Table Of ContentATTENTION
DEFICIT
DISORDER
Clinical and Basic Research
EDITED BY
TERJE SAGVOLDEN
TREVOR ARCHER
iRoutledge
Taylor & Francis Group
Attention Deficit Disorder
Clinical and Basic Research
edited by
Terje Sagvolden
University of Oslo, Norway
Trevor Archer
Astra AlabAB, Sddert&lje, and
University ofUmed, Sweden
Routledge
jjj % Taylor & Francis Croup
NEW YORK AND LONDON
First Published by
Lawrence Erlbaum Associates, Inc., Publishers
365 Broadway
Hillsdale, New Jersey 07642
Transferred to Digital Printing 2009 by Routledge
270 Madison Avenue, New York, NY 10016
27 Church Road, Hove, East Sussex BN3 2FA
Copyright © 1989 by Lawrence Erlbaum Associates, Inc.
All rights reserved. No part of this book may be reproduced in
any form, by photostat, microform, retrieval system, or any other
means, without the prior written permission of the publisher.
Library of Congress Cataloging-in-Publication Data
Attention deficit disorder: clinical and basic research / edited by
Terje Sagvolden and Trevor Archer,
p. cm.
Dased on a conference of the European Brain and Behaviour Society
held July 21-24,1987 in Oslo, Norway.
Bibliography: p.
Includes indexes.
ISBN 0-8058-0098-0
1. Attention deficit disorders-Congresses. I. Sagvolden, Terje.
II. Archer, Trevor. III. European Brain and Behaviour Society.
RJ496.A86A875 1989
618.92’8589-dcl9 88-12113
CIP
Publisher’s Note
The publisher has gone to great lengths to ensure the quality
of this reprint but points out that some imperfections in the
original may be apparent.
Contents
Preface v
1. Attention Deficit Disorder/Hyperkinetic Syndrome:
Conceptual and Research Issues Regarding Diagnosis
and Classification
Michael Rutter
2. Attention Deficit Disorder: Clinical Issues
Terje Sagvolden and Trevor Archer
3. On the Epidemiology of Hyperactivity
Eric Taylor
4. Critical Issues in Attention Deficit Disorder
Sally E. Shaywitz and Bennett A. Shaywitz
5. The Long-Term Outcome of the Attention Deficit
Disorder/Hyperkinetic Syndrome
Rachel Gittelman Klein and Salvatore Mannuzza
CONTENTS
6. Six-Year-Old Children with Perceptual, Motor and
Attentional Deficits: Outcome in the 6-Year Perspective 93
I. Carina Gillberg and Christopher Gillberg
7. Cerebral Processes Underlying Neuropsychological and
Neuromotor Impairment in Children with ADD/MBD 105
Hans M. Borchgrevink
8. The Hypoarousal Hypothesis: What is the Evidence? 131
Hallgrim Kl0ve
9. Activation: Base-Level and Responsivity. A Search
for Sub-Types of ADDH Children by means of
Electrocardiac, Dermal, and Respiratory Measures 137
Eddy Brand and Harry van der Vlugt
10. The Diagnostic Significance of Attentional Processing:
Its significance for ADDH Classification—A Future DSM 151
Joseph Sergeant and Jaap J. van der Meere
11. The Role of Psychostimulants and Psychosocial Treatments
in Hyperkinesis 167
Rachel Gittelman Klein and Howard Abikoff
12. Practical Aspects of Dietary Management of the
Hyperkinetic Syndrome 181
Philip J. Graham
13. Basic Mechanisms of Drug Action:
Catecholaminergic Issues 191
Trevor Archer and Terje Sagvolden
CONTENTS v
14. Central Stimulants, Transmitters and Attentional Disorder:
A Perspective from Animal Studies 199
Trevor J. Robbins, G.H. Jones, and Barbara J. Sahakian
15. Neurotransmitters in Attention Deficit Disorder 223
Lewis S. Seiden, Frederic E. Miller, and Thomas G. Heffner
16. Issues regarding Possible Therapies using
Cognitive Enhancers 235
H.J. Normile, HJ. Altman, and Samuel Gershon
17. Model Experiments of Attention Deficit Disorder
and Hyperkinetic Syndrome 255
Trevor Archer and Terje Sagvolden
18. Results from a Comparative Neuropsychological Research
Program Indicate Altered Reinforcement Mechanisms
in Children with ADD 261
Terje Sagvolden, Boaz Wultz, Edvard I. Moser, May-Britt Moser,
and Lars M0rkrid
19. Neurotoxin-Induced Cognitive and Motor Activity
Modifications: A Catecholamine Connection 287
Trevor Archer
20. Dopamine and Learning: Implications for Attention Deficit
Disorder and Hyperkinetic Syndrome 323
Richard J. Beninger
21. The Cerebellum: Motor Skills, Procedural Learning,
and Memory and Hyperactivity 339
Richard F. Thompson
vi CONTENTS
22. Attention Deficit Disorder and Hyperkinetic Syndrome:
Biological Perspectives 353
Robert D. Oades
23. Future Perspectives on ADD Research:
An Irresistible Challenge 369
Terje Sagvolden and Trevor Archer
Author Index 391
Subject Index 411
Preface
This book grew out of an European Brain and Behaviour Society Workshop
on Attention Deficit Disorder, Minimal Brain Dysfunction, Hyperkinetic
Syndrome, and related dysfunctions held in Oslo, Norway in 1987.
Virtually millions of children and adults suffer from problems variously
described as attention deficit disorder (ADD), minimal brain dysfunction (MBD),
hyperkinetic syndrome, or, most recently, attention- deficit hyperactivity disorder
(ADHD). In these related disorders there are interactions between brain function
ing and the psychological environment. In recent years, we have seen a virtual ex
plosion of knowledge within the neurosciences. There was an urgent need to bring
about a rapproachement between the neurosciences and the behavioral sciences.
The major purpose of the conference and this book is to unite clinical and basic re
searchers in order to improve our understanding of ADD and related dysfunctions.
Thus, hopefully, this book will aid both clinicians and researchers in the neuros
ciences interested in allieviating these problems.
A main conclusion of the conference was that the attention problems of ADD
children might be secondary to basic motor-control problems. Although sensory
and motor processes interact, by placing the problems more on the motor side, one
might be closer to the heart of the hyperkinesis problem. Another conclusion was
that ADD might be related to dysfunctions in the central catecholaminergic sys
tems.
We would like to acknowledge the help of the following individuals in or
ganizing and running the conference: Jan Blegeberg, Hans M. Borchgrevink, Hal-
vor Dahl, Knut Klippcnberg, Hallgrim Kl0ve, Edvard I. Moser, May-Britt Moser,
Michael Rutter, Espen Sagvolden, Geir Sagvolden, Liv Sagvolden, Yvonne Wade,
Boaz Wultz, Ester Wultz, and finally, Torbj0m Danielsen and his students.
The conference was supported by: European Brain and Behaviour Society
(EBBS), International Brain Research Organization (IBRO), The Norwegian
Research Council for Science and the Humanities (NAVF), University of Oslo,
The Norwegian Directorate of Heal th (Ministry of Health and Social Affairs), Astra
Alab AB, Bik Bok, Christian Berner, Ciba Geigy Norway, Den Norske Creditbank,
Norsk Kollektiv Pensjonskasse, Postgiro, and Smith, Kline, and French. Terje
Sagvoldcn has in part been supported by a Senior Fulbright Scholar Fellowship.
Terje Sagvolden
Trevor Archer
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1
Attention Deficit Disorder/
Hyperkinetic Syndrome:
Conceptual and Research Issues
Regarding Diagnosis
and Classification
Michael Rutter
MRC Child Psychiatry Unit
Institute of Psychiatry
University of London
CONCEPT OF MINIMAL BRAIN DYSFUNCTION
Current concepts of hyperkinetic and attentional deficit disorders have several
historical roots (Rutter, 1982; Schachar, 1986; Weiss & Hechtman, 1986).
However, much of the earlier literature was based on the notion that the disorder
was synonymous with “minimal brain dysfunction” or MBD (Wender, 1971;
Clements, 1966). This idea derived from the writings of Strauss and his colleagues
(Strauss & Lehtinen, 1947) regarding behavioural syndromes supposedly due to
brain damage in mildly mentally handicapped individuals; from the studies of
Pasamanick and his colleagues (Pasamanick & Knobloch, 1966) linking a “con
tinuum of reproductive casualty” with hyperactive behaviour; and most of all
from Bradley’s (1937) discovery of the therapeutic effect of amphetamines in the
treatment of behavioural and educational problems. Much of the argument in
favour of the concept of “minimal brain dysfunction” was based on circular
reasoning of various types and it has not stood the test of time (Rutter, 1983).
The hypothesis of a single characteristic MBD syndrome that takes the form of
hyperactivity no longer warrants serious scientific consideration.
Because the diagnostic term ‘MBD’ continues to be used by some clinicians
and a few researchers, it is perhaps important to make explicit what is, and is
not, being rejected. There is, of course, no doubt that there can be substantial
brain disease or damage without this being evident in abnormalities on the clini
cal neurological examination (Rutter, 1983; Rutter, Chadwick & Schachar, 1983).
It cannot therefore be doubted that some psychiatric syndromes for which there
is no clinical evidence of neurological disorder at present will ultimately turn
out to have a basis in organic brain pathology. As our understanding of brain
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