Relationship between ADHD, Oppositional Defiant, Conduct, and Disruptive Mood Dysregulation Disorder Symptoms and Age in Children with ADHD and Autism
DOI:
https://doi.org/10.12970/2310-8231.2020.08.08Keywords:
Autism, ADHD, oppositional defiant disorder, externalizing problems, age, factor analysis.Abstract
No study has simultaneously analyzed externalizing symptoms in children with autism, ADHD-Combined, and ADHD-Inattentive to (1) determine the relationship between oppositional behavior, irritability/anger/tantrums, aggression, conduct problems, inattention, impulsivity, and hyperactivity, (2) compare symptom frequencies between diagnostic groups, and (3) examine symptom frequencies relative to age. Mothers rated 1,436 children with autism and 1,056 with ADHD without autism, 2-17 years, on Pediatric Behavior Scale externalizing symptoms. Results yielded three factors: (1) inattentive, impulsive, and hyperactive, (2) disobedient/defiant, irritable/angry/tantrums, aggressive, and bully, and (3) lies/cheats and steals. Children with autism and children with ADHD-Combined were similar in symptom profiles and more impaired in all areas (except inattention) than children with ADHD-Inattentive. Hyperactivity and aggression decreased with age in ADHD-Combined and autism. Age was not related to any symptoms in ADHD-I. Results support the ICD-11 decision to make irritability/anger an ODD specifier and argue against disruptive mood dysregulation disorder as a stand-alone DSM-5 diagnosis. Results also support including aggression as an ODD specifier. Findings show that most children with autism have ADHD symptoms that should be targeted for evaluation and treatment. Conversely, autism needs to be ruled in or out in children presenting with ADHD symptoms. Inattention, impulsivity, hyperactivity, oppositional behavior, and irritability/tantrums were significant problems for the majority of children with ADHD-Combined and children with autism in all age groups. Because these symptoms are present and measurable during the preschool years and continue to be reported in adolescence, early identification and treatment are critical and may positively affect outcome.
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