Psychosocial and clinical correlates of ADHD in a community sample of school-age children

Objective: To identify the psychosocial and clinical correlates of attentio n-deficit hyperactivity disorder (ADHD) in a community sample of children a nd to examine the validity of a subclinical form of ADHD. Method: The sampl e of 449 children (mean age 9.2 years, SD 1.78; 53.6% boys) participated in the second stage of a community survey. Of these, 359 (80%) screened posit ive at stage 1. On the basis of a structured diagnostic interview with a pa rent, children were classified into 1 of 3 mutually exclusive groups: ADHD (n = 89), subthreshold ADHD (n = 100), and non-ADHD (n = 260). Results: As measured by the Children's Global Assessment Scale, the ADHD group was more impaired than the subthreshold group, which was more impaired than the non -ADHD group (p <.05 for each test). Children in the ADHD group were more li kely to be male, to Rave mothers with a history of psychiatric treatment, t o have fathers with a history of excessive alcohol use, and to live in low- income families with higher levels of family dysfunction (p <.05 for all va riables). A model containing male gender family dysfunction, and low income was most predictive of ADHD status (p <.01). ADHD was also associated with psychiatric comorbidity, especially disruptive behavior disorders. Conclus ions: These results support a dimensional approach to ADHD. More severe for ms of ADHD are associated with psychosocial adversity and psychiatric comor bidity.