Objective: Although findings have been mixed, accumulating evidence suggests that co-occurring attention-deficit/hyperactivity disorder (ADHD) diagnoses and symptoms negatively predict cognitive-behavioral therapy (CBT) outcomes for anxious youth. The current study extends past research by examining the association of not only ADHD but also other features of ADHD with treatment outcomes of youth who received an intensive CBT for a specific phobia. Method: 135 youth (ages 6-15; 52.2% female; 88.2% white) were randomized to either an individual or parent-augmented intensive CBT targeting a specific phobia. Latent growth curve models were used to explore the association of ADHD symptoms, effortful control, sluggish cognitive tempo, maternal depression and the two treatment conditions (i.e., individual versus parent-augmented) with pre-treatment severity of the specific phobia and the trajectory of change in the severity of the specific phobia from pre-treatment to the 6-month follow up after the intervention. Results: As expected, higher levels of ADHD symptoms were associated with lower levels of effortful control and increased maternal depression at pre-treatment. Contrary to expectations, ADHD symptoms and its associated difficulties were not significantly associated with treatment outcomes. Conclusion: Overall, the findings lend support to the generalizability of intensive CBT for a specific phobia to youth with comorbid ADHD and associated difficulties. Implications and limitations of the study are discussed. / Ph. D.

Recent research suggests that increased demands placed upon working memory elicit elevated symptoms of hyperactivity in children diagnosed with ADHD. Such findings suggest that demands placed on working memory processing may influence motor activity. To investigate this relationship further, 43 undergraduate students from the University of Central Florida were given three versions of a visuo-spatial working memory task (including low, moderate, and high demand conditions). As the participants were engaged in these tasks, activity level was measured and recorded using 3-axis accelerometers. Participants also were given a continuous performance task (CPT) and the Conners' Adult ADHD Rating Scale Self Report, Screening Version (CAARS-S:SV) to assess symptoms of ADHD. Activity level of participants was found to increase as visuo-spatial working memory demands were increased. When those participants who reported symptoms of ADHD were statistically removed from the sample, a significant increase in activity between tasks remained. However, participants who reported elevated ratings of ADHD symptoms showed significantly more activity than those participants who did not report elevated ratings of ADHD as visuo-spatial working demands were increased. Implications for these findings are discussed.

The purpose of this study was to assess the relationship among parent child-rearing practices, children’s internal/external attributional styles and social skills between Attention Deficit Disorder/Hyperactivity (ADD/H) and non-Attention Deficit Disorder/Hyperactivity (non-ADD/H) children. A review of the literature revealed a need to investigate the social skills and internal/external attributional styles of ADD/H and non-ADD/H children and their relationship to child-rearing practices. Results indicated group differences between the parents of ADD/H children versus the parents of non-ADD/H children on the dimension of encouragement of independence. It was found that the mothers of ADD/H children reported higher mean scores as compared to mothers of non-ADD/H children. Differences between the parents of ADD/H children versus the parents of non-ADD/H children were found on the authoritarian control dimension. Further analysis indicated that the mothers of ADD/H children reported higher authoritarian control scores than did the mothers of non-ADD/H children. Overall group differences were found on the parental control dimension with parents of ADD/H children having higher combined scores than the parents of non-ADD/H children. The relationship between parents’ child-rearing practices and their children’s internal/external attributional styles were examined. The results indicated a relationship between the child-rearing dimension of encouragement of independence and the children’s attributional styles for mothers only. No other significant correlations were found on the remaining child-rearing dimensions for mothers or fathers. Finally, some support was found for the prediction that the children’s ADD/H status and the attributional style (internal/external) of the children were related to their social functioning. The external ADD/H children reported lower overall social functioning, lower appropriate social functioning, and higher negative social skill scores than internal non-ADD/H children. / Ph. D.

The purpose of this study was to determine whether or not children diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD) or Central Auditory Processing Disorder (CAPD) can be distinguished from one another on the basis of both objective and subjective assessment of attention and behavior. First, children and adolescents diagnosed with ADHD, CAPD, and concomitant ADHD/CAPD were compared to participants with emotional problems on measures of attention/concentration, depression, anxiety, and parental reports of internalzing and externalizing behaviors. Overall, statistical analyses did not reveal significant differences between performances of children diagnosed with ADHD and those diagnosed with CAPD. However, clinical comparisons across groups of children diagnosed with ADHD, CAPD, comorbid ADHD/CAPD and Affective Disorders revealed condition-specific clinical profiles, thus providing some support for CAPD as a distinct clinical entity. Second, exploratory cluster analysis was performed to further investigate the relationship between ADHD and CAPD. This procedure lead to the identification of four distinct clusters. However, analyses of these clusters revealed no distinct pattern of performance for children diagnosed with either ADHD or CAPD. Rather, participants with these diagnoses were evenly distributed throughout the clusters. Additionally, no cluster clearly represented the expected clinical profile for a diagnosis of CAPD- namely, significant auditory attentional/processing problems in the absence of other attentional difficulties. Implications for the assessment and treatment of childhood attentional disorders are discussed and recommendations for future research provided.

Individuals with attention deficit hyperactivity disorder (ADHD) with and without a learning disorder (LD) and a control group of clinically referred individuals with behavioral problems were compared on four neuropsychological tests of frontal lobe functioning. Test results were collected to examine if ADHD individuals with and without LD have deficits in frontal lobe functioning. Two age groups were used to examine developmental differences. In the six to ten age group there were 27 ADHD, 17 ADHD/LD and seven other clinically referred individuals. In the 11 -20 age group there were 12 ADHD, 23 ADHD/LD and 24 other clinically referred individuals. The ADHD and ADHD/LD groups performed at a lower level than the other diagnostic group on the freedom from distractibility factor of the WISC-R and the omission and commission errors of the Gordon Diagnostic system. Differences for the ADHD and ADHD/LD groups were also found on the number of correct responses for the Gordon Diagnostic system, the Speech Sounds test and the Seashore Rhythm test. The developmental differences that were found were not influenced by diagnosis. The deficits that the ADHD individuals with and without LD demonstrated were not affected by age.

Metopic synostosis is a condition in which the metopic suture of the human cranium fuses prematurely and may be related to poor behavioral inhibition leading to behaviors commonly associated with Attention-Deficit Hyperactivity Disorder (ADHD). The purpose of this project was to examine the behavior patterns among children with a history of metopic synostosis. It was hypothesized that children with a history of metopic synostosis would exhibit many of the same behavioral patterns associated with ADHD. It was also hypothesized that children with a history of simple synostosis not involving the metopic suture would not evidence this type of behavioral pattern. In order to test these hypotheses, the behavior of three groups of children was compared including (1) children who had a history of metopic synostosis (M= 7.63 years, SD = 1.92 years), (2) children who had a history of simple craniosynostosis not involving the metopic suture (M= 7.54 years, SD = 1.88 years), and (3) a group of children diagnosed with ADHD (M=7.78 year, SD = 1.87 years). It was found using the Home and School versions of the Attention Deficit Disorders Evaluation Scale (ADDES) that children with a history of metopic synostosis demonstrate significantly more behavioral disturbances than children with a history of simple craniosynostosis not involving the metopic suture. Using the BASC Teacher Rating Form it was found that children with a history of metopic synostosis have a behavior pattern similar to children diagnosed with ADHD and a dissimilar behavior pattern compared to children who have a history of craniosynostosis not involving the metopic suture. Using the BASC Parent Rating Form it was found that children with a history of metopic synostosis have a behavior pattern dissimilar to children diagnosed with ADHD and a dissimilar behavior pattern compared to children who have a history of craniosynostosis not involving the metopic suture.

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed disorders of childhood. This study was designed to evaluate the effectiveness of combined parent training and structured group therapy with children diagnosed with ADHD. The study sought to evaluate the amount of parent training needed to lead to significant changes in children and parents. Families were assigned to a wait-list control condition or to one of two parent treatment conditions: a complete parent group or a handout-only group. Children participated in a seven session social skills and behavior management group. The treatments were designed to concurrently enhance skills of both parents and children. Dependent measures assessed change in the following three areas: (1) child symptomatic behaviors, (2) parental attitudes, and (3) parental behaviors. Results showed that the full parent group led to greater levels of improvement in both child behavior problems and parental feelings of stress and control. The full parent group also led to greater consistency in parenting methods. Findings in the study are discussed in the context of the parent-child coercive cycle model.

Attention-deficit hyperactivity disorder (ADHD), once considered a childhood-limited neuropsychiatric condition, is now recognized as often persisting into adolescence and beyond. Recent studies of ADHD and its symptom domains--hyperactivity and inattention--indicate that symptoms can wax and wane over time and follow discrete trajectories characterized by different symptom levels and shapes. However, little is known about symptom trajectories in high-risk groups, such as boys from low socioeconomic backgrounds. Childhood ADHD is associated with cigarette smoking in adolescence, but whether the risk is specific to hyperactivity or inattention or their respective symptom trajectories is not clear. The aims of my dissertation research were to identify trajectories of hyperactivity and inattention symptom scores in a sample of boys from low socioeconomic backgrounds and to assess the associations of those trajectories with cigarette smoking outcomes in late adolescence and young adulthood. In pursuit of those aims, I first conducted a narrative literature review to assess current evidence regarding the persistence of childhood ADHD, hyperactivity and inattention into adolescence, and the associations of persistent ADHD and its symptom domains with the risks of cigarette smoking and nicotine abuse and dependence in adolescence and early adulthood. Data on boys of low socioeconomic status, where available, were summarized. Evidence suggests that nearly 50% of individuals with childhood ADHD or its symptom domains continue to have symptoms in adulthood. Hyperactivity symptom trajectories are likely to decline over time, whereas inattention symptom trajectories are more stable. The sparse literature on the association between ADHD, hyperactivity, and inattention symptom persistence and high symptom score trajectories and smoking outcomes suggests that high inattention symptom score trajectories are associated with earlier onset and higher risk of nicotine abuse or dependence in early adulthood than lower trajectories. Evidence on hyperactivity symptom score trajectories and similar smoking outcomes is inconclusive. Literature on symptom trajectories in low socioeconomic boys is sorely lacking; no study has evaluated the association of symptom score trajectories with smoking outcomes. Second, in a sample of 1,037 boys from low socioeconomic neighborhoods, I derived trajectories of hyperactivity and inattention symptom scores between childhood and mid-adolescence (ages 6-15 years), using teachers’ and mothers’ ratings, separately. I also evaluated risk factors for high symptom score trajectories. Three trajectories were identified for both hyperactivity and inattention symptom scores. Hyperactivity symptom scores generally declined over time (high declining, moderate declining, and low declining), whereas inattention symptom scores remained stable (high stable, moderate stable, and low stable). Most boys had low symptom scores over time (i.e., low declining for hyperactivity or low stable for inattention), but approximately one-fifth to one-third followed high symptom score trajectories (high declining for hyperactivity or high stable for inattention). Mothers were more likely than teachers to rate boys as having higher symptom scores. Boys’ behavioral symptom scores (hyperactivity, inattention, opposition, and anxiety) at age 6 years and lack of family intactness were risk factors for high hyperactivity and inattention symptom score trajectories. Third, in the same sample of boys from low socioeconomic neighborhoods, I assessed the associations of the hyperactivity and inattention symptom score trajectories with frequency of cigarette smoking at ages 16-17 years (late adolescence) and daily and heavy (≥1 pack/day) smoking at ages 23 and 28 years (young adulthood). I further conducted mediational analyses to assess the potential impact of cigarette smoking frequency and use of alcohol, marijuana, and other drugs in late adolescence on smoking outcomes in young adulthood. High vs. low symptom score trajectories of hyperactivity (i.e., high declining vs. low declining) and inattention (i.e., high stable vs. low stable) were associated with nearly doubled odds of high cigarette smoking frequency (≥40 times in the past year) in late adolescence (hyperactivity: OR=1.97 [95% CI=1.30-2.98]; inattention: OR=1.87 [1.27-2.76]). High (vs. low) symptom score trajectory of inattention, but not hyperactivity, was further associated with elevated risk for daily cigarette smoking (OR=2.67 [1.53-4.64]) and heavy cigarette smoking (OR=1.95 [1.10-3.45]) in young adulthood. Part of the associations (about 11-23%) was mediated by high cigarette smoking frequency in late adolescence. The mediation roles of other substances were not statistically significant. Although the socioeconomically disadvantaged boys whose data I analyzed were similar in number of symptom score trajectories and trends (declining for hyperactivity and stable for inattention) to boys in general populations, they were at elevated risk for high scores for both of the symptom domains over time. Childhood behavioral problems as well as lack of family intactness were associated with high symptom score trajectories of both hyperactivity and inattention. High trajectories of both hyperactivity and inattention scores were associated with high risk of cigarette smoking frequency in late adolescence, but inattention appeared to have a longer-term impact on smoking behaviors. Altogether, my research findings suggest that children with high symptom levels of hyperactivity and/or inattention at an early age, especially those with symptoms that persist over time, might benefit from early interventions to manage and reduce their symptoms and their risk of becoming cigarette smokers.

Syftet med uppsatsen var att undersöka hur det kan vara att leva med ADHD som vuxen inom tre områden; arbete, fritidsaktiviteter och vardagsliv, och på så vis öka förståelsen för dessa individer.  Som underlag för studien gjordes kvalitativa intervjuer med tre vuxna män med ADHD-diagnos. Resultatet från dessa intervjuer analyserades med hjälp av teorier om copingstrategier och KASAM.  Intervjumaterialet visade på en stor spridning av hur funktionsnedsättningen ADHD påverkade livet. Det var främst symptomen uppmärksamhetsstörning och hyperaktivitet som ledde till svårigheter i arbetsliv, fritid och vardagsliv. Svårigheterna yttrade sig dock på väldigt olika sätt. Symptomet hyperaktivitet upplevdes i vissa situationer som en tillgång. Eftersom ADHD påverkade intervjupersonerna olika gavs exempel på ett flertal copingstrategier. Det gavs också olika exempel på hur ADHD påverkade intervjupersonernas upplevelse av begriplighet, hanterbarhet och meningsfullhet. / The purpose of this paper was to examine life with ADHD as an adult in three areas: work, leisure activities and daily life, and thereby increase the understanding of these individuals. The empirical research of the study was interviews with three adult males with ADHD. The result from the interviews was analyzed using theories of coping strategies and SOC. The result revealed a width of how the disability ADHD affected the interviewee’s lives.  It was mainly the symptoms of inattention and hyperactivity that affected work, leisure and everyday life. The difficulties were manifested in very different ways. The symptom hyperactivity could in some situations be seen as a benefit. Since ADHD affected the interviewees in different ways a number of various coping strategies were given as examples of how the interviewees deal with stressful situations in live. Various examples of how ADHD affected the interviewee’s experience of SOC were reviled in the study.

Through employing a two-faceted approach to the sociological study of Attention Deficit- Hyperactivity Disorder (ADHD), this thesis seeks to further the study of this mental illness and also to elucidate new methodological directions for the sociology of similar phenomena. Past approaches in the sociology of mental disorder have considerable merit, but may also be limited in the type of analyses they offer. One particular limitation concerns sociological accounts of mental illness that portray the meaning of such illnesses as unified and that this unification results from the collusion of special interests. Sociologists who address mental illnesses as social problems, for example, appear wont to portray such illnesses as social constructions which arise from specific agents of labeling. With regard to ADHD, previous sociological accounts often make a case for the rhetorical and political power of government agencies, medical practitioners, and pharmaceutical companies. Though such agents are certainly influential in shaping public conceptions of ADHD, this thesis demonstrates that ADHD is interpreted in various ways. These assertions are supported through the analysis of two different data sources: 1) textual data; and 2) interview data. The textual data for the first part of the thesis comprises the subject matter for a genealogy of ADHD. Through examining past and contemporary texts that frame this disorder, including medical journal articles, medical manuals, popular writings, and parental guidebooks, the author argues that the historical and current discussions of ADHD are replete with differing interpretations of the causes and treatments for ADHD. These ADHD discourses, as they are seen through written accounts, offer a variety of perspectives towards the disorder, drawing from many opposing schools of thought. Most notable in this regard are psychodynamic and neurological approaches to ADHD. I argue that even though the neurological perspective towards ADHD appears to be the most dominant in diagnosing and treating the disorder, it is far from monolithic. ' The second part of the thesis draws upon interview data from sixty-two respondents associated with cases of ADHD: twenty clinicians, twenty parents, and twenty-two teachers. Each of these groups of respondents were asked questions designed to solicit their subjective experiences with the disorder, including how they perceived ADHD children and their sources of ADHD knowledge. The analysis of such data is placed against the backdrop of the genealogical part of the thesis. Responses from participants are examined as reflecting ADHD discourses. Some respondents, for example, demonstrate a commitment to neurological perspectives towards ADHD, while others gravitate towards psychodynamic or combined understandings of the disorder. Through combining these two data sources, this thesis analyzes ADHD discourses that give rise to conceptions of the disorder and shows how these discourses influence attitudes and actions towards ADHD. By giving less salience to the collusive relationships between government agencies, medical practitioners, and pharmaceutical companies, and by putting more focus on the relationship between the three major groupings directly involved in the ADHD experience—clinicians, teachers, and parents—this thesis furthers the sociological study of ADHD.