Developmental processes in peer problems of children with attention-deficit/hyperactivity disorder in the Multimodal Treatment Study of Children With ADHD: developmental cascades and vicious cycles

Abstract

We examined the developmental processes involved in peer problems among children (M age = 10.41 years) previously diagnosed with attention-deficit/hyperactivity disorder (ADHD) at study entry (N = 536) and a comparison group (N = 284). Participants were followed over a 6-year period ranging from middle childhood to adolescence. At four assessment periods, measures of aggression, social skills, positive illusory biases (in the social and behavioral domains), and peer rejection were assessed. Results indicated that children from the ADHD group exhibited difficulties in each of these areas at the first assessment. Moreover, there were vicious cycles among problems over time. For example, peer rejection was related to impaired social skills, which in turn predicted later peer rejection. Problems also tended to spill over into other areas, which in turn compromised functioning in additional areas across development, leading to cascading effects over time. The findings held even when controlling for age and were similar for males and females, the ADHD and comparison groups, and among ADHD treatment groups. The results suggest that the peer problems among children with and without ADHD may reflect similar processes; however, children with ADHD exhibit greater difficulties negotiating important developmental tasks. Implications for interventions are discussed.

Figures

Figure 1

Freely estimated paths for nested models. PIB = Positive Illusory Biases;. SocSk = social skills; Agg = aggressive behavior; Rej = peer rejection. All models include within-time correlations and the paths from the previous models. Solid grey lines represent stability estimates. Dashed black lines represent cross-lagged paths between social skills, aggression, and rejection. Solid black lines represent cross-lagged paths between positive illusions and social skills and aggression at the first time lag. Gray dashed lines represent cross-lagged paths between positive illusions and social skills and aggression at the second two time lags.

Figure 2

Significant pathways for final model for illusory biases in the social domain (Model 3). R2 values are in parentheses. Grey lines reflect stability estimates and black lines reflect cross-lagged paths. PIBSoc = Positive Illusory Biases in the Social Domain;. SocSk = low social skills; Agg = aggressive behavior; Rej = peer rejection. All included paths are significant at p < .05. Stability paths are depicted in gray. Although not included in the figure, within-time correlations across domains were also estimated.

Figure 3

Significant pathways for final model for illusory biases in the behavioral domain (Model 4). R2 values are in parentheses. Grey lines reflect stability estimates and black lines reflect cross-lagged paths. PIBBeh = Positive Illusory Biases in the Behavioral Domain;. SocSk = low social skills; Agg = aggressive behavior; Rej = peer rejection. All included paths are significant at p < .05. Stability paths are depicted in gray. Although not included in the figure, within-time correlations across domains were also estimated.