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needs to be followed up both with regard to facets of Neuroticism
In fact, another possibility is that ADHD symptoms, along with
(in particular, relatively  internalizing vs. relatively  externaliz-
temperament and other experiential factors, contribute to the de- ing components) and with regard to ADHD subtypes and comor-
velopment of adult personality traits. Indeed, the adult outcomes of
bidity. In the most general terms, then, our findings for the two
ADHD symptoms in childhood, which are only now beginning
major symptom domains suggest the following conclusion: overall
to be mapped, sometimes include personality disturbance, both
ADHD symptoms are related to low Conscientiousness, low
in terms of antisocial personality and other Axis II disorders
Agreeableness, and high Neuroticism. This association is ex-
(Tzelepis et al., 1995). If the current results are taken at face value,
plained by the fact that ADHD has at least two major components:
it may be that one subclinical manifestation of a range of ADHD
one is related to low Conscientiousness and secondarily to high
symptom severity in childhood is to shape personality traits in
Neuroticism, whereas the other relates to low Agreeableness and,
adulthood. The latter possibility will be an interesting focus in
under some models, to Neuroticism. The primary findings in
future prospective studies. For example, it would be of value to
relation to ADHD each warrant further comment.
examine Conscientiousness in adult twins discordant for ADHD.5 Links with low conscientiousness. The link of core symptoms
With these considerations in mind, we consider further the results
of ADHD with low Conscientiousness is interesting for several
relating specific symptom domains and traits.
reasons. From a theoretical developmental viewpoint, it might
suggest one route to ADHD development. Early temperament
precursors of Conscientiousness, such as the effortful control di-
Two Major ADHD Symptom Domains and the Big Five
mension identified by Rothbart and colleagues (Derryberry &
Although the two major symptom domains of ADHD are sub-
Rothbart, 1997; Rothbart & Ahadi, 1994; Rothbart & Bates, 1998),
stantially correlated (about .50), they have different patterns of
develop in the toddler years in conjunction with early development
external correlates. Symptoms of inattention-disorganization are
of the prefrontal cortex. This temperament dimension has been
associated with learning problems and with internalizing symp-
related to the ability to regulate attention. One implication of our
toms, such as anxiety and depression; hyperactive-impulsive
data taken together with the developmental data (Rothbart &
symptoms are associated more strongly with aggression, antisocial
Bates, 1998) may be that when this trait develops in the direction
behavior, peer rejection, and global functional impairment (Lahey
of poor control, ADHD symptoms emerge in the inattentive-
et al., 1994; Lahey & Willcutt, 1998; McBurnett et al., 1999;
disorganization domain. In adulthood, the residual effect may be
Willcutt, Pennington, Chhabildas, Friedman, & Alexander, 1999).
extremely low Conscientiousness, as we observed in our patient
Thus, we both expected and observed a differential pattern of
sample. Prospective studies of temperament, ADHD, and person-
personality correlates for these two domains.
ality will be of interest to evaluate this possibility further.
The most consistently defined ADHD symptom domain, atten-
This scenario also would be consistent with extensive neuro-
tion problems, was uniformly and strongly associated with low
psychological investigations that associate ADHD symptoms with
Conscientiousness. The Hyperactivity-Impulsivity domain in
problems in executive control functions such as behavioral inhi-
DSM IV differed somewhat from its closest match in the other
bition and working memory (Barkley, 1997; Pennington & Ozo-
approaches. Nonetheless, all were consistently related to low
noff, 1996). Conscientiousness thus may be the normal-trait
Agreeableness. Achenbach adult intrusiveness (the closest match
marker for the prefrontally mediated domain of executive func-
with DSM IV childhood Hyperactivity-Impulsivity), however, was
tioning described in the neuropsychological literature (Nigg, 2000,
also related to high Extraversion.
2001). This interpretation is also consistent with findings that
The association with Extraversion may be limited to self-
Conscientiousness is the only dimension in the Big Five taxonomy
reports, as was true for DSM IV Hyperactivity. The findings using
that is consistently related to school and work performance (John
clinical diagnoses supported the association of ADHD with Agree-
& Srivastava, 1999). Further neuropsychological executive func-
ableness but not Extraversion. However, it was notable that this
tion studies that incorporate Conscientiousness and ADHD symp-
pattern for the DSM IV symptoms (see Table 4) was not equally
toms would test this conjecture.
clear for men and women. ADHD symptoms in women may be
Links with low agreeableness. Second, the DSM IV Hyper-
associated more with Extraversion than (low) Agreeableness,
activity-Impulsivity symptoms appeared to have unique associations
whereas the reverse may be true in men, suggesting an intriguing
with low Agreeableness. This association speaks to both the overlap [ Pobierz całość w formacie PDF ]