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Background
·
Many individuals with ADHD display a positive illusory bias (viewing
themselves as more competent that they actually are) for their academic, behavioral, and social
competencies (see Hoza et al., 2012)
·
Evidence that children and adolescents with ADHD
display higher levels of positive illusory bias than children with moderate to
severe behavioral, emotional, and social disturbances but without ADHD (Whitley
et al., 2008)
·
Positive illusory bias varies across domains
(more likely to overestimate competence in areas with greatest deficits; Hoza
et a., 2004) – Possibility of domain-specific positive illusory bias in
individuals with ADHD has been proposed and is being investigated
·
Comorbid problems may moderate the presence of
positive illusory bias (e.g., Treuting & Hinshaw, 2001; Hoza et al., 2004)
– children with comorbid internalizing problems appear to more accurately rate
their abilities
Present Study
·
Goal of Present: compare parent reports to child reports of competence on different
activities of daily life in children and adolescents with and without ADHD
·
Participants: 183 children and adolescents (89
with ADHD, 94 control); predominantly male (88%); average age of 11.5 years
(ranges from 6 to 15; SD = 2.3)
·
Illusory Bias calculated by subtracting the
parent ratings from the child/adolescent ratings for each area of daily living
(measured using the Competence Scale for Children and Adolescents) à Positive value =
overestimation of ability (positive illusory bias); Negative value =
underestimation of ability (negative illusory bias)
·
Results:
o
Using the summary score (composite score of all
34 activities of daily life), children and adolescents with ADHD displayed a
positive illusory bias
o
Activities of daily life that best predicted
group membership were:
§
Dealing with difficult situations
§
Playing by the rules
§
Concentrating
§
Being able to wait
§
Asking for help
o
Children and adolescents with ADHD displayed
positive illusory bias on activities involving cognition (i.e. memorizing
school material); graphomotor skills (i.e. writing); executive tasks (i.e.
tidying up); and activities related to ADHD symptomatology (i.e. able to wait;
concentrating). They did not display such a bias in personal
care activities (i.e. washing hands, putting on pants)
o
Several predictors of positive illusory bias
were found:
§
Age – positive illusory bias tends to decrease
with age (this depending on group membership however) à age was significant for
control children but not for children with ADHD
§
High total CBCL and subscale scores on the CBCL
were positively related to illusory bias à
greater behavioral disturbances related to greater illusory bias
·
Externalizing symptoms in particular predicted
the degree of illusory bias
§
Length of treatment, intelligence, medication,
marital status and ADHD subtype were all not related to illusory bias
Discussion Questions
1. The
reason for this positive illusory bias is still unknown. I am curious what people’s thoughts are on
why it is present.
o
One proposed explanation is that children with
ADHD may have a “self-serving bias” in which they deny their deficits in order
to prevent distress and to protect their self- image. Do you agree with this?
o
There is some evidence that there may be positive illusory bias may serve as a protective
factor for depressive cognitions for children with ADHD (McQuade, Hoza,
Murray-Close, Waschbusch, & Owens, 2011)
2.
Given the suggested domain-specific positive
illusory bias, what domains would you think children and adolescents would
display such biases in?
3. This
study found no effect of ADHD subtype on positive illusory bias. However, other studies have found that
children with ADHD – Primarily Inattentive type do not seem to display the
positive illusory bias that children with ADHD – Primarily
Hyperactive/Impulsive type and Combined type display (e.g., Owens &
Hoza, 2003). Would you expect
there to be differences in positive illusory bias based on if children display
hyperactive/impulsive symptoms compared to inattention? Why might this be the case?
4. What
implications do you think having a positive illusory bias could have as these
children and adolescents with ADHD move to adulthood?
5.
What suggestions do you have for interventions
for children with ADHD who display a positive illusory bias?
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