Toward Defining Deficient Emotional Self-regulation in Children with Attention-deficit/hyperactivity Disorder Using the Child Behavior Checklist: a Controlled Study

Overview

Journal Postgrad Med

Publisher Informa Healthcare

Specialty General Medicine

Date 2011 Sep 10

PMID 21904086

Citations 46

Authors

Thomas J Spencer

Stephen V Faraone

Craig B H Surman

Carter Petty

Allison Clarke

Holly Batchelder

Janet Wozniak

Joseph Biederman

Affiliations

Soon will be listed here.

Abstract

Objective: Deficient emotional self-regulation (DESR) is characterized by deficits in self-regulating the physiological arousal caused by strong emotions. We examined whether a unique profile of the Child Behavior Checklist (CBCL) would help identify DESR in children with attention-deficit/hyperactivity disorder (ADHD).

Methods: Subjects included 197 children with ADHD and 224 children without ADHD. We defined DESR if a child had an aggregate cut-off score of > 180 but < 210 on the Anxiety/Depression, Aggression, and Attention scales of the CBCL (CBCL-DESR). This profile was selected because of: 1) its conceptual congruence with the clinical concept of DESR; and 2) because its extreme (> 210) form has been previously associated with severe forms of mood and behavioral dysregulation in children with ADHD. All subjects were comprehensively assessed with structured diagnostic interviews and a wide range of functional measures.

Results: Forty-four percent of children with ADHD had a positive CBCL-DESR profile versus 2% of controls (P < 0.001). The CBCL-DESR profile was associated with elevated rates of anxiety and disruptive behavior disorders, as well as significantly more impairments in emotional and interpersonal functioning.

Conclusions: The CBCL-DESR profile helped identify a subgroup of children with ADHD who had a psychopathological and functional profile consistent with the clinical concept of DESR.

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References

Reimherr F, Marchant B, Williams E, Strong R, Halls C, Soni P . Personality disorders in ADHD Part 3: Personality disorder, social adjustment, and their relation to dimensions of adult ADHD. Ann Clin Psychiatry. 2010; 22(2):103-12. View

Orvaschel H . Psychiatric interviews suitable for use in research with children and adolescents. Psychopharmacol Bull. 1985; 21(4):737-45. View

Mick E, Biederman J, Pandina G, Faraone S . A preliminary meta-analysis of the child behavior checklist in pediatric bipolar disorder. Biol Psychiatry. 2003; 53(11):1021-7. DOI: 10.1016/s0006-3223(03)00234-8. View

Biederman J, Faraone S, Mick E, Williamson S, Wilens T, Spencer T . Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources. J Am Acad Child Adolesc Psychiatry. 1999; 38(8):966-75. DOI: 10.1097/00004583-199908000-00012. View

Ayer L, Althoff R, Ivanova M, Rettew D, Waxler E, Sulman J . Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) and CBCL Posttraumatic Stress Problems (CBCL-PTSP) scales are measures of a single dysregulatory syndrome. J Child Psychol Psychiatry. 2009; 50(10):1291-300. DOI: 10.1111/j.1469-7610.2009.02089.x. View

Althoff R, Ayer L, Rettew D, Hudziak J . Assessment of dysregulated children using the Child Behavior Checklist: a receiver operating characteristic curve analysis. Psychol Assess. 2010; 22(3):609-17. PMC: 2936710. DOI: 10.1037/a0019699. View

Barkley R . Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull. 1997; 121(1):65-94. DOI: 10.1037/0033-2909.121.1.65. View

Surman C, Biederman J, Spencer T, Miller C, McDermott K, Faraone S . Understanding deficient emotional self-regulation in adults with attention deficit hyperactivity disorder: a controlled study. Atten Defic Hyperact Disord. 2013; 5(3):273-81. PMC: 4009378. DOI: 10.1007/s12402-012-0100-8. View

Biederman J, Petty C, Monuteaux M, Evans M, Parcell T, Faraone S . The Child Behavior Checklist-Pediatric Bipolar Disorder profile predicts a subsequent diagnosis of bipolar disorder and associated impairments in ADHD youth growing up: a longitudinal analysis. J Clin Psychiatry. 2009; 70(5):732-40. PMC: 3066229. DOI: 10.4088/JCP.08m04821. View

10.

Biederman J, Petty C, Byrne D, Wong P, Wozniak J, Faraone S . Risk for switch from unipolar to bipolar disorder in youth with ADHD: a long term prospective controlled study. J Affect Disord. 2009; 119(1-3):16-21. PMC: 2787086. DOI: 10.1016/j.jad.2009.02.024. View

11.

John K, Gammon G, Prusoff B, Warner V . The Social Adjustment Inventory for Children and Adolescents (SAICA): testing of a new semistructured interview. J Am Acad Child Adolesc Psychiatry. 1987; 26(6):898-911. DOI: 10.1097/00004583-198726060-00015. View

12.

Biederman J, Faraone S, Milberger S, Guite J, Mick E, Chen L . A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry. 1996; 53(5):437-46. DOI: 10.1001/archpsyc.1996.01830050073012. View

13.

Althoff R, Rettew D, Ayer L, Hudziak J . Cross-informant agreement of the Dysregulation Profile of the Child Behavior Checklist. Psychiatry Res. 2010; 178(3):550-5. PMC: 2914203. DOI: 10.1016/j.psychres.2010.05.002. View

14.

Holtmann M, Buchmann A, Esser G, Schmidt M, Banaschewski T, Laucht M . The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: a longitudinal analysis. J Child Psychol Psychiatry. 2010; 52(2):139-47. DOI: 10.1111/j.1469-7610.2010.02309.x. View

15.

Jensen S, Rosen L . Emotional reactivity in children with attention-deficit/hyperactivity disorder. J Atten Disord. 2005; 8(2):53-61. DOI: 10.1177/108705470400800203. View

16.

Wozniak J, Biederman J, Kwon A, Mick E, Faraone S, Orlovsky K . How cardinal are cardinal symptoms in pediatric bipolar disorder? An examination of clinical correlates. Biol Psychiatry. 2005; 58(7):583-8. DOI: 10.1016/j.biopsych.2005.08.014. View

17.

Wozniak J, Faraone S, Mick E, Monuteaux M, Coville A, Biederman J . A controlled family study of children with DSM-IV bipolar-I disorder and psychiatric co-morbidity. Psychol Med. 2009; 40(7):1079-88. PMC: 3077106. DOI: 10.1017/S0033291709991437. View

18.

Faraone S, Althoff R, Hudziak J, Monuteaux M, Biederman J . The CBCL predicts DSM bipolar disorder in children: a receiver operating characteristic curve analysis. Bipolar Disord. 2006; 7(6):518-24. DOI: 10.1111/j.1399-5618.2005.00271.x. View