European Child & Adolescent Psychiatry

, Volume 24, Issue 1, pp 21–30 | Cite as

Comparison of neuropsychological performances and behavioral patterns of children with attention deficit hyperactivity disorder and severe mood dysregulation

Original Contribution

Abstract

We aimed to investigate the similarities and differences in neuropsychological test performance, demographic features and behavioral patterns of children and adolescents with the attention deficit hyperactivity disorder combined type (ADHD-C), and the severe mood dysregulation (SMD). Study includes 112 children: 67 with ADHD-C, 24 with SMD and 21 healthy controls. These groups were identified by using the schedule for affective disorders, and schizophrenia for the school-age children-present and lifetime version (KSADS-PL) and the K-SADS-PL-SMD Module. Conners’ Parent and Teacher Rating Scale-revised long form (CPRS-R:L and CTRS-R:L) and neuropsychological tests were administered to the research groups. ADHD-C group’s performances in Wisconsin Card Sorting Test, Trail Making Test, Stroop Test TBAG form and Controlled Oral Word Association Test were significantly poorer than the control group’s performances (p < 0.05). Performance of the SMD group was only descriptively intermediate between performances of the ADHD-C and control group. In the “Oppositional”, “Hyperactivity”, “Social Problems”, “Impulsive”, “Emotional Lability” and “Conners’ Global Index” subscales of CPRS-R:L, the average scores of the SMD group were significantly higher than the ADHD-C and control group’s average scores (p < 0.05). ADHD-C group (but not SMD) could be significantly differentiated from healthy controls with the neuropsychological tests used. SMD group could be differentiated from the ADHD-C and healthy control groups with CPRS-R:L; i.e., ADHD-C versus SMD could be differentiated at the behavioral level only.

Keywords

Attention deficit hyperactivity disorder Severe mood dysregulation Neuropsychological test 

Notes

Acknowledgments

We thank Gül Ergün, who kindly undertook the statistical analysis, and Aynur Şahin Aközel, who assisted with the neuropsychological tests.

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

References

  1. 1.
    Emiroglu FN, Diler RS (2009) Pediatric bipolar disorders: from the perspective of Turkey. J Can Acad Child Adolesc Psychiatry 18:206–214PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Leibenluft E, Charney DS, Towbin KE, Bhangoo RK, Pine DS (2003) Defining clinical phenotypes of juvenile mania. Am J Psychiatry 160:430–437PubMedCrossRefGoogle Scholar
  3. 3.
    Stringaris A, Zavos H, Leibenluft E (2012) Adolescent irritability: phenotypic associations and genetic links with depressed mood. Am J Psychiatry 169:47–54PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Stringaris A, Cohen P, Pine DS (2009) Adult outcomes of youth irritability: a 20-year prospective community-based study. Am J Psychiatry 166:1048–1054PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Brotman MA, Schmajuk M, Rich BA, Dickstein DP, Guyer AE, Costello EJ et al (2006) Prevalence, clinical correlates, and longitudinal course of severe mood dysregulation in children. Biol Psychiatry 60:991–997PubMedCrossRefGoogle Scholar
  6. 6.
    Copeland WE, Angold A, Costello EJ, Egger H (2013) Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. Am J Psychiatry 170:173–179PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th edn.). American Psychiatric Publishing, WashingtonGoogle Scholar
  8. 8.
    Jonkman LM, Kemner C, Verbaten MN, Van Engeland H, Camfferman G, Buitelaar JK, Koelega HS (2000) Attentional capacity, a probe ERP study: differences between children with attention deficit hyperactivity disorder and normal control children and effects of methylphenidate. Psychophysiology 37:334–346PubMedCrossRefGoogle Scholar
  9. 9.
    Blair RJ (2010) Psychopathy, frustration, and reactive aggression: the role of ventromedial prefrontal cortex. Br J Psychol 101:383–399PubMedCrossRefGoogle Scholar
  10. 10.
    Dickstein DP, Finger EC, Brotman MA, Rich BA, Pine DS, Blair JR, Leibenluft E (2010) Impaired probabilistic reversal learning in youths with mood and anxiety disorders. Psychol Med 40:1089–1100PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Leibenluft E (2011) Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. Am J Psychiatry 168:129–142PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Sonuga-Barke EJS, Sergeant AJ, Nigg J, Willcutt E (2008) Executive dysfunction and delay aversion in attention deficit hyperactivity disorder: nosologic and diagnostic implications. Child Adolesc Psychiatr Clin N Am 17:367–384PubMedCrossRefGoogle Scholar
  13. 13.
    Sonuga-Barke EJS, Dalen L, Remington RER (2003) Do delay aversion and inhibitory deficits make distinct contributions to pre-school AD/HD? J Am Acad Child Adolesc Psychiatry 42:1335–1342PubMedCrossRefGoogle Scholar
  14. 14.
    Pennington BF, Ozonoff S (1996) Executive functions and developmental psychopathology. J Child Psychol Psychiatry 37:51–87PubMedCrossRefGoogle Scholar
  15. 15.
    Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF (2005) Validity of executive function theory and attention deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 57:1336–1346PubMedCrossRefGoogle Scholar
  16. 16.
    Mikita N, Stringaris A (2013) Mood dysregulation. Eur Child Adolesc Psychiatry 22:11–16PubMedCentralCrossRefGoogle Scholar
  17. 17.
    Beesdo K, Lau JY, Guyer AE, McClure-Tone EB, Monk CS, Nelson EE, Fromm SJ, Goldwin MA, Wittchen HU, Leibenluft E, Ernst M, Pine DS (2009) Common and distinct amygdala-function perturbations in depressed vs anxious adolescents. Arch Gen Psychiatry 66:275–285PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Chapman LJ, Chapman JP (1987) The measurement of handedness. Brain Cogn 6:175–183PubMedCrossRefGoogle Scholar
  19. 19.
    Nalçacı E, Kalaycıoğlu C, Güneş E, Çiçek M (2002) El tercihi anketinin geçerlik ve güvenilirliği. Turk Psikiyatri Derg 13:99–106PubMedGoogle Scholar
  20. 20.
    Savaşır I, Şahin N (1995) Wechsler Çocuklar İçin Zeka Ölçegi (WISCR) El Kitabı. Türk Psikologlar Dernegi Yayınları, AnkaraGoogle Scholar
  21. 21.
    Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y (2004) Reliability and validity of Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version. Turk J Child Adoles Mental Health 11:109–116Google Scholar
  22. 22.
    Çöp E (2009) DEHB’de ADD Yaygınlığı. Eşlik Eden Hastalıklar ve Bilişsel Özellikleri, Yayınlanmamış Tıpta Uzmanlık Tezi Hacettepe Üniversitesi, AnkaraGoogle Scholar
  23. 23.
    Conners CK, Sitarenios G, Parker JD, Epstein JN (1998) Revision and restandardization of the Conners parent rating scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol 26:257–268PubMedCrossRefGoogle Scholar
  24. 24.
    Conners CK, Sitarenios G, Parker JD, Epstein JN (1998) Revision and restandardization of the Conners teacher rating scale (CTRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol 26:279–291PubMedCrossRefGoogle Scholar
  25. 25.
    Kaner S, Büyüköztürk Ş, İşeri E, Ak A, Özaydın L (2011) Conners’ parent rating scale long form-revised: factor structure, reliability and validity studies. Turk J Child Adoles Mental Health 18:45–58Google Scholar
  26. 26.
    Spreen OE, Strauss A (1998) Compendium of neuropsychological tests: administration, norms, and commentary. Oxford University Press, New YorkGoogle Scholar
  27. 27.
    Berg EA (1948) A simple objective technique for measuring flexibility in thinking. J Gen Psychol 39:15–22PubMedCrossRefGoogle Scholar
  28. 28.
    Karakaş S, Doğutepe Dinçer E (eds) (2011) Bilnot Bataryası El Kitabı. Bilnot-Çocuk Cilt-I-II, Nobel Tıp Kitabevleri, İstanbulGoogle Scholar
  29. 29.
    Stroop JR (1935) Studies of interference in serial verbal reactions. J Exp Psychol 18:643–662CrossRefGoogle Scholar
  30. 30.
    Mitrushina M, Bone KB, Razani J, D’Elia LF (2005) Handbook of normative data for neuropsychological assessment, 2nd edn. Oxford University Pres, New YorkGoogle Scholar
  31. 31.
    Grodzinsky GM, Barkley RA (1999) Predictive power of frontal lobe tests in the diagnosis of attention deficit hyperactivity disorder. Clin Neuropsychol 13:12–21PubMedCrossRefGoogle Scholar
  32. 32.
    Sergeant JA, Geurts H, Oosterlaan J (2002) How specific is a deficit of executive functioning for attention deficit/hyperactivity disorder? Behavioral Brain Res 130:3–28CrossRefGoogle Scholar
  33. 33.
    Tripp G, Ryan J, Peace K (2002) Neuropsychological functioning in children with DSM-IV combined type attention deficit hyperactivity disorder. Aust N Z J Psychiatry 36:771–779PubMedCrossRefGoogle Scholar
  34. 34.
    Houghton S, Douglas G, West J, Whiting K, Wall M, Langsford S, Powell L, Carroll A (1999) Differential patterns of executive function in children with attention-deficit hyperactivity disorder according to gender and subtype. J Child Neurol 14:801–805PubMedCrossRefGoogle Scholar
  35. 35.
    Weber P, Lütschg J, Fahnenstich H (2005) Cerebral hemodynamic changes in response to an executive function task in children with attention-deficit hyperactivity disorder measured by near-infrared spectroscopy. J Dev Behav Pediatr 26:105–111PubMedCrossRefGoogle Scholar
  36. 36.
    Chiang M, Gau SS (2008) Validation of attention-deficit-hyperactivity disorder subtypes among Taiwanese children using neuropsychological functioning. Aust NZJ Psychiatry 42:526–535CrossRefGoogle Scholar
  37. 37.
    Hale JB, Reddy LA, Decker SL, Thompson R, Henzel J, Teodori A, Forrest E, Eusebio E, Denckla MB (2009) Development and validation of an attention-deficit/hyperactivity disorder (ADHD) executive function and behavior rating screening battery. J Clin Exp Neuropsychol 31:897–912PubMedCrossRefGoogle Scholar
  38. 38.
    Qian Y, Shuai L, Cao Q, Chan RC, Wang Y (2010) Do executive function deficits differentiate between children with attention deficit hyperactivity disorder (ADHD) and ADHD comorbid with oppositional defiant disorder? A cross-cultural study using performance-based tests and the behavior rating. İnventory of executive function. Clin Neuropsychol 24:793–810PubMedCrossRefGoogle Scholar
  39. 39.
    Wakschlag LS, Choi SW, Carter AS, Hullsiek H, Burns J, McCarthy K, Leibenluft E, Briggs-Gowan MJ (2012) Defining the developmental parameters of temper loss in early childhood: implications for developmental psychopathology. J Child Psychol Psychiatry 53:1099–1108PubMedCentralPubMedCrossRefGoogle Scholar
  40. 40.
    Biederman J, Petty CR, Day H, Goldin RL, Spencer T, Faraone SV, Surman CB, Wozniak J (2012) Severity of the aggression/anxiety-depression/attention child behavior checklist profile discriminates between different levels of deficits in emotional regulation in youth with attention-deficit hyperactivity disorder. J Dev Behav Pediatr 33:236–243PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Ochsner KN (2008) The social-emotional processing stream: five core constructs and their translational potential for schizophrenia and beyond. Biol Psychiatry 64:48–61PubMedCentralPubMedCrossRefGoogle Scholar
  42. 42.
    Happaney K et al (2004) Development of orbitofrontal function: current themes and future directions. Brain Cogn 55:1–10PubMedCrossRefGoogle Scholar
  43. 43.
    Zelazo PD (2004) The development of conscious control in childhood. Trends Cogn Sci 8:12–17PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Child and Adolescent Psychiatry DepartmentHatay Woman and Children HospitalAntakyaTurkey
  2. 2.Child and Adolescent Psychiatry DepartmentAnkara University School of MedicineAnkaraTurkey
  3. 3.Hatay Kadın Doğum ve Çocuk Hastalıkları HastanesiAntakyaTurkey

Personalised recommendations