Comparison of internalizing and externalizing symptoms in children with attention-deficit hyperactivity disorder with and without comorbid tic disorder

Citation
Cb. Pierre et al., Comparison of internalizing and externalizing symptoms in children with attention-deficit hyperactivity disorder with and without comorbid tic disorder, J DEV BEH P, 20(3), 1999, pp. 170-176
Citations number
58
Categorie Soggetti
Psycology,Pediatrics
Journal title
JOURNAL OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
ISSN journal
0196206X → ACNP
Volume
20
Issue
3
Year of publication
1999
Pages
170 - 176
Database
ISI
SICI code
0196-206X(199906)20:3<170:COIAES>2.0.ZU;2-5
Abstract
This study examined the relation between internalizing and externalizing sy mptoms in two groups of prepubertal boys (with and without multiple chronic tic disorder) with diagnosed attention-deficit hyperactivity disorder (ADH D). Parents and teachers completed the Child Behavior Checklist (CBCL) and Teacher's Report Form (TRF), respectively. Children were carefully evaluate d for the absence of a chronic tic disorder. Boys with ADHD and chronic mul tiple tic disorder (ADHD/+tics) received significantly higher (p = .0032, B onferroni correction) scores for the Anxious/Depressed, Thought Problems, a nd Attention Problem scales of the CBCL and the Delinquent Behavior, Though t Problems, and Somatic Complaints scales of the TRF than did boys without chronic tic disorder (ADHD/-tics). Although many of the individual items th at differentiated (p < .05) the two groups of boys pertained to behaviors t hat characterize motor ties, obsessions, or compulsions, the ADHD/+tics gro up exhibited higher rates of anxious behavior (CBCL) and obscene language ( TRF) than did the ADHD/-tics group. Anxiety/depressive symptoms were associ ated with aggressive/oppositional behavior in both samples. Children with m ild tic disorder were more similar (CBCL) to ADHD/- ties boys than they wer e to children with more severe tic disorder. The relatively higher rate of comorbidity in the ADHD/+tics group suggests that ties may be a marker for more severe symptomatology in clinic-referred samples of children with ADHD . Furthermore, these data suggest that it is not the presence, per se, but rather the severity of tic disorder that is associated with higher rates of emotional and behavioral disturbances.