Objective The authors examined the discriminant validity of the diagnosis of attention deficit disorder with hyperactivity. Method They used standardized rating scales of life stresses and child and family functioning to assess psychosocial and family risk factors in 47 children who had the diagnosis of attention deficit disorder with hyperactivity, a matched group of 47 children in the community, and a matched group of 47 children seen in a psychiatric clinic. Results Children who had the diagnosis of attention deficit disorder and children in the psychiatric clinic reported significantly more depression and anxiety than did the children in the community; furthermore, children diagnosed as having attention deficit disorder with hyperactivity had more externalizing symptoms than did children in the psychiatric clinic. Children diagnosed as having attention deficit disorder with hyperactivity plus a comorbid anxiety or depressive disorder had higher levels of coexisting life stresses and parental symptoms than did children who had the single diagnosis of attention deficit disorder with hyperactivity. Conclusions These results underscore the need for future studies to carefully assess children diagnosed as having attention deficit disorder with hyperactivity for concurrent psychiatric disorders as well as family and psychosocial stressors that may contribute to childhood symptoms. Such information is essential because different subtypes of attention deficit disorder with comorbid disorders may arise from different etiologic pathways, may require varying treatment options, and may foreshadow different eventual outcomes.

Anxiety and depressive disorders in attention deficit disorder with hyperactivity: New findings.

Comorbidity of Diagnosis in Attention-Deficit Hyperactivity Disorder

The usefulness of the Behavioral Assessment System for Children (BASC) and Child Behavior Checklist (CBCL) Parent scales was examined with respect to (a) differentiating students with attention deficit-hyperactivity disorder (ADHD) from non-ADHD students and (b) discriminating between the predominantly inattentive-type and combined-type ADHD-afflicted students. For both the BASC and the CBCL, a different optimal discriminant classification tree analysis (CTA) model was developed for each of the 2 diagnostic predictions. For distinguishing ADHD students from non-ADHD students, the BASC model was more parsimonious and accurate than the CBCL model. Toward the goal of differentiating between primarily inattentive and combined types, the CBCL's model was superior for predicting primarily inattentive students. The results demonstrate the diagnostic utility of the BASC and CBCL and describe salient behavioral dimensions associated with subtypes of ADHD.

Diagnosing attention deficit disorders with the behavioral assessment system for children and the child behavior checklist: Test and construct validity analyses using optimal discriminant classification trees

Studies have investigated associations between the Child Behavior Checklist (CBCL) and clinical diagnoses without assessing the impact of comorbidity on these results. This study evaluates associations between parental reports from the CBCL and a structured diagnostic interview in children with attention deficit disorder with hyperactivity (ADDH) stratified by the presence (ADDH+) or absence (ADDH-) of psychiatric comorbidity. Interview-defined ADDH children scored significantly worse on all scales of the CBCL compared with scores from interview-defined non-ill comparisons. However, these findings were accounted for by the subgroup of children with ADDH+. The results indicate a good correspondence between CBCL-based ratings and interview-defined diagnoses. These findings also suggest that the CBCL may be a good screening instrument, not only for ADDH but also for comorbid psychiatric disorders.

Psychiatric Comorbidity in Attention Deficit Disorder: Impact on the Interpretation of Child Behavior Checklist Results

Objective: This study examines whether the Child Behavior Checklist (CBCL) can be used as an accurate psychiatric screening tool for children in community mental health settings. Method: Associatio...

Use of the Child Behavior Checklist as a Diagnostic Screening Tool in Community Mental Health

The authors compared two approach methods for the diagnosis of attention deficit disorder with hyperactivity (ADDH) in a sample of 114 9-year-old children in the community. One method was the categorical approach using a structured interview of parents about their children (DISC-P) and the other was the dimensional approach using Achenbach's Child Behavior Checklist (CBCL) filled in by the parents. There were 14 children diagnosed as having ADDH by DISC-P. Of these, two were "diagnosed" by CBCL. The children diagnosed as ADDH by DISC-P differed on the Achenbach's Externalizing factors from the children who did not have any DSM-III diagnosis by DISC-P and from those who had other DSM-III diagnoses; and on the Achenbach's Internalizing Factors they only differed from the children with no diagnosis and not from children with other diagnoses. Finally it is concluded that it is unlikely that a single cut-off score on any rating scale will be an adequate substitute for a systemic evaluation using several data sources.

Dimensional and Categorical Approaches to the Diagnosis of Attention Deficit Disorder in Children

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Dimensional and Categorical Approaches to the Diagnosis of Attention Deficit Disorder in Children