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Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): clinical correlates and familial prevalence

Esther Sobanski, Tobias Banaschewski, Philip Asherson, Jan Buitelaar, Wai Chen, Barbara Franke, Martin Holtmann, Bertram Krumm, Jospeh Sergeant, Edmund Barke, et al. (2010) JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY. 51(8). p.915-923
abstract
Background: The goal of this study was to investigate the occurrence, severity and clinical correlates of emotional lability (EL) in children with attention deficit/hyperactivity disorder (ADHD), and to examine factors contributing to EL and familiality of EL in youth with ADHD. Methods: One thousand, one hundred and eighty-six children with ADHD combined type and 1827 siblings (aged 6-18 years) were assessed for symptoms of EL, ADHD, associated psychopathology and comorbid psychiatric disorders with a structured diagnostic interview (PACS) as well as parent and teacher ratings of psychopathology (SDQ; CPRS-R:L; CTRS-R:L). Analyses of variance, regression analyses, chi 2-tests or loglinear models were applied. Results: Mean age and gender-standardized ratings of EL in children with ADHD were > 1.5 SD above the mean in normative samples. Severe EL (> 75th percentile) was associated with more severe ADHD core symptoms, primarily hyperactive-impulsive symptoms, and more comorbid oppositional defiant, affective and substance use disorders. Age, hyperactive-impulsive, oppositional, and emotional symptoms accounted for 30% of EL variance; hyperactive-impulsive symptoms did not account for EL variance when coexisting oppositional and emotional problems were taken into account, but oppositional symptoms explained 12% of EL variance specifically. Severity of EL in probands increased the severity of EL in siblings, but not the prevalence rates of ADHD or ODD. EL and ADHD does not co-segregate within families. Conclusion: EL is a frequent clinical problem in children with ADHD. It is associated with increased severity of ADHD core symptoms, particularly hyperactivity-impulsivity, and more symptoms of comorbid psychopathology, primarily symptoms of oppositional defiant disorder (ODD), but also affective symptoms, and substance abuse. EL in ADHD seems to be more closely related to ODD than to ADHD core symptoms, and is only partly explainable by the severity of ADHD core symptoms and associated psychopathology. Although EL symptoms are transmitted within families, EL in children with ADHD does not increase the risk of ADHD and ODD in their siblings.
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author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
TEMPERAMENT, HETEROGENEITY, SCALE, BOYS, BIPOLAR DISORDER, PATHWAY MODEL, DEVELOPMENTAL PSYCHOPATHOLOGY, DEFICIT-HYPERACTIVITY DISORDER, IRRITABILITY, ASSOCIATION
journal title
JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY
J. Child Psychol. Psychiatry
volume
51
issue
8
pages
915 - 923
Web of Science type
Article
Web of Science id
000279736900007
JCR category
PSYCHOLOGY, DEVELOPMENTAL
JCR impact factor
4.36 (2010)
JCR rank
6/66 (2010)
JCR quartile
1 (2010)
ISSN
0021-9630
DOI
10.1111/j.1469-7610.2010.02217.x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1107742
handle
http://hdl.handle.net/1854/LU-1107742
date created
2011-01-21 13:38:00
date last changed
2016-12-19 15:45:03
@article{1107742,
  abstract     = {Background: The goal of this study was to investigate the occurrence, severity and clinical correlates of emotional lability (EL) in children with attention deficit/hyperactivity disorder (ADHD), and to examine factors contributing to EL and familiality of EL in youth with ADHD.
Methods: One thousand, one hundred and eighty-six children with ADHD combined type and 1827 siblings (aged 6-18 years) were assessed for symptoms of EL, ADHD, associated psychopathology and comorbid psychiatric disorders with a structured diagnostic interview (PACS) as well as parent and teacher ratings of psychopathology (SDQ; CPRS-R:L; CTRS-R:L). Analyses of variance, regression analyses, chi 2-tests or loglinear models were applied.
Results: Mean age and gender-standardized ratings of EL in children with ADHD were {\textrangle} 1.5 SD above the mean in normative samples. Severe EL ({\textrangle} 75th percentile) was associated with more severe ADHD core symptoms, primarily hyperactive-impulsive symptoms, and more comorbid oppositional defiant, affective and substance use disorders. Age, hyperactive-impulsive, oppositional, and emotional symptoms accounted for 30\% of EL variance; hyperactive-impulsive symptoms did not account for EL variance when coexisting oppositional and emotional problems were taken into account, but oppositional symptoms explained 12\% of EL variance specifically. Severity of EL in probands increased the severity of EL in siblings, but not the prevalence rates of ADHD or ODD. EL and ADHD does not co-segregate within families.
Conclusion: EL is a frequent clinical problem in children with ADHD. It is associated with increased severity of ADHD core symptoms, particularly hyperactivity-impulsivity, and more symptoms of comorbid psychopathology, primarily symptoms of oppositional defiant disorder (ODD), but also affective symptoms, and substance abuse. EL in ADHD seems to be more closely related to ODD than to ADHD core symptoms, and is only partly explainable by the severity of ADHD core symptoms and associated psychopathology. Although EL symptoms are transmitted within families, EL in children with ADHD does not increase the risk of ADHD and ODD in their siblings.},
  author       = {Sobanski, Esther and Banaschewski, Tobias and Asherson, Philip and Buitelaar, Jan and Chen, Wai and Franke, Barbara and Holtmann, Martin and Krumm, Bertram and Sergeant, Jospeh and Barke, Edmund and Stringaris, Argyris and Taylor, Eric and Anney, Richard and Ebstein, Richard P and Gill, Michael and Miranda, Ana and Mulas, Fernando and Oades, Robert D and Roeyers, Herbert and Rothenberger, Aribert and Steinhausen, Hans-Christoph and Faraone, Stephen V},
  issn         = {0021-9630},
  journal      = {JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY},
  keyword      = {TEMPERAMENT,HETEROGENEITY,SCALE,BOYS,BIPOLAR DISORDER,PATHWAY MODEL,DEVELOPMENTAL PSYCHOPATHOLOGY,DEFICIT-HYPERACTIVITY DISORDER,IRRITABILITY,ASSOCIATION},
  language     = {eng},
  number       = {8},
  pages        = {915--923},
  title        = {Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): clinical correlates and familial prevalence},
  url          = {http://dx.doi.org/10.1111/j.1469-7610.2010.02217.x},
  volume       = {51},
  year         = {2010},
}

Chicago
Sobanski, Esther, Tobias Banaschewski, Philip Asherson, Jan Buitelaar, Wai Chen, Barbara Franke, Martin Holtmann, et al. 2010. “Emotional Lability in Children and Adolescents with Attention Deficit/hyperactivity Disorder (ADHD): Clinical Correlates and Familial Prevalence.” Journal of Child Psychology and Psychiatry 51 (8): 915–923.
APA
Sobanski, E., Banaschewski, T., Asherson, P., Buitelaar, J., Chen, W., Franke, B., Holtmann, M., et al. (2010). Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): clinical correlates and familial prevalence. JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY, 51(8), 915–923.
Vancouver
1.
Sobanski E, Banaschewski T, Asherson P, Buitelaar J, Chen W, Franke B, et al. Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): clinical correlates and familial prevalence. JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY. 2010;51(8):915–23.
MLA
Sobanski, Esther, Tobias Banaschewski, Philip Asherson, et al. “Emotional Lability in Children and Adolescents with Attention Deficit/hyperactivity Disorder (ADHD): Clinical Correlates and Familial Prevalence.” JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY 51.8 (2010): 915–923. Print.