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Strengths and Difficulties Regarding Attention Deficit Hyperactivity Disorder: Correlation with Social Responsiveness and Disorder Severity

Year 2024, Articles Online First, 1 - 7
https://doi.org/10.12956/tchd.1464417

Abstract

Objective: Children with neurodevelopmental disabilities often experience social difficulties. Children with attention deficit hyperactivity disorder (ADHD) are more likely to experience peer rejection and cognitive, academic, family, and professional difficulties. This investigation aimed to identify the predictors of difficulties faced by children and adolescents with ADHD.

Material and Methods: We established ADHD diagnoses based on DSM-5 criteria. Moreover, every participant had a diagnostic evaluation by a child and adolescent psychiatrist using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) and a detailed sociodemographic form documented. Parents completed the Turgay DSM IV-Based Child and Adolescent Behavioural Disorders Screening and Rating Scale (T-DSM-IV-S), the Strengths and Difficulties Questionnaire (SDQ), and the Social Responsiveness Scale (SRS) for their children.

Results: The study included 99 children, 59 in the ADHD group and 40 in the control group. There was no significant difference between the groups regarding gender and age. The mean scores of T-DSM-IV-S [Attention deficit (AD), Hyperactivity/impulsivity (H/I), Oppositional defiant disorder (ODD), Conduct disorder (CD)], SDQ, and SRS were significantly higher in the ADHD group than in the control group. Among the independent variables in the regression model, SRS total scores significantly predicted SDQ-total (β = 0.238, p = 0.033) and SDQ-emotion (β =0.439, p = 0.001) scores in the ADHD group.

Conclusion: Children diagnosed with ADHD may have more receptive deficits in mutual interactions than their peers, which greatly impacts their social behaviors. Early social skills training for social functioning impairments may reduce the condition’s social impact

Ethical Statement

The study was approved by The Alaaddin Keykubat University Faculty of Medicine Ethical Committee (10354421-2023/5-09).

Supporting Institution

No financial support was received for this study.

Thanks

Thank you for considering the manuscript.

References

  • Leitner Y. The co-occurrence of autism and attention deficit hyperactivity disorder in children - what do we know? Front Hum Neurosci 2014;8:268.
  • Polanczyk G, Jensen P. Epidemiologic Considerations in Attention Deficit Hyperactivity Disorder: A Review and Update. Child Adolesc Psychiatr Clin N Am 2008;17:245–60.
  • Kang L, Liu J, Liu Y, Liang W, Yang F and Liu M. Global, regional, and national disease burden of autism spectrum disorder among children under 5 years from 1990 to 2019: An analysis for the Global Burden of Disease 2019 Study. Asian J Psychiatr 2023;79:103359.
  • Deserno MK, Bathelt J, Groenman AP, Geurts HM. Probing the overarching continuum theory: data-driven phenotypic clustering of children with ASD or ADHD. Eur Child Adolesc Psychiatry 2023;32:1909–23.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: APA 2013.
  • Sprenger L, Bühler E, Poustka L, Bach C, Heinzel-Gutenbrunner M, Kamp-Becker I, et al. Impact of ADHD symptoms on autism spectrum disorder symptom severity. Res Dev Disabil 2013;34:3545–52.
  • Cooper M, Martin J, Langley K, Hamshere M, Thapar A. Autistic traits in children with ADHD index clinical and cognitive problems. Eur Child Adolesc Psychiatry 2014;23:23–34.
  • Antshel KM, Russo N. Autism Spectrum Disorders and ADHD: Overlapping Phenomenology, Diagnostic Issues, and Treatment Considerations. Curr Psychiatry Rep 2019;21:1–11.
  • Mayes SD, Calhoun SL, Mayes RD, Molitoris S. Autism and ADHD: Overlapping and discriminating symptoms. Res Autism Spectr Disord 2012;6:277–85.
  • Mulligan A, Anney RJL, O’Regan M, Chen W, Butler L, Fitzgerald M, et al. Autism symptoms in Attention-Deficit/Hyperactivity Disorder: a familial trait which correlates with conduct, oppositional defiant, language and motor disorders. J Autism Dev Disord 2009;39:197–209.
  • Happé F, Booth R, Charlton R, Hughes C. Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: examining profiles across domains and ages. Brain Cogn 2006;61:25–39.
  • Eliez S, Reiss AL. Annotation: MRI Neuroimaging of Childhood Psychiatric Disorders: A Selective Review. J Child Psychol Psychiatry 2000;41:679–94.
  • Geurts HM, Verté S, Oosterlaan J, Roeyers H, Sergeant JA. How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? J Child Psychol Psychiatry 2004;45:836–54.
  • Rao PA, Landa RJ. Association between severity of behavioral phenotype and comorbid attention deficit hyperactivity disorder symptoms in children with autism spectrum disorders. Autism 2014;18:272–80.
  • Greene RW, Biederman J, Faraone SV, Ouellette , Penn C and Griffin SM. Toward a new psychometric definition of social disaility in children with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1996;35:571–8.
  • Wyman PA, Sandler I, Wolchik S, Nelson, K. Resilience as cumulative competence promotion and stress protection: Theory and intervention. In Cicchetti D, Rappaport J, Sandler I, Weissberg RP (Eds.), The promotion of wellness in children and adolescents In 2000:133-84.
  • Barkley RA. Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. 3rd Edition, Guilford Press, New York USA 2006.
  • Terry R, Coie JD. A Comparison of Methods for Defining Sociometric Status Among Children. Dev Psychol 1991;27:867–80.
  • Carpenter Rich E, Loo SK, Yang M, Dang J, Smalley SL. Social functioning difficulties in ADHD: Association with PDD risk. Clin Child Psychol Psychiatry 2009;14:329.
  • Pliszka SR. Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: An overview. J Clin Psychiatry 1998;59:50–8.
  • Biederman J, Petty CR, Dolan C, Hughes S, Mick E, Monuteaux MC, et al. The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: findings from a controlled 10-year prospective longitudinal follow-up study. Psychol Med 2008;38:1027–36.
  • Gnanavel S, Sharma P, Kaushal P, Hussain S. Attention deficit hyperactivity disorder and comorbidity: A review of literature. World J Clin Cases 2019;7:2420.
  • Kim H, Jung E, Lee T, Kim S, Kim HW. Impact of Comorbid Oppositional Defiant Disorder on the Clinical and Neuropsychological Characteristics of Korean Children With Attention-Deficit/Hyperactivity Disorder. Psychiatry Investig 2023;20:962.
  • Gökler B, Ünal F, Pehlivantürk B, Kültür EC, Akdemir D, Taner Y. Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-turkish version (k-sads-pl-t). Turk J Child Adolesc Ment Health 2004;11:109-16.
  • Ercan ES, Amado S, Somer O and Çıkoğlu S. Development of A Test Battery for the Assessment of Attention Deficit Hyperactivity Disorder. Turk J Child Adolesc Ment Health 2001; 8:132-44.
  • Güvenir T, Özbek A, Baykara B, Arkar H, Şentürk B, İncekaş S. Psychometric properties of the Turkish version of the Strengths and Difficulties Questionnaire (SDQ). Turk J Child Adolesc Ment Health 2008;15: 65-74.
  • Ünal S, Güler AS, Dedeoğlu C, Taşkın B and Yazgan Y. Dikkat Eksikliği Hiperaktivite Bozukluğu tanısı olan klinik örneklemde sosyal karşılıklılık: Okul örnekleminden elde edilen kontrol grubu ile karşılaştırma. Poster bildirisi. 19. Ulusal Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Kongresi. Hatay 2009.
  • Spencer TJ. ADHD and Comorbidity in Childhood. J Clin Psychiatry 2006;67:27-31.
  • Johnston C. Parent characteristics and parent-child interactions in families of nonproblem children and ADHD children with higher and lower levels of oppositional-defiant behavior. J Abnorm Child Psychol 1996;24:85–104.
  • Pardini DA, Fite PJ. Symptoms of Conduct Disorder, Oppositional Defiant Disorder, Attention-Deficit/Hyperactivity Disorder, and Callous-Unemotional Traits as Unique Predictors of Psychosocial Maladjustment in Boys: Advancing an Evidence Base for DSM-V. J Am Acad Child Adolesc Psychiatry 2010;49:1134-44.
  • Noordermeer SDS, Luman M, Weeda WD, et al. Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2017;26:1155-64.
  • İmren SG, Rodopman Arman A, Gümüştaş F, Yulaf Y, Çakıcı Ö. Family Functioning in Attention Deficit Hyperactivity Disorder with or without Oppositional Defiant Disorder/Conduct Disorder Comorbidity. Cukurova Med J 2013;38:22–30.
  • Reiersen AM, Constantino JN, Todd RD. Co-occurrence of motor problems and autistic symptoms in attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2008;47:662–72.
  • AB Ayaz, M Ayaz, Yazgan Y. Alterations in Social Reciprocity in Attention-Deficit Hyperactivity Disorder Türk Psikiyatri Dergisi 2013;24:101-10.
  • Pelham WE, Bender ME, Caddell J, Booth S, Moorer SH. Methylphenidate and children with attention deficit disorder. Dose effects on classroom academic and social behavior. Arch Gen 1985;42:948–52.
  • Guevremont DC, Dumas MC. Peer Relationship Problems and Disruptive Behavior Disorders 1994;2:164–72.
  • Stroes A, Alberts E, Van Der Meere JJ. Boys with ADHD in social interaction with a nonfamiliar adult: an observational study. J Am Acad Child Adolesc Psychiatry 2003;42:295–302.

Dikkat Eksikliği Hiperaktivite Bozukluğunda Güçler ve Zorluklar: Sosyal Cevaplılık ve Bozukluk Şiddeti ile İlişkisi

Year 2024, Articles Online First, 1 - 7
https://doi.org/10.12956/tchd.1464417

Abstract

Amaç: Nörogelişimsel bozukluğu olan çocuklar sıklıkla sosyal zorluk yaşarlar. Dikkat eksikliği hiperaktivite bozukluğu (DEHB) olan çocukların akran reddi ve bilişsel, akademik, ailevi ve mesleki zorluklar yaşama olasılığı daha yüksektir. Bu araştırma, DEHB’li çocuk ve ergenlerin günlük yaşamlarında karşılaştığı zorlukların belirleyicilerini tespit etmeyi amaçlamıştır.

Gereç ve Yöntemler: DEHB tanıları DSM-5 kriterlerine göre belirlenmiştir. Ayrıca, her katılımcı bir çocuk veya ergen psikiyatristi tarafından Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi- Şimdi ve Yaşam Boyu Şekli- (ÇDŞG-ŞY-T) kullanılarak tanısal bir değerlendirmeye tabi tutulmuş ve ayrıntılı bir sosyodemografik form belgelenmiştir. Ebeveynler çocukları için Turgay DSM IV Tabanlı Çocuk ve Ergen Davranış Bozuklukları Tarama ve Derecelendirme Ölçeğini (T-DSM-IV-S), Güçler ve Güçlükler Anketini (SDQ) ve Sosyal Duyarlılık Ölçeğini (SRS) doldurmuştur.

Bulgular: Bu çalışmaya 99 çocuk dahil edilmiştir. DEHB grubunda 59 ve kontrol grubunda 40 çocuk. Gruplar arasında cinsiyet ve yaş açısından anlamlı bir fark yoktu. T-DSM-IV-S (AD, H/I, ODD, CD), SDQ ve SRS ortalama puanları DEHB grubunda kontrol grubuna göre anlamlı derecede yüksektir. DEHB grubunda oluşturulan regresyon modelindeki bağımsız değişkenler arasından SRS toplam skoru toplam SDQ (β = 0.238, p = 0.033) ve SDQ-duygu alt ölçeği (β =0.439, p = 0.001) skorlarını anlamlı şekilde yordamıştır.

Sonuç: DEHB tanısı alan çocuklar, karşılıklı etkileşimlerde akranlarına göre daha fazla alıcı eksikliğe sahip olabilir ve bu da sosyal davranışlarını büyük ölçüde etkiler Sosyal işlevsellik bozuklukları için erken sosyal beceri eğitimi, durumun etkisini azaltabilir.

References

  • Leitner Y. The co-occurrence of autism and attention deficit hyperactivity disorder in children - what do we know? Front Hum Neurosci 2014;8:268.
  • Polanczyk G, Jensen P. Epidemiologic Considerations in Attention Deficit Hyperactivity Disorder: A Review and Update. Child Adolesc Psychiatr Clin N Am 2008;17:245–60.
  • Kang L, Liu J, Liu Y, Liang W, Yang F and Liu M. Global, regional, and national disease burden of autism spectrum disorder among children under 5 years from 1990 to 2019: An analysis for the Global Burden of Disease 2019 Study. Asian J Psychiatr 2023;79:103359.
  • Deserno MK, Bathelt J, Groenman AP, Geurts HM. Probing the overarching continuum theory: data-driven phenotypic clustering of children with ASD or ADHD. Eur Child Adolesc Psychiatry 2023;32:1909–23.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: APA 2013.
  • Sprenger L, Bühler E, Poustka L, Bach C, Heinzel-Gutenbrunner M, Kamp-Becker I, et al. Impact of ADHD symptoms on autism spectrum disorder symptom severity. Res Dev Disabil 2013;34:3545–52.
  • Cooper M, Martin J, Langley K, Hamshere M, Thapar A. Autistic traits in children with ADHD index clinical and cognitive problems. Eur Child Adolesc Psychiatry 2014;23:23–34.
  • Antshel KM, Russo N. Autism Spectrum Disorders and ADHD: Overlapping Phenomenology, Diagnostic Issues, and Treatment Considerations. Curr Psychiatry Rep 2019;21:1–11.
  • Mayes SD, Calhoun SL, Mayes RD, Molitoris S. Autism and ADHD: Overlapping and discriminating symptoms. Res Autism Spectr Disord 2012;6:277–85.
  • Mulligan A, Anney RJL, O’Regan M, Chen W, Butler L, Fitzgerald M, et al. Autism symptoms in Attention-Deficit/Hyperactivity Disorder: a familial trait which correlates with conduct, oppositional defiant, language and motor disorders. J Autism Dev Disord 2009;39:197–209.
  • Happé F, Booth R, Charlton R, Hughes C. Executive function deficits in autism spectrum disorders and attention-deficit/hyperactivity disorder: examining profiles across domains and ages. Brain Cogn 2006;61:25–39.
  • Eliez S, Reiss AL. Annotation: MRI Neuroimaging of Childhood Psychiatric Disorders: A Selective Review. J Child Psychol Psychiatry 2000;41:679–94.
  • Geurts HM, Verté S, Oosterlaan J, Roeyers H, Sergeant JA. How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism? J Child Psychol Psychiatry 2004;45:836–54.
  • Rao PA, Landa RJ. Association between severity of behavioral phenotype and comorbid attention deficit hyperactivity disorder symptoms in children with autism spectrum disorders. Autism 2014;18:272–80.
  • Greene RW, Biederman J, Faraone SV, Ouellette , Penn C and Griffin SM. Toward a new psychometric definition of social disaility in children with attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1996;35:571–8.
  • Wyman PA, Sandler I, Wolchik S, Nelson, K. Resilience as cumulative competence promotion and stress protection: Theory and intervention. In Cicchetti D, Rappaport J, Sandler I, Weissberg RP (Eds.), The promotion of wellness in children and adolescents In 2000:133-84.
  • Barkley RA. Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. 3rd Edition, Guilford Press, New York USA 2006.
  • Terry R, Coie JD. A Comparison of Methods for Defining Sociometric Status Among Children. Dev Psychol 1991;27:867–80.
  • Carpenter Rich E, Loo SK, Yang M, Dang J, Smalley SL. Social functioning difficulties in ADHD: Association with PDD risk. Clin Child Psychol Psychiatry 2009;14:329.
  • Pliszka SR. Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: An overview. J Clin Psychiatry 1998;59:50–8.
  • Biederman J, Petty CR, Dolan C, Hughes S, Mick E, Monuteaux MC, et al. The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: findings from a controlled 10-year prospective longitudinal follow-up study. Psychol Med 2008;38:1027–36.
  • Gnanavel S, Sharma P, Kaushal P, Hussain S. Attention deficit hyperactivity disorder and comorbidity: A review of literature. World J Clin Cases 2019;7:2420.
  • Kim H, Jung E, Lee T, Kim S, Kim HW. Impact of Comorbid Oppositional Defiant Disorder on the Clinical and Neuropsychological Characteristics of Korean Children With Attention-Deficit/Hyperactivity Disorder. Psychiatry Investig 2023;20:962.
  • Gökler B, Ünal F, Pehlivantürk B, Kültür EC, Akdemir D, Taner Y. Reliability and validity of schedule for affective disorders and schizophrenia for school age children-present and lifetime version-turkish version (k-sads-pl-t). Turk J Child Adolesc Ment Health 2004;11:109-16.
  • Ercan ES, Amado S, Somer O and Çıkoğlu S. Development of A Test Battery for the Assessment of Attention Deficit Hyperactivity Disorder. Turk J Child Adolesc Ment Health 2001; 8:132-44.
  • Güvenir T, Özbek A, Baykara B, Arkar H, Şentürk B, İncekaş S. Psychometric properties of the Turkish version of the Strengths and Difficulties Questionnaire (SDQ). Turk J Child Adolesc Ment Health 2008;15: 65-74.
  • Ünal S, Güler AS, Dedeoğlu C, Taşkın B and Yazgan Y. Dikkat Eksikliği Hiperaktivite Bozukluğu tanısı olan klinik örneklemde sosyal karşılıklılık: Okul örnekleminden elde edilen kontrol grubu ile karşılaştırma. Poster bildirisi. 19. Ulusal Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Kongresi. Hatay 2009.
  • Spencer TJ. ADHD and Comorbidity in Childhood. J Clin Psychiatry 2006;67:27-31.
  • Johnston C. Parent characteristics and parent-child interactions in families of nonproblem children and ADHD children with higher and lower levels of oppositional-defiant behavior. J Abnorm Child Psychol 1996;24:85–104.
  • Pardini DA, Fite PJ. Symptoms of Conduct Disorder, Oppositional Defiant Disorder, Attention-Deficit/Hyperactivity Disorder, and Callous-Unemotional Traits as Unique Predictors of Psychosocial Maladjustment in Boys: Advancing an Evidence Base for DSM-V. J Am Acad Child Adolesc Psychiatry 2010;49:1134-44.
  • Noordermeer SDS, Luman M, Weeda WD, et al. Risk factors for comorbid oppositional defiant disorder in attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2017;26:1155-64.
  • İmren SG, Rodopman Arman A, Gümüştaş F, Yulaf Y, Çakıcı Ö. Family Functioning in Attention Deficit Hyperactivity Disorder with or without Oppositional Defiant Disorder/Conduct Disorder Comorbidity. Cukurova Med J 2013;38:22–30.
  • Reiersen AM, Constantino JN, Todd RD. Co-occurrence of motor problems and autistic symptoms in attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2008;47:662–72.
  • AB Ayaz, M Ayaz, Yazgan Y. Alterations in Social Reciprocity in Attention-Deficit Hyperactivity Disorder Türk Psikiyatri Dergisi 2013;24:101-10.
  • Pelham WE, Bender ME, Caddell J, Booth S, Moorer SH. Methylphenidate and children with attention deficit disorder. Dose effects on classroom academic and social behavior. Arch Gen 1985;42:948–52.
  • Guevremont DC, Dumas MC. Peer Relationship Problems and Disruptive Behavior Disorders 1994;2:164–72.
  • Stroes A, Alberts E, Van Der Meere JJ. Boys with ADHD in social interaction with a nonfamiliar adult: an observational study. J Am Acad Child Adolesc Psychiatry 2003;42:295–302.
There are 37 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section ORIGINAL ARTICLES
Authors

Pınar Aydoğan Avşar 0000-0001-5938-3243

Tayfun Kara 0000-0002-2156-3457

Orhan Kocaman 0000-0002-7504-5604

Tacettin Kuru 0000-0002-0313-558X

Early Pub Date July 31, 2024
Publication Date
Submission Date April 4, 2024
Acceptance Date May 29, 2024
Published in Issue Year 2024 Articles Online First

Cite

Vancouver Aydoğan Avşar P, Kara T, Kocaman O, Kuru T. Strengths and Difficulties Regarding Attention Deficit Hyperactivity Disorder: Correlation with Social Responsiveness and Disorder Severity. Türkiye Çocuk Hast Derg. 2024:1-7.


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