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ADHD Correlates, Comorbidity, and Impairment in Community and Treated Samples of Children and Adolescents

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Abstract

Patterns of correlates, comorbidity and impairment associated with attention-deficit hyperactivity disorder (ADHD) in children and youth were examined in representative samples from the community and from treatment facilities serving medically indigent youth in Puerto Rico. Information from caretakers and youths was obtained using the Diagnostic Interview Schedule for Children, (version IV), measures of global impairment, and a battery of potential correlates. In the community (N = 1,896) and the treated samples (N = 763), 7.5 and 26.2% of the children, respectively, met criteria for DSM-IV ADHD in the previous year. Although the prevalence rates and degree of impairment differed, the general patterns of correlates, comorbidity and impairment were similar in both populations. The exceptions were associated with conduct disorder, anxiety, impairment in the ADHD comorbid group, and age factors that appeared to be related to selection into treatment.

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Notes

  1. Let BM be the regression coefficient for the community sample, and SM be its standard error. Let BL be the comparable coefficient for the clinical sample, and SL be its standard error. The test statistic, which under the null hypothesis is asymptotically distributed as a standard normal deviate, is \( {z = {\left( {B_{M} - B_{L} } \right)}} \mathord{\left/ {\vphantom {{z = {\left( {B_{M} - B_{L} } \right)}} {{\left( {S_{M} ^{2} + S_{L} ^{2} } \right)}}}} \right. \kern-\nulldelimiterspace} {{\left( {S_{M} ^{2} + S_{L} ^{2} } \right)}}^{{1 \mathord{\left/ {\vphantom {1 2}} \right. \kern-\nulldelimiterspace} 2}} . \)

  2. After adjusting for selection variables, it appears that children with ADHD in both samples might be even less likely to experience grade failure than other children.

  3. Note, however, that caretaker’s childhood I or HI approached significance (p = 0.06) in the community sample.

  4. The strength of the association between CD and ADHD was so much stronger in the community that even the conditional rates of disorder shown in columns 2 and 3 were higher in the community. This was despite the fact that overall rates of both ADHD and CD were lower in the community.

  5. In addition, the previous models were augmented adjusting for demographic variables. However, since the latter did not alter significantly the patterns of associations, the results presented in last column in Table 4 are adjusted only for other comorbid conditions.

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Acknowledgement

Data for this study were obtained through NIMH funded grants: MH54827. Canino (PI) and P01-MH 59876-02 Alegría (PI), and from P20 MD000537-01 Canino (PI) from the National Center for Minority Health Disparities. We thank Lizbeth Fabregas, the project director of the study, Graciela Reina and Adrianne Anderson for their generous assistance, and Bill Sribney for his comments on an earlier version of the manuscript.

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Authors and Affiliations

  1. Behavioral Sciences Research Institute (BSRI), University of Puerto Rico (UPR), San Juan, Puerto Rico

    José J. Bauermeister, Rafael Ramírez, Milagros Bravo, Margarita Alegría, Alfonso Martínez-Taboas, Ligia Chávez, Maritza Rubio-Stipec, Pedro García, Julio C. Ribera & Glorisa Canino

  2. Department of Psychology, New York University, New York, NY, USA

    Patrick E. Shrout

  3. Graduate School of Education, UPR, San Juan, Puerto Rico

    Milagros Bravo

  4. Carlos Albizu University, San Juan, Puerto Rico

    Alfonso Martínez-Taboas

  5. San Juan Veterans Administration Hospital, San Juan, Puerto Rico

    Julio C. Ribera

  6. Department of Psychiatry, Harvard University, Cambridge, MA, USA

    Margarita Alegría

  7. Cambridge Health Alliance, Cambridge, MA, USA

    Margarita Alegría

  8. 177 Las Caobas St, San Juan, Puerto Rico, 00927

    José J. Bauermeister

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  1. José J. Bauermeister
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Correspondence to José J. Bauermeister.

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Bauermeister, J.J., Shrout, P.E., Ramírez, R. et al. ADHD Correlates, Comorbidity, and Impairment in Community and Treated Samples of Children and Adolescents. J Abnorm Child Psychol 35, 883–898 (2007). https://doi.org/10.1007/s10802-007-9141-4

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