Behavioral disinhibition, anxiety, and response to methylphenidate and behavior management in children with attention deficit hyperactivity disorder

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Herbert C. Quay, Committee Chair

Second Committee Member

Donald K. Routh, Committee Member


Seventy boys ages seven to thirteen who met stringent ADHD criteria were subjects for the investigation of the relationships between parent and teacher-rated disinhibition (impulsivity plus hyperactivity) and anxiety symptoms in children with ADHD, and response to Methylphenidate (MPH) and behavior intervention. Few subjects (N = 3) displayed clinically significant anxiety as assessed by the Revised Children's Manifest Anxiety Scale (RCMAS); thus primary analyses explored the relationship between behavioral disinhibition and response to Methylphenidate (MPH). Consistent with hypotheses, children high in disinhibition displayed a more positive response to MPH for behaviors including interrupting, verbal abuse to staff, and compliance with adult directives, and a marginally greater response to MPH for name calling/teasing.A structured point system alone appeared sufficient in managing the behavior of children low in disinhibition, with MPH adding little clinically significant benefit. In contrast, high disinhibited children displayed elevated levels of negative behaviors with behavior management alone, and improved significantly on MPH.Jeffrey Gray's theory was cited as explaining possible etiological mechanisms underlying ADHD symptoms, as well as providing a neurochemical and neuroanatomical explanation for differential response to MPH in high and low disinhibited children.


Psychology, Behavioral; Health Sciences, Pharmacology; Psychology, Clinical

Link to Full Text


Link to Full Text