Dissertations / Theses on the topic 'Oppositional defiant disorder in children. Attention-deficit hyperactivity disorder'

Children with Disruptive Behavior Disorders (DBD), including Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) have poorer language skills compared to typically developing children; however, language as a potential risk factor for DBD has received little empirical attention or evaluation. Receptive, expressive, and pragmatic language skills in preschoolers with DBD were examined. Participants were 82 preschool-age children and their primary caregivers. Primary caregivers completed a semi-structured interview and symptom and language questionnaires. Preschoolers completed measures of receptive and expressive language. Results indicated that preschoolers with DBD were more impaired on receptive, expressive, and pragmatic language compared to non-DBD children. Pragmatic language appears particularly impaired in children with DBD, and language problems appear most linked with increased hyperactivity-impulsivity (vs. inattention or oppositional-defiance). This work suggests the need for early assessment of language in preschoolers with DBD, as well as the possibly utility of tailored interventions focusing on improving pragmatic language.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008.
Additional advisors: Margaret Rice, Boyd Rogan, Foster Watkins, Martha Barber. Description based on contents viewed May 29, 2008; title from title screen. Includes bibliographical references (p. 112-120).

This study aimed to examine the association between specific maternal characteristics (i.e., parents&rsquo
personality, depression, anxiety, affective state, and coping strategies) and childhood ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) symptoms in children with and without the diagnosis of ADHD. Method: Data was obtained from 231 subjects including mothers of 77 children who were just diagnosed by Child Mental Health Departments of Hacettepe University or IMGE Child Mental Health Center and 154 children without any psychiatric diagnosis, who were receiving education from Nebahat Keskin Elementary School. Among 154 non-diagnosed subjects the ones who match best with the 77 ADHD group participants were chosen, considering ages of the children, income of the family, and education of the mother. Results and Discussion: (1) Psychometric Characteristics of the TBFI and CARSS were examined. The internal consistency coefficients of the TBFI varied from .51 (for Agreeableness) to .75 (for Neuroticism) and all subscales of CARSS had moderate to high degree of internal consistencies ranging from .65 (Conduct Disorder) to .92. (e.g., Attention Deficit). Additionally, concurrent validity of TBFI and criterion validity of CARSS were studied. Results revealed that TBFI had sufficient internal consistency and validity, and also revealed that CARSS was a highly reliable and valid measure, successfully differentiating the diagnosed group from the non-diagnosed group on each subscale. (2) Group differences on maternal characteristics were examined. Compared to non-diagnosed children, children with ADHD had mothers with higher Depression symptoms, higher Negative Affect, higher Neuroticism, lower Positive Affect. (3) Regression analyses, which were conducted separately for each group and the whole group, revealed that different maternal characteristics were associated with symptoms of diagnosed and non-diagnosed children. In general while symptom levels of children, who have ADHD diagnosis, was associated with higher maternal Negative and lower Positive Affect and higher Depression and Anxiety symptoms, and lower Extraversion scores
symptom level of Comparison children was associated more with Conscientiousness. These differences were explained by means of the fit between maternal characteristics and vulnerability, lower tolerance, lower adaptation, and compensation skills of children with ADHD (when compared to Comparison group). Results addressed the importance of maternal factors regarding its association with presence, and the severity of ADHD and comorbid symptoms of children.

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common behavioral disorders diagnosed within childhood and affects approximately 9.5% of children in the United States. Additionally, approximately 35% to 60% of clinic-referred children will also meet the criteria for Oppositional Defiant Disorder (ODD). Increased levels of parenting stress are commonly experienced among parents of children diagnosed with ADHD and a number of factors contribute to this association. ADHD subtype has consistently presented itself as a factor; however, observing parenting stress levels between ADHD subtypes and ADHD with comorbid ODD within the same study has not been pursued in the literature. The present study utilized the Parenting Stress Index-Short Form (PSI/SF) to compare scores on the Total Stress, Parental Distress, and Parent-Child Dysfunctional interaction scales among mothers of children diagnosed with ADHD Predominantly Inattentive Type (ADHD-I), ADHD Combined Type (ADHD-C) and comorbid ADHD and ODD (ADHD/ODD). Following a One-Way Analysis of Covariance, a significant difference was found on the level of Total Stress reported by mothers of children diagnosed with ADHD/ODD when compared with mothers of children diagnosed with ADHD-C. No other significant differences were uncovered. Additionally, the current study attempted to gain a better understanding of the relationship between parenting stress and chronological age of the diagnosed child by observing the correlation between child age and the level of parenting stress reported by mothers of children diagnosed with ADHD, in addition to a comorbid diagnosis of ADHD and ODD. Pearson product-moment correlation coefficients were calculated between child age and the Total Stress and Difficult Child scales on the PSI/SF; however neither achieved statistical significance. Finally, the present study compared the correlations between child age and maternal scores on the Total Stress and Difficult Child scales on the PSI/SF among children with a sole diagnosis of ADHD, to those of children with a comorbid diagnosis of ADHD/ODD. Correlations within the ADHD/ODD group among child age and the Total Stress and Difficult Child scales were both in the negative direction. In contrast, the correlations within the ADHD group were both in a positive direction.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent and impairing childhood disorders (5%; American Psychiatric Association, 2013), yet it is often studied in isolation. Such an approach is at odds with the clinical reality, where ADHD has a high comorbidity with oppositional defiant disorder, anxiety, and depression (Jensen, Martin, & Cantwell, 1997). Based on the possible presentations of ADHD with both externalizing and internalizing symptoms, there may be differences in associated characteristics, areas of impairment, and resulting assessment interventions. Therefore, the present study investigated how ADHD comorbidities manifested in a population of 233 elementary age children and how these profiles varied in already established characteristics (i.e., traits, social behaviors) and areas of deficit for children with ADHD (i.e., social functioning, academics, narrative comprehension). Characteristics and outcomes were examined using rating scales, behavior observations, laboratory tasks, and grades. Based on latent profile analyses, different patterns of comorbidity were identified using both parent and teacher ratings of ADHD. Based on parent and teacher report, those with high ADHD/ODD symptoms had more negative characteristics and outcomes. Network analyses corroborated these results, showing that internalizing symptoms were less relevant for associated characteristics and outcomes compared to ADHD and ODD symptoms. Overall, these results suggest that ADHD comorbidities may be primarily driven by ADHD and ODD symptoms, with this profile displaying more severe negative characteristics and outcomes.

Conduct Disorder (CD) is a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated. It is one of the most common problems in South African schools, particularly in those that are poverty-stricken. The child who participated in the study lived in the shelter that was for homeless and disadvantaged children. He attended at Amasango School where the majority of children in the shelter attended. There were many conduct-disordered children in the shelter and the school, particularly in the school. They disrupted classes making in difficult for teachers to carry out their education activities. The aim of this study was to draw on the standard procedures of the CBT in order to design interventions that would be effective in reducing aggressive behaviour in an adolescent who had CD Adolescent-Type and who lived at the shelter. This case study evaluated the effectiveness of a multi-modal CBT programme in a 16 year-old Black male who had been displaying aggressive behaviour for about a year. The treatment consisted of 23 sessions and included teacher counseling, contingency management, self-control and self-instructional training. The treatment was evaluated qualitatively by means of interviews with the child and teacher and quantitatively by means of repeated applications of behaviour checklists completed by the teacher. The results showed a decrease in the client's aggressive behaviour and an increase in prosocial behaviour. The client ultimately ceased from all aggressive behaviour towards his peers and this outcome was sustained during his last two months in therapy.

Introdução: Os maus tratos na infância e adolescência são considerados um problema de saúde pública devido a alta prevalência no Brasil e no mundo. A exposição a maus tratos está associada a alterações no desenvolvimento cognitivo, porém, há uma escassez de estudos brasileiros que investiguem o tema. Objetivos: Comparar o funcionamento neuropsicológico de adolescentes com e sem histórico de maus tratos, bem como estudar as relações entre essas vivências, desempenho neuropsicológico e sintomas psiquiátricos relacionados a impulsividade, oposição, hiperatividade e desatenção. Método: Cento e oito adolescentes foram selecionados em dois programas de atendimento a população em situação de vulnerabilidade e/ou risco social de São Paulo (SP). De acordo com a pontuação do Questionário de Traumas na Infância (QUESI), foram classificados em três grupos: GMT1 (grupo de maus tratos leves, n=35), GMT2 (grupo de maus tratos moderado a grave, n=19) e GC (grupo de comparação, n=54). Os adolescentes passaram por avaliação neuropsicológica com o foco na investigação de funções relacionadas a percepção visual e spam atencional (primeira unidade funcional), processamento e armazenamento de informações (segunda unidade funcional) e funcionamento executivo (terceira unidade funcional). Foram utilizadas escalas para avaliação psiquiátrica (K-SADS-PL) e investigação de sintomas de impulsividade, hiperatividade, desatenção e oposição (BIS-1, SNAP-IV). Os resultados obtidos nos grupos foram comparados com o controle estatístico de variáveis sociais (dificuldades socioeconômicas, escolaridade e abrigamento) e clínicas (transtornos psiquiátricos internalizantes e externalizantes, uso de medicação psiquiátrica e quociente intelectual estimado- QI). Por fim, foram feitas associações entre exposição a maus tratos, funcionamento neuropsicológico e sintomas psiquiátricos. Resultados: Os GMTs (grupos de maus tratos) apresentaram pior funcionamento intelectual em relação ao GC, sendo que o pior desempenho foi encontrado no GMT2 (p< 0,001). Medidas menores de QI estiveram associadas a prejuízo nas três unidades funcionais (p<= 0,049) e a mais sintomas de hiperatividade e desatenção (p <= 0,008). Foi encontrado pior desempenho dos GMTs nos testes para avaliação de segunda unidade funcional (p<= 0,001), porém, não foram encontradas diferenças entre os grupos na primeira e terceira unidades. Apesar disso, os testes de correlação indicaram que o aumento das pontuações no QUESI estava associado à piora do desempenho em todas as unidades funcionais (p<= 0,046). Os GMTs apresentaram maior impulsividade e oposição (p<= 0,008) e, quanto maior a pontuação no QUESI, maior a presença de sintomas de impulsividade, oposição, sintomas isolados de desatenção e sintomas mistos de desatenção e hiperatividade (p<= 0,006). Conclusão: Os resultados obtidos corroboram a associação entre exposição a maus tratos e dificuldades cognitivas e psiquiátricas. Os dados obtidos poderão contribuir para o planejamento de políticas públicas voltadas tanto à prevenção quanto para o tratamento de patologias associadas ao desenvolvimento neurobiológico alterado de crianças e adolescentes que crescem em condições adversas.
Introduction: Maltreatment experiences in childhood and adolescence are considered a public health problem due to high prevalence in Brazil and worldwide. The exposure to maltreatment is associated with changes in cognitive development; however, there is a shortage of Brazilian research that investigates this topic. Objectives: Comparison of neuropsychological functioning of adolescents with and without maltreatment history, as well as the research of relationships between these experiences, neuropsychological performance, and psychiatric symptoms relating to impulsivity, opposition, hyperactivity, and inattention. Methods: One hundred and eight adolescents were selected from two assistance programs for people in vulnerability and social risk situation in the city of Sao Paulo (SP). According to the Childhood Trauma Questionnaire (CTQ), three groups were classified: GMT1 Group (Mild Maltreatment, n = 35), GMT2 (group of moderate to severe maltreatment, n = 19) and GC (comparison group, n = 54). The adolescents underwent neuropsychological evaluation with a focus on the investigation of functions related to visual perception and attention spam (first functional unit), processing and retention of information (second functional unit) and executive functioning (third functional unit). Scales were used for psychiatric assessment (K-SADS-PL) and investigation of impulsivity, hyperactivity, inattention, and opposition symptoms (SNAP-IV, BIS-11). Results obtained in these groups were compared with statistical control of social variables (socioeconomic, school level, and shelter), and clinical variables (internalizing and externalizing psychiatric disorders, use of psychiatric medication, and estimated intellectual quotient - IQ). Lastly, associations between exposure to maltreatment, neuropsychological functioning and psychiatric symptoms were made. Results: The GMT (maltreatment groups) had a worse intellectual functioning compared to GC, while the worst performance was found in GMT2 (p < 0.001). Lower IQ measures were associated to impairment on the three functional units (p<= 0.049) and to more symptoms of inattention and hyperactivity (p <= 0.008). Worse performance on tests for evaluation of the second functional unit (p<= 0.001) was found for GMT, but no differences were found between the groups on the first and third units. Nevertheless, the correlation tests indicated that the increase in CTQ scores was associated to worse performance in all of the functional units (p<= 0,046). The GMT presented higher impulsivity and opposition (p<= 0,008) and the higher the CTQ score the more symptoms of impulsivity, opposition, isolated symptoms of inattention, and mixed symptoms of inattention and hyperactivity (p<= 0,006). Conclusion: The results confirm the negative association between exposure to maltreatment and psychiatric and cognitive difficulties. The data obtained will contribute to the planning of public policies for both prevention and treatment of diseases associated to altered neurobiological development of children and adolescents who grow up in adverse conditions.

碩士
國立臺灣大學
流行病學與預防醫學研究所
100
Background： Mental health problems, like Attention-deficit/ hyperactivity disorder (ADHD) and Oppositional defiant disorder (ODD) had increasing prevalence among children, so did the allergic diseases (atopic dermatitis, asthma, and allergic rhinitis). Recently, there were literatures reporting the association of allergic diseases with ADHD. A cross-sectional study was held here to clarify the association. Material & Methods: The Taiwan Children Health Study (TCHS) is an ongoing cohort study. Fourth-grade children were enrolled from 14 diverse Taiwanese communities in 2010. We obtained 2896 subjects data in 2011. The questionnaires included: Swanson, Nolan and Pelham questionnaire (SNAP-IV 26), Center for Epidemiologic Studies Depression Scale (CES-D), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI). Result: The overall prevalence of ever AD, asthma, and AR were 9.1%, 9.7% and 31.6% respectively. The symptom of AD, asthma, and AR within recent one year was 7.0%, 3.0%, and 19.9%. The prevalence of having symptom of ADHD was 6.1%, while the ADHD subtypes like ADHD-inattention, ADHD-hyperactivity, ADHD-combined were 3.0%, 4.6%, and 2.2% respectively, and the ODD was 2.9%. Children with AD within recent one year had higher risk to developed symptom of ADHD (OR 1.88, 95%CI 1.15-3.07), ADHD-inattention (OR 2.86, 95%CI 1.56-5.24) and ODD (OR 2.28, 95%CI 1.21-4.31). Children with asthma episode within recent one year had higher risk to developed symptom of ODD (OR 2.69, 95%CI 1 .12-6.44). AR within recent one year had higher risk to developed symptom of ADHD-inattention (OR 1.61, 95%CI 1.00-2.58) and ADHD-combined (OR 2.56, 95%CI 1 .52 to 4.31). The interaction analysis showed depression interacted with ever asthma toward symptom of ODD significantly (P=0.02). Children with asthma and depressive symptom had higher risk in ODD (OR 8.54, 95%CI 3 .87 to 18.87). Stress interacted with ever AD significantly toward symptom of ADHD, ADHD-hyperactivity impulsitivity, ADHD-combined and ODD (P=0.03, P=0.02, P=0.05, and P=0.008). Poor sleep quality interacted with ever asthma toward symptom of ODD significantly (P=0.03). Children with asthma and poor sleep quality had higher risk in ODD (OR 8.24, 95%CI 3 .58 to 18.98). Conclusion: Children with allergic disease, like AD, asthma, and allergic rhinitis may have higher risk to develop different subtypes of ADHD or ODD. The strongest association was noted in “AD within one year”. AD patients interacted with stress to develop symptoms of ADHD and ODD. Stress is an effect modifier between AD and ADHD. However, Asthma patients interacted with depression and poor sleep quality to developed symptoms of ODD. Depression and poor sleep quality are effect modifiers between asthma and ODD. We concluded that there were different pathways between allergic diseases and ADHD/ODD. A fulfill prevention, education, and treatment program composing by many specialists is the future trend.

This thesis was designed to investigate differences in aggression between girls with and without attention-deficit/hyperactivity disorder (ADHD). Forty girls with ADHD and 43 girls without ADHD aged 9- to 12- years and their mothers and teachers participated. A multiassessment methodology was used to investigate these differences, employing mothers' reports, teachers' reports, and a laboratory aggression analogue task (a computer game involving simulated girls in other rooms). The results indicated that mothers and teachers saw girls with ADHD as having much higher levels of all types of aggression assessed, including overt, relational, proactive, and reactive aggression, than girls in the control group. On the lab task, girls with ADHD used a strategy that involved more threatening and bragging comments, and social exclusions of their co-players. Expected differences on some of the lab task measures did not emerge. Also, according to mothers, teachers, and the results from the lab task, girls with ADHD were significantly less prosocial than girls in the control group. Where significant group differences had been found, follow-up tests generally indicated that girls with ADHD and comorbid oppositional-defiant disorder (ODD) were more aggressive than girls in the control group, with girls with ADHD but not ODD falling in between. In sum, these results indicate substantial cause for concern for the concurrent and future psychosocial well-being of girls with ADHD.

Parents raising children with Attention-deficit/hyperactivity disorder (ADHD) experience high levels of parenting stress, especially when ADHD is accompanied by comorbid Oppositional Defiant Disorder (ADHD/ODD). Children with ADHD experience difficulties with their executive functions in such areas as inhibition control, working memory, and emotional regulation. Despite evidence linking ADHD with parenting stress, and ADHD with executive function difficulties (EFDs), there is little research exploring whether EFDs within an ADHD population are associated with parenting stress. This dissertation’s main objective is to determine whether parent-reported and teacher-reported childhood EFDs are associated with elevated levels of parenting stress. A secondary data analysis was completed on a cross-section of parent and teacher completed psychiatric assessment measures for children (n=243) diagnosed with ADHD. Measures included the Behavior Rating Inventory of Executive Function, the Conners’ Parent Rating Scale and the Parenting Stress Index, Long Form. A number of important findings were produced; key of which was the finding that a strong association exists between parent-reported EFDs and Child Domain parenting stress. Consistent with prior ADHD research, difficulties with emotional control and inhibition were found to be potent predictors of Child Domain parenting stress. To a lesser degree, children’s difficulties with initiation and self-monitoring were associated with Child Domain parenting stress, suggesting that daily hassles pose challenges for parents, especially when the child attends a new school. Also important was the finding that parent-reported oppositionality partially mediated the relationship between EFDs with emotional control, inhibition and shift, and Child Domain parenting stress. Despite teachers’ reports that children displayed more severe behaviours than were reported by parents, teacher-reported EFDs were not significantly associated with Child Domain parenting stress, with a few exceptions. Although not a well-explored concept within the literature on ADHD and parenting stress, parental acceptance of the child emerged as source of Child Domain parenting stress and a potential focus for assessment and treatment. Findings from the current study suggest that early identification and intervention with emotional control difficulties and ODD are vital due to their strong association with clinically significant levels of Child Domain parenting stress.