Preschoolers Classified as Having Attention-Deficit Hyperactivity Disorder (ADHD): DSM-IV Symptom Endorsement Pattern

Abstract

In the present study, 50 preschoolers were formally and independently classified using both the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and third edition-revised (DSM-III-R) criteria for attention-deficit hyperactivity disorder (ADHD). The sample consisted of 25 preschoolers classified as having ADHD and 25 typically developing preschoolers for comparison; the sample was matched on gender, age, and socioeconomic status. All 50 preschoolers were without neurologic or neurodevelopmental disorders, oppositional defiant disorder, or language delay. There were four key findings: first, of the 25 preschoolers with ADHD, DSM-IV classification was as follows: hyperactive-impulsivity type (68%), combined type (28%), and inattentive type (4%). Second, the DSM-IV profiles showed that several symptoms were either infrequently endorsed by parents, reflecting limited applicability to preschoolers with ADHD, or frequently endorsed by parents of typically developing preschoolers, thus reducing their diagnostic value. Third, of the 25 preschoolers classified as having ADHD using DSM-IV criteria, 16% would not have been classified as having ADHD using the DSM-III-R criteria. The DSM-IV criteria therefore appear to be more lenient than the DSM-III-R criteria for this age group. Fourth, two symptoms that were not included in the DSM-IV, but were part of the DSM-III-R, were found to have clinical value for differentiating preschoolers with ADHD from their typically developing peers.

A systematic review and economic model of the effectiveness and cost-effectiveness of methylphenidate, dexamfetamine and atomoxetine for the treatment of attention deficit hyperactivity disorder in children and adolescents

“…15,16 The internal validity of the ICD-10 and DSM-IV models is also a focus of research and discussion. [17][18][19][20][21][22][23][24] Studies have been carried out, for example, to compare the impact of application across cultures and age groups. Issues of prevalence, co-morbidity and aetiology, related to internal validity, are highlighted below.…”

Early manifestations of behavioral disorders in children and adolescents

“…Os pré-escolares com TDAH estão mais propensos a acidentes leves, mas não são mais suscetíveis a lesões graves 37 . Quando o diagnóstico de TDAH é estabelecido em pré-escolares usando-se os critérios do DSM-IV, tem-se observado que as manifestações de hiperatividade e impulsividade são mais proeminentes que aquelas relacionadas ao déficit de atenção 38 .…”

Estudo epidemiológico dos sintomas do transtorno do déficit de atenção/hiperatividade e transtornos de comportamento em escolares da rede pública de Florianópolis usando a EDAH

“…Authors such as Barkley 32 discuss whether the type with predominance of inattention (without hyperactivity) truly represents a subtype of ADHD. In the study by Byrne et al 33 with pre-school children, 68% of them showed hyperactive/impulsive ADHD type, 28% combined ADHD, and 4% had predominance of inattention using DSM-IV criteria. As for the sample of Montiel-Nava et al, 31 using the Conners Scale with students aged 6 to 12 years, in Venezuela, there was a 5.7% prevalence of combined ADHD,1.14% with predominance of attention deficit and only 0.35% with hyperactive/impulsive predominance.…”