ADHD & BULLY

General Data of patient

20463608

14 years old

Gender: male

Occupation: student

Key persons: mother and dad

Source of information: patient himself and his mother

ADHD(6
yr)

poor attention, distractibility, poor

compliance at school, refused doing jobs,
poor attention, reckless mistakes,
hypertalkative, hyperactive, poor impulse
control
Regular follow up in OPD/always made conflicts
poor relationship and mood
problems

the diagnosis was changed

into ASD(7th grade)
transferred to resource class
Elevated mood, irritable,
decrease need of sleep, flight of
idea, abnormally increase goal
directed activity, pressure speech
and auditory hallucination

admission
played firework at
home (2016/11/14)

Bipolar I disorder, single, manic episode, with psychotic

feature

After admission

Treatment:
- for mood: Lithium +risperdal less euphoric
- for sleep: Rivotril

Educate the importance of drug adherence

CBT for abnormal behavior

- hostile against his caregiver and stole other patients
money

This patient had conflicts with his peers often

ADHD initially contributes to problematic relationships

with peers Hoza B. Peer Functioning in Children with ADHD. Ambulatory pediatrics: the official journal of the Ambulatory Pediatric Association.

Does ADHD cause bullying in children?

Are ADHD Students More Likely to Bully, Be Bullied?

2007;7(1 Suppl):101-106. doi:10.1016/j.ambp.2006.04.011.

Bullying & ADHD

Correlation

Compared with those who are not involved in bullying, b

oth bullying victims and perpetrators have significant ris
ks of depression, suicidal ideation and attempts, and alc
ohol abuse disorder.

A cross-sectional community study of 10-year-old childr

en in Sweden found that the diagnosis of ADHD was signi
ficantly associated with bullying victimization and perpe
tration.

A follow-up community study in Korean 10-year-old chil

dren found that ADHD symptoms can predict bullying vic
timization 2 years later.

How?

The most frequently proposed risk factor for bullying inv

olvement among children and adolescents with ADHD is
severe ADHD symptoms, including hyperactivity/impulsi
vity and inattention.

Attention problems impede the ability to recognize soci

al cues that are essential for effective social interaction
s.

Whether the severity of ADHD symptoms is positively ass

ociated with bullying victimization and perpetration req
uires further study.

Compared with the general population, people with ADH

D have low inhibition as measured with the BIS , low dri
ve as measured on the BAS , and high fun seeking on the
BAS.

Whats our goal?

The aims of the present study were to examine the prev

alences of various types of bullying involvement and ass
ociations of bullying involvement with gender, age, BIS,
BAS, ADHD characteristics, psychiatric comorbidity, and
family factors in a clinical group of adolescents diagnos
ed with ADHD in Taiwan.

Methods

Participants: recruited from the child and adolescent ps

ychiatric outpatient clinics of two medical centers in Ka
ohsiung, Taiwan. Adolescents aged between 11 and 18 y
ears diagnosed with ADHD according to the diagnostic cr
iteria in the DSM-IV-TR.

316 adolescents were invited

287 (90.8%) agreed to participate.

ADHD was diagnosed by applying multiple data sources,

including (a) an interview with a child psychiatrist, (b) c
linical observation of the participants behavior, and (c)
a history provided by the parents and the short version
of the SNAP-IV ScaleChinese version

C-SBEQ

Chinese version of the School Bullying Experience Quest

ionnaire(C-SBEQ): Evaluate participants involvement in
school bullying in the previous 1 year, which including:
- 16 items
- Likert-type 4-point scale range with 0-3
- Items 1 to 8 evaluate the experiences of
bullying victimization

- Item 9 to 16 evaluate the experiences of bullying perp

etration.

BIS/BAS

20 items ranked on a 4-point Likert-type scale that asse

ss the sensitivity of the two motivational systems accord
ing to reinforcement sensitivity theory.

BIS measures the degree to which respondents expect to

feel anxious when confronted with cues for punishment

BAS comprises subscales of reward responsiveness, drive

, and fun seeking, which measure the degree to which r
ewards lead to positive emotions, a persons tendency t
o actively pursue appetitive goals, and the tendency to
seek and impulsively engage in potentially rewarding ac
tivities,
respectively.

Results

Participants demographic

251(87.5%) were boys and 36 (12.5%) were girls, mean a

ge was 13.1 years

19.2% victims of passive bullying/5.6% victims of active

bullying/11.5% perpetrators of passive bullying/3.5% per
petrators of active bullying

14.6% pure victims/8.4% pure perpetrators/5.6% victimperpetrators/71.4% neutral group.

The results indicated that young age, a high score on th

e BIS, comorbidity of ASD, and low satisfaction with fam
ily relationships were significantly associated with sever
e bullying victimization.

A high score of fun seeking on the BAS and low satisfacti

on with family relationships were significantly associate
d with severe bullying perpetration.

Discussion

young age

Young adolescents with ADHD reported more serious bull

ying victimization.

had older classmates

not yet acquired the social skills to deal effectively with

bullying incidents

a high score on the BIS

The significant association between high BIS scores and

bullying victimization could be due to bidirectional inter
action.

high BIS temperaments -> perceived to be odd and alien

ated by their peers-> increases the risk of being bullied

Bullying victims-> anxious and self-limit their interactio

n with others

comorbidity of ASD

comorbidity with ASD was significantly associated with

more serious bullying victimization in adolescents

lack the necessary social cognition to interact effectivel

y with peers

lack quality friendships to protect them from bullying

low satisfaction with family r

elationships

less satisfaction with family relationships was significant

ly associated with not only more serious bullying victimi
zation but also more serious bullying perpetration

poor family relationships have adverse impacts on youth

s framework for perceiving stressful situations

Youth who grow up with intra-family conflicts perceive t

he need for self-protection in social interaction and the
n act violently to peers

Cyber Bully in AD
HD and Asperger S
yndrome populati
on
B0102011

Cyber bully
Technology as tool to bully
Bully occur through email, instant message, in a chatroom,
on webpage, or through digital image or message sent to ce
llphone

Cyber bully

Cyber bully

Victim targeted in angry comment on social networking

site harassed by hundreds of spam text, have a website
devoted to their humiliation.

Cyber bully

Cyber bully shows some features as follow:

Repeated over time

Power imbalance

50 percent of victims not knowing the identity

--people say thing anonymously that they never

do in face-to-face interaction

say or

Victims of cyber bullying having the technology by whic

h they were targeted removed by parents or other auth
ority.

Cyber bully
x24

x18

Participents diagnosis
with Aspergers syndrome
ranged in age between
10 to 20.

Cyber bully

Parents uniform about children experence with bully and cyber bully

9% discuss cyber bully with children, 51%knew the term of cyber bully

Cyber bully

Traditional bullying perpetrator shows

much higher cyber bullying victim rate
than traditional bullying victim.

Prospect

Investigating the most effective prevention and interven

tion efforts to use with children with disabilities.

Traditional bully vs Cyber bully

Similarities

repeated infliction of harm

deliberate, long term

symptoms of anxiety or depression, poor self-esteem existed in

victims

Differences
Traditional bully

Cyber bully

face to face

- instant messaging

society, ex: school

- social networking sites

recognized the bullies

limited

- anonymity
- everywhere/anytime

Parents awareness

Parents are more aware of traditional bully than cyber b

ully.

parents are unaware of

(a) the likelihood of their child becoming a victim

(b) the serious effects that can follow from incidents of cy
ber bullying

Depression and Anxiety

The higher levels of depression and anxiety observed in

the present study among those who were involved with
traditional bullying.

Although the same effects with cyber bullying did not a

pproach signicance, the means were in the expected d
irection.