Review article
Social and Emotional Impairment in Children and Adolescents with ADHD and the Impact on Quality of Life

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Abstract

This review provides an overview as to how the social and emotional impairments involved in Attention-Deficit/Hyperactivity Disorder affect the quality of life of patients and their families. A model of three categories into which the emotional difficulties fall, and how they impair quality of life, is also presented.

Section snippets

Social Impairment

The social impairments associated with ADHD have been investigated with various questionnaires, sociometric assessments, and videotaped interactions [19]. Children and adolescents with ADHD are known to have poorer social and communication skills than children and adolescents without ADHD [37]. The social difficulties tend to be even greater if comorbid disorders such as oppositional defiant disorder (ODD) or conduct disorder (CD) are present, which is the case in approximately 60% of these

Emotional Impairment

The emotional impairments of children and adolescents with ADHD may include poor self-regulation of emotion, greater excessive emotional expression, especially anger and aggression, greater problems coping with frustration, reduced empathy, and decreased arousal to stimulation [13]. In the United States, more than one-third of children with ADHD were reported to have high levels of emotional difficulties [30]. A study from Europe clearly showed that children and adolescents with ADHD have more

Transition to Adolescence and Adulthood

Transition to adolescence is associated with a number of issues that affect the adolescent's body, behavior, and social interactions [13]. This transition touches upon most areas of the adolescent's daily life and involves an increase in physical size and maturation (including neurological and sexual maturation), the desire to individuate from parents, with a resulting decrease in the influence of parents on the adolescent's behavior, an increase in the time spent away from home, an increase in

Impact on Quality of Life

The terms Quality of Life (QoL) and Health-Related Quality of Life are associated with considerable conceptual challenges [79]. The medical perspective on QoL has resulted in a broad range of definitions that reflect various aspects of physical and/or mental health. Following one of many possible definitions, QoL can be thought of as a multidimensional concept that reflects a number of subjective physical, social, and psychological aspects of health and is distinct from symptoms of the disorder

Clinical Implications and Conclusions

Both ADHD and related disruptive behavior disorders such as ODD and CD have been investigated from dimensional as well as categorical perspectives. Both types of externalizing behavior patterns may be related in fundamental ways to the problem of inhibitory control as well as to behavioral and emotional dysregulation [100]. The ability to control emotion seems to involve interactions between pre-frontal and cingulate regions of the cortex as well as subcortical regions of the brain [101], [102].

Acknowledgments/Disclosure

Peter M. Wehmeier and Alexander Schacht are employees of Eli Lilly and Company. Russell A. Barkley has worked as consultant and speaker for Eli Lilly and Company and Shire, and as a speaker for Medice, Janssen-Cilag, and Novartis, and has received honoraria from these companies.

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