Deficient social problem-solving in boys with ODD/CD, with ADHD, and with both disorders

Objective: To study social problem-solving skills in psychiatrically defined aggressive boys, starting from Dodge's social information-processing model. Method: Videotaped stimuli of problematic social situations and questions were presented to elicit responses that indicate boys' social problem-solving skills (encoding and interpretation of social cues, generation of possible responses, evaluation of responses, self-efficacy evaluation, and response selection). Boys aged 7 to 12 years with oppositional defiant or conduct disorder (ODD/CD) (n = 48), attention-deficit hyperactivity disorder (ADHD) (n = 27), and both disorders (ODD/CD+ADHD) (n = 29) were involved as well as a normal control group (n = 37) and a psychiatric control group with internalizing disorders (n = 23). Results: When compared with normal controls, boys with ADHD, with ODD/CD, and with ODD/CD+ADHD encoded fewer social cues and generated fewer responses. Boys with ODD/CD and with ODD/CD+ADHD moreover were more confident in their ability to enact an aggressive response than normal controls. When ODD/CD boys and ODD/CD+ADHD boys were given the opportunity to select a response from various types of responses shown, they selected an aggressive response more often than normal controls. Thus, in ADHD boys social problem-solving was affected only in encoding and in the generation of responses, whereas in ODD/CD and ODD/CD+ADHD boys social problem-solving was affected throughout the process. Conclusion: For the further study of social problem-solving in aggressive children, it is essential to differentiate between children with ADHD and children with ODD/CD and ODD/CD+ADHD.