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Thought Disorder in Attention-Deficit Hyperactivity Disorder

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ABSTRACT

Objective

This study compared thought disorder and associated cognitive variables in attention-deficit hyperactivity disorder (ADHD) and schizophrenia.

Method

Speech samples of 115 ADHD, 88 schizophrenic, and 190 normal children, aged 8 to 15 years, were coded for thought disorder. A structured psychiatric interview, the WISC-R, the Continuous Performance Test, and the Span of Apprehension task were administered to each child.

Results

The ADHD and schizophrenic groups had thought disorder compared with the normal children. However, the subjects with ADHD had a narrower range of less severe thought disorder than did the schizophrenic subjects. The younger children with ADHD and schizophrenia had significantly more thought disorder than did the older children with these diagnoses. IQ, attention, and working memory were associated with thought disorder in the ADHD but not the schizophrenic group.

Conclusions

Thought disorder in childhood is not specific to schizophrenia and reflects impaired development of children's communication skills.

Section snippets

SUBJECTS

The study included 115 children with ADHD, 88 children with schizophrenia, and 190 normal children (Table 1). The thought disorder findings of the schizophrenic and normal children have been published (Caplan et al., 2000). As shown in Table 1, the children with schizophrenia had significantly lower IQ scores than the normal children. Furthermore, the ADHD group included more white children but fewer Asian and African-American children than did the normal group. The schizophrenic group had

Between-Group Differences

The loose associations scores of the children with ADHD (mean = 0.008, SD = 0.02) and normal children (mean = 0.002, SD = 0.01) were significantly lower than those of the schizophrenic children (mean = 0.07, SD = 0.14). Table 2 shows pairwise comparisons of the other thought disorder scores among the ADHD, normal, and schizophrenic groups at each of the chosen IQ levels. The comparisons used Z scores derived from the estimated means and standard errors.

ADHD Versus Normal. At all three IQ

DISCUSSION

This study demonstrates that, above and beyond differences in IQ, gender, ethnicity, and socioeconomic status, children with ADHD have poorly organized thoughts (i.e., increased use of illogical thinking, exophora) and impaired use of cohesive devices (i.e., decreased use of conjunctions, increased use of lexical cohesion) to connect ideas across sentences compared with normal children. Children with ADHD have a narrower range (i.e., no loose associations, referential cohesion,

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    This study was supported by grants MH-00538 (R.C.) and MH-45114 (R.F.A.). The authors appreciate the assistance of Amy Mo, Natasha Wheeler, Psy.D., Mathias Mendez, and Nancy O'shea.

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