Paper 1 provides a systematic review on the association between children over-rating their competence, termed Positive Illusory Bias (PIB), and Attention deficit hyperactivity disorder (ADHD). The evidence towards this construct was examined, in addition to its environmental specificity and modifiability. Findings confirmed an association between PIB and ADHD, with most studies evidencing higher discrepancies between self and adult ratings of competence in children with ADHD compared to controls. The nature and magnitude of this association was less clear however, with some of these studies showing absolute ratings of children to be similar to controls, and a PIB only evidenced when adults were used as objective evaluators, not actual performance. Thus the review was unable to discount the idea that the PIB may, in part, be a function of the system around children with ADHD under-estimating their abilities. Clinical implications are discussed. Paper 2 presents an investigation into the efficacy and feasibility of a metacognitive therapy technique, Attention Training (ATT) in children with ADHD. A novel intervention in this population, the study employed a single case series design, followed by an uncontrolled trial, both with a 6-week follow up. A total of 16 children aged 7-11 under the care of a children and adolescent mental health service received 5 sessions of the ATT. Findings revealed that children rated their attention as significantly improved, despite no statistical improvement found on parent ratings. Significant improvements were also shown in working memory and other aspects of executive functioning. Adherence to home practice of the ATT was generally poor, but session attendance was good and the treatment was well-liked by parents. Clinical implications and directions for future research are indicated. Paper 3 is a critical reflection of the research process. Reflections on paper 1 and 2 are given, including limitations and clinical implications. The impact of the research process on my personal development and learning is also discussed.

The overarching goal of this dissertation was to examine the self-perceptions of adolescents with ADHD with regard to their core ADHD symptoms and associated problem behaviors. Self-perceptions were examined in relation to awareness of problem behaviors (i.e., presence of a “positive illusory bias” or PIB), attributions, and stigma. Study 1 examined the PIB in relation to the ignorance of incompetence hypothesis in 74 13-to-18 year old adolescents [40 ADHD; 34 Typically-Developing Comparison (TD)]. Compared to TD adolescents, adolescents with ADHD underestimated their ADHD symptoms and associated oppositional, academic, and social problems relative to parent raters, indicating that they have a PIB. Nevertheless, they were cognizant of their patterns of academic achievement and social problems. The only area in which adolescents with ADHD demonstrated limited awareness of their difficulties was for oppositional behaviors. Within the ADHD sample, adolescents with external locus of causality attributions had a higher PIB for oppositional behaviors than adolescents with ADHD with internal locus of causality attributions. Using a cross-sectional design, Study 2 examined the PIB, attributions, and stigma perceptions in 66 14-to-18 year old adolescents (31 ADHD, 35 TD) and 107 9-to-12 year old children (65 ADHD, 42 TD); cognitive immaturity as a mechanism for the PIB and developmental differences in attribution patterns and stigmatization were the focus. Although both children and adolescents with ADHD demonstrated a PIB for their ADHD symptoms, the magnitude of the PIB was reduced in adolescence (particularly for hyperactivity-impulsivity). Both adolescents with and without ADHD showed a reduction in the PIB for inattentive symptoms relative to children. Participants with ADHD viewed their problem behaviors as more pervasive, uncontrollable, and stigmatizing than participants without ADHD, and adolescents viewed their behaviors as more pervasive, uncontrollable, and stigmatizing than children. The findings offered theoretical support to the cognitive immaturity mechanism for the PIB and to Harters(2012) model of normative development of self-representations. Associations were found between the PIB and attributions. Minimal support was obtained for the ignorance of incompetence hypothesis in most domains. Future research directions and clinical implications are discussed.

The overarching goal of this dissertation was to examine the self-perceptions of adolescents with ADHD with regard to their core ADHD symptoms and associated problem behaviors. Self-perceptions were examined in relation to awareness of problem behaviors (i.e., presence of a “positive illusory bias” or PIB), attributions, and stigma. Study 1 examined the PIB in relation to the ignorance of incompetence hypothesis in 74 13-to-18 year old adolescents [40 ADHD; 34 Typically-Developing Comparison (TD)]. Compared to TD adolescents, adolescents with ADHD underestimated their ADHD symptoms and associated oppositional, academic, and social problems relative to parent raters, indicating that they have a PIB. Nevertheless, they were cognizant of their patterns of academic achievement and social problems. The only area in which adolescents with ADHD demonstrated limited awareness of their difficulties was for oppositional behaviors. Within the ADHD sample, adolescents with external locus of causality attributions had a higher PIB for oppositional behaviors than adolescents with ADHD with internal locus of causality attributions. Using a cross-sectional design, Study 2 examined the PIB, attributions, and stigma perceptions in 66 14-to-18 year old adolescents (31 ADHD, 35 TD) and 107 9-to-12 year old children (65 ADHD, 42 TD); cognitive immaturity as a mechanism for the PIB and developmental differences in attribution patterns and stigmatization were the focus. Although both children and adolescents with ADHD demonstrated a PIB for their ADHD symptoms, the magnitude of the PIB was reduced in adolescence (particularly for hyperactivity-impulsivity). Both adolescents with and without ADHD showed a reduction in the PIB for inattentive symptoms relative to children. Participants with ADHD viewed their problem behaviors as more pervasive, uncontrollable, and stigmatizing than participants without ADHD, and adolescents viewed their behaviors as more pervasive, uncontrollable, and stigmatizing than children. The findings offered theoretical support to the cognitive immaturity mechanism for the PIB and to Harters(2012) model of normative development of self-representations. Associations were found between the PIB and attributions. Minimal support was obtained for the ignorance of incompetence hypothesis in most domains. Future research directions and clinical implications are discussed.

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The positive illusory bias (PIB) – over-reporting levels of self-competence compared to other raters – has been demonstrated in youth with attention-deficit/hyperactivity disorder (ADHD), despite increased impairment rates. However, due to inconsistent definitions of the PIB, conflicting findings have emerged regarding prevalence of the PIB in youth with ADHD and whether parent or child report is actually “biased” and driving the PIB. Additionally, stability of the PIB across time is unknown. The present study used person-centered methodology cross-sectionally and longitudinally to evaluate the prevalence of the PIB in adolescents with ADHD. Results revealed a cross-domain global PIB group at baseline (18.4% of sample) but only a small social PIB group was present and stable across time. Parents in the PIB group were better reporters of scholastic competence relative to an objective measure than were youth. These findings suggest that the PIB may be significantly less prevalent in this population than previously thought.

ADHD research has mainly focused on objective performance measures. Performance, however, is only one aspect of functioning. Other aspects of how individuals function are their personal experiences and their evaluations of those experiences. The aim of this thesis is to expand knowledge on the topic of ADHD by presenting studies that investigate objective performance and subject perspective, simultaneously. The empirical work presented here has a dimensional approach to ADHD, which is reflected in the use of samples selected to represent a wide variation in ADHD symptoms. Herein, both objective performance and subject perspective are conceptualized in various ways, to address unanswered questions and to question previous research. ADHD is related to underperformance within the academic realm and within the social realm. By introducing novel subject perspective measures, and including objective performance measures in new ways, a more nuanced understanding of these underperformance areas was gained. More specifically, we obtained an overview of the influence of ADHD symptoms in late childhood and adolescence in relation to academic performance by studying a longitudinal framework of concomitant factors. Furthermore, we disentangled the interplay of ADHD and ODD symptoms and cognitive performance in predicting social acceptance and the "positive illusory bias". Additionally, we questioned the link between disorganized attachment representations and ADHD symptoms by investigating the potential relationship between attachment representations and ADHD symptoms, whilst considering concurrent conduct problems, cognitive performance and narrative responses to non-attachment related story stems. Main results indicate that academic performance is influenced by ADHD symptoms and previous academic performance; adolescent self-perceptions of academic competence are negligible in this context. Moreover, ADHD symptoms in adolescence have a negative influence on views of the future, beyond academic performance and parental education. Further, results indicate that positive illusory bias relates more to ODD behaviors. Finally, results also indicate that children with high levels of ADHD symptoms could falsely appear to be disorganized due to a propensity to include negative content in narratives. In conclusion, when studied together, objective performance and subject perspective give new insight into ADHD. The findings presented motivate the simultaneous inclusion of different perspectives of functioning in ADHD research.

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No description available.

The purpose of this study was to investigate perceptions of academic and social competence among adolescents with a continuum of inattentive and hyperactive/impulsive symptoms. Past literature suggests that children with Attention-Deficit/Hyperactivity Disorder (ADHD) display self-perceptions that are overly positive compared to external indicators of competence, a phenomenon that is referred to as the positive illusory bias (PIB; Owens, Goldfine, Evangelista, Hoza, & Kaiser, 2007). The PIB is well supported among children with ADHD, and recent research suggests that the PIB persists into adolescence. To date, research on the PIB has relied on difference scores (i.e., an indicator of competence is subtracted from student self-ratings); however, difference scores suffer from numerous methodological limitations (Edwards, 2002). The current study investigated the relationship between self and teacher ratings of academic and social competence and inattentive, hyperactive/impulsive, and overall ADHD symptoms among a diverse sample of 395 students and their teachers. Polynomial regression and response surface methods were used to account for self and teacher ratings separately and decrease reliance on differences scores. These methods have been recommended to answer complex questions related to agreement and disagreement between ratings. The results of this study suggest that some adolescents with ADHD symptoms demonstrate the PIB, while others perceive their impairments and rate themselves as having low competence aligned with teacher ratings. Accurate ratings of low competence were more common within the academic domain than the social domain for students with overall ADHD symptoms as well as specific inattentive and hyperactive/impulsive symptoms. Results within the social domain indicate that all ADHD symptoms increased more sharply as the discrepancy between self and teacher ratings increased. Student overestimation of competence in both the academic and social domains was shown to be more predictive of high inattentive symptoms compared to hyperactive/impulsive symptoms. These findings suggest this new analysis approach allowed for a more nuanced understanding of the complex relationship between student and teacher competence ratings and ADHD symptoms. Gaining a better understanding of the PIB through this improved methodology has the potential to influence assessment and intervention practices among school psychologists, and to contribute to future research in this area. This study contributes to the literature by being the first to (1) examine the PIB in relation to a range of general and specific ADHD symptoms, (2) use polynomial regression/response surface methods to address limitations of difference scores, and (3) explore the PIB among a school-based sample of adolescents.

No description available.