ADHD Youth Research Articles

Comorbid Depression May Aggravate ADHD in Youth

Comorbid Depression May Aggravate ADHD in Youth

Neuropsychological functioning in relatives of girls with and without ADHD

A limited number of studies have examined neuropsychological functioning in the family members of ADHD youth, and none have focused exclusively on relatives of females. Structured diagnostic interviews and neuropsychological batteries were administered to parents and siblings enrolled in a family study of girls with and without ADHD. Relatives were stratified into three groups: relatives of DSM-IV ADHD probands with ADHD (n = 106), relatives of ADHD probands without ADHD (n = 189) and relatives of controls without ADHD (n = 243). Analyses were also conducted on a subgroup of families in which more than one member had The neuropsychological battery as a whole distinguished affected and unaffected ADHD relatives from controls. The Wechsler Oral Arithmetic subtest, the Stroop Word, Color and Color-Word subscales were impaired in affected ADHD relatives, as were the WRAT-R Arithmetic and Reading subtests. Only the Stroop Color-Word and Interference subtests and the WRAT-R Arithmetic subtest showed significant impairments in unaffected relatives. In multiplex families, additional impairments were found in unaffected relatives on the Stroop Color subtest and the Wechsler Oral Arithmetic subtest. Analyses based on DSM-III-R diagnoses produced nearly identical results. Minor differences emerged across relatives of probands with different DSM-IV subtypes. Data were consistent with our previous study of relatives of boys with ADHD. Neuropsychological impairments in relatives of female ADHD probands were primarily associated with the diagnosis of ADHD, but subtle cognitive impairments that index familial vulnerability to the disorder may exist.

An Investigation of Relationships Between Social Behavior and ADHD in Children and Youth

This article describes two related studies focusing on the relationship of social behavior and ADHD characteristics of children and youth.The primary purpose of these studies was to empirically investigate the construct validity of the Home and Community Social Behavior Scales (HCSBS), a new behavior rating scale for use by parents in assessing social and antisocial behavior of children and youth. A secondary purpose was to examine in detail relationships between ADHD characteristics and social behavior in children. Results of these studies indicated that as ADHD symptoms increased, antisocial behaviors increased and positive social behavior decreased. Overall, the results indicated an exceptionally strong link between social behavior and ADHD, and provide strong evidence in support of the validity of the HCSBS. Practical applications of these findings are discussed.

A psychometric measure of learning disability predicts educational failure four years later in boys with Attention-Deficit/Hyperactivity Disorder

Objective: Although most children with ADHD experience school problems, only a subset of these youth meet psychometric criteria for learning disabilities (LD) in reading or mathematics. Considering the well-documented adverse impact of both ADHD and LD on school performance, the presence of both conditions in a given child may herald a particularly poor educational outcome for affected youth. This issue has not been adequately addressed in previous follow-up studies of ADHD. Design: In a four-year follow-up study of ADHD children, the educational, psychiatric, and psychosocial outcomes in ADHD youth with and without LD were examined. Results: Among children with ADHD, LD at baseline selectively predicted poorer educational functioning at follow-up, as manifested by higher rates of grade retention, in-school tutoring, and placement in special classes. In contrast, psychiatric comorbidity and psychosocial outcomes were comparable in ADHD youth with and without LD. Conclusions: Results suggest that LD predicts impaired academic outcomes among ADHD children. It does not, however, predict impaired social or psychiatric outcomes. These results stress the importance of including an evaluation of LD in the assessment of ADHD youth.

Is bipolar disorder a risk for cigarette smoking in ADHD youth?

Despite emerging literature linking juvenile bipolar disorder (BPD) and substance abuse, little is known about a link between BPD and cigarette smoking. To this end, we evaluated the association between BPD and cigarette smoking in youth. Subjects were 31 bipolar adolescents derived from a cohort of boys with DSM-III-R ADHD (N = 128) and non-ADHD comparisons (N = 109) followed prospectively for 4 years into mid-adolescence. Information on cigarette smoking was obtained in a standardized manner blind to the proband's clinical status. Logistic regression models were used to determine risk for smoking at follow-up. BPD was associated with a higher risk for cigarette smoking in mid-adolescence, which was largely accounted for by conduct disorder. The developmental onset of BPD in adolescence (age 13-18 years) conferred a greater risk for cigarette smoking compared to those youths with the onset of their BPD prepubertally (< or = 12 years; odds ratio = 10.8, p < 0.01), even after controlling for conduct disorder and other confounds. The naturalistic treatment of BPD with combined counseling and pharmacotherapy appeared to reduce the risk for cigarette smoking. BPD, particularly when it onsets in adolescence, is a significant risk factor for the early initiation of cigarette smoking in these ADHD youths. These data coupled with the literature strongly suggest that juveniles with BPD need to be carefully monitored for the early initiation of cigarette smoking and substance abuse.

Towards defining a meaningful anxiety phenotype for research in ADHD children

Objective: To combine anxiety diagnoses empirically into a meaningful definition of a comorbid anxiety syndrome in ADHD children. Methods: The prevalence of all DSM-111-R anxiety disorders was examined in our ADHD sample (N =237) and a Receiver Operating Characteristic (ROC) analysis was conducted to combine the information optimally from these many disorders into a single anxiety phenotype. Results: We found that two or more anxiety disorders correctly identified a large number of ADHD children as anxious (SN=0.75) while maintaining a reasonable false positive rate (Sp=0.67). In contrast, the criterion of three or more anxiety disorders correctly identified only half the sample and the criterion of one or more anxiety disorders had a much higher false positive rate. The necessary data are also presented for those that may wish to use a definition other than 2 or more anxiety disorders. Conclusion: These findings suggest that using 2 or more anxiety disorders may offer a useful approach to defining comorbid anxiety in ADHD youth.

The Multidimensional Anxiety Scale for Children (MASC): Confirmatory factor analysis in a pediatric ADHD sample

While considerable attention has been paid to discriminating attention-deficit/hyperactivity and anxiety disorders, there are as yet no published confirmatory factor analytic studies of any self-report anxiety scale in ADHD youth. The Multidimensional Anxiety Scale for Children (MASC) is a 39-item, 4-point Likert self-report scale that robustly represents the factor structure of anxiety in children aged 8 to 18 years. Using confirmatory factor analytic methods, the present paper reports a replication of the four-factor measurement model for the MASC in a large sample of ADHD youth aged 7 to 10 years. The fit indices proved to be comparable to those obtained in the MASC clinical and non-clinical (normative) samples. Clinically, therefore, this report strengthens confidence that the MASC is a valid measure of anxiety in diverse populations. With respect to research, it provides supporting evidence that results obtained using the MASC in the MTA and other research studies reflect valid estimates of anxiety in those samples.

The unexplored void of ADHD and African-American research: A review of the literature

Objective: To identify the body of knowledge exploring the subject of ADHD and African- Americans. Method: A systematic review of the literature was conducted through the Medline, Psychlit and Psychlnfo databases. Results: In contrast to thousands of articles on ADHD, only 16 articles were identified that dealt with ADHD in African-American youth. Additionally, only a handful of these articles had ethnicity as the primary focus of research. Studies that examined ADHD among African-Americans in a school context showed that race may affect how teachers diagnose hyperactivity. Treatment studies suggested that African-Americans may respond similarly to the same ADHD medications as do Caucasians. Studies evaluating ADHD assessment tools were so sparse that they were largely inconclusive. Discussion: The paucity of studies on the subject of ADHD and African-Americans suggests the urgent need for more research to be done in this area. Such studies should be based on culturally sensitive designs.