The Nosology of Attention-deficit Hyperactivity Disorder


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This study examined five central issues regarding the classification of attention-deficit hyperactivity disorder (ADHD) in an epidemiologically derived sample of primary school children. A monothetic schema (DSM-III) differed from a polythetic-only schema (DSM-III-R) by having a higher frequency of comorbid conduct disorder. A pervasive model was too restrictive, identifying only the most severe disruptive or conduct disordered children. Raising the minimum threshold above eight symptoms (DSM-III-R) missed less disruptive children who nevertheless exhibit significant functional impairment. There was minimal support for the independence of a syndrome of attention deficit disorder without hyperactivity (DSM-III). Finally, ADHD patients commonly have other diagnoses, most frequently conduct disorder, oppositional defiant disorder, and anxiety disorder.

Original languageEnglish (US)
Pages (from-to)155-165
Number of pages11
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number1
StatePublished - 1993

Bibliographical note

Funding Information:
Accepted April 14, 1992. Dr. August is Associate Professor and Director of ADHD and Learning Disorders Clinic, and Dr. Garfinkel is Director ofthe Division of Child and Adolescent Psychiatry, University of Minnesota Medical School, Minneapolis. The authors wish to acknowledge the support of the McArthur Foundation for the data reanalysis funded through the DSM-1V task force. The data and opinions presented in this paper are those ofthe authors and do not necessarily represent the opinions at the DSM-IV task force. Reprint request to Dr. August, Division of Child and Adolescent Psychiatry, Box 95, UMHC, Harvard Street at East River Road, Minneapolis, MN 55455. 0890-8567/93/3201-0155$03.00/0©1993 by the American Academy of Child and Adolescent Psychiatry.

Copyright 2017 Elsevier B.V., All rights reserved.


  • attention-deficit hyperactivity disorder
  • monothetic classification
  • nosology
  • polythetic classification

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