Jeneva L. Ohan

Ten-Year Review of Rating Scales. III

OBJECTIVE This article summarizes information on scales assessing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. METHOD The authors sampled articles on ADHD over the past decade. Several popular older ADHD measures have recently been revised, and new ADHD scales have been developed. The authors selected primarily ADHD scales based on the DSM-IV construct of ADHD that also have multiple literature citations. They then reviewed their psychometric properties. Those with adequate psychometric functioning plus considerable literature citations, known wide usage in clinical practice, or a current niche are presented here. RESULTS Several rating scales consistent with the DSM-IV conceptualization of ADHD are now available for use in both home and school settings. Many of the instruments demonstrate solid psychometric properties and a strong normative base. However, some popular scales have not been adequately investigated. Some measures are restricted to the comprehensive assessment of ADHD, whereas others also include symptoms of other disorders. The potential applications for these scales with youths diagnosed with ADHD are broad. CONCLUSIONS Rating scales can reliably, validly, and efficiently measure DSM-IV-based ADHD symptoms in youths. They have great utility in research and clinical work, assist treatment planning, and help to ensure accountability in practice.

Ten-Year Review of Rating Scales. V: Scales Assessing Attention-Deficit/Hyperactivity Disorder

OBJECTIVE This article summarizes information on scales assessing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. METHOD The authors sampled articles on ADHD over the past decade. Several popular older ADHD measures have recently been revised, and new ADHD scales have been developed. The authors selected primarily ADHD scales based on the DSM-IV construct of ADHD that also have multiple literature citations. They then reviewed their psychometric properties. Those with adequate psychometric functioning plus considerable literature citations, known wide usage in clinical practice, or a current niche are presented here. RESULTS Several rating scales consistent with the DSM-IV conceptualization of ADHD are now available for use in both home and school settings. Many of the instruments demonstrate solid psychometric properties and a strong normative base. However, some popular scales have not been adequately investigated. Some measures are restricted to the comprehensive assessment of ADHD, whereas others also include symptoms of other disorders. The potential applications for these scales with youths diagnosed with ADHD are broad. CONCLUSIONS Rating scales can reliably, validly, and efficiently measure DSM-IV-based ADHD symptoms in youths. They have great utility in research and clinical work, assist treatment planning, and help to ensure accountability in practice.

Are the performance overestimates given by boys with ADHD self-protective?

Tested the self-protective hypothesis that boys with attention deficit hyperactivity disorder (ADHD) overestimate their performance to protect a positive self-image. We examined the impact of performance feedback on the social and academic performance self-perceptions of 45 boys with and 43 boys without ADHD ages 7 to 12. Consistent with the self-protective hypothesis, positive feedback led to increases in social performance estimates in boys without ADHD but to decreases in estimates given by boys with ADHD. This suggests that boys with ADHD can give more realistic self-appraisals when their self-image has been bolstered. In addition, social performance estimates in boys with ADHD were correlated with measures of self-esteem and positive presentation bias. In contrast, for academic performance estimates, boys in both groups increased their performance estimates after receiving positive versus average or no feedback, and estimates were not correlated with self-esteem or social desirability for boys with ADHD. We conclude that the self-protective hypothesis can account for social performance overestimations given by boys with ADHD but that other factors may better account for their academic performance overestimates.

Does Knowledge about Attention-Deficit/Hyperactivity Disorder Impact Teachers' Reported Behaviors and Perceptions?.

This study surveyed elementary school teachers in Melbourne, Australia to investigate their knowledge about attention-deficit/hyperactivity disorder (ADHD) and its impact on their reported behavior toward and perceptions of children with ADHD. Consistent with previous international findings, teachers demonstrated good overall knowledge about ADHD, with strengths in knowledge of symptoms/diagnosis and weaknesses in knowledge of causes and treatments. To investigate how knowledge impacted reported behaviors and perceptions, teachers also read vignettes of children with ADHD symptoms and rated their reactions to these children. In general, teachers with high, and to some extent average, knowledge about ADHD reported more helpful behaviors (e.g., help-seeking for their students) and perceptions (e.g., perceive the benefit of behavioral and educational treatments). However, teachers with high and average knowledge also predicted that these children would be more disruptive in the classroom, and reported having less confidence in their ability to manage these children. Implications and need for future research are discussed.

Oppositional Defiant Disorder Rating Scale Preliminary Evidence of Reliability and Validity

In this article, the authors report the psychometric properties of a parent-completed rating scale based on the criteria for oppositional defiant disorder (ODD) in the Diagnostic and Statistical Manual of Mental Disorders— Fourth Edition—Text Revision (DSM-IV-TR). Mothers of 294 boys and 48 girls with attention-deficit/hyperactivity disorder (ADHD) and 53 boys and 45 girls without behavior problems completed the Oppositional Defiant Disorder Rating Scale (ODDRS). Fathers of 44 boys with ADHD also completed the scale,and 71 mothers of boys with ADHD provided 1-year test—retest data.The ODDRS had high internal consistency, high interrater reliability, and moderate 1-year test—retest reliability.The scale had one principal component and correlated as expected with related subscales from the Child Behavior Checklist and with overreactive parenting. Scores were not significantly correlated with parent or child age or with socioeconomic status.The strong psychometric properties indicate that this measure holds considerable promise for briefly assessing ODD in a manner consistent with the DSM-IV-TR.

Aggression after paediatric traumatic brain injury: A theoretical approach

Primary objective: To examine aggression in adolescent males with and without traumatic brain injury (TBI). Design: Quasi-experimental, matched-participants design. Methods: Thirty-nine adolescents were examined, including a TBI group (n= 11) and a matched, uninjured comparison group (n= 28). Participants with TBI were injured an average of 8.3 years (SD = 4.2 years) prior. Participants and parents completed the Youth Self Report (YSR) and the Child Behavior Checklist (CBCL), both measures of global psychopathology. In addition, the theoretically-driven Reactive and Proactive Aggression Questionnaire (RPQ) and the Form of Aggression Scale (FAS) were completed. Main outcomes and results: When compared using the YSR and CBCL, no group differences were detected. In contrast, using the self-report RPQ, participants with TBI reported more reactive and proactive aggression than non-injured peers. Using the FAS, participants with TBI reported engaging in aggression out of frustration and not to dominate or acquire objects. Conclusion: Aggressive behaviours are a long-term outcome after paediatric TBI. Measures of global psychopathology do not permit detailed examination of specific behaviour problems such as aggression, which may provide inaccurate data from which to derive incidence rates. In contrast, theoretically-driven measures can provide greater insight into post-TBI aggression with important treatment implications.

Sex differences in structural brain asymmetry predict overt aggression in early adolescents

The devastating social, emotional and economic consequences of human aggression are laid bare nightly on newscasts around the world. Aggression is principally mediated by neural circuitry comprising multiple areas of the prefrontal cortex and limbic system, including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), amygdala and hippocampus. A striking characteristic of these regions is their structural asymmetry about the midline (i.e. left vs right hemisphere). Variations in these asymmetries have been linked to clinical disorders characterized by aggression and the rate of aggressive behavior in psychiatric patients. Here, we show for the first time that structural asymmetries in prefrontal cortical areas are also linked to aggression in a normal population of early adolescents. Our findings indicate a relationship between parent reports of aggressive behavior in adolescents and structural asymmetries in the limbic and paralimbic ACC and OFC, and moreover, that this relationship varies by sex. Furthermore, while there was no relationship between aggression and structural asymmetries in the amygdala or hippocampus, hippocampal volumes did predict aggression in females. Taken together, the results suggest that structural asymmetries in the prefrontal cortex may influence human aggression, and that the anatomical basis of aggression varies substantially by sex.

When similarity leads to sparing: probing mechanisms underlying the attentional blink

When two targets are embedded in a temporal stream of distractors, second-target identification is initially impaired and then gradually improves as inter-target interval lengthens (attentional blink; AB). Notably, in about half of the published studies, this deficit is partially ameliorated when the targets follow one another directly, a condition known as “lag-1 sparing”. Here, we probe the impact of target-distractor similarity on lag-1 sparing, with the surprising finding that while high similarity impairs second-target accuracy at all subsequent lags, it actually improves accuracy when the targets follow one another directly. We suggest that this improvement reflects the positive influence of over-committing resources to target processing in the AB.

Chronic Illness and Developmental Vulnerability at School Entry

OBJECTIVE: This study examined the association between chronic illness and school readiness, by using linked administrative population data. METHODS: The sample included children born in 2003–2004 who were residing in Western Australia in 2009 and had a complete Australian Early Development Census record (N = 22 890). Health and demographic information was also analyzed for 19 227 mothers and 19 030 fathers. The impact of child chronic illness on 5 developmental domains (social, emotional, language, cognitive, and physical) at school entry was analyzed. Analyses examined the association between child developmental outcomes and chronic illness generally, single or multiple chronic illness diagnosis, and diagnosis type. Logistic regression models estimated odds ratios for each outcome, adjusted for child, parent, and community sociodemographic variables. RESULTS: In the adjusted models, children with a chronic illness had an increased risk of being classified as developmentally vulnerable on all domains, compared with children without a chronic illness (20%–35% increase in risk). There was no increased risk for children with multiple chronic illness diagnoses over those with a single diagnosis (all Ps > .05). There was no evidence of a disease-specific effect driving this risk. CONCLUSIONS: Regardless of the number or type of conditions, chronic illness in young children is a risk factor for reduced school readiness. These effects were seen for health conditions not traditionally considered detrimental to school readiness, such as chronic otitis media. Thus, the implications of a broader range of chronic health conditions in early childhood on school readiness need to be considered.

Is all sparing created equal? Comparing lag-1 sparing and extended sparing in temporal object perception.

When two targets (T1, T2) are presented amongst a rapid stream of distractors, T2 accuracy is impaired if the targets are separated by at least one distractor (attentional blink). However, this impairment largely disappears if the targets follow one another directly (lag-1 sparing), and, in fact, as many as four or five consecutive targets may be identified quite accurately under these conditions (extended sparing). Although all current models propose a common mechanism for both lag-1 and extended sparing, this hypothesis has yet to be tested. To this end, we examined the effect of various types of attentional switches, known to impact lag-1 sparing, on extended sparing in order to determine whether they would have a similar effect. Results suggested substantial parallels between the two types of sparing. We discuss these results in terms of a unified account of sparing in temporal object perception.