Longitudinal Prediction of the One-Year Course of Preschool ADHD Symptoms: Implications for Models of Temperament-ADHD Associations

Using the Infant Sibling-Design to Explore Associations Between Autism and ADHD Traits in Probands and Temperament in the Younger Siblings

The purpose of the current study was to use the infant sibling design to explore whether proband traits of autism and ADHD could provide information about their infant sibling's temperament. This could help us to gain information about the extent to which infant temperament traits are differentially associated with autism and ADHD traits. We used parent-ratings of autistic traits and ADHD traits (CRS-3) in older siblings diagnosed with autism (age range 4 to 19 years), and their infant siblings' temperament traits (IBQ) at 9 months of age in 216 sibling pairs from two sites (BASIS, UK, and EASE, Sweden) to examine associations across siblings. We found specific, but modest, associations across siblings after controlling for sex, age, developmental level and site. Proband autistic traits were specifically related to low levels of approach in the infant siblings, with infant developmental level explaining part of the variance in infant approach. Proband ADHD traits were specifically related to high levels of infant activity even after controlling for covariates. Our findings suggest that proband traits of autism and ADHD carry information for infant sibling's temperament, indicating that inherited liability may influence early emerging behaviours in infant siblings. The impact of sex, age, developmental level and site are discussed.

The Developmental Unfolding of ADHD Symptoms from Early Childhood Through Adolescence: Early Effects of Exuberant Temperament, Parenting and Executive Functioning

Temperament, parenting, and executive functioning (EF) are individual and contextual factors that have been identified to play a role in the development of Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms. Specifically, exuberant temperament in toddlerhood has been associated with both adaptive and maladaptive outcomes, including ADHD symptoms. Therefore, it is important to understand factors that predict which exuberant children experience increased ADHD symptoms and the specific mechanisms through which early exuberant temperament impacts later ADHD symptoms. Using a multi-method, prospective longitudinal design, this study examined a moderated mediation model wherein the interactive effects of observed exuberance and parenting at age 3 predicted the development of parent-reported ADHD symptoms from childhood through adolescence (age 5, 7, 9, 12, and 15) via child EF (i.e., inhibitory control) at age 4. Parent-child dyads (n = 291) from a longitudinal study on child temperament were included. A piecewise model of ADHD symptom growth demonstrated stability in ADHD symptoms from age 5-9 and a decrease from age 9-15. Results support a moderated mediation model wherein an increase in ADHD symptoms throughout childhood was predicted from early childhood exuberant temperament by way of EF, but only for children whose parents displayed less directive parenting. Findings suggest identifiable early markers of risk, including temperament, parenting, and EF- pointing to possible targets for early intervention/prevention.

Associations of household tobacco smoking status with childhood temperament among U.S. preschool-aged children

BACKGROUND

This study investigated the association between household tobacco smoking status and temperament among U.S. 3-5-year-olds.

METHODS

A secondary analysis of 2019-2020 National Survey of Children's Health data (N = 11,100) was conducted. Temperament dimensions of effortful control (characterized by attention focusing), negative affectivity (characterized by anger and soothability), and surgency (characterized by activity level and shyness) were assessed. Weighted ordinal regression models were conducted while adjusting for child and family covariates.

RESULTS

Approximately 13 % of children lived with smokers. Compared to children who did not live with smokers, children living with smokers displayed behaviors of poorer effortful control and were more likely to be easily distracted (AOR = 1.59, 95%CI = 1.24-2.04) and less likely to keep working on tasks until finished (AOR = 0.56, 95%CI = 0.44-0.71). Children living with smokers displayed behaviors of greater negative affectivity and were at increased odds of being angry or anxious when transitioning between activities (AOR = 1.50, 95%CI = 1.13-1.98) and losing their temper when things did not go their way (AOR = 1.53, 95%CI = 1.20-1.96), and were at decreased odds of calming down quickly when excited (AOR = 0.54, 95%CI = 0.42-0.70). Children living with smokers displayed behaviors of poorer surgency and were less likely to play well with others (AOR = 0.58, 95%CI = 0.45-0.76) and sit still compared to same-aged children (AOR = 0.56, 95%CI = 0.44-0.71).

LIMITATIONS

The NSCH uses a cross-sectional survey design; longitudinal associations and objective measures could not be assessed. However, the NSCH is nationally representative and results are generalizable to U.S. 3-5-year-olds.

CONCLUSIONS

Findings suggest household tobacco smoking influences temperament in early childhood. Results signify the need to promote household tobacco cessation.

Inhibitory deficits and symptoms of attention-deficit hyperactivity disorder: How are they related to effortful control?

Separate studies with clinical and community-based samples have identified an association between symptoms of attention-deficit hyperactivity disorder (ADHD) and inhibitory control deficits and ADHD and weak effortful control. We tested whether differences in effortful control explained the associations between ADHD symptoms and inhibitory control deficits, controlling for conduct problems. In a community sample, parents rated ADHD symptoms, conduct problems, effortful control, surgency and negative affect in 77 4-7-year-olds (47 girls), who performed an inhibitory control task. ADHD symptoms, deficient inhibitory control and low effortful control were correlated. Controlling for conduct problems, path analysis showed the ADHD symptoms - inhibitory control link was mediated statistically by effortful control. This focuses attention on cognitive-energetic factors associated with ADHD-related executive deficits.

Individual differences in sensitivity to positive home environment among children "at risk" for attention-deficit/hyperactivity disorder: A review

Although the evidence for the genetic basis of attention-deficit/hyperactivity disorder (ADHD) is strong, environmental factors, such as the quality of parenting or the home environment, may moderate such genetic liability. The plausible negative effect of a low-quality home environment and negative parenting on child outcomes is well-established; however, the positive effect of a high-quality environment and positive parenting remained largely uninvestigated. Due to the presence of genetic, temperamental, or physiological factors, children who were traditionally considered at-risk for ADHD may be more sensitive to aspects of their environment compared to children who are not at such risk. Therefore, they would be more affected by their environmental experience, either for good or bad. Under supportive environmental conditions, such at-risk individuals might actually outperform their non-vulnerable peers, suggesting that these individual factors might be considered susceptibility factors rather than risk factors. Little is known regarding the positive effect of the environment in the ADHD literature, but it has been demonstrated in cognitive functions that are closely associated with ADHD, such as executive functions (EF). We review this literature and examine the extant empirical support for sensitivity to aspects of the home environment and parenting in the case of ADHD and EF. Moreover, we review factors that could help identify the specific aspects of the home environment and parenting that these children might be more susceptible to. Such knowledge could be valuable when designing preventive interventions and identifying those children that are especially sensitive and could benefit from such interventions. Recommendations for future studies are discussed as well.

Longitudinal Temperament Pathways to ADHD Between Childhood and Adolescence

The current investigation extended prior cross-sectional mapping of etiological factors, transdiagnostic effortful and affective traits, and ADHD symptoms to longitudinal pathways extending from two etiological domains: polygenic and prenatal risk. Hypotheses were (1) genetic risk for ADHD would be related to inattentive ADHD symptoms in adolescence and mediated by childhood effortful control; (2) prenatal smoking would be related to hyperactive-impulsive ADHD symptoms during childhood and mediated by childhood surgency; and (3) there would be age-related variation, such that mediation of genetic risk would be larger for older than younger ages, whereas mediation of prenatal risk would be larger in earlier childhood than at later ages. Participants were 849 children drawn from the Oregon ADHD-1000 Cohort, which used a case control sample and an accelerated longitudinal design to track development from childhood (at year 1 ages 7-13) through adolescence (at year 6 ages 13-19). Results showed the mediational pathway from prenatal smoking through surgency to hyperactivity-impulsivity at Year 1 was significant (indirect effect estimate = .053, p < .01). The mediational pathway from polygenic risk through effortful control to inattention at Year 6 was also significant (indirect effect estimate = .084, p < .01). Both results were independent of the association between inattention and hyperactivity-impulsivity and control for the alternative etiological input and held across parent- and teacher-report of ADHD symptoms. In line with dual pathway models of ADHD, early prenatal risk for hyperactivity-impulsivity appears to operate through surgency, while polygenic genetic risk for inattention appears mediated by effortful control.

Preschool Temperament as a Factor of Risk and Protection for Later Childhood Psychopathology

BACKGROUND

Temperament might be considered as a risk factor as well as a resilience factor for later externalizing and internalizing disorders. Therefore, this study examines different dimensions of temperament in preschool age with regard to their predictive value for psychopathology later in childhood.

METHODS

A total of 76 patients (63.2% male) were assessed in a special psychiatric consultation for preschool age at measuring point time t1 (x = 4.2) and measuring point time t2 (x = 9.2). At t1, the Integrative Child Temperament Inventory (ICTI) was used for assessment. At t2, parents completed the Strengths and Difficulties Questionnaire SDQ. Multiple regression analyses were used to test if the temperament factors of the ICTI predicted clinical abnormalities in the SDQ subscales or total difficulties score.

RESULTS

SDQ total difficulties score as an indicator of total psychiatric disturbance in childhood appears to be good predicted by the temperament factor frustration/anger. Sensory sensitivity in preschoolers serves as a risk factor for later emotional symptoms, whereas high activity levels appear to prevent later emotional symptoms. Behavioral inhibition appears to protect against hyperactivity/inattention.

CONCLUSION

Our data suggests that preschool temperament contributes differently to the development of externalizing and internalizing problems in childhood. The temperament factor frustration/anger in preschool children might be a strong predictor of the general mental condition in childhood at nine years of age and can therefore be used as a target for prevention of psychopathology in children. On one hand, high sensory sensitivity can be a predictor to identify preschool children at risk for later emotional symptoms, on the other hand, activity level acts as a protective factor against later emotional symptoms. An increased level of behavioral inhibition might be protective against the development of hyperactivity/inattention symptoms. Overall, this study illustrates the complexity and ambiguity of temperament in child development.

Treatment Response among Preschoolers with Disruptive Behavior Disorders: The Role of Temperament and Parenting

Objective: This study examined associations between temperament (negative affect, effortful control, and surgency) and symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) within a diverse preschool sample. Interactions between temperament and parenting in the prediction of ADHD/ODD symptoms before and after an 8-week early intervention program (i.e., Summer Treatment Program for Pre-kindergartners; STP-PreK) were also examined.Method: The sample included 215 children (Mage = 5.0, 80.9% male, 84.7% Latinx) with a diagnosis of ADHD and/or ODD who completed the STP-PreK. Temperament was measured via parent report while ADHD/ODD symptoms were assessed via combination of parent and teacher report. Positive and negative parenting were assessed via rating scales and a standardized parent-child interaction observation.Results: Higher surgency was associated with greater symptom severity of ADHD/ODD pre- and post-treatment. Higher negative affect was associated with greater symptom severity of ODD pre- and post-treatment, while higher effortful control was only associated with lower symptom severity of inattention pre-treatment. Positive parenting predicted lower symptom severity of ADHD/ODD post-treatment. Moderation analyses indicated that the benefits of low levels of negative parenting only occurred when paired with low temperament risk for symptoms of hyperactivity and ODD. Additionally, only the combination of high surgency and high observed negative parenting resulted in greater symptom severity of ODD. Finally, decreases in inconsistent discipline predicted decreases across all symptom domains post-treatment.Conclusions: Our findings add to the temperament-based model of ADHD/ODD by highlighting temperament's unique prediction of treatment response as well as important interactions with the caregiving environment.

Cognitive and personality differences between adolescents with and without attention deficit/hyperactivity disorder

BACKGROUND

The relationships between cognitive and personality profile in teenagers with and without ADHD were assessed.

METHOD

Two groups of teenagers, one with ADHD (N = 135; mean age = 13.93) and another group without ADHD (N = 199, mean age = 14.29) were evaluated using the K-BIT and 16PF-APQ tests.

RESULTS

In cognitive variables, the results revealed that the ADHD group returned higher scores in the Matrices subtest and the IQ test. In personality variables, the group with ADHD exhibited higher scores in Tough-Mindedness and lower scores in Self-Control than the group without the disorder. The canonical correlation analysis applied to each group revealed a differing pattern of interrelationships between the cognitive-personality variables in the two groups. In adolescents with ADHD, we observed that higher scores in cognitive variables were associated with a more extroverted personality and less self-control, while in adolescents without ADHD, higher scores in cognitive variables were associated with less tough-mindedness and lower levels of self-control.

CONCLUSIONS

The cognitive and personality variables of adolescents with and without ADHD differ. These results will be useful for establishing a cognitive and personality profile for this section of the population. The educational implications of the study are under discussion.

Sensory modulation and negative affect in children at familial risk of ADHD

BACKGROUND/AIMS

Sensory modulation difficulties are commonly reported in patients with ADHD, however there has been little focus on the development of these difficulties in young children at a higher risk of later ADHD diagnosis. This study investigated whether children with a familial history of ADHD show greater sensory modulation difficulties. We also explored whether sensory modulation was linked to negative affectivity, which has been highlighted as a potential early marker of ADHD.

METHODS

Parents of children under 6 years with a family history of ADHD (n = 65) and no family history (n = 122) completed questionnaires on sensory modulation and temperament.

RESULTS

Children from families with ADHD were reported to display extreme patterns of hyperresponsiveness and hyporesponsiveness, relative to controls. No differences emerged for the sensory seeking domain. Some children within the high-risk group reported high scores across all three sensory modulation patterns. Regression analysis revealed that hyperresponsiveness predicted higher levels of negative affect.

CONCLUSIONS/IMPLICATIONS

This study is the first to report greater sensory modulation difficulties in children at familial risk of ADHD. Future research should establish whether children with sensory modulation and temperament difficulties in early childhood are more vulnerable to developing ADHD.

How Does Temperament in Toddlers at Elevated Likelihood for Autism Relate to Symptoms of Autism and ADHD at Three Years of Age?

The current study investigated longitudinal associations between parent-rated temperament, observed exuberance and accelerometer activity level at 18-months and symptoms of ASD and ADHD at 36-months in a sample of 54 children at elevated likelihood for ASD. For the specific parent-rated temperament scales, most observed significant associations appeared to be specific for either ASD or ADHD symptoms. Indeed, by controlling for overlapping symptoms a different pattern of associations emerged. These results illustrate how temperamental measures may signal risk for later ASD versus ADHD symptomatology in infants at elevated likelihood for ASD. In addition, they indicate the potential of adopting a broader view on neurodevelopmental disorders by investigating not only ASD traits, but also co-occurring disorders such as ADHD in samples of elevated likelihood for ASD.

Temperament in individuals with Autism Spectrum Disorder: A systematic review

The study of temperament in Autism Spectrum Disorder (ASD) has the potential to provide insight regarding variability in the onset, nature, and course of both core and co-morbid symptoms. The aim of this systematic review was to integrate existing findings concerning temperament in the context of ASD. Searches of Medline, PsychInfo and Scopus databases identified 64 relevant studies. As a group, children and adolescents with ASD appear to be temperamentally different from both typically developing and other clinical non-ASD groups, characterized by higher negative affectivity, lower surgency, and lower effortful control at a higher-order level. Consistent with research on typically developing children, correlational findings and emerging longitudinal evidence suggests that lower effortful control and higher negative affect are associated with increased internalizing and externalizing problems in ASD samples. Longitudinal studies suggest there may be temperamental differences between high familial risk infants who do and do not develop ASD from as early as 6-months of age. Limitations of existing research are highlighted, and possible directions for future research to capitalize on the potential afforded through the study of temperament in relation to ASD are discussed.

"My Brain Can Stop": An ERP Study of Longitudinal Prediction of Inhibitory Control in Adolescence

We examined the longitudinal predictors of electrophysiological and behavioral markers of inhibitory control in adolescence. Participants were 63 adolescent boys who have been followed since birth as part of a prospective longitudinal study on the developmental pathways to attention-deficit hyperactivity disorder (ADHD). At 17 years of age, they completed the stop-signal task (SST) while electroencephalography (EEG) was continuously recorded. Inhibitory control was evaluated by the stop-signal reaction time (SSRT) as well as by the amplitude of the event-related potential (ERP) component of N2 during successful inhibition. We found that higher inattention symptoms throughout childhood predicted reduced amplitude (i.e., less negative) of the N2 in adolescence. Furthermore, the N2 amplitude was longitudinally predicted by the early precursors of child familial risk for ADHD and early childhood temperament. Specifically, father's inattention symptoms (measured in the child's early infancy) and child's effortful control at 36 months of age directly predicted the N2 amplitude in adolescence, even beyond the consistency of inattention symptoms throughout development. The SSRT was predicted by ADHD symptoms throughout childhood but not by the early precursors. Our findings emphasize the relevance of early familial and temperamental risk for ADHD to the prediction of a later dysfunction in inhibitory control.

Child Temperament Outcomes After Laser Surgery for Twin-Twin Transfusion Syndrome

OBJECTIVE

Twin-twin transfusion syndrome (TTTS) is a severe pregnancy complication of monochorionic (identical) twins that results in markedly discordant in utero environments for each twin. The aim of this study was to test for differences in temperament between former donor (hypovolemic, smaller) and recipient (hypervolemic, larger) twins with TTTS.

METHODS

Parents of dual survivors aged 3 to 7 years who underwent in utero laser surgery for TTTS were surveyed using the Children's Behavior Questionnaire-Very Short Form (CBQ-VSF). The CBQ-VSF assessed 3 traits: Surgency, Negative Affect, and Effortful Control. Differences in traits between donor and recipients were assessed using a paired t test.

RESULTS

We studied 85 twin pairs treated in utero for TTTS. There were no statistically significant differences in Surgency, Negative Affect, or Effortful Control between recipients and donors, although score differences for each trait varied widely among sibling pairs.

CONCLUSION

Despite varied in utero environments, no temperament differences between donor and recipient monozygotic twins were found for the population as a whole. This finding may be of some reassurance to parents whose pregnancies are complicated by TTTS.

ADHD and ODD Symptoms in Toddlers: Common and Specific Associations with Temperament Dimensions

The aim of this work was to study the relationship between temperament and signs of psychopathology in typically developing toddlers. More specifically, Attentional Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) symptoms were analyzed in connection with fine-grained temperament dimensions. The sample was composed of 65 toddlers aged between 18 and 35 months. Bivariate correlations showed that higher levels of negative emotionality and approach tendencies, and lower levels of inhibitory control, were related to more ADHD and ODD manifestations. Bivariate correlations also indicated unique associations: lower levels of soothability were associated with higher ODD symptoms, whereas lower attentional focusing and low-intensity pleasure were related with higher ADHD symptoms. Additionally, regression and path analysis models indicated that ADHD was predominantly associated with attentional focusing and motor activation whereas ODD was most closely related to frustration. Our findings highlight the relevance of studying early correlates of psychopathological manifestations to identify children who could benefit from prevention and early intervention programs.

Weight gain, feeding and eating in the first year of life of babies of smoking and non-smoking mothers

Babies of mothers who smoke during pregnancy tend to be born underweight but are at risk for pediatric obesity. Maternal feeding practices, maternal disordered eating, and child temperament were assessed as potential mediators of early weight gain in babies of smoking and non-smoking mothers. The BMIs of babies of 88 smoking and 107 non-smoking mothers were recorded at birth and reported one year later. Mothers self-reported on disordered eating and child feeding practices, and on their infants' temperament. Babies of smoking mothers had lower BMI at birth but not at age one. For babies of non-smoking but not for those of smoking mothers, BMI at birth predicted BMI at age one. Smoking mothers' disordered eating and pressure for children to eat predicted their babies' BMI at age one. In the non-smoking group only, there were significant correlations between babies' temperamental difficulties and babies' BMI at age one. In contrast to non-smoking mothers, smoking mothers tend to pressure their babies to eat, and not to feed them in response to their distress. This interim picture may provide insight into the transition of the children of smoking mothers from underweight newborns to children classified as overweight.

Cross-Sectional and Longitudinal Associations of Temperament and Mental Disorders in Youth

Here we evaluate the cross-sectional and longitudinal associations between temperament and mental disorders in adolescents. Temperament was assessed in a cohort of 1540 youths by the revised self-report Early Adolescence Temperament Questionnaire (EATQ-R) at baseline and confirmatory factor analyses were used to test the best empirical model. Mental disorders were assessed by parental interview using the Development and Well-Being Behavior Assessment at baseline and at 3-year follow-up. Participants were grouped into Typically Developing Comparisons, Phobias, Distress, Attention-Deficit/Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders (DBD). Logistic regression models tested the effects of temperament on incidence and remission of mental disorders. The bifactor model of EATQ-R presented the best fit. Distress, ADHD and DBD have lower levels of effortful control in baseline. Adjusted longitudinal analysis showed that effortful control predicted lower incidence of Phobias (OR 0.74; p = 0.018), distress (OR 0.74; p = 0.014) and DBD (OR 0.68; p = 0.037). Temperament factors did not predicted remission rates.

The role of effortful control in the development of ADHD, ODD, and CD symptoms

Many adolescents have difficulty regulating their impulses and become prone to externalizing problems (e.g., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], and conduct disorder [CD]) and other adverse consequences. Using multimethod data from a longitudinal study of Mexican-origin youth (N = 674), assessed annually from age 10 to 16, we examined the relations between effortful control and ADHD, ODD, and CD symptoms over time. Bivariate latent growth curve models showed negative correlations between the trajectories of effortful control and ADHD, ODD, and CD, indicating that steeper decreases in effortful control were related to steeper increases in ADHD, ODD, and CD symptoms. Using a novel statistical technique, the factor of curves model (FOCUS), we found that ADHD, ODD, and CD share a common "externalizing" trajectory during adolescence. Although effortful control was strongly associated with this common trajectory, it had few unique associations with the individual disorder trajectories, above and beyond their shared trajectory. When we extended the FOCUS model to include the effortful control trajectory as an indicator, we found that ADHD and ODD had strong loadings, whereas effortful control and CD had comparatively weak loadings on the shared developmental trajectory. Follow-up analyses showed that a two-factor solution, with externalizing symptom trajectories on one factor and the effortful control facet trajectories on a separate factor, was a better fit to the data than a one-factor solution. Finally, parent ASPD symptoms were related to increases in CD, but had no significant influence on effortful control, ADHD, or ODD. We discuss the implications for personality and externalizing problem development. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Predicting ADHD Symptoms in Adolescence from Early Childhood Temperament Traits

Extreme levels of certain temperament traits can be early markers of different developmental pathways of attention-deficit/hyperactivity disorder (ADHD). However, the long-term utility of using these traits as predictors of ADHD is not fully known. This study includes 64 male adolescents (M age = 13.5), who have been followed since birth as part of a longitudinal study. The primary aim was to test effortful control (EC), activity level, and anger, measured in early childhood - both with mother's reports and laboratory assessments -as predictors of ADHD symptoms in adolescence. Further, we investigated the specificity of this prediction to the different ADHD symptom domains. The results demonstrated that early temperament dimensions of EC and activity level were predictive of ADHD symptoms about 10 years later, when the participants reached adolescence. Moreover, activity level showed specificity only to hyperactivity-impulsivity symptoms whereas EC was a predictor of the two symptom domains. Anger had a predictive correlation with ADHD symptoms; however, it did not have a unique predictive contribution. These results emphasize the relevance of EC and activity level in the developmental course of ADHD. Identification of early risk factors can lead to more efficient design and implementation of intervention programs.

Relation between temperament dimensions and attention-deficit/hyperactivity disorder symptoms

INTRODUCTION

The relation between temperament and attention-deficit/hyperactivity disorder (ADHD) is complex and understood in different ways, with the most common being risk model and spectrum model. However, the evidence is mixed and emerging.

AIM

To assess the relationship between ADHD symptoms and temperament dimensions in a clinical sample of school-aged children.

METHODS

A retrospective assessment of temperament of 50 children with ADHD was done on temperament measurement schedule. The mean and standard deviation was computed for continuous variables and frequency and percentage for discontinuous variables and correlation and regression analysis was computed.

RESULTS

Children with ADHD were high on activity level, intensity of reaction, approach, and distractibility and low on persistence and threshold of responsiveness. The strength of significant correlations between temperamental dimensions and ADHD symptoms (P < 0.05) ranged from 0.32 to 0.41. On regression analysis, temperament could explain 22% variance of inattention subscale and around 20% variance in hyperactivity/impulsivity subscale.

CONCLUSION

This moderate level of relation suggests that though certain temperamental traits are related to symptoms of ADHD, temperament and ADHD are phenotypically separate constructs, further favoring the risk model.

Temperament and character profiles for children with ADHD with and without tic disorders

There is no research about whether ADHD with tic disorder that temperamental features that differ from the ADHD. This research aimed to identify temperament and character profiles for children with ADHD according to tic disorder by comparing them with a healthy control group. A discriminant analysis was conducted to identify whether temperament and character profiles can discriminate comorbidity. The sample consisted of three groups (N = 40 per group): ADHD alone, ADHD with tic disorder and age- and sex- matched healthy control. The parents of 120 children (mean age 8.57 ± 1.71 years) completed the Junior Temperament and Character Inventory (JTCI). The two ADHD groups showed higher novelty seeking and low persistence, self-directedness and cooperativeness than the control group. The ADHD alone group had lower scores for persistence and self-directedness than the other two groups. Temperament and character profiles were useful for discriminating ADHD from the control group. However, their discriminating power was relatively low for all three groups. Results indicated that differences in temperament and character in ADHD children were present according to comorbid tic disorders. JTCI's discriminating power for ADHD alone and ADHD with tic disorder was relatively lower than that of the combined ADHD group and the control group.

An Examination of the Structure and Construct Validity of the Wender Utah Rating Scale

The Wender Utah Rating Scale (Ward, Wender, & Reimherr, 1993 ) has been widely used in adult attention-deficit/hyperactivity disorder (ADHD) research to assess childhood symptoms retrospectively, but little research has examined its factor structure and specificity in predicting ADHD versus other psychopathology. Consequently, this study had 2 goals: (a) to examine the Wender Utah Rating Scale's structure, and (b) to explicate the construct validity of this measure by relating factors from our structural analyses to other ADHD, psychopathology, and personality measures. Structural analyses in an adult community sample (N = 294) yielded a 3-factor structure of aggression (e.g., angry), internalizing distress (e.g., depressed), and academic difficulties (e.g., underachiever). Correlational and regression analyses indicated that these factors failed to display specificity in their associations with ADHD versus other psychopathology. Aggression and internalizing distress associated most strongly with indicators of externalizing (e.g., ill temper, manipulativeness) and internalizing psychopathology (e.g., depression, anxiety), respectively. Academic difficulties associated most strongly with ADHD symptoms, but these relations were relatively weak. Taken together, these findings raise concerns about the Wender Utah Rating Scale's construct validity, although additional longitudinal research is needed to clarify to what extent the Wender Utah Rating Scale validly assesses childhood ADHD symptoms.

Autism spectrum disorder and attention-deficit/hyperactivity disorder in early childhood: A review of unique and shared characteristics and developmental antecedents

Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have overlapping characteristics and etiological factors, but to which extent this applies to infant- and preschool age is less well understood. Comparing the pathways to ASD and ADHD from the earliest possible stages is crucial for understanding how phenotypic overlap emerges and develops. Ultimately, these insights may guide preventative and therapeutic interventions. Here, we review the literature on the core symptoms, temperament and executive function in ASD and ADHD from infancy through preschool age, and draw several conclusions: (1) the co-occurrence of ASD and ADHD increases with age, severity of symptoms and lower IQ, (2) attention problems form a linking pin between early ASD and ADHD, but the behavioral, cognitive and sensory correlates of these attention problems partly diverge between the two conditions, (3) ASD and ADHD share high levels of negative affect, although the underlying motivational and behavioral tendencies seem to differ, and (4) ASD and ADHD share difficulties with control and shifting, but partly opposite behaviors seem to be involved.

DRD4 VNTRs, observed stranger fear in preschoolers and later ADHD symptoms

Fear of strangers is a developmental milestone in childhood that encompasses behavioral inhibition and decreased novelty seeking. Children with attention deficit/hyperactivity disorder (ADHD) often exhibit fearless and impulsive behaviors, similar to those observed in children with atypically low levels of stranger fear. It is currently unknown whether these behaviors share common underlying biological mechanisms. Polymorphisms in the dopamine receptor 4 gene (DRD4) have been implicated in the risk for developing ADHD symptoms in childhood. Here we investigate whether (1) DRD4 variable number tandem repeats (VNTRs) are associated with both stranger fear and ADHD symptoms, and (2) stranger fear in preschoolers mediates the link between DRD4 VNTRs and ADHD in later childhood. Stranger fear was observed in a large sample (N=589) of 3-year-old Caucasian children and ADHD symptoms were assessed by a validated, mother-rated questionnaire at 6 years. We found evidence that longer DRD4 variants were associated with increased ADHD symptoms at 6 years, and that this relationship was partially mediated by lower levels of observed stranger fear at 3 years. Our results suggest a common underlying neurobiological mechanism in the association between low stranger fear and ADHD symptoms; variation in DRD4 may be an important contributor to this mechanism.