Social Problems and Peer Victimization in Children With ADHD: Examination of Behavioural Phenotypes

• In Event: Poster Session 05
  In Poster Session: PS 05 Topic - Developmental Disabilities

Abstract

Introduction
Youths with Attention Deficit Hyperactivity Disorder (ADHD) struggle with social and emotional development particularly with peer relationships (Humphrey et al., 2007). Core symptoms of ADHD such as inattention may disrupt social learning. Additionally, problem behaviours reported in children with ADHD may negatively influence peer relationships, such as rule breaking behaviours, aggression, and social withdrawal (Frankel & Feinberg, 2002; Humphrey et al., 2017). Expression of problem behaviours likely varies among youth with different ADHD subtype diagnoses. Our aim is to explore whether behaviours differ between ADHD diagnosis subtypes compared to typically-developing (TD) youth.

Methods
Youths (8-17 years) with and without neurodevelopmental disorders were recruited to the study (Alexander et al., 2017). Problem behaviours in youths were assessed based on parent-report using the Child Behaviour Checklist (CBCL). Subscales of the CBCL that were used included to measure problem behaviours included the Aggressive Behaviour, Rule Breaking Behaviour, Social Problems, and Withdrawn scales (Achenbach, 1991). A higher score on the subscales is indicative of increased problems. General Linear Models were used to examine the relationship between the youth problem behaviours and diagnosis group (no diagnosis, ADHD combined-type [ADHD-CT] & ADHD-inattentive type [ADHD-IT]), adjusting for age, sex, data collection site, and socioeconomic status (SES) measured by the Barratt Simplified Measure of Social Status (BSMSS).

Results
A total number of 230 children (median age = 9.76 years; boys=77.4 %) with ADHD and 205 TD children (median age= 9.59 years; boys= 50.2 %) were recruited (median age = 9.64 years, IQR = 7.83-12.14 years). A total of 107 children with ADHD (median age = 8.58 years, boys = 79.5, %) had the combined subtype and 123 children had the inattentive subtype (median age = 10.5 years, boys = 75.6 %). A total of 435 parents completed the CBCL.

Compared to TD children, youth with ADHD-CT and ADHD-IT had significantly higher scores on the Social Problems (both, p<0.05) and Aggressive Behaviour (p<0.001) sub-scales of the CBCL. Additionally, youth with ADHD-CT had significantly higher scores on the Rule Breaking Behaviour (p<0.001) subscale when compared to TD children. However, Youth with ADHD-CT had higher scores on the Social Problems (p<0.001), Aggressive Behaviour (p<0.001), and Rule Breaking Behaviour (p<0.001) compared to children the ADHD-IT subtype.

To focus in on peer relationships, a sub-analysis was conducted with the CBCL Peer Victimization scale (McCloskey & Stuewig, 2001). ADHD-CT children experienced significantly more peer victimization than children with ADHD-IT (p<0.001) and TD controls. No differences in peer victimization were seen between ADHD-IT and TD children (p>0.05).

No significant group differences were evident for the withdrawn subscale (p=0.088, p=0.110).

Discussion
Children with ADHD-CT subtype exhibited more problem behaviours (i.e. rule breaking, aggression) that contribute to the difficulties youths can experience with building positive peer relationships. The symptoms of hyperactivity associated with a diagnosis of ADHD-CT may be the underlying factor associated with greater peer victimization, consistent with recent research (Winters et al., 2020). Future research is needed to explore hyperactivity in relation to peer relationships in children with ADHD.

Authors

• Alissa Papadopoulos, University of Western Ontario
  Presenting Author

• Diane Seguin, University of Western Ontario
  Non-Presenting Author

• Emma Gail Duerden, Western University
  Non-Presenting Author