A symptom level perspective on reactive and proactive aggressive behaviours and ADHD symptoms in childhood

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood disorders, affecting around 6.5% of youths worldwide. One common and impairing correlate of ADHD is aggressive behaviour which likely acts as a major contributor to the negative outcomes associated with ADHD. ADHD symptoms and aggression are both heterogeneous and it has been speculated that certain symptoms of ADHD might map more closely to certain types of aggressive behaviour. This study uses a symptom-level analysis to investigate the concurrent and temporal links between symptoms of ADHD and aggressive behaviours. This allows insights into whether specific symptoms are more likely to be connected which is highly important to refine intervention targets aiming to reduce aggressive behaviours associated with ADHD.Method: Using Gaussian Graphical Models and Graphical Vector Autoregression Models, cross-sectional and longitudinal networks of ADHD symptoms and aggressive behaviours, measured using parent-reported Social Behaviour Questionnaires (SBQ), were estimated. Participants included 1379 children taking part in the longitudinal Swiss z-proso cohort study at ages 7, 9 and 11. Results: Cross-sectional networks indicated that impulsivity symptoms and fidgeting were connected to reactive aggression under different types of provocation, with fidgeting also connected to a form of proactive aggression, namely dominating other children. The longitudinal network highlighted that ADHD symptoms and aggressive behaviours share a multitude of reciprocal temporal relations with inattentive ADHD symptoms preceding both reactive and proactive aggression. Conclusion: Findings from the current study present preliminary evidence indicating that interventions should focus on both hyperactive/impulsive and inattentive symptoms in order to reduce aggressive behaviours in children with ADHD. They further highlight that it is important to target feedback loops resulting from aggressive behaviours. Future research is needed to better understand the mechanisms through which ADHD and aggressive behaviours become linked.

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Diagnostic operationalization and phenomenological heterogeneity in psychiatry: the case of attention deficit hyperactivity disorder

Salud Mental ◽

10.17711/sm.0185-3325.2018.037 ◽

2018 ◽

Vol 41 (6) ◽

pp. 249-259 ◽

Cited By ~ 2

Author(s):

Giovanni Abrahão Salum ◽

◽

Ary Gadelha ◽

Guilherme Vanoni Polanczyk ◽

...

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Latent Trait ◽

Reaction Times ◽

Adhd Symptoms ◽

Validity And Reliability ◽

Hyperactivity Disorder ◽

Two Samples ◽

Symptom Level ◽

The Impact

Introduction. We assessed the impact of polythetic conceptualizations of mental disorders on the validity and reliability of psychiatric diagnosis, with a specific focus on two levels of heterogeneity: phenomenological and pathophysiological. Objective. We investigated this issue using attention deficit hyperactivity disorder (ADHD) as an example. Method. We examined individuals from two samples enriched for psychopathology (n = 1 255 children in Porto Alegre and 1 257 children in São Paulo, Brazil). We conducted a series of data analyses to investigate phenomenological heterogeneity, including confirmatory factor analysis. We also investigated pathophysiological heterogeneity using symptom-level regressions between ADHD symptoms and four neurocognitive processes consistently linked to ADHD (working memory, inhibitory control, intra-subject variability in reaction times, and temporal processing). Lastly, we assessed the performance of polythetic systems for reliability testing inter-rater and test-rest reliability of two well-known symptomatic scales. Results. Among the 116 200 possible combinations of symptoms to achieve DSM symptomatic threshold for categorical ADHD diagnosis, we found 173 combinations in the two independent samples, and only four were replicated in both samples (2.3%). We also found that the number of ADHD symptoms is a poor indicator of variation in the general ADHD latent trait. Overall, symptoms did not have specific profiles of associations with any of the neurocognitive processes. Reliability analyses revealed that increasing the number of items augments overall reliability of measurements. Discussion and conclusion. Our findings illustrate both potential benefits and problems inherent to the polythetic system for ADHD. Implications for the search of mechanisms underlying psychiatric disorders are discussed.

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Executive Functioning and Impairment in Emerging Adult College Students With ADHD Symptoms

Journal of Attention Disorders ◽

10.1177/1087054718787883 ◽

2018 ◽

Vol 23 (14) ◽

pp. 1759-1765

Author(s):

Morgan M. Dorr ◽

Kevin J. Armstrong

Keyword(s):

College Students ◽

Executive Functioning ◽

Adhd Symptom ◽

Adult Adhd ◽

Negative Relationship ◽

Emerging Adult ◽

Adhd Symptoms ◽

Symptom Level ◽

Adult College Students ◽

Students With Adhd

Objective: To better understand current issues with adult ADHD assessment contributing to adult ADHD being under recognized and undertreated. Method: This study examined the relationship between symptoms, impairment, and executive functioning (EF) in a college sample. Results: Among individuals screening negative for ADHD, those higher in EF experienced significantly less impairment than those lower in EF. Executive functioning was shown to have a negative relationship with impairment while ADHD symptomology was shown to have a positive relationship with impairment. In addition, impairment was significantly predicted by ADHD symptom level and EF, and there was a significant interaction between EF and ADHD symptom level in predicting impairment. However, high EF did not significantly protect against impairment in individuals reporting a significant level of ADHD symptoms. Conclusion: Further research is needed to clarify the relationships between these variables in emerging adult college students.

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Developmental Relations Between Internalising Problems and ADHD in Childhood: a Symptom Level Perspective

Research on Child and Adolescent Psychopathology ◽

10.1007/s10802-021-00856-3 ◽

2021 ◽

Author(s):

Lydia Gabriela Speyer ◽

Manuel Eisner ◽

Denis Ribeaud ◽

Michelle Luciano ◽

Bonnie Auyeung ◽

...

Keyword(s):

Graphical Models ◽

Psychosocial Functioning ◽

Social Behaviour ◽

Adhd Symptoms ◽

Gaussian Graphical Models ◽

Cross Sectional ◽

Reciprocal Relations ◽

Symptom Level ◽

Internalising Problems ◽

Graphical Vector

AbstractADHD and internalising problems commonly co-occur with up to 50% of children diagnosed with ADHD also suffering from anxiety or depression. However, their developmental relations are currently not well understood. Longitudinal symptom level analyses can provide valuable insights into how difficulties in these areas of psychosocial functioning affect each other. Using Gaussian Graphical Models and Graphical Vector Autoregression Models, this study estimated cross-sectional and longitudinal networks of ADHD and internalising symptoms in 1387 children using parent- and teacher-reported Social Behaviour Questionnaires (SBQ) when children were aged 7, 9 and 11. Cross-sectional and longitudinal networks suggested that ADHD shares reciprocal relations with internalising symptoms through a number of potential bridge symptoms that are primarily connected to anxiety symptoms. High scores on child cannot sit still, is restless, or hyperactive were found to be the strongest bridge symptom acting as an antecedent to higher internalising symptoms whereas child is worried was the strongest antecedent for higher ADHD symptoms. Findings of this study highlight several potential bridge symptoms that may serve as key intervention targets and further emphasise the need for clinicians to assess children presenting with ADHD symptoms for internalising problems and vice versa.

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Developmental Relations between Internalising Problems and ADHD in Childhood: A Symptom Level Perspective

10.31234/osf.io/mtns6 ◽

2021 ◽

Author(s):

Lydia Gabriela Speyer ◽

Manuel Eisner ◽

Denis Ribeaud ◽

Michelle Luciano ◽

Bonnie Auyeung ◽

...

Keyword(s):

Graphical Models ◽

Psychosocial Functioning ◽

Social Behaviour ◽

Adhd Symptoms ◽

Gaussian Graphical Models ◽

Cross Sectional ◽

Reciprocal Relations ◽

Symptom Level ◽

Internalising Problems ◽

Graphical Vector

ADHD and internalising problems commonly co-occur with up to 50% of children diagnosed with ADHD also suffering from anxiety or depression. However, their developmental relations are currently not well understood. Longitudinal symptom level analyses can provide valuable insights into how difficulties in these areas of psychosocial functioning affect each other. Using Gaussian Graphical Models and Graphical Vector Autoregression Models, this study estimated cross-sectional and longitudinal networks of ADHD and internalising symptoms in 1387 children using parent- and teacher-reported Social Behaviour Questionnaires (SBQ) when children were aged 7, 9 and 11. Cross-sectional and longitudinal networks suggested that ADHD shares reciprocal relations with internalising symptoms through a number of potential bridge symptoms that are primarily connected to anxiety symptoms. High scores on child cannot sit still, is restless, or hyperactive were found to be the strongest bridge symptom acting as an antecedent to higher internalising symptoms whereas child is worried was the strongest antecedent for higher ADHD symptoms. Findings of this study highlight several potential bridge symptoms that may serve as key intervention targets and further emphasise the need for clinicians to assess children presenting with ADHD symptoms for internalising problems and vice versa.

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Basic numerical processing, calculation, and working memory in children with dyscalculia and/or ADHD symptoms

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000450 ◽

2016 ◽

Vol 44 (5) ◽

pp. 365-375 ◽

Cited By ~ 9

Author(s):

Jörg-Tobias Kuhn ◽

Elena Ise ◽

Julia Raddatz ◽

Christin Schwenk ◽

Christian Dobel

Keyword(s):

Working Memory ◽

Processing Speed ◽

Verbal Working Memory ◽

Typically Developing ◽

Cognitive Profiles ◽

Adhd Symptoms ◽

Memory Processing ◽

Numerical Processing ◽

Hyperactivity Disorder ◽

Neurocognitive Measures

Abstract. Objective: Deficits in basic numerical skills, calculation, and working memory have been found in children with developmental dyscalculia (DD) as well as children with attention-deficit/hyperactivity disorder (ADHD). This paper investigates cognitive profiles of children with DD and/or ADHD symptoms (AS) in a double dissociation design to obtain a better understanding of the comorbidity of DD and ADHD. Method: Children with DD-only (N = 33), AS-only (N = 16), comorbid DD+AS (N = 20), and typically developing controls (TD, N = 40) were assessed on measures of basic numerical processing, calculation, working memory, processing speed, and neurocognitive measures of attention. Results: Children with DD (DD, DD+AS) showed deficits in all basic numerical skills, calculation, working memory, and sustained attention. Children with AS (AS, DD+AS) displayed more selective difficulties in dot enumeration, subtraction, verbal working memory, and processing speed. Also, they generally performed more poorly in neurocognitive measures of attention, especially alertness. Children with DD+AS mostly showed an additive combination of the deficits associated with DD-only and A_Sonly, except for subtraction tasks, in which they were less impaired than expected. Conclusions: DD and AS appear to be related to largely distinct patterns of cognitive deficits, which are present in combination in children with DD+AS. 

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Effectiveness of the Prevention Program for Externalizing Problem Behavior (PEP) in Preschoolers with Severe and No or Mild ADHD Symptoms

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000425 ◽

2016 ◽

Vol 44 (3) ◽

pp. 231-239 ◽

Cited By ~ 3

Author(s):

Ilka Eichelberger ◽

Julia Plücka ◽

Christopher Hautmann ◽

Charlotte Hanisch ◽

Manfred Döpfner

Keyword(s):

Problem Behavior ◽

Prevention Program ◽

Adhd Symptoms ◽

Aggressives Verhalten ◽

Externalizing Problem Behavior ◽

Externalizing Problem ◽

Expansives Problemverhalten

Abstract. Zusammenfassung: Fragestellung: Das Präventionsprogramm für Expansives Problemverhalten (PEP), entwickelt für Eltern (EL) und ErzieherInnen (ER) von Vorschulkindern, zeigte in beiden Modulen (PEP-EL und PEP-ER) in der Routineversorgung positive Effekte. Das Ziel dieser Sekundäranalyse war die Untersuchung der Effekte beider Module bezogen auf Vorschulkinder mit hoch ausgeprägter ADHS-Symptomatik im Vergleich zu Kindern mit keiner oder wenig ausgeprägter ADHS-Symptomatik. Methodik: In einem Eigenkontrollgruppendesign werden die Veränderungen der Symptomatik und des Problemverhaltens der Kinder in spezifischen Situationen zu Hause und in der Schule in einer Wartephase mit den Veränderungen in einer Interventionsphase verglichen (jeweils 3 Monate). Ergebnisse: Durch das Elterntraining reduzieren sich für Kinder mit hoch ausgeprägter ADHS-Symptomatik die spezifischen Problemsituationen zu Hause (HSQ-D) und durch das ErzieherInnentraining zeigen sich signifikante Effekte für oppositionell-aggressives Verhalten und im Gesamtscore des Fragebogen für ErzieherInnen von Klein- und Vorschulkindern (C-TRF 1½-5). Kinder mit keiner oder weniger ausgeprägter ADHS-Symptomatik zeigen Veränderungen im HSQ-D, im oppositionell-aggressiven Verhalten und im Gesamtwert des Elternfragebogen für Klein- und Vorschulkinder (CBCL 1½-5), während sich für das ErzieherInnentraining in allen Zielvariablen signifikante Effekte zeigen. Schussfolgerungen: Die Befunde, dass sich Effekte auf unterschiedlichen Dimensionen von Problemverhalten zeigen, legen nahe, dass die Kombination beider Trainingsmodule eine potentielle präventive Strategie für Vorschulkinder mit ADHS darstellt.

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The Attenuation of Very Low Frequency Brain Oscillations in Transitions from a Rest State to Active Attention

Journal of Psychophysiology ◽

10.1027/0269-8803.23.4.191 ◽

2009 ◽

Vol 23 (4) ◽

pp. 191-198 ◽

Cited By ~ 26

Author(s):

Suzannah K. Helps ◽

Samantha J. Broyd ◽

Christopher J. James ◽

Anke Karl ◽

Edmund J. S. Sonuga-Barke

Keyword(s):

Brain Activity ◽

Sampling Rate ◽

Low Frequency ◽

Future Research ◽

Adhd Symptoms ◽

Default Mode ◽

Very Low Frequency ◽

Wide Range ◽

Interference Hypothesis ◽

Mode Interference

Background: The default mode interference hypothesis ( Sonuga-Barke & Castellanos, 2007 ) predicts (1) the attenuation of very low frequency oscillations (VLFO; e.g., .05 Hz) in brain activity within the default mode network during the transition from rest to task, and (2) that failures to attenuate in this way will lead to an increased likelihood of periodic attention lapses that are synchronized to the VLFO pattern. Here, we tested these predictions using DC-EEG recordings within and outside of a previously identified network of electrode locations hypothesized to reflect DMN activity (i.e., S3 network; Helps et al., 2008 ). Method: 24 young adults (mean age 22.3 years; 8 male), sampled to include a wide range of ADHD symptoms, took part in a study of rest to task transitions. Two conditions were compared: 5 min of rest (eyes open) and a 10-min simple 2-choice RT task with a relatively high sampling rate (ISI 1 s). DC-EEG was recorded during both conditions, and the low-frequency spectrum was decomposed and measures of the power within specific bands extracted. Results: Shift from rest to task led to an attenuation of VLFO activity within the S3 network which was inversely associated with ADHD symptoms. RT during task also showed a VLFO signature. During task there was a small but significant degree of synchronization between EEG and RT in the VLFO band. Attenuators showed a lower degree of synchrony than nonattenuators. Discussion: The results provide some initial EEG-based support for the default mode interference hypothesis and suggest that failure to attenuate VLFO in the S3 network is associated with higher synchrony between low-frequency brain activity and RT fluctuations during a simple RT task. Although significant, the effects were small and future research should employ tasks with a higher sampling rate to increase the possibility of extracting robust and stable signals.

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