Poster #17 - Peer Functioning Difficulties Exacerbate ADHD and Irritability Symptoms Over Time

• In Event: Poster Session 20

Abstract

Children diagnosed with attention-deficit/hyperactivity disorder (ADHD) have been consistently found to experience impairments in peer functioning (Ros & Graziano, 2018). Children with ADHD tend to be more rejected and victimized by peers and have less mutual friendships as compared to those without ADHD (Efron et al., 2021; Grygiel et al., 2018; Hoza, 2007). Irritability is highly prevalent in children with ADHD (Eyre et al., 2017) and might worsen social functioning deficits given the frequent temper outbursts and low frustration tolerance characterizing irritability (Stringaris et al., 2018). However, research on the temporal interactions between ADHD symptoms, irritability, and peer functioning have been limited. Temporal network analysis (Epskamp, 2020) is a novel and promising approach to analyze these complex interactions over time. The present study investigates these dynamic associations in a sample of 739 children (ages 8-11 years) assessed at three timepoints, 6 months apart. Inattention and hyperactivity/impulsivity were assessed using parent-report on the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV; Swanson et al. 2001), and irritability symptoms were measured using parents’ ratings on the Child Behavior Checklist (CBCL; Achenbach, 1991) irritability items. Children’s peer functioning (i.e., peer acceptance, peer rejection, number of friendships, and relational and physical victimization) was measured via peer nomination. To analyze the longitudinal associations between symptoms of ADHD and irritability and the peer functioning variables, we built a graphical vector autoregression (GVAR) model for panel data using the psychonetrics package in R (Epskamp, 2020). We assessed the robustness of the results by evaluating how often each edge was included in 1000 bootstrapped models. The longitudinal network (displayed in Figure 1) highlighted that poor peer functioning contributed to increases in ADHD and irritability symptoms over time. Specifically, 1) physical victimization predicted increases in future inattention, hyperactivity, and irritability symptoms, and 2) peer rejection predicted increases in later inattention, which in turn predicted more irritability. The network also showed that 3) peer acceptance predicted decreases in inattention and irritability symptoms over time, and 4) a higher number of mutual friendships increased inattention symptoms, but decreased irritability. Theses results suggest that negative social environment that involves physical bullying and rejection by peers may aggravate the ADHD and irritability symptomatology. Conversely, this study also revealed that positive social interactions, such as having reciprocated friendships and being liked by peers, may improve inattention and irritability symptoms. In this short-term longitudinal study, irritability and ADHD symptoms seemed to be a consequence, rather than a “cause”, of developmental changes in peer functioning impairments. Taken together, these findings suggest that promoting social-emotional skills and fostering positive social environments in children with ADHD and irritability may be a promising target for future interventions to reduce symptoms.

Authors

• Nellia Bellaert, Yale School of Medicine
  Presenting Author

• Wan-Ling Tseng, Yale School of Medicine