By Alex Crumbley

Kevin Meehan, Joe Reynoso, Jasmine Ueng-McHale, and Ben Harris presented a paper entitled “The Nature of Interpersonal Representations in Children with ADHD” at the Division 39 conference on April 15. The panel was chaired by Steve Tuber, who spearheaded the project.

Joe started off the two-hour presentation by introducing the study as an investigation into the object relations and cognitive-affective resources of ADHD children. He gave an overview of research on ADHD, pointing out that the field has largely failed to investigate aspects of personality and internal representation in the diagnostic group. Joe went on to argue for the potential benefit of a psychoanalytic approach to ADHD, adding that Rorschach research could provide a valuable paradigm for accessing the internal representations of children with the diagnosis.

Kevin then described the population, which consists of 36 children from a larger study conducted in Hilary Gomes’s Neuropsychological Center for Children. After describing in detail the difficulties with diagnosis and establishing a clinical group for the project, he went on to state the purpose of the investigation: to examine the relationship between ADHD symptomatology and social problems, and to explore how the Rorschach variables, as indicators of internal resources, relate to this relationship.

Jasmine followed with some findings. The data indicate that children with attentional difficulties have less access to indicators of internal resources on the Rorschach, give more constricted protocols, and have more difficulty accessing and engaging color. Also, children struggling with impulsivity may have difficulty marshaling inner resources to buffer against stimuli. She hypothesized that such resources may partially mediate the relationship between attentional difficulties and social problems.

Ben gave two case illustrations to illuminate the data presented. First, he described an ADHD girl who had a very constricted protocol, positing that she was so overwhelmed by the stimuli that she deadened her responses as a defense. Next, he presented an ADHD boy whose responses were not constricted but rather revealed a bimodal way of handling the blots. On achromatic cards, his answers were very deadened, as he did not have the inner vitality readily available enough to "bring something" to the cards. But on the color cards, he showed high levels of inanimate movement and poor form quality, indicating the extent to which the color enlivened him, but in an unmodulated, anxiety-driven way. Ben went on to argue that this is ultimately good sign, as it indicates that the boy has access to resources that can be worked with and modulated through therapy.

Steve then went on to link the findings more broadly to the clinical presentations of such children and their impact on their family, friends and in the therapeutic relationship. He also discussed the importance of integrating nomothetic and idiopathic data to enhance our understanding of these children’s phenomenology.