Social functioning, social cognition, and executive functioning differences associated with Attention-Deficit/Hyperactivity Disorder subtypes

ADHD is a well researched disorder in children and is associated with impairments in social functioning (Barkley, 2006). However, little is known about the etiology of social difficulties. An emerging body of literature is beginning to address the possible role social cognition may share in the social functioning outcomes in children with ADHD (Buitelaar et al., 1999; Corbett & Glidden, 2000; DaFonseca et al., 2009; Rapport et al., 2002; Sibley et al., 2010; Yuill & Lyon, 2007). Yet, research focusing on social cognition deficits in ADHD that accounts for subtype differences is limited. Some studies evaluated social cognition in CT children only (Corbett & Glidden, 2000; DaFonseca et al., 2009; Rapport et al., 2002) while other research utilized behavior ratings or sociometric studies (Matthys et al., 1999; Zentall et al., 2001). Another body of literature has examined the impact executive functioning deficits may have on social functioning (Barkley, 1997; Charman et al., 2001; Chhabildas et al., 2001). The purpose of the current study was to identify factors that predict social functioning impairments in children with ADHD as well as differentiate between ADHD subtypes. Participants included 89 youth with ages ranging from 6 to 16 years (M = 10.19, SD = 2.76). Forty-nine children met the diagnostic criteria for ADHD, Predominantly Inattentive Subtype (PI) and 40 for ADHD, Combined Type (CT). Results indicated CT youth demonstrated more aggressive and rule-breaking behavior than PI youth. Measures of social cognition did not predict ADHD subtype, and when compared to a normative sample, participants performed in the average range on affect recognition and theory of mind tasks. Performance-based measures of executive functioning largely associated with inattention (i.e., vigilance, processing speed, and working memory) best predicted subtype differences with CT youth being more impaired. Executive functioning, not social cognition, was predictive of social maladjustment in CT and PI youth. For CT youth, deficits in emotion control, shift, and initiate were related to anxiety, aggressive behavior, and depressed mood. Similarly, emotion control and shift were predictors of aggressive behavior, anxiety, and depressed mood in PI youth with deficits in self-monitoring, initiate, and inhibit as secondary predictors.