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Journal of Child and Family Studies

, Volume 27, Issue 7, pp 2328–2342 | Cite as

Mother’s Observations of Biased Self-Perceptions in Children with ADHD

  • Sarah A. Fefer
  • Julia D. McQuade
  • Caitlin Virga
  • Autumn Johnson
  • Kayla Gordon
  • Maria Santiago-Rosario
  • Erik Reinbergs
  • Jessica Porter
Original Paper
  • 137 Downloads

Abstract

A large body of research suggests that children with ADHD tend to overestimate their functioning across multiple domains. This overestimation, termed a positive illusory bias (PIB), is most often examined in controlled research settings in which child ratings are compared to ratings from an adult. We sought to advance our understanding of how a PIB presents in daily life for children with ADHD by using mixed methodology to assess mothers’ (N = 12) perceptions of their child’s self-awareness. Information was gathered from mothers of children with ADHD using surveys and an interview protocol. A grounded theory approach was used to identify themes that emerged through interview data and discrepancy methodology to confirm the presence of the PIB. Qualitative and quantitative data suggested that children with ADHD displayed limited self-awareness, with mothers reporting overestimation of competence across domains. However, some children were reported to be aware of their areas of difficulty, with variability in self-awareness based on domain, feedback, and setting. Mothers reported that children responded to evidence of their impairment both with apathy and frustration. Results help to clarify past evidence of heterogeneity in PIB levels and provide examples of how limited self-awareness and denial of difficulties are manifested in the family context for children with ADHD, according to mother’s observations. These results demonstrate the value of using mixed methodology to better understand the self-perceptions of children with ADHD in their daily lives.

Keywords

Positive illusory bias ADHD Parent perceptions Mixed methods Self-awareness 

Notes

Author Contributions

S.F.: designed and carried out the study, trained team members in data collection and analysis procedures, led qualitative data analysis, and collaboratively wrote the paper. J.M.: collaborated with all aspects of carrying out and writing the study, collected quantitative data. C.V.: collaborated on the design and writing of the study, organized qualitative analysis. A.J.: collaborated on data collection, analysis, and writing of method/results. K.G.: collaborated on data collection, analysis, and writing of methods/results. M.S.R.: collaborated on data analysis and writing of results. E.R.: collaborated on data analysis and writing of results. J.P.: collaborated on data collection and analysis.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Institutional Review Board (IRB) approval was obtained from Amherst College.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families.Google Scholar
  2. Barber, S., Grubbs, L., & Cottrell, B. (2005). Self-perception in children with attention deficit/hyperactivity disorder. Journal of Pediatric Nursing, 20, 235–245.  https://doi.org/10.1016/j.pedn.2005.02.012.CrossRefPubMedGoogle Scholar
  3. Baumeister, R. F., Smart, L., & Boden, J. M. (1996). Relation of threatened egotism to violence and aggression: the dark side of high self-esteem. Psychological Review, 103, 5–33.  https://doi.org/10.1037/0033-295X.103.1.5.CrossRefPubMedGoogle Scholar
  4. Beatty, P. C., & Willis, G. B. (2007). The practice of cognitive interviewing. The Public Opinion Quarterly, 71, 287–311.  https://doi.org/10.1093/poq/nfm006.CrossRefGoogle Scholar
  5. Bjorklund, D. F. (1997). The role of immaturity in human development. Psychological Bulletin, 122, 153–169.  https://doi.org/10.1037/0033-2909.122.2.153.CrossRefPubMedGoogle Scholar
  6. Bourchtein, E., Langberg, J. M., Owens, J. S., Evans, S. W., & Perera, R. A. (2017). Is the positive illusory bias common in young adolescents with ADHD? A fresh look at the prevalence and stability using latent profile and transition analyses. Journal of Abnormal Child Psychology, 45, 1063–1075.CrossRefPubMedGoogle Scholar
  7. Carol Ho, S., Tong Chien, W., & Wang, L. (2011). Parents’ perceptions of care-giving to a child with attention deficit hyperactivity disorder: an exploratory study. Contemporary Nurse, 40, 41–56. doi: 10.5172-56/conu.2011.40.1.41.CrossRefGoogle Scholar
  8. Creswell, J. W., & Plano Clark, V. L. (2006). Designing and conducting mixed methods research.. Thousand Oaks, CA: SAGE Publishing.Google Scholar
  9. Davis, C. C., Claudius, M., Palinkas, L. A., Wong, J. B., & Leslie, L. K. (2012). Putting families in the center: family perspectives on decision making and ADHD and implications for ADHD care. Journal of Attention Disorders, 16, 675–684.  https://doi.org/10.1177/1087054711413077.CrossRefPubMedGoogle Scholar
  10. Diener, M. B., & Milich, R. (1997). Effects of positive feedback on the social interactions of boys with attention deficit hyperactivity disorder: a test of the self-protective hypothesis. Journal of Clinical Child Psychology, 26, 256–265.  https://doi.org/10.1207/s15374424jccp2603_4.CrossRefPubMedGoogle Scholar
  11. Edwards, J. R. (2001). Ten difference score myths. Organizational Research Methods, 4, 265–287.CrossRefGoogle Scholar
  12. Evangelista, N. M., Owens, J. S., Golden, C. M., & Pelham, W. E. (2008). The positive illusory bias: do inflated self-perceptions in children with ADHD generalize to perceptions of others? Journal of Abnormal Child Psychology, 36, 779–791.  https://doi.org/10.1007/s10802-007-9210-8.CrossRefPubMedGoogle Scholar
  13. Fefer, S. A., Ogg, J. A., & Dedrick, R. F. (2015). Use of polynomial regression to investigate biased self-perceptions and ADHD symptoms in young adolescents. Journal of Attention Disorders.  https://doi.org/10.1177/1087054715573993, accessed 11 Mar 2015.
  14. Firmin, M. W., & Phillips, A. (2009). A qualitative study of families and children possessing diagnoses of ADHD. Journal of Family Issues, 30, 1155–1174.  https://doi.org/10.1177/0192513X09333709.CrossRefGoogle Scholar
  15. Fusch, P. I., & Ness, L. R. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report, 20(9), 1408–1416. http://www.nova.edu/ssss/QR/QR20/9/fusch1.pdf.
  16. Gajria, K., Livote, E., Sikirica, V., Reilly, K., & Erder, M. H. (2014). Validation of the Weiss Functional Impairment Rating Scale—Parent Report Form in attention deficit/hyperactivity disorder. European Neuropsychopharmacology, 24, S711.CrossRefGoogle Scholar
  17. Goodwille, G. (2014). Protective vigilance: a parental strategy in caring for a child diagnosed with ADHD. Journal of Family Therapy, 36, 255–267.  https://doi.org/10.1111/1467-6427.12010.CrossRefGoogle Scholar
  18. Harter, S. (1985). Manual for the self-perception profile for children. University of Denver, Denver, CO.Google Scholar
  19. Hoza, B., Pelham, W. E., Dobbs, J., Owens, J. S., & Pillow, D. R. (2002). Do boys with attention deficit/hyperactivity disorder have positive illusory self-concepts? Journal of Abnormal Psychology, 111, 268–278.  https://doi.org/10.1037/0021-843X.111.2.268.CrossRefPubMedGoogle Scholar
  20. Hoza, B., Waschbusch, D. A., Owens, J. S., Pelham, W. E., & Kipp, H. (2001). Academic task persistence of normally achieving ADHD and control boys: Self evaluations, and attributions. Journal of Consulting and Clinical Psychology, 69, 271–283.  https://doi.org/10.1037/0022-006X.69.2.271.CrossRefPubMedGoogle Scholar
  21. Hoza, B., Gerdes, A. C., Hinshaw, S. P., Arnold, L. E., Pelham, W. E., & Molina, B. S. G., et al. (2004). Self-perceptions of competence in children with ADHD and comparison children. Journal of Consulting and Clinical Psychology, 72, 382–391.  https://doi.org/10.1037/0022-006X.72.3.382.CrossRefPubMedGoogle Scholar
  22. Hoza, B., Waschbusch, D. A., Pelham, W. E., Molina, B. S. G., & Milich, R. (2000). Attention-deficit/hyperactivity disordered and control boys’ responses to social success and failure. Child Development, 71, 432–446.  https://doi.org/10.1111/1467-8624.00155.CrossRefPubMedGoogle Scholar
  23. Hoza, B., Vaughn, A., Waschbusch, D. A., Murray-Close, D., & McCabe, G. (2012). Can children with ADHD be motivated to reduce bias in self-reports of competence? Journal of Counseling and Clinical Psychology, 80, 245–254.  https://doi.org/10.1037/a0027299.CrossRefGoogle Scholar
  24. Hoza, B., Murray-Close, D., Arnold, L. E., Hinshaw, S. P., & Hechtman, L., The MTA Cooperative Group. (2010). Time-dependent changes in positively biased self perceptions of children with attention-deficit/hyperactivity disorder: A developmental psychopathology perspective. Development and Psychopathology, 22, 375–390.  https://doi.org/10.1017/S095457941000012X.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Kaiser, N. M., Hoza, B., Pelham, W. E., Gnagy, E., & Greiner, A. R. (2008). ADHD status and degree of positive illusions—moderational and mediational relations with actual behavior. Journal of Attention Disorders, 12, 227–238.  https://doi.org/10.1177/1087054707311661.PubMedGoogle Scholar
  26. Kendall, J. (1997). The Use of qualitative methods in the study of wellness in children with attention deficit hyperactivity disorder. Journal of Child and Adolescent Psychiatric Nursing, 10, 27–38.  https://doi.org/10.1111/j.1744-6171.1997.tb00419.x.CrossRefPubMedGoogle Scholar
  27. Laird, R. D., & De Los Reyes, A. (2013). Testing informant discrepancies as predictors of early adolescent psychopathology: why difference scores cannot tell you what you want to know and how polynomial regression may. Journal of Abnormal Child Psychology, 41, 1–14.CrossRefPubMedGoogle Scholar
  28. Linnea, K., Hoza, B., Tomb, M., & Kaiser, N. (2012). Does a positive bias relate to social behavior in children with ADHD? Behavior Therapy, 43, 862–875.  https://doi.org/10.1016/j.beth.2012.05.004.CrossRefPubMedPubMedCentralGoogle Scholar
  29. McQuade, J. D., & Breaux, R. P. (2017). Are elevations in ADHD symptoms associated with physiological reactivity and emotion dysregulation in children? Journal of Abnormal Child Psychology, 45, 1091–1103.  https://doi.org/10.1007/s10802-016-0227-8.CrossRefPubMedGoogle Scholar
  30. McQuade, J. D., Hoza, B., Waschbusch, D. A., Murray-Close, D., & Owens, J. S. (2011). Changes in self-perceptions in children with ADHD: A longitudinal study of depressive symptoms and attributional style. Behavior Therapy, 42, 170–182.  https://doi.org/10.1016/j.beth.2010.05.003.CrossRefPubMedGoogle Scholar
  31. McQuade, J. D., Tomb, M., Hoza, B., Waschbusch, D. A., Hurt, E. A., & Vaughn, A. J. (2011). Cognitive deficits and positively biased self-perceptions in children with ADHD. Journal of Abnormal Child Psychology, 39, 307–319.  https://doi.org/10.1007/s10802-010-9453-7.CrossRefPubMedPubMedCentralGoogle Scholar
  32. McQuade, J. D., Mendoza, S. A., Larsen, K. L., & Breaux, R. P. (2017). The nature of social positive illusory bias: reflection of social impairment, self-protective motivation, or poor executive functioning? Journal of Abnormal Child Psychology, 45, 289–300.  https://doi.org/10.1007/s10802-016-0172-6.CrossRefPubMedGoogle Scholar
  33. Milich, R. (1994). The response of children with ADHD to failure: if at first you don’t succeed, do you try, try again? School Psychology Review, 23, 11–28.Google Scholar
  34. Ohan, J. L., & Johnston, C. (2002). Are the performance overestimates given by boys with ADHD self-protective? Journal of Clinical Child and Adolescent Psychology, 31, 230–241.  https://doi.org/10.1207/S15374424JCCP3102_08.CrossRefPubMedGoogle Scholar
  35. Owens, J. S., Goldfine, M. E., Evangelista, N. M., Hoza, B., & Kaiser, N. M. (2007). A critical review of self-perceptions and bias in children with ADHD. Clinical Child Family Psychology Review, 10, 335–351.  https://doi.org/10.1007/s10567-007-0027-3.CrossRefPubMedGoogle Scholar
  36. Owens, J. S., & Hoza, B. (2003). The role of inattention and hyperactivity/impulsivity in the positive illusory bias. Journal of Consulting and Clinical Psychology, 71, 680–691.  https://doi.org/10.1037/0022-006X.71.4.680.CrossRefPubMedGoogle Scholar
  37. Pelham, W. E., Gnagy, E. M., Greenslade, K. E., & Milich, R. (1992). Teacher ratings of DSM-III—R symptoms for the disruptive behavior disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 210–218.  https://doi.org/10.1097/00004583-199203000-00006.CrossRefGoogle Scholar
  38. Pelham, W. E., Fabiano, G. A., & Massetti, G. M. (2005). Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 449–476.  https://doi.org/10.1207/s15374424jccp3403_5.CrossRefPubMedGoogle Scholar
  39. Prigatano, G. P., & Kloff, P. S. (1998). A clinician’s rating scale for evaluating impaired self-awareness and denial of disability after brain injury. The Clinical Neuropsychologist, 12, 56–67. doi:.CrossRefGoogle Scholar
  40. Sandelowski, M. (1995). Sample size in qualitative research. Research in Nursing & Health, 18, 179–183. doi: 10.1076-83/clin.12.1.56.1721.CrossRefGoogle Scholar
  41. Sells, S. P., Smith, T. E., & Sprenkle, D. H. (1995). Integrating qualitative and quantitative research methods: A research model. Family Process, 34, 199–218.  https://doi.org/10.1111/j.1545-5300.1995.00199.x.CrossRefPubMedGoogle Scholar
  42. Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 28–38.  https://doi.org/10.1097/00004583-200001000-00014.CrossRefGoogle Scholar
  43. Strauss, A., & Corbin, J. (1998). Basics of qualitative research. 2nd ed Thousand Oaks, CA: SAGE Publishing.Google Scholar
  44. Swanson, E.N., Owens, E.B., & Hinshaw, S.P. (2012). Is the positive illusory bias illusory? Examining discrepant self-perceptions of competence in girls with ADHD. Journal of Abnormal Child Psychology, 40, 487–998.  https://doi.org/10.1007/s10802-012-9615-x, accessed 29 Oct 2015.
  45. Taylor, S. E., & Brown, J. D. (1988). Illusion and well-being: a social psychological perspective on mental health. Psychological Bulletin, 103, 193–210.  https://doi.org/10.1037/0033-2909.103.2.193.CrossRefPubMedGoogle Scholar
  46. Volz-Sidiropoulou, E., Boecker, M., & Gauggel, S. (2016). The positive illusory bias in children and adolescents with ADHD: further evidence. Journal of Attention Disorders, 20, 178–186.  https://doi.org/10.1177/1087054713489849
  47. Weiner, J., Malone, M., Varma, A., Markel, C., Biondic, D., Tannock, R., & Humphries, T. (2012). Children’s perceptions of their ADHD symptoms: positive illusions, attributions, and stigma. Canadian Journal of School Psychology, 27, 217–242.  https://doi.org/10.1177/0829573512451972.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sarah A. Fefer
    • 1
  • Julia D. McQuade
    • 2
  • Caitlin Virga
    • 1
  • Autumn Johnson
    • 1
  • Kayla Gordon
    • 1
  • Maria Santiago-Rosario
    • 1
  • Erik Reinbergs
    • 1
  • Jessica Porter
    • 1
  1. 1.Department of Student DevelopmentUniversity Massachusetts AmherstAmherstUSA
  2. 2.Amherst CollegeAmherstUSA

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