Cited by 462Attention Deficit Hyperactivity DisorderDevelopmental and Educational NeuropsychologyChild and Adolescent Psychosocial and Emotional Development

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A Comparison of the Neuropsychological Profiles of the DSM-IV Subtypes of ADHD

Chhabildas, Nomita, Pennington, Bruce F., Willcutt, Erik G.·2001·Journal of Abnormal Child Psychology

DOI 10.1023/a:1012281226028

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Abstract

Recent research on the DSM-IV subtypes of attention-deficit/hyperactivity disorder (ADHD) has demonstrated that the subtypes differ in demographic characteristics, types of functional impairment, and profiles of comorbidity with other childhood disorders. However, little research has tested whether the subtypes differ in underlying neuropsychological deficits. This study compared the neuropsychological profiles of children without ADHD (n = 82) and children who met symptom criteria for DSM-IV Predominantly Inattentive subtype (ADHD-IA; n = 67), Predominantly Hyperactive Impulsive subtype (ADHD-HI; n = 14), and Combined subtype (ADHD-C; n = 33) in the areas of processing speed, vigilance, and inhibition. We hypothesized that children with elevations of inattention symptoms (ADHD-IA and ADHD-C) would be impaired on measures of vigilance and processing speed, whereas children with significant hyperactivity/impulsivity (ADHD-HI and ADHD-C) would be impaired on measures of inhibition. Contrary to prediction, symptoms of inattention best predicted performance on all dependent measures, and ADHD-IA and ADHD-C children had similar profiles of impairment. In contrast, children with ADHD-HI were not significantly impaired on any dependent measures once subclinical symptoms of inattention were controlled. Our results do not support distinct neuropsychological deficits in ADHD-IA and ADHD-C children, and suggest that symptoms of inattention, rather than symptoms of hyperactivity/impulsiv…

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Self-citation
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Background
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“Although some authors have argued that the differences between the subtypes are clear and that ADHD-C and ADHD-PI should be classified as entirely different disorders because of differences in prevalence, gender, age of onset and comorbidity with externalizing disorders (Milich 2001), others, particularly those who ha…”
Background
Attention-deficit/hyperactivity disorder evaluation and diagnosis
REIFF, M. I., & Stein, M. T. (2003) · Pediatric Clinics of North America · doi:10.1016/s0031-3955(03)00077-4 · Cited by 48
“No consistent neuro-psychological test or battery of tests has been found that can provide external validation for the ADHD diagnostic criteria, that clearly discriminates between children and adolescents with predominantly inattentive and combined subtypes [36], or that differentiates children with ADHD from those wi…”
Background
Defining the neural substrate of the adult outcome of childhood ADHD: a multimodal neuroimaging study of response inhibition
Szekely, E., Sudre, G. P., Sharp, W., Leibenluft, E., & Shaw, P. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.16111313 · Cited by 47
The developmental trajectories of executive function of children and adolescents with Attention Deficit Hyperactivity Disorder
Qian, Y., Shuai, L., Chan, R. C. K., Qian, Q., & Wang, Y. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.01.033 · Cited by 46
Neuropsychological Deficits in Relation to Symptoms of ADHD: Independent Contributions and Interactions
Wåhlstedt, C. (2009) · Child Neuropsychology · doi:10.1080/09297040802524198 · Cited by 46
“This finding is in accordance with previous studies showing that EF impairment is primarily related to symptoms of inattention rather than to hyperactivity/impulsivity (e.g., Castellanos et al., 2006; Chhabildas et al., 2001; Willcutt, Doyle, et al., 2005).”
Result
Performance and Private Speech of Children with Attention-Deficit/Hyperactivity Disorder While Taking the Tower of Hanoi Test: Effects of Depth of Search, Diagnostic Subtype, and Methylphenidate
Kopecky, H., Chang, H. T., Klorman, R., Thatcher, J. E., & Borgstedt, A. D. (2005) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-005-6742-7 · Cited by 46
“However, in contrast to these reports, Chhabildas, Pennington, and Willcutt (2001) found that symptoms of inattention, rather than those of hyperactivity/impulsivity, were closely associated with deficits of inhibition, vigilance, and processing speed.”
Result
Neurocognitive Function in Attention-Deficit–Hyperactivity Disorder with and Without Comorbid Disruptive Behaviour Disorders
Barnett, R. L., Maruff, P. T., & Vance, A. L. A. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670903001927 · Cited by 51
Nocturnal Enuresis: A Suggestive Endophenotype Marker for a Subgroup of Inattentive Attention-Deficit/Hyperactivity Disorder
Elia, J., Takeda, T., deBerardinis, R., Burke, J., Accardo, J., Ambrosini, P. J., Blum, N. J., Brown, L. W., Lantieri, F., Berrettini, W. H., et al. (2009) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2009.02.031 · Cited by 45
The Relationship Between Working Memory, Inhibition, and Performance on the Wisconsin Card Sorting Test in Children With and Without ADHD
Mullane, J. C., & Corkum, P. V. (2007) · Journal of Psychoeducational Assessment · doi:10.1177/0734282906297627 · Cited by 52
Preschool Neuropsychological Measures as Predictors of Later Attention Deficit Hyperactivity Disorder
Breaux, R. P., Griffith, S. F., & Harvey, E. A. (2016) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-016-0140-1 · Cited by 45
Multivariate genomewide linkage scan of neurocognitive traits and ADHD symptoms: Suggestive linkage to 3q13
Doyle, A. E., Ferreira, M. A. R., Sklar, P. B., Lasky-Su, J. A., Petty, C. R., Fusillo, S. J., Seidman, L. J., Willcutt, E. G., Smoller, J. W., Purcell, S., et al. (2008) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.30868 · Cited by 44
Self-citation
The Specificity of Inhibitory Impairments in Autism and Their Relation to ADHD-Type Symptoms
Sanderson, C., & Allen, M. L. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1650-5 · Cited by 50
Gene by environment interactions influencing reading disability and the inattentive symptom dimension of attention deficit/hyperactivity disorder
Rosenberg, J., Pennington, B. F., Willcutt, E. G., & Olson, R. K. (2011) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2011.02452.x · Cited by 45
Self-citation
Examining Relationships Between Executive Functioning and Delay Aversion in Attention Deficit Hyperactivity Disorder
Karalunas, S. L., & Huang-Pollock, C. L. (2011) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2011.614578 · Cited by 44
“However, reliable subtype differences on neuropsychological tasks have proven difficult to find (Baeyens, Roeyers, & Walle, 2006 ; Chhabildas, Pennington, & Willcutt, 2001 ; Geurts, Verte, Oosterlaan, Roeyers, & Sergeant, 2005; Huang-Pollock & Nigg, 2003 ).”
Merely Misunderstood? Receptive, Expressive, and Pragmatic Language in Young Children With Disruptive Behavior Disorders
Gremillion, M. L., & Martel, M. M. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.822306 · Cited by 46
Attention profiles in autism spectrum disorder and subtypes of attention-deficit/hyperactivity disorder
Boxhoorn, S., Lopez, E., Schmidt, C., Schulze, D., Hänig, S., & Freitag, C. M. (2018) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-018-1138-8 · Cited by 46
Task Complexity Enhances Response Inhibition Deficits in Childhood and Adolescent Attention-Deficit/Hyperactivity Disorder: A Meta-Regression Analysis
Huizenga, H. M., van Bers, B. M. C. W., Plat, J., van den Wildenberg, W. P. M., & van der Molen, M. W. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.06.021 · Cited by 42
Cognitive switching processes in young people with attention-deficit/hyperactivity disorder
Oades, R. D., & Christiansen, H. (2008) · Archives of Clinical Neuropsychology · doi:10.1016/j.acn.2007.09.002 · Cited by 46
Investigating the Relationship Between Attention and Working Memory in Clinical and Community Samples
Alloway, T. P., Elliott, J., & Place, M. (2010) · Child Neuropsychology · doi:10.1080/09297040903559655 · Cited by 44
“This finding extends previous neuropsychological evidence for the lack of distinctiveness between these two groups with respect to executive function skills (Barkley et al., 1992; Chhabildas et al., 2001; Faraone et al., 1998; Murphy et al., 2001).”
BackgroundResult
Measuring Impulsivity in Children: Adaptation and Validation of a Short Version of the UPPS-P Impulsive Behaviors Scale in Children and Investigation of its Links With ADHD
Geurten, M., Catale, C., Gay, P., Deplus, S., & Billieux, J. (2018) · Journal of Attention Disorders · doi:10.1177/1087054718775831 · Cited by 47
Examining ODD/ADHD Symptom Dimensions as Predictors of Social, Emotional, and Academic Trajectories in Middle Childhood
Evans, S. C., Cooley, J. L., Blossom, J. B., Pederson, C. A., Tampke, E. C., & Fite, P. J. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1644645 · Cited by 48
Therapeutic and mechanistic intervention of vitamin D in neuropsychiatric disorders
Rihal, V., Khan, H., Kaur, A., Singh, T. G., & Abdel‐Daim, M. M. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114782 · Cited by 42
Teachers' reporting of behavioural problems and cognitive‐academic performances in children aged 5–7 years
Giannopulu, I., Escolano, S., Cusin, F., Citeau, H., & Dellatolas, G. (2007) · British Journal of Educational Psychology · doi:10.1348/000709907x204372 · Cited by 44
“The factor structure of our questionnaire is very similar to previous analyses of behaviour scales completed by the teachers (Conners, 1969, 1997; Goyette et al., 1978; Roussos et al., 1999). Using 21 questions, we obtained 4 factors. The three of them, i.e. ‘conduct problems’, ‘hyperactivity’ and ‘inattention’, are a…”
BackgroundResult
Adult Dyslexia and Attention Deficit Disorder in Finland—Project DyAdd
Laasonen, M. R., Leppämäki, S., Tani, P., & Hokkanen, L. (2009) · Journal of Learning Disabilities · doi:10.1177/0022219409345013 · Cited by 43
Effect of vitamin D treatment in children with attention-deficit hyperactivity disorder
Dehbokri, N., Noorazar, G., Ghaffari, A., Mehdizadeh, G., Sarbakhsh, P., & Ghaffary, S. (2018) · World Journal of Pediatrics · doi:10.1007/s12519-018-0209-8 · Cited by 41
Parent-of-origin effects in attention-deficit hyperactivity disorder
Goos, L. M., Ezzatian, P., & Schachar, R. J. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2006.08.006 · Cited by 43
Comparison of the Performance of College Students Classified as ADHD, LD, and LD/ADHD in Foreign Language Courses
sparks, R. L., Javorsky, J., & Philips, L. (2005) · Language Learning · doi:10.1111/j.0023-8333.2005.00292.x · Cited by 40
Standardized Observational Assessment of Attention Deficit Hyperactivity Disorder Combined and Predominantly Inattentive Subtypes. I. Test Session Observations
McConaughy, S. H., Ivanova, M. Y., Antshel, K., & Eiraldi, R. B. (2009) · School Psychology Review · doi:10.1080/02796015.2009.12087849 · Cited by 38
“The null findings for ADHD-C versus ADHD-IN on the WISC-IV or WIAT-II are consistent with other research studies showing few, if any, differences between the ADHD subtypes in cognitive functioning, academic achievement, or laboratory and neuropsychological tests (Chhabildas et al., 2001; Nigg et al., 2002; Solanto et…”
Result
Cognitive Profile for Children with ADHD by Using WISC-IV: Subtype Differences? // Detección de perfiles cognitivos mediante WISC-IV en niños diagnosticados de TDAH: ¿Existen diferencias entre subtipos?
Fenollar-Cortés, J., Navarro-Soria, I., González-Gómez, C., & García-Sevilla, J. (2014) · Revista de Psicodidactica / Journal of Psychodidactics · doi:10.1387/revpsicodidact.12531 · Cited by 39
Speed of Language Comprehension is Impaired in ADHD
Wassenberg, R., Hendriksen, J. G. M., Hurks, P. P. M., FERON, F. J. M., Vles, J. S. H., & Jolles, J. (2008) · Journal of Attention Disorders · doi:10.1177/1087054708326111 · Cited by 43
“…(Bedard et al., 2003), processing speed on the coding subtest of the WISC-III (Chhabildas, Pennington, & Willcutt, 2001), and reaction time on focused and divided attention tasks (Kalff et al., 2005), although not all studies support this assumption (Chhabildas et al., 2001; Kalff et al., 2003).”
MethodResult
Intellectual Profiles in Children with ADHD and Comorbid Learning and Motor Disorders
Parke, E. M., Thaler, N. S., Etcoff, L. M., & Allen, D. N. (2020) · Journal of Attention Disorders · doi:10.1177/1087054715576343 · Cited by 37
ADHD-hyperactive/impulsive subtype in adults
Gibbins, C., Weiss, M. D., Goodman, D. W., Hodgkins, P., Landgraf, J. M., & Faraone, S. V. (2010) · Mental Illness · doi:10.4081/mi.2010.e9 · Cited by 38
Performance Lapses in Children with Attention-Deficit/Hyperactivity Disorder Contribute to Poor Reading Fluency
Jacobson, L. A., Ryan, M., DENCKLA, M. B., Mostofsky, S. H., & Mahone, E. M. (2013) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/act048 · Cited by 45
Prediction of Preschool Aggression from DRD4 Risk, Parental ADHD Symptoms, and Home Chaos
Farbiash, T., Berger, A., Atzaba-Poria, N., & Auerbach, J. G. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9791-3 · Cited by 37
“The consistency of the contribution of inattention to home chaos, compared to hyperactivityimpulsivity, is supported by studies that have shown that executive function deficits are more highly related to inattention symptoms than to hyperactivity-impulsivity symptoms (Chhabildas et al. 2001; Nigg et al. 2005; Willcutt…”
Result
Working memory demands impair skill acquisition in children with ADHD.
Huang-Pollock, C. L., & Karalunas, S. L. (2010) · Journal of Abnormal Psychology · doi:10.1037/a0017862 · Cited by 38
Differentiating Symptoms of ADHD in Preschoolers: The Role of Emotion Regulation and Executive Function
Landis, T. D., Garcia, A. M., Hart, K. C., & Graziano, P. A. (2020) · Journal of Attention Disorders · doi:10.1177/1087054719896858 · Cited by 47
“A significant body of research highlights the heterogeneity of ADHD symptom presentation and associated impairment (Chhabildas et al., 2001; Wåhlstedt et al., 2008).”
Background
Movement–attention coupling in infancy and attention problems in childhood
Friedman, A. H., Watamura, S. E., & Robertson, S. (2005) · Developmental Medicine & Child Neurology · doi:10.1017/s0012162205001350 · Cited by 37
Functional Brain Connectivity Differences Between Different ADHD Presentations: Impaired Functional Segregation in ADHD-Combined Presentation but not in ADHD-Inattentive Presentation
Ghaderi, A. H., Nazari, M. A., Shahrokhi, H., & Darooneh, A. H. (2017) · Basic and Clinical Neuroscience Journal · doi:10.18869/nirp.bcn.8.4.267 · Cited by 39
Interval timing deficits assessed by time reproduction dual tasks as cognitive endophenotypes for attention-deficit/hyperactivity disorder
Hwang-Gu, S.-L., & Gau, S. S.-F. (2015) · PLOS ONE · doi:10.1371/journal.pone.0127157 · Cited by 36
“The time reproduction dual task requires great attention capacity [21], and prior studies showed that symptoms of inattention were associated with a deficit in executive function in ADHD, including performance in attention tasks [37].”
Background
Effects of Methylphenidate on Intelligence and Attention Components in Boys with Attention-Deficit/Hyperactivity Disorder
Hellwig-Brida, S., Daseking, M., Keller, F., Petermann, F., & Goldbeck, L. (2011) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2010.0041 · Cited by 36
“…et al. 1996; Willcutt et al. 2005), and inhibition (Barkley 1997; Willcutt et al. 2005), and according to some studies also in processing speed (Chhabildas et al. 2001; Bedard et al. 2002; Shanahan et al. 2006) as well as in various components of attention such as set shifting (Koschack et…”
Neurocognitive Profile of Children with Attention Deficit Hyperactivity Disorders (ADHD): A comparison between subtypes.
Ahmadi, N., Mohammadi, M. R., Araghi, S. M., & Zarafshan, H. (2014) · PubMed Central · Cited by 35
Interference Control in Children with Attention Deficit/Hyperactivity Disorder
van Mourik, R., Papanikolau, A., Bijlhout, J., van Oostenbruggen, J., Veugelers, D., Uiterweer, A. P., Sergeant, J. A., & Oosterlaan, J. (2008) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-008-9277-x · Cited by 37
“These results are in line with previous work that failed to find group differences on neuropsychological profiles between children with the inattentive subtype and the combined subtype (Chhablidas et al. 2001).”
Result
Adolescents' strengths and difficulties: approach to attachment styles
Keskin, G., & Çam, O. (2010) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2009.01540.x · Cited by 34
“Clinical researches show that inattentive type does not have the onset of the first symptom until age 9 through 14 years (Chhabildas et al. 2001, Öner et al. 2002, Abalı et al. 2006).”
Background
WISC-III Cognitive Profiles in Children with ADHD: Specific Cognitive Impairments and Diagnostic Utility
Moura, O., Costa, P., & Simões, M. R. (2019) · The Journal of General Psychology · doi:10.1080/00221309.2018.1561410 · Cited by 33
“For example, Chhabildas, Pennington, and Willcutt (2001) observed that children with ADHD-I and ADHD-C had similar deficits in tasks that require assessing inhibition, processing speed, and vigilance, whereas children with ADHD-HI were not significantly impaired from carrying out any of these tasks…”
Background

Authors: Chhabildas, N., Pennington, B. F., & Willcutt, E. G.
Affiliations: University of Denver (US)
University of Colorado Boulder (US)
Corresponding author: Chhabildas, Nomita
ORCID: Pennington, Bruce F.
Willcutt, Erik G.
Venue: Journal of Abnormal Child Psychology
Publisher: Springer Science and Business Media LLC
Published: 2001-12
Volume: 29
Issue: 6
Pages: 529-540
ISSN: 0091-0627 (ISSN-L)
1573-2835
DOI: 10.1023/a:1012281226028
OpenAlex: W2142256026
Cited by: 461
References: 49
Citations by year: 2026: 5 · 2025: 6 · 2024: 4 · 2023: 13 · 2022: 14 · 2021: 9 · 2020: 16 · 2019: 16 · 2018: 18 · 2017: 16 · 2016: 17 · 2015: 16 · 2014: 20 · 2013: 20 · 2012: 27
FWCI: 6.44
Type: journal article
Language: en
Open access: closed
Licence: www.springernature.com/gp/researchers/text-and-data-mining (tdm)
www.springernature.com/gp/researchers/text-and-data-mining (vor)
Locations: Research on Child and Adolescent Psychopathology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (1f31mh012017-01, 5p01hd011681-12)
National Institute of Mental Health (F31 MH12017, F32 MH 12100, F32MH012100, MH 38820, MH 00419)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 27802, HD11681, P50HD027802)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: attention deficit hyperactivity disorder, combined subtype, neuropsychological deficits, processing speed, sustained attention, inhibition, inattentive symptoms, hyperactivity/impulsivity, children
MeSH terms: Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychometrics, Reproducibility of Results, Comorbidity

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A Comparison of the Neuropsychological Profiles of the DSM-IV Subtypes of ADHD

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