Behavioral characteristics of DSM-IV ADHD subtypes in a school-based population

From an ethnically diverse sample of 2,744 school children, 221 attention deficit hyperactivity disorder (ADHD) [123 (4.5%) predominantly inattentive (IA), 47 (1.7%) predominantly hyperactive/impulsive (HI), and 51 (1.9%) combined type (C)] were identified using teacher ratings on a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) symptom checklist. Subjects were compared to 221 controls on teacher ratings of behavioral, academic, and social functioning. The results revealed relatively independent areas of impairment for each diagnostic group. The IA children were impaired in all areas, but were rated as displaying more appropriate behavior and fewer externalizing problems than HI or C children. The HI group displayed externalizing and social problems, but was rated as no different than controls in learning or internalizing problems. The C group demonstrated severe and pervasive difficulties across domains. These findings support the validity of the DSM-TV ADHD subtypes; all ADHD groups demonstrated impairment relative to controls, but show different patterns of behavioral characteristics.