Objective:To compare the neuro-cognitive profiles among initial clinic referred medication naive sample of children with anxiety disorders (ANXs) and ADHD in a youth sample. Method: Three groups of patients, ANX (n = 40), ADHD (n = 48), and ANX + ADHD (n = 33), aged 7 to 12 years, were compared with respect to their Physical and Neurological Examination for Subtle Signs (PANESS) and cognitive measures (digit span, digit symbol, Trail Making Test [TMT]-A and TMT-B, Stroop test). Results: ADHD group performed worse than the other two groups with regard to soft signs and cognitive test performance; ANX + ADHD were impaired relative to ANX but better than ADHD. Significant differences were found for gait and station problems, overflows and timed movements, TMT error points, and Stroop interference scores. ADHD patients had more difficulty in warding off irrelevant responses and lower speed of time-limited movements. Conclusion: This clinical evaluation study suggested that ANX and ADHD seem to have significantly different neuro-cognitive features: Poorest outcomes were observed among children with ADHD; rather than problems of attention, inhibitory control deficits were the most prominent differences between ANX and ADHD; and the presence of ANX appears to have mitigating effect on ADHD-related impairments.
AchenbachT. M. (1991a). Manual for the child behavior checklist and 1991 profile. Burlington: Department of Psychiatry, University of Vermont.
2.
AchenbachT. M. (1991b). Manual for the teacher’s report form and 1991 profile. Burlington: Department of Psychiatry, University of Vermont.
3.
AchenbachT. M.RescorlaL. A. (2001). Manual for the ASEBA school-age forms & profiles. Burlington: Research Centre for Children, Youth and Families, University of Vermont.
4.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.
5.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
6.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
7.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
8.
BarkleyR. A. (1990). A critique of current diagnostic criteria for attention deficit hyperactivity disorder: Clinical and research implications. Journal of Developmental and Behavioral Pediatrics, 11, 343-352.
9.
BrownT. E. (2008). ADD/ADHD and impaired executive function in clinical practice. Current Psychiatry Reports, 10, 407-411.
10.
CardoE.CasanovasS.delaBandaG.ServeraM. (2008). Soft neurological signs: Are they of any value in the assessment and diagnosis of attention deficit hyperactivity disorder?Revista de Neurolgia, 46(Suppl 1), 51-54.
11.
ColeW. R.MostofskyS. H.LarsonJ. C.DencklaM. B.MahoneE. M. (2008). Age-related changes in motor subtle signs among girls and boys with ADHD. Neurology, 71, 1514-1520.
12.
DegnanK. A.FoxN. A. (2007). Behavioral inhibition and anxiety disorders: Multiple levels of a resilience process. Developmental Psychopathology, 19, 729-746.
13.
DencklaM. B. (1985). Revised neurological examination for subtle signs. Psychopharmacology Bulletin, 21, 773-800.
14.
DumenciL.ErolN.AchenbachT. M.SimsekZ. (2004). Measurement structure of the Turkish translation of the Child Behavior Checklist using confirmatory factor analytic approaches to validation of syndromal constructs. Journal of Psychological Abnormalities in Children, 32, 335-340.
15.
EmckC.BosscherR.BeekP.DoreleijersT. (2009). Gross motor performance and self-perceived motor competence in children with emotional, behavioral, and pervasive developmental disorders: A review. Developmental Medicine & Child Neurology, 51, 501-517.
16.
ErezO.GordonC. R.SeverJ.SadehA.MintzM. (2004). Balance dysfunction in childhood anxiety: Findings and theoretical approach. Journal of Anxiety Disorders, 18, 341-356.
17.
ErolN.SimsekZ. (2000). Mental health of Turkish children: Behavioral and emotional problems reported by parents, teachers, and adolescents. In SinghN. N.LeungJ. P.SinghA. N. (Eds.), International perspectives on child & adolescent mental health (pp. 223-247). London, England: Elsevier Science.
18.
FriedmanN. P.MiyakeA. (2004). The relations among inhibition and interference control functions: A latent-variable analysis. Journal of Experimental Psychology: General, 133, 101-135.
19.
GhanizadehA. (2011). Predictors of postural stability in children with ADHD. Journal of Attention Disorders, 15, 604-610.
20.
GoklerB.UnalF.PehlivantürkB.KültürÇ. E.AkdemirD.TanerY. (2004). Okul çagi çocuklari icin duygulanim bozukluklari ve sizofreni gorusme cizelgesi–simdi ve yasam boyu sekli—Türkce uyarlamasi’nin gecerlik ve guvenirligi [The reliability and validity of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version- Turkish version (K-SADS-PL-K)]. Turkish Journal of Child and Adolescent Mental Health, 11, 109-116.
21.
GoldenC. J. (1976) Identification of brain disorders by the Stroop Color and Word Test. Journal of Clinical Psycholology, 32, 654-658.
22.
GreenbergP. E.SisitskyT.KesslerR. C.FinkelsteinS. N.BerndtE. R.DavidsonJ. R.. . . FyerA. J. (1999). The economic burden of anxiety disorders in the 1990s. Journal of Clinical Psychiatry, 60, 427-435.
23.
GuyW., (1976). ECDEU assessment manual for psychopharmacology. Rockville, MD: National Institute for Mental Health, U.S. Department of Health, Education, and Welfare Publication (ADM)76-338.
24.
HollingsheadA. B.RedlichF. C. (2007). Social class and mental illness: A community study. 1958. American Journal of Public Health, 97, 1756-1757.
25.
JansiewiczE. M.GoldbergM. C.NewschafferC. J.DencklaM. B.LandaR.MostofskyS. H. (2006). Motor signs distinguish children with high functioning autism and Asperger’s syndrome from controls. Journal of Autism and Developmental Disorders, 36, 613-621.
26.
JarrettM. A.OllendickT. H. (2008). A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety: Implications for future research and practice. Clinical Psychology Review, 28, 1266-1280.
27.
JarrettM. A.WolffJ. C.DavisT. E.CowartM. J.OllendickT. H. (2012). Characteristics of children with ADHD and comorbid anxiety. Journal of Attention Disorders. Advance online publication. doi:10.1177/1087054712452914
28.
JensenP. S.HinshawS. P.KraemerH. C.LenoraN.NewcornJ. H.AbikoffH. B.. . . VitielloB. (2001). ADHD comorbidity findings from the MTA study: Comparing comorbid subgroups. Journal of the American Academy of Child & Adolescent Psychiatry, 40, 147-158.
29.
KaufmanJ.BirmaherB.BrentD.RaoU.FlynnC.MoreciP.. . . RyanN. (1997). Schedule for Affective Disorders and Schizophrenia for School Age Children–present and life time version (KSADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980-988.
30.
KesslerR. C.DemlerO.FrankR. G.OlfsonM.PincusH. A.WaltersE. E.. . . ZaslavskyA. M. (2005). Prevalence and treatment of mental disorders, 1990 to 2003. The New England Journal of Medicine, 352, 2515-2523.
31.
KonicarovaJ.BobP.RabochJ. (2014). Balance deficits and ADHD symptoms in medication-naïve school-aged boys. Neuropsychiatric Disease and Treatment, 15, 85-88.
32.
LarsonJ. C.MostofskyS. H.GoldbergM. C.CuttingL. E.DencklaM. B.MahoneE. M. (2007). Effects of gender and age on motor exam in typically developing children. Development Neuropsychology, 32, 543-562.
33.
MacLeodC. M. (1991). Half a century of research on the Stroop effect: An integrative review. Psychology Bulletin, 109, 162-203.
34.
ManassisK.TannockR.BarbosaJ. (2000). Dichotic listening and response inhibition in children with comorbid anxiety disorders and ADHD. Journal of American Academy of Child and Adolescent Psychiatry, 39, 1152-1159.
35.
ManassisK.TannockR.YoungA.Francis-JohnS. (2007). Cognition in anxious children with attention deficit hyperactivity disorder: A comparison with clinical and normal children. Behavioral and Brain Functions, 3(4).
36.
MaoH. Y.KuoL. C.YangA. L.SuC. T. (2014). Balance in children with attention deficit hyperactivity disorder-combined type. Research in Developmental Disabilities, 35, 1252-1258.
37.
MostofskyS. H.SimmondsD. J. (2008). Response inhibition and response selection: Two sides of the same coin. Journal of Cognitive Neuroscience, 20, 751-761.
38.
NiggC. R. (2001). Explaining adolescent exercise behavior change: A longitudinal application of the transtheoretical model. Annals of Behavioral Medicine, 23, 11-20.
39.
OosterlaanJ.SergeantJ. A. (1998). Response inhibition and response re-engagement in attention-deficit/hyperactivity disorder, disruptive, anxious and normal children. Behavioural Brain Research, 94, 33-43.
40.
PasiniA.D’agatiE. (2009). Pathophysiology of NSS in ADHD. The World Journal of Biological Psychiatry: The Official Journal of the World Federation of Societies of Biological Psychiatry, 10, 495-502.
41.
PasiniA.D’AgatiE.PitziantiM.CasarelliL.CuratoloP. (2012). Motor examination in children with Attention-deficit/hyperactivity Disorder and Asperger Syndrome. Acta Paediatrica, 101, 15-18.
42.
PatankarV. C.SangleJ. P.ShahH. R.DaveM.KamathR. M. (2012). Neurological soft signs in children with attention deficit hyperactivity disorder. Indian Journal of Psychiatry, 54, 159-165.
43.
PliszkaS. R. (1989). Effect of anxiety on cognition, behavior, and stimulant response in ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 28, 882-887.
44.
PliszkaS. R. (1992). Comorbidity of attention-deficit hyperactivity disorder and overanxious disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 31, 197-203.
45.
SavaşirI.ŞahinN. (1978). WISC uyarlama çalişmalari ön rapor -I [Adaptation of WISC for Turkish Population - Preliminary Report (1)]. Turkish Journal of Psychology, 1, 33-37.
46.
SchatzD. B.RostainA. L. (2006). ADHD with comorbid anxiety: A review of the current literature. Journal of Attention Disorders, 10, 141-149.
47.
SkirbekkB.HansenB. H.OerbeckB.Wentzel-LarsenT.KristensenH. (2012). Motor impairment in children with anxiety disorders. Psychiatry Research, 198, 135-139.
48.
SkountiM.PhilalithisA.GalanakisE. (2007). Variations in prevalence of attention deficit hyperactivity disorder worldwide. European Journal of Pediatric Surgery, 166, 117-123.
49.
SpreenO.StraussE. (1998). A compendium of neuropsychological tests: Administration, norms and commentary (2nd ed.). New York: Oxford University Press.
50.
StinsJ. F.LedebtA.EmckC.van DokkumE. H.BeekP. J. (2009). Patterns of postural sway in high anxious children. Behavior and Brain Function, 2, 5-42.
51.
TsengM. H.HendersonA.ChowS. M.YaoG. (2004). Relationship between motor proficiency, attention, impulse, and activity in children with ADHD. Developmental Medicine and Child Neurology, 46, 381-388.
52.
VitielloB.StoffD.AtkinsM.MahoneyA. (1990). Soft neurological signs and impulsivity in children. Journal of Developmental and Behavioral Pediatrics, 11, 112-115.
53.
VloetT. D.MarxI.Kahraman-LanzerathB.ZepfF. D.Herpertz-DahlmannB.KonradK. (2010). Neurocognitive performance in children with ADHD and OCD. Journal of Abnormal Child Psychology, 38, 961-969.
