hyperactivity disorder

Research in Developmental Disabilities 70 (2017) 59–66

Contents lists available at ScienceDirect

Research in Developmental Disabilities journal homepage: www.elsevier.com/locate/redevdis

Research Paper

Relationships of bullying involvement with intelligence, attention, and executive function in children and adolescents with attentiondeficit/hyperactivity disorder ⁎

Tai-Ling Liua,b,1, Nai-Wen Guoc,1, Ray C. Hsiaod, Huei-Fan Hue, , Cheng-Fang Yena,b,

MARK

⁎⁎

a

Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan c Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Taiwan d Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, and Seattle Children's Hospital, Seattle, WA, United States e Department of Psychiatry, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan b

AR TI CLE I NF O

AB S T R A CT

Number of reviews completed is 1.

This study investigated the relationship of bullying victimization and perpetration with the levels of intelligence, attention, and executive function in children who had received a diagnosis of attention-deficit/hyperactivity disorder (ADHD). The experiences of bullying involvement in 105 children with ADHD were assessed using the Chinese version of the School Bullying Experience Questionnaire. Their scores for four intelligence indexes on the Wechsler Intelligence Scale for Children 4th Edition-Chinese version were determined. Their levels of attention and executive function were assessed using the Comprehensive Nonverbal Attention Test Battery. The results of logistic regression analyses indicated that a high Perceptual Reasoning Index was significantly associated with a decreased risk of being victims of bullying. A high level of executive function was significantly associated with a decreased risk of being victims and perpetrators of bullying. Bullying victimization and perpetration in children with ADHD having a low PRI and low executive function should be routinely surveyed.

Keywords: Attention-deficit/hyperactivity disorder Bullying Intelligence Executive function

What this paper adds? This paper adds knowledge to the field of examining the relationship of neurocognitive functions, including intelligence, attention, and executive function, with bullying victimization and perpetration in youths with ADHD. 1. Introduction 1.1. Bullying involvement and attention-deficit/hyperactivity disorder Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) have been identified to have a high risk of ⁎

Corresponding author at: Department of Psychiatry, Tainan Municipal Hospital, 670 Chongde Road, East District, Tainan 701, Taiwan. Corresponding author at: Department of Psychiatry, Kaohsiung Medical University Hospital, 100 Tzyou 1st Rd, Kaohsiung, Taiwan. E-mail addresses: [email protected] (H.-F. Hu), [email protected] (C.-F. Yen). 1 Contributed equally to this study. ⁎⁎

http://dx.doi.org/10.1016/j.ridd.2017.08.004 Received 6 May 2016; Received in revised form 31 July 2017; Accepted 10 August 2017 0891-4222/ © 2017 Elsevier Ltd. All rights reserved.

Research in Developmental Disabilities 70 (2017) 59–66

T.-L. Liu et al.

bullying victimization and perpetration. Cross-sectional community studies have reported that both ADHD diagnosis and ADHD symptoms are significantly associated with bullying victimization and perpetration (Holmberg & Hjern, 2008; Kumpulainen et al., 1998; Yen et al., 2014). A study evaluated children and adolescents with ADHD and reported that compared with controls, children with ADHD had significant victimization experiences (Twyman et al., 2010). In addition, prospective cohort studies have reported that ADHD symptoms predict subsequent bullying victimization (Yang, Stewart et al., 2013) and perpetration (Verlinden et al., 2015). These results indicate that children and adolescents with ADHD may more likely be involved in bullying. 1.2. Relationship between intelligence quotient and bullying involvement Identification of risk factors and protective factors for bullying involvement in youths is fundamental for developing prevention and intervention strategies. In particular, unchangeable risk factors for bullying involvement can be used as indicators of prevention and early detection. Moreover, modifiable risk factors and protective factors can serve as targets of interventions for preventing bullying involvement. Among youths with ADHD, being a female (Elkins, Malone, Keyes, Iacono, & McGue, 2011), young age (Chou, Liu, Yang, Yen, & Hu, 2014), ADHD symptoms (Kawabata, Tseng, & Gau, 2012), high behavioral temperament of inhibition (Chou et al., 2014), comorbid autism spectrum disorders (Chou et al., 2014), and low satisfaction with family relationships (Chou et al., 2014) have been associated with severe bullying victimization, whereas being a male (Novik, Hervas, & Ralston, 2006), ADHD symptoms (Kawabata et al., 2012), high fun-seeking behavior (Chou et al., 2014), and low satisfaction with family relationships (Chou et al., 2014) have been associated with severe bullying perpetration. However, as a neurodevelopmental disorder (American Psychiatric Association, 2013), the relationship between neurocognitive function and bullying involvement in youths with ADHD remains unexamined. Intelligence consists of multidimensional neurocognitive abilities that help in adapting to daily life activities within an environment (Wechsler, 2003). Given that low intelligence quotient (IQ) may render effectively resolving peer conflicts and developing complex nonaggressive social problem-solving skills difficult for youths (Huesmann, Eron, & Yarmel, 1987), it is reasonable to hypothesize that low IQ increases the risk of peer victimization and perpetration. However, related studies on different populations have yielded inconsistent results. A follow-up study reported that low IQ increased the risk of chronic victimization in children in a community (Bowes et al., 2013), whereas low IQ was associated with low verbal victimization (Day et al., 2015) but with high bullying perpetration (Yau et al., 2013) in extremely low-birth-weight children. Therefore, additional studies evaluating the relationship between intelligence and bullying involvement in children and adolescents who receive a clinical diagnosis of ADHD are required. Except for differences in study samples, another possible etiology accounting for the discrepancies among the results of previous studies is that only specific components of IQ, but not the overall IQ, is significantly associated with bullying involvement. A prospective cohort study reported that low nonverbal IQ predicted the risk of victimization (Verlinden et al., 2014). In addition, a cross-sectional study reported an association of lower fluid intelligence with both perpetration and physical bullying victimization (Huepe et al., 2011). Additional studies examining whether various components of intelligence have different relationships with bullying involvement in youths with ADHD are required. 1.3. Relationship of attention and executive function with bullying involvement Both inattention (Salum et al., 2014) and executive function impairment (Sonuga-Barke et al., 2008) are the core neurocognitive characteristics of ADHD. Self-reported (Kumpulainen et al., 1998; Yen et al., 2014) and parent-reported (Yang, Stewart et al., 2013) inattention symptoms have been significantly associated with bullying victimization and perpetration. However, clinical inattention symptoms were correlated with but not equal to inattention performance measured using neurocognitive tests (Salum et al., 2014). No study has yet examined the relationship between inattention measured using neurocognitive tests and bullying involvement in youths with a clinical diagnosis of ADHD. Executive function is one of the neurocognitive functions crucial for building a successful peer relationship among youths (Séguin & Zelazo, 2005). A prospective cohort study reported that executive function problems at the age of 4 years increased the risk of bullying victimization and perpetration in the first grade of elementary school (Verlinden et al., 2014). However, no study has yet examined the relationship between executive function and bullying involvement in children and adolescents with ADHD. 1.4. Aims of this study This study investigated the relationship between bullying victimization and perpetration by examining the levels of neurocognitive functions, including intelligence, attention, and executive function, in children who had received a clinical diagnosis of ADHD. We hypothesized that low intelligence, inattention, and low executive function are significantly associated with the risk of bullying victimization and perpetration. 2. Methods 2.1. Participants Participants were recruited from the child psychiatric outpatient clinic of a medical center in Kaohsiung, Taiwan. Children aged 6–12 years who had received a diagnosis of ADHD on the basis of diagnostic criteria outlined in the Diagnostic and Statistical Manual 60

Research in Developmental Disabilities 70 (2017) 59–66

T.-L. Liu et al.

of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric Association, 2000) between November 2010 and October 2011 were invited to participate in this study. The National Health Insurance program in Taiwan allows people to visit any medical unit to see a doctor without transfer. Moreover, most child psychiatrists and psychologists in Taiwan work in medical centers. Thus, participants in the present study were representative of the community sample of children and adolescents with ADHD in Taiwan. ADHD was diagnosed on the basis of multiple data sources including (a) an interview with a child psychiatrist, (b) clinical observation of a participant’s behavior, and (c) history provided by parents and the results of the short version of the Swanson, Nolan, and Pelham Version IV (SNAP-IV) Scale-Chinese version (Gau, Shang, & Liu, 2008; Swanson et al., 2001). Children who exhibited intellectual disability, schizophrenia, bipolar disorder, and difficulty communicating or any cognitive deficits that prevented the children from understanding the study purpose or completing the questionnaires were excluded. In total, 115 children who had received a diagnosis of ADHD were invited to participate in this study. Among them, 108 (93.9%) agreed to participate, of which 3 had full-scale IQ (FSIQ) less than 70 and thus were excluded. Finally, the data of 105 children (26 girls and 79 boys) with ADHD were included for analysis. All participants and their parents received psychoeducation about the etiology, symptom presentation, and treatment strategies of ADHD. In addition, the parents of children also received counseling about the skills to manage children’s ADHD symptoms and how to communicate with them. In total, 89 (84.8%) and 16 (15.2%) participants received medication and group cognitive-behavioral psychotherapy (CBT), respectively, for their ADHD symptoms. The Institutional Review Board of Kaohsiung Medical University Hospital approved this study. 2.2. Measures 2.2.1. Wechsler Intelligence Scale for Children 4th Edition-Chinese version The Wechsler Intelligence Scale for Children 4th Edition-Chinese version (WISC-IV-Chinese) is an individually administered and norm-referenced instrument designed for measuring intelligence (Wechsler, 2003, 2007). The WISC-IV-Chinese contains four index scores. The Verbal Comprehension Index (VCI) includes the Vocabulary, Similarities, and Comprehension subtests; the Perceptual Reasoning Index (PRI) includes the Block, Design, Picture Concepts, and Matrix Reasoning subtests; the Working Memory Index (WMI) includes the Digit Span and Letter–Number Sequencing subtests; and the Processing Speed Index (PSI) includes the Coding and Symbol Search subtests. Yang, Cheng et al. (2013) reported that the profiles of the WISC-IV-Chinese index scores of Mandarinspeaking children with ADHD were similar to those of children with ADHD in English-speaking countries. 2.2.2. Comprehensive Nonverbal Attention Test Battery The Comprehensive Nonverbal Attention Test Battery (CNAT) was used to evaluate nonverbal attention and includes five subtests (Focus, Search, Behavior Inhibition, Distract, and Shift) with increasing complexity (Chang, Guo, Huang, Wang, & Tsai, 2000; Guo, 2000). Each subtest has different rules designed for evaluating the attention and executive function of participants. A participant’s task is to push a button as soon as possible, without breaking the rules, after the assigned light stimulus, which is preceded by a warning tone, is observed. The reaction time and the number of impulse and omission errors were transformed into a percentile according to the norm. The higher the mean of the percentile of the reaction time in Focus, Search, Behavior Inhibition, Distract, and Shift tests, the better the attention. The higher the mean of the percentile of impulse errors in Focus and Search tests and that of omission errors in Behavior Inhibition, Distract, and Shift tests, the better the executive function. 2.2.3. Chinese version of the School Bullying Experience Questionnaire The self-reported Chinese version of the School Bullying Experience Questionnaire (C-SBEQ) was used to evaluate participants’ involvement in school bullying in the previous year; 16 items included in this scale were answered on a 4-point Likert scale (Kim, Koh, & Noh, 2001; Yen, Kim, Tang, Wu, & Cheng, 2012). This scale is composed of two 8-item subscales that evaluate whether a participant has been a victim of bullying (including social exclusion, being called a mean nickname, being spoken ill of, being beaten up, being forced to do work, and having money, school supplies, and snacks taken away) or a perpetrator of bullying. Participants who answered 2 or 3 on any item among items 1–8 and items 9–16 were identified as self-reported victims of bullying and perpetrators of bullying, respectively. The results of a previous study examining the psychometrics of the C-SBEQ have been described elsewhere and supported the reliability and validity of the questionnaire (Yen et al., 2012). 2.2.4. ADHD and oppositional symptoms The short version of the SNAP-IV-Chinese version was used to assess the parent-reported severity of DSM-IV-TR–derived inattention, hyperactivity/impulsivity, and oppositional symptoms in the month preceding the study (Gau et al., 2008; Swanson et al., 2001). Each item is rated on a 4-point Likert scale ranging from 0 (not at all) to 3 (very much), with a higher total subscale score indicating higher severity of the parent-reported inattention, hyperactivity/impulsivity, and oppositional symptoms. The Cronbach’s α of the three subscales in this study ranged from .87 to .91. 2.3. Statistical analysis The number of male and female participants and that of victims and perpetrators of bullying are reported as percentages. The age; levels of inattention, hyperactivity/impulsivity, and oppositional symptoms on the SNAP-IV; IQ on the WISC-IV-Chinese; and the 61

Research in Developmental Disabilities 70 (2017) 59–66

T.-L. Liu et al.

Table 1 Sex, age, bullying involvement, and the levels of ADHD and oppositional defiant symptoms, IQ, attention, impulsivity, and executive function of the participants (N = 105). n (%) Sex Girls Boys Age

Mean (SD)

26 (24.8) 79 (75.2) 9.3 (1.7)

Bullying involvement Victims of bullying Perpetrators of bullying Symptoms on the SNAP-IV Inattention Hyperactivity/impulsivity Oppositional defiant

48 (45.7) 27 (25.7) 15.5 (5.3) 13.5 (6.0) 12.0 (6.0)

WISC-IV-Chinese FSIQ Verbal Comprehension index Perceptual Reasoning Index Processing Speed Index Working Memory Index Percentile of attention on the CNAT Percentile of executive function the CNAT

89.9 91.5 94.2 92.2 91.0 30.8 32.1

(13.9) (11.9) (15.9) (13.0) (15.7) (20.6) (19.7)

ADHD: attention-deficit/hyperactivity disorder; CNAT: Comprehensive Nonverbal Attention Test Battery; FSIQ: Full Scale IQ; SNAP-IV: Swanson, Nolan, and Pelham, Version IV Scale; SD: standard deviation; WISC-IV-Chinese: Wechsler Intelligence Scale for Children 4th edition-Chinese version.

percentiles of attention and executive function on the CNAT are presented as means with standard deviations. The associations of IQ, attention, and executive function with victims and perpetrators of bullying were examined using logistic regression analysis to control for the effects of sex, age, ADHD, and oppositional symptoms. The significance of statistical analyses is presented as odds ratio with a 95% confidence interval.

3. Results 3.1. Relationship of IQ, attention, and executive function with being victims of bullying The participants’ sex, age, bullying involvement, and levels of ADHD and oppositional defiant symptoms, IQ, attention, and executive function are presented in Table 1. Overall, 48 (45.7%) and 27 (25.7%) participants reported being victims and perpetrators of bullying, respectively. The results of logistic regression analysis performed for examining the correlates of being victims of bullying after controlling for the effects of sex, age, inattention, hyperactivity/impulsivity, and oppositional symptoms are listed in Table 2. The results of Model I indicated that FSIQ was not significantly associated with being victims of bullying. The results of Model II indicated that a high PRI was significantly associated with a decreased risk of being victims of bullying. The results of Model III indicated that attention was not significantly associated with being victims of bullying. The results of Model IV indicated that high executive function was significantly associated with a decreased risk of being victims of bullying. Table 2 The association of intelligence, attention, and executive function with bullying victimizationa.

FSIQ Verbal Comprehension index Perceptual Reasoning Index Processing Speed Index Working Memory Index Attention Executive function Cox & Snell R

2

OR

Victims Model I 95% CI

.975

.945–1.006

OR

Victims Model II 95% CI

1.034 .954 .988 1.006

.985–1.085 .918–.991 .945–1.034 .973–1.041

0.025

OR

Victims Model III 95% CI

.996

.977–1.016

0.08

FSIQ: Full-Scale IQ. a Controlling for the effects of sex, age, inattention, hyperactivity/impulsivity and oppositional defiant symptoms.

62

0.002

OR

Victims Model IV 95% CI

.972

.950–.994 0.06

Research in Developmental Disabilities 70 (2017) 59–66

T.-L. Liu et al.

Table 3 The associations of intelligence, attention, and executive function with bullying perpetrationa.

FSIQ Verbal Comprehension index Perceptual Reasoning Index Processing Speed Index Working Memory Index Attention Executive function Cox & Snell R2

OR

Perpetrators Model V 95% CI

.976

.939–1.014

OR

Perpetrators Model VI 95% CI

1.026 .969 .970 1.004

.971–1.085 .926–1.014 .920–1.024 .966–1.044

OR

Perpetrators Model VII 95% CI

1.001

.979–1.024

OR

.972 0.014

0.043

< 0.001

Perpetrators Model VIII 95% CI

.946−.999 0.04

FSIQ: Full-Scale IQ. a Controlling for the effects of sex, age, inattention, hyperactivity/impulsivity and oppositional defiant symptoms.

3.2. Relationship of IQ, attention, and executive function with being perpetrators of bullying The results of logistic regression analysis performed for examining the correlates of being perpetrators of bullying after controlling for the effects of sex, age, inattention, hyperactivity/impulsivity, and oppositional symptoms are presented in Table 3. The results of Models V, VI, and VII indicated that IQ and attention were not significantly associated with being perpetrators of bullying. The results of Model VIII indicated that high executive function was significantly associated with a decreased risk of being perpetrators of bullying. 4. Discussion In the present study, we found that after controlling for the effects of sex, age, inattention, hyperactivity/impulsivity, and oppositional symptoms, a high PRI was significantly associated with a decreased risk of being victims of bullying in the children and adolescents with ADHD. High executive function was significantly associated with a decreased risk of being victims and perpetrators of bullying. The FSIQ, VCI, WMI, and PSI on the WISC-IV-Chinese and attention on the CNAT were not significantly associated with a risk of being victims or perpetrators of bullying. The strength of the present study is that we recruited children and adolescents who had received a clinical diagnosis of ADHD to evaluate the relationship between various components of intelligence, attention, and executive function and bullying involvement. Because the participants in the present study were representative of the community sample of children and adolescents with ADHD in Taiwan, the results of this study can be applied to community-dwelling children and adolescents with ADHD studying in schools. 4.1. Relationship between IQ and bullying involvement We found that the PRI but not FSIQ was significantly associated with a decreased risk of being victims of bullying. The PRI focuses on reasoning in solving problems not usually taught in school (Cattell, 1963; Wechsler, 2003). The PRI examines nonverbal fluid reasoning skills, indicating the mental operations used for organizing thoughts; examining novel problems, rules, and logical relationships; and creating and testing solutions (Cattell, 1971; Wechsler, 2003). Children and adolescents with a superior PRI are considered to be above average in their nonverbal communication skills. They learn about the world around them by imbibing information and clues from images or through observation. Thus, youths with ADHD having a higher PRI are more likely to succeed in managing peer conflicts and less likely to be victims of bullying. In addition, studies on general youths have reported that fluid nonverbal IQ predicted a decreased risk of being victims of bullying (Huepe et al., 2011; Verlinden et al., 2014). The results of the present study support that prevention and intervention programs for bullying victimization in youths with ADHD should consider PRI improvement as an essential target. By contrast, it is hypothesized that youths with lower fluid nonverbal IQ find it difficult to succeed in any endeavor, resulting in increased frustration, low self-esteem, and stimulated aggression (Huesmann et al., 1987). In addition, a study on typical development reported that low fluid nonverbal IQ predicted an increased risk of being perpetrators of bullying (Huepe et al., 2011). However, we did not observe the same result in youths with ADHD. Additional studies are warranted for evaluating whether the PRI has a different role in bullying perpetration according to the diagnosis of ADHD. 4.2. Relationship between executive function and bullying victimization We found that high executive function was significantly associated with a decreased risk of being victims of bullying in youths with ADHVerlinden et al. (2014) studied a population-based sample of children and reported that low executive function at the age of 4 years was associated with a risk of being perpetrators and victims of bullying in the first grade of elementary school. Executive function refers to self-regulation mechanisms involved in goal-setting and problem-solving processes and to the ability to inhibit behavior, control emotions, and plan and organize thoughts and actions (Séguin & Zelazo, 2005). When encountering peer-conflicting situations, children and adolescents must have adequate problem-solving abilities to resolve situations smoothly. On the basis of the 63

Research in Developmental Disabilities 70 (2017) 59–66

T.-L. Liu et al.

framework proposed by Zelazo, Carter, Reznick and Frye (1997), the four sequential phases of executive function essential for resolving peer-conflicting situations include problem representation, planning, execution, and evaluation (Zelazo et al., 1997). Executive function failures in one or several of these phases may compromise the adequacy of managing conflicts during peer interactions. Peers may label youths with low executive function as odd or weak and target them for bullying; thus, the risk of being victims of bullying increases. Moreover, bullying victimization may last for a longer duration. Mugge, Chase and King (2016) reported that being bullied during development may alter the self-perceptions of strengths and weaknesses in the selected areas of executive function. Thus, low executive function and bullying victimization may have a mutual bidirectional relationship. The results highlight that peer relationships are involved in the development of strengths and deficits in executive function and vice versa. 4.3. Relationship between executive function and bullying perpetration We found that high executive function was significantly associated with a decreased risk of being perpetrators of bullying in youths with ADHD. This result was consistent with that of a previous study that associated impairment in planning/organizing, learning, and memory with bullying perpetration (Coolidge, DenBoer, & Segal, 2004). Low executive function may impair youths’ inhibitory control (Hughes, White, Sharpen, & Dunn, 2000) and increase their difficulty in choosing the most appropriate behavioral strategy for reacting to interaction events, eventually putting them at a high risk of acting aggressively for dominating their interpersonal relationships. In addition, low executive function may increase youths’ difficulties in daily routine performance and academic achievement, thus lowering their self-esteem. Bullying performance may serve as a method of compensation to maintain their self-esteem in social interactions. By contrast, bullying victimization may compromise the development of executive function in childhood. A prospective study using a cross-lagged design reported that experiencing peer problems contributed to lower executive function later in childhood and that high executive function reduced the likelihood of experiencing peer problems later in childhood and middle adolescence (Holmes, Kim-Spoon, & Deater-Deckard, 2016). In parallel support of the proposed reciprocal relation between executive function and peer problems, Stenseng et al. (2014) found that social exclusion was associated with impaired development of self-regulation 2 years later and that poor self-regulation was associated with higher social exclusion 2 years later (Stenseng, Belsky, Skalicka, & Wichstrøm, 2014). The results of the present study indicated that executive function should be a target of assessment and intervention based on its correlation with bullying victimization and perpetration in children and adolescents with ADHD. In addition, detecting the occurrence of bullying and stopping it on time are crucial to prevent the deterioration of executive function. 4.4. Relationship between inattention and bullying involvement Youths with significant inattention problems may neglect social cues and have difficulties in interacting appropriately with others. Kawabata et al. (2012) reported that parent-reported inattention symptoms were significantly associated with a risk of bullying victimization and perpetration among children with ADHD. However, we found that after controlling for the effects of parent-reported inattention symptoms, attention on the CNAT was not significantly associated with a risk of bullying involvement among the children and adolescents who had received medication or group CBT for ADHD. Additional studies are required for examining the relationship of attention measured using neurocognitive measures with bullying involvement in youths with ADHD. 4.5. Implications The results of the present study supported that the PRI and executive function should be the targets of assessment and intervention programs for youths with ADHD. The Olweus Bullying Prevention Program proposed by Professor Dan Olweus is a comprehensive approach that includes schoolwide, classroom, individual, and community components to reduce and prevent bullying problems among school children and to improve peer relations at school (Olweus & Limber, 2010). This program also emphasizes whole-school interventions, which included multiple disciplines and complementary components directed at different levels of the school organization (Olweus & Limber, 2010). A systemic review found that whole-school interventions more often reduced victimization and bullying compared with interventions that included only classroom-level curricula or social skills groups (Vreeman & Carroll, 2007). Moreover, a study reported that a school-based treatment program for school youth with ADHD that combined family management training, academic learning guidance, social skill training, and behavioral therapy could improve participants’ attention, social and family function, and peer relationship (Evans, Langberg, Raggi, Allen, & Buvinger, 2005). A neuropsychotherapy program combined the Comprehensive Attention Training Systems and the concept of autonomy throughout the whole training process with Neurofeedback technique can improve mental functions, including attention monitoring, executive functions, and daily life behaviors among the children with ADHD (Liao, Guo, Chen, Tsai, & Su, 2015). However, the effects of computerized training programs on neurocognitive function in youth with ADHD warrant further examination. Klingberg and colleagues developed the computerized Cogmed Working Memory Training (CWMT) program and proved it effectiveness for youths with ADHD (Klingberg et al., 2005). A study examining the effects of the CWMT applied in the school situation for children with ADHD showed that the CWMT improved visual spatial working memory (van der Donk, Hiemstra-Beernink, Tjeenk-Kalff, van der Leij, & Lindauer, 2015). 4.6. Limitations This study has several limitations. First, this is a cross-sectional research design that limited our ability to make direct associations 64

Research in Developmental Disabilities 70 (2017) 59–66

T.-L. Liu et al.

of intelligence, attention, and executive function with bullying involvement. Additional longitudinal studies are necessary for examining this association. Second, the data regarding bullying involvement were provided by children and adolescents, and no information on bullying involvement was obtained from parents and teachers. 4.7. Conclusion We found that a high PRI was significantly associated with a decreased risk of being victims of bullying among the children and adolescents with ADHD. High executive function was significantly associated with a decreased risk of being victims and perpetrators of bullying. Owing to their correlation with bullying victimization and perpetration in children and adolescents with ADHD, the PRI and executive function should be the targets of assessment and intervention programs for youths with ADHD. 5. Role of the funding Source The funding source had no involvement in the study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the article for publication. Acknowledgements This study was partially supported by grant NSC 98-2410-H-037-005-MY3 awarded by the National Science Council, Taiwan (ROC). References American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association text revision. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association. Bowes, L., Maughan, B., Ball, H., Shakoor, S., Ouellet-Morin, I., Caspi, A., et al. (2013). Chronic bullying victimization across school transitions: the role of genetic and environmental influences. Development and Psychopathology, 25(2), 333–346. http://dx.doi.org/10.1017/s0954579412001095. Cattell, R. B. (1963). Theory of fluid and crystallized intelligence: a critical experiment. Journal of Educational Psychology, 54, 1–22. Cattell, R. B. (1971). Abilities: their structure, growth and action. Boston: Houghton-Mifflin. Chang, Y. C., Guo, N. W., Huang, C. C., Wang, S. T., & Tsai, J. J. (2000). Neurocognitive attention and behavior outcome of school-age children with a history of febrile convulsions: A population study. Epilepsia, 41, 412–420. Chou, W. J., Liu, T. L., Yang, P., Yen, C. F., & Hu, H. F. (2014). Bullying victimization and perpetration and their correlates in adolescents clinically diagnosed with ADHD. Journal of Attention Disorders. http://dx.doi.org/10.1177/1087054714558874 ]in press. Coolidge, F. L., DenBoer, J. W., & Segal, D. L. (2004). Personality and neuropsychological correlates of bullying behavior. Personality and Individual Differences, 36, 1559–1569. http://dx.doi.org/10.1016/j.paid.2003.06.005. Day, K. L., Van Lieshout, R. J., Vaillancourt, T., Saigal, S., Boyle, M. H., & Schmidt, L. A. (2015). Peer victimization in extremely low birth weight survivors. Clinical Pediatrics, 54(14), 1339–1345. http://dx.doi.org/10.1177/0009922815580770. Elkins, I. J., Malone, S., Keyes, M., Iacono, W. G., & McGue, M. (2011). The impact of attention-deficit/hyperactivity disorder on preadolescent adjustment may be greater for girls than for boys. Journal of Clinical Child & Adolescent Psychology, 40, 532–545. http://dx.doi.org/10.1080/15374416. Evans, S. W., Langberg, J., Raggi, V., Allen, J., & Buvinger, E. C. (2005). Development of a school-based treatment program for middle school youth with ADHD. Journal of Attention Disorders, 9, 343–353. Gau, S. S., Shang, C. Y., & Liu, S. K. (2008). Psychometric properties of the Chinese version of the Swanson, Nolan, and Pelham, version IV scale −parent form. International Journal of Methods in Psychiatric Research, 17, 35–44. http://dx.doi.org/10.1002/mpr.237. Guo, N. W. (2000). Comprehensive non-verbal attention and memory test battery manual. Taipei, Taiwan: National Taiwan Normal University, Special Education Center. Holmberg, K., & Hjern, A. (2008). Bullying and attention-deficit hyperactivity disorder in 10-year-olds in a Swedish community. Developmental Medicine and Child Neurology, 50, 134–138. http://dx.doi.org/10.1111/j.1469-8749. Holmes, C. J., Kim-Spoon, J., & Deater-Deckard, K. (2016). Linking executive function and peer problems from early childhood through middle adolescence. Journal of Abnormal Child Psychology, 44, 31–42. http://dx.doi.org/10.1007/s10802-015-0044-5. Huepe, D., Roca, M., Salas, N., Canales-Johnson, A., Rivera-Rei, A. A., Zamorano, L., et al. (2011). Fluid intelligence and psychosocial outcome: from logical problem solving to social adaptation. PloS One, 6(9), e24858. http://dx.doi.org/10.1371/journal.pone.0024858. Huesmann, L. R., Eron, L. D., & Yarmel, P. W. (1987). Intellectual functioning and aggression. Journal of Personality and Social Psychology, 52, 232–240. http://dx.doi. org/10.1037/0022-3514.52.1.232. Hughes, C., White, A., Sharpen, J., & Dunn, J. (2000). Antisocial, angry, and unsympathetic: Hard-to-manage preschoolers’ peer problems and possible cognitive influences. Journal of Child Psychology and Psychiatry, 41, 169–179. http://dx.doi.org/10.1017/s0021963099005193. Kawabata, Y., Tseng, W. L., & Gau, S. S. (2012). Symptoms of attention-deficit/hyperactivity disorder and social and school adjustment: the moderating roles of age and parenting. Journal of Abnormal Child Psychology, 40, 177–188. http://dx.doi.org/10.1007/s10802-011-9556-9. Kim, Y. S., Koh, Y. J., & Noh, J. (2001). Development of Korean-Peer nomination inventory (K-PNI): An inventory to evaluate school bullying. Journal of Korean Neuropsychiatry Association, 40, 867–875. Klingberg, T., Fernell, E., Olesen, P., Johnson, M., Gustafsson, P., Dahlström, K., et al. (2005). Computerized training of working memory in children with ADHD– A randomized: Controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 44, 177–186. Kumpulainen, K., Räsänen, E., Henttonen, I., Almqvist, F., Kresanov, K., Linna, S. L., et al. (1998). Bullying and psychiatric symptoms among elementary school-age children. Child Abuse and Neglect, 22(7), 705–717. Liao, Y. C., Guo, N. W., Chen, S. J., Tsai, H. F., & Su, B. Y. (2015). The effectiveness of neurofeedback-based neuropsychotherapy on improving meta-attention functions for children with ADHD. Bulletin of Educational Psychology, 47(2), 281–304. Mugge, J. R., Chase, S. L., & King, A. R. (2016). Child peer abuse and perceptions of executive-functioning competencies. Applied Neuropsychology: Child, 5(1), 67–75. Novik, T. S., Hervas, A., & Ralston, S. J. (2006). Influence of gender on attention-deficit/hyperactivity disorder in Europe-ADORE. European Child and Adolescent Psychiatry, 15–24. http://dx.doi.org/10.1007/s00787-006-1003-z. Olweus, D., & Limber, S. P. (2010). The olweus bullying preveniton program: implementation and evaluation over two decades. In S. R. Jimerson, S. M. Swearer, & D. L. Espelage (Eds.). The handbook of school bullying: an international perspective (pp. 277–402). New York: Routledge. Séguin, J. R., & Zelazo, P. D. (2005). Executive function in early physical aggression. In R. E. Tremblay, W. W. Hartup, & J. Archer (Eds.). Developmental origins of aggression (pp. 307–329). New York, NY: Guilford Press. Salum, G. A., Sonuga-Barke, E., Sergeant, J., Vandekerckhove, J., Gadelha, A., Moriyama, T. S., et al. (2014). Mechanisms underpinning inattention and hyperactivity:

65

Research in Developmental Disabilities 70 (2017) 59–66

T.-L. Liu et al.

neurocognitive support for ADHD dimensionality. Psychological Medicine, 44(15), 3189–3201. http://dx.doi.org/10.1017/s0033291714000919. Sonuga-Barke, E. J., Sergeant, J. A., Nigg, J., & Willcutt, E. (2008). Executive dysfunction and delay aversion in attention deficit hyperactivity disorder: nosologic and diagnostic implications. Child and Adolescent Psychiatric Clinics of North America, 17(2), 367–384. http://dx.doi.org/10.1016/j.chc.2007.11.008. Stenseng, F., Belsky, J., Skalicka, V., & Wichstrøm, L. (2014). Social exclusion predicts impaired self-regulation: A 2-year longitudinal panel study including the transition from preschool to school. Journal of Personality, 83 212-220.10.1111/jopy.12096. Swanson, J. M., Kraemer, H. C., Hinshaw, S. P., Arnold, L. E., Conners, C. K., Abikoff, H. B., et al. (2001). Clinical relevance of the primary findings of the MTA: Success rates based on severity of ADHD and ODD symptoms at the end of treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 168–179. http:// dx.doi.org/10.1097/00004583-200102000-00011. Twyman, K. A., Saylor, C. F., Saia, D., Macias, M. M., Taylor, L. A., & Spratt, E. (2010). Bullying and ostracism experiences in children with special health care needs. Journal of Developmental and Behavioral Pediatrics, 31, 1–8. http://dx.doi.org/10.1097/DBP.0b013e3181c828c8. Verlinden, M., Veenstra, R., Ghassabian, A., Jansen, P. W., Hofman, A., Jaddoe, V. W. V., et al. (2014). Executive functioning and non-verbal intelligence as predictors of bullying in early elementary school. Journal of Abnormal Child Psychology, 42, 953–966. http://dx.doi.org/10.1007/s10802-013-9832-y. Verlinden, M., Jansen, P. W., Veenstra, R., Jaddoe, V. W. V., Hofman, A., & Tiemeier, H. (2015). Preschool attention-deficit/hyperactivity and oppositional defiant problems as antecedents of school bullying. Journal of the American Academy of Child and Adolescent Psychiatry, 54(7), 571–579. http://dx.doi.org/10.1016/j.jaac. 2015.05.002. Vreeman, R. C., & Carroll, A. E. (2007). A systematic review of school-based interventions to prevent bullying. Archives of Pediatrics and Adolescent Medicine, 161, 78–88. http://dx.doi.org/10.1001/archpedi.161.1.78. Wechsler, D. (2003). Wechsler intelligence scale for children (4th ed.). San Antonio, TX: Psychological Corporation. Wechsler, D. (2007). Wechsler intelligence scale for children-fourth edition -Chinese version. Taipei, Taiwan: The Chinese Behavioral Science Corporation. Yang, P., Cheng, C. P., Chang, C. L., Liu, T. L., Hsu, H. Y., & Yen, C. F. (2013). Wechsler Intelligence Scale for Children 4th edition-Chinese version index scores in Taiwanese children with attention-deficit/hyperactivity disorder. Psychiatry and Clinical Neurosciences, 67, 83–91. http://dx.doi.org/10.1111/pcn.12014. Yang, S. J., Stewart, R., Kim, J. M., Kim, S. W., Shin, I. S., Dewey, M. E., et al. (2013). Differences in predictors of traditional and cyber-bullying: a 2-year longitudinal study in Korean school children. European Child & Adolescent Psychiatry, 22, 309–318. http://dx.doi.org/10.1007/s00787-012-0374-6. Yau, G., Schluchter, M., Taylor, H. G., Margevicius, S., Forrest, C. B., Andreias, L., et al. (2013). Bullying of extremely low birth weight children: associated risk factors during adolescence. Early Human Development, 89(5), 333–338. http://dx.doi.org/10.1016/j.earlhumdev.2012.11.004. Yen, C. F., Kim, Y. S., Tang, T. C., Wu, Y. Y., & Cheng, C. P. (2012). Factor structure, reliability, and validity of the Chinese version of the School Bullying Experience Questionnaire. The Kaohsiung Journal of Medical Sciences, 28, 500–505. http://dx.doi.org/10.1016/j.kjms.2012.04.008. Yen, C. F., Yang, P., Wang, P. W., Lin, H. C., Liu, T. L., Wu, Y. Y., et al. (2014). Association between school bullying levels/types and mental health problems among Taiwanese adolescents. Comprehensive Psychiatry, 55, 405–413. http://dx.doi.org/10.1016/j.comppsych.2013.06.001. Zelazo, P. D., Carter, A., Reznick, J. S., & Frye, D. (1997). Early development of executive function: a problem-solving framework. Review of General Psychology, 1, 198–226. http://dx.doi.org/10.1037/1089-2680.1.2.198. van der Donk, M. L., Hiemstra-Beernink, A. C., Tjeenk-Kalff, A. C., van der Leij, A. V., & Lindauer, R. J. (2015). Cognitive training for children with ADHD: a randomized controlled trial of cogmed working memory training and ‘paying attention in class’. Frontier of Psychology, 6, 1081. http://dx.doi.org/10.3389/fpsyg. 2015.01081.

66