The Adolescent Behavior Checklist: Validation Using Structured Diagnostic Interviews

The purpose of this study was to evaluate the discriminant validity of scores from the Adolescent Behavior Checklist (ABC), a self-report measure of ADHD symptomatology for adolescents ages 11–17 years. Validity was assessed through correlational, univariate, and discriminant function analyses using three groups: (1) adolescents diagnosed with ADHD, (2) adolescents currently experiencing a mood and/or anxiety disorder, and (3) adolescents with no major psychological disorder. Convergent and divergent validity of the ABC factor scores was demonstrated through correlational results with (1) parent and adolescent report of ADHD symptoms during structured psychiatric interviews and (2) scores on questionnaires measuring related and nonrelated constructs. Univariate analyses indicated that the ADHD group obtained significantly higher scores than did the nonclinical adolescents across all ABC factors. Additionally, the ADHD group scored significantly higher than did the psychiatric controls on the following ABC factors: Conduct Problems, Impulsivity/Hyperactivity, and Social Problems. Results from discriminant analyses supported the reliability of ABC scores in correctly classifying participants into groups. Compared to the Youth Self-Report, the ABC was found to be somewhat better at classifying when used in a multiinformant discriminant analysis. Therefore, overall results from the current study suggest that the ABC is a valid and useful self-report screening measure for ADHD symptoms and related difficulties.     

Direct assessment of the cognitive correlates of attention deficit disorders with and without hyperactivity

The cognitive functioning of children identified as attention deficit disorder with hyperactivity (ADD/H) was compared to that of children identified as attention deficit disorder without hyperactivity (ADD/WO). Based on information on symptoms supplied by teachers, 20 ADD/H and 15 ADD/ WO children were selected according to DSM-III criteria from a large elementaryschool learning disabilities and behavior disorders population. For comparison purposes, 16 normal children from regular classrooms were also selected. Children from all three groups were evaluated with a battery of cognitive tests. Intelligence test scores differentiated the two ADD groups, with the ADD/H children obtaining significantly lower Full Scale IQ scores than both ADD/WO and control children. In addition, ADD/H children obtained significantly lower Verbal IQ scores than ADD/WO children. Both ADD groups performed more poorly than controls on Spelling and Reading Achievement, and the ADD/WO group performed more poorly on Math Achievement. The two ADD groups took longer to complete six Stroop and rapid naming tasks than the control groups but did not differ among themselves. The ADD/WO group made more errors on a visual matching task than the controls, but neither ADD group differed from controls on the accuracy of the Stroop tasks, rapid naming tasks, measures of receptive and expressive language, visual-motor integration, or sustained visual attention. The differences between the two ADD groups were fewer than expected on the basis of previous research and are more global than specific.The assistance of John Junginger, Jason Walker, and Cynthia Jones at various stages of the project is gratefully acknowledged. Particular thanks are extended to the teachers and staff of Clarke County schools.     

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.     

The Predictive Validity of Parent and Teacher Reports of ADHD Symptoms

The objectives were to evaluate the ability of the Inattention and Hyperactivity–Impulsivity factors of the ADHD Rating Scale-IV to differentiate children with ADHD from a control group and to discriminate children with different subtypes of ADHD. Also, we sought to determine optimal cutoff scores on the teacher and parent versions of this scale for making diagnostic decisions about ADHD. In a sample of 92 boys and girls 6 to 14 years of age referred to a regional ADHD program, we assessed ADHD diagnostic status using categorical and dimensional approaches as well as parent- and teacher-report measures. Logistic regression analyses showed that the Inattention and Hyperactivity–Impulsivity factors of the ADHD Rating Scale-IV were effective in discriminating children with ADHD from a control group and differentiating children with ADHD, Combined Type from ADHD, Inattentive Type. Although both teacher and parent ratings were significantly predictive of diagnostic status, teacher ratings made a stronger contribution to the prediction of subtype membership. Using symptom utility estimates, optimal cutoff scores on the Inattention and Hyperactivity–Impulsivity scales for predicting subtypes of ADHD were determined.     

THE DIFFERENTIAL EFFECTS OF TEACHER AND PEER ATTENTION ON THE DISRUPTIVE CLASSROOM BEHAVIOR OF THREE CHILDREN WITH A DIAGNOSIS OF ATTENTION DEFICIT HYPERACTIVITY DISORDER

We conducted functional analyses of classroom disruption during contingent teacher and peer attention conditions for 3 children with attention deficit hyperactivity disorder. Attention provided by peer confederates appeared to function as a distinct form of positive reinforcement for all 3 children.     

Agreement of parent and teacher rating scales with comprehensive clinical assessments of attention deficit disorder with hyperactivity

Forty-one clinic-referred children were given the DSM-III diagnosis of attention deficit disorder with hyperactivity (ADD/H) based on structured diagnostic interviews of the child and mother and on two teacher and two parent rating scales. The degree of agreement between diagnostic classification of ADD/H based solely on criterion scores on each rating scale and classification based on the comprehensive clinical assessments that included use of the same rating scaleswas assessed by comparing the ratings of the 41 children with ADD/H to those of 47 clinic-referred children given other diagnoses or no diagnosis. The accuracy of classification was highly similar across scales. Increasing the cutoff score increased the acing true positives. Using the point of intersection of these two curves to choose the optimal cutoff scores resulted in 70–75% accurate classification and 25–30% misclassification of children given clinical diagnoses of ADD/H. This rate of misclassification suggests that rating scales alone should not be used to classify ADD/H for most clinical and research purposes, especially because the method of comparison used in this study favored finding a high degree of correspondence.     

Experiences of physical and relational victimization in children with ADHD: The role of social problems and aggression

The social risk factors for physical and relational peer victimization were examined within a mixed‐gender sample of children with and without attention‐deficit/hyperactivity disorder (ADHD). Participants were 124 children (ages 8–12 years; 48% boys), with 47% exhibiting sub‐clinical or clinical elevations in ADHD symptoms. ADHD and oppositional defiant disorder (ODD) symptom counts were assessed based on parent‐ and teacher‐reports; parents rated children's social problems and teachers rated children's use of physical and relational aggression and experiences of physical and relational victimization. A multiple mediator model was used to test whether there were indirect effects of ADHD or ODD symptoms on physical and relational victimization through social problems, physical aggression, or relational aggression. At the bivariate level, ADHD and ODD symptoms were both significantly associated with higher rates of physical and relational victimization. In the mediational model, there were significant indirect effects of ADHD symptoms on relational victimization via social problems, of ODD on relational victimization via relational aggression, and of ODD symptoms on physical victimization via physical aggression. Results suggest that there are distinct risk factors implicated in the physical and relational victimization of youth with ADHD and that the co‐occurrence of ODD symptoms is important to assess. Clinical implications for addressing victimization in children with ADHD are discussed.

     

Do Executive Function Deficits Differentiate Between Adolescents with ADHD and Oppositional Defiant/Conduct Disorder? A Neuropsychological Study Using the Six Elements Test and Hayling Sentence Completion Test

Two neuropsychological measures of executive functions—Six Elements Tests (SET) and Hayling Sentence Completion Test (HSCT)—were administered to 110 adolescents, aged 12–15 years. Participants comprised four groups: Attention Deficit Hyperactivity Disorder (ADHD) only (n = 35), ADHD and Oppositional Defiant Disorder/Conduct Disorder (ODD/CD) (n = 38), ODD/CD only (n = 11), and a normal community control group (n = 26). Results indicated that adolescents with ADHD performed significantly worse on both the SET and HSCT than those without ADHD, whether or not they also had ODD/CD. The adolescents with ADHD and with comorbid ADHD and ODD/CD were significantly more impaired in their ability to generate strategies and to monitor their ongoing behavior compared with age-matched controls and adolescents with ODD/CD only. It is argued that among adolescents with clinically significant levels of externalizing behavior problems, executive function deficits are specific to those with ADHD. The findings support the sensitivity of these two relatively new tests of executive functions and their ecological validity in tapping into everyday situations, which are potentially problematic for individuals with ADHD.     

儿童注意缺陷多动障碍医学化的历史展演

儿童注意缺陷多动障碍是医学化研究的经典案例,凸显医学向日常生活领域扩张的态势。20世纪90年代,伴随医学化的全球化,儿童注意缺陷多动障碍传入中国,进行本土化适应与发展。如今,注意缺陷多动障碍已成中国儿童常见精神障碍问题。研究从医学化视角切入,一方面回溯医学化的发展历史,梳理儿童注意缺陷多动障碍在西方的展演;另一方面聚焦中国,探究其传入路径、本土化适应与发展,尤其关注区别于西方药物市场的本土替代治疗市场发展,为理解医学化的全球化提供案例剖析。

     

Noncontingent peer attention as treatment for disruptive classroom behavior

A functional analysis isolated peer attention as the primary maintaining variable for disruptive behavior displayed by a student with attention deficit hyperactivity disorder. Using a brief reversal design, noncontingent reinforcement was then shown to reduce disruptive behavior relative to the peer attention condition. Implications for assessing behavior disorders in mainstream school settings are discussed.     

Is the Cogmed program effective for youths with attention deficit/hyperactivity disorder under pharmacological treatment?

The primary objective of this study was to examine the effects of the Cogmed training program on working memory among youths 7 to 13 years old, with attention deficit/hyperactivity disorder (ADHD) type and comorbidity controlled for. A secondary objective was to examine the generalization of effects to ADHD symptoms, nonverbal reasoning, attentional and executive functions, inhibition, reading comprehension, and mathematical reasoning. Participants were under pharmacological treatment for ADHD combined type and a comorbidity. They were randomized into an experimental group that received the Cogmed program and an active control group that received a low-intensity comparison version of the training. They were evaluated at three time points: 6 weeks prior to intervention onset (T1), immediately prior to onset (T2), and 1 week following intervention completion (T3). Results indicate no significant effect attributable to the Cogmed program. The fact that participants were on medication at the time of training and evaluation normalized their performances and limited the detection of effects. Moreover, cognitive training did not lead to a reduction in ADHD symptoms or to an improvement in the other cognitive functions measured or in academic performance. The results of this study do not demonstrate the effectiveness of the Cogmed program for youths with ADHD combined type and a comorbidity when they receive the training while under pharmacological treatment.