Attention Deficit Hyperactivity Disorder Medical Psychiatry Series Editor Emeritus William A Frosch, M.D Weill Medical College of Cornell University New York, New York, U.S.A Advisory Board Jonathan E Alpert, M.D., Ph.D Siegfried Kasper, M.D Massachusetts General Hospital and Harvard University School of Medicine Boston, Massachusetts, U.S.A Medical University of Vienna Vienna, Austria Mark H Rapaport, M.D Bennett Leventhal, M.D University of Chicago School of Medicine Chicago, Illinois, U.S.A Cedars-Sinai Medical Center Los Angeles, California, U.S.A Handbook of Depression and Anxiety: A Biological Approach, edited by Johan A den Boer and J M Ad Sitsen Anticonvulsants in Mood Disorders, edited by Russell T Joffe and Joseph R Calabrese Serotonin in Antipsychotic Treatment: Mechanisms and Clinical Practice, edited by John M Kane, H.-J Moller, and Frans Awouters ă Handbook of Functional Gastrointestinal Disorders, edited by Kevin W Olden Clinical Management of Anxiety, edited by Johan A den Boer Obsessive-Compulsive Disorders: Diagnosis • Etiology • Treatment, edited by Eric Hollander and Dan J Stein Bipolar Disorder: Biological Models and Their Clinical Application, edited by L Trevor Young and Russell T Joffe Dual Diagnosis and Treatment: Substance Abuse and Comorbid Medical and Psychiatric Disorders, edited by Henry R Kranzler and Bruce J Rounsaville Geriatric Psychopharmacology, edited by J Craig Nelson 10 Panic Disorder and Its Treatment, edited by Jerrold F Rosenbaum and Mark H Pollack 11 Comorbidity in Affective Disorders, edited by Mauricio Tohen 12 Practical Management of the Side Effects of Psychotropic Drugs, edited by Richard Baton 13 Psychiatric Treatment of the Medically III, edited by Robert G Robinson and William R Yates 14 Medical Management of the Violent Patient: Clinical Assessment and Therapy, edited by Kenneth Tardiff 15 Bipolar Disorders: Basic Mechanisms and Therapeutic Implications, edited by Jair C Scares and Samuel Gershon 16 Schizophrenia: A New Guide for Clinicians, edited by John G Csernansky 17 Polypharmacy in Psychiatry, edited by S Nassir Ghaemi 18 Pharmacotherapy for Child and Adolescent Psychiatric Disorders: Second Edition, Revised and Expanded, David R Rosenberg, Pablo A Davanzo, and Samuel Gershon 19 Brain Imaging In Affective Disorders, edited by Jair C Scares 20 Handbook of Medical Psychiatry, edited by Jair C Scares and Samuel Gershon 21 Handbook of Depression and Anxiety: A Biological Approach, Second Edition, edited by Siegfried Kasper, Johan A den Boer, and J M Ad Sitsen 22 Aggression: Psychiatric Assessment and Treatment, edited by Emitl Coccaro 23 Depression in Later Life: A Multidisciplinary Psychiatric Approach,edited by James Ellison and Sumer Verma 24 Autism Spectrum Disorders, edited by Eric Hollander 25 Handbook of Chronic Depression: Diagnosis and Therapeutic Management, edited by Jonathan E Alpert and Maurizio Fava 26 Clinical Handbook of Eating Disorders: An Integrated Approach, edited by Timothy D Brewerton 27 Dual Diagnosis and Psychiatric Treatment: Substance Abuse and Comorbid Disorders: Second Edition, edited by Henry R Kranzler and Joyce A Tinsley 28 Atypical Antipsychotics: From Bench to Bedside, edited by John G Csernansky and John Lauriello 29 Social Anxiety Disorder, edited by Borwin Bandelow and Dan J Stein 30 Handbook of Sexual Dysfunction, edited by Richard Balon and R Taylor Segraves 31 Borderline Personality Disorder, edited by Mary C Zanarini 32 Handbook of Bipolar Disorder: Diagnosis and Therapeutic Approaches, edited by Siegfried Kasper and Robert M A Hirschfeld 33 Obesity and Mental Disorders, edited by Susan L McElroy, David B Allison, and George A Bray 34 Depression: Treatment Strategies and Management, edited by Thomas L Schwartz and Timothy J Petersen 35 Bipolar Disorders: Basic Mechanisms and Therapeutic Implications, Second Edition, edited by Jair C Soares and Allan H Young 36 Neurogenetics of Psychiatric Disorders, edited by Akira Sawa and Melvin G Mclnnis 37 Attention Deficit Hyperactivity Disorder: Concepts, Controversies, New Directions, edited by Keith McBurnett and Linda Pfiffner Attention Deficit Hyperactivity Disorder Concepts, Controversies, New Directions Edited by Keith McBurnett University of California, San Francisco, USA Linda Pfiffner University of California, San Francisco, USA Informa Healthcare USA, Inc 52 Vanderbilt Avenue New York, NY 10017  2008 by Informa Healthcare USA, Inc Informa Healthcare is an Informa business No claim to original U.S Government works Printed in the United States of America on acid-free paper 10 International Standard Book Number-10: 0-8247-2927-7 (Hardcover) International Standard Book Number-13: 978-0-8247-2927-1 (Hardcover) This book contains information obtained from authentic and highly regarded sources Reprinted material is quoted with permission, and sources are indicated A wide variety of references are listed Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequence of their use No part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers For permission to photocopy or use material electronically from this work, please access www copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc (CCC) 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400 CCC is a not-for-profit organization that provides licenses and registration for a variety of users For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Library of Congress Cataloging-in-Publication Data Attention deficit hyperactivity disorders: concepts, controversies, new directions / edited by Keith McBurnett, Linda Pfiffner p ; cm – (Medical psychiatry; 37) Includes bibliographical references and index ISBN-13: 978-0-8247-2927-1 (hb : alk paper) ISBN-10: 0-8247-2927-7 (hb : alk paper) Attention-deficit hyperactivity disorder I McBurnett, Keith II Pfiffner, Linda Jo III Series [DNLM: Attention Deficit Disorder with Hyperactivity W1 ME421SM v.37 2008 / WS 350.8.A8 A88307 2008] RJ506.H9A936 2008 2007043380 618.920 8589–dc22 For Corporate Sales and Reprint Permissions call 212-520-2700 or write to: Sales Department, 52 Vanderbilt Ave., 16th floor, New York, NY 10017 Visit the Informa web site at www.informa.com and the Informa Healthcare Web site at www.informahealthcare.com Preface This book bridges the gap between the several existing introductory works on attention deficit hyperactivity disorder and those more advanced texts that focus on a narrow issue or subpopulation It targets readers in training (medical and nursing students, residents, graduate students, etc.) rather than a lay audience, and thus it is a natural companion to the attention deficit hyperactivity disorder section in the Diagnostic and Statistical Manual of Mental Disorders -IV-TR Although it can be used as an introductory text, it also covers specialized topics that will be of interest to seasoned clinicians and to anyone affected by attention deficit hyperactivity disorder who wishes to broaden their understanding of the disorder We asked experts around the world to contribute chapters, with the guideline that they be brief and concise We granted significant “wiggle room” when contributors needed more length Some topics received extra emphasis, in order to present readers with more of what they might need to know rather than what they already know about attention deficit hyperactivity disorder For example, because most of what is known about the disorder comes from research with school-age boys, we thought it essential to include chapters spanning ages and genders We also overweighted psychosocial approaches to treatment, because the sub-modalities of evidence-based psychosocial treatment are rarely presented Coverage of medication was limited to the essentials, because pharmacotherapy of attention deficit hyperactivity disorder is already widely disseminated online and in book form and because continuing medical education and pharmaceutical-medical liaisons are sources of continual updates for the prescribing community This book also asks readers to challenge their assumptions about attention deficit hyperactivity disorder The chapter by Pelham is an iconoclastic manifesto on the primary importance of psychosocial treatment It stems from the fact that the first reported result of the Multimodal Treatment of ADHD Study—that well-managed pharmacotherapy is more effective than psychosocial treatment, and that little is gained from adding psychosocial treatment to pharmacotherapy alone—is often over-interpreted By considering a broader context, Pelham’s chapter stimulates the reader into becoming more sophisticated about medication versus psychosocial issues Diller’s chapter reminds the reader that, even with the amount of research iii iv Preface currently available on the disorder, much work remains to be done before some fundamental questions can be put to rest Regardless of the reader’s viewpoint, the chapters in the “Controversies” section will leave the reader better able to defend their views Our choice of emphases should not be misconstrued Our personal views are that attention deficit hyperactivity disorder is a valid and undertreated disorder, that multimodal treatment (medication and psychosocial) is often the best treatment, that federal funding of research on this and related disorders should be quadrupled, and that major revisions are needed to how treatment is provided and reimbursed Everyone is affected by attention deficit hyperactivity disorder, whether they have it or not Given the worldwide estimated prevalence of 5.29%, chances are that one out of every 20 people one encounters (including drivers of other cars) has the disorder Untreated and under-treated, it closes off many paths to better education, better jobs, better health, and better social relationships It is a costly disorder for everyone We know a great deal about identifying and helping individuals with attention deficit hyperactivity disorder, but we mustn’t allow ourselves to smugly think we know enough If our book stimulates readers to consider new views on it and to develop their own insights, it will have done its job We owe a debt of gratitude for the scholarly efforts of the contributors to this book Special thanks are due to Russell Schachar, Joel Nigg, and Glen Elliott, who helped in the conceptualization and early planning Keith McBurnett Linda Pfiffner Contents Preface iii Contributors ix SECTION I: ASSESSMENT The Diagnosis and How We Got There Keith McBurnett Differential Diagnosis of Attention and Auditory Processing Disorders Laurent Demanez SECTION II: CLINICAL CONCEPTUALIZATIONS Clinical Testing of Intelligence, Achievement, and Neuropsychological Performance in ADHD 21 Leah Ellenberg and Joel Kramer Self-Esteem and Self-Perceptions in ADHD Nina M Kaiser and Betsy Hoza 29 The Family Context of ADHD 41 Charlotte Johnston and Douglas Scoular Comorbidity as an Organizing Principle Linda J Pfiffner 51 Dysfunctions of Attention, Learning, and Central Auditory Processing: What’s the Difference? 63 Juliana Sanchez Bloom and George W Hynd SECTION III: CLINICAL NEUROSCIENCE Neuroanatomy of ADHD 71 F Xavier Castellanos and Eleanor Ainslie v Index [Attention deficit hyperactivity disorders (ADHD)] deficits of, 138 endophenotypes in, 373–388 essential elements, of, 138 evidence-based treatments for, 302 family context of, 41–46 financing services for, 213–217 head trauma and, 77–78 neuroanatomical abnormalities in, 73–77 basal ganglia, 76–77 cerebellum, 77 decreased global brain volume, 73 prefrontal brain, 73–76 neuroanatomy of, 71–79 neuropsychological testing, 24–25 organizing, 217–219 probable causes of, 77 psychopathophysiology, study of, 111 relation with APD, 15–16 research on, 213 self perceptions, 29–37 self-esteem, 29–37 structuring of delivery services for, 217–219 symptoms, 137 theoretical underpinnings, of, 291–293 Attention network test (ANT), 398 Attention process training (APT), 397, 400 See Attention training (ATT) Attention training (ATT), 397–407 applications of, 399–401 approaches of, 397–398 concept of, 397 criticism of, 398 and CUIDAR PROGRAM, 402–406 child groups, 404 parent groups, 403–404 preschool children, 401–402 Attentional dysfunction, 275 Attentional orientation, 103–104 Attention deficit disorder without hyperactivity (ADD-WO), 351, 353 Auditory agnosie, defined, Auditory Continuous Performance Test (ACPT), 16 attention measurement by, 16 impulsivity.measurement by, 16 Automatic orientation, 104 413 Band-Pass Binaural Fusion test, 14 Barkley’s theoretical model, 138 Barkley’s theory of self-control, 181 Basal ganglia, 73 76–77 Beck Depression Inventory, 25 Behavior modification, 146, 204–205, 302–303, 306 response cost, 164 Behavior Rating Inventory of Executive Function (BRIEF), The, 25, 139 Behavioral criteria, 21–22, 25 in diagnosis of (ADHD), 21 Behavioral inhibition, 34, 87 as basis for ADHD, 129 Behavioral inhibition system (BIS), 87–89, 292 Behavioral intensity, 181 Behavioral interventions, 53, 55, 169, 302–310, 326 home based, 161 teacher consultation, 173, 249 Behavioral-first treatment approach, 305–309 benefits of, 305–309 studies of, 307–309 Bell-shaped dimensional model for ADHD, 325 Binaural interaction tests, 12, 14–15 Band-Pass Binaural Fusion test, 14 binaural release from masking, 15 interaural difference timer tasks, 14 RASP, 14 Binaural release from masking, 15 Biological plausibility, 381 candidate endophenotypes, 386 genetic endophenotypes, 381 Boys with ADHD, 31–32, 35, 259–265 aggressive behaviors of, 181 self-perceptions of, 31–33 versus comparison boys, 31–32 versus control boys, 32 Brain anomalies, in adults, 276–277 Breaking rules, 182 Broad functional domains, 144 Buffalo treatment algorithm, for ADHD, 310–311 Bupropion, 229 dosage, 229 effectiveness, 229 414 [Bupropion] in adults with ADHD, 229 XL form, 229 Camp teachers, 263 Candidate endophenotypes, 378, 381, 382–386 biological plausibility, 386 executive functions as, 382–383 familial aggregation, 385 feasibility, 386 heritability, genetic sensitivity, and genetic specificity, 384–385 presence in unaffected family members, 385 sensitivity and specificity, 383–384 sound psychometric properties, 386 state-independence, 385–386 Candidate gene, 360–361, 364, 365, 378 catechol-O-methyltransferase (COMT), 360 dopa-b-hydroxylase (DBH), 360 dopamine receptors, 360, 364 DRD2, 360, 364 DRD4, 360, 364 DRD5, 360, 364 dopamine transporter (DAT1), 360, 361–364 serotonin receptor (5HT1B), 360 synaptosomal-associated protein (SNAP-25), 360 CAPD See Central auditory processing disorders Central Auditory Processes (CAP), 10, 16, 64, 69 current model of, 10 defined, 10 dysfunctions of, 64–69 tests, 16 Central auditory processing disorders (CAPD), 9–15 a developmental disorder, 63 appeal signs of, 11–12 in adults, 12 in children, 11–12 and ADHD, overlapping symptomatology, 64 central auditory processing tests, 12–15 children and, 65 conceptual difference with ADHD, 66–67 Index [Central auditory processing disorders (CAPD)] conceptual difference with language-based LD, 66–67 defined, 9, 64 evidence for discrete disorders, 64–66 inconsistent findings in, 68–69 language-based LD and, 66 prevalence of, 11 symptoms, 63, 64 understudied areas of, 68–69 Central auditory processing tests, 12–15 binaural interaction tests, 14–15 binaural release from masking, 15 interaural difference timer tasks, 14 dichotic speech tests, 12–13 Competing Sentences Test (CST), 13 Dichotic Digits Test (DDT), 13 Staggered Spondaic Word (SSW), 13 low-redundancy speech tests, 12 low-pass filtering, 12 temporal processing tests, 13–14 temporal integrations or summation, 13 temporal masking, 13 temporal resolution, 13 Cerebellum, 73, 77 Challenging Horizons Program (CHP), 249–250 after-school model of, 249–250 consulting model, 252–253 counselors, 251 mentors, 251 models of, 249–250, 252–253 targets of, 249 Child Behavior Checklist, 25, 351, 355 Child life and attention skills program, 172–176 Child Organization Hyperactivity Index, 139 Child welfare entitlement funds, 214 Childhood Depression Inventory, 25 Children with CAPD, 64–69 difficulties of, 65 symptoms of, 65 distractibility, 65 learning problems, 66 inattentiveness to auditory stimuli, 66 Children, with ADHD families of, 41–46 functional impairments, 189 maladaptive behaviors, 189 Index [Children, with ADHD] marital relationship, and, 45 OTMP deficits 138 parental behaviors, 42–43 parental cognitions, and, 44–45 parental psychopathology, 43 ratings of, 141 summer treatment programs, 199–206 symptoms, 64 weak competencies, 201 Children’s Organizational Skills Scale (COSS), 140, 141–143, 149 CHOC-UCI Initiative for the Development of Attention and Readiness (CUIDAR), 398, 402–406 alerting, 405 ATT in, 404–406 alerting, 405 executive Control, 405–406 child groups, 404 executive control, 405–406 parent groups, 403–404 Chronic argumentativeness, in ODD, 51 Cigarette smoking, 275 in adults, with ADHD, 275 Cingulate cortex, 90 role of, 277 Classroom behavior, 161, 162, 164 Classroom Challenge (CC), 173–174 Classroom interventions, 140, 154, 202, 348 Clomipramine, 56 Clonidine, 230 See also Alpha-agonists comorbid, aggression, 230 dosage, 230 efficacy of, 230 titration of, 231 Cognition and motivation, in models of ADHD, 112–115 delay aversion in ADHD, 113–115 executive dysfunction in ADHD, 112–113 Cognitive distortions, 181 Cognitive neuroscience, 98, 402 Cognitive Skills Index (CSI), 22 Cognitive-behavioral strategies, 175 Cognitive treatment strategies, 34 self-instructing, 34 problem solving, 34 self-reinforcement, 34 self-redirection, 34 415 Combined type of ADHD (ADHD-C), 169–172 ADHD-I and, 169–172 behavioral interventions, 169 children with, 171–172 psychosocial interventions, 170 stimulant treatment (ST), 169 Community parent education (COPE) program, 403 Comorbid anxiety, with ADHD, 53–55, 283 conduct disorder (CD), 52–53 depression, 33 oppositional defiant disorder (ODD), 52–53 with ADHD, 51 Comorbidity, 51–57 Comorbid anxiety, 52, 53–55 Comorbid disorders, 21, 66, 89, 179, 236–237, 296–297 Comorbid disruptive behavior disorders, 52, 53, 261 emergence of, 52 Competing Sentences Test (CST), 13 Concerta, 226, 280, 328 Conduct disorder (CD), 51–53, 191, 203, 267, 332, 377 oppositional defiant disorder (ODD) and, 51–53 Conners Teacher Rating Scale, 334 Contingencies, 295 factors influencing effect of, 295–296 medication, 295–296 Continuous Performance Test, 24, 101, 262 Controlled Oral Word Association Test, 24 COPE model, 403–404 parenting strategies, 403 Cortical deafness, Cortical excitability, 125–133 Cortical silent period (CSP), 127–131 Cortico-striatalthalamo-cortical (CSTC) circuits, 79 COSS See Children’s Organizational Skills Scales Covert-orienting procedures, 98 Cross-factor cluster, 142 CUIDAR program See CHOC-UCI Initiative for the Development of Attention and Readiness Cutpoint, 4–5 416 CYP2D6 See Cytochrome P450 2D6 (CYP2D6) Cytochrome P450 2D system, 230 medications inhibiting, 230 Cytochrome P450 2D6 (CYP2D6), 360, 365 d, l-Methylphenidate, 225 dosage, 225 D2 dopamine receptor gene, 276 D4 dopamine receptor gene, 276 Daily report cards, 161–166 advantages of, 161–162 defined, 161 effectiveness, of, 162 implementation of, 163–164 negative consequences, adding of, 164–165 target of 162–163 treatment acceptability of, 165–166 treatment outcome, 164 utilization of, 162–163 Daydreaming, 295, 351–353 Daytrana, 226 Deafness, cortical, verbal, Defiance, in ODD, 51 Delay aversion hypothesis, 292 Delay Aversion, in ADHD, 113–117 Depression, 25, 218, 219 in adults with ADHD, 275 an aspect of parental psychopathology, 43 comorbid depression, 33 an internalizing disorder, 261 in girls with ADHD, 265 parental depression, 52, 56 in mothers, 43 Depressive disorders, 51, 54, 55–57 Design Fluency, 24 Desipramine, 56, 281, 282, 283 See Tricyclic antidepressants Dexedrine Spansule, 225, 226 dosage, 225, 226 Dexedrine, 225, 226, 280 Dextroamphetamine, 226, 280 Dextrostat, 225 Diagnosis, ADHD, 21, 332 in adults 274–276 assessment and, 276 Index [Diagnosis, ADHD] based on behavioral criteria, 21–22 based on test performance, 24 combined-type ADHD, 115 diagnostic recommendations, 332–335 differential diagnosis, 239 effects of delay in, 236 Diagnostic and Statistical Manual of Mental Disorders, DSM-II, DSM-III, 3, 5–6, 71, 351, 353 DSM-III-R, 3, 5, 6, 354 DSM-IV, 3, 5–6, 15, 21, 69, 276, 284, 332 DSM-V, 5–6 Diagnostic threshold, defined, 4–5 Dichotic speech tests, 12–13 Competing Sentences Test (CST), 13 Dichotic Digits Test (DDT), 13 Digit Span, 22, 387, 400 Dimensional change control task (DCCT), 405 Disorders anxiety, 53–55 CAPD, 63–69 depressive, 55–57 disruptive behavior, 51–53 Disruptive behavior disorders, 51–55 conduct disorder (CD) oppositional defiant disorder (ODD), parental depression, 52 types, 51 Distractibility, 15, 63 in ADHD, 64 in CAPD, 63, 64 d-methylphenidate, 225 Domain-specific self-perceptions of competence, 30–31 children with ADHD versus comparison children, 30–31 Dopamine Receptors, 360, 364 DRD2, 364 DRD4, 364 DRD5, 364 Dopamine transporter (DAT) gene, 276 Dopamine Transporter (DAT1), 361–364 Dopamine, 113, 229 Dopamine-beta-hydroxylase gene, 276 DRD2, 360, 364 DRD4, 360, 364 DRD5, 360, 364 Index Drowsiness, 351 Dual pathway hypothesis, ADHD, 111–117 Duration Pattern Test (DPT), 14 Dyadic friendships, 180–181 development of, 186–187 Dysfunctional parenting, 52–53 ADHD children and, 52–53 emergence of comorbid disruptive behavior disorders, 52 kinds of, 52 Dysgraphia, 23 Dyslexia, 23, 24 Early Periodic Screening, Diagnosis and Treatment (EPSDT), 213–214 Edginess, 279, 280, 282 Educational policy, 341–349 clinical implications, 347–349 IDEA, 342 stages of policy interpretation, 342–345 section 504 stages of policy interpretation, 345–347 Empirically supported treatments (ESTs), 212, 220, 221 Endogenous cues, 99–100 Endophenotype, 373–388 candidate endophenotypes,, 378, 381, 382–386 defined, 377 genetic endophenotypes, 378–383 in genetic research, 387–388 potential of, 377–378 putative, 378, 381–382 Endophenotype, putative, 378, 379, 381–382 Evidence-based treatments, ADHD, 302–303 Executive control, 398–399 ATT in CUIDAR, 405–406 Executive dysfunction, 112, 113 in ADHD, 112–113 inhibitory-based, 115–116 Executive function (EF), 25, 26, 92, 137, 262, 274, 381–383 as candidate endophenotypes,, 382–383 defined, 382 importance of, 382 Executive functioning, 24–26, 34 assessment of, 25 tests of, 24 417 Exogenous cues, 98, 99, 102 orientation to, 99 Extensive metabolizers (EMs), 365 Familial aggregation, 380 candidate endophenotypes, 385 genetic endophenotypes, 380 Family, 246–248 Family Check-Up, 247 Family context of ADHD, 41 marital relationships, 45 parenting behaviors, 42–43 parental cognitions, 44–45 parental psychopathology, 43–44 parent–child interactions, 42–43 Family Resource Center (FRC), 247 Family Therapy (FFT), 153, 246–248 effectiveness, 246 involvement in treatment, 45–46 Family-based treatments, 246 parent training in behavior management skills, 246 phases of, 246 problem-solving and communication training, 246 structural family therapy, 246 Feasibility, 382 candidate endophenotypes, 374 genetic endophenotypes, 382 Federal Medicaid program, 213–214 Financing services, 213–216 child welfare entitlement funds, 214 cost-effective, 213 Early Periodic Screening, Diagnosis and Treatment (EPSDT), 213–214 federal Medicaid program, The, 213–214 potential barriers, 216 public funds, 214 role of states, 214 First-line pharmacotherapy, 282, 283 Focalin, 225 Forgetfulness, 172, 351 Functional impairments, 29, 191, 201 academic problems, 201 peer relationship problems, 201 Functional magnetic resonance imaging (fMRI), 126, 133, 386 418 Genetic endophenotypes, 378–383 biological plausibility, 381 familial aggregation, 380 feasibility, 382 heritability, genetic sensitivity, and genetic specificity, 379–380 presence in unaffected family members, 380 sensitivity and specificity, 378–379 sound psychometric properties, 381–382 state-independence, 380–381 Genetic research, 374 sources of variation, 374–377 endophenotypes in, 386–387 Genetics of ADHD and neurobiology, 278 Genome-wide scans, 365 Girls with ADHD, 259–268 clinical relevance, 265–267 comorbidity, 261–263 development processes, 262–265 historical perspective, 260 epidemiology, 260–261 future directions , 255–256 impairment, 261–263 internalizing disorders, higher rates of, 261 lower IQ, 261, 262 parent–child relationships, 263 theoretical implications, 267–268 versus boys with ADHD, 259 Global self-esteem, 29 in children, 30 Globus pallidus, 77, 277, 381 Grabbing, 182 Gray matter, in brain development, 75, 382, 385 Gray Oral Reading Test-4, 23 Gray’s model of emotion and anxiety, 292 Guanfacine, 230, 366 See also Alpha-agonists dose titration of, 231 Haplotype, 360 Head injury See Head trauma Head trauma, 77 and ADHD, association of, 77–78 Headache, 227, 279, 280 Height, 319–320 Index [Height] stimulant effects of, 319–320 Hemianacusia, 10 Heritability, 276, 360–361, 379–380 candidate endophenotypes, 384–385 genetic endophenotypes, 379–380 Heritability rates, 374 High behavior modification treatment (HBM), 204 High perceptual load, 103, 105 Home based intervention, 162 Home-based reward programs, 163 Home-based treatment, 161 academic problems in classroom, 161 behavior problems in classroom, 161 Home problems, 275 Homework Management Plan (HMP), 250 Hyperactivity, 3–6, 125–126 as ADHD symptom, 29, 65–66 Hyperactivity-impulsivity, 4–6 Hypoactivity, 352 Imipramine, 229, 230, 281 See also Tricyclic antidepressants (TCAs) dosage, 230 Impaired performance, 3, 67, 276, 277 Impulsivity, 3–6, 65, 191 ACPT, 16 as ADHD symptom, 29 Inattention, 3–6, 65, 191 as ADHD symptom, 29 Individualized Educational Plan (IEP), 158–159, 215 behavioral interventions, 215 educational goals, 215 Individuals with Disabilities Education Act (IDEA), 23, 158, 341–348 and § 504, 342–343 clinical implications, 347–349 stages of policy interpretations, 343–345 Individuals with Disabilities Education Improvement Act (IDEIA), 214 Inhibitory-based executive dysfunction;115–116 delay-aversion, 115–116 Inhibitory control, 113, 379, 382–386 as a candidate endophenotype for ADHD, 383–386 Index Inhibitory motivation, punishment-related, 88–89 Insomnia, 230, 279, 280, 282, 365 Intelligence testing use in ADHD, 22–23 Interaural difference timer tasks, 14 Internalizing disorders, 261 anxiety, 261 depression, 261 Interventions, risks and benefits of, 302–305 behavioral interventions, 304–305 pharmacotherapy, 303–304 Intervention selection, 154–155 Intracortical excitability, 131–133 ADHD, 131–133 MPH and, 131–133 normals, 131–133 Intracortical facilitation (ICF), 127–128, 131–133 Intracortical inhibition (ICI), 127–133 Intracortical inhibition, 130, 132 IQ measure, 22 Juvenile justice, 211, 212, 217–218 Kaufman Assessment Battery, 22 King-Kopetzky syndrome, 10 Laboratory measures, Language-based learning disabilities (language-based LD), 63 conceptual difference with ADHD, 66–67 conceptual difference with CAPD, 66–67 Lapses in Memory and Materials Management, 141 Learning, 11 dysfunctions of, 63–69 Learning disability, 23, 26, 162, 214 Legal problems, 179, 243 adolescents, with, ADHD, 243 Lisdexamfetamine dimesylate, 226 Locomotor hyperactivity, 126 Long-acting stimulants, 224, 227 Long-term treatment groups, 223 419 [Long-term treatment groups] combined treatment, 223 community controls, 223 medication management, 223 psychosocial intervention, 223 Low behavior modification treatment (LBM), 204–205 Low perceptual load, 103, 104, 105 Low-redundancy speech tests, 12 low-pass filtering, 12 Magnetic resonance imaging (MRI), 71–72 Major depression (MD), 56, 301 Maladaptive behaviors, 201 aggression, 201 noncompliance, 201 Managed care, 213, 217–218 Marital conflict, 45 Marital relationships, 45 in families of children with ADHD, 45 Masking Level Difference (MLD), 15 Maternal smoking, 376 Math disabilities, 262 Medical pharmaceutical (MP) model, 212 Medication titration, 223 principles of, 223–231 stimulants, 223–231 alpha-agonists, 230–231 atomoxetine, 228–229 bupropion, 229 TCAs, 229–230 Mental health professional, for ADHD, 153–160 advocacy role, 159 consultation techniques school consultation, 153–160 rationale for, 153–154 strategies of, 153–154 Mental health services, 211 physicians role in, 244–245 potential barriers, 216 difficulties with insurance coverage, 216 lack of transportation, 216 limited clinic hours, 216 no school-based service, 216 systemic reform in delivery of, 217–218 420 Metabolizers extensive, 365 poor, 365 Metadate-CD, 226 dosage, 226 Methylphenidate, 55, 140, 362 doses, 224 in ADHD, 56 in, comorbid anxiety, 55 Minnesota Multiphase of Personality Inventory-2 (MMPI-2), 25 Modifying contingencies, effects of, 293 factors influencing, 295–297 comorbid disorders, 296–297 medication, 295–296 Molecular genetic findings ADHD, 360 Motivational systems, 85, 115, 183 attentional systems and, 92–93 punishment-related inhibitory motivation, 88–89 reward-related appetitive motivation, 86–88 Motivational theories, 293, 295 Motor control, deficits in children with ADHD, 128–129 children with comorbid ADHD, 129–131 children with TIC disorderb, 129–131 Motor hyperactivity, 125, 131 Motor response, 124, 383–384, 386–388 Motor system excitability, parameters of, 127 cortical silent period (CSP), 127–131 intracortical facilitation (ICF), 127–128, 131–133 intracortical inhibition (ICI), 127–133 motor threshold (MS), 127–128, 132 Motor threshold (MS), 127–128, 132 Motor-evoked potentials (MEP), 127 Motoric inhibition, 276 MPH See Methylphenidate intracortical excitability, 131–133 in ADHD, 131–133 in normals, 131–133 Multimodal Treatment of ADHD (MTA), 319 studies of using stimulants, 319 Multimodal Treatment Study of Children with ADHD, 199, 203, 267 Index Multisite Treatment Study of ADHD, 295 Multisystemic therapy (MST), 53 Narcolepsy, 353 National Initiative for Children’s Healthcare Quality (NICHQ), 336–367 Negative behaviors, 179, 182 blurting, 250 breaking rules, 182 complaining, 250 grabbing, 182 interrupting, 182 teasing, 250 Nelson Denny Reading Test, 23 Nervousness, 227 NET See Norepinephrine Transporter (NET) Protein Neuroanatomical abnormalities, ADHD, 73–77 basal ganglia, 76 volumetric differences, in, 76–77 cerebellum, 77 smaller cerebellar hemispheric volumes, 77 decreased global brain volume, 73, 74, 78–79 prefrontal brain, 73, 75–76 volumetric differences in the PFC, 75 Neuroanatomy, ADHD, 71–79 Neurobiological functioning, 237 Neurobiology, 276 ADHD in adults, 276–278 and genetics of ADHD, 278 Neuroimaging studies, adult ADHD, 277–278 Neuroimaging techniques, 126 for human brain development, 126 Neuropsychological testing, 24–25 in ADHD, 24–25 No behavior modification (NBM) treatment, 204 Noncompliance, 193, 201, 250 in boys with ADHD, 265 in girls with ADHD, 265 Nonparental adults, 263 Non-tricyclic norepinephrine, 228 atomoxetine (Strattera), 228–229 Norepinephrine Transporter (NET) Protein 1, 364–365 Index Norepinephrine, 132, 229, 278–279, 364–365 Nortriptyline, 230 Obscure auditory dysfunction, 10 Office of Civil Rights (OCR), 217 Oppositional defiant disorder (ODD), 51–53, 55, 184, 191–193, 219 and conduct disorder, 51–53 noncompliance, characteristic of, 193 Oppositionality, 125 Optimal dose, 227 Organizational, time management, and planning (OTMP), 137–140 in children, 138 OTMP behaviors , assessment, 141–142 Children’s Organizational Skills Scale (COSS), 140, 141–142 OTMP intervention program, 142 future aspects of, 149–150 overview of, 146–149 rationale, 142 treatment principles and features, 143–145 skills, 139–141, 143–147 Organized behaviors, 141 Orienting, 398, 405 paradigm, 100–101 visuospatial attentional, 98–101 OTMP intervention program, 142 generalization procedures, 147 maintenance procedures, 148 manuals features, 149 rationale, 142 treatment adherence and fidelity, 148 treatment principles and features, 143–145 engagement, 145 generalization, 144 maintenance, 145 reinforcement, 145 skills acquisition, 143–144 treatment tailoring, 143 OTMP skills, 139–141, 143–148 assessment measures of, 139, 141 use of, 148 Outcomes, ADHD, 301 academic problems, 301 delinquency in adolescents, 301 421 [Outcomes, ADHD] disruptions in relationships, 301 substance use, 301 Overactivity, 117, 191, 194 Overlapping symptomatology, 63 CAPD and ADHD, 64 auditory attention problems, 64 distractibility, 64 inattentiveness, 64 Parent–child interaction, 42–43 Parent skills component, 174 Parent Training program, 192–193 Parent training, in treatment ADHD, 191–195 disruptive behavior, management of, 193 future behavior problem management of, 193 Parental cognitions, 44–45 types of, 44 attributions for child behavior, 44–45 parenting efficacy, 44 Parental psychopathology, 43–44 aspects of, 43 ADHD among parents, 44 antisocial behavior, 44 depression, 43 parental alcohol problems, 44 in families of children with ADHD, 43–44 Parenting, 43 See also Parental behaviors childhood ADHD and, 42–46 dysfunctional, 52 Parenting behaviors, 42–43 Parent–child interaction, 42–43 Parents and Teachers Helping Kids get Organized (PATHKO), 149 Peer interventions, improvement of, 186–188, 305 Peer problems, 181, 201, 205 social skills training for, 183–186 Peer rejection, 29, 34, 186, 265 Peer relations, 187, 239, 246, 311 in ADHD, 179 outcomes of difficulties in, 179 Peer status, 180–181 Peer tutoring, 187 Peer-mediated interventions, 157 Pemoline, 279, 280, 282 422 Perceptual load model of selective attention, 103–106 Perceptual load, 103, 104–105 defined, 103 high, 103, 105 low, 103, 104–105 Pharmacogenetics, 359 defined, 359 finding, 360 Pharmacogenomics, 359 clinical relevance, 366 future directions, 366–367 genome-wide investigations, 365 goal, 367 investigation, 362 preliminary studies, 361–365 Cytochrome P450 2D6 (CYP2D6), 365 Dopamine Transporter (DAT1), 361–364 Dopamine Transporter (DAT1), 364 Norepinephrine Transporter (NET) Protein 1, 364–365 Pharmacotherapy, 303–304 limitations of, 303–304 Phenylketonuria (PKU), 324 Physicians, 244–245 as referrals to mental health professionals, 245 medication treatment, 244 role of, 244–245 Pitch Pattern Sequence Test (PPST), 14 Plausibility, biological See Biological plausibility Point systems, 251, 403 Polymorphisms, 360–361, 365, 367 Poor metabolizers (PMs), 365 Positive illusions, ADHD, 30, 32–34, 36–37 Positron emission tomography (PET), 126, 277 Posterior attention system (PAS), 99 Potential mechanisms, 30, 34–36 Predominantly Hyperactive-Impulsive Type (PHT), 332 Predominantly Inattentive Type (PIT), 332, 333 Prefrontal cortex (PFC), 73 role in ADHD, 73 Prematurity, Preschoolers, with ADHD, 235–240 assessment of, 236–237 context Matters, 237 Index [Preschoolers, with ADHD] developmental status, 238–239 differential diagnosis, 239 distinguishing symptoms, 238 functional impairment, evaluation of, 239 naturalistic settings, observations in, 237–238 Primary care physician (PCP), 332–335 Primary Disorder of Vigilance (PVD), 352–353 diagnostic criteria for, 353 Private health insurance, 213 Problem solving, 34, 173, 175, 182–185 Psychoeducation, 146, 244 Psychological functioning, 21, 25, 43–44 assessment, of, 25 Psychosocial adversity, 376, 385 Psychosocial interventions (PST), 169 Psychosocial interventions, 169–170, 186, 245, 253, 254 Public funds, 214 Punishment, 293–297 effectiveness, 294–295 imprudent, 294 prudent, 294 Putative endophenotype, 378, 379, 381–382 RCTs, 212 treatment efficacy, 212 Rapidly Alternating Speech Perception (RASP), 14 Rating scales, 125, 155, 157, 246 Reaction time (RT), 98, 352, 400 Reconciliation Act of 1989 [PL 101–239], 214 Reinforcement, 292 delayed, 292 timing of, 292 Rejection, 180, 184, 263 Relational aggression, 181 Remediation, 142 organizational skills deficits in children with ADHD, 143–150 Report cards, 251 Research diagnostic criteria (RDC), 2–3 Response cost, defined, 164 Response inhibition, 73, 75, 112, 277, 292, 293, 383 Revised Behavior Problem Checklist, 351 Index Rewards, impact of, 294–295 Reward, contingent, 293 Reward magnitude, 292 factor affecting, 292 Reward threshold, 292 ADHD and, 292–293 Rey-Osterrieth Complex Figure, 24 Ritalin LA, 226, 280 dosage, 226 Ritalin, 225, 323, 327 School consultation, 153–160 formalized special services, 158–159 by mental health professional, 153 rationale for, 153–154 secondary students, 157–158 steps, 155–156 techniques, following, 156–158 punishment of inappropriate behaviors, 156 systematic ignoring, 156 systematic verbal feedback, 156 School dropout, 179, 243 School psychologists See Mental health professional, for ADHD School, 214 mental health services, for, 214 services to children, 214 School-home notes, 162, 164 Second-line therapies, 283 See also Bupropion, Tricyclic antidepressants (TCAs) Section 504 of the Rehabilitation Act (§504), 341–348 and IDEA, 342–343 clinical implications, 345–347 stages of policy interpretations, 345–347 Self-esteem, 29 as a key treatment goal, 36 clinical relevance, 36–37 global, 30 in ADHD, 29–37 research on, 30 researches on, 29–33 Self-instructing, 34 Self-monitoring, 140, 173, 248 Self-perceptions, 30–33 See also Self-esteem 423 [Self-perceptions] boys with ADHD, 33 clinical relevance, 36–37 domain-specific, 30–31 positive illusory, 34–35 potential mechanisms, 34–36 research on, 30, 34, 36 task-specific, 31–33 Self-reinforcement, 34, 140 Self-report forms, 25 Sensitivity and specificity, 378 candidate endophenotypes, 383–384 genetic endophenotypes, 378–379 Sensomotor system, inhibitory deficits in, 130 Serotonin transporter (SERT), 360 Session performance forms, 149 Side effect questionnaire, 227 Single-nucleotide polymorphisms (SNPs), 360 Single-positron emission computer tomography (SPECT), 126, 132 Sluggish cognitive tempo (SCT), 3–6, 351–355 in DSM-III, 353 in DSM-IV, 354 external validity, 354 future aspects, , 355 measurement difficulties, 355 symptoms, 351–352, 354 daydreaming, 351–352 drowsiness, 351 forgetfulness, 351 hypoactivity, 352 sluggishness, 351 Sluggishness, 351 SNAP 25, 276, 278, 360 Social impairment, 169, 171, 181, 186, 252 Social skills training (SST), 179–188, 311 improving peer interventions, 186–188 remediate peer problems in ADHD, 183–186 Social skills training programs, 183–186 Social problems, 181–183 mechanisms underlying, 181–183 Social profile , ADHD youth, 179–181 Sound psychometric properties, 381–382 candidate endophenotypes, 386 genetic endophenotypes, 381–382 Specificity, 378 candidate endophenotypes, 382–384 genetic endophenotypes, 378–379 Staggered Spondaic Word (SSW), 13 424 State-independence, 380–381 candidate endophenotypes, 385–386 genetic endophenotypes, 380–381 Stimulant abuse, 327–328 medication, 243, 302–304, 324–325, 326 adolescents, with, ADHD, 242–244 effectiveness, 244 limitations of, 244 misuse, 327–328 Stimulants, 223–228 alpha-agonists, 230–231 atomoxetine, 228–229 bupropion, 229 controversies over, 323–329 effects of height, 319–320 effects of weight, 318–319 long-acting stimulants, 224 methylphenidate, 235–236 side effects of, 279, 304 TCAs, 229–230 Stop signal reaction time (SSRT), 383, 386 Strattera, 228–229 Stroop Color-Word Interference Test, 25 Structural family therapy, 246 Student support team (SST), 156 Substance abuse, 217, 243 adolescents, with, ADHD, 243 Substance use, 158, 275, 301, 304 Summer Treatment Program (STP), for children, 199–206 activities of, 199–200 description of, 199–200 empirical support, 202–205 future aspects, of 205–206 goals, 200 a key component of psychosocial treatment, 199 targets of, 201 functional impairments, 201 maladaptive behaviors, 201 weak competencies, 201 theoretical rationale, 201–202 treatment approach in, 201–202 Symptom utility, 4, Symptoms of ADHD, 179 comorbid depressive, 33 core, 22, 139–140 distinguishing, 238 Index [Symptoms] distractibility, 65 inattention, 4, 65 hyperactivity-impulsivity, 4–5 motoric, 77 overactivity, 117 Systemic reforms, 211–213 approach of, 211–212 empirically supported systems and, 211–213 focus of, 212 managed care, 217 Systems of care, 212–213 Target behaviors, 162–163, 165, 173 Task planning, 141 Task-specific self-perceptions of competence, 31–33 children with ADHD versus comparison and control children, 31–33 Temperament, 42, 85, 353 Temporal integrations, 13 Temporal masking, 13 Temporal processing tests, 13–14 temporal integrations or summation, 13 temporal masking, 13 temporal resolution, 13 Temporal resolution, 13 Gap Detection method, 13 Temporal Modulation Transfer Function (TMTF) method, 13 Titration immediate release stimulant medications, 225 long acting stimulant medications, 226 principles of medication titration, 223–231 Toolkit ADHD, 336–338 drawbacks to, 337 Total caudate volume, in ADHD patients, 76 Trails B, 24 Transcranial magnetic stimulation (TMS), 126–128 neuronal system activation by, 127 neuronal system inhibition by, 127 Treatment adherence forms, 149 Treatment fidelity forms, 149 Treatment planning, 24 importance of speed of mental processing, 24–25 Index Treatment, 25 ADHD, 25–26 comorbid CD, 53 comorbid ODD, 53 empirically supported, 211–213 evidence-based behavioral, 57 evidence-based treatments, 302 family based interventions, 246 family involvement in, 45–46 implications for, 25–26, 309–312 medication, 223–231 parent training, 191–195 recommendations for, 335–336 role of parents, 45–46 sessions for, 146 Tricyclic antidepressants (TCAs), 56, 229 desipramine, 229 imipramine, 229–230 nortriptyline, 229 metabolized by cytochrome P450 2D system, 230 Tricyclics, 229 imipramine, 229 nortriptyline, 229 Type II diabetes, 327 Verbal deafness, Video game control (VGC), 400 Visuospatial attentional orienting, 98–103 use in clinical researches, 99 Vyvanse, 225, 226 dosage, 225, 226 425 Web-based systems, 245 Wechsler Individual Achievement Test (WIAT), 23 Wechsler Intelligence Scale for Children-IV (WISC-IV), 22 Weight, 318–319 stimulant effects on, 318–319 Weight-based dosing, 225 White matter, brain, 72–76 Wide Range Achievement- Test-IV (WRAT-IV), 23 Wisconsin Card Sort Test, 24 Woodcock-Johnson Tests of AchievementIII, 23 Youth with ADHD, 179 mechanisms underlying social problems, 181–183 affect regulation, 181 behavioral intensity, 181 cognitive distortions, 181 lack of skills, 181 peer status, 180 social profile, 179–181 antisocial behavior, 181 comorbid aggression, 181 oppositional behavior, 181 social skills training, 183–186 didactic instruction, 174, 184 factors for positive effects, 185–186 to peer problems, 183–186 token reinforcement system, 184 ... ISBN-13: 97 8-0 -8 24 7-2 92 7-1 (hb : alk paper) ISBN-10: 0-8 24 7-2 92 7-7 (hb : alk paper) Attention- deficit hyperactivity disorder I McBurnett, Keith II Pfiffner, Linda Jo III Series [DNLM: Attention Deficit. .. Mclnnis 37 Attention Deficit Hyperactivity Disorder: Concepts, Controversies, New Directions, edited by Keith McBurnett and Linda Pfiffner Attention Deficit Hyperactivity Disorder Concepts, Controversies,. .. Library of Congress Cataloging-in-Publication Data Attention deficit hyperactivity disorders: concepts, controversies, new directions / edited by Keith McBurnett, Linda Pfiffner p ; cm – (Medical