Attention Deficit Hyperactivity Disorder Boys Research Articles

Otoacoustic emissions measured in children diagnosed with attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is generally acknowledged to be more prevalent in males than in females. Further, some precursors to ADHD appear early in life. Together these facts suggest that ADHD may be influenced by androgenic mechanisms operating early in development. This reasoning raises the question of whether the otoacoustic emissions (OAEs) of children with ADHD are masculinized. Click-evoked OAEs were measured for one click level in 8 boys and 3 girls diagnosed as ADHD/Combined, in 11 males and 5 females diagnosed as ADHD/Inattentive (IA), and in 17 male and 18 female controls. The ages of these samples ranged between 7 and 15. As in adults, the CEOAEs of the control males were weaker than those of the control females. Further, the CEOAEs of the ADHD/IA males were weaker than in the control males (a hypermasculinization) and the CEOAEs of the IA females were weaker than in the female controls (a masculinization). The CEOAEs of the Combined groups were slightly stronger (feminized) than those of the control males and females. One interpretation is that the IA subgroup of ADHD boys and girls (but not the Combined subgroup) was exposed to higher-than-normal levels of androgens sometime early in development. [Work supported by NIDCD.]

Attention-deficit/hyperactivity disordered boys' relationships with their mothers and fathers: child, mother, and father perceptions.

Self-perceptions of parent-child relationship quality were examined for 142 boys with attention-deficit/hyperactivity disorder (ADHD) and 55 control boys. Parent perceptions were examined as well. Mothers and fathers of ADHD boys perceived their relationships with their children more negatively than mothers and fathers of control boys. Interestingly, despite these differences in parental perceptions, ADHD boys did not differ from control boys in their perceptions of their relationships with their parents. Further, when ADHD boys' perceptions were compared directly to those of their parents, ADHD boys' reports were positively enhanced relative to those of control parent-child dyads. Together, these results may be viewed as providing support for a positive illusory bias in the social self-perceptions of ADHD children.

Evidence for Unexpected Weaknesses in Learning in Children with Attention-Deficit/Hyperactivity Disorder Without Reading Disabilities

This study examined the mechanisms underlying verbal learning in children with and without attention-deficit/hyperactivity disorder (ADHD), none of whom had reading disabilities. Children with ADHD were compared to typically developing children on both process and product scores from the California Verbal Learning Test for Children. The findings indicated that children with ADHD initially learned the same number of words as controls but showed weaknesses recalling the words after delays, suggesting that children with ADHD are less efficient learners. Regardless of ADHD status, boys and girls performed differently. Boys used semantic clustering less frequently and recalled fewer words from the middle region of the list than girls; girls also outperformed boys in terms of overall performance, despite lower verbal IQ scores. These findings show that children with ADHD can exhibit unexpected weaknesses in learning even without a formal learning disability. Gender differences in verbal learning are also illustrated.

Childhood ADHD and Later Antisocial Behavior and Drug Use

ADHD children, especially those with the Combined or Hyperactive Types, frequently demonstrate high levels of conduct problems or social aggression in their childhood years (Barkley, 1998; Hinshaw, 1987). Followed into adolescence, these children, particularly those with comorbid social aggression, have a significantly elevated risk for oppositional defiant disorder, conduct disorder (CD), and delinquent or antisocial activities (August, Stewart, & Holmes, 1983; Barkley et al., 1990; Klein & Mannuzza, 1991; Weiss & Hechtman, 1993). Along with those risks, there occurs a greater likelihood of being arrested (Satterfield, Swanson, Schell, & Lee, 1994) and a greater propensity for substance experimentation, use, and eventual abuse (Biederman, Wilens, et al., 1997; Lambert & Hartsough, 1998), particularly among that subset of ADHD children having CD by adolescence (Molina, Smith, & Pelham, 1999).

Disentangling weak coherence and executive dysfunction: planning drawing in autism and attention-deficit/hyperactivity disorder.

A tendency to focus on details at the expense of configural information, 'weak coherence', has been proposed as a cognitive style in autism. In the present study we tested whether weak coherence might be the result of executive dysfunction, by testing clinical groups known to show deficits on tests of executive control. Boys with autism spectrum disorders (ASD) were compared with age- and intelligence quotient (IQ)-matched boys with attention-deficit/hyperactivity disorder (ADHD), and typically developing (TD) boys, on a drawing task requiring planning for the inclusion of a new element. Weak coherence was measured through analysis of drawing style. In line with the predictions made, the ASD group was more detail-focused in their drawings than were either ADHD or TD boys. The ASD and ADHD groups both showed planning impairments, which were more severe in the former group. Poor planning did not, however, predict detail-focus, and scores on the two aspects of the task were unrelated in the clinical groups. These findings indicate that weak coherence may indeed be a cognitive style specific to autism and unrelated to cognitive deficits in frontal functions.

On-line story representation in boys with attention deficit hyperactivity disorder.

Children with attention deficit hyperactivity disorder (ADHD) face an increased risk of poor achievement in school. Thus, knowledge of the cognitive processing abilities of children with ADHD is critical to understanding and improving their academic performance. Although many studies have focused on the specific nature of the attention deficit experienced by children with ADHD, few have examined higher order cognitive processing such as comprehension of stories. The present study examined the processes of encoding story information, building a story representation, and modifying a story representation in boys with ADHD and nonreferred boys. Boys were asked to narrate a story from a picture book twice. Boys with ADHD showed deficits in representing goals and goal plans in their narrations, as compared to nonreferred boys. Boys with ADHD also committed more errors than nonreferred boys, but did correct certain types of errors on their second telling. Implications are discussed in terms of future research needed to identify the cognitive deficits that account for these narrative deficits.

Family-based and case-control association studies of catechol-O-methyltransferase in attention deficit hyperactivity disorder suggest genetic sexual dimorphism.

Attention deficit hyperactivity disorder (ADHD) is the most common childhood-onset behavioral disorder. Boys are more often affected than girls. Family, twin, and adoption studies have supported a strong genetic basis. Some studies show that a catechol-O-methyltransferase (COMT) polymorphism affecting enzyme activity was associated with personality characteristics and diseases, such as novelty-seeking personality, substance abuse, and heroin addiction, whose features are similar to ADHD or are associated with ADHD. These findings suggest that the COMT gene may be a candidate gene for ADHD. TDT, HHRR, and case-control association studies were conducted within a sample of 202 nuclear ADHD families, 340 ADHD cases, and 226 controls in the Han Chinese population. Diagnoses and ADHD subtypes were ascertained according to DSM-IV criteria using American Clinical Diagnostic Interviewing Scales. The HHRR analysis suggested that the low enzyme-activity COMT Met allele was preferentially transmitted to ADHD boys (160 trios, chi(2) = 3.858, P = 0.05, df = 1) but not girls. This association is particularly pronounced among male ADHD probands without any comorbidity (50 trios, HHRR: chi(2) = 5.128, P = 0.024, df = 1; TDT: chi(2) = 4.558, P = 0.033, df = 1), especially the ADHD-I subtype (32 trios, HHRR: chi(2) = 5.792, P = 0.016, df = 1; TDT: chi(2) = 5.333, P = 0.021, df = 1). The case-control study revealed that the Val allele was more frequent in females meeting ICD-10 or DSM-IV criteria for ADHD than in female controls (86 and 79.5%, respectively, chi(2) = 4.059, P = 0.044, df = 1). Although these results suggest the COMT gene exerts some influence on the risk for ADHD in the Han Chinese population, given the potential for Type I error, these findings require replication before drawing definitive conclusions.

ADHD + Conduct Disorder May Signal Trouble Ahead

ADHD + Conduct Disorder May Signal Trouble Ahead

A family study of psychiatric comorbidity in girls and boys with attention-deficit/hyperactivity disorder

Background: Because attention-deficit/hyperactivity disorder (ADHD) is relatively infrequent among girls, little is known about the nature and causes of psychiatric comorbidity in girls and the reason for gender differences in the prevalence of these comorbidities.Methods: Using blinded, structured psychiatric interviews, we studied two groups of boys: 140 ADHD probands and 120 non-ADHD comparisons. These groups had 454 and 368 first-degree biological relatives, respectively. We also studied two groups of girls: 140 ADHD probands and 122 non-ADHD comparisons. These groups had 417 and 369 first-degree biological relatives, respectively.Results: The co-occurrence of ADHD and comorbid psychopathology in families was the same for families ascertained through boy and girl probands.Conclusions: Our results suggest that boys and girls do not differ in the familial risk factors that mediate comorbid psychopathology and the familial aggregation of comorbid disorders in ADHD families. Although this is consistent with prior work suggesting more similarities than differences in the nature of psychiatric comorbidity in ADHD boys and girls, we cannot make strong conclusions, owing to the possibility of cohort effects.

Neuroelectrical signs of selective attention to color in boys with attention-deficit hyperactivity disorder

In order to gain insight into the functional and macroanatomical loci of visual selective processing deficits that may be basic to attention-deficit hyperactivity disorder (ADHD), the present study examined multi-channel event-related potentials (ERPs) recorded from 7- to 11-year-old boys clinically diagnosed as having ADHD ( n=24) and age-matched healthy control boys ( n=24) while they performed a visual (color) selective attention task. The spatio-temporal dynamics of several ERP components related to attention to color were characterized using topographic profile analysis, topographic mapping of the ERP and associated scalp current density distributions, and spatio-temporal source potential modeling. Boys with ADHD showed a lower target hit rate, a higher false-alarm rate, and a lower perceptual sensitivity than controls. Also, whereas color attention induced in the ERPs from controls a characteristic early frontally maximal selection positivity (FSP), ADHD boys displayed little or no FSP. Similarly, ADHD boys manifested P3b amplitude decrements that were partially lateralized (i.e., maximal at left temporal scalp locations) as well as affected by maturation. These results indicate that ADHD boys suffer from deficits at both relatively early (sensory) and late (semantic) levels of visual selective information processing. The data also support the hypothesis that the visual selective processing deficits observed in the ADHD boys originate from deficits in the strength of activation of a neural network comprising prefrontal and occipito-temporal brain regions. This network seems to be actively engaged during attention to color and may contain the major intracerebral generating sources of the associated scalp-recorded ERP components.

Time-on-task analysis using wavelet networks in an event-related potential study on attention-deficit hyperactivity disorder

Objective: The aim of this event-related potential (ERP) study was to test time-on-task analysis at the level of single sweeps in a clinical trial. Since inattentiveness is one of the main symptoms of attention-deficit hyperactivity disorder (ADHD), this child psychiatric disorder was chosen as an exemplary application.Methods: Twenty-four healthy and 24 ADHD boys, aged 9–15 years, performed an auditory selective attention task for about 5 min. ERP single trials were analyzed using wavelet networks. Time-on-task analysis was applied to omission errors, reaction time and slow ERP components (frontal negativity, parietal positivity), represented by a low-frequency wavelet component.Results: Both performance and ERP measures showed distinct temporal dynamics. Time-on-task effects were not only linear, but also of higher order and started after less than 1 min. For ADHD children, earlier time-on-task effects, i.e. an earlier increase of omission errors and frontal negativity, resulted. Healthy children could allocate more attentional resources during the course of the experiment.Conclusion: Time-on-task analysis at the level of single trials revealed phenomena probably reflecting ADHD children's attentional deficits. Thus, a more differentiated ERP analysis may provide a better understanding of the pathophysiological background in neuropsychiatric disorders.

The influence of three months of methylphenidate treatment on platelet-poor plasma biogenic amine levels in boys with attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) is related to dysregulation in the activity of brain monoamines. The aim of the present study was to assess the impact of three months' methylphenidate (MPH) treatment on platelet-poor plasma (PPP) norepinephrine (NE), dopa and serotonin (5-HT) levels as well as on ADHD symptomatology. Three months of MPH treatment in 16 ADHD boys, aged 11.4 +/- 1.6 years, resulted in a significant reduction in PPP NE levels (p < 0.05). A tendency towards a reduction of PPP 5-HT and dopa levels was detected (p < 0.1 for both). The decrease in PPP biogenic amine levels after three months of MPH treatment was accompanied by a significant reduction in all psychometric characteristics of ADHD. This result indicates the possible role of overactivity of the noradrenergic system in the pathophysiology of ADHD and suggests that the MPH therapeutic action may be related to stimulant-induced inhibitory effect on the noradrenergic system. Copyright 2001 John Wiley & Sons, Ltd.

Academic task persistence of normally achieving ADHD and control boys: performance, self-evaluations, and attributions.

The authors examined academic task persistence, pretask expectancies, self-evaluations, and attributions of boys with attention-deficit/hyperactivity disorder (ADHD) as compared with control boys. Participants were 83 ADHD boys and 66 control boys, all normally achieving. Prior to the task, performance expectancies were assessed. After a success-failure manipulation with find-a-word puzzles, performance on subsequent trials, self-evaluations, and attributions were evaluated. Compared with controls, ADHD boys solved fewer test puzzles, quit working more often, and found fewer words on a generalization task. Consistent with these behavioral findings, research assistants rated ADHD boys as less effortful and less cooperative than control boys. Although ADHD boys did not differ significantly from controls in their posttask self-evaluations, they did differ significantly from controls in some aspects of their attributions. Attributional data indicated that ADHD boys endorsed luck as a reason for success more strongly and lack of effort as a reason for failure less strongly than controls.

Effects of methylphenidate and expectancy on performance, self-evaluations, persistence, and attributions on a social task in boys with ADHD.

This study examined the effects of 0.3 mg/kg methylphenidate (MPH) and expectancy regarding medication on the performance and persistence of 137 boys with attention-deficit/ hyperactivity disorder (ADHD) in a get-acquainted dyadic interaction with a peer, using a balanced-placebo design. Boys in 4 groups—administered placebo or MPH crossed with being told they received placebo or MPH—interacted with child confederates in experimental situations in which social success and failure were manipulated. In contrast with studies of academic persistence, MPH did not affect boys' task persistence or performance. Boys gave more positive self-evaluations and talked more in the success condition as compared with the failure condition. Boys attributed success to effort and ability and failure to task difficulty, and neither MPH nor expectancy affected this pattern. These findings are consistent with other studies in failing to find debilitating effects of MPH or medication expectancies on ADHD boys' attributions or self-evaluations. The primary features of attention-deficityhyperactivity disorder (ADHD) include inattention, impulsivity, and excessive motor activity. ADHD also has a number of secondary features, one of the most important being peer rela

Effects of methylphenidate and expectancy on performance, self-evaluations, persistence, and attributions on a social task in boys with ADHD.

This study examined the effects of 0.3 mg/kg methylphenidate (MPH) and expectancy regarding medication on the performance and persistence of 137 boys with attention-deficit/hyperactivity disorder (ADHD) in a get-acquainted dyadic interaction with a peer, using a balanced-placebo design. Boys in 4 groups-administered placebo or MPH crossed with being told they received placebo or MPH-interacted with child confederates in experimental situations in which social success and failure were manipulated. In contrast with studies of academic persistence, MPH did not affect boys' task persistence or performance. Boys gave more positive self-evaluations and talked more in the success condition as compared with the failure condition. Boys attributed success to effort and ability and failure to task difficulty, and neither MPH nor expectancy affected this pattern. These findings are consistent with other studies in failing to find debilitating effects of MPH or medication expectancies on ADHD boys' attributions or self-evaluations.

Depression and self-esteem in boys with attention-deficit/hyperactivity disorder: associations with comorbid aggression and explanatory attributional mechanisms.

It was tested whether boys with attention-deficit/hyperactivity disorder (ADHD), subgrouped by aggressive status, would show higher rates of depressive symptomatology and lower levels of self-esteem than would comparison boys and, in a subsample, explored attributional mechanisms that may be related to such internalizing features. Study 1 utilized 114 boys with ADHD (all prior recipients of stimulant medication) and 87 comparison boys, aged 7-12 years. Aggressive boys with ADHD reported more symptoms of depression than did nonaggressive boys with ADHD, who, in turn, reported more depression than did comparison boys. Effect sizes were moderate to large and did not vary with a depression rating scale uncontaminated by ADHD-related items. For self-esteem, the most pronounced effect was that aggressive boys with ADHD showed lower levels than did nonaggressive ADHD or comparison boys; effects were again moderate to large. Study 2 participants were a subsample of boys with ADHD from Study 1 (N = 27). We probed causal attributions in ADHD-related domains through responses to hypothetical vignettes, in which the protagonist's medication status (medicated, not medicated) was crossed with type of outcome (good, bad). Medication-related attributions were frequent. In describing the protagonist's success in relation to medication treatment, the sample showed significant associations between (a) medication-related attributions and (b) increased depressive symptomatology as well as decreased self-esteem. We discuss attributional processes that may help to explain the variation in internalizing symptoms among children with ADHD.

Sports behavior of ADHD children

This study examined differences in sport behavior between boys with and without AttentionDeficit/Hyperactivity Disorder (ADHD). Sport behavior was measured by parent-report on the Sports Behavior Checklist (SBC). The SBC assessed which sports the child had participated in, length of participation, aggression, emotional reactivity, frequency of injury, and frequency of disqualification across both team and individual sports settings. Results from the study showed that boys with ADHD displayed higher levels of aggression, emotional reactivity, and disqualification than did their non-ADHD peers. Additionally, both groups of boys displayed higher levels of aggression, emotional reactivity, and injury in team sports compared to individual sports. Practical implications for the parents of ADHD boys involved in sports are discussed. Results are also considered with respect to current theories of ADHD.

Stimulant treatment in young boys with symptoms suggesting childhood mania: a report from a longitudinal study.

This study used data from a completed longitudinal study to examine the effects of methylphenidate on 6-12-year-old boys presumably at risk for bipolar disorder. Of 75 boys referred, diagnosed with hyperkinetic reaction of childhood (minimal brain dysfunction), treated clinically with methylphenidate, and followed as young adults, 23% (the maximorbid or MAX group) had childhood symptoms of irritability and emulated DSM-IV diagnoses of attention deficit hyperactivity disorder (ADHD), plus oppositional defiant or conduct disorder (ODD/CD) and anxiety or depression or both. The remaining boys (the minimorbid or MIN group) had fewer symptoms and disorders. MAX and MIN groups did not differ in rated response to methylphenidate, duration of treatment, clinically determined maintenance doses, concurrent or subsequent treatment with other medications, or other aspects of medication experience. At ages 21-23, individuals with bipolar-related lifetime diagnoses (adult mania, hypomania, or cyclothymia) did not differ from those without bipolar-related diagnoses in any aspect of early methylphenidate treatment history. These findings indicate that ADHD boys with symptoms suggesting childhood mania do not respond differently to methylphenidate than boys without such symptoms, and there is no evidence here that methylphenidate precipitates young adult bipolar disorders in susceptible individuals.

Brain mapping of bilateral interactions in attention deficit hyperactivity disorder and control boys

Objectives: Children with attention deficit hyperactivity disorder (ADHD) are thought to have deficits in attentional control, whereas the status of deficits at visual and pre-motor processing stages is unclear. Methods: The timing of such deficits was examined with event-related potential (ERP) microstates (stimulus- and response-related) and continuous force recordings in 15 ADHD and 16 control boys in a choice reaction time task. Unilateral and bilateral stimulus and response conditions were used to assess bilateral interactions at visual, central, and pre-motor stages. Results: ADHD boys showed poorer performance, particularly in the bilateral conditions. In the visual P1 microstates, they exhibited less suppression of visual evoked potential (VEP) amplitudes but similar speeding of VEP latencies in the bilateral compared to the summed unilateral condition. The central P3 and pre-/post-response microstates were attenuated and topographically altered in ADHD boys. The attenuation was most pronounced in the bilateral condition and was similar for stimulus- and response-related averages. The lateralized readiness potential was also reduced in ADHD boys; this was most pronounced for the left hand responses. Conclusions: Brain mapping during uni- and bilateral stimulus and response conditions thus indicates multilevel deficits in ADHD boys affecting visuo-attentional, central, and pre-motor processes.

The Predictive Power of Combined Neuropsychological Measures for Attention-Deficit/Hyperactivity Disorder in Children

The present study explores the predictive power of seven neuropsychological assessment tools used in combination in classifying children with attention-deficit/hyperactivity disorder (ADHD). Twenty-one ADHD boys and 22 community control children participated. Group differences were significant on the continuous performance test only; however, battery analysis did increase overall predictive power, which was moderate. This study highlights the difficulty in identifying consistent mean differences on tests of frontal/executive functioning across studies, as well as the need to assess the predictive validity of these tests in classifying children with ADHD. The study suggests that these tests may provide greater predictive validity when used in combination. Inconsistencies in the literature are discussed, with consideration of research methodology, the heterogeneity of the ADHD population, and comorbid diagnoses.