Co‐occurrence of conduct disorder and depression in a clinic‐based sample of boys with ADHD

Drabick, Deborah A. G.; Gadow, Kenneth D.; Sprafkin, Joyce

doi:10.1111/j.1469-7610.2006.01625.x

Cited by 84 publications

(92 citation statements)

References 48 publications

(72 reference statements)

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“…Consistent with other findings (Garland & Garland, 2001) and the separate ODD and GAD literatures (Burke et al, 2002;Donovan & Spence, 2000), ODD/M + GAD/M was associated with higher levels of familial conflict and more co-occurring symptoms than the ODD/M, GAD/M, and comparison groups. The teacher-defined, source-specific syndrome groups (ODD/T Only, GAD/T Only) were differentiated from each other on more measures than the mother-defined counterparts, similar to previous research indicating that psychosocial correlates vary depending on informant used (e.g., Boyle et al, 1996;Cluett et al, 1998;Drabick et al, 2006). Teachers and mothers reported elevated CD symptoms in the ODD/T Only symptom group and teachers reported elevated MDD symptoms in the GAD/T Only symptom group, indicating that co-occurring symptoms for the teacher-defined groups were consistent with their respective broad-band internalizing/externalizing spectra (Achenbach, 1991a, b).…”

Section: Discussionsupporting

confidence: 66%

“…As has been the case in previous research (e.g., Drabick et al, 2006;Gadow et al, 2004;Kazdin, 1989;MacLeod et al, 1999;Rubio-Stipec et al, 2003), the psychosocial correlates associated with both within-informant or mixed-informant symptom groups were often dependent on the informant used to define the symptom groups. For example, mother-rated parental detachment was higher for mother-rated ODD symptom groups.…”

Section: Discussionmentioning

confidence: 80%

“…For instance, boys in the ODD/M + GAD/T group obtained higher teacher ADHD:C ratings than the ODD/M Only group, indicating that children who are perceived as anxious, inattentive, and hyperactive/impulsive in school are more likely to be oppositional at home. Alternatively, the contextual demands of the school setting may minimize the display of ODD behaviors and/or exacerbate the display of ADHD:C behaviors.As has been the case in previous research (e.g., Drabick et al, 2006;Gadow et al, 2004;Kazdin, 1989;MacLeod et al, 1999;Rubio-Stipec et al, 2003), the psychosocial correlates associated with both within-informant or mixed-informant symptom groups were often dependent on the informant used to define the symptom groups. For example, mother-rated parental detachment was higher for mother-rated ODD symptom groups.…”

mentioning

confidence: 80%

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Co-Occurring ODD and GAD Symptom Groups: Source-Specific Syndromes and Cross-Informant Comorbidity

Drabick

Gadow

Loney

2008

Journal of Clinical Child & Adolescent Psychology

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Despite important clinical and nosological implications, the comorbidity of oppositional defiant disorder (ODD) and generalized anxiety disorder (GAD) has received little attention. A clinicbased sample of 243 boys (ages 6-10 years), their parents, and teachers participated in an evaluation that involved assessments of behavioral, academic, and family functioning. ODD and GAD symptom groups were defined using various combinations of mother and teacher reports. ODD symptom groups were associated with conduct disorder symptoms, and GAD symptom groups with major depressive disorder symptoms, regardless of rater. Attention deficit/ hyperactivity disorder (ADHD) symptoms were associated with ODD and GAD symptom groups; however, covarying ADHD symptoms altered few findings. The ODD+GAD symptom groups were associated with higher rates of co-occurring symptoms and risk factors within (sourcespecific syndromes) and across (cross-informant comorbidity) informants.Although comorbidity is more the rule than the exception among child emotional and behavioral disorders (Angold, Costello, & Erkanli, 1999;Lilienfeld, 2003), the cooccurrence of oppositional defiant disorder (ODD) and generalized anxiety disorder (GAD) has received relatively little attention in spite of the fact that ODD likely alters the course, correlates, and treatment response for children with GAD (Flannery-Schroeder, Suveg, Safford, Kendall, & Webb, 2004;Garland & Garland, 2001;Kendall, Panichelli-Mindel, Sugarman, & Callahan, 1997). For instance, oppositional behavior in the context of an anxiety disorder may lead to reluctance to engage in exposures and comply with treatment. In addition, parents of children with anxiety disorders report that their children's oppositional behavior is particularly difficult to manage (Garland & Garland, 2001). Unfortunately, research to date generally has examined overanxious disorder, which was replaced by GAD in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.[DSM-IV]; American Psychiatric Association, 1994), and/or has combined multiple anxiety or disruptive behavior disorders (for reviews, see Angold et al., 1999;Russo & Beidel, 1994), which obscures specific relations between ODD and GAD. Copyright © Taylor & Francis Group, LLCCorrespondence should be addressed to Deborah A. G. Drabick, Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA 19122-6085. ddrabick@temple.edu. Publisher's Disclaimer: The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material. NIH Public AccessAuthor Manuscript J Clin Child Adolesc Psychol. Author...

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 80%

mentioning

confidence: 80%

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Co-Occurring ODD and GAD Symptom Groups: Source-Specific Syndromes and Cross-Informant Comorbidity

Drabick

Gadow

Loney

2008

Journal of Clinical Child & Adolescent Psychology

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“…But this overlap would be more embodied in Proposal 4, which emphasizes shared environmental risk factors, than in Proposal 1 that suggests co-occurrence by chance. But the findings are based on too few subjects to test reliably the shared ''toxic environment'' hypothesis (exemplified by Proposal 4: Taylor et al 1991;Drabick et al 2006). However, the implication is that a shared exposure to the same pathogenic features of the environment could be a contributor in some instances, for there were increased rates of all 3 disturbances assessed in the siblings of cases with ADHD þ CP.…”

Section: Support For the Proposals And Consistency With Other Findingsmentioning

confidence: 99%

“…Taylor and colleagues (1991) proposed that comorbid ADHD þ CD may be a separate condition arising mainly out of poor impulse control, and exacerbated by high parental expressed emotion. More recently Drabick et al (2006) also reported hostile, inconsistent, and detached parenting to be associated with CD symptoms in ADHD children. Consistent with this Hurtig et al (2007) reported that adolescents with comorbid CD exhibited more severe symptoms of ADHD than those without CD, and were more likely to come from nonintact families with disaffected mothers.…”

Section: Introductionmentioning

confidence: 99%

Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder

et al. 2008

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Summary. Common disorders of childhood and adolescence are attentiondeficit=hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD). For one to two cases in three diagnosed with ADHD the disorders may be comorbid. However, whether comorbid conduct problems (CP) represents a separate disorder or a severe form of ADHD remains controversial. We investigated familial recurrence patterns of the pure or comorbid condition in families with at least two children and one definite case of DSM-IV ADHDct (combined-type) as part of the International Multicentre ADHD Genetics Study (IMAGE). Using case diagnoses (PACS, parental account) and symptom ratings (Parent=Teacher Strengths and Difficulties [SDQ], and Conners Questionnaires [CPTRS]) we studied 1009 cases (241 with ADHDonly and 768 with ADHD þ CP), and their 1591 siblings. CP was defined as !4 on the SDQ conduct-subscale, and T ! 65, on Conners' oppositional-score. Multinomial logistic regression was used to ascertain recurrence risks of the pure and comorbid conditions in the siblings as predicted by the status of the cases. There was a higher relative risk to develop ADHD þ CP for siblings of cases with ADHD þ CP (RRR ¼ 4.9; 95%CI: 2.59-9.41); p < 0.001) than with ADHDonly. Rates of ADHDonly in siblings of cases with ADHD þ CP were lower but significant (RRR ¼ 2.9; 95%CI: 1.6-5.3, p < 0.001). Children with ADHD þ CP scored higher on the Conners ADHDct symptom-scales than those with ADHDonly. Our finding that ADHD þ CP can represent a familial distinct subtype possibly with a distinct genetic etiology is consistent with a high risk for cosegregation. Further, ADHD þ CP can be a more severe disorder than ADHDonly with symptoms stable from childhood through adolescence. The findings provide partial support for the ICD-10 distinction between hyperkinetic disorder (F90.0) and hyperkinetic conduct disorder (F90.1).

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Effectiveness of Child‐Centered Play Therapy and Person‐Centered Teacher Consultation on ADHD: A Single‐Case Study Design

Schottelkorb¹

2010

Child‐Centered Play Therapy Research

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Schottelkorb, April A. Effectiveness of child-centered play therapy and personcentered teacher consultation on ADHD behavioral problems of elementary school children: A single case design. Doctor of Philosophy (Counseling), December 2007, 197 pp., 7 tables, 63 figures, references, 75 titles. I examined the effectiveness of child-centered play therapy (CCPT) and personcentered teacher consultation (PCTC) for elementary school children identified with clinical or borderline levels of ADHD behaviors on the Teacher Report Form and the Conners' Teacher Rating Scale Revised -Short Form. Additionally, I examined the impact of CCPT and PCTC on the levels of parenting and teaching stress. Due to the current trend to determine interventions that are evidence-based through betweengroup or single case designs, for this study, I utilized a single case design experiment for which the behaviors of five children were examined. Trained observers utilized the Direct Observation Form in observations of all five students three times per week. Additionally, parents and teachers completed behavioral rating scales and stress inventories at pre-, mid-, and post-intervention. To prevent biased observational ratings, observers were blind to the assignment of the five children. Three students participated in 24 sessions of twice-weekly 30-minute sessions of CCPT, and these students' teachers participated in six sessions of once-weekly 10minute PCTC. Two students participated in twice-weekly 30-minute sessions of reading mentoring, after which they participated in 14 sessions of CCPT. Visual analysis of the data indicated mixed results. Three students demonstrated substantial improvement in the observed ADHD behaviors within the classroom. Results of the parent and teacher assessment data were inconsistent, but did indicate behavior change for some children and a reduction in teaching stress for one teacher. Parenting stress appeared unaffected. Implications for future research regarding the use of single case design, the measurement of student behavior change, and issues of comorbidity are indicated.

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Co‐occurrence of conduct disorder and depression in a clinic‐based sample of boys with ADHD

Cited by 84 publications

References 48 publications

Co-Occurring ODD and GAD Symptom Groups: Source-Specific Syndromes and Cross-Informant Comorbidity

Co-Occurring ODD and GAD Symptom Groups: Source-Specific Syndromes and Cross-Informant Comorbidity

Co-transmission of conduct problems with attention-deficit/hyperactivity disorder: familial evidence for a distinct disorder

Effectiveness of Child‐Centered Play Therapy and Person‐Centered Teacher Consultation on ADHD: A Single‐Case Study Design

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