title: Psychosocial and clinical correlates of ADHD in a community sample of school-age children.
abstract: OBJECTIVE
  To identify the psychosocial and clinical correlates of attention-deficit hyperactivity disorder (ADHD) in a community sample of children and to examine the validity of a subclinical form of ADHD.
  
  
  METHODS
  The sample of 449 children (mean age 9.2 years, SD 1.78; 53.6% boys) participated in the second stage of a community survey. Of these, 359 (80%) screened positive at stage 1. On the basis of a structured diagnostic interview with a parent, children were classified into 1 of 3 mutually exclusive groups: ADHD (n = 89), subthreshold ADHD (n = 100), and non-ADHD (n = 260).
  
  
  RESULTS
  As measured by the Children's Global Assessment Scale, the ADHD group was more impaired than the subthreshold group, which was more impaired than the non-ADHD group (p < .05 for each test). Children in the ADHD group were more likely to be male, to have mothers with a history of psychiatric treatment, to have fathers with a history of excessive alcohol use, and to live in low-income families with higher levels of family dysfunction (p < .05 for all variables). A model containing male gender, family dysfunction, and low income was most predictive of ADHD status (p < .01). ADHD was also associated with psychiatric comorbidity, especially disruptive behavior disorders.
  
  
  CONCLUSIONS
  These results support a dimensional approach to ADHD. More severe forms of ADHD are associated with psychosocial adversity and psychiatric comorbidity.
authors.affiliation: Yale Child Study Center, New Haven, CT 06520-7900, USA. lawrence.scahill@yale.edu
authors.forename: L
authors.initials: L
authors.lastname: Scahill
authors.forename: M
authors.initials: M
authors.lastname: Schwab-Stone
authors.forename: K R
authors.initials: KR
authors.lastname: Merikangas
authors.forename: J F
authors.initials: JF
authors.lastname: Leckman
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: S
authors.initials: S
authors.lastname: Kasl
mesh_terms: D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000150:complications; D016017:Odds Ratio; D012720:Severity of Illness Index; D012959:Socioeconomic Factors