Daring-Impulsive (DI) Traits Versus ADHD Features in Adolescent Boys with Conduct Problems

While daring-impulsive (DI) traits have been deemed an important concept in subtyping youth with conduct disorder (CD) as part of a multispecifier model, no work has examined whether DI traits add to the existing practice of designating youth with CD beyond co-occurring attention-deficit/hyperactivity disorder (ADHD).

This study examined the utility of DI traits (versus ADHD features) in a sample of 322 justice-involved adolescent boys (ages 16-17 years). In addition to a diagnostic interview to determine severity of CD, adolescents completed measures of DI, ADHD, as well as other relevant characteristics.

Findings revealed differential associations between DI and ADHD in relation to indices of CD, externalizing psychopathology (i.e. reactive aggression, proactive aggression, substance use), internalizing psychopathology (i.e. anxiety, depression), and domains of impulsivity (i.e. positive urgency, negative urgency, sensation seeking, premeditation, perseverance). Additionally, over and above ADHD, DI contributed incremental information in explaining CD, externalizing psychopathology, positive urgency, sensation seeking, and lack of premeditation, but not internalizing psychopathology nor negative urgency and lack of perseverance. Of the 286 adolescents with CD, 114 (39.9%) were in the DI group and only 81 (28.3%) were in the ADHD group. Finally, differential correlates emerged between adolescents exhibiting CD alone, high CD and high DI traits, and high CD and high ADHD features.

Findings tentatively suggest DI traits and ADHD features are empirically distinct from each other in relation to CD and relevant characteristics and, therefore, improved clinical care for adolescents with CD will likely require differential consideration of DI and ADHD.