Social perception in children with Attention Deficit / Hyperactivity Disorder: a Rorschach study

Abstract

Attention-Deficit / Hyperactivity Disorder (ADHD) has been long associated with ineffective or inappropriate social interactions and the debate regarding the role of perception in successfully navigating interpersonal interactions is growing. Despite the growing literature in the field of social competence in children with ADHD, few studies have directly examined the role of perception in social interactions regarding children with ADHD. Preliminary evidence suggests that perceptual deficits contribute to the social dysfunction in ADHD/Primarily Inattentive Type (ADHD/PI) whereas production deficits contribute to social dysfunction in ADHD/Combined Type (ADHD/C) (Kaufman, Wilson, Lyle, Semrud-Clikeman, & Young, 2000; Whalen & Henker, 1985; Wheeler & Carlson, 1994). Therefore, the current study was designed to explore the nature of their visual perceptual processes using the Rorschach Inkblot Test to determine the quality of their misinterpretations. It was hypothesized that children with ADHD/PI would demonstrate a restricted stimulus field (Pure F%), visual distortion (X-%), and less interest in others (PureH) compared to ADHD/C and control children. It was also hypothesized that children with both ADHD/PI and ADHD/C would demonstrate more interpersonal difficulties (CDI) compared to control children. Fifty-three participants between 8 and 14 years were recruited from a larger study investigating social competence in children with ADHD. Statistical analyses did not reveal statistical significant differences between the groups. However, clinical analyses indicated that children with both subtypes of ADHD experience difficulties effectively navigating their social interactions (CDI) at a clinically meaningful level despite an appropriate interest in others and their social world (Pure H). Clinical findings suggested that, although the underlying mechanism may differ across the subtypes, stimulus field restriction (Pure F%) coupled with stimulus distortion (X-%) contribute to difficulties successfully navigating the complex social world for children with both subtypes of ADHD. Although the current data does not identify differences in visual perceptual processing in children with ADHD/PI and ADHD/C, it is hoped that the study results have provided useful information as to where to intervene in order to help children with both subtypes of ADHD develop more effective social processing skills.