As discussed in a recent issue of Attention Research Update - www.helpforadd.com/2010/october.htm
- children with ADHD often struggle in their peer relationships and are frequently
disliked and rejected. Furthermore, the friendships they establish tend
to be of poorer quality than those of other children.
Because peer relationships are so important to children's healthy development,
many researchers have focused on helping children with ADHD in this area.
Unfortunately, these efforts have not yielded consistently positive findings.
For example, in the MTA Study - the largest treatment study of ADHD ever
conducted (see www.helpforadd.com/mta-study
for a review) neither state-of-the-art medication treatment nor intensive
behavior therapy yielded meaningful improvements in children's peer relations,
even though significant reductions in core ADHD symptoms were obtained.
Although children with ADHD often have significant social difficulties,
it is noteworthy that they actually tend to overestimate their social competence.
Thus, in studies where the social competence ratings of children with and
without ADHD are compared to ratings made by parents and teachers, the discrepancy
between child and adult ratings is significantly higher for children with
ADHD than for other children. In other words, they view their social
competence more positively relative to how adults view them then do other
Some have argued that this 'positive illusory bias' (PIB) is a good thing
in that it enables children with ADHD to maintain positive feelings about
themselves despite their frequent social struggles. Others, however, suggest
that a lack of awareness about their social problems, i.e., seeing themselves
as more competent than they really are, may reduce their motivation to change
their social behavior and thus contributes to perpetuating their social difficulties.
Although the existence of a positive illusory bias in children with ADHD
is an interesting finding, several important questions remain. First,
the research has largely been restricted to boys with ADHD, as relatively
few girls have been included in prior research on this issue. Carefully examining
whether the PIB found to characterize boys with ADHD is also clearly present
in girls is thus an important question to address, especially since the
link between social difficulties and psychological maladjustment may be
stronger in girls than in boys.
Second, important questions remain about the relationship between overestimating
one's social competence and actual social functioning in children with ADHD.
As noted above, there is currently no consensus as to whether a PIB is harmful
for children with ADHD, and some have argued that it serves an important
self-protective role. One way to address this question is to examine
the magnitude of the PIB in relation to children's actual social competence.
If children with larger PIBs are actually regarded as less socially competent,
it would suggest that overestimating one's competence may undermine a child's
likelihood of experiencing social success.
These questions were addressed in a study recently published online in
the Journal of Abnormal Child Psychology
[Ohan & Johnswton (2011).
Positive illusions of social competence in girls with and without ADHD.
Journal of Abnormal Child Psychology
, published online 25 January 2011.]
Participants were 42 9-12 year old girls with ADHD and 40 girls without.
Measures of social competence were collected from the girls themselves, their
mothers, and their teachers. In addition, all girls participated in
a laboratory social task so that their social competence could be directly
observed by the researchers. Additional measures of girls psychosocial
functioning, i.e., their number of friends, impairment in various domains,
and aggressive behavior were also collected.
To compute PIB scores, each girls rating of her social competence was
subtracted from the score provided by their parent, teacher, and the researcher
who observed them during the laboratory social interaction task. Thus,
3 different PIB scores were computed for each child with positive scores reflecting
the child's rating herself higher than she was rated by the other source,
i.e., a positive illusory bias.
Question 1 - "Do girls with ADHD show a stronger tendency to overestimate
their social competence than other girls?"
The answer to this question was clearly yes as all 3 PIB scores were significantly
higher for girls with ADHD relative to comparison girls. The magnitude
of the difference was large for scores based on mother and teacher ratings,
and smaller - but still statistically significant - for scores computed based
on the lab-based social interaction measure.
When examining factors within the group of girls with ADHD that were associated
with higher PIB scores, the researchers found that scores were higher among
girls who also had high levels of oppositional-defiant behavior and hyperactive-impulsive
symptoms and lower in girls with higher levels of depressive and inattentive
Question 2 - "Is there evidence that overestimating social competence
is associated with poorer social functioning?"
To address this question, the researchers examined the correlation between
children's PIB scores and various indices of social adjustment, e.g., number
of friends reported by the mother, functional impairment reported by mothers
and teachers, aggressive behavior reported by mothers and teachers.
The results were quite interesting. For girls without ADHD, higher
PIB scores tended to be associated with more positive social functioning.
That is, for these girls, seeing oneself as more socially competent than
may actually be the case was linked to better overall social adjustment. This
reflects the potential benefits of a 'positive illusory bias' that some researchers
For girls with ADHD, however, the results were decidedly different.
For these girls, higher PIB scores were negatively and significantly associated
with virtually every aspect of social functioning the researchers examined.
Thus, the more girls with ADHD overestimated their social competence, the
fewer friends they had, the more aggressively they behaved, and the more
impaired they were judged to be. This is exactly the opposite of what
was found for the comparison girls.
- Summary and implications
Results from this study extend earlier work with boys by documenting that
girls with ADHD also tend to overestimate their social competence relative
to other girls. The fact that this was found regardless of whether
overestimation was in relation to parent ratings, teacher ratings, or observations
of girls' social behavior allows for greater confidence in the results.
In addition to this primary finding, the results also offer strong initial
evidence that overestimating one's social competence operates differently
in girls with and without ADHD, and that for girls with ADHD, over-estimates
are consistently associated with poorer adjustment.
In discussing the clinical implications of their findings, the authors
suggest that "...the PIB may be an obstacle to instigating independent self-improvement
in areas that are needed most..." and reference related work in the PIB is
associated with poorer treatment outcomes. They note that this may
be especially true for girls with ADHD and Oppositional Defiant Disorder,
"...as their negative and hostile attitude towards others may be worsened
or maintained by an overly positive self-view."
What remains unclear from the current study is the degree to which girls
with ADHD are actually self-aware of their social difficulties and provide
overly positive reports to portray a more positive self-presentation, i.e.,
they are being defensive, versus being truly unaware of their limitations.
The authors suggest that if children are deliberately presenting themselves
in an unrealistically positive light, treatment will need to address this
defensive coping style. If, however, they are truly unaware of how
they are perceived by others, than helping them develop more accurate self-evaluation
skills may be necessary and appropriate. Of course, this is unlikely
to be an 'either-or' phenomenon and both processes may be occurring.
Either way, this line of research contributes to a fuller understanding
of the social difficulties experienced by girls with ADHD and will hopefully
contribute to the development of interventions that effectively promote their