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Articles by M. J Gruber
Total Records ( 2 ) for M. J Gruber
  R. C Kessler , J. G Green , L. A Adler , R. A Barkley , S Chatterji , S. V Faraone , M Finkelman , L. L Greenhill , M. J Gruber , M Jewell , L. J Russo , N. A Sampson and D. L. Van Brunt
 

Context  Controversy exists about the appropriate criteria for a diagnosis of adult attention-deficit/hyperactivity disorder (ADHD).

Objective  To examine the structure and symptoms most predictive of DSM-IV adult ADHD.

Design  The data are from clinical interviews in enriched subsamples of the National Comorbidity Survey Replication (n = 131) and a survey of a large managed health care plan (n = 214). The physician-administered Adult ADHD Clinical Diagnostic Scale (ACDS) was used to assess childhood ADHD and expanded symptoms of current adult ADHD. Analyses examined the stability of symptoms from childhood to adulthood, the structure of adult ADHD, and the adult symptoms most predictive of current clinical diagnoses.

Setting  The ACDS was administered telephonically by clinical research interviewers with extensive experience in the diagnosis and treatment of adult ADHD.

Participants  An enriched sample of community respondents.

Main Outcome Measure  Diagnoses of DSM-IV /ACDS adult ADHD.

Results  Almost half of the respondents (45.7%) who had childhood ADHD continued to meet the full DSM-IV criteria for current adult ADHD, with 94.9% of these patients having current attention-deficit disorder and 34.6% having current hyperactivity disorder. Adult persistence was much greater for inattention than for hyperactivity/impulsivity. Additional respondents met the full criteria for current adult ADHD despite not having met the full childhood criteria. A 3-factor structure of adult symptoms included executive functioning (EF), inattention/hyperactivity, and impulsivity. Stepwise logistic regression found EF problems to be the most consistent and discriminating predictors of adult DSM-IV /ACDS ADHD.

Conclusions  These findings document the greater persistence of inattentive than of hyperactive/impulsive childhood symptoms of ADHD in adulthood but also show that inattention is not specific to ADHD because it is strongly associated with other adult mental disorders. In comparison, EF problems are more specific and consistently important predictors of DSM-IV adult ADHD despite not being in the DSM-IV, suggesting that the number of EF symptoms should be increased in the DSM-V/ICD-11.

  R. C Kessler , K. A McLaughlin , J. G Green , M. J Gruber , N. A Sampson , A. M Zaslavsky , S Aguilar Gaxiola , A. O Alhamzawi , J Alonso , M Angermeyer , C Benjet , E Bromet , S Chatterji , G de Girolamo , K Demyttenaere , J Fayyad , S Florescu , G Gal , O Gureje , J. M Haro , C. y Hu , E. G Karam , N Kawakami , S Lee , J. P Lepine , J Ormel , J Posada Villa , R Sagar , A Tsang , T. B Ustun , S Vassilev , M. C Viana and D. R. Williams
 

Background

Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders.

Aims

To examine joint associations of 12 childhood adversities with first onset of 20 DSM–IV disorders in World Mental Health (WMH) Surveys in 21 countries.

Method

Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM–IV disorders with the WHO Composite International Diagnostic Interview (CIDI).

Results

Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries.

Conclusions

Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.

 
 
 
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