Temperament and character profiles for children with ADHD with and without tic disorders

Temperament Profiles Associated with Internalizing Symptoms and Externalizing Behavior in Adolescents with ADHD

The current study investigated temperament profiles associated with internalizing symptoms and externalizing behavior in adolescents with ADHD. Participants were 121 adolescents (90 males) with ADHD, ranging in age from 13 to 18 years (M = 15.40, SD = 1.59). Emotional and behavioral ratings were obtained using the Strengths and Difficulties Questionnaire (SDQ) and temperament profiles were assessed by administering the Temperament and Character Inventory (TCI). Multivariate profile analyses and post hoc tests revealed that youth high in internalizing symptoms were significantly higher in harm avoidance and lower in self-directedness. Youth high in externalizing behavior were significantly lower in cooperativeness. No cognitive differences were observed across groups, but youth high in externalizing behavior had more ADHD symptoms and greater impairment in daily life. Findings reveal unique temperament factors associated with comorbid concerns, which may have implications for adapting and personalizing intervention efforts based on these different profiles within adolescents with ADHD.

Can Temperament and Character Traits Be Used in the Diagnostic Differentiation of Children With ADHD?

ABSTRACT

In this study, it was aimed to determine the contributions of temperament and character traits to the diagnosis of attention deficit hyperactivity disorder (ADHD) in children. Thirty-six patients between the ages of 9 and 14 with a diagnosis of combined type ADHD and 39 healthy children were included in the study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Version and the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale parent form were used to assess hyperactivity/impulsivity and inattentiveness, and comorbid disorders. The Junior Temperament and Character Inventory-Revised form was used to evaluate temperament-character traits. The classification-based association rules (CBARs) method was used for finding rules predicting ADHD accurately. Low persistence and self-directedness scores, and higher disorderliness and fatigability subgroup scores were found in the ADHD group. In CBARs, the separation of children with ADHD from healthy controls could be made with 0.83 accuracy, 0.80 sensitivity, and 0.86 specificity. The results of our study support the view that temperament-character traits can help clinical diagnosis of ADHD.

Predicting the Adult Clinical and Academic Outcomes in Boys With ADHD: A 7- to 10-Year Follow-Up Study in China

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood and causes adverse effects on social functioning. The present study aimed to widely investigate the predictors, particularly childhood intelligence quotient (IQ) and family environment factors, on adult clinical and academic outcomes in boys with ADHD. Methods: A total of 101 boys with ADHD in a Chinese Han ADHD cohort were followed up 7-10 years later. Baseline ADHD symptoms were evaluated using the parent version of the ADHD Rating Scale-IV (ADHD-RS-IV) and the Chinese version of the Conners' Parent Rating Scale-Revised (CPRS-48). The intelligence of the child was tested by the China-Wechsler Intelligence Scale for Children (C-WISC), and family function was assessed by the Family Environment Scale-Chinese Edition (FES-CV). Adult ADHD persistence was defined using DSM-IV criteria for ADHD, and academic outcome fell into two categories: higher academic level group (studying in senior middle school or above) and lower academic level group (studying in vocational secondary schools or below). Results: Stepwise multiple logistic regression analysis revealed that the father's character, impulsive-hyperactive index as measured by the CPRS-48, and intellectual-cultural index as measured by the FES-CV independently predicted clinical outcomes in adults, with an AUC of 0.770 (p < 0.001, 95% CI = 0.678-0.863). The corresponding sensitivity and specificity were 0.743 and 0.727, respectively. The father's education level, family economic level, and verbal IQ (VIQ) on the C-WISC independently predicted adult academic outcomes, with an AUC of 0.870 (p < 0.001, 95% CI = 0.796-0.944). The corresponding sensitivity and specificity were 0.813 and 0.783, respectively. Conclusion: Initial ADHD symptom severity and IQ, father's character and education level, and family atmosphere and function affect adult clinical and academic outcomes. Addressing these areas early may help to improve the prognosis of ADHD into adulthood.

If you believe that breaking is possible, believe also that fixing is possible: a framework for ruptures and repairs in child psychotherapy

Safran and Muran's classic theoretical framework of alliance rupture and repair suggests effective techniques for repairing alliance ruptures. Accumulating empirical evidence suggests that successful processes of rupture and repair result in better therapeutic outcome and reduced dropout rates. Although ruptures in the alliance in child psychotherapy are frequent, little is known about how to repair them. The present paper proposes a model for identifying and repairing ruptures in child psychotherapy based on Safran and Muran. It consists of four phases: i) identifying the rupture and understanding its underlying communication message, ii) indicating the presence of the rupture, iii) accepting responsibility over the therapists' part in the rupture and emphasizing the children's active role as communicators of their distress, and iv) resolving the rupture using change strategies and meta-communication by constructing a narrative story. The theoretical rationale of each phase is explained in detail, and practical clinical guidelines are provided. Empirical studies are needed to examine the effectiveness of the proposed framework.