Developmental processes in peer problems of children with attention-deficit/hyperactivity disorder in the multimodal treatment study of children with ADHD: Developmental cascades and vicious cycles

We examined the developmental processes involved in peer problems among children (M age = 10.41 years) previously diagnosed with attention-deficit/ hyperactivity disorder (ADHD) at study entry (N = 536) and a comparison group (N = 284). Participants were followed over a 6-year period ranging from middle childhood to adolescence. At four assessment periods, measures of aggression, social skills, positive illusory biases (in the social and behavioral domains), and peer rejection were assessed. Results indicated that children from the ADHD group exhibited difficulties in each of these areas at the first assessment. Moreover, there were vicious cycles among problems over time. For example, peer rejection was related to impaired social skills, which in turn predicted later peer rejection. Problems also tended to spill over into other areas, which in turn compromised functioning in additional areas across development, leading to cascading effects over time. The findings held even when controlling for age and were similar for males and females, the ADHD and comparison groups, and among ADHD treatment groups. The results suggest that the peer problems among children with and without ADHD may reflect similar processes; however, children with ADHD exhibit greater difficulties negotiating important developmental tasks. Implications for interventions are discussed.