DSM-V and the future diagnosis of attention-deficit/hyperactivity disorder

Swanson, James M.; Wigal, Timothy; Lakes, Kimberley D.

doi:10.1007/s11920-009-0060-7

Cited by 28 publications

(32 citation statements)

References 46 publications

(119 reference statements)

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“…It seems clear that direct comparison of the relationships between symptom severity and brain-activation levels between ADHD-C and ADHD-I samples will be needed across several meaningful task contexts in order to shed further light on the question of unique versus shared etiological influence. Such a dimensional approach to analyses is consistent with recent thinking in psychiatry (Swanson et al, 2009), as well as the emphasis placed in DSM-V on clinical “presentations” of ADHD symptom domains, rather than diagnostic subtypes.…”

Section: Discussionsupporting

confidence: 67%

Brain activity in predominantly-inattentive subtype attention-deficit/hyperactivity disorder during an auditory oddball attention task

Orinstein

Stevens

2014

Psychiatry Research: Neuroimaging

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Previous functional neuroimaging studies have found brain activity abnormalities in attention-deficit/hyperactivity disorder (ADHD) on numerous cognitive tasks. However, little is known about brain dysfunction unique to the predominantly-inattentive subtype of ADHD (ADHD-I), despite debate as to whether DSM-IV-defined ADHD subtypes differ in etiology. This study compared brain activity of 18 ADHD-I adolescents (ages 12–18) and 20 non-psychiatric age-matched control participants on a functional magnetic resonance image (fMRI) auditory oddball attention task. ADHD-I participants had significant activation deficits to infrequent target stimuli in bilateral superior temporal gyri, bilateral insula, several midline cingulate/medial frontal gyrus regions, right posterior parietal cortex, thalamus, cerebellum, and brainstem. To novel stimuli, ADHD-I participants had reduced activation in bilateral lateral temporal lobe structures. There were no brain regions where ADHD-I participants had greater hemodynamic activity to targets or novels than controls. Brain activity deficits in ADHD-I participants were found in several regions important to attentional orienting and working memory-related cognitive processes involved in target identification. These results differ from those in previously studied adolescents with combined-subtype ADHD, who had a lesser magnitude of activation abnormalities in frontoparietal regions and relatively more discrete regional deficits to novel stimuli. The divergent findings suggest different etiological factors might underlie attention deficits in different DSM-IV-defined ADHD subtypes, and they have important implications for the DSM-V reconceptualization of subtypes as varying clinical presentations of the same core disorder.

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Section: Discussionsupporting

confidence: 67%

Brain activity in predominantly-inattentive subtype attention-deficit/hyperactivity disorder during an auditory oddball attention task

Orinstein

Stevens

2014

Psychiatry Research: Neuroimaging

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“…However, they also implied that the relationship between RD and ADHD subtypes are likely to be complex, and therefore, warrant additional research 9. Moreover, recent studies of ADHD subtypes suggest a lack of stability of subtypes over time and thus question their validity as categorical diagnoses 27–29. The retrospective nature of this study and changes in the terms of ADHD subtype over time prevented us from obtaining precise information about ADHD subtype for our subjects, and we are therefore unable to address the issue of the influence of ADHD subtype on the extent of comorbidity between ADHD and RD.…”

Section: Discussionmentioning

confidence: 99%

Gender, Attention-Deficit/Hyperactivity Disorder, and Reading Disability in a Population-Based Birth Cohort

Yoshimasu

Barbaresi

Colligan³

et al. 2010

Pediatrics

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Objective This study determined the incidence of reading disability (RD) among children with and without research-identified attention-deficit/hyperactivity disorder (ADHD), separately by gender, in a population-based birth cohort. Method Subjects included all children born 1976–1982 remaining in Rochester, MN after age five (n = 5718). Information from medical, school, and private tutorial records was abstracted. Cumulative incidence of RD, by any of three RD formulas, in children with and without ADHD and corresponding hazard ratios (HR) were calculated separately by gender. Results Cumulative incidence of RD by age 19 was significantly higher in children with ADHD (51% in boys, 46.7% in girls) compared to those without ADHD (14.5% in boys, 7.7% in girls). Among children with ADHD, the risk for RD was similar in boys vs. girls (HR=1.0). However, among children without ADHD, boys were 2.0 times more likely than girls to meet RD criteria. Among girls, the HR for the risk for RD associated with ADHD (vs. non-ADHD) was 8.1 (95% CI 5.7–11.5); this was significantly higher than the corresponding HR among boys (3.9, 95% CI, 3.2–4.9). Conclusions The risk for RD is significantly greater among ADHD children compared to non-ADHD children. Among ADHD children, the risk for RD is the same for both boys and girls. However, among non-ADHD children, boys are more at risk for RD than girls. Among girls, the magnitude of increased risk for RD associated with ADHD is nearly twice that among boys because non-ADHD girls are less likely to have RD than non-ADHD boys.

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“…A useful way forward can be seen in another recent DSM-5 conceptual change that recognizes the importance of a dimensional perspective in psychiatry in general (e.g., McHugh and Slavney, 1998; Maser and Patterson, 2002; Haslam, 2003; Helzer et al, 2006a; Helzer et al, 2006b; Helzer et al, 2006c), and ADHD in particular. According to a dimensional perspective, differing profiles of severity (e.g., based either on the severity or the frequency of ADHD symptoms (Swanson et al, 2009) might reflect important etiological differences. Clear depiction of these abnormalities would be missed if one only considered the presence or absence of an arbitrary-numbered constellation of symptoms.…”

Section: Introductionmentioning

confidence: 99%

Relationship between white matter microstructure abnormalities and ADHD symptomatology in adolescents

Witt

Stevens

2015

Psychiatry Research: Neuroimaging

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The present study sought to evaluate whether white matter microstructure abnormalities observed in a cohort of adolescents with attention-deficit/hyperactivity disorder (ADHD) have specific relationships with either or both Hyperactivity/Impulsivity and Inattentive ADHD symptom domains that would support a dimensional view of ADHD as adopted in the DSM-V. Diffusion tensor imaging (DTI) data were acquired on 22 adolescents diagnosed with ADHD. Multiple regression analyses were performed to determine whether scalar DTI measures in 13 tracts-of-interest demonstrated meaningful associations with Hyperactivity/Impulsivity or Inattentive symptom severity. Fractional anisotropy and radial diffusivity measures of white matter integrity exhibited significant linear relationships with Hyperactivity/Impulsivity and Inattentive symptom severity. However, only radial diffusivity in the right superior longitudinal fasciculus was specifically linked to Inattentive symptom severity and not Hyperactivity/Impulsivity symptom severity. Our results provide preliminary evidence that symptom domains in ADHD are linked to neuroanatomical substrates and confirm the value in examining ADHD from a dimensional perspective.

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DSM-V and the future diagnosis of attention-deficit/hyperactivity disorder

Cited by 28 publications

References 46 publications

Brain activity in predominantly-inattentive subtype attention-deficit/hyperactivity disorder during an auditory oddball attention task

Brain activity in predominantly-inattentive subtype attention-deficit/hyperactivity disorder during an auditory oddball attention task

Gender, Attention-Deficit/Hyperactivity Disorder, and Reading Disability in a Population-Based Birth Cohort

Relationship between white matter microstructure abnormalities and ADHD symptomatology in adolescents

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