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Aggression Among Children with ADHD, Anxiety, or Co-occurring Symptoms: Competing Exacerbation and Attenuation Hypotheses

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Abstract

Competing hypotheses for explaining the role of anxiety in the relation between attention-deficit/hyperactivity disorder (ADHD) symptoms and childhood aggression were evaluated. Two studies tested whether anxiety exacerbated, attenuated, or had no effect on the relation between ADHD and aggression subtypes among psychiatrically hospitalized children. In Study 1 (N = 99), children who scored above clinical cut-off levels for anxiety only, ADHD only, and co-occurring ADHD and anxiety were compared on aggression subtypes (i.e., reactive, proactive, overt, and relational aggression). In Study 2, the moderating role of anxiety on the relation between ADHD and aggression subtypes was examined with a larger sample (N = 265) and with continuous variables. No support was found for either the attenuation or exacerbation hypothesis, and results remained consistent when separately examining hyperactivity/impulsivity and inattention symptoms of ADHD. Although ADHD symptoms were significantly associated with all aggression subtypes, this association did not remain when including symptoms of oppositional defiant disorder.

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Notes

  1. Although unavailable for the full sample, parent-reported DSM-IV diagnoses were available for 79 of the children using the Diagnostic Interview Schedule for Children (DISC-IV). Of particular interest given the use of psychiatrically hospitalized children in the present studies is the potential for elevated rates of bipolar disorder and posttraumatic stress disorder (PTSD) that may cloud our examination of ADHD and anxiety given symptom overlap. Among the children for whom DISC diagnoses were available, few met criteria for either mania or PTSD. Specifically, 1 child met criteria for mania and 6 children met criteria for PTSD. These children were retained in the study analyses since DISC diagnoses were not available for the full sample and thus could not be used consistently as an exclusionary criterion across all participating children.

  2. When ADHD-Inattentive and ADHD-Hyperactive/Impulsive symptoms were examined simultaneously, ADHD-Hyperactive/Impulsive symptoms significantly predicted all aggression outcomes above and beyond ADHD-Inattentive symptoms. ADHD-Inattentive symptoms no longer predicted any aggression outcome above and beyond ADHD-Hyperactive/Impulsive symptoms.

References

  • Abikoff, H. B., Jensen, P. S., Arnold, L. L. E., Hoza, B., Hechtman, L., Pollack, S., et al. (2002). Observed classroom behavior of children with ADHD: relationship to gender and comorbidity. Journal of Abnormal Child Psychology, 30, 349–359. doi:10.1023/A:1015713807297.

    Article  PubMed  Google Scholar 

  • Achenbach, T. M. (2001). Child behavior checklist for ages 6 to 18. Burlington: University of Vermont, Research Center for Children, Youth, and Families.

    Google Scholar 

  • Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms and profiles. Burlington: University of Vermont, Research Center for Children, Youth, and Families.

    Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.

  • Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–87. doi:10.1111/1469-7610.00424.

    Article  PubMed  Google Scholar 

  • Applegate, B., Lahey, B. B., Hart, E. L., Biederman, J., Hynd, G. W., Barkley, R. A., et al. (1997). Validity of the age-of-onset criterion for ADHD: a report from the DSM-IV field trials. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1211–1221. doi:10.1097/00004583-199709000-00013.

    Article  PubMed  Google Scholar 

  • Askénazy, F. L., Sorci, K., Benoit, M., Lestideau, K., Myquel, M., & Lecrubier, Y. (2003). Anxiety and impulsivity levels identify relevant subtypes in adolescents with at-risk behavior. Journal of Affective Disorders, 74, 219–227. doi:10.1016/S0165-0327(02)00455-X.

    Article  PubMed  Google Scholar 

  • Baldwin, J. S., & Dadds, M. R. (2008). Examining alternative explanations of the covariation of ADHD and anxiety symptoms in children: a community study. Journal of Abnormal Child Psychology, 36, 67–79. doi:10.1007/s10802-007-9160-1.

    Article  PubMed  Google Scholar 

  • Becker, S. P., & Kerig, P. K. (2011). Posttraumatic stress symptoms are associated with the frequency and severity of delinquency among detained boys. Journal of Clinical Child and Adolescent Psychology, 40, 765–771. doi:10.1080/15374416.2011.597091.

    Article  PubMed  Google Scholar 

  • Bennett, D. S., Pitale, M., Vora, V., & Rheingold, A. A. (2004). Reactive vs. proactive antisocial behavior: differential correlates of child ADHD symptoms? Journal of Attention Disorders, 7, 197–204. doi:10.1177/108705470400700402.

    Article  PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Biederman, J., Faraone, S. V., Doyle, A., Lehman, B. K., Kraus, I., Perrin, J., et al. (1993). Convergence of the Child Behavior Checklist with structured interview-based psychiatric diagnoses of ADHD children with and without comorbidity. Journal of Child Psychology and Psychiatry, 34, 1241–1251. doi:10.1111/j.1469-7610.1993.tb01785.x.

    Article  PubMed  Google Scholar 

  • Blachman, D. R., & Hinshaw, S. P. (2002). Patterns of friendship among girls with and without attention-deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 30, 625–640. doi:10.1023/A:1020815814973.

    Article  PubMed  Google Scholar 

  • Boxer, P. (2007). Aggression in very high-risk youth: examining developmental risk in an inpatient psychiatric population. American Journal of Orthopsychiatry, 77, 636–646. doi:10.1037/0002-9432.77.4.636.

    Article  PubMed  Google Scholar 

  • Bubier, J. L., & Drabick, D. A. G. (2009). Co-occurring anxiety and disruptive behavior disorders: the roles of anxious symptoms, reactive aggression, and shared risk processes. Clinical Psychology Review, 29, 658–669. doi:10.1016/j.cpr.2009.08.005.

    Article  PubMed  Google Scholar 

  • Burke, J. D., Loeber, R., Lahey, B. B., & Rathouz, P. J. (2005). Developmental transitions among affective and behavioral disorders in adolescent boys. Journal of Child Psychology and Psychiatry, 46, 1200–1210. doi:10.1111/j.1469-7610.2005.00422.x.

    Article  PubMed  Google Scholar 

  • Card, N. A., & Little, T. D. (2006). Proactive and reactive aggression in childhood and adolescence: a meta-analysis of differential relations with psychosocial adjustment. International Journal of Behavioral Development, 30, 466–480. doi:10.1177/0165025406071904.

    Article  Google Scholar 

  • Card, N. A., Stucky, B. D., Sawalani, G. M., & Little, T. D. (2008). Direct and indirect aggression during childhood and adolescence: a meta-analytic review of gender differences, intercorrelations, and relations to maladjustment. Child Development, 79, 1185–1229. doi:10.1111/j.1467-8624.2008.01184.x.

    Article  PubMed  Google Scholar 

  • Carlson, C. L., Tamm, L., & Gaub, M. (1997). Gender differences in children with ADHD, ODD, and co-occurring ADHD/ODD identified in a school population. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1706–1714. doi:10.1097/00004583-199712000-00019.

    Article  PubMed  Google Scholar 

  • Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2002). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). London: Routledge Academic.

    Google Scholar 

  • Connor, D. F., & McLaughlin, T. J. (2006). Aggression and diagnosis in psychiatrically referred children. Child Psychiatry and Human Development, 37, 1–14. doi:10.1007/s10578-006-0015-8.

    Article  PubMed  Google Scholar 

  • Connor, D. F., Edwards, G., Fletcher, K. E., Baird, J., Barkley, R. A., & Steingard, R. J. (2003). Correlates of comorbid psychopathology in children with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 193–200. doi:10.1097/00004583-200302000-00013.

    Article  PubMed  Google Scholar 

  • Connor, D. F., Doerfler, L. A., Toscano, P. F., Volungis, A. M., & Steingard, R. J. (2004). Characteristics of children and adolescents admitted to a residential treatment center. Journal of Child and Family Studies, 13, 497–510. doi:10.1023/B:JCFS.0000044730.66750.57.

    Article  Google Scholar 

  • Connor, D. F., Chartier, K. G., Preen, E. C., & Kaplan, R. F. (2010). Impulsive aggression in attention-deficit/hyperactivity disorder: symptom severity, co-morbidity, and attention-deficit/hyperactivity disorder subtype. Journal of Child and Adolescent Psychopharmacology, 20, 119–126. doi:10.1089/cap.2009.0076.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Cunningham, C. E., & Boyle, M. H. (2002). Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: family, parenting, and behavioral correlates. Journal of Abnormal Child Psychology, 30, 555–569. doi:10.1023/A:1020855429085.

    Article  PubMed  Google Scholar 

  • Cunningham, N. R., & Ollendick, T. H. (2010). Comorbidity of anxiety and conduct problems in children: implications for clinical research and practice. Clinical Child and Family Psychology Review, 13, 333–347. doi:10.1007/s10567-010-0077-9.

    Article  PubMed  Google Scholar 

  • Deming, A. M., & Lochman, J. E. (2008). The relation of locus of control, anger, and impulsivity to boys’ aggressive behavior. Behavioral Disorders, 33, 108–119.

    Google Scholar 

  • Dodge, K. A., & Coie, J. D. (1987). Social-information-processing factors in reactive and proactive aggression in children’s peer groups. Journal of Personality and Social Psychology, 53, 1146–1158. doi:10.1037/0022-3514.53.6.1146.

    Article  PubMed  Google Scholar 

  • Dodge, K. A., Lochman, J. E., Harnish, J. D., Bates, J. E., & Pettit, G. S. (1997). Reactive and proactive aggression in school children and psychiatrically impaired chronically assaultive youth. Journal of Abnormal Psychology, 106, 37–51. doi:10.1037/0021-843X.106.1.37.

    Article  PubMed  Google Scholar 

  • Drabick, A. G., Ollendick, T. H., & Bubier, J. L. (2010). Co-occurrence of ODD and anxiety: shared risk processes and evidence for a dual-pathway model. Clinical Psychology: Science and Practice, 17, 307–318. doi:10.1111/j.1468-2850.2010.01222.x.

    Article  Google Scholar 

  • Fergusson, D. M., Boden, J. M., & Horwood, L. J. (2010). Classification of behavior disorders in adolescence: scaling methods, predictive validity, and gender differences. Journal of Abnormal Psychology, 119, 699–712. doi:10.1037/a0018610.

    Article  PubMed  Google Scholar 

  • Fite, P. J., Stauffacher, K., Ostrov, J. M., & Colder, C. R. (2008). Replication and extension of Little et al.’s (2003) forms and functions of aggression measure. International Journal of Behavioral Development, 32, 238–242. doi:10.1177/0165025408089273.

    Article  Google Scholar 

  • 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. doi:10.1097/00004583-200310000-00011.

    Article  PubMed  Google Scholar 

  • Frick, P. J., Lilienfeld, S. O., Ellis, M., Loney, B., & Silverthorn, P. (1999). The association between anxiety and psychopathy dimensions in children. Journal of Abnormal Child Psychology, 27, 383–392. doi:10.1023/A:1021928018403.

    Article  PubMed  Google Scholar 

  • Gadow, K. D., & Nolan, E. E. (2002). Differences between preschool children with ODD, ADHD, and ODD+ADHD symptoms. Journal of Child Psychology and Psychiatry, 43, 191–201. doi:10.1111/1469-7610.00012.

    Article  PubMed  Google Scholar 

  • Gaub, M., & Carlson, C. L. (1997). Gender differences in ADHD: a meta-analysis and critical review. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1036–1045. doi:10.1097/00004583-199708000-00011.

    Article  PubMed  Google Scholar 

  • Goren, S., Singh, N. N., & Best, A. M. (1993). The aggression-coercion cycle: use of seclusion and restraint in a child psychiatric hospital. Journal of Child and Family Studies, 2, 61–73. doi:10.1007/BF01321301.

    Article  Google Scholar 

  • Gray, J. A. (1987). The psychology of fear and stress (2nd ed.). Cambridge: Cambridge University Press.

    Google Scholar 

  • Harty, S. C., Miller, C. J., Newcorn, J. H., & Halperin, J. M. (2009). Adolescents with childhood ADHD and comorbid disruptive behavior disorders: aggression, anger, and hostility. Child Psychiatry and Human Development, 40, 85–97. doi:10.1007/s10578-008-0110-0.

    Article  PubMed  Google Scholar 

  • Hinshaw, S. P. (1987). On the distinction between attentional deficits/hyperactivity and conduct problems/aggression in child psychopathology. Psychological Bulletin, 101, 443–463. doi:10.1037/0033-2909.101.3.443.

    Article  PubMed  Google Scholar 

  • Ialongo, N., Edelsohn, G., Werthamer-Larsson, L., Crockett, L., & Kellam, S. (1996). The course of aggression in first-grade children with and without comorbid anxious symptoms. Journal of Abnormal Child Psychology, 24, 445–456. doi:10.1007/BF01441567.

    Article  PubMed  Google Scholar 

  • Jarrett, M. A., & Ollendick, T. H. (2008). A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety: implications for future research and practice. Clinical Psychology Review, 28, 1266–1280. doi:10.1016/j.cpr.2008.05.004.

    Article  PubMed  Google Scholar 

  • Jensen, P. S., Watanabe, H. K., Richters, J. E., Roper, M., Hibbs, E. D., Salzberg, A. D., et al. (1996). Scales, diagnoses, and child psychopathology: II. Comparing the CBCL and the DISC against external validators. Journal of Abnormal Child Psychology, 24, 151–168. doi:10.1007/BF01441482.

    Article  PubMed  Google Scholar 

  • Jensen, P., Hinshaw, S., Kraemer, H., Lenora, N., Newcorn, J., Abikoff, H., et al. (2001). ADHD comorbidity findings from the MTA study: comparing comorbid subgroups. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 147–158. doi:10.1097/00004583-200102000-00009.

    Article  PubMed  Google Scholar 

  • Kendall, P. C., Brady, E. U., & Verduin, T. L. (2001). Comorbidity in childhood anxiety disorders and treatment outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 787–794. doi:10.1097/00004583-200107000-00013.

    Article  PubMed  Google Scholar 

  • Kendall, P. C., Puliafico, A. C., Barmish, A. J., Choudhury, M. S., Henin, A., & Treadwall, K. S. (2007). Assessing anxiety with the child behavior checklist and the teacher report form. Journal of Anxiety Disorders, 21, 1004–1015. doi:10.1016/j.janxdis.2006.10.012.

    Article  PubMed  Google Scholar 

  • Kerr, M., Tremblay, R. E., Pagani, L., & Vitaro, F. (1997). Boys’ behavioral inhibition and the risk of later delinquency. Archives of General Psychiatry, 54, 809–816.

    Article  PubMed  Google Scholar 

  • Kovacs, M., & Devlin, B. (1998). Internalizing disorders in childhood. Journal of Child Psychology and Psychiatry, 39, 47–63. doi:10.1111/1469-7610.00303.

    Article  PubMed  Google Scholar 

  • Lahey, B. B., Waldman, I. D., & McBurnett, K. (1999). Annotation: the development of antisocial behavior: an integrative causal model. Journal of Child Psychology and Psychiatry, 40, 669–682. doi:10.1111/1469-7610.00484.

    Article  PubMed  Google Scholar 

  • Levy, K., Hunt, C., & Heriot, S. (2007). Treating comorbid anxiety and aggression in children. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1111–1118. doi:10.1097/chi.0b013e318074eb32.

    Article  PubMed  Google Scholar 

  • Lilienfeld, S. O. (2003). Comorbidity between and within childhood externalizing and internalizing disorders: reflections and directions. Journal of Abnormal Child Psychology, 31, 285–291. doi:10.1023/A:1023229529866.

    Article  PubMed  Google Scholar 

  • Little, T. D., Jones, S. M., Henrich, C. C., & Hawley, P. H. (2003). Disentangling the “whys” from the “whats” of aggressive behaviour. International Journal of Behavioral Development, 27, 122–133. doi:10.1080/01650250244000128.

    Article  Google Scholar 

  • Luebbe, A. M., Bell, D., Allwood, M., Swenson, L., & Early, M. (2010). Social information processing in children: specific relations to anxiety, depression, and affect. Journal of Clinical Child and Adolescent Psychology, 39, 386–399. doi:10.1080/15374411003691685.

    Article  PubMed  Google Scholar 

  • Maedgen, J. W., & Carlson, C. L. (2000). Social functioning and emotional regulation in the attention deficit hyperactivity disorder subtypes. Journal of Clinical Child Psychology, 29, 30–42. doi:10.1207/S15374424jccp2901_4.

    Article  PubMed  Google Scholar 

  • March, J. S., Swanson, J. M., Arnold, L. E., Hoza, B., Conners, C. K., Hinshaw, S. P., et al. (2000). Anxiety as a predictor and outcome variable in the Multimodal Treatment Study of Children with ADHD (MTA). Journal of Abnormal Child Psychology, 28, 527–541. doi:10.1023/A:1005179014321.

    Article  PubMed  Google Scholar 

  • Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Aveneoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989. doi:10.1016/j.jaac.2010.05.017.

    Article  PubMed  Google Scholar 

  • Mikami, A. Y., & Lorenzi, J. (2011). Gender and conduct problems predict peer functioning among children with attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 40, 777–786. doi:10.1080/15374416.2011.597089.

    Article  PubMed  Google Scholar 

  • Mikami, A. Y., Ransone, M. L., & Calhoun, C. D. (2011). Influence of anxiety on the social functioning of children with and without ADHD. Journal of Attention Disorders, 15, 473–484. doi:10.1177/1087054710369066.

    Article  PubMed  Google Scholar 

  • Murray-Close, D., Ostrov, J. M., & Crick, N. R. (2007). A short-term longitudinal study of growth of relational aggression during middle childhood: associations with gender, friendship intimacy, and internalizing problems. Development and Psychopathology, 19, 187–203. doi:10.1017/S0954579407070101.

    Article  PubMed  Google Scholar 

  • Nakamura, B. J., Ebesutani, C., Bernstein, A., & Chorpita, B. F. (2009). A psychometric analysis of the Child Behavior Checklist DSM-oriented scales. Journal of Psychopathology and Behavioral Assessment, 31, 178–189. doi:10.1007/s10862-008-9119-8.

    Article  Google Scholar 

  • Newcorn, J. H., Halperin, J. M., Jensen, P. S., Abikoff, H. B., Arnold, L. E., Cantwell, D. P., et al. (2001). Symptom profiles in children with ADHD: effects of comorbidity and gender. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 137–146. doi:10.1097/00004583-200102000-00008.

    Article  PubMed  Google Scholar 

  • Nigg, J. T., Goldsmith, H. H., & Sachek, J. (2004). Temperament and attention deficit hyperactivity disorder: the development of a multiple pathway model. Journal of Clinical Child and Adolescent Psychology, 33, 42–53. doi:10.1207/S15374424JCCP3301_5.

    Article  PubMed  Google Scholar 

  • O’Brien, B. S., & Frick, P. J. (1996). Reward dominance: associations with anxiety, conduct problems, and psychopathy in children. Journal of Abnormal Child Psychology, 24, 223–240. doi:10.1007/BF01441486.

    Article  PubMed  Google Scholar 

  • Pardini, D. A., & Fite, P. J. (2010). Symptoms of conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, and callous-unemotional traits as unique predictors of psychosocial maladjustment in boys: Advancing an evidence base for DSM-V. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 1134–1144. doi:10.1016/j.jaac.2010.07.010.

    PubMed  Google Scholar 

  • Perrin, S., & Last, C. G. (1996). Relationship between ADHD and anxiety in boys: results from a family study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 988–996. doi:10.1097/00004583-199608000-00009.

    Article  PubMed  Google Scholar 

  • Pliszka, S. R. (1989). Effect of anxiety on cognition, behavior, and stimulant response in ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 882–887. doi:10.1097/00004583-198911000-00012.

    Article  PubMed  Google Scholar 

  • Power, T. J., Costigan, T. E., Eiraldi, R. B., & Leff, S. S. (2004). Variations in anxiety and depression as a function of ADHD subtypes defined by DSM-IV: Do subtype differences exist or not? Journal of Abnormal Child Psychology, 32, 27–37. doi:10.1023/B:JACP.0000007578.30863.93.

    Article  PubMed  Google Scholar 

  • Quay, H. C. (1988). The behavioral reward and inhibition system in childhood behavior disorders. In L. M. Bloomingdale (Ed.), Attention deficit disorder (Vol. 3, pp. 176–186). New York: Pergamon.

    Google Scholar 

  • Raine, A., Dodge, K., Loeber, R., Gatzke-Kopp, L., Lynam, D., Reynolds, C., et al. (2006). The reactive-proactive aggression questionnaire: differential correlates of reactive and proactive aggression in adolescent boys. Aggressive Behavior, 32, 159–171. doi:10.1002/ab.20115.

    Article  PubMed  Google Scholar 

  • Sørensen, L., Plessen, K. J., Nicholas, J., & Lundervold, A. J. (2011). Is behavioral regulation in children with ADHD aggravated by comorbid anxiety disorder? Journal of Attention Disorders, 15, 56–66. doi:10.1177/1087054709356931.

    Article  PubMed  Google Scholar 

  • Tremblay, R. E., Pihl, R. O., Vitaro, F., & Dobkin, P. L. (1994). Predicting early onset on male antisocial behavior from preschool behavior. Archives of General Psychiatry, 51, 732–739. doi:10.1001/archpsyc.1994.03950090064009.

    Article  PubMed  Google Scholar 

  • Vitaro, F., Brendgen, M., & Tremblay, R. E. (2002). Reactively and proactively aggressive children: antecedent and subsequent characteristics. Journal of Child Psychology and Psychiatry, 43, 495–505. doi:10.1111/1469-7610.00040.

    Article  PubMed  Google Scholar 

  • Walton, K. E., Ormel, J., & Krueger, R. F. (2011). The dimensional nature of externalizing behaviors in adolescence: evidence from a direct comparison of categorical, dimensional, and hybrid models. Journal of Abnormal Child Psychology, 39, 553–561. doi:10.1007/s10802-010-9478-y.

    Article  PubMed  Google Scholar 

  • Waschbusch, D. A., & Willoughby, M. T. (2008). Attention-deficit/hyperactivity disorder and callous-unemotional traits as moderators of conduct problems when examining impairment and aggression in elementary school children. Aggressive Behavior, 34, 139–153. doi:10.1002/ab.20224.

    Article  PubMed  Google Scholar 

  • Waschbusch, D. A., Willoughby, M. T., & Pelham, W. E., Jr. (1998). Criterion validity and the utility of reactive and proactive aggression: comparisons to attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, and other measures of functioning. Journal of Clinical Child Psychology, 27, 396–405. doi:10.1207/s15374424jccp2704_3.

    Article  PubMed  Google Scholar 

  • Wilens, T. E., Biederman, J., & Spencer, T. J. (2002). Attention-deficit/hyperactivity disorder across the lifespan. Annual Review of Medicine, 53, 113–131. doi:10.1146/annurev.med.53.082901.103945.

    Article  PubMed  Google Scholar 

  • Zalecki, C. A., & Hinshaw, S. P. (2004). Overt and relational aggression in girls with attention deficit hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 33, 125–137. doi:10.1207/S15374424JCCP3301_12.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, Miami University, 90 North Patterson Avenue, Oxford, OH, 45056, USA

    Stephen P. Becker & Aaron M. Luebbe

  2. Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA

    Laura Stoppelbein

  3. Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA

    Leilani Greening

  4. Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA

    Paula J. Fite

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  1. Stephen P. Becker
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  2. Aaron M. Luebbe
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  3. Laura Stoppelbein
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  4. Leilani Greening
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  5. Paula J. Fite
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Correspondence to Stephen P. Becker.

Additional information

Portions of this paper were presented at the 83rd Annual Meeting of the Midwestern Psychological Association, Chicago, Illinois (May, 2011). The authors thank the families who participated in these studies, as well as comments by Joshua Langberg on an earlier draft of this article.

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Becker, S.P., Luebbe, A.M., Stoppelbein, L. et al. Aggression Among Children with ADHD, Anxiety, or Co-occurring Symptoms: Competing Exacerbation and Attenuation Hypotheses. J Abnorm Child Psychol 40, 527–542 (2012). https://doi.org/10.1007/s10802-011-9590-7

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