(PS1-C62) Social Functioning in Children with ADHD: An Examination of Inhibition, Self-control, and Working Memory as Potential Mediators

Background: Children with ADHD experience myriad social problems related to their noncompliant, disruptive, and aggressive behaviors that often result in rejection by peers and ultimately fewer friendships (e.g., Erhardt & Hinshaw, 1994). Children with ADHD also exhibit significant impairments in a broad range of neurocognitive/executive functions (e.g., Rapport et al., 2008; Sonuga-Barke et al., 2010). Only a handful of studies have concurrently examined multiple executive functions to address construct overlap and parse the unique contributions of each toward social functioning in children and youth with ADHD (Kofler et al., 2018; Miller & Hinshaw, 2010; Rinsky & Hinshaw, 2011). Furthermore, self-control has not been examined as a potential mediator, even though self-control is deficient in children with ADHD (Patros et al., 2016) and significantly associated with interpersonal skills (Finkel & Campbell, 2001) and social acceptance among peers (Feldman et al., 1995).

Aims: To address the gaps in the literature, the primary aims of our study were to explore the relative contributions of self-control, behavioral inhibition, and working memory to ADHD-related social problems.

Method: One hundred and twenty-one children (ADHD n=58, Typically Developing n=63) aged 8-12 years completed a Go/No-Go (GNG) inhibition task, a phonological working memory task, and a self-control task as part of a larger battery. Children’s social functioning was assessed by the Social Problems narrow band scale on the Child Behavior Checklist and Teacher Report Form (Achenbach & Rescorla, 2001). A series of mediations were conducted with the grouping variable (ADHD vs. TD) predicting each neurocognitive function, which in turn predicted parent/teacher rated social functioning.

Results: Bias-corrected, bootstrapped modeling indicated that the relation between ADHD status and teacher ratings of child social functioning was significantly mediated by children’s phonological working memory abilities. No other assessed neurocognitive function predicted parent/teacher social functioning or mediated relations between ADHD status and parent/teacher ratings of social functioning.

Conclusion: Our findings are consistent with recent literature of working memory effects on teacher-rated social functioning (Kofler et al., 2011; Kofler et al., 2018). However, these studies also found support for working memory effects on parent-rated social functioning, which the current study did not. This may be due to working memory being a limited resource (Phillips et al., 2007) and parents not seeing the same social deficits as teachers. Furthermore, this study was consistent with prior evidence that behavioral inhibition may not play a role in ADHD symptoms or social functioning related deficits as previously expected (Alderson et al., 2012). The finding that self-control was unrelated to social functioning was unexpected, but may be explained by previous experimental evidence suggesting that self-control deficits in ADHD are downstream from working memory deficits (Patros et al., 2015).