Steven Landau

The Relation Between Disinhibition and Emotion Regulation in Boys With Attention Deficit Hyperactivity Disorder

This study examined group differences of 49 boys ages 6 to 11 years with and without attention deficit hyperactivity disorder (ADHD) in emotion regulation during frustrating peer competition. Half of all boys in each group were explicitly instructed to hide their feelings if they became upset during the competition. Behavioral inhibition, both before and after the competitive task, was examined using the Stop Signal Task (SST), and emotion regulation was assessed via structured observation data. Effect sizes indicated that impulsive ADHD boys displayed greater disinhibition and were less effective at emotion regulation than comparison boys. In addition, boys with ADHD were unsuccessful in masking their emotions even when instructed to do so. In contrast, comparison boys were more successful at emotion regulation when given instruction to self-regulate, and these regulatory attempts predicted later inhibitory control. Findings are discussed in the context of current ADHD-related theories of inhibitory deficit, and suggestions for future research are provided.

Evaluating Attention Deficit Hyperactivity Disorder using multiple informants : The incremental utility of combining teacher with parent reports

In a sample of students referred to a school-based Pupil Assistance Committee, the Inattention and Hyperactivity-impulsivity factors of the Attention Deficit Hyperactivity Disorder (ADHD) Rating Scale-IV were used to predict diagnostic status, determined by a parent-reported diagnostic interview and teacher rating scale. Results of logistic regression and receiver operating curve analyses indicated that the Inattention and Hyperactivity-Impulsivity factors differentiated students with ADHD from controls and distinguished children with different ADHD subtypes. Symptom utility estimates demonstrated that a single informant approach was best suited for ruling out ADHD, whereas a combined informant method was optimal for positively diagnosing this disorder. Methods for determining the incremental utility of combining teacher with parent reports were demonstrated.

PEER RELATIONS OF CHILDREN WITH ATTENTION‐DEFICIT HYPERACTIVITY DISORDER

Children with attention‐deficit hyperactivity disorder (ADHD) present numerous problems associated with deficits in attentional and behavioral control. Unfortunately, many of these children also experience seriously disturbed peer relations. They have few, if any, friends, and are considered intrusive, boisterous, and annoying playmates. As a consequence, children with ADHD are at great risk for being rejected by their peers. Explanations for these interpersonal problems are explored, and potentially relevant social skills training programs are presented. Multimodal programs that rely on parent training, school‐based anger‐control, and peer coaching by popular classmates may hold promise for these unsettling difficulties.

A Social-Psychological Analysis of HIV-Related Stigma A Two-Factor Theory

Despite the best efforts of public health agencies, HIV/AIDS continues to carry a significant stigma in the general population. Research indicates that peoples negative reactions to persons with AIDS (PWAs) are due to their relatively automatic reactions to a disease that has become associated with death, promiscuity, drugs, and homosexuality. There is also evidence that more controlled or effortful information processing influences how people respond to PWAs. A model of HIV-related stigma is developed that assumes psychological reactions to stigmatized persons are governed by a primarily associative and a rule-based system, and that there is a temporal pattern such that initial reactions are governed by the associative system whereas subsequent reactions are governed by the rule-based system. Because associations to PWAs often are negative, relatively automatic reactions tend to be negative; however, if perceivers have enough time, motivation, and cognitive resources, they may adjust their initial reactions in a more positive direction. This theoretical model has general implications for understanding how any perceived stigma influences social cognition processes.

Preschool peer perceptions of the behavior of hyperactive and aggressive children

To assess if preschool children can successfully identify externalizing symptomatic behaviors in their male classmates, and if these perceptions are associated with peer-rated popularity and rejection, 154 preschool boys and girls were interviewed using a peer nomination procedure. Behavioral data on the same preschool boys (N=86) were also provided by their respective teachers. Preschool children were capable of providing stable nominations of popularity, rejection, and aggression, boys and girls significantly agreed in their nominations, and these nominations were not a function of the age of the rated child, although they differed somewhat as a function of the age of the rater. Teachers and peers reflected significant convergence in ratings of hyperactivity and aggression and teacher ratings of peer problems significantly agreed with actual peer nominations of popularity and rejection. Boys nominated as aggressive were more rejected by their classmates, whereas boys nominated as hyperactive were either more popular and /or more rejected. Limited evidence for differential patterns of relationships among hyperactivity, aggression, and peer status was obtained for both the peer and teacher data.

Assessing ADHD Across Settings: Contributions of Behavioral Assessment to Categorical Decision Making

Adapted methods of behavioral assessment to assess home and school functioning in a way that maps directly to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., [DSM-IV]; American Psychiatric Association, 1994). The study was conducted in a school-based sample with 5- to 12-year-old children referred to a school intervention team. A multigate set of procedures was used to assign children to one of 3 groups: attention deficit hyperactivity disorder (ADHD), inattentive group; ADHD, combined group; and a non-ADHD control group. The ADHD Rating Scale-IV was used to assess parent and teacher ratings of ADHD symptoms as delineated in DSM-IV. The findings suggest that the use of a fixed cutoff point (i.e., 6 or more symptoms), which is employed in the DSM-IV, is often not the best strategy for making diagnostic decisions. The optimal approach depends on whether diagnostic information is being provided by the parent or teacher and whether the purpose of assessment is to conduct a screening or a diagnostic evaluation. Also, the results indicate that a strategy that aggregates symptoms in the order in which they are accurate in predicting a diagnosis of ADHD is a more effective strategy than the approach used in DSM-IV, which aggregates any combination of a specific number of items. Implications for using methods of behavioral assessment to make diagnostic decisions using DSM-IV criteria are discussed.

Differential diagnosis of attention deficit and conduct disorders using conditional probabilities.

Attention deficit and conduct disorders require an important yet often difficult differential diagnosis. Prior efforts to determine which symptoms are optimal for making this differential diagnosis have been limited by a reliance on statistics that do not supply the probability of the disorders given a symptoms presence (positive predictive power) or the probability that the disorder is not present given the absence of the symptom (negative predictive power). This investigation examined the utility of these latter statistics in the differential diagnosis of childhood attention deficit and conduct disorders. The data consisted of symptoms from a standardized maternal psychiatric interview collected for a sample of 76 clinic-referred boys. Results indicated that some symptoms are optimal as inclusion criteria, some as exclusion criteria, some as neither, and some as both. Furthermore, some symptoms that have been traditionally associated with the diagnosis of one disorder were actually found to be more useful in the diagnosis of the other disorder.

A Comparison of Teacher and Peer Assessment of Social Status

Previous research has suggested that a simple teacher ranking of popularity can better predict observed social competence than a peer sociometric nomination procedure. This is an important finding as peer‐generated sociometric data are difficult and time consuming to collect. In order to further asssess this issue, teacher popularity rankings and peer popularity and rejection nominations were collected on 49 kindergarten boys. Additionally, the social interaction behavior of these boys was observed during free play activities. When examining popularity, results were consistent in demonstrating that teachers and peers provide essentially redundant information. However, when peer nominations of rejection were considered, peers did significantly better than teachers in the prediction of observed social behaviors. These findings are discussed in terms of their implications for an enhanced understanding of social status constructs.

Assessment of social competence of boys with attention-deficit/hyperactivity disorder: problematic peer entry, host responses, and evaluations.

Anecdotally and empirically, there is clear evidence that children with the Combined subtype of Attention-deficit/Hyperactivity Disorder (ADHD) experience disturbed peer relations, yet the field has not clearly established the origin of these difficulties. This is the first known investigation to examine the role of peer entry as a means to determine the social competence of boys with ADHD as they joined lab-based games played by age-mates who were good friends but unfamiliar with entry boys. Observational data of entry boys and their hosts, plus coders’ ratings, indicate that 7- to 12-year-old boys with and without ADHD did not differ in the use of competent entry strategies known to lead to acceptance from peers. However, boys with ADHD relied more heavily on incompetent entry strategies (e.g., disruptive attention-getting) known to exacerbate negative peer reputation. In addition, they failed to apply a frame-of-reference that was relevant to host boys’ ongoing activity. As such, host boys considered boys with ADHD less likeable as they spent more time with them. This pattern of findings has theoretical implications and informs the foci of social skills interventions for children with ADHD.

School Psychologists: Strategic Allies in the Contemporary Practice of Primary Care Pediatrics

Immense changes in the developmental/behavioral aspects of primary care pediatrics have resulted from revisions in special education laws, introduction of managed care, widened dissemination of information about disabilities to parents, and the changing character of American society. Challenges associated with contemporary pediatric practice can be diminished by routine collaboration with school psychologists. An alliance with school-based psychologists permits pediatricians access to children in their natural environments and potential collaboration for preventing illness and emotional/behavior problems. Further, school psychologists can provide a partner for assessing and treating both common and low-incident disorders without the constraints imposed by managed care.