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Comorbid symptom severity in attention-deficit/hyperactivity disorder: a clinical study
Daniel F Connor1, Julian D Ford
1Department of Psychiatry, Division of Child & Adolescent Psychiatry, University of Connecticut School of Medicine, Farmington, CT 06030-1410, USA. dconnor@uchc.edu
The Journal of Clinical Psychiatry
|June 16, 2012
Summary
Children with attention-deficit/hyperactivity disorder (ADHD) often experience emotional and behavioral problems, including aggression. These externalizing behaviors correlate with ADHD symptom severity and may improve with effective ADHD treatment.
Area of Science:
- Child and Adolescent Psychiatry
- Neurodevelopmental Disorders
- Behavioral Science
Background:
- Current attention-deficit/hyperactivity disorder (ADHD) diagnostic criteria do not explicitly include emotional symptoms, externalizing behaviors, or aggression.
- Research on ADHD has primarily focused on comorbid disorders rather than associated symptoms that impact treatment and outcomes.
- Clinicians frequently encounter these emotional and behavioral symptoms in ADHD patients, necessitating further investigation.
Purpose of the Study:
- To describe emotional and behavioral symptoms in children and adolescents diagnosed with ADHD.
- To compare the prevalence and severity of these symptoms in ADHD patients versus non-ADHD control groups.
- To investigate the relationship between ADHD symptom severity and associated emotional and behavioral issues.
Main Methods:
- A comparative study involving clinically referred children and adolescents with ADHD (combined and inattentive subtypes) and two control groups (non-ADHD psychiatric and non-ADHD community).
- Data collected between 1995 and 2005 using diagnostic criteria from the DSM-IV.
- Statistical controls for age, sex, and family income were applied to comparisons of emotional symptoms, externalizing behavior problems, and aggression.
Main Results:
- Both ADHD groups exhibited depressive symptom severity comparable to the non-ADHD psychiatric group and greater than the community control group.
- Externalizing behavior problems and aggression were significantly more severe in the ADHD combined subtype group compared to all other groups.
- Increased ADHD symptom severity correlated with greater severity of externalizing behaviors and aggression, but not internalizing symptoms. Family income showed an independent association with externalizing disorders.
Conclusions:
- Clinical samples of children and adolescents with ADHD present high rates of internalizing emotional symptoms, externalizing behaviors, and aggression.
- Externalizing behaviors and aggression appear linked to the hyperactive-impulsive ADHD domain and overall symptom severity.
- Further research is needed to determine if treating core ADHD symptoms will alleviate associated emotional/behavioral symptoms and enhance daily functioning.
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