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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-52775

Rizzo, P. Accuracy of self-perceptions in children and adults with ADHD. 2011, University of Zurich, Faculty of Arts.

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Abstract

ADHD is associated with a wide range of social, emotional and cognitive sequelae. This accumulation of negative experiences has an impact on various factors, such as the individual’s selfperceptions of competence and self-esteem, which in turn may advocate maladaptive coping strategies and interfere with treatment. Therefore, early assessment and intervention promoting accurate self-perception and meta-cognitive skills are crucial. Since ADHD is a disorder that persists in up to two thirds of the children into adulthood, it remains unclear whether eventual inaccurate self-perceptions are something that children with ADHD eventually outgrow, or whether they persist into adolescence and adulthood. Existing studies of self-perceptions and self-concept in patients with ADHD have yielded mixed results. Thus, the goal of the present thesis was to investigate whether children and adults with ADHD are able to make accurate judgments of their self-regulatory skills. To that aim, we first developed and evaluated a new age-appropriate instrument of metacognitive knowledge of selfregulatory skills in young children – the SelfReg –, which demonstrated to be a valid and sensitive instrument. In a next step, the accuracy of self-perceptions of children with ADHD on this new ageappropriate instrument was analyzed. Accuracy of self-perceptions in adults with ADHD was examined by means of existing self-report inventories assessing cognitive and executive deficits in everyday situations, and compared them to those of adults without ADHD. Consistent with the hypothesis, results indicated that children and adults with ADHD are able to provide accurate self-perceptions when tested with an ecologically valid and appropriate instrument. In accordance with previous findings assessing the self-concept of patients with ADHD, adults with ADHD presented with significantly lower self-concepts compared to controls. Of note, findings persisted even when controlling for possible confounding depressive symptoms. However, effect sizes in study 2, investigating children with ADHD, indicated a tendency toward a positive bias after all, when children with ADHD were compared to controls. Therefore, an additional exploratory cluster analysis was performed. Results offered evidence for characteristic overestimation as well as for underestimation or accurate estimation of skills in different subgroups of children with ADHD. Children belonging to the “positive bias” group were slightly younger and tended to have lower IQ scores than other children with ADHD. This finding was in accordance with the “meta-cognitive deficit” explanation of inflated self-perceptions (e.g. Poissant, 2005), but in contrast to recent studies claiming that inflated self-perceptions persist in ADHD over the years (Hoza et al. 2010). Finally, the study provided further support for the findings of previous studies postulating greater predictive power of behavioural questionnaires over executive function test in the assessment of executive impairments in daily life of patients with ADHD. However, the results should also be considered in the context of some limitations. The findings suggest that over- and underestimation of self-regulatory skills is not universal to ADHD, but may be restricted to a distinct subgroup of ADHD patients whose special characteristics and developmental risks remain to be fully described. Therefore, further research with larger samples is warranted to determine whether this association exists in different populations with different levels of executive function and self-awareness. In the majority of cases, however, self-reports from patients with ADHD, assessed with ecologically valid and age-appropriate instruments such as the SelfReg, seem to constitute reliable and important source of information for clinical intervention.

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Additional indexing

Item Type:Dissertation
Referees:Steinhausen H C, Wilkening F
Communities & Collections:04 Faculty of Medicine > Center for Child and Adolescent Psychiatry
06 Faculty of Arts > Institute of Psychology
Dewey Decimal Classification:150 Psychology
610 Medicine & health
Language:English
Date:2011
Deposited On:08 Jan 2012 15:02
Last Modified:10 Mar 2013 00:45
Number of Pages:159

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