Skip to main content
SpringerLink
Log in

Variations in Anxiety and Depression as a Function of ADHD Subtypes Defined by DSM-IV: Do Subtype Differences Exist or Not?

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

Concerns have been raised about the ability of diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) to distinguish subtypes that are clearly distinct from each other with regard to clinical correlates. One area of concern is that research regarding differences in anxiety and depression as a function of ADHD subtype has produced discrepant findings. This study was designed to systematically evaluate whether the ADHD subtypes differ with regard to level of internalizing symptoms. From a large pool of children referred to an ADHD center based in a pediatric hospital, children were differentiated into three groups: ADHD, Combined Type (ADHD/COM); ADHD, Inattentive Type (ADHD/I); and a non-ADHD, comparison group (COMP). Parent- and child-report measures using both dimensional and categorical methods were used to assess internalizing symptoms. The results indicated that children with ADHD/COM and ADHD/I had similar levels of anxiety and depression. Subtype differences related to parent-reported depression were accounted for by group differences in level of externalizing problems. The results were discussed with regard to their implications for refining the criteria used to differentiate children with ADHD into subtypes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications for cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213-232.

    Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.) Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th edn.) Washington, DC: Author.

    Google Scholar 

  • Barkley, R. A. (1997). ADHD and the nature of self-control. New York: Guilford.

    Google Scholar 

  • Barkley, R. A. (1998). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Barkley, R. A., DuPaul, G. J., & McMurray, M. B. (1990). A comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. Journal of Consulting and Clinical Psychology, 58, 775-789.

    Google Scholar 

  • Bauermeister, J. J., Bird, H. R., Canino, G., Rubio-Stipec, M., Bravo, M., & Alegria, M. (1995). Dimensions of attention deficit hyperactivity disorder: Findings from a community teacher and parent reports in a community sample. Journal of Clinical Child Psychology, 24, 264-271.

    Google Scholar 

  • Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry, 148, 564-577.

    Google Scholar 

  • Carlson, C. L., & Mann, M. (2000). Attention deficit hyperactivity disorder, predominantly inattentive subtype. Child and Adolescent Psychiatric Clinics of North America, 9, 499-510.

    Google Scholar 

  • Carlson, C. L., & Mann, M. (2002). Sluggish cognitive tempo predicts a different pattern of impairment in the attention deficit hyperactivity disorder, predominantly inattentive type. Journal of Clinical Child and Adolescent Psychology, 31, 123-129.

    Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale-IV: Checklists, norms, and clinical interpretation. New York: Guilford Press.

    Google Scholar 

  • DuPaul, G. J., Power, T. J., Anastopoulos, A. D., Reid, R., McGoey, K. E., & Ikeda, M. (1997). Teacher ratings of attention deficit hyperactivity disorder symptoms: Factor structure and normative data. Psychological Assessment, 9, 436-444.

    Google Scholar 

  • Eiraldi, R. B., Power, T. J., Karustis, J. L., & Goldstein, S. G. (2000). Assessing ADHD and comorbid disorders in children: The Child Behavior Checklist and the Devereux Scales of Mental Disorders. Journal of Clinical Child Psychology, 29, 3-16.

    Google Scholar 

  • Eiraldi, R. B., Power, T. J., & Nezu, C. M. (1997). Patterns of comorbidity associated with subtypes of attention-deficit/hyperactivity disorder among 6-12 year old children. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 503-514.

    Google Scholar 

  • Faraone, S. V., Biederman, J., Weber, W., & Russell, R. L. (1998). Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: Results from a clinically referred sample. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 185-193.

    Google Scholar 

  • Gaub, M., & Carlson, C. L. (1997). Behavioral characteristics of DSMIV ADHD subtypes in a school-based population. Journal of Abnormal Child Psychology, 25, 103-112.

    Google Scholar 

  • Hinshaw, S. P. (1994). Attention deficits and hyperactivity in children. Thousand Oaks, CA: Sage.

    Google Scholar 

  • Hollingshead, A. B. (1975). Four factor index of social status. New Haven, CT: Yale University.

    Google Scholar 

  • Keppel, G., & Zedeck, S. (1989). Data analysis for research designs: Analysis of variance and multiple regression/correlation approaches. New York: Freeman.

    Google Scholar 

  • Kovacs, M. (1992). Children's Depression Inventory. North Tonawanda, NY: Multi-Health Systems.

    Google Scholar 

  • Lahey, B. B., Applegate, B., McBurnett, K., Biederman, J., Greenhill, L., Hynd, G. W., et al. (1994). DSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents. American Journal of Psychiatry, 151, 1673-1685.

    Google Scholar 

  • Lahey, B. B., & Carlson, C. L. (1992). Validity of the diagnostic category of attention deficit disorder without hyperactivity: A review of the literature. In S. E. Shaywitz & B. A. Shaywitz (Eds.), Attention deficit disorder comes of age: Toward the twenty-first century (pp. 119-144). Austin, TX: Pro-Ed.

    Google Scholar 

  • Lahey, B. B., Pelham, W. E., Schaughency, E. A., Atkins, M. S., Murphy, H. A., Hynd, et al. (1988). Dimensions and types of attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 330-335.

    Google Scholar 

  • Lahey, B. B., Schaughency, E. A., Hynd, G. W., Carlson, C. L., & Nieves, N. (1987). Attention deficit disorder with and without hyperactivity: Comparison of behavioral characteristics of clinic-referred children. American Academy of Child and Adolescent Psychiatry, 26, 718-723.

    Google Scholar 

  • Laurent, J., Landau, S., & Stark, K. D. (1993). Conditional probabilities in the diagnosis of depressive and anxiety disorders in children. School Psychology Review, 22, 98-114.

    Google Scholar 

  • Loeber, R., Burke, J. D., Lahey, B. B., Winters, A., & Zera, M. (2000). Oppositional defiant and conduct disorder: A review of the past 10 years, part I. Journal of the American Academy of Child and Adolescent Psychiatry, 23, 1468-1484.

    Google Scholar 

  • Loeber, R., Green, S. M., Lahey, B. B., & Stouthamer-Loeber, M. (1990). Optimal informants on child disruptive behavior disorders. Developmental Psychopathology, 1, 317-337.

    Google Scholar 

  • Mannuzza, S., Klein, R. G., & Moulton, J. L. (2002). Young adult outcome of children with “situational” hyperactivity: A prospective, controlled follow-up study. Journal of Abnormal Child Psychology, 30, 191-198.

    Google Scholar 

  • McBurnett, K., Pfiffner, L. J., & Frick, P. J. (2001). Symptom properties as a function of ADHD type: An argument for continued study of sluggish cognitive tempo. Journal of Abnormal Child Psychology, 29, 207-213.

    Google Scholar 

  • Mirsky, A. F. (1996). Disorders of attention: A neuropsychological perspective. In R. G. Lyon & N. A. Krasnegor (Eds.), Attention, memory, and executive functioning (pp. 71-96). Baltimore, MD: Paul H. Brookes.

    Google Scholar 

  • Morgan, A. E., Hynd, G. W., Riccio, C. A., & Hall, J. (1996). Validity of DSM-IV ADHD predominantly inattentive and combined types: Relationship to previous DSM diagnoses/subtype differences. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 325-333.

    Google Scholar 

  • MTA Cooperative Group. (1999). Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1088-1096.

    Google Scholar 

  • Patterson, G. R., Reid, J. B., & Dishion, T. J. (1992). Antisocial boys. Eugene, OR: Castalia Press.

    Google Scholar 

  • Posner, M. I., & Raichle, M. E. (1994). Images of mind. New York: Scientific American Library.

    Google Scholar 

  • Power, T. J., Andrews, T. J., Eiraldi, R. B., Doherty, B. J., Ikeda, M. J., DuPaul, G. J., et al. (1998). Evaluating attention deficit hyperactivity disorder using multiple informants: The incremental utility of combining teacher with parent reports. Psychological Assessment, 10, 250-260.

    Google Scholar 

  • Power, T. J., Costigan, T. E., Leff, S. S., Eiraldi, R. B., & Landau, S. (2001). Assessing ADHD across settings: Contributions of behavioral assessment to categorical decision making. Journal of Clinical Child Psychology, 30, 399-412.

    Google Scholar 

  • Rapee R. M., Barrett, P. M., Dadds, M. R., & Evans, L. (1994). Reliability of the DSM-III-R childhood anxiety disorder using structured interviews: Interrater and parent-child agreement. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 984-992.

    Google Scholar 

  • Reich, W., Leacock, N., & Shanfeld, K. (1995). Diagnostic Interview for Children and Adolescents-Parent Version. St. Louis, MO: Washington University.

    Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (1992). Behavior assessment system for children. Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Reynolds, C. R., & Richmond, B. O. (1985). Revised Children's Manifest Anxiety Scale. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Shaffer, D., Fisher, P., Dulcan, M. K., Davies, M., Piacentini, J., Schwab-Stone, M. E., et al. (1996). The NIMH Diagnostic Interview Schedule for Children-Version 2.3 (DICS-2.3): Description, acceptability, prevalence rates, and performance in the MECA study (Methods for the Epidemiology of Child and Adolescent Mental Disorders Study). Journal of the American Academy of Child and Adolescent Psychiatry, 35, 865-877.

    Google Scholar 

  • Stark, K. D., & Laurent, J. (2001). Joint factor analysis of the Children's Depression Inventory and the Revised Children's Manifest Anxiety Scale. Journal of Clinical Child Psychology, 30, 552-567.

    Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariate statistics (4th ed.). Boston, MA: Allyn and Bacon.

    Google Scholar 

  • Todd, R. D., Rasmussen, E. R., Neumann, R. J., Reich, W., Hudziak, J. J., Bucholz, K. K., et al. (2001). Familiality and heritability of subtypes of attention deficit hyperactivity disorder in a population sample of adolescent female twins. American Journal of Psychiatry, 158, 1891-1898.

    Google Scholar 

  • Wolraich, M. L., Hannah, J. N., Pinnock, T. Y., Baumgaertel, A., & Brown, J. (1996). Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sample. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 319-324.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

    Thomas J. Power, Ricardo B. Eiraldi & Stephen S. Leff

  2. American Institutes for Research, Washington, District of Columbia

    Tracy E. Costigan

Authors
  1. Thomas J. Power
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tracy E. Costigan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ricardo B. Eiraldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephen S. Leff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas J. Power.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Power, T.J., Costigan, T.E., Eiraldi, R.B. et al. Variations in Anxiety and Depression as a Function of ADHD Subtypes Defined by DSM-IV: Do Subtype Differences Exist or Not?. J Abnorm Child Psychol 32, 27–37 (2004). https://doi.org/10.1023/B:JACP.0000007578.30863.93

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:JACP.0000007578.30863.93

Search

Navigation