School bullying behavior in attention-deficit hyperactivity disorder patients with and without comorbid autism spectrum disorder at King Chulalongkorn Memorial Hospital

Abstract

Background: Children and adolescents with attention-deficit hyperactivity disorder (ADHD) are at high-risk of being involved in school bullying behavior. Studying the situation of bullying behavior and the factors affecting school bullying behavior of children with ADHD will lead to understanding and promote guideline development for school bullying behavior in these population.

Objectives: The purposes of present study were to study the prevalence, role, pattern, frequency and behavior of school bullying and victimization in children and adolescents with ADHD, including the other related factors to school bullying behavior, such as, personal factors and the severity of ADHD with comorbidities, especially ASD.

Methods: Cross-sectional descriptive study was applied in this study. The guardians of 10 – 18 years old children with ADHD, who were attending their children at the Child-Psychiatric Unit of King Chulalongkorn Memorial Hospital during February to December 2019, were requested to answer Swanson, Nolan, and Pelham, version (IV) (SNAP - IV) form to assess the severity of ADHD and the Autism Spectrum Screening Questionnaire (ASSQ) -Thai version form to screen for ASD symptoms. The children with ADHD were required to answer the Bully/Victim Questionnaire (BVQ) form to assess the prevalence, roles, form, frequency, and patterns of school bullying and victimization in children and adolescents with ADHD.

Results: The prevalence of school bullying behavior in ADHD children were 70.5%. Most children, were both bully and victims (31.9%). The verbal bullying was found as the most common pattern (38.1%). The statistically significant risk factors for being victims were ASSQ score which 19 points or higher (odds ratio (OR) = 2.47, P = 0.004). Risk factors for being bully were male gender (OR = 4.53, P = 0.001). Mild group of Oppositional Defiant (OR = 2.32, P = 0.013) and Moderate- Severe group of Oppositional Defiant (OR = 2.67, P = 0.013).

Conclusion: Currently, school bullying behavior in children and adolescents with ADHD are of high prevalence. Several factors were correlated with school bullying behavior. Comorbid ASD in ADHD children had increased the greater risk of victimization as 2.48 times of children without comorbid ASD. Understanding these factors will lead to develop new guidelines on prevention of school bully behavior in the future.