Cynthia L. Frame

Are Attention Deficit Disorders with and without Hyperactivity Similar or Dissimilar Disorders

From a population of 625 children in grades 2–5, 10 children were identified as those with attention deficit disorder with hyperactivity (ADD/H) and 20 children were identified as those with attention deficit disorder without hyperactivity (ADD/WO). When compared with matched normal control children on a battery of teacher ratings, peer ratings, and self-report measures, markedly different patterns of characteristics were found for the two ADD groups. ADD/H children exhibited aggressive conduct disorders, bizarre behavior, were guiltless, very unpopular, and performed poorly in school. In contrast, ADD/WO children were found to be anxious, shy, socially withdrawn, moderately unpopular, and poor in sports and school performance. Both groups exhibited depression and poor self-concepts, but differed in the specific areas of low self-esteem. These different patterns suggest that ADD/ H and ADD/WO are dissimilar syndromes and perhaps should not be considered to be subtypes of the same disorder.

Characteristics of children with extreme scores on the children's depression inventory

The concurrent validity of the Childrens Depression Inventory (CDI) was examined by assessing the relationship between this instrument and other measures of psychological and social functioning with which it would be expected to correlate. From a sample of 252 second through fifth graders, 15 children were identified who obtained extreme scores on the CDI (score 19 or greater). A matched comparison group of 15 children who received low scores on the CDI (scores of 5 or below) was also formed. A battery of self‐report, peer, and teacher measures was administered to assess anxiety, self‐esteem, academic status, teacher ratings of child behavior, sociometric status, social functioning, and other child characteristics. Findings suggested that children with extreme scores on the CDI displayed many of the characteristics critical in the diagnosis of depression and features believed to be associated with depression in children and adults. These included low self‐esteem, anxiety, unassertiveness, social withdraw...

Teacher Ratings of Attention Problems in Children Experimentally Classified as Exhibiting Attention Deficit Disorder with and without Hyperactivity

From a total of 625 children, 30 children in grades 2–5 were experimentally classified as having Attention Deficit Disorder with Hyperactivity (ADD/H: N = 10) or Attention Deficit without Hyperactivity (ADD/WO: N = 20) using teacher ratings of behavior on the Revised Behavior Problem Checklist (RBPC). These groups were compared to normal control children ( N = 20) on each of the items that comprise the Attention Problem-Immaturity (API) factor of the RBPC. Both ADD groups were rated by teachers as exhibiting significantly greater attention problems than controls on 12 of the 16 items on the factor. However, the ADD/H children were rated as more irresponsible, sloppy, distractible, impulsive, less sluggish, more likely to answer without thinking, and faster in finishing assignments than the ADD/WO children. In addition, only the ADD/H group differed significantly from controls on ratings of impulsivity and anwering without thinking, and only the ADD/WO group differed from controls on ratings of sluggishness and drowsiness. A stepwise discriminant analysis showed that the two ADD groups could be accurately discriminated (average canonical r 2 = 0.83) by a combination of ratings of impulsivity, sluggishness, immaturity, sloppiness, slowness, and need for supervision. These results suggest that ADD/H and ADD/WO may exhibit dissimilar types of attention deficits. Journal of the American Academy of Child Psychiatry , 24, 5:613–616, 1985.

Sociometric status of clinic-referred children with attention deficit disorders with and without hyperactivity.

Peer sociometric nominations of clinic-referred children given the diagnosis of Attention) Deficit Disorder with Hyperactivity (ADD/H) or Attention Deficit Disorder without Hyperactivity (ADD/WO) were compared to one another and to those of normal control children. Only children with ADD diagnoses in the absence of other major diagnoses were included. Both children with ADD/H (n=16) and ADD/WO (n=11) received significantly fewer “liked most” nominations, more “liked least” nominations, and lower social preference scores than normal control (n=45) children. These results confirm previous findings of social deficits in children with ADD/H, even when codiagnoses are excluded. In addition, they support the validity of the diagnostic category of ADD/WO by demonstrating that the ADD/WO behavior pattern is apparently “psychopathological” in being associated with peer unpopularity after codiagnoses are excluded. When larger groups including all codiagnoses (primarily Conduct Disorder) of children with ADD/H (n=36) and ADD/WO (n=20) were compared, identical patterns of peer unpopularity were found, except that children with ADD/H also were significantly more likely to be nominated as a child who “fights most”.

Sexual Coercion and Attraction to Sexual Aggression in a Community Sample of Young Men

Few studies have examined sexually coercive behavior in nonoffending yound adults other than college students. The present investigation examined self-report measures of peer delinquency, sexual promiscuity, hostility toward women, anger, and alcohol consumption on dates as predictors of sexual coercion and attraction to sexual aggression in a cross section of 65 nonoffending young men from a rural community. Delinquency was the strongest predictor of both coercive sexual behavior and attraction to sexual aggression. Attraction to sexual aggression also was significantly predicted by hostility toward women. Individuals with no histories of committing sexually coercive acts but who were highly attracted to sexual aggression shared profiles similar to sexually coercive men on hostility toward women, delinquency, and alcohol consumption on dates. Sexually noncoercive men low on attraction scored significantly lower than sexually coercive men on hostility toward women and alcohol consumption on dates and reported significantly less delinquent behavior than both other groups.

The association between social withdrawal and internalizing problems of children

Children identified as low-frequency interactors or socially withdrawn were compared to outgoing children to evaluate whether socially withdrawn children display concurrent internalizing problems. From a sample of 640 children in grades 2–5, 48 children were identified by teachers as lowfrequency interactors and 72 children were selected as outgoing or sociable. When these two groups were compared on a battery of teacher, peer, and selfreport measures that assessed internalizing difficulties, the lowfrequency interactors were found to display concurrent problems in adjustment. Children who rarely interacted with peers were less well liked by their peers, displayed poorer self-concepts, and were more depressed and anxious than sociable children. In contrast to these findings regarding internalizing problems, the two groups did not differ on measures of externalizing problems. The results lend support to the concurrent validity of the low-interaction method of identifying socially withdrawn children.

Epidemiology and treatment of mental health problems in juvenile delinquents

Abstract In an effort to establish the comorbidity rates of various mental health problems and juvenile delinquency and to determine the most efficacious treatments for such dually diagnosed youths, over 75 publications were reviewed. Despite a dearth of methodologically sound findings, some tentative conclusions were possible. First, in addition to conduct disorder, several other diagnosable mental disorders appear to occur frequently in the population of juvenile delinquents. These problems include personality, affective, attention deficit hyperactivity, and substance abuse disorders, and mental retardation. Most reported treatment studies were for conduct problems, although there were a few reports of interventions for sexual disorders, substance abuse prevention, and mental retardation, most of which were somewhat successful on a short-term basis. Reasons for the lack of high quality empirical studies of the mental health problems of juvenile delinquents were proposed, and the importance of increasing our knowledge base and improving service delivery for such comorbid disorders was stressed.

Behavioral treatment of depression in a prepubertal child.

The present study evaluated behavioral treatment of symptoms of depression in a 10 yr-old boy. Diagnosis of the childs depression was made on the basis of DSM-III criteria. Information was obtained from separate interviews with the child and mother and from multiple assessment instruments. Ratings from several sources (mother, psychiatrist, psychologist and staff) confirmed the diagnosis. Four behaviors that characterized the childs depression were selected for intervention and included inappropriate body position, lact of eye contact, poor speech and bland affect. Treatment, evaluated in a multiple-baseline design across symptoms, consisted of the combination of instructions, modeling, role-playing and feedback. Results indicated that behaviors characteristic of childhood depression could be reliably identified and effectively treated by behavioral techniques. Treatment effects were maintained at 12-week follow-up assessment.

The Perception of obesity by normal-weight versus obese school-age children

There appears to be little difference between obese and normal weight children in their perceptions of obese individuals. Both groups of children endorse negative stereotypes of obese persons when information about body type is the only available cue. However, these stereotypes may be somewhat negated in the minds of both groups when the obese person is physically attractive and/or is in a position of authority.

Juvenile delinquency entry and persistence: Do attention problems contribute to conduct problems?

We examined the role of attention deficit hyperactivity disorder (ADHD) in juvenile delinquency. Forty-two incarcerated male delinquents participated. Thirty of these youths met the criterion for conduct disorder (CD), only while 12 met the criterion for CD and ADHD. The results indicated that the latter group were arrested at an earlier age and had more total arrests than those in the former group; however, they did not have more criminal charges against them. The role of intellectual and academic skills in these findings was considered. It appears that ADHD has an important additive influence on the development and persistence of juvenile delinquency. Implications for the behavior therapist are discussed.