Neurofeedback is a neuronal self-regulation technique that teaches people to modulate their brain frequencies using visual and auditory reinforcements presented on a computer screen. To assess the effect of neurofeedback training in children with ADHD as far as improved attention and impulse control, and analyze whether or not there are differences between the inattentive and hyperactive subtypes. Fifty children diagnosed with ADHD participated in the study: 14 comprised the control group, and 36 the experimental group (16 with the inattentive ADHD subtype, 20 with the hyperactive ADHD subtype). Attention and impulse control were assessed using the Integrated Visual Auditory CPT (IVA/CPT). Results indicated that the predominantly inattentive group showed significant differences on the Control Scale (p = .023, d = 1.31) and the Attention Scale (p < .01, d = 1.89) of the IVA/CPT; meanwhile the predominantly hyperactive group showed significant improvement on the Control Scale (p = .016, d = 1.21). The control group exhibited no significant differences on either of the two scales (p > .5). In terms of theta/beta ratio, no significant differences were detected (p = .10) between ADHD subtypes. The findings suggest that neurofeedback training using the theta/beta protocol was more effective in the predominantly inattentive subset of individuals with ADHD.

Three hypotheses for cognitive deficits among psychopaths were tested: executive dysfunction, left hemisphere activation, and an interaction between the two. Twenty-one psychopathic and 23 nonpsychopathic criminal offenders identified with the Hare Psychopathy Checklist-Revised participated in verbal and visual-spatial tasks during which the level of executive processing demands was manipulated. Consistent with prior research, psychopathic offenders made more errors than controls, but only during the verbal task and only on trials with high executive demand. Within those trials, most errors occurred when set-maintenance demands were the highest. No response latency differences between groups were found. (JINS, 2006, 12, 538–548.)This article is a replication and extension of our previous study that was published in the JINS, volume 11, 2005. The article appeared as “State-dependent Executive Deficits Among Psychopathic Offenders,” by Suchy & Kosson, 2005, JINS, 11:3, pp. 311–321. There was no overlap in participants between the two studies.

The education of children with behavioural difficulties is under scrutiny from various quarters. The provision of specialised school environments is being questioned, at the same time as there is pressure to minimise the exclusion of disruptive pupils. This study looked at the rate of psychiatric disorder that was prevalent in a school for emotionally and behaviourally disordered (EBD) pupils, and found, using DSM III-R criteria, that 24% of the sample had depression, 11% had overanxiousness, and 70% had a diagnosis of Attention Deficit Disorder with Hyperactivity (ADHD). Educational attainment assessment showed that 75% had a reading age that was at least 2 years below their chronological age. These results suggest that such settings are dealing with a very disturbed group of youngsters.

A conceptual model has recently been hypothesized in which parallel but correlated developmental pathways exist for attention deficit behaviors and conduct problems. An important component of this model suggests that attention deficit behaviors are related to later scholastic underachievement, whereas conduct problems are unrelated to scholastic underachievement except by their common correlation with attention deficit and intelligence. The present study replicated the general model using a cross-sectional sample of 325 children, and examined whether hypothesized dual pathways (behavioral and cognitive) better account for the relationship between attention deficit, intelligence, and later scholastic achievement. Results of the structural equation modeling analysis were consistent with the hypothesized dual pathway model and suggest that school behavior and select cognitive abilities serve as important mediators between attention deficit, intelligence, and later scholastic achievement. Implications of these results for understanding the developmental trajectory of children with attention deficit and general theoretical models of ADHD are discussed.

Hyperactivity is a potentially confusing concept with different terminology and history in Europe and the U.S.A. There is a certain amount of suspicion among U.K. practitioners as to whether it is appropriate to recognise it as a primary condition. Perhaps because of this, assessment procedures vary between practitioners and centres. Using our experience of running a specialist overactivity and attention disorders clinic (now defunct) at St George's Hospital, London we draw together recommendations for the assessment of this serious clinical problem.

The goal of this study was to evaluate the effect of methylphenidate (MPH) and clonidine in comparison with placebo on response inhibition and state regulation in children with Attention Deficit Hyperactivity Disorder (ADHD). The study utilised a double-blind cross-over design in which children were randomly assigned without replacement to placebo, MPH, and clonidine following baseline assessment. The primary dependent measures were derived from children's performance (reaction time and errors) on a GO–NO GO task under three conditions that altered the inter-stimulus interval (ISI) for presented GO–NO GO stimuli: ISI of 1 sec (fast condition), 4 sec (medium condition), and 8 sec (slow condition). Findings indicated no difference in task performance between groups treated for 7 weeks with placebo, MPH, and clonidine. We concluded that the state regulation problem in ADHD is resistant to MPH and clonidine.

Boys with Attention Deficit Hyperactivity Disorder (ADHD, N=50), Specific Learning Disorder (LD, N=45), combined Specific Learning Disorder and ADHD (LD/ADHD, N=25), and controls (N=51) completed effortful and automatic information processing tasks based on Treisman and Gelade's (1980) “information integration theory”. ADHD and LD/ADHD subjects did not differ from controls at baseline or under feedback and reward conditions, suggesting that they were investing similar levels of mental effort in the tasks. The LD group had a superior performance in the effortful task and an inferior performance in the automatic task compared with the other groups at baseline. The data suggest a potential method of distinguishing primary LD from learning difficulties that occur secondary to ADHD.

Objective: To identify similarities and differences in neuropsychiatric correlates in children with Tourette's syndrome (TS) and those with ADHD. Method: The sample consisted of children with Tourette's syndrome with ADHD(N=79), children with Tourette's syndrome without ADHD (N=18), children with ADHD (N=563), psychiatrically referred children (N=212), and healthy controls (N=140). Results: Disorders specifically associated with Tourette's syndrome were obsessive compulsive disorder (OCD) and simple phobias. Rates of other disorders, including other disruptive behavioral, mood, and anxiety disorders, neuropsychologic correlates, and social and school functioning were indistinguishable in children with Tourette's and ADHD. However, children with Tourette's syndrome plus ADHD had more additional comorbid disorders overall and lower psychosocial function than children with ADHD. Conclusions: These findings confirm previously noted associations between Tourette's syndrome and OCDbut suggest that disruptive behavioral, mood, and anxiety disorders as well as cognitive dysfunctions may be accounted for by comorbidity with ADHD. However, Tourette's syndrome plus ADHD appears to be a more severe condition than ADHD alone.

ADHD is a familial disorder with high rates of comorbidity with conduct disorder in childhood and antisocial personality and substance use disorders in adulthood. A growing literature suggests that ADHD with antisocial comorbidity may be nosologically distinct from other forms of ADHD. Previously, we proposed a family-based stratification that defined Antisocial families as those with either conduct disorder or antisocial personality disorder in the probands or relatives. To provide predictive validity for that stratification, we assessed psychopathology in these families 4 years after their initial assessment. Results show that the probands and siblings from Antisocial families had higher rates of psychopathology during the 4-year follow-up period compared with siblings from Non-antisocial and control families. They also had more deviant ratings on the Child Behavior Checklist (especially for anxious/depressed, delinquent, and aggressive behavior). We found fewer group differences in the academic, psychosocial, and intellectual correlates of ADHD. These results confirm and extend previous work indicating that Antisocial ADHD may be a nosologically and clinically meaningful subform of ADHD.

Boys identified as hard-to-manage at age 4 and age-matched controls were assessed on laboratory measures of inattention, impulsivity, and hyperactivity at ages 4, 6, and 9. Hard-to-manage boys still exhibited some behavioral difficulties at age 9, but were not more inattentive or impulsive than controls. Boys with Attention Deficit Disorder (ADD) at age 9 showed performance deficits in each symptom-related domain relative to problem boys without ADD and controls. However, hard-to-manage problem boys with and without ADD did not differ on most earlier measures of inattention, impulsivity, and hyperactivity, suggesting that symptoms specific to ADD emerged more clearly between ages 6 and 9.

There are mixed research results in the literature regarding a possible association between Attention Deficit Hyperactivity Disorder (ADHD) and atopic disorders. If such an association were supported, the implications for underlying pathophysiology would be significant. We evaluated level of atopic responsiveness (based on IgE-mediated response to skin prick tests) in 312 referrals to a pediatric allergist. Based on the atopy code, children were categorized as non-atopic, or moderately or severely atopic. Parents completed the Child Behavior Checklist (CBCL). Univariate analyses on the eight CBCL subscales revealed no differences between the atopic groups. Our results do not support an association between IgE-mediated atopic responsiveness and ADHD, but they do not rule out an association between allergic symptoms and ADHD based on some other mechanism.

Although a role for family and parent factors in the development of behavioral problems in childhood is often acknowledged, the roles of specific parental characteristics in relation to specific child actions need further elucidation. We studied parental “Big Five” personality traits and psychiatric diagnoses in relation to their children's antisocial diagnoses and naturalistically observed antisocial behaviors, in boys with and without the diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD). First, regardless of comorbid antisocial diagnosis, boys with ADHD, more often than comparison boys, had mothers with a major depressive episode and/or marked anxiety symptoms in the past year, and fathers with a childhood history of ADHD. Second, compared to the nondiagnosed group, boys with comorbid ADHD+Oppositional Defiant or Conduct Disorder (ODD/CD) had fathers with lower Agreeableness, higher Neuroticism, and more likelihood of having Generalized Anxiety Disorder. Third, regarding linkages between parental characteristics and child externalizing behaviors, higher rates of child overt antisocial behaviors observed in a naturalistic summer program were associated primarily with maternal characteristics, including higher Neuroticism, lower Conscientiousness, presence of Major Depression, and absence of Generalized Anxiety Disorder. The association of maternal Neuroticism with child aggression was larger in the ADHD than in the comparison group. In contrast, higher rates of observed child covert antisocial behaviors were associated solely with paternal characteristics, including history of substance abuse and higher Openness. Results provide external validation in parent data for a distinction between overt and covert antisocial behaviors and support inclusion of parent personality traits in family studies. The interaction of maternal Neuroticism and child ADHD in predicting child aggression is interpreted in regard to a conceptualization of child by parent “fit.”

Abbreviations: ADHD: Attention-Deficit Hyperactivity Disorder; CBCL: Child Behavior Checklist; CD: Conduct Disorder; DBD: Disruptive Behaviors Checklist; DIS-3-R: Diagnostic Interview Schedule for DSM-III-R; MMPI: Minnesota Multiphasic Personality Inventory; NEO-FFI: Neuroticism, Extraversion, Openness Five Factor Inventory; ODD: Oppositional Defiant Disorder; WURS: Wender Utah Rating Scale.

Conceptual and technological advances in cognitive neuroscience and molecular genetics have the potential to identify the pathogenesis of psychiatric disorders. This article reviews the application of these technologies to the scientific study of attention deficit hyperactivity disorder. It begins with a summary of shifts in conceptualization and scientific study of this common condition. This is followed by a critical review of findings from recent cognitive, neuroimaging, and genetic studies. The available data do not yet permit an integration across these different levels of enquiry, but implicate problems in response inhibition, dysfunction of frontostriatal networks, and genetic factors in the pathogenesis of this complex behavioral phenotype. The review closes with suggestions for future interdisciplinary research.