Preadolescent girls with attention-deficit/hyperactivity disorder: II. Neuropsychological performance in relation to subtypes and individual classification.

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Abstract

This study examined executive functions, motor speed, and language processing in a diverse, preadolescent sample of 93 girls with attention-deficit/hyperactivity disorder (ADHD) combined type, 47 ADHD inattentive type, and 88 age- and ethnicity-matched comparison girls. Testing was performed without stimulant medication. All 10 neuropsychological variables showed significant omnibus subgroup differences, with 8 of 10 combined versus comparison contrasts significant (average effect size medium) and 6 of 10 inattentive versus comparison contrasts significant (average effect size small to medium), but only 2 of 10 combined versus inattentive contrasts significant (average effect size small). Results were robust to statistical control of demographic variables, comorbidities, and IQ. Discriminant function analysis revealed relatively high sensitivity but only modest specificity in predicting ADHD from comparison status from test performance; classification of the inattentive type was extremely poor.

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Most cited references 41

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Executive Functions and Developmental Psychopathology

Bruce F. Pennington, Sally Ozonoff (1996)

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Hypofrontality in attention deficit hyperactivity disorder during higher-order motor control: a study with functional MRI.

S Overmeyer, K. Rubia, M Brammer … (1999)

Functional magnetic resonance imaging (MRI) was used to investigate the hypothesis that attention deficit hyperactivity disorder (ADHD) is associated with a dysfunction of prefrontal brain regions during motor response inhibition and motor timing. Generic brain activation of seven adolescent boys with ADHD was compared to that of nine comparison subjects equivalent in sex, age, and IQ while they were performing a stop task, requiring inhibition of a planned motor response, and a motor timing task, requiring timing of a motor response to a sensory cue. The hyperactive adolescents showed lower power of response in the right mesial prefrontal cortex during both tasks and in the right inferior prefrontal cortex and left caudate during the stop task. ADHD is associated with subnormal activation of the prefrontal systems responsible for higher-order motor control. Functional MRI is a feasible technique for investigation of neural correlates of ADHD.

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DSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents.

Laura R. Barkley, Laurence L Greenhill, Joseph Biederman … (1994)

Optimal diagnostic thresholds were determined for DSM-IV attention deficit hyperactivity disorder, and the psychometric properties were compared to alternative definitions. Structured diagnostic interviews of multiple informants for 380 clinic-referred youths aged 4-17 years were conducted. In addition, standardized clinicians' validation diagnoses of attention deficit disorder were obtained to assess agreement with clinical judgment. Measures of impairment were obtained to assess the accuracy of identifying youth with an impairing condition. Three subtypes of attention deficit hyperactivity disorder (predominantly inattentive, predominantly hyperactive-impulsive, and combined types) were distinguished on the basis of the degree of deviance on separate dimensions of inattention and hyperactivity-impulsivity. These three subtypes were found to differ in terms of types of impairment, age, and sex ratio, but not ethnicity. In terms of case identification of attention deficit hyperactivity disorder, DSM-IV was found to be very similar to DSM-III-R, except that DSM-IV identified more impaired girls and preschool children. These results support the decision to subdivide the heterogeneous category of DSM-III-R attention deficit hyperactivity disorder into three subtypes. The resulting DSM-IV definition appears to be somewhat less biased toward the symptom pattern typical of elementary school boys.