Diagnostic Procedures for Preschoolers with Attention Deficit Hyperactivity Disorder with and without Comorbid Oppositional Defiant Disorder: A Comparison of Dimensional and Categorical Approaches to Classification
Doctor of Philosophy
Other advisers/committee members
DuPaul, George; Cole, Christine; Soffer, Stephen
The early onset, temporal stability, and adverse outcomes associated with neurodevelopmental and disruptive behavior disorders underscore the importance of early identification and treatment. However, there are significant obstacles to diagnosis at the preschool level. This study examined the ways in which dimensional measures of behavior (parent ratings, teacher ratings, and direct observation) differentiated among preschoolers who met DISC-IV criteria for ADHD and/or ODD. Cluster analysis suggested the presence of two distinct clusters. The first cluster (Significant Concerns) was characterized by more elevated concerns in every area in which significant between-cluster differences occurred (oppositional/delinquent behavior, social problems, hyperactivity, thought problems, anxious/shy behavior, and perfectionism). The second cluster (Moderate Concerns) exhibited more inattention and problem behaviors than typical peers (per inclusion criteria), but were rated as exhibiting lower levels of problem behavior and social problems than Cluster 1 participants. Teacher ratings also reflected stronger social skills among Cluster 2 participants. Chi square analysis indicated no significant relationship between cluster membership and diagnostic classification. The diagnostic composition of both clusters was highly similar. The results indicated that the clusters were distinguished primarily by differences in symptom severity, rather than symptom presence/ absence. Parent and teacher ratings followed a similar pattern, being more elevated for Cluster 1 than Cluster 2 on nearly every variable. Implications for assessment and treatment are considered and possible directions for future research are suggested.
DeKett, Lisa, "Diagnostic Procedures for Preschoolers with Attention Deficit Hyperactivity Disorder with and without Comorbid Oppositional Defiant Disorder: A Comparison of Dimensional and Categorical Approaches to Classification" (2014). Theses and Dissertations. 1471.