Peer-based differences among boys with ADHD

Examined the peer interactions and peer acceptance of three groups of boys ages 8 to 11 1/2 years: attention deficit hyperactivity disorder (ADHD), predominantly inattentive type; ADHD, combined type; and nonclinical controls (N = 45). Peer nominations were obtained from each boy's classroom. Newly acquainted peers consisting of boys from each of the 3 groups were observed for 3 play sessions, after which peer nominations were obtained. Both ADHD groups were more likely than nonclinical controls to receive lower social preference scores from peers in the classroom but not in the play groups. In both settings, boys from the predominantly inattentive group were more likely to be nominated as very shy, whereas boys from the combined type group were more likely to be nominated for starting fights and arguments. Observations of the play group showed that boys from the predominantly inattentive group displayed a marked pattern of social withdrawal. The findings suggest that the peer rejection experienced by these 2 groups may result from very different social behavior patterns.     

Online cognitive engagement of boys with ADHD

The present study was designed to examine the role that attentional problems may play in accounting for difficulties in story comprehension experienced by children with ADHD. A secondary task methodology was used to examine whether or not online variations in cognitive engagement with a televised story were related to the continuity of central or incidental information. Twenty-two 9- to 11 -year-old boys with ADHD and 36 of their nonreferred peers watched a television program and responded to auditory probes presented at preselected points during continuous sequences of central or incidental information. The reaction times to the probes for nonreferred boys showed the expected linear increase in cognitive engagement (i.e., the RTs increased) as central, plot-relevant sequences continued. In contrast, boys with ADHD showed the expected increase in RTs relatively late in the central sequences. The results were discussed in terms of how delays in engaging with central information may contribute to the academic difficulties experienced by boys with ADHD.     

Greater delay discounting among girls,but not boys,with ADHD correlates with cognitive control

Cognitive neuroscience models suggest both reward valuation and cognitive control contribute to reward-based decision-making. The current study examined the relationship between cognitive control and delay discounting (i.e., choosing smaller, immediate over larger, delayed rewards) in a large sample of boys and girls diagnosed with attention-deficit/hyperactivity disorder (ADHD; N = 95) and typically developing control children (TD; N = 59). Specifically, we examined performance on multiple measures of cognitive control (i.e., Go/No-Go task, Stop Signal task, and Spatial Span task) and delay discounting (i.e., Classic Delay Discounting and Real-Time Delay Discounting tasks), as well as the relationship between these measures. Results indicated that sex moderated the effects of group on task performance. Specifically, girls with ADHD, but not boys with the disorder, exhibited atypical delay discounting of real-time rewards. Results from correlational analyses indicated that delay discounting and cognitive control were not significantly correlated in the overall sample. Multiple regression analyses demonstrated that among girls with ADHD poorer spatial working memory and inhibitory control predicted greater real-time discounting. Collectively, findings provide support for distinct patterns of cognitive control and delay discounting among school-aged girls and boys with ADHD. Additionally, findings suggest that among girls with ADHD, those who exhibit relatively poor working memory and inhibitory control might be a particularly vulnerable subgroup with the greatest propensity to exhibit maladaptive decision-making.     

The speech and vocalization patterns of boys with ADHD compared with boys with dyslexia and boys without learning disabilities

This research study dealt with an inquiry into the speech and vocalization patterns of boys with Attention Deficit Hyperactivity Disorder (ADHD) who were not under the influence of stimulating medication, compared with the speech and vocalization patterns of boys with reading disabilities and a control group of learners without learning disabilities. The voices of 105 participants were recorded during interviews and analyzed in the laboratory using equipment that examined the temporal speech patterns and physical features of vocalization. The speech patterns were examined with a frequency examination, speech unit length duration, and correlation between the vocalization and pauses in the speech unit. The physical features of vocalization were examined with volume and frequency scales. The research results indicated that the speech and vocalization patterns of boys with ADHD were significantly different from those of boys with reading disabilities and from the boys in the control group. The results support the assumption that speech and vocalization indicators can be used as objective indicators for the diagnosis of hyperactivity syndrome with attention and concentration difficulties.     

Social Cognition and Interpersonal Impairment in Young Adolescents with ADHD

The purpose of this study is twofold. First, it aims to examine whether the impairment in peer functioning and social-cognitive deficits (i.e., hostile attribution bias, social comprehension, social problem-solving) found in elementary school aged children with ADHD also occur in adolescence. Second, it aims to provide evidence for a predictive relationship between these social-cognitive deficits and an adolescent’s functional impairment in the social domain. To address these aims, several social-cognitive tasks were administered to a small sample of young adolescents with ADHD (N = 27) and a comparison sample without an ADHD diagnosis (N = 18). Parent report of functional impairment and peer sociometric data were also gathered. Comparisons of both parent and peer report of adolescent social functioning suggest that individuals with ADHD continue to experience difficulties with peers into the adolescent years and data from the social-cognitive tasks show evidence of social comprehension and problem-solving deficits. Further analyses indicated a significant link between functional impairment and social cognition. Findings herein are discussed in the context of both the developmental changes that arise during adolescence and consideration of the importance of social cognition for understanding the impaired social functioning experienced by adolescents with ADHD.     

Emotional distraction in boys with ADHD: Neural and behavioral correlates

Although, in everyday life, patients with attention deficit hyperactivity disorder (ADHD) are frequently distracted by goal-irrelevant affective stimuli, little is known about the neural and behavioral substrates underlying this emotional distractibility. Because some of the most important brain responses associated with the sudden onset of an emotional distracter are characterized by their early latency onset and short duration, we addressed this issue by using a temporally agile neural signal capable of detecting and distinguishing them. Specifically, scalp event-related potentials (ERPs) were recorded while 20 boys with ADHD combined type and 20 healthy comparison subjects performed a digit categorization task during the presentation of three types of irrelevant, distracting stimuli: arousing negative (A−), neutral (N) and arousing positive (A+). Behavioral data showed that emotional distracters (both A− and A+) were associated with longer reaction times than neutral ones in the ADHD group, whereas no differences were found in the control group. ERP data revealed that, compared with control subjects, boys with ADHD showed larger anterior N2 amplitudes for emotional than for neutral distracters. Furthermore, regression analyses between ERP data and subjects’ emotional ratings of distracting stimuli showed that only in the ADHD group, emotional arousal (ranging from calming to arousing) was associated with anterior N2: its amplitude increased as the arousal content of the visual distracter increased. These results suggest that boys with ADHD are more vulnerable to the distracting effects of irrelevant emotional stimuli than control subjects. The present study provides first data on the neural substrates underlying emotional distractibility in ADHD.     

What they want and what they get: The social goals of boys with ADHD and comparison boys

Twenty-seven boys diagnosed with attention-deficit hyperactivity disorder (ADHD) and 18 comparison boys participated in a competitive tetradic interaction task. Boys were individually interviewed before the game about their goals for the interaction, and adult observers inferred boys' social goals from videotapes of the interaction. Social acceptance was determined by combining positive and negative sociometric nominations collected through individual interviews at the end of the summer research program in which the interaction was held. In their self-reports, ADHD-high aggressive boys prioritized trouble-seeking and fun at the expense of rules to a greater extent than did both ADHD-low aggressive and comparison boys. Observers judged ADHD-high-aggressive boys to seek attention more strongly and seek fairness less strongly than the other two groups. Self-reported goals of defiance and cooperation predicted boys' end-of-program social standing, even with interactional behaviors and subgroup status controlled statistically. Observer-inferred goals were differentially associated with social acceptance for ADHD and comparison boys, suggesting discontinuities in peer interaction processes. Differentiation of goals from behavior and the integral role of children's goals in peer acceptance are discussed.This research received primary support from National Institute of Mental Health Grant RO1 MH45064, awarded to Stephen P. Hinshaw. Special acknowledgments are due to the child participants and the many dedicated interviewers and behavior observers who made this study possible.     

Mother-child interactions in ADHD and comparison boys: Relationships with overt and covert externalizing behavior

Reciprocal relationships between child characteristics and such familial factors as parental psychopathology and interaction style with the child characterize the development and maintenance of attention-deficit hyperactivity disorder (ADHD) as well as its comorbidity with antisocial behavior. Our goal was to ascertain the ability of negative maternal behavior exhibited during mothers-on interactions to predict independently observed overt and covert externalizing behavior in the child, controlling for current maternal symptomatology and the boy's acting out behavior during the interaction. Participants were 49 boys with ADHD and 37 comparison boys, aged 6 to 12 years. Hierarchical multiple-regression analyses revealed that, even with maternal psychopathology and child negativity with the mother partialed, maternal negative behaviors predicted both observed noncompliance exhibited in class and play settings and laboratory stealing. Stealing was predicted from maternal negativity even with child interactional compliance controlled. Differential predictions of noncompliance were revealed in ADHD versus comparison families, yet similar patterns emerged for stealing within each group. Results are discussed in light of the high risk for antisocial behavior in ADHD children.This article is based, in part, on a doctoral dissertation written by Carolyn A. Anderson at the University of California, Los Angeles. The research received primary support from National Institute of Mental Health Grant 45064, awarded to Stephen P. Hinshaw. Partial support was received from the Fernald Child Study Center of the University of California, Los Angeles, where the 1990 summer research program was housed, and from a Faculty Research Grant to Stephen P. Hinshaw from the University of California, Berkeley. We express our deep appreciation to the many behavior observers and research staff, too numerous to mention individually, who were essential in collecting and coding the primary data for the study, and to the children and families who participated in the family assessments and summer research programs.     

Neuropsychological functioning,motor speed,and language processing in boys with and without ADHD

We administered a neuropsychological battery to boys aged 6 to 12 years old diagnosed with attention-deficit hyperactivity disorder (ADHD; n= 51) and to comparison boys of the same age range (n= 31). Boys with ADHD had greater difficulty than comparison youngsters on nonautomated language and motor tasks administered with a fast instructional set and on one of two traditional frontal executive measures (Porteus mazes). When tasks requiring automatic processing were paired with similar tasks requiring greater use of selective attention processes, the latter, controlled processing tasks differentiated groups better than did automated tasks. This differential effect of otherwise similar tasks is interpreted in terms of an output deficit mediated by response organization as detailed in the information processing literature. The ADHD group also exhibited slow gross motor output, measured independently of verbal output. The findings are evaluated in terms of both Luria's (1973) tripartite model of neurocognitive organization and frontal striatal models, with an emphasis on output processes. The observed language deficits could represent frontal lobe processes intricately related to self-monitoring and planning. The utility of controlled processing, self-paced tasks with fast instructional sets in assessing language and motor skills in ADHD is highlighted. This research was supported primarily by National Institute of Mental Health Grant R01 MH45064 awarded to Stephen P. Hinshaw. Joel T. Nigg was partially supported by NIH Research Service Award F31 MH10462-01. The authors wish to thank Deborah P. Waber, Ph.D., of Harvard University for her assistance in scoring the Rey-Osterreith complex design, and Jennifer Ablow, Margaret Kuklinsksi, Jeff Measelle, Teron Park, Cassandra Simmel, and Jennifer Treuting for helping to administer the measures, code the results, and discuss the study. We also acknowledge the enthusiastic participation of the children and families in the summer programs.     

Effects of methylphenidate on the persistence of ADHD boys following failure experiences

We examined the effects of methylphenidate on the task persistence of 21 boys with attention-deficit hyperactivity disorder (ADHD), after they had been exposed to both solvable and insolvable problems. The boys attempted to solve 10 different find-a-word puzzles on each of 4 days, involving the crossing of medication (placebo vs. 0.3 mg/kg) and prior task difficulty (solvable vs. insolvable). The results revealed that medication prevented the decrement in performance following the insolvable problems that was evident with the placebo days. In addition, on medication compared with placebo, the boys were more likely to make external attributions for failure and internal attributions for success. The results are discussed in terms of the impact of medication on ADHD boys' performance as medicated by cognitivemotivational state mechanisms.This study was undertaken in the 1989 Summer Treatment Program conducted at Western Psychiatric Institute and Clinic. We thank the staff of the program for their cooperation, particularly Mary Vodde-Hamilton, Karen Greenslade, and Gary Vallano. The authors thank Monica Harris for her helpful comments.