Do early internalizing and externalizing problems predict later irritability in adolescents with attention-deficit/hyperactivity disorder?

2016 ◽  
Vol 51 (4) ◽  
pp. 393-402 ◽  
Author(s):  
Melissa Mulraney ◽  
Nardia Zendarski ◽  
Fiona Mensah ◽  
Harriet Hiscock ◽  
Emma Sciberras
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Symptom Severity ◽  
Externalizing Problems ◽  
Cross Sectional ◽  
Hyperactivity Disorder ◽  
Parent Mental Health ◽  
Disorder Symptom ◽  
Internalizing And Externalizing

Objective: Irritable mood is common in children with attention-deficit/hyperactivity disorder. Research to date has primarily comprised cross-sectional studies; thus, little is known about the antecedents of irritability. Furthermore, existing cross-sectional studies generally focus on the association between irritability and comorbidities and do not examine broader aspects of functioning. Finally, previous research has neglected to include child-report of irritability. This study aimed to address these gaps using data from a longitudinal study of children with attention-deficit/hyperactivity disorder. Method: Children aged 5–13 years (mean = 10.2; standard deviation = 1.9) with attention-deficit/hyperactivity disorder were recruited from pediatric practices across Victoria, Australia. This study reports on those who had reached adolescence (12 years or older, mean = 13.8; standard deviation = 1.2) at the 3-year follow-up ( n = 140). Internalizing and externalizing problems were measured using the Strengths and Difficulties Questionnaire. At follow-up, parent-reported and adolescent self-reported irritability was assessed using the Affective Reactivity Index. Parent and adolescent outcomes measured at follow-up included attention-deficit/hyperactivity disorder symptom severity, sleep, behavior and parent mental health. Results: Children with externalizing problems at age 10 had higher parent-reported irritability (β = 0.31, 95% confidence interval = [0.17,–0.45], p = 0.001) in adolescence. Cross-sectional analyses found that irritability was associated with increased attention-deficit/hyperactivity disorder symptom severity and sleep problems; poorer emotional, behavioral and social functioning; and poorer parent mental health. Conclusion: Our findings highlight the importance of assessing for and managing early conduct problems in children with attention-deficit/hyperactivity disorder, as these predict ongoing irritability which, in turn, is associated with poorer functioning across a number of domains.

scholarly journals Gender differences in externalizing and internalizing problems in Singaporean children and adolescents with attention-deficit/hyperactivity disorder

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tsz Wing Ivy Lau ◽  
Choon Guan Lim ◽  
Sanchalika Acharryya ◽  
Nikki Lim-Ashworth ◽  
Yi Ren Tan ◽  
...  
Keyword(s):  
Gender Differences ◽  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Social Factors ◽  
Externalizing Problems ◽  
Physical Punishment ◽  
Internalizing And Externalizing Problems ◽  
Hyperactivity Disorder ◽  
Internalizing And Externalizing

Abstract Background Studies on gender differences in attention-deficit/hyperactivity disorder (ADHD) comorbidities in the Asian populations have been limited and previous studies have shown inconclusive findings. Singapore is a city-state country in Southeast Asia with a population of 5.7 million. This study examined gender differences in internalizing and externalizing problems in Singaporean children and adolescents with ADHD. The plausible social factors underlying the gender differences were discussed. Methods A total of 773 participants (aged 6 to 18, 88% males) newly diagnosed with ADHD were recruited from the largest public child and adolescent psychiatric center in Singapore. Their internalizing and externalizing problems were assessed using the Child Behavioral Checklist and Teacher’s Report Form by parents and teachers respectively. Demographics and relevant social factors were collected using parent questionnaires. Results Females with ADHD were reported to have less delinquent and aggressive behavior but more depressive symptoms than their male counterparts, similar to findings in the Western literature. Gender remained a significant predictor of externalizing problem after controlling for other factors. Lower socioeconomic status and parental use of physical punishment were significant predictors of both internalizing and externalizing problems. Conclusions Gender differences in ADHD comorbidities do exist in the Asian clinical population. The lack of externalizing symptoms in females with ADHD has made timely referral and diagnosis challenging. More research is needed in understanding the gender differences in ADHD and the biopsychosocial mechanism underlying the differences in order to improve the detection of ADHD in females.

scholarly journals Gender differences in externalizing and internalizing problems in Singaporean children and adolescents with attention-deficit/ hyperactivity disorder

2020 ◽  
Author(s):  
Tsz Wing Ivy Lau ◽  
Choon Guan Lim ◽  
Sanchalika Acharryya ◽  
Nikki Lim-Ashworth ◽  
Yi Ren Tan ◽  
...  
Keyword(s):  
Gender Differences ◽  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Social Factors ◽  
Externalizing Problems ◽  
Physical Punishment ◽  
Internalizing And Externalizing Problems ◽  
Hyperactivity Disorder ◽  
Internalizing And Externalizing

Abstract Background: Studies on gender differences in attention-deficit/ hyperactivity disorder (ADHD) comorbidities in the Asian populations have been limited and previous studies have shown inconclusive findings. Singapore is a city-state country in Southeast Asia with a population of 5.7 million. This study examined gender differences in internalizing and externalizing problems in Singaporean children and adolescents with ADHD. The plausible social factors underlying the gender differences were discussed.Methods: A total of 773 participants (aged 6 to 18, 88% males) newly diagnosed with ADHD were recruited from the largest public child and adolescent psychiatric center in Singapore. Their internalizing and externalizing problems were assessed using the Child Behavioral Checklist and Teacher’s Report Form by parents and teachers respectively. Demographics and relevant social factors were collected using parent questionnaires.Results: Females with ADHD were reported to have less delinquent and aggressive behavior but more depressive symptoms than their male counterparts, similar to findings in the Western literature. Older age, lower socioeconomic status and parental use of physical punishment were associated with higher internalizing and externalizing problems after controlling for other factors.Conclusions: Gender differences in ADHD comorbidities do exist in the Asian clinical population. The lack of externalizing symptoms in females with ADHD has made timely referral and diagnosis challenging. More research is needed in understanding the gender differences in ADHD and the biopsychosocial mechanism underlying the differences in order to improve the detection of ADHD in females.

scholarly journals Gender differences in externalizing and internalizing problems in Singaporean children and adolescents with attention-deficit/ hyperactivity disorder

2020 ◽  
Author(s):  
Tsz Wing Ivy Lau ◽  
Choon Guan Lim ◽  
Sanchalika Acharryya ◽  
Nikki Lim-Ashworth ◽  
Yi Ren Tan ◽  
...  
Keyword(s):  
Gender Differences ◽  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Social Factors ◽  
Externalizing Problems ◽  
Physical Punishment ◽  
Internalizing And Externalizing Problems ◽  
Hyperactivity Disorder ◽  
Internalizing And Externalizing

Abstract Background : Studies on gender differences in attention-deficit/ hyperactivity disorder (ADHD) comorbidities in the Asian populations have been limited and previous studies have shown inconclusive findings. Singapore is a city-state country in Southeast Asia with a population of 5.7 million. This study examined gender differences in internalizing and externalizing problems in Singaporean children and adolescents with ADHD. The plausible social factors underlying the gender differences were discussed. Methods : A total of 773 participants (aged 6 to 18, 88% males) newly diagnosed with ADHD were recruited from the only public child and adolescent psychiatric center in Singapore. Their internalizing and externalizing problems were assessed using the Child Behavioral Checklist and Teacher’s Report Form by parents and teachers respectively. Demographics and relevant social factors were collected using parent questionnaires. Results : Females with ADHD were reported to have less delinquent and aggressive behavior but more depressive symptoms than their male counterparts, similar to findings in the Western literature. Older age, lower socioeconomic status and parental use of physical punishment were associated with higher internalizing and externalizing problems after controlling for other factors. Conclusions: Gender differences in ADHD comorbidities do exist in the Asian clinical population. This suggests a need for gender-specific assessment of ADHD as females do not present with much externalizing problem which makes identification more difficult.

scholarly journals An examination of the relationships between attention/deficit hyperactivity disorder symptoms and functional connectivity over time

2021 ◽  
Author(s):  
Luke J. Norman ◽  
Gustavo Sudre ◽  
Marine Bouyssi-Kobar ◽  
Wendy Sharp ◽  
Philip Shaw
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Functional Connectivity ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Resting State ◽  
Inferior Frontal Gyrus ◽  
Eigenvector Centrality ◽  
Cross Sectional ◽  
Hyperactivity Disorder

AbstractPrevious cross-sectional work has demonstrated resting-state connectivity abnormalities in children and adolescents with attention/deficit hyperactivity disorder (ADHD) relative to typically developing controls. However, it is unclear to what extent these neural abnormalities confer risk for later symptoms of the disorder, or represent the downstream effects of symptoms on functional connectivity. Here, we studied 167 children and adolescents (mean age at baseline = 10.74 years (SD = 2.54); mean age at follow-up = 13.3 years (SD = 2.48); 56 females) with varying levels of ADHD symptoms, all of whom underwent resting-state functional magnetic resonance imaging and ADHD symptom assessments on two occasions during development. Resting-state functional connectivity was quantified using eigenvector centrality mapping. Using voxelwise cross-lag modeling, we found that less connectivity at baseline within right inferior frontal gyrus was associated with more follow-up symptoms of inattention (significant at an uncorrected cluster-forming threshold of p ≤ 0.001 and a cluster-level familywise error corrected threshold of p < 0.05). Findings suggest that previously reported cross-sectional abnormalities in functional connectivity within inferior frontal gyrus in patients with ADHD may represent a longitudinal risk factor for the disorder, in line with efforts to target this region with novel therapeutic methods.

scholarly journals Did Affiliate Stigma Predict Affective and Behavioral Outcomes in Caregivers and Their Children with Attention-Deficit/Hyperactivity Disorder?

2021 ◽  
Vol 18 (14) ◽  
pp. 7532
Author(s):  
Chih-Cheng Chang ◽  
Yu-Min Chen ◽  
Ray C. Hsiao ◽  
Wen-Jiun Chou ◽  
Cheng-Fang Yen
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Behavioral Problems ◽  
Attention Deficit ◽  
Externalizing Symptoms ◽  
Children With Adhd ◽  
Hyperactivity Disorder ◽  
Affiliate Stigma ◽  
Internalizing And Externalizing ◽  
Internalizing And Externalizing Symptoms

The aim of this follow-up study was to examine the predictive values of caregivers’ affiliate stigma at baseline for depression in caregivers and internalizing and externalizing symptoms in children with attention-deficit/hyperactivity disorder (ADHD) 1 year later. The Study on Affiliate Stigma in Caregivers of Children with ADHD surveyed the levels of affiliate stigma and depression in 400 caregivers and the behavioral problems of their children with ADHD. The levels of the caregivers’ depression and children’s behavioral problems were assessed 1 year later. The associations of caregivers’ affiliate stigma at baseline with depression in caregivers and internalizing and externalizing symptoms in children with ADHD at follow-up were examined using stepwise multiple regression. The results indicated that before caregivers’ depression and children’s behavioral problems at baseline were controlled, caregivers’ affiliate stigma at baseline positively predicted caregivers’ depression and all children’s behavioral problems. After caregivers’ depression and children’s behavioral problems at baseline were controlled, caregivers’ affiliate stigma at baseline still positively predicted children’s affective and somatic problems. Parenting training and cognitive behavioral therapy should be provided to caregivers with intense affiliate stigma to prevent emotional problems and difficulties in managing their children’s behavioral problems.

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