CHICAGO (Reuters Health) - The majority of young boys with attention-deficit/hyperactivity disorder (ADHD) are no more likely to exhibit destructive, delinquent behavior as teenagers than children without the disorder, researchers report.

However, a minority of boys with ADHD and a co-existing pattern of aggressive behaviors may be at increased risk for delinquency in later life.

"The essential finding here is that ADHD in and of itself does not predict the severity or seriousness of delinquency in adolescence. It really is ADHD kids who are also aggressive who are at much more significant risk," said researcher Dr. Steven Lee of the University of California at Berkeley.

He presented the findings here earlier this week at the annual meeting of the American Psychological Association.

ADHD is characterized by impulsive behavior and difficulties in paying attention, as well as academic and behavioral problems. Up to 5% of school-age children are estimated to have ADHD, with boys diagnosed up to four times more often than girls.

Speaking with Reuters Health, Lee said that over the past 30 years, studies on the long-term behavioral outcomes of ADHD children have been "relatively inconsistent."

"The biggest problem," he said, "was the fact that anywhere between 35% and 50% of children with ADHD are also aggressive at the same time," exhibiting a pattern of behaviors such as physical or verbal assault against others, usually other children.

Beginning in the early 1990s, Lee and colleagues used a summer camp format to follow the 5-year development of 175 boys ranging from 6 to 12 years of age. One hundred of the boys were diagnosed with ADHD, while the remaining 75 showed no signs of the disorder.

Based on interviews with parents, camp counselors and the children themselves, they determined which boys also showed signs of aggressive behaviors.

By the end of the study the boys had grown to 11 to 18 years of age, "that ripe period for adolescent development and delinquency," according to Lee.

The investigators found that boys who had scored "in the highest (top 25%) level of aggression were 17 times more likely to be in the relatively more severe category of delinquency relative to the remaining 75% of the kids," Lee said.

The researchers' definition of "severe" delinquency included behaviors such as gang fighting, property damage or other violent acts.

On the other hand, boys diagnosed with ADHD but without high levels of aggression appeared to be "at no greater risk" of delinquency than typical kids, Lee said. "They are not aggressive and consequently they are not at risk for adolescent and adult antisocial behavior."

And even boys with ADHD plus aggression are not doomed to delinquency down the road, Lee added. "Even if you are in the top 1% of ADHD-aggression, there are successful interventions that show good effects over time," he said.

Studies show that both child- and parent-centered psychotherapies can be effective in changing antisocial behaviors in exactly these types of boys, according to the researcher. "Early intervention, in school, at home, in social relationships is really crucial for the children to develop successfully," Lee said.

He stressed that data on all of the children in the study were collected only when they were not on ADHD medications such as Ritalin. While medication may help curb ADHD, evidence on its ability to prevent aggression is mixed, Lee noted. For aggressive boys, "only in very rare circumstances would medication alone be better than having medication in addition to psycho-social interventions," he said.

The Berkeley researchers are currently conducting a similar study focused on girls with ADHD.

Reference Source 89

For more information on how to prevent other diseases, use
PreventDisease.com's "Quick Prevention Resources".