Children with FA did not have increased anxiety; however, there was a trend for mothers of children with allergies to report more symptoms of panic disorder in their children. It remains important to screen families for anxiety-related symptoms and refer them to mental health services when indicated.
The psychometric properties of the parent-report version of the Inventory of Callous–Unemotional Traits (ICU) in school-aged children requires further examination. In a nationally representative sample of U.S. children ( N = 1,064, M age = 8.42, 51.7% boys), the current study examined the factor structure, measurement invariance, and the moderating role of parent rated ICU scores on conduct problems. Results supported (a) a two-factor model consisting of a CU factor and a limited prosocial emotions (LPE) factor; (b) an invariant structure of the ICU across child sex, as well as (to a lesser extent) across child age and parent sex; and (c) the moderating role of the LPE factor on the relationship between conduct problems and relevant outcomes (i.e., impairment, need for treatment). Normative data on the parent-report version of the ICU for elementary-aged school children in the United States were also presented. Clinical implications regarding use of the parent-report version of the ICU for school-aged children are discussed.
To date, there remains no consensus about the best evidence-based method for integrating multiple informant data in the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). Several approaches exist, including the psychometrically sound approach of averaging scores, as well as the use of "OR" and "AND" algorithms, which are still commonly used in research. The current study tested these major integration methods in their concurrent and longitudinal prediction of clinician-rated impairment, teacherrated academic, and parent-and self-rated social skill ratings in children overrecruited for ADHD across a 6-year span from childhood to adolescence. The sample included a total of 800 children, 480 with ADHD, ages 6 to 13, who completed a "gold standard" assessment of ADHD and associated impairment. Overall, the "OR," "AND," and average integration approaches showed significantly high interrelations with one another (r range from .78 to .96) and were all significantly and strongly related to impairment measures concurrently and longitudinally. Multivariate regressions demonstrated that the average integration approach concurrently and longitudinally out predicted the other two approaches. Results demonstrated that the average approach slightly outperformed the other two in its prediction of concurrent and longitudinal clinician-rated impairment, teacher-rated academic skills, and parent-and self-rated child social skills across childhood and adolescence. Evidence-based assessment integration of parent and teacher ratings of ADHD in childhood might best utilize an averaging approach, as it is most related to later impairment ratings, particularly if such findings are replicated by other groups.
Public Significance StatementAn average approach to integrating parent and teacher ratings of ADHD slightly outperforms other, more complicated integration approaches in prediction of later clinician-rated impairment, teacher-rated academic skills, and parent-and self-rated social skills. Therefore, average integration of ADHD symptom ratings may be the best and easiest integration approach for use in clinical practice.
Using network analysis and random forest regression, this study identified attention-deficit/hyperactivity disorder (ADHD) symptoms most important for indicating impairment in various functional domains. Participants comprised a nationally representative sample of 1249 adults in the United States. Bridge symptoms were identified as those demonstrating unique relations with impairment domains that, in total, were stronger than those involving other symptoms. Results suggested three inattentive (i.e., difficulty organizing; does not follow through; makes careless mistakes) and one hyperactive ( difficulty engaging in leisure activities) bridge symptoms. Random forest regression results supported bridge symptoms as most important (compared to other symptoms) for predicting global and specific impairment domains. Hyperactive/impulsive symptoms appeared more strongly related to impairment in women, whereas difficulty organizing and easily distracted appeared more related to impairment in men. Clarification of bridge symptoms may help identify core characteristics of ADHD in adulthood and specify screening and intervention targets to reduce risk for related impairment.
Girls with attention deficit hyperactivity disorder (ADHD) are at high risk of a range of socialemotional difficulties, including peer rejection, suicide attempts, and borderline personality disorder (BPD), which are associated with serious, long-term impairment and have not emerged as clearly in samples of boys with ADHD. BPD is a particularly concerning longterm outcome of ADHD in girls, given the high risk for suicidality and long-lasting relationship difficulties. Very little research has focused on treatment for the interpersonal impairments of girls with ADHD, or on addressing risk for developing BPD. This case study describes the use of behavioral parent training (BPT) with adjunctive social skills training (SST) to address the social-emotional difficulties of a 9-year-old girl, "Violet," who was diagnosed with ADHD Combined Presentation and was being treated with medication for anxiety. Violet presented with many social difficulties, including low self-esteem, emotional dysregulation, and unstable relationships, which were conceptualized as borderline personality features (BPF). Treatment was associated with improvements in parent functioning, including reductions in caregiver strain and inconsistent discipline, as well as improvements in child functioning, including reductions in ADHD symptoms, a range of impairments, and BPF. This case study illustrates the benefit of a brief psychosocial intervention in reducing multiple indices of interpersonal impairment, including BPF, for a girl with ADHD.
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