Positive Illusory Bias Still Illusory? Investigating Discrepant Self-Perceptions in Girls with ADHD

Abstract

Objective To examine whether girls with attention deficit/hyperactivity disorder (ADHD) demonstrate positive illusory self-perceptions during adolescence and young adulthood. Methods We tested, across a 5-year longitudinal span, whether self-perceptions versus external-source ratings were more strongly predictive of young adulthood impairment and depressive symptoms. Participants included an ethnically diverse sample of 140 girls with ADHD and 88 comparison girls, aged 11–18 years (M = 14.2) at adolescent and 19–24 years (M = 19.6) at young adult assessment. Results Although girls with ADHD rated themselves more positively than indicated by external ratings, their self-reports still did not differ significantly from external ratings in both scholastic competence and social adjustment domains. Comparison girls, on the other hand, rated themselves significantly less positively than indicated by external ratings in social adjustment. Positive discrepancy scores in adolescence did not significantly predict depressive symptoms in young adulthood and vice versa. Crucially, measures of actual competence in adolescence were more strongly associated with young adulthood impairments than were inaccurate self-perceptions for girls with ADHD. Conclusions Our findings continue to challenge the existence of a positive illusory bias among girls with ADHD, including any association of such bias with key indicators of impairment.

Development and Content Validation of a Clinical Screening Scale to Identify Attention Deficit Hyperactivity Disorder Considering the Gender Perspective: An eDelphi Study

“…Numerous studies over recent decades support gender differences in ADHD [19][20][21]25,43,44,56,65,66]. However, there is ongoing controversy regarding how to detect gender differences and their clinical manifestation in boys and girls.…”

“…However, most instruments have focused on behavioral aspects reported by children or their informants rather than the children's internal symptoms. Currently, several studies support that children can be reliable informants of their difficulties, or no less valid than third parties [64][65][66][67]. Thus, due to the more internal basis of differential symptomatology between boys and girls [64][65][66][67][68], the decision was made to develop a self-report scale for boys and girls aged 6 to 12 years.…”

Revisiting ADHD age-of-onset in adults: to what extent should we rely on the recall of childhood symptoms?

“…However, this predominance of females occurs not only in the Pelotas Cohorts (Matte et al ., 2012; Vitola et al ., 2017) but also in the Netherlands population (Kooij et al ., 2005). One of the possible explanations for this phenomenon could be related to a tardive perception of ADHD in inattentive women, despite controversy (Tu et al ., 2019).…”

ADHD in Adolescents: Commentary on the Special Issue of Ripple Effects in Self-Perceptions and Social Relationships

“…Further, like Colomer and colleagues, studies have found depressive symptoms to be associated with a lower self-perception bias (Jiang & Johnston, 2014) and depressive symptoms rise markedly across adolescence (again, especially for females) (Avenevoli et al, 2015). Perhaps because of the attenuating effect of cooccurring depressive symptoms, recent studies have questioned whether self-perception biases are as common among adolescents with ADHD (Bourchtein et al, 2017;Tu et al, 2019) or linked to later impairments (Swanson et al, 2012;Tu et al, 2019) as previously believed. In line with these studies, longitudinal analyses in the Multimodal Treatment of ADHD (MTA) Study found that biases in social competence peaked around age 11.5 years among youth with ADHD before decreasing across adolescence, whereas biases in behavioral competence were greatest at the initial assessment point (age 8 years) and then declined across childhood and adolescence (Hoza et al, 2010).…”