The relationship between executive function and comorbid diagnoses in ADHD children is examined. One hundred six children between 7 and 15 years of age are assessed using the Tower of London (TOL), a test of executive function, and the Kiddie Schedule of Affective Disorders and Schizophrenia, Present and Lifetime Version, a diagnostic interview. All children met the diagnostic criteria for ADHD. A majority of the children had comorbid anxiety disorders, mood disorders, or oppositional defiant disorder. Measures on the TOL are total move score, total initiation time, and total rule violations. Age is predictive in all three measures of executive function as assessed by the TOL. Gender is predictive of total initiation time and total rule violations. Comorbid disorders are found to not have significance on executive function as measured by the TOL. This study concludes that comorbid disorders may not affect executive function
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2.
Anderson, P., Anderson, V., & Lajoie, G. (1996). The Tower of London test: Validation and standardization for pediatric populations. The Clinical Neuropsychologist, 10(1), 54-65.
3.
Baker, S. C., Rogers, R. D., Owen, A. M., Frith, C. D., Dolan, R. J., Frackowiak, R. S., et al. (1996). Neural systems engaged by planning: A PET study of the Tower of London task. Neuropsychologia, 34(6), 515-526.
4.
Barkley, R. A. (1991). Attention deficit hyperactivity disorder. Psychiatric Annals, 21(12), 725-733.
5.
Barkley, R. A. (1996). ADD research: A look at today and tomorrow. In Attention!. Landover, MD: Children and Adults With Attention Deficit Disorder (CHADD). Retrieved January 31, 1999, from http://www.chadd.org/barkley.htm
6.
Barkley, R. A. (1997). ADHD and the nature of self-control. New York: Guilford.
7.
Barkley, R. A. (1998). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (2nd ed.). New York: Guilford.
8.
Barkley, R. A., & Biederman, J. (1997). Towards a broader definition of the age of onset criterion for attention deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 36(9), 1204-1210.
9.
Biederman, J., Faraone, S. V., Keenan, K., Steingard, R., & Tsuang, M. T. (1991). Familial association between attention deficit disorder and anxiety disorders. American Journal of Psychiatry, 148(2), 251-256.
10.
Biederman, J., Faraone, S. V., Mick, E., Williamson, S., Wilens, T. E., Spencer, T. J., et al. (1999). Clinical correlates of ADHD in females. Journal of the American Academy of Child and Adolescent Psychiatry, 38(8), 966-975.
11.
Biederman, J., Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry, 148(5), 564-577.
12.
Bird, H. R., Gould, M. S., & Staghezza, B. M. (1993). Patterns of diagnostic comorbidity in a community sample of children aged 9 to 16 years. Journal of the American Academy of Child and Adolescent Psychiatry, 32(2), 361-368.
13.
Brown, T. E. (2000). Emerging understandings of attention-deficit disorders and comorbidities. In T. E. Brown (Ed.), Attention-deficits and comorbidities in children, adolescents, and adults (pp. 3-55). Washington, DC: American Psychiatric Press.
14.
Conners, C. K., & Jett, J. L. (1999). Attention deficit hyperactivity disorder (in adults and children): The latest assessment and treatment strategies. Kansas City, MO: Compact Clinicals.
15.
Corkum, P., & Siegel, L. (1993). Is the continuous performance task a valuable research tool for use with children with attention-deficithyperactivity disorder?Journal of Child Psychology and Psychiatry, 34(7), 1217-1239.
16.
Culbertson, W. C., & Zillmer, E. A. (1998a). The construct validity of the Tower of London DX as a measure of the executive functioning of ADHD children. Assessment, 5(3), 215-226.
17.
Culbertson, W. C., & Zillmer, E. A. (1998b). The Tower of London DX: A standardized approach to assessing executive functioning in children. Archives of Clinical Neurology, 13(3), 285-301.
18.
Culbertson, W. C., & Zillmer, E. A. (1999). Tower of London: Examiner’s manual. North Towanda, NY: Multi-Health Systems.
19.
Denckla, M. B. (1996). A theory and model of executive function: A neuropsychological perspective. In G. R. Lyon & N. A. Krasnegor (Eds.), Attention, memory and executive function (pp. 263-277). Baltimore: Paul H. Brooks.
20.
Faraone, S. V., Biederman, J., Weber, W., & Russell, R. L. (1998). Psychiatric, neuropsychological, and psychosocial features of DSMIV 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.
21.
Gall, M. D., Borg, W. R., & Gall, J. P. (1996). Educational research: An introduction (6th ed.). White Plains, NY: Longman.
22.
Gaub, M., & Carlson, C. L. (1997). Gender differences in ADHD: A meta-analysis and critical review. Journal of the American Academy of Child and Adolescent Psychiatry, 36(8), 1036-1045.
23.
Gershon, J. (2002). A meta-analytic review of gender differences in ADHD. Journal of Attention Disorders, 5(3), 143-154.
24.
Gnys, J. A., & Willis, W. G. (1991). Validation of executive function tasks with young children. Developmental Neuropsychology, 7(4), 487-501.
25.
Gorman, J. M. (2001). Generalized anxiety disorder. Clinical Cornerstone, 3(3), 37-46.
26.
Gresham, F. M. (2000). Comorbidity of conduct problems and ADHD: Identification of “fledgling psychopaths.”Journal of Emotional and Behavioral Disorders, 8(2), 83-93.
27.
Jensen, P. S., Kettle, L., Roper, M. T., Sloan, M. T., Dulcan, M. K., Hoven, C., et al. (1999). Are stimulants overprescribed? Treatment of ADHD in four U.S. communities. Journal of the American Academy of Child and Adolescent Psychiatry, 38(7), 797-804.
28.
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADSPL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36(7), 980-988.
29.
Krikorian, R., Bartok, J., & Gay, N. (1994). Tower of London procedure: A standard method and developmental data. Journal of Clinical and Experimental Neuropsychology, 16(6), 840-850.
30.
Leibson, C. L., Katusic, S. K., Barbaresi, W. J., Ransom, J., & O’Brien, P. C. (2001). Use and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder. Journal of the American Medical Association, 285(1), 60-66.
31.
Levin, H. S., Culhane, K. A., Hartmann, J., Evankovich, K., Mattson, A. J., Harwood, H., et al. (1991). Developmental changes in performance on tests of purported frontal lobe functions. Developmental Neuropsychology, 7(3), 377-396.
32.
Levin, H. S., Fletcher, J. M., Kufera, J. A., Harward, H., Lilly, M. A., Mendelsohn, D., et al. (1996). Dimensions of cognition measured by the Tower of London and other cognitive tasks in head-injured children and adolescents. Developmental Neuropsychology, 12(1), 17-34.
33.
Levin, H. S., Mendelsohn, D., Lilly, M. A., Fletcher, J. M., Culhane, K. A., Chapman, S. B., et al. (1994). Tower of London performance in relation to magnetic resonance imaging following closed head injury in children. Neuropsychology, 8(2), 171-179.
34.
Mezzacappa, E., Kindlon, D., & Earls, F. (1999). Relations of age to sognitive and motivational elements of impulse control in boys with and without externalizing behavior problems. Journal of Abnormal Child Psychology, 27(2), 473-583.
35.
Murji, S., & DeLuca, J. W. (1998). Preliminary validity of the cognitive function checklist: Prediction of Tower of London performance. The Clinical Neuropsychologist, 12(3), 358-364.
36.
Oosterlaan, J., Logan, G. D., & Sergeant, J. A. (1998). Response inhibition in AD/HD, CD, and comorbid AD/HD + CD, anxious and control children: A meta-analysis of studies with the stop task. Journal of Child Psychology and Psychiatry, 39(3), 411-425.
37.
Pennington, B. F., Bennetto, L., McAleer, O., Roberts, R. J., Jr., & Krasnegor, N. (1996). Executive functions and working memory: Theoretical and measurement issues. In G. R. Lyon (Ed.), Attention, memory, and executive function (pp. 327-348). Baltimore: Paul H. Brookes.
38.
Pillow, D. R., Pelham, W. E., Hoza, B., Molina, B. S. G., & Stultz, C. H. (1998). Confirmatory factor analyses examining attention deficit hyperactivity disorder symptoms and other childhood disruptive behaviors. Journal of Abnormal Child Psychology, 26(4), 293-300.
39.
Pineda, D., Ardila, A., & Rosselli, M. (1999). Neuropsychological and behavioral assessment of ADHD in seven-to-twelve year old children: A discriminant analysis. Journal of Learning Disabilities, 32(2), 159-173.
40.
Pliszka, S. R. (1989). Effect of anxiety on cognition, behavior, and stimulant responding in ADHD. Journal of American Academy of Child and Adolescent Psychiatry, 28(6), 882-887.
41.
Pliszka, S. R., Carlson, C. L., & Swanson, J. M. (1999). ADHD with comorbid disorders: Clinical assessment and management. New York: Guilford.
42.
Popper, C. W. (2000). Pharmacological alternatives to psychostimulants for the treatment of attention-deficit hyperactivity disorder. In D. E. Stubbe (Ed.), Child and adolescent psychiatric clinics of North America: Vol. 9. Attention-deficit/hyperactivity disorder (pp. 605-646). Philadelphia: W. B. Saunders.
43.
Quinn, P. O., & Nadeau, K. G. (2000). Gender issues and attention deficit disorder. In P. J. Accardo, T. A. Blondis, B. Y. Whitman, & M. A. Stein (Eds.), Pediatric habilitation: Vol. 10. Attention deficits and hyperactivity in children and adults: Diagnosis, treatment, management (pp. 215-227). New York: Marcel Dekker.
44.
Roberts, R. J., & Pennington, B. F. (1996). An interactive framework for examining prefrontal cognitive processes. Developmental Neuropsychology, 12(1), 105-126.
45.
Schachar, R., Mota, V. L., Logan, G. D., Tannock, R., & Klim, P. (2000). Confirmation of an inhibitory control deficit in attention-deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 28(3), 227-235.
46.
Schachar, R., & Tannock, R. (1995). Test of four hypotheses for the comorbidity of attention-deficit hyperactivity disorder and conduct disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 34(5), 639-649.
47.
Schachar, R. J., Tannock, R., & Logan, G. (1993). Inhibitory control, impulsiveness, and attention deficit hyperactivity disorder. Clinical Psychology Review, 13, 721-739.
48.
Schnirman, G. M., Welsh, M. C., & Retzlaff, P. D. (1998). Development of the Tower of London-Revised. Assessment, 5(4), 355-360.
49.
Seidman, L. J., Biederman, J., Faraone, S. V., Milberger, S., Dennis, N., Seiverd, K., et al. (1995). Effects of family history and comorbidity on the neuropsychological performance of children with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 34(8), 1015-1024.
50.
Seidman, L. J., Biederman, J., Faraone, S. V., Weber, W., Mennin, D., & Jones, J. (1997). A pilot study of neuropsychological function in girls with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 36(3), 366-373.
51.
Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society of London: Series B, Biological Sciences, 298(1089), 199-209.
52.
Siegel, L. S., & Ryan, E. B. (1989). The development of working memory in normally achieving and subtypes of learning disabled children. Child Development, 60(4), 973-980.
53.
Tannock, R., Ickowicz, A., & Schachar, R. (1995). Differential effects of methylphenidate on working memory in ADHD children with and without comorbid anxiety. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 886-896.
54.
The Multimodal Treatment Study of Children With ADHD Cooperative Group. (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56(12), 1073-1086.
55.
Welsh, M. C., & Pennington, B. F. (1988). Assessing frontal lobe functioning in children: Views from developmental psychology. Developmental Neuropsychology, 4(3), 199-230.
56.
Welsh, M. C., Pennington, B. F., & Grossier, D. B. (1991). A normative-developmental study of executive function: A window on prefrontal function in children. Developmental Neuropsychology, 7(2), 131-149.
57.
Willcutt, E. G., Pennington, B. F., Boada, R., Tunick, R. A., Ogline, J., Chhabildas, N. A., et al. (1999). A comparison of the cognitive deficits in reading disability and attention-deficit/hyperactivity disorder. Journal of Abnormal Psychology, 110, 157-172.
58.
Willcutt, E. G., Pennington, B. F., Chhabildas, N. A., Friedman, M. C., & Alexander, J. (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.
