Gender and conduct problems predict peer functioning among children with attention-deficit/hyperactivity disorder

Children with attention-deficit/hyperactivity disorder (ADHD) often have poor relationships with peers. However, research on this topic has predominantly focused on boys. This study considered child gender, ADHD status, and dimensionally assessed conduct problems as predictors of peer relationship difficulties. Participants were 125 children (ages 6-10; 67% male), 63 with clinical diagnoses of ADHD and 62 non-ADHD comparison youth. Conduct problems were reported by teachers and observed in a lab playgroup. Peer relationships were assessed by parent report, teacher report, and peer sociometric nominations in the playgroup. Results suggested that children with ADHD, as well as those with high conduct problems, displayed more impaired peer relationships than did comparison children and those with low conduct problems, but overall there were no gender differences in social functioning. However, statistical interactions appeared such that the negative impact of conduct problems on peer relationships was stronger for girls than for boys.     

Impact of gender and age on executive functioning: do girls and boys with and without attention deficit hyperactivity disorder differ neuropsychologically in preteen and teenage years?

ADHD is known to have neuropsychological correlates, characterized mainly by executive function (EF) deficits. However, most available data are based on studies of boys through age 12. Our goal was to assess whether girls with ADHD express neuropsychological features similar to those found in boys, and whether these impairments are found in both preteen and teen samples. Participants were 101 girls and 103 boys with DSM--III--R ADHD, and 109 comparison girls and 70 boys without ADHD, ages 9 to 17 years. Information on neuropsychological performance was obtained in a standardized manner blind to clinical status. Primary regression analyses controlled for age, socioeconomic status, learning disability, and psychiatric comorbidity. Girls and boys with ADHD were significantly more impaired on some measures of EFs than healthy comparisons but did not differ significantly from each other. With the exception of 1 test score there were no significant Sex × Diagnosis interactions. Moreover, there were no more significant interactions among age, gender, and diagnosis than would be expected by chance. Neuropsychological measures of EFs were comparably impaired in girls compared to boys with ADHD, and these impairments are found at ages 9 to 12 and ages 13 to 17. These findings suggest that executive dysfunctions are correlates of ADHD regardless of gender and age, at least through the late teen years.     

Gender differences in the learning status of diabetic children.

The learning status of 95 diabetic boys and girls and 97 matched controls was evaluated using the Wechsler Intelligence Scale for Children--Revised IQ factors and school histories. Of interest was whether diabetic boys would evidence more learning difficulties. Results indicated that diabetic boys had significantly lower Freedom From Distractibility scores compared with scores of diabetic girls and control Ss and lower Perceptual Organization scores compared with scores of control boys. Although group scores were still within the average range of functioning, a significantly high percentage of diabetic boys (40%) compared with diabetic girls (16%) had learning problems that warranted either special instructional services or grade retention. Diabetic children experienced more learning difficulties (24%) than controls (13%), supporting research findings that diabetes is associated with increased risk of learning problems.     

Neuropsychological functioning in relatives of girls with and without ADHD

BACKGROUND: A limited number of studies have examined neuropsychological functioning in the family members of ADHD youth, and none have focused exclusively on relatives of females. METHOD: Structured diagnostic interviews and neuropsychological batteries were administered to parents and siblings enrolled in a family study of girls with and without ADHD. Relatives were stratified into three groups: relatives of DSM-IV ADHD probands with ADHD (n = 106), relatives of ADHD probands without ADHD (n = 189) and relatives of controls without ADHD (n = 243). Analyses were also conducted on a subgroup of families in which more than one member had RESULTS: The neuropsychological battery as a whole distinguished affected and unaffected ADHD relatives from controls. The Wechsler Oral Arithmetic subtest, the Stroop Word, Color and Color-Word subscales were impaired in affected ADHD relatives, as were the WRAT-R Arithmetic and Reading subtests. Only the Stroop Color-Word and Interference subtests and the WRAT-R Arithmetic subtest showed significant impairments in unaffected relatives. In multiplex families, additional impairments were found in unaffected relatives on the Stroop Color subtest and the Wechsler Oral Arithmetic subtest. Analyses based on DSM-III-R diagnoses produced nearly identical results. Minor differences emerged across relatives of probands with different DSM-IV subtypes. CONCLUSIONS: Data were consistent with our previous study of relatives of boys with ADHD. Neuropsychological impairments in relatives of female ADHD probands were primarily associated with the diagnosis of ADHD, but subtle cognitive impairments that index familial vulnerability to the disorder may exist.     

Predictive Accuracy of the Wide Range Assessment of Memory and Learning in Children With Attention Deficit Hyperactivity Disorder and Reading Difficulties

The predictive accuracy of the Wide Range Assessment of Memory and Learning (WRAML; Sheslow & Adams, 1990) over and above more standardized diagnostic tools in children with attention deficit hyperactivity disorder (ADHD) and reading disabilities (RD) was examined. Fifty-three children with ADHD, 63 with RD, 63 with ADHD-RD, and 112 normal comparison children were administered the WRAML, the Wechsler Intelligence Scale for Children-Third Edition (WISC-III; Wechsler, 1991), the Achenbach (1991) Child Behavior Checklist (CBCL), and the Woodcock-Johnson Psycho-Educational Battery-Revised (WJ-R; Woodcock & Johnson, 1989). Results of a series of discriminant function analyses revealed that the academic, intellectual, and behavioral measures could correctly classify 73.1% of children, but the WRAML subtests alone were able to correctly classify only 58.5% of participants. Combining all of the memory, academic, intellectual, and behavioral measures resulted in 77.5% of cases being correctly classified. These results suggest that the use of a measure of memory functioning such as the WRAML did not significantly improve the predictive accuracy of a diagnosis of ADHD, RD, or both over and above more standard diagnostic academic, intellectual, and behavioral measures.     

Masculinized finger-length ratios of boys, but not girls, are associated with attention-deficit/hyperactivity disorder

Gonadal hormones may exert permanent organizational effects on sexually dimorphic finger-length ratios and sexually dimorphic behavior expressed in childhood attention deficit-hyperactivity disorder (ADHD). This study extended recent work examining associations between finger-length ratios (specifically, 2D:4D) and ADHD in a well-characterized, clinically diagnosed, community-recruited sample of boys and girls. A multistage, diagnostic procedure was utilized to identify 113 children with ADHD and 137 non-ADHD comparison children. Right-hand digit ratios showed significant mean differences by gender, as well as associations with ADHD diagnosis. Boys with ADHD had more masculinized digit ratios than control-group boys. More masculine right 2D:4D and 3D:4D ratios were correlated with parent- and teacher-rated inattentive and hyperactive-impulsive symptoms in boys but not in girls. Masculinized finger-length ratios were associated with hyperactive-impulsive and oppositional- defiant symptoms, but associations were largest with symptoms of inattention. It is concluded that prenatal, organizational effects of gonadal hormones may play a role in the development of ADHD and contribute to explaining sex differences in the prevalence rates of this childhood disorder.     

Salivary cortisol levels in children of low-income women with high depressive symptomatology

Children (N = 324 boys, 315 girls) between the ages of 2.5 and 6 (mean age = 3.63) were identified in a house to house survey in low-income areas (income <20th percentile nationally) of urban Mexico. The Center for Epidemiologic Studies-Depression Scale was administered to mothers of all children. Salivary cortisol samples were taken in children as a measure of hypothalamic-pituitary-adrenocortical (HPA) system activity at time of arrival (baseline, Time 0), 25 min after arrival (Time 1), and 50 min after arrival (Time 2). Between Time 0 and Time 1, children were administered several cognitive tests. Results of hierarchical linear modeling analyses revealed that higher levels of maternal depressive symptoms were associated with lower baseline cortisol levels in their children (p < .05), while controlling for age, gender, and time since awakening. Higher levels of maternal depressive symptoms were associated with less of an increase in salivary cortisol to the arrival of the experimenters and subsequent cognitive testing (p < .05). All results were moderated by gender, with enhanced cortisol response in girls and no response in boys. These results suggest that among very low-income families, high maternal depressive symptoms are associated with hypoactivity of the HPA system in children, particularly boys.     

镇江市学龄前儿童注意缺陷障碍流行病学调查

目的 调查镇江城乡学龄前儿童注意缺陷多动障碍患病情况及相关因素.方法 采取流行病学的整群抽样的方法,在城乡各抽取4所幼儿园,有效同卷共724份.以Corners儿童父母症状问卷进行调查.结果 学龄前儿童多动障碍检出率为3.18％,其中男女检出率分别为4.63％、1.68％,两者差异有显著统计学意义(x2=5.16,P＜...     

Are there sex differences in the predictive validity of DSM-IV ADHD among younger children?

We assessed the predictive validity of attention-deficit/hyperactivity disorder (ADHD) in 20 girls and 98 boys who met the Diagnostic and Statistical Manual for Mental Disorders (4th ed., American Psychiatric Association, 1994) criteria for ADHD at 4 to 6 years of age compared to 24 female and 102 male comparison children. Over the next 8 years, both girls and boys who met criteria for ADHD in Year 1 exhibited more ADHD symptoms and impairment than same-sex comparison children. Effect sizes were consistently large, indicating that the diagnosis of ADHD at 4 to 6 years of age has predictive validity for both sexes. Both girls and boys with ADHD in Year 1 also exhibited higher levels of symptoms of conduct disorder, major depression, and anxiety disorders in early adolescence than same-sex comparison children, controlling levels of the same symptoms in Year 1. This indicates both substantial homotypic and heterotypic continuity for ADHD in both sexes, but significant interactions with time indicated that childhood ADHD predicts more steeply rising symptoms of anxiety and depression during early adolescence in girls than in boys.     

Attention problems in a representative sample of extremely preterm/extremely low birth weight children

The aim of this study was to examine attention in a large, representative, contemporary cohort of children born extremely preterm (EP) and/or extremely low birth weight (ELBW). Participants included 189 of 201 surviving children born EP (<28 weeks' gestation) or ELBW (<1,000 g) in 1997 in the state of Victoria, Australia. A comparison group of 173 of 199 children born full term and normal birth weight (FT/NBW) were randomly selected matching for birth hospital, expected due date, gender, mother's country of birth, and health insurance status. Participants were assessed at 8 years of age on subtests from the Test of Everyday Attention for Children (TEA-Ch) and the Wechsler Intelligence Scale for Children-4th Edition (WISC-IV). Measures of selective attention, sustained attention, attention encoding, and executive attention (inhibition, shifting attention, and divided attention) were administered. To assess behavioral elements of inattention, the primary caregiver completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Conners' ADHD/DSM-IV Scale (CADS-P). The EP/ELBW group performed more poorly across all cognitive and behavioral measures than the FT/NBW group, with the exception of inhibition. The EP/ELBW group also had significantly elevated rates of impairment in selective, sustained, shifting and divided attention, as well as attention deficit hyperactivity disorder (ADHD) symptoms. No significant gender or gradient effects (e.g., <26 weeks' gestation vs. ≥ 26 weeks' gestation) were identified. Neonatal medical factors were not strong predictors of attention, although necrotizing enterocolitis (NEC) and cystic periventricular leukomalacia (PVL) were independent predictors of selective attention. In conclusion, our comprehensive assessment of attention provides strong evidence that children born EP/ELBW are at increased risk for attentional impairments, and as such, this population should be monitored closely during early and middle childhood with a focus on attention functioning.     

肥胖儿童短时间静态平衡特征

目的 通过比较肥胖和非肥胖儿童6种站立情况下的压力中心（center of pressure, COP）偏移,研究肥胖儿童短时间静态平衡特征。方法 应用Footscan人体平衡系统获取47名肥胖儿童和50名非肥胖儿童分别双足、单足睁眼和闭眼站立10 s时COP摆动参数。结果 在双足闭眼站立时,肥胖儿童前后方向上的最大动摇径显著大于非肥胖儿童。在左足睁眼站立时,肥胖男孩COP摆动速度、左右方向上的最大动摇径显著小于非肥胖男孩,肥胖女孩左右方向上的最大动摇径显著大于非肥胖女孩。在左足闭眼站立时,男孩的COP摆动速度显著大于女孩。结论 短时间内,双足闭眼站立时,肥胖儿童前后方向上的平衡能力比非肥胖儿童差;肥胖对不同性别儿童的静态平衡影响不同。左足睁眼站立时,肥胖男孩平衡能力优于非肥胖男孩,肥胖女孩平衡能力差于非肥胖女孩;左足闭眼站立时,女孩的平衡能力优于男孩,其他情况下男女无显著差异。由于肥胖及性别因素会影响儿童短时静态平衡能力,建议对于不同性别肥胖儿童减重采取不同的运动模式。     

Parent Stress and Coping in Relation to Child ADHD Severity and Associated Child Disruptive Behavior Problems

Examined parent role distress and coping in relation to childhood attention deficit hyperactivity disorder (ADHD) in mothers and fathers of 66 children age 7 to 11 (42 boys, 24 girls; mean age = 10.2). Parents of children with ADHD combined and inattentive subtypes expressed more role dissatisfaction than parents of control children. Parents of ADHD combined and inattentive type children did not differ significantly in levels of distress. For mothers, child inattention and oppositional-conduct problems but not hyperactivity contributed uniquely to role distress (dissatisfaction related to parenting or parenting performance). For fathers, parenting role distress was associated uniquely with child oppositional or aggressive behaviors but not with ADHD symptom severity. Parent coping by more use of positive reframing (thinking about problems as challenges that might be overcome) was associated with higher role satisfaction for both mothers and fathers. Community supports were associated with higher distress for mothers only.     

What aspects of peer relationships are impaired in children with attention-deficit/hyperactivity disorder?

Participants included 165 children with attention-deficit/hyperactivity disorder (ADHD; 130 boys, 35 girls) and their 1,298 same-sex classmates (1,026 boys, 272 girls) who served as raters. For each child with ADHD, a child of the same sex was randomly selected from the same classroom to serve as a comparison child, which yielded 165 dyads. Consistent with predictions, contrasted with the comparison children, those with ADHD were lower on social preference, higher on social impact, less well liked, and more often in the rejected social status category; they also had fewer dyadic friends. When liking ratings that children made versus received were examined, children with ADHD had less positive imbalance and greater negative imbalance relative to comparison children. Analyses that considered the types of peers who chose children with ADHD as friends or nonfriends demonstrated that children with ADHD were nominated as nonfriends by children of higher social preference and who were better liked by others.     

Digit Span components as predictors of attention problems and executive functioning in children.

This study examined the extent to which digits forward (DF) or digits backward (DB) account for variance in parent ratings of attention and executive function in children. The sample (n=90) included children with no diagnosis and children with a range of clinical problems, including attention deficit hyperactivity disorder (ADHD). Clinical groups differed from the No Diagnosis group on cognitive ability as well as achievement. Once cognitive ability was controlled, no group differences emerged for Digit Span or digits forward; notably, the ADHD-Predominantly Inattentive group was able to recall significantly more digits backward than the ADHD-Combined Type group. Regression analyses indicated that Full Scale IQ explained significant variance in parent ratings of attention and executive function; DF emerged as a significant predictor only for one measure of attention. When only children with ADHD were considered, DF no longer was a significant predictor. Results support the notion that DF and DB are differing constructs, as well as highlighting the importance of controlling for cognitive ability in consideration of group differences on behavioral measures.     

学习困难儿童智力水平与结构分析

学习困难是学龄儿童常见的问题。国外研究报道学习困难的发生率为 2 0 - 2 5 % ,国内一些地区的报道为 13- 17% [1] 。帮助这些儿童一直是我们研究工作者、教师和家长们迫切需要解决而又十分棘手的问题。为了改善学习困难儿童的状况 ,有必要了解其能力和学习的薄弱环节。本研究中对 6 2例学习困难儿童的智力水平和智力结构进行了调查分析 ,报告结果如下。1　对象与方法1.1　对象所有受试者均取自上海浦东三林小学 1～ 4年级的学生 ,年龄在 6 .5～ 11岁。学习困难儿童入组标准 :(1)以ＷＩＳＣ -ＣＲ测查智商 ,总智商 (ＦＩＱ)在70以上 ;(2 )…     

Children's fantasy play and emotional understanding

Examined the relation between affective and cognitive processes in fantasy play and emotional understanding. Sixty-six children in the 1st and 2nd grades played with puppets (Affect in Play Scale; Russ, 1993), answered questions about their understanding of emotions (Kusche Affective Interview-Revised; Kusche, Greenberg, & Beilke, 1988), and completed a measure of verbal intelligence (Wechsler Intelligence Scale for Children-111; Wechsler, 1991). The major finding of this study was that consistent, yet modest, relations were found between dimensions of fantasy play and emotional understanding. Cognitive dimensions of fantasy play, but not affect expression, were related to facets of emotional understanding. These relations were independent of verbal ability. A composite fantasy play score accounted for a significant amount of variance in a composite emotional understanding score when verbal ability was accounted for. Variations in the pattern of correlations for girls and boys suggest sex differences in the relation between fantasy play and emotional understanding. Implications for clinical research and interventions are discussed.     

Young children's representations of conflict and distress: a longitudinal study of boys and girls with disruptive behavior problems

We investigated narratives, symbolic play, and emotions in children who varied in severity of disruptive behavior problems. Children's representations of hypothetical situations of conflict and distress were assessed at 4-5 and 7 years. Behavior problems also were assessed then and again at 9 years. Children's aggressive and caring themes differentiated nonproblem children, children whose problems remained or worsened with age, and those whose problems improved over time. Differences in boys and girls whose problems continued sometimes reflected exaggerations of prototypic gender differences seen across the groups. Boys with problems showed more hostile themes (physical aggression and anger), whereas girls with problems showed more caring (prosocial) themes relative to the other groups. Modulated (verbal) aggression, more common in girls than boys, showed developmentally appropriate increases with age. However, this was true only for children without problems and those whose problems improved. We consider how these findings contribute to an understanding the inner worlds of boys and girls who differ in their early developmental trajectories for behavior problems.     

注意缺陷多动障碍儿童感觉统合与执行功能的相关分析

目的：探讨注意缺陷多动障碍(ADHD)儿童感觉统合与执行功能之间的关系。方法：对282例符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)ADHD诊断标准的门诊儿童，进行感觉统合功能和执行功能评定，对结果进行相关性分析。结果：感觉统合功能量表中，大肌肉及平衡能力的等级评分与Stroop测验的A反应时、总反应时呈正相关，与韦氏记忆中倒背数字得分呈负相关；触觉过度防御及情绪不稳的等级评分与Stroop测验的C错误数和色干扰呈负相关；本体感不佳、身体协调不良的等级评分与Stroop测验的C错误数和总错误数呈负相关；学习能力发展不足或协调不良的等级评分与Stroop测验的D反应时、总反应时、D错误数、总错误数以及瑞文标准推理测验的标准等级分呈正相关；大年龄的特殊问题的等级评分与Stroop测验的C错误数、D错误数、总错误数呈负相关。结论：ADHD儿童感觉统合功能，尤其是大肌肉和平衡能力、学习能力发展不足或协调不良与执行功能有关；ADHD儿童的感统失调，尤其是前庭网状结构功能失调引起的注意力损害,多动和冲动,与患儿的行功能缺陷有密切的联系．     

Neuropsychological and academic functioning in preschool boys with attention deficit hyperactivity disorder

We compared 34 preschool boys with attention deficit hyperactivity disorder (ADHD) to 30 community comparison boys without behavioral problems on a battery of neuropsychological and academic achievement tests along with behavioral observations. The battery of 25 measures was reduced to 4 dimensions through dimensional (factor) analysis. Comparison of the 2 groups revealed that boys with ADHD performed more poorly than comparison boys on 2 of the 4 dimensions, these being motor control and working memory‐persistence. No differences were found on the dimensions of verbal learning‐memory or picture identification‐factual knowledge. The results suggest that achievement problems are evident early in development in clinic‐referred children with ADHD and may be related to deficiencies in more fundamental neuropsychological functions. These early deficits in motor control and working memory seem to be an inherent part of ADHD, supporting both the neuromaturational nature of the disorder and current efforts to more broadly conceptualize it as involving deficits in executive functions beyond the core problems in behavioral inhibition and sustained attention.     

Baroreflex sensitivity during rest and executive functioning in attention-deficit/hyperactivity disorder. The TRAILS study

Children with attention-deficit/hyperactivity disorder (ADHD) often show executive function (EF) problems and neurophysiological hypoarousal. Baroreceptor activation, as part of the baroreflex short-term blood pressure regulatory mechanism, has been linked to cortical inhibition and attenuated cognitive-attentional functioning. We investigated the hypothesis that higher resting baroreflex sensitivity (BRS) predicts poorer EF performance in children with ADHD. EF measures of speed and accuracy were regressed upon resting BRS in 10-12-year-old children with ADHD from a clinic-referred sample (n=181) and healthy (n=194) and clinic-referred (n=260) comparison samples. Resting BRS was positively associated with poorer EF performance (e.g., response variability, working memory, response inhibition), especially in ADHD combined type, boys, and unmedicated children. Comparison samples partly suggested negative associations. We conclude that higher resting BRS is related to poorer cognitive performance in children with ADHD. Findings suggest afferent influences of the body's visceral state on higher-order cognitive functioning and imply energetic state dysregulation in ADHD.