Objective To investigate the association of attention control ability with behavioral problems, social functioning, and video electroencephalography (V-EEG) abnormalities in children with attention-deficit/hyperactivity disorder (ADHD), so as to provide reference for clinical assessment and individualized intervention. Methods A total of 130 children with ADHD who attended the Child Health Center of Wuhan First Hospital from June 2022 to June 2025 were enrolled, and their clinical data were retrospectively collected. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the children were classified as inattentive type (ADHD-I, n=49), hyperactive/impulsive type (ADHD-HI, n=36), and combined type (ADHD-C, n=45). All participants completed the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), Conners Parent Symptom Questionnaire (PSQ), and Weiss Functional Impairment Rating Scale–Parent Report (WFIRS-P) and underwent video electroencephalography (V-EEG). Behavioral problems, social functioning, and V-EEG abnormality rates were compared among the three ADHD types. After adjustment for age and full-scale intelligence quotient (IQ), partial correlation analyses were used to examine the associations of IVA-CPT attention and response-control quotients with PSQ and WFIRS-P scores. Partial point-biserial correlation analyses were used to assess the associations between these quotients and V-EEG abnormalities. Results No significant differences were found in sex, age, or total IQ among the three groups (P>0.05). Compared with the ADHD-I group, the ADHD-C and ADHD-HI groups had higher scores for conduct problems, hyperactivity/impulsivity, and the hyperactivity index (P<0.05), while the ADHD-C group had higher learning-problem and hyperactivity/impulsivity scores than both other groups (P<0.05). In terms of WFIRS-P, the ADHD-C group scored higher than the ADHD-HI group in the learning/school domain and higher than both other groups in the risk-taking domain (P<0.05). The V-EEG abnormality rates were 18.4%, 22.2%, and 28.9% in the ADHD-I, ADHD-HI, and ADHD-C groups, respectively, with no significant difference among the three groups (P=0.476). After adjustment for age and full-scale IQ, response-control quotients were negatively correlated with conduct problems, hyperactivity/impulsivity, hyperactivity index, and impairment in life skills (partial r=-0.536 to -0.309, P<0.05). Attention quotients were negatively correlated with learning problems and impairment in the learning/school and risk-taking domains (partial r=-0.520 to -0.233, P<0.05). Both attention and response-control quotients were negatively correlated with V-EEG abnormalities (partial point-biserial r=-0.339 to -0.220, P<0.05). Conclusions Different ADHD subtypes exhibit heterogeneity in behavioral problems and social functioning impairments, with the combined subtype being the most severely affected in several domains. Attention and response-control quotients are associated with several measures of behavioral problems and social functioning impairment and with V-EEG abnormalities, suggesting that differences in attention and response control may be related to the clinical heterogeneity of ADHD. However, V-EEG abnormality rates do not differ significantly across ADHD subtypes, limiting their utility for distinguishing different subtypes.
Key words
attention-deficit/hyperactivity disorder /
heterogeneity /
attention and response control /
behavioral problems /
social functioning /
video-electroencephalogram
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