1
|
Wu ZM, Wang P, Liu J, Liu L, Cao XL, Sun L, Yang L, Cao QJ, Wang YF, Yang BR. The clinical, neuropsychological, and brain functional characteristics of the ADHD restrictive inattentive presentation. Front Psychiatry 2023; 14:1099882. [PMID: 36937718 PMCID: PMC10014598 DOI: 10.3389/fpsyt.2023.1099882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/07/2023] [Indexed: 03/05/2023] Open
Abstract
Objectives There is an ongoing debate about the restrictive inattentive (RI) presentation of attention deficit hyperactivity disorder (ADHD). The current study aimed to systematically investigate the clinical, neuropsychological, and brain functional characteristics of children with ADHD restrictive inattentive presentation. Methods A clinical sample of 789 children with or without ADHD participated in the current study and finished clinical interviews, questionnaires, and neuropsychological tests. Those individuals with a diagnosis of ADHD were further divided into three subgroups according to the presentation of inattentive and/or hyperactive/impulsive symptoms, the ADHD-RI, the ADHD-I (inattentive), and the ADHD-C (combined) groups. Between-group comparisons were carried out on each clinical and neuropsychological measure using ANCOVA, with age and sex as covariates. Bonferroni corrections were applied to correct for multiple comparisons. Two hundred twenty-seven of the subjects also went through resting-state functional magnetic resonance imaging scans. Five ADHD-related brain functional networks, including the default mode network (DMN), the dorsal attention network (DAN), the ventral attention network, the executive control network, and the salience network, were built using predefined regions of interest (ROIs). Voxel-based group-wise comparisons were performed. Results Compared with healthy controls, all ADHD groups presented more clinical problems and weaker cognitive function. Among the ADHD groups, the ADHD-C group had the most clinical problems, especially delinquent and aggressive behaviors. Regarding cognitive function, the ADHD-RI group displayed the most impaired sustained attention, and the ADHD-C group had the worst response inhibition function. In terms of brain functional connectivity (FC), reduced FC in the DMN was identified in the ADHD-C and the ADHD-I groups but not the ADHD-RI group, compared to the healthy controls. Subjects with ADHD-I also presented decreased FC in the DAN in contrast to the control group. The ADHD-RI displayed marginally significantly lower FC in the salience network compared to the ADHD-I and the control groups. Conclusion The ADHD-RI group is distinguishable from the ADHD-I and the ADHD-C groups. It is characterized by fewer externalizing behaviors, worse sustained attention, and better response inhibition function. The absence of abnormally high hyperactive/impulsive symptoms in ADHD-RI might be related to less impaired brain function in DMN, but potentially more impairment in the salience network.
Collapse
Affiliation(s)
- Zhao-Min Wu
- Shenzhen Children's Hospital, Shenzhen, China
- *Correspondence: Zhao-Min Wu,
| | - Peng Wang
- Cardiac Rehabilitation Center, Fuwai Hospital, CAMS and PUMC, Beijing, China
| | - Juan Liu
- Shenzhen Children's Hospital, Shenzhen, China
| | - Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | | | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Li Yang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Qing-Jiu Cao
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Yu-Feng Wang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
- Yu-Feng Wang,
| | - Bin-Rang Yang
- Shenzhen Children's Hospital, Shenzhen, China
- Bin-Rang Yang,
| |
Collapse
|
2
|
Rogers EA, Graves SJ, Freeman AJ, Paul MG, Etcoff LM, Allen DN. Improving accuracy of ADHD subtype diagnoses with the ADHD symptom rating scale. Child Neuropsychol 2022; 28:962-978. [DOI: 10.1080/09297049.2022.2044768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Erick A. Rogers
- Department of Psychology, Box 455030, University of Nevada, Las Vegas, NV, USA
| | - Stacy J. Graves
- Department of Psychology, Box 455030, University of Nevada, Las Vegas, NV, USA
| | - Andrew J. Freeman
- Department of Psychology, Box 455030, University of Nevada, Las Vegas, NV, USA
| | - Michelle G. Paul
- Department of Psychology, Box 455030, University of Nevada, Las Vegas, NV, USA
| | - Lewis M. Etcoff
- Department of Psychology, Box 455030, University of Nevada, Las Vegas, NV, USA
| | - Daniel N. Allen
- Department of Psychology, Box 455030, University of Nevada, Las Vegas, NV, USA
| |
Collapse
|
3
|
Krakowski AD, Szatmari P, Crosbie J, Schachar R, Duku E, Georgiades S, Anagnostou E. Latent Structure of Combined Autistic and ADHD Symptoms in Clinical and General Population Samples: A Scoping Review. Front Psychiatry 2021; 12:654120. [PMID: 34987421 PMCID: PMC8721217 DOI: 10.3389/fpsyt.2021.654120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Many phenotypic studies have estimated the degree of comorbidity between Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), but few have examined the latent, or unobserved, structure of combined ASD and ADHD symptoms. This is an important perquisite toward better understanding the overlap between ASD and ADHD. Methods: We conducted a scoping review of studies that examined the factor or latent class structure of ASD and ADHD symptoms within the same clinical or general population sample. Results: Eight studies met final inclusion criteria. Four factor analysis studies found that ASD and ADHD domains loaded separately and one found that some ASD and ADHD domains loaded together. In the three latent class studies, there were evidence of profiles with high levels of co-occurring ASD and ADHD symptoms. Conclusions: Our scoping review provides some evidence of phenotypic overlap between ASD and ADHD at the latent, or unobserved, level, particularly when using a "person-centered" (latent class analysis) vs. a "variable-centered" (factor analysis) approach.
Collapse
Affiliation(s)
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Hospital for Sick Children, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Hospital for Sick Children, Toronto, ON, Canada
| | - Russell Schachar
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, McMaster Children's Hospital and McMaster University, Hamilton, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, McMaster Children's Hospital and McMaster University, Hamilton, ON, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
4
|
Katsuki D, Yamashita H, Yamane K, Kanba S, Yoshida K. Clinical Subtypes in Children with Attention-Deficit Hyperactivity Disorder According to Their Child Behavior Checklist Profile. Child Psychiatry Hum Dev 2020; 51:969-977. [PMID: 32166459 DOI: 10.1007/s10578-020-00977-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study sought to identify subgroups of attention-deficit hyperactivity disorder (ADHD) defined by specific patterns of emotional and behavioral symptoms according to the parent-rated Child Behavior Checklist (CBCL). Our clinical sample comprised 314 children (aged 4 to 15 years) diagnosed with ADHD according to the DSM-5. In addition, comorbid psychiatric disorders, general functioning, and medication status were assessed. Cluster analysis was performed on the CBCL syndrome subscales and yielded a solution with four distinct subgroups. The "High internalizing/externalizing" group displayed an overlap between internalizing and externalizing problems in the CBCL profile. In addition, the "High internalizing/externalizing" group revealed a high rate of comorbid autism spectrum disorder and elevated autistic traits. The "Inattention and internalizing" group revealed a high rate of the predominantly inattentive presentation according to ADHD specifier from the DSM-5. The "Aggression and externalizing" group revealed a high rate of comorbid oppositional defiant disorder and conduct disorder. The "Less psychopathology" group scored low on all syndrome scales. Children with ADHD were subdivided into four distinct subgroups characterized by psychopathological patterns, with and without internalizing and externalizing problems. The overlap between internalizing and externalizing problems may be mediated with emotional dysregulation and associated neurobiological bases.
Collapse
Affiliation(s)
- Daisuke Katsuki
- Department of Child Psychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashiku, Fukuoka City, Fukuoka, 8128582, Japan.
| | - Hiroshi Yamashita
- Department of Child Psychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenichi Yamane
- Department of Child Psychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigenobu Kanba
- Japan Depression Center, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashiku, Fukuoka City, Fukuoka, 8128582, Japan
| | - Keiko Yoshida
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashiku, Fukuoka City, Fukuoka, 8128582, Japan.,Iris Psychiatric Clinic, Fukuoka, Japan
| |
Collapse
|
5
|
Jacobson LA, Pritchard AE, Koriakin TA, Jones KE, Mahone EM. Initial Examination of the BRIEF2 in Clinically Referred Children With and Without ADHD Symptoms. J Atten Disord 2020; 24:1775-1784. [PMID: 27519529 PMCID: PMC5303680 DOI: 10.1177/1087054716663632] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Clinical utility of the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) was examined in 1,381 clinically referred youth (62.5% male, 5 to 18 years) with and without ADHD symptoms. Method: Participants included children with restricted inattentive symptoms (IA only), restricted hyperactivity/impulsivity symptoms (HI only), symptoms in both domains (Combined), and non-ADHD clinical comparison. Results: Greater hyperactivity (Combined, HI only) was associated with higher Behavior Regulation (BRI) and Emotion Regulation (ERI) scores, whereas greater inattentiveness (IA only, Combined) was associated with higher Cognitive Regulation scores. Effect sizes were largest for Inhibit, Working Memory, and Organization of Materials scales; these scales discriminated children with and without ADHD symptoms and restricted inattentive and hyperactive presentations. Conclusion: The BRIEF2 distinguishes associated features of ADHD and the day-to-day executive impact. Sensitivity was consistently poorer than specificity. The referred nature of the sample and examination of restricted presentations suggest additional work is needed to examine whether ERI and BRI are dissociable.
Collapse
Affiliation(s)
- Lisa A. Jacobson
- Kennedy Krieger Institute, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alison E. Pritchard
- Kennedy Krieger Institute, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Kelly E. Jones
- Kennedy Krieger Institute, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E. Mark Mahone
- Kennedy Krieger Institute, Baltimore, MD, USA,Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
6
|
Karalunas SL, Gustafsson HC, Fair D, Musser ED, Nigg JT. Do we need an irritable subtype of ADHD? Replication and extension of a promising temperament profile approach to ADHD subtyping. Psychol Assess 2018; 31:236-247. [PMID: 30359050 DOI: 10.1037/pas0000664] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is emblematic of unresolved heterogeneity in psychiatric disorders-the variation in biological, clinical, and psychological correlates that impedes progress on etiology. One approach to this problem is to characterize subgroups using measures rooted in biological or psychological theory, consistent with the National Institute of Mental Health's research domain criteria initiative. Within ADHD, a promising application involves using emotion trait profiles that can address the role of irritability as a complicating feature for ADHD. Here, a new sample of 186 children with ADHD was evaluated using community detection analysis to determine if meaningful subprofiles existed and if they replicated those previously identified. The new sample and a prior sample were pooled for evaluation of (a) method dependence, (b) longitudinal assessment of the stability of classifications, and (c) clinical prediction 2 years later. Three temperament profiles were confirmed within the ADHD group: one with normative emotional functioning ("mild"), one with high surgency ("surgent"), and one with high negative affect ("irritable"). Profiles were similar across statistical clustering approaches. The irritable group had the highest external validity: It was moderately stable over time and it enhanced prospective prediction of clinical outcomes beyond standard baseline indicators. The irritable group was not reducible to ADHD + oppositional defiant disorder, ADHD + disruptive mood dysregulation disorder, or other patterns of comorbidity. Among the negative affect domains studied, trait proneness to anger uniquely contributed to clinical prediction. Results extend our understanding of chronic irritability in psychiatric disorders and provide prospects for a fresh approach to assessing ADHD heterogeneity focused on the distinction between ADHD with and without anger/irritability. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | - Damien Fair
- Department of Psychiatry, Oregon Health & Science University
| | - Erica D Musser
- Department of Psychology, Florida International University
| | - Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University
| |
Collapse
|
7
|
van der Meer JMJ, Lappenschaar MGA, Hartman CA, Greven CU, Buitelaar JK, Rommelse NNJ. Homogeneous Combinations of ASD-ADHD Traits and Their Cognitive and Behavioral Correlates in a Population-Based Sample. J Atten Disord 2017; 21:753-763. [PMID: 24819924 DOI: 10.1177/1087054714533194] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Autism Spectrum Disorders (ASD) and ADHD are assumed to be the extreme manifestations of continuous heterogeneous traits that frequently co-occur. This study aims to identify subgroups of children with distinct ASD-ADHD trait profiles in the general population, using measures sensitive across both trait continua, and show how these subgroups differ in cognitive functioning. METHOD We examined 378 children (6-13 years) from a population-based sample. RESULTS Latent class analyses (LCA) detected three concordant classes with low (10.1%), medium (54.2%), or high (13.2%) scores on both traits, and two discordant classes with more ADHD than ASD characteristics (ADHD > ASD, 18.3%) and vice versa (ASD > ADHD, 4.2%). Findings suggest that ASD and ADHD traits usually are strongly related in the unaffected population, and that a minority of children displays atypical discordant trait profiles characterized by differential visual-spatial functioning. CONCLUSION This dissociation suggests that heterogeneity in ASD and ADHD is rooted in heterogeneity in the lower unaffected end of the distribution.
Collapse
Affiliation(s)
- Jolanda M J van der Meer
- 1 Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.,2 Karakter Child and Adolescent Psychiatry University Center Nijmegen, Nijmegen The Netherlands
| | | | - Catharina A Hartman
- 4 Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Corina U Greven
- 1 Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- 1 Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.,2 Karakter Child and Adolescent Psychiatry University Center Nijmegen, Nijmegen The Netherlands
| | - Nanda N J Rommelse
- 2 Karakter Child and Adolescent Psychiatry University Center Nijmegen, Nijmegen The Netherlands.,5 Department of Psychiatry, Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
8
|
DuPaul GJ, Morgan PL, Farkas G, Hillemeier MM, Maczuga S. Academic and Social Functioning Associated with Attention-Deficit/Hyperactivity Disorder: Latent Class Analyses of Trajectories from Kindergarten to Fifth Grade. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 44:1425-38. [PMID: 26750108 DOI: 10.1007/s10802-016-0126-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) are known to exhibit significantly lower academic and social functioning than other children. Yet the field currently lacks knowledge about specific impairment trajectories experienced by children with ADHD, which may constrain early screening and intervention effectiveness. Data were analyzed from a nationally representative U.S. cohort in the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K) for 590 children (72.7 % male) whose parents reported a formal diagnosis of ADHD. Children's math, reading, and interpersonal skills were assessed at 5 time points between kindergarten and fifth grade. Growth mixture model analyses indicated 4 latent trajectory classes for reading, 8 classes for math, and 4 classes for interpersonal skills. Membership in reading and math trajectory classes was strongly related; overlaps with interpersonal skills classes were weaker. Trajectory class membership was correlated with demographic characteristics and behavioral functioning. Children with ADHD display substantial heterogeneity in their reading, math, and interpersonal growth trajectories, with some groups of children especially likely to display relatively severe levels of academic and social impairment over time. Early screening and intervention to address impairment, particularly reading difficulties, among kindergarten students with ADHD is warranted.
Collapse
Affiliation(s)
- George J DuPaul
- Department of Education and Human Services, Lehigh University, 111 Research Drive, Bethlehem, PA, 18015, USA.
| | - Paul L Morgan
- Pennsylvania State University, University Park, PA, USA
| | | | | | - Steve Maczuga
- Pennsylvania State University, University Park, PA, USA
| |
Collapse
|
9
|
Ercan ES, Suren S, Bacanlı A, Yazıcı KU, Callı C, Ardic UA, Aygunes D, Kosova B, Ozyurt O, Aydın C, Rohde LA. Altered structural connectivity is related to attention deficit/hyperactivity subtypes: A DTI study. Psychiatry Res Neuroimaging 2016; 256:57-64. [PMID: 27130841 DOI: 10.1016/j.pscychresns.2016.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 01/21/2016] [Accepted: 04/08/2016] [Indexed: 11/24/2022]
Abstract
This study aimed to provide novel insights into the white matter (WM) microstructural properties of Attention Deficit/Hyperactivity Disorder (ADHD) subtypes by recruiting a relatively large sample of stimulant-naïve children and adolescents who had no comorbidity other than Oppositional Defiant Disorder and were homogenous according to the DAT1 gene polymorphism. A sample of 72 ADHD subjects and 24 controls aged 8-15 years were enrolled in the study. We applied tract-based spatial statistics to the DTI measures for obtaining fractional anisotropy (FA) and axial, radial diffusivity (AD, RD) measures to explore ADHD type-related differences in WM for the whole brain. Comparing ADHD-Combined group (ADHD-C) with the ADHD predominantly inattentive group (ADHD-I) we detected increased RD in several bilateral brain area and increased AD mostly in left side of the brain, including the body and splenium of the corpus callosum; the anterior and posteriors limbs of the internal capsule; the superior, anterior and posterior corona radiata; the posterior thalamic radiation; and the superior longitudinal fasciculus. Likewise, mostly in the overlapping brain areas, the ADHD-C group presented increased AD values than ADHD-RI. Significant differences among ADHD types could be a preliminary evidence that they have distinct microstructural properties. There were no significant differences in diffusivity between controls and both the ADHD group as whole or any ADHD subgroups.
Collapse
Affiliation(s)
- Eyup Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey.
| | | | | | - Kemal Utku Yazıcı
- Child and Adolescent Psychiatry Department, Medical Faculty, Fırat University, Elazığ, Turkey
| | - Cem Callı
- Radiology Department, Medical Faculty, Ege University, Turkey
| | - Ulku Akyol Ardic
- Denizli State Hospital, Child and Adolescent Psychiatry Department, Denizli, Turkey
| | - Duygu Aygunes
- Medical Biology Department, Medical Faculty, Ege University, Turkey
| | - Buket Kosova
- Medical Biology Department, Medical Faculty, Ege University, Turkey
| | - Onur Ozyurt
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Cahide Aydın
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Luis Augusto Rohde
- ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents, Brazil
| |
Collapse
|
10
|
Ercan ES, Suren S, Bacanlı A, Yazici KU, Callı C, Ozyurt O, Aygunes D, Kosova B, Franco AR, Rohde LA. Decreasing ADHD phenotypic heterogeneity: searching for neurobiological underpinnings of the restrictive inattentive phenotype. Eur Child Adolesc Psychiatry 2016; 25:273-82. [PMID: 26058607 DOI: 10.1007/s00787-015-0731-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/30/2015] [Indexed: 11/25/2022]
Abstract
During the process of developing the DSM-5, a new phenotype of ADHD was proposed-the ADHD restrictive inattentive presentation (ADHD-RI), describing subjects with high endorsement of inattentive symptoms and a low level of hyperactivity. However, this phenotype was not included in the DSM-5 because of the lack of robust neurobiological data. We aimed to assess the specific neurobiological underpinnings of individuals presenting ADHD-RI. We compared a sample of 301 subjects (101 ADHD-Combined; 50 ADHD-RI; 50 ADHD predominantly inattentive type and 100 typically developing subjects) aged 8-15 years, using a complete neuropsychological battery, molecular genetic data (DRD4 and DAT1 most studied polymorphisms) and functional MRI during a Go-No/Go task. Subjects with ADHD-RI had a significantly different neuropsychological profile compared with the other groups, including lower psychomotor speeds, longer reaction times and the worst overall performance in the global neurocognitive index. The proportion of subjects with the presence of DRD4-7 repeat allele was significantly higher in ADHD-RI. The fMRI data suggested that more attention-related posterior brain regions (especially temporo-occipital areas) are activated in ADHD-RI during both Go and No-Go cues compared to TD controls and ADHD predominantly inattentive type. ADHD-RI may represent a different phenotype than other types of ADHD. In addition, our results suggest that reducing the phenotypic heterogeneity may aid in the search for the neurobiological underpinnings of ADHD.
Collapse
Affiliation(s)
- Eyup Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey.
| | | | | | - Kemal Utku Yazici
- Child and Adolescent Psychiatry Department, Medical Faculty, Fırat University, Elazig, Turkey
| | - Cem Callı
- Radiology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Onur Ozyurt
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Duygu Aygunes
- Medical Biology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Buket Kosova
- Medical Biology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Alexandre Rosa Franco
- Brain Institute of Rio Grande do Sul (InsCer), PUCRS, Porto Alegre, Brazil.,School of Engineering, PUCRS, Porto Alegre, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| |
Collapse
|
11
|
Mazaheri A, Fassbender C, Coffey-Corina S, Hartanto TA, Schweitzer JB, Mangun GR. Differential oscillatory electroencephalogram between attention-deficit/hyperactivity disorder subtypes and typically developing adolescents. Biol Psychiatry 2014; 76:422-9. [PMID: 24120092 PMCID: PMC3972379 DOI: 10.1016/j.biopsych.2013.08.023] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 08/15/2013] [Accepted: 08/22/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND A neurobiological-based classification of attention-deficit/hyperactivity disorder (ADHD) subtypes has thus far remained elusive. The aim of this study was to use oscillatory changes in the electroencephalogram (EEG) related to informative cue processing, motor preparation, and top-down control to investigate neurophysiological differences between typically developing (TD) adolescents, and those diagnosed with predominantly inattentive (IA) or combined (CB) (associated with symptoms of inattention as well as impulsivity/hyperactivity) subtypes of ADHD. METHODS The EEG was recorded from 57 rigorously screened adolescents (12 to 17 years of age; 23 TD, 17 IA, and 17 CB), while they performed a cued flanker task. We examined the oscillatory changes in theta (3-5 Hz), alpha (8-12 Hz), and beta (22-25 Hz) EEG bands after cues that informed participants with which hand they would subsequently be required to respond. RESULTS Relative to TD adolescents, the IA group showed significantly less postcue alpha suppression, suggesting diminished processing of the cue in the visual cortex, whereas the CB group showed significantly less beta suppression at the electrode contralateral to the cued response hand, suggesting poor motor planning. Finally, both ADHD subtypes showed weak functional connectivity between frontal theta and posterior alpha, suggesting common top-down control impairment. CONCLUSIONS We found both distinct and common task-related neurophysiological impairments in ADHD subtypes. Our results suggest that task-induced changes in EEG oscillations provide an objective measure, which in conjunction with other sources of information might help distinguish between ADHD subtypes and therefore aid in diagnoses and evaluation of treatment.
Collapse
Affiliation(s)
- Ali Mazaheri
- Academic Medical Center, Department of Psychiatry, University of Amsterdam, The Netherlands.
| | - Catherine Fassbender
- M.I.N.D. Institute, University of California, Davis, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA,Imaging Research Center, University of California, Davis, CA, USA,Center for Mind and Brain, University of California, Davis, CA, USA
| | | | | | - Julie B. Schweitzer
- M.I.N.D. Institute, University of California, Davis, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - George R. Mangun
- Center for Mind and Brain, University of California, Davis, CA, USA,Department of Psychology, University of California, Davis, CA, USA,Department of Neurology, University of California, Davis, CA, USA
| |
Collapse
|
12
|
Hogue A, Dauber S, Lichvar E, Spiewak G. Adolescent and caregiver reports of ADHD symptoms among inner-city youth: agreement, perceived need for treatment, and behavioral correlates. J Atten Disord 2014; 18:212-25. [PMID: 22544384 PMCID: PMC3664252 DOI: 10.1177/1087054712443160] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study investigated adolescent and caregiver reports of ADHD symptoms in a sample of clinically referred inner-city adolescents. METHOD Participants (N = 168) included youth ages 12-18 (54% male, 98% ethnic minority) and their caregivers who each completed diagnostic interviews of ADHD symptoms and assessments of perceived need for ADHD treatment and correlated behavior problems. RESULTS Informants showed poor agreement on DSM-IV diagnostic categories and also dimensional scales, Inattention/Disorganization (I/D) and Hyperactivity/Impulsivity (H/I). Both caregiver and adolescent reports of I/D symptoms, but not H/I symptoms, were related to perceived need for ADHD treatment. Caregiver reports were linked to behavioral correlates typically associated with ADHD: I/D symptoms correlated with planning/organization and socioemotional deficits, and H/I symptoms correlated with externalizing and behavior regulation deficits. In contrast, adolescent reports of I/D were related to internalizing and externalizing problems, and their reports of H/I correlated with externalizing only. Few gender effects were found. CONCLUSION Study results underscore the developmental salience of I/D symptoms and have implications for ADHD diagnosis and treatment planning for adolescents.
Collapse
|
13
|
Abstract
OBJECTIVE Findings about the association of left-handedness and ADHD are inconsistent. While abnormal brain laterality is reported in children with ADHD, it is unclear if hand preference is associated with ADHD, severity symptoms, age, gender, comorbid psychiatric problems, or parental characteristics. METHOD Subjects were 520 boys and girls with a mean age of 9.04 (2.3) years. Only four children were with mixed-handedness. ADHD was diagnosed according to clinical assessment using accepted diagnostic criteria. In addition to the demographic characteristics and hand-use preference, inattention severity, hyperactivity severity, oppositional behavior symptoms, anxiety symptoms, and developmental coordination problems were assessed. RESULTS A total of 87.4% were right handed. A total of 12.6% were left handed. Left- or right-hand preference was not associated with age, gender, inattentiveness score, hyperactivity-impulsivity score, comorbid psychiatric problems, developmental coordination problems score, or parental characteristics. CONCLUSION Left handedness is not associated with higher parent-reported inattentiveness or hyperactivity. Hand-use preference is not gender related in ADHD.
Collapse
Affiliation(s)
- Ahmad Ghanizadeh
- Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Shiraz University of Medical Sciences, Iran.
| |
Collapse
|
14
|
Ghanizadeh A. Parents reported oral sensory sensitivity processing and food preference in ADHD. J Psychiatr Ment Health Nurs 2013; 20:426-32. [PMID: 22074155 DOI: 10.1111/j.1365-2850.2011.01830.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Oral sensory processing in children with attention deficit hyperactivity disorder (ADHD) is an area with limited research. Oppositional defiant disorder (ODD) and separation anxiety disorder (SAD) symptoms usually co-occur with ADHD. This study investigates the association of oral sensory processing problems with ODD and SAD symptoms in children with ADHD. The parents of 189 children with ADHD completed Oral Over- and Underresponsivity Behaviors Inventory reporting oral overresponsivity (OR) and underresponsivity (UR) of their children. Only ODD score predicted OR scale score. None of ADHD severity, anxiety score, age and gender predicted OR score. UR scale score was only predicted by SAD and inattention scores. ODD score and hyperactivity/impulsivity score did not predict UR score. The ODD behaviour in children with ADHD needs to be evaluated and managed more extensively and it should include oral sensory occupational therapy. Future studies should extend this research to children with ADHD and obesity and food reward system.
Collapse
Affiliation(s)
- A Ghanizadeh
- Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Shiraz University of Medical Sciences, Hafez Hospital, Shiraz, Iran.
| |
Collapse
|
15
|
Hogue A, Dauber S. Diagnostic Profiles among Urban Adolescents with Unmet Treatment Needs: Comorbidity and Perceived Need for Treatment. JOURNAL OF EMOTIONAL AND BEHAVIORAL DISORDERS 2013; 21:18-32. [PMID: 23997569 PMCID: PMC3753112 DOI: 10.1177/1063426611407500] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The goal of this study was to document comorbidity profiles of psychiatric disorder and perceived need for treatment among urban adolescents with unmet behavioral health needs. Participants were 303 community-referred adolescents and their primary caregivers. Adolescents included both boys (54%) and girls and were primarily Hispanic (58%), African American (23%), and multiracial (13%). Home-based interviews with both adolescents and caregivers were used to assess DSM-IV diagnoses and perceived treatment needs. Most adolescents (80%) were diagnosed with multiple disorders and most families (66%) reported a need to treat more than one disorder. Latent class analysis of endorsed DSM-IV disorders identified five distinct diagnostic profiles: Parental Concern, Adolescent Distress, Basic Externalizers, Severely Distressed, and Comorbid Externalizers. Diagnostic profiles were compared on perceived treatment need and related psychosocial risk characteristics. Implications for behavioral health care policy and practice for youth with unmet treatment needs are discussed.
Collapse
Affiliation(s)
- Aaron Hogue
- The National Center on Addiction and Substance Abuse at Columbia University
| | | |
Collapse
|
16
|
Are autism spectrum disorder and attention-deficit/hyperactivity disorder different manifestations of one overarching disorder? Cognitive and symptom evidence from a clinical and population-based sample. J Am Acad Child Adolesc Psychiatry 2012; 51:1160-1172.e3. [PMID: 23101742 DOI: 10.1016/j.jaac.2012.08.024] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 08/22/2012] [Accepted: 08/28/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD) frequently co-occur. Given the heterogeneity of both disorders, several more homogeneous ASD-ADHD comorbidity subgroups may exist. The current study examined whether such subgroups exist, and whether their overlap or distinctiveness in associated comorbid symptoms and cognitive profiles gives support for a gradient overarching disorder hypothesis or a separate disorders hypothesis. METHOD Latent class analysis was performed on Social Communication Questionnaire (SCQ) and Conners' Parent Rating Scale (CPRS-R:L) data for 644 children and adolescents (5 through 17 years of age). Classes were compared for comorbid symptoms and cognitive profiles of motor speed and variability, executive functioning, attention, emotion recognition, and detail-focused processing style. RESULTS Latent class analysis revealed five classes: two without behavioral problems, one with only ADHD behavior, and two with both clinical symptom levels of ASD and ADHD but with one domain more prominent than the other (ADHD[+ASD] and ASD[+ADHD]). In accordance with the gradient overarching disorder hypothesis were the presence of an ADHD class without ASD symptoms and the absence of an ASD class without ADHD symptoms, as well as cognitive functioning of the simple ADHD class being less impaired than that of both comorbid classes. In conflict with this hypothesis was that there was some specificity of cognitive deficits across classes. CONCLUSIONS The overlapping cognitive deficits may be used to further unravel the shared etiological underpinnings of ASD and ADHD, and the nonoverlapping deficits may indicate why some children develop ADHD despite their enhanced risk for ASD. The two subtypes of children with both ASD and ADHD behavior will most likely benefit from different clinical approaches.
Collapse
|
17
|
Smith LC, Tamm L, Hughes CW, Bernstein IH. Separate and overlapping relationships of inattention and hyperactivity/impulsivity in children and adolescents with attention-deficit/hyperactivity disorder. ACTA ACUST UNITED AC 2012; 5:9-20. [PMID: 22996914 DOI: 10.1007/s12402-012-0091-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 08/30/2012] [Indexed: 11/24/2022]
Abstract
There is debate regarding the dimensional versus categorical nature of attention-deficit/hyperactivity disorder (ADHD). This study utilized confirmatory factor analysis to examine this issue. ADHD symptoms rated on interviews and rating scales from a large sample of individuals (ages 3-17, 74 % male, 75 % Caucasian) with ADHD were examined (n = 242). Four potential factor structures were tested to replicate prior findings in a sample with a wide age range and included only participants who met DSM-IV-TR diagnostic criteria for ADHD. Correlations with executive function measures were performed to further assess the separability and validity of the derived factors. The data support a bifactor model with a general ADHD factor and two specific factors, inattention and hyperactivity/impulsivity. Importantly, the individual factors were also differentially correlated with executive functioning measures. This study adds to a growing literature suggesting both a general component to ADHD, as well as dimensional traits of inattention and hyperactivity/impulsivity, associated with distinct executive functioning profiles. The presence of a general underlying factor contraindicates separating the inattentive and combined subtypes of ADHD into distinct disorders.
Collapse
Affiliation(s)
- Lauren C Smith
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8589, USA
| | | | | | | |
Collapse
|
18
|
Kóbor A, Takács Á, Urbán R, Csépe V. The latent classes of subclinical ADHD symptoms: convergences of multiple informant reports. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:1677-1689. [PMID: 22584200 DOI: 10.1016/j.ridd.2012.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 04/06/2012] [Accepted: 04/10/2012] [Indexed: 05/31/2023]
Abstract
The purpose of the present study was to conduct latent class analysis on the Hyperactivity scale of the Strengths and Difficulties Questionnaire in order to identify distinct subgroups of subclinical ADHD in a multi-informant framework. We hypothesized a similar structure between teachers and parents, and differences in symptom severity across latent classes. Data was collected from a non-referred sample of children aged 8-13 years. We performed latent class analyses on parent (n = 383) and teacher (n = 391) ratings of the Hyperactivity scale items from both versions of the questionnaire. Those children who had ratings from both informants (n = 272) were included in the cross-informant analyses, in which the similar or equivalent classes across raters were determined. A three-class solution for parent report and a five-class solution for teacher report emerged in the subsample of boys. For girls, a three-class structure for parents and a four-class structure for teachers were optimal. Besides non-symptomatic groups, mild and severe combined classes, mild inattentive-impulsive classes, and among boys, a mild hyperactive-impulsive class was obtained. The cross-informant analyses demonstrated that quite similar subgroups were detached regardless of informant; however, the teacher classes were somewhat more elaborated. The results are in line with the previous latent class analytic studies, and support the combination of dimensional and categorical approaches. The importance of milder symptoms and sub-threshold ADHD categories are emphasized for the fields of neuropsychology, neuroscience, and education, as well as for diagnosis and personalized treatment.
Collapse
Affiliation(s)
- Andrea Kóbor
- Doctoral School of Psychology, Eötvös Loránd University, Izabella utca 46, H-1064 Budapest, Hungary.
| | | | | | | |
Collapse
|
19
|
Frick PJ, Nigg JT. Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Annu Rev Clin Psychol 2011; 8:77-107. [PMID: 22035245 PMCID: PMC4318653 DOI: 10.1146/annurev-clinpsy-032511-143150] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This review evaluates the diagnostic criteria for three of the most common disorders for which children and adolescents are referred for mental health treatment: attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Although research supports the validity and clinical utility of these disorders, several issues are highlighted that could enhance the current diagnostic criteria. For ADHD, defining the core features of the disorder and its fit with other disorders, enhancing the validity of the criteria through the lifespan, considering alternative ways to form subtypes of the disorder, and modifying the age-of-onset criterion are discussed relative to the current diagnostic criteria. For ODD, eliminating the exclusionary criteria of CD, recognizing important symptom domains within the disorder, and using the cross-situational pervasiveness of the disorder as an index of severity are highlighted as important issues for improving classification. Finally, for CD, enhancing the current subtypes related to age of onset and integrating callous-unemotional traits into the diagnostic criteria are identified as key issues for improving classification.
Collapse
Affiliation(s)
- Paul J Frick
- Department of Psychology, University of New Orleans, New Orleans, Louisiana 70148, USA.
| | | |
Collapse
|
20
|
Schmitz M, Ludwig H, Rohde LA. Do hyperactive symptoms matter in ADHD-I restricted phenotype? JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2011; 39:741-8. [PMID: 21058122 DOI: 10.1080/15374416.2010.517170] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The objective of the current study was to evaluate a proposed restrictive inattentive type of Attention Deficit Hyperactivity Disorder (ADHD) by comparing clinical correlates among youths with ADHD inattentive type (ADHD-I) as a function of the number of hyperactivity symptoms presented (none vs. 3 or less) and controls (individuals without ADHD). The sample for this community-based study was comprised of youths aged 6 to 18 years from 12 public schools in Porto Alegre, Brazil. ADHD-I groups had lower levels of adaptive functioning (p < .001) and a higher occurrence of familial ADHD (p < .001) when compared with the controls. There was no significant difference between the two ADHD-I groups. Also, both ADHD-I groups had higher rates of oppositional defiant disorder than controls (p < .001) without significant difference between them. For generalized anxiety disorder and social phobia, only the ADHD-I without HI group showed significant differences compared to controls.
Collapse
Affiliation(s)
- Marcelo Schmitz
- Child and Adolescent Psychiatric Division, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil.
| | | | | |
Collapse
|
21
|
Reiersen AM, Todorov AA. Association between DRD4 genotype and Autistic Symptoms in DSM-IV ADHD. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2011; 20:15-21. [PMID: 21286365 PMCID: PMC3024719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 12/17/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To explore the association of the DRD4 exon 3 7-repeat allele with clinically significant levels of autistic symptoms among children and adolescents with DSM-IV Attention-Deficit/Hyperactivity Disorder (ADHD). METHODS Subjects included in the main analysis were 954 Missouri-born twins from a study of the genetic epidemiology of ADHD with complete data on DSM-IV ADHD diagnosis, DRD4 genotype and the parent-rated Social Responsiveness Scale (SRS). Logistic regression was used to investigate the association of the DRD4 7-repeat allele with clinically elevated SRS score. RESULTS Among individuals with DSM-IV ADHD (any subtype), the DRD4 7-repeat allele was associated with high SRS score. The distribution of raw SRS scores appeared bimodal among subjects with at least one copy of the DRD4 7-repeat allele, suggesting a possible interaction between this DRD4 genotype and other, unmeasured variables. CONCLUSIONS The DRD4 7-repeat allele may increase the risk for clinically elevated autistic symptoms in children and adolescents with ADHD. Further studies are needed to confirm this finding and explore the role of specific gene-gene and gene-environment interactions in the development of autistic symptoms and other co-occurring psychopathology among individuals with ADHD.
Collapse
Affiliation(s)
- Angela M. Reiersen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Alexandre A. Todorov
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
22
|
Goth-Owens TL, Martinez-Torteya C, Martel MM, Nigg JT. Processing speed weakness in children and adolescents with non-hyperactive but inattentive ADHD (ADD). Child Neuropsychol 2010; 16:577-91. [PMID: 20560083 DOI: 10.1080/09297049.2010.485126] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
DSM-IV-TR defines ADHD-Predominantly Inattentive as allowing up to five symptoms of hyperactivity/impulsivity, while theories of the inattentive type usually assume a group that is hypoactive and characterized by processing speed and cognitive interference deficits. In a community-recruited sample of 572 children and adolescents, a pure inattentive subtype of ADHD (ADD) was defined as those who met DSM-IV-TR criteria for ADHD-PI but had two or fewer hyperactive/impulsive symptoms. Processing and output speeds of those with ADD were compared to those identified with DSM-IV-TR ADHD combined type and non-ADHD controls. These results were then contrasted with those found when DSM-IV-TR defined ADHD-PI was compared with ADHD-C and controls. Processing and output speed were assessed with the Trailmaking A and B and the Stroop Naming Tests. Cognitive interference control was assessed with the interference score from the Stroop Task. Slower cognitive interference speed was found in the ADD vs. ADHD-C and controls comparisons, but not the ADHD-PI versus ADHD-C and controls comparisons. On output speed measures, ADD exhibited the slowest performance, significantly different from controls and the effect size for the set-shifting speed contrast (Trailmaking B) was double that of the ADHD-PI vs. control comparison. ADHD-Inattentive type as defined by the DSM-IV-TR is a heterogeneous condition with a meaningful proportion of those affected exhibiting virtually no hyperactive/impulsive symptoms. This subgroup may represent a distinct inattentive condition characterized by poor cognitive interference control and slow processing or output speed.
Collapse
|
23
|
Ghanizadeh A. The predictors of parent reported behaviors related to olfactory information processing in children with ADHD. Psychiatry Investig 2010; 7:116-21. [PMID: 20577620 PMCID: PMC2890865 DOI: 10.4306/pi.2010.7.2.116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 03/08/2010] [Accepted: 03/15/2010] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder with contradictory findings about smell detection function. It is not clear if the parent perceived behavior related to olfactory function is associated with age, gender, severity of ADHD, and cooccurring symptoms of anxiety and oppositional behavior in children with ADHD. METHODS Participants were a clinical sample of 104 children and adolescents with ADHD using DSM-IV diagnostic criteria by a semi-structured interview. Parent perceived behavior related to olfactory processing function was assessed trough a questionnaire. The parent reported Olfactory Functioning Checklist was used to evaluate "seeking behavior and over-responsiveness to smell (SSBO)" and "smell detection ability (SDA)". RESULTS ADHD and separation anxiety symptoms count (severity) predicted the SDA scale score. None of the variables of gender, age, ADHD subtypes, co-morbidity with oppositional defiant disorder (ODD), and symptom count of ODD predicted SSBO and SDA scales' scores. CONCLUSION Parent reported behavior related to olfactory detection impairment increased with higher ADHD and anxiety severity. It is independent of age and gender.
Collapse
Affiliation(s)
- Ahmad Ghanizadeh
- Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry, Shiraz University of Medical Sciences, Hafez Hospital, Shiraz, Iran
| |
Collapse
|
24
|
Carr L, Henderson J, Nigg JT. Cognitive control and attentional selection in adolescents with ADHD versus ADD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2010; 39:726-40. [PMID: 21058121 PMCID: PMC3059559 DOI: 10.1080/15374416.2010.517168] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
An important research question is whether Attention Deficit Hyperactivity Disorder (ADHD) is related to early- or late-stage attentional control mechanisms and whether this differentiates a nonhyperactive subtype (ADD). This question was addressed in a sample of 145 ADD/ADHD and typically developing comparison adolescents (aged 13-17). Attentional blink and antisaccade tasks were used to assay early- and late-stage control, respectively. ADD was defined using normative cutoffs to ensure low activity level in children who otherwise met full criteria for ADHD. The ADD group had an attenuated attentional blink versus controls and ADHD-combined. The effect was not produced using DSM--IV definition of ADHD-primarily inattentive type or DSM symptom counts. ADHD-combined showed greater weakness in response inhibition, as manifest in the antisaccade task. Combining tasks yielded an interaction differentiating group performance on the two tasks.
Collapse
Affiliation(s)
- Laurie Carr
- Department of Psychology, Michigan State University, USA.
| | | | | |
Collapse
|
25
|
Swanson JM, Wigal T, Lakes K. DSM-V and the future diagnosis of attention-deficit/hyperactivity disorder. Curr Psychiatry Rep 2009; 11:399-406. [PMID: 19785982 PMCID: PMC3632645 DOI: 10.1007/s11920-009-0060-7] [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] [Indexed: 10/20/2022]
Abstract
In general, recommendations for the DSM-V and future diagnoses of psychiatric disorders include a dimensional approach to complement the standard categorical approach. For the assessment of attention-deficit/hyperactivity disorder (ADHD), dimensional approaches to supplement the rigid categorical approach of the DSM-IV abound. Historically, dimensions based on severity of symptoms of ADHD and severity of general psychopathology have been used. General dimensional approaches described by a workgroup organized by the American Psychiatric Association are reviewed to provide background and context for a discussion of old and new dimensional approaches to complement future categorical diagnosis of ADHD in the DSM-V.
Collapse
|