Mary F. Russo

Dimensions and types of attention deficit disorder

Abstract DSM-III-R provides a unidimensional definition of attention deficit-hyperactivity disorder (ADHD), based on the assumption that inattention, impulsivity, and motor hyperactivity are unitary aspects of the same dimension. The definition of undifferentiated attention deficit disorder (UADD), however, contradicts this assumption by treating inattention as a separate dimension. The present study evaluated these assumptions empirically. A cluster analysis of three factors derived from factor analyses of teacher ratings of ADD symptoms and a broader list of ADD symptoms produced three distinct clusters: patients without ADD, those with both inattention and hyperactivity, and a group that exhibited inattention and sluggish tempo but not hyperactivity. The association was very strong between the empirically derived clusters and clinical DSM-III diagnoses of ADD with and without hyperactivity. These findings do not support the DSM-III-R unidimensional definition of ADHD.

Anxiety, Inhibition, and Conduct Disorder in Children: I. Relations to Social Impairment

Jeffrey A. Gray has proposed a model in which conduct disorder (CD) is viewed as the result of both excessive activity of a behavioral activation system that mediates appetitive and aggressive behavior and deficient activity of a behavioral inhibition system that mediates both anxiety and the inhibition of behavior in the presence of cues signalling impending punishment or frustration. The relation of anxiety to antisocial behavior was examined in 177 clinic-referred boys, aged 7 to 12 years, 68 of whom met DSM-III-R criteria for CD. As predicted by Grays model, boys with CD and comorbid anxiety disorder were markedly less impaired than boys with CD alone.

A sensation seeking scale for children: Further refinement and psychometric development

A revision of the Sensation Seeking Scale for Children (SSSC) was standardized and validated on a community sample of 660 elementary- and middle-school children and 168 clinic-referred male children. Factor analysis of the combined samples yielded three unique factors, entitled Thrill and Adventure Seeking, Drug and Alcohol Attitudes, and Social Disinhibition. Psychometric indices of reliability and validity were acceptable, but test-retest reliability was only moderate. Differences in SSSC scores according to sex, ethnic group, age, and intellectual status were similar to those found previously with the adult Sensation Seeking Scales. Consistent with documented relations between adult antisocial personality and sensation seeking, the SSSC distinguished boys with conduct disorder (CD) from clinic controls, but the SSSC scores of boys with CD did not differ from those of the community sample boys. Discussion includes suggestions as to the continued study of the assessment of sensation seeking in children.

Comorbidity of childhood anxiety and externalizing disorders: Prevalence, associated characteristics, and validation issues

Abstract The prevalence of co-occurring anxiety and externalizing (i.e., attention deficithyperactivity, oppositional, and conduct disorders) conditions is examined in both epidemiological and clinic-referred studies among child and adolescent samples. In the context of comorbid anxious and externalizing conditions, issues of age, gender, and familial differences are explored. Literature that describes the associated characteristics of children diagnosed with comorbid anxiety and attention deficit disorders is reviewed, followed by a similar review of the literature with respect to comorbid anxiety and conduct disorders of childhood. Validation issues and suggestions for improvements to future research on comorbid childhood anxiety and externalizing disorders are discussed.

Comparison of DSM-III and DSM-III-R diagnoses for prepubertal children: changes in prevalence and validity.

A structured and reliable diagnostic procedure based on a revised version of the Diagnostic Interview Schedule for Children for children, parents, and teachers was used to assign both DSM-III and DSM-III-R diagnoses to 177 outpatient boys aged 7 to 12 years. Compared to their DSM-III counterparts, DSM-III-R oppositional defiant disorder was 25.5% less prevalent, DSM-III-R dysthymia was 37.8% less prevalent, and DSM-III-R conduct disorder (CD) was 44.3% less prevalent. However, DSM-III-R attention deficit hyperactivity disorder was 14.4% more prevalent than DSM-III attention deficit disorder with hyperactivity. The two definitions of CD were compared to exemplify an empirical approach to diagnostic validation. The DSM-III-R diagnosis of CD appears to be more valid as it is more strongly associated with police contacts, school suspensions, and history of antisocial personality disorder in the biological father, but both CD diagnoses are associated with family histories of criminal convictions.

Preliminary development of a sensation seeking scale for children

Abstract A sensation seeking scale designed for use with school-aged children (SSSC) was standardized on an elementary school population. Test-retest reliability was adequate and gender differences were comparable to the adult sensation seeking scale. The SSSC was administered to 176 clinic-referred boys aged 7–12 years. Factor analysis of the scores of the combined school and clinic samples yielded two factors which corresponded to the Boredom Susceptibility (BS) and Thrill and Adventure Seeking (TAS) factors of the adult Sensation Seeking Scales. Boys with diagnoses of conduct disorder (CD), childhood anxiety disorders (ANX), and attention deficit-hyperactivity disorder (ADHD) were compared to a clinic control group in a 2 × 2 × 2 factorial design. Main effects for ADHD and CD were significant for the BS subscale, reflecting higher scores in children with CD and lower scores in children with ADHD. A marginally significant CD × ANX interaction for total SSSC score may indicate a moderating effect of anxiety on sensation seeking in children with CD. These results tentatively suggest that sensation seeking can be validly measured in prepubertal children, but argue for further refinements in the SSSC.

Sexual and Physical Abuse Among Adolescent Girls with Disruptive Behavior Problems

We examined the prevalence and age of onset of physical and sexual abuse in a clinic-referred sample of adolescent girls, as well as differences in diagnoses and symptoms among abused and non-abused girls. Forty-nine girls (aged 13–17 years) with disruptive behavior were interviewed along with their primary caretaker. Data were gathered through both a structured interview with the girl and her parent, as well as self and parent-report questionnaires. Findings indicated that the prevalence of Conduct Disorder (CD) and Major Depression were higher for abused girls. Somatoform Pain Disorder was significantly less likely for physically abused girls, compared to girls who were both physically and sexually abused. Of CD symptoms, truancy was twice as high for the physically and sexually abused group, compared to the prevalence for non-abused girls. Internalizing symptoms were also highest for the dual abuse group. Onset graphs show that the onset of sexual abuse usually occurred at an earlier age than the onset of physical abuse. Abused girls showed an earlier age of onset of CD symptoms. Results indicated that the experience of combined types of abuse is associated with a poorer psychiatric prognosis.