Differentiating co-occurring behavior problems in children with ADHD: patterns of emotional reactivity and executive...

This study examined whether "top-down" and "bottom-up" control processes can differentiate children with ADHD who exhibit co-occurring aggression and/or internalizing symptoms.

Participants included 74 children (M age = 10.7 years) with a Diagnostic and statistical manual of mental disorders (4th ed.; DSM-IV) diagnosis of ADHD. The authors' top-down measure was executive functioning (EF) indexed via two neuropsychological tasks whereas their bottom-up measure was emotional reactivity. Parents also reported on children's aggression and internalizing symptoms.

Emotional reactivity was associated with co-occurring aggressive symptoms, regardless of the presence of internalizing symptoms or ADHD symptom severity, whereas EF deficits were less likely to occur in children with ADHD and co-occurring internalizing symptoms.

The authors' findings highlight the importance of integrating top-down and bottom-up regulatory measures when studying the multipathway conception of ADHD and its co-occurring problems.