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Heterogeneity in ADHD: Neuropsychological Pathways, Comorbidity and Symptom Domains
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
2009 (English)In: Journal of Abnormal Child Psychology, ISSN 0091-0627, E-ISSN 1573-2835, Vol. 37, no 4, 551-564 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to investigate different neuropsychological impairments and comorbid behavioral problems in relation to symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), studying the independent effects of different functions as well as specific relations to symptoms of hyperactivity/impulsivity and inattention. A community-based sample of school children (n∈=∈182; the higher end of the ADHD symptom range was oversampled) completed neuropsychological tasks designed to measure executive function (EF), state regulation and delay aversion. Behavioral symptoms were measured through parental and teacher ratings of the DSM-IV criteria for ADHD and Oppositional Defiant Disorder (ODD). Both categorical and dimensional analyses were used to acquire a deeper understanding of ADHD. The results supported the notion that EF and state regulation constitute independent pathways to ADHD, primarily to symptoms of inattention. In addition, the present study points to the importance of viewing ADHD as a heterogeneous condition also with regard to the differential impact of neuropsychological functioning and comorbidity on different ADHD symptom groups and the two ADHD symptom domains.

Place, publisher, year, edition, pages
2009. Vol. 37, no 4, 551-564 p.
Keyword [en]
ADHD, Comorbidity, Heterogeneity, Hyperactivity, Inattention, Neuropsychological factors
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-97906DOI: 10.1007/s10802-008-9286-9ISI: 000264879800008PubMedID: 19016322OAI: oai:DiVA.org:uu-97906DiVA: diva2:173018
Available from: 2008-12-11 Created: 2008-12-11 Last updated: 2015-03-19Bibliographically approved
In thesis
1. Specifying the Heterogeneity in Children with ADHD: Symptom Domains, Neuropsychological Processes, and Comorbidity
Open this publication in new window or tab >>Specifying the Heterogeneity in Children with ADHD: Symptom Domains, Neuropsychological Processes, and Comorbidity
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Heterogeneity in children with Attention Deficit Hyperactivity Disorder (ADHD) symptoms is a well-known phenomenon. Empirically, this heterogeneity is evident in at least three different respects: expression of the two ADHD symptom domains (hyperactivity/impulsivity and inattention), neuropsychological impairments, and comorbid behavior problems. The major aim of the present thesis was to examine the heterogeneity characterizing children with ADHD symptoms to enhance our understanding by examining neuropsychological factors with regard to common and independent contributions, and specificity of the two ADHD symptom domains in relation to neuropsychological factors and comorbid behavioral problems. Particular emphasis is placed on prominent neuropsychological processes such as executive functions, state regulation and delay aversion. The present thesis is based on findings from four studies on community-based samples of children – studies involving concurrent and longitudinal designs as well as both categorical and dimensional approaches.

Results provide support for the notion that executive function and state regulation, but not delay aversion, constitute independent pathways to ADHD, primarily to symptoms of inattention. However, delay aversion was shown to have an effect in combination with state regulation on both hyperactivity/impulsivity and inattention. Additionally, symptoms of hyperactivity/impulsivity and inattention have different primary correlates concerning neuropsychological factors and comorbidity. More specifically, executive function, state regulation, internalizing problems and academic achievement were specifically related to inattention but not to hyperactivity/impulsivity. Oppositional Defiant Disorder (ODD) was specifically related to hyperactivity/impulsivity, but not to inattention.

The present thesis has contributed with important and new knowledge about the heterogeneity of children with ADHD symptoms concerning neuropsychological pathways, and specificity of the two ADHD symptom domains in relation to neuropsychological factors and comorbid behavioral problems. Knowledge such as this can help us understand how to identify more homogeneous ADHD subgroups, and contribute to the further development of multiple pathway models within this area of research.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 101 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 47
Keyword
ADHD, Heterogeneity, Hyperactivity/Impulsivity, Inattention, Neuropsychological Pathways, Comorbidity
Research subject
Psychology
Identifiers
urn:nbn:se:uu:diva-9485 (URN)978-91-554-7370-9 (ISBN)
Public defence
2009-01-16, Sal IX, Universitetshuset, Uppsala, 13:15
Opponent
Supervisors
Available from: 2008-12-11 Created: 2008-12-11 Last updated: 2015-03-20Bibliographically approved

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