Multimethod assessment of covert antisocial behavior in children: Laboratory observations, adult ratings, and child self-report.

Given the high risk for delinquency of children with attention-deficit hyperactivity disorder (ADHD), their display of covert or clandestine antisocial behavior is important developmentally and theoretically. In a laboratory probe of the temptation to (a) steal small amounts of money and desired objects, (b) destroy property, and (c) use an answer key to cheat on a worksheet, counts of these covert behaviors were reliably made. Laboratory property destruction was highly correlated with parallel naturalistic behaviors. Stealing and property destruction (but not cheating) formed a factor that was distinct from overt physical and verbal aggression. These covert indexes clearly distinguished ADHD from comparison samples as well as high- from low-aggressive ADHD subgroups; they showed external validity with maternal reports, global staff ratings, and child self-reports of similar constructs. The authors discuss psychometric and ethical issues in the assessment of covert antisocial behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Good health according to the residents of the community

Although a role for family and parent factors in the development of behavioral problems in childhood is often acknowledged, the roles of specific parental characteristics in relation to specific child actions need further elucidation. We studied parental "Big Five" personality traits and psychiatric diagnoses in relation to their children's antisocial diagnoses and naturalistically observed antisocial behaviors, in boys with and without the diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD). First, regardless of comorbid antisocial diagnosis, boys with ADHD, more often than comparison boys, had mothers with a major depressive episode and/or marked anxiety symptoms in the past year, and fathers with a childhood history of ADHD. Second, compared to the nondiagnosed group, boys with comorbid ADHD + Oppositional Defiant or Conduct Disorder (ODD/CD) had fathers with lower Agreeableness, higher Neuroticism, and more likelihood of having Generalized Anxiety Disorder. Third, regarding linkages between parental characteristics and child externalizing behaviors, higher rates of child overt antisocial behaviors observed in a naturalistic summer program were associated primarily with maternal characteristics, including higher Neuroticism, lower Conscientiousness, presence of Major Depression, and absence of Generalized Anxiety Disorder. The association of maternal Neuroticism with child aggression was larger in the ADHD than in the comparison group. In contrast, higher rates of observed child covert antisocial behaviors were associated solely with paternal characteristics, including history of substance abuse and higher Openness. Results provide external validation in parent data for a distinction between overt and covert antisocial behaviors and support inclusion of parent personality traits in family studies. The interaction of maternal Neuroticism and child ADHD in predicting child aggression is interpreted in regard to a conceptualization of child by parent "fit."     

The relationship of attention deficit hyperactivity disorder and conduct disorder to juvenile delinquency: legal implications

Attention deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are both disorders of childhood and adolescence that all too frequently extend into adulthood. But just what is the relationship between these two disorders? This study explores the overlap between these two disorders as they relate to juvenile delinquency; both are significant risk factors for the development of antisocial behavior. But there is more significance to the presence or absence of ADHD or CD in later antisocial behavior. Higher levels of defiant and/or aggressive behavior lead to antisocial acts as compared with lower levels of defiance and antisocial acts. Boys diagnosed with ADHD have higher felony rates than normal control boys, yet ADHD is not nearly as strong a predictor of offending behavior as is CD in study subjects. The presence of both CD and ADHD contributes to illegal behavior, and it is likely that early intervention in both disorders will reduce the prevalence of antisocial behavior.     

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)     

Initial sociometric impressions of attention-deficit hyperactivity disorder and comparison boys: Predictions from social behaviors and from nonbehavioral variables.

Compared the influence of naturalistic social behaviors and nonbehavioral variables on the development of peer status in 49 previously unfamiliar boys, aged 6–12 yrs. 25 boys with attention deficit hyperactivity disorder (ADHD) and 24 comparison boys participated. Physical attractiveness, motor competence, intelligence, and academic achievement constituted the nonbehavioral variables; social behaviors included noncompliance, aggression, prosocial actions, and isolation, measured by live observations of classroom and playground interactions. As early as the first day of interaction, ADHD and comparison Ss displayed differences in social behaviors, and the ADHD Ss were overwhelmingly rejected. Whereas prosocial behavior independently predicted friendship ratings during the 1st wk, the magnitude of prediction was small. In contrast, the Ss' aggression (or noncompliance) strongly predicted negative nominations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological correlates of childhood attention-deficit/hyperactivity disorder: explainable by comorbid disruptive behavior or reading problems?

Questions remain as to whether neuropsychological processing deficits associated with child attention-deficit/hyperactivity disorder (ADHD) are accounted for by co-occurring disorders, especially in clinical samples. The authors examined ADHD and comorbid oppositional defiant, conduct, and reading disorders. Boys with ADHD displayed hypothesized deficits on effortful neuropsychological tasks regardless of categorical or dimensional control of comorbid antisocial behavior problems. The same result held when reading problems were controlled, although boys with ADHD plus reading disorder (n = 16) exhibited specific impairment on linguistic output tasks. Simultaneous control of reading and behavior problems yielded the same result. Overall, results suggest that in a clinical sample, difficulties on effortful neuropsychological tasks that require planning or controlled motor output pertain at least in part to ADHD and are not fully accounted for by comorbid conditions.     

Perceived social support by children with characteristics of Attention-Deficit/Hyperactivity Disorder.

Examined students' perceptions of social support behaviors exhibited by significant adults and peers at school. A total of 29 teachers and 94 boys, in Grades 3–6, and their parents participated in the study. Approximately half of the boys displayed significant levels of behaviors characteristic of attention deficit hyperactivity disorder (ADHD). The remaining boys did not display characteristics of ADHD. Information on students' academic performance, social skills, self-concept, and problem behaviors was assessed via rating scales completed by the students and their respective parents and teachers. Brief questionnaires were also used to collect perceptions of social support from the teachers and parents. The data indicated that children with characteristics of ADHD perceived lower frequencies of overall social support. Both the ADHD characteristics group and comparison group perceived the importance of social support similarly; social support was moderately and significantly correlated with self-concept and student-reported positive social skill behaviors; and students' perceptions of social support were moderately related to parents' and teachers' perceptions of the frequency of social support they make available. These results are discussed and their implications for future research and practice are outlined. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Genetic heterogeneity in attention-deficit hyperactivity disorder (ADHD): Gender, psychiatric comorbidity, and maternal ADHD.

The authors examined the siblings of 140 attention-deficit hyperactivity disorder (ADHD) and 120 control probands and classified families as antisocial if the proband had conduct disorder or a parent had antisocial personality. Partial support was found for the hypothesis that the ADHD gender effect would be limited to antisocial families. Boys had an increased risk for ADHD compared with girls, but only among siblings from antisocial families. The effect size for predicting ADHD in siblings of probands was greater for maternal compared with paternal ADHD, but only for families exhibiting antisocial disorders. Strong support was found for the hypothesis that, compared with siblings from nonantisocial families, those from antisocial families would have more psychopathology (ADHD, depression, substance use, and conduct disorders). The presence of antisocial disorders signals a distinct subtype of ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Injury risk factors in children with attention deficit hyperactivity disorder.

Processes related to injury in children with Attention Deficit Hyperactivity Disorder (ADHD) were examined. Two groups of 7–11-year-old boys (14 ADHD and 16 controls) watched a videotape simulating play activities in order for them to identify risky behaviors and then answered questions about risky scenes. Groups did not differ in ability to identify hazards, but children with ADHD anticipated less severe consequences following risky behavior and reported fewer active methods of preventing injury than did controls. Cognitive factors, including lower expectations of personal risk in hazardous situations and less ability to generate prevention strategies and safety rules, may contribute to increased injury liability in boys with ADHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

High risk for children with DAMP/ADHD to become addicts later in life

The prevalence of attention deficit hyperactivity disorder (ADHD) and of the overlapping condition, deficit in attention, motor control and perception (DAMP), among children of early school age is approximately 5 per cent (1.5% being severe cases). Boys are more commonly affected than girls. The symptoms continue to be disabling at 20 years of age in 50 per cent of cases, and social maladjustment is common. Half of the young boys develop oppositional defiant disorder (ODD), very often progressing to conduct disorder (CD) and antisocial personality disorder (ASPD). Low socio-economic status, parental mental disorder, and persistence of DAMP/ADHD symptoms are all predictors of the development of CD/ASPD. Prospective studies of children with DAMP/ADHD have shown them to be characterised by a high level of alcohol and/or drug abuse comorbidity, particularly the subgroup progressing to CD/ASPD. Conversely, studies of drug abuse and of alcohol abuse series have shown them to be characterised by a high level of DAMP/ADHD comorbidity. Approximately one in five alcoholics has or has had DAMP/ADHD, a comorbidity probably even more pronounced among type II alcoholics. Approximately every third substance-abuser has or has had DAMP/ADHD. The need of more persevering support and treatment efforts for the well-defined category of boys at high risk is emphasised. Better awareness, active diagnosis and treatment of adults with persisting DAMP/ADHD is also warranted.     

Personal values as a mediator between parent and peer expectations and adolescent behaviors.

The current study examined the mediating role of adolescents' personal values on the relation between maternal and peer expectations for prosocial behaviors and adolescents' self-reported prosocial and antisocial behaviors. One hundred thirty-four adolescents (mean age = 16.22 years, 54% girls) completed measures of their own values and behaviors, as well as their perceptions of the positive expectations that their mother and their best friend(s) had for their (the adolescents') prosocial behaviors. Stepwise regression analyses suggested that adolescents' personal prosocial values mediated the relation between adolescents' perceptions of both maternal and peer expectations and adolescents' prosocial behaviors. In addition, for boys, perceptions of positive peer expectations were directly and negatively related to antisocial behaviors. The current study has important implications for parents, educators, and practitioners who are concerned about promoting adolescents' positive behaviors and discouraging negative behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in ADHD: a meta-analysis and critical review

OBJECTIVE: To quantitatively review and critically evaluate literature examining gender differences in attention-deficit hyperactivity disorder (ADHD). METHOD: A meta-analysis of relevant research based on 18 studies meeting inclusion criteria was performed. Domains evaluated included primary symptomatology, intellectual and academic functioning, comorbid behavior problems, social behavior, and family variables. RESULTS: Gender differences were not found in impulsivity, academic performance, social functioning fine motor skills, parental education, or parental depression. However, compared with ADHD boys, ADHD girls displayed greater intellectual impairment, lower levels of hyperactivity, and lower rates of other externalizing behaviors; it was not possible to evaluate the extent to which referral bias affected these findings. Some gender differences were clearly mediated by the effects of referral source; among children with ADHD identified from nonreferred populations, girls with ADHD displayed lower levels of inattention, internalizing behavior, and peer aggression than boys with ADHD, while girls and boys with ADHD identified from clinic-referred samples displayed similar levels of impairment on these variables. CONCLUSIONS: The need for future research examining gender differences in ADHD is strongly indicated, with attention to methodological limitations of the current literature, including the potential confounding effects of referral bias, comorbidity, developmental patterns, diagnostic procedures, and rater source.     

Adolescent outcome of boys with attention-deficit/hyperactivity disorder and social disability: Results from a 4-year longitudinal follow-up study.

IQ-achievement discrepancy methodology similar to that used in defining learning disabilities has recently been used to identify a subset of boys with attention-deficit/hyperactivity disorder (ADHD) evidencing marked impairment in social functioning. In this study, 2 issues were examined: (a) What is the longitudinal outcome of boys with ADHD identified at baseline as "socially disabled?" (b) Is social disability at baseline a significant predictor of severe long-term outcomes (such as substance use disorders) in boys with ADHD? If so, are its predictive relationships accounted for by conditions that are comorbid with ADHD? Results showed that, at follow-up, ADHD boys with ADHD who also had social disability evidenced significantly higher rates of mood, anxiety, disruptive, and substance use disorders, compared with nonsocially disabled boys with ADHD and comparison boys without ADHD. Findings also showed that social disability at baseline in boys with ADHD was a significant predictor of later conduct disorder and most substance use disorders after baseline mood and conduct disorders and behavior checklist ratings of aggressive behavior and attention problems were controlled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting adolescent peer problems and antisocial activities: The relative roles of aggression and dysregulation.

This study examined the relative roles of aggression and other dysregulated behaviors in the prediction of adolescent peer problems and antisocial behavior. The social adjustment of 145 boys studied first in Grades 3–6 was assessed again 4 years later in Grades 7–10. At each time, peer ratings of aggressive, hyperactive-disruptive, withdrawn, and irritable-inattentive behaviors were collected. Aggression and withdrawal showed stability and were linked to peer difficulties in elementary school and in adolescence, but these behaviors indicated significant risk for adolescent rejection, victimization, and antisocial activity primarily when accompanied by irritable-inattentive behaviors. Results are discussed in terms of the potential role that difficulties regulating negative affect may play in the genesis of the particular constellation of irritable-inattentive behaviors studied here and the developmental significance of aggressive or withdrawn problem profiles that are or are not accompanied by these behavioral indicators of dysregulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of medication, behavioral, and combined treatments on parents' and children's attributions for the behavior of children with attention-deficit hyperactivity disorder.

Seventy-four mothers and 41 fathers and their 6 to 13 year old sons with attention-deficit hyperactivity disorder (ADHD) watched videos of child ADHD symptoms, compliance, and noncompliance. Participants were told either that the child was receiving medication, behavioral treatment, a combination of the two, or was not receiving treatment and were asked to rate the cause of the behavior. Parents attributed less control but greater stability to positive child behaviors when the child was receiving medication. However, for negative behaviors, medication increased attributions of control but diminished stability. With behavior management, compliance was seen as more external and stable and noncompliance as more controllable but less stable. For all treatments, boys reported increased control over ADHD symptoms and noncompliance. The implications of these treatment-related attributions for parenting and children's self-perceptions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aggressive, prosocial, and nonsocial behavior in hyperactive boys: Dose effects of methylphenidate in naturalistic settings.

Given the importance of interpersonal interactions for hyperactive children, we evaluated the impact of methylphenidate on specific categories of social behavior in 25 boys, aged 6–12, with attention deficit–hyperactivity disorder (ADHD). These children participated in a 3-week, double-blind, crossover trial with placebo and low (0.3 mg/kg) and moderate (0.6 mg/kg) dosages of methylphenidate during a naturalistic summer research program. Fifteen comparison boys, without problems in attention and behavior, were also observed. In addition to decreasing noncompliance, methylphenidate reduced a combined category of physical and verbal aggression for the ADHD boys, with a significant linear trend across dosages. The medication decreased aggression to levels comparable with those of the comparison boys. There were no medication effects on the frequency of nonsocial or prosocial behaviors. Results are discussed in light of the need to effect durable change in both the quantity and quality of social behavior for hyperactive children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Academic task persistence of normally achieving ADHD and control boys: Self-evaluations, and attributions.

The authors examined academic task persistence, pretask expectancies, self-evaluations, and attributions of boys with attention-dcficit/hyperactivity disorder (ADHD) as compared with control boys. Participants were 83 ADHD boys and 66 control boys, all normally achieving. Prior to the task, performance expectancies were assessed. After a success-failure manipulation with find-a-word puzzles, performance on subsequent trials, self-evaluations, and attributions were evaluated. Compared with controls, ADHD boys solved fewer test puzzles, quit working more often, and found fewer words on a generalization task. Consistent with these behavioral findings, research assistants rated ADHD boys as less effortful and less cooperative than control boys. Although ADHD boys did not differ significantly from controls in their posttask self-evaluations, they did differ significantly from controls in some aspects of their attributions. Attributional data indicated that ADHD boys endorsed luck as a reason for success more strongly and lack of effort as a reason for failure less strongly than controls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The structure of childhood disruptive behaviors.

Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) frequently co-occur. Comorbidity of these 2 childhood disruptive behavior domains has not been satisfactorily explained at either a structural or etiological level. The current study evaluated a bifactor model, which allows for a “g” factor in addition to distinct component factors, in relation to other models to improve understanding of the structural relationship between ADHD and ODD. Participants were 548 children (321 boys, 227 girls) between the ages of 6 years and 18 years who participated in a comprehensive diagnostic assessment incorporating parent and teacher ratings of symptoms. Of these 548 children, 153 children were diagnosed with ADHD (without ODD), 114 children were diagnosed with ADHD + ODD, 26 children were diagnosed with ODD (without ADHD), and 239 children were classified as non-ADHD/ODD comparison children (including subthreshold cases). ADHD symptoms were assessed via parent report on a diagnostic interview and via parent and teacher report on the ADHD Rating Scale. ODD symptoms were assessed via teacher report. A bifactor model of disruptive behavior, comprising a “g” factor and the specific factors of ADHD and ODD, exhibited best fit, compared to 1-factor, 2-factor, 3-factor, and 2nd-order factor models of disruptive behaviors. It is concluded that a bifactor model of childhood disruptive behaviors is superior to existing models and may help explain common patterns of comorbidity between ADHD and ODD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Do boys with attention-deficit/hyperactivity disorder have positive illusory self-concepts?

One hundred ninety-five boys with attention-deficit/hyperactivity disorder (ADHD) were compared with 73 comparison boys (M=9.83 years, SD=1.30) on self-perceptions relative to a teacher-rated criterion. Emphasis was placed on ADHD subgroup comparisons according to level of aggression, academic achievement, and depression compared with control boys. Consistent with the authors' prediction, ADHD boys overestimated relative to teacher report, more than did controls, in the scholastic competence, social acceptance, and behavioral conduct domains. Examination of discrepancy scores (child rating--teacher rating) by comorbidity subgroups suggested that aggressive and low-achieving ADHD boys tended to overestimate their competence the most in the domains in which they were the most impaired. Results are discussed in terms of prior literature on "positive illusions" in ADHD children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)