Family and cognitive factors: modeling risk for aggression in children with ADHD.

OBJECTIVE: To explore the relationships of family and cognitive factors to aggression as reported by parents and teachers. METHOD: Data regarding different types of aggressive behavior were collected from parents and teachers of 165 school-age (7-11 years old) children referred to a study of attention-deficit/hyperactivity disorder and disruptive behavior. Structural equation modeling was used to examine the differential relationships of family and cognitive factors to aggression in the home and school settings. RESULTS: Family risk factors influenced aggression reported at home and at school, whereas cognitive risk factors may exert their influence on aggression at school. Significant covariance between parent and teacher report of aggressive behavior was observed. CONCLUSIONS: Intervention at the family level may serve to reduce aggressive behaviors in both home and school environments.

Growth hormone response to guanfacine in boys with attention deficit hyperactivity disorder: a preliminary study.

OBJECTIVE: This preliminary study evaluated a method for assessing central noradrenergic function in children via the growth hormone response to a single dose of the alpha-2 adrenergic receptor agonist guanfacine and examined whether this measure distinguishes between attention deficit hyperactivity disorder (ADHD) boys with and without reading disabilities (RD). METHODS: Plasma growth hormone was assessed before and after the oral administration of guanfacine and placebo in boys with ADHD who were divided into subgroups based on the presence (n = 3) or absence (n = 5) of RD. RESULTS: Guanfacine and placebo conditions did not differ at baseline, but peak growth hormone was significantly higher following guanfacine. The increase in growth hormone following guanfacine was significantly greater in boys without RD as compared to those with RD, with no overlap between the groups. CONCLUSIONS: Consistent with findings using peripheral measures of noradrenergic function, these preliminary data suggest that ADHD boys with and without RD may differ in central noradrenergic function.

Familial correlates of central serotonin function in children with disruptive behavior disorders.

Previous findings suggest a relationship between childhood aggression, parental history of aggression and central serotonin (5-HT) function. The present study extended these findings by examining the impact of childhood aggression and central 5-HT function on the incidence of psychopathology in first- and second-degree relatives of pre-pubertal children with disruptive behavior disorders. Family history of psychopathology was obtained for 58 aggressive and 44 non-aggressive clinically referred children who were further sub-divided based on central 5-HT function. Central 5-HT function was assessed by measuring the prolactin response to a 1 mg/kg oral dose of d,l-fenfluramine. Aggressive children with low-prolactin responses to fenfluramine had a significantly greater incidence of first- and second-degree relatives with aggressive and antisocial characteristics compared to both non-aggressive children and aggressive children with high-prolactin responses. No group differences were found in the frequency of relatives with symptoms of cognitive impairment or inattention and hyperactivity. These data suggest that there are both familial and non-familial forms of aggression in children, and that only the familial type is associated with reduced 5-HT function.

Reliability, validity, and preliminary normative data for the Children's Aggression Scale-Teacher Version.

OBJECTIVE: To provide preliminary psychometric data on the Children's Aggression Scale-Teacher Version (CAS-T), which was designed to assess severity and frequency of aggressive, as distinct from nonaggressive, disruptive behaviors. METHOD: The CAS-T has 23 items representing five domains: Verbal aggression, Aggression against objects and animals, Provoked physical aggression, Unprovoked physical aggression, and Use of weapons. The CAS-T was completed for 273 nonreferred boys and 67 clinically referred children (60 boys; 7 girls). Coefficient alpha was assessed separately in clinical and nonreferred groups. Validity was evaluated by comparing CAS-T scores of children with different disruptive behavior disorder diagnoses and by examining the relationship of CAS-T scores to other parent and teacher ratings. RESULTS: The scale as a whole had excellent reliability as measured by coefficient alpha. Children with conduct disorder were rated significantly higher than those with oppositional defiant disorder, attention-deficit/hyperactivity disorder, and no disruptive behavior disorder diagnosis. Further, patterns of correlations with other rating scales provide strong support for the convergent and discriminant validity of the CAS-T. CONCLUSIONS: The CAS-T may fill a gap in that it distinguishes among various types and severity of aggression, as distinct from oppositional-defiant behaviors.

Development, reliability, and validity of the children's aggression scale-parent version.

OBJECTIVE: To provide preliminary psychometric data on the Children's Aggression Scale-Parent Version (CAS-P), which assesses severity, frequency, pervasiveness, and diversity of aggressive, as distinct from nonaggressive, disruptive behaviors. METHOD: The scale has 33 items representing five domains: Verbal Aggression, Aggression Against Objects and Animals, Provoked Physical Aggression, Unprovoked Physical Aggression, and Use of Weapons. The CAS-P was completed for 73 clinically referred children. Validity was evaluated dimensionally by examining the relationship of CAS-P scores to other parent and teacher rating scales, and categorically by comparing scores of children with attention-deficit hyperactivity disorder (ADHD) alone, oppositional defiant disorder, and conduct disorder. RESULTS: The scale as a whole had excellent internal consistency (alpha = .93). Children with conduct disorder were rated significantly higher than those with oppositional defiant disorder, who were rated significantly higher than those with ADHD alone. The CAS-P did not distinguish clinical control children from those with ADHD only. Correlations with other rating scales provide further support for the validity of the CAS-P. CONCLUSIONS: The CAS-P assesses distinct components of aggressive behavior and may fill a gap in that it distinguishes among various types and severity of aggressive behaviors, and the settings in which they take place.