Peer Rejection, Social Relationships and ADHD Methylphenidate (Ritalin) Treatment and Hostility

17th October 2023

Research indicates that use of drugs for ADHD can cause hostility in children and damage their interpersonal relationships

A recent study was summarized by David Rabiner in his ADHD newsletter. The study by Dr. S. King and associations, which was supported by a grant an NSHRF Student Research Award awarded to Dr. King.

Research indicates that use of drug treatment for ADHD can cause hostility in some children and damage their interpersonal relationships.

Dr. Rabiner summarizes the findings of the recently published research (December 24, 2008), as follows,

"And, an unfortunate aspect of ADHD for many children is difficulty with peer relations. Rejection by peers can have a negative effect on children's self-esteem and contribute to the development of loneliness and depression.

In addition, children who are excluded from the main-stream peer group often gravitate towards one another during adolescence, and can wind up reinforcing and escalating the types of negative behaviors that initially contributed to their being disliked in the first place. Understanding the reasons for peer rejection and developing effective ways to help disliked children develop more positive peer relationships has thus been the subject of extensive research in developmental and clinical psychology."

"However, in situations that involved ambiguous provocation by peers, children with ADHD who are on medication generated ideas for dealing with the situation that are more likely to include elements of retaliation, which could certainly lead to making things worse." (Rabiner,D., 2009)

Dr. Rabiner cautions that his does not necessarily "prove" that the medication treatment, in this case methylphenidate (Ritalin) leads to more aggression, however, in her summation, the King study concludes,

"Results showed that children with ADHD who received MPH generated more hostile responses to provocation than controls, but children with ADHD on placebo did not. Findings suggest that children with ADHD generate more aggressive responses to provocation than controls and that this may be exacerbated by administration of MPH." (King, et al., 2008)

"However, it is clearly the case that medication was in no way associated with more adaptive and prosocial responding, and may have possibly exacerbated it. And, it is noteworthy that the only prior study to examine the effects of medication on social cognition in children with ADHD also provided evidence that medication may increase aggressive responding in at least some children with ADHD." (Rabiner, D., 2009).

ADHD Research - King, et al. study:

75 children (56 boys, 19 girls) aged 6-12 years, including 41 children with ADHD and 34 controls. Children were randomized into medication conditions such that 20 children with ADHD participated after receiving placebo and 21 participated after receiving methylphenidate (MPH).

One can conclude from this that prescribing stimulants to children who might be prone to hostility, is not necessarily the answer, that at times, more hostile responses may be a result from treatment with medication for ADHD.

ADHD Research References:

Rabinder, D. (July 2009) Social information processing not helped by ADHD medication. Attention Research Update.

Sara King, Daniel A. Waschbusch, William E. Pelham Jr, Bradley W. Frankland, Brendan F. Andrade, Sophie Jacques and Penny V. Corkum. (December 24, 2008). Social Information Processing in Elementary-School Aged Children with ADHD: Medication Effects and Comparisons with Typical Children. Journal of Abnormal Child Psychology.