Skip to main content
SpringerLink
Log in

A Comparison of the Neuropsychological Profiles of the DSM-IV Subtypes of ADHD

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

Recent research on the DSM-IV subtypes of attention-deficit/hyperactivity disorder (ADHD) has demonstrated that the subtypes differ in demographic characteristics, types of functional impairment, and profiles of comorbidity with other childhood disorders. However, little research has tested whether the subtypes differ in underlying neuropsychological deficits. This study compared the neuropsychological profiles of children without ADHD (n = 82) and children who met symptom criteria for DSM-IV Predominantly Inattentive subtype (ADHD-IA; n = 67), Predominantly Hyperactive Impulsive subtype (ADHD-HI; n = 14), and Combined subtype (ADHD-C; n = 33) in the areas of processing speed, vigilance, and inhibition. We hypothesized that children with elevations of inattention symptoms (ADHD-IA and ADHD-C) would be impaired on measures of vigilance and processing speed, whereas children with significant hyperactivity/impulsivity (ADHD-HI and ADHD-C) would be impaired on measures of inhibition. Contrary to prediction, symptoms of inattention best predicted performance on all dependent measures, and ADHD-IA and ADHD-C children had similar profiles of impairment. In contrast, children with ADHD-HI were not significantly impaired on any dependent measures once subclinical symptoms of inattention were controlled. Our results do not support distinct neuropsychological deficits in ADHD-IA and ADHD-C children, and suggest that symptoms of inattention, rather than symptoms of hyperactivity/impulsivity, are associated with neuropsychological impairment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65–94.

    Google Scholar 

  • Barkley, R. A., DuPaul, G. J., & McMurray, M. B. (1990). Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. Journal of Consulting and Clinical Psychology, 58, 775–789.

    Google Scholar 

  • Barkley, R. A., & Murphy, K. (1998). Attention-deficit hyperactivity disorder: A clinical workbook (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Berkson, J. (1946). Limitations of the application of fourfold table analysis to hospital data. Biometrics Bulletin, 2, 47–53.

    Google Scholar 

  • Borenstein, M., & Cohen, J. (1988). Statistical power analyses: A computer program. Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Carlson, C. L. (1986). Attention deficit disorder without hyperactivity: A review of preliminary experimental evidence. In B. B. Lahey & A. E. Kazdin (Eds.), Advances in clinical child psychology (pp. 153–175). New York: Plenum.

    Google Scholar 

  • Carlson, C. L., & Mann, M. (under review). Sluggish cognitive tempo predicts a different pattern of impairment in the Attention Deficit Hyperactivity Disorder, Predominantly Inattentive Type.

  • DeFries, J. C. (1985). Colorado reading project. In D. Gray & J. Kavanaugh J. (Eds.), Biobehavioral measures of dyslexia. Parkton, MD: York Press.

    Google Scholar 

  • DeFries, J. C., Filipek, P. A., Fulker, D. F., Olson, R. K., Pennington, B. F., Smith, S. D., & Wise, B.W. (1997). Colorado Learning Disabilities Research Center. Learning Disabilities, 8, 7–19.

    Google Scholar 

  • Dunn, L. M., & Markwardt, F. C. (1970). Examiner's manual: Peabody Individual Achievement Test. Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • DuPaul, G. J., Anastopoulos, A. D., McGoey, K. E., Power, T. J., Reid, R., & Ikeda, M. J. (1997). Teacher ratings of attention deficit hyperactivity disorder symptoms: Factor structure and normative data. Psychological Assessment, 9, 436–444.

    Google Scholar 

  • Eiraldi, R. B., Power, T. J., & Nezu, C. M. (1997). Patterns of comorbidity associated with subtypes of Attention-Deficit Hyperactivity Disorder among 6–to 12–year-old children. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 503–514.

    Google Scholar 

  • Faraone, S., Biederman, J., Weber,W., & Russell, R. (1998). Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: Results from a clinically referred sample. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 185–193.

    Google Scholar 

  • Gordon, M., & Mettelman, B. B. (1988). The assessment of attention: I. Standardization and reliability of a behavior-based measure. Journal of Clinical Psychology, 44, 682–690.

    Google Scholar 

  • Hart, E. L., Lahey, B. B., Loeber, R., Applegate, B., Green, S. M., & Frick, P. J. (1995). Developmental change in attention-deficit hyperactivity disorder in boys:Afour-year longitudinal study. Journal of Abnormal Child Psychology, 23, 729–749.

    Google Scholar 

  • Houghton, S., Douglas, G., West, J., Whiting, K., Wall, M., Langsford, S., Powell, L., & Carroll, A. (1999). Differential patterns of executive function in children with attention-deficit hyperactivity disorder according to gender and subtype. Journal of Child Neurology, 14, 801–805.

    Google Scholar 

  • Hynd, G. W., Nieves, N., Conner, R., Stone, P., Town, P., Becker, M. G., Lahey, B. B., & Lorys, A. R. (1989). Speed of neurocognitive processing in children with attention deficit disorder with and without hyperactivity. Journal of Learning Disabilities, 22, 573–579.

    Google Scholar 

  • Klorman, R., Hazel-Fernandez, L. A., Shaywitz, S. E., Fletcher, J. M., Marchione, K. E., Holahan, J. M., Stuebing, K. K., & Shaywitz, B. A. (1999). Executive functioning deficits in attention-deficit/ hyperactivity disorder are independent of oppositional defiant or reading disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1148–1155.

    Google Scholar 

  • Lahey, B. B., Applegate, B., McBurnett, K., Biederman, J., Greenhill, L., Hynd, G. W., Barkley, R. A., Newcornn, J., Jensen, P., Richters, J., Garfinkel, B., Kerdy, K. L., Rick, P. J., Ollendick, T., Perez, D., Hart, E. L., Waldman, I., & Shaffer, D. (1994). DSM-IV field trials for Attention Deficit Hyperactivity Disorder in children and adolescents. American Journal of Psychiatry, 151, 673–685.

    Google Scholar 

  • Lahey, B. B., Pelham, W. E., Schaughency, E. A., Atkins, M. S., Murphy, H. A., Hynd, G. W., Russo, M., Hartdagen, S., & Lorys-Vernon, A. (1988). Dimensions and types of attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 330–335.

    Google Scholar 

  • Lahey, B. B., Pelham, W. E., Stein, M. A., Loney, J., Trapani, C., Nugent, K., Kipp, H., Schmidt, E., Lee, S., Cale, M., Gold, E., Hartung, C. M., Willcutt, E. G., & Baumann, B. (1998). Validity of DSM-IV Attention-deficit/Hyperactivity Disorder for young children. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 695–702.

    Google Scholar 

  • Logan, G. D. (1994). On the ability to inhibit thought and action: A user's guide to the stop signal paradigm. In D. Dagenbach and T. H. Carr (Eds.), Inhibitory processes in attention, memory, and language (pp. 189–239). San Diego: Academic Press.

    Google Scholar 

  • Logan, G. D., Cowan, W. B., & Davis, K. A. (1984). On the ability to inhibit simple and choice reaction time responses: A model and a method. Journal of Experimental Psychology: Human Perception and Performance, 10, 276–291.

    Google Scholar 

  • Logan, G. D., Schachar, R. J., & Tannock, R. (1997). Impulsivity and inhibitory control. Psychological Science, 8, 60–64.

    Google Scholar 

  • Maedgen, J. W., & Carlson, C. L. (2000). Social functioning and emotional regulation in the attention deficit hyperactivity disorder subtypes. Journal of Clinical Child Psychology, 29, 30–42.

    Google Scholar 

  • McBurnett, K. (1997). Attention Deficit Hyperactivity Disorder: A review of diagnostic issues. In T. A. Widiger, A. J. Frances, H. Pincus, R. Ross, M. First, & W. Davis (Eds.), DSM sourcebook (pp. 111–143). Washington DC: American Psychiatric Association.

    Google Scholar 

  • McBurnett, K., Pfiffner, L. J., & Frick, P. J. (2001). Symptom Properties as a Function of ADHD Type: An Argument for Continued Study of Sluggish Cognitive Tempo. Journal of Abnormal Child Psychology, 29, 207–213.

    Google Scholar 

  • McBurnett, K., Pfiffner, L. J., Willcutt, E., Tamm, L., Lerner, M., Ottolini, Y. L., & Furman, M. B. (1999). Experimental cross-validation of the DSM-IV types of Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 17–24.

    Google Scholar 

  • Milich, R., Balentine, A. C., & Lynam, D. R. (in press).ADHD-combined type and ADHD predominately inattentive type are distinct and unrelated disorders. Clinical Psychology: Science and Practice.

  • Nigg, J. T. (1999). The ADHD response-inhibition deficit as measured by the stop task: Replication with DSM-IV combined type, extension, and qualification. Journal of Abnormal Child Psychology, 27, 393–402.

    Google Scholar 

  • Nigg, J. T., Blaskey, L., Huang-Pollack, C., & Rappley, M. D. (under review). Neuropsychological Executive Functions and ADHD DSM-IV Subtypes.

  • Nigg, J. T., Hinshaw, S. P., Carte, E. T., & Treuting, J. J. (1998). Neuropsychological correlates of childhood Attention-Deficit/Hyperactivity Disorder: Explainable by comorbid disruptive behavior or reading problems? Journal of Abnormal Psychology, 107, 468–480.

    Google Scholar 

  • Oosterlaan, J., & Sergeant, J. A. (1998). Response inhibition in ADHD, CD, comorbid ADHD C CD, anxious and normal children: A meta-analysis of studies with the stop task. Journal of Child Psychology and Psychiatry, 39, 411–426.

    Google Scholar 

  • Pennington, B. F., Grossier, D., & Welsh, M. C. (1993). Contrasting cognitive deficits in Attention Deficit Hyperactivity Disorder versus Reading Disability. Developmental Psychology, 29, 511–523.

    Google Scholar 

  • Pennington, B. F., & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37, 51–87.

    Google Scholar 

  • Piacentini, J. C., Cohen, P., & Cohen, J. (1992). Combining discrepant information from multiple sources: Are complex algorithms better than simple ones? Journal of Abnormal Child Psychology, 20, 51–62.

    Google Scholar 

  • Plomin, R., DeFries, J. C., McClearn, G. E., & Rutter, M. (1997). Behavioral genetics (3rd ed.). New York: Freeman.

    Google Scholar 

  • Reitan, R., & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery: Theory and clinical interpretation. Tucson: Neuropsychology Press.

    Google Scholar 

  • Rosvold, H. E., Mirsky, A. F., Sarason, I., Bransome, E. D., & Beck, L. H. (1956). A continuous performance test of brain damage. Journal of Consulting Psychology, 20, 343–350.

    Google Scholar 

  • Sandberg, S. (Ed.). (1996). Hyperactivity disorders of childhood. Cambridge monographs on child and adolescent psychiatry 2. New York: Cambridge University Press.

    Google Scholar 

  • Schaughency, E. A., Lahey, B. B., Hynd, G. W., Stone, P. A., & Piacentini, J. C. (1989). Neuropsychological test performance and the attention deficit disorders: Clinical utility of the Luria-Nebraska Neuropsychological Battery-Children's Revision. Journal of Consulting and Clinical Psychology, 57, 112–116.

    Google Scholar 

  • Sergeant, J. A., & Scholten, C. A. (1985). On data limitations in hyperactivity. Journal of Child Psychology and Psychiatry and Allied Disciplines, 26, 111–124.

    Google Scholar 

  • Wechsler, D. (1974). Examiner's manual: Wechsler Intelligence Scale for Children-Rev. New York: The Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (1981). Manual for the Wechsler Adult Intelligence Scale-Rev. San Antonio: The Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (1991). Manual for the Wechsler Intelligence Scale for Children (3rd ed.). San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Werry, J. S., Elkind, G. S., & Reeves, J. C. (1987). Attention deficit, conduct, oppositional, and anxiety disorders in children: III. Laboratory differences. Journal of Abnormal Child Psychology, 15, 409–428.

    Google Scholar 

  • Willcutt, E. G., Pennington, B. F., Chhabildas, N. A., Friedman, M. C., & Alexander, J. A. (1999). Psychiatric comorbidity associated with DSM-IV ADHD in a nonreferred sample of twins. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1355–1362.

    Google Scholar 

  • Willcutt, E. G., Pennington, B. F., & DeFries, J. C. (2000). Etiology of inattention and hyperactivity/impulsivity in a community sample of twins with learning difficulties. Journal of Abnormal Child Psychology, 28, 149–159.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Denver, Denver, Colorado

    Nomita Chhabildas & Bruce F. Pennington

  2. University of Colorado Institute for Behavioral Genetics, Boulder, Colorado

    Erik G. Willcutt

Authors
  1. Nomita Chhabildas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bruce F. Pennington
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Erik G. Willcutt
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chhabildas, N., Pennington, B.F. & Willcutt, E.G. A Comparison of the Neuropsychological Profiles of the DSM-IV Subtypes of ADHD. J Abnorm Child Psychol 29, 529–540 (2001). https://doi.org/10.1023/A:1012281226028

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1012281226028

Search

Navigation