Attention-deficit/hyperactivity Disorder Inattentive Type Research Articles

Personality profiles in adults with attention deficit hyperactivity disorder (ADHD).

BackgroundPrevious studies suggested that the presence of ADHD in children and young adolescents may affect the development of personality. Whether or not the persistence of ADHD in adult life is associated with distinct personality patterns is still matter for debate. To address this issue, we compared the profiles of the Temperament and Character Inventory (TCI) that assesses personality dimensions in 119 adults ADHD and 403 controls.MethodsANCOVA were used to examine group differences (controls vs. ADHD and ADHD inattentive type vs. ADHD combined + hyperactive/impulsive types) in Temperaments and Characters. Partial correlation coefficients were used to assess correlation between TCI and expression and severity of symptoms of ADHD.ResultsHigh novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) scores as well as low self-directedness (SD) and cooperativeness (C) scores were associated with ADHD diagnosis. Low SD was the strongest personality trait associated with adult ADHD. Cases with the ADHD inattentive type showed higher HA and lower SD scores compared to the combined and hyperactive/impulsive types. High HA scores correlated with inattention symptoms whereas high NS and ST scores were related to hyperactive symptoms. Finally low SD and high NS were associated with increased ADHD severity.ConclusionsDistinct temperaments were associated with inattentive versus hyperactive/impulsive symptoms supporting the heterogeneous nature of the disorder.

Attention deficit hyperactivity disorder in children with primary monosymptomatic nocturnal enuresis: A case-control study.

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood neurological disorders. The aim of this study was to investigate ADHD in children with primary monosymptomatic nocturnal enuresis (PMNE) and compare it with healthy children. A total of 100 five to 16-year-old children with PMNE and 100 healthy children without NE were included in this case-control study as the cases and control groups, respectively. Subjects were selected from children who were referred to the pediatric clinic of the Amir Kabir Hospital of Arak, Iran, based on inclusion and exclusion criteria. ADHD was diagnosed by Conner's Parent Rating Scale-48 and the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria and was confirmed by consultation with a psychiatrist. Data were analyzed by binomial test using SPSS18. ADHD inattentive type was observed in 16 cases (16%) with PMNE and five controls (5%) (P=0.01). Despite these significant differences in the case and control groups, 25 (25%) and 16 (16%) children were affected by ADHD hyperactive-impulsive type (P=0.08) and 15 (15%) and 16 (16%) children were affected by ADHD mixed type (P=0.84), respectively. ADHD inattentive type in children with PMNE was significantly more common than that in healthy children. The observed correlation between ADHD inattentive type and PMNE makes psychological counseling mandatory in children with PMNE.

Attention-deficit/hyperactivity disorder in children undergoing peritoneal dialysis.

Background:Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood psychiatric disorder. This disorder is more prevalent in some chronic disease.Objectives:The aim of this study was to investigate ADHD in children with end-stage renal disease (ESRD) undergoing continuous ambulatory peritoneal dialysis (CAPD) and to compare the results with those of healthy children.Patients and Methods:This case-control study was conducted for six months (December 22, 2013 to June 21, 2014) on five to 16-year-old children, visiting the Pediatric Dialysis Unit of Amirkabir Hospital, Arak, Iran, and Taleghani Hospital, Kermanshah, Iran. A total of 100 children with ESRD who had undergone CAPD for at least six months and 100 healthy children were included in this study as case and control groups, respectively. ADHD was diagnosed by Conner's Parent Rating Scale-48 (CPRS-48) and DSM-IV-TR criteria, and was confirmed through consultation by psychologist. Data were analyzed by Binomial test in SPSS 18.Results:The ADHD inattentive type was observed in 16 cases (16%) with CAPD and five controls (5%) (P = 0.01). Moreover, ADHD hyperactive-impulsive type was observed in 27 cases (27%) with CAPD and seven controls (9%) (P = 0.002). Despite these significant differences, no children were diagnosed with ADHD combined type among all subjects.Conclusions:Inattentive type and hyperactive-impulsive type of ADHD are more prevalent in children with ESRD undergoing CAPD. Therefore screening methods for ADHD is necessary in these patients.

Test Anxiety and College Students With Attention Deficit Hyperactivity Disorder

Test anxiety was examined in college students with and without attention deficit hyperactivity disorder (ADHD). Results indicated that, relative to college students without ADHD, college students with ADHD reported higher total test anxiety as well as specific aspects of test anxiety, including worry (i.e., cognitive aspects of test anxiety) and emotionality (i.e., physiological aspects of test anxiety). Effect sizes were large for total test anxiety and the worry aspect of test anxiety. Nearly half of college students with ADHD reported clinically significant levels of the worry aspect of test anxiety. Females with ADHD reported higher levels of the emotionality aspect of test anxiety than did males with ADHD. Those with combined type and inattentive type ADHD did not differ on any aspect of test anxiety. Implications for assessment and intervention are discussed.

Thyroid dysfunction in attention-deficit hyperactivity disorder and effect of comorbidity

Introduction Attention-deficit hyperactivity disorder (ADHD) is considered to have a biologic basis, but the precise cause is unknown. It is one of the neurodevelopmental abnormalities observed frequently in children with generalized resistance to thyroid hormone, suggesting that thyroid abnormalities may be related to ADHD. Aim To assess thyroid dysfunction in children with ADHD and to detect the most common comorbidity. Participants and methods This was a case-control cross sectional study, in which 30 ADHD children were recruited from the Kasr Aini Pediatric Hospital (Abu-El Rish) outpatient psychiatry clinic and compared with 14 healthy control children, siblings of the patient group who participated in this research. Psychometric procedure The Stanford Binet Intelligence Scale, the Arabic version of Conners' Parent Rating Scale-Revised-Long version, and social score were used to calculate social standards of families. Laboratories assessment Serum total T3, total T4, and thyroid-stimulating hormone were assessed using the enzyme-linked immunosorbent assay. Results About 80% of the participants were males and 20% were females. Diagnosis according to the Diagnostic and statistical manual of mental disorders, 4th ed. (DSM-IV) showed that 29 (96.7%) of the patients were diagnosed with ADHD combined type by DSM-IV and only one patient (3.3%) had ADHD inattentive type. Forty percent of the patients were from low socioeconomic class, followed by 26.7% from moderate socioeconomic, and a very low socioeconomic class; however, 6.6% were from a high socioeconomic class. There was a statistically significant difference between cases and control groups in all components of Conners' Parent Rating Scale; all cases had higher means than the control group (P = 0.001). There was no significant difference between both the study group and their siblings in serum total T3, thyroid-stimulating hormone, T4 (P > 0.05). Fifty percent of the patients had no or only one comorbidity and 15 (50%) had two or more comorbidities. On comparing the two subgroups (group with no or one comorbidity and the other group with two or more comorbidities), we found that there were no statistically significant differences between the two groups in the IQ components test. There were only statistically significant differences between two subgroups in the social problem subscale of Conners' scale, which showed higher scores in the subgroup of patients with two or more comorbidities. Also, there were no statistically significant differences in the thyroid profile of the two subgroups and the thyroid functions were within normal. Conclusion Oppositional defiant disorder was the most common comorbidity. Social problems are common in children with ADHD with comorbidity. Children with ADHD have no thyroid dysfunction.

The possible effect of methylphenidate on kleptomania in a school-age girl with attention-deficit/hyperactivity disorder

Kleptomania is an impulse-control disorder (ICD) defined as the recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value. Kleptomania is a relatively rare condition; therefore, few studies have been conducted, and the treatment of the disorder tends to be based on small studies or case reports [1, 4, 6, 8]. Because the frequency of attention deficit/ hyperactivity disorder (ADHD) was found to be higher in patients with ICD [2], some research has focused on the effects of ADHD drugs on the treatment of kleptomania. Two different case reports examined the effect of methylphenidate (MPH) in these patients. In the first report, the authors showed that a combination of sertraline and MPH was successful in treating a child with kleptomania and ADHD [4]. In the second report, the positive effect of MPH on kleptomania was examined on an adolescent with kleptomania and ADHD [8]. The current report presents the case of a 7-year-old girl with kleptomania and ADHD who displayed a complete remission from kleptomania during MPH therapy. The subject patient was referred to the child and adolescent psychiatry outpatient clinic with complaints of stealing behavior, oppositional behavior, and inattention. Her stealing behavior had been observed since she had attended kindergarten. She had stolen her friends’ school materials, including pencil sharpeners, pen cap, eraser dust, a puzzle piece, or Legos. The frequency of her stealing behaviors increased over time, and for last 6 months, she had been stealing these materials nearly every day. Her parents reported that although she collected the things that she had stolen, she almost never used them. They also reported that the girl did not steal the items in anger, and her stealing behavior did not show a temporal relationship with her oppositional attitudes. Although her parents were unsure whether she experienced tension prior to stealing, she typically seemed to be comfortable after the acts. Although the parents had used various punishments to reprimand her for her actions, no reduction in her stealing behaviors was observed. During her psychiatric assessment, inattentiveness, mild hyperactivity, and impulsiveness were clinically observed. There were no signs of anxiety, elevated or depressed mood, psychosis, or compulsive behaviors. Her physical examination was within normal limits, and she had no history of any physical disease. According to Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR), she met criteria for ADHD (inattentive type) and kleptomania. The severity of her ADHD and kleptomania were detected with using Conner’s Parent Rating Scale and Clinical Global Impression Scale (Table 1) [5, 7]. The patient’s parents were reluctant to try behavioral intervention, so it was not undertaken at this stage. An 18 mg osmotic-release oral system MPH treatment was initiated daily. It resulted in moderate improvement in the girl’s ADHD symptoms and the complete resolution of the kleptomania within the first 10 days. The parents reported improvement in her ADHD, and her coexisting disruptive behavioral disorders’ symptoms continued over time. Complete resolution of the kleptomania continued as well. At the 4-month follow-up, the girl had not exhibited any stealing behavior. According to DSM-IV-TR, when diagnosing kleptomania, a patient’s stealing behavior is not better accounted for S. Yilmaz (&) A. Bilgic Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey e-mail: drsavash@gmail.com

Young adult romantic couples' conflict resolution and satisfaction varies with partner's attention-deficit/hyperactivity disorder type.

Attention-deficit/hyperactivity disorder (ADHD) has previously been associated with less satisfaction and success in romantic relationships. This study compares conflict resolution and problem-solving behaviors in young adult romantic couples either having one partner with ADHD combined type (C-couples), having one partner identified with ADHD inattentive type (IA-couples), or in which neither partner has an ADHD diagnosis (nondiagnosed [ND] couples). Self-reports of current and childhood ADHD symptoms corroborated diagnostic status and speaker and listener behaviors, coded via the Rapid Couples Interaction Scoring System (Gottman, 1996), were the primary dependent variables. Analyses revealed greater negativity and less positivity in C-couples' behavior during a conflict resolution task, relative to IA and ND couples, and this corresponded with couples' relational satisfaction. IA-couples emitted relational behavior that was largely similar to ND couples. Findings support that relational impairment exists in C-couples, and to some degree, contrast with previous research suggesting that individuals with predominant inattention experience greater social impairment in adulthood than those with other types of ADHD.

The Effects of Methylphenidate on Cognitive Function in Children with Attention–Deficit/Hyperactivity Disorder

Focusing on behavioral criteria for attention–deficit/hyperactivity disorder (ADHD) diagnosis leads to considerable neuropsychological profile heterogeneity among diagnosed children, as well as variable response to methylphenidate (MPH) treatment. Documenting “cold” executive working memory (EWM) or “hot” self–regulation (SR) neuropsychological impairments could aid in the differential diagnosis of ADHD subtypes and may help to determine the optimal MPH treatment dose. In this study, children with ADHD inattentive type (n = 19), combined type (n = 33), and hyperactive–impulse type (n = 4) underwent randomized controlled MPH trials; neuropsychological, behavioral, and observational data were collected to evaluate the children's responses. Those with moderate or significant baseline EWM/SR impairment showed robust MPH response, whereas response for those with lower baseline impairment was equivocal. Implications for medication use and titration, academic achievement, and long–term treatment efficacy are examined.

Pilot study: potential transcription markers for adult attention-deficit hyperactivity disorder in whole blood

Attention-deficit hyperactivity disorder (ADHD) is a common behavioural disorder that affects not only children and adolescents but also adults; however, diagnosis of adult ADHD is difficult because patients seem to have reduced externalized behaviour. ADHD is a multifactorial disorder in which many genes, all with small effects, are thought to cause the disorder in the presence of unfavourable environmental conditions. Therefore, in this pilot study, we explored the expression profile of a list of previously established candidate genes in peripheral blood samples from adult ADHD subjects (n = 108) and compared these results with those of healthy controls (n = 35). We demonstrate that combining the gene expression levels of dopamine transporter (SLC6A3), dopamine D5 receptor, tryptophan hydroxylase-1, and SNAP25 as predictors in a regression model resulted in sensitivity and specificity of over 80 % (ROC: max R(2) = 0.587, AUC = 0.917, P < 0.001, 95 % CI: 0.900-0.985). In conclusion, the combination of these four genes could represent a potential method for estimating risk and could be of diagnostic value for ADHD. Nevertheless, further investigation in a larger independent population including different subtypes of ADHD (inattentive, hyperactive, or combined type) patients is required to obtain more specific sets of biomarkers for each subtype as well as to differentiate between child, adolescent, and adulthood forms.

ADHD-200 Global Competition: diagnosing ADHD using personal characteristic data can outperform resting state fMRI measurements

Neuroimaging-based diagnostics could potentially assist clinicians to make more accurate diagnoses resulting in faster, more effective treatment. We participated in the 2011 ADHD-200 Global Competition which involved analyzing a large dataset of 973 participants including Attention deficit hyperactivity disorder (ADHD) patients and healthy controls. Each participant's data included a resting state functional magnetic resonance imaging (fMRI) scan as well as personal characteristic and diagnostic data. The goal was to learn a machine learning classifier that used a participant's resting state fMRI scan to diagnose (classify) that individual into one of three categories: healthy control, ADHD combined (ADHD-C) type, or ADHD inattentive (ADHD-I) type. We used participants' personal characteristic data (site of data collection, age, gender, handedness, performance IQ, verbal IQ, and full scale IQ), without any fMRI data, as input to a logistic classifier to generate diagnostic predictions. Surprisingly, this approach achieved the highest diagnostic accuracy (62.52%) as well as the highest score (124 of 195) of any of the 21 teams participating in the competition. These results demonstrate the importance of accounting for differences in age, gender, and other personal characteristics in imaging diagnostics research. We discuss further implications of these results for fMRI-based diagnosis as well as fMRI-based clinical research. We also document our tests with a variety of imaging-based diagnostic methods, none of which performed as well as the logistic classifier using only personal characteristic data.

Kernel Principal Component Analysis for dimensionality reduction in fMRI-based diagnosis of ADHD

This study explored various feature extraction methods for use in automated diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) from functional Magnetic Resonance Image (fMRI) data. Each participant's data consisted of a resting state fMRI scan as well as phenotypic data (age, gender, handedness, IQ, and site of scanning) from the ADHD-200 dataset. We used machine learning techniques to produce support vector machine (SVM) classifiers that attempted to differentiate between (1) all ADHD patients vs. healthy controls and (2) ADHD combined (ADHD-c) type vs. ADHD inattentive (ADHD-i) type vs. controls. In different tests, we used only the phenotypic data, only the imaging data, or else both the phenotypic and imaging data. For feature extraction on fMRI data, we tested the Fast Fourier Transform (FFT), different variants of Principal Component Analysis (PCA), and combinations of FFT and PCA. PCA variants included PCA over time (PCA-t), PCA over space and time (PCA-st), and kernelized PCA (kPCA-st). Baseline chance accuracy was 64.2% produced by guessing healthy control (the majority class) for all participants. Using only phenotypic data produced 72.9% accuracy on two class diagnosis and 66.8% on three class diagnosis. Diagnosis using only imaging data did not perform as well as phenotypic-only approaches. Using both phenotypic and imaging data with combined FFT and kPCA-st feature extraction yielded accuracies of 76.0% on two class diagnosis and 68.6% on three class diagnosis—better than phenotypic-only approaches. Our results demonstrate the potential of using FFT and kPCA-st with resting-state fMRI data as well as phenotypic data for automated diagnosis of ADHD. These results are encouraging given known challenges of learning ADHD diagnostic classifiers using the ADHD-200 dataset (see Brown et al., 2012).

ADHD Comorbidities: Handbook for ADHD Complications in Children and Adultsedited by BrownThomas E., Ph.D., Washington, DC, American Psychiatric Publishing, 2009, 478 pp., $99.00.

Back to table of contents Previous article Next article Communications and UpdatesFull AccessADHD Comorbidities: Handbook for ADHD Complications in Children and AdultsManpreet Kaur Singh, M.D., M.S.,Manpreet Kaur SinghSearch for more papers by this author, M.D., M.S.,Published Online:1 May 2011https://doi.org/10.1176/appi.ajp.2011.11010072AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail edited by BrownThomas E., Ph.D., Washington, DC, American Psychiatric Publishing, 2009, 478 pp., $99.00.In recognition of the fact that attention deficit hyperactivity disorder (ADHD) is a complex disorder, with the co-occurrence of other psychiatric disorders being among the most challenging complications, this textbook provides a comprehensive review of how ADHD relates to other disorders and how this interaction can be effectively recognized and treated. In addition, the book provides updated information about developmental aspects of ADHD not current in its preceding volume (Attention-Deficit Disorders and Comorbidities in Children, Adolescents, and Adults, published in 2000). To my knowledge, there are few definitive textbooks that cover this clinical disorder over the life span and provide a developmental context for its various presentations over time. Moreover, phenomenological descriptions are not limited to DSM criteria but rather integrated with the rich knowledge gained about this disorder from the field of neuroscience. After establishing the developmental complexities, genetics, and common presentations of ADHD from preschool to adulthood, the body of the book focuses on the co-occurrence of the disorder with a variety of psychiatric syndromes, including mood and anxiety disorders, oppositionality and aggression, obsessive-compulsive disorders, language and learning disorders, substance use disorders, autism spectrum disorders, developmental coordination disorder, sleep disturbances, and Tourette's syndrome. This thematic organization is helpful not only to a clinician but also to educators and laypersons, who might observe attentional problems manifested in a variety of different contexts outside of a clinical setting.Compared with the earlier edition of this book, interim knowledge has suggested conceptual models of ADHD that embrace its heterogeneity among individuals and its susceptibility to change across development and environmental variations. In addition, ADHD is no longer considered simply a disorder of executive function as defined by neuropsychological tests but rather a complex syndrome of impairments across multiple overlapping cognitive operations, including motivation and emotion regulation. This book also makes the point that whereas early studies cautioned against the use of psychostimulant therapy for individuals with ADHD and comorbid conditions such as mood or anxiety disorders, recent literature suggests that many patients may in fact benefit from such treatment. This new framework is illustrative of the contemporary view that individual patients rarely have symptoms that fit neatly into unified diagnostic groups. Moreover, treatment should be tailored to target overlapping symptoms and dimensional features and should incorporate pertinent sources of stress and support. Although controversies abound regarding the diagnosis and treatment of highly comorbid conditions such as ADHD, DSM-5 work groups are being challenged to consider alternative views of psychiatric diagnoses that incorporate these types of complexities. In this way, this textbook will prove to be an excellent compendium to the DSM, focused specifically on attentional dysfunction and related disorders.As a child psychiatrist and pediatrician, I found myself drawn to the case vignettes, information about clinical course with complicated ADHD, and treatment recommendations. Each chapter ends with key clinical bullets, recommended readings, and Internet resources, all useful tools for a busy clinician. The chapters at the end of the book provide another level of guidance on the assessment and intervention of ADHD, synthesizing special considerations described in the preceding chapters. It would be nice to see more speculation on gaps in current knowledge and what kind of study designs will help advance research in this field. For example, although much has been learned in the past decade about the benefits of certain medications and behavioral approaches for the treatment of ADHD from the Preschool ADHD Treatment Study, the Multimodal Treatment Study of Children with ADHD, and the National Comorbidity Survey Replication, few studies have helped us optimize treatments and outcomes for individuals with predominantly ADHD inattentive type, familial ADHD, or ADHD as a result of a perinatal developmental insult (e.g., fetal alcohol syndrome). If advancements in the past decade are any indication of the trajectory of knowledge gained in this field, I look forward to the next generation of studies that will provide even greater levels of sophistication in the evaluation and treatment of ADHD.Stanford, Calif.Book review accepted for publication January 2011.Dr. Singh receives research grant support from the Klingenstein Third Generation Foundation, the National Alliance for Research on Schizophrenia and Affective Disorders, the National Institute of Mental Health (Grant MH085919), the American Psychiatric Association, and Stanford's Child Health Research Program. FiguresReferencesCited byDetailsCited ByCurrent World LiteratureCurrent Opinion in Psychiatry, Vol. 25, No. 3 Volume 168Issue 5 May 2011Pages 555-555 Metrics PDF download History Accepted 1 January 2011 Published online 1 May 2011 Published in print 1 May 2011

The Structure of Psychopathology in a Community Sample of Preschoolers

Despite growing interest in the development of alternative diagnostic classification systems for psychopathology in young children, little is known about the adequacy of the DSM symptom structure for describing psychopathology in this population. This paper examines the fit of the DSM-IV emotional (ED) and disruptive behavior disorder (DD) symptom structure in a community sample of 796 4-year-old children. Using the parent-report Child Symptom Inventory (CSI), the best model fit for ED included separate factors for Social Phobia, Separation Anxiety Disorder, Generalized Anxiety Disorder, and Major Depressive Disorder. For DD, the best model included separate Attention Deficit Hyperactivity Disorder-Inattentive type (ADHD-I), Attention Deficit Hyperactivity Disorder-Hyperactive/Impulsive type (ADHD-HI), and Oppositional Defiant Disorder diagnoses. These findings support using DSM-IV nosology to classify EDs in a community sample of preschool children, and suggest differentiation of ADHD into ADHD-I and ADHD-HI.

Memory capacity, selective control, and value-directed remembering in children with and without attention-deficit/hyperactivity disorder (ADHD).

The ability to select what is important to remember, to attend to this information, and to recall high-value items leads to the efficient use of memory. The present study examined how children with and without attention-deficit/hyperactivity disorder (ADHD) performed on an incentive-based selectivity task in which to-be-remembered items were worth different point values. Participants were 6-9 year old children with ADHD (n = 57) and without ADHD (n = 59). Using a selectivity task, participants studied words paired with point values and were asked to maximize their score, which was the overall value of the items they recalled. This task allows for measures of memory capacity and the ability to selectively remember high-value items. Although there were no significant between-groups differences in the number of words recalled (memory capacity), children with ADHD were less selective than children in the control group in terms of the value of the items they recalled (control of memory). All children recalled more high-value items than low-value items and showed some learning with task experience, but children with ADHD Combined type did not efficiently maximize memory performance (as measured by a selectivity index) relative to children with ADHD Inattentive type and healthy controls, who did not differ significantly from one another. Children with ADHD Combined type exhibit impairments in the strategic and efficient encoding and recall of high-value items. The findings have implications for theories of memory dysfunction in childhood ADHD and the key role of metacognition, cognitive control, and value-directed remembering when considering the strategic use of memory.

Attention-deficit hyperactivity disorder in children chronically exposed to high level of vehicular pollution

The purpose of this study is to explore whether sustained exposure to vehicular air pollution affects the behavior and activities of children. The prevalence of attention-deficit hyperactivity disorder (ADHD) was assessed in two childhood populations. In a cross-sectional study 969 school-going children (9-17 years) and 850 age- and sex-matched children from rural areas were assessed, following the criteria of Diagnostic and Statistical Manual of conduct disorders (DSM-IV) of American Pediatric Association. Data of ambient particulate matter with a diameter of less than 10 μm (PM₁₀) were obtained from Central Pollution Control Board and aerosol monitor. ADHD was found in 11.0% of urban children in contrast to 2.7% of the control group (p < 0.001). Major risk factors were male gender, lower socioeconomic status, 12-14 year age group, and PM₁₀ level in breathing air. ADHD was more prevalent among boys both in urban and rural areas. It was prevalent among 18.0% of the boys enrolled in Delhi against 4.0% of the girls, giving a male/female ratio of 4.5:1. Inattentive type of ADHD was predominant followed by hyperactive-impulsive type and combined type of ADHD. Controlling potential confounder, ambient PM₁₀ level was positively correlated with ADHD (OR = 2.07; 95% CI, 1.08-3.99). The results of this study point to a possible association between air pollution and behavioral problems in children. Though gender, socioeconomic status, and age play a very important factor in ADHD prevalence, the association is highest and strongest between particulate pollution and prevalence of ADHD.

Do Hyperactive Symptoms Matter in ADHD-I Restricted Phenotype?

The objective of the current study was to evaluate a proposed restrictive inattentive type of Attention Deficit Hyperactivity Disorder (ADHD) by comparing clinical correlates among youths with ADHD inattentive type (ADHD-I) as a function of the number of hyperactivity symptoms presented (none vs. 3 or less) and controls (individuals without ADHD). The sample for this community-based study was comprised of youths aged 6 to 18 years from 12 public schools in Porto Alegre, Brazil. ADHD-I groups had lower levels of adaptive functioning (p < .001) and a higher occurrence of familial ADHD (p < .001) when compared with the controls. There was no significant difference between the two ADHD-I groups. Also, both ADHD-I groups had higher rates of oppositional defiant disorder than controls (p < .001) without significant difference between them. For generalized anxiety disorder and social phobia, only the ADHD-I without HI group showed significant differences compared to controls.

Identification of Autism Spectrum Disorders Using the Child Behavior Checklist in Singapore

We tested the ability of the 2001 CBCL syndromes to discriminate among 86 children with Autism Spectrum Disorder (ASD), 117 children with Attention Deficit Hyperactivity Disorder-Inattentive type, 426 children with Attention Deficit Hyperactivity Disorder-Hyperactive-Impulsive or Combined type, 200 clinically referred children who did not receive a diagnosis, and 436 typically-developing children in a community sample. The Withdrawn/Depressed, Social Problems, and Thought Problems syndromes significantly discriminated the ASD group from the four other groups. An ASD scale, constructed from nine CBCL items, demonstrated moderate to high sensitivity (68 to 78%) and specificity (73 to 92%). Consistent with previous research, findings from this study provide strong support for the CBCL as a screening tool for ASD.

Evaluating the Utility of Sluggish Cognitive Tempo in Discriminating Among DSM-IV ADHD Subtypes

The objective of the current study was to evaluate how the inclusion of 3 Sluggish Cognitive Tempo (SCT) symptoms in Attention-Deficit/Hyperactivity Disorder (ADHD) diagnostic criteria influences the external validity of the ADHD subtypes. The sample comprised 228 children (166 boys, 62 girls) ranging in age from 5-18 years who were referred to clinics for attentional, behavioral, and/or learning problems and diagnosed with DSM-IV ADHD (124 Combined type, 81 Inattentive type, 23 Hyperactive-Impulsive type). Parent ratings of ADHD symptoms were obtained using the Emory Combined Rating Scale (ECRS), which assesses symptoms of the common DSM-IV childhood psychiatric disorders. Regression analyses incorporating planned comparisons were conducted to examine how the inclusion of SCT symptoms affects differences among ADHD subtypes on several external validity indicators (i.e., gender, age-of-onset, and overlapping conditions). The regression analyses did not yield any significant differences in gender ratios, mean age-The objective of the current study was to evaluate how the inclusion of 3 Sluggish Cognitive Tempo (SCT) symptoms in Attention-Deficit/Hyperactivity Disorder (ADHD) diagnostic criteria influences the external validity of the ADHD subtypes. The sample comprised 228 children (166 boys, 62 girls) ranging in age from 5-18 years who were referred to clinics for attentional, behavioral, and/or learning problems and diagnosed with DSM-IV ADHD (124 Combined type, 81 Inattentive type, 23 Hyperactive-Impulsive type). Parent ratings of ADHD symptoms were obtained using the Emory Combined Rating Scale (ECRS), which assesses symptoms of the common DSM-IV childhood psychiatric disorders. Regression analyses incorporating planned comparisons were conducted to examine how the inclusion of SCT symptoms affects differences among ADHD subtypes on several external validity indicators (i.e., gender, age-of-onset, and overlapping conditions). The regression analyses did not yield any significant differences in gender ratios, mean age-of- onset, or overlapping externalizing or internalizing problems when the ADHD Inattentive type was subdivided into high- versus low-SCT groups. In conclusion, the current results suggest that the inclusion of parent-reported SCT symptoms in the ADHD diagnostic criteria has limited utility for isolating diagnostically meaningful subgroups of the Inattentive type or for enhancing the external validity of the ADHD subtypes in clinic-referred samples.

Standardized Observational Assessment of Attention Deficit Hyperactivity Disorder Combined and Predominantly Inattentive Subtypes. II. Classroom Observations

.Trained classroom observers used the Direct Observation Form (DOF; McConaughy & Achenbach, 2009) to rate observations of 163 6- to 11-year-old children in their school classrooms. Participants were assigned to four groups based on a parent diagnostic interview and parent and teacher rating scales: Attention Deficit Hyperactivity Disorder (ADHD)—Combined type (n = 64); ADHD—Inattentive type (n = 22); clinically referred without ADHD (n = 51); and nonreferred control children (n = 26). The ADHD—Combined group scored significantly higher than the referred without ADHD group and controls on the DOF Intrusive and Oppositional syndromes, Attention Deficit Hyperactivity Problems scale, Hyperactivity-Impulsivity subscale, and Total Problems; and significantly lower on the DOF On-Task score. The ADHD—Inattentive group scored significantly higher than controls on the DOF Sluggish Cognitive Tempo and Attention Problems syndromes, Inattention subscale, and Total Problems; and significantly lower on the DOF On-Task score. Implications are discussed regarding the discriminative validity of standardized classroom observations for identifying children with ADHD and differentiating between the two ADHD subtypes.

Attention Deficit Hyperactivity and Oppositional Defiance Disorder in HIV-Infected South African Children

To determine the prevalence of attention deficit-hyperactivity disorder (ADHD) and oppositional defiance disorder (ODD) in HIV-infected South African children. Swanson, Nolan and Pelham (SNAP-IV) questionnaires were used to determine ADHD and ODD severity and a draw-a-person (DAP) test was used to screen for developmental disorders. Associations between behavioural subtypes, psychological functioning, demographic and health variables were investigated. The SNAP-IV caregiver questionnaires showed a 26% prevalence of ADHD inattentive type; 38% hyperactive type and 24% combined type. The prevalence of ODD was 12% on parent questionnaires and 9.5% on teacher's questionnaires. Parents/caregiver-only SNAP-IV questionnaires indicate a high prevalence of significant ADHD (all subtypes) and ODD in HIV-infected children. No significant differences were found between the severity of HIV disease and the presence of a behavioural disorder. The SNAP IV questionnaires and DAP test may prove valuable screening tools in HIV children with behavioural problems.