Diagnostic Stability of ADHD in a Community Sample of School-Aged Children Screened for Disruptive Behavior

A large school-based sample of children in Grades 1, 2, 3, and 4 were screened for disruptive behavior and subsequently assessed over a 5-year period for DSM-III-R symptoms of attention deficit hyperactivity disorder (ADHD) and other externalizing and internalizing behavior disorders. Parents completed structured diagnostic interviews in Years 1, 4, and 5, and teachers completed Behavioral Assessment for Children—Teacher Rating Scales behavioral ratings annually. For parent-derived diagnostic data, both inattention and hyperactivity/impulsivity symptom groups declined from Year 1 to Year 4, with hyperactivity showing more significant decline. For teacher-rated behavioral dimensions, the Attention Problems scale declined from Year 1 to Year 3 and stabilized thereafter. The Hyperactivity scale showed stability during the first 3 years before declining in Year 4. Of those children diagnosed with ADHD in Year 1, 69% still met criteria for ADHD in either Year 4 or 5. Persisters were more likely to exhibit coexisting conduct disorder in Year 1 and oppositional defiant disorder in Years 1, 4, and 5. Parents of persisters reported more psychosocial adversity on measures of parenting and marital satisfaction.     

A multistudy analysis of socioeconomic status (SES) and the measures and outcomes of cognitive-behavioral treatment with children

The relationship of the child's socioeconomic status (SES) to improvement and generalization from cognitive behavioral-treatment was investigated by comparing high and low SES groups on teacher ratings, performance measures, and judges' ratings of improvement and maintenance of positive change. Fifty-eight teacher referred classroom problem children (grades 2–6) who had served as treated subjects in one of three treatment outcome studies were examined. SES data were collected by administration of a questionnaire to the head of each household. The judges' ratings were performed on clusters of teacher ratings and clusters of performance measures that were present in each study. Results indicated that, despite SES group variation in level of performance, improvement, when it occurred, was evident for both high and low SES groups. In addition, there were significant differences on a number of the performance measures at pretreatment, posttreatment, and follow-up. Initial SES group differences in verbal ability as measured by the Peabody Picture Vocabulary Test (PPVT) appear to have been an important factor in these performance differences.This research was supported by grant number 441 0749 5236 02 from the Graduate School of the University of Minnesota, awarded to Philip C. Kendall. Portions of this research were presented at the Association for the Advancement of Behavior Therapy Convention, San Francisco, December 1979. Portions of the material were prepared while the second author was at the Center for Advanced Study in the Behavioral Sciences and supported by NIMH (No. 5-T32-MH 14581-05) and the MacArthur Foundation. The authors wish to thank Dorothy Raney for her valuable assistance.     

Neurotoxicity of Kainate to the Hippocampus is not Accrued by Aging, Stress and Exogenous Corticosterone in Wistar Kyoto and Spontaneously Hypertensive Rats

It has been reported that a high corticosterone milieu can exacerbate various experimental insults to the nervous system, in particular to the hippocampus. However, in many of these studies the above milieu was attained by injecting corticosterone in doses (e.g. 10 mg/rat) producing supraphysiological concentrations. In the present study we have investigated whether high plasma corticosterone levels, such as those associated with aging or stress, potentiate a hippocampal excitotoxic insult. Male Wistar Kyoto (WKY) and Spontaneously Hypertensive Rats (SHR) at the age of 6, 12, 18 and 24 months (only WKY for the oldest age) were used. As in other strains, aging in these rats was marked by an increase in basal plasma corticosterone levels. Rats were infused in the dorsal hippocampus with kainic acid (0.035 μg/hippocampus) and the neuronal injury was evaluated within the areas CA3 and CA4. Results indicated that neither aging nor the hypertensive condition affected kainic acid neurotoxicity. In order to study the effect of stress, rats were stressed twice a day, with alternate types of stressors to avoid possible habituation, 3 days prior to and 3 days following the kainic acid infusion. Using this experimental paradigm the hippocampal damage in stressed rats was of the same degree as in non-stressed controls. In a complementary set of experiments, 6 month old WKY and SHR rats were injected with corticosterone (10 mg/rat s.c.). Four hours after administration plasma corticosterone levels in the range of 60-70 μg/100 ml were found. Moreover, a time-course study showed a plasma corticosterone peak in the range of 240 μg/100 ml. Daily corticosterone administration for 3 days before and 3 days after kainic acid infusion potentiated the hippocampal damage in 6 months old SHR but not in the WKY. These results demonstrate that elevation of corticosterone levels within physiological range does not exacerbate hippocampal kainate neurotoxicity and that pharmacological doses of glucocorticoid hormone, which produces plasma levels well above those observable in any physiopathological condition, might, with some strain dependency, potentiate a hippocampal neurotoxic insult.