Clinical assessment of Hispanic youth diagnosed with attention-deficit/hyperactivity disorder and other externalizing disorders.

Author(s):  
José J. Cabiya ◽  
Nanet M. López-Córdova
2016 ◽  
Vol 28 (4pt1) ◽  
pp. 1053-1069 ◽  
Author(s):  
Neil McNaughton ◽  
Philip J. Corr

AbstractWe discuss comorbidity, continuity, and discontinuity of anxiety-related disorders from the perspective of a two-dimensional neuropsychology of fear (threat avoidance) and anxiety (threat approach). Pharmacological dissection of the “neurotic” disorders justifies both a categorical division between fear and anxiety and a subdivision of each mapped to a hierarchy of neural modules that process different immediacies of threat. It is critical that each module can generate normal responses, symptoms of another syndrome, or syndromal responses. We discuss the resultant possibilities for comorbid dysfunction of these modules both with each other and with some disorders not usually classified as anxiety related. The simplest case is symptomatic fear/anxiety comorbidity, where dysfunction in one module results in excess activity in a second, otherwise normal, module to generate symptoms and apparent comorbidity. More complex is syndromal fear/anxiety comorbidity, where more than one module is concurrently dysfunctional. Yet more complex are syndromal comorbidities of anxiety that go beyond the two dimensional fear/anxiety systems: depression, substance use disorder, and attention-deficit/hyperactivity disorder. Our account of attention-deficit/hyperactivity disorder–anxiety comorbidity entails discussion of the neuropsychology of externalizing disorders to account for the lack of anxiety comorbidity in some of these. Finally, we link the neuropsychology of disorder to personality variation, and to the development of a biomarker of variation in the anxiety system among individuals that, if extreme, may provide a means of unambiguously identifying the first of a range of anxiety syndromes.


The Oxford Textbook of Attention Deficit Hyperactivity Disorder provides an authoritative, multidisciplinary text displaying the latest research developments in the diagnosis, assessment, and management of patients with ADHD. Organized into eight key sections, this textbook covers the aetiology, pathophysiology, epidemiology, clinical presentation, comorbidity, clinical assessment, and clinical management of ADHD. Individual chapters address key topics, such as the clinical assessment of ADHD in adults and different presentations of ADHD. They contain information on best practice, current diagnostic guidelines, including DSM-5 and ICD-11, and key up-to-date references for further reading.


2021 ◽  
Vol 12 ◽  
Author(s):  
Susan Schloß ◽  
Friederike Derz ◽  
Pia Schurek ◽  
Alisa Susann Cosan ◽  
Katja Becker ◽  
...  

Objectives: Neurocognitive functions might indicate specific pathways in developing attention deficit hyperactivity disorder (ADHD). We focus on reward-related dysfunctions and analyze whether reward-related inhibitory control (RRIC), approach motivation, and autonomic reactivity to reward-related stimuli are linked to developing ADHD, while accounting for comorbid symptoms of oppositional defiant disorder (ODD), and callous-unemotional (CU) traits.Methods: A sample of 198 preschool children (115 boys; age: m = 58, s = 6 months) was re-assessed at age 8 years (m = 101.4, s = 3.6 months). ADHD diagnosis was made by clinical interviews. We measured ODD symptoms and CU traits using a multi-informant approach, RRIC (Snack-Delay task, Gift-Bag task) and approach tendency using neuropsychological tasks, and autonomic reactivity via indices of electrodermal activity (EDA).Results: Low RRIC and low autonomic reactivity were uniquely associated with ADHD, while longitudinal and cross-sectional links between approach motivation and ADHD were completely explained by comorbid ODD and CU symptoms.Conclusion: High approach motivation indicated developing ADHD with ODD and CU problems, while low RRIC and low reward-related autonomic reactivity were linked to developing pure ADHD. The results are in line with models on neurocognitive subtypes in externalizing disorders.


Author(s):  
Daniel T. Chrzanowski ◽  
Elisabeth B. Guthrie ◽  
Matthew B. Perkins ◽  
Moira A. Rynn

Common disorders of children and adolescents include neurodevelopmental disorders (e.g., intellectual disability, autistic spectrum disorder, and learning disorders), internalizing disorders (e.g., mood and anxiety disorders), and externalizing disorders (e.g., oppositional defiant disorder and conduct disorder). The assessment of a child or adolescent patient always includes multiple informants, the context in which the child’s difficulties occur, and a functional behavioral assessment. Patients with autism spectrum disorder tend to have persistent deficits in social communication and social interaction, a restricted repertoire of behaviors and interests, and abnormal cognitive functioning. Children with disruptive mood dysregulation disorder experience chronic and severe irritability and frequent temper outbursts. Attention deficit hyperactivity disorder is characterized by hyperactivity, impulsivity, and inattention before 12 years of age. Behavior therapy has been effectively used to treat children and adolescents with neurodevelopmental disorders, attention deficit hyperactivity disorder, tic disorders, feeding and elimination disorders, and externalizing disorders. Fluoxetine is approved for treatment of depression in children and escitalopram, for adolescents. Methylphenidate and amphetamine preparations are first-line treatment for children with attention deficit hyperactivity disorder.


2011 ◽  
Vol 35 (10) ◽  
pp. 380-383 ◽  
Author(s):  
Carsten Vogt ◽  
Amirreza Shameli

Aims and methodTo appraise the value of additional information from objective measurements (QbTest system) in the clinical assessment of children and adolescents with attention-deficit hyperactivity disorder (ADHD). Two groups of ADHD assessments were compared. In the first group, assessments were undertaken without objective measures, whereas in the second group objective measures were added to the assessment. Practice outcomes were followed up over 1 year.ResultsObjective measures improve differentiating between ADHD and other conditions whose symptoms are known to overlap with ADHD. Objective measurements reduce the risk of unidentified ADHD (P < 0.0035) as measured by subsequent rates of revised diagnosis over a 12-month period.Clinical implicationsIntroducing objective measurements into the clinical assessment of ADHD provides an increased robustness of the clinical diagnosis strengthening clinical decisions for treatment interventions.


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