Social Functioning in Children With or At Risk for Attention Deficit/Hyperactivity Disorder: A Meta-Analytic Review

Abstract

Considerable work has demonstrated significant impairment in social functioning for children with attention deficit/hyperactivity disorder (ADHD). The social functioning profiles of children with ADHD are marked by impairments across diverse domains as they tend to experience greater rates of peer rejection, have lower levels of social skills, and have impaired social cognitions. The purpose of this study was to (a) quantitatively examine the association between ADHD and deficits across several domains of social functioning (peer functioning, social skills, social information processing), (b) examine differences in the magnitude of such associations, and (c) examine the effect of potential moderators. A meta-analysis of 109 studies (n = 104,813) revealed that children with ADHD have the most impairment within the peer functioning domain (weighted effect size [ES] r = .33) followed by significantly smaller effects within the social skills (weighted ES r = .27) and social information-processing domains (weighted ES r = .27). When examining potential moderators, results revealed that the association between ADHD and deficits within the social skills domain was weaker among studies that controlled for co-occurring conduct problems (CP). Studies that utilized sociometric and teacher reports of peer status reported the largest effects within the peer functioning domain. In addition, studies that utilized the "gold standard" approach to diagnosing ADHD documented the largest effects within both the social skills and peer functioning domains. Last, studies utilizing younger samples revealed the largest effects for deficits within the peer functioning domain. Theoretical and clinical implications are discussed.

Invariance of ADHD Symptoms Across Sex and Age: a Latent Analysis of ADHD and Impairment Ratings from Early Childhood into Adolescence

“…Both IN and HI also predicted significant new impairment in these domains at several later assessments. However, consistent with recent meta-analytic results (Ros & Graziano, 2017), the effects were strongest for HI at the earlier assessments, whereas levels of IN were only associated with future recreational impairment after fourth and ninth grade. Although the reasons for these differences are unclear, they may reflect the impact of early impulsivity on social and recreational functioning or changes in the nature of recreational activities later in development to include more significant attentional demands.…”

Beyond diagnosis: Mentalization and mental health from a transdiagnostic point of view in adolescents from non-clinical population

“…Second, there is a zeitgeist in the recent years pointing the importance of psychological functioning beyond the psychopathological domain. The inclusion of functioning (i.e., social, role, or general functioning) in the studies about impairment, prognostic and recovery suggests that functioning emerges as an important additional indicator of mental health, beyond symptoms (e.g., Cardozo, et al, 2000;Dickerson, 1997;Laird et al, 2017;Ros and Graziano, 2018;Schorre and Vandvik, 2004). This is consistent to the World Health Organization's vision of Health and Mental Health (WHO, 2016(WHO, , 2018.…”

“…General multi-informed indexes of psychological functioning were generated with the information from parents and teachers through CBCL and TRF, respectively, according (Ros and Graziano, 2018;Sheinbaum et al, 2015).…”

Effects of Discontinuing Methylphenidate on Strengths and Difficulties, Quality of Life and Parenting Stress

“…M ethylphenidate is the first-line pharmacological treatment for children with attention-deficit/hyperactivity disorder (ADHD) (NICE guideline, 2018) and its short-term efficacy for reducing ADHD symptoms is well established (Cortese et al, 2018). ADHD symptoms are often accompanied by comorbid symptoms such as oppositional behaviors, aggression, mood problems, anxiety, and by impaired social functioning (Biederman, 2005;Ros and Graziano, 2018). Besides, patients with ADHD often experience a lower quality of life (QoL) (Lee et al, 2016;Mulraney et al, 2017).…”