scholarly journals Reward-Related Dysfunctions in Children Developing Attention Deficit Hyperactivity Disorder—Roles of Oppositional and Callous-Unemotional Symptoms

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):  
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.


Author(s):  
Yi-Lung Chen ◽  
Ray C. Hsiao ◽  
Wen-Jiun Chou ◽  
Cheng-Fang Yen

This study examined the levels of agreement between the reports of 207 adolescents with attention-deficit/hyperactivity disorder (ADHD) and their parents regarding the adolescents’ callous–unemotional (CU) traits and investigated the factors influencing adolescent–parent agreement. Adolescent–parent agreement about CU traits in three dimensions according to the Chinese version of the Inventory of Callous and Unemotional Traits was examined. The influence of demographic characteristics, comorbid conduct disorder (CD), oppositional defiant disorder (ODD), and ADHD symptoms on adolescent–parent agreement was also examined. The results indicated that adolescent–parent agreement on the CU trait of uncaringness was moderate, whereas agreement on the CU traits of callousness and unemotionality was poor. Adolescent–parent agreement on the three dimensions of CU traits varied depending on the adolescents’ sex and comorbid CD and ODD symptoms as well as parental age. Therefore, multiple sources of information are required when assessing the severity of CU traits in adolescents with ADHD. The factors influencing the levels of the agreement should also be considered.


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.


Author(s):  
Chen-Lin Chang ◽  
Tai-Ling Liu ◽  
Ray C. Hsiao ◽  
Pinchen Yang ◽  
Yi-Lung Chen ◽  
...  

This study examined parent–adolescent agreement on the callous, uncaring, and unemotional dimensions of callous–unemotional (CU) traits and the differences in adolescent-reported and parent-reported CU traits among 126 adolescents with autism spectrum disorder (ASD), 207 adolescents with attention-deficit/hyperactivity disorder (ADHD), and 203 typically developing (TD) adolescents. Adolescent-reported and parent-reported CU traits on the three dimensions of the Inventory of Callous and Unemotional Traits were obtained. The strength of CU traits and the differences between adolescent-reported and parent-reported traits were compared among the three groups using analysis of covariance. Parent–adolescent agreement was examined using intraclass correlation. The results reveal that both adolescent-reported and parent-reported callousness and uncaring traits in the ASD and ADHD groups were significantly stronger than those in the TD group. Parent–adolescent agreement on the uncaring trait was fair across the three groups, whereas that on callousness was poor across all three groups. Parent–adolescent agreement on unemotionality was fair in the TD group but poor in the ADHD and ASD groups. ASD and ADHD groups had significantly greater differences in scores reported by parents and adolescents on the callousness trait than the TD group. The parent–adolescent score differences in the uncaring trait were also larger in the ASD group than in the TD group. Thus, these results support the application of a multi-informant approach in CU trait assessment, especially for adolescents with ASD or ADHD.


2020 ◽  
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 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. Method: A total of 227 preschool children (89 with ADHD, 51 with Autism Spectrum Disorder [ ASD ]], and 87 Typically Developing Children [ TDC ]]) aged 4 5 years old were recruited. The participants were diagnosed using the Diagnostic Infant and Preschool Assessment (DIPA), and assessed using t he Swanson, Nolan, and Pelham Rating Scale IV , The Inventory of Callous Unemotional Traits I CU ), t he Behavior Rating Scale of Executive Function Preschool Version BRIEF P )), and t he parent rated Strengths and Difficulties Questionnaire (SDQ ). Results: The results showed that there was a significant difference between ICU subscale scores and total scores among the ADHD, ASD and TDC groups F 59.87 P < 0.001 with the ASD group s coring the higheset 37.16±10.19 ) and the TDC scoring the lowest 20.39±7.40 )). T he callousness scores in the ADHD+ODD group showed the highest level of significance , and the ADHD only group was significantly higher than the TDC F 20.42 , P < 001) The ICU subscales showed low to moderate positive correlations with the SDQ subscales γ 0.21 ~ 0.68 P < 0.01) except the unemotional subscale T he ICU subscales were also negatively associated with the prosocial behaviour subscale γ = 0.45 ~ 0.68 P < The total ICU score was moderately and positively related to the BRIEF-P subscales (γ = 0.4 7 ~0.6 7 P < 0.01). The CU traits were also used to predict oppositional defiant symptoms β = 0.32, R2 = 0.11, P < 0.001). The callousness and uncaring subscale scores and the total ICU score were significantly correlated with ADHD symptoms and explained a significant 3 proportion of the variance (15-24%).Conclusions: The current study indicated that having high CU scores was associated with increased odds of having ADHD. Screening for CU traits could be used to predict ADHD diagnosis in preschool children .


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