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Attention Training and the Positive Illusory Bias in Attention Deficit Hyperactivity Disorder

Hill, Jemma

[Thesis]. Manchester, UK: The University of Manchester; 2016.

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Abstract

Thesis AbstractPaper 1 provides a systematic review on the association between children over-rating their competence, termed Positive Illusory Bias (PIB) and Attention deficit hyperactivity disorder (ADHD). The evidence towards this construct was examined, in addition to its environmental specificity and modifiability. Findings confirmed an association between PIB and ADHD, with most studies evidencing higher discrepancies between self and adult ratings of competence in children with ADHD compared to controls. The nature and magnitude of this association was less clear however, with some of these studies showing absolute ratings of children to be similar to controls, and a PIB only evidenced when adults were used as objective evaluators, not actual performance. Thus the review was unable to discount the idea that the PIB may, in part, be a function of the system around children with ADHD under-estimating their abilities. Clinical implications are discussed.Paper 2 presents an investigation into the efficacy and feasibility of a metacognitive therapy technique, Attention Training (ATT) in children with ADHD. A novel intervention in this population, the study employed a single case series design, followed by an uncontrolled trial, both with a 6-week follow up. A total of 16 children aged 7-11 under the care of a children and adolescent mental health service received 5 sessions of the ATT. Findings revealed that children rated their attention as significantly improved, despite no statistical improvement found on parent ratings. Significant improvements were also shown in working memory and other aspects of executive functioning. Adherence to home practice of the ATT was generally poor, but session attendance was good and the treatment was well-liked by parents. Clinical implications and directions for future research are indicated.Paper 3 is a critical reflection of the research process. Reflections on paper 1 and 2 are given, including limitations and clinical implications. The impact of the research process on my personal development and learning is also discussed.