title: Impairment in children with and without ADHD: contributions from oppositional defiant disorder and callous-unemotional traits.
abstract: OBJECTIVE
  To ascertain the association of childhood ADHD and oppositional defiant disorder (ODD) on functional impairment and to test the moderating influence of callous-unemotional (CU) traits.
  
  
  METHODS
  Ethnically diverse 6- to 9-year-old children with (n = 59) and without (n = 47) ADHD were ascertained using multiple methods (i.e., rating scales and structured interview) and informants (i.e., parent, teacher, and interviewer).
  
  
  RESULTS
  Using ratings of impairment that were independent of the diagnostic assessment of ADHD and ODD, the association between ADHD and impairment was significantly moderated by CU traits, such that CU traits positively predicted impairment at low and moderate levels of ADHD but not at high levels of ADHD. CU traits did not moderate the association of ODD and impairment.
  
  
  CONCLUSIONS
  The authors discuss findings within the context of multiple pathways to and from negative outcomes and the utility of evaluating CU traits in studies of ADHD and conduct problems.
authors.affiliation: University of California at Los Angeles, Los Angeles, CA, USA.
authors.forename: Whitney A
authors.initials: WA
authors.lastname: Brammer
authors.forename: Steve S
authors.initials: SS
authors.lastname: Lee
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000523:psychology*; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004644:Emotions; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male