Correlates between attention-deficit/hyperactivity disorder dimensional behavioral scales and urinary neurochemical excretion

166 Pages·2001·6 MB·English

by  Yang, Benson Pin-Sheng

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Correlates between Attention-Deficit/Hyperactivity Disorder
Dimensional Behavioral Scales
and Urinary Neurochemical Excretion
A Thesis Submitted to the
Yale University School of Medicine
in Partial Fulfillment of the Requirements for the
Degree of Doctor of Medicine
by
Benson Pin-Sheng Yang
2001
YALE MEDICAL LIBRARY
AUG 2 4 2001
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CORRELATES BETWEEN ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
DIMENSIONAL BEHAVIORAL SCALES AND URINARY NEUROCHEMICAL
EXCRETION. Benson P. Yang, John M. Holahan, George M. Anderson, and Bennett A.
Shaywitz. Department of Pediatrics, Yale University, School of Medicine, New Haven, CT.
Attention-deficit/hyperactivity disorder (ADHD) is a neurobiological condition characterized
by inattention, impulsivity, and hyperactivity. This study of 251 boys attempts to establish
biological correlates of the core features of ADHD through measurable differences in
sympathoadrenomedullary function. Behavioral constructs based on recent DSM notions of
ADHD were empirically derived from factor analysis of several assessment instruments. The
constructs were examined as dimensional variables to determine whether certain behavioral
profiles were predictive of catecholamine or cortisol excretion. Data from parents and
teachers were analyzed separately to examine the relationship between informant source and
urinary neurochemical levels. Bivariate analyses revealed that reduced urinary epinephrine
excretion was significantly correlated with the DSM-IV-based inattention scale. These
correlations were stronger when children were rated by teachers (r=-0.213, p=0.001) than
when they were rated by parents (r=-0.145, p=0.022). Furthermore, significant negative
correlations were found between the DSM-IV-based inattention scales and urinary
norepinephrine excretion, but only for teacher-completed ratings (r=-0.177, p=0.005).
Analysis using a multiple regression model reaffirmed the results found with bivariate
correlations. Overall, measurements of neurochemical excretion support the construct
validity of the DSM-IV characterization of ADHD which separates inattention and impulsivity
over the DSM-III characterization which combines these constructs.