Cognitive flexibility, empathy and social self-efficacy in children with ADHD and their parents: An actor-partner interdependence model

Objective Children with Attention deficit/hyperactivity disorder (ADHD) typically exhibit compromised social self-efficacy. However, how parent-child cognitive and empathic attributes reciprocally shape mutual social self-efficacy remains unclear. Methods A total of 109 parent-child dyads were recruited, comprising 59 children diagnosed with ADHD (aged 8–13 years) and 50 comparison children without any neurodevelopmental or mental health diagnoses, with one parent participating for each child. Children and parents completed self-report measures on cognitive flexibility, empathy, and social self-efficacy. The Actor-Partner Interdependence Model (APIM) was employed to analyze dyadic data with Bayesian estimation. Results Within the ADHD group, actor effects revealed that: (1) children's cognitive flexibility positively correlated with their empathy and social self-efficacy, and children's empathy significantly accounted for the association between cognitive flexibility and social self-efficacy; (2) parents' cognitive flexibility positively correlated with their social self-efficacy, whereas parents' empathy negatively correlated with their social self-efficacy. Regarding partner effects: (1) children's empathy positively correlated with parents' social self-efficacy; (2) parents' empathy negatively correlated with children's social self-efficacy. Conclusions The cognitive flexibility of children with ADHD is significantly associated with higher social self-efficacy, while that of their parents is also linked to this outcome. However, their empathy exerts diverging effects on social interactions. These findings provide valuable insights for psychosocial interventions in children with ADHD.