The relationship between ethnicity and the diagnosis of attention-deficit/hyperactivity disorder in children and adolescents

Abstract

The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) of the American Psychiatric Association, has provided data on prevalence rates for ADHD in children; however, the definition and behavioral characteristics listed are from a population of largely White non-Hispanic participants. ADHD children and adolescents are commonly described as having persistent difficulties with inattention and/or hyperactivity-impulsivity. Additionally, numerous studies have examined the comorbid diagnoses found in children with ADHD. For example, research has shown that the comorbidity percentages range from 27% to 49% for anxiety disorders to 9% to 32% for mood disorders. Since the vast majority of prevalence, assessment and treatment studies have focused mainly on White non-Hispanic children, there has been an increasing interest in the field on the contribution of gender and ethnicity to the frequency of the diagnosis of ADHD (e.g., Arnold, 1996). With the ever-changing and evolving ethnic composition of our schools, the challenges of competent assessment for all children becomes an increasingly important issue. Compared to previous years children of diverse cultural backgrounds currently comprise one third of all children enrolled in public schools (U.S. Department of Education, 1998-99). The purpose of the present study was to determine the relationship between the diagnosis of Attention-Deficit/Hyperactivity Disorder and ethnicity in a sample of children and adolescents referred to two geographically different mental health clinics. Data were collected from these clinics and evaluated using chi-square and multi-way frequency analysis. Significant relationships were evaluated with a multiple comparison Least Significant Difference (LSD) post-hoc analysis. It was determined that both samples were significantly different (p < .05) in their make-up when compared to U.S. Census figures for each relevant region. Additionally, when evaluating comorbid conditions, there were no age group x gender interactions for Hispanic, White non-Hispanic, and other groupings. There was, however, a significant finding for the African American males 5 to 10 years of age, who were identified at a significantly higher rate to their sample representation for conduct disorder. We have found that gender and ethnic grouping accounts for much of the interaction effects seen in this study and the literature as a whole, however, until that literature provides more information on comorbidity and ethnicity, there is little that can be done to improve the current analysis.