to inadequate social skills. Yet, the factors mediating predictions of social problems from childhood ADHD are not well understood. In the present study, we investigated social functioning in 186 (69 % male) 6 to 10 year-old (M = 7.88, SD = 1.17) children with (n = 98) and without (n = 87) ADHD who were followed prospectively for two years. We implemented a well-validated measure of social problems as well as a novel social decision-making task assessing dynamic response to changing affective cues at the two-year follow-up. According to separate parent and teacher report, baseline ADHD symptoms positively predicted social problems at the two-year follow-up; individual differences on the social decision-making task mediated this association. This finding was replicated when ADHD dimensions (i.e., inattention and hyperactivity/impulsivity) were separately examined. These findings suggest that the deficient use of affective cues to effectively guide behavior may partially underlie poor social functioning among children with ADHD. If replicated, these preliminary findings suggest that social skills interventions that target interpretation of affective cues to aid in social decision-making behavior may improve social outcomes negatively affected by early ADHD symptoms.

Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review

Introduction

Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning.

Objective

To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults.

Methods

A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria.

Results

Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity.

Conclusions

The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

Should schools expect poor physical and mental health, social adjustment, and participation outcomes in students with disability?

The literature on whether students with disabilities have worse physical and mental health, social adjustment, and participation outcomes when compared to their peers without disabilities is largely inconclusive. While the majority of case control studies showed significantly worse outcomes for students with disabilities; the proportion of variance accounted for is rarely reported. The current study used a population cross-sectional approach to determine the classification ability of commonly used screening and outcome measures in determining the disability status. Furthermore, the study aimed to identify the variables, if any, that best predicted the presence of disability. Results of univariate discriminant function analyses suggest that across the board, the sensitivity of the outcome/screening tools to correctly identify students with a disability was 31.9% higher than the related Positive Predictive Value (PPV). The lower PPV and Positive Likelihood Ratio (LR+) scores suggest that the included measures had limited discriminant ability (17.6% to 40.3%) in accurately identifying students at-risk for further assessment. Results of multivariate analyses suggested that poor health and hyperactivity increased the odds of having a disability about two to three times, while poor close perceived friendship and academic competences predicted disability with roughly the same magnitude. Overall, the findings of the current study highlight the need for researchers and clinicians to familiarize themselves with the psychometric properties of measures, and be cautious in matching the function of the measures with their research and clinical needs.

Thyrotoropin receptor knockout changes monoaminergic neuronal system and produces methylphenidate-sensitive emotional and cognitive dysfunction

Attention deficit/hyperactivity disorder (ADHD) has been reported in association with resistance to thyroid hormone, a disease caused by a mutation in the thyroid hormone receptor β (TRβ) gene. TRβ is a key protein mediating down-regulation of thyrotropin (TSH) expression by 3,3',5-tri-iodothyronine (T3), an active form of thyroid hormone. Dysregulation of TSH and its receptor (TSHR) is implicated in the pathophysiology of ADHD but the role of TSHR remains elusive. Here, we clarified a novel role for TSHR in emotional and cognitive functions related to monoaminergic nervous systems. TSHR knockout mice showed phenotypes of ADHD such as hyperactivity, impulsiveness, a decrease in sociality and increase in aggression, and an impairment of short-term memory and object recognition memory. Administration of methylphenidate (1, 5 and 10mg/kg) reversed impulsiveness, aggression and object recognition memory impairment. In the knockout mice, monoaminergic changes including decrease in the ratio of 3-methoxy-4-hydroxyphenylglycol/noradrenaline and increase in the ratio of homovanillic acid/dopamine were observed in some brain regions, accompanied by increase in the expression of noradrenaline transporter in the frontal cortex. When TSH was completely suppressed by the supraphysiological administration of T3 to the adult mice, some behavioral and neurological changes in TSHR KO mice were also observed, suggesting that these changes were not due to developmental hypothyroidism induced by the inactivation of TSHR but to the loss of the TSH-TSHR pathway itself. Taken together, the present findings suggest a novel role for TSHR in behavioral and neurological phenotypes of ADHD.

Prosocial skills may be necessary for better peer functioning in children with symptoms of disruptive behavior disorders

Children with disruptive behavior disorders experience substantial social challenges; however, the factors that account for (i.e., mediate), or influence (i.e., moderate), peer problems are not well understood. This study tested whether symptoms of Oppositional Defiant Disorder and Conduct Disorder were associated with peer impairment and whether prosocial skills mediated or moderated these associations. Teacher ratings were gathered for 149 children (Mage = 9.09, SD = 1.71, 26% female) referred for behavioral concerns to an urban child psychiatry clinic. Path-analytic linear regressions testing mediation and moderation effects showed that prosocial skills significantly moderated the negative effects of symptoms of Conduct Disorder on peer impairment. Children showed less peer impairment only when they had relatively few conduct symptoms and high prosocial skills. Measurement of prosocial skills, in addition to conduct problems, may best capture factors which contribute to peer problems of children with disruptive behaviors.

Psychopathology and academic performance, social well-being, and social preference at school: the TRAILS study

Psychopathology during adolescence has been associated with poor academic performance, low social well-being, and low social preference by peers at school. However, previous research has not accounted for comorbid psychopathology, informant-specific associations between psychopathology and functioning, and gender and age differences. This study addresses these limitations by examining adolescents' psychopathology and functioning at school, reported by child, parent, teacher, and peers during primary and secondary school in a large Dutch longitudinal cohort study (N = 2230). Teacher reports of psychopathology, especially regarding attention problems and withdrawn/depressed problems, followed by parent reports regarding hyperactivity, were most strongly associated with academic performance. The same held for social preference which was associated with teacher and parent ratings of withdrawn/depressed problems and hyperactivity. In contrast, social well-being was best predicted by child reports (at primary school) of affective problems. In girls, the association between ADHD problems and poor academic performance was stronger than in boys and conduct problems were more often associated with poor school functioning in general. These findings can help identify adolescents at risk for poor functioning and design interventions that effectively reduce or prevent poor school functioning.

Additive effects of parent adherence on social and behavioral outcomes of a collaborative school-home behavioral intervention for ADHD

The present study evaluated the impact of the Collaborative Life Skills Program (CLS), a novel school-home psychosocial intervention, on social and behavioral impairments among children with attention and behavior problems. Fifty-seven ethnically/racially diverse children (70 % boys) with attention and/or behavior problems in the second through fifth grades participated in a pilot study. Ten school-based mental health professionals were trained and then implemented the intervention at their respective schools. Children significantly improved from pre- to post-treatment on parent, teacher, and report card ratings of children's social and behavioral functioning. Treatment improvements were consistent for children with and without co-occurring disruptive behavior problems. The impact of the intervention was enhanced when parents used the intervention strategies more regularly, according to both clinicians' and parents' reports. Findings support the emphasis of CLS on coordinating intervention strategies across contexts to facilitate the generalization of treatment-related improvements in social and behavioral functioning.

The Link between Peer Relations, Prosocial Behavior, and ODD/ADHD Symptoms in 7-9-Year-Old Children

Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms that hinder successful positive interaction with peers. The main goal of this study was to examine if the presence of symptoms of ODD and ADHD affects the relationship between positive social behavior and peer status found in 7–9-year-old children who show symptoms typical of ADHD and/or ODD. Furthermore, the possible interaction with sex was investigated. We used data collected in the first wave of The Bergen Child Study of mental health (BCS), a prospective longitudinal total population study of children's developmental and mental health. The target population consisted of children in the second to the fourth, in all public, private, and special schools in Bergen, Norway, in the fall of 2002 (N = 9430). All 79 primary schools in Bergen participated in the study. Both teacher (8809 complete cases) and parent (6253 complete cases) report were used in the analyses. ADHD and ODD scores were estimated using the Swanson Noland and Pelham rating scale version IV (SNAP-IV), and peer problems and prosocial behavior were assessed using the Strengths and Difficulties Questionnaire (SDQ). We replicated the relationship between peer problems and prosocial behavior found previously in typically developing children. Our results showed that the relationship between peer problems and prosocial behavior became weaker as the ODD symptoms increased in number and severity. For ADHD this effect was only found in the teacher report of the children. A sex effect for ODD symptoms was found only using the parent report: boys with ODD symptoms showed less prosocial behavior than girls with similar levels of ODD symptoms. Since this effect was not found using the teacher data, it may imply a situational effect (school/home) for girls with high levels of ODD. The moderator effect of ODD/ADHD was comparable for boys and girls. Our findings suggest that even if children with ADHD/ODD symptoms have the opportunity to practice their social skills in peer relationships, this is not necessarily accompanied by an increase in prosocial behavior.

The direct effects of inattention and hyperactivity/impulsivity on peer problems and mediating roles of prosocial and conduct problem behaviors in a community sample of children

OBJECTIVE

This study tested whether children's symptoms of inattention and hyperactivity/impulsivity were associated with peer problems and whether these associations were mediated by conduct problems and prosocial behaviors.

METHOD

A community sample of 500 children, including 245 boys and 255 girls, who ranged in age from 6 to 9 years (M = 7.6, SD = 0.91) were recruited. Teachers' report of children's inattention, hyperactivity/impulsivity, conduct problems, prosocial behaviors, and peer problems was collected.

RESULTS

Symptoms of inattention and hyperactivity/impulsivity were significantly positively associated with peer problems. Conduct problems were associated with more peer problems and prosocial behaviors with less peer problems. Conduct problems and prosocial behaviors partially mediated the association between hyperactivity/impulsivity and peer problems and fully mediated the inattention-peer problems association.

CONCLUSION

Findings show that prosocial behaviors and conduct problems are important variables that account for some of the negative impact of symptoms of inattention and hyperactivity/impulsivity on peer functioning.

Amizade em meninos com Transtorno de Déficit de Atenção/Hiperatividade

Crianças com Transtorno de Déficit de Atenção/Hiperatividade tendem a participar de relações de pares insatisfatórias, podendo ser rejeitadas socialmente e até vitimizadas. O objetivo deste trabalho foi de comparar a percepção da qualidade da melhor amizade e do conflito nessa relação, em 17 meninos com e 19 sem Transtorno de Déficit de Atenção/Hiperatividade, de sete a nove anos de idade, por meio de entrevista semiestruturada e da Escala da Qualidade da Amizade. Os meninos com Transtorno de Déficit de Atenção/Hiperatividade não diferenciaram daqueles sem o transtorno na percepção da qualidade da amizade; destes últimos, os mais velhos pontuaram melhor o amigo. Foi maior a percepção de situações de conflito com o amigo por parte de meninos com Transtorno de Déficit de Atenção/Hiperatividade, inclusive dos mais velhos. É possível que o portador de Transtorno de Déficit de Atenção/Hiperatividade perceba mais os conflitos com o amigo em virtude do aumento etário, pois o avanço sociocognitivo pode auxiliar a captar melhor as reações negativas dos pares a seu comportamento frequentemente desrespeitoso às regras sociais.

Challenges in treating oppositional defiant disorder in a pediatric medical setting: a case study

The following case study is presented to highlight the importance of consistency in identifying and treating oppositional defiant disorder in a pediatric patient with a life-threatening medical illness. A pediatric transplant patient's oppositional behaviors are described, as well as the educational behavioral training program provided to the patient's caregivers and medical staff. As a result of the training, the patient engaged in less oppositional behavior, was more cooperative and pleasant with staff, and was more compliant with her treatment. Subjective reports from caregivers indicated that the training with its emphasis on consistency effectively reduced the patient's symptoms and enhanced the caregivers' ability to care for the patient.

The interplay among preschool child and family factors and the development of ODD symptoms

The present study examined (a) the interactions between early behavior, early parenting, and early family adversity in predicting later oppositional defiant disorder (ODD) symptoms, and (b) the reciprocal relations between parent functioning and ODD symptoms across the preschool years. Participants were 258 three-year-old children (138 boys, 120 girls) and their parents from diverse backgrounds who participated in a 4-year longitudinal study. Early child behavior, parenting, and family adversity did not significantly interact in the predicted direction. Reciprocal relations between ODD symptoms and parent functioning were observed for maternal and paternal depression, and maternal warmth. Paternal laxness at age 4 predicted ODD symptoms at age 5 and paternal laxness at age 5 predicted ODD symptoms at age 6, but child ODD did not significantly predict paternal laxness. Results suggest that ODD symptoms may develop through a transactional process between parent and child functioning across the preschool years.

Trajectories of attention deficit hyperactivity disorder and oppositional defiant disorder symptoms as precursors of borderline personality disorder symptoms in adolescent girls

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1,233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8 to 10 and 10 to 13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10 to 13 and the rate of growth in ODD scores from 8 to 10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls.

Social adjustment among Taiwanese children with symptoms of ADHD, ODD, and ADHD comorbid with ODD

This study examined social problems at school and relationships with peers, siblings, mothers, and fathers among children with ADHD only (n = 41), ODD only (n = 14), ADHD + ODD (n = 47), and normal controls (n = 204) from a school-based sample of 2,463 first to ninth graders in Taiwan. ADHD and ODD symptoms were determined by teacher and mother reports on the Conners' Rating Scales and social adjustment problems were assessed by mother reports on the Social Adjustment Inventory for Children and Adolescents. Results indicated that relative to normal controls, children with ADHD + ODD displayed greater levels of social adjustment problems across domains (i.e., school, peers, siblings, and parents) while children with ADHD were significantly more impaired only in social adjustment at schools and children with ODD were more impaired only in social adjustment at home. Some similarities and differences in our findings, in relation to the Western literature, were discussed.

Social function assessment tools for children and adolescents: a systematic review from 1988 to 2010

Advances in neuroscience have added to the understanding of social functioning which has become an increasing area of focus in the psychology and neuropsychology literature. Given importance of appropriate social functioning to everyday interactions, as well as psychological well-being, accurately identifying and documenting such functions constitute a critical undertaking for both researchers and clinicians in psychology and related health professions. This review aimed to identify available social function assessment tools for children and adolescents using a comprehensive search method. Eighty-six measures were identified. Information on the assessment tools including the theoretical model they are based on, age range, sample used in development, and psychometric information are described. Results will aid researchers, psychologists and other health professionals in the selection of an appropriate tool to assess social function.

Symptoms of conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, and callous-unemotional traits as unique predictors of psychosocial maladjustment in boys: advancing an evidence base for DSM-V

OBJECTIVE

The incremental utility of symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits for predicting psychosocial outcomes across multiple domains was examined in a community sample of 1,517 boys.

METHOD

Several outcomes were assessed semiannually across a 2-year follow-up, including antisocial behavior, internalizing problems, peer conflict, and academic difficulties. Official criminal charges were also examined across adolescence.

RESULTS

CD symptoms emerged as the most robust predictor of future antisocial outcomes. However, ODD symptoms predicted later criminal charges and conduct problems, and CU traits were robustly associated with serious and persistent criminal behavior in boys. Attention-deficit/hyperactivity disorder symptoms predicted increases in oppositional defiant behavior and conduct problems over time and were uniquely related to future academic difficulties. Both ADHD and ODD symptoms predicted social and internalizing problems in boys, whereas CU traits were associated with decreased internalizing problems over time.

CONCLUSIONS

The current findings have implications for revisions being considered as part of the DSM-V. Specifically, incorporating CU traits into the diagnostic criteria for Disruptive Behavior Disorders (DBD) may help to further delineate boys at risk for severe and persistent delinquency. Although currently prohibited, allowing a diagnosis of ODD when CD is present may provide unique prognostic information about boys who are at risk for future criminal behavior, social problems, and internalizing problems.

Social information processing in elementary-school aged children with ADHD: medication effects and comparisons with typical children

Examined social information processing (SIP) in medicated and unmedicated children with ADHD and in controls. Participants were 75 children (56 boys, 19 girls) aged 6-12 years, including 41 children with ADHD and 34 controls. Children were randomized into medication conditions such that 20 children with ADHD participated after receiving placebo and 21 participated after receiving methylphenidate (MPH). Children were shown scenarios depicting peer interactions and asked to interpret each scenario and to generate possible responses to the scenario. Results showed that children with ADHD who received MPH generated more hostile responses to provocation than controls, but children with ADHD on placebo did not. Results also showed that children with ADHD regardless of medication generated more hostile responses to provocation than to peer entry, whereas controls did not. Findings suggest that children with ADHD generate more aggressive responses to provocation than controls and that this may be exacerbated by administration of MPH. Limitations and future directions are discussed.

Affective decision-making and externalizing behaviors: the role of autonomic activity

We tested a conceptual model involving the inter-relations among affective decision-making (indexed by a gambling task), autonomic nervous system (ANS) activity, and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in a largely impoverished, inner city sample of first through third grade children (N=63, 54% male). The present study hypothesized that impaired affective decision-making and decreased sympathetic and parasympathetic activation would be associated with higher levels of ADHD and ODD symptoms, and that low sympathetic and parasympathetic activation during an emotion-inducing task would mediate the relation between affective decision-making and child externalizing symptoms. In support of our model, disadvantageous decision-making on a gambling task was associated with ADHD hyperactivity/impulsivity symptoms among boys, and attenuated sympathetic activation during an emotion-inducing task mediated this relation. Support for the model was not found among girls.

Attention-deficit/hyperactivity disorder and social dysfunctioning

Attention-deficit/hyperactivity disorder (ADHD) is associated with functional impairments in different areas of daily life. One such area is social functioning. The purpose of this paper is to critically review research on social dysfunctioning in children with ADHD. Children with ADHD often have conflicts with adults and peers, and suffer from unpopularity, rejection by peers, and a lack of friendships, in part as a consequence of their ADHD symptoms. Comorbid oppositional defiant or conduct disorder aggravates these impairments. In some cases the inadequate social behavior of children with ADHD may be phenomenologically and etiologically related to pervasive developmental disorders (PDD). However, the causes and consequences of PDD symptoms in ADHD are understudied. Also, the relative contributions of ADHD, on the one hand, and comorbid disorders, on the other, to the course of social impairments are unknown. Social dysfunctioning in children with ADHD appears to increase their risk of later psychopathology other than ADHD. Thus far effective treatment for social dysfunctioning is lacking. Future research should address the exact nature and long-term consequences of social dysfunctioning in children with ADHD, and focus on development of effective treatment strategies.

Validation of population-based ADHD subtypes and identification of three clinically impaired subtypes

Statistically based classification methods have successfully refined ADHD into homogenous and heritable subtypes. External validity and impairment of these subtypes was examined using the Child Behavior Checklist (CBCL). We compared mean CBCL syndrome and competency t-scores across ADHD subtypes defined by latent class analysis in a sample of 1,346 individual twins from Missouri. The potential for comorbidity with conduct disorder (CD), oppositional defiant disorder (ODD), or major depression (MD) to increase impairment in specific ADHD subtypes was also examined. CBCL profiles confirm differences in severity, with more severe classes having increased syndrome scale and decreased competency scale CBCL scores. Clinically significant impairment was found for severe inattentive and combined subtypes and the mild combined subtype. Overall, the presence of comorbid CD, ODD, or MD did not result in increased ADHD subtype impairment. CBCL scores distinguish impairment in ADHD subtypes created through LCA. Comorbidity with CD, ODD, or MD does not significantly increase impairment among ADHD subtypes. The mild combined ADHD subtype represents a clinically significant but under-studied form of ADHD.

Social skills and executive function deficits in children with the 22q11 Deletion Syndrome

The 22q11 Deletion Syndrome (22q11DS) is among the most frequent gene deletion disorders, occurring once in every 6,000 live births. Descriptive reports have suggested marked social differences in affected children. Empirical studies are needed to verify possible social skills deficits among children with 22q11DS, and also to examine possible associations between their frequently reported executive function deficits and social anomalies. Fifty-two parents of affected children (n = 52) and participating control siblings (n=26) completed the Social Skills Rating System (SSRS) and Behavior Inventory of Executive Function (BRIEF). When compared with control siblings, children with 22q11DS had significantly lower SSRS ratings for Cooperation, Assertion, Responsibility, and Self-Control. Affected children had significantly higher BRIEF ratings for Initiation, Planning, Working Memory, and Monitoring. In affected children, global Social Skill was negatively correlated with BRIEF Global Composite scores. Initiation and Monitoring significantly predicted Social Skill. Children with 22q11DS have marked differences in social skill development which are associated with executive dysfunction.

A psychometric evaluation of the social skills rating system in children with attention deficit hyperactivity disorder

The social skills rating system (SSRS) was developed to assess social skills of children, as observed by multiple raters (teacher, parent, child). Studies of the SSRS have been conducted with handicapped, mentally retarded and learning disabled children. No studies have reported the psychometric properties of the SSRS in a clinical ADHD sample. This is important, because deficient social functioning is associated with ADHD. The present study assesses the psychometric properties of the teacher, parent and child versions of the SSRS in children with ADHD (n = 123), and normal controls (n = 239). Also, the social skills of children with ADHD, as rated on the SSRS were examined. Results support the factor structure and internal consistency of the original SSRS-teacher version. Moreover, support was found for 3 out of 4 scales of the SSRS-parent version. The factor structure of the SSRS-child version could not be replicated. An explanatory factor analysis on the SSRS-child version yielded two factors. Evidence was found for discriminative ability of the SSRS between normal controls and children with ADHD. Finally, informant agreement between raters was found to be poor.

The structure of child and adolescent psychopathology: generating new hypotheses

To begin to resolve conflicts among current competing taxonomies of child and adolescent psychopathology, the authors developed an interview covering the symptoms of anxiety, depression, inattention, and disruptive behavior used in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994), the International Statistical Classification of Diseases and Related Health Problems (ICD-10; World Health Organization, 1992), and several implicit taxonomies. This interview will be used in the future to compare the internal and external validity of alternative taxonomies. To provide an informative framework for future hypothesis-testing studies, the authors used principal factor analysis to induce new testable hypotheses regarding the structure of this item pool in a representative sample of 1,358 children and adolescents ranging in age from 4 to 17 years. The resulting hypotheses differed from the DSM-IV, particularly in suggesting that some anxiety symptoms are part of the same syndrome as depression, whereas separation anxiety, fears, and compulsions constitute a separate anxiety dimension.