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Perez-Beltran M, Roldán-Merino J, Russi ME, Rolandi MG, Colome Roura R, Sampaio F, Del Campo MD, Farres-Tarafa M, Pardos BH, Alda Díez JÁ. The Development and Content Validation of a Clinical Screening Scale to Identify Attention-Deficit Hyperactivity Disorder Cases Based on the Gender Perspective: An e-Delphi Study. Healthcare (Basel) 2024; 12:1282. [PMID: 38998817 PMCID: PMC11241727 DOI: 10.3390/healthcare12131282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/11/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Although many studies analyse gender differences in the clinical expression of Attention-Deficit Hyperactivity Disorder (ADHD) and prevalence studies show that girls with ADHD are underdiagnosed, there are no instruments that are sensitive to the detection of girls with ADHD. OBJECTIVE The objective of this study is to develop a self-report early detection instrument for boys and girls with ADHD aged 7 to 16, which includes the gender perspective and is sensitive to the detection of girls with ADHD. METHODS The scale was developed and the items that comprised it were created from the thematic analysis of ADHD and its evaluation in children based on the diagnostic criteria of the DSM-5-TR. A modified e-Delphi method involving a three-round web survey was used to establish a consensus on the content of the scale. Ten experts were recruited to form a professional panel. The panel members were asked to assess the differential symptomatology of ADHD in boys and girls, the dimensions to be evaluated, and the importance of scale items to evaluate the content. RESULTS A consensus was reached regarding 13 total items distributed in three dimensions: inattention; hyperactivity/impulsivity; and, a third dimension, internalisation, which includes symptoms most present in the expression of ADHD in girls. CONCLUSIONS To the best of our knowledge, the development of this scale using the Delphi method is the first specific scale used for identifying ADHD that also addresses the gender perspective and the differential symptomatology between boys and girls. However, we must proceed to the analysis of psychometric properties, as the scale requires an exhaustive study of its reliability and validity. We can anticipate that this scale will provide relevant and reliable information that can be used for the identification of ADHD in both boys and girls.
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Affiliation(s)
- Meritxell Perez-Beltran
- School of Nursing, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Calle Sant Benito Menni 18-20, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Facultat de Psicología, University of Barcelona, Pg. de la Vall d'Hebron, 171, 08035 Barcelona, Spain
- Neuropsychologist at Avan Neurology Center, Carrer Estrella, 10, Sabadell, 08201 Barcelona, Spain
| | - Juan Roldán-Merino
- School of Nursing, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Calle Sant Benito Menni 18-20, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Mental Health, Psychosocial and Complex Nursing Care Research Group (NURSEARCH), University of Barcelona, Gran Via de les Corts Catalanes, 585, 08007 Barcelona, Spain
| | - Maria Eugenia Russi
- Neuropediatrician in the Pediatric Neurology Service, Sant Joan de Déu Hospital, Pg. de Sant Joan de Déu, 2, 08950 Barcelona, Spain
| | - Maria Garau Rolandi
- Neurology Service and in the Learning Disorders Unit (UTAE), Sant Joan de Deu Hospital, 08950 Barcelona, Spain
- Psychology and Neurotherapy Centers, Carrer de Gresolet, 14, Sarrià-Sant Gervasi, 08034 Barcelona, Spain
| | - Roser Colome Roura
- Neurology Service and in the Learning Disorders Unit (UTAE), Sant Joan de Deu Hospital, 08950 Barcelona, Spain
| | - Francisco Sampaio
- Nursing School of Porto, Rua Dr. António Bernardino de Almeida, 830, 844, 856, 4200-072 Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - Marta Domínguez Del Campo
- Parc Sanitari Sant Joan de Déu-Research Center, Carrer del Camí Vell de la Colònia, 25, 08830 Barcelona, Spain
| | - Mariona Farres-Tarafa
- School of Nursing, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Calle Sant Benito Menni 18-20, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Barbara Hurtado Pardos
- School of Nursing, Campus Sant Joan de Déu de Barcelona-Fundació Privada, Calle Sant Benito Menni 18-20, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - José Ángel Alda Díez
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Pg. de Sant Joan de Déu, 2, 08950 Barcelona, Spain
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa, 08830 Esplugues de Llobregat, Spain
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2
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Collins K. Female athletes with ADHD: time to level the playing field. Br J Sports Med 2024; 58:695-697. [PMID: 38688694 DOI: 10.1136/bjsports-2024-108068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/02/2024]
Affiliation(s)
- Kelly Collins
- Human Movement, The University of Queensland, Brisbane, Queensland, Australia
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De Ronda AC, Rice L, Zhao Y, Rosch KS, Mostofsky SH, Seymour KE. ADHD-related sex differences in emotional symptoms across development. Eur Child Adolesc Psychiatry 2024; 33:1419-1432. [PMID: 37368082 PMCID: PMC10986680 DOI: 10.1007/s00787-023-02251-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/19/2023] [Indexed: 06/28/2023]
Abstract
To investigate developmental changes in emotion dysregulation (ED) and associated symptoms of emotional lability, irritability, anxiety, and depression, among girls and boys with and without ADHD from childhood through adolescence. Data were collected from a sample of 8-18-year-old children with (n = 264; 76 girls) and without (n = 153; 56 girls) ADHD, with multiple time-points from a subsample of participants (n = 121). Parents and youth completed rating scales assessing child ED, emotional lability, irritability, anxiety, and depression. Mixed effects models were employed to examine effects and interactions of diagnosis, sex [biological sex assigned at birth], age among boys and girls with and without ADHD. Mixed effects analyses showed sexually dimorphic developmental patterns between boys and girls, such that boys with ADHD showed a greater reduction in ED, irritability, and anxiety with age compared to girls with ADHD, whose symptom levels remained elevated relative to TD girls. Depressive symptoms were persistently elevated among girls with ADHD compared to boys with ADHD, whose symptoms decreased with age, relative to same-sex TD peers. While both boys and girls with ADHD showed higher levels of ED during childhood (compared to their sex-matched TD peers), mixed effects analyses revealed substantial sexually dimorphic patterns of emotional symptom change during adolescence: Boys with ADHD showed robust improvements in emotional symptoms from childhood to adolescence while girls with ADHD continued to show high and/or increased levels of ED, emotional lability, irritability, anxiety and depression.
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Affiliation(s)
- Alyssa C De Ronda
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Laura Rice
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Yi Zhao
- Department of Biostatistics, Indiana University School of Medicine, 410 West 10th Street, Indianapolis, IN, 46202, USA
| | - Keri S Rosch
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins University School of Medicine , 716 North Broadway, Baltimore, MD, 21205, USA
| | - Karen E Seymour
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 716 North Broadway, Baltimore, MD, 21205, USA.
- Department of Mental Health, Johns Hopkins University School of Public Health, 6701 Rockledge Drive, Bethesda, MD, 20892, USA.
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4
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Martin J. Why are females less likely to be diagnosed with ADHD in childhood than males? Lancet Psychiatry 2024; 11:303-310. [PMID: 38340761 DOI: 10.1016/s2215-0366(24)00010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
ADHD is less likely to be diagnosed in females than males, especially in childhood. Females also typically receive the diagnosis later than males and are less likely to be prescribed ADHD medication. Understanding why these sex differences in clinical care and treatment for ADHD occur is key to improving timely diagnosis in people affected by ADHD. This Personal View is a conceptual review synthesising literature on this topic. This publication considers potential biological explanations (eg, genetic factors), influence of diagnostic practices (eg, criteria suitability, diagnostic overshadowing, and sex-specific diagnostic thresholds), and sociocultural explanations (eg, sex differences in presentation and compensatory behaviours), for the observed sex differences in ADHD clinical practice. This Personal View also outlines future research directions for improving understanding of sex differences in recognition and diagnosis of ADHD.
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Affiliation(s)
- Joanna Martin
- Centre for Neuropsychiatric Genetics and Genomics and Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK.
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5
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Gilbert M, Boecker M, Reiss F, Kaman A, Erhart M, Schlack R, Westenhöfer J, Döpfner M, Ravens-Sieberer U. Gender and Age Differences in ADHD Symptoms and Co-occurring Depression and Anxiety Symptoms Among Children and Adolescents in the BELLA Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01622-w. [PMID: 37851158 DOI: 10.1007/s10578-023-01622-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/19/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most diagnosed neurodevelopmental disorders of childhood. Current studies addressing gender and age differences in ADHD are lacking. The present study aims to fill this research gap by dimensionally evaluating gender and age differences in ADHD symptoms, as measured by a DSM-5-based parent rating scale, in children and adolescents who participated in the two-year follow-up of the community-based BELLA study (n = 1326). Associations between ADHD symptoms and depression symptoms and anxiety symptoms were also examined. Multiple linear regressions revealed significant associations between gender and all ADHD symptoms. Age was significantly associated with hyperactive/impulsive symptoms. Additional multiple linear regressions demonstrated significant positive associations between depression and anxiety symptoms and ADHD symptoms. Further, female gender was found to be positively associated with both depression and anxiety symptoms. These findings may suggest a need for more gender-specific approaches to ADHD diagnosis and treatment, as well as more research into the intersections of ADHD and depression and anxiety symptoms in children and adolescents.
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Affiliation(s)
- Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Alice Salomon University of Applied Sciences, Berlin, Germany
- Apollon University of Applied Sciences, Bremen, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Joachim Westenhöfer
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Section "Child Public Health", University Medical Center Hamburg-Eppendorf, Martinistraße 52, W 29, 20246, Hamburg, Germany.
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Altwaijri Y, Kazdin AE, Al-Subaie A, Al-Habeeb A, Hyder S, Bilal L, Naseem MT, De Vol E. Lifetime prevalence and treatment of mental disorders in Saudi youth and adolescents. Sci Rep 2023; 13:6186. [PMID: 37061556 PMCID: PMC10105730 DOI: 10.1038/s41598-023-33005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
Previous global and regional studies indicate that adolescents and young adults (i.e., youth) are affected by various mental disorders with lifelong consequences. However, there are no national estimates of mental disorders prevalent among Saudi youth. Using data from the Saudi National Mental Health Survey (SNMHS), we examined the lifetime prevalence, treatment, and socio-demographic correlates of mental disorders among Saudi youth (aged 15-30). A total of 4004 interviews were conducted using the adapted Composite International Diagnostic Interview (CIDI 3.0). Cross tabulations and logistic regression were used to generate estimates for the SNMHS youth sample (n = 1881). The prevalence of a mental disorder among Saudi youth was 40.10%, where anxiety disorders affected 26.84% of the sample, followed by disruptive behavior disorders (15.44%), mood disorders (9.67%), substance use disorders (4%) and eating disorders (7.06%). Sex, education, parental education, income, marital status, region, and family history of disorders were significant correlates of various classes of mental disorders. Only 14.47% of Saudi youth with any mental disorder received treatment for a lifetime disorder. Age, parental education, and family history of disorders emerged as significant correlates of mental health treatment. Lifetime mental disorders are highly prevalent among Saudi youth. There is an unmet need for culturally sensitive and age-appropriate treatment of lifetime mental disorders among youth in Saudi Arabia.
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Affiliation(s)
- Yasmin Altwaijri
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia.
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Alan E Kazdin
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Edrak Medical Center, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Sanaa Hyder
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Health and Meaningful Dialogue (HAMD) Centre, Manchester, UK
| | - Lisa Bilal
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Talal Naseem
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Edward De Vol
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
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7
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Kopp S, Asztély KS, Landberg S, Waern M, Bergman S, Gillberg C. Girls With Social and/or Attention Deficit Re-Examined in Young Adulthood: Prospective Study of Diagnostic Stability, Daily Life Functioning and Social Situation. J Atten Disord 2023; 27:830-846. [PMID: 36915033 DOI: 10.1177/10870547231158751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Investigate diagnostic stability, daily life functioning and social situation in women diagnosed with ADHD and/or ASD in childhood. METHODS Prospective 17 to 20-year follow-up study of 100 girls of whom 92 diagnosed in childhood with main DSM-IV ADHD or ASD, and 60 comparison girls. Ninety and 54 of these women were examined (M = 27, 4 years old) with semi-structured interviews and questionnaires, close relatives were interviewed. RESULTS At follow-up, 89% of women with ADHD or ASD in childhood still met the criteria for either of these diagnoses. Very few women were "in remission." In 34% the main diagnosis shifted from ADHD to ASD. Women with ADHD and ASD had significantly more disability and unfavorable social situation than comparison women. CONCLUSION Women with ADHD and/or ASD in childhood had impairing problems 17 to 20 years later. Early ADHD changed to ASD in adulthood in some cases. Nearly all with ASD met criteria for ADHD as adults.
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Affiliation(s)
- Svenny Kopp
- University of Gothenburg Institute of Neuroscience and Physiology, Göteborg, Sweden
| | | | - Sara Landberg
- University of Gothenburg Institute of Neuroscience and Physiology, Göteborg, Sweden
| | - Margda Waern
- University of Gothenburg Institute of Neuroscience and Physiology, Göteborg, Sweden
| | - Stefan Bergman
- University of Gothenburg Institute of Medicine, Göteborg, VG Region, Sweden
| | - Christopher Gillberg
- University of Gothenburg Institute of Neuroscience and Physiology, Göteborg, Sweden
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Helleman A, Rubin RT, Gardner W, Lourie A, Taylor AN, Cochran J, Dorn LD, Susman E, Barrowman N, Bijelić V, Leininger L, Pajer K. Circadian cortisol secretion in adolescent girls with conduct disorder. Psychoneuroendocrinology 2023; 148:105972. [PMID: 36462295 PMCID: PMC10038075 DOI: 10.1016/j.psyneuen.2022.105972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022]
Abstract
Severe antisocial behavior in girls, best exemplified by conduct disorder (CD), is a serious clinical and public health problem. Treatment is difficult, particularly in girls with comorbid internalizing disorders. Identifying biological correlates may help to develop new treatments or diagnostic, prognostic, or treatment response biomarkers. Based on our earlier work and research from others occurring primarily in boys with severe antisocial behavior, it is possible that abnormalities in the hypothalamic pituitary adrenal (HPA) axis circadian cortisol cycle may be associated with female CD. Additionally, research suggests that the presence of comorbid internalizing disorders may be related to differences in cortisol secretion, compared to subjects who only have CD. Our study aimed: 1) to compare the circadian cortisol cycle in 98 girls with CD, 15-16 years of age to 47 girls without any psychiatric disorder (ND) and 2) to compare the cycle in girls with CD and comorbid internalizing disorders (CD + INT) to those without such comorbidity (CD Only). Salivary cortisol was collected over 24 h during weekdays at scheduled times, with protocol adherence measures in place. Unstructured covariance pattern modeling, controlling for effects of age, social class, IQ, and awakening time was used to analyze cortisol data. CD was associated with overall lower cortisol secretion (p = 0.03), but this difference was due to a lower volume of cortisol secreted 30 min after awakening (area under the curve with respect to ground, p = 0.01). Circadian cortisol secretion was no different in the CD+INT group compared to the CD Only group (p = 0.52). Our findings need to be replicated using current consensus guidelines for the assessment of the CAR. We also suggest two new avenues of research in this field.
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Affiliation(s)
| | - Robert T Rubin
- David Geffen School of Medicine at UCLA, Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA
| | - William Gardner
- CHEO Research Institute, Ottawa, Ontario, Canada; The Research Institute at Nationwide Children's Hospital, The Ohio State University, Department of Pediatrics, Columbus, OH, USA
| | - Andrea Lourie
- The Research Institute at Nationwide Children's Hospital, The Ohio State University, Department of Pediatrics, Columbus, OH, USA
| | - Anna N Taylor
- David Geffen School of Medicine at UCLA, Department of Neurobiology, Los Angeles, CA, USA
| | - Justinn Cochran
- The Research Institute at Nationwide Children's Hospital, The Ohio State University, Department of Pediatrics, Columbus, OH, USA
| | - Lorah D Dorn
- Cincinnati Children's Hospital Medical Center, Division of Adolescent Medicine, Cincinnati, OH, USA
| | - Elizabeth Susman
- College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
| | | | - Vid Bijelić
- CHEO Research Institute, Ottawa, Ontario, Canada
| | - Lisa Leininger
- The Research Institute at Nationwide Children's Hospital, The Ohio State University, Department of Pediatrics, Columbus, OH, USA
| | - Kathleen Pajer
- CHEO Research Institute, Ottawa, Ontario, Canada; The Research Institute at Nationwide Children's Hospital, The Ohio State University, Department of Pediatrics, Columbus, OH, USA.
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Young S, Adamo N, Ásgeirsdóttir BB, Branney P, Beckett M, Colley W, Cubbin S, Deeley Q, Farrag E, Gudjonsson G, Hill P, Hollingdale J, Kilic O, Lloyd T, Mason P, Paliokosta E, Perecherla S, Sedgwick J, Skirrow C, Tierney K, van Rensburg K, Woodhouse E. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry 2020; 20:404. [PMID: 32787804 PMCID: PMC7422602 DOI: 10.1186/s12888-020-02707-9] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. METHODS The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. RESULTS A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. CONCLUSIONS This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.
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Affiliation(s)
- Susan Young
- Psychology Services Limited, PO 1735, Croydon, London, CR9 7AE, UK.
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.
| | - Nicoletta Adamo
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
- Service for Complex Autism and Associated Neurodevelopmental Disorders, South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, London, UK
| | | | | | | | | | | | - Quinton Deeley
- National Autism Unit, Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Emad Farrag
- South London & Maudsley NHS Foundation Trust, Maudsley Health, Abu Dhabi, UAE
| | - Gisli Gudjonsson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Peter Hill
- Independent Consultant in Child and Adolescent Psychiatry, Private Practice, London, UK
| | - Jack Hollingdale
- Michael Rutter Centre, South London and Maudsley Hospital, London, UK
| | | | | | - Peter Mason
- ADHD and Psychiatry Services Limited, Liverpool, UK
| | | | | | - Jane Sedgwick
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
- Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Caroline Skirrow
- Cambridge Cognition, Cambridge, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Kevin Tierney
- Neuropsychiatry Team, National Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kobus van Rensburg
- Adult ADHD and AS Team & CYP ADHD and ASD Service in Northamptonshire, Northampton, UK
| | - Emma Woodhouse
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
- Compass, London, UK
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10
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Martin J, Ghirardi L, Chen Q, Hartman CA, Rosenqvist MA, Taylor MJ, Birgegård A, Almqvist C, Lichtenstein P, Larsson H. Investigating gender-specific effects of familial risk for attention-deficit hyperactivity disorder and other neurodevelopmental disorders in the Swedish population. BJPsych Open 2020; 6:e65. [PMID: 32552921 PMCID: PMC7345736 DOI: 10.1192/bjo.2020.47] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Many psychiatric disorders show gender differences in prevalence. Recent studies suggest that female patients diagnosed with anxiety and depression carry more genetic risks related to attention-deficit hyperactivity disorder (ADHD) compared with affected males. AIMS In this register-based study, we aimed to test whether female patients who received clinical diagnoses of anxiety, depressive, bipolar and eating disorders are at higher familial risk for ADHD and other neurodevelopmental disorders, compared with diagnosed male patients. METHOD We analysed data from a record-linkage of several Swedish national registers, including 151 025 sibling pairs from 103 941 unique index individuals diagnosed with anxiety, depressive, bipolar or eating disorders, as well as data from 646 948 cousin pairs. We compared the likelihood of having a relative diagnosed with ADHD/neurodevelopmental disorders in index males and females. RESULTS Female patients with anxiety disorders were more likely than affected males to have a brother with ADHD (odd ratio (OR) = 1.13, 95% CI 1.05-1.22). Results for broader neurodevelopmental disorders were similar and were driven by ADHD diagnoses. Follow-up analyses revealed similar point estimates for several categories of anxiety disorders, with the strongest effect observed for agoraphobia (OR = 1.64, 95% CI 1.12-2.39). No significant associations were found in individuals with depressive, bipolar or eating disorders, or in cousins. CONCLUSIONS These results provide modest support for the possibility that familial/genetic risks for ADHD may show gender-specific phenotypic expression. Alternatively, there could be gender-specific biases in diagnoses of anxiety and ADHD. These factors could play a small role in the observed gender differences in prevalence of ADHD and anxiety.
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Affiliation(s)
- Joanna Martin
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, UK; and Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Laura Ghirardi
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Qi Chen
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Catharina A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Mina A Rosenqvist
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Mark J Taylor
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | | | - Catarina Almqvist
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden; and Pediatric Allergy and Pulmonology Unit at Astrid Lindgren Children's Hospital, Karolinska University Hospital, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology & Biostatistics, Karolinska Institutet; and School of Medical Sciences, Örebro University, Sweden
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11
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DuPaul GJ, Fu Q, Anastopoulos AD, Reid R, Power TJ. ADHD Parent and Teacher Symptom Ratings: Differential Item Functioning across Gender, Age, Race, and Ethnicity. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:679-691. [DOI: 10.1007/s10802-020-00618-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Lapalme M, Bégin V, Le Corff Y, Déry M. Comparison of Discriminant Validity Indices of Parent, Teacher, and Multi-Informant Reports of Behavioral Problems in Elementary Schoolers. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-019-09782-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Vildalen VU, Brevik EJ, Haavik J, Lundervold AJ. Females With ADHD Report More Severe Symptoms Than Males on the Adult ADHD Self-Report Scale. J Atten Disord 2019; 23:959-967. [PMID: 27461728 DOI: 10.1177/1087054716659362] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To investigate gender differences in self-reported ADHD symptoms in a group of adults with ADHD and a control group. METHODS A total of 682 adults with ADHD (49.9% females) and 882 controls (59.2% females) completed the Adult ADHD Self-Report Scale (ASRS), listing the 18 symptoms included in the diagnostic criteria of ADHD. RESULTS Within the ADHD group, females reported more severe symptoms of inattention and hyperactivity/impulsivity than males. This higher symptom report of females was not found in the control group, where the number of severe inattention symptoms rather was higher in males. CONCLUSION The results suggest that childhood symptoms of ADHD may have gone unnoticed in girls, emphasizing the need for longitudinal studies of ADHD symptoms across the life span.
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Affiliation(s)
- Victoria U Vildalen
- 1 Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Erlend J Brevik
- 1 Department of Biological and Medical Psychology, University of Bergen, Norway.,2 Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,3 K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway
| | - Jan Haavik
- 2 Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,3 K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway.,4 Department of Biomedicine, University of Bergen, Norway
| | - Astri J Lundervold
- 1 Department of Biological and Medical Psychology, University of Bergen, Norway.,3 K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway
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Mowlem F, Agnew-Blais J, Taylor E, Asherson P. Do different factors influence whether girls versus boys meet ADHD diagnostic criteria? Sex differences among children with high ADHD symptoms. Psychiatry Res 2019; 272:765-773. [PMID: 30832197 PMCID: PMC6401208 DOI: 10.1016/j.psychres.2018.12.128] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/06/2018] [Accepted: 12/23/2018] [Indexed: 01/13/2023]
Abstract
We investigate if different factors influence whether girls versus boys meet diagnostic criteria for attention-deficit/hyperactivity disorder(ADHD) among children with high ADHD symptoms. Participants were 283 children aged 7-12 from a population-based study. Girls and boys meeting diagnostic criteria for ADHD, based on an objective investigator-based interview, were compared to children who did not meet criteria despite high symptoms on a rating-scale measure of ADHD. We assessed factors that could differentially relate to diagnosis across girls and boys including ADHD symptoms, co-occurring behavioural/emotional problems and impairment, and sex-effects in rater perceptions of ADHD symptoms. While overall similar factors distinguished girls and boys who met diagnostic criteria from high-symptom peers, effect sizes were larger in girls. Emotional problems were particularly salient to distinguishing diagnosed versus high-symptom girls but not boys. Parents rated boys meeting diagnostic criteria as more impaired than high-symptom boys but did not do so for girls, and under-rated diagnosed girls' hyperactive/impulsive symptoms compared to more objective interview assessment, with the opposite observed in boys. Results suggest girls' ADHD may need to be made more prominent by additional behavioural/emotional problems for them to meet full diagnostic criteria and that sex differences in parental perceptions of ADHD behaviours and impairment exist.
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Affiliation(s)
- Florence Mowlem
- Social, Genetic, and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience, King's College London, DeCrespigny Park, Denmark Hill, London SE5 8AF, UK.
| | - Jessica Agnew-Blais
- Social, Genetic, and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience, King's College London, DeCrespigny Park, Denmark Hill, London SE5 8AF, UK
| | - Eric Taylor
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philip Asherson
- Social, Genetic, and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience, King's College London, DeCrespigny Park, Denmark Hill, London SE5 8AF, UK
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Atherton OE, Ferrer E, Robins RW. The development of externalizing symptoms from late childhood through adolescence: A longitudinal study of Mexican-origin youth. Dev Psychol 2017; 54:1135-1147. [PMID: 29251969 DOI: 10.1037/dev0000489] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Youth who exhibit externalizing problems during childhood and adolescence are at an increased risk for a wide range of detrimental life outcomes. Despite the profound consequences of externalizing problems for children, their families, and their communities, we know less about the precise trajectory of externalizing symptoms across late childhood and adolescence, because of the paucity of fine-grained longitudinal research. The present study examined the development of externalizing symptoms in a large sample (N = 674) of Mexican-origin youth, assessed annually from age 10 to 17. Specifically, we conducted analyses to better understand the trajectories of attention-deficit-hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms (and their codevelopment), as well as how gender and cultural factors influence symptom trajectories. On average, ADHD symptoms slowly declined from age 10 to 17; ODD symptoms increased until age 13 and then declined thereafter; and, CD symptoms slowly increased until age 15 and then leveled off. ADHD, ODD, and CD symptoms predicted change in each other, indicating youth may accumulate multiple forms of externalizing problems over time. Boys reported fewer externalizing problems than girls, contrary to expectations. Consistent with the Immigrant Paradox, we found that 2nd + generation youth, youth who endorsed fewer traditional Mexican cultural values (traditional gender roles, traditional family values, and religiosity), and youth who engaged in less Spanish/more English language use were at increased risk for exhibiting ADHD, ODD, and CD symptoms from childhood through adolescence. We discuss the theoretical and practical implications of these developmental patterns among Mexican-origin youth. (PsycINFO Database Record
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Tung I, Li JJ, Meza JI, Jezior KL, Kianmahd JS, Hentschel PG, O’Neil PM, Lee SS. Patterns of Comorbidity Among Girls With ADHD: A Meta-analysis. Pediatrics 2016; 138:peds.2016-0430. [PMID: 27694280 PMCID: PMC9923580 DOI: 10.1542/peds.2016-0430] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Although children with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk for comorbid psychopathology, the clinical correlates of ADHD in girls are far less understood relative to boys, despite ADHD being one of the most common childhood disorders in girls. OBJECTIVE To meta-analytically summarize rates of comorbid internalizing (anxiety, depression) and externalizing (oppositional defiant disorder [ODD], conduct disorder [CD]) psychopathology among girls with and without ADHD. DATA SOURCES Literature searches (PubMed, Google Scholar) identified published studies examining comorbid psychopathology in girls with and without ADHD. STUDY SELECTION Eighteen studies (1997 participants) met inclusion criteria and had sufficient data for the meta-analysis. DATA EXTRACTION Odds ratios for each comorbid disorder were calculated from available data. Demographic (eg, age, race/ethnicity) and study characteristics (eg, referral source, diagnostic method) were also coded. RESULTS Compared with girls without ADHD, girls with ADHD were significantly more likely to meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for each comorbid disorder assessed. Relative odds were higher for externalizing (ODD: 5.6×; CD: 9.4×) relative to internalizing disorders (anxiety: 3.2×; depression: 4.2×). Meta-regression revealed larger effect sizes of ADHD on anxiety for studies using multiple diagnostic methods, featuring younger children, and including clinic-referred (versus community-referred) girls; the effect of ADHD on ODD varied based on diagnostic informant. LIMITATIONS Findings were derived from cross-sectional studies, precluding causal inferences. CONCLUSIONS Girls with ADHD frequently exhibit comorbid externalizing and internalizing disorders. We discuss future research priorities and consider intervention implications for ADHD and comorbid psychopathology in girls.
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Affiliation(s)
- Irene Tung
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - James J. Li
- Department of Psychology, University of Wisconsin, Madison, Wisconsin; and
| | - Jocelyn I. Meza
- Department of Psychology, University of California, Berkeley, Berkeley, California
| | - Kristen L. Jezior
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Jessica S.V. Kianmahd
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Patrick G. Hentschel
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Paul M. O’Neil
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Steve S. Lee
- Department of Psychology, University of California, Los Angeles, Los Angeles, California;,Address correspondence to Steve S. Lee, PhD, Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095. E-mail:
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17
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Demmer DH, Hooley M, Sheen J, McGillivray JA, Lum JAG. Sex Differences in the Prevalence of Oppositional Defiant Disorder During Middle Childhood: a Meta-Analysis. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 45:313-325. [DOI: 10.1007/s10802-016-0170-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Serial drawing in girls who display oppositional defiant behavior in the classroom. ACTA COLOMBIANA DE PSICOLOGIA 2015. [DOI: 10.14718/acp.2015.18.2.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
This study investigated the correlations between participation in therapy sessions involving non-directive serial drawing and subsequent improvements, or lack thereof, in the oppositional defiant behavior (ODB) of five girls aged eight to ten years in an inner-city school in London, England. Each child individually attended fifteen forty-minute sessions on a weekly basis. Each child was invited to draw anything that she wished and then to tell the story of her drawing to the researcher. The class teachers completed the ODB Questionnaire to determine a baseline measurement of this conduct. Changes in the girls’ emotional and classroom behaviors were identified based on the ODB Weekly Questionnaire completed by their teachers. The teachers also completed a Strengths and Difficulties Questionnaire (SDQ) before the first therapy session and after the fifteenth. The House-Tree-Person (HTP) method was used on sessions one, eight and fifteen, and the results were assessed by the researcher. At the end of the study, the teachers completed the Drawing Sessions End Form. Four of the five girls showed improvements in their ODB symptoms, and one demonstrated a slight progress. Results suggested that the use of non-directive drawing encourages girls with ODB to express their thoughts and emotions in a symbolic way within a safe environment, which reduces the frequency and intensity of their emotional and behavioral outbursts in the classroom.
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Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord 2014; 16:13r01596. [PMID: 25317366 DOI: 10.4088/pcc.13r01596] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/27/2014] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To describe the clinical presentation of attention-deficit/hyperactivity disorder (ADHD) in women and girls and factors influencing proper diagnosis and treatment. DATA SOURCES A PubMed search was conducted in April 9, 2012 for English-language publications from the previous 10 years. Search terms included attention deficit hyperactivity disorder, attention deficit/hyperactivity disorder, ADHD, and AD/HD combined with gender, girls, females, women, continuity, discontinuity, gap, treatment, untreated, and lack of treatment. STUDY SELECTION/DATA EXTRACTION A total of 41 articles were reviewed for relevance. Reference lists from relevant articles were reviewed for additional publications; sources known to the authors were also included. RESULTS Attitudes about ADHD among individuals with ADHD and knowledgeable informants (families, teachers, colleagues) vary on the basis of the diagnosed individual's gender. The ADHD prevalence rates are higher among boys than girls. A low index of clinical suspicion exists for girls; their presentation is considered "subthreshold" because inattentiveness is more prominent than hyperactivity/impulsivity. Females with ADHD may develop better coping strategies than males to mask their symptoms. Lastly, anxiety and depression, common comorbidities in female patients with ADHD, can lead to missed or misdiagnosis. If not properly diagnosed and treated, girls with ADHD experience the same negative consequences as boys, including poor academic performance and behavioral problems. Unique issues related to hormonal effects on ADHD expression and treatment response are also experienced by women and girls. CONCLUSIONS Accurate ADHD diagnosis in women and girls requires establishing a symptom history and an understanding of its gender-specific presentation. Coexisting anxiety and depression are prominent in female patients with ADHD; satisfactory academic achievement should not rule out an ADHD diagnosis.
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Affiliation(s)
- Patricia O Quinn
- National Center for Girls and Women With ADHD, Washington, DC (Dr Quinn); and Neuroscience Medical Strategy, Shire Development LLC, Wayne, Pennsylvania (Dr Madhoo)
| | - Manisha Madhoo
- National Center for Girls and Women With ADHD, Washington, DC (Dr Quinn); and Neuroscience Medical Strategy, Shire Development LLC, Wayne, Pennsylvania (Dr Madhoo)
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20
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Dupuy FE, Clarke AR, Barry RJ, McCarthy R, Selikowitz M. EEG Differences Between the Combined and Inattentive Types of Attention-Deficit/Hyperactivity Disorder in Girls: A Further Investigation. Clin EEG Neurosci 2014; 45:231-237. [PMID: 24131620 DOI: 10.1177/1550059413501162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 07/18/2013] [Indexed: 11/16/2022]
Abstract
This study further investigated electroencephalogram (EEG) differences between girls with the Combined and Inattentive types of attention-deficit/hyperactivity disorder (AD/HD). We selected subjects with widely separated scores on hyperactivity-impulsivity symptoms to behaviorally exaggerate diagnostic group differences. Twenty girls with AD/HD Combined type, 20 girls with AD/HD Inattentive type, and 20 controls (aged 7-12 years) had an eyes-closed resting EEG recorded from 19 electrodes. The EEG was fast Fourier transformed, and estimates for total power, absolute and relative power in the delta, theta, alpha, and beta frequency bands, and the theta/beta ratio were calculated and analyzed in 9 scalp regions. Girls of the Combined type, compared with girls of the Inattentive type, had elevated midline total power, elevated temporal absolute alpha activity, elevated posterior absolute beta activity, reduced right hemisphere relative delta and reduced left hemisphere relative alpha activity, and reduced theta/beta ratio in the left hemisphere. Although topographic differences were again found between the AD/HD types, significant global differences remain elusive in the EEGs of girls with the Combined and Inattentive types. Despite creating behaviorally exaggerated AD/HD type groups, girls' EEG activity failed to replicate differences found previously in mixed-sex groups. The EEG profiles of AD/HD types in girls are markedly different from those found in boys. This reinforces the notion that it is no longer appropriate to apply the male-based literature to all AD/HD groups; rather, the use of single-sex subject groups is necessary in EEG research of AD/HD.
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Affiliation(s)
- Franca E Dupuy
- Brain & Behavior Research Institute and School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia .,Centre for Psychophysics, Psychophysiology, and Psychopharmacology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Adam R Clarke
- Brain & Behavior Research Institute and School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.,Centre for Psychophysics, Psychophysiology, and Psychopharmacology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Robert J Barry
- Brain & Behavior Research Institute and School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.,Centre for Psychophysics, Psychophysiology, and Psychopharmacology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Rory McCarthy
- Sydney Developmental Clinic, Sydney, New South Wales, Australia
| | - Mark Selikowitz
- Sydney Developmental Clinic, Sydney, New South Wales, Australia
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Abstract
BACKGROUND The distribution and co-morbidity of common psychiatric disorders can be largely explained as manifestations of two broad psychopathological spectra of internalizing and externalizing disorders. Twin studies suggest that these spectra arise from genetic factors. METHOD Structural equation twin modeling was applied to interview and questionnaire data on personality traits and lifetime psychiatric disorders on more than 5300 members of male-male (MM) and female-female (FF) twin pairs. RESULTS The best-fitting models for both the externalizing and internalizing spectra differed significantly in males and females. In males, the externalizing genetic common factor was best indexed by four disorders in the following order: antisocial personality disorder (ASPD), drug abuse/dependence (DAD), alcohol abuse dependence (AAD) and conduct disorder (CD). In females, the four disorders most closely related to the externalizing common factor were, in order: DAD, AAD, nicotine dependence (ND) and ASPD. Personality traits of novelty seeking (NS) and extraversion (E) better indexed the genetic externalizing spectrum in females than in males. In both males and females, major depression (MD) and generalized anxiety disorder (GAD) best indexed the genetic internalizing common factor. Panic disorder (PD) and agoraphobia (AgP) better reflected the internalizing genetic common factor in women, and neuroticism (N) in men. Genetic correlations between the two spectra were estimated at + 0.53 in males and + 0.52 in females. CONCLUSIONS The disorders that optimally index the genetic liability to externalizing and internalizing disorders in the general population differ meaningfully in men and women. In both sexes, these genetic spectra are better assessed by psychiatric disorders than by personality traits.
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Affiliation(s)
- K. S. Kendler
- Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - J. Myers
- Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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22
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Scharoun SM, Bryden PJ, Otipkova Z, Musalek M, Lejcarova A. Motor skills in Czech children with attention-deficit/hyperactivity disorder and their neurotypical counterparts. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4142-4153. [PMID: 24060728 DOI: 10.1016/j.ridd.2013.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 08/06/2013] [Accepted: 08/06/2013] [Indexed: 06/02/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioural disorder. Characterized by recurring problems with impulsiveness and inattention in combination with hyperactivity, motor impairments have also been well documented in the literature. The aim of this study was to compare the fine and gross motor skills of male and female children with ADHD and their neurotypical counterparts within seven skill assessments. This included three fine motor tasks: (1) spiral tracing, (2) dot filling, (3) tweezers and beads; and four gross motor tasks: (1) twistbox, (2) foot tapping, (3) small plate finger tapping, and (4) large plate finger tapping. It was hypothesized that children with ADHD would display poorer motor skills in comparison to neurotypical controls in both fine and gross motor assessments. However, statistically significant differences between the groups only emerged in four of the seven tasks (spiral tracing, dot filling, tweezers and beads and foot tapping). In line with previous findings, the complexity underlying upper limb tasks solidified the divide in performance between children with ADHD and their neurotypical counterparts. In light of similar research, impairments in lower limb motor skill were also observed. Future research is required to further delineate trends in motor difficulties in ADHD, while further investigating the underlying mechanisms of impairment.
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Affiliation(s)
- S M Scharoun
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1.
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23
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Dupuy FE, Clarke AR, Barry RJ. EEG Activity in Females with Attention-Deficit/Hyperactivity Disorder. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/10874208.2013.759024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
OBJECTIVE Measurement invariance deals with whether the expected scores on a measure are the same or different across different groups when the groups have the same level of the underlying latent trait scores. The study used multiple-group confirmatory factor analysis (CFA) to examine measurement invariance across male and female adolescent self-ratings of the ADHD symptoms (recoded as binary scores). METHOD To accomplish this, 178 male and 185 female adolescents, between 12 and 17 years of age, completed an ADHD rating scale. RESULTS For the measurement model, the results support the invariance for the configural model (same factor structure and the same items associated with the latent factors), metric invariance (same strength of the associations of items with the factors) for the factor loadings of 17 of the 18 symptoms, and all the error variances. For the construct model, there was invariance for the inattention (IA) and hyperactivity/impulsivity (HI) latent factor variances, covariances, and mean scores. Thus, there was good support for gender equivalency for the ADHD symptoms. CONCLUSION These findings extend existing gender invariance data for the ADHD symptoms. The theoretical and clinical implications of the findings as well as the revision implications for Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V) are discussed.
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Reliability and validity of the Dutch version of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). PLoS One 2012; 7:e38762. [PMID: 22715411 PMCID: PMC3371000 DOI: 10.1371/journal.pone.0038762] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 05/10/2012] [Indexed: 11/19/2022] Open
Abstract
Background The Brief Infant-Toddler Social and Emotional Assessment (BITSEA) is a relatively new and short (42-item) questionnaire that measures psychosocial problems in toddlers and consists of a Problem and a Competence scale. In this study the reliability and validity of the Dutch version of the BITSEA were examined for the whole group and for gender and ethnicity subgroups. Methods Parents of 7140 two-year-old children were invited in the study, of which 3170 (44.4%) parents completed the BITSEA. For evaluation of the score distribution, the presence of floor/ceiling effects was determined. The internal consistency (Cronbach's alpha) was evaluated and in subsamples the test-retest, parent-childcare provider interrater reliability and concurrent validity with regard to the Child Behavioral Checklist (CBCL). Discriminative validity was evaluated by comparing scores of parents that worry and parents that do not worry about their child's development. Results The BITSEA showed no floor or ceiling effects. Psychometric properties of the BITSEA Problem and Competence scale were respectively: Cronbach's alphas were 0.76 and 0.63. Test-retest correlations were 0.75 and 0.61. Interrater reliability correlations were 0.30 and 0.17. Concurrent validity was as hypothesised. The BITSEA was able to discriminate between parents that worry about their child and parents that do not worry. The psychometric properties of the BITSEA were comparable across gender and ethnic background. Conclusion The results in this large-scale study of a diverse sample support the reliability and validity of the BITSEA Problem scale. The BITSEA Competence scale needs further study. The performance of the BITSEA appears to be similar in subgroups by gender and ethnic background.
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Waller RJ, Albertini CL, Waller KS. Self-Monitoring of Performance to Promote Accurate Work Completion: A Functional Based Intervention for a 4th Grade Student Presenting Challenging Behavior. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/1754730x.2011.9715623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Banny AM, Heilbron N, Ames A, Prinstein MJ. Relational benefits of relational aggression: adaptive and maladaptive associations with adolescent friendship quality. Dev Psychol 2011; 47:1153-66. [PMID: 21299275 DOI: 10.1037/a0022546] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Two longitudinal studies examined associations between relational aggression and friendship quality during adolescence. In Study 1, 62 adolescents in Grades 6 (25.8%), 7 (32.3%), and 8 (41.9%) completed assessments of friendship affiliations, relational and overt aggression, and friendship quality at 2 time points, 1 year apart. Results using actor partner interdependence modeling indicated that high levels of relational aggression predicted increases in self-reported positive friendship quality 1 year later. In Study 2, 56 adolescents in Grades 9 (66.7%) and 10 (33.3%) attended a laboratory session with a friend in which their conversations were videotaped and coded for relationally aggressive talk. Target adolescents completed measures of positive and negative friendship quality during the laboratory session and during a follow-up phone call 6 months later. Analyses revealed that high levels of relationally aggressive talk at Time 1 predicted increases in negative friendship quality 6 months later. In addition, among adolescents involved in a reciprocal best friendship, high levels of observed relationally aggressive talk predicted increases in positive friendship quality over time. Taken together, these studies provide support for the idea that relational aggression may be associated with adaptive as well as maladaptive outcomes within the dyadic context of adolescent friendship.
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Affiliation(s)
- Adrienne M Banny
- Institute of Child Development, University of Minnesota, Minneapolis, MN 55455, USA.
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Kopp S, Gillberg C. The Autism Spectrum Screening Questionnaire (ASSQ)-Revised Extended Version (ASSQ-REV): an instrument for better capturing the autism phenotype in girls? A preliminary study involving 191 clinical cases and community controls. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:2875-2888. [PMID: 21664105 DOI: 10.1016/j.ridd.2011.05.017] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 05/08/2011] [Accepted: 05/10/2011] [Indexed: 05/30/2023]
Abstract
We wanted to develop and validate an extension of the Autism Spectrum Screening Questionnaire (ASSQ)-the ASSQ Revised Extended Version (ASSQ-REV)--for better capturing the female phenotype of autism spectrum disorders (ASD). Clinic girls and Clinic boys, most of whom with ASD and/or attention-deficit/hyperactivity disorder (ADHD), and Community girls without a clinical diagnosis of any kind of neuropsychiatric disorder were compared on the results of the parent-rated ASSQ and on a new set of items (ASSQ-GIRL). The ASSQ-REV discriminated well between cases and non-cases. Certain single ASSQ-GIRL items were much more typical of girls than of boys with ASD. The most striking of these were "avoids demands", "very determined", "careless with physical appearance and dress" and "interacts mostly with younger children". The issue of whether or not there is a gender-specific ASD for phenotype is discussed.
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Affiliation(s)
- Svenny Kopp
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Sweden.
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Underwood MK, Beron KJ, Rosen LH. Joint trajectories for social and physical aggression as predictors of adolescent maladjustment: internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. Dev Psychopathol 2011; 23:659-78. [PMID: 21532919 PMCID: PMC3082442 DOI: 10.1017/s095457941100023x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This investigation examined the relation between developmental trajectories jointly estimated for social and physical aggression and adjustment problems at age 14. Teachers provided ratings of children's social and physical aggression in Grades 3, 4, 5, 6, and 7 for a sample of 255 children (131 girls, 21% African American, 52% European American, 21% Mexican American). Participants, parents, and teachers completed measures of the adolescent's adjustment to assess internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. Results showed that membership in a high and rising trajectory group predicted rule-breaking behaviors and borderline personality features. Membership in a high desister group predicted internalizing symptoms, rule-breaking behaviors, and borderline and narcissistic personality features. The findings suggest that although low levels of social and physical aggression may not bode poorly for adjustment, individuals engaging in high levels of social and physical aggression in middle childhood may be at greatest risk for adolescent psychopathology, whether they increase or desist in their aggression through early adolescence.
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Affiliation(s)
- Marion K Underwood
- School of Behavioral and Brain Sciences, University of Texas at Dallas, 800 West Campbell Road, GR 41, Richardson, TX 75080, USA.
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Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B, Georgiades K, Heaton L, Swanson S, Olfson M. Service utilization for lifetime mental disorders in U.S. adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 2011; 50:32-45. [PMID: 21156268 PMCID: PMC4408275 DOI: 10.1016/j.jaac.2010.10.006] [Citation(s) in RCA: 877] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/09/2010] [Accepted: 10/18/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Mental health policy for youth has been constrained by a paucity of nationally representative data concerning patterns and correlates of mental health service utilization in this segment of the population. The objectives of this investigation were to examine the rates and sociodemographic correlates of lifetime mental health service use by severity, type, and number of DSM-IV disorders in the National Comorbidity Survey-Adolescent Supplement. METHOD Face-to-face survey of mental disorders from 2002 to 2004 using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview in a nationally representative sample of 6,483 adolescents 13 to 18 years old for whom information on service use was available from an adolescent and a parent report. Total and sector-specific mental health service use was also assessed. RESULTS Approximately one third of adolescents with mental disorders received services for their illness (36.2%). Although disorder severity was significantly associated with an increased likelihood of receiving treatment, half of adolescents with severely impairing mental disorders had never received mental health treatment for their symptoms. Service rates were highest in those with attention-deficit/hyperactivity disorder (59.8%) and behavior disorders (45.4%), but fewer than one in five affected adolescents received services for anxiety, eating, or substance use disorders. Comorbidity and severe impairment were strongly associated with service utilization, particularly in youth with behavior disorders. Hispanic and non-Hispanic Black adolescents were less likely than their White counterparts to receive services for mood and anxiety disorders, even when such disorders were associated with severe impairment. CONCLUSIONS Despite advances in public awareness of mental disorders in youth, a substantial proportion of young people with severe mental disorders have never received specialty mental health care. Marked racial disparities in lifetime rates of mental health treatment highlight the urgent need to identify and combat barriers to the recognition and treatment of these conditions.
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Affiliation(s)
- Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, Bethesda, MD 20892, USA.
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Dupuy FE, Clarke AR, Barry RJ, McCarthy R, Selikowitz M. Girls with attention-deficit/hyperactivity disorder: EEG differences between DSM-IV types. Clin EEG Neurosci 2011; 42:1-5. [PMID: 21309436 DOI: 10.1177/155005941104200104] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated EEG differences between the Combined and Inattentive types of Attention-Deficit/Hyperactivity Disorder (AD/HD) in girls. Thirty girls with AD/HD of the Combined type, 30 girls with the inattentive type, and 30 controls (aged 8-12 years) had a resting eyes-closed EEG recorded from 21 electrodes. The EEG was Fast Fourier Transformed and estimates for total power, and absolute and relative power in the delta, theta, alpha and beta frequency bands, were analyzed in nine cortical regions. Across the scalp, girls with AD/HD had elevated total power, elevated absolute delta and theta, reduced relative delta and beta, and increased relative theta compared with controls. Compared with the Inattentive group, the Combined group had greater right hemisphere absolute theta and greater midline posterior absolute beta activity. The Combined group also had reduced right hemisphere relative delta, greater left hemisphere relative theta, reduced midline posterior relative alpha and reduced central relative beta activity. In conclusion, girls with AD/HD had increased slow wave (delta and theta) activity and reduced beta activity, which are robust results in the predominantly-male AD/HD literature, and exhibited the elevated theta/beta abnormality. The lack of global differences between DSM-IV AD/HD types differs from previous studies of boys and mixed-sex groups. The present results highlight the homogeneity of EEG profiles in AD/HD girls, which could be due to sex-bias in the diagnostic criteria. This study is the first to investigate EEG differences between the Inattentive and Combined types of AD/HD with a purely female sample.
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Affiliation(s)
- Franca E Dupuy
- Brain & Behaviour Research Institute, School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Australia.
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Vera J, Ezpeleta L, Granero R, de la Osa N. Antisocial behavior, psychopathology and functional impairment: association with sex and age in clinical children and adolescents. Child Psychiatry Hum Dev 2010; 41:465-78. [PMID: 20411321 DOI: 10.1007/s10578-010-0181-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined the prevalence, degree of association and differential effect, by sex and age, of conduct disorder symptoms on psychopathology and functioning. Participants included 680 Spanish children and adolescents between 8 and 17 years and their parents, attending to psychiatric outpatient consultation. Data were obtained through structured diagnostic interviews, and other measures of psychopathological outcomes and functional impairment. In general, the prevalence of antisocial behavior did not differ significantly by sex or age. Results indicated a higher frequency for 13-17 year olds, and a greater number of symptoms in boys. Moreover, some symptoms of conduct disorder showed developmental variations. Sex and age differentially affected the expression of some conduct disorder symptoms and their associations with functional impairment and severity of psychopathology. Knowing the different expression of each symptom could help to identify these problems in clinical children and adolescents, contributing to an early detection of population at the highest risk of serious psychopathology and worse prognosis.
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Affiliation(s)
- Juan Vera
- Unit of Epidemiology and Diagnosis in Developmental Psychopathology, Universitat Autònoma of Barcelona, Edifici B, 08193, Bellaterra (Barcelona), Spain.
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Kopp S, Kelly KB, Gillberg C. Girls with social and/or attention deficits: a descriptive study of 100 clinic attenders. J Atten Disord 2010; 14:167-81. [PMID: 19541882 DOI: 10.1177/1087054709332458] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Examine clinical correlates and distinguishing features of autism spectrum disorders (ASD), ADHD, and tic disorders in girls referred for social impairment, attention/academic deficits, and/or tics. METHOD One hundred 3- to 18-year-old girls referred for social impairment and attention symptoms were assessed in detail. Sixty of these girls, 7 to 16 years of age (IQ >or= 80) were compared with age-matched girls (IQ >or= 80) from the community. RESULTS Main diagnoses of ASD, ADHD, tic disorders, and "other psychiatric disorder" were made in 46, 46, 3, and 5, respectively, of the referred girls. The ASD and ADHD groups (mean age at diagnosis 8.8 and 13.0 years, respectively) had the same types and high rates of psychiatric comorbidity. Girls with ASD had more problems with global functioning and adaptive levels of daily living skills than girls with ADHD. Differences between these girls referred for investigation and the community sample of girls were very considerable across a range of factors. CONCLUSIONS Girls referred for social and/or attention deficits usually meet diagnostic criteria for either ASD or ADHD. They have severe psychiatric comorbidities and low global levels of functioning.
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Affiliation(s)
- Svenny Kopp
- Department of Child and Adolescent Psychiatry, University of Göteborg, Sweden.
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Goldstein RB, Dawson DA, Grant BF. Antisocial Behavioral Syndromes in Adulthood and Alcohol Use Disorder Treatment over Three-Year Follow-Up: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. J Am Psychiatr Nurses Assoc 2010; 16:212-26. [PMID: 20838468 PMCID: PMC2936770 DOI: 10.1177/1078390310375846] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Antisocial personality disorder (ASPD) is associated with poorer treatment outcomes, but more help seeking, for alcohol use disorders (AUDs); however, associations of ASPD with AUD treatment in the general population have not been studied prospectively. OBJECTIVE To examine prediction of treatment over 3-year follow-up among adults with AUDs by baseline ASPD and syndromal adult antisocial behavior without conduct disorder before age 15 (AABS). METHOD Face-to-face interviews with 34,653 respondents to the National Epidemiologic Survey on Alcohol and Related Conditions, of whom 3875 had prevalent AUDs between Waves 1 and 2 and ASPD, AABS, or no antisocial syndrome at Wave 1. RESULTS In unadjusted analyses, baseline ASPD predicted AUD treatment but AABS did not. After adjustment for additional need, predisposing, and enabling factors, antisocial syndromes did not predict treatment. Baseline predictors of treatment included more past-year AUD symptoms, and past-year nicotine dependence and AUD treatment. CONCLUSIONS That baseline antisocial syndrome did not predict AUD treatment may reflect strong associations of antisociality with previously identified predictors of help seeking.
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Affiliation(s)
- Risë B. Goldstein
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Deborah A. Dawson
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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Abstract
Attention-deficit hyperactivity disorder (ADHD) is recognized to exist in males and females although the literature supports a higher prevalence in males. However, when girls are diagnosed with ADHD, they are more often diagnosed as predominantly inattentive than boys with ADHD. This article provides a review of gender differences noted across the lifespan. Males and females with ADHD are more similar than different, and generally ADHD profiles are not sex specific. Small gender differences have been found: adolescent girls with ADHD have lower self-efficacy and poorer coping strategies than adolescent boys with ADHD; rates of depression and anxiety may be higher, and physical aggression and other externalizing behaviors lower in girls and women with ADHD. Men with ADHD seem to be incarcerated more often than women with ADHD. However, many studies suffer from small sample sizes, referral biases, differences in diagnostic procedures, and possible rater influences. Treatments are reviewed and discussed with reference to the reported gender differences in functioning and the global deficits noted in all samples. The data available so far suggest that treatments are likely to be equally effective in males and females. However, referral bias is a problem, in that females with ADHD are less likely to be referred for treatment than males with ADHD. Future research should include equal representation of both sexes in samples such that sex by treatment analyses can be routinely conducted.
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.
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Retz-Junginger P, Rösler M, Jacob C, Alm B, Retz W. Gender differences in self- and investigator-rated psychopathology in adult attention-deficit/hyperactivity disorder. ACTA ACUST UNITED AC 2010; 2:93-101. [DOI: 10.1007/s12402-010-0024-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2009] [Accepted: 04/15/2010] [Indexed: 11/29/2022]
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Goldstein RB, Compton WM, Grant BF. Antisocial behavioral syndromes and additional psychiatric comorbidity in posttraumatic stress disorder among u.s. Adults: results from wave 2 of the national epidemiologic survey on alcohol and related conditions. J Am Psychiatr Nurses Assoc 2010; 16:145-65. [PMID: 20661317 PMCID: PMC2909139 DOI: 10.1177/1078390310370209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite the relatively high prevalence of antisocial personality disorder (ASPD) in individuals with posttraumatic stress disorder (PTSD), associations of ASPD with clinical presentation of PTSD, including additional comorbidity, have not been investigated. OBJECTIVE To present nationally representative findings on associations of DSM-IV ASPD versus syndromal adult antisocial behavior without conduct disorder before age 15 with additional psychiatric disorders among U.S. adults with PTSD. METHOD Face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV version in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653). RESULTS After adjustment for sociodemographics and additional comorbidity, both antisocial syndromes were significantly associated with bipolar I, attention-deficit/hyperactivity, substance use, and paranoid, schizoid, histrionic, and obsessive-compulsive personality disorders among respondents with PTSD. Odds of major depressive and generalized anxiety disorders were significantly reduced among men with ASPD. CONCLUSIONS Interventions targeting PTSD may require attention to co-occurring antisociality and additional comorbidity.
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Affiliation(s)
- Risë B Goldstein
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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Murray-Close D, Ostrov JM, Nelson DA, Crick NR, Coccaro EF. Proactive, reactive, and romantic relational aggression in adulthood: measurement, predictive validity, gender differences, and association with Intermittent Explosive Disorder. J Psychiatr Res 2010; 44:393-404. [PMID: 19822329 PMCID: PMC2849926 DOI: 10.1016/j.jpsychires.2009.09.005] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2009] [Revised: 09/04/2009] [Accepted: 09/08/2009] [Indexed: 10/20/2022]
Abstract
The psychometric properties of a recently introduced adult self-report of relational aggression are presented. Specifically, the predictive utility of proactive and reactive peer-directed relational aggression, as well as romantic relational aggression, are explored in a large (N=1387) study of adults. The measure had adequate reliability and validity and the subscales demonstrated unique predictive abilities for a number of dependent variables. In particular, reactive but not proactive relational aggression was uniquely associated with history of abuse, hostile attribution biases, and feelings of distress regarding relational provocation situations. Reactive relational aggression was also more strongly related to anger and hostility than proactive aggression. In addition, relational aggression in the context of romantic relationships was uniquely related to anger, hostility, impulsivity, history of abuse, hostile attribution biases, and emotional sensitivity to relational provocations, even when controlling for peer-directed relational aggression. Gender differences in overall levels of relational aggression were not observed; however, males were most likely to engage in peer-directed proactive and reactive relational aggression whereas females were most likely to engage in romantic relational aggression. In a second study (N=150), relational aggression was higher in a sample of adults with Intermittent Explosive Disorder than in a sample of healthy controls or psychiatric controls. The findings highlight the importance of assessing subtypes of relational aggression in adult samples. Ways in which this measure may extend research in psychology and psychiatry are discussed.
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Drechsler R, Rizzo P, Steinhausen HC. Decision Making with Uncertain Reinforcement in Children with Attention Deficit/Hyperactivity Disorder (ADHD). Child Neuropsychol 2010; 16:145-61. [DOI: 10.1080/09297040903190774] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rydell AM, Diamantopoulou S, Thorell LB, Bohlin G. Hyperactivity, shyness, and sex: development and socio-emotional functioning. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2010; 27:625-48. [PMID: 19994572 DOI: 10.1348/026151008x346996] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Based on formulations about the possible consequences for adaptation of gender nonnormative behaviour, we investigated predictive and concurrent relations of hyperactivity and shyness to various aspects of adaptation focusing on possible effects of sex. At ages 5-6, parents and preschool teachers rated hyperactivity and shyness for 151 children (50% boys). At age 9, we obtained teacher ratings of hyperactivity, internalizing and externalizing problems, self-ratings of trait anxiety, and peer nominations of shyness, social preference, and aggression. Several effects of sex were found. Hyperactivity ratings were more strongly related across time and raters for boys than for girls. In the predictive analyses, boys' hyperactivity was more strongly related to aggression than was girls' hyperactivity, and in concurrent analyses, girls' hyperactivity was more strongly associated with low social preference than was boys' hyperactivity. There was a protective effect of shyness with regard to aggression that applied only to boys, that is, at high hyperactivity levels, boys with high shyness levels were less aggressive than boys with low shyness levels. There were also main effects of hyperactivity and shyness. In predictive and concurrent analyses, hyperactivity was associated with low social preference, high levels of externalizing problems and with aggression, whereas shyness was associated with high levels of internalizing problems. Finally, there was an interactive effect of hyperactivity and shyness. In the concurrent analyses, an exacerbating effect was demonstrated insofar as high shyness was associated with low social preference at high, but not at low levels of hyperactivity. The different developmental risks of hyperactivity and shyness were discussed.
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Affiliation(s)
- Ann-Margret Rydell
- Department of Psychology, Uppsala University, Uppsala Se-751 42, Sweden.
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Goldstein RB, Grant BF. Three-year follow-up of syndromal antisocial behavior in adults: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2009; 70:1237-49. [PMID: 19538901 PMCID: PMC2760631 DOI: 10.4088/jcp.08m04545] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Accepted: 09/11/2008] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To present nationally representative findings on total antisocial personality disorder (ASPD) symptoms, major violations of others' rights (MVOR), and violent symptoms over a 3-year follow-up in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions among adults diagnosed at Wave 1 with ASPD versus syndromal adult antisocial behavior without conduct disorder before age 15 years (AABS, not a codable DSM-IV disorder). METHOD Face-to-face interviews were conducted with 34,653 respondents aged 18 years and older. Antisocial syndromes and comorbid lifetime substance use, mood, and 6 additional personality disorders were diagnosed at Wave 1 using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version (AUDADIS-IV). The Wave 2 AUDADIS-IV assessed antisocial symptoms over follow-up, lifetime attention-deficit/hyperactivity disorder (ADHD) and posttraumatic stress disorder, and borderline, narcissistic, and schizotypal personality disorders. Wave 1 was conducted in 2001-2002 and Wave 2 in 2004-2005 by the National Institute on Alcohol Abuse and Alcoholism. RESULTS In unadjusted analyses, respondents with ASPD reported significantly more total, MVOR, and violent symptoms over follow-up than did respondents with AABS. Adjustment for baseline sociodemographics and psychiatric comorbidity attenuated these associations; after further adjustment for parallel antisocial symptom counts from age 15 years to Wave 1, associations with antisocial syndromes disappeared. Independent Wave 1 predictors of persistent antisociality over follow-up included male sex, not being married or cohabiting, low income, high school or less education, lifetime drug use disorders, additional personality disorders, and ADHD. CONCLUSIONS The distinction between ASPD and AABS holds limited value in predicting short-term course of antisocial symptomatology among adults. However, the prediction of persistent antisociality by psychiatric comorbidity argues for comprehensive diagnostic assessments, treatment of all identified disorders, and investigation of whether treatment of comorbidity might hasten remission of antisociality.
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Affiliation(s)
- Risë B. Goldstein
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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Ohan JL, Visser TAW. Why Is There a Gender Gap in Children Presenting for Attention Deficit/Hyperactivity Disorder Services? JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2009; 38:650-60. [DOI: 10.1080/15374410903103627] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gelhorn H, Hartman C, Sakai J, Mikulich-Gilbertson S, Stallings M, Young S, Rhee S, Corley R, Hewitt J, Hopfer C, Crowley T. An item response theory analysis of DSM-IV conduct disorder. J Am Acad Child Adolesc Psychiatry 2009; 48:42-50. [PMID: 19034046 PMCID: PMC2773289 DOI: 10.1097/chi.0b013e31818b1c4e] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We examined DSM-IV conduct disorder (CD) symptom criteria in a community sample of male and female adolescents to evaluate the extent to which DSM-IV criteria characterize the range of severity of adolescent antisocial behavior within and across sex. METHOD Interviews were conducted with 3,208 adolescents between the ages of 11 and 18 years using the Diagnostic Interview Schedule for Children. Item response theory analyses were performed to obtain severity and discrimination parameters for each of the lifetime DSM-IV CD symptom criteria. In addition, item response theory-based differential item functioning analyses were conducted to examine the extent to which the symptom criteria function similarly across sex. RESULTS The DSM-IV CD symptom criteria are useful and meaningful indicators of severe adolescent antisocial behavior. A single item ("Steal without Confrontation") was a poor indicator of severe antisocial behavior. The CD symptom criteria function similarly across sex; however, three items had significantly different severity parameters. CONCLUSIONS The DSM-IV CD criteria are informative as categorical and continuous measures of severe adolescent antisocial behavior; however, some CD criteria display sex bias.
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Affiliation(s)
- Heather Gelhorn
- School of Medicine at the University of Colorado, Denver, CO, USA.
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Bussing R, Fernandez M, Harwood M, Wei Hou, Garvan CW, Eyberg SM, Swanson JM. Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample. Assessment 2008; 15:317-28. [PMID: 18310593 PMCID: PMC3623293 DOI: 10.1177/1073191107313888] [Citation(s) in RCA: 367] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
To examine Swanson, Nolan, and Pelham-IV (SNAP-IV) psychometric properties, parent (N = 1,613) and teacher (N = 1,205) data were collected from a random elementary school student sample in a longitudinal attention deficit hyperactivity disorder (ADHD) detection study. SNAP-IV reliability was acceptable. Factor structure indicated two ADHD factors and an oppositional defiant disorder (ODD) factor. Parent and teacher scores varied by gender and poverty status (d = .49-.56) but not age; only teacher scores varied by race (d = .25-.55). Screening and diagnostic utility was evaluated with likelihood ratios (LRs) and posttest probabilities. Parent SNAP-IV scores above 1.2 increased probability of concern (LR > 10) and above 1.8, of ADHD diagnosis (LR > 3). Teacher hyperactivity/impulsivity scores above 1.2 and inattention scores above 1.8 increased probabilities of concern only (LR = 4.2 and >5, respectively). Higher teacher scores for African American children and race differences in measurement models require future study.
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45
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Valles NL, Knutson JF. Contingent responses of mothers and peers to indirect and direct aggression in preschool and school-aged children. Aggress Behav 2008; 34:497-510. [PMID: 18506676 DOI: 10.1002/ab.20268] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The primary goal of the study was to determine whether mother and peer's responses to direct and indirect aggression would contribute to children's use of direct and indirect aggression. Using adaptations of the Direct and Indirect Aggression Scale, a multi-informant strategy, and a sample of disadvantaged families, data were collected from 296 mothers of children ages 4-11, 237 children ages 6-11, and 151 teachers of those children. Mothers and peers were reported to react more harshly in response to direct aggression compared with indirect aggression, and higher rates of direct aggression were associated with reduced popularity. These findings were seen as being consistent with the hypothesis that different forms of aggression result in differential responding by mothers and peers, as well as the notion that direct aggression is a higher cost option than indirect aggression. Results also replicated previous findings that boys tend to use physical aggression more than girls, but girls use indirect aggression more than boys. Finally, low IQ was correlated with higher direct aggression in girls but had no relation with aggression in boys.
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Affiliation(s)
- Nizete-Ly Valles
- Department of Psychology, The University of Iowa, Iowa City, Iowa 52242, USA
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Rucklidge JJ. Gender differences in ADHD: implications for psychosocial treatments. Expert Rev Neurother 2008; 8:643-55. [PMID: 18416665 DOI: 10.1586/14737175.8.4.643] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has now been recognized to exist in both males and females, albeit the literature supports a higher prevalence in males. However, when girls are diagnosed with ADHD, they are more often diagnosed as predominantly inattentive than boys with ADHD. This paper provides a review of gender differences noted across the lifespan in terms of psychosocial functioning, cognitive abilities and psychiatric comorbidities. Males and females with ADHD are more similar than different, and generally symptoms of ADHD are not sex specific. Small gender differences have been found: adolescent girls with ADHD have lower self-efficacy and poorer coping strategies than adolescent boys with ADHD, but these differences tend to disappear by adulthood; rates of depression and anxiety may be higher (especially in adolescence) while physical aggression and other externalizing behaviors may be lower in girls and women with ADHD, although not all studies support these findings (e.g., non-referred samples show similar rates of coexisting psychiatric disorders between boys and girls with ADHD). However, many studies suffer from small sample sizes, referral biases, differences in diagnostic procedures and possible rater influences. Psychosocial treatments are reviewed and discussed with reference to the reported gender differences in functioning as well as the global deficits noted in all samples. Although the data available so far suggest that psychosocial treatments are likely to be equally effective in males and females, this conclusion is based more on the small number of gender differences noted in overall functioning and less on empirical research on treatment by sex effects and the moderating role of sex, an effect only investigated by the Multi-modal Treatment Study of ADHD group, to date. Future research should include equal representation of both sexes in samples such that treatment analyses by gender can be routinely conducted.
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.
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Child characteristics and receipt of stimulant medications: a population-based study. ACTA ACUST UNITED AC 2008; 8:175-81. [PMID: 18501864 DOI: 10.1016/j.ambp.2008.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2006] [Revised: 01/24/2008] [Accepted: 01/29/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Predictive factors associated with prescription of psychostimulant drugs to children remain poorly understood. We aimed to identify child-related factors that predict receipt of methylphenidate (MPH: Ritalin) by children in a large population-based study. METHODS With data from time 1 (1994-1995) and time 2 (1996-1997) of the National Longitudinal Survey of Children and Youth, we analyzed the role of child background, and behavioral and functional characteristics, all measured at time 1, in predicting receipt of MPH at time 2 in a series of logistic regression models. RESULTS Parent- and teacher-reported attention-deficit/hyperactivity disorder (ADHD) symptoms were consistent and significant predictors of receipt of MPH (odds ratios [ORs] ranging from 5.3-7.0, and from 3.2-4.1, respectively), particularly when concordant. Parent-reported aggressive behaviors (OR 1.91, 95% confidence interval [CI], 1.24-2.96) and teacher-reported internalizing symptoms (OR 3.01, 95% CI, 1.74-5.54) also predicted receipt of MPH, whereas higher levels of academic functioning predicted lower likelihood of receiving MPH (OR 0.54, 95% CI, 0.34-0.85), even after controlling for child background characteristics, ADHD symptoms, and prior receipt of MPH. Across models, male gender predicted a higher likelihood of receiving MPH (ORs ranging from 3.5-4.5) over and above ADHD and other behavioral symptoms. The strongest predictor of MPH receipt across models was prior receipt of MPH (ORs ranging from 83.7-128.3). CONCLUSIONS Child characteristics and behavioral symptoms other than ADHD symptoms predict prescription and uptake of MPH, possibly attributable to their serving as clinically convenient indicators of impairment. Gender effects in receipt of stimulant medications among children with ADHD symptoms warrant further investigation.
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Abstract
OBJECTIVE Relational aggression was introduced more than a decade ago as a female-typical form of aggression and has become widely used in developmental psychopathology research. In considering whether relational aggression should be included in DSM-V disruptive behavior disorders, we provide data on the reliability and validity of relational aggression when reported by the informants most commonly used to generate clinical diagnoses (parents and youth), the degree of overlap between relational aggression and DSM-IV oppositional defiant disorder (ODD) and conduct disorder (CD), and the amount of variance in impairment explained by relational aggression controlling for ODD and CD. METHOD Data were collected on 9- to 17-year-old girls and boys participating in the population-based Georgia Health and Behavior Study. RESULTS Reliability and validity of youth and parent reports were adequate. Relational aggression was moderately correlated with symptoms of ODD and CD, and substantial overlap was observed between high levels of relational aggression and meeting symptom criteria for ODD or CD. Relational aggression explained a small but significant amount of unique variance in impairment, controlling for ODD and CD symptoms. At clinically significant levels of impairment, however, there was no additional variance explained by relational aggression. CONCLUSIONS Some additional information about girls' and boys' functioning is gained by assessing relational aggression using parents and youth as informants, but perhaps not a sufficient amount to warrant inclusion in the nomenclature.
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Affiliation(s)
- Kate Keenan
- Dr. Keenan and Ms. Coyne are with the Department of Psychiatry and Dr. Lahey is with the Department of Health Studies, University of Chicago.
| | - Claire Coyne
- Dr. Keenan and Ms. Coyne are with the Department of Psychiatry and Dr. Lahey is with the Department of Health Studies, University of Chicago
| | - Benjamin B Lahey
- Dr. Keenan and Ms. Coyne are with the Department of Psychiatry and Dr. Lahey is with the Department of Health Studies, University of Chicago
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Goldstein RB, Dawson DA, Stinson FS, June Ruan W, Patricia Chou S, Pickering RP, Grant BF. Antisocial behavioral syndromes and body mass index among adults in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Compr Psychiatry 2008; 49:225-37. [PMID: 18396181 PMCID: PMC2730646 DOI: 10.1016/j.comppsych.2007.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Revised: 10/19/2007] [Accepted: 10/23/2007] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To describe associations of antisocial behavioral syndromes, including DSM-IV antisocial personality disorder (ASPD) and conduct disorder without progression to ASPD ("CD only"), and syndromal antisocial behavior in adulthood without CD before age 15 (AABS, not a codable DSM-IV disorder), with body mass index (BMI) status in the general US adult population. METHODS This report is based on the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43093; response rate, 81%). Respondents were classified according to whether they met criteria for ASPD, AABS, "CD only," or no antisocial syndrome, and on current BMI status based on self-reported height and weight. Associations of antisocial syndromes with BMI status were examined using multinomial logistic regression. RESULTS Among men, antisociality was not associated with BMI. Among women, ASPD was significantly associated with overweight and extreme obesity; AABS was associated with obesity and extreme obesity; and "CD only" was significantly associated with overweight, obesity, and extreme obesity. CONCLUSIONS Assessment of antisocial features appears warranted in overweight, obese, and extremely obese women, and assessment of BMI status appears indicated in antisocial women. Prevention and treatment guidelines for overweight and obesity may need revision to address comorbid antisociality, and interventions targeting antisociality may need to include attention to weight concerns.
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Bowie BH. Relational Aggression, Gender, and the Developmental Process. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2007; 20:107-15. [PMID: 17598804 DOI: 10.1111/j.1744-6171.2007.00092.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
TOPIC Defining and exploring the concept of relational aggression, or the purposeful intent to inflict harm on another through a social relationship. PURPOSE This study aims to describe the concept of relational aggression as it has been shaped through recent research, to contrast relational aggression with other types of aggression, and to explore the influence of gender and the formation of a self-concept in the development of relational aggression. SOURCES A review of the literature from 1969 to 2005 from selected nursing, child development, women's studies, and psychology publications. CONCLUSIONS Some degree of relational aggression seems to be a normal response to conflict for many girls, from preschool through adolescence; however, more research needs to be conducted to determine at what level, or what subtypes, of relational aggression are predictive of future deviant behavior.
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Affiliation(s)
- Bonnie H Bowie
- School of Nursing, University of Washington, Seattle, WA, USA
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