ADHD and Resilience: Examining Profiles of Resilient Children With and Without ADHD.

• In Event: Poster Session 01
  In Poster Session: PS 01 Topic - Developmental Disabilities

Abstract

Introduction: Considerable knowledge has been accumulated on the risk factors associated with ADHD, however, little is known about the minority of children with ADHD who may be flourishing despite this neurodevelopmental risk (Lee, Sibley, & Epstein, 2016). In this context, the present multi-informant study is an initial step towards this line of research with the basic, but essential and unanswered, question: Are there resilient children with ADHD? Additional exploratory analyses assessed demographic, clinical, and behavioral profiles of resilient children with ADHD, and tested whether these characteristics are protective (i.e., exert greater benefits for children with ADHD) or promotive (i.e., associated with resilience similarly for children with and without ADHD; Dvorsky & Langberg, 2016).

Method: Participants included a well-characterized, clinically evaluated sample of children with ADHD (N=108) and without ADHD (N=98) ages 8-13 years. Reliable change analysis (Jacobson & Truax, 1991) based on the parent and teacher BASC-3 Resiliency subscale was used to classify the ADHD and non-ADHD groups into low, average, and high resilience subgroups. Profile analyses involving a series of ADHD (Yes/No) x Resilience (Low vs. Average/High) chi-square analyses and ANOVAs were then conducted on each factor shown in Table 1. A main effect of Resilience in the absence of an interaction with ADHD Status indicated a promotive effect. For significant Resilience x ADHD interaction effects, post-hoc tests were used to indicate whether a characteristic was beneficial for non-ADHD children only or had particularly salient effects (protective) for children with ADHD.

Results: Reliable change analysis indicated that a majority of children with ADHD are perceived by their parents and teachers as resilient (52.8%-59.2%), and rates did not significantly differ from the Non-ADHD sample (p>.09). Additionally, among the ADHD group a small subset were perceived to be more resilient than same age/sex neurotypical peers (3%-6%), though a sizeable minority exhibited low levels of resilience (40.7%-47.2%). Profile analyses indicated resilient children with ADHD tended to have higher IQ, better math achievement, more anxiety, and less oppositional-defiance than their non-resilient peers with ADHD based on parent and/or teacher report, and – presumably as a consequence – be less likely to require psychostimulant medication treatment. Interestingly, anxiety emerged as a protective factor for children with ADHD despite being a risk factor for children without ADHD. In contrast, children with ADHD do not appear to benefit from the protective effects of higher SES despite children with and without ADHD benefiting similarly from higher IQ.

Conclusion: The current study is consistent with a growing body of evidence for heterogeneity across cognitive, behavioral, and affective domains among children with ADHD (e.g., Wahlstedt et al., 2009), while providing initial evidence that ADHD is also characterized by heterogeneity in resilience. Our pattern of findings further suggests factors promotive for children in general (Masten, 2014) may operate differently or not confer the same benefits for children with ADHD. Looking ahead, if replicated, our findings provide a strong empirical basis for a line of basic and applied resilience research towards identifying assets that improve adaptive and treatment outcomes uniquely for pediatric ADHD.

Authors

• Elizabeth S.M. Chan, Florida State Univeristy
  Presenting Author

• Michael J. Kofler, Florida State University
  Non-Presenting Author

• Nicole Groves, Florida State Univeristy
  Non-Presenting Author

• Carolyn L. Marsh, Florida State University
  Non-Presenting Author

• Caroline Miller, University of Texas at Austin
  Non-Presenting Author

• Kijana P. Richmond, George Mason University
  Non-Presenting Author