Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
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Clinical Characteristics and Neuropsychological Profiles of the Children with ADHD and Their Siblings

주의력결핍 과잉행동장애 아동과 형제의 임상특징 및 신경심리학 소견

  • Lee, Hyun-Jeong (Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Park, Jangho (Department of Psychiatry, University of Ulsan College of Medicine, Ulsan University Hospital) ;
  • Kim, Hyo-Won (Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center)
  • 이현정 (울산대학교 의과대학 서울아산병원 정신과학교실) ;
  • 박장호 (울산대학교 의과대학 울산대학교병원 정신과학교실) ;
  • 김효원 (울산대학교 의과대학 서울아산병원 정신과학교실)
  • Received : 2013.11.18
  • Accepted : 2013.11.27
  • Published : 2013.12.31
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Abstract

Objectives : This study aims to investigate the clinical characteristics and neuropsychological profiles of children with attention-deficit hyperactivity disorder (ADHD) and their siblings. Methods : Eighteen children (age $8.2{\pm}1.7$ years, 12 boys) with ADHD and their 18 siblings (age $7.8{\pm}1.6$ years, 8 boys) completed Continuous Performance (CPT), Stroop, Children's Trail Making, Rey-Kim Memory, and Kim's Frontal Executive Function tasks. The parents of these subjects underwent the Attention-Deficit/Hyperactivity Disorder Rating Scale (ARS), 10-item Parent General Behavior Inventory (P-GBI), and the Social Responsiveness Scale (SRS). Paired t-tests were used. Results : The inattention (p=.020), and hyperactivity-impulsivity (p=.001), scores of the ARS and the P-GBI score (p=.004) were significantly higher in children with ADHD than in their siblings. Deficits in social communication and motivation on SRS were higher in children with ADHD than in their siblings (p=.017 and p=.011, respectively). Z-scores of omission and commission errors as well as response time variability on visual CPT and omission errors on auditory CPT were in clinically significant range, and z-score of omission errors on auditory CPT was in borderline range in siblings. Omission (p=.018) and commission errors on Visual CPT (p=.007) were significantly higher in children with ADHD compared to their siblings. Recognition efficiency on Kim's Frontal Executive Function Task was lower in children with ADHD compared to their siblings, but in normal range in both groups. Stroop interference and figure fluency on Kims Frontal Executive Function Task were in borderline range in ADHD group, and figure fluency was in borderline range in siblings. Conclusion : Our results support a preliminary evidence for mild degree of attention deficit in ADHD siblings. Further studies are needed to examine the cognitive functions of siblings with ADHD in larger samples.

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References

  1. Dulcan M. Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder. American Academy of Child and Adolescent Psychiatry. J Am Acad Child Adolesc Psychiatry 1997;36(10 Suppl):85S-121S. https://doi.org/10.1097/00004583-199710001-00007
  2. Faraone SV, Perlis RH, Doyle AE, Smoller JW, Goralnick JJ, Holmgren MA, et al. Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry 2005;57:1313-1323. https://doi.org/10.1016/j.biopsych.2004.11.024
  3. Nigg JT, Stavro G, Ettenhofer M, Hambrick DZ, Miller T, Henderson JM. Executive functions and ADHD in adults: evidence for selective effects on ADHD symptom domains. J Abnorm Psychol 2005;114:706-717. https://doi.org/10.1037/0021-843X.114.3.706
  4. Barkley RA. Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. J Clin Psychiatry 2002;63 Suppl 12:10-15.
  5. Biederman J, Petty CR, Fried R, Doyle AE, Spencer T, Seidman LJ, et al. Stability of executive function deficits into young adult years: a prospective longitudinal follow-up study of grown up males with ADHD. Acta Psychiatr Scand 2007;116:129-136. https://doi.org/10.1111/j.1600-0447.2007.01008.x
  6. Biederman J, Petty CR, Fried R, Kaiser R, Dolan CR, Schoenfeld S, et al. Educational and occupational underattainment in adults with attention-deficit/hyperactivity disorder: a controlled study. J Clin Psychiatry 2008;69:1217-1222. https://doi.org/10.4088/JCP.v69n0803
  7. Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF. Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 2005;57: 1336-1346. https://doi.org/10.1016/j.biopsych.2005.02.006
  8. Bacchini D, Affuso G, Trotta T. Temperament, ADHD and peer relations lations among schoolchildren: the mediating role of school bullying. Aggress Behav 2008;34:447-459. https://doi.org/10.1002/ab.20271
  9. McQuade JD, Vaughn AJ, Hoza B, Murray-Close D, Molina BS, Arnold LE, et al. Perceived Social Acceptance and Peer Status Differentially Predict Adjustment in Youth With and Without ADHD. J Atten Disord 2012. [Epub ahead of print]
  10. Buitelaar JK, van der Wees M, Swaab-Barneveld H, van der Gaag RJ. Theory of mind and emotion-recognition functioning in autistic spectrum disorders and in psychiatric control and normal children. Dev Psychopathol 1999;11:39-58. https://doi.org/10.1017/S0954579499001947
  11. Herrmann MJ, Biehl SC, Jacob C, Deckert J. Neurobiological and psychophysiological correlates of emotional dysregulation in ADHD patients. Atten Defic Hyperact Disord 2010;2:233-239. https://doi.org/10.1007/s12402-010-0047-6
  12. Martel MM. Research review: a new perspective on attention-deficit/ hyperactivity disorder: emotion dysregulation and trait models. J Child Psychol Psychiatry 2009;50:1042-1051. https://doi.org/10.1111/j.1469-7610.2009.02105.x
  13. Barkley RA. The relevance of the still lectures to attention-deficit/ hyperactivity disorder: a commentary. J Atten Disord 2006;10:137-140. https://doi.org/10.1177/1087054706288111
  14. Franke B, Faraone SV, Asherson P, Buitelaar J, Bau CH, Ramos- Quiroga JA, et al. The genetics of attention deficit/hyperactivity disorder in adults, a review. Mol Psychiatry 2012;17:960-987. https://doi.org/10.1038/mp.2011.138
  15. Reimherr FW, Marchant BK, Strong RE, Hedges DW, Adler L, Spencer TJ, et al. Emotional dysregulation in adult ADHD and response to atomoxetine. Biol Psychiatry 2005;58:125-131. https://doi.org/10.1016/j.biopsych.2005.04.040
  16. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for Affective Disorders and Schizophrenia for School- Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997;36:980-988. https://doi.org/10.1097/00004583-199707000-00021
  17. Kim YS, Cheon KA, Kim BN, Chang SA, Yoo HJ, Kim JW, et al. The reliability and validity of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean version (K-SADS-PL-K). Yonsei Med J 2004;45:81-89. https://doi.org/10.3349/ymj.2004.45.1.81
  18. Park KS, Yoon JY, Park HJ, Park HJ, Kwon KU. Development of KEDI-WISC, individual intelligence test for Korean children. Seoul: Korean Educational Development Institute;1996.
  19. DuPaul GJ. Parent and teacher ratings of ADHD symptoms: psychometric properties in a community-based sample. J Clin Child Adolesc Psychol 1991;20:245-253 https://doi.org/10.1207/s15374424jccp2003_3
  20. So YK, Noh JS, Kim YS, Ko SG, Koh YJ. The reliability and validity of Korean Parent and Teacher ADHD Rating Scale. J Korean Neuropsychiatr Assoc 2002;41:283-289.
  21. Youngstrom EA, Findling RL, Danielson CK, Calabrese JR. Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory. Psychol Assess 2001;13:267-276. https://doi.org/10.1037/1040-3590.13.2.267
  22. Youngstrom EA, Frazier TW, Demeter C, Calabrese JR, Findling RL. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry 2008;69:831-839. https://doi.org/10.4088/JCP.v69n0517
  23. Constantino JN, Gruber CP. The Social Responsiveness Scale (SRS) Manual. Los Angeles: Western Psychological Services;2002.
  24. Shin MS, Cho SC, Chun SY, Hong KE. A study of the development and standardization of ADHD diagnostic system. J Korean Acad Child Adolesc Psychiatry 2000;11:91-99.
  25. Koo HJ, Shin MS. A standardization study of Childrenʼs Color Trails Test (CCTT). J Korean Acad Child Adolesc Psychiatry 2008;19:28-37.
  26. Kim H. Rey-Kim memory test. Daegu: Neuropsychology Publishing Company;1999.
  27. Kim H. Kims Frontal-Executive Neuropsychological Test: The guide. Daegu: Neuropsychology Publishing Company;1999.
  28. Pasini A, Paloscia C, Alessandrelli R, Porfirio MC, Curatolo P. Attention and executive functions profile in drug naive ADHD subtypes. Brain 2007;29:400-408.
  29. Muller BW, Gimbel K, Keller-Pliessnig A, Sartory G, Gastpar M, Davids E. Neuropsychological assessment of adult patients with attention- deficit/hyperactivity disorder. Eur Arch Psychiatry Clin Neurosci 2007;257:112-119. https://doi.org/10.1007/s00406-006-0688-9
  30. Manly T, Anderson V, Nimmo-Smith I, Turner A, Watson P, Robertson IH. The differential assessment of children's attention: the Test of Everyday Attention for Children (TEA-Ch), normative sample and ADHD performance. J Child Psychol Psychiatry 2001;42:1065-1081. https://doi.org/10.1111/1469-7610.00806
  31. Frazier TW, Demaree HA, Youngstrom EA. Meta-analysis of intellectual and neuropsychological test performance in attentiondeficit/ hyperactivity disorder. Neuropsychology 2004;18:543-555. https://doi.org/10.1037/0894-4105.18.3.543
  32. Schwartz K, Verhaeghen P. ADHD and Stroop interference from age 9 to age 41 years: a meta-analysis of developmental effects. Psychol Med 2008;38:1607-1616. https://doi.org/10.1017/S003329170700267X
  33. Martel M, Nikolas M, Nigg JT. Executive function in adolescents with ADHD. J Am Acad Child Adolesc Psychiatry 2007;46:1437-1444. https://doi.org/10.1097/chi.0b013e31814cf953
  34. Lin YJ, Lai MC, Gau SS. Youths with ADHD with and without tic disorders: comorbid psychopathology, executive function and social adjustment. Res Dev Disabil 2012;33:951-963. https://doi.org/10.1016/j.ridd.2012.01.001
  35. Di Trani M, Casini MP, Capuzzo F, Gentile S, Bianco G, Menghini D, et al. Executive and intellectual f unctions in attention-deficit/ hyperactivity disorder with and without comorbidity. Brain Dev 2011;33:462-469. https://doi.org/10.1016/j.braindev.2010.06.002
  36. Tannock R, Ickowicz A, Schachar R. Differential effects of methylphenidate on working memory in ADHD children with and without comorbid anxiety. J Am Acad Child Adolesc Psychiatry 1995;34:886-896. https://doi.org/10.1097/00004583-199507000-00012
  37. Shuai L, Chan RC, Wang Y. Executive function profile of Chinese boys with attention-deficit hyperactivity disorder: different subtypes and comorbidity. Arch Clin Neuropsychol 2011;26:120-132. https://doi.org/10.1093/arclin/acq101
  38. Barkley RA. Attention-Deficit/Hyperactivity Disorder: A Handbook for diagnosis and treatment. New York: Guilford;2006.
  39. Rommelse NN, Altink ME, Oosterlaan J, Buschgens CJ, Buitelaar J, Sergeant JA. Support for an independent familial segregation of executive and intelligence endophenotypes in ADHD families. Psychol Med 2008;38:1595-1606. https://doi.org/10.1017/S0033291708002869
  40. Bidwell LC, Willcutt EG, Defries JC, Pennington BF. Testing for neuropsychological endophenotypes in siblings discordant for attention- deficit/hyperactivity disorder. Biol Psychiatry 2007;62:991-998. https://doi.org/10.1016/j.biopsych.2007.04.003
  41. Slaats-Willemse D, Swaab-Barneveld H, De Sonneville L, Buitelaar J. Familial clustering of executive functioning in affected sibling pair families with ADHD. J Am Acad Child Adolesc Psychiatry 2005;44:385-391. https://doi.org/10.1097/01.chi.0000153227.34473.c7
  42. Thissen AJ, Rommelse NN, Hoekstra PJ, Hartman C, Heslenfeld D, Luman M, et al. Attention deficit hyperactivity disorder (ADHD) and executive functioning in affected and unaffected adolescents and their parents: challenging the endophenotype construct. Psychol Med 2013:1-12.
  43. Jones KB, Welsh RK, Glassmire DM, Tavegia BD. Psychological functioning in siblings of children with attention deficit hyperactivity disorder. J Child Fam Stud 2006;15:757-763.
  44. Faraone SV, Biederman J, Mennin D, Gershon J, Tsuang MT. A prospective four-year follow-up study of children at risk for ADHD: psychiatric, neuropsychological, and psychosocial outcome. J Am Acad Child Adolesc Psychiatry 1996;35:1449-1459. https://doi.org/10.1097/00004583-199611000-00013
  45. Reiersen AM, Constantino JN, Volk HE, Todd RD. Autistic traits in a population-based ADHD twin sample. J Child Psychol Psychiatry 2007;48:464-472. https://doi.org/10.1111/j.1469-7610.2006.01720.x
  46. Mulligan A, Anney RJ, O’Regan M, Chen W, Butler L, Fitzgerald M, et al. Autism symptoms in Attention-Deficit/Hyperactivity Disorder: a familial trait which correlates with conduct, oppositional defiant, language and motor disorders. J Autism Dev Disord 2009;39:197-209. https://doi.org/10.1007/s10803-008-0621-3