Journal of Abnormal Child Psychology

, Volume 26, Issue 5, pp 345–356

Diagnostic Stability of ADHD in a Community Sample of School-Aged Children Screened for Disruptive Behavior

  • Gerald J. August
  • Lauren Braswell
  • Paul Thuras
Article

Abstract

A large school-based sample of children in Grades 1, 2, 3, and 4 were screened for disruptive behavior and subsequently assessed over a 5-year period for DSM-III-R symptoms of attention deficit hyperactivity disorder (ADHD) and other externalizing and internalizing behavior disorders. Parents completed structured diagnostic interviews in Years 1, 4, and 5, and teachers completed Behavioral Assessment for Children—Teacher Rating Scales behavioral ratings annually. For parent-derived diagnostic data, both inattention and hyperactivity/impulsivity symptom groups declined from Year 1 to Year 4, with hyperactivity showing more significant decline. For teacher-rated behavioral dimensions, the Attention Problems scale declined from Year 1 to Year 3 and stabilized thereafter. The Hyperactivity scale showed stability during the first 3 years before declining in Year 4. Of those children diagnosed with ADHD in Year 1, 69% still met criteria for ADHD in either Year 4 or 5. Persisters were more likely to exhibit coexisting conduct disorder in Year 1 and oppositional defiant disorder in Years 1, 4, and 5. Parents of persisters reported more psychosocial adversity on measures of parenting and marital satisfaction.

ADHD DSM-III-R persistence comorbidity 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington: University of Vermont, Department of Psychiatry.Google Scholar
  2. American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.). Washington, DC: Author.Google Scholar
  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  4. August, G. J., & Garfinkel, B. D. (1993). The nosology of ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 155–165.PubMedGoogle Scholar
  5. August G. J., Realmuto, G. R., Crosby, R. D., & MacDonald, A. W. (1995). Community-based multiple-gate screening of children at-risk for conduct disorder. Journal of Abnormal Child Psychology, 23, 521–544.PubMedGoogle Scholar
  6. August, G. J., Stewart, M. A., & Holmes C. S. (1983). A four-year follow-up of hyperactive boys with and without conduct disorder. British Journal of Psychiatry, 143, 192-198.Google Scholar
  7. Barkley, R. A. (1996). Attention deficit hyperactivity disorder. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (pp. 63–112). New York: Guilford Press.Google Scholar
  8. Barkley, R. A. (1997). Age dependent decline in ADHD: True recovery or statistical illusion? ADHD Report, 5, 1–5.Google Scholar
  9. Barkley R. A., Fischer, M., Edelbrock, C. S., & Smallish, L. (1990). The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 546–557.PubMedGoogle Scholar
  10. Biederman, J., Faraone, S., Milberger, S., Curtis, S., Chen, L., Marrs, A., Quellette, C., Moore, R., & Spencer, T. (1996). Predictors of persistence and remission of ADHD into adolescence: Results from a four-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 343–351.PubMedGoogle Scholar
  11. Braswell, L., August, G. J., Bloomquist, M. L., Realmuto, G. M., Skare, S. S., & Crosby, R. D. (1997). School-based secondary prevention for children with disruptive behavior: Initial outcomes. Journal of Abnormal Child Psychology, 25, 197–208.PubMedGoogle Scholar
  12. Campis, L. K., Lyman, R. D., & Prentice-Dunn, S. (1986). The parental locus of control scale: Development and validation. Journal of Clinical Child Psychology and Psychiatry, 15, 260–267.Google Scholar
  13. Gittelman, R., Mannuzza, S., Shenker, R., & Bonagura, N. (1985). Hyperactive boys almost grown up. I. Psychiatric status. Archives of General Psychiatry, 42, 937–947.PubMedGoogle Scholar
  14. Goyette, C. H., Conners, C. K., & Ulrich, R. F. (1978). Normative data on Revised Conners Parent and Teacher Rating Scales. Journal of Abnormal Child Psychology, 6, 221–236.PubMedGoogle Scholar
  15. Hart, E. L., Lahey, B. B., Loeber, R., Appelgate, B., & Frick, P. J. (1995). Developmental change in attention-deficit hyperactivity disorder in boys: A four-year longitudinal study. Journal of Abnormal Child Psychology, 23, 729–749.PubMedGoogle Scholar
  16. Hill, J. C., & Schoener, E. P. (1996). Age-dependent decline of attention deficit hyperactivity disorder. American Journal of Psychiatry, 153, 1143–1146.PubMedGoogle Scholar
  17. Hollingshead, A. B. (1975). Four Factor Index of Social Status. New Haven, CT: Yale University.Google Scholar
  18. Kaufman, A. S., & Kaufman, N. L. (1990). Kaufman Brief Intelligence Test (K-BIT). Circle Pines, MN: American Guidance Clinic.Google Scholar
  19. Klein, R. G., & Mannuzza, S. (1991). Long-term outcome of hyperactive children: A review. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 383–387.PubMedGoogle Scholar
  20. Loeber, R., & Farrington, D. P. (1994). Problems and solutions in longitudinal and experimental treatment studies of child psychopathology and delinquency. Journal of Consulting and Clinical Psychology, 62, 887–900.PubMedGoogle Scholar
  21. Loney, J., Whaley-Klahn, M. A., Kosier, T., & Conboy, J. (1983). Hyperactive boys and their brothers at 21: Predictors of aggressive and antisocial outcomes. In K. T. Van Dusen & S. A. Mednick (Eds.), Prospective studies of crime and delinquency (pp. 181–206). Boston: Kluwer-Nijhoff.Google Scholar
  22. Reich, W., Shayla, J. J., & Taibelson, C. (1992). The Diagnostic Interview for Children and Adolescents—Revised (DICA-R) (structured psychiatric interview). St Louis, MO: Washington University.Google Scholar
  23. Reynolds C. R., & Kamphaus, R. C. (1992). BASC: Behavioral Assessment System for Children. Circle Pines, MN: American Guidance Clinic.Google Scholar
  24. Roberts, M. W., Joe, V. C., & Rowe-Hallbert, A. (1992). Oppositional child behavior and parent locus of control. Journal of Clinical Child Psychology, 21, 170–177.Google Scholar
  25. Siegel, S. (1956). Nonparametric statistics. New York: McGraw-Hill.Google Scholar
  26. Taylor, E., Sandberg, S., Thorley, G., & Giles, S. (1991). The epidemiology of childhood hyperactivity. New York: Oxford University Press.Google Scholar
  27. Ullman, R. K., Sleator, E. K., & Sprague, R. L. (1985). A change of mind: The Conners Abbreviated Rating Scales reconsidered. Journal of Abnormal Child Psychology, 13, 553–566.PubMedGoogle Scholar
  28. Weiss, G., & Hechtman, L. (1993). Hyperactive children grown up. New York: Guilford Press.Google Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • Gerald J. August
    • 1
  • Lauren Braswell
    • 1
  • Paul Thuras
    • 1
  1. 1.University of Minnesota Medical SchoolMinneapolis
  2. 2.Division of Child and Adolescent PsychiatryUniversity of Minnesota Medical SchoolMinneapolisUSA

Personalised recommendations