Validity of DSM-IV ADHD Predominantly Inattentive and Combined Types: Relationship to Previous DSM Diagnoses/Subtype Differences

Morgan, Allison E.; Hynd, George W.; Riccio, Cynthia A.; Hall, Josh

doi:10.1097/00004583-199603000-00014

Cited by 153 publications

(105 citation statements)

References 35 publications

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“…More recently, in a population-based study of reactions to a dental examination of children with and without ADHD, indications of a blunted HPA axis response in children with ADHD with high hyperactivity/ impulsivity scores were found [11]. Several studies suggest an overall relationship between hyperactivity and DBD, which suggests that hyperactivity may be a risk factor for the further development of DBD [19,30,49,67,73]. Although none of our patients met the diagnostic criteria for a comorbid disorder, from a dimensional point of view we found negative correlations between HPA axis reactivity and externalizing problem scores; furthermore, we found positive correlations between HPA axis reactivity and scores for social withdrawal.…”

Section: Discussionmentioning

confidence: 99%

Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

West

Claes

Deboutte

2009

Eur Child Adolesc Psychiatry

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Some evidence suggests that the HPA axis may be dysfunctional in children with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to investigate whether a different pattern of HPA axis activity is found between the inattentive (I) and combined (C) subtypes of ADHD, in comparison with healthy control children. A total of 100 prepubertal subjects [52 children with ADHD combined type (ADHD-C), 23 children with ADHD predominantly inattentive type (ADHD-I), and 25 healthy control subjects] were studied. The effects of stress were studied by comparing cortisol responses to a psychosocial stressor, consisting of a public speaking task. Children with ADHD-I showed an elevated cortisol response to the psychosocial stressor, in contrast to children with ADHD-C who showed a blunted cortisol response to the psychosocial stressor. When a distinction was made between responders and non-responders (a subject was classified as a responder when there was an increase in cortisol reactivity), hyperactivity symptoms were clearly related to a lower cortisol reactivity to stress. The results indicate that a low-cortisol responsivity to stress may be a neurobiological marker for children with ADHD-C, but not for those with ADHD-I. Directions for future research and clinical implications are discussed.

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Section: Discussionmentioning

confidence: 99%

Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

West

Claes

Deboutte

2009

Eur Child Adolesc Psychiatry

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“…Current estimates of reliability for DSM-IV childhood disruptive behavior disorders range from kappas in the .50s to kappas in the .80s (Morgan, Hynd, Riccio, & Hall, 1996). However, these figures pertain to agreement involving multiple-reporter structured interviews and diagnoses by clinicians who have access to full assessment batteries.…”

Section: Discussionmentioning

confidence: 99%

Agreement among teachers' behavior ratings of adolescents with a childhood history of attention deficit hyperactivity disorder

Molina

Pelham²,

Blumenthal³

et al. 1998

Journal of Clinical Child Psychology

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Examined agreement among secondary school teachers' behavior ratings for 66 adolescent boys with a history of attention deficit hyperactivity disorder. Behavior ratings consisted of the Teacher Report Form, Iowa/Abbreviated Conners, and the Disruptive Behavior Disorders Rating Scale. Ratings from 2 to 5 teachers were collected for each adolescent. In contrast to previous studies, agreement was examined using statistical indices that corrected for chance agreement and discrepancies in scores (i.e., intraclass correlation [ICC], kappa) in addition to traditional indices (i.e., Pearson correlation and percentage agreement) typically used in the relatively sparse literature on teacher agreement for adolescent behavior ratings. Agreement was poor for dimensional subscale scores (Pearson correlations were in the .40-.50 range, and ICCs were in the .20-.50 range) as well as for categorization of youth as above or below clinical cutoffs (percentage agreement was between 52% and 96%, but ICCs and kappas ranged from .17 to .57). Findings suggest that, regardless of behavior rating scale used, a multiple teacher assessment strategy should be adopted for clinical assessment, treatment design, and evaluation of treatment efficacy.Teacher ratings of child behavior are tremendously useful when a goal of clinical work or research is to assess the disruptive behavior of a child (i.e., overactivity, impulsivity, attentional difficulties, defiance, or severe conduct problems). Not only is determination of treatment efficacy dependent upon teachers' observations, but adequate diagnosis of disruptive behavior disorders depends upon their input. For example, diagnosis of attention deficit hyperactivity disorder (ADHD) requires determination of impaired functioning in Requests for reprints should be sent to Brooke Molina, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213. molinab@msx.umpc.edu. Jonathan Blumenthal is now with the National Institute of Mental Health, Bethesda, MD.Portions of this study were presented at the 1996 meeting of the American Psychological Association, Toronto, Ontario, Canada. [DSM-IV]; American Psychiatric Association, 1994). Because children spend so much of their time in school, functioning in the academic domain is of particular importance. Furthermore, academic performance is often severely impaired by difficulties with behaviors such as attentional problems and noncompliance, making teachers especially salient and ecologically valid reporters of child functioning. Research has also shown that teacher ratings are more sensitive than parent ratings to stimulant medication effects (Sprague, Christensen, & Werry, 1974), which makes collection of teacher reports imperative when a goal of treatment is to determine medication efficacy. Clearly, examination of a child's functioning in school should always be included in comprehensive assessments and treatment of childhood disruptive behavior disorders. HHS Public AccessAn incr...

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“…These studies found comorbidity rates ranging from about 17-66%, with an epidemiological sample showing a 30% rate of overlap (Beitchman et al 1986). Although these studies used the diagnostic equivalents of ADHD from earlier versions of the DSM (APA 1980(APA , 1987, there is considerable symptom overlap between the earlier definitions and the current DSM-IV-TR ADHD criteria (Morgan et al 1996).…”

Section: Previous Studies Of Speech-language Disorders and Adhdmentioning

confidence: 99%

Children with Comorbid Speech Sound Disorder and Specific Language Impairment are at Increased Risk for Attention-Deficit/Hyperactivity Disorder

McGrath

Hutaff-Lee

Scott

et al. 2007

J Abnorm Child Psychol

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This study focuses on the comorbidity between attention-deficit/hyperactivity disorder (ADHD) symptoms and speech sound disorder (SSD). SSD is a developmental disorder characterized by speech production errors that impact intelligibility. Previous research addressing this comorbidity has typically used heterogeneous groups of speech-language disordered children. This study employed more precise speech-language diagnostic criteria and examined ADHD symptomatology in 108 SSD children between the ages of 4 and 7 years old with specific language impairment (SLI) (n=23, 14 males, 9 females) and without SLI (n=85, 49 males, 36 females). We also examined whether a subcategory of SSD, persistent (n=39, 25 males, 14 females) versus normalized SSD (n=67, 38 males, 29 females), was associated with ADHD and/or interacted with SLI to predict ADHD symptomatology. Results indicated that participants in the SSD + SLI group had higher rates of inattentive ADHD symptoms than those in the SSD-only and control groups. In addition, an unexpected interaction emerged such that children with SLI and normalized-SSD had significantly higher ADHD inattentive ratings than the other subgroups. A proposed explanation for this interaction is discussed.

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Validity of DSM-IV ADHD Predominantly Inattentive and Combined Types: Relationship to Previous DSM Diagnoses/Subtype Differences

Cited by 153 publications

References 35 publications

Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

Differences in hypothalamic–pituitary–adrenal axis functioning among children with ADHD predominantly inattentive and combined types

Agreement among teachers' behavior ratings of adolescents with a childhood history of attention deficit hyperactivity disorder

Children with Comorbid Speech Sound Disorder and Specific Language Impairment are at Increased Risk for Attention-Deficit/Hyperactivity Disorder

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