Does a social self-perceptual bias mask internalizing symptoms in children with attention-deficit/hyperactivity disorder?

J Child Psychol Psychiatry. 2019 Jun;60(6):630-637. doi: 10.1111/jcpp.13024. Epub 2019 Feb 26.

Abstract

Background: Children with attention-deficit/hyperactivity disorder (ADHD) often present with additional psychiatric conditions. Comorbidity is associated with poorer long-term outcomes, highlighting the need for effective assessment and intervention. However, self-perceptual biases may mask the presence of symptoms for a subgroup of children with ADHD. This study examined the role of social self-perceptual biases in children with ADHD versus control children on self-reports of loneliness, and depressive and anxious symptoms.

Methods: The research question was examined in two samples. Sample 1 consisted of 7.7-12.8-year-old boys with ADHD (n = 199) and control boys (n = 74); Sample 2 consisted of 7.7-11.4-year-old boys and girls with ADHD (n = 178) and control children (n = 86). Across samples, children reported social competence and symptoms of anxiety and depression. Child-reported loneliness was examined in Sample 1. A social competence discrepancy score (difference between self-report and teacher-report) was used as an indicator of social self-perceptual bias.

Results: Hierarchical multiple regression analyses tested social self-perceptual bias as a suppressor variable. The magnitude of the associations between ADHD and self-reported feelings of depression, anxiety and loneliness was greater when social self-perceptual bias was included in models as compared to models that did not include social self-perceptual bias (ΔR2 s range = 0.04-0.19).

Conclusions: Findings across both samples suggest that social self-perceptual biases may mask internalizing symptom severity on self-reports for individuals who overestimate their social competence. More research is needed to determine the best approach to assessing internalizing problems among children with ADHD.

Keywords: Attention-deficit/hyperactivity disorder; clinical assessment; self-perceptual bias; youth self-report.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anxiety / physiopathology*
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Child
  • Depression / physiopathology*
  • Female
  • Humans
  • Loneliness*
  • Male
  • Self Concept*
  • Self Report
  • Severity of Illness Index
  • Social Skills*