Confirming the Factor Structure of Attention Deficit Hyperactivity Disorder Symptoms in Adult, Nonclinical Samples

Three separate models have been proposed to describe the factor structure of attention deficit hyperactivity disorder (ADHD) in the past 20 years. The Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III, 1980) proposed 3 separate factors of inattention, hyperactivity, and impulsivity. The DSM-III-R (1987) proposed a single factor. The DSM-IV (1994) described the disorder as having 2 factors: hyperactivity/impulsivity and inattention. The following 2 studies employed confirmatory factor analysis to compare each of these models and 3 alternative models. University students completed questionnaires that assessed each of the 18 symptoms listed in the DSM-IV for ADHD. The 3-factor model fit the data significantly better than each of the other models in both studies. These findings suggest that a 3-factor model of inattention, hyperactivity, and impulsivity describes adult ADHD symptoms better than current alternatives.     

ADHD儿童与正常儿童在视觉—动作方面的比较研究

10岁到13岁男性ADHD儿童在镶嵌图形、眼手协调、视力追踪和数字划销等视觉—动作实验上的分数显著低于同一年龄段的男性正常儿童,显示ADHD儿童的视觉—动作能力比正常儿童差.ADHD儿童与正常儿童相比,知觉方式的场独立性较弱,心理机能分化程度较低.ADHD儿童在长度估计实验上没有发现异常.     

Predicting the Early Developmental Course of Symptoms of Attention Deficit Hyperactivity Disorder

Data from the National Institute of Child Health and Human Development Study of Early Child Care were examined to test whether: attention deficit/hyperactivity disorder (ADHD) symptoms remain stable from 54 months through early elementary school; behavioral inhibition and attention deficits assessed at 54 months predict ADHD symptoms in elementary school, even after controlling for their temporal stability; and early behavioral inhibition and attention deficits moderate the longitudinal stability in ADHD symptoms. Data were examined using continuous and categorical measures of symptoms. Modest stability in ADHD symptoms from 54 months to third grade was found. Measures of inhibition and inattention predicted later teacher ratings uniquely, but no evidence was found for moderation. Measures of preschool behavioral inhibition also predicted “persistently at risk status” defined by elevated teacher ratings over time. Results are discussed in terms of executive and motivational facets of inhibition that may be related to early signs of ADHD.     

Establishing a Link Between Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder and Childhood Physical Abuse

Attention deficit disorder and attention deficit/hyperactivity disorders (ADD/ADHD) are found in approximately 5% to 10% of school-aged children. This study examined whether childhood physical abuse was associated with ADD/ADHD. Data were derived from a population-based sample of 13,054 adults from the 2005 Canadian Community Health Survey. We used logistical regression analysis in 2 models, both of which had ADD/ADHD as the criterion variable. There were 7 times higher odds of ADD/ADHD among those who reported they had been abused after controlling for several potential mediating factors, including age, race, gender, and 3 other types of adverse childhood experiences (parental divorce, parental addictions, and long-term parental unemployment) in comparison to those who were not abused. The results of this analysis show a strong link between childhood abuse and ADD/ADHD, an association that requires further study.     

Understanding the Covariation Among Childhood Externalizing Symptoms: Genetic and Environmental Influences on Conduct Disorder,Attention Deficit Hyperactivity Disorder,and Oppositional Defiant Disorder Symptoms

Conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) are common childhood externalizing disorders that frequently co-occur. However, the causes of their comorbidity are not well understood. To address that question, we analyzed data from > 600 Finnish twin pairs, who completed standardized interviews at age 14. Behavior genetic methods were used to examine how genetic/environmental factors contribute to each disorders symptoms and to their covariation. We found significant genetic effects on each disorder with only modest evidence of shared environmental influences. Our data suggest the comorbidity among CD, ADHD, and ODD is primarily explained by shared genetic influences; however, each disorder was also under unique genetic influence, supporting the distinction of each disorder.     

Interference Control in Children with Attention Deficit/Hyperactivity Disorder

The view that Attention Deficit/Hyperactivity Disorder (ADHD) is associated with a diminished ability to control interfference is controversial and based exclusively on results of (verbal)-visual interference tasks, primarily the Stroop Color Word task. The present study compares medication-naïve children with ADHD (n?=?35 and n?=?51 in Experiments 1 and 2, respectively) with normal controls (n?=?26 and n?=?32, respectively) on two interference tasks to assess interference control in both the auditory and the visual modality: an Auditory Stroop task and a Simon task. Both groups showed reliable but equal degrees of interference on both tasks, suggesting that children with ADHD do not differ from normal controls in their ability to control interference in either modality.     

Inhibition and Attention Deficit Hyperactivity Disorder

This paper updates the author's earlier hypothesis that Attention Deficit Hyperactivity Disorder (ADHD) reflects underactivity in Gray's Behavioral Inhibition System. Five areas of research are reviewed: (1) studies using the stop-signal task, (2) studies of errors of commission, (3) a study of inhibition indexed by eye movements, (4) a neuroimaging study of the corpus callosum, and (5) a study on the prediction of response to methylphenidate. Data from the many different dependent variables in these studies are interpreted as supporting disinhibition as a core deficit in ADHD.     

Creative Thinking in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD)

A widened attentional focus, that is typically associated with ADHD, has been postulated to be accompanied by enhanced creative ability. However, creativity has been only limitedly examined in ADHD. Performance across several creativity measures were investigated in three groups: adolescents with ADHD, those with conduct disorder, and a healthy control sample. The ADHD group exhibited selective cognitive advantages and disadvantages by demonstrating an enhanced ability in overcoming the constraining influence of examples, but a reduced capacity to generate a functional invention during an imagery task. These findings are interpreted with reference to inhibitory control mechanisms and the contextual modulation of creative cognition.     

The Development of Selective Attention in Children With Attention Deficit Hyperactivity Disorder

The influence of age on a selective attention task was studied in a sample of children with and without Attention Deficit Hyperactivity Disorder (ADHD). The impact of methylphenidate (MPH) treatment on selective attention was also investigated in the children with ADHD. Two age groups of children with ADHD and two age groups of control children were tested using a timed computer task. The task consisted of identifying visual target stimuli under various distracter conditions. Distracters varied on the basis of modality (i.e., visual, auditory, or both) and task relevance (i.e., meaningful or irrelevant). Reaction times and accuracy were measured. Children with ADHD were less efficient on the selective attention task than were children without ADHD, and older children were more efficient than younger children in both groups. Children without ADHD were influenced more by the nature of distracters than were children with ADHD. For children with ADHD, MPH improved performance overall.     

Language Abilities in Children with Attention Deficit Hyperactivity Disorder, Reading Disabilities, and Normal Controls

Research has demonstrated a high prevalence of language impairments (LI) and reading disabilities (RD) in children with attention deficit hyperactivity disorder (ADHD). Since RD is also associated with LI, it is unclear whether the language impairments are specific to ADHD or associated with comorbid RD. The language abilities of ADHD children with and without RD were investigated in a task requiring recall of a lengthy narrative, and in tests assessing knowledge of the semantic aspects of language. The study was conducted with 50 boys—14 ADHD, 14 ADHD + RD, 8 RD, and 14 normal controls, aged 7 to 11. Children with ADHD (ADHD-only, ADHD + RD) exhibited difficulties in organizing and monitoring their story retelling. Children with RD (RD-only, ADHD + RD) demonstrated deficits in receptive and expressive semantic language abilities on the language processing tests. The comorbid group (ADHD + RD) exhibited the deficits of both ADHD and RD children. The deficiencies of ADHD children are consistent with higher-order executive function deficits while the deficits of RD children are consistent with deficits in the basic semantics of language processing.     

Quantitative EEG Assessment During Neuropsychological Task Performance in Adults with Attention Deficit Hyperactivity Disorder

This study evaluated the neuropsychological performance of adults with and without Attention Deficit Hyperactivity Disorder (ADHD) during the Paced Auditory Serial Addition Test (PASAT), Wisconsin Card Sorting Test: Computerized Version 3 (WCST), and the Integrated Visual and Auditory Continuous Performance Test (IVA). Quantitative electroencephalographic (QEEG) data were also collected during task performance to examine differences in cortical activity between groups and tasks. Results suggest that adults with ADHD demonstrated lower levels of performance on the PASAT and IVA, tasks that involve working memory and processing speed, and sustained attention, respectively. Adults with ADHD also had more upper alpha activity during the IVA. Lastly, for the ADHD group, an increased theta/beta ratio during the IVA was significantly related to poorer attentional performance. The current results support reinforcing specific types of cortical activity though EEG operant conditioning (neurofeedback) as a treatment option in adults with ADHD. This paper is based largely in part on a dissertation by J. Noland White in partial fulfillment of the requirements of his doctoral program at The University of Tennessee. Portions of this study have been presented in summary form at several professional conferences.     

注意缺陷多动障碍儿童的表征搜索

为探索ADHD儿童在时间维度上的视觉选择性注意的基本机制,揭示其表征搜索能力是否存在缺陷,研究采用RSVP范式,通过实验材料(字母和数字)和呈现方式操作两种搜索方式:序列搜索和平行搜索,比较ADHD儿童(18名)和控制组儿童(17名)的成绩差异。结果发现:①在平行搜索和序列搜索条件下,ADHD儿童的成绩均低于正常控制组;②比较平行搜索和序列搜索条件下的成绩变化,以及由低难度到高难度上成绩的变化,无论是正确率还是反应时均发现ADHD儿童和正常儿童具有相同的成绩变化模式。结论认为ADHD儿童在视觉选择性注意的基本搜索机制上并不存在明显缺陷。     

Children with Attention Deficit Hyperactivity Disorder

ABSTRACT

It is estimated that there have been over 4,000 articles in the literature on the subject of attentional problems, addressing its etiology, epidemiology, assessment, diagnosis, and treatment. This article reviews recent and relevant literature with an eye toward functional conclusions and linkages between assessment and intervention. The article concludes by providing a problem-solving model that integrates parent or teachers' referral concerns, reasons for these concerns, assessment methods, and intervention strategies. In the end, four definitive conclusions are drawn, and the importance of multimodal strategies that collaboratively involve home, school, and community settings is emphasized.     

Executive Functioning, Temporal Discounting, and Sense of Time in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD)

Clinic-referred teens (ages 12–19) with ADHD and ODD (N = 101) were compared to community control (CC) teens, equated for age and sex, (N = 39) on a variety of psychological tasks assessing executive functioning (EF), temporal reward discounting, and time estimation and reproduction. A factor analysis reduced the EF measures to three dimensions, representing CPT Inattention, Working Memory, and CPT Inhibition. Results indicated that the ADHD group had significantly more CPT Inattention than the CC group. No differences were found for Working Memory or CPT Inhibition. The ADHD group displayed significantly greater temporal discounting of delayed hypothetical monetary rewards relative to immediate ones and manifested more impaired time reproduction, but not time estimation, than did the CC group. Main effects for level of IQ were found only on the Working Memory factor and largely did not interact with the group factor otherwise. The group differences in CPT Inattention, temporal discounting, and time reproduction were not a function of level of comorbid oppositional defiant disorder, delinquency, or anxiety–depression. Results are reasonably consistent with past research on EF and sense of time in children with ADHD and extend these findings to the adolescent age group. Problems with working memory and CPT inhibition found in prior studies of children with ADHD, however, were not evident here, perhaps owing to age-related improvements or insufficient task difficulty.     

Decision Making with Uncertain Reinforcement in Children with Attention Deficit/Hyperactivity Disorder (ADHD)

Reward-related processes are impaired in children with ADHD. Whether these deficits can be ascribed to an aversion to delay or to an altered responsiveness to magnitude, frequency, valence, or the probability of rewards still needs to be explored. In the present study, children with ADHD and normal controls aged 7 to 10 years performed a simple probabilistic discounting task. They had to choose between alternatives where the magnitude of rewards was inversely related to the probability of outcomes. As a result, children with ADHD opted more frequently for less likely but larger rewards than normal controls. Shifts of the response category after positive or negative feedback, however, occurred as often in children with ADHD as in control children. In children with ADHD, the frequency of risky choices was correlated with neuropsychological measures of response time variability but unrelated to measures of inhibitory control. It is concluded that the tendency to select less likely but larger rewards possibly represents a separate facet of dysfunctional reward processing, independent of delay aversion or altered responsiveness to feedback.     

Task Switching and Attention Deficit Hyperactivity Disorder

The main goal of the present set of studies was to examine the efficiency of executive control processes and, more specifically, the control processes involved in task set inhibition and preparation to perform a new task in attention deficit hyperactivity disorder (ADHD) and non-ADHD children. This was accomplished by having ADHD children, both on and off medication, and non-ADHD children perform the task-switching paradigm, which involves the performance of two simple tasks. In nonswitch trials, an individual task is performed repeatedly for a number of trials. In switch trials, subjects must rapidly and accurately switch from one task to the other, either in a predictable or unpredictable sequence. Switch costs are calculated by subtracting performance on the nonswitch trials from performance on the switch trials. These costs are assumed to reflect the executive control processes required for the coordination of multiple tasks. ADHD children showed substantially larger switch costs than non-ADHD children. However, when on medication, the ADHD children's switch performance was equivalent to control children. In addition, medication was observed to improve the ADHD children's ability to inhibit inappropriate responses. These data are discussed in terms of models of ADHD and cognition.     

Assessing Culturally Different Students for Attention Deficit Hyperactivity Disorder Using Behavior Rating Scales

Behavior rating scales are commonly used in the assessment of attention deficit-hyperactivity disorder (ADHD). However, there is little information available concerning the extent to which scales are valid with culturally different students. This study explored the use of the ADHD-IV Rating Scale School Version with male Caucasian (CA) and African American (AA) students from ages 5 to 18 years. Teachers rated AA students higher on all symptoms across all age groups. LISREL analysis indicated that scale does not perform identically across groups. This was supported by the results of multidimensional scaling with suggested that there is a different relation between items across groups. Implications for research and practice are discussed.     

DSM-IV Attention Deficit Hyperactivity Disorder Symptoms: Agreement Between Informants in Prevalence and Factor Structure at Different Ages

The agreement between teachers’ and parents’ ratings of the prevalence of DSM-IV attention deficit hyperactivity disorder (ADHD) symptoms and the concordance of the factor structure of ADHD symptoms was analyzed in a sample of 653 Spanish schoolchildren aged 4 to 12 divided into two age groups. The prevalence of ADHD symptoms ranged between 0.66 and 16.73% and was higher when the rater was the teacher. Agreement between parents and teachers was low. Confirmatory factor analysis (CFA) shows a slightly better fit for the three-factor model (Inattention, Hyperactivity and Impulsivity) than for the two-factor model (Inattention and Hyperactivity–impulsivity), except for parents’ ratings in the sample of children under six. CFA using a multitrait–multimethod model (CFA-MTMM) shows similar results.     

Confirmation of an Inhibitory Control Deficit in Attention-Deficit/Hyperactivity Disorder

The objective of this study was to determine whether deficient inhibitory control distinguishes children with a diagnosis of attention-deficit/hyperactivity (ADHD) disorder, conduct disorder (CD), and comorbid ADHD + CD from normally developing children. Participants were rigorously diagnosed children (age 7 to 12 years) with ADHD (N = 72), CD (N = 13) or ADHD + CD (N = 47) and 33 control children (NC). We studied inhibitory control using the stop-signal paradigm, a laboratory task that assessed the ability to inhibit an ongoing action. The ADHD group had significantly impaired inhibitory control compared to NC, CD, and ADHD + CD children. These results indicate that children with ADHD have deficient inhibition as measured in the stop-signal paradigm and that ADHD occurring in the presence of ADHD + CD may represent a phenocopy of CD rather than a variant of ADHD.