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Despite important clinical and nosological implications, the comorbidity of oppositional defiant disorder (ODD) and generalized anxiety disorder (GAD) has received little attention. A clinic-based sample of 243 boys (ages 6-10 years), their parents, and teachers participated in an evaluation that involved assessments of behavioral, academic, and family functioning. ODD and GAD symptom groups were defined using various combinations of mother and teacher reports. ODD symptom groups were associated with conduct disorder symptoms, and GAD symptom groups with major depressive disorder symptoms, regardless of rater. Attention deficit/hyperactivity disorder (ADHD) symptoms were associated with ODD and GAD symptom groups; however, covarying ADHD symptoms altered few findings. The ODD + GAD symptom groups were associated with higher rates of co-occurring symptoms and risk factors within (source-specific syndromes) and across (cross-informant comorbidity) informants. (Contains 4 tables.)

Retrospective childhood attention-deficit/hyperactivity disorder (ADHD) symptoms are required to diagnosis adult ADHD, but the validity of self-rated symptoms across time is questionable. Here, boys with ADHD-related problems, their brothers without ADHD, and former schoolmates rated themselves during young adulthood for ages 9, 14, and 19. Brothers rated probands retrospectively at the same ages. The young adults referred as children for ADHD (a) acknowledged childhood symptoms; (b) described improvement over time; (c) did not differ from brothers or controls on most self-ratings of young adult symptoms; (d) rated themselves as more symptomatic at age 9, but less symptomatic at age 19, than their brothers rated them; and (e) agreed only to some degree with brothers' ratings of probands' aggression (median correlation = 0.22). Probands' ratings showed limited agreement with judges' symptom ratings (median correlation = 0.16) and young adult follow-up examiners' ratings (median correlation = 0.14). These findings are not accounted for solely by changes in informants, nor by the course of ADHD psychopathology. They suggest some stability but limited internal consistency and validity for retrospective ADHD ratings by probands and brothers.

Objective: To examine differences in risk factors and comorbid conditions for oppositional defiant disorder (ODD) symptom groups in a sample of 248 elementary schoolboys (ages 6-10) recruited from 1994 to 1996. Method: The boys and their mothers received multiple assessments of cognitive, behavioral, academic, and family functioning, including a clinic-based evaluation in Stony Brook, NY. ODD was defined using four different strategies for aggregating data from mother and teacher reports of DSM-IV symptoms. Results: Source-specific ODD symptom groups had better internal validity and were more differentiated than groups defined using the other strategies. The mother-defined ODD symptom group (ODD/M) had higher levels of maternal detachment than the teacher-defined symptom group (ODD/T), and the ODD/T group had more social problems than the ODD/M group. The classification agreement group (ODD/M + T) evidenced higher levels of sensation-seeking, maternal control, and comorbid symptoms than the ODD/M and ODD/T groups. Controlling for co-occurring attention-deficit/hyperactivity disorder and conduct disorder symptoms altered some of the relationships among ODD, comorbid symptoms, and psychosocial correlates. Conclusions: Patterns of co-occurring psychiatric symptoms and psychosocial correlates of ODD symptom groups varied depending on the rater(s) used to determine group membership. Results support continued research into source specificity for conceptualizing ODD. (Contains 3 tables.)

We assessed the predictive validity of attention-deficit/hyperactivity disorder (ADHD) in 20 girls and 98 boys who met the Diagnostic and Statistical Manual for Mental Disorders (4th ed., American Psychiatric Association, 1994) criteria for ADHD at 4 to 6 years of age compared to 24 female and 102 male comparison children. Over the next 8 years, both girls and boys who met criteria for ADHD in Year 1 exhibited more ADHD symptoms and impairment than same-sex comparison children. Effect sizes were consistently large, indicating that the diagnosis of ADHD at 4 to 6 years of age has predictive validity for both sexes. Both girls and boys with ADHD in Year 1 also exhibited higher levels of symptoms of conduct disorder, major depression, and anxiety disorders in early adolescence than same-sex comparison children, controlling levels of the same symptoms in Year 1. This indicates both substantial homotypic and heterotypic continuity for ADHD in both sexes, but significant interactions with time indicated that childhood ADHD predicts more steeply rising symptoms of anxiety and depression during early adolescence in girls than in boys.

Short measures of child inattention-overactivity (IO), aggression-defiance (AG), and anxiety-depression or emotionality (EM) derived through a double validation procedure are administered to mothers of 243 clinic-referred suburban New York boys between 6 and 10 years of age. Mother-rated IO is uniquely related to poor performance on cognitive and achievement tests; observed inattentive, hyperactive, and impulsive behaviors in a restricted academic setting; less father education and lower family income; and most mother-reported impairments and treatment use. Mothers of high-IO boys describe themselves and their sons as having similar childhood symptoms. AG is uniquely related to child-reported disruptive behavior and sensation seeking, many measures of family conflict and negative parenting styles, and mother-reported symptom pervasiveness and number of treatments. EM is uniquely related only to poorer cognitive and achievement test performance, living with one parent, parents who considered themselves too busy, and fewer friends. Each dimension also is associated with parallel teacher-rated factors. (Contains 7 tables.)

Background: This study examines differences between the three subtypes of attention-deficit/hyperactivity disorder (ADHD), inattentive (I), hyperactive-impulsive (H), and combined (C), in a heterogeneous sample of 248 boys (ages 6 to 10 years) with emotional and behavioral problems who were recruited for participation in a diagnostic study. Method: The boys and their mothers participated in an extensive evaluation that involved multiple assessments of cognitive, behavioral, academic, and family functioning. ADHD subtypes were defined on the basis of teacher alone, mother alone, and mother/teacher ratings of DSM-IV symptoms. Results: Results indicated ADHD symptom groups showed a differential pattern of impairment socially (H,C greater than I) and cognitively (I,C greater than H). The C and H groups were the most and least impaired overall, respectively, and all subtypes were differentiated from the nonADHD clinical control or NONE (N) group in a manner consistent with the primary findings. External validation of group differences was limited, and there were marked inconsistencies in the pattern of findings depending on how groups were defined. For the most part, although the mother/teacher grouping strategy (compared with either alone) captured a greater diversity of differences between subtypes, it also obscured some. Conclusions: Observed findings are consistent with the notion that mothers and teachers interpret symptom statements in terms of behaviors that are most relevant for their daily concerns.

A study investigated how 15 children (ages 6 to 10) who identified themselves as having attention-deficit/hyperactivity disorder (ADHD) would differ from 74 adult-identified boys (ages 6 to 10). Although no significant differences were found in observed disruptive behavior, the child self-identified group endorsed significantly more internalizing items on commonly used self-rating scales. (Author/CR)

The study explored the intellectual functioning of 90 hyperkinetic, minimally brain damaged boys (mean age 12 years) via an analysis of student test performance in relation to the factor composition of the Wechsler Intelligence Scale for Children (WISC). (SBH)

A state-of-the-art review of childhood hyperactivity, conclusions from empirical findings, and implications for clinical work are presented. Diagnosis and etiology of hyperactivity are explored with emphasis on the multivariate aspects of the disorder and the difficulty of specifying behavior which is by definition unpredictable. (PHR)