Carolyn S. Hartsough

Prospective Study of Tobacco Smoking and Substance Dependencies Among Samples of ADHD and Non-ADHD Participants

This study focused on an audience at high risk for heavy use of licit and illicit substances: young adults who as children had attention-deficit/hyperactivity disorder (ADHD). The participants in this study were part of a longitudinal study of the life histories of 492 children, one third of whom were identified as hyperactive in 1974 and whose childhood symptom ratings and medical histories were used to establish Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; DSM-III-R) ADHD diagnoses (American Psychiatric Association, 1987). The objectives of the study centered on describing (a) developmental history of tobacco use among ADHD and non-ADHD participants in a longitudinal sample, (b) the characteristic adult patterns of tobacco use from early adolescence through early adulthood, and (c) the relationship between ADHD status and tobacco and substance dependence outcomes. Adult data were obtained for 81% of the original 492 participants (77% of the ADHD and 86% of the controls). Lifetime and current tobacco use were assessed from child, adolescent, and adult data, yielding eight measures of smoking status. The study showed that participants with and without ADHD did not differ in age of initiation to smoking, but there was a significant difference in the age they began smoking regularly. By age 17, 46% of all participants with ADHD, as contrasted with 24% of the age-mate controls, reported smoking cigarettes daily. In adulthood, the proportion of participants with ADHD who were current smokers (42%) continued to exceed that of the age-mate controls (26%). Among current adult smokers, 35% with ADHD smoked daily as compared to 16% of the age-mate controls. There were significantly different lifetime tobacco dependence rates—40% compared to 19% for age-mate controls. The rates for cocaine dependence were 21% for participants with ADHD and 10% for age-mate controls. We reported a significant difference in rates of daily smoking and tobacco dependence for those with ADHD who had used stimulant medication in childhood in contrast to controls. Results were interpreted to support a possible link between ADHD treatment histories and levels of tobacco smoking and tobacco dependence in adulthood.

Childhood Conduct Problems, Hyperactivity‐impulsivity, and Inattention as Predictors of Adult Criminal Activity

This study reconsiders the relationship of childhood Attention Deficit/Hyperactivity Disorder (ADHD) and childhood conduct problems with adult criminal activity by clarifying the role of the cardinal behaviors associated with the DSM-IV ADHD subtypes (inattention and hyperactivity/impulsivity). Since their childhood (average age 9 years), 230 male and 75 female subjects have been followed prospectively and were interviewed as young adults (average age 26 at follow-up). Early childhood behavior ratings by parents and teachers were examined to determine the role of conduct problems, hyperactivity-impulsivity, and inattention in predicting adult criminal involvement as measured by both official arrest records and self-report. Results show that both hyperactivity-impulsivity and early conduct problems independently, as well as jointly, predict a greater likelihood of having an arrest record for males, but not for females. For male subjects with 10 or more self-reported crimes, both early conduct problems and hyperactivity-impulsivity were significant predictors, both alone and in combination. Therefore, it appears that predominantly the symptoms of hyperactivity-impulsivity, but not inattention, contribute to the risk for criminal involvement over and above the risk associated with early conduct problems alone.

MEDICAL FACTORS IN HYPERACTIVE AND NORMAL CHILDREN: Prenatal, Developmental, and Health History Findings

Guided by the goal of documenting the natural course of the life histories of a large sample of hyperactive children and their control counterparts, this research reports the extent to which prenatal, developmental, and health history factors distinguish hyperactive and control groups, as well as the relative contributions of the various medical factors. Results indicate that prenatal factors, rather than those occurring later in the childs medical history, are the best predictors of subsequent hyperactive diagnosis.

PERSISTENCE OF HYPERACTIVITY SYMPTOMS FROM CHILDHOOD TO ADOLESCENCE AND ASSOCIATED OUTCOMES

Hyperactive boys and matched controls from a large-scale epidemiological study, followed for at least three years to age 12, were compared on parent and teacher reports and assessments of attention, achievement, and intellectual functioning. Three outcome groups, based on presence or absence of hyperactivity symptoms, were derived and compared to the DSM-III description of ADD-H. Problem-free adolescents who were hyperactive in childhood were found to be more mature cognitively and behaviorally than those whose problems persisted.

Students Identified as Seriously Emotionally Disturbed in School-Based Day Treatment: Cognitive, Psychiatric, and Special Education Characteristics.

In the continuum of services for students with emotional and behavioral problems, school-based day treatment programs are at the point at which maximum collaboration and coordination between school and mental health is typically involved. With shared diagnostic and program responsibility, a mutually identified student cohort, and frequent interaction across agency boundaries, this interface between school and mental health presents a unique opportunity to examine diagnostic similarities and differences between the two systems. Archival record searches were conducted to gather data regarding the diagnostic and treatment histories of 85 children and adolescents served in two exemplary school-based day treatment programs in California. Findings suggest a significant lag time between first symptoms, referral for services, and treatment; marked instability of psychiatric diagnoses over time; and lack of concordance between DSM diagnoses and IDEA SED characteristics. These data raise serious concerns regarding the availability of prevention and early intervention services, even in locales striving to develop a coordinated system-of-care approach to treatment. They also raise questions about the integrity and congruity of the psychiatric and educational diagnostic systems utilized by school and mental health personnel.

A comparison of self-report of criminal involvement and official arrest records

Self-reports of arrests and official arrest records were compared for 250 male and 80 female participants in the ongoing Hyperactivity Follow-Up Study of Young Adults at University of California at Berkeley. For males, kappa coefficients indicated good statistical agreement between arrest records and self-report measures for 7 of the 12 types of crimes. Statistical agreement, however, may not be the most meaningful yardstick to judge concordance. Additional analyses reveal that for almost all of the crimes examined, one third or more of those with an arrest record for the crime failed to reveal this information on the self-report measure. Arrests for both some high-frequency, less serious crimes and some low-frequency, more serious crimes were not revealed in the subjects’ self-reports. An examination of the unique information gained from self-reports found that the subjects most often reported committing public disorder crimes for which they were not caught (over 30%) and were least likely to self-report crimes against people (less than 10%). Furthermore, subjects with more convictions were more likely to accurately self-report their criminal involvement. Since both self-report and official records each contribute unique information and reflect different sources of error, it is proposed that a combination of both types of records is the most inclusive indicator of criminal activity in adulthood. Aggr. Behav. 27:44–54, 2001.

Scaling Behavioral Attributes of Children Using Multiple Teacher Judgments of Pupil Characteristics

THE objective of this investigation was (a) to develop an interval scale of measurement for attributes assessing several nonintellectual behaviors of children and (b) to anchor each scale by having teachers assign scale values to behavior descriptors of children possessing the attributes to varying degrees. Attempts to capitalize on the teacher’s long term observation of her class members in the development of rating scales have a long history in psychological and educational research. This investigation should produce scales which maximize the usefulness of teacher observations.

CONTRIBUTION OF PREDISPOSITIONAL FACTORS TO THE DIAGNOSIS OF HYPERACTIVITY

Hyperactivity is a complex childhood problem and may represent several groups or syndromes, each with its own etiological patterns. This paper presents results of analyses indicating that, although biological and demographic factors may predispose children to being identified and treated as hyperactive, the major contributions to the condition are early manifestations of temperament and the quality of the familys interaction with the child.

Evaluation of a Nonintellectual Assessment Procedure for the Early Screening of Exceptionality.

Abstract Using a battery of nonintellectual measures with demonstrated validity for the screening of learning disabled and emotionally handicapped pupils, this study evaluated the feasibility of screening for potential educable mentally retarded (EMR) and gifted candidates. The criterion measure used to establish evidence of potential EMR and gifted eligibility was an individually-administered intelligence test. Teacher nominations of pupils they would refer for learning disabled (LD), EMR and gifted evaluation were obtained prior to administration of the screening instruments in a subsample of the participating districts in order to compare IQ criterion groups and screening results with teacher referrals. Results showed that the group of pupils screened by the nonintellectual measures contained 91% of those in the low IQ group (potential EMR) and 86% of those in the high IQ group (potential gifted). By contrast, teacher referrals failed to screen any of those deemed potentially eligible based on IQ criterion scores. The evidence suggests that reliance on conventional methods of teacher referral is inadequate for screening of EMR and gifted pupils, but that screening with the nonintellectual measures demonstrates a promise worthy of wider consideration.

Dimensions of the group environment scale

Student teachers in yearlong mental health consultation groups completed Mooss Group Environment Scale (GES) and three semantic differential ratings of their satisfaction with the group experience. Factor analysis of the GES yielded four dimensions, the first two corresponding to Mooss hypothesized dimensions of Relationship and System Maintenance/System Change. Intercorrelations of factor composite scores with the differential ratings provided concurrent validity evidence for the factored dimensions. Results were interpreted as supporting a multidimensional rather than unidimensional structure for the GES.