Patterns of Comorbidity Associated With Subtypes of Attention-Deficit/Hyperactivity Disorder Among 6− to 12-Year-Old Children

Eiraldi, Ricardo; Power, Thomas J.; Nezu, Christine Maguth

doi:10.1097/00004583-199704000-00013

Cited by 181 publications

(159 citation statements)

References 34 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…The combined type of ADHD is more prevalent than the inattentive or hyperacComorbid ADHD and conduct problems: a separate disorder? tive-impulsive forms, and manifests comorbidity with CP more frequently than the other forms (Eiraldi et al 1997). The sample consisting only of combined-type ADHD therefore minimizes the effects of confounding factors present in a sample of mixed ADHD subtypes.…”

Section: The Present Studymentioning

confidence: 99%

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

et al. 2008

View full text Add to dashboard Cite

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).

show abstract

Section: The Present Studymentioning

confidence: 99%

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

et al. 2008

View full text Add to dashboard Cite

show abstract

“…A recent population-study ) of 7-year-old children showed almost exactly the same rate (60%) of ODD in ADHD. Other studies report an overlap of about 30 to 60% between ADHD and ODD, either alone or combined with conduct disorder, in both clinical and community surveys of children and adolescents (Biederman et al 1991, Baumgaertel et al 1995, Wolraich et al 1996, Eiraldi et al 1997. ODD was significantly less common in children with ADHD of the inattentive subtype and particularly frequent in the combined subtype.…”

Section: Discussionmentioning

confidence: 94%

Attention‐deficit‐hyperactivity disorder with and without oppositional defiant disorder in 3‐ to 7‐year‐old children

Kadesjö

Hägglöf

Gillberg

2003

Develop Med Child Neuro

View full text Add to dashboard Cite

Attention-deficit-hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a high degree of associated behavioural problems. In order to study characteristics of ADHD with and without oppositional defiant disorder (ODD) in a representative group of young children with clinical impairment in Sweden, 131 children (101 males, 30 females) with ADHD (mean age 5 years, SD 1 year 5 months; range 3 to 7 years) were clinically examined, and their parents interviewed. Independent questionnaire data (Child Behavior Checklist, ADHD Rating Scale-IV, ODD Rating Scale-IV, Conners Hyperactivity Index) were collected. For comparison 131 children without ADHD were matched for sex, age, marital status, and socioeconomic status (115 males, 16 females; mean age 4 years 10 months, SD 1 year 5 months; range 3 to 7 years). Sixty percent of those with ADHD met full DSM-IV criteria for ODD. Only 10 of the 131 children with ADHD had no symptoms of ODD at all. The rate of children meeting full diagnostic criteria for ODD was similar across all age cohorts. Males were overrepresented in ODD, as were children of divorced parents and of mothers with low socioeconomic status. ADHD combined subtype was a stable independent factor influencing the diagnosis of ODD, regardless of psychosocial factors. Those with ADHD with ODD consistently showed higher rates of ADHD symptoms than did those with ADHD without ODD. The prevalent comorbidity of ADHD with ODD indicates that all children presenting with ADHD or ODD symptoms need to be assessed with a view to exploring both types of problem behaviours. The link between ODD and some psychosocial variables indicates the need to address these, possibly by measures such as parent training and network support.

show abstract

“…Furthermore, decreased sympathetic activation during exposure to emotion-inducing stimuli mediated the relation between affective decision-making and ADHD-H symptoms. The relations between impaired affective-decision making and ADHD-H, but not ADHD-I, symptoms, provide further support for continued differentiation among ADHD subtypes (Eiraldi et al 1997;Gadow et al 2000Gadow et al , 2004Gaub and Carlson 1997). Moreover, the associations among attenuated sympathetic activation during exposure to emotion-inducing videos, disadvantageous decision-making, and ADHD-H symptoms among boys suggest that boys who are unable to generate somatic markers related to fear and sadness may be more impulsive, perhaps because they lack the physiological representations of emotions (provided by the OFC and amygdala) that are important for guiding and learning socially appropriate behavior.…”

mentioning

confidence: 78%

“…Similarly, the ADHD-predominantly inattentive (ADHD-I) and ADHDpredominantly hyperactive-impulsive (ADHD-H) subtypes differ in terms of correlates. For instance, the ADHD-I subtype is associated with higher levels of academic difficulties and internalizing problems, whereas the ADHD-H subtype is associated with social impairment, motor inhibition deficits, and externalizing symptoms (Eiraldi et al 1997;Gadow et al 2000Gadow et al , 2004McBurnett et al 1999;Nigg et al 2002). Despite these differences, most studies compare ADHD-I and the combined subtype of ADHD (ADHD-I + ADHD-H), likely because of the relatively lower base rates of pure ADHD-H.…”

mentioning

confidence: 99%

Affective Decision-Making and Externalizing Behaviors: The Role of Autonomic Activity

Bubier

Drabick

2008

J Abnorm Child Psychol

View full text Add to dashboard Cite

We tested a conceptual model involving the inter-relations among affective decision-making (indexed by a gambling task), autonomic nervous system (ANS) activity, and attention-deficit/ hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in a largely impoverished, inner city sample of first through third grade children (N=63, 54% male). The present study hypothesized that impaired affective decision-making and decreased sympathetic and parasympathetic activation would be associated with higher levels of ADHD and ODD symptoms, and that low sympathetic and parasympathetic activation during an emotion-inducing task would mediate the relation between affective decision-making and child externalizing symptoms. In support of our model, disadvantageous decision-making on a gambling task was associated with ADHD hyperactivity/impulsivity symptoms among boys, and attenuated sympathetic activation during an emotion-inducing task mediated this relation. Support for the model was not found among girls. KeywordsADHD; ODD; Psychophysiology; Decision-making Both attention-deficit/hyperactivity disorder (ADHD), which is characterized by problems with attention, hyper-activity, and impulsivity, and oppositional defiant disorder (ODD), which is defined by a pattern of negativistic, hostile, and oppositional behaviors toward adults, are relatively common in childhood (American Psychiatric Association 2000), and are associated with numerous negative correlates and sequelae. These correlates include deficient social problem-solving skills and impaired social functioning (Frankel and Feinberg 2002;Matthys et al. 1999), poor academic achievement Rapport et al. 1999), and co-occurring internalizing disorders Jensen et al. 2001). In addition, ADHD and ODD are related prospectively to substance use, poor academic achievement, conduct disorder (CD), and antisocial behavior (Masten et al. 2005;van Bokhoven et al. 2005), though the association between ADHD and CD may be accounted for by co-occurring ODD (Lahey et al. 2002;van Lier et al. 2007).Despite some similar correlates and outcomes, research has shown significant differences among children with ADHD vs. ODD in terms of cognitive functioning and academic performance Keenan and Wakschlag 2000), prenatal/perinatal complications (Harvey et al. 2007 Drabick et al. 2004), and family psychiatric history Harvey et al. 2007). Similarly, the ADHD-predominantly inattentive (ADHD-I) and ADHDpredominantly hyperactive-impulsive (ADHD-H) subtypes differ in terms of correlates. For instance, the ADHD-I subtype is associated with higher levels of academic difficulties and internalizing problems, whereas the ADHD-H subtype is associated with social impairment, motor inhibition deficits, and externalizing symptoms (Eiraldi et al. 1997;Gadow et al. 2000Gadow et al. , 2004McBurnett et al. 1999;Nigg et al. 2002). Despite these differences, most studies compare ADHD-I and the combined subtype of ADHD (ADHD-I + ADHD-H), likely because of the relatively lower base rates of pu...

show abstract

Patterns of Comorbidity Associated With Subtypes of Attention-Deficit/Hyperactivity Disorder Among 6− to 12-Year-Old Children

Cited by 181 publications

References 34 publications

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

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

Attention‐deficit‐hyperactivity disorder with and without oppositional defiant disorder in 3‐ to 7‐year‐old children

Affective Decision-Making and Externalizing Behaviors: The Role of Autonomic Activity

Contact Info

Product

Resources

About