The social worlds of hyperactive (ADDH) children

doi:10.1016/0272-7358(85)90004-2

Clinical Psychology Review

Volume 5, Issue 5, 1985, Pages 447-478

https://doi.org/10.1016/0272-7358(85)90004-2 Get rights and content

Abstract

The social realm is particularly problematic for the majority of hyperactive (or attention deficit disordered) children. Typical patterns of social discordance are delineated, with the focus on interpersonal acts that are inept, irritating, immoderate, aggressive, or intense. Next, the status of these children in peer societies is described. Possible mediating mechanisms for dysfunctional social behaviors are also considered, including social cognition processes, interpersonal agendas, behavioral styles, vicarious learning, and reinforcement sensitivity. The unevenness of social skills and the domains in which hyperactive children show normal (and perhaps even superior) functioning are underscored. The final section highlights some clinical implications as well as some critical gaps in empirical knowledge about the interpersonal functioning of hyperactive children.

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En 2030, la dépression occupera la première cause mondiale de morbidité selon l’Organisation mondiale de la santé. Le passage à l’acte suicidaire en est la complication la plus redoutée. Chez l’adolescent, une place croissante est accordée aux traitements non médicamenteux, et en particulier aux psychothérapies. Peu connue en France, malgré d’excellentes évaluations internationales, la thérapie interpersonnelle est une psychothérapie brève, structurée, en 12 à 16 séances à un rythme hebdomadaire, centrée sur un domaine interpersonnel problématique actuel. Quatre ont été montrés comme significativement corrélés à l’émergence de la dépression : le deuil, la transition de rôle, les conflits et le déficit interpersonnel. Elle a fait les preuves de son efficacité dans le traitement aigu ambulatoire de la dépression de l’adulte et de l’adolescent, et plusieurs projets de recherche ont testé sa validité, avec plus ou moins de réussite, dans d’autres contextes, d’autres groupes de sujets, et dans d’autres pathologies psychiatriques. Chez l’adolescent, elle présente un intérêt indéniable, mais sa forme originale doit être adaptée aux particularités propres à cette population. Cet article expose des généralités sur la thérapie interpersonnelle, puis les éléments propres à sa réalisation avec des adolescents dépressifs.
Depression disorder may become the first cause of morbidity by 2030, according to the World Health Organization. It is actually one of the main causes of disease and handicap in children aged from 10 to 19. The major risk is suicide, whose prevalence is estimated, in France, around 6.7 for 100,000, which is probably underestimated. At present, the discussions about prescription of antidepressants in an adolescent's depression remain intense which is why psychotherapy becomes the first choice of treatment. We propose here to present one of them, Interpersonal PsychoTherapy (IPT), which remains largely unknown in France, and its adaptations in the adolescent population.
IPT is a brief psychotherapy, structured in twelve to sixteen sessions, which was created by Klerman and Weissman in the seventies inspired by the biopsychosocial model of Meyer, interpersonal theory of Sullivan, and attachment theory of Bowlby. It is divided into three parts: the initial phase, the intermediate phase, and the termination phase.
IPT was adapted for adolescents by Mufson in 1993, but a few modifications must be considered. Parental implication is the first. Indeed, parents, rather than the adolescent, often ask for the consultation; but it is the latter who benefits from the therapy. Parents may be met at some point in the therapy, for example between each phase and at the end. The initial phase is very close for the adolescent as for the adult; but the therapist must be careful about employing the “sick role” which can be used by the adolescent to avoid school, and as a consequence, to exacerbate the interpersonal deficit. The intermediate phase focuses on one of the four interpersonal issues: complicated bereavement, role transition, interpersonal role disputes, and interpersonal deficit. Complicated bereavement may become problematic when prolonged or when the adolescent had complicated relations with the deceased. The therapist essentially works on emotion verbalization. The role of transition is very common during adolescence: children become adults, they pass from high school to college, or their parents get divorced, etc. The patient and the therapist work on giving up the old role with its emotional expression (guilt, anger, and loss), and acquiring new skills, and identifying positive aspects of the new role. Interpersonal role disputes are common during adolescence, with parents or teachers for example. To determine a treatment plan, the therapist may first determine the stage of the role dispute, among impasse, renegotiation, or dissolution, and then work on the communication mode of the patient. At the least, the interpersonal deficit may be the most difficult area to work on because of the risk of psychiatric comorbidity. The therapist must be especially careful about anxious disorder which may complicate the psychotherapy and for which IPT is not the best therapy. The termination phase focuses on the new skills and abilities and works on the future without therapy. IPT is one of the psychotherapies recommended in the treatment of depression disorder in the international recommendations. But in France, all psychotherapies are considered equally. This may be a consensual approach, but the authors wonder if it is the best, especially to motivate research in the psychotherapy field.
Finally, IPT has been developed in other indications in the past years, and many others are presently in research projects: depression during pregnancy, prevention of depression relapse, eating disorders, attention deficit and hyperactivity disorder, self-harm for example.
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Moreover, research cites impairments in emotion processing, ranging from the perception of emotional states in others to the experience and expression of emotion in oneself (Blaskey, Harris, & Nigg, 2007; Martel, 2009; Scime & Norvilitis, 2006; Sobanski et al., 2010). As one consequence of these deficits in affective appraisal and social processing, children and adolescents with ADHD display substantial difficulty interacting with peers and forming relationships (Whalen & Henker, 1985). These interpersonal problems are pervasive and remain fairly stable over time, with long-term implications for social adjustment in adulthood (Nixon, 2001; Whalen & Henker, 1985).
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The social worlds of hyperactive (ADDH) children

Abstract

Clinical Psychology Review

Journal of the American Academy of Child Psychiatry

Advances in Experimental Social Psychology

A classroom code for hyperactive children: A replication of validity

Journal of Consulting and Clinical Psychology

A psychosocial study of hyperactive and learning-disabled boys

Journal of Abnormal Child Psychology

Diagnostic and statistical manual of mental disorders

Children with peer adjustment problems: Sequential and nonsequential analyses of school behaviors

Journal of Consulting and Clinical Psychology

Children's social competence in peer relations: Sociometric and behavioral assessment

Hyperactive children. A handbook for diagnosis and treatment

Hyperactivity

The effects of methylphenidate on the mother-child interactions of hyperactive children

Archives of General Psychiatry

A multitrait-multimethod analysis of reflection-impulsivity

Child Development

An observational analysis of classroom behaviors of children with learning disabilities

Journal of Learning Disabilities

The stability and determinants of sociometric status and friendship choice: A longitudinal perspective

Developmental Psychology

Development of a more reliable version of the Matching Familiar Figures Test

Developmental Psychology

Sociometry, psychometry, and social structure: A commentary on six recent studies of popular, rejected, and neglected children

Merrill-Palmer Quarterly

Mother-child interaction: A comparison of hyperactive, learning disabled, and normal boys

American Journal of Orthopsychiatry

Peer relationships of young children with behavior problems

Three-year follow-up of hyperactive preschoolers into elementary school

Journal of Child Psychology and Psychiatry

Peer relations in hyperactive children

Journal of Child Psychology and Psychiatry

Continuities and changes in children's social status: A five-year longitudinal study

Merrill-Palmer Quarterly

Dimensions and types of social status: A cross-age perspective

Developmental Psychology

A behavioral analysis of emerging social status in boys' groups

Child Development

Rating scales for use in drug studies with children

Psychopharmacology Bulletin

Long-term follow-up of early detected vulnerable children

Journal of Consulting and Clinical Psychology

The interactions of normal and hyperactive children with their mothers in free play and structured tasks

Child Development

Social cognition and children's aggressive behavior

Child Development

Behavioral antecedents of peer social status

Child Development

Information processing mechanisms in aggressive children

Behavior patterns of socially rejected and neglected preadolescents: The roles of social approach and aggression

Journal of Abnormal Child Psychology

Social cognitive biases and deficits in aggressive boys

Child Development

The assessment of intention-cue detection skills in children: Implications for developmental psychopathology

Child Development

Biased decision-making processes in aggressive boys

Journal of Abnormal Psychology

The role of cue-utilization in attributional biases among aggressive children

Attentional and cognitive problems

Effects of reward on delayed reaction time task performance of hyperactive children

Journal of Abnormal Child Psychology

Toward a clearer definition of the attentional deficit of hyperactive children

The consistency of aggressive behavior across time and situations

The relation of prosocial behavior to the development of aggression and psychopathology

The effects of reward and punishment on reaction times and autonomic activity in hyperactive and normal children

Journal of Abnormal Child Psychology

Child competence and psychiatric risk. III. Comparisons based on diagnosis of hospitalized parent

The Journal of Nervous and Mental Disease

Concept learning in hyperactive and normal children

Journal of Abnormal Psychology

Follow-up study of hyperactive children: A preliminary report

Peer and self rating: Children's perception of behavior relevant to hyperkinetic impulse disorder

Journal of Abnormal Child Psychology

Normative data on revised Conners Parent and Teacher Rating Scales

Journal of Abnormal Child Psychology

Social interactions as predictors of children's likability and friendship patterns: A multiple regression analysis

Journal of Behavioral Assessment

Peer relations