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注意缺陷多动障碍中的社会问题:是技能习得问题还是表现问题?

Social Problems in ADHD: Is it a Skills Acquisition or Performance Problem?

作者信息

Aduen Paula A, Day Taylor N, Kofler Michael J, Harmon Sherelle L, Wells Erica L, Sarver Dustin E

机构信息

University of Virginia, Curry School of Education.

Florida State University, Department of Psychology.

出版信息

J Psychopathol Behav Assess. 2018 Sep;40(3):440-451. doi: 10.1007/s10862-018-9649-7. Epub 2018 Mar 21.

Abstract

Recent models suggest that social skills training's inefficacy for children with ADHD may be due to target misspecification, such that their social problems reflect inconsistent performance rather than knowledge/skill gaps. No study to date, however, has disentangled social skills acquisition from performance deficits in children with ADHD. Children ages 8-12 with ADHD (=47) and without ADHD (=23) were assessed using the well-validated social behavioral analysis framework to quantify cross-informant social skills acquisition deficits, performance deficits, and strengths. Results provided support for the construct and predictive validities of this Social Skills Improvement System (SSIS) alternate scoring method, including expected magnitude and valence relations with BASC-2 social skills and ADHD symptoms based on both parent and teacher report. Acquisition deficits were relatively rare and idiosyncratic for both the ADHD and Non-ADHD groups, whereas children with ADHD demonstrated cross-informant social performance deficits (0.82-0.99) on several specific behaviors involving attention to peer directives, emotion regulation, and social reciprocity. Relative to themselves, children with ADHD were perceived by parents and teachers as exhibiting more social strengths than social acquisition deficits; however, they demonstrated significantly fewer social strengths than the Non-ADHD group ( = -0.71 to -0.89). These findings are consistent with recent conceptualizations suggesting that social problems in ADHD primarily reflect inconsistent performance rather than a lack of social knowledge/skills. Implications for refining social skills interventions for ADHD are discussed.

摘要

最近的模型表明,社交技能训练对多动症儿童无效可能是由于目标设定错误,即他们的社交问题反映的是表现不一致,而非知识/技能差距。然而,迄今为止,尚无研究能够区分多动症儿童社交技能的习得与表现缺陷。研究人员使用经过充分验证的社会行为分析框架,对47名患有多动症和23名未患多动症的8至12岁儿童进行了评估,以量化不同信息提供者报告的社交技能习得缺陷、表现缺陷和优势。研究结果为这种社交技能提升系统(SSIS)替代评分方法的结构效度和预测效度提供了支持,包括基于家长和教师报告所预期的与BASC-2社交技能及多动症症状的大小和效价关系。对于多动症组和非多动症组而言,习得缺陷相对较少且具有独特性,而患有多动症的儿童在涉及关注同伴指令、情绪调节和社交互惠等几种特定行为上表现出不同信息提供者报告的社交表现缺陷(0.82 - 0.99)。相对于自身而言,家长和教师认为患有多动症的儿童表现出的社交优势多于社交习得缺陷;然而,他们表现出的社交优势明显少于非多动症组(范围为 -0.71至 -0.89)。这些发现与最近的概念化观点一致,即多动症中的社交问题主要反映的是表现不一致,而非缺乏社交知识/技能。文中还讨论了对改进多动症社交技能干预措施的启示。

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