Sustained attention and visual processing speed in children and adolescents with bipolar disorder and other psychiatric disorders

To investigate the cognitive functioning of children and adolescents with bipolar illness, 112 child and adolescent psychiatric inpatients and day-hospital patients at a state psychiatric hospital were administered the Wechsler Intelligence Scale for Children-III (WISC-III) as part of an admission psychological assessment. There were 22 patients with Bipolar Disorder and 90 with other psychiatric disorders; all were between 8 and 17 years of age. The patients with Bipolar Disorder had a mean age of 14 yr., a mean Verbal IQ of 78, a mean Performance IQ of 76, and a mean Full Scale IQ of 75. When their WISC-III scores were compared with those who had Schizophrenia Spectrum disorders (Schizophrenia and Schizoaffective Disorder), Psychosis Not Otherwise Specified, Attention Deficit Hyperactivity Disorder, and Conduct Disorder and Oppositional Defiant Disorder, there were no significant between-group mean differences for Verbal IQ, but patients with Bipolar Disorder had a significantly lower mean Performance IQ than those with ADHD and those with Conduct Disorder and Oppositional Defiant Disorder. Contrary to the expectation that the patients with Bipolar Disorder might have better sustained attention (higher Digit Span scores) than those with Schizophrenia Spectrum disorders and worse visual processing speed (lower Coding scores) than the other diagnostic groups, the bipolar patients' Digit Span and Coding scores did not differ significantly from those of the other groups. The patients with Psychosis, Not Otherwise Specified had significantly lower mean Performance IQ, Full Scale IQ, and Coding than the ADHD and the Conduct Disorder and Oppositional Disorder groups.     

Neuropsychological Dysfunction in Children with Borderline Personality Disorder Features: A Preliminary Investigation

Borderline personality disorder (BPD) is often linked to neuropsychological deficits, yet few studies have examined BPD or its features and concomitant neuropsychological dysfunction in childhood. This study examined children with borderline features (n = 21) using the Coolidge Personality and Neuropsychological Inventory for Children and compared them to controls (n = 21) with features of at least one personality disorder, but not BPD. As hypothesized, the BPD group scored significantly higher than the control group on the Attention Deficit/Hyperactivity Disorder, Executive Functions Deficits, Mild Neurocognitive Disorder, Conduct Disorder, and Oppositional Defiant Disorder scales. It appears that behavioral disturbances associated with BPD are linked strongly with neuropsychological dysfunction. Because none of the children with BPD features in the present sample had a history of traumatic brain injury (TBI), it appears likely that TBI in the histories of adult BPD patients may not be the cause of BPD, but traits such as anger and impulsivity in BPD may cause TBI. Clinical implications and future research directions are discussed.     

The Structure of Psychopathology in a Community Sample of Preschoolers

Despite growing interest in the development of alternative diagnostic classification systems for psychopathology in young children, little is known about the adequacy of the DSM symptom structure for describing psychopathology in this population. This paper examines the fit of the DSM-IV emotional (ED) and disruptive behavior disorder (DD) symptom structure in a community sample of 796 4-year-old children. Using the parent-report Child Symptom Inventory (CSI), the best model fit for ED included separate factors for Social Phobia, Separation Anxiety Disorder, Generalized Anxiety Disorder, and Major Depressive Disorder. For DD, the best model included separate Attention Deficit Hyperactivity Disorder-Inattentive type (ADHD-I), Attention Deficit Hyperactivity Disorder-Hyperactive/Impulsive type (ADHD-HI), and Oppositional Defiant Disorder diagnoses. These findings support using DSM-IV nosology to classify EDs in a community sample of preschool children, and suggest differentiation of ADHD into ADHD-I and ADHD-HI.     

Sensory Processing Differences in Children Diagnosed With Tourette's Disorder

The objectives of this research were to determine whether sensory processing differences existed in children between the ages of 5 and 10 years diagnosed with Tourette's disorder and to examine whether further differences existed if these children had an additional diagnosis of Attention Deficit Hyperactivity Disorder. The Short Sensory Profile was completed by caregivers for 75 children with Tourette's disorder, 47 who were also diagnosed with Attention Deficit Hyperactivity Disorder. Differences in sensory processing were identified in the total sample. More significant differences were found in the group of children with dual diagnoses, especially in the area of auditory processing.     

A Program Intervention for Pediatric Bipolar Disorder: Preliminary Results

The effectiveness of a behaviorally based day treatment program for young children diagnosed with Pediatric Bipolar Disorder (PBD) was evaluated using pretreatment and posttreatment mean scores from the Child Behavior Checklist (CBCL). Data were evaluated in aggregate and using the clinically significant change method for children diagnosed with PBD, Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Adjustment Disorder, and no diagnosis/clinical and subclinical groups. Significant effects were found for all groups except the no diagnosis/subclinical group on the Internalizing scale and for all groups on the Externalizing scale. Clinically significant change was supported for the PBD, ADHD, ODD, and Adjustment Disorder groups. Implications and limitations of the study are discussed.     

Teachers' knowledge, misconceptions, and lacks concerning Attention Deficit Hyperactivity Disorder

This study was designed to analyze the knowledge, misconceptions, and lacks about Attention Deficit Hyperactivity Disorder (ADHD) in a sample of 193 teachers, as a replication of the study carried by Sciutto, Terjesen and Bender in 2000. Teachers completed the Knowledge of Attention Deficit Hyperactivity Disorder (KADDS) (Spanish version), adapted by the authors of this research, to measure knowledge of ADHD in three content areas: general knowledge, symptoms/diagnosis, and treatment. Results indicated an average of correct responses of 31.67, 63.88 and 40.46% in general knowledge, symptoms/diagnosis and treatment, respectively. Teachers displayed significantly more knowledge in the Symptoms/Diagnosis scale than in the other scales. Their knowledge correlated positively with: years of experience with hyperactive children, number of hyperactive pupils in their classrooms, and level of perceived self-efficacy. These findings are consistent with those obtained by Sciutto and colleagues.     

Word memory test performance in children.

One-hundred and thirty-five children between the ages of 7 and 18 years were evaluated clinically. Their diagnoses included Fetal Alcohol Syndrome (FAS) or Effects, Schizophrenia, Bipolar Mood Disorder, various neurological diseases, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder, Oppositional-Defiant Disorder and learning disabilities. As part of a comprehensive neuropsychological assessment, the children were given the Word Memory Test (WMT; Green, Allen, & Astner, 1996; Green & Astner, 1995), containing various subtests which measure, respectively, effort and verbal memory. Although age and verbal intelligence are known to affect scores on most ability tests, they were not found to be significant determinants of WMT effort scores. Younger children did not score any lower on the effort subtests than older children. The children scored as well as a group of parents seeking custody of their children and they scored higher than adult patients with mild head injuries. The computerized WMT requires some basic reading skills and some children with lower than a grade 3 reading level scored at a relatively low level on the effort subtests. The current data suggest that most children with at least a grade 3 reading level can pass the WMT using the adult criteria. It is concluded that the WMT is potentially useful in the evaluation of effort during pediatric neuropsychological evaluations. Further research is needed to replicate these findings and to develop child norms for the memory subtests.     

Word Memory Test Performance in Children

One-hundred and thirty-five children between the ages of 7 and 18 years were evaluated clinically. Their diagnoses included Fetal Alcohol Syndrome (FAS) or Effects, Schizophrenia, Bipolar Mood Disorder, various neurological diseases, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder, Oppositional-Defiant Disorder and learning disabilities. As part of a comprehensive neuropsychological assessment, the children were given the Word Memory Test (WMT; Green, Allen, & Astner, 1996; Green & Astner, 1995), containing various subtests which measure, respectively, effort and verbal memory. Although age and verbal intelligence are known to affect scores on most ability tests, they were not found to be significant determinants of WMT effort scores. Younger children did not score any lower on the effort subtests than older children. The children scored as well as a group of parents seeking custody of their children and they scored higher than adult patients with mild head injuries. The computerized WMT requires some basic reading skills and some children with lower than a grade 3 reading level scored at a relatively low level on the effort subtests. The current data suggest that most children with at least a grade 3 reading level can pass the WMT using the adult criteria. It is concluded that the WMT is potentially useful in the evaluation of effort during pediatric neuropsychological evaluations. Further research is needed to replicate these findings and to develop child norms for the memory subtests.     

College students' acceptance of potential treatments for ADHD

The purpose of the current study was to investigate the influence that the professional occupation of a consultant making a treatment recommendation may have on college students' (82 women and 52 men) acceptance of a proposed treatment for a child displaying characteristics of Attention Deficit/Hyperactivity Disorder. Consultants were special education teachers, school psychologists, or physicians. The study also examined college students' ratings of treatment acceptability associated with three frequently implemented interventions of either nonspecific medication, token economy with response cost, or time-out for children with characteristics of Attention Deficit/Hyperactivity Disorder. Analysis indicated college students found a token economy intervention was the least acceptable recommendation by a physician.     

The Effects of Choice on the Reading Comprehension and Enjoyment of Children with Severe Inattention and no Attentional Difficulties

Research on Child and Adolescent Psychopathology - It has been proposed that enhancing motivation supports the learning of children with Attention Deficit Hyperactivity Disorder (ADHD). Less is...     

Family coherence and ADHD

A lack of perseverance, poor attention, and poorly modulated behaviour are important criteria of Attention Deficit Hyperactivity Disorder (ADHD). Instructions often must be repeated, sometimes even by different family members, before a child with ADHD attends and complies. The hyperkinetic child might cause less disruption in families with high coherence. Families of 15 boys (aged 6 to 12 years) diagnosed with ADHD using the Mannheim Parent's Interview and the teacher's form of the Conners scale were compared with a matched healthy control group of 15 boys. Parents completed a form assessing the family's cooperation and childrearing practices. Intrafamilial coherence seems to have little positive association with the family's characteristics, especially for boys with Attention Deficit Hyperactivity Disorder. Low coherence among family members may reduce ADHD symptoms and may have protective effects on children with ADHD.     

Family Correlates of Comorbid Anxiety Disorders in Children with Attention Deficit/Hyperactivity Disorder

This study evaluated parental anxiety and parenting practices associated with comorbid Anxiety Disorders among children with Attention Deficit/Hyperactivity Disorder. Clinic-referred families (n=143) were diagnosed using DSM criteria. Parents and children completed measures of parenting practices. Comorbid anxiety in children was significantly associated with maternal anxiety, overprotectiveness, and a lack of positive parenting. The relative odds of comorbid anxiety appeared to be especially high when all three factors were present. These findings are consistent with theory linking those three family factors to the development of anxiety in all children. Implications for adjunctive treatment of anxiety that is comorbid with ADHD are discussed.     

Attention Deficit Hyperactivity Symptoms,Impulsivity, and Cyberdeviance in an Adult Population

Journal of Psychopathology and Behavioral Assessment - Previous research suggests a link between Attention Deficit Hyperactivity Disorder (ADHD) and criminal behaviour. The present study explored...     

Rates of forgetting in attention deficit hyperactivity disorder

The present study evaluated rates of forgetting on verbal and nonverbal memory tests in children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Although children with ADHD are known to have poor organizational and attentional problems that may impair memory performance, we hypothesized that savings scores would remain intact, because poor recall reflects difficulty with initial learning versus memory per se. Fifty-seven children diagnosed with ADHD were administered tests of nonverbal memory (Rey-Osterreith Complex Figure) and verbal memory (Story Memory, Wide Range Assessment of Memory and Learning) as part of a comprehensive neuropsychological evaluation. Subjects showed no evidence of rapid forgetting of information across the delay on either nonverbal memory (mean savings score=93%) or verbal memory (mean savings score=88%) tests. Cognitive remediation for children with ADHD should address ways to initiate and execute organizational strategies so that more information is learned upon immediate presentation.     

基于学校的儿童注意缺陷多动障碍综合干预

摘 要 对117名注意缺陷多动障碍（ADHD）儿童进行为期8周的综合干预,探讨其长短期的干预效果。综合干预以儿童行为干预和父母训练为主、药物治疗为辅,半年后随访长期效果。发现综合干预组只在短期效果上显著好于药物组与对照组,但长期效果不显著。综合干预组家长对综合干预的依从性显著高于其他两组,并能保持较长时间。不同类型ADHD儿童的长、短期效果不同。     

Sociometric status of clinic-referred children with Attention Deficit Disorders with and without Hyperactivity

Peer sociometric nominations of clinic-referred children given the diagnosis of Attention) Deficit Disorder with Hyperactivity (ADD/H) or Attention Deficit Disorder without Hyperactivity (ADD/WO) were compared to one another and to those of normal control children. Only children with ADD diagnoses in the absence of other major diagnoses were included. Both children with ADD/H (n=16) and ADD/WO (n=11) received significantly fewer liked most nominations, more liked least nominations, and lower social preference scores than normal control (n=45) children. These results confirm previous findings of social deficits in children with ADD/H, even when codiagnoses are excluded. In addition, they support the validity of the diagnostic category of ADD/WO by demonstrating that the ADD/WO behavior pattern is apparently psychopathological in being associated with peer unpopularity after codiagnoses are excluded. When larger groups including all codiagnoses (primarily Conduct Disorder) of children with ADD/H (n=36) and ADD/WO (n=20) were compared, identical patterns of peer unpopularity were found, except that children with ADD/H also were significantly more likely to be nominated as a child who fights most.     

Response inhibition in children with DSM-IV subtypes of AD/HD and related disruptive disorders: the role of reward.

The current study had four aims: (a) to replicate previous findings of slow response inhibition in Attention Deficit/Hyperactivity Disorder (AD/HD), (b) to explore whether poor response inhibition in children with AD/HD is a core problem or rather a result of an underlying problem related to reward, (c) to investigate the specificity of poor response inhibition and the role of reward in relation to AD/HD, and (d) to study whether findings would be different for three subtypes of AD/HD. In order to address these issues, a stop paradigm was administered under a reward condition and under a nonreward condition to an AD/HD group (n=24), an Oppositional Defiant Disorder (ODD)/Conduct Disorder (CD) group (n=21), a comorbid AD/HD+ODD/CD group (n=27), and a normal control (NC) group (n=41). Firstly, contrary to prediction, none of the Disruptive Behavior Disorder (DBD) groups differed from the NC group with respect to the speed of the inhibition process. Secondly, it was shown that children with AD/HD and children with comorbid AD/HD+ODD/CD, but not children with ODD/CD alone, slowed down more dramatically in the reward condition than normal controls. This finding was interpreted as a strategy to increase the chance of being rewarded in children with AD/HD and children with comorbid AD/HD+ODD/CD, but not in children with pure ODD/CD. Finally, analysis of AD/HD subtypes did not change the main findings of this study.     

Response Inhibition in Children With DSM-IV Subtypes of AD/HD and Related Disruptive Disorders: The Role of Reward

The current study had four aims: (a) to replicate previous findings of slow response inhibition in Attention Deficit/Hyperactivity Disorder (AD/HD), (b) to explore whether poor response inhibition in children with AD/HD is a core problem or rather a result of an underlying problem related to reward, (c) to investigate the specificity of poor response inhibition and the role of reward in relation to AD/HD, and (d) to study whether findings would be different for three subtypes of AD/HD. In order to address these issues, a stop paradigm was administered under a reward condition and under a nonreward condition to an AD/HD group (n = 24), an Oppositional Defiant Disorder (ODD)/Conduct Disorder (CD) group (n = 21), a comorbid AD/HD+ODD/ CD group (n = 27), and a normal control (NC) group (n = 41). Firstly, contrary to prediction, none of the Disruptive Behavior Disorder (DBD) groups differed from the NC group with respect to the speed of the inhibition process. Secondly, it was shown that children with AD/HD and children with comorbid AD/HD+ODD/CD, but not children with ODD/CD alone, slowed down more dramatically in the reward condition than normal controls. This finding was interpreted as a strategy to increase the chance of being rewarded in children with AD/HD and children with comorbid AD/HD+ODD/CD, but not in children with pure ODD/CD. Finally, analysis of AD/HD subtypes did not change the main findings of this study.     

Teacher Ratings of Attention Deficit Hyperactivity Disorder Symptoms in Hispanic Children

This study compared teacher's ratings of attention deficit hyperactivity disorder in groups of nonreferred Hispanic and non-Hispanic White children via the Teacher Report Form, the Attention Deficit Hyperactivity Disorder Scales—IV, and the Conners Abbreviated Teacher Rating Scale. A total of 61 non-Hispanic White teachers completed behavior ratings of 61 Hispanic and non-Hispanic White children between 6 and 11 years old. Significant differences were found between boys and girls, with girls showing fewer behavior problems and fewer hyperactive/inattentive symptoms compared to boys. In addition, Hispanics scored similar or lower than non-Hispanic Whites on multiple subscales measuring symptomatology related to attention deficit hyperactivity disorder and overall behavioral disorders. In no instance did Hispanic children score as more pathological than non-Hispanic White children. The need to consider the rater's ethnicity is discussed, and findings are explained in terms of childhood socialization patterns that might help to discern the behavior displayed by Hispanic children in classroom settings.     

The paired associate learning task: Is it an externally valid instrument for assessing methylphenidate response in children with attention deficit disorder?

The Paired Associate Learning Task (PAL-T) is a laboratory-based instrument commonly used for assessing psychostimulant response (and specifically cognitive nonresponse or toxicity) in children with Attention Deficit Disorder/Hyperactivity (ADDH). The present study examined the PAL-T's sensitivity in detecting overall and between-dose methylphenidate (MPH) effects, its operating characteristics, and its relationship with academic performance in 36 children with ADDH who underwent a placebo controlled trial of MPH at four dose levels. Children's PAL-T performance under active medication resembled but was uncorrelated with direct observations of their academic performance in the classroom. Negative predictive power (NPP) rates indicated that cognitive nonresponse to MPH did not portend a poor response in children's academic efficiency under identical dose conditions in the classroom. Clinical implications are discussed.The authors are grateful to the undergraduate and graduate student members of the Children's Learning Clinic who assisted with the conduct of this study.