Peer Rejection and Attention Deficit Hyperactivity Disorder Symptoms: Reciprocal Relations Through Ages 4, 6, and 8

Exploring the Prevalence of Learning Disabilities in a Community Sample of Children Using the Greek Weschler Intelligence Scale for Children (WISC-V GR)

This study aimed to explore the prevalence of learning disabilities (LDs) and the emotional-behavioral difficulties in 208 children from the Crete region in Greece, and who voluntarily presented themselves for study and were evaluated by a university-based interdisciplinary team of mental health professionals. The Greek version of the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V GR) was used, with its five Primary Index scores and full-scale IQ (Verbal Comprehension Index, VCI; Visual Spatial Index, VSI; Fluid Reasoning Index, FRI; Working Memory Index, WMI; and Processing Speed, PCI). Five diagnostic categories were established for the purpose of analysis: (a) no LDs (TD group), (b) Attention Deficit Hyperactivity Disorder (ADHD), (c) Specific Learning Disabilities (SLDs), (d) Extremely Low FSIQ (below 79), and (e) Emotional/Behavioral difficulties. The results revealed a 25.5% prevalence of SLDs, 18.75% ADHD, 8.65% Extremely Low FSIQ, and 5.29% emotional/behavioral problems, suggesting that 58% of the study population struggled with some kind of learning difficulty. Statistically significant differences were observed between the "Extremely Low FSIQ" group, the "SLD", the "ADHD", and the "TD" diagnostic groups in terms of the "VCI", "FRI", and the "FSIQ" scales (p < 0.001). Likewise, the "Extremely Low FSIQ" group differed significantly from the "SLD" and "TD" groups in terms of the "VSI", the WMI, and the "PSI" (p < 0.001). The "Behavioural/emotional" and "SLD" groups differed in terms of "VCI" and "Full scale IQ" (p < 0.001). The analysis indicated that the children with severe learning difficulties differed from the other groups in terms of their cognitive profiles and that they needed tailor-made educational programs and interventions in a typical classroom. This study offers comparative data from a community sample of children, as well as generated initial evidence from non-clinical settings on the usability and the diagnostic accuracy of the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V). Further research is suggested. The present study was funded by the Crete Region (MIS 5162111).

Attention-deficit hyperactivity disorder symptoms and bullying victimization from childhood to adolescence - A within-person cross-lagged approach

Attention-deficit hyperactivity disorder (ADHD) and subclinical symptoms of hyperactivity-impulsivity and inattentiveness coincide with an increased risk of peer victimization. What remains unclear are the developmental dynamics of these associations. In a sample drawn from two Norwegian birth cohorts (n = 872; 49.94 % girls), assessed biennially from age 6 to age 14, reciprocal relations between ADHD symptoms and victimization were examined while controlling for symptoms of anxiety and depression. ADHD symptoms were assessed through clinical interviews with parents, whereas victimization was reported by teachers using questionnaires. Random-intercept cross-lagged panel modeling revealed a consistent reciprocal within-person effect of increased ADHD symptoms on victimization, and vice versa. Analyses of subdimensions of ADHD projected a consistent cross-lagged bidirectional relationship between victimization and inattentiveness symptoms only, whereas no such reciprocity was found for hyperactivity-impulsivity symptoms. Results did not differ by gender. Findings suggest that the social context may constitute a vulnerability factor in the etiology of the inattentive subtype of ADHD, and at the same time, that inattentiveness symptoms pose a risk for becoming victimized.

The pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Attention-deficit/hyperactivity disorder is one of the most common childhood neurobehavioral disorders, which has a serious negative effect on educational achievement, peer relationships, social functioning, behavior, and self-esteem of children. However, the pooled prevalence of attention-deficit/hyperactivity disorder is not well known in Ethiopia. Therefore, the main objective of this systematic review and meta-analysis is to estimate the pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Ethiopia.

METHODS

PubMed, HINARI, Science Direct, Psych INFO, Google Scholar, African Journals Online, and cross-referenced were searched to identify relevant articles. Quality appraisal was done using the Joanna Briggs Institute checklist. Heterogeneity was tested using the I-square statistics. Publication bias was tested using a funnel plot visual inspection. Further, trim and fill analysis was done to correct publication bias.Forest plots and tables were used to present results. The random effect model was used to compute the pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents.

RESULTS

The overall pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Ethiopia was 14.2% (95% CI: 8.48, 22.83). Being male (OR: 2.19, 95% CI: 1.54; 3.12), being aged 6-11 years (OR: 3.67, 95% CI: 1.98; 6.83), low family socioeconomic status (OR: 3.45 95% CI: 2.17; 5.47), maternal complication during pregnancy (OR: 3.29, 95% CI: 1.97; 5.51) and family history of mental illness (OR: 3.83, 95% CI:2.17; 6.77) were factors associated with a higher odds of attention-deficit/hyperactivity disorder among children and adolescents.

CONCLUSIONS

The overall pooled prevalence of attention-deficit/hyperactivity disorder among children and adolescents is high in Ethiopia as compared to previous literature. To reduce the prevalence of attention-deficit/hyperactivity disorder among children and adolescents, emphasis has to be given to prevention, early detection, and management of pregnancy-related complications. Moreover, parents with mental illness should be supported and properly treated to reduce the impact of hostile parenting on their child's health.

TRIAL REGISTRATION

Registered in PROSPERO with ID: CRD42024536334.

Association of Childhood Attention Deficit/Hyperactivity Disorder With Adolescent Traditional and Cyberbullying Victimization in the Digital Generation: A Population-Based Cohort Study

PURPOSE

This population-based cohort study aimed to examine the association with childhood attention deficit/hyperactivity disorder (ADHD) and bullying experiences during adolescence among Digital Generation individuals, exploring both traditional and cyberbullying.

METHODS

This study included data from 15,240 participants, collected from the Taiwan Adolescent to Adult Longitudinal Study project. Participants, initially in seventh and 10th grade in 2015, were selected through a multistage stratified sampling approach. Self-report questionnaires assessed traditional and cyberbullying victimization experiences during adolescence, with 5-year longitudinal follow-up. Childhood ADHD diagnoses were identified by linking data to Taiwan's National Health Insurance Research Database from 2000 to 2015. Logistic regression models were employed to examine the relationship between childhood ADHD and bullying victimization while controlling for relevant covariates.

RESULTS

Individuals diagnosed with childhood ADHD exhibited a significantly higher likelihood of experiencing bullying during adolescence (adjusted odds ratio (aOR) = 1.52, 95% confidence interval (CI): 1.28-1.80). This association extended to various forms of bullying, including physical (aOR = 1.42, 95% CI: 1.20-1.68), verbal (aOR = 1.42, 95% CI: 1.20-1.67), relational (aOR = 1.45, 95% CI: 1.22-1.71), and cyber (aOR = 1.35, 95% CI: 1.14-1.61). Additional factors positively associated with bullying victimization included male, binge drinking, and depression, while a positive campus atmosphere was protective against bullying. However, there is no evidence for interactions between these factors and ADHD in their associations with bullying.

DISCUSSION

Childhood ADHD increases the risk of both traditional and cyberbullying during adolescence. Recognizing this risk is essential for targeted interventions and further research on underlying mechanisms.

Peer functioning difficulties may exacerbate symptoms of attention-deficit/hyperactivity disorder and irritability over time: a temporal network analysis

BACKGROUND

Children with attention-deficit/hyperactivity disorder (ADHD) have been consistently found to experience impairments in peer functioning. Irritability is highly prevalent in children with ADHD and may worsen social impairments given the frequent temper outbursts and low frustration tolerance characterizing irritability. However, it is still unclear how ADHD and irritability symptoms interact with peer functioning difficulties over time. Assessing these temporal dynamics using a novel longitudinal approach (i.e., temporal network analysis) may reveal precise targets for intervention.

METHODS

This study investigates the dynamic associations between ADHD symptoms, irritability, and peer functioning in a community sample of 739 children (ages 8-11 years, Mage = 10.06 [SD = 0.59], 47.77% females) assessed at three timepoints, 6 months apart, in a school-based study. Parents reported their child's ADHD symptoms using the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV), and irritability symptoms using the Child Behavior Checklist (CBCL) irritability items. Children's peer functioning (i.e., peer acceptance, peer rejection, number of friendships, and victimization) was measured via peer nomination. To estimate the longitudinal associations between the variables, we built a graphical vector autoregression model for panel data.

RESULTS

The longitudinal network highlighted that poor peer functioning contributed to increases in symptoms over time. Specifically, (1) physical victimization predicted increases in inattention, hyperactivity, and irritability; (2) peer rejection predicted increases in inattention, which in turn predicted increases in irritability; (3) peer acceptance predicted decreases in inattention and irritability; and (4) higher numbers of mutual friendships increased inattention.

CONCLUSIONS

These results suggest that a negative social environment involving physical bullying and rejection may aggravate ADHD and irritability symptoms. Conversely, positive social interactions, such as being liked by peers, may improve inattention and irritability symptoms. Fostering social-emotional skills and positive social interactions and environments in children with ADHD and irritability may be a promising target for future interventions to reduce symptoms.

Adult ADHD Symptoms in a Large Metropolitan Area From Brazil: Prevalence and Associations with Psychiatric Comorbidity, Bullying, Sexual Abuse, and Quality of Life

OBJECTIVE

The aim of this study was to investigate the prevalence and psychiatric correlates of symptomatic ADHD in a large metropolitan area of a middle-income country.

METHODS

An in-person household survey with randomly selected 2,297 adults aged 19 to 60 from Rio de Janeiro, Brazil, assessed by trained lay interviewers. The Adult Self-Rating Scale Screener (ASRS-6) was used. Chi-square and logistic regression were conducted.

RESULTS

ADHD prevalence was 4.59 (95% CI [3.56, 5.44]). Those with ADHD were younger and more often unemployed; they displayed more psychiatric symptoms (depression, anxiety, and alcohol abuse) and a history of bullying and sexual abuse. They also had worse physical health indicators. Findings remained significant when controlling for socioeconomic variables.

CONCLUSION

Adults with symptomatic ADHD from a large metropolitan area in Brazil show a pattern of findings consistent with what has been observed in higher-income countries.

Social withdrawal and academic achievement, intertwined over years? Bidirectional effects from primary to upper secondary school

BACKGROUND

Socially withdrawn children tend to perform poorer academically than their peers. What remains unknown, is the temporal ordering of the two phenomena. Also, substantial gender differences exist in both social withdrawal and academic achievement; thus, it is conceivable that the strength of the relation between them is gendered as well.

AIMS

To investigate cross-sectional correlates and test directional effects of social withdrawal and academic achievement from primary to upper secondary school, and to examine potential gendered effects.

METHODS

Prospective associations were analysed from age 6 to age 14 using biannual teacher ratings of children's social withdrawal and academic achievement in a representative community sample (n = 845), by means of random intercept cross-lagged panel modelling.

RESULTS

In boys, increased academic achievement at ages 8 and 12 forecasted decreased social withdrawal 2 years later, whereas increased social withdrawal at age 10 predicted reduced academic achievement at age 12. No such effects were seen in girls.

CONCLUSIONS

Social withdrawal and academic achievement are bidirectionally related among boys, but not girls. Results are discussed in light of need-to-belong theory, and practical implications for schools and teachers are illuminated.

Reciprocal Developmental Relations Between ADHD and Anxiety in Adolescence: A Within-Person Longitudinal Analysis of Commonly Co-Occurring Symptoms

Objective: Significant anxiety often occurs in the presence of ADHD symptoms; however, the reasons are not well understood. We aimed to establish whether the relations between ADHD symptons and anxiety are bidirectional or unidirectional.

METHOD

Weexamined the developmental relations between ADHD and anxiety symptoms across adolescence (ages 13, 15, and 17) in a community-ascertained, normative longitudinal sample of 1,483 youth (52% male). We used an autoregressive latent trajectory model with structured residuals (ALT-SR) to examine within-person developmental relations between ADHD and anxiety symptoms to determine whether it is ADHD symptoms that lead to anxiety symptoms and/or the reverse.

RESULTS

Results suggested that there are reciprocal within-person developmental relations between ADHD and anxiety symptoms.

CONCLUSIONS

Our findings support the recommendation that targeting ADHD symptoms can be fruitful for addressing anxiety symptoms; however, they suggest that targeting anxiety symptoms may also benefit ADHD symptoms. Results also underline the importance of careful assessment for underlying ADHD symptoms among adolescents presenting with anxiety.

Social skills moderate the time-varying association between aggression and peer rejection among children with and without ADHD

Although childhood aggression is typically associated with peer rejection, some children concurrently employ coercive and socially skilled behavior and successfully avoid negative peer outcomes. However, research on children's dual use of coercive and social behavior has largely employed cross-sectional designs with nonclinical populations and, as a result, little is known about the covariation of aggression with social skills, particularly among high-risk samples. We directly addressed this limitation by testing childhood aggression and social skills as separate time-varying predictors of prospective change in peer rejection in a sample of children with and without attention-deficit/hyperactivity disorder (ADHD). Two hundred and two 5-10-year-old children (M = 7.9 years, SD = 1.2) with and without ADHD were followed prospectively for 6 years. Key constructs, including children's overt aggression, social skills, and peer rejection, were collected at each of the three waves using multiple methods and informants. Controlling for demographic factors and time-varying ADHD symptoms, longitudinal change in child-, parent-, and teacher-reported aggression positively predicted prospective change in parent- and teacher-reported peer rejection. Importantly, predictions were moderated by parent- and teacher-reported social skills, such that aggression inversely predicted peer rejection for children with high social skills. These results demonstrate that social skills meaningfully alter trajectories of peer rejection predicted from cross-time variation in aggression. We discuss the theoretical and empirical implications of these findings within a developmental psychopathology framework, including recommendations for directions for future research.

Disrupted Association Between Empathy and Brain Structure in Attention-Deficit/Hyperactivity Disorder

Objectives

To investigate the relationship between brain structure and empathy in early adolescents with attention-deficit/hyperactivity disorder (ADHD).

Methods

Nineteen early adolescents with ADHD and 20 healthy controls underwent 3T MRI. All the participants were assessed for different aspects of empathy using measures including the Interpersonal Reactivity Index and Empathy Quotient. Cortical thickness and subcortical structural volume based on T1-weighted scans were analyzed using FreeSurfer.

Results

Cognitive empathy (t=-2.52, p=0.016) and perspective taking (t=-2.10, p=0.043) were impaired in the ADHD group compared with the control group. The cluster encompassing the left posterior insular, supramarginal, and transverse temporal cortices [cluster-wise p-value (CWP)=0.001], which are associated with emotional empathy, was significantly smaller in the ADHD group, and the volume of the left nucleus accumbens was greater than that of the control group (F=10.12, p=0.003, effect size=0.22). In the control group, the left superior temporal (CWP=0.002) and lingual cortical (CWP=0.035) thicknesses were positively associated with cognitive empathy, while the right amygdala volume was positively associated with empathic concern (Coef=14.26, t=3.92, p=0.001). However, there was no significant correlation between empathy and brain structure in the ADHD group.

Conclusion

The ADHD group had a smaller volume of the cortical area associated with emotional empathy than the control group, and there was no brain region showing significant correlation with empathy, unlike in the control group.

Bivariate latent change score analysis of peer relations from early childhood to adolescence: Leading or lagging indicators of psychopathology

Understanding longitudinal associations between problematic peer relations and psychopathology are needed to inform public health. Three models have been proposed: poor peer relations i) lead or are a risk factor for psychopathology; ii) lag or are a consequence of psychopathology; iii) both lead and lag psychopathology. Another model is that poor peer relations lead or lag psychopathology depending upon the developmental period. To test these models, youth's peer relations and clinical symptoms were assessed up to 6 times between ages 3-11 in 306 children. Bivariate latent change score models tested leading/lagging longitudinal relationships between children's peer relations (peer victimization/rejection, peer-directed aggression, social withdrawal, prosocial behavior) and psychopathology (depression, anxiety, and externalizing symptoms). Peer victimization/rejection was a leading indicator of depression from early childhood into preadolescence. Peer-directed aggression was a leading indicator of externalizing symptoms (in late childhood).

Developmental relations between ADHD symptoms and bullying perpetration and victimization in adolescence

It has previously been hypothesized that individuals with elevated attention deficit hyperactivity disorder (ADHD) symptoms are at greater risk of bullying perpetration and victimization. Using autoregressive latent trajectory models with structured residuals (ALT-SR) and four waves (ages 11, 13, 15, and 17) of longitudinal data from the normative z-proso study (n = 1526, 52% male), we evaluated the developmental relations between ADHD and bullying using both self- and teacher-reported ADHD symptom data. Analyses suggested that ADHD symptoms primarily increase the risk of bullying perpetration, with a within-person effect of ADHD symptoms on bullying perpetration symptoms identified across ages 13-15 (β = .13) and ages 15-17 (β = .19) based on self-reported ADHD symptoms and a similar effect identified across ages 11-13 (β = .24) and 13-15 (β = .29) based on teacher-reported inattention symptoms. There were also some indications of reciprocal effects and effects involving victimization that merit further exploration in future research. Results imply that the content of bullying intervention and prevention programs should take account of ADHD symptoms to ensure that those with elevated symptoms can benefit as much as their typically developing peers. This will involve addressing bullying perpetration that may reflect impulsive/reactive aggression and impaired social skills rather than instrumental aggression. Further, programs should go beyond classical curriculum/classroom-based delivery to ensure that individuals with elevated ADHD symptoms can be successfully engaged.

Bidirectional Associations between Peer Relations and Attention Problems from 9 to 16 Years

We examined the bidirectional relations between peer relations and attention problems from middle childhood through adolescence. Using data from the Longitudinal Study of Chinese Children and Adolescents (LSCCA, N = 2157, 51.9% male), three key aspects of peer relations (acceptance, rejection, and victimization) were assessed annually from 9 to 16 years of age. Attention problems were assessed at 9 and 15 years. Latent growth modeling indicated that greater attention problems at age 9 were linked with a lower intercept for peer acceptance, and higher intercepts for rejection and victimization. Also, prior lower acceptance and greater rejection and victimization, along with a higher increase over time in rejection and lower decrease over time in victimization, predicted attention problems at age 15. Cross-lagged analysis showed that attention problems were associated with less subsequent peer acceptance and greater subsequent rejection and victimization. Only peer rejection (but neither victimization nor acceptance) predicted more subsequent attention problems. Findings point to bidirectional associations between attention problems and peer relations in the developmental transition across adolescence. Evidence for differential bidirectionality of attention problems with the multiple peer experience (group versus dyadic; good versus bad) emerged, and future replications are needed.

Mental health and cultural and linguistic diversity as challenges in school? An interview study on the implications for students and teachers

Mental health and cultural and linguistic diversity in classrooms are part of students’ lives. Both factors can lower the achievements of students and classrooms and pose a challenge for teachers. Yet, little is known about the effects on other areas of school life besides achievements. Also, the consequences for classmates and teachers as well as possible resources are mostly disregarded. Semi-structured interviews were held to investigate the diverse effects of mental health issues and cultural and linguistic diversity on students, classmates and teachers. In total 20 interviews were conducted, seven with teachers, seven with external professionals and six with students. Recordings were transcribed and analysed using qualitative text analysis. Results show that especially externalizing symptoms of mental health issues are a burden to classmates and teachers. Teachers face time management problems and emotional stress. Linguistic diversity constitutes a serious challenge at school for students, classmates and teachers. Yet, cultural and linguistic diversity also imports several resources like fostering openness and integration. Future research should expand this research to older children and investigate the specific needs of teachers.

Peer-Victimization of Young Children With Developmental and Behavioral Difficulties-A Population-Based Study

OBJECTIVE

The aim is to investigate if young children with developmental and behavioral difficulties (DBDs) have greater risk of peer-victimization compared with typically developing (TD) children.

METHOD

The sample was drawn from the Norwegian Mother and Child Cohort Study (MoBa). MoBa has collected population-based data on children's health and development for 114,500 children. We included children that were 5 years of age (n = 41,609). Multivariate logistic regression was used to estimate the effect of different DBDs and of co-occurring DBDs on peer-victimization compared with TD children. Categories of DBDs included autistic traits, emotional difficulties, behavioral difficulties, general learning difficulties, attention difficulties/impulsive behavior, motor development difficulties, language difficulties, and hearing and vision difficulties. Results were adjusted for socioeconomic status and the child's sex.

RESULTS

Peer-victimization was 2.8% (933) among TD children, and 8.0% (615) among children with DBD. The highest risk of peer-victimization was found among children with autistic traits and children with five or more co-occurring DBDs (adjusted odds ratios [ORs] = 12.76; 95% confidence interval [CI] 8.64-18.84; p ≤ .001) and 17.37 (95% CI 12.15-24.82; p ≤ .001)], respectively. The lowest risk was found among children with hearing and vision difficulties and children with only one DBD [adjusted ORs = 1.98 (95% CI 1.71-2.29; p ≤ .001) and 1.95 (95% CI 1.70-2.22; p ≤ .001)].

CONCLUSION

Children with DBD have a substantially higher risk of peer-victimization compared with TD children. Peer-victimization varies with type of DBD and increases cumulatively by number of DBDs.

Theory of Mind and Empathy in Children With ADHD

Objective: The current study compared empathy and theory of mind (ToM) between children with ADHD and healthy controls, and assessed changes in ToM among children with ADHD following administration of methylphenidate (MPH). Method: Twenty-four children with ADHD (mean age = 10.3 years) were compared with 36 healthy controls. All children completed the interpersonal reactivity index (IRI), a self-reported empathy questionnaire, and performed the "faux-pas" recognition task (FPR). Children with ADHD performed the task with and without MPH. Results: Children with ADHD showed significantly lower levels of self-reported empathy on most IRI subscales. FPR scores were significantly lower in children with ADHD and were improved, following the administration of MPH, to a level equal to that found in healthy controls. Conclusion: Children with ADHD show impaired self-reported empathy and FPR when compared with healthy controls. Stimulants improve FPR in children with ADHD to a level equal to that in healthy controls.

Examining ODD/ADHD Symptom Dimensions as Predictors of Social, Emotional, and Academic Trajectories in Middle Childhood

The goal of this article is to investigate the symptom dimensions of oppositional defiant disorder (ODD; irritability, defiance) and attention deficit/hyperactivity disorder (ADHD; inattention, hyperactivity-impulsivity) as predictors of academic performance, depressive symptoms, and peer functioning in middle childhood. Children (N = 346; 51% female) were assessed via teacher-report on measures of ODD/ADHD symptoms at baseline (Grades K-2) and academic performance, depressive symptoms, peer rejection, and victimization on 7 occasions over 4 school years (K-2 through 3-5). Self-report and grade point average data collected in Grades 3-5 served as converging outcome measures. Latent growth curve and multiple regression models were estimated using a hierarchical/sensitivity approach to assess robustness and specificity of effects. Irritability predicted higher baseline depressive symptoms, peer rejection, and victimization, whereas defiance predicted higher baseline peer rejection; however, none of these ODD-related effects persisted 3 years later to Grades 3-5. In contrast, inattention predicted persistently poorer academic performance, persistently higher depressive symptoms, and higher baseline victimization; hyperactivity-impulsivity predicted subsequent peer rejection and victimization in Grades 3-5. In converging models, only inattention emerged as a robust predictor of 3-year outcomes (viz., grade point average, depressive symptoms, peer rejection, and relational victimization). Broadly, ODD dimensions-particularly irritability-may be linked to acute disturbances in social-emotional functioning in school-age children, whereas ADHD dimensions may predict more persistent patterns of peer, affective, and academic problems. By examining all 4 ODD/ADHD symptom dimensions simultaneously, the present analyses offer clarity and specificity regarding which dimensions affect what outcomes, and when. Findings underscore the importance of multidimensional approaches to research, assessment, and intervention.

Peer problems, bullying involvement, and affective decision-making in adolescence

We investigated, using a cross-lagged design, the longitudinal association of bullying involvement and peer problems with affective decision-making in adolescence (ages 11 and 14 years) in 13,888 participants of the Millennium Cohort Study. Affective decision-making (risk-taking, quality of decision-making, risk adjustment, deliberation time, and delay aversion) was measured with the Cambridge Gambling Task, bullying involvement (bully, bully-victim, victim, or 'neutral' status) with self-report measures, and peer problems with the parent-reported Strengths and Difficulties Questionnaire. In general, peer problems were associated with decision-making in the unadjusted model but not after controlling for confounding. However, bullying involvement was related to decision-making even after adjustment. Compared to 'neutral' males, bullies and bully-victims improved over time in risk adjustment, and bully-victims in deliberation time, too. In both sexes, bullies showed more risk-taking compared to their 'neutral' counterparts. It seems that bullies are more sensitive to reward (or less sensitive to punishment) than those not involved in bullying. The finding that male bullies show improvement in decision-making warrants further research. Statement of contribution What is already known on this subject? In adults, decision-making deficits and social exclusion or rejection are linked In youth, only two studies have explored this link with gambling tasks measuring real-world difficulties in decision-making. Both studies were cross-sectional and small-scale. What does this study add? We explore this link in adolescence, using a large, general population longitudinal sample and the Cambridge Gambling Task. Bullies were more sensitive to reward (or less sensitive to punishment) than those not involved in bullying. Male bullies improved over time in risk adjustment, a finding that warrants further research.

A Pilot Study of the Efficacy of a Cognitive Training Based on Board Games in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

Objective: The main aim of this study was to prove the efficacy of an intervention based on board games on executive functions (EFs) and clinical symptoms in children with attention-deficit/hyperactivity disorder (ADHD). Materials and Methods: A nonblinded randomized controlled trial was conducted with a sample of children with a diagnosis of ADHD (diagnosed by psychiatrists and clinical psychologists in a mental health center). Children were randomly allocated by matching age and sex, into two groups: experimental EF training group (n = 13; mean [M]_age = 9.46, standard deviation [SD] = 1.20; boys = 53.8%) or a wait-list control group (n = 14; M_age = 9.50, SD = 1.09; boys = 71.4%). Measures assessed individually at pretest, posttest, and follow-up intervention included EFs and clinical symptoms. Results: Analysis of covariance repeated measures analysis showed that linguistic short-term memory, F(1,28) = 7.45, p = 0.02, and conduct problems, F(1,28) = 12.51, p = 0.00, significantly improved with larger effects in the board games training group after intervention when compared to the wait-list group. Although nonsignificant effects were reported at the follow-up, large effect sizes were actually found. Conclusion: Although future studies are needed, the results of this study highlight the importance of board games and its efficacy as a possible therapeutic and/or preventive intervention on ADHD.

Psychiatric problems and quality of life in a clinical sample of adolescents: The role of peer relations

BACKGROUND

The quality of peer relations is linked to mental health in childhood and adolescence, but few studies have investigated its clinical relevance. In particular, the potential mediating role of peer functioning in the associations between different dimensions of symptoms and quality of life (QoL) has not been sufficiently examined.

OBJECTIVE

In a clinical sample of adolescents, we examined peer relations in light of psychiatric diagnoses, as well as QoL and symptoms of mental health problems, with particular focus on symptoms of anxiety, depression, and ADHD. We also examined the potential mediating role of peer problems in the relationship between such symptoms and QoL.

METHODS

The sample consisted of 603 adolescents (ages 13-18) referred to clinical assessment. Psychiatric diagnoses according to the criteria of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, were collected from participants' clinical charts. Symptoms of disorders, QoL, and quality of peer relations were measured by self-report questionnaires.

RESULTS

Adolescents diagnosed with anxiety/depressive disorder reported more peer problems and lower QoL than adolescents with attention deficit/hyperactivity disorder. These findings were supported with symptom ratings. A path model with bootstrapping was used to assess the potential mediating role of peer problems in the association between symptoms and QoL, showing that peer problems partly mediated the relationship between emotional symptoms and QoL, but not the relationship between ADHD-symptoms and QoL.

CONCLUSION

Improvement of peer relations may be a fruitful path for enhancing QoL among adolescents with symptoms of anxiety and depression.

Explaining the relationship between temperament and symptoms of psychiatric disorders from preschool to middle childhood: hybrid fixed and random effects models of Norwegian and Spanish children

BACKGROUND

Four explanations for the concurrent and prospective associations between temperament and psychopathology in children have been suggested: predisposition, complication/scar, common cause/continuity, and pathoplasty/exacerbation. Because the confounding effects of common causes have not been ruled out in prior work, the support for the various explanations is uncertain.

METHODS

Screen-stratified community samples of 4-year olds in Trondheim, Norway (n = 1,042), and 3-year olds in Barcelona, Spain (n = 622), were assessed biennially for symptoms of attention-deficit/hyperactivity (ADHD), oppositional defiant (ODD), conduct (CD), anxiety, and depressive disorders through interviewer-based psychiatric interviews across four waves of data collection. The parents completed child temperament ratings. The data were analyzed with random and fixed effects regression adjusted for all time-invariant unmeasured confounders (e.g., genetics, common methods bias, item overlap).

RESULTS

In both Norway and Spain and across ages, negative affect predisposed children to symptoms of all disorders except CD, low effortful control predisposed children to ADHD and ODD-symptoms, and surgency predisposed children to increased ADHD-symptoms. Complication effects were observed in the Spanish children for ADHD-symptoms, which increased surgency and diminished effortful control, and for ODD-symptoms, which decreased surgency. The common cause and pathoplasty/exacerbation explanations were not supported.

CONCLUSIONS

The present results are consistent with the view that temperament plays a causal role in the development of symptoms of psychiatric disorders in children. Because temperament is malleable, interventions targeting the affective, attentional, and behavioral regulatory components of temperament may reduce psychopathology in children.

Peer Problems Among Postinstitutionalized, Internationally Adopted Children: Relations to Hypocortisolism, Parenting Quality, and ADHD Symptoms

Seventy-eight postinstitutionalized (PI) children adopted at ages 17-36 months were assessed 2, 8, 16, and 24 months postadoption on measures of cortisol and parenting quality, and compared to same-aged children adopted from foster care (FC, n = 45) and nonadopted children (NA, n = 45). In kindergarten (M_age  = 6.0 years), teachers, parents, and trained observers completed measures of peer relationships and attention deficit hyperactivity disorder (ADHD) symptoms. PI children had more peer problems and ADHD symptoms according to teachers and observers than NA children with FC children in between, whereas both PI and FC children were at significantly greater risk of hypocortisolism (i.e., blunted cortisol diurnal rhythm and reactivity). Hypocortisolism and ADHD symptoms mediated the association between preadoption adversity and peer difficulties. Higher postadoption parenting quality was protective.

Homotypic and heterotypic continuity of symptoms of psychiatric disorders from age 4 to 10 years: a dynamic panel model

BACKGROUND

Childhood psychiatric disorders and their symptoms evince both within-disorder (homotypic) and between-disorder (heterotypic) continuities. These continuities may be due to earlier symptoms causing later symptoms or, alternatively, that the same (unknown) causes (e.g., genetics) are operating across time. Applying a novel data analytic approach, we disentangle these two explanations.

METHODS

Participants in a Norwegian community study were assessed biennially from 4 to 10 years of age with clinical interviews (n = 1,042). Prospective reciprocal relations between symptoms of disorders were analyzed with a dynamic panel model within a structural equation framework, adjusting for all unmeasured time-invariant confounders and time-varying negative life-events.

RESULTS

Homotypic continuities in symptoms characterized all disorders; strongest for attention-deficit/hyperactivity disorder (ADHD) (r = .32-.62), moderate for behavioral disorders (r = .31-.48) and for anxiety and depression (r = .15-.40), and stronger between 8 and 10 than between 4 and 6 years. Heterotypic continuity also characterized all disorders. A dynamic panel model showed that most continuities were due to unmeasured time-invariant factors rather than effects of earlier symptoms on later symptoms, although symptoms of behavioral disorders, which evinced two-year homotypic continuity (B = .14, 95% CI: .04, .25), did influence later symptoms of ADHD (B = .13, CI: .03, .23), and earlier ADHD symptoms influenced later anxiety disorder symptoms (B = .07, CI: .01, .12).

CONCLUSIONS

Homotypic and heterotypic continuities of symptoms of childhood psychiatric disorders are mostly due to unobserved time-invariant factors. Nonetheless, symptoms of earlier behavioral disorders may affect later symptoms of such disorders and of ADHD, and ADHD may increase the risk of later anxiety. Thus, even if interventions do not alter basic etiological factors, symptom reduction may itself cause later symptom reduction.

Preschool Predictors of ADHD Symptoms and Impairment During Childhood and Adolescence

PURPOSE OF REVIEW

This paper summarizes key, recently published research examining longitudinal outcomes for preschoolers with high levels of inattention and/or hyperactivity/impulsivity.

RECENT FINDINGS

Symptom trajectories show that hyperactivity/impulsivity declines across childhood. At the group level, the course of inattention appears more variable. However, identification of subgroups of children showing stable, rising, and falling inattention over time is promising. Early ADHD-like symptoms portend risk for academic and social difficulties, as well as comorbid emotional and behavioral problems in childhood and adolescence. Several early risk factors appear to moderate these relations, including comorbid symptoms, parental psychopathology, socioeconomic disadvantage, and perhaps neuropsychological dysfunction. Furthermore, high levels of inattention and/or hyperactivity/impulsivity during the preschool period appear to compromise development of regulatory and neuropsychological functions, which in turn increases risk for negative outcomes later in childhood. Identified risk factors are targets for novel interventions, which ideally would be delivered early to at-risk children.

Peer Problems and Hyperactivity-Impulsivity Among Norwegian and American Children: The Role of 5-HTTLPR

Peer problems are linked to attention deficit hyperactivity disorder (ADHD) symptoms and the serotonin system is thought to be involved in ADHD-related behavior. Hence, from a Gene × Environment perspective, the serotonin transporter 5-HTTLPR may play a moderating role. In two large community samples, the moderating role of 5-HTTLPR was examined related to more hyperactivity-impulsivity symptoms (HI symptoms) predicted by more peer problems. In Study 1, involving 642 Norwegian children, results indicated that for s-allele carriers only, caregiver-reported peer problems at age 4 predicted more parent-reported HI symptoms at age 6. In Study 2, similar results emerged involving 482 American children. Discussion focuses on differential sensitivity to the adverse effects of poor peer relations.

Deficits in Response Inhibition in Patients with Attention-Deficit/Hyperactivity Disorder: The Impaired Self-Protection System Hypothesis

Problems in inhibitory control are regarded in Psychology as a key problem associated with attention-deficit/hyperactivity disorder (ADHD). They, however, might not be primary deficits, but instead a consequence of inattention. At least two components have been identified and dissociated in studies in regards to inhibitory control: interference suppression, responsible for controlling interference by resisting irrelevant or misleading information, and response inhibition, referring to withholding a response or overriding an ongoing behavior. Poor error awareness and self-monitoring undermine an individual's ability to inhibit inadequate responses and change course of action. In non-social contexts, an individual depends on his own cognition to regulate his mistakes. In social contexts, however, there are many social cues that should help that individual to perceive his mistakes and inhibit inadequate responses. The processes involved in perceiving and interpreting those social cues are arguably part of a self-protection system (SPS). Individuals with ADHD not only present impulsive behaviors in social contexts, but also have difficulty perceiving their inadequate responses and overriding ongoing actions toward more appropriate ones. In this paper, we discuss that those difficulties are arguably a consequence of an impaired SPS, due to visual attention deficits and subsequent failure in perceiving and recognizing accurately negative emotions in facial expressions, especially anger. We discuss evidence that children with ADHD exhibit problems in a series of components involved in the activation of that system and advocate that the inability to identify the anger expressed by others, and thus, not experiencing the fear response that should follow, is, ultimately, what prevents them from inhibiting the ongoing inappropriate behavior, since a potential threat is not registered. Getting involved in high-risk situations, such as reckless driving, could also be a consequence of not registering a threat and thus, not experiencing fear.