Differentiating co-occurring behavior problems in children with ADHD: patterns of emotional reactivity and executive functioning

J Atten Disord. 2013 Apr;17(3):249-60. doi: 10.1177/1087054711428741. Epub 2011 Dec 29.

Abstract

Objective: This study examined whether "top-down" and "bottom-up" control processes can differentiate children with ADHD who exhibit co-occurring aggression and/or internalizing symptoms.

Method: Participants included 74 children (M age = 10.7 years) with a Diagnostic and statistical manual of mental disorders (4th ed.; DSM-IV) diagnosis of ADHD. The authors' top-down measure was executive functioning (EF) indexed via two neuropsychological tasks whereas their bottom-up measure was emotional reactivity. Parents also reported on children's aggression and internalizing symptoms.

Results: Emotional reactivity was associated with co-occurring aggressive symptoms, regardless of the presence of internalizing symptoms or ADHD symptom severity, whereas EF deficits were less likely to occur in children with ADHD and co-occurring internalizing symptoms.

Conclusion: The authors' findings highlight the importance of integrating top-down and bottom-up regulatory measures when studying the multipathway conception of ADHD and its co-occurring problems.

MeSH terms

  • Adolescent
  • Aggression / psychology
  • Arousal
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Child
  • Child Behavior Disorders / diagnosis*
  • Child Behavior Disorders / psychology*
  • Comorbidity
  • Emotional Intelligence*
  • Executive Function*
  • Female
  • Humans
  • Internal-External Control
  • Male
  • Neuropsychological Tests / statistics & numerical data
  • Psychometrics
  • Temperament