Targeting Peer Contagion Dynamics in Children with ADHD: Effects from a Two-Site Randomized Controlled Trial

ABSTRACT

Objective

Parental Friendship Coaching (PFC) teaches parents to coach their children in friendship skills. This paper examines whether PFC fosters positive peer contagion processes (i.e. dyadic mutuality) and reduces negative peer contagion processes (i.e. coercive joining) within the friendships of children with attention-deficit/hyperactivity disorder (ADHD).

Method

Participants were 134 families of children with ADHD and peer problems (age 6–11 years; 69% male; 72% white) at two Canadian sites, randomized to PFC or CARE (an active comparison intervention). Children were observed in the lab at baseline, post-treatment, and at 8-month follow-up during cooperation and competition tasks with a real-life friend. Amount and reciprocity of dyadic mutuality indicators (i.e. positive affect and positive behaviors) and coercive joining indicators (i.e. aggressive, controlling, and rule-breaking behaviors) between friends were coded.

Results

Across treatment conditions, children showed an increase in the amount of dyadic mutuality during cooperation and a decrease in the amount of coercive joining during competition over time. Relative to CARE, PFC induced a reduced amount of coercive joining behaviors during cooperation at post-treatment and follow-up. However, PFC led to decreases in the reciprocity of positive affect during cooperation at post-treatment and to increases in the reciprocity of coercive joining during competition at follow-up relative to CARE. Moderation analyses suggest PFC was associated with better outcomes for children with externalizing comorbidity, and for those with a stable or a best friend.

Conclusions

Findings highlight the importance of transactional processes, contextual differences, externalizing comorbidities, and friendship status when assessing the efficacy of PFC.

Acknowledgments

This work was supported by the Canadian Institutes of Health Research (CIHR) under Grant MOP-125897 and by the Fonds de recherche du Québec - Société et culture (FRQSC) under Grant 2019-SE3-259636. The authors are grateful to the families, schools, clinicians, collaborators, and research assistants who participated in this study.

Disclosure statement

Drs. Mikami and Normand receive royalties from sales of the Parental Friendship Coaching Treatment manual.

Supplementary data

Supplemental material for this article can be accessed online at https://doi.org/10.1080/15374416.2024.2335633.

Notes

1 We are grateful to anonymous reviewers for suggesting these moderator analyses, which we conducted post hoc.

Additional information

Funding

The work was supported by the Canadian Institutes of Health Research [Grant MOP-125897] and Fonds de Recherche du Québec-Société et Culture [Grant 2019-SE3-259636].