The Predominantly Inattentive Subtype of Attention-Deficit/Hyperactivity Disorder

CNS Spectrums ◽  
2000 ◽  
Vol 5 (6) ◽  
pp. 45-51 ◽  
Author(s):  
Mary V. Solanto

AbstractThe predominantly inattentive (IN) subtype of attention-deficit/hyperactivity disorder (ADHD) is a recently defined condition that is often overlooked by professionals and is still not completely understood. Characterized by symptoms of inattentiveness, such as distractibility, failure to complete work, forgetfulness, and disorganization, the IN subtype differs from the more commonly recognized combined (CB) subtype of ADHD in that symptoms of hyper activity and impulsivity are absent or minimal. Large-scale epidemiologic studies suggest that the IN subtype is at least as prevalent as the CB subtype, and is at least as likely to be associated with academic and/or social impairment. Diagnosis of the IN subtype, however, may be more challenging because in addition to inattentiveness, other symptoms, including learning problems, depression, and anxiety, may also present without externalizing behaviors. Several studies have shown that compared with the CB subtype, the IN subtype has a later age of onset and referral, a relatively larger proportion of affected females, and is much less likely to be associated with symptoms of oppositional defiant disorder or conduct disorder. Research is currently under way to examine the cognitive characteristics of the IN subtype and its genetic and neurobiologic underpinnings, as well as to evaluate the effectiveness of pharmacotherapy and other treatments.

2021 ◽  
pp. 108705472110179
Author(s):  
Eyup Sabri Ercan ◽  
Gul Unsel-Bolat ◽  
Ali Evren Tufan ◽  
Sevcan Karakoc Demirkaya ◽  
Oznur Bilac ◽  
...  

Objective: This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children. Method: The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants. Results: The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses. Conclusion: Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.


Author(s):  
Jinsong Zhang ◽  
Wei Li ◽  
Huifeng Zhang ◽  
Amanda Wilson ◽  
Lan Shuai ◽  
...  

Abstract Background Children with early onset of Callous-Unemotional (CU) traits are at a higher risk for long-term, persistent psychosocial problems. The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder (ADHD) and the diagnostic significance of CU traits in ADHD. Methods A total of 176 preschool children (89 with ADHD and 87 Typically Developing Children [TDC]) aged 4–5 years old were recruited to the study. The participants were assessed for CU traits, emotional and behavioral problems, and how their executive functioning was associated with ADHD using multiple assessment scales. Multiple linear regression analysis was performed to assess the incremental validity of the Inventory of Callous-Unemotional Traits (ICU), adjusting for possible covariates by child’s sex, conduct problems, and oppositional defiant symptoms. Results The results showed that there was a significant difference of ICU scores between the ADHD and TDC groups (F = 30.12, P < 0.001). In terms of callousness, ADHD + Oppositional Defiant Disorder (ODD) group showed a significant high score, and the ADHD only group scored significantly higher than the TDC group (F = 20.42, P < 0.001). The ICU was negatively associated with the prosocial behaviour subscale (γ = − 0.57, P < 0.01) and showed low to moderate positive correlations with emotional and behavioural problems, as well as executive function (γ = 0.24–0.67, P < 0.05). The ICU scores explained 6% of the incremental validity in ADHD symptoms. The diagnostic value of the ICU for ADHD was medium and acceptable. Conclusions The current study indicated that early identification of CU traits may help clinicians better understand symptoms and behavioural problems in children with ADHD. CU traits therefore could be considered as a useful assessment tool for ADHD.


2013 ◽  
Vol 26 (4) ◽  
pp. 202-208 ◽  
Author(s):  
Sophie Beyer von Morgenstern ◽  
Ingrid Becker ◽  
Judith Sinzig

Introduction and HypothesisSome authors draw a connection between the dopaminergic pathways and emotional perception. The present study is based on that association and addresses the question whether methylphenidate and the resulting amelioration of the disturbed dopamine metabolism lead to an improvement of the facial affect recognition abilities in children with attention-deficit/hyperactivity disorder (ADHD).MethodsA computer test was conducted on 21 participants, aged 7–14 years and with a diagnosis of ADHD – some with comorbid oppositional defiant disorder – conducted the FEFA (Frankfurt Test and Training of Facial Affect), a computer test to examine their facial affect recognition abilities. It consists of two subtests, one with faces and one with eye pairs. All participants were tested in a double-blind cross-over study, once under placebo and once under methylphenidate.Results and DiscussionThe collected data showed that methylphenidate leads to amelioration of facial affect recognition abilities, but not on a significant level. Reasons for missing significance may be the small sample size or the fact that there exists some overlapping in cerebral connections and metabolic pathways of the site of action of methylphenidate and the affected dopaminergic areas in ADHD. However, consistent with the endophenotype concept, certain gene locations of the dopaminergic metabolism as both an aetiological factor for ADHD and the deficient facial affect recognition abilities with these individuals were considered. Consulting current literature they were found to be not concordant. Therefore, we conclude that the lacking significance of the methylphenidate affect on facial affect recognition is based on this fact.


2017 ◽  
Author(s):  
Paul Croarkin ◽  
Reem Shafi

Oppositional defiant disorder (ODD) is a psychiatric disorder classified in the DSM-5 among disruptive, impulse control, and conduct disorder. The core features of ODD include a pervasive and impairing pattern of anger, irritability, inflexibility, defiance, malevolence, and aggression. Symptoms of ODD typically present during preschool. ODD can be a harbinger of conduct disorder. Isolated, transient symptoms of ODD are normal during development. Mood disorders, attention-deficit/hyperactivity disorder, and neurodevelopmental disorders are important considerations in differential diagnosis. However, ODD frequently co-occurs with other psychiatric diagnoses. Complex interactions with temperamental emotional dysregulation, family stress, early life stress, inconsistent parenting, and genetic and physiologic factors likely underlie the risk, pathophysiology, and prognosis of ODD. Unfortunately, these interactions and the neurobiological underpinnings of ODD are still poorly characterized. Although first-line treatments for ODD involve behavioral and psychosocial interventions, a thoughtful consideration of pharmacotherapy for co-occurring disorders and severe symptoms is an important component of treatment planning. Herein we review the epidemiology, etiology, pathophysiology, diagnostic evaluation, and treatment planning of ODD. Recent applicable controversies such as dimensional conceptualization of psychiatric disorders and the potential intersection of ODD and disruptive mood dysregulation disorder are also summarized.  This review contains 5 figures, 4 tables, and 44 references. Key words: aggression, attention-deficit/hyperactivity disorder, conduct disorder, defiance, disruptive behaviors, disruptive mood dysregulation disorder, DSM-5, irritability, oppositional defiant disorder, parent management training


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