Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder

Authors

  • Bothild Bendiksen Oslo University Hospital Department of Psychiatric Research and Development University of Oslo, Faculty of Medicine
  • Heidi Aase The Norwegian Institute of Public Health Division of Mental Health.
  • Elisabeth Svensson Department of Clinical Epidemiology University of Aarhus, Denmark
  • Svein Friis University of Oslo, Faculty of Medicine, Norway Oslo University Hospital, Department of Psychiatric Research and Development, Norway
  • Anne Margrethe Myhre University of Oslo, Faculty of Medicine. Oslo University Hospital, Department of Psychiatric Research and Development.
  • Ted Reichborn-Kjennerud The Norwegian Intitute of Public Health, Division of Mental Health.
  • Pål Zeiner Oslo University Hospital, Department of Psychiatric Research and Development

Keywords:

Impairment, preschool children, parent ratings, attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, subtype, gender differences

Abstract

Background: We have limited knowledge of the impact of attention-deficit/hyperactivity disorder (ADHD) symptoms on the daily functioning of young preschool children.

Objective: This study investigated the level of impairment related to symptoms of ADHD in different functional domains. It also addressed how impairment caused by ADHD was related to ADHD subtype, symptom load, gender, and the co-occurrence of oppositional defiant disorder, conduct disorder, or both.

Method: Participating children (N = 807) who were 3.5 years old were recruited from a population-based sample included in The Norwegian Mother and Child Cohort Study. Children who scored above the 90th percentile for ADHD symptoms were included in the present sample. The assessment of the symptoms and functional impairment described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text revision, was based on parental ratings and the semi-structured psychiatric interview entitled “The Preschool Age Psychiatric Assessment.”

Results: Added burden and discord within family relationships were the areas that were most severely affected. All domain scores were strongly intercorrelated, and they were added to each child’s total score. Children with symptoms of ADHD, inattentive type (mean [M], 3.5; standard deviation [SD], 3.4), or ADHD, hyperactive/impulsive type (M, 2.9; SD, 2.7), were significantly less impaired than children with symptoms of ADHD, combined type (M = 6.4; SD = 3.8; p < .001). Furthermore, co-occurring oppositional defiant disorder was associated with higher impairment scores (M, 6.1; SD, 4.3) than ADHD alone (M, 3.2; SD, 2.9; p < .001. About 30% of the variance of impairment score of ADHD was explained by symptoms of ADHD and co-occurring symptoms of oppositional defiant disorder and conduct disorder. Few gender differences were observed.

Conclusion: Overall, these non-referred young children with clinical symptoms of ADHD were only modestly impaired. Impairment related to ADHD occurred mainly in the areas of family functioning, and it was associated with ADHD subtype and comorbidity. Still, it is important to assess the impact of ADHD symptoms and coexisting difficulties among preschoolers to identify children and families who are in need of early intervention efforts.

 

Author Biographies

Bothild Bendiksen, Oslo University Hospital Department of Psychiatric Research and Development University of Oslo, Faculty of Medicine

MD. Phd candidate. Child Psychiatry.

Heidi Aase, The Norwegian Institute of Public Health Division of Mental Health.

PhD. Psychology.

Elisabeth Svensson, Department of Clinical Epidemiology University of Aarhus, Denmark

Phd. Epidemiology.

Svein Friis, University of Oslo, Faculty of Medicine, Norway Oslo University Hospital, Department of Psychiatric Research and Development, Norway

MD. PhD. Professor. Psychiatry.

Anne Margrethe Myhre, University of Oslo, Faculty of Medicine. Oslo University Hospital, Department of Psychiatric Research and Development.

MD. PhD. Child psychiatry.

Ted Reichborn-Kjennerud, The Norwegian Intitute of Public Health, Division of Mental Health.

MD. PhD. Professor. Psychiatry.

Pål Zeiner, Oslo University Hospital, Department of Psychiatric Research and Development

MD. PhD. Child Psychiatry.

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Published

2014-09-15

How to Cite

Bendiksen, B., Aase, H., Svensson, E., Friis, S., Myhre, A. M., Reichborn-Kjennerud, T., & Zeiner, P. (2014). Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder. Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 2(3), 95–105. Retrieved from https://tidsskrift.dk/sjcapp/article/view/17131

Issue

Vol. 2 No. 3 (2014)

Section

Articles

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