Variation in latent social profiles of adolescent ADHD and related clinical features

Social impairment is a hallmark of Attention-deficit/hyperactivity disorder (ADHD), but the extent of variation in adolescent social strengths and weaknesses is unclear. We compared teacher-reported characteristics of social functioning in adolescents with a history of ADHD (N = 340), and without ADHD (N = 182) from the NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) at 72-month follow-up (13 - 15.9 years-old). Latent profile analysis of teacher-reported cooperation, assertion and self-control on the Social Skills Rating System (SSRS), was used to identify "social profiles". Their associations with clinical features were explored. Significant differences in social functioning were identified between adolescents with a history of ADHD, and without ADHD (ES = 0.54 - 0.77). Four distinct social profiles were identified in adolescents with a history of ADHD: unskilled (N = 24, 7%), low average (N = 144, 42%), average (N = 141, 41%), and skilled (N = 31, 9%). Profiles with worse social functioning (low average, unskilled) displayed more symptoms of inattention, hyperactivity/impulsivity, oppositionality, depression, global impairment, and were less liked, more rejected and ignored by peers than average and skilled. Social profile membership was not associated with sex, anxiety symptoms, or remittance / persistence of ADHD. Social functioning in adolescents with a history of ADHD is variable, and associated with worse symptomology, global functioning, and peer relationships, irrespective of persistence or remittance of ADHD. Group level summaries of social difficulties in ADHD may be inadequate given nearly half of adolescents with a history of ADHD presented with average or skilled social profiles.