Attention-deficit/hyperactivity disorder (ADHD) is a common childhood psychiatric disorder characterized by developmentally inappropriate levels of inattentiveness, impulsivity and hyperactivity. Current theories of ADHD cite evidence from neuropsychological and brain imaging studies suggesting that abnormalities in the structure and function of the frontal lobes and connected brain regions are associated with impaired behavioural inhibition, constituting the primary deficit in ADHD. While most reviewers conclude that neuropsychological studies have failed to find specific deficits in various aspects of attention in ADHD, poor performance on attentional tasks, including the continuous performance task (CPT), is a common finding and previous electrophysiological studies suggest evidence of impaired attentional processing. This study aimed to investigate the cortical activity associated with attentional processes in children with and without ADHD, using steady-state probe topography (SSPT). Seventeen boys diagnosed with ADHD and seventeen age matched control boys participated. Changes in the amplitude and latency of the steady-state visually evoked potential (SSVEP) associated with correct responses to targets in the �X� and �AX� versions of the CPT were examined. At critical time points in both tasks, the control group demonstrated SSVEP changes suggesting increased activation and increased speed of neural processing. These effects occurred predominantly in medial frontal, right prefrontal, right parietal and occipital regions, suggesting enhanced activity in regions previously shown to be involved in attentional processes. The ADHD group demonstrated much smaller increases in activation and processing speed in frontal regions and predominantly reduced activation and slower processing in parieto-occipital regions. Group differences suggesting reduced activity in the ADHD group were observed in response to the presentation of both cues and targets, as well as in the intervals leading up to target presentation, especially in the cued CPT-AX. These results suggest that processing of task relevant stimuli as well as preparatory and motor processes may be associated with dysfunctional activation of brain networks of attention in ADHD, involving deficits in both frontal and parietal cortical regions. These regions may also be involved in the maintenance of information required for correct task performance and the results also suggest possible deficits in these processes in ADHD. The findings are consistent with others of reduced activation and cognitive deficits in ADHD involving these brain regions and networks, and with the idea that ADHD may be associated with a diminished ability to regulate levels of arousal and activation appropriate to task demands.

Thesis (Ph. D.)--Illinois State University, 2005. / Title from title page screen, viewed on April 13, 2007. Dissertation Committee: Steven Landau (chair), Thomas Critchfield, Corinne Zimmerman, Mark Swerdlik, Robert Lusk. Includes bibliographical references (leaves 109-123) and abstract. Also available in print.

Thesis (M.A.) - Simon Fraser University, 2005. / Theses (Faculty of Education) / Simon Fraser University. Also issued in digital format and available on the World Wide Web.

Thesis (M. Ed.(Opv. Sielk.)--Universiteit van Pretoria, 2000. / Includes bibliographical references.

Thesis (Ed. S.)--University of South Florida, 2003. / Title from PDF of title page. Document formatted into pages; contains 142 pages. Includes bibliographical references.

Objective: Current studies examining the co-morbidity patterns of ADHD with internalizing disorders have reported inconsistent findings. Some studies have found that the inattentive subtype (ADHD-I) is more likely to be comorbid with internalizing disorders, while other studies found similar levels of comorbid internalizing disorders between the ADHD subtypes. Moreover, anxiety and depression were found to be comorbid in inattentive children high in sluggish cognitive tempo (SCT), characterized by features of sluggishness, drowsiness, and daydreaming. SCT has been postulated to be useful in discriminating a distinct inattentive subtype of ADHD-I with a different pattern of impairments. More recently, low levels of behavioral inhibition (BI)—manifested in the form of disinhibited behaviors—have also been implicated in the development of ADHD in children. The current study examines the relationships between ADHD and internalizing symptoms. The roles of SCT and BI in ADHD and internalizing symptoms are also investigated. Methods: The sample was comprised of 1,965 Hong Kong primary students between 8 and 14 years old and their parents/caregivers from 10 local schools. The children completed two self-report scales: the Revised Children Anxiety and Depression Scale (RCADS) and the Behavioral Inhibition System Scale (BISS). Their parents/caregivers completed three scales: the Attention Deficit Hyperactivity Disorder Rating Scale–IV (ADHDRS-IV), the Oppositional Defiant Disorder Scale (ODDS), and the Sluggish Cognitive Tempo Scale (SCTS). Using a psychometric approach, the relationships between the symptom clusters of ADHD (inattention and hyperactivity-impulsivity), anxiety, depression, SCT, and BI were systematically examined with correlation, regression, and factor analyses. A categorical approach was also used to classify children meeting the DSM symptom criteria to compare levels of internalizing symptoms among the three subtypes of ADHD: ADHD-I, ADHD-HI (hyperactive-impulsive), and ADHD-C (combined hyperactive and inattentive). An SCT cutoff score of 20 (the mean SCT rating among ADHD-I children) was used to further divide the ADHD-I into high- and low-SCT subgroups for planned between-group comparisons. Results: In the dimensional analyses, the inattention dimension of ADHD correlated slightly higher than the hyperactivity-impulsivity dimension with anxiety and depression as predicted. But the hyperactivity-impulsivity dimension was also significantly correlated with anxiety and depression, suggesting that hyperactive children were as likely as inattentive children to feel anxious and depressed. Regression analyses found that inattention was not predictive of anxiety and depression, while hyperactivity-impulsivity was marginally predictive of anxiety, but not depression. BI and SCT emerged as significant predictors of internalizing symptoms after controlling for age, gender, and ODD symptoms. There was evidence that SCT mediated the relationship between anxiety/depression and inattention symptoms. Using the categorical approach, between-group differences were found between the ADHD subtypes and the no-ADHD category. ADHD-I children were more anxious and depressed than children without ADHD. Differences in depressive symptoms were found between the ADHD subtypes. Children with ADHD-I had higher levels of depressive symptoms when compared to children with ADHD-HI and ADHD-C. Contrary to predictions, however, the high-SCT ADHD-I group and the low-SCT ADHD-I group did not differ in symptom levels for any anxiety disorders, major depressive disorder, or externalizing symptoms of ODD. Subtype differences in comorbid anxiety were found to be related to gender differences. The symptom levels of panic disorder were higher in females with ADHD-I, and the symptom levels of separation-anxiety disorder were higher for females with ADHD-C. Inattentive girls might present with higher levels of anxiety symptoms than boys. Conclusions: Consistent with previous studies, children with ADHD were more comorbid with anxiety and depression than children without ADHD. In addition, children with ADHD-I were more comorbid with depressive symptoms than children with ADHD-HI and ADHD-C. The higher ratings of depression in ADHD-I children appeared to be related to higher ratings of SCT found in this subtype. There was no difference in anxiety symptoms among the ADHD subtypes, but girls with clinical levels of inattention tend to experience a wider spectrum of anxiety disorders than boys. Contrary to previous research, the findings did not support the idea that SCT is useful in discriminating a distinct inattentive subtype, since this study found no comorbidity differences between the high-SCT ADHD-I and low-SCT ADHD-I groups. Despite the fact that the ADHD-I group had higher BI, there was no evidence that they had higher anxiety symptoms. Reasons for the lack of a direct relationship between BI and internalizing symptoms in ADHD are discussed. The complex roles of SCT and BI in ADHD symptoms and internalizing symptoms call for the need of further local investigation in both clinical and community samples. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

This waitlist-controlled study aimed to evaluate the effects of the “Development Of Executive Skills (DOES)” program (Education Bureau, HKSAR, 2010) on the executive functions of children with Attention-Deficit/Hyperactivity Disorder symptoms. Sixteen participants (15 boys, 1 girl), aged 7 to 8 years (M = 7.95, SD = 0.59), were recruited voluntarily from a local service center. Half of them, the DOES group, received the 7 weekly training sessions after the pre-tests; the other half, the Waitlist group, joined the same program after the post-tests. Their demographic characteristics, medical conditions and nonverbal intelligence were comparable. Cognitive measures and parent observations assessing their executive skills and social behavioral functions were taken before the study, after the training for the DOES group and that for the Waitlist group. No statistically significant intervention effect was found. Effect size analyses, however, suggested potential social benefits of the program. Recommendations on improving the program effectiveness were discussed. / published_or_final_version / Educational Psychology / Master / Master of Social Sciences

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Differing opinions among the disciplines involved in the diagnosis and treatment of children with attention-deficit/hyperactivity disorder (ADHD) have left parents navigating in a maze of divergent languages, explanations, and treatment recommendations. This quantitative research study addressed the question of whether a parent training program was an effective treatment for families of children with ADHD residing in a rural community. Although this community-based study did not demonstrate statistically significant outcome measures, it did reveal some interesting side effects. The limitations and the clinical significance of the findings of the study are examined for future research purposes. In particular, the implications for social work practice with families of children with ADHD residing in rural communities are explored from an ecological perspective.

This thesis was designed to investigate differences in aggression between girls with and without attention-deficit/hyperactivity disorder (ADHD). Forty girls with ADHD and 43 girls without ADHD aged 9- to 12- years and their mothers and teachers participated. A multiassessment methodology was used to investigate these differences, employing mothers' reports, teachers' reports, and a laboratory aggression analogue task (a computer game involving simulated girls in other rooms). The results indicated that mothers and teachers saw girls with ADHD as having much higher levels of all types of aggression assessed, including overt, relational, proactive, and reactive aggression, than girls in the control group. On the lab task, girls with ADHD used a strategy that involved more threatening and bragging comments, and social exclusions of their co-players. Expected differences on some of the lab task measures did not emerge. Also, according to mothers, teachers, and the results from the lab task, girls with ADHD were significantly less prosocial than girls in the control group. Where significant group differences had been found, follow-up tests generally indicated that girls with ADHD and comorbid oppositional-defiant disorder (ODD) were more aggressive than girls in the control group, with girls with ADHD but not ODD falling in between. In sum, these results indicate substantial cause for concern for the concurrent and future psychosocial well-being of girls with ADHD.