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ADHD

Why do inattentive children have more trouble with peers later?

Thorsen AL, Meza J, Hinshaw S, et al. · Frontiers in psychology · 2017

Open access · cc by · source: Europe PMC

Children with more inattention symptoms had more peer problems three to four years later, partly because they tended to have slower processing speed.

Study at a glance

Design
Cohort — Three-wave longitudinal analysis from the Bergen Child Study: parent/teacher-rated inattention and hyperactivity-impulsivity at ages 7-9, WISC-III intellectual indices about a year later, and parent-rated peer problems at ages 11-13; hierarchical regression, variable selection (LARS) and bootstrapped parallel mediation, controlling for baseline peer problems
N
N=127 · 127 children with complete data at all three time points (32 met criteria for ADHD), drawn from 329 children who took part in the clinical assessment phase
Population
Norwegian schoolchildren from a population-based study, oversampled for mental-health difficulties, followed from about age 7-9 to 11-13
Outcome
Parent-reported peer problems (SDQ peer problems subscale) at ages 11-13

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Key findings

After accounting for demographics, diagnosis and earlier peer problems, ADHD symptoms added about 4.5% of explained variance in later peer problems, and this was driven by inattention, not hyperactivity-impulsivity. Of the four intelligence indices, only processing speed significantly mediated the link: more inattentive children tended to have slower processing speed, which in turn predicted more peer problems. Inattention still had a direct effect, so processing speed explained only part of the association, and the results held when ADHD diagnosis was controlled.

Methodology

The researchers followed children from a large Norwegian population study across three time points. Parents and teachers rated inattention and hyperactivity-impulsivity when the children were 7-9, the children took the WISC-III intelligence test about a year later, and parents rated peer problems (bullying, friendships, being liked) again at 11-13. The analyses controlled for age, sex, ADHD diagnosis and peer problems at the first time point, then tested which intelligence indices carried the link from symptoms to later peer problems.

Limitations

Peer problems were measured only by a short parent questionnaire; there were no peer nominations or observations, and teacher reports were too incomplete to use. Intelligence was measured once, so the mediation model cannot establish that inattention caused slower processing speed, which then caused peer problems. The analysed sample of 127 children with complete data was enriched for mental-health difficulties and drawn from a fairly homogeneous Norwegian population, which limits generalisation, and the mediated effect was modest.

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