ADHD is a persistent psychological disorder with far-reaching effects on many facets of an individual’s development. Despite this, there are a number of developmental outcomes that have not been extensively researched. Among these topics; is whether there is a risk of harm that may be inherent in life-course persistent ADHD symptomatology. Based on an integrated theory of ADHD phenotypology; this thesis contains a study comprising of four phases that explore the relationship between ADHD and four risk-laden outcomes. The sample for this study consisted of 67 adults from Christchurch, New Zealand (average age 33) of whom a sample of 35 adults met criteria for ADHD, which persisted into adulthood. The group of adults with ADHD were matched across demographic factors with a control group of adults with whom they were compared across a raft of psychosocial variables. The first phase illustrates the relationship between ADHD and self-destructive behaviours including self-harm and suicidal ideation and attempts, which were found to be significantly mediated by coping behaviour and psychological comorbidity. The second phase reports on the relationship between ADHD and a range of risk-taking behaviours including: violence risk, nicotine use and sexual risk-taking, and the mediating role of motivational variances, including reward sensitivity and temporal discounting. The third phase illustrates the moderating effect of childhood abuse victimisation on ADHD in increasing the vulnerability of the development of mood disorders in adulthood. A fourth phase explores a range of physical health outcomes including diet, exercise, chronic illness and disability which were not found to be significantly associated with ADHD in adulthood. Based on the literature previewed below, it is theorised in this thesis that ADHD symptomatology may act as a diathesis that, coupled with comorbid psychosocial stressors, may contribute to an individual’s level of risk to themselves and others. Overall, this research suggests that ADHD symptomatology that persists into adulthood may pose a significant risk to some individuals, in the form of deliberate and non-deliberate forms of harm. These findings may challenge previously held beliefs regarding the innocuousness of ADHD as a psychological disorder and highlight the need to consider risk and safety issues in the assessment and treatment of adult ADHD.

The purpose of the study was to examine the use of the Bender Gestalt Test Second Edition (BGT-II) with children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). Previous research has examined the relationship of ADHD and visual-motor functioning based on overall developmental scores or specific "emotional indicators." Although several of these studies have examined the relationship of the previous edition of the BGT and ADHD symptoms, methodological problems, a lack of a clear theoretical rationale, and psychometric problems associated with the original edition, limit the validity and generalizability of these results.This study sought to examine the utility of the revised edition of the BGT, the BGT-II, in the assessment of behaviors associated with ADHD. Based upon a broad theory of ADHD (Barkley, 1997b), several hypotheses were made regarding how areas of deficit (e.g., self-regulation, planning, working memory, motor control) were expected to he manifested in BGT-I1 performance. An ADHD group (N = 67) was compared to a control group of normal subjects (N = 100) and a group of subjects diagnosed with mental retardation (N = 59). Additionally, the performances of children diagnosed with subtypes of ADHD were compared in an attempt to clarify the nature of the disorder.The results of the study do not support the use of the BGT-11 in the assessment of ADHD. Although those with ADHD tended to perform more poorly than controls on the BGT-II, these differences disappeared when intellectual level was controlled. Traditional emotional indicators purporting to reflect impulsivity and attention problems also failed to demonstrate their efficacy. With the exception of the indicator Confused Order, they were no more indicative of individuals diagnosed with ADHD than those with no knowndisabilities. The proposed ADHD-related indicators also failed to demonstrate the ability to differentiate between the ADHD group and controls. / Department of Educational Psychology

The purpose of this investigation was two-fold. First, to examine the level of diagnostic accuracy of psychologists when their decisions were subjected to statistical procedures that analyzed group differences and group membership predictions. Second, to examine the sensitivity of the Wisconsin Card Sorting Test (WCST; Heaton, Chelune, Talley, Kay, & Curtiss, 1993) in differentially identifying children who experience ADHD and RD-LD symptoms. The diagnostic battery used to identify ADHD, RD-LD, and Normal subjects included intellectual, academic achievement, attention, and hyperactivity measures recognized as sensitive to these disorders. Performance on the WCST was then examined to determine its usefulness in discriminating between the aforementioned groups.Scores for the diagnostic variables for 115 subjects (mean age = 9.8 years; males = 80; females = 35) were analyzed using oneway ANOVAs to determine differences between groups. A subsequent cluster analysis was conducted using Ward's method to determine group membership of the subjects and resulted in a sample of 87. This cluster analysis resulted in a four cluster solution with the groups being identified as ADHD, RD-LD, Normal, and "Close Calls."Two linear discriminant analyses were performed with the first using the diagnostic groups diagnosed by the previous psychologists as groups and diagnostic variables as predictors. The second used the diagnostic groups diagnosed by evaluating psychologists and the WCST variables used as predictors to examine their ability to discriminate between groups and predict membership.The first linear discriminant analysis yielded two significant functions of three indicating confidence in the diagnoses provided by the evaluating psychologists. The second linear discriminant analysis yielded no significant findings when using the WCST variables as predictors. As a result, it appears the WCST provides little useful information in the differentiation between ADHD, RD-LD, and normals. / Department of Educational Psychology

The present study was undertaken to determine the relationship between perinatal complications and subsequent development of Attention Deficit Hyperactivity Disorder (ADHD) and other behavioral characteristics. The biological mothers of 74 children diagnosed with ADHD and 77 children displaying no characteristics of the disorder completed the Maternal Perinatal Scale (MPS), the Behavior Assessment System for Children-Parent Rating Scales (BASC-PRS), and a demographic survey. In addition, the biological mothers of 120 children with no characteristics of ADHD or any other behavior disorders completed only the MPS so that exploratory factor analysis of the MPS could be completed.Following factor analysis, stepwise discriminant analysis of the resulting five factors was utilized to explore the nature of the relationship between such perinatal factors and ADHD. Results of this analysis indicated that emotional factors, or the amount of stress encountered during pregnancy and the degree to was planned, were the items that maximized the separation between the ADHD and Non-ADHD groups. Additional discrimination between the groups was attributed to the extent of insult or trauma to the developing fetus and the outcome of prior pregnancies. ADHD children were also found to have experienced twice as many behavioral, social, or medical problems, and were more likely to reach developmental milestones with delays.Stepwise discriminant analysis also revealed the Attention Problems and Hyperactivity scales of the BASC-PRS were most significant in differentiating between the ADHD and Non-ADHD subjects. Using the BASC-PRS resulted in approximately 90% of the total sample being correctly classified as ADHD or NonADHD. Canonical correlation analysis indicated that emotional factors and the general health of both the mother and the developing fetus were the best predictors of later behavioral patterns reported on the BASC-PRS. / Department of Educational Psychology

Access to abstract permanently restricted to Ball State community only. / Access to thesis permanently restricted to Ball State community only. / Department of Educational Psychology

This multi-method study provides detailed information about the friendships of 87 children with ADHD (77.0% boys) and 46 comparison children (73.9% boys) between the ages of 7 and 13. The methods used in the study included parent and teacher ratings, self-report measures, and direct observation of friends’ dyadic behaviours in three structured analogue tasks. Results indicated that, in contrast with comparison children, children with ADHD had friends with high levels of ADHD and oppositional symptoms; they perceived fewer positive features and more negative features, and were less satisfied in their friendships. Observational data indicated that children with ADHD performed both more legal and more illegal manoeuvres than comparison children in a fast-paced competitive game. While negotiating with their friends, children with ADHD made more insensitive and self-centred proposals than comparison children. In dyads consisting of one child with ADHD and one typically developing child, children with ADHD were often more controlling than their non-diagnosed friends. Globally, these results were robust and did not seem to be affected by age differences, ADHD subtypes, comorbidities, and medication status. Given the increased recognition of ADHD in adolescence and adulthood as well as the fact that negative peer reputation in childhood very strongly predicts mental-health status by early adulthood, this research may lead to the discovery of meaningful ways to help people with ADHD achieve improved mental health and happiness over their lifespan.

The aim of this thesis is to examine objective laboratory measures of Attention Deficit Hyperactivity Disorder (ADHD) in adult persons and to develop measures for diagnosis and treatment using a psychometric instrument called the Quantified Behavior Test Plus. The instrument objectively quantifies cardinal symptom manifestations in adult ADHD using motion tracking devices and continuous performance testing. Paper I-IV suggest that ADHD predisposes adult persons to perform poorer on continuous performance tasks and to have higher levels of motor activity while performing these tasks as compared to other clinical as well as non-clinical groups. Performance by adults with ADHD is normalized following stimulant treatment which implicates therapeutic effects and measures of response to treatment and remission for ADHD is suggested. Paper I concludes that the psychometric instrument needs to be calibrated with regard to adult ADHD and emphasizes the importance of a composite measure for the disorder. Paper II generates two new measures, the Weighed Core Symptom scale (WCS) - a composite measure of adult ADHD ranging from 0 to 100, and Prediction of ADHD (PADHD) - a categorical variable of the diagnostic status with good predictive power. A majority of participants with ADHD has low points on WCS (indicating high levels of symptoms) and a majority of non-ADHD normative participants has high points on WCS (indicating low levels of symptoms). Paper III examines WCS and PADHD among complex clinical groups with shared symptoms vis-à-vis ADHD. Here, findings from Paper II are replicated since participants with ADHD present the highest level of global symptoms, followed by participants with bipolar II disorder and borderline personality disorder, participant with diconfirmed ADHD and finally, non-clinical participants has the lowest level of global symptoms. In Paper IV, the measures are proposed as indications of response to treatment and remission after titration with stimulant treatment and WCS indicates response to small changes in dose level. The major findings of the present thesis may be summarized as the construction of two new objective measures for ADHD in adult persons with practical implications for diagnosis and treatment. Hyperactivity is the most specific marker of ADHD in both men and women, followed by the cognitive markers of inattention and impulsivity. The composite measure, WCS, quantifies the global amount of ADHD symptoms and provides the most sensitive measure for the disorder. PADHD and WCS may not replace a thorough neuropsychiatric assessment and further studies promoting diagnostic subtype stratification is suggested. Future studies may want to consider these measures in outcome-based investigations of treatment efficacy as well as in the study of neuropsychological endophenotypes. Practical implications include clinical strategies to enhance objectivity during assessment as well as optimizing beneficial effects of treatment and attaining remission.

Research indicates a relationship between prenatal maternal stress (PNMS) and attention levels in children. Studies with non-human primates suggest that both exposure to PNMS and the timing of a stressor during pregnancy are associated with greater attention problems in offspring; however, this has not been sufficiently tested in humans because of methodological constraints. We explored the relationship between objective and subjective measures of PNMS for 85 women who were pregnant during the 1998 Quebec Ice Storm and attention levels in their 5.5 year-old children, while controlling for socioeconomic status, child's sex, and maternal state anxiety. As a group, children in the study displayed significantly less attentive behaviour compared to a standardized norm. Boys in this group were significantly less attentive than girls. Objective PNMS exposure during 1st trimester correlated positively with attention problems in the children, accounting for 15.2% of the variance in attention levels as rated by Kindergarten teachers. In a behavioural task to detect sustained attention difficulties and Attention Deficit-Hyperactivity Disorder (ADHD) symptoms, children exposed during the 3rd trimester obtained significantly worse scores compared to children exposed in other trimesters. However, in this case, objective and subjective PNMS appeared to act as protective factors, raising the possibility of the presence of another unknown mechanism that negatively affected the attention variables.

This thesis effects a (dis)ordered look as a disordered construct. A Thesis by Publication format has been employed, where instead of a traditional linear argument: A + B = Conclusion, this work follows a cartographical route - instead of traditional thesis chapters, there are scholarly journal articles. Whilst related, these papers each concentrate on different threads of the problem that we currently call &quotAttention Deficit Hyperactivity Disorder". Connected by short linking summaries, they constitute a cartographic survey utilising Foucault's (1977; 2003b) notion of a discursive/technological grid to examine &quotADHD" as a discursive formation and schooling as a system of formation of &quotdisorderly" objects.

Thesis (MPsych(Clin))--University of South Australia, 1995