Big five dimensions and ADHD symptoms: links between personality traits and clinical symptoms

Attention-deficit/hyperactivity disorder (ADHD) in adulthood is conceptualized as originating in childhood. Despite considerable theoretical interest, little is known about how ADHD symptoms relate to normal personality traits in adults. In 6 studies, the Big Five personality dimensions were related to ADHD symptoms that adults both recalled from childhood and reported concurrently (total N = 1,620). Substantial effects emerged that were replicated across samples. First, the ADHD symptom cluster of inattention-disorganization was substantially related to low Conscientiousness and, to a lesser extent, Neuroticism. Second, ADHD symptom clusters of hyperactivity-impulsivity and oppositional childhood and adult behaviors were associated with low Agreeableness. Results were replicated with self-reports and observer reports of personality in community and clinical samples. Findings support theoretical connections between personality traits and ADHD symptoms.     

Parenting of children with attention-defecit/hyperactivity disorder (ADHD): the role of parental ADHD symptomatology

OBJECTIVE: The present study examined the relation between parental ADHD symptomatology and parent-child behavior among 46 mothers and 26 fathers of ADHD children. RESULTS: Fathers' self-reports of inattention and impulsivity were strongly associated with self-reports of lax parenting both before and after parent training, and with self-reports of overreactivity after parent training. Fathers' impulsivity was also associated with more arguing during audiotaped observations of parent-child interactions prior to parent training. Mothers' self-reports of inattention were modestly associated with self-reports of laxness before and after parent training. Prior to parent training, there were non-linear relations between mothers' inattention and observations of mother-child behavior, with mothers who reported moderate levels of inattention engaging in the most negative parent-child interactions. After parent training, these relations were linear, with the mothers who reported the most inattention engaging in the most negative parent-child interactions. These results were weakened but were generally still significant when parental depression and alcohol use were controlled.     

Personality development from late adolescence to young adulthood: differential stability, normative maturity, and evidence for the maturity-stability hypothesis

This investigation examined personality development during the transition from adolescence to adulthood using the brief form of the Multidimensional Personality Questionnaire (Patrick, Curtin, & Tellegen, 2002). Parent and self-reports of personality were obtained in 1994 (average age=17.60 years), and self-reports were obtained in 2003 (average age=27.24 years). There was evidence of both differential stability and normative changes in the direction of increased functional maturity during this transition. Moreover, adolescents with more mature personalities in 1994 tended to show fewer personality changes from 1994 to 2003. These maturity-stability effects held when parent reports were used to assess personality. All told, there was evidence of both stability and change in personality during the transition to adulthood.     

The Accuracy of Retrospective Recall of Childhood ADHD: Results from a Longitudinal Study

Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset condition that may continue into adulthood. When assessing adult patients, clinicians usually rely on retrospective reports of childhood symptoms to evaluate the age-of-onset criterion. Since inaccurate symptom recall may impede the diagnosis and treatment of ADHD, knowledge about the factors influencing retrospective reports is needed. This longitudinal study investigated (a) the accuracy of retrospective symptom ratings by adult participants with a childhood diagnosis of ADHD (self-ratings) and parents or significant others (proxy ratings), and (b) the influence of current ADHD symptom severity and ADHD-associated impairments on retrospective symptom ratings. Participants (N =?55) were members of the Cologne Adaptive Multimodal Treatment (CAMT) study who had been referred and treated for ADHD in childhood and were reassessed in adulthood (average age 27 years). Participants’ retrospective self-ratings were substantially lower than, and did not correlate with, parents’ ADHD symptom ratings provided at study entry, while retrospective symptom ratings provided by proxy respondents correlated moderately with parents’ childhood ratings. In addition, participants were more likely to underreport childhood symptoms (79%) and more frequently denied the presence of three or more childhood symptoms (17%) compared to proxy respondents (65% underreporting, 10% false-negative recall). Proxy respondents’ symptom recall was best predicted by childhood ADHD, while participants’ symptom recall was best predicted by current ADHD symptom severity. ADHD-associated impairments were not correlated with symptom recall after controlling for childhood ADHD. Together, these findings suggest a recall bias in adult patients and question the validity of retrospective reports, even in clinical samples.

     

Clinical,Sociobiological, and Cognitive Predictors of ADHD Persistence in Children Followed Prospectively Over Time

With increasing awareness that ADHD is chronically disabling, a burgeoning literature has examined childhood clinical indicators of ADHD persistence. This study investigates whether childhood factors reflecting biological risk and cognitive reserve have additive predictive value for the persistence of ADHD that is unique beyond childhood indicators of disorder severity. One-hundred thirty children with ADHD (mean age = 8.9 years, 75 % male) were followed into adolescence (mean age = 14.0 years). Childhood ADHD and co-morbidities were assessed via interviews with parents and teachers; parental psychopathology was assessed via parent interview; exposure to neurobiological and psychosocial adversity were indexed by parent questionnaire; and cognitive reserve was evaluated through children’s performance on measures of IQ and executive functioning. Univariate analyses identified childhood inattention and hyperactivity-impulsivity, co-morbid oppositional defiant disorder, overall impairment, and paternal anxiety and depression as more prevalent amongst adolescents with persistent compared with remitted ADHD. Only child-level predictors remained significant in a final multivariate model. These results suggest that children who are most likely to experience persistent ADHD have a more severe clinical presentation in childhood, reflected by increased levels of inattention, oppositional behavior, and impairment. They also are more likely to have fathers with internalizing concerns, but these concerns do not uniquely predict ADHD persistence beyond child-level factors. Contrary to expectations, childhood adversity and cognitive functioning did not predict the course of ADHD.     

Adolescents with attention deficit hyperactivity disorder: Mother-adolescent interactions,family beliefs and conflicts,and maternal psychopathology

A group of 83 adolescents with attention deficit hyperactivity disorder (ADHD) were subdivided into those with ADHD alone (n = 27) and those with ADHD and oppositional defiant disorder (ADHD/ODD, n = 56). They were compared to each other and a community control group (n = 77) on measures of family conflicts, family beliefs, maternal adjustment, and observations of mother-adolescent interactions during both a neutral and conflict discussion. Both ADHD groups had more topics on which there was conflict and more angry conflicts at home than control adolescents on parent reports. Only the ADHD/ODD adolescents reported more such conflicts, endorsed more extreme and unreasonable beliefs about their parent-teen relations, and demonstrated greater negative interactions during a neutral discussion than the control teenagers. Similarly, only mothers of the ADHD/ODD teens displayed greater negative interactions during a neutral discussion, more extreme and unreasonable beliefs about their parent-teen relations, greater personal distress, and less satisfaction in their marriages than the mothers in the control group. Most findings for the ADHD only group were between the control group and the group with mixed ADHD/ODD but did not differ from either group. Results imply that it is the combination of ODD symptoms with those of ADHD that is associated with the greater-than-normal conflicts, anger, poor communications, unreasonable beliefs, and negative interactive styles seen in ADHD adolescents. These same characteristics typify their mothers' interactions as well such that both the adolescents' ODD symptoms and maternal psychological distress (hostility) make unique contributions to the degree of conflict and anger in the parent-teen relations of ADHD adolescents.     

Evaluation of a domain-specific anger expression assessment strategy

Previous studies have shown that self-reports of an individual's anger expression vary between the home and the work domain. The aim of this study was to investigate the validity of such self-reports by comparing them with reports of intimate partners and work colleagues in the respective domain. Participants (N= 86) rated their anger expression on the general and on domain-specific versions of the State-Trait-Anger Expression Inventory (Spielberger, 1988). The self-rated anger-out-home scores correlated highly with partner ratings of anger-out-home scores (r = .61) and colleague ratings of anger-out-work scores correlated substantially with self-rated anger-out-work scores (r = .54). A similar but weaker correlation pattern emerged for anger control but not for anger-in. Self-other correspondence was higher for the domain-specific anger expression assessment than for the general anger expression assessment. These results demonstrate that the domain-specific strategy for the assessment of self-reported anger expression can validly measure differences in anger expression in different domains.     

Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety

Adolescents experiencing social anxiety often experience co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms. Yet, assessing for social anxiety poses challenges given the already time-consuming task of distinguishing social anxiety from other commonly co-occurring internalizing conditions (e.g., generalized anxiety, major depression). Assessors need short screening devices to identify socially anxious adolescents in need of intensive ADHD assessments. A six-item version of the ADHD Self-Report Scale (ASRS-6) was originally developed to identify adults who likely meet diagnostic criteria for ADHD, but its psychometric properties have yet to be examined among adolescents. We tested the psychometric properties of the ASRS-6 when administered in clinical assessments for adolescent social anxiety. Eighty-nine 14–15 year old adolescents and their parents (67.4% female; 62.1% African American; 30 Clinic-Referred; 59 Community Control) completed the ASRS-6, measures of adolescent social anxiety and depressive symptoms, and parent-adolescent conflict. Adolescent self-reported and parent-reported ASRS-6 positively related with scores from established measures of social anxiety, depressive symptoms, and parent-adolescent conflict. Further, adolescent self-reported (but not parent-reported) ASRS-6 scores significantly discriminated adolescents on referral status. Adolescent self-reported (but not parent-reported) ASRS-6 scores incrementally predicted social anxiety over-and-above depressive symptoms, which commonly co-occur with social anxiety. Conversely, parent-reported (but not adolescent self-reported) ASRS-6 scores incrementally predicted parent-adolescent conflict over-and-above depressive symptoms, which commonly co-occur with conflict. When assessing adolescent ADHD symptoms, adolescents’ and parents’ reports meaningfully vary in their links to validity indicators. As such, among adolescents assessed for social anxiety, clinical assessments of adolescent ADHD symptoms should include both parent reports and adolescent self-reports.     

Contribution of ADHD symptoms to substance problems and delinquency in conduct-disordered adolescents

We examined adolescents with conduct disorder (CD) and substance problems to determine if those with attention deficit hyperactivity disorder (ADHD) symptomatology had more severe delinquency and substance involvement. ADHD symptomatology was assessed in two ways: (1) by self-reports using the Diagnostic Interview Schedule for Children (DISC) and (2) by use of DISC plus reports of others (parents, program staff, and program teacher). We divided boys into three ADHD groups based on DISC: those who met criteria, those who reported at least eight current symptoms, and those who reported fewer than eight symptoms. We also divided the same boys into two groups: those with reports of ADHD by two or more sources and those without this multisource ADHD. Examining these definitions of ADHD revealed that boys with either self- or multisource ADHD had more CD symptoms, earlier age of CD onset, more substance dependence diagnoses, and more comorbid depression and anxiety.This investigation was supported by the National Institute on Drug Abuse Grant No. DAO6941.     

Anxiety and Depression in Children with HFASDs: Symptom Levels and Source Differences

The purpose of this study was to: (1) examine symptom levels of anxiety and depression in children with high-functioning autism spectrum disorders (HFASDs) compared with matched control children using child self-reports and parent ratings; and (2) examine source differences within the two condition groups. An overall multivariate effect indicated significantly elevated depression and anxiety symptoms for children with HFASDs based on parent reports; however no significant between-group differences based on child self-reports. Within-condition source comparisons (parent vs. child) revealed a significant multivariate effect indicating a significant difference in symptoms of depression and anxiety for the HFASD group but none for the control. Correlations between parent and child reports for the HFASD group suggested some positive association between child-reports and parent-reports for depressive symptoms only; however, the difference in average scores reflected a substantial discrepancy in the magnitude of symptoms by rater. Implications for clinical assessment and future research are provided.     

Cross-cultural comparison of ADHD symptoms among Japanese and US university students

Problems related to attention, hyperactivity, and impulsiveness are known to impact social, academic, and vocational success. When the problems begin in childhood and lead to impaired functioning, the syndrome is identified as attention-deficit/hyperactivity disorder (ADHD). Symptoms of the syndrome persist into adolescence and adulthood for many individuals, but less is known about characteristics of adults compared to children, especially adults attending university. Furthermore, there is little cross-national and cross-cultural research. This study compared DSM-IV-TR ADHD symptoms of US university students (N=271) to Japanese peers (N=712). Comparison of group means on a DSM-IV-TR-based checklist indicated that Japanese students reported more problems with inattention (and overall ADHD symptoms) but not hyperactive-impulsive symptoms. Although differences were statistically significant, effect sizes were small, indicating that for practical purposes, the students reported similar levels of symptoms. Japanese students reported higher rates of meeting or exceeding symptom counts that comprise diagnostic criteria for ADHD, but differences were quite small. Using DSM-IV-TR thresholds, 5.70% of US students and 6.27% of Japanese students reported enough symptoms to meet the cut-off for inattentive, hyperactive/impulsive, or combined type during childhood. With regard to recent problems, 2.66% of US students and 4.52% of Japanese students reported enough symptoms to meet the cut-off for one of the three subtypes. Comparisons using other methods of calculating rates are also provided. This research adds to the limited knowledge of ADHD symptoms in university students across countries and it supports the view that ADHD is not merely a cultural construct. This study is among the first to identify potential attention problems in Japanese university students.     

Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample

To examine Swanson, Nolan, and Pelham-IV (SNAP-IV) psychometric properties, parent (N = 1,613) and teacher (N = 1,205) data were collected from a random elementary school student sample in a longitudinal attention deficit hyperactivity disorder (ADHD) detection study. SNAP-IV reliability was acceptable. Factor structure indicated two ADHD factors and an oppositional defiant disorder (ODD) factor. Parent and teacher scores varied by gender and poverty status (d = .49-.56) but not age; only teacher scores varied by race (d = .25-.55). Screening and diagnostic utility was evaluated with likelihood ratios (LRs) and posttest probabilities. Parent SNAP-IV scores above 1.2 increased probability of concern (LR > 10) and above 1.8, of ADHD diagnosis (LR > 3). Teacher hyperactivity/impulsivity scores above 1.2 and inattention scores above 1.8 increased probabilities of concern only (LR = 4.2 and >5, respectively). Higher teacher scores for African American children and race differences in measurement models require future study.     

Attentional networks,vigilance, and distraction as a function of attention-deficit/hyperactivity disorder symptoms in an adult community sample

Attentional difficulties are a core axis in attention-deficit/hyperactivity disorder (ADHD). However, establishing a consistent and detailed pattern of these neurocognitive alterations has not been an easy endeavour. Based on a dimensional approach to ADHD, the present study aims at comprehensively characterizing three key attentional domains: the three attentional networks (alerting, orienting, and executive attention), two components of vigilance (executive and arousal vigilance), and distraction. To do so, we modified a single, fine-grained task (the ANTI-Vea) by adding irrelevant distractors. One hundred and twenty undergraduates completed three self-reports of ADHD symptoms in childhood and adulthood and performed the ANTI-Vea. Despite the low reliability of some ANTI-Vea indexes, the task worked successfully. While ADHD symptoms in childhood were related to alerting network and arousal vigilance, symptoms in adulthood were linked to executive vigilance. No association between ADHD symptom severity and executive attention and distraction was found. In general, our hypotheses about the relationships between ADHD symptoms and attentional processes were partially supported. We discuss our findings according to ADHD theories and attention measurement.     

Comorbid attention-deficit/hyperactivity disorder in borderline patients defines an impulsive subtype of borderline personality disorder

In order to examine the impulsive profile of a BPD sample with comorbid ADHD, adult patients who met criteria for BPD were assessed for ADHD with the CAADID and the WURS. A high rate of ADHD in the BPD sample was found, with sixty-nine (38.1%) BPD patients diagnosed as having comorbid adult ADHD. BPD-ADHD group had higher rates of general substance use disorder (59.4% vs. 38.4%), antisocial personality disorder (7.2% vs. 0.9%) and obsessive-compulsive personality disorder (21.7% vs. 6.3%). The BPD group without comorbid adult ADHD showed a higher rate of mood disorders (62.5% vs. 37.7%), panic disorders (54.5% vs. 23.1%) and benzodiazepine abuse (18.8% vs. 5.8%). Only in BPD patients without ADHD was comorbid avoidant personality disorder found. BPD patients could be distinguished in two clear subgroups related to the adult ADHD comorbidity. BPD-ADHD patients showed a more homogeneous and impulsive profile while BPD without ADHD comorbidity had more anxiety and depressive disorders.     

Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults

Researchers who study subtypes of attention-deficit/hyperactivity disorder (ADHD) in children have identified a subset having a sluggish cognitive tempo (SCT) typified by symptoms of daydreaming, mental confusion, sluggish-lethargic behavior, and hypoactivity, among others who differ in many respects from ADHD. No studies have examined the nature and correlates of SCT in adults. This study sought to do so using a general population sample in which those having high levels of SCT symptoms were identified (≥95th percentile) and compared to adults having high levels of ADHD symptoms and adults having both SCT and ADHD symptoms. From a representative sample of 1,249 U.S. adults 18-96 years four groups were created: (a) high levels of SCT but not ADHD (N = 33), (b) high levels of ADHD but not SCT (N = 46), (c) high levels of both SCT and ADHD (N = 39), and (d) the remaining adults as a control group (N = 1,131). As in children, SCT formed a distinct dimension from ADHD symptoms that was unrelated to age, sex, or ethnicity. Adults in both ADHD groups were younger than those with SCT only or control adults. The SCT-only group had less education than the control group, whereas both SCT groups earned less annual income than the control or ADHD-only group. More individuals in the combined group were out of work on disability. In their EF, both SCT groups reported greater difficulties with self-organization and problem solving than controls or the ADHD-only group. Otherwise, the SCT + ADHD group reported significantly greater problems with all other domains of EF than the other groups. But both the SCT-only and ADHD-only groups had significantly more EF difficulties than controls though not differing from each other. A similar pattern was evident on most ratings of psychosocial impairment, except in work and education where SCT was more impairing than ADHD alone and in driving where ADHD was more impairing. SCT contributed unique variance to EF deficits and psychosocial impairment apart from ADHD inattention and hyperactive-impulsive symptoms. Results further suggested that a symptom threshold of 5 or more out of 9 along with a requirement of impairment would result in 5.1% of the population as having SCT. It is concluded that SCT may be a separate disorder from ADHD yet with comorbidity occurring in approximately half of all cases of each. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Longitudinal impact of parental and adolescent personality on parenting

This study provides a test of how personality may shape social behaviors in a long-lasting dyad: the parent-adolescent relationship. In a large Belgian community sample, it was examined which parent Big Five characteristics were related to parenting and whether adolescent Big Five characteristics elicited certain parenting behaviors. Further, the proposition that individual differences are amplified under stress was examined by exploring whether parent personality was differentially related to parenting for parents of "easy" versus "difficult" adolescents. Moreover, possible differences in associations across parental and adolescent gender were explored. Mothers (N = 467) and fathers (N = 428) reported on their personality using the Five-Factor Personality Inventory; adolescents (N = 475) assessed their personality with the Hierarchical Personality Inventory for Children. Two types of parenting behaviors, overreactive discipline and warmth, were assessed 2 years later by parent self-reports, partner reports, and adolescent reports, from which multi-informant latent factors were created. Results indicate that parental personality was more relevant than adolescent personality for explaining overreactivity, but parent and adolescent personality were similarly relevant in explaining warmth. Especially parental and adolescent Agreeableness and adolescent Extraversion were important predictors of both types of parenting. Associations between parental personality and parenting were similarly related to parents of easy versus difficult adolescents, and for mothers and fathers parenting daughters or sons. Together, results show that parent characteristics as well as adolescent characteristics importantly affect dysfunctional and adaptive parenting.     

A Rational-Emotive Treatment program with conduct disorder and attention-deficit hyperactivity disorder adolescents

This study investigated the effects of a 12-week treatment program, based on Rational-Emotive Therapy, with conduct disorder (CD) and attention-deficit hyperactivity disorder (ADHD) adolescents. Two independent homogeneous CD (N=12) and ADHD (N=12) groups were selected on the basis of the DSM-111-R and use of methylphenidate. The dependent variables were irrational thinking, depression, and anger. Lecture, discussion, and theYou Can Do It!Motivational Program video were used in the treatment intervention. Discriminant function analysis of pretest scores revealed that 96% of the students were correctly classified (CD=100%, ADHD=92%). Multivariate analysis of pre-posttest scores revealed that the CD group significantly changed on all dependent variables, while no significant differences were found with the ADHD group. A comparison of posttest scores on the measure of irrational thinking revealed that the CD group accepted responsibility for their upsetness and were more willing to change than the ADHD group. The results of the study are interpreted in terms of the distinguishing characteristics of each group.G. Barry Morris Ph.D., is Director of the Canadian Institute for Rational-Emotive Therapy. He is a Fellow and training supervisor in Rational-Emotive Therapy, a professor at the University of Saskatchewan, a licensed psychologist, and is engaged in private practice.     

Neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder

The goal of this study was to assess neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder (ADHD). Participants were 156 siblings of ADHD probands with (N = 40) and without (N = 116) ADHD (according to criteria of the Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised; American Psychiatric Association, 1987) and 118 siblings of non-ADHD normal controls of similar age, IQ, and grade level. Information on attention, executive, and memory functions was obtained in a standardized manner without knowledge of clinical status. Compared with siblings of controls, siblings with ADHD were significantly impaired on the Stroop test and on verbal learning and memory. In contrast, siblings without ADHD were similar to controls on virtually all measures. These data suggest that some executive, attention, and verbal learning deficits are found in nonreferred individuals with ADHD but that neuropsychological deficits are unlikely to constitute an endophenotype to ADHD.     

The role of task persistence in young adolescence for successful educational and occupational attainment in middle adulthood

The main purpose of the present study was to investigate the importance of task persistence in young adolescence for successful educational and occupational attainment in middle adulthood. Data from age 13 (N = 1,092) and adult age (age 43 for women, N = 569 and age 47 for men, N = 393) were taken from the Swedish longitudinal research program entitled "Individual Development and Adaptation." In line with previous research, task persistence was found to be related to changes in grades between age 13 and age 16, over and above other childhood factors. Task persistence at age 13 was also a significant predictor of both income and occupational level in middle adulthood for the men, controlling for a number of childhood factors (including intelligence), and even when educational attainment in adulthood was taken into account. Finally, task persistence was related to educational attainment in adulthood. The authors suggest that task persistence is a second fundamental factor besides general mental ability, influencing attainment within the area of working life and education. The influence of task persistence is discussed in form of personality-environment selection mechanisms.     

Sluggish Cognitive Tempo Symptoms Contribute to Heterogeneity in Adult Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) persists into adulthood in over 50% of cases, although its associated symptom profiles, comorbid problems, and neuropsychological deficits change substantially across development. Sluggish cognitive tempo (SCT) symptoms may contribute to associations between ADHD and comorbid problems and may partially explain the substantial heterogeneity observed in its correlates. 349 adults aged 18–38 years (M = 23.2, SD = 4.5, 54.7% male, 61.03% with ADHD) completed a multi-informant diagnostic procedure and a comprehensive neuropsychological battery. Adults with ADHD (n = 213) were retained for analyses. Latent class analyses (LCA) revealed three profiles of SCT symptoms among those with ADHD, which we classified as minimal, moderate, or severe SCT. Multiple analysis of covariance (MANCOVA) revealed significant differences among these profiles, which remained when controlling for persistence of ADHD symptoms and sex. In general, adults with ADHD combined with SCT symptoms (moderate and severe) had significantly more symptoms of anxiety, depression, and persistent inattention, and had more severe professional and relational impairment compared to ADHD adults without SCT. Compared to those with moderate or minimal SCT symptoms, the severe SCT group had the most symptoms of depression and internalizing disorders, and the most impairment in the domain of daily responsibility. No significant differences based on externalizing symptoms emerged when controlling for sex and persistence of inattention symptoms, suggesting the moderate and severe SCT groups do not simply reflect more symptoms. Moreover, follow-up mediation analyses revealed that SCT might at least partially explain the heterogeneity in ADHD. Findings have implications for refinement of etiological conceptualization, assessment methods, and intervention strategies.