Factors Associated with Healthy and Impaired Social Functioning in Young Adolescents with ADHD

There is variability in the extent to which adolescents with attention-deficit/hyperactivity disorder (ADHD) exhibit social impairment, as the same diagnosis does not necessarily entail impairment in the same area(s) of functioning. The current study entailed a cross-sectional examination of enhancers to healthy social functioning and risk factors to parent- and self-rated social impairment in 324 middle school youth (ages 10–14 years) with ADHD. A series of binary logistic regression analyses were conducted to evaluate a risk-resilience model for social functioning, including testing compensatory (i.e., main; buffering) and protective (i.e., interaction) effects of enhancers in the presence of identified risk factors. Youth conduct problems, youth depression, and negative parenting emerged as risk factors. Self-rated social acceptance, activity participation (breadth and intensity), and parent involvement were enhancers of healthy social functioning. Of these enhancers, activity participation (breadth and intensity) and parent involvement showed buffering effects against the negative impact of the risk factors on social functioning. None of the enhancers displayed protective effects. The findings of this study enhance our understanding of the social functioning of young adolescents with ADHD, who comprise an understudied population relative to younger children with similar problems.     

Interventions to Address the Academic Impairment of Children and Adolescents with ADHD

There exists a strong link between ADHD and academic underachievement. Both the core behavioral symptoms of ADHD and associated executive functioning deficits likely contribute to academic impairment. Current evidence-based approaches to the treatment of ADHD (i.e., stimulant medication, clinical behavior therapy and classroom behavioral interventions) have demonstrated a robust impact on behavioral variables such as attention and disruptive behavior within classroom analogue settings; however, their efficacy in improving academic outcomes is much less clear. Although surprisingly few treatment outcome studies of ADHD have attempted to incorporate interventions that specifically target academic outcomes, the studies that are available suggest that these interventions may be beneficial. The state of the treatment literature for addressing academic impairment in children and adolescents with ADHD will be reviewed herein, as well as limitations of current research, and directions for future research.     

Inconsistent Self-Report of Delinquency by Adolescents and Young Adults with ADHD

The purpose of the current study was to test the ability of adolescents and young adults with childhood ADHD to reliably self-report delinquency history. Data were examined from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of children diagnosed with ADHD between 1987 and 1996. Self-report of lifetime delinquency history was compared to concurrent parent-report and to self-report 1 year later. Participants included 313 male probands and 209 demographically similar comparison individuals without ADHD. Results indicated that adolescents and young adults with childhood ADHD were more likely than comparison participants to fail to report delinquent acts reported by a parent and to recant acts they endorsed 1 year earlier. This trend was most apparent for acts of mild to moderate severity. After controlling for several covariates, current ADHD symptom severity and parent-report of the participant’s tendency to lie predicted reporting fewer delinquent acts than one’s parent. Current ADHD symptom severity also predicted more recanting of previously endorsed acts. Based on these findings, several recommendations are made for the assessment of delinquency history in adolescents and young adults with childhood ADHD.     

Childhood Social Withdrawal,Interpersonal Impairment,and Young Adult Depression: A Mediational Model

Building on interpersonal theories of depression, the current study sought to explore whether early childhood social withdrawal serves as a risk factor for depressive symptoms and diagnoses in young adulthood. The researchers hypothesized that social impairment at age 15 would mediate the association between social withdrawal at age 5 and depression by age 20. This mediational model was tested in a community sample of 702 Australian youth followed from mother’s pregnancy to youth age 20. Structural equation modeling analyses found support for a model in which childhood social withdrawal predicted adolescent social impairment, which, in turn, predicted depression in young adulthood. Additionally, gender was found to moderate the relationship between adolescent social impairment and depression in early adulthood, with females exhibiting a stronger association between social functioning and depression at the symptom and diagnostic level. This study illuminates one potential pathway from early developing social difficulties to later depressive symptoms and disorders.     

Longitudinal Evaluation of the Role of Academic and Social Impairment and Parent-Adolescent Conflict in the Development of Depression in Adolescents with ADHD

Older adolescents with attention-deficit/hyperactivity disorder (ADHD) have a significantly increased likelihood of developing comorbid depression. It is important to evaluate factors during the early adolescent period that may contribute to this risk. A predominant theory is that impairment and failure experiences lead to the development of low-self efficacy and depression, and that parent and family factors also play a role. In a sample of 326 young adolescents with ADHD (Mage?=?12), the present study evaluated whether parent-adolescent conflict mediated the association between social and academic impairment and the development of depression. This study builds upon prior work by evaluating these associations longitudinally and by using a multi-rater approach, including the parent, adolescent, and teacher perspectives. Social and academic impairment directly predicted depression controlling for baseline levels of depression and change in ADHD symptoms. The association between social impairment and depression was partially mediated by parent-adolescent conflict. Mediation through conflict was not found for academic impairment, and the association between academic impairment and depression was no longer significant when accounting for conflict. These findings highlight the importance of social impairment in the development of depression in adolescents with ADHD. Caregivers may play an important role in determining whether adolescents with ADHD internalize social impairment and failure experiences and develop depressive symptoms. Implications of these findings in terms of the importance of interventions focused on parent-adolescent conflict are discussed.     

Associations of Lifetime Depression with Trauma Exposure,Other Environmental Adversities,and Impairment in Adolescents with ADHD

Depression is a common, potentially devastating comorbidity in youth with attention-deficit/hyperactivity disorders (ADHD). Various environmental adversities are well-described as correlates of depression in general pediatric populations, but not in youth with ADHD. In 104 adolescents with ADHD, we examined potential environmental correlates of lifetime depression, including trauma exposure, recent negative life events and current parent-child conflict, along with current and past ADHD severity and current impairment. Controlling for demographic variables, comorbid disorders, and ADHD severity, we noted significant associations between lifetime depression and environmental adversities, including victimization trauma, parent-child conflict, and behaviorally-independent negative life events. Current impairment but not ADHD severity was also highly associated with lifetime depression, controlling for the same covariates. Findings from this preliminary, cross-sectional study suggest that environmental adversities and impairment in youth with ADHD should also be targeted along with the ADHD when contemplating strategies to treat or prevent comorbid depression.     

ADHD Correlates, Comorbidity, and Impairment in Community and Treated Samples of Children and Adolescents

Patterns of correlates, comorbidity and impairment associated with attention-deficit hyperactivity disorder (ADHD) in children and youth were examined in representative samples from the community and from treatment facilities serving medically indigent youth in Puerto Rico. Information from caretakers and youths was obtained using the Diagnostic Interview Schedule for Children, (version IV), measures of global impairment, and a battery of potential correlates. In the community (N = 1,896) and the treated samples (N = 763), 7.5 and 26.2% of the children, respectively, met criteria for DSM-IV ADHD in the previous year. Although the prevalence rates and degree of impairment differed, the general patterns of correlates, comorbidity and impairment were similar in both populations. The exceptions were associated with conduct disorder, anxiety, impairment in the ADHD comorbid group, and age factors that appeared to be related to selection into treatment.     

Social and Academic Impairment in Youth with ADHD, Predominately Inattentive Type and Sluggish Cognitive Tempo

Sluggish cognitive tempo (SCT) was originally identified as a construct that characterized the inattention problems of some children with attention deficit disorder (ADD). Research has indicated that using SCT symptoms to identify a subset of youth with attention-deficit/hyperactivity disorder, predominately inattentive type (ADHD-IT) may elucidate distinct patterns of impairment and thereby improve the external validity of ADHD subtypes. The objective of the current study was to investigate whether youth with clinically-assessed ADHD-IT and high levels of SCT exhibit unique social and academic impairments. In a clinic-referred sample of youth (N?=?209; 23 % female) aged 6 to 17 years, participants who met criteria for three different groups were identified: ADHD, Combined Type (ADHD-CT; n?=?80), ADHD-IT with low SCT symptoms (n?=?74), and ADHD-IT with high SCT symptoms (n?=?55). These groups were compared on indicators of social and academic functioning while considering the effects of co-occurring internalizing and disruptive behavior disorders. Youth with ADHD-IT high in SCT exhibited uniquely elevated withdrawal, as well as low leadership and low peer-directed relational and overt aggression, which were not accounted for by co-occurring disorders. This high-SCT group was also the only group to have more homework problems than the ADHD-CT group, but only when other disruptive behavior disorders were absent. The distinctiveness of the high-SCT group, which was primarily evident in social as opposed to academic functioning, provides partial support for the external validity and clinical utility of SCT.     

Interpersonal Correlates of Narcissism in Adolescents

Researchers investigated the relationship between measures of interpersonal behavior and narcissism. Eight octant measures of interpersonal behavior were constructed, and validity and reliability estimates were obtained. High school and junior high school students (N = 333) completed five measures of narcissistic vulnerability, eight octant measures of interpersonal behavior, and a measure of social desirability. Canonical correlational analysis indicated a specific pattern of interpersonal behaviors for individuals with differing levels and types of narcissistic vulnerability. A multivariate analysis of variance (MANOVA) indicated that scores on several of the scales were found to differ significantly by sex and by treatment for emotional, behavioral, or educational difficulties. Implications for counseling are considered.     

Shyness Clinic: A Social Development Program for Adolescents and Young Adults

Shyness clinic groups were offered in a university counseling center for adolescents and young adults experiencing discomfort and difficulties in interpersonal relationships. Thirty-four students went through a preassessment and screening procedure. Twenty-three participated fully in the program. The first part of the program focused on anxiety management; the second on assertiveness in social relationships; and the third on development of conversational skills. According to results on preprogram and postprogram self-report inventories, written feedback from participants, and observations of the group leaders, participants improved in social skills and ability to manage anxiety.     

The Structure of Self-Consciousness in Children and Young Adolescents and Relations to Social Anxiety

Decades of research have examined the structure of self-consciousness in adults and its relationship to social anxiety. This study examined the structure of self-consciousness via the Self-Consciousness Scales (Fenigstein et al., J. Consult. Clin. Psychol. 43:522–527, 1975) in a school sample of 175 children and young adolescents (92 girls; mean age = 11.5). Confirmatory factor analysis best supported a five-factor solution (Internal State Awareness, Self-Reflectiveness, Appearance Consciousness, Style Consciousness and Social Anxiety). Although some factor based subscales evidenced low internal consistencies, convergent and discriminant correlations with self-report measures of social phobia, negative affect, and positive affect as well as parent-report measures of internalizing and externalizing problems provided additional support for the five-factor model. Future studies should further examine the multidimensional nature as well as the developmental course of self-consciousness and its relation to social anxiety longitudinally.

Interpersonal Expectations as the Building Blocks of Social Cognition: An Interdependence Theory Perspective

In this paper I use interdependence theory as an analytic framework for depicting the logically interconnected network of expectations that determines social interaction. The framework focuses on expectations about a partner’s goals (B) relevant to particular interdependence situations (S), and suggests that expectations about these two elements define the social situation that activates a person’s own goals (A). Together, these elements determine interaction behavior (I). This SABI framework is complementary to Mischel and Shoda’s (1995) CAPS theory of personality in its logic. It depicts a person’s interpersonal dispositions as having profiles or signatures dependent on both the expected features of situations and the expected dispositions of partners. A taxonomic theory for classifying both situations and the functionally relevant goals of interaction partners is outlined. Research on attachment theory and trust is used to illustrate the model. Finally, I suggest that people’s expectations about partners’ prosocial motivations—their perceived responsiveness toward the self—play an imperial role in social cognition, and, further, that complex SABI models can be seen as detailing a set of security operations that serve as a program for social action. SABI models detail the set of mechanisms that constitute the basic survival kit of interpersonal relations.     

Callous-Unemotional Traits,Relational and Social Aggression,and Interpersonal Maturity in a Sample of Behaviorally Disordered Adolescents

The authors examined the degree to which callous-unemotional traits and narcissism predict relational aggression, social aggression, and prosocial skills in a sample of 79 adolescent offenders (13–18 years old; 26% girls; 74% boys) attending a school for youth with behavior disorders in the Mid-Atlantic United States. Narcissism made a significant contribution to the prediction of both relational aggression and social aggression, accounting for most of the unique variance in the prediction of these indirect forms of aggression. Conversely, callous-unemotional traits—but not narcissism—made a significant contribution to the prediction of lower prosocial skills. Furthermore, in contrast to the large number of studies indicating gender differences in the expression of aggression, no significant gender differences in the present study were found.     

Executive Functioning Characteristics Associated with ADHD Comorbidity in Adolescents with Disruptive Behavior Disorders

The nature of executive dysfunction in youth with disruptive behavior disorders (DBD) remains unclear, despite extensive research in samples of children with attention-deficit hyperactivity disorder (ADHD). To determine the relationship between DBD, ADHD, and executive function deficits in aggressive teens, adolescents with DBD and comorbid ADHD (DBD + ADHD; n = 25), DBD without ADHD (DBD-ADHD; n = 23), and healthy controls (HC; n = 25) were compared on neurocognitive tests and questionnaires measuring executive functioning. Teens with DBD + ADHD performed worse on both neurocognitive and questionnaire measures of executive function than the DBD-ADHD and HC groups. Results suggest that subgroups of DBD may exist depending on the presence or absence of comorbid ADHD, which may have implications for the selection and efficacy of treatment strategies.     

Logic and Social Cognition

This article takes off from Johan van Benthem’s ruminations on the interface between logic and cognitive science in his position paper “Logic and reasoning: Do the facts matter?”. When trying to answer Van Benthem’s question whether logic can be fruitfully combined with psychological experiments, this article focuses on a specific domain of reasoning, namely higher-order social cognition, including attributions such as “Bob knows that Alice knows that he wrote a novel under pseudonym”. For intelligent interaction, it is important that the participants recursively model the mental states of other agents. Otherwise, an international negotiation may fail, even when it has potential for a win-win solution, and in a time-critical rescue mission, a software agent may depend on a teammate’s action that never materializes. First a survey is presented of past and current research on higher-order social cognition, from the various viewpoints of logic, artificial intelligence, and psychology. Do people actually reason about each other’s knowledge in the way proscribed by epistemic logic? And if not, how can logic and cognitive science productively work together to construct more realistic models of human reasoning about other minds? The paper ends with a delineation of possible avenues for future research, aiming to provide a better understanding of higher-order social reasoning. The methodology is based on a combination of experimental research, logic, computational cognitive models, and agent-based evolutionary models.     

Neurological Impairment and Hypersensitivity Among Psychiatrically Disturbed Adolescents

Cerebral dysfunction that occurs prior to maturity can be related to emotional and behavioral problems for the developing child and adolescent. The recent development of measurement technology allows for evaluating specific relationships between cerebral deficits and hyperactivity in a psychiatrically disturbed inpatient adolescent group. Findings suggest that neuropsychological deficits may be a diffuse problem that systemically affects complex cognitive functioning.