Antisocial behavior reduces the association between subdimensions of ADHD symptoms and alcohol use in a large population‐based sample of adolescents

The aim of this study was to investigate possible effects of antisocial behavior on reducing the association between subdimensions of ADHD symptoms (inattention, hyperactivity and impulsivity) and alcohol use. Boys and girls were analyzed separately using a population‐based Swedish adolescent sample. A randomly selected cross‐sectional survey was performed in secondary and upper secondary schools in Västmanland County during 2010. Participants were a population of 2,439 15–16 year‐olds and 1,425 17–18 year‐olds (1,947 girls and 1,917 boys). Psychosocial adversity, antisocial behaviors, symptoms of ADHD and alcohol use were assessed by questionnaires. Except for girls' inattention, subdimensions of ADHD symptoms were not associated with alcohol use when variance due to antisocial behavior was accounted for. Among boys, instead of an indirect effect of antisocial behavior on the association between impulsivity and alcohol use, a moderating effect was found. Among girls, the inattention component of ADHD was independently associated with alcohol use even when adjusted for antisocial behavior. The reduced associations between symptoms of hyperactivity, impulsivity, and alcohol use for boys and girls after adjusting for antisocial behavior suggest a considerable overlap between hyperactivity, impulsivity, and antisocial behavior. The direct pathway between inattention and alcohol use among girls suggests that girls with inattention symptoms are at risk of alcohol use regardless of antisocial behavior. Special attention should be given to these girls. Accounting for antisocial behavior reduced the relation between subdimensions of ADHD symptoms and alcohol use, and antisocial behaviors should therefore be screened for when symptoms of ADHD are present.     

Assessing inattention and impulsivity in children during the Go/NoGo task

Behavioural performance in the Go/NoGo task was compared with caregiver and teacher reports of inattention and hyperactivity‐impulsivity in 1,151 children (N=557 boys; N=594 girls) age 9–10 years old. Errors of commission (NoGo errors) were significantly correlated with symptom counts of hyperactivity‐impulsivity, while errors of omission (Go errors) were significantly correlated with symptom counts for inattention in both caregiver and teacher reports. Cross‐correlations were also evident, however, such that errors of commission were related to inattention symptoms, and errors of omission were related to hyperactivity‐impulsivity. Moreover, hyperactivity‐impulsivity and inattention symptoms were highly intercorrelated in both caregiver (r=.52) and teacher reports (r=.70), while errors of commission and omission were virtually uncorrelated in the Go/NoGo task (r=.06). The results highlight the difficulty in disentangling hyperactivity‐impulsivity and inattention in questionnaires, and suggest that these constructs may be more clearly distinguished in laboratory measures such as the Go/NoGo task.     

Developmental change in the relation between executive functions and symptoms of ADHD and co‐occurring behaviour problems

In a sample of 92 children aged 6–13 years this study investigates the normal developmental change in the relation between executive functioning (EF) and the core behavioural symptoms associated with attention deficit hyperactivity disorder (ADHD) (hyperactivity/impulsivity and inattention) as well as symptoms often co‐occurring with childhood hyperactivity (conduct‐ and internalizing problems). EF was assessed by using multiple tests grouped through prior factor analysis, resulting in cognitive measures relating to disinhibition, speed/arousal, verbal working memory, non‐verbal working memory, and fluency. The results showed that although disinhibition was positively related to hyperactivity/impulsivity and inattention mainly for the youngest age group, there were no significant age effects for these relations. Instead, age effects were found for the relations between speed/arousal and inattention as well as for the relations between verbal working memory/fluency and inattention. In the oldest age group poor performance on these cognitive measures was associated with high ratings of inattention. For the total sample a relation was obtained between disinhibition and hyperactivity/impulsivity as well as between both working memory measures and internalizing problems. In conclusion, the results from this study suggest that poor inhibition is most clearly associated with ADHD symptoms for younger children, whereas poor functioning with regard to later developing and more complex executive functions such as working memory and fluency is associated with ADHD symptoms for older children. Copyright © 2006 John Wiley & Sons, Ltd.     

Changes in 10‐year‐old children's body esteem: A time‐lag study between 2000 and 2010

This time‐lag study examined if there has been any changes in body esteem over a 10‐year period for 10‐year old children in Gothenburg, Sweden. Two cohorts of children, one in year 2000 and one in 2010, answered the same questionnaire about body esteem. A total of 960 children, 515 girls and 445 boys, participated in the first wave in 2000 and a total of 342 children, 171 girls and 171 boys participated in the second wave in 2010. The results showed a general stability in levels of body esteem for both girls and boys over the past 10 years. The gender differences, with boys being more satisfied with their appearance and weight compared to girls also seems to be stable over the years. In addition, the results also showed a somewhat positive development among the overweight girls with enhanced body esteem for the overweight girls compared to the non‐overweight girls during the ten years studied. Unfortunately, the same pattern was not found for overweight boys. For them the discrepancy in body esteem compared to non‐overweight boys, with the overweight boys being more dissatisfied, found in 2000 remained in 2010.     

Evidence for a General ADHD Factor from a Longitudinal General School Population Study

Recent factor analytic studies in Attention-Deficit/Hyperactivity Disorder (ADHD) have shown that hierarchical models provide a better fit of ADHD symptoms than correlated models. A hierarchical model includes a general ADHD factor and specific factors for inattention, and hyperactivity/impulsivity. The aim of this 12-month longitudinal study was to test the generalizability of the hierarchical models of ADHD within an elementary school population of 6–9 year old children (250 boys, 260 girls). Examination of differences as a function of informant (parent vs. teacher ratings), sex, and time was conducted. Six potential factor structures for the 18 items of the SWAN (Strengths and Weaknesses of ADHD-symptoms and Normal-behavior) scale were tested using confirmatory and exploratory factor analyses. Hierarchical models with a general ADHD factor and two or three specific factors best accounted for parent and teacher reports of symptoms for both boys and girls and at two time points separated by a 12-month interval. Findings indicate that the 18 SWAN items measure a common latent trait as well as orthogonal factors or dimensions of inattention and hyperactivity/impulsivity.     

Measurement and structural invariance of parent ratings of ADHD and ODD symptoms across gender for American and Malaysian children

The purpose of this study was to examine the measurement (configural, metric, scalar, and residual) and structural (factor variance, factor covariance, and factor means) invariance of parent ratings of the attention-deficit/hyperactivity disorder - inattention (ADHD-IN), ADHD - hyperactivity/impulsivity (ADHD-HI), and oppositional defiant disorder (ODD) symptoms as described in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) across boys and girls. In an American pediatric sample (N = 1,015) and a Malaysian elementary school-age sample (N = 928), there was strong support for configural, metric, scalar, residual, factor variance, and covariance invariance across gender within each sample. Both American and Malaysian boys had significantly higher scores on the ADHD-IN and ADHD-HI factor means than did girls, whereas only in the American sample did boys score significantly higher on the ODD factor than did girls. The implications of the results for the study of gender, ethnic, and cultural differences associated with ADHD and ODD are discussed.     

The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes

Klenberg, L., Jämsä, S., Häyrinen, T., Lahti‐Nuuttila, P. & Korkman, M. (2010). The Attention and Executive Function Rating Inventory (ATTEX): Psychometric properties and clinical utility in diagnosing ADHD subtypes. Scandinavian Journal of Psychology, 51, 439–448. This study presents a new inventory, the Attention and Executive Function Rating Inventory (ATTEX), and examines the psychometric properties and the clinical utility of ATTEX in indentifying the attention deficit hyperactivity disorder combined type (ADHD‐C) and the ADHD predominantly inattentive type (ADHD‐I) in school environments. A normative sample of Finnish 7‐ to 15‐year‐old children and adolescents (N = 701) and a clinical sample consisting of children with ADHD‐C (N = 190) and ADHD‐I (N = 25) were examined with the ATTEX and the ADHD Rating Scale‐IV. The ATTEX and its scales had good internal consistency reliability (0.67–0.98) and criterion validity (0.68–0.95). Normative data was provided for the total normative sample and for boys and girls separately. Gender differences were noted in the ATTEX scores, boys having consistently higher scores on all ATTEX scales. The effect of age was significant only for one of the ten scales, the Motor hyperactivity scale, 7‐year‐olds having more problems of hyperactivity than 14‐year‐olds. Lower parent education level and the child’s learning difficulties were related to higher ratings of EF problems in ATTEX. When different cutoff scores for boys and girls were applied, ATTEX was sensitive in identifying children with attention deficit disorders. In addition, ATTEX was accurate in differentiating children with ADHD‐I from children with ADHD‐C. In this Finnish sample, ATTEX showed solid psychometric properties and could be used as a reliable tool in the diagnostic evaluation of ADHD‐C and ADHD‐I.     

Aggressivity,inattention, hyperactivity,and impulsivity in boys at high and low risk for substance abuse

Aggressivity, inattention, hyperactivity, and impulsivity are cardinal dimensions of externalizing behavior problems of childhood. They are diagnostic and clinical features of childhood disorders, and are thought to be linked to the subsequent development of adult disorders such as substance abuse (SA). Little is known, however, about the convergent and discriminant validity of these four constructs. We used multiple measures to develop indices of aggressivity, inattention, hyperactivity, and impulsivity in a sample of 10- to 12-year-old boys (N=183) with and without a family history of SA. Data were taken from mother reports, child reports, teacher reports, and laboratory tasks. The study aims were (1) to test the convergent and discriminant validity of aggressivity, inattention, hyperactivity, and impulsivity; (2) to examine whether the data were consistent with a model specifying the four constructs as indicators of one superordinate factor; and (3) to differentiate boys with and without a family history of SA in construct scores. The results supported the convergent and discriminant validity of the four constructs. Although discriminable, the constructs covaried strongly and were consistent with a model specifying them as indicators of a single superordinate factor. Boys with a family history of substance abuse scored higher than control boys on aggressivity, inattention, and impulsivity scores, but the groups did not differ on hyperactivity scores. The results are discussed in terms of the role of childhood behavior problems in vulnerability to SA.This work was supported by the National Institute on Drug Abuse grant No. DA 05605.     

A Preliminary Study of ADHD Symptoms and Correlates: Do Abused Children Differ from Nonabused Children?

In this pilot study, differences in inattention, impulsivity, and hyperactivity as well as demographic factors were investigated in a community sample of 8- through 11-year-olds, approximately half of whom had experienced child abuse or neglect. Parents completed the Attention Deficit Hyperactivity Disorder Test, the SNAP-IV, the Brief Betrayal Trauma Survey – Parent version, and additional questions. Abused children had more severe impulsivity and inattention, but not hyperactivity, symptoms. Abused boys and girls had a similar age of onset of symptoms, whereas nonabused girls had a much later age of onset than nonabused boys. ADHD is a significant problem among maltreated children. These data support large scale studies investigating possible differences in etiology, presentation, and treatment.     

Behaviour–emotional characteristics of primary‐school children rated as having language problems

Background Primary‐school teachers are expected to detect problems related to language function, but the teachers' evaluations may be heavily influenced by gender and classroom behaviour. Aim To investigate the relationship between language problems (LPs) and behaviour–emotional problems as rated by primary‐school teachers. Methods All participants participated in a population‐based study, the Bergen Child Study (BCS). Teachers of 9,072 children and parents of 6,234 children completed forms containing questions pertaining to language function and the strengths and difficulties questionnaire (SDQ) to screen for behaviour–emotional problems. LP was defined as a score above the 95th percentile on the sum score of five language items. Children achieving a total SDQ score above the 90th percentile were defined as high scorers, indicating a high risk for behavioural–emotional problems. Results Based on teacher reports, 540 children were defined as having LP, more boys (N = 366) than girls. Children defined as having LP were reported to have significantly higher scores on all SDQ subscales, and a higher total difficulty score than children without language problems (NLP). More LP boys than LP girls were defined as high scorers on the SDQ, with the highest effect size on the hyperactivity–inattention subscore. The agreement between teachers and parents was moderate to low, with the highest consensus of behaviour–emotional problems in children with LP. Conclusions Primary‐school children defined as having LP according to their teachers are frequently characterized by behavioural–emotional problems. Further assessment is warranted for primary‐school children defined as having LP by their teachers.     

Telling stories: Gender differences in peers’ emotion talk and communication style

Eighty girls and 64 boys (M= 6 years; 8 months, SD= .65) narrated a wordless picture book in mixed‐ or same‐gender dyads. In mixed‐gender as well as same‐gender dyads, girls used more emotion explanations than did boys. Combined across dyad type, girls used more emotion labels than did boys. Girls used a higher proportion of collaborative speech acts than did boys in same‐gender dyads, but girls and boys used the same amount in mixed‐gender dyads. Whereas girls used a higher proportion of informing acts in mixed‐gender dyads than did boys, boys used more than did girls in same‐gender dyads. The findings support contextual models of gender and suggest that speaker as well as partner gender influence emotion expression and conversational style.     

Parent–Adolescent Agreement on Disruptive Behavior Symptoms: A Multitrait-Multimethod Model

This study examined parent–adolescent agreement on reports of inattention, hyperactivity/impulsivity, and conduct disorder in 203 adolescents (94 girls, 109 boys) ranging in age from 13 to 18 years (M = 15.21, SD = 1.37). Results of confirmatory factor analyses provided additional evidence of construct validity for these traits in adolescents. Internal consistency was examined for parent reports and adolescent self-reports. In addition, correlational analyses were used in a multitrait-multimethod format (MTMM; D. T. Campbell & D. W. Fiske, 1959) to examine convergent and discriminant validity. Results showed that parents provided more consistent and valid reports of inattention and hyperactivity/impulsivity, whereas adolescents provided more consistent and valid reports of conduct disorder. In addition, interviews produced higher levels of convergence than rating scales. These findings are discussed in terms of implications for assessment of disruptive behavior disorders.     

Four‐year‐olds' beliefs about how others regard males and females

Children's awareness of how others evaluate their gender could influence their behaviours and well‐being, yet little is known about when this awareness develops and what influences its emergence. The current study investigated culturally diverse 4‐year‐olds' (N = 240) public regard for gender groups and whether exposure to factors that convey status and highlight gender influenced it. Children were asked whether most people thought (i) girls or boys, and (ii) women or men, were better. Overall, children thought others more positively evaluated their own gender. However more TV exposure and, among girls only, more traditional parental division of housework predicted children stating that others thought boys were better, suggesting more awareness of greater male status. Children's public regard was distinct from their personal attitudes.     

Effects of maternal postpartum depression in a well‐resourced sample: Early concurrent and long‐term effects on infant cognitive,language, and motor development

This study examined early and long‐term effects of maternal postpartum depression on cognitive, language, and motor development in infants of clinically depressed mothers. Participants were 83 mothers and their full‐term born children from the urban region of Copenhagen, Denmark. Of this group, 28 mothers were diagnosed with postnatal depression three to four months postpartum in a diagnostic interview. Cognitive, language, and motor development was assessed with the Bayley Scales of Infant and Toddler Development third edition, when the infants were 4 and 13 months of age. We found that maternal postpartum depression was associated with poorer cognitive development at infant age four months, the effect size being large (Cohen's d = 0.8) and with similar effects for boys and girls. At 13 months of age infants of clinical mothers did not differ from infants of non‐clinical mothers. At this time most (79%) of the clinical mothers were no longer, or not again, depressed. These results may indicate that maternal depression can have an acute, concurrent effect on infant cognitive development as early as at four months postpartum. At the same time, in the absence of other risk factors, this effect may not be enduring. The main weaknesses of the study include the relatively small sample size and that depression scores were only available for 35 of the non‐clinical mothers at 13 months.     

Self‐esteem and emotional health in adolescents – gender and age as potential moderators

Moksnes, U. K. & Espnes, G. A. (2012). Self‐esteem and emotional health in adolescents – gender and age as a potential moderators. Scandinavian Journal of Psychology 53, 483–489. The present paper investigates possible gender and age differences on emotional states (depression and anxiety) and self‐esteem as well as the association between self‐esteem and emotional states. The cross‐sectional sectional sample consists of 1,209 adolescents 13–18 years from public elementary and secondary schools in mid‐Norway. The results showed that girls reported higher scores on state anxiety and state depression, whereas boys consistently scored higher on self‐esteem in all age groups. Self‐esteem was strongly and inversely associated with both state depression and state anxiety. An interaction effect of gender by self‐esteem was found on state depression, where the association was stronger for girls than for boys. The associations found give support for the positive role of self‐esteem in relation to adolescents’ emotional health and well‐being.     

Boys’ and girls’ involvement in science learning and their self‐efficacy in Taiwan

This cross‐sectional study investigated the significant differences in students’ self‐efficacy and their involvement in learning science. Nine hundred and twenty‐two elementary school fifth graders, 499 junior high school eighth graders, and 1455 senior or vocational high school eleventh graders completed the students’ questionnaire. Analyses of variance (ANOVAs) and independent t‐tests compared the significant similarities and differences across school levels and genders. The initial findings were as follows: A sharp decline in boys’ and girls’ self‐efficacy scores from elementary to secondary school levels; boys have significantly higher self‐efficacy scores than girls at vocational and senior high school levels; students with more involvement in science learning presented significantly higher self‐efficacy scores than those with less involvement. The significant discrepancies in terms of gender and age in students’ self‐efficacy and involvement in learning science need to be addressed. Implications and limitations are provided.     

Sex differences in school-aged children with pervasive attention deficit hyperactivity disorder

This study investigated 54 children (37 boys and 17 girls) with cross-situational attention deficit hyperactivity disorder (ADHD) to determine whether there are sex differences in the expression of either the primary or secondary symptomatology of ADHD. Results indicated that the male and female ADHD groups were strikingly similar on all measures of primary (impulsivity, inattention, and overactivity) and secondary (learning problems, externalizing symptoms, internalizing symptoms, peer relationship difficulties, and self-perceptions) symptomatology included in this study. The lack of significant sex differences conflicts with prior reports in the literature, and these conflicting results are discussed in terms of differences in inclusion criteria. Implications for understanding the long-term outcome of ADHD in girls are also discussed.     

Rearing practices and impulsivity/hyperactivity symptoms in relation to inflated responsibility and obsessive‐compulsive symptoms

Smári, J., Rúrik Martinsson, D., & Einarsson, H. (2010). Rearing practices and impulsivity/hyperactivity symptoms in relation to inflated responsibility and obsessive‐compulsive symptoms. Scandinavian Journal of Psychology, 51, 392–397. The aim of the study was to investigate potential precursors of inflated responsibility (responsibility attitudes) and obsessive‐compulsive (OCD) symptoms. It was argued that both parental overprotection and impulsivity, separately and in interaction with each other, contribute to inflated responsibility and OCD symptoms. In a large sample of young adults (N = 570), self‐report measures of OCD symptoms (OCI‐R), responsibility attitudes (RAS), anxiety/depression (HADS), rearing practices (EMBU), present and past impulsivity/hyperactivity symptoms (IMP/HY) were administered. Overprotection as well as IMP/HY were found to predict OCD symptoms as well as inflated responsibility. Finally, a significant interaction was found between IMP/HY and overprotection with regard to both OCD symptoms and inflated responsibility. This effect reflected that IMP/HY was more strongly related to OCD symptoms and responsibility in people who had not been overprotected than in people who had been. Conversely overprotection was related to OCD symptoms and responsibility in people low but not in people high in IMP/HY. The results seem to indicate that the inadequacy between offer and need for parental control may play a role in the development of OCD symptoms.     

Prenatal Smoke Exposure Predicts Hyperactive/Impulsive but Not Inattentive ADHD Symptoms in Adolescent and Young Adult Girls

We examined the longitudinal associations between prenatal tobacco smoke exposure (PSE) and attention‐deficit hyperactivity disorder (ADHD) symptom domains in adolescence and young adulthood. A sample of girls with ADHD combined presentation (N = 93), ADHD predominantly inattentive presentation (N = 47), and matched comparisons (N = 88) was assessed prospectively. Symptoms of hyperactivity/impulsivity (HI), inattention (IA), and oppositionality (oppositional defiant disorder) were measured via multiple informants 5 (M age = 14 years; retention rate = 92%) and 10 years (M age = 20 years; retention rate = 95%) following childhood ascertainment. PSE was captured via maternal self‐report. We used linear regressions to examine the prediction from PSE to both HI and IA in adolescence and early adulthood after stringent control of relevant confounding variables. PSE significantly predicted HI during adolescence and young adulthood across multiple informants but did not predict IA at either wave. Symptoms of HI may have partial etiological independence from IA symptoms. Copyright © 2015 John Wiley & Sons, Ltd.