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Chan ES, Shero JA, Hand ED, Cole AM, Gaye F, Spiegel JA, Kofler MJ. Are Reading Interventions Effective for At-Risk Readers with ADHD? A Meta-Analysis. J Atten Disord 2023; 27:182-200. [PMID: 36278436 PMCID: PMC9913889 DOI: 10.1177/10870547221130111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Utilizing a multi-level meta-analytic approach, this review is the first to systematically quantify the efficacy of reading interventions for school-aged children with ADHD and identify potential factors that may increase the success of reading-related interventions for these children. METHOD 18 studies (15 peer-reviewed articles, 3 dissertations) published from 1986 to 2020 (N = 564) were meta-analyzed. RESULTS Findings revealed reading interventions are highly effective for improving reading skills based on both study-developed/curriculum-based measures (g = 1.91) and standardized/norm-referenced achievement tests (g = 1.11) in high-quality studies of children with rigorously-diagnosed ADHD. Reading interventions that include at least 30 hours of intervention targeting decoding/phonemic awareness meet all benchmarks to be considered a Level 1 (Well-Established) Evidence-Based Practice with Strong Research Support for children with ADHD based on clinical and special education criteria. CONCLUSIONS Our findings collectively indicate that reading interventions should be the first-line treatment for reading difficulties among at-risk readers with ADHD.
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Svanström K, Hallböök T, Rezanova J, Olsson I, Carlén C, Reilly C. Supporting Attention in Children with Epilepsy (SPACE): Pilot of a psychoeducational intervention. Epilepsy Behav 2023; 138:108996. [PMID: 36459814 DOI: 10.1016/j.yebeh.2022.108996] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Children with epilepsy are at high risk for impairing symptoms of attention deficit hyperactivity disorder (ADHD), especially difficulties with attention. There is limited evidence regarding the use of psychological interventions for children with epilepsy and attention difficulties. We developed and piloted a novel psychoeducational intervention -Supporting Attention in Children with Epilepsy (SPACE). METHODS Eligible children with epilepsy (8-13 years) and difficulties with attention underwent a comprehensive psychological assessment and took part in a single-arm trial of the SPACE intervention. The first three sessions of SPACE took place in groups of 3-5 children and two psychologists. The final three sessions involved one psychologist meeting the child and parent(s). The child's teacher joined for one of the final three sessions. The first group of participants participated in the intervention in person. Subsequent groups took part online due to COVID-19-related restrictions. Measures of ADHD -inattention symptoms (parent and teacher), executive functioning (child, parent, and teacher), and epilepsy-specific and general Health-Related Quality of Life (HRQOL) (child and parent) were administered before and three months after completing the intervention. RESULTS Twenty-seven children with epilepsy expressed an interest in participating. Sixteen children met eligibility criteria and participated in a single-arm pilot of the intervention. All 16 participants completed the intervention. Pre- and post-intervention data were available for 15 of the 16 children. Improvement in function was noted on all measures and reached statistical significance for child ratings of executive functioning (p = 0.030) and HRQOL (p = 0.043), and parent-rated child HRQOL (p < 0.001). Qualitative feedback regarding content and acceptability was positive. CONCLUSION A psychoeducational intervention for children with epilepsy and difficulties with attention can lead to improved executive functioning and HRQOL. Such an intervention may be a useful first-line intervention for children with epilepsy at risk for or diagnosed with ADHD and/or be used in combination with pharmacological treatment with children with epilepsy and ADHD. However, more robustly designed studies are needed.
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Affiliation(s)
- Klara Svanström
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Member of the ERN EpiCARE, Gothenburg, Sweden
| | - Tove Hallböök
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Member of the ERN EpiCARE, Gothenburg, Sweden; Dept. of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Julia Rezanova
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Member of the ERN EpiCARE, Gothenburg, Sweden
| | - Ingrid Olsson
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Member of the ERN EpiCARE, Gothenburg, Sweden; Dept. of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Clara Carlén
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Member of the ERN EpiCARE, Gothenburg, Sweden
| | - Colin Reilly
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Member of the ERN EpiCARE, Gothenburg, Sweden; Dept. of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Hai T, Swansburg R, Kahl CK, Frank H, Stone K, Lemay JF, MacMaster FP. Right Superior Frontal Gyrus Cortical Thickness in Pediatric ADHD. J Atten Disord 2022; 26:1895-1906. [PMID: 35815438 PMCID: PMC9605998 DOI: 10.1177/10870547221110918] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE We investigated the right Superior Frontal Gyrus (right-SFG) and Anterior Cingulate Cortex (ACC) in children with ADHD and their clinical relevance with Executive Function (EF) and ADHD symptom severity. METHODS About 26 children with ADHD and 24 typically developing children (TDC; 7‒16 years) underwent Magnetic Resonance Imaging (MRI) and completed an EF assessment battery. RESULTS Significantly thinner right-SFG in the ADHD group was found compared to the TDC group (t (48) = 2.81, p = .007, Cohen's d = 0.84). Linear regression models showed that 12.5% of inattention, 13.6% of hyperactivity, and 9.0% of EF variance was accounted for by the right-SFG thickness. CONCLUSIONS Differences in the right-SFG thickness were found in our ADHD group and were associated with parent ratings of inattentive and hyperactive symptoms as well with EF ratings. These results replicate previous findings of thinner right-SFG and are consistent with the delayed cortical maturation theory of ADHD.
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Affiliation(s)
- Tasmia Hai
- University of Calgary, AB, Canada,University of Alberta, Edmonton, Canada
| | | | | | | | | | | | - Frank P. MacMaster
- University of Calgary, AB, Canada,Addictions and Mental Health Strategic Clinical Network, Calgary, AB, Canada,Frank P. MacMaster, Child and Adolescent Imaging Research Program, Alberta Children’s Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada.
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Arnett AB, Peisch V, Levin AR. The role of aperiodic spectral slope in event-related potentials and cognition among children with and without attention deficit hyperactivity disorder. J Neurophysiol 2022; 128:1546-1554. [PMID: 36382902 PMCID: PMC9902214 DOI: 10.1152/jn.00295.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 11/17/2022] Open
Abstract
Aperiodic spectral slope is a measure of spontaneous neural oscillatory activity that is believed to support regulation of brain responses to environmental stimuli. Compared to typically developing (TD) control participants, children with attention deficit hyperactivity disorder (ADHD) have been shown to have flatter aperiodic spectral slope at rest as well as attenuated event-related potential (ERP) amplitudes in response to environmental stimuli. A small body of research suggests that aperiodic slope may also explain differences in behavioral responses. In this study, we examine associations between prestimulus aperiodic slope, stimulus characteristics, environmental demands, and neural as well as behavioral responses to these stimuli. Furthermore, we evaluate whether ADHD diagnostic status moderates these associations. Seventy-nine children with ADHD and 27 TD school-age children completed two visual ERP experiments with predictable alternating presentations of task-relevant and task-irrelevant stimuli. Aperiodic slope was extracted from prestimulus time windows. Prestimulus aperiodic slope was steeper for the TD relative to ADHD group, driven by task-relevant rather than task-irrelevant stimuli. For both groups, the aperiodic slope was steeper during a task with lower cognitive demand and before trials in which they responded correctly. Aperiodic slope did not mediate the association between ADHD diagnosis and attenuated P300 amplitude. The aperiodic spectral slope is dynamic and changes in anticipation of varying stimulus categories to support performance. The aperiodic slope and P300 amplitude reflect distinct cognitive processes. Background neural oscillations, captured via aperiodic slope, support cognitive behavioral control and should be included in etiological models of ADHD.NEW & NOTEWORTHY This study constitutes the first investigation of associations between aperiodic spectral slope and three aspects of neurocognition: event-related potential (ERP) amplitudes, cognitive load, and task performance. We find that background oscillatory activity is dynamic, shifting in anticipation of varying levels of task relevance and in response to increasing cognitive load. Moreover, we report that aperiodic activity and ERPs constitute distinct neurophysiological processes. Children with attention deficit hyperactivity disorder (ADHD) show reduced aperiodic dynamics in addition to attenuated ERP amplitudes.
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Affiliation(s)
- Anne B Arnett
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts
- Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Virginia Peisch
- Division of Developmental Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - April R Levin
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts
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Dinçer M, Uğurtaş Gökçe FS, Gül H, Taş Torun Y, Bodur Ş, Cöngöloğlu MA. Is Processing Speed (Gs) related to Hyperactivity (As a Narrow Cognitive Area of Gps): A Dimensional Approach to Heterogeneity of Clinical and WISC-IV Cognitive Profiles in ADHD From RDoC/HiTOP Perspective. J Atten Disord 2022; 26:1747-1761. [PMID: 35579206 DOI: 10.1177/10870547221099963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the relationship between symptomatology and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) cognitive profiles in Attention Deficit and Hyperactivity Disorder (ADHD), taking into account clinical heterogeneity. METHOD The WISC-IV was administered to 60 children aged 6 to 13 years with ADHD who had not previously taken psychotropic medication. Conners Teacher-Rating Scale (CTRS-R/L) and Conners Parent-Rating Scale (CPRS-R/L) were completed by parents and teachers. RESULTS We found a statistically significant positive correlation between the symptoms of hyperactivity/impulsivity and PSI (Processing Speed Index). A statistically significant negative correlation was found between the CTRS-R/L's DSM-IV Inattentive subscale and PRI (Perceptual Reasoning Index). No relationship was found between the inattention or hyperactivity/impulsivity symptomatology with Working Memory Index (WMI). WMI stood out as the most frequently reported weakness among the four index scores. CONCLUSION Considering the relationship between the cognitive domains of RDoC (Research Domain Criteria) and dimensions of HiTOP with the ADHD symptom clusters, the assessment of cognitive and behavioral symptoms may be useful for phenotyping ADHD. According to the CHC (Cattell-Horn-Carroll) theory; the positive correlation level between PSI, which is accepted as Gs, and hyperactivity/impulsivity symptoms in people with ADHD may be due to the fact that hyperactivity is one of the narrow cognitive domains of Gps.
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Affiliation(s)
- Mustafa Dinçer
- Mehmet Akif inan Training and Research Hospital, Şanlıurfa, Turkey
| | | | - Hesna Gül
- Gülhane Training and Research Hospital, Ankara, Turkey
| | | | - Şahin Bodur
- Gülhane Training and Research Hospital, Ankara, Turkey
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Perkins ER, Joyner KJ, Foell J, Drislane LE, Brislin SJ, Frick PJ, Yancey JR, Soto EF, Ganley CM, Keel PK, Sica C, Flor H, Nees F, Banaschewski T, Bokde ALW, Desrivières S, Grigis A, Garavan H, Gowland P, Heinz A, Ittermann B, Martinot JL, Martinot MLP, Artiges E, Orfanos DP, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Walter H, Whelan R, Schumann G, Patrick CJ. Assessing general versus specific liability for externalizing problems in adolescence: Concurrent and prospective prediction of symptoms of conduct disorder, ADHD, and substance use. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:793-807. [PMID: 36222627 PMCID: PMC9710196 DOI: 10.1037/abn0000743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This study explored the generality versus specificity of two trait-liability factors for externalizing problems-disinhibition and callousness-in the concurrent and prospective prediction of symptoms of conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and substance use (i.e., alcohol use disorder and history of illicit substance use). Disinhibition involves an impulsive, unrestrained cognitive-behavioral style; callousness entails a dispositional lack of social-emotional sensitivity. Participants were European adolescents from the multisite IMAGEN project who completed questionnaires and clinical interviews at ages 14 (N = 1,504, Mage = 14.41, 51.13% female) and 16 (N = 1,407, Mage = 16.46, 51.88% female). Disinhibition was related concurrently and prospectively to greater symptoms of conduct disorder, ADHD, and alcohol use disorder; higher scores on a general externalizing factor; and greater likelihood of having tried an illicit substance. Callousness was selectively related to greater conduct disorder symptoms. These findings indicate disinhibition confers broad liability for externalizing spectrum disorders, perhaps due to its affiliated deficits in executive function. In contrast, callousness appears to represent more specific liability for antagonistic (aggressive/exploitative) forms of externalizing, as exemplified by antisocial behavior. Results support the utility of developmental-ontogenetic and hierarchical-dimensional models of psychopathology and have important implications for early assessment of risk for externalizing problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | - Paul J. Frick
- Louisiana State University, USA
- Australian Catholic University, Australia
| | - James R. Yancey
- Rocky Mountain Network Mental Illness Research, Education, and Clinical Center, VA Salt Lake City Health Care System, USA
- University of Utah, USA
| | | | | | | | | | - Herta Flor
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
- University of Mannheim, Germany
| | - Frauke Nees
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
- University Medical Center Schleswig-Holstein – Kiel, Germany
| | - Tobias Banaschewski
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | | | | | | | | | - Penny Gowland
- University of Nottingham – University Park, United Kingdom
| | | | | | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 “Trajectoires développementales en psychiatrie”; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 “Trajectoires développementales en psychiatrie”; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- AP-HP Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 “Trajectoires développementales en psychiatrie”; Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- EPS Barthélémy Durand, Etampes, France
| | | | | | - Sarah Hohmann
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | | | | | | | | | - Gunter Schumann
- King’s College London, United Kingdom
- Charité – Universitätsmedizin Berlin, Germany
- Leibniz Institute for Neurobiology, Germany
- Fudan University, China
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Wong TY, Chang YT, Wang MY, Chang YH. The effectiveness of child-centered play therapy for executive functions in children with attention-deficit/hyperactivity disorder. Clin Child Psychol Psychiatry 2022:13591045221128399. [PMID: 36125333 DOI: 10.1177/13591045221128399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Child-centered play therapy (CCPT) is a practical and recommended non-medication intervention for children with Attention-deficit/hyperactivity disorder (ADHD) but the mechanism in between is unclear. AIM This study proposed to examine the effectiveness of CCPT on neuropsychological deficits and behavioral symptoms in ADHD. METHODS Participants with ADHD diagnosis were referred from senior child and adolescent psychiatrists, and typical developmental children (TD) were recruited from community as a control group. All participants' executive functions were evaluated using Cambridge Neuropsychological Test Automated Battery. First of all, the participants were evaluated using Child Behavior Checklist (CBCL) by their parents. The ADHD participants were assigned into CCPT (ADHDc) and waitlist (ADHDw) group; and the ADHDc group then received CCPT weekly for 12 sessions, while the ADHDw continuously received their regular treatment (i.e., medication treatment or other alternative treatments) as usual. RESULTS Total 52 participants were recruited (17 with ADHD and 35 typically developed children, TD). The results showed that overall the ADHD groups had worse neuropsychological performance and more behavioural disturbance than did the TD (ps < .05). After receiving the CCPT, the results showed that the ADHDc group had significant improvement in the cognitive flexibility (p < .05); while the ADHDw group had no changes.
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Affiliation(s)
- Tsz-Yan Wong
- Department of Psychology, Asia University, Taichung, Taiwan.,38020DA-MING Ophthalmology Hospital, Taichung, Taiwan
| | - Yu-Tzu Chang
- Division of Pediatric Neurology, China Medical University Children's Hospital, Taichung, Taiwan.,38026School of Post Baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Ming-Yu Wang
- 38026Department of Psychiatry, China-Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Yun-Hsuan Chang
- 38026Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,38026Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University; Tainan, Taiwan.,38026Institute of Genomics and Bioinformatics, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan.,38026Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
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Ludyga S, Mücke M, Leuenberger R, Bruggisser F, Pühse U, Gerber M, Capone-Mori A, Keutler C, Brotzmann M, Weber P. Behavioral and neurocognitive effects of judo training on working memory capacity in children with ADHD: A randomized controlled trial. Neuroimage Clin 2022; 36:103156. [PMID: 35988343 PMCID: PMC9402389 DOI: 10.1016/j.nicl.2022.103156] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Children with Attention Deficit Hyperactivity Disorder (ADHD) face deficits in working memory capacity that often persist into adulthood. In healthy peers, exercise targeting motor skill acquisition benefits visuospatial working memory, but its potential to reduce ADHD-related deficits remains unclear. We investigated the effect of a judo training program targeting motor skills on behavioral and neurocognitive indices of working memory capacity in children with ADHD. METHODS Children with ADHD aged 8 to 12 years (N = 57) were randomly allocated to a judo training group and a wait-list control group. The training program encompassed 120 min of judo per week over three months. Before and after the intervention period, participants completed a bilateral Change Detection task with low and high memory load conditions and the Movement Assessment Battery for Children-2 (MABC-2). The contralateral delay activity (CDA) elicited by the cognitive task was recorded using electroencephalography. RESULTS Compared to the control group, the judo training group showed a higher K-score on the Change Detection task and an increased negativity of the CDA on the high load condition following the intervention, when pretest scores (and confounders) were accounted for. In contrast, no group differences were found for MABC-2 score. CONCLUSION In children with ADHD, judo training may complement the pharmacological treatment by increasing the effectiveness of working memory maintenance processes. On a behavioral level, this improvement is accompanied with an increased capacity to store visuospatial information.
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Affiliation(s)
- Sebastian Ludyga
- University of Basel, Department of Sport, Exercise and Health, Basel, Switzerland.
| | - Manuel Mücke
- University of Basel, Department of Sport, Exercise and Health, Basel, Switzerland
| | - Rahel Leuenberger
- University of Basel, Department of Sport, Exercise and Health, Basel, Switzerland
| | - Fabienne Bruggisser
- University of Basel, Department of Sport, Exercise and Health, Basel, Switzerland
| | - Uwe Pühse
- University of Basel, Department of Sport, Exercise and Health, Basel, Switzerland
| | - Markus Gerber
- University of Basel, Department of Sport, Exercise and Health, Basel, Switzerland
| | - Andrea Capone-Mori
- Kantonsspital Aarau, Clinic for Children and Teenagers, Division of Neuropediatrics, Aarau, Switzerland
| | - Clemens Keutler
- St. Elisabethen Krankenhaus Lörrach, Clinic of Childhood and Adolescent Psychiatry and Psychotherapy, Lörrach, Germany
| | - Mark Brotzmann
- University of Basel, University Children's Hospital, Division of Neuropediatrics and Developmental Medicine, Basel, Switzerland
| | - Peter Weber
- University of Basel, University Children's Hospital, Division of Neuropediatrics and Developmental Medicine, Basel, Switzerland
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Rapport MD, Friedman LM, Pothoven C, Calub C. Attention-Deficit/Hyperactivity Disorder (ADHD) and Forgetfulness: Does Time-Related Decay Reflect Deficient Rehearsal? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09979-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hernandez ML, Spiegel JA, Coxe S, Dick AS, Graziano PA. Individual Differences in Germ Spreading Behaviors Among Children With Attention-Deficit/Hyperactivity Disorder: The Role of Executive Functioning. J Pediatr Psychol 2022; 47:892-904. [PMID: 35773970 PMCID: PMC9372749 DOI: 10.1093/jpepsy/jsac056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/09/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Infectious diseases, such as coronavirus disease 2019 (COVID-19), are commonly transmitted by respiratory droplets and contact with contaminated surfaces. Individuals with attention-deficit/hyperactivity disorder (ADHD) are more likely to be infected with COVID-19 and experience more hospitalizations than individuals without ADHD. The current study investigated the role of ADHD symptomatology and executive functioning (EF) in germ spreading behavior frequency among young children with and without ADHD and parenting responses to these behaviors. METHODS Participants included 53 children diagnosed with ADHD and 47 typically developing (TD) children between the ages of 4-5 years (76% male; Mage = 4.62; 86% Hispanic/Latinx). Parents and teachers reported on children's ADHD symptomatology and children completed three EF tasks. Germ spreading behavior frequency (direct contact of hand to face and toy in mouth) and parenting responses (verbal and nonverbal behaviors) were observed during a 5-min parent-child play situation. RESULTS Negative binomial regression analyses indicated that both ADHD diagnostic status and poor metacognition predicted both higher rates of toy to mouth (β = 1.94, p < .001; β = 0.03, p = .004) and face touching frequency (β = 0.60, p = .03; β = 0.03, p = .004), respectively. Additionally, poor attention and worse cognitive flexibility only predicted higher rates of toy to mouth frequency (β = 0.09, p < .001; β = -0.04, p = .001), respectively. CONCLUSIONS Young children with ADHD are at high risk for spreading germs via putting toys in their mouth and touching their face. Particularly, high levels of inattention and poor EF appear to be associated with higher rates of germ spreading behaviors.
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Affiliation(s)
- Melissa L Hernandez
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Jamie A Spiegel
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Stefany Coxe
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Anthony S Dick
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Paulo A Graziano
- Department of Psychology, Center for Children and Families, Florida International University, USA
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Chan ESM, Macias M, Kofler MJ. Does Child Anxiety Exacerbate or Protect Against Parent–Child Relationship Difficulties in Children with Elevated ADHD Symptoms? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022; 44:924-936. [PMID: 35967514 PMCID: PMC9360658 DOI: 10.1007/s10862-021-09922-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2021] [Indexed: 11/01/2022]
Abstract
Pediatric ADHD is associated with parent–child relationship difficulties. However, the extent to which these relations are attributable to specific ADHD symptom clusters (i.e., inattentive vs. hyperactive/impulsive), and the extent to which child anxiety symptoms may exacerbate or protect against these difficulties, remains unclear. To address these gaps in the literature, the current study combined multi-informant measures (parent, teacher, child) with a clinically-evaluated and carefully-phenotyped sample of 188 children with and without ADHD and anxiety (ages 8–13; 63 girls). Results indicated that child-reported anxiety (β = .46) and teacher-reported inattentive (β = .71) symptoms, and their interaction (β = -1.06), along with child age and IQ (β = -.14 to -.15), predict the extent to which parents perceive themselves as confident and competent parents (all p < .05). In contrast, only comorbid oppositional-defiant disorder conferred risk for increased parent-reported relational frustration, and we were unable to detect any reliable child-level demographic, diagnostic, or behavioral predictors of parent-reported discipline practices. These findings were robust to control for child demographic characteristics, clinical diagnoses, and intellectual functioning, with sensitivity analyses highlighting the importance of assessing ADHD inattentive vs. hyperactive/impulsive symptoms separately for understanding parenting outcomes. Taken together, the current findings suggest that child ADHD and anxiety symptoms may influence specific rather than broad-based aspects of the parent–child relationship, and produce differently valenced outcomes in the presence vs. absence of the other condition. Interestingly, it appears that the combination of greater child inattention and anxiety, rather than elevations in either symptom domain independently, predict adverse parenting outcomes in terms of reduced parental confidence.
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Lambek R, Thomsen PH, Sonuga-Barke EJS, Jennum P, Sørensen AV. The Association between Sleep Problems and Neuropsychological Deficits in Medication-naïve Children with ADHD. Behav Sleep Med 2022; 20:429-441. [PMID: 34081546 DOI: 10.1080/15402002.2021.1931222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Children with ADHD are reported to have sleep problems and neuropsychological deficits, but studies examining a potential association between the two are scarce and the use of varying methodology can complicate conclusions. PARTICIPANTS A clinical sample of 59 medication-naïve children with ADHD between the ages of 6 and 14 years (71% male). METHODS Children underwent polysomnography and multiple sleep latency test, and parent rated sleep habits on the Children's Sleep Habits Questionnaire. Children also completed an extensive neuropsychological battery of executive function and delay aversion tasks, and parents and teachers rated executive function behavior on the Behavior Rating Inventory of Executive Function. Linear regression analyses were conducted with each of the neuropsychological outcomes included as the outcome variable and the sleep parameters as the predictor variables. RESULTS The correlations between sleep and neuropsychological outcomes were generally modest, but some sleep parameters (primarily sleep stages and sleep latencies) were associated with objectively and subjectively measured executive function and delay aversion. CONCLUSIONS Using objective and subjective gold standard assessment procedures this study supports a (modest) association between sleep and neuropsychological function in children with ADHD.
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Affiliation(s)
- Rikke Lambek
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Per Hove Thomsen
- Department of Child & Adolescent Psychiatry, Research Unit, Psychiatry, Aarhus University Hospital ,Aarhus, Denmark
| | - Edmund J S Sonuga-Barke
- Department of Child & Adolescent Psychiatry, Research Unit, Psychiatry, Aarhus University Hospital ,Aarhus, Denmark.,School of Academic Psychiatry, King's College London, London, UK
| | - Poul Jennum
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, Rigshospitalet, Copenhagen, Denmark
| | - Anne Virring Sørensen
- Department of Child & Adolescent Psychiatry, Research Unit, Psychiatry, Aarhus University Hospital ,Aarhus, Denmark
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63
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Fenesy MC, Lee SS. Childhood ADHD and Executive Functioning: Unique Predictions of Early Adolescent Depression. Res Child Adolesc Psychopathol 2022; 50:753-770. [PMID: 34862961 PMCID: PMC9130164 DOI: 10.1007/s10802-021-00845-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 11/30/2022]
Abstract
Given the increasing prevalence of adolescent depression, identification of its early predictors and elucidation of the mechanisms underlying its individual differences is imperative. Controlling for baseline executive functioning (EF), we tested separate ADHD dimensions (i.e., inattention, hyperactivity-impulsivity) as independent predictors of early adolescent depression, including temporally-ordered causal mediation by academic functioning and social problems, using structural equation modeling. At baseline, participants consisted of 216 children (67% male) ages 6-9 years old with (n = 112) and without (n = 104) ADHD who subsequently completed Wave 2 and 3 follow-ups approximately two and four years later, respectively. Predictors consisted of separate parent and teacher ratings of childhood ADHD and laboratory-based assessments of key EF domains. At Wave 2, parents and teachers completed normed rating scales of youth academic and social functioning; youth completed standardized assessments of academic achievement. At Wave 3, youth self-reported depression. Baseline inattention positively predicted early adolescent depression whereas childhood hyperactivity-impulsivity and EF did not. Neither academic nor social functioning significantly mediated predictions of depression from baseline ADHD and EF. We consider prediction of early adolescent depression from inattention, including directions for future intervention and prevention research.
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Affiliation(s)
- Michelle C Fenesy
- Department of Child & Adolescent Psychiatry, New York-Presbyterian Hospital, Columbia University Irving Medical Center, 622 W. 168th St., New York, NY, 10032, USA
- Department of Psychology, University of California, Box 951563, 1285 Franz Hall, Los Angeles, CA, 90095-1563, USA
| | - Steve S Lee
- Department of Psychology, University of California, Box 951563, 1285 Franz Hall, Los Angeles, CA, 90095-1563, USA.
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64
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Groves NB, Wells EL, Soto EF, Marsh CL, Jaisle EM, Harvey TK, Kofler MJ. Executive Functioning and Emotion Regulation in Children with and without ADHD. Res Child Adolesc Psychopathol 2022; 50:721-735. [PMID: 34762251 PMCID: PMC9091051 DOI: 10.1007/s10802-021-00883-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
Difficulties with emotion regulation affect the majority of youth with attention-deficit/hyperactivity disorder (ADHD) and predict greater functional impairment than ADHD symptoms alone. Deficits in executive functioning are also present for most children with ADHD, and have been linked with emotion regulation difficulties in both clinical and neurotypical populations throughout development. The current study was the first to assess all three core executive functions (working memory, inhibitory control, set shifting) simultaneously in a clinically-diverse sample of children with and without ADHD and common comorbidities and investigate the extent to which they uniquely predict emotion dysregulation. A sample of 151 children ages 8-13 years (M = 10.36, SD = 1.52; 52 girls; 70.2% White/Non-Hispanic) were assessed using a criterion battery of executive functioning tasks, teacher-reported ADHD symptoms, and parent-reported emotion regulation. Results of the bias-corrected, bootstrapped conditional effects path model revealed that better-developed working memory predicted better emotion regulation (β = 0.23) and fewer ADHD symptoms (β = -0.21 to -0.37), that ADHD symptoms (β = -0.18 to -0.20) independently predicted emotion dysregulation, and that working memory exerted indirect effects on emotion regulation through both inattention and hyperactivity/impulsivity (β = 0.04-0.07). Sensitivity analyses indicated that these effects were generally robust to control for age, sex, executive function interrelations, and inclusion/exclusion of children with co-occurring ASD. These findings underscore the importance of working memory (relative to inhibitory control and set shifting) and its relations with ADHD symptoms for understanding children's emotion regulation skills, and may help explain the limited efficacy of first-line ADHD treatments, which do not target working memory, for improving emotion regulation skills.
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Affiliation(s)
- Nicole B Groves
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306, USA
| | - Erica L Wells
- Center for Children and Families, Florida International University, 11200 SW 8th St, Miami, FL, 33199, USA
| | - Elia F Soto
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306, USA
| | - Carolyn L Marsh
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306, USA
| | - Emma M Jaisle
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306, USA
| | - T Kathy Harvey
- Department of Educational Psychology and Learning Systems, Florida State University, 3210 Stone Building, Tallahassee, FL, 32306, USA
| | - Michael J Kofler
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306, USA.
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65
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Honkasilta J, Koutsoklenis A. The (Un)real Existence of ADHD-Criteria, Functions, and Forms of the Diagnostic Entity. FRONTIERS IN SOCIOLOGY 2022; 7:814763. [PMID: 35707639 PMCID: PMC9189308 DOI: 10.3389/fsoc.2022.814763] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
The contemporary conceptualization of Attention Deficit Hyperactivity Disorder (ADHD) as a complex, multifactorial neurodevelopmental disorder cannot be understood as such without a complex assemblage of political, economic, and cultural processes that deem the conceptualization to be valuable and useful. In this article we use the notion of psychiatrization as a lens through which to see parts of these processes that make up ADHD what it is. In the first part of the article, we critically assess the scientific basis of the ADHD diagnosis via examining its diagnostic criteria as presented in the current fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM), the so called "Bible" of modern psychiatry. The second part of the article asks what is done with the ADHD diagnostic entity and with the idea that it represents a natural neurodevelopmental state within an individual-something an individual has-as represented in the DSM-5. Drawn from our previous research, we analyze how ADHD becomes real in discourse practice as a powerful semiotic mediator through analysis of the various functions and forms in which it takes shape in institutional, social, and individual levels. We conclude that the frequent changes in the diagnostic criteria of ADHD do not reflect any real scientific progress. Among other reasons, they change to match better the maneuvers of individuals when navigating an increasingly psychiatrized society in the search for recognition, support, category membership, immunity, sympathy, and sense of belonging.
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Affiliation(s)
- Juho Honkasilta
- Department of Education, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
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66
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ADHD-inattentive versus ADHD-Combined subtypes: A severity continuum or two distinct entities? A comprehensive analysis of clinical, cognitive and neuroimaging data. J Psychiatr Res 2022; 149:28-36. [PMID: 35219873 DOI: 10.1016/j.jpsychires.2022.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/27/2021] [Accepted: 02/14/2022] [Indexed: 12/11/2022]
Abstract
The current study aimed to explore the multimodal differences between the inattentive ADHD (ADHD-I) subtype and the combined ADHD (ADHD-C) subtype. A large sample of medication-naïve children with pure ADHD (i.e., without any comorbidity) (145 with ADHD-I, 132 with ADHD-C) and healthy controls (n = 98) were recruited. A battery of multiple scales and cognitive tests were utilized to assess the clinical and cognitive profiles of each individual. In addition, structural and diffusion magnetic resonance imaging (MRI) were acquired for 120 subjects with ADHD and 85 controls. Regional gray matter volume, white matter volume, and diffusion tensors, e.g., axial diffusivity (AD), were compared among the three groups in a whole-brain voxel-wise manner. Compared with healthy controls, both ADHD groups exhibited elevated levels of behavioral and emotional problems. The ADHD-C group had more behavioral problems and emotional liability, as well as less anxiety, than the ADHD-I group. The two ADHD groups were equally impaired in most cognitive domains, with the exception of sustained attention. Compared with healthy controls, the ADHD-C group showed a high gray matter volume (GMV) in the bilateral thalamus and a high white matter volume in the body of the corpus callosum, while the ADHD-I group presented an elevated GMV mainly in the left precentral gyrus and posterior cingulate cortex. Compared with participants with ADHD-C and healthy controls, subjects with ADHD-I showed increased AD in widespread brain regions. Our study has revealed a distinct, interconnected pattern of behavioral, cognitive, and brain structural characteristics in children with different ADHD subtypes.
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67
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Yao A, Shimada K, Kasaba R, Tomoda A. Beneficial Effects of Behavioral Parent Training on Inhibitory Control in Children With Attention-Deficit/Hyperactivity Disorder: A Small-Scale Randomized Controlled Trial. Front Psychiatry 2022; 13:859249. [PMID: 35573335 PMCID: PMC9094443 DOI: 10.3389/fpsyt.2022.859249] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/17/2022] [Indexed: 11/28/2022] Open
Abstract
The purpose of this study was to examine whether the beneficial effects of behavioral parent training (BPT), as an indirect type of psychosocial treatment, are extended to cognitive manifestations beyond behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD). Although previous studies of community families have shown an association between parenting quality and a child's cognitive functions, little is known about the effects of BPT on cognitive manifestations in children with ADHD. In this study, we focused on inhibitory control among cognitive domains, which is considered to be the most malleable to direct types of psychosocial treatment for ADHD. We hypothesized that inhibitory control is affected by BPT, which uses parents as the primary agents of change to help their children. Thirty school-age children (6-12 years old) with ADHD and their parents (mothers) participated and were randomly assigned to either the standard BPT or waitlist control group. Using two objective laboratory-based tasks of inhibitory control (i.e., go/no-go and single response selection tasks), we assessed baseline and post-treatment response inhibition to suppress task-irrelevant responses and response selection to select task-relevant responses. In addition to decreased ADHD symptoms and negative parenting, the BPT group exhibited significantly improved performance in the single response selection task, but not in the go/no-go task, compared with the waitlist control group. Although tentative, these findings partially support our hypothesis that BPT has beneficial effects on the cognitive inhibitory control of ADHD, highlighting the potential for supportive environmental modifications to advance cognitive development in children with ADHD.
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Affiliation(s)
- Akiko Yao
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan
| | - Koji Shimada
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, Fukui, Japan
| | - Ryoko Kasaba
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan
| | - Akemi Tomoda
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Fukui, Japan
- Department of Child and Adolescent Psychological Medicine, University of Fukui Hospital, Fukui, Japan
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68
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Morea A, Calvete E. Understanding the Perpetuation of Cyberbullying Victimization in Adolescents: The Role of Executive Functions. Res Child Adolesc Psychopathol 2022; 50:1299-1311. [PMID: 35438446 PMCID: PMC9606089 DOI: 10.1007/s10802-022-00926-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
AbstractThe consequences of cyberbullying victimization can lead to its perpetuation over time, initiating a vicious cycle. Thus, it is important to identify the factors that contribute to the persistence of victimization. This study aimed to examine some longitudinal mechanisms involved in the perpetuation of cyberbullying victimization in adolescents. The secondary aim was to study the protective role of executive functions (cognitive flexibility and selective attention) in this process, filling a gap in the literature. Sex differences were also studied. The sample consisted of 698 adolescents between 12 and 17 years of age (M = 14.59, SD = 1.36; 40.83% girls) from the Basque Country (Spain). Adolescents participated in a longitudinal study with three waves, in which 5–6 months elapsed between waves. The participants completed measures of executive functions in wave 1, of cyberbullying perpetration and depressive symptoms in waves 1 and 2, and of cyberbullying victimization in all three waves. The findings indicated that cyberbullying victimization was perpetuated through an increase of cyberbullying perpetration and depressive symptoms. Concerning executive functions, cognitive flexibility attenuated the impact of cyberbullying victimization on cyberbullying perpetration and depressive symptoms, and these in turn predicted lower levels of future victimization. Sex differences revealed that selective attention acted as a risk factor for cyberbullying victimization in girls and as a protective factor in boys. The results highlight the importance of considering mediating mechanisms involved in the perpetuation of cyberbullying victimization as well as the beneficial role played by cognitive flexibility in reducing the stability of cyberbullying victimization.
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Affiliation(s)
- Aida Morea
- Department of Psychology, University of Deusto, Avenida de las Universidades 24, 48007, Bilbao, Spain.
| | - Esther Calvete
- Department of Psychology, University of Deusto, Avenida de las Universidades 24, 48007, Bilbao, Spain
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69
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Aita SL, Holding EZ, Greene J, Carrillo A, Moncrief GG, Isquith PK, Gioia GA, Roth RM. Multivariate base rates of score elevations on the BRIEF2 in children with ADHD, autism spectrum disorder, or specific learning disorder with impairment in reading. Child Neuropsychol 2022; 28:979-996. [DOI: 10.1080/09297049.2022.2060201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Stephen L. Aita
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Emily Z. Holding
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Jennifer Greene
- Department of Research and Development, Psychological Assessment Resources, Lutz, FL, USA
| | - Alicia Carrillo
- Department of Research and Development, Psychological Assessment Resources, Lutz, FL, USA
| | - Grant G. Moncrief
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Peter K. Isquith
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Gerard A. Gioia
- Department of Neuropsychology, Children’s National Medical Center, Washington, District of Columbia, USA
| | - Robert M. Roth
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
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70
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Friedman LM, Rapport MD, Fabrikant-Abzug G. Consistently Inconsistent Working Memory Performance Among Children with ADHD: Evidence of Response Accuracy Variability (RAV). JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-022-09967-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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71
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Astle DE, Holmes J, Kievit R, Gathercole SE. Annual Research Review: The transdiagnostic revolution in neurodevelopmental disorders. J Child Psychol Psychiatry 2022; 63:397-417. [PMID: 34296774 DOI: 10.1111/jcpp.13481] [Citation(s) in RCA: 90] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 12/11/2022]
Abstract
Practitioners frequently use diagnostic criteria to identify children with neurodevelopmental disorders and to guide intervention decisions. These criteria also provide the organising framework for much of the research focussing on these disorders. Study design, recruitment, analysis and theory are largely built on the assumption that diagnostic criteria reflect an underlying reality. However, there is growing concern that this assumption may not be a valid and that an alternative transdiagnostic approach may better serve our understanding of this large heterogeneous population of young people. This review draws on important developments over the past decade that have set the stage for much-needed breakthroughs in understanding neurodevelopmental disorders. We evaluate contemporary approaches to study design and recruitment, review the use of data-driven methods to characterise cognition, behaviour and neurobiology, and consider what alternative transdiagnostic models could mean for children and families. This review concludes that an overreliance on ill-fitting diagnostic criteria is impeding progress towards identifying the barriers that children encounter, understanding underpinning mechanisms and finding the best route to supporting them.
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Affiliation(s)
- Duncan E Astle
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Joni Holmes
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Rogier Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Susan E Gathercole
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.,Department of Psychiatry, University of Cambridge, Cambridge, UK
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72
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Calub CA, Rapport MD, Irurita C, Eckrich SJ, Bohil C. Attention Control in Children With ADHD: An Investigation Using Functional Near Infrared Spectroscopy (fNIRS). Child Neuropsychol 2022; 28:1072-1096. [PMID: 35285411 DOI: 10.1080/09297049.2022.2047913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Attention problems are a predominant contributor to near- and far-term functional outcomes in attention-deficit/hyperactivity disorder (ADHD); however, most interventions focus on improving the alerting attentional network, which has failed to translate into improved learning for a majority of children with ADHD. Comparatively less is known regarding the executive attentional network and its overarching attention control process, which governs the ability to maintain relevant information in a highly active, interference-free state, and is intrinsic to a broad range of cognitive functions. This is the first study to compare attention control abilities in children with ADHD and typically developing (TD) children using the Visual Array Task (VAT) and to simultaneously measure hemodynamic functioning (oxyHb) using functional Near-Infrared Spectroscopy (fNIRS). Nineteen children with ADHD Combined type and 18 typically developing (TD) children aged 8 to 12 years were administered the VAT task while prefrontal activity was monitored using fNIRS. Results revealed that children with ADHD evinced large magnitude deficits in attention control and that oxyHb levels in the left dorsal lateral prefrontal cortex (dlPFC) were significantly greater in children with ADHD relative to TD children. These findings suggest that poor attention control abilities in children with ADHD may be related to increased left dlPFC activation in response to an underdeveloped and/or inefficient right dlPFC. The need to design interventions that target and strengthen attention control and its corresponding neural network is discussed based on the likelihood that attention control serves as the potential quaesitum for understanding a wide array of ADHD-related deficits.
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Affiliation(s)
- Catrina A Calub
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Mark D Rapport
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Carolina Irurita
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Samuel J Eckrich
- Department of Neuropsychology, Kennedy Krieger Institute/Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Corey Bohil
- Department of Psychology, University of Central Florida, Orlando, FL, USA
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73
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Chen C, Li Z, Liu X, Pan Y, Wu T. Cognitive Control Deficits in Children With Subthreshold Attention-Deficit/Hyperactivity Disorder. Front Hum Neurosci 2022; 16:835544. [PMID: 35360286 PMCID: PMC8963720 DOI: 10.3389/fnhum.2022.835544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Subthreshold Attention-Deficit/Hyperactivity Disorder (ADHD) is defined as a neurobiological condition with some core inattentive or hyperactive/impulsive symptoms of ADHD which do not meet the full diagnosis clinically. Although it has been well documented that deficits in cognitive control, a high-level cognitive construct closely related to attention, are frequently found among children with ADHD, whether subthreshold ADHD is also associated with similar deficits remains unclear. In this study, we examined the attention functions and the cognitive control capacity (CCC) in children with ADHD (n = 39), those with subthreshold ADHD (n = 34), and typically developing peers (TD, n = 36). The results showed that the ADHD and subthreshold ADHD groups exhibited similar patterns of the impaired executive function of attention (revealed as an augment in flanker conflict effect) and reduced cognitive control capacity, and no significant difference was found between the two groups. These findings suggest that although children with subthreshold ADHD have not met the full criteria of ADHD, they showed reduced efficiency in cognitive control and attention function, similar to children with ADHD.
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Affiliation(s)
- Caiqi Chen
- School of Psychology, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, South China Normal University, Guangzhou, China
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Zhuangyang Li
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, National Demonstration Center for Experimental Psychology Education, Beijing Normal University, Beijing, China
| | - Xiqin Liu
- School of Foreign Languages, South China University of Technology, Guangzhou, China
| | - Yongling Pan
- School of Psychology, South China Normal University, Guangzhou, China
| | - Tingting Wu
- Beijing Key Lab of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
- Department of Psychology, Queens College, The City University of New York, New York, NY, United States
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74
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Abstract
OBJECTIVE The adverse outcomes associated with ADHD are well known, but less is known about the minority of children with ADHD who may be flourishing despite this neurodevelopmental risk. The present multi-informant study is an initial step in this direction with the basic but unanswered question: Are there resilient children with ADHD? METHOD Reliable change analysis of the BASC-3 Resiliency subscale for a clinically evaluated sample of 206 children with and without ADHD (ages 8-13; 81 girls; 66.5% White/Non-Hispanic). RESULTS Most children with ADHD are perceived by their parents and teachers as resilient (52.8%-59.2%), with rates that did not differ from the comorbidity-matched Non-ADHD sample. CONCLUSION Exploratory analyses highlighted the importance of identifying factors that promote resilience for children with ADHD specifically, such that some child characteristics were promotive (associated with resilience for both groups), some were protective (associated with resilience only for children with ADHD), and some were beneficial only for children without ADHD.
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75
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Münger M, Sele S, Candrian G, Kasper J, Abdel-Rehim H, Eich-Höchli D, Müller A, Jäncke L. Longitudinal Analysis of Self-Reported Symptoms, Behavioral Measures, and Event-Related Potential Components of a Cued Go/NoGo Task in Adults With Attention-Deficit/Hyperactivity Disorder and Controls. Front Hum Neurosci 2022; 16:767789. [PMID: 35250513 PMCID: PMC8894259 DOI: 10.3389/fnhum.2022.767789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
This study characterizes a large sample of adults with attention-deficit/hyperactivity disorder (ADHD) and healthy controls regarding their task performance and neurophysiology; cross-sectionally and longitudinally. Self-reported symptoms, behavioral measures, and event-related potentials from a classical cued Go/NoGo task were used to outline the symptom burden, executive function deficits and neurophysiological features, and the associations between these domains. The study participants (N = 210 ADHD, N = 158 controls, age: 18–62 years) were assessed five (ADHD) or three (controls) times over two years. We describe cross-sectional and longitudinal group differences, and associations between symptom burden, and behavioral and event-related potential (ERP) components variables by latent growth curve models, including random slopes and intercepts. The ADHD group showed increased reaction time variability, increased commission and omission errors, and attenuated cueP3, CNV, N2d, and P3d amplitudes. We observed a decrease in self-reported symptoms in the ADHD group over the two years. The behavioral measures (reaction time variability, number of omission, and commission errors) did not change over time, whereas the cueP3, P3d, and N2d amplitude attenuated in both groups. There was no evidence for a robust association between symptom burden and behavioral or ERP measures. The changes in the ERP components with stable task performance, potentially indicate more efficient neuronal processing over the two years. Whether the lack of association between symptom burden and behavioral or ERP measures might be due to the low reliability of the ADHD assessment criteria, or the inappropriateness of the objective measures cannot be inferred.
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Affiliation(s)
- Marionna Münger
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- *Correspondence: Marionna Münger,
| | - Silvano Sele
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) “Dynamics of Healthy Aging”, Zurich, Switzerland
| | - Gian Candrian
- Brain and Trauma Foundation Grisons, Chur, Switzerland
| | - Johannes Kasper
- Praxisgemeinschaft Psychiatrie und Psychotherapie, Lucerne, Switzerland
| | | | - Dominique Eich-Höchli
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | | | - Lutz Jäncke
- Division of Neuropsychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) “Dynamics of Healthy Aging”, Zurich, Switzerland
- Lutz Jäncke,
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76
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Hai T, Climie EA. Positive Child Personality Factors in Children with ADHD. J Atten Disord 2022; 26:476-486. [PMID: 33666141 DOI: 10.1177/1087054721997562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder. While previous studies have shown substantial impact of ADHD across multiple domains, relatively little attention has been devoted to studying positive personality factors in individuals with ADHD. To address this, the current study examined strength-based factors in children with ADHD in relation to their social skills. METHOD Sixty-four children (aged 8-12 years) with ADHD completed questionnaires related to their social skills and strength-based factors (e.g., optimism, resilience, self-concept, and coping skills). RESULTS Findings indicated significant differences between different levels of social skills in children with ADHD, with children with higher social skills reporting higher levels of resiliency, greater behavioral competence, and greater prosocial attitudes than those with lower social skills. CONCLUSIONS The results highlight the importance of fostering strong social skills in children with ADHD, leading them to perceive themselves as competent and resilient.
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Affiliation(s)
- Tasmia Hai
- University of Alberta, Edmonton, AB, Canada
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Ludyga S, Ishihara T. Brain structural changes and the development of interference control in children with ADHD: The predictive value of physical activity and body mass index. NEUROIMAGE: CLINICAL 2022; 35:103141. [PMID: 36002962 PMCID: PMC9421503 DOI: 10.1016/j.nicl.2022.103141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/15/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022] Open
Abstract
Children with ADHD show deficits in interference control during preadolescence. Abnormalities in gray-white matter ratio contributed contribute to these deficits. Higher physical activity and lower body mass index predict higher interference control. Gray-white matter ratio underlies the predictive value of body mass index. Brain structure does not explain the predictive value of physical activity.
Background Children with ADHD face deficits in interference control due to abnormalities in brain structure. A low body mass index and high physical activity are factors promoting brain health and may have the potential to reduce ADHD-related cognitive deficits. We aimed to investigate the predictive values of ADHD, body mass index and physical activity for interference control and the potential mediation of these associations by brain structure. Method At 9 and 11 years, 4576 children with ADHD and neurotypical peers from the ABCD-cohort completed a Flanker task, anthropometric assessments and reported physical activity. Additionally, T1- and T2-weighted magnet resonance images were collected at both measurement time points. Results ADHD, lower physical activity and higher body mass index at baseline predicted lower interference control. Gray matter volume, surface area and gray-white matter ratio contributed to interference control. The longitudinal association between body mass index and interference control was mediated by gray-white-matter ratio. This mediating effect was stronger for children with ADHD than neurotypical peers and mainly restricted to regions associated with cognitive control. Conclusion The maintenance of a lower body mass index contributes to interference control by a tendency to normalize regional alterations in grey-white-matter ratio. Being compliant with physical activity also promises higher interference control, but brain structure does not seem to underlie this association.
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Groves NB, Chan ESM, Marsh CL, Gaye F, Jaisle EM, Kofler MJ. Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial. Front Psychiatry 2022; 13:1034722. [PMID: 36561637 PMCID: PMC9763728 DOI: 10.3389/fpsyt.2022.1034722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Approximately 48-54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targets given their functional, if not causal, links with ADHD-related emotion dysregulation. METHODS This preregistered randomized controlled trial tested whether two digital therapeutic training protocols that have been previously shown to improve working memory (Central Executive Training [CET]) and inhibitory control (Inhibitory Control Training [ICT]) can improve emotion regulation in a sample of 94 children with ADHD aged 8-13 years (M = 10.22, SD = 1.43; 76% White/non-Hispanic; 29 girls). RESULTS Results of Bayesian mixed model ANOVAs indicated both treatment groups demonstrated significant decreases in emotion dysregulation relative to pre-treatment at immediate post-treatment (parent report; d = 1.25, BF10 = 8.04 × 1013, p < 0.001), at 1-2 months after completing treatment (teacher report; d = 0.99, BF10 = 1.22 × 106, p < 0.001), and at 2-4-months follow-up (parent report; d = 1.22, BF10 = 1.15 × 1014, p < 0.001). Contrary to our hypotheses, the CET and ICT groups demonstrated equivalent reductions in emotion dysregulation and maintenance of effects. Exploratory analyses revealed that results were robust to control for informant expectancies, ADHD medication status/changes, in-person vs. at-home treatment, child age, and time from treatment completion to post-treatment ratings. DISCUSSION To determine whether working memory and inhibitory control are causally linked with ADHD-related emotion dysregulation, future studies should include active control conditions that do not train executive functions prior to making decisions about the clinical utility of CET/ICT for the treatment of emotion dysregulation in ADHD. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier [NCT03324464].
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Affiliation(s)
- Nicole B Groves
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Elizabeth S M Chan
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Carolyn L Marsh
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Fatou Gaye
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Emma M Jaisle
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael J Kofler
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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Rosenau PT, Openneer TJC, Matthijssen AM, van de Loo‐Neus GHH, Buitelaar JK, van den Hoofdakker BJ, Hoekstra PJ, Dietrich A. Effects of methylphenidate on executive functioning in children and adolescents with ADHD after long-term use: a randomized, placebo-controlled discontinuation study. J Child Psychol Psychiatry 2021; 62:1444-1452. [PMID: 33778945 PMCID: PMC9292145 DOI: 10.1111/jcpp.13419] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/12/2021] [Accepted: 02/14/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Methylphenidate may improve executive functioning in children with attention-deficit/hyperactivity disorder (ADHD). However, it is unclear if there are still acute effects of methylphenidate on executive functioning after long-term use. METHODS In a randomized double-blind, placebo-controlled discontinuation study, 94 children and adolescents (ages 8-18 years) who used methylphenidate beyond two years were either assigned to seven weeks of continued treatment with 36 or 54 mg of extended-release methylphenidate or to gradual withdrawal over three weeks to placebo for four weeks. Performance on neuropsychological tasks, measuring working memory, response inhibition, attentional flexibility and psychomotor speed was compared between both groups using mixed models for repeated measures. Additionally, we investigated within the discontinuation group if a deterioration on the investigator-rated Clinical Global Impressions Improvement scale after withdrawing to placebo was related to a worse performance on the neuropsychological tasks. This study was registered in the Netherlands Trial Register (www. Trialregister.nl) with identifier 5252. RESULTS After withdrawal of methylphenidate, the discontinuation group made more errors on working memory (β = -1.62, SD = 0.56, t = -2.88, p = .01, Cohen's f2 = .14), independent from reaction time compared to baseline, in contrast to the continuation group. We did not find differences in changes in response inhibition, attentional flexibility and psychomotor speed between the two groups. Also, there were no significant differences in task measures between the participants who deteriorated clinically and those who did not. CONCLUSIONS Our study shows that methylphenidate has a beneficial effect on working memory after two years of use. Future studies should explore whether cognitive outcomes may aid clinical decision-making on the continued use of methylphenidate, given dissociation between cognitive and behavioural effects of stimulant medication.
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Affiliation(s)
- Paul T. Rosenau
- Department of Child and Adolescent PsychiatryUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Thaïra J. C. Openneer
- Department of Child and Adolescent PsychiatryUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Anne‐Flore M. Matthijssen
- Department of Child and Adolescent PsychiatryUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | | | - Jan K. Buitelaar
- Karakter Child and Adolescent Psychiatry Center NijmegenNijmegenThe Netherlands,Cognitive Neuroscience, Donders Institute for Brain, Cognition and BehaviourRadboud University Nijmegen Medical CenterNijmegenThe Netherlands
| | - Barbara J. van den Hoofdakker
- Department of Child and Adolescent PsychiatryUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Pieter J. Hoekstra
- Department of Child and Adolescent PsychiatryUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Andrea Dietrich
- Department of Child and Adolescent PsychiatryUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Kanevski M, Booth JN, Oldridge J, McDougal E, Stewart TM, McGeown S, Rhodes SM. The relationship between cognition and mathematics in children with attention-deficit/hyperactivity disorder: a systematic review. Child Neuropsychol 2021; 28:394-426. [PMID: 34724883 DOI: 10.1080/09297049.2021.1985444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cognitive processes play an imperative role in children's mathematics learning. Difficulties in cognitive functioning are a core feature of Attention Deficit Hyperactivity Disorder (ADHD) in children, who also tend to show lower levels of mathematics attainment than their typically developing peers. This review (registration number: CRD42020169708) sought to aggregate findings from studies assessing the relationship between cognition and mathematics in children with a clinical ADHD diagnosis aged 4-12 years. A total of 11,799 studies published between 1992 and August 2020 were screened for eligibility using various database (PsycINFO, PubMed, SCOPUS, EMBASE, ERIC, Web of Science, and additional sources), from which four studies met inclusion criteria. A narrative synthesis was conducted on the correlations between mathematics and cognitive domains, including an evaluation of the risk of bias within the studies. Across four studies meeting inclusion criteria, memory, inhibitory control, and processing speed were assessed. The results showed a positive association between cognition and mathematics performance in this population. The strength of associations across these studies varied as a function of the cognitive domain in question, means by which mathematics performance was assessed, as well as whether confounding factors such as age and IQ were controlled for. Collectively, this review demonstrates a lack of research in this area and points to various methodological considerations for identifying the association between cognition and mathematics performance in ADHD.
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Affiliation(s)
- Margarita Kanevski
- Child Life and Health, Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Josephine N Booth
- Institute of Education, Community and Society, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Jessica Oldridge
- Child Life and Health, Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Emily McDougal
- Child Life and Health, Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tracy M Stewart
- Institute of Education, Community and Society, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Sarah McGeown
- Institute of Education, Community and Society, Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Sinead M Rhodes
- Child Life and Health, Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Laslo-Roth R, George-Levi S, Rosenstreich E. Protecting children with ADHD against loneliness: Familial and individual factors predicting perceived child's loneliness. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.110971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Which 'Working' Components of Working Memory aren't Working in Youth with ADHD? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:647-660. [PMID: 31989344 DOI: 10.1007/s10802-020-00621-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Despite replicated evidence for working memory deficits in youth with ADHD, no study has comprehensively assessed all three primary 'working' subcomponents of the working memory system in these children. Children ages 8-13 with (n = 45) and without (n = 41) ADHD (40% female; Mage = 10.5; 65% Caucasian/Non-Hispanic) completed a counterbalanced battery of nine tasks (three per construct) assessing working memory reordering (maintaining and rearranging information in mind), updating (active monitoring of incoming information and replacing outdated with relevant information), and dual-processing (maintaining information in mind while performing a secondary task). Detailed analytic plans were preregistered. Bayesian t-tests indicated that, at the group level, children with ADHD exhibited significant impairments in working memory reordering (BF10 = 4.64 × 105; d = 1.34) and updating (BF10 = 9.49; d = 0.64), but not dual-processing (BF01 = 1.33; d = 0.37). Overall, 67%-71% of youth with ADHD exhibited impairment in at least one central executive working memory domain. Reordering showed the most ADHD-related impairment, with 75% classified as below average or impaired, and none demonstrating strengths. The majority of children with ADHD (52%-57%) demonstrated average or better abilities in the remaining two domains, with a notable minority demonstrating strengths in updating (8%) and dual-processing (20%). Notably, impairments in domain-general central executive working memory, rather than individual subcomponents, predicted ADHD severity, suggesting that common rather than specific working memory mechanisms may be central to understanding ADHD symptoms. These impairment estimates extend prior work by providing initial evidence that children with ADHD not only exhibit heterogeneous profiles across cognitive domains but also exhibit significant heterogeneity within subcomponents of key cognitive processes.
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83
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Haywood D, Baughman FD, Mullan BA, Heslop KR. Going "Up" to Move Forward: S-1 Bifactor Models and the Study of Neurocognitive Abilities in Psychopathology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7413. [PMID: 34299862 PMCID: PMC8307957 DOI: 10.3390/ijerph18147413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 11/17/2022]
Abstract
Recently, structural models of psychopathology, that address the diagnostic stability and comorbidity issues of the traditional nosological approach, have dominated much of the psychopathology literature. Structural approaches have given rise to the p-factor, which is claimed to reflect an individual's propensity toward all common psychopathological symptoms. Neurocognitive abilities are argued to be important to the development and maintenance of a wide range of disorders, and have been suggested as an important driver of the p-factor. However, recent evidence argues against p being an interpretable substantive construct, limiting conclusions that can be drawn from associations between p, the specific factors of a psychopathology model, and neurocognitive abilities. Here, we argue for the use of the S-1 bifactor approach, where the general factor is defined by neurocognitive abilities, to explore the association between neurocognitive performance and a wide range of psychopathological symptoms. We use simulation techniques to give examples of how S-1 bifactor models can be used to examine this relationship, and how the results can be interpreted.
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Affiliation(s)
- Darren Haywood
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
- Health Psychology & Behavioural Medicine Research Group, School of Population Health, Curtin University, Perth 6845, Australia
- WA Cancer Prevention Research Unit, School of Population Health, Curtin University, Perth 6845, Australia
| | - Frank D. Baughman
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
| | - Barbara A. Mullan
- Discipline of Psychology, School of Population Health, Curtin University, Perth 6845, Australia; (F.D.B.); (B.A.M.)
- Health Psychology & Behavioural Medicine Research Group, School of Population Health, Curtin University, Perth 6845, Australia
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, Perth 6845, Australia;
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Lin CF, Huang CJ, Tsai YJ, Chueh TY, Hung CL, Chang YK, Hung TM. Resting Theta/Beta Ratios Mediate the Relationship Between Motor Competence and Inhibition in Children With Attention Deficit/Hyperactivity Disorder. Front Psychol 2021; 12:649154. [PMID: 34149535 PMCID: PMC8211439 DOI: 10.3389/fpsyg.2021.649154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022] Open
Abstract
Despite that previous studies have supported relationships between motor ability and inhibitory function, and between resting brain theta/beta power ratios (TBR) and inhibition in children with attention deficit/hyperactivity disorder (ADHD), little research has examined the mechanism within these relationships. The purpose of this study was to investigate whether TBR would mediate the relationship between motor ability and inhibitory function. A total of 71 children with ADHD were recorded resting electroencephalographic (EEG) data during eyes-open. Motor abilities were evaluated by Movement Assessment Battery for Children-2 (MABC-2) and inhibitory ability were assessed by a modified Eriksen’s flanker task. The results of mediation analyses revealed that TBR could completely mediate the relationship between motor competence and response speed (indirect effect = −0.0004, 95% CI [−0.0010, −0.0001]) and accuracy (indirect effect = 0.0003, 95% CI [0.0000, 0.0010]) in the incongruent condition of the flanker task. This study suggests that TBR may be one of the mechanisms between motor ability and inhibition function in children with ADHD.
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Affiliation(s)
- Chi-Fang Lin
- Department of Physical Education and Sport Science, National Taiwan Normal University, Taipei, Taiwan
| | - Chung-Ju Huang
- Graduate Institute of Sport Pedagogy, University of Taipei, Taipei, Taiwan
| | - Yu-Jung Tsai
- Department of Physical Education and Sport Science, National Taiwan Normal University, Taipei, Taiwan
| | - Ting-Yu Chueh
- Department of Physical Education and Sport Science, National Taiwan Normal University, Taipei, Taiwan
| | - Chiao-Ling Hung
- Department of Athletics and Master Program of Sport Facility Management and Health Promotion, National Taiwan University, Taipei, Taiwan
| | - Yu-Kai Chang
- Department of Physical Education and Sport Science, Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
| | - Tsung-Min Hung
- Department of Physical Education and Sport Science, Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
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85
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Ren FF, Chen FT, Zhou WS, Cho YM, Ho TJ, Hung TM, Chang YK. Effects of Chinese Mind-Body Exercises on Executive Function in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:656141. [PMID: 34093345 PMCID: PMC8175659 DOI: 10.3389/fpsyg.2021.656141] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Chinese mind-body exercises (CMBEs) are positively associated with executive function (EF), but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through June 2020 (PubMed, Web of Science, Embase, Cochrane Controlled Trials Register, Wanfang, China National Knowledge Infrastructure, and Weipu). Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment (MCI) and with or without chronic diseases were included. A total of 29 studies (N = 2,934) ultimately were included in this study. The results indicated that CMBEs improved overall EF (Standardized Mean Differences = 0.28, 95% CI 0.12, 0.44), as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type (Tai Chi, Qigong), frequency of group classes (≤2 time, 3-4 time, ≥5 times), session time (≤45 min, 46-60 min), total training time (≥150 to ≤300 min, >300 min), and length of the CMBEs (4-12 week, 13-26 week, and >26 week), in addition to that more frequent participation in both group classes and home practice sessions (≥5 times per week) resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age (50-65 years old, >65 years old), sex (only female, both), and cognitive statuses (normal, MCI, not mentioned), health status (with chronic disease, without chronic disease), as well as training mode (group class, group class plus home practice) and study language (English, Chinese). This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES (effect size) samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF.
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Affiliation(s)
- Fei-Fei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Feng-Tzu Chen
- Sport Neuroscience Division, Advanced Research Initiative for Human High Performance, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Wen-Sheng Zhou
- College of Physical Education, Nanjing Xiaozhuang University, Nanjing, China
| | - Yu-Min Cho
- Tzu Chi Medical Foundation, Alhambra, CA, United States
| | - Tsung-Jung Ho
- Integration Center of Traditional Chinese and Modern Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan.,Department of Chinese Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Tsung-Min Hung
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan.,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
| | - Yu-Kai Chang
- Department of Physical Education, National Taiwan Normal University, Taipei, Taiwan.,Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
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86
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Irwin LN, Soto EF, Chan ES, Miller CE, Carrington-Forde S, Groves NB, Kofler MJ. Activities of daily living and working memory in pediatric attention-deficit/hyperactivity disorder (ADHD). Child Neuropsychol 2021; 27:468-490. [PMID: 33459154 PMCID: PMC8035253 DOI: 10.1080/09297049.2020.1866521] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
Most children with ADHD have impaired working memory abilities. These working memory deficits predict impairments in activities of daily living (ADLs) for adults with ADHD. However, our understanding of the relation between pediatric ADHD and ADLs is limited. Thus, this study aimed to examine (1) the extent to which pediatric ADHD is associated with ADL difficulties; and if so (2) the extent to which these difficulties are related to their well-documented working memory difficulties and/or core ADHD inattentive and hyperactive/impulsive symptom domains. A well-characterized, clinically evaluated sample of 141 children ages 8-13 years (M = 10.36, SD = 1.46; 51 girls; 70% White/non-Hispanic) were administered a battery of well-validated working memory tests and assessed for ADHD symptoms (teacher-ratings) and ADL difficulties (parent-ratings); cross-informant reports were used to control for mono-informant bias. Children with ADHD exhibited medium magnitude difficulties with ADLs (d = 0.61, p < .005, 38% impaired). Results of the bias-corrected, bootstrapped conditional effects model indicated that lower working memory predicted reduced performance of age-expected ADLs (β =0.28) and greater ADHD inattentive (β = -0.40) and hyperactive/impulsive symptoms (β = -0.16). Greater inattentive, but not hyperactive/impulsive, symptoms predicted greater ADL difficulties (β = -0.36) even after controlling for working memory. Interestingly, working memory exerted a significant indirect effect on ADLs via inattentive (indirect effect: β = 0.15, effect ratio = .54) but not hyperactive/impulsive symptoms. These findings implicate ADHD inattentive symptoms as a potential mechanism underlying ADL difficulties for children with ADHD, both independently and via working memory's role in regulating attention.
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Affiliation(s)
| | - Elia F. Soto
- Florida State University, Department of Psychology
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Mukherjee P, Hartanto T, Iosif AM, Dixon JF, Hinshaw SP, Pakyurek M, van den Bos W, Guyer AE, McClure SM, Schweitzer JB, Fassbender C. Neural basis of working memory in ADHD: Load versus complexity. NEUROIMAGE-CLINICAL 2021; 30:102662. [PMID: 34215140 PMCID: PMC8175567 DOI: 10.1016/j.nicl.2021.102662] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 11/15/2022]
Abstract
Working memory (WM). Load versus Complexity. ADHD. FMRI. Working Memory Striatum and Cerebellum.
Working memory (WM) deficits are key in attention deficit hyperactivity disorder (ADHD). Nevertheless, WM is not universally impaired in ADHD. Additionally, the neural basis for WM deficits in ADHD has not been conclusively established, with regions including the prefrontal cortex, cerebellum, and caudate being implicated. These contradictions may be related to conceptualizations of WM capacity, such as load (amount of information) versus operational-complexity (maintenance-recall or manipulation). For instance, relative to neurotypical (NT) individuals, complex WM operations could be impaired in ADHD, while simpler operations are spared. Alternatively, all operations may be impaired at higher loads. Here, we compared the impact of these two components of WM capacity: load and operational-complexity, between ADHD and NT, behaviorally and neurally. We hypothesized that the impact of WM load would be greater in ADHD, and the neural activation would be altered. Participants (age-range 12–23 years; 50 ADHD (18 females); 82 NT (41 females)) recalled three or four objects (load) in forward or backward order (operational-complexity) during functional magnetic resonance imaging scanning. The effects of diagnosis and task were compared on performance and neural engagement. Behaviorally, we found significant interactions between diagnosis and load, and between diagnosis, load, and complexity. Neurally, we found an interaction between diagnosis and load in the right striatum, and between diagnosis and complexity in the right cerebellum and left occipital gyrus. The ADHD group displayed hypo-activation compared to NT group during higher load and greater complexity. This informs mechanisms of functional problems related to WM in adolescents and young adults with ADHD (e.g., academic performance) and remedial interventions (e.g., WM-training).
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Affiliation(s)
- Prerona Mukherjee
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA.
| | - Tadeus Hartanto
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Davis, CA 95616, USA
| | - J Faye Dixon
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, 3rd Floor, Berkeley Way West Building, 2121 Berkeley Way West, Berkeley, CA 94720, USA
| | - Murat Pakyurek
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Wouter van den Bos
- Department of Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, Netherlands
| | - Amanda E Guyer
- Department of Human Ecology, University of California, Davis, 1 Shields Ave, Davis, CA 95616, USA; Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA
| | - Samuel M McClure
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Catherine Fassbender
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA; School of Psychology, Dublin City University, DCU Glasnevin Campus, Dublin 9, Ireland
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88
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Aiding diagnosis of childhood attention-deficit/hyperactivity disorder of the inattentive presentation: Discriminant function analysis of multi-domain measures including EEG. Biol Psychol 2021; 161:108080. [PMID: 33744372 DOI: 10.1016/j.biopsycho.2021.108080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We developed a neurocognitive assessment tool (NCAT) in consultation with mental health professionals working with children with AD/HD as a diagnostic aid and screening tool. This study examines the predictive utility of NCAT in the classification of children with AD/HD Inattentive presentation. METHOD Fifty three children with AD/HD Inattentive presentation and 161 typically-developing children completed an NCAT assessment. Discriminant function analyses examined group membership prediction for separate components of NCAT and for the components combined. RESULTS The combined model correctly classified 93.4 % of participants, with 91.4 % sensitivity and 93.9 % specificity. Contributions to classification were from SNAP-IV, psychological needs satisfaction, self-regulation, executive function performance, and EEG. The combined model resulted in a 9.3 % increase in specificity and 5.9 % increase in sensitivity compared to SNAP-IV alone. CONCLUSIONS NCAT provides good discrimination between children with and without AD/HD of the Inattentive presentation, and further investigation including other subtypes and comorbidities is warranted.
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Abstract
Forster and Lavie (Journal of Experimental Psychology: Learning, Memory, and Cognition, 40[1], 251-260, 2014; Psychological Science, 27[2], 203-212, 2016) found that task-irrelevant distraction correlated positively with a measure of mind-wandering and a report of attention-deficit/hyperactivity disorder (ADHD) symptomology. Based primarily on these results, Forster and Lavie claimed to establish an attention-distractibility trait. Here, I tested whether these associations could be distinguished from associations with working memory capacity and task-relevant distraction (measured with an antisaccade task). With data collected from 226 subjects (ns differ among analyses), the results from the current study suggest that the measures of task-irrelevant distraction and working memory capacity were not (or only very weakly) associated with measures of mind wandering (measured both with a stand-alone questionnaire and in-task thought probes) and ADHD symptomology. Task-relevant interference (i.e., antisaccade accuracy) was associated with mind-wandering reports from in-task thought probes (presented in a separate task), but not the stand-alone mind wandering questionnaire or ADHD symptomology. Additionally, the measure of irrelevant-distraction exhibited low internal consistency suggesting that (as measured) it may not be a suitable individual difference measure. [Preregistration, data, analysis scripts and output are available via the Open Science Framework: https://osf.io/bhs24/ ].
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90
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Distinct Patterns of Impaired Cognitive Control Among Boys and Girls with ADHD Across Development. Res Child Adolesc Psychopathol 2021; 49:835-848. [PMID: 33646480 DOI: 10.1007/s10802-021-00792-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2021] [Indexed: 11/27/2022]
Abstract
This study examined whether girls and boys with ADHD show similar impairments in cognitive control from childhood into adolescence and the developmental relationship between cognitive control and ADHD symptoms. Participants include 8-17-year-old children with ADHD (n = 353, 104 girls) and typically developing (TD) controls (n = 241, 86 girls) with longitudinal data obtained from n = 137. Participants completed two go/no-go (GNG) tasks that varied in working memory demand. Linear mixed-effects models were applied to compare age-related changes in cognitive control for each GNG task among girls and boys with ADHD and TD controls and in relation to ADHD symptoms. Boys with ADHD showed impaired response inhibition and increased response variability across tasks. In contrast, girls with ADHD showed impaired response inhibition only with greater working memory demands whereas they displayed increased response variability regardless of working memory demands. Analysis of age-related change revealed that deficits in cognitive control under minimal working memory demands increase with age among girls with ADHD and decrease with age among boys with ADHD. In contrast, deficits in cognitive control with greater working memory demands decrease with age among both boys and girls with ADHD compared to TD peers. Among children with ADHD poor response inhibition during childhood predicted inattentive symptoms in adolescence and was associated with less age-related improvement in inattentive symptoms. These findings suggest that girls and boys with ADHD show differential impairment in cognitive control across development and response inhibition in childhood may be an important predictor of ADHD symptoms in adolescence.
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91
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Becker SP, Dvorsky MR, Tamm L, Willoughby MT. Preschool Neuropsychological Predictors of School-aged Sluggish Cognitive Tempo and Inattentive Behaviors. Res Child Adolesc Psychopathol 2021; 49:197-210. [PMID: 33369703 PMCID: PMC7855990 DOI: 10.1007/s10802-020-00728-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 12/31/2022]
Abstract
Sluggish cognitive tempo (SCT) is characterized by excessive daydreaming, slowed thinking, and mental confusion and 'fogginess'. A growing body of research supports the empirical differentiation of sluggish cognitive tempo (SCT) from the inattentive (IN) behaviors that characterize attention-deficit/hyperactivity disorder (ADHD). Further SCT and IN are uniquely associated with clinical correlates across academic, social, and emotional domains; however, there is limited understanding of how neuropsychological functioning contributes to SCT and/or IN behaviors. The two broad domains of neuropsychological functioning that have been most frequently examined in relation to SCT behaviors are processing speed and executive functions (EF). The present study tested whether EF and processing speed measured when children were on average age five years were predictive of teacher-rated IN and SCT behaviors in 1st - 3rd grades. Participants included 1,022 children from the Family Life Project, an ongoing prospective longitudinal study of child development in low-income, non-metropolitan communities. EF and processing speed uniquely made independent contributions to the prediction of IN and SCT. In secondary analyses that focused on specific facets of EF and processing speed, inhibitory control and working memory abilities predicted lower IN but not SCT behaviors, whereas slower processing speed significantly predicted both greater SCT and IN behaviors. These results are discussed as they inform developmental models of SCT and IN.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Melissa R Dvorsky
- Division of Psychology and Behavioral Health, Children's National Hospital, Washington, DC, USA
| | - Leanne Tamm
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michael T Willoughby
- Education and Workforce Development, RTI International, Research Triangle Park, NC, USA.
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92
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Perry RC, Ford TJ, O’Mahen H, Russell AE. Prioritising Targets for School-Based ADHD Interventions: A Delphi Survey. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-020-09408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractMany studies have investigated the effectiveness of school-based ADHD interventions at modifying different social, emotional and behavioural target outcomes. However, there is a lack of evidence about which targets stakeholders perceive to be most important. This study sought to obtain consensus on which outcomes are perceived to be most important. A total of 114 people with ADHD, educational professionals, parents of children with ADHD, clinicians and researchers participated in a Delphi survey with 3 rounds. The importance of 52 intervention targets was rated on a scale from 0 to 8 (8 being extremely important). Consensus was reached if >70% of a stakeholder group rated a target as between 6–8 and <15% rated it as 0–2. Targets were dropped from subsequent rounds if more than 50% of stakeholder groups rated it as 0–5. Targets that all four stakeholder groups reached consensus on in any round were automatically included in our final outcome set. Comments were analysed using Thematic Analysis. All four stakeholder groups reached consensus on the importance of seven targets: ability to pay attention, conflict with teachers and peers, executive functioning, global functioning and quality of life, inattention symptoms, organisation skills and self-esteem. Four overarching themes were identified: Complexity of ADHD, Relationships, School Context, and What ADHD means to me. School-based ADHD interventions should target outcomes identified as most important to those who stand to benefit from such interventions. Some outcomes prioritised by our participants have not yet been targeted in school-based ADHD interventions. Implications of our findings for intervention and research design are discussed.
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93
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Dixson DD, Scalcucci SG. Psychosocial perceptions and executive functioning: Hope and school belonging predict students' executive functioning. PSYCHOLOGY IN THE SCHOOLS 2021. [DOI: 10.1002/pits.22475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Dante D. Dixson
- Department of Counseling, Educational Psychology, and Special Education, School Psychology, College of Education Michigan State University East Lansing Michigan USA
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Einziger T, Ben-Shachar MS, Devor T, Shmueli M, Auerbach JG, Berger A. "My Brain Can Stop": An ERP Study of Longitudinal Prediction of Inhibitory Control in Adolescence. Brain Sci 2021; 11:100. [PMID: 33451149 PMCID: PMC7828591 DOI: 10.3390/brainsci11010100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 11/16/2022] Open
Abstract
We examined the longitudinal predictors of electrophysiological and behavioral markers of inhibitory control in adolescence. Participants were 63 adolescent boys who have been followed since birth as part of a prospective longitudinal study on the developmental pathways to attention-deficit hyperactivity disorder (ADHD). At 17 years of age, they completed the stop-signal task (SST) while electroencephalography (EEG) was continuously recorded. Inhibitory control was evaluated by the stop-signal reaction time (SSRT) as well as by the amplitude of the event-related potential (ERP) component of N2 during successful inhibition. We found that higher inattention symptoms throughout childhood predicted reduced amplitude (i.e., less negative) of the N2 in adolescence. Furthermore, the N2 amplitude was longitudinally predicted by the early precursors of child familial risk for ADHD and early childhood temperament. Specifically, father's inattention symptoms (measured in the child's early infancy) and child's effortful control at 36 months of age directly predicted the N2 amplitude in adolescence, even beyond the consistency of inattention symptoms throughout development. The SSRT was predicted by ADHD symptoms throughout childhood but not by the early precursors. Our findings emphasize the relevance of early familial and temperamental risk for ADHD to the prediction of a later dysfunction in inhibitory control.
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Affiliation(s)
- Tzlil Einziger
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel
| | - Mattan S. Ben-Shachar
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel
| | - Tali Devor
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
| | - Michael Shmueli
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
| | - Judith G. Auerbach
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
| | - Andrea Berger
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel
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95
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Breitling-Ziegler C, Zaehle T, Wellnhofer C, Dannhauer M, Tegelbeckers J, Baumann V, Flechtner HH, Krauel K. Effects of a five-day HD-tDCS application to the right IFG depend on current intensity: A study in children and adolescents with ADHD. PROGRESS IN BRAIN RESEARCH 2021; 264:117-150. [PMID: 34167653 DOI: 10.1016/bs.pbr.2021.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Impaired executive functions in ADHD are associated with hypoactivity of the right inferior frontal gyrus (IFG). This region was targeted via repetitive applications of anodal, high-definition transcranial direct current simulation (HD-tDCS) on five consecutive days in 33 ADHD patients (10-17years) and in a healthy control group (n=13, only sham). Patients received either sham (n=13) or verum tDCS with 0.5mA (n=9) or 0.25mA (n=11) depending on individual cutaneous sensitivity. During stimulation, participants performed a combined working memory and response inhibition paradigm (n-back/nogo). At baseline, post, and a 4-month follow up, electroencephalography was recorded during this task. Moreover, interference control (flanker task) and spatial working memory (spanboard task) were assessed to explore possible transfer effects. Omission errors and reaction time variability in all tasks served as measures of attention. In the 0.25mA group increased nogo commission errors indicated a detrimental tDCS effect on response inhibition. After the 5-day stimulation, attentional improvements in the 0.5mA group were indicated by reduced omission errors and reaction time variability. Variability improvements were still evident at follow up. In all groups, nogo P3 amplitudes were reduced post-stimulation, but in the 0.5mA group this reduction was smaller than in the 0.25mA group. Results of the current study suggest distinct effects of tDCS with different current intensities demonstrating the importance of a deeper understanding on the impact of stimulation parameters and repeated tDCS applications to develop effective tDCS-based therapy approaches in ADHD.
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Affiliation(s)
- Carolin Breitling-Ziegler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany.
| | - Tino Zaehle
- Department of Neurology, Otto von Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University, Magdeburg, Germany
| | - Christian Wellnhofer
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Moritz Dannhauer
- Scientific Computing and Imaging Institute, Center for Integrated Biomedical Computing, University of Utah, Salt Lake City, UT, United States
| | - Jana Tegelbeckers
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany; Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Valentin Baumann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Hans-Henning Flechtner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Kerstin Krauel
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Otto von Guericke University, Magdeburg, Germany
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Knez R, Stevanovic D, Nasic S, Doric A, Wentz E. The Impact of Methylphenidate on QbTest Performance of Children with ADHD: A Retrospective Clinical Study. Neuropsychiatr Dis Treat 2021; 17:19-32. [PMID: 33447036 PMCID: PMC7802589 DOI: 10.2147/ndt.s277490] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/07/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The Quantified behavior Test (QbTest), which combines a continuous performance task (CPT) and motion tracking, provides data for the core signs of attention-deficit/hyperactivity disorder (ADHD): attention, hyperactivity, and impulsivity. This study aimed to evaluate the performance of children and adolescents with ADHD on the QbTest before and after a single methylphenidate (MPH) dose. SUBJECTS AND METHODS This retrospective chart review study included data from 149 children and 215 adolescents who completed the QbTest. A summary index of the CPT and motion capture data on the QbTest is provided by three cardinal parameters: QbActivity, QbImpulsivity, and QbInattention. The test was performed twice on the same day, before and up to three hours after MPH intake. A decrease by ≥ 0.5 in a cardinal parameter score was considered an improvement, whereas an increase by ≥ 0.5 a deterioration. RESULTS QbActivity improvement after MPH intake was present in 71.7% and 76.2% of the children and adolescents, respectively. QbImpulsivity improvement was observed in 50.4% of the children and 44.7% of the adolescents, and QbInattention improvement in 85.1% and 91.1% of the children and adolescents, respectively. All three parameters improved simultaneously in 27.7% of the children and 28.7% of the adolescents. The likelihood that one parameter deteriorated after MPH use was greater if that parameter was within the normal range before medication. This was most pronounced for QbImpulsivity. Among male adolescents, QbInattention improvement was often accompanied by QbImpulsivity deterioration. CONCLUSION The QbTest inattention and motor activity parameters improved markedly after a single MPH dose in children and adolescents with ADHD, while less so for impulsivity. Improvement of one parameter is not necessarily associated with improvement of the other two, and deterioration, especially regarding impulsivity, may occur. If confirmed, these results highlight the need for optimization and individualization of MPH treatment, while monitoring all aspects of the ADHD symptomatology based on the QbTest performance.
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Affiliation(s)
- Rajna Knez
- Department of Pediatrics, Skaraborgs Hospital, Skövde, Sweden; Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Dejan Stevanovic
- Psychiatry Department, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Salmir Nasic
- Research & Development Centre, Skaraborgs Hospital, Skövde, Sweden
| | - Ana Doric
- Department of Psychology, Faculty of Humanity and Social Sciences, University of Rijeka, Rijeka, Croatia
| | - Elisabet Wentz
- Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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97
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Lin HY, Chang WD, Hsieh HC, Yu WH, Lee P. Relationship between intraindividual auditory and visual attention in children with ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 108:103808. [PMID: 33242747 DOI: 10.1016/j.ridd.2020.103808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 10/13/2020] [Accepted: 10/26/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND AIM Most previous attention-deficit/hyperactivity disorder (ADHD) studies have used only a single sensory modality (usually vision) to investigate attentional problems, although patients with ADHD might display deficits of auditory attention similar to their visual attention. This study explored intraindividual auditory and visual attention in children with and without ADHD to examine the relationship between these two dimensions of attention. METHODS Attentional performances of 140 children (70 children with ADHD and 70 typically developing peers) were measured through the Test of Variables of Attention (TOVA) in the present study. RESULTS For both groups, most attentional indices showed significant differences between the two modalities (d ranging from 0.32 to 0.72). The correlation coefficients of most of the attentional variables in children with ADHD were lower than their typically developing peers. All attentional indices of children with ADHD (ranging from 12.8%-55.7%) were much higher than those of their typically developing peers (ranging from 1.4%-8.6%). CONCLUSION These results not only indicate that typically developing children display more consistent attentional performance, but also support the view that children with ADHD may show attention deficiency in one modality but not necessarily in the other.
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Affiliation(s)
- Hung-Yu Lin
- Department of Occupational Therapy at Asia University, Taichung, Taiwan.
| | - Wen-Dien Chang
- Department of Sport Performance at National Taiwan University of Sport, Taichung, Taiwan
| | - Hsieh-Chun Hsieh
- Department of Special Education at National Tsing Hua University, Hsinchu, Taiwan
| | - Wan-Hui Yu
- Department of Occupational Therapy at Asia University, Taichung, Taiwan
| | - Posen Lee
- Department of Occupational Therapy at I-Shou University, Kaohsiung, Taiwan
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98
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Hilger K, Sassenhagen J, Kühnhausen J, Reuter M, Schwarz U, Gawrilow C, Fiebach CJ. Neurophysiological markers of ADHD symptoms in typically-developing children. Sci Rep 2020; 10:22460. [PMID: 33384437 PMCID: PMC7775445 DOI: 10.1038/s41598-020-80562-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/23/2020] [Indexed: 12/24/2022] Open
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms of inattention, impulsivity, and hyperactivity. Neurophysiological correlates of ADHD include changes in the P3 component of event-related brain potentials (ERPs). Motivated by recent advances towards a more dimensional understanding of ADHD, we investigate whether ADHD-related ERP markers relate to continuous variations in attention and executive functioning also in typically-developing children. ERPs were measured while 31 school children (9-11 years) completed an adapted version of the Continuous Performance Task that additionally to inhibitory processes also isolates effects of physical stimulus salience. Children with higher levels of parent-reported ADHD symptoms did not differ in task performance, but exhibited smaller P3 amplitudes related to stimulus salience. Furthermore, ADHD symptoms were associated with the variability of neural responses over time: Children with higher levels of ADHD symptoms demonstrated lower variability in inhibition- and salience-related P3 amplitudes. No effects were observed for ERP latencies and the salience-related N2. By demonstrating that ADHD-associated neurophysiological mechanisms of inhibition and salience processing covary with attention and executive functioning in a children community sample, our study provides neurophysiological support for dimensional models of ADHD. Also, temporal variability in event-related potentials is highlighted as additional indicator of ADHD requiring further investigation.
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Affiliation(s)
- Kirsten Hilger
- Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany. .,Department of Psychology I, University Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany. .,IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.
| | - Jona Sassenhagen
- Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jan Kühnhausen
- IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,LEAD Graduate School and Research Network, Eberhard Karls University Tübingen, Tübingen, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, University Hospital Tübingen, Tübingen, Germany
| | - Merle Reuter
- IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,Department of Psychology, University Tübingen, Tübingen, Germany
| | - Ulrike Schwarz
- IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,Department of Psychology, University Tübingen, Tübingen, Germany
| | - Caterina Gawrilow
- IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,Department of Psychology, University Tübingen, Tübingen, Germany
| | - Christian J Fiebach
- Department of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany.,IDeA Center for Individual Development and Adaptive Education, Frankfurt am Main, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
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99
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Cross-sectional and prospective associations of P300, RewP, and ADHD symptoms in female adolescents. Int J Psychophysiol 2020; 158:215-224. [DOI: 10.1016/j.ijpsycho.2020.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 07/31/2020] [Accepted: 08/16/2020] [Indexed: 12/29/2022]
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100
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Disentangling the effects of attentional difficulties on fears of social evaluation and social anxiety symptoms: Unique interactions with sluggish cognitive tempo. J Psychiatr Res 2020; 131:39-46. [PMID: 32919100 PMCID: PMC7669641 DOI: 10.1016/j.jpsychires.2020.08.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/07/2020] [Accepted: 08/22/2020] [Indexed: 11/23/2022]
Abstract
Although fears of negative and positive social evaluation are hallmark cognitive features of social anxiety, attentional difficulties may exacerbate the relation between fears of social evaluation and social anxiety. Thus, the goal of the current study was to test whether two different types of self-reported attentional difficulties, specifically sluggish cognitive tempo (SCT) and attention-deficit/hyperactivity disorder (ADHD) inattention symptoms, moderate the relation between fears of social evaluation and social anxiety. Participants (N = 4756; Mage = 19.28 years; 72.7% female) enrolled in five universities across the United States completed self-report measures of fears of negative and positive evaluation and psychopathology symptoms. Results indicated a significant two-way interaction of fear of negative evaluation and SCT in relation to social anxiety symptoms, as well as a significant two-way interaction of fear of positive evaluation and SCT in relation to social anxiety symptoms. In both instances, the associations between fears of negative and positive evaluation in relation to social anxiety became increasingly stronger at higher levels of SCT. Conversely, the interactions between fears of negative and positive evaluation with ADHD inattentive symptoms were non-significant. These results are the first to report that self-reported SCT, but not ADHD inattentive symptoms, exacerbate the relation between fears of social evaluation and social anxiety, and suggest that attentional difficulties characteristic of SCT may prolong engagement in fears.
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