Attention-Deficit Hyperactivity Disorder, Positive Illusory Bias, and the Dual-Factor Model of Mental Health
Background: Positive illusory bias refers to overestimations of competence relative to a criterion such as objective performance or ratings by others. Positive illusory bias occurs across academic, behavioral, social, and functional domains. Historically, positive illusory bias is associated with attention-deficit hyperactivity disorder (ADHD) but is not necessarily limited to this disorder. This study uses the dual-factor model of mental health (DFM) to understand the impact of positive illusory bias and psychopathology (e.g., ADHD) on subjective well-being. The major research question asks if positive illusory bias is maladaptive or self-protective with respect to subjective well-being. Purpose: This three-part study focused on (1) evaluating conceptual definitions and measurement of positive illusory bias, (2) adding to the literature by exploring relationships between positive illusory bias, subjective well-being, and ADHD symptomatology, and (3) examining the extent to which positive illusory bias and mental health status predict functional impairment, social impairment, and academic success in young adults with and without ADHD. Methods: The first paper was a scoping review examining conceptual definitions and measurement methodology of positive illusory bias across studies of children and adolescents with ADHD. It followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) framework. The second paper was a quantitative study which explored positive illusory bias, mental health status, and impairment in young adult college students with and without ADHD (N = 195). The third paper explored conceptual and practical implications of positive illusory bias in mental health practice. Results: The scoping review extracted 37 studies focused on positive illusory bias in youth with ADHD. This study identified four major elements to a conceptual definition of positive illusory bias: actual competence, self-perception of competence, intensity of the bias, and interrater discrepancy. Discrepancy analysis and pre-task prediction/post-task performance were the two most common methodology used in measuring positive illusory bias. The quantitative study found that subjective well-being and ADHD symptomatology were negatively correlated, positive illusory bias significantly moderated this relationship, ADHD symptomatology and subjective well-being were significant predictors of functional impairment, positive illusory bias and subjective well-being were significant predictors of social impairment and academic success. Conclusion: positive illusory bias has potentially important clinical implications for persons with and without ADHD. Measuring positive illusory bias may result in a better understanding of subjective well-being.