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Validity of DSM-IV ADHD Predominantly Inattentive and Combined Types: Relationship to Previous DSM Diagnoses/Subtype Differences

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ABSTRACT

Since 1980, three different diagnostic nomenclatures have been published regarding attention-deficit hyperactivity disorder (ADHD). These changing conceptualizations and diagnostic criteria have generated considerable confusion.

Objective

To examine the multidimensional DSM-IV ADHD criteria in relation to how children and adolescents with a previous DSM-III ADD diagnosis or a DSM-III-R ADHD diagnosis are diagnosed according to DSM-IV criteria. Method: Children whose original diagnoses were according to DSM-III and DSM-III-R criteria received retrospective diagnoses according to DSM-IV criteria. Results: Predominantly inattentive (n = 30) and combined types (n= 26) were compared on their previous DSM-III and DSM-III-R diagnoses and on demographic, behavioral, cognitive, and comorbidity variables. Predominantly inattentive and combined type diagnoses corresponded with DSM-III ADD/WO and ADD/H diagnoses, respectively. The DSM-III-R ADHD diagnosis did not correspond with either DSM-IV subtype. Children with the combined type diagnosis had more externalizing codiagnoses, and their parents reported more externalizing, delinquent, and aggressive behaviors. Children with the predominantly inattentive type had more math learning disability codiagnoses. Conclusion: Results support a multidimensional conceptualization of ADHD. There exists close correspondence between the DSM-III ADD/H type and the DSM-IV predominantly inattentive type and between the DSM-III ADD/H type and the DSM-IV combined type. J. Am. Acad. Child Adolesc. Psychiatry, 1996, 35(3):325–333.

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    Supported in part by a grant ( R01-HD26890–02) awarded to G.W.H. from the National Institute of Child Health and Human Development, National Institutes of Health.

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    Copyright © 1996 The American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.