Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-25T13:52:27.292Z Has data issue: false hasContentIssue false

The specificity of clinical characteristics in adults with attention-deficit/hyperactivity disorder: a comparison with patients with borderline personality disorder

Published online by Cambridge University Press:  16 April 2020

J.H. Dowson*
Affiliation:
Department of Psychiatry, Box 189, Addenbrooke’s Hospital, Cambridge University, CambridgeCB2 2QQ, UK
A. McLean
Affiliation:
Department of Psychiatry, Box 189, Addenbrooke’s Hospital, Cambridge University, CambridgeCB2 2QQ, UK
E. Bazanis
Affiliation:
Department of Psychiatry, Box 189, Addenbrooke’s Hospital, Cambridge University, CambridgeCB2 2QQ, UK
B. Toone
Affiliation:
Department of Psychological Medicine, Kings College Hospital, London, UK
S. Young
Affiliation:
Department of Psychology, Institute of Psychiatry, London, UK
T.W. Robbins
Affiliation:
Department of Experimental Psychology, Cambridge University, CambridgeCB2 2QQ, UK
B. Sahakian
Affiliation:
Department of Psychiatry, Box 189, Addenbrooke’s Hospital, Cambridge University, CambridgeCB2 2QQ, UK
*
*Corresponding author. E-mail address: [email protected] (J.H. Dowson).
Get access

Abstract

Characteristics of DSM-IV attention-deficit/hyperactivity disorder (ADHD) in adults can also be found as part of other psychiatric disorders. This study investigated the specificity of adult ADHD features in relation to patients with borderline personality disorder (BPD), a syndrome which shares some of its intrinsic features with ADHD and often co-occurs with ADHD. A group of 20 adult patients selected on the basis of a diagnosis of ADHD and 20 patients selected on the basis of a diagnosis of BPD were assessed by the self-report Attention Deficit Scales for Adults (ADSA). The two groups were matched for age, verbal IQ and gender. Of the nine ADSA scales, seven showed significant inter-group differences, in particular involving attention, organisation and persistence. The ‘Consistency/Long-Term’ scale, which mainly reflects impaired task and goal persistence, was the best discriminator between the groups. Furthermore, ratings on this scale correlated significantly with the error score of a computer-administered task of spatial working memory, the performance of which has been reported to be impaired in patients with ADHD. The results provide further validation for the ADSA scales and support a previous claim that ‘long-term consistencies’, i.e., related to task and goal persistence, is ‘the centrepiece behavioural issue’ for adults with ADHD.

Type
Original article
Copyright
Copyright © 2004 European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed.Washington DC: APA; 1987 Revised (DSM-III-R).Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed.Washington DC: APA; 1994 Revised (DSM-IV).Google Scholar
Barkley, RAMurphy, KAAttention-deficit hyperactivity disorder.A clinical workbook. 2nd ed.New York: The Guilford Press; 1998.Google Scholar
Bazanis, ERogers, RDDowson, JHTaylor, PMeux, CStaley, Cet al. Neurocognitive deficits in decision-making and planning of patients with DSM-III-R borderline personality disorder. Psychol Med 2002; 32:1395–405.CrossRefGoogle ScholarPubMed
Conners, CKConners’ rating scales—revised: technical manual. New York: Multi-Health Systems; 2000.Google Scholar
Conners, CKErhardt, DSparrow, MAConners’ adult ADHD rating scales (CAARS). New York: Multi-Health Systems; 1999. p. 9, 22.Google Scholar
Crean, JPde Wit, HRichards, JBReward discounting as a measure of impulsive behaviour in a psychiatric outpatient population. Exp Clin Psychopharmacol 2000;8(2):155–62.CrossRefGoogle Scholar
Daruna, JBarnes, PAA neurodevelopmental view of impulsivity. In: McCann, WGJohnson, JLShire, MBeditors. The impulsive client: theory, research and treatment. Washington DC: American Psychological Association; 1993.Google Scholar
Derogatis, LRBrief symptom inventory (BSI): administration, scoring and procedures manual. 3rd ed.Minneapolis (MN): National Computer Systems; 1993.Google Scholar
Dinn, WMRobbins, NCHarris, CLAdult attention-deficit/hyperactivity disorder: neuropsychological correlates and clinical presentation. Brain Cogn 2001;46(1,2):114–21.CrossRefGoogle ScholarPubMed
Dowson, JHAssessment of DSM-III-R personality disorders by self-report questionnaire: the role of informants and a screening test for co-morbid personality disorders (STCPD). Brit J Psychiat 1992;161: 344–52.Google Scholar
Ekselius, LLindstrom, Evon Knorring, LBodlund, OKullgren, GSCID II interviews and the SCID screen questionnaire as diagnostic tools for personality disorder in DSM-III-R. Acta Psychiat Scand 1994;90:120–3.CrossRefGoogle ScholarPubMed
Evenden, JImpulsivity: a discussion of clinical and experimental findings. J Psychopharmacol 1999;13(2):180–92.CrossRefGoogle ScholarPubMed
Faraone, SVBiederman, JSpencer, TWilens, TSeidman, LJMick, Eet al.Attention-deficit/hyperactivity disorder in adults: an overview. Biol Psychiat 2000;48:9–20.CrossRefGoogle ScholarPubMed
Gansler, DAFucetola, RKrengel, MStetson, SZimering, RMakary, CAre the cognitive subtypes in adult attention deficit/hyperactivity disorder? J Nerv Ment Dis 1998;186:776–81.CrossRefGoogle ScholarPubMed
Gallagher, RBlader, JThe diagnosis and neuropsychological assessment of adult attention-deficit hyperactivity disorder. Scientific study and practical guidelines. Ann NY Acad Sci 2001;931:148–71.CrossRefGoogle ScholarPubMed
Gualtieri, CTWargin, WKanoy, RPatrick, KShen, DYoung- blood, Wet al.Clinical studies of methylphenidate serum levels in children and adults. J Am Acad Child Psychiat 1982;21:19–26.CrossRefGoogle ScholarPubMed
Hornig, MAddressing co-morbidity in adults with attention-deficit/hyperactivity disorder. J Clin Psychiat 1998;59(Supp 17):69–75.Google ScholarPubMed
Hyler, SERieder, ROPersonality diagnostic questionnaire—revised (PDQ-R). New York: New York State Psychiatric Institute; 1987.Google Scholar
Hyler, SERieder, ROWilliams, JBWSpitzer, RLLyons, MHendler, JA comparison of clinical and self-report diagnosis of DSM-III personality disorders in 552 patients. Comp Psychiat 1989;30:170–8.CrossRefGoogle ScholarPubMed
Kempton, SVance, AMaruff, PLuk, ECostin, JPantelis, CExecutive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children. Psychol Med 1999;29:527–38.CrossRefGoogle ScholarPubMed
Linehan, MMBorderline personality disorder: concepts, controversies and definitions. In: Linehan, MMeditor. Cognitive-behavioural treatment of borderline personality disorder. New York: The Guilford Press; 1993. p. 3.Google Scholar
Lockwood, KAMarcotte, ACStern, CDifferentiation of attention-deficit/hyperactivity disorder subtypes: application of a neuropsycho-logical model of attention. J Clin Exp Neuropsychol 2001;23(3):317–30.Google Scholar
Moran, PStudies of associated conditions.Antisocial personality disorder. Dorchester (UK): Gaskell, Henry Ling; 1999.Google ScholarPubMed
Nelson, HENational adult reading test (NART): test manual. Windsor (UK): NFER-Nelson; 1982.Google Scholar
Norusis, MJSPSS 9.0 guide to data analysis. New Jersey: Prentice-Hall Inc; 1999.Google Scholar
Owen, AMDownes, JJSahakian, BJPolkey, CERobbins, TWPlanning and spatial working memory following frontal lobe lesions in man. Neuropsychologia 1990;28:1021–34.CrossRefGoogle ScholarPubMed
Pfohl, BBlack, DWNoyes, RCoryell, WHBarrash, JAxis I and axis II comorbidity findings: implications for validity. In: Oldham, JMeditor. Personality disorders: new perspectives on diagnostic validity. Washington DC: American Psychiatric Press; 1990. p. 147–61.Google Scholar
Sachdev, PAttention-deficit/hyperactivity disorder in adults. Psychol Med 1999;29:507–14.CrossRefGoogle Scholar
Spencer, TBiederman, JWilens, TEFaraone, SVAdults with attention-deficit/hyperactivity disorder: a controversial diagnosis. J Clin Psychiat 1998;59(Suppl 7):59–68.Google ScholarPubMed
Spitzer, RAWilliams, JBWGibbon, MFirst, MBStructured clinical interview for DSM-III-R personality disorders (SCID-II version 1.0). Washington DC: American Psychiatric Press; 1990.Google Scholar
Stuart, SPfohl, BBattaglia, MBellodi, LGrove, WCadoret, RThe co-occurrence of DSM-III-R personality disorders. J Pers Dis 1998; 12(4):302–15.CrossRefGoogle Scholar
Triolo, SJMurphy, KRAttention-deficit scales for adults (ADSA). Manual for scoring and interpretation. NewYork (NY): Brunner/Maze Inc; 1996.Google Scholar
Wender, PHPharmacotherapy of attention-deficit/hyperactivity disorder in adults. J Clin Psychiat 1998;59(Suppl 7):76–9.Google ScholarPubMed
Wender, PHWolf, LEWasserstein, JAdults with ADHD. An overview. Ann N Y Acad Sci 2001;931:1–16.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.