Parent–Adolescent Conflict in Teenagers with ADHD and ODD

Eighty-seven male teens (ages 12–18 years) with ADHD/ODD and their parents were compared to 32 male teens and their parents in a community control (CC) group on mother, father, and teen ratings of parent–teen conflict and communication quality, parental self-reports of psychological adjustment, and direct observations of parent–teen problem-solving interactions during a neutral and conflict discussion. Parents and teens in the ADHD/ODD group rated themselves as having significantly more issues involving parent–teen conflict, more anger during these conflict discussions, and more negative communication generally, and used more aggressive conflict tactics with each other than did parents and teens in the CC group. During a neutral discussion, only the ADHD/ODD teens demonstrated more negative behavior. During the conflict discussion, however, the mothers, fathers, and teens in the ADHD/ODD group displayed more negative behavior, and the mothers and teens showed less positive behavior than did participants in the CC group. Differences in conflicts related to sex of parent were evident on only a few measures. Both mother and father self-rated hostility contributed to the level of mother–teen conflict whereas father self-rated hostility and anxiety contributed to father–teen conflict beyond the contribution made by level of teen ODD and ADHD symptoms. Results replicated past studies of mother–child interactions in ADHD/ODD children, extended these results to teens with these disorders, showed that greater conflict also occurs in father–teen interactions, and found that degree of parental hostility, but not ADHD symptoms, further contributed to levels of parent–teen conflict beyond the contribution made by severity of teen ADHD and ODD symptoms.     

Inhibition,Reinforcement Sensitivity and Temporal Information Processing in ADHD and ADHD+ODD: Evidence of a Separate Entity?

This study compared children with ADHD-only, ADHD+ODD and normal controls (age 8–12) on three key neurocognitive functions: response inhibition, reinforcement sensitivity, and temporal information processing. The goal was twofold: (a) to investigate neurocognitive impairments in children with ADHD-only and children with ADHD+ODD, and (b) to test whether ADHD+ODD is a more severe from of ADHD in terms of neurocognitive performance. In Experiment 1, inhibition abilities were measured using the Stop Task. In Experiment 2, reinforcement sensitivity and temporal information processing abilities were measured using a Timing Task with both a reward and penalty condition. Compared to controls, children with ADHD-only demonstrated impaired inhibitory control, showed more time underestimations, and showed performance deterioration in the face of reward and penalty. Children with ADHD+ODD performed in-between children with ADHD-only and controls in terms of inhibitory controls and the tendency to underestimate time, but were more impaired than controls and children with ADHD-only in terms of timing variability. In the face of reward and penalty children with ADHD+ODD improved their performance compared to a neutral condition, in contrast to children with ADHD-only. In the face of reward, the performance improvement in the ADHD+ODD group was disproportionally larger than that of controls. Taken together the findings suggest that, in terms of neurocognitive functioning, comorbid ADHD+ODD is a substantial different entity than ADHD-only.     

Is It ADHD,LD, Depression or Allergies?

Abstract

This article presents a model for understanding the complexity of diagnosing Attention Deficit Hyperactivity Disorder (ADHD). The model uses a continuum of attentional skills to help the reader understand why accurate diagnosis is so important. Issues related to differential determination of attentional problems that may be attributed to learning disabilities, allergies and childhood depression are explored. Specific guidelines to help teachers understand how to judge the appropriateness and comprehensiveness of the diagnostic process are provided.     

A Multitrait–Multisource Confirmatory Factor Analytic Approach to the Construct Validity of ADHD and ODD Rating Scales with Malaysian Children

Confirmatory factor analysis (CFA) was used to model a multitrait by multisource matrix to determine the convergent and discriminant validity of measures of attention-deficit hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and oppositional defiant disorder (ODD) in 917 Malaysian elementary school children. The three trait factors were ADHD-IN, ADHD-HI, and ODD. The two source factors were parents and teachers. Similar to earlier studies with Australian and Brazilian children, the parent and teacher measures failed to show convergent and discriminant validity with Malaysian children. The study outlines the implications of such strong source effects in ADHD-IN, ADHD-HI, and ODD measures for the use of such parent and teacher scales to study the symptom dimensions.     

A Common Genetic Factor Explains the Covariation Among ADHD ODD and CD Symptoms in 9–10 Year Old Boys and Girls

Previous studies examining the covariation among Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) have yielded inconsistent results. Some studies have concluded that the covariation among these symptoms is due to common genetic influences, whereas others have found a common environmental overlap. The present study investigated the genetic and environmental correlations among these three childhood disorders, based on a sample of 1,219 twins, age 9–10 years. A latent externalizing behavior factor was found to explain the covariance among ADHD, ODD and CD symptoms. Genetic influences explained more than half of the variance in this externalizing factor in both boys and girls. There were also unique genetic and environmental influences in each set of symptoms, suggesting some etiological independence of the three disorders. Our findings have implications for molecular genetic studies trying to identify susceptibility genes for these disorders. This study was funded by NIMH (R01 MH58354). Catherine Tuvblad was supported by post-doctoral stipends from the Swedish Council for Working Life and Social Research (Project 2006-1501) and the Sweden-America Foundation. Adrian Raine was supported by NIMH (Independent Scientist Award K02 MH01114-08). We thank the Southern California Twin Project staff for their assistance in collecting data, and the twins and their families for their participation.     

Which Executive Functioning Deficits Are Associated With AD/HD,ODD/CD and Comorbid AD/HD+ODD/CD?

This study investigated (1) whether attention deficit/hyperactivity disorder (AD/HD) is associated with executive functioning (EF) deficits while controlling for oppositional defiant disorder/conduct disorder (ODD/CD), (2) whether ODD/CD is associated with EF deficits while controlling for AD/HD, and (3)~whether a combination of AD/HD and ODD/CD is associated with EF deficits (and the possibility that there is no association between EF deficits and AD/HD or ODD/CD in isolation). Subjects were 99~children ages 6–12 years. Three putative domains of EF were investigated using well-validated tests: verbal fluency, working memory, and planning. Independent of ODD/CD, AD/HD was associated with deficits in planning and working memory, but not in verbal fluency. Only teacher rated AD/HD, but not parent rated AD/HD, significantly contributed to the prediction of EF task performance. No EF deficits were associated with ODD/CD. The presence of comorbid AD/HD accounts for the EF deficits in children with comorbid AD/HD+ODD/CD. These results suggest that EF deficits are unique to AD/HD and support the model proposed by R. A. Barkley (1997).     

A confirmatory factor analysis on the DSM-IV ADHD and ODD symptoms: what is the best model for the organization of these symptoms?

Confirmatory factor analysis (CFA) was used to evaluate five different models for the organization of the DSM-IV ADHD and oppositional defiant disorder (ODD) symptoms (Model 1: a single factor model; Model 2: an ADHD and ODD two factor model; Model 3a: an inattention (INA), hyperactivity/impulsivity (HYP/IMP), and ODD three factor model; Model 3b: an INA, HYP/IMP, and ODD three factor model where the three IMP symptoms cross-load on the ODD factor; Model 4: an INA, HYP, IMP, and ODD four factor model). To evaluate these models, maternal ratings of ADHD and ODD symptoms were obtained at outpatient pediatric clinics on 742 children not in treatment and 91 children in treatment for ADHD. Model 3a resulted in a good fit as well as a significantly better fit than Model 2. Model 3a was also equivalent across treatment status, gender, and age groupings for the most part. Though Models 3b and 4 provided a statistically better fit than Model 3a, the improvement in fit was small and other model selection criteria argued against these more complex models.     

PDD Symptoms in ADHD,an Independent Familial Trait?

The aims of this study were to investigate whether subtle PDD symptoms in the context of ADHD are transmitted in families independent of ADHD, and whether PDD symptom familiality is influenced by gender and age. The sample consisted of 256 sibling pairs with at least one child with ADHD and 147 healthy controls, aged 5–19 years. Children who fulfilled criteria for autistic disorder were excluded. The Children’s Social Behavior Questionnaire (CSBQ) was used to assess PDD symptoms. Probands, siblings, and controls were compared using analyses of variance. Sibling correlations were calculated for CSBQ scores after controlling for IQ, ADHD, and comorbid anxiety. In addition, we calculated cross-sibling cross-trait correlations. Both children with ADHD and their siblings had higher PDD levels than healthy controls. The sibling correlation was 0.28 for the CSBQ total scale, with the CSBQ stereotyped behavior subscale showing the strongest sibling correlation (r = 0.35). Sibling correlations remained similar in strength after controlling for IQ and ADHD, and were not confounded by comorbid anxiety. Sibling correlations were higher in female than in male probands. The social subscale showed stronger sibling correlations in elder than in younger sibling pairs. Cross-sibling cross-trait correlations for PDD and ADHD were weak and not-significant. The results confirm that children with ADHD have high levels of PDD symptoms, and further suggest that the familiality of subtle PDD symptoms in the context of ADHD is largely independent from ADHD familiality.     

The Contribution of Maternal ADHD Symptomatology,Maternal DAT1, and Home Atmosphere to Child ADHD Symptomatology at 7 Years of Age

Children of mothers with attention-deficit/hyperactivity disorder (ADHD) have an increased genetic and environmental risk for ADHD. The unique and interactive contributions of a maternal dopamine receptor gene (DAT1), maternal ADHD symptoms (hyperactive- impulsive, inattentive), and home atmosphere to the prediction of ADHD symptoms (hyperactive- impulsive, inattentive) in 7- year-old boys (N = 96) were examined using data from a longitudinal study of familial risk for ADHD. During the first 6 months of the study, mothers and their spouses completed a questionnaire about the mother’s ADHD symptoms. Home atmosphere questionnaire data were collected 4 years later. At the 7-year assessment, mothers reported on their child’s ADHD symptoms. Negative home atmosphere was significantly associated with child hyperactive-impulsive and inattentive symptoms. Maternal inattentive symptoms were significantly correlated with both child symptom dimensions. Regression models, with child genotype and maternal education controlled, showed main effects for maternal inattentive symptoms, maternal DAT1 10/10 genotype, and home atmosphere in the prediction of child inattentive symptoms. Only home atmosphere predicted child hyperactive-impulsive symptoms. There was a significant home atmosphere x maternal hyperactive-impulsive symptoms interaction in the prediction of child hyperactive-impulsive symptoms. Boys with higher levels of symptoms came from homes characterized by higher levels of negative atmosphere and had mothers with higher levels of hyperactive-impulsive symptoms. There was also a trend (p = 0.075) for a maternal DAT1 x home atmosphere interaction. Boys with higher levels of inattentive symptoms came from homes with higher levels of negative atmosphere and had mothers with the homozygous 10/10 genotype. The maternal heterozygous 9/10 genotype did not predict child symptoms.     

What Do Sex, Twins, Spotted Hyenas, ADHD, and Sexual Orientation Have in Common?

ABSTRACT— The otoacoustic emissions (OAEs) measured in a collection of special populations of humans and certain nonhuman species suggest that OAEs may provide a window into some processes of human prenatal development and sexual differentiation. For reasons that are unclear, OAEs appear to be highly sensitive to events occurring during prenatal development that seem to be related to the degree of exposure to androgens a fetus receives. The (largely circumstantial) evidence for a relationship between androgen exposure and OAE strength comes from a series of studies of twins, children with attention-deficit/hyperactivity disorder, people of differing sexual orientations, and spotted hyenas, among others. Some conclusions are bolstered by parallel studies using auditory evoked potentials (AEPs). OAEs and AEPs are simple, objective, noninvasive measures that appear to have potential as tools of value to researchers working on a wide variety of basic and applied topics beyond audition.     

ADHD儿童的选择性抑制

采用较传统停止信号任务更为精确的选择性停止信号任务,探索ADHD的选择性抑制缺陷的机制。结果发现,ADHD儿童在选择性停止信号任务上,抑制失败的比率明显高于正常儿童,但是其执行加工速度和抑制加工速度与正常儿童没有差异,另外,ADHD儿童表现出了更大的反应变异性。研究认为,ADHD在选择性停止信号任务上的抑制缺陷并非由于抑制加工速度过慢所导致,而是由于其不能很好地维持最佳的激活状态所导致,状态调节理论更能反映ADHD的本质。     

Pre-existing Perceptions of ADHD Predict Children’s Sociometrics Given to Classmates with ADHD

Considerable research documents that even young children possess stigma about mental illness, which may affect how they evaluate peers with mental health conditions. This study examined children’s pre-existing perceptions of Attention Deficit/Hyperactivity Disorder (ADHD) behaviors as predictors of their subsequent sociometric judgments of classmates with ADHD in a 2-week summer day camp. Participants were previously unacquainted children ages 6.8–9.8 years (113 typically-developing and 24 with ADHD; 48.2% boys; 81% White). Children initially more inclined to interact with a hypothetical classmate with ADHD gave fewer “dislike” nominations to real-life classmates with ADHD at camp. Children who initially believed that ADHD symptoms were uncontrollable gave more “dislike” nominations and lower liking ratings to classmates with ADHD when those classmates displayed severe ADHD symptoms. For children who had ADHD, their attribution of uncontrollability for ADHD symptoms predicted fewer “like” nominations and more “dislike” nominations given to classmates with ADHD. Lastly, children who initially reported they would help a hypothetical classmate with ADHD gave higher liking ratings to classmates with ADHD. These results were found after statistical control of the actual level of ADHD behaviors displayed by the classmates with ADHD. In summary, other children’s pre-existing or stigmatizing perceptions of ADHD behaviors may contribute, in part, to the substantial peer rejection typically experienced by ADHD populations. Findings have implications for understanding peer problems in children with this common mental health condition.     

Emotional Impulsivity in Children with ADHD Associated with Comorbid—Not ADHD—Symptomatology

Children with ADHD often demonstrate sudden and intense shifts in both positive and negative affect. This study examined the role of diagnostic status on emotional impulsivity in children utilizing ecological momentary assessment (EMA). Parents of 64 8–12 year old children (15 ADHD-only; 27 ADHD-comorbid; 22 control) completed a diagnostic structured interview and then an EMA protocol, rating the child’s affect thrice daily for 28 days. Analysis of covariance (ANCOVA) suggested that children with ADHD and a comorbid disorder demonstrated significantly more EMA-derived emotional impulsivity than children with ADHD only and control children. No difference was found between children with ADHD only and control children. This study suggested that children with ADHD demonstrate significantly higher levels of emotional impulsivity than control children only in the presence of a comorbid disorder.     

Is attention impaired in ADHD?

Explanations of Attention Deficit Hyperactivity Disorder (ADHD) in terms of a weakness in Executive Function (EF) or related concepts, such as inhibition, are briefly reviewed. Some alternative views are considered, in particular a proposal by Manly and others that ADHD is a weakness primarily of sustained attention (plus control of attention), but not of selective attention, as measured by the Test of Everyday Attention in Children (TEA-Ch; Manly et al., 2001). The underlying structure of the TEA-Ch is analysed and it is concluded that the distinction between selective attention, sustained attention, and control of attention in this battery is not well-founded. Furthermore, evidence from studies by Wilding and others, from visual search tasks similar to those employed by Manly et al. to measure selective attention, demonstrates that, while unimpaired- and impaired-attention groups do not differ in speed of performance on such tasks (the measure employed in the TEA-Ch), they do differ reliably in accuracy. Available evidence from other visual search tasks comparing such groups is reviewed and found to be inconsistent. An attempt is made to resolve the inconsistencies and it is suggested that search tasks including demands that engage EF processes are more likely to demonstrate differences between these groups. It is concluded therefore that the most plausible explanation at present of impaired attention is in terms of weaknesses in EF. Suggestions for improving the precision and detail of this type of explanation are offered.     

Is ADHD a disinhibitory disorder?

Attention deficit hyperactivity disorder (ADHD) is widely theorized to stem from dysfunctional inhibitory processes. However, the definition of inhibition is imprecisely distinguished across theories. To clarify the evidence for this conception, the author relies on a heuristic distinction between inhibition that is under executive control and inhibition that is under motivational control (anxiety or fear). It is argued that ADHD is unlikely to be due to a motivational inhibitory control deficit, although suggestions are made for additional studies that could overturn that conclusion. Evidence for a deficit in an executive motor inhibition process for the ADHD combined type is more compelling but is not equally strong for all forms of executive inhibitory control. Remaining issues include specificity to ADHD, whether inhibitory problems are primary or secondary in causing ADHD, role of comorbid anxiety and conduct disorder, and functional deficits in the inattentive ADHD subtype.