Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD

We followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 5 years, from middle childhood through early/midadolescence, with the aim of determining whether childhood levels of executive function (EF) would predict adolescent multi-informant outcomes of social functioning and psychopathology, including comorbidity between externalizing and internalizing symptomatology. Predictors were well-established measures of planning, response inhibition, and working memory, along with a control measure of fine motor control. Independent of ADHD versus comparison group status, (a) childhood planning and response inhibition predicted adolescent social functioning and (b) childhood planning predicted comorbid internalizing/externalizing disorders in adolescence. Subgroup status (ADHD-Combined, ADHD-Inattentive, and comparison) moderated the relationship between childhood planning and adolescent internalizing/externalizing comorbidity, with the combined type revealing particularly strong associations between baseline planning and adolescent comorbidity. Mediation analyses indicated that adolescent social functioning mediated the prediction from childhood EF to comorbidity at follow-up; in turn, in the girls with ADHD, adolescent comorbidity mediated the prediction from childhood EF to social functioning at follow-up. We conclude that childhood interventions should target EF impairments in addition to behavioral symptoms.     

Childhood Irritability: Predictive Validity and Mediators of Adolescent Psychopathology

Despite its transdiagnostic significance, there is modest evidence with respect to the predictive validity of childhood irritability, especially across developmental periods; similarly, little is known about explanatory factors underlying these predictions. This study had two goals: (1) to test the predictive validity of childhood irritability with respect to adolescent internalizing and externalizing problems, controlling for baseline ADHD and related psychopathology and (2) to test theoretically-derived family (i.e., parenting behavior, parenting stress) and social (i.e., peer status, social skills) constructs as explanatory factors of adolescent psychopathology. Two hundred thirty ethnically diverse (51.5% White) 5–10-year-old youth (32% female) with (n?=?121) and without (n?=?110) ADHD completed three separate laboratory-based assessments across six to seven years. Temporally-ordered predictors, putative mediators, and psychopathology outcomes were assessed using multiple informants (i.e., parent, teacher, youth) and methods (i.e., structured interviews, normed rating scales). Controlling for demographic factors, clinical correlates, and baseline psychopathology, childhood irritability uniquely predicted adolescent externalizing problems, but not internalizing problems. Next, analyses revealed that low social skills partially explained predictions of adolescent internalizing problems. However, family or social factors did not underlie predictions of adolescent externalizing problems. These preliminary findings support the predictive validity of childhood irritability with respect to early adolescent externalizing problems and implicate low social skills as a potentially unique mediator of internalizing outcomes. Intervention-induced improvements in social skills may minimize emergent psychopathology initiated by significant childhood irritability.

     

Childhood Executive Function Continues to Predict Outcomes in Young Adult Females with and Without Childhood-Diagnosed ADHD

We prospectively followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n?=?140) and matched comparison girls (n?=?88) over a period of 10?years, from middle childhood through late adolescence/young adulthood. Our aim was to examine the ability of childhood measures of executive function (EF) to predict functional outcomes at follow-up. Measures of EF comprised the childhood predictors, with academic, socioemotional, occupational, and global functioning serving as young adult criterion measures. Results indicated that childhood EF - particularly measures of global EF and working memory - predicted academic and occupational functioning across our entire sample (independent of diagnostic group status), but diagnostic status (ADHD versus comparison) moderated the association between (a) working memory and reading achievement and (b) a global EF measure and suspensions/expulsions. That is, in the ADHD group, low working memory predicted poor reading scores and impaired global EF predicted higher suspensions/expulsions, but this was not the case in the comparison group. Overall, these results extend previous findings of associations between EF and adolescent outcomes in girls with and without ADHD into young adulthood. Findings continue to suggest the importance of assessing and developing interventions that target EF impairments early in life in order to prevent long-term difficulties across a range of important functional domains.     

Risk as a Moderator of the Effects of Prevention Programs for Children from Divorced Families: A Six-Year Longitudinal Study

Program by risk interactions were assessed to evaluate whether the long-term effects of two preventive interventions for children from divorced families were moderated by baseline levels of risk. Six-year prospective relations between childhood (ages 9-12) and adolescence (ages 15-19) were examined in 68 children who comprised the control group of a randomized trial. Analyses indicated that two childhood variables predicted multiple adolescent outcomes: environmental stressors and externalizing problems. A risk index composed of these 2 variables was highly predictive of internalizing and externalizing problems, competence, substance use, and mental disorder 6 years later. Analyses of the full sample (N = 218) indicated that program effects were greater for children with higher risk scores and that the programs attenuated the relation between risk and adolescent internalizing and externalizing problems, competence, and mental disorder.     

Does Childhood Executive Function Predict Adolescent Functional Outcomes in Girls with ADHD?

We prospectively followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 5 years, from middle childhood through early/mid-adolescence. Our aim was to examine the ability of measures of childhood executive function (EF) to predict functional outcomes in adolescence. Measures of neuropsychological functioning comprised the childhood predictors, with academic, social, and global functioning serving as adolescent criterion measures. Results indicated that childhood EF predicted (a) academic achievement and social functioning across our entire sample (independent of diagnostic group status) and (b) global functioning only in girls with ADHD (independent of IQ). These results highlight the non-specificity of EF deficits and suggest the importance of assessing and developing interventions that target EF impairments, particularly in those at high-risk for negative outcomes, in order to prevent long-term difficulties across a range of important functional domains.     

Friendship as Protection from Peer Victimization for Girls with and without ADHD

The goal of this study was to examine the ability of friendship to moderate the association between behavioral risk and peer victimization for girls with attention-deficit/hyperactivity disorder (ADHD; n = 140) and comparison girls (n = 88) in a 5-week naturalistic summer camp setting. Participants were an ethnically and socioeconomically diverse group of girls ages 6–12. Parents and teachers reported on pre-summer internalizing behavior, externalizing behavior, and social competence. Participants reported on friendships and peer victimization through a peer report measure at the summer camps; friendship was scored via mutual nominations. Pre-summer externalizing behavior, internalizing behavior, and low social competence predicted peer victimization at the summer camps. Friendship moderated the association between behavioral risk and victimization for the entire sample, such that the presence of at least one friend reduced the risk of victimization. Additional analyses suggested that girls with ADHD were no more or less protected by the presence of a friendship than were comparison girls. Finally, preliminary analyses suggested that girls having only friends with ADHD were not significantly less protected than girls with at least one comparison friend. Future directions and implications for intervention are discussed.     

Eating pathology among adolescent girls with attention-deficit/hyperactivity disorder

The authors investigated prospectively assessed eating pathology (body image dissatisfaction and bulimia nervosa symptoms) among an ethnically and socioeconomically diverse sample of adolescent girls with attention-deficit/hyperactivity disorder-combined type (ADHD-C; n=93), ADHD-inattentive type (ADHD-I; n=47), and a comparison group (n=88). The sample, initially ages 6-12 years, participated in a 5-year longitudinal study (92% retention rate). After statistical control of relevant covariates, girls with ADHD-C at baseline showed more eating pathology at follow-up than did comparison girls; girls with ADHD-I were intermediate between these two groups. Baseline impulsivity symptoms, as opposed to hyperactivity and inattention, best predicted adolescent eating pathology. With statistical control of ADHD, baseline peer rejection and parent- child relationship problems also predicted adolescent eating pathology. The association between punitive parenting in childhood and pathological eating behaviors in adolescence was stronger for girls with ADHD than for comparison girls. Results are discussed in terms of the expansion of longitudinal research on ADHD to include female-relevant domains of impairment, such as eating pathology.     

Buffers of peer rejection among girls with and without ADHD: the role of popularity with adults and goal-directed solitary play

We investigated a risk-resilience model in 91 girls with ADHD and 58 age- and ethnicity-equated comparison girls, who participated in all-female naturalistic summer research camps. The hypothesized risk factor was peer rejection (assessed via sociometric nominations), with criterion measures including multiinformant composites of aggressive behavior and anxious/depressed symptoms. The two hypothesized protective factors were the girls' popularity with adult staff (assessed via staff ratings) and objective observations of goal-directed solitary play. Peer rejection was related to higher levels of aggressive behavior and depressed/anxious behavior, confirming its status as a risk factor. Next, for all girls, popularity with adults predicted lower levels of aggression and goal-directed solitary play predicted lower levels of anxiety/depression. Whereas popularity with adults was most protective among the peer-accepted subgroup, solitary play was most protective among the peer-rejected subgroup. Diagnostic status (ADHD versus comparison) moderated the findings such that engaging in meaningful solitary play was a stronger predictor of lower levels of anxious/depressed behavior in girls with ADHD than in comparison girls. We discuss the need for replication in prospective research and implications for research and intervention regarding the social functioning of peer-rejected children, particularly those with behavior disorders.     

ADHD symptoms,academic achievement,self‐perception of academic competence and future orientation: A longitudinal study

In the investigation of the effect of attention deficit hyperactivity disorder (ADHD) symptoms on school careers there is a need to study the role of adolescent and childhood ADHD symptoms and academic achievement, and to incorporate measures that include the individual's perspective. Our aim was to gain an overview of the long‐term development of school careers in relation to ADHD symptoms. We studied associations between ADHD symptoms and academic achievement at different time‐points and future orientation at the end of high school, and assessed the role of self‐perceptions of academic competence in these associations. Participants were 192 children (47% girls) with a range of ADHD symptoms taken from a community sample. Collecting data at three time points, in 6th, 11th and 12th grade we tested a structural equation model. Results showed that ADHD symptoms in 6th grade negatively affected academic achievement concurrently and longitudinally. ADHD symptoms in 11th grade negatively affected concurrent academic achievement and academic self‐perception and future orientation in 12th grade. Academic achievement had a positive influence on academic self‐perception and future orientation. Given the other factors, self‐perception of academic competence did not contribute to outcomes. We concluded that early ADHD symptoms may cast long shadows on young people's academic progress. This happens mainly by way of stability in symptoms and relations to early low academic achievement.     

Attention-Deficit/Hyperactivity Disorder,Trait Impulsivity,and Externalizing Behavior in a Longitudinal Sample

Attention-deficit/hyperactivity disorder (ADHD) is highly comorbid with and predictive of externalizing behavior, yet is most often examined categorically, not dimensionally. We tested a recently proposed trait impulsivity model by dimensionally examining measures of childhood inattention and hyperactivity/impulsivity separately as predictors of later externalizing behavior in an all-female longitudinal sample of 228 young women. We also examined influences of parenting and peer relations, given the transactional nature and importance of environmental factors. We analyzed the relative contribution of hyperactive/impulsive (HI) and inattentive (IA) symptoms of girls with and without childhood-diagnosed ADHD (M age?=?9.5; 140 ADHD and 88 Comparison) to the development of externalizing behaviors in adolescence (M age?=?14.2) and early adulthood (M age?=?19.6). Authoritarian parenting was examined as a moderator and adolescent externalizing behavior as a mediator of the relation between childhood HI and later externalizing behavior. Childhood HI symptoms significantly predicted multiple externalizing behaviors in adolescence and early adulthood, after accounting for IA and covariates (ΔR ² ranged from 2.6 to 7.5 %). Mother’s authoritarian parenting moderated this relation. Adolescent externalizing behavior mediated the relation between childhood HI symptoms and early adult externalizing behavior. In no case did childhood IA significantly predict externalizing behavior after accounting for HI symptoms. Findings support a trait impulsivity model, as HI symptoms, but not IA symptoms, significantly predicted later externalizing behavior. Results support the importance of dimensional predictors of developmental trajectories. We discuss implications for assessment, intervention, and future research.     

儿童的同伴交往与孤独感:一项2年纵向研究

用提名法和问卷法对小学的3、4年级274名儿童进行两年追踪调查,采用交叉滞后设计,考察了同伴交往4个特征水平上的变量与孤独感的相互预测关系。结果发现：（1）自我报告的同伴交往变量——友谊质量和社交自我知觉与孤独感之间的交叉滞后效应显著;而同伴评定的同伴交往变量——积极提名、消极提名、受同伴欺负、消极退缩与孤独感之间的交叉滞后效应不显著;另外,前测的互选朋友数能显著负向预测后测的孤独感,前测的孤独感不能显著预测后测的互选朋友数。（2）在排除了早期其它变量的效应之后,积极提名分、消极提名分、受同伴欺负得分、消极退缩得分、互选朋友数在两年之间仍然呈现出高度的稳定性;友谊质量和社交自我知觉以及孤独感则表现出中等程度的稳定性     

Is the Positive Illusory Bias Illusory? Examining Discrepant Self-Perceptions of Competence in Girls with ADHD

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.     

Longitudinal Links Between Childhood Peer Victimization, Internalizing and Externalizing Problems, and Academic Functioning: Developmental Cascades

Developmental cascade models linking childhood peer victimization, internalizing and externalizing problems, and academic functioning were examined in a sample of 695 children assessed in Grade 3 (academic only) and Grades 5, 6, 7, and 8. Results revealed several complex patterns of associations in which poorer functioning in one domain influenced poorer outcomes in other areas. For example, a symptom driven pathway was consistently found with internalizing problems predicting future peer victimization. Support for an academic incompetence model was also found— lower GPA in Grade 5, 6, and 7 was associated with more externalizing issues in the following year, and poor writing performance in Grade 3 predicted lower grades in Grade 5, which in turn predicted more externalizing problems in Grade 6. Results highlight the need to examine bidirectional influences and multifarious transactions that exist between peer victimization, mental health, and academic functioning over time.     

Perceptions of autonomy support,parent attachment,competence and self-worth as predictors of motivational orientation and academic achievement: an examination of sixth- and ninth-grade regular education students

This project examined the hypothesis that students' perceptions of teacher autonomy support, parent attachment, competence, and self-worth would predict motivational orientation and achievement test performance. Participants were 135 sixth-grade and 91 ninth-grade regular education students from a large, ethnically diverse school district. Stepwise regression analyses indicated that autonomy support, parent attachment, scholastic competence, and self-worth predicted the academic criterion variables. Interestingly, scholastic competence was a significant predictor in all of the regression models. Implications of the findings are discussed in terms of classroom practices.     

Psychopathic Traits in Boys With and Without Attention-Deficit/Hyperactivity Disorder: Concurrent and Longitudinal Correlates

To investigate the role of psychopathic traits in a clinical and comparison sample, we obtained dimensional California Child Q-Set (CCQ) personality profiles for 66 preadolescent boys with attention-deficit/hyperactivity disorder (ADHD) and 56 comparison boys during naturalistic summer programs and correlated each boy's CCQ profile with an expert-derived CCQ psychopathy prototype. These scores, representing each boy's degree of similarity to the prototype, were significantly associated with concurrent externalizing diagnoses and symptoms and, with statistical control of these externalizing features, concurrent measures of objectively observed noncompliance, overt and covert antisocial behavior, and peer sociometric nominations indexing peer rejection. Psychopathic traits were not associated with peer acceptance. CCQ psychopathy dimension scores also predicted severity of delinquency at a 5-7-year prospective follow-up, with statistical control of age, baseline externalizing diagnoses and symptoms, and baseline objective observations of antisocial behavior. Predictions held when overt behavioral items from the CCQ, which may have overlapped with the delinquency outcome criterion, were eliminated. Despite these strong effects, a plethora of false positives were evident in the prospective predictions to delinquency status. We discuss research and clinical implications of measuring psychopathic traits in childhood.     

Callous-Unemotional Traits are Uniquely Associated with Poorer Peer Functioning in School-Aged Children

This study examines externalizing symptoms (attention-deficit/hyperactivity disorder [ADHD], conduct problems, and callous-unemotional [CU] traits) in relation to domains of peer functioning (social competence, loneliness, and close friendship quality), with a specific focus on the role of CU traits. One hundred twenty-four elementary students (grades 3–6; 45% boys) completed multiple measures of peer functioning, and teachers completed measures of externalizing symptoms and social competence. After controlling for demographic variables and other externalizing symptoms, CU traits were significantly associated with poorer peer functioning across all variables except for demands of exclusivity in close friendships. ADHD symptoms were also uniquely associated with poorer social functioning across a number of variables. In contrast, conduct problems were at times associated with better social functioning after controlling for the effects of other externalizing problems. These findings bolster the importance of developing and evaluating social skills interventions for children displaying elevated CU traits.     

Attachment, Friendship, and Psychosocial Functioning in Early Adolescence

Fifth-graders' (N = 162; 93 girls) relationships with parents and friends were examined with respect to their main and interactive effects on psychosocial functioning. Participants reported on parental support, the quality of their best friendships, self-worth, and perceptions of social competence. Peers reported on aggression, shyness and withdrawal, and rejection and victimization. Mothers reported on psychological adjustment. Perceived parental support and friendship quality predicted higher global self-worth and social competence and less internalizing problems. Perceived parental support predicted fewer externalizing problems, and paternal (not maternal) support predicted lower rejection and victimization. Friendship quality predicted lower rejection and victimization for only girls. Having a supportive mother protected boys from the effects of low-quality friendships on their perceived social competence. High friendship quality buffered the effects of low maternal support on girls' internalizing difficulties.     

Modeling relations between hassles and internalizing and externalizing symptoms in adolescents: a four-year prospective study

This study examined the relations between hassles and internalizing and externalizing symptoms across 4 years in adolescents who varied with regard to their risk for psychopathology. The sample comprised 240 adolescents assessed in 6th, 7th, 8th, and 9th grades regarding their level of peer and academic hassles and internalizing and externalizing symptoms. Structural equation modeling was used to construct latent variables of hassles and internalizing and externalizing syndromes. Results varied by informant about the teens' symptoms. For adolescent report, the stress exposure model fit the data best for internalizing syndromes; that is, higher levels of stressors predicted significantly higher levels of self-reported symptoms 1 year later. For mother report of adolescents' symptoms, the stress generation model fit the data best for both internalizing and externalizing syndromes; that is, higher levels of adolescents' internalizing and externalizing symptoms, as reported by their mothers, significantly predicted higher levels of hassles 1 year later.     

Personal and interpersonal antecedents and consequences of victimization by peers

This study was designed to determine whether the personal and interpersonal difficulties that characterize victimized children are antecedents of victimization, consequences of victimization, or both. Boys and girls in the 3rd through 7th grades (N = 173, mean age = 11.3 years) were assessed on victimization, personal variables (internalizing problems, externalizing problems, and physical strength), and interpersonal variables (number of friends and peer rejection). One year later children were assessed again on all variables. Internalizing problems, physical weakness, and peer rejection contributed uniquely to gains in victimization over time. Moreover, initial victimization predicted increases in later internalizing symptoms and peer rejection. These reciprocal influences suggest the existence of a vicious cycle that supports the strong temporal stability of peer victimization.     

Prospective Relations Between Organized Activity Participation and Psychopathology During Adolescence

This longitudinal study examined psychopathology as a predictor and outcome of organized activity involvement during high school among 198 adolescents who varied in risk for psychopathology as a function of their mother's depression history. Higher levels of internalizing and externalizing symptoms in eighth grade significantly predicted lower levels of involvement in academic clubs during high school, over and above risk and SES. Tobacco use prior to high school predicted lower levels of involvement overall and in academic clubs and performance arts. Controlling for psychopathology prior to high school, higher levels of activity involvement were associated with lower levels of externalizing symptoms, less tobacco use, and fewer diagnoses of behavior disorders and substance abuse in 12th grade. The positive association between risk and adolescent psychopathology was not buffered by adolescent activity involvement. Overall, these findings suggest that involvement in organized activities may contribute to lower levels of externalizing psychopathology during high school even when controlling for prior psychopathology.