The third report of the series of a comprehensive study on behavioralpronblems children,followed the population and clinical studies reproted in the previous twopapers,deepens particularly into physiological and biochemical arears through EEG andurine MHPG assessments.Based on the data of EEG routine and computer analyses andfluorometric estimation of urine MHPG?SO_4 with a modified method,together with theprevious findings of neurophysiological examination,it was found that behavioral problemchildren were with significantly delayed development of central nervious system.Both the ab-normal EEG and urine MHPG associate closely with harmful factors seen in the period ofmother pregnancy and genetic factors too,supporting the hypothesis of biological basis forthe development of child behavioral problem,at least in partial identified children.However,it was also revealed in a multi-step regression analysis that these abnormalities in EEG andurine MHPG assesments showed a close relations with certain psychosocial varibles,such asbad temparament,hyperactivity,unstability of emotion and negative family issues.

Objective:To study the differences of brain functions between children with attention deficit hyperactivity disorder(ADHD) predominantly inattentive (ADHD-I) and combined(ADHD-C) subtypes in resting state using functional magnetic resonance imaging(fMRI).Methods:A newly reported regional homogeneity(ReHo) approach was used to analyze blood oxygen level-dependent fMRI(BOLD-fMRI) data in resting state among 6 ADHD-C,9 ADHD-I and 15 normal control boys.Results:The brain regions showing differences among the three groups included bilateral frontal lobe,right cuneus and right inferior temporal gyrus.Compared with the normal controls,ADHD-C showed decreased ReHo in left frontal lobe and right inferior temporal gyrus,ADHD-I showed decreased ReHo in bilateral frontal and temporal lobe and right cerebellum and increased ReHo in bilateral occipital lobe and right inferior parietal gyrus.There were no brain regions showing different ReHo between ADHD-C and ADHD-I.Conclusion:Although both ADHD-C and ADHDI showed abnormal neural activity in resting state compared with the normal controls,there were no differences for brain functions in resting state between ADHD-C and ADHD-I.

This paper is a literature review of impact of comorbidity on the executive function(EF) of patients with attention deficit hyperactivity disorder(ADHD).Over 80% of children and adolescents and 65%-89% of adults with ADHD suffer from one or more additional psychiatric disorders.EF deficits in ADHD of all ages can be demonstrated to be independent of psychiatric comorbidity.The presence of comorbid learning disorder(LD) and mood disorder(MD) appears to increase the EF deficits in ADHD which seems to be decreased by the the presence of comorbid anxiety disorder and oppositional defiant disorder and conduct disorder(ODD/CD).However,the comorbidity of LD,MD,ODD/CD and Tourette syndrome may have no impact on the EF deficits in ADHD.

Objective:To explore effectiveness of Russell Barkley's parent training in children with comorbid attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD),and to evaluate its applicability in mainland China.Methods:Parents of 30 DSM-Ⅳ ADHD+ODD children were given 10 weekly trainings.Results:Total numbers of symptoms,symptoms of ADHD,symptoms of inattention,hyperactivity/impulsivity and ODD declined significantly(P

Objective:To explore the therapeutic effect,security and influencing factors of methylphenidate titration program,try to find the potential predicting index of therapeutic effect.Methods:This study was openly designed.The patients who were fit for DSM-Ⅳ diagnosis criteria of attention deficit hyperactivity disorder(ADHD) underwent systematic methylphenidate titration treatment until they attained the most optimal dose with best therapeutic effect and minimal side effects.The primary evaluative index of therapeutic effect was ADHD rating scale filled by teachers(ADHD-RS-Ⅳ),and secondary index included abbreviated Conners questionnaire filled by teachers,ADHD rating scale and Conners questionnaire filled by parents.The matching sample t analyses were used,then the differences of rating scale between pre and post treatment were compared.The potential influencing factors information of therapeutic effects including symptom severity degree when visiting,IQ,sensory integration capability and achievement of school etc.were collected.Finally,the correlation analysis was used for continuous variables andvariance analysis for dichotomization variables to analyze and check the factors' influence of declining scores of behavior scale.Results:The final prescribed daily dose for patients who completed dose titration was(17.3?7.7) mg on average,computed by kilo bodyweight was(0.45?0.11) mg/(kg?d).All the scale scores between pre and post treatment were significantly different(the pre-treatment score of ADHD rating scale completed by teachers was 30.25?9.16,and post-treatment score were 19.87?10.03,P

Objective:To test the reliability and validity of the behavior rating scale of executive function(BRIEF) parent form for school age children in China.Methods:A total of 216 patients [attention deficit hyperactivity disorder(ADHD) or schizophrenia or autism] and 311 normal controls were involved in this research.Parents of the subjects completed the BRIEF,ADHD rating scale-Ⅳ,Conners,and Rutter rating scales.And performance-based tests of executive function were carried out among some of the controls and ADHD subjects.These tests included Rey-Osterrieth complex figure(ROCF),trail-making test,digit span test,Tower of Hanoi(TOH), and Stroop test.Results:Test-retest reliability was 0.68—0.89 and Cronbach a coefficient was 0.74—0.96 except for the initial subscale(0.61).Subscales of BRIEF were moderately correlated(r=0.41—0.64) with subscales of other criteria scales such as ADHD rating scale-Ⅳ,etc.And there were correlations(r=0.32—0.41) between subscales of BRIEF and some indexes of the performance-based tests of executive function in the control group while the correlations in the diagnostic group were negative.For example,the inhibition subscale correlated with detailed score of ROCF delayed recall test and Stroop word-color interference time(r=-0.32,0.38).The working memory subscale correlated with time for trial B of the trail-making test,numbers of backwards digit test and Stroop word-color interference time(r=0.30,-0.39,0.41).Lisrel Confirmatory factor analysis showed that the 8-subscale model of BRIEF was reasonable.Compared with the control group,the diagnostic groups(ADHD-C,ADHD-I,schizophrenia and autism) got significant higher scores almost on all subscales of BRIEF(Z=-3.17—-4.17,P

Objective:To explore risk factors of attention deficit hyperactivity disorder(ADHD) comorbid with oppositional defiant disorder(ODD) in children.Methods:Parents of 43 pure ADHD+ODD children,and 43 pure ADHD children(criteria of DSM-Ⅳ;group matched by sex,age and ADHD subtypes) were asked to complete a set of investigation questionnaires including child and family information;family history;pregnancy,delivery and infancy complications;physical development and temperament;and predisposing factors and parents' or teachers' responses toward children's misbehaviors.Results:Probabilities of psychosis or schizophrenia of family members,long-term conflict between parents and parents' constant/stringent criticism to children in ADHD+ODD group were significantly higher than those in ADHD group(psychosis or schizophrenia of family members(16% vs 2%,P=0.058,OR=8.167);long-term conflict between parents(23% vs 7%,P=0.035,OR=4.040);parents' constant/stringent criticism to children(51% vs 28%,P=0.027,OR=2.706);probability of having anoxia at birth in ADHD group was significantly higher than that in ADHD+ODD group(12% vs 0,P=0.055,OR=0.469).Setting diagnosis of ADHD+ODD as dependent variable,and factors with significant difference between the two groups as independent variables,after 2 steps of regression analyses,one factor,i.e.parents' constant/stringent criticism to children was left in the model(P=0.054,OR=2.879).The regression formula had a sensitivity of 53.5%,a specificity of 83.7%,and total correction rate of 68.6%.Conclusion:Inappropriate parenting is a risk factor of ADHD comorbid with ODD,and long-term conflict between parents and positive family history of psychoses might have influence on ADHD comorbid with ODD.

Objective:To answer the question whether executive function(EF) deficits are specific to attention deficit hyperactivity disorder(ADHD) or whether such deficits are also associated with disruptive behavior disorders(DBD),including oppositional defiant disorder(ODD) and conductive disorder(CD).Methods:A total of 19 pure ADHD boys,19 ADHD + DBD boys and 19 normal controls(criteria of DSM-Ⅳ) were collected as our samples.The groups were matched by age(less than 6 months).The research instruments included Stroop color-word task,Rey complex figure test,digit span test, trail making test,tower of Hanoi and verbal fluency test.Results:The differences of IQs weren't significant among three groups.(1) Both pure ADHD group and ADHD+DBD group performed worse(P0.05).(2) Pure ADHD group also showed deficits in the aspects of errors of Stroop 2,time and errors of Stroop 3, word interference time;immediate memory structure score of Rey complex figure test;time and errors of number-letter part and shifting time of trail making test;total time and steps of completing tower of Hanoi.The differences were significant(P

Objective:To examine postural control between normal and attention deficit hyperactivity disorder(ADHD)boys,and compare the development characters.Methods:In the study,146 ADHD boys and 84 normal boys participated,ages being between 7 and 12 years.Balance Master was used to assess posture control.Posture stabilities were tested under 4 different conditions(firm surface with eyes open,firm surface with eyes closed,foam pad with eyes open,foam pad with eyes closed).We tested three times for one condition,20 s per time.The mean sway velocity was recorded.Results:(1)Normal boys:In firm surface with eyes open,analyses of variance between normal boys revealed no significant differences between different age groups,and the 11-and 12-year-old group did not achieve scores comparable to the adult(t=6.145,P

Objective:To study the executive function(EF)characteristics in boys with attention deficit hyperactivity disorder(ADHD)comorbid learning disabilities(LD).Methods:A total of 22 pure ADHD boys,22 ADHD + LD boys and 22 normal controls(by criteria of DSM-Ⅳ)were collected as our samples.The groups were matched by ages(less than 6 months)and ADHD subtypes.The research instruments included the Stroop color-word task,Rey complex figure test,digit span test,trail making test,tower of Hanoi and verbal fluency test.Results:The differences of VIQ weren't significant among the three groups;pure ADHD and ADHD+LD groups had lower PIQ than the control group;ADHD+LD boys had lower IQ than the controls.The performance in the EF tests:(1)Both pure ADHD and ADHD+LD groups performed worse in the aspects of time of number-letter part and shifting time,the repeat response of verbal fluency,and the differences were significant.But the differences between ADHD and ADHD+LD weren't significant.(2)ADHD+LD group also showed deficits in the aspects of time and errors of Stroops 2 and 4,time of Stroop 4,word interference time,the immediate memory and delayed recalling detail score of Rey complex figure test,time of number trail making,error steps(rule violation)of Tow of Hanoi,and the differences were significant.(3)Both ADHD+LD and pure ADHD groups made more errors in the naming color of the color-word card(Stroop part 4),and ADHD+LD boys performed worse than pure ADHD boys.Conclusion:The findings support the hypothesis that ADHD is related to EF deficit,whether or not comorbid LD.ADHD+LD showed significant difference in the aspects of inhibition,working memory,set shifting and fluency as compared with normal group,ADHD+LD boys perform more poorly than the pure ADHD boys.It's plausible that both ADHD and LD are associated with deficits of executive function.