Behavior Ratings and Observations of Externalizing Symptoms in Girls: The Role of Child Popularity with Adults

This study examined staff ratings and live observations of externalizing behavior in 149 girls with and without attention-deficit/hyperactivity disorder (ADHD), who participated in all-female naturalistic research camps. Girls' popularity with adult camp staff was hypothesized to explain discrepancies between ratings and observations. Compared to behavior observations, staff ratings overestimated the externalizing behavior of girls who were disliked by staff. In contrast, ratings and observations were consistent for girls who were liked by staff. Among girls who were disliked by staff, unpopularity with peers predicted a larger discrepancy between staff ratings and observations, but peer status made little difference in rating–observation discrepancies of girls liked by staff. All results held after controlling for the participants' ADHD versus comparison status. Results suggest that staff ratings may be biased by personal feelings about children and that direct observations may be more immune to such bias.     

7—10岁儿童不同亚型ADHD行为与共病问题

摘要：通过流行病学测查,探讨不同亚型ADHD儿童的情绪、行为和社会功能的差异。采用SDQ（长处与困难问卷）对4500名7-10岁儿童进行大样本筛查,应用K-SADS-PL量表和DSM-Ⅳ诊断标准对其中263名高危儿童进行临床评估,诊断出119名儿童ADHD。诊断出的ADHD儿童中,男性与女性的比率大约为2.22︰1,存在显著的性别差异。混合型儿童ADHD的多动性不能得分显著高于注意缺陷性;混合型ADHD的社会功能得分显著低于注意缺陷型和多动型。7岁儿童ADHD的多动情况显著低于8岁、9岁。ADHD共病率为12.6%,ADHD儿童伴有学习困难的比例为43.2%。     

注意缺陷多动症与犯罪的关系及其司法启示

注意缺陷多动症(Attention deficit hyperactivity disorder, ADHD) 是一种常见于儿童期的精神障碍, 也可能持续到青少年及成年阶段, 其症状表现为难于集中注意力、难于控制其行为及活动过度等, 这些缺陷可能会增加患者犯罪的几率。轻微脑功能障碍、自我调节学说、强化敏感性理论、相关人格特质等在一定程度上可解释ADHD与犯罪的关系。ADHD作用于犯罪存在三种不同的可能路径, 即独立作用、间接作用和无作用。文中特别指出ADHD患者在刑事司法过程中表现的特点及其司法启示。未来研究应从基因、神经心理机制及其与环境的交互作用上进一步探讨ADHD与犯罪的关系, 并提示在犯罪预防、审讯、法庭审判以及罪犯矫治中需要考量ADHD的可能影响。     

Academic Achievement Over 8 Years Among Children Who Met Modified Criteria for Attention-deficit/Hyperactivity Disorder at 4–6 Years of Age

The predictive validity of symptom criteria for different subtypes of ADHD among children who were impaired in at least one setting in early childhood was examined. Academic achievement was assessed seven times over 8 years in 125 children who met symptom criteria for ADHD at 4–6 years of age and in 130 demographically-matched non-referred comparison children. When intelligence and other confounds were controlled, children who met modified criteria for the predominantly inattentive subtype of ADHD in wave 1 had lower reading, spelling, and mathematics scores over time than both comparison children and children who met modified criteria for the other subtypes of ADHD. In some analyses, children who met modified criteria for the combined type had somewhat lower mathematics scores than comparison children. The robust academic deficits relative to intelligence in the inattentive group in this age range suggest either that inattention results in academic underachievement or that some children in the inattentive group have learning disabilities that cause secondary symptoms of inattention. Unexpectedly, wave 1 internalizing (anxiety and depression) symptoms independently predicted deficits in academic achievement controlling ADHD, intelligence, and other predictors.     

Few Preschool Boys and Girls with ADHD are Well-Adjusted During Adolescence

To estimate the prevalence of being well-adjusted in adolescence, boys and girls with (n = 96) and without (n = 126) attention-deficit/hyperactivity disorder (ADHD) were assessed seven times in eight years starting when they were 4–6 years of age. Symptoms of ADHD, ODD/CD, and depression/anxiety in addition to social skills and social preference were gathered using multiple methods and informants. Being well-adjusted was defined by surpassing thresholds in at least four of the five domains. At the 7- and 8-year follow-up, when youth were 11–14 years old, probands were significantly less likely to be well-adjusted relative to age- and ethnicity-matched control children. Only a minority of children with ADHD was well-adjusted in adolescence when emotional, behavioral, and social domains were considered simultaneously. Even when their ADHD symptoms improved over time, most probands exhibited significant impairment 7–8 years after their initial assessment.     

Associations between Maternal Attention-Deficit/Hyperactivity Disorder Symptoms and Parenting

Mothers of children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for an ADHD diagnosis themselves, which is likely associated with impairments in parenting. The present study utilized a multi-method assessment of maternal ADHD and parenting to examine the extent to which maternal ADHD symptoms are associated with maladaptive parenting. Participants included 70 6–10 year old children with DSM-IV ADHD and their biological mothers. Results suggested that mothers with higher levels of ADHD symptoms reported lower levels of involvement and positive parenting and higher levels of inconsistent discipline. During observed parent–child interactions, maternal ADHD symptoms were negatively associated with positive parenting, and positively associated with negative parenting and repeated commands before giving the child an opportunity to comply. Given prior research suggesting that maladaptive parenting behaviors are risk factors for the later development of conduct problems among children with ADHD, these findings have important clinical implications for family-based assessment and treatment of ADHD.     

The Effects of Incentives on Visual–Spatial Working Memory in Children with Attention-deficit/Hyperactivity Disorder

Working memory is one of several putative core neurocognitive processes in attention-deficit/hyperactivity disorder (ADHD). The present work seeks to determine whether visual–spatial working memory is sensitive to motivational incentives, a laboratory analogue of behavioral treatment. Participants were 21 children (ages 7–10) with a diagnosis of ADHD-combined type. Participants completed a computerized spatial span task designed to assess storage of visual–spatial information (forward span) and manipulation of the stored information (backward span). The spatial span task was completed twice on the same day, once with a performance-based incentive (trial-wise feedback and points redeemable for prizes) and once without incentives. Participants performed significantly better on the backward span when rewarded for correct responses, compared to the no incentive condition. However, incentives had no effect on performance during the forward span. These findings may suggest the use of motivational incentives improved manipulation, but not storage, of visual–spatial information among children with ADHD. Possible explanations for the differential incentive effects are discussed, including the possibility that incentives prevented a vigilance decrement as task difficulty and time on task increased.     

The Development of Hyperactive–Impulsive Behaviors During the Preschool Years: The Predictive Validity of Parental Assessments

The objectives of this study were to establish the different developmental trajectories of hyperactive-impulsive behaviors on the basis of both mother and father ratings at 19, 32, 50, and 63 months, and to examine the predictive validity of these trajectories with respect to later hyperactive-impulsive behaviors, as rated by teachers in the first 2 years of school. Hyperactive-impulsive behaviors were assessed in a population-based sample of 1,112 twins (565 boys and 547 girls) at 19, 32, 50, and 63 months of age. The results revealed a differentiated and consistent view of developmental trajectories of hyperactive-impulsive behaviors derived from these repeated assessments, with 7.1% of children seen by mothers (7% for fathers) as displaying high and stable hyperactive-impulsive behaviors. According to mother ratings, children on a high-chronic trajectory were more likely than other children to display hyperactive-impulsive behaviors at 72 and 84 months according to their teachers. Repeated measures over time and father-based trajectories significantly added to the prediction teacher later ratings of hyperactive-impulsive behaviors. These results support the predictive validity of parental assessment of hyperactive-impulsive behaviors during the preschool years and their use to identify children at risk for further evaluation and possible intervention.     

ADHD and Behavioral Inhibition: A Re-examination of the Stop-signal Task

The current study investigates two recently identified threats to the construct validity of behavioral inhibition as a core deficit of attention-deficit/hyperactivity disorder (ADHD) based on the stop-signal task: calculation of mean reaction time from go-trials presented adjacent to intermittent stop-trials, and non-reporting of the stop-signal delay metric. Children with ADHD (n = 12) and typically developing (TD) children (n = 11) were administered the standard stop-signal task and three variant stop-signal conditions. These included a no-tone condition administered without the presentation of an auditory tone; an ignore-tone condition that presented a neutral (i.e., not associated with stopping) auditory tone; and a second ignore-tone condition that presented a neutral auditory tone after the tone had been previously paired with stopping. Children with ADHD exhibited significantly slower and more variable reaction times to go-stimuli, and slower stop-signal reaction times relative to TD controls. Stop-signal delay was not significantly different between groups, and both groups’ go-trial reaction times slowed following meaningful tones. Collectively, these findings corroborate recent meta-analyses and indicate that previous findings of stop-signal performance deficits in ADHD reflect slower and more variable responding to visually presented stimuli and concurrent processing of a second stimulus, rather than deficits of motor behavioral inhibition.     

Response Style Differences in the Inattentive and Combined Subtypes of Attention-Deficit/Hyperactivity Disorder

This study examined potential differences between the inattentive and combined ADHD subtypes using laboratory tasks assessing behavioral inhibitory processes. Seventy-five children completed two tasks of behavioral inhibition believed to isolate different processes: the cued reaction time task (CRT), a basic inhibition task, and the go/no-go task (GNG), a complex inhibition task that incorporates motivational contingencies. Three groups of participants were identified, including ADHD/Inattentive (n = 17), ADHD/Combined (n = 37), and comparison (n = 21). Results indicated that rather than showing behavioral inhibition deficits, the ADHD/I children appeared overly inhibited, as evidenced by slower reaction times across the two tasks and significantly higher errors of omission in the GNG task. Additionally, the ADHD/I children did not demonstrate cue dependency effects on the CRT task, suggesting that they were failing to incorporate relevant information before making a response. The sluggish and inhibited performance of the ADHD/I group challenges the idea that it is a subtype of ADHD.