Why Being a Friend is Difficult? Relations of Inhibition Control and Emotion Recognition to Peer Interaction in Children with ADHD

Children with ADHD have poor quality of friendships. They are found to have fewer friends and to be more socially rejected. Additionally, they exhibit difficulty inhibiting thoughts and responses, and poorer understanding of others. In order to understand the challenges facing children with ADHD in forming stable friendships, we explored how inhibition control and emotion recognition relate to peer interaction in children with ADHD compared to controls, during competitive play.

Using a cross-sectional design, 66 11-13-year-old participants (42 with ADHD and 24 controls) were evaluated on 3 computerized gaze tracking tasks measuring: emotional recognition (Golan, 2015), response inhibition (Logan, 1984), and interference control (Stroop, 1935); and a semi-structured competitve peer play (Normand, 2011). Results indicated that children with ADHD showed poorer response inhibition and interference control, and fixated their gaze less efficiently as compared to controls. Additionally, during peer interaction, children with ADHD showed less pro-social behavior, social eye contact, and affect gestures, but showed better compliance with rules. Among children with ADHD, but not controls, inhibitory control difficulties were associated with more negative social behavior during their peer interaction. Comparatively, in controls, but not in children with ADHD, difficulties in emotion recognition were associated with fewer pro-social behaviors towards a close friend.

Findings suggest that while children with ADHD strive to withhold an inappropriate response towards a close friend to maintain the friendship, they have difficulties in expressing prosocial gestures towards them. Furthermore difficulties in response inhibition and interference control affect the quality of friendship in childhood ADHD.