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Deficient emotional self-regulation and pediatric attention deficit hyperactivity disorder: a family risk analysis

Published online by Cambridge University Press:  24 August 2011

J. Biederman ,
T. Spencer ,
A. Lomedico ,
H. Day ,
C. R. Petty  and
S. V. Faraone
J. Biederman*
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA Psychiatry Department, Harvard Medical School, Cambridge, MA, USA
T. Spencer
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA Psychiatry Department, Harvard Medical School, Cambridge, MA, USA
A. Lomedico
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA
H. Day
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA
C. R. Petty
Affiliation:
Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, Boston, MA, USA
S. V. Faraone
Affiliation:
Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
*
*Address for correspondence: J. Biederman, M.D., Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care, YAW-6A-6900, 32 Fruit Street, Boston, MA 02114–3139, USA. (Email: jbiederman@partners.org)
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Abstract

Background

Although deficient emotional self-regulation (DESR) is associated with attention deficit hyperactivity disorder (ADHD), little research investigates this association and little is known about its etiology. Family studies provide a method of clarifying the co-occurrence of clinical features, but no family studies have yet addressed ADHD and DESR in children.

Method

Subjects were 242 children with ADHD and 224 children without ADHD. DESR was operationalized using an aggregate score ⩾180 and <210 in the anxious/depressed, attention and aggression scales (AAA profile) of the Child Behavior Checklist (CBCL), termed the CBCL-DESR profile. The CBCL-bipolar (CBCL-BP) profile was defined as ⩾210 on the CBCL-AAA scale. We examined the familial transmission of ADHD and the CBCL-AAA scale in families selected through probands with and without these conditions.

Results

We found a linear increase in the prevalence of CBCL-DESR in siblings as indexed by the Control, ADHD, ADHD+CBCL-DESR and ADHD+CBCL-BP proband groups. While the ADHD siblings were at elevated risk for both the CBCL-DESR and CBCL-BP compared with non-ADHD siblings, a significantly higher rate of CBCL-BP in the siblings of ADHD+CBCL-BP probands was found compared with siblings of the Control probands.

Conclusions

ADHD shows the same degree of familial transmission in the presence or absence of DESR. CBCL-DESR and CBCL-BP are familial, but further work is needed to determine if these definitions are distinctly familial or represent a continuum of the same psychopathology.

Keywords

ADHDdeficient emotional self-regulationpediatric
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 3 , March 2012 , pp. 639 - 646
Copyright
Copyright © Cambridge University Press 2011

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References

Achenbach, TM (1991). Manual for the Child Behavior Checklist/4–18 and the 1991 Profile. University of Vermont, Department of Psychiatry: Burlington, VT.Google Scholar
Barkley, RA (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological Bulletin 121, 65–94.CrossRefGoogle ScholarPubMed
Barkley, RA, Fischer, M (2010). The unique contribution of emotional impulsiveness to impairment in major life activities in hyperactive children as adults. Journal of the American Academy of Child & Adolescent Psychiatry 49, 503–513.Google ScholarPubMed
Barkley, RA, Murphy, KR, Fischer, M (2008). ADHD in Adults: What the Science Says. Guilford Press: New York.Google Scholar
Biederman, J, Faraone, SV, Mick, E, Williamson, S, Wilens, TE, Spencer, TJ, Weber, W, Jetton, J, Kraus, I, Pert, J, Zallen, B (1999). Clinical correlates of ADHD in females: findings from a large group of girls ascertained from pediatric and psychiatric referral sources. Journal of the American Academy of Child and Adolescent Psychiatry 38, 966–975.CrossRefGoogle ScholarPubMed
Biederman, J, Faraone, S, Milberger, S, Guite, J, Mick, E, Chen, L, Mennin, D, Marrs, A, Ouellette, C, Moore, P, Spencer, T, Norman, D, Wilens, T, Kraus, I, Perrin, J (1996). A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Archives of General Psychiatry 53, 437–446.CrossRefGoogle ScholarPubMed
Biederman, J, Petty, CR, Monuteaux, MC, Evans, M, Parcell, T, Faraone, SV, Wozniak, J (2009). 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. Journal of Clinical Psychiatry 70, 732–740.CrossRefGoogle Scholar
Biederman, J, Wozniak, J, Kiely, K, Ablon, S, Faraone, S, Mick, E, Mundy, E, Kraus, I (1995). CBCL clinical scales discriminate prepubertal children with structured-interview derived diagnosis of mania from those with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry 34, 464–471.CrossRefGoogle ScholarPubMed
Diler, RS, Birmaher, B, Axelson, D, Goldstein, B, Gill, M, Strober, M, Kolko, DJ, Goldstein, TR, Hunt, J, Yang, M, Ryan, ND, Iyengar, S, Dahl, RE, Dorn, LD, Keller, MB (2009). The Child Behavior Checklist (CBCL) and the CBCL-bipolar phenotype are not useful in diagnosing pediatric bipolar disorder. Journal of Child and Adolescent Psychopharmacology 19, 23–30.CrossRefGoogle Scholar
Faraone, SV, Althoff, RR, Hudziak, JJ, Monuteaux, MC, Biederman, J (2005). The CBCL predicts DSM bipolar disorder in children: a receiver operating characteristic curve analysis. Bipolar Disorders 7, 518–524.CrossRefGoogle ScholarPubMed
Faraone, SV, Biederman, J, Spencer, T, Mick, E, Murray, K, Petty, C, Adamson, JJ, Monuteaux, MC (2006). Diagnosing adult attention deficit hyperactivity disorder: are late onset and subthreshold diagnoses valid? American Journal of Psychiatry 163, 1720–1729; quiz 1859.CrossRefGoogle ScholarPubMed
Hollingshead, AB (1975). Four Factor Index of Social Status. Yale Press: New Haven.Google Scholar
Huber, PJ (1967). The behavior of maximum likelihood estimates under non-standard conditions. Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability 1, 221–233.Google Scholar
Hudziak, J, Althoff, RR, Rettew, DC, Derks, EM, Faraone, SV (2005). The prevalence and genetic architecture of CBCL-juvenile bipolar disorder. Biological Psychiatry 58, 562–568.CrossRefGoogle Scholar
Mick, E, Biederman, J, Pandina, G, Faraone, SV (2003). A preliminary meta-analysis of the child behavior checklist in pediatric bipolar disorder. Biological Psychiatry 53, 1021–1027.CrossRefGoogle ScholarPubMed
Nigg, JT, Casey, BJ (2005). An integrative theory of attention-deficit/ hyperactivity disorder based on the cognitive and affective neurosciences. Developmental Psychopathology 17, 785–806.CrossRefGoogle ScholarPubMed
Orvaschel, H (1994). Schedule for Affective Disorder and Schizophrenia for School-Age Children Epidemiologic Version. Nova Southeastern University, Center for Psychological Studies: Ft. Lauderdale.Google Scholar
Reimherr, F, Marchant, BK, Strong, RE, Hedges, DW, Adler, L, Spencer, TJ, West, SA, Soni, P (2005). Emotional dysregulation in adult ADHD and response to atomoxetine. Biological Psychiatry 58, 125–131.CrossRefGoogle ScholarPubMed
Reimherr, FW, Williams, ED, Strong, RE, Mestas, R, Soni, P, Marchant, BK (2007). A double-blind, placebo-controlled, crossover study of osmotic release oral system methylphenidate in adults with ADHD with assessment of oppositional and emotional dimensions of the disorder. Journal of Clinical Psychiatry 68, 93–101.CrossRefGoogle ScholarPubMed
Rosen, PJ, Epstein, JN (2010). A pilot study of ecological momentary assessment of emotion dysregulation in children. Journal of ADHD and Related Disorders 1, 39–52.Google Scholar
Spencer, T, Biederman, J, Surman, C, Petty, C, Clarke, A, Batchelder, H, Faraone, S (in press). Towards defining deficient emotional self regulation in youth with attention deficit hyperactivity disorder using the CBCL: a controlled study. Postgraduate Medicine.Google Scholar
Spitzer, RL, Williams, JB, Gibbon, M, First, MB (1990). Structured Clinical Interview for DSM-III-R: Non-Patient Edition (SCID-NP, Version 1.0). American Psychiatric Press: Washington, DC.Google Scholar
StataCorp (2007). Stata Statistical Software: Release 10. StataCorp LP: College Station, TX.Google Scholar
Surman, CB, Biederman, J, Spencer, T, Yorks, D, Miller, CA, Petty, CR, Faraone, SV (2011). Deficient emotional self regulation and adult attention deficit hyperactivity disorder: a family risk analysis. American Journal of Psychiatry 168, 617–623.CrossRefGoogle ScholarPubMed
Wender, PH (1995). Attention-Deficit Hyperactivity Disorder in Adults. Oxford University Press: New York.Google Scholar
Youngstrom, E, Youngstrom, JK, Starr, M (2005). Bipolar diagnoses in community mental health: Achenbach Child Behavior Checklist profiles and patterns of comorbidity. Biological Psychiatry 58, 569–575.CrossRefGoogle ScholarPubMed