Relations Between CBCL Scores and DSM-IV ADHD Subtypes in an Australian National Sample

Graetz et al. (2001) tested relations between CBCL scale scores and DSM-IV diagnoses of Inattentive, Hyperactive-Impulsive, and Combined ADHD subtypes in a nationally representative sample of 3,597 Australian 6- to 17-year-olds.

DSM-IV diagnoses were made from parents’ reports on the Diagnostic Interview Schedule for Children Version IV (DISC-IV). Parents also completed the CBCL and the 50-item parent version of the Child Health Questionnaire (CHQ-PF50), which assesses children’s quality of life and the impact of their problems on their families.

Children who qualified for any of the three ADHD subtypes scored significantly higher on most CBCL problem scales and lower on the CHQ-PF50 Psychosocial Health scales than did control children who did not qualify for ADHD diagnoses. In addition, several CBCL scales significantly discriminated between the three ADHD subtypes as follows: On both the CBCL Externalizing syndromes and the Externalizing scale, children with ADHD-Combined diagnoses scored significantly higher than children with Hyperactive-Impulsive diagnoses, who, in turn, scored significantly higher than children with Inattentive diagnoses. Although children with Combined diagnoses also tended to score high on other problem scales, children with Inattentive diagnoses scored significantly higher than children with Hyperactive-Impulsive diagnoses on the Social Problems and Attention Problems syndromes.

This indicates that, although the symptoms defining the ADHD Inattentive subtype are less disruptive than those defining the ADHD Hyperactive-Impulsive subtype, the Inattentive symptoms are accompanied by more problems in social relations and by more problems from the CBCL Attention Problems syndrome.

Reference: Graetz, B.W., Sawyer, M.G., Hazell, P.L., Arney, F., & Baghurst, P. (2001). Validity of DSM-IV subtypes in a nationally representative sample of Australian children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1410-1417.