Executive functioning and olfactory identification in young adults with attention deficit-hyperactivity disorder.

Young adults with attention deficit-hyperactivity disorder (ADHD; N?=?105) were compared with a control group (N?=?64) on 14 measures of executive function and olfactory identification using a 2 (group) × 2 (sex) design. The ADHD group performed significantly worse on 11 measures. No Group × Sex interaction was found on any measures. No differences were found in the ADHD group as a function of ADHD subtype or comorbid oppositional defiant disorder. Comorbid depression influenced the results of only 1 test (Digit Symbol). After IQ was controlled for, some group differences in verbal working memory, attention, and odor identification were no longer significant, whereas those in inhibition, interference control, nonverbal working memory, and other facets of attention remained so. Executive function deficits found in childhood ADHD exist in young adults with ADHD and are largely not influenced by comorbidity but may be partly a function of low intelligence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can teaching of the WISC—R be improved? Quasi-experimental exploration.

Investigated a new approach to teaching administration and scoring of the Wechsler Intelligence Scale for Children—Revised (WISC—R), using a quasi-experimental design in which Ss were sequential cohorts in a master's-level clinical psychology program. The experimental treatment involved giving the experimental group detailed information about frequent errors made by the control group and explicit rules for avoiding these errors. The experimental group (n?=?9) made fewer errors and assigned more accurate IQ scores than did the control group (n?=?14). The accuracy of both groups did not improve over 7 practice administrations. Findings suggest that giving students in testing courses explicit information about likely errors will improve the reliability and validity of IQ scores. Also, the common approach of limiting class instruction to allow students more time to give practice administrations needs to be examined carefully. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correspondence and disparity in the self- and other ratings of current and childhood ADHD symptoms and impairment in adults with ADHD.

[Correction Notice: An erratum for this article was reported in Vol 23(2) of Psychological Assessment (see record 2011-09525-001). There was an omission in the author note. The author note should have included a disclosure as follows, “Russell A. Barkley receives royalties for books, videos, and rating scales from Guilford Publications, and is the author of Barkley Adult ADHD Rating Scale-IV (BAARS-IV), Barkley Deficits in Executive Functioning Scale (BDEFS), and Barkley Functional Impairment Scale (BFIS), all published by Guilford Press.”] Experts recommend that clinicians evaluating adults for attention-deficit/hyperactivity disorder (ADHD) obtain information from others who know the patient well. The authors examined correspondence between the self- and other-ratings of ADHD symptoms and impairment using 3 groups of adults recruited on the basis of their severity of ADHD: ADHD diagnosis (n = 146), clinical controls self-referring for ADHD but not diagnosed (n = 97), and community controls (n = 109). The influences of diagnostic group, informant relationship, sex of participant, IQ, and comorbid anxiety and depression on self-informant disparities were also examined. Results indicated moderate to high agreement (.59–.80) between self and others on current functioning and slightly lower levels (.53–.75) between self- and parent ratings of childhood functioning. Examination of difference scores between self- and other ratings revealed small mean disparities (?0.1 to +5.0 points) but substantial variation (SDs = –2.4 to 8.9 points) for both current and childhood ratings. Clinic referrals not diagnosed with ADHD, particularly women, had higher disparities than was evident in the ADHD and community groups. Age, IQ, and education were not associated with disparities in most ratings. Higher anxiety, in contrast, was associated with greater disparities on all current and childhood measures of both ADHD and impairment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A comparison of the cognitive deficits in reading disability and attention-deficit/hyperactivity disorder.

This study used a nonreferred sample of twins to contrast the performance of individuals with reading disability (RD; n?=?93), attention-deficit/hyperactivity disorder (ADHD; n?=?52), RD and ADHD (n?=?48), and neither RD nor ADHD (n?=?121) on measures of phoneme awareness (PA) and executive functioning (EF). Exploratory factor analysis of the EF measures yielded underlying factors of working memory, inhibition, and set shifting. Results revealed that ADHD was associated with inhibition deficits whereas RD was associated with significant deficits on measures of PA and verbal working memory. The RD?+?ADHD group was most impaired on virtually all measures, providing evidence against the phenocopy hypothesis as an explanation for comorbidity between RD and ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Barkley et al. (2011).

Reports an error in "Correspondence and disparity in the self- and other ratings of current and childhood ADHD symptoms and impairment in adults with ADHD" by Russell A. Barkley, Laura E. Knouse and Kevin R. Murphy (Psychological Assessment, , , np). There was an omission in the author note. The author note should have included a disclosure as follows, “Russell A. Barkley receives royalties for books, videos, and rating scales from Guilford Publications, and is the author of Barkley Adult ADHD Rating Scale-IV (BAARS-IV), Barkley Deficits in Executive Functioning Scale (BDEFS), and Barkley Functional Impairment Scale (BFIS), all published by Guilford Press.” (The following abstract of the original article appeared in record 2011-04636-001.) Experts recommend that clinicians evaluating adults for attention-deficit/hyperactivity disorder (ADHD) obtain information from others who know the patient well. The authors examined correspondence between the self- and other-ratings of ADHD symptoms and impairment using 3 groups of adults recruited on the basis of their severity of ADHD: ADHD diagnosis (n = 146), clinical controls self-referring for ADHD but not diagnosed (n = 97), and community controls (n = 109). The influences of diagnostic group, informant relationship, sex of participant, IQ, and comorbid anxiety and depression on self-informant disparities were also examined. Results indicated moderate to high agreement (.59–.80) between self and others on current functioning and slightly lower levels (.53–.75) between self- and parent ratings of childhood functioning. Examination of difference scores between self- and other ratings revealed small mean disparities (?0.1 to +5.0 points) but substantial variation (SDs = –2.4 to 8.9 points) for both current and childhood ratings. Clinic referrals not diagnosed with ADHD, particularly women, had higher disparities than was evident in the ADHD and community groups. Age, IQ, and education were not associated with disparities in most ratings. Higher anxiety, in contrast, was associated with greater disparities on all current and childhood measures of both ADHD and impairment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Executive functions and adhd in adults: Evidence for selective effects on ADHD symptom domains.

Dual-process models of attention-deficit/hyperactivity disorder (ADHD) suggest that both executive functioning and regulatory functions (e.g., processing speed) are involved and that executive function weaknesses may be associated specifically with symptoms of inattention-disorganization but not hyperactivity-impulsivity. Adults aged 18-37 (105 with ADHD, 90 controls) completed a neuropsychological battery. The ADHD group had weaker performance than did the control group (p = .01) on both executive and speed measures. Symptoms of inattention-disorganization were uniquely related to executive functioning with hyperactivity-impulsivity controlled. Inattention was associated with slower response speed, and hyperactivity-impulsivity with faster output speed. Results were not accounted for by IQ, age, gender, education level, or comorbid disorders. Findings are discussed in terms of developmental and dual-process models of ADHD leading into adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discrimination of attention deficit hyperactivity disorder by the continuous performance test

OBJECTIVE: To investigate the Continuous Performance Test in discriminating a group of 56 attention deficit hyperactivity disorder (ADHD) children from 56 school children individually matched for age, sex and social class. METHODOLOGY: The children all completed the Continuous Performance Task (CPT). The mothers and teachers completed a Conners Parent-Teacher Rating Scale for the clinic children. RESULTS: The ADHD sample was selected so that the average IQ was 99.8 to match the school sample. A non-parametric discriminant function showed that the subtests of the CPT that best discriminated ADHD were age-normalized errors of commission (NCPTC) and age-normalized mean reaction time (NMNRT). CONCLUSION: Optimal use of the CPT for discrimination of ADHD should include age normalization and mean reaction time to targets. Further evoked potential studies may show brief cortical events involved in reaction time over the course of the CPT, and the processes involved in behavioural control.     

A neuropsychological examination of the underlying deficit in attention deficit hyperactivity disorder: Frontal lobe versus right parietal lobe theories.

A neuropsychological approach was used to examine the frontal lobe and right parietal lobe theories of attention deficit hyperactivity disorder (ADHD). Considerable attempts were made to select as pure a group of ADHD boys as possible. The performance of 10-14-year-old ADHD boys (n?=?22), both on and off stimulant medication, was compared with the performance of non-ADHD control boys (n?=?22) on tasks purported to assess frontal lobe functioning (Stopping Task, Antisaccade Task, Tower of Hanoi) and right parietal lobe functioning (Visual-Spatial Cuing Task, Turning Task, Spatial Relations). Three important findings emerged: (a) unmedicated ADHD boys exhibited performance deficits on tasks in both frontal and parietal domains compared with control boys, (b) unmedicated ADHD boys appeared to be more severely impaired on the frontal tasks than on the parietal tasks, and (c) medicated ADHD boys performed better in both task domains compared with unmedicated ADHD boys. Several alternative interpretations of the results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Academic underachievement and the disruptive behavior disorders": Correction.

Reports an error in the original article by P. J. Frick et al (Journal of Consulting and Clinical Psychology, 1991, Vol 59[2], 289–294). The correct formula to calculate the discrepancy score between IQ and academic achievement, Step 3, is provided. (The following abstract of this article originally appeared in record 1991-21350-001.) Academic underachievement (AU) was studied among 177 clinic-referred boys (aged 7–12 yrs) reliably diagnosed as having attention-deficit hyperactivity disorder (ADHD) or conduct disorder (CD). Unlike previous studies, the present study assessed AU using a formula that determined the discrepancy between a child's predicted level of achievement and actual level of achievement while controlling for regression and age effects. AU was associated with both ADHD and CD when the disorders were examined individually. However, when examined in multivariate logit model analyses, the apparent relation between CD and AU was found to be due to its comorbidity with ADHD. When boys with ADHD were divided into those with attention deficits only and those with co-occurring hyperactivity, findings did not support the hypothesis that the association with AU is stronger for attention deficits without co-occurring hyperactivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder.

The goal of this study was to assess neuropsychological functioning in nonreferred siblings of children with attention deficit/hyperactivity disorder (ADHD). Participants were 156 siblings of ADHD probands with (N?=?40) and without (N?=?116) ADHD (according to criteria of the Diagnostic and Statistical Manual of Mental Disorders [3rd edition, revised; American Psychiatric Association, 1987]) and 118 siblings of non-ADHD normal controls of similar age, IQ, and grade level. Information on attention, executive, and memory functions was obtained in a standardized manner without knowledge of clinical status. Compared with siblings of controls, siblings with ADHD were significantly impaired on the Stroop test and on verbal learning and memory. In contrast, siblings without ADHD were similar to controls on virtually all measures. These data suggest that some executive, attention, and verbal learning deficits are found in nonreferred individuals with ADHD but that neuropsychological deficits are unlikely to constitute an endophenotype to ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive factors differentiating attention deficit–hyperactivity disorder with and without a comorbid mood disorder.

Mood disorders and attention deficit–hyperactivity disorder (ADHD) co-occur in 20–30% of children and adolescents diagnosed in both epidemiological and clinical studies, but little information is available regarding cognitive factors that may be relevant to the expression of co-occurring mood disorders and ADHD. This study examined whether ADHD with and without a comorbid mood disorder could be differentiated on the basis of cognitive factors associated with prominent theories of depression. Children meeting diagnostic criteria for ADHD (n?=?14) or ADHD and a comorbid mood disorder (n?=?27) were assessed on a variety of cognitive indices. Children in the comorbid group reported more negative views of themselves and a more depressogenic attributional style. Cognitive disturbances associated with A. T. Beck's (1967) cognitive model and attributional style theories of depression differentiate ADHD children with significant mood pathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-control game interventions for attention-deficit hyperactivity disorder.

Compared the effects of self-control training, using cognitive-behavioral game play (CB) and biofeedback game play (BF), on the behaviors of 58 male and 5 female 8–12 yr olds with Full Scale IQ of 90 or higher on the Wechsler Intelligence Scale for Children--Revised (WISC--R) and diagnosed with attention deficit hyperactivity disorder (ADHD). The experimental groups were compared to a control game group (GC), which received no self-control training. A 3?×?3 (treatment?×?time) factorial design with repeated measures, using IQ as a covariate, and multiple outcome criteria was employed comparing the groups. Findings support the hypothesis that self-control training by BF reduces a child's perception of his or her self-control problems, but the same does not generalize to parental report of self-control or behavioral measures. Hyperactivity, one of the cardinal symptoms of ADHD, was significantly decreased in GC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety sensitivity and depression: How are they related?

Anxiety sensitivity is the fear of anxiety-related bodily sensations, which arises from beliefs that the sensations have harmful somatic, psychological, or social consequences. Elevated anxiety sensitivity, as assessed by the Anxiety Sensitivity Index (ASI), is associated with panic disorder. The present study investigated the relationship between anxiety sensitivity and depression. Participants were people with panic disorder (n?=?52 ), major depression (n?=?46), or both (n?=?37 ). Mean ASI scores of each group were elevated, compared to published norms. Principal components analysis revealed 3 factors of anxiety sensitivity: (a) fear of publicly observable symptoms, (b) fear of loss of cognitive control, and (c) fear of bodily sensations. Factors 1 and 3 were correlated with anxiety-related measures but not with depression-related measures. Conversely, factor 2 was correlated with depression related measures but not with anxiety-related measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal look at the relation between depression and anxiety in children and adolescents.

Elementary school students (n?=?330) and their parents (n?=?228) participated in a 3-year longitudinal study of the temporal relation between anxiety and depressive symptoms in children. Every 6 months, children and parents completed depression and anxiety questionnaires for a total of 6 waves. Structural equation modeling revealed that individual differences on all measures were remarkably stable over time. Nevertheless, high levels of anxiety symptoms at 1 point in time predicted high levels of depressive symptoms at subsequent points in time even after controlling for prior levels of depression symptoms. These findings were consistent across self- and parent reports. Results support the temporal hypothesis that anxiety leads to depression in children and adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender study of neuropsychological and neuromotor function in children with Tourette syndrome with and without attention-deficit hyperactivity disorder

Neuropsychological and neuromotor functions were compared between boys and girls with Tourette syndrome (TS only), attention-deficit hyperactivity disorder (ADHD only), Tourette syndrome with ADHD (TS+ADHD), and a comparison group, in an age (mean = 10 years) and IQ (Wechsler Full-Scale mean = 111) matched sample (n = 116). There were no timed-task neuromotor differences among the groups. Analyses of variance revealed a group x gender interaction for Letter Word Fluency and the Rapid Automatized Naming test. Girls with ADHD only were faster than boys on both tasks. When data for girls only were analyzed, girls with Tourette syndrome with ADHD had the greatest variability of reaction time on the Test of Variables of Attention, and were slowest on Letter Word Fluency. Girls with TS only were slower than girls in the other three groups on Letter Word Fluency. Poor Letter Word Fluency is explained as a linguistic executive dysfunction involving speed and efficiency of memory search in this bright group of girls with Tourette syndrome, not otherwise at risk for linguistic difficulties.     

Systematic nonlinearities in the memory representation of time.

The representation of time was investigated by testing rats with intervals that changed by 2 s across trials. In Experiment 1, 2 ranges (20–150 s, 30–160 s; n?=?10 rats per group) were examined. The times at which response bursts occurred (start time) were approximately proportional to interval durations. However, systematic departures from linearity were observed. Nonlinearities were related to the absolute duration of intervals, rather than to durations relative to the range. In Experiment 2, 660-s trials were inserted into the sequence of intervals (10–140 s, n?=?20). Start and end times of response bursts were approximately proportional to intervals, but nonlinearities in start and end times were correlated, indicating that the source of nonlinearity was in the memory representation of time rather than in a decision process. These results indicate that the representation of time is nonlinearly related to physical time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Wechsler Intelligence Scale for Children-Third and -Fourth Edition predictors of academic achievement in children with attention-deficit/hyperactivity disorder.

IQ and achievement scores were analyzed for 678 children with attention-deficit/ hyperactivity disorder (ADHD; 6-16 years of age, IQ≥80) administered the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; n=586) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV, n=92). Approximately 76% of children in both samples were identified with a learning disability (LD). LD in written expression was more common than in reading or math. For both the WISC-III and the WISC-IV, full-scale IQ was the strongest single predictor of achievement in all areas. The verbal subtests comprising the Freedom from Distractibility/Working Memory Index (FDI/WMI) and Verbal Comprehension Index were more highly correlated with achievement scores than the nonverbal subtests on both the WISC-III and WISC-IV. The most powerful predictors of LD, however, were the FDI/WMI and Processing Speed Index (PSI) subtests. These findings suggest that verbal intelligence is more influential in determining level of academic achievement, whereas cognitive abilities assessed by FDI/WMI and PSI are more important in determining LD in children with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A qualitative versus quantitative approach to evaluating the Draw-A-Person and Kinetic Family Drawing: A study of mood- and anxiety-disorder children.

Compared 2 methods of scoring the Draw-A-Person (DAP) and the Kinetic Family Drawing (KFD). A quantitative scoring method based on traditional individual indicators was contrasted with a qualitative scoring method based on an integrative approach designed to assess overall psychological functioning. The participants were 52 children with a mean age of 11? yrs. Using Diagnostic and Statistical Manual of Mental Disorders-III—Revised (DSM-III—R), they were assigned to the following groups: mood disorder (n?=?12), anxiety disorder (n?=?11), mood/anxiety (n?=?16), and control (n?=?13). Unlike scores from the quantitative approach, scores obtained from the qualitative approach on the DAP differentiated children with mood disorders and mood/anxiety disorders, but not children with only anxiety disorders, from control children. Similarily, and again unlike scores from the quantitative approach, scores from the qualitative approach on the KFD differentiated children with mood disorders (but not mood/anxiety disorders) from control children. In addition, scores from the qualitative DAP and KFD scoring methods were significantly correlated with self-reported self-concept and aspects of family functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body vigilance in panic disorder: Evaluating attention to bodily perturbations.

Body vigilance, consciously attending to internal cues, is a normal adaptive process. The present report investigated whether body vigilance is exaggerated among those with panic disorder, a condition characterized by intense fear and worry regarding bodily sensations. The Body Vigilance Scale is validated in nonclinical and anxiety disorder patients. Study 1 suggests that body vigilance is normally distributed in a nonclinical sample (n?=?472) but vigilance is related to a history of spontaneous panic attacks, anxiety symptomatology, and anxiety sensitivity. Study 2 suggests that body vigilance is elevated in panic disorder patients (n?=?48) relative to social phobia patients (n?=?18) and nonclinical controls (n?=?71). During cognitive-behavioral treatment, panic disorder patients show substantial reductions in body vigilance associated with reductions in anxiety symptomatology. Anxiety sensitivity was found to be related to body vigilance and to predict changes in body vigilance during treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of Children's Depression Inventory factors to major depression among adolescents.

This study examined the relationship between the Children"s Depression Inventory (CDI) scores and major depression, conduct disorder, and anxiety disorder diagnoses. Participants were 107 (58 male, 49 female) psychiatric inpatients, aged 12–18 years (M?=?15.4, SD?=?1.5). Definite major depression participants (n?=?26) reported higher scores than nondepressed participants (absence of any depression diagnosis, n?=?81) on all 5 CDI factor scores and the total CDI score. Conduct disorder participants scored higher on the externalizing factor; no other significant main or interaction effects were obtained for conduct disorder or anxiety. A discriminant function model using the 5 CDI factor scores classified participants as depressed versus nondepressed with a high degree of accuracy; a model using only the CDI total score yielded comparable discriminatory accuracy. The CDI total score was recommended as the most practical measure for classifying participants as depressed or not depressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)