Item Response Theory Analyses of the Parent and Teacher Ratings of the DSM-IV ADHD Rating Scale

The graded response model (GRM), which is based on item response theory (IRT), was used to evaluate the psychometric properties of the inattention and hyperactivity/impulsivity symptoms in an ADHD rating scale. To accomplish this, parents and teachers completed the DSM-IV ADHD Rating Scale (DARS; Gomez et al., Journal of Child Psychology and Psychiatry, 40, 265–274, 1999) for a group of 1,475 primary school-aged children. The results for the discrimination parameters showed that all symptoms for both groups of respondents were generally good for discriminating their respective latent traits. For virtually all symptoms, their threshold values showed moderate to large increases in the level of the latent trait at each subsequent response dichotomy, with the symptoms being especially good at representing the appropriate traits from mean to moderately high trait levels. The item information function values for most symptoms indicated reasonable reliability from, approximately, the mean trait levels to moderately high trait levels. These findings indicate good psychometric properties for the parent and teacher ratings of the DARS. The implications of the findings for the use of the DARS and other similar scales are discussed.     

The Positive Illusory Bias: Do Inflated Self-Perceptions in Children with ADHD Generalize to Perceptions of Others?

This study examined whether children with symptoms of attention-deficit/hyperactivity disorder (ADHD) demonstrate positive illusory perceptions of their own competence and others' competence. Participants (67 children with ADHD symptoms; 40 non-ADHD children) completed the Self-Perception Profile for Children and rated actors' competence in videos clips where inconsistent cues of performance had to be integrated in order to determine the actor's competence. Teachers completed the Teacher Rating Scale of Child's Actual Behavior. Children with ADHD symptoms overestimated their own competence relative to teachers' estimates in all domains significantly more than non-ADHD children. There were no significant group differences in perceptions of others' competence. Findings suggest that positive illusions are exclusive to perceptions of self and do not extend to perceptions of others.     

You are not alone – adolescents’ experiences of participation in a structured skills training group for ADHD

Little is known about how adolescents with attention deficit/hyperactivity disorder (ADHD) experience participating in group therapy, an important factor to consider when developing treatment methods for this age group. This study aimed to explore how adolescents with ADHD experience participating in a structured skills training group program based on dialectical behavioral therapy. Semi-structured interviews were conducted with 20 adolescents (15–18 years of age) with ADHD after participating in a structured skills training group. The interviews were transcribed verbatim and qualitative content analysis were used to analyze the text. The participants emphasized the value of meeting other adolescents with ADHD and the opportunity to exchange experiences, strategies and tips. Participating in the group treatment made the adolescents realize that they were not alone, and feelings of togetherness and an increased acceptance of themselves were described. The participants associated the treatment with elevated knowledge and understanding, for example, about ADHD, their own functioning and helpful strategies. They also described emotional and behavioral changes, such as higher self-esteem, fewer inter-personal conflicts and improved concentration. Activating and experiential exercises were considered important elements of the treatment, and the participants expressed a need for a variation of exercises, as well as more time for practicing skills, discussions and breaks. The results indicate that the group format add an extra value to the treatment and that the use of an active approach throughout the treatment is of importance for this group of patients.     

Comorbid depression and heart rate variability as predictors of aggressive and hyperactive symptom responsiveness during inpatient treatment of conduct‐disordered,ADHD boys

The primary objective of the present study was to assess the utility of (1) comorbid depression and (2) parasympathetic influence on cardiac function as markers for treatment response among aggressive preadolescent males. Inpatient records of 53 patients with conduct disorder and attention deficit hyperactivity disorder (17 with a comorbid depressive disorder) were examined, including an intake electrocardiogram and daily tallies of several indices of aggressive behavior across 3 weeks of stay. The relations of comorbid depression, heart rate variability, and residualized heart rate (primarily of sympathetic origin) to treatment response were assessed through analyses of linear growth functions. Significant vagal tone by diagnostic status interactions were obtained for both frequency and duration indices of aggression, whereby nondepressed patients with high vagal tone deteriorated and depressed patients with high vagal tone improved during hospitalization. No such relation was found for attention deficit hyperactivity disorder symptoms. Patients in the comorbid group also exhibited greater heart rate variability than their nondepressed counterparts. Furthermore, residualized heart rate was predictive of maternal substance use and paternal incarcerations. These findings suggest complex relations among treatment response, comorbid depression, and emotion regulation in male preadolescents with severe behavior disorders. Additionally, the differential prediction afforded by vagal tone and residualized heart rate underscores the importance of assessing both parasympathetic and sympathetic indices of cardiac function as distinct physiological markers. Aggr. Behav. 26:425–441, 2000. © 2000 Wiley‐Liss, Inc.     

Brain structure mediates the association between socioeconomic status and attention‐deficit/hyperactivity disorder

Low socioeconomic status (SES) is associated with greater risk for symptoms of attention‐deficit/hyperactivity disorder (ADHD). One mechanism through which SES may confer risk for ADHD is by influencing brain structure. Alterations to cortical thickness, surface area and subcortical volume have been associated with low SES and with the presence of ADHD across multiple studies. The current study examined whether cortical thickness, surface area or subcortical volume mediate the associations between SES and ADHD in youth 3–21 years old (N = 874) from the Pediatric Imaging, Neurocognition and Genetics Study. Freesurfer was used to estimate cortical thickness, surface area and subcortical volume from structural magnetic resonance imaging. Parents reported on demographics, family SES, ADHD diagnoses and the presence of child attention problems. Statistical mediation was assessed using a bootstrap resampling procedure. Controlling for parental ADHD, child age, gender, birth weight and scanner, children in low SES families were more likely to be in the ADHD group. Consistent with previous reports in this sample, low SES was associated with reduced surface area across the frontal lobe and reduced subcortical volume in the amygdala, cerebellum, hippocampus and basal ganglia. Of these regions, a significant indirect effect of SES on ADHD status through subcortical volume was observed for the left cerebellum (95% confidence interval: 0.004, 0.022), the right cerebellum (95% confidence interval: 0.006, 0.025), and the right caudate (95% confidence interval: 0.002, 0.022). Environmentally mediated changes in the cerebellum and the caudate may be neurodevelopmental mechanisms explaining elevated risk of ADHD in children in low SES families.     

Normal executive attention but abnormal orienting attention in individuals with sluggish cognitive tempo

Background/objective: Sluggish Cognitive Tempo (SCT) is an attentional disorder characterized by the symptoms of slowness in behavior or thinking, a lack of en.ergy, difficulty initiating and sustaining effort, daydreaming, and drowsiness. The aim of the present study was to investigate the distinctive attentional characteristics of SCT as compared to Attention-Deficit/Hyperactivity Disorder (ADHD). Method: A total of 110 adults were recruited and divided into four groups: SCT+ADHD, SCT, ADHD, and healthy controls. The Revised version of Attention Networks Test was used to investigate each group’s attentional profile. Results: The results revealed that the two SCT groups (SCT+ADHD and SCT) showed a significantly weaker orienting network due to the problems of engaging and disengaging attention than the other two groups. Additionally, the two ADHD groups (SCT+ADHD and ADHD) showed a significantly weaker executive control network than the other two groups. Conclusions: The findings demonstrate an attentional distinction between the SCT and the ADHD groups with a greater dysfunction in the orienting network in the SCT group as compared to the ADHD group. Furthermore, a greater executive control dysfunction was observed in the ADHD group as compared to the SCT group.     

Risky decision-making in children with and without ADHD: A prospective study

Learning from past decisions can enhance successful decision-making. It is unclear whether difficulties in learning from experience may contribute to risky decision-making, which may be altered among individuals with attention-deficit/hyperactivity disorder (ADHD). This study follows 192 children with and without ADHD aged 5 to 10 years for approximately 2.5 years and examines their risky decision-making using the Balloon Emotional Learning Task (BELT), a computerized assessment of sequential risky decision-making in which participants pump up a series of virtual balloons for points. The BELT contains three task conditions: one with a variable explosion point, one with a stable and early explosion point, and one with a stable and late explosion point. These conditions may be learned via experience on the task. Contrary to expectations, ADHD status was not found to be related to greater risk-taking on the BELT, and among younger children ADHD status is in fact associated with reduced risk-taking. In addition, the typically-developing children without ADHD showed significant learning-related gains on both stable task conditions. However, the children with ADHD demonstrated learning on the condition with a stable and early explosion point, but not on the condition with the stable and late explosion point, in which more pumps are required before learning when the balloon will explode. Learning during decision-making may be more difficult for children with ADHD. Because adapting to changing environmental demands requires the use of feedback to guide future behavior, negative outcomes associated with childhood ADHD may partially reflect difficulties in learning from experience.     

Mentalizing skills of non-native,early signers: A longitudinal perspective

Using a population-based sample consisting of 401 6- to 12-year-olds, this study examined normative age and sex distributions on motor activity as measured in an actigraphic-based motion tracking system (MTS) and on attention-related functions derived from a Continuous Performance Test (CPT). Specific objectives were to present new knowledge on age-related change in motor activity and to study age effects on changes in motor activity and CPT performance as a function of time on task. Further, continuous relations between the two ADHD symptom domains and CPT performance and motor activity, and importantly, age effects in these relations were examined. CPT performance improved, and level of motor activity decreased with age. Linear associations between the two ADHD symptom domains and several of the CPT and MTS parameters support available research describing the nature of ADHD as a continuous dimension with variable expression throughout the general population. Further, our study is one of the first to provide developmental data using a time on task design, particularly with regard to motor activity. Imperative for ADHD future research are our results showing that age matters in the relation between ADHD behaviours and neuropsychological function.     

A New Tactile Illusion: Temporal Limits on the Processing of Spatiotemporal Patterns

A novel illusion was observed when 12 tactile point-stimulators arranged in a circle were sequentially activated so that each quadrant was first traced in a clockwise manner, then counterclockwise, and again in a clockwise manner, after which the next quadrant was similarly traced. Under certain temporal conditions this stimulus pattern was experienced as a point moving through an overall circular path but looping inwardly about once per quadrant. The effects of variations in rate of presentation of such stimuli were investigated by having subjects make drawings of their perceptual experiences. Three skin surfaces were used (palm, fingers, and forearm), and all produced similar results except for lower confidence and reliability of drawings made from forearm stimulation. Pattern presentation rate, however, had a consistent and powerful effect, with the looping illusion most frequently observed at rates around 25 pattern points per s and with different perceptual organizations dominating as rates departed widely from this optimum. The illusory perceptual organizations were interpreted as compromises between past and present stimulation necessitated by the relative slowness of tactile processing of spatio-temporal patterns.