ABSTRACT
This study examined whether children who initiate physical fights are impulsive as measured by a continuous performance test. A series of 111 7-13-year-old psychiatric patients were diagnosed using DSM-III-R criteria and divided according to whether they showed a persistent pattern of initiating physical fights. Children who initiated fights were impulsive irrespective of whether ADHD was present or not, although ADHD was also associated with increased impulsivity. Oppositional-defiant disorder and conduct disorder diagnoses were not associated with impulsivity. These findings are discussed in terms of an underlying impulsive personality trait and its possible relationship to outcome in children with disruptive behavior disorders.
Subject(s)
Aggression/psychology , Child Behavior Disorders/psychology , Impulsive Behavior/psychology , Adult , Agonistic Behavior , Attention , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Child , Child Behavior Disorders/diagnosis , Female , Humans , Impulsive Behavior/diagnosis , Male , Personality Assessment , Psychomotor PerformanceABSTRACT
OBJECTIVE: This study was designed to assess central serotonergic (5-HT) function in aggressive and nonaggressive boys with attention deficit hyperactivity disorder. METHOD: Prolactin response to a challenge dose of the 5-HT agonist d,l-fenfluramine was assessed in 25 7-11-year-old boys with attention deficit hyperactivity disorder who were divided into aggressive and nonaggressive subgroups. In addition, the subgroups were compared on plasma catecholamine metabolites and platelet 5-HT. RESULTS: The aggressive group had a significantly greater prolactin response to the fenfluramine challenge than the nonaggressive subgroup. The groups did not differ on peripheral measures of neurotransmitter function. CONCLUSIONS: These data suggest that aggressive and nonaggressive children with attention deficit hyperactivity disorder differ in central 5-HT functioning.
Subject(s)
Aggression/physiology , Attention Deficit Disorder with Hyperactivity/physiopathology , Receptors, Serotonin/physiology , Attention Deficit Disorder with Hyperactivity/blood , Child , Fenfluramine/pharmacology , Humans , Male , Prolactin/blood , Receptors, Serotonin/drug effectsABSTRACT
OBJECTIVE: The primary purpose of this study was to assess the discriminant validity of attention-deficit hyperactivity disorder (ADHD) relative to well-defined groups of children with other psychiatric disorders. METHOD: Clinic-referred patients diagnosed as having ADHD without any other comorbid diagnosis (N = 13), were compared with patients with only anxiety disorders (N = 20), disruptive disorders other than ADHD (N = 15), and nonreferred controls (N = 18) on measures of cognitive and academic functioning, as well as on objective measures of attention, impulse control, and activity level. RESULTS: All three patient groups were found to have cognitive and academic achievement difficulties relative to controls. However, the ADHD group was found to be inattentive and impulsive relative to the other patient groups and the nonreferred controls. Objective measurement of activity level distinguished the ADHD group from controls but not from the other two patient groups. CONCLUSIONS: These data support the diagnostic validity of a small subgroup of ADHD children (i.e., those without comorbid diagnoses) and demonstrates, that as a group, these children can be distinguished from patients with anxiety as well as other disruptive disorders on objective test measures.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Personality Assessment/statistics & numerical data , Adolescent , Attention Deficit Disorder with Hyperactivity/psychology , Child , Discriminant Analysis , Female , Humans , Male , PsychometricsABSTRACT
Children with attention-deficit hyperactivity disorder (ADHD) were compared with non-ADHD psychiatric patients and normal controls on objective measures of inattention, impulsivity, and hyperactivity to determine the specificity of these symptoms to ADHD. Inattention and impulsivity were assessed using a continuous performance test, and activity was measured using solid state actigraphs. Both patient groups were inattentive relative to normals, but were indistinguishable from each other. However, the ADHD group was more active than both non-ADHD patients and normals, who did not differ from each other. These data suggest that inattention may be a nonspecific symptom of child psychiatric disorder. However, ADHD may be uniquely characterized by overactivity.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Attention , Impulsive Behavior/diagnosis , Motor Activity , Adolescent , Attention Deficit Disorder with Hyperactivity/psychology , Child , Diagnosis, Differential , Female , Humans , Impulsive Behavior/psychology , Male , Personality Assessment , Personality TestsABSTRACT
Response to a single, 5-mg dose of methylphenidate was compared in aggressive and nonaggressive attention-deficit hyperactivity disorder (ADHD) children using objective measures of inattention, impulsivity, and activity level. After medication, both ADHD groups had a significant decrease in inattention, whereas impulsivity remained unchanged. Activity level decreased only in the nonaggressive ADHD group. Unmedicated normal controls showed no change on any measure. These results support the hypothesis that aggressive and nonaggressive ADHD children have somewhat different underlying determinants for some of their symptoms. In addition, they suggest that inattention, impulsivity, and overactivity may be mediated by partially distinct neural mechanisms.
