Advertisement

Journal of Abnormal Child Psychology

, Volume 35, Issue 6, pp 883–898 | Cite as

ADHD Correlates, Comorbidity, and Impairment in Community and Treated Samples of Children and Adolescents

  • José J. BauermeisterEmail author
  • Patrick E. Shrout
  • Rafael Ramírez
  • Milagros Bravo
  • Margarita Alegría
  • Alfonso Martínez-Taboas
  • Ligia Chávez
  • Maritza Rubio-Stipec
  • Pedro García
  • Julio C. Ribera
  • Glorisa Canino
Article

Abstract

Patterns of correlates, comorbidity and impairment associated with attention-deficit hyperactivity disorder (ADHD) in children and youth were examined in representative samples from the community and from treatment facilities serving medically indigent youth in Puerto Rico. Information from caretakers and youths was obtained using the Diagnostic Interview Schedule for Children, (version IV), measures of global impairment, and a battery of potential correlates. In the community (N = 1,896) and the treated samples (N = 763), 7.5 and 26.2% of the children, respectively, met criteria for DSM-IV ADHD in the previous year. Although the prevalence rates and degree of impairment differed, the general patterns of correlates, comorbidity and impairment were similar in both populations. The exceptions were associated with conduct disorder, anxiety, impairment in the ADHD comorbid group, and age factors that appeared to be related to selection into treatment.

Keywords

ADHD Correlates Prevalence Comorbidity Hispanic/Latino 

Notes

Acknowledgement

Data for this study were obtained through NIMH funded grants: MH54827. Canino (PI) and P01-MH 59876-02 Alegría (PI), and from P20 MD000537-01 Canino (PI) from the National Center for Minority Health Disparities. We thank Lizbeth Fabregas, the project director of the study, Graciela Reina and Adrianne Anderson for their generous assistance, and Bill Sribney for his comments on an earlier version of the manuscript.

References

  1. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th. ed.). Washington, DC: American Psychiatric Association.Google Scholar
  2. Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–87.PubMedCrossRefGoogle Scholar
  3. Barkley, R. (2003). Attention deficit hyperactivity disorder. In E. J. Mash, & R. A., Barkley (Eds.), Child psychopathology (2nd. ed.) (pp. 75–143). New York: Guilford.Google Scholar
  4. Barkley, R. A., Fischer, M., Edelbrock, C. S., & Smallish, L. (1990). The adolescent outcome of hyperactive children diagnosed by research criteria: I An 8–9 year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 546–557.PubMedCrossRefGoogle Scholar
  5. Barkley, R. A., Fischer, M., Edelbrock, C., & Smallish, L. (1991). The adolescent outcome of hyperactive children diagnosed by research criteria-III. Mother–child interactions, family conflicts and maternal psychopathology. Journal of Child Psychology and Psychiatry, 32, 233–255.PubMedCrossRefGoogle Scholar
  6. Barkley, R. A., Fischer, M., Smallish, L., & Fletcher, K. (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology, 111, 279–289.PubMedCrossRefGoogle Scholar
  7. Berkson, J. (1950). Are there two regressions? Journal of the American Statistical Association, 45, 164–180.CrossRefGoogle Scholar
  8. Biederman, J., Faraone, S. V., Keenan, K., Benjamin, J., Krifcher, B., Moore, C., et al. (1992). Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder. Patterns of comorbidity in probands and relatives psychiatrically and pediatrically referred samples. Archives of General Psychiatry, 49, 728–738.PubMedGoogle Scholar
  9. Biederman, J., Keenan, K., & Faraone, S. V. (1990). Parent-based diagnosis of attention deficit disorder predicts a diagnosis based on teacher report. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 698–701.PubMedCrossRefGoogle Scholar
  10. Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry, 148, 564–577.PubMedGoogle Scholar
  11. Binder, D. A. (1983). On the variances of asymptotically normal estimators from complex surveys. International Statistics Review, 51, 279–292.CrossRefGoogle Scholar
  12. Bird, H. R., Andrew, H., Shwab-Stone, M., Goodman, S. H., Dulcan, M., Richters, J., et al., (1996). Global measures of impairment for epidemiologic and clinical use with children and adolescents. International Journal of Methods in Psychiatric Research, 6, 295–307.CrossRefGoogle Scholar
  13. Bird, H. R., Canino, G. J., Davies, M., Ramirez, R., Chavez, L., Duarte, C., et al. (2005). The Brief Impairment Scale (BIS): A multidimensional scale of functional impairment for children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 699–707.PubMedCrossRefGoogle Scholar
  14. Bird, H. R., Canino, G. J., Davies, M., Zhang, H., Ramirez, R., & Lahey, B. B. (2001). Prevalence and correlates of antisocial behaviors among three ethnic groups. Journal of Abnormal Child Psychology, 29, 465–478.PubMedCrossRefGoogle Scholar
  15. Bird, H. R., Canino, G., Rubio-Stipec, M., Gould, M. S., Ribera, J., Sesman, M., et al. (1988). Estimates of the prevalence of childhood maladjustment in a community survey in Puerto Rico: The use of combined measures. Archives of General Psychiatry, 45, 1120–1126.PubMedGoogle Scholar
  16. Bird, H. R., Gould, M. S., Yager, T., Stahezza, B., & Canino, G. (1989). Risk factors for maladjustment in Puerto Rican children. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 847–850.PubMedCrossRefGoogle Scholar
  17. Bravo, M., Ribera, J., Rubio-Stipec, M., Canino, G., Shrout, P., Ramirez, R., et al. (2001). Test–retest reliability of the Spanish version of the Diagnostic Interview Schedule for Children (DISC-IV). Journal of Abnormal Child Psychology, 29, 433–444.PubMedCrossRefGoogle Scholar
  18. Breslau, N., Brown, G. G., DelDotto, J. E., Kumar, S., Ezhuthachan, S., Andreski, P., et al. (1996). Psychiatric sequelae of low birth weight at 6 years of age. Journal of the Abnormal Child Psychology, 24, 385–400.CrossRefGoogle Scholar
  19. Buitelaar, J. K. (2002). Epidemiological aspects: What have we learned over the last decade? In S. Sandberg (Ed.), Hyperactivity and attention disorders of childhood (pp.30–63). New York: Cambridge University Press.Google Scholar
  20. Canino, G., Shrout P. E., Rubio-Stipec, M., Bird, H. R., Bravo, M., Ramirez, R., et al. (2004). The DSM-IV rates of child and adolescent disorders in Puerto Rico: Prevalence, correlates, service use, and the effects of impairment. Archives of General Psychiatry, 61, 85–93.PubMedCrossRefGoogle Scholar
  21. Cohen, P., & Cohen, J. (1984). The clinician’s illusion. Archives of General Psychiatry, 41, 1178–1182.PubMedGoogle Scholar
  22. Corkum, P., Tannock, R., & Moldofsky, H. (1998). Sleep disturbances in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 637–646.PubMedCrossRefGoogle Scholar
  23. Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844.PubMedCrossRefGoogle Scholar
  24. Fischer, M. (1990). Parenting stress and the child with attention deficit hyperactivity disorder. Journal of Clinical Child Psychology, 19, 337–346.CrossRefGoogle Scholar
  25. Ford, T., Goodman, R., & Meltzer, H. (2003). The British child and adolescent mental health survey 1999: The prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1203–1211.PubMedCrossRefGoogle Scholar
  26. Freeman, H. (1962). Introduction to statistical inference. Reading, MA: Addison-Wesley.Google Scholar
  27. Garland, A. F., Hough, R. L., McCabe, K. M., Yeh, M., Wood, P. A., & Aarons, G. A. (2001). Prevalence of psychiatric disorders in youths across five sectors of care. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 409–418.PubMedCrossRefGoogle Scholar
  28. Goodman, S. H., Hoven, C. W., Narrow, W. E., Cohen, P., Fielding, B., Alegría, M., et al. (1998). Measurement of risk for mental disorders and competence in a psychiatric epidemiologic community survey: The National Institute of Mental Health Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Social Psychiatry and Psychiatric Epidemiology, 33, 162–173.PubMedCrossRefGoogle Scholar
  29. Goodman, S. H., Lahey, B. B., Fielding, B., Dulcan, M., Narrow, W., & Regier, D. (1997). Representativeness of clinical samples of youths with mental disorders: A preliminary population-based study. Journal of Abnormal Psychology, 106, 3–14.PubMedCrossRefGoogle Scholar
  30. Hart, H. E., Lahey, B. B., Loeber, R., Applegate, B., & Frick, P. J. (1995). Developmental changes in attention-deficit hyperactivity disorder in boys: A four-year longitudinal study. Journal of Abnormal Child Psychology, 23, 729–750.PubMedCrossRefGoogle Scholar
  31. Heptinstall, E., & Taylor E. (2002). Sex differences and their significance. In S. Sandberg (Ed.), Hyperactivity and attention disorders of childhood (pp 99–125). New York: Cambridge University Press.Google Scholar
  32. Hinshaw, S. P. (2002). Is ADHD an impairing condition in childhood and adolescence? In P. S. Jensen, & J. R. Cooper (Eds.), Attention deficit hyperactivity disorder (pp. 5–21). Kingston, New Jersey: Civil Research Institute.Google Scholar
  33. Hudson, W. W. (1982). Methodological observations on applied behavioral science. A measurement package for clinical workers. Journal of Applied Behavioral Science, 18, 229–238.PubMedCrossRefGoogle Scholar
  34. Jensen, P. S., Martin, D., & Cantwell, D. P. (1997). Comorbidity in ADHD: Implications for research, practice, and DSM-V. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1065–1079.PubMedCrossRefGoogle Scholar
  35. Jensen, P. S., Rubio-Stipec, M., Canino, G., Bird, H., Dulcan, M. K., Schwab-Stone, M. E., et al. (1999). Parent and child contributions to diagnosis of mental disorder are both informants always necessary? Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1569–1579.PubMedCrossRefGoogle Scholar
  36. Keown, L. J., & Woodward, L. J. (2002). Early parent–child relations and family functioning of preschool boys with pervasive hyperactivity. Journal of Abnormal Child Psychology, 30, 541–553.PubMedCrossRefGoogle Scholar
  37. Kish, L. (1965). Survey sampling. New York: Wiley.Google Scholar
  38. Lish, J. D., Weissman, M. M., Adams, P. B., Hoven, C. W., & Bird, H. (1995). Family psychiatric screening instruments for epidemiologic studies: Pilot testing and validation. Psychiatry Research, 57, 169–180.PubMedCrossRefGoogle Scholar
  39. Messer, S. C., Angold, A., Costello, E. J., & Burns, B. J. (1996). The Child and Adolescent Burden Assessment (CABA): Measuring the family impact of emotional and behavioral problems. International Journal of Methods in Psychiatric Research, 6, 261–284.CrossRefGoogle Scholar
  40. Nevares, D., Wolfgang, M. E., & Tracy, P. T. (1990). Delinquency in Puerto Rico: The 1970 birth cohorts study. Westport, CT: Greenwood.Google Scholar
  41. Research Triangle Institute. (2001). SUDAAN user’s manual, Release 8.0. Research Triangle Park, NC: Research Triangle Institute.Google Scholar
  42. Scahill, L., Schwab-Stone, M., Merikangas, K. R., Leckman, J. F., Zhang, H., & Kasl, S. (1999). Psychosocial and clinical correlates of ADHD in a community sample of school-age children. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 976–984.PubMedCrossRefGoogle Scholar
  43. Schwab-Stone, M., Fallon, T., Briggs, M., & Crowther, B. (1994). Reliability of diagnostic reporting for children aged 6–11 years: A test–retest study of the Diagnostic Interview Schedule for Children-Revised. American Journal of Psychiatry, 151, 1048–1054.PubMedGoogle Scholar
  44. Smith, C., & Krohn, M. D. (1995). Delinquency and family life among male adolescents: The role of ethnicity. Journal of Youth and Adolescent, 24, 69–93.CrossRefGoogle Scholar
  45. Szatmari, P., Offord, D. R., & Boyle, M. H. (1989). Correlates, associated impairments and patterns of service utilization of children with attention deficit disorder: Findings from the Ontario Child Health Study. Journal of Child Psychology and Psychiatry, 30, 205–217.PubMedCrossRefGoogle Scholar
  46. Tannock, R. (1998). Attention deficit hyperactivity disorder: Advances in cognitive, neurobiological, and genetic research. Journal of Child Psychology and Psychiatry, 39, 65–99.PubMedCrossRefGoogle Scholar
  47. Tannock, R., & Schachar, R. (1996). Executive dysfunction as an underlying mechanism of behavior and language problems in attention deficit hyperactivity disorder. In J. H. Beitchman, N. Cohen, M. Konstantareas, & R. Tannock (Eds.), Language, learning, and behavior disorders: Developmental, biological, and clinical perspectives (pp. 128–155). New York: Cambridge University Press.Google Scholar
  48. Tracy, P. E., Wolfgang, M. E., & Figlio, R. M. (1990). Delinquency careers in two birth cohorts. New York, New York: Plenum.Google Scholar
  49. Wolfgang, M. E., Figlio, R., & Sellin, T. (1972). Delinquency in a birth cohort. Chicago: University of Chicago Press.Google Scholar
  50. Woodward, L., Taylor, E., & Dowdney, L. (1998). The parenting and family functioning of children with hyperactivity. Journal of Child Psychology and Psychiatry, 39, 161–169.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • José J. Bauermeister
    • 1
    • 8
    Email author
  • Patrick E. Shrout
    • 2
  • Rafael Ramírez
    • 1
  • Milagros Bravo
    • 1
    • 3
  • Margarita Alegría
    • 1
    • 6
    • 7
  • Alfonso Martínez-Taboas
    • 1
    • 4
  • Ligia Chávez
    • 1
  • Maritza Rubio-Stipec
    • 1
  • Pedro García
    • 1
  • Julio C. Ribera
    • 1
    • 5
  • Glorisa Canino
    • 1
  1. 1.Behavioral Sciences Research Institute (BSRI)University of Puerto Rico (UPR)San JuanPuerto Rico
  2. 2.Department of PsychologyNew York UniversityNew YorkUSA
  3. 3.Graduate School of Education, UPRSan JuanPuerto Rico
  4. 4.Carlos Albizu UniversitySan JuanPuerto Rico
  5. 5.San Juan Veterans Administration HospitalSan JuanPuerto Rico
  6. 6.Department of PsychiatryHarvard UniversityCambridgeUSA
  7. 7.Cambridge Health AllianceCambridgeUSA
  8. 8.San JuanPuerto Rico

Personalised recommendations