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Cleaton MAM, Tal-Saban M, Hill EL, Kirby A. Gender and age differences in the presentation of at-risk or probable Developmental Coordination Disorder in adults. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 115:104010. [PMID: 34139601 DOI: 10.1016/j.ridd.2021.104010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Developmental Coordination Disorder (DCD), also called Dyspraxia, is a common Neurodevelopmental Disorder (NDD) that affects motor coordination with a marked impact on both academic and day-to-day living activities. It is increasingly clear that NDDs such as Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder may present differently in males and females, resulting in underdiagnoses of women and girls. AIMS To consider age and gender differences in the presentation of at-risk and probable DCD. METHODS AND PROCEDURES A sample of 1,476 adults aged 16-60 years were surveyed online using the Adult DCD Checklist. OUTCOMES AND RESULTS Women with at-risk (n = 1 8 6, 1 6. 6 %) or probable DCD (n = 6 4 3, 5 6. 6 %) reported significantly greater gross motor and non-motor difficulties and significantly greater impact on activities and participation, whereas men with at-risk (n = 58,16.3 %) or probable (n = 177,49.9 %), DCD reported significantly greater fine motor difficulties. Emerging adults (aged 16-25 years) with at-risk (n = 65,14.3 %) or probable (293,64.3 %) DCD reported significantly greater non-motor difficulty than adults (aged 26-60+ years) with at-risk (n = 179,17.5 %) or probable (n = 518, 50.8 %) DCD. CONCLUSIONS AND IMPLICATIONS Both age and gender differences were found in the presentation of at-risk and probable DCD in adults. This may have implications for the development of future DCD assessment tools and for the training of front-line staff who may encounter individuals with DCD throughout their lives, including teachers, doctors and employers' Human Resources and Occupational Health staff.
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Affiliation(s)
- Mary A M Cleaton
- Do-IT Solutions Ltd., Ocean Park House, East Tyndall Street, Cardiff, United Kingdom
| | - Miri Tal-Saban
- School of Occupational Therapy, the Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elisabeth L Hill
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Amanda Kirby
- Do-IT Solutions Ltd., Ocean Park House, East Tyndall Street, Cardiff, United Kingdom.
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102
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Nolan C, Murphy C, Kelly M. Using the IRAP to Investigate Gender Biases Towards ADHD and Anxiety. PSYCHOLOGICAL RECORD 2021. [DOI: 10.1007/s40732-021-00474-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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103
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Emotion Regulation via the Autonomic Nervous System in Children with Attention-Deficit/Hyperactivity Disorder (ADHD): Replication and Extension. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:361-373. [PMID: 31808007 DOI: 10.1007/s10802-019-00593-8] [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: 12/23/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder characterized by symptoms of inattention, hyperactivity, and/or impulsivity, as well as executive dysfunction. Recent work underlines the importance in understanding the role of emotion reactivity and regulatory deficits in the context of the disorder. One study (i.e., Musser et al. 2011) utilized a positive and negative emotion induction and suppression task, as well as indexes of autonomic nervous system reactivity, to examine emotional functioning in youth with ADHD. This study revealed inflexible parasympathetic-based regulation across emotion conditions among youth with ADHD compared to typically developing youth. The present study sought to replicate and extend these findings to a clinically recruited, diverse sample, while also examining sympathetic functioning. Two hundred fifty-nine participants (160 youth with ADHD), aged 5 to 13, completed the task utilized in Musser et al. 2011, while indexes of parasympathetic (i.e., respiratory sinus arrhythmia [RSA]) and sympathetic (i.e., pre-ejection period [PEP] and electrodermal activity [EDA]) reactivity were obtained. ADHD was associated with significantly elevated parasympathetic (i.e., augmented RSA) and sympathetic (as indexed by EDA) reactivity. Overall, results replicate and extend Musser et al. 2011, revealing sympathetic-linked disruptions in emotion reactivity and parasympathetic-linked disruptions in emotion regulation among youth with ADHD. Future studies of behavioral therapies for ADHD should consider the efficacy of adding an emotion regulation skills training component.
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104
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Wright AJ. Psychological and neuropsychological underpinnings of attention-deficit/hyperactivity disorder assessment. Clin Child Psychol Psychiatry 2021; 26:783-794. [PMID: 33624519 DOI: 10.1177/1359104521996765] [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
The identification and diagnosis of attention-deficit/hyperactivity disorder (ADHD) is extremely important in order to help change the trajectory of an individual's life outcomes. A review of the current state of evidence-based assessment of ADHD is dominated by the DSM-5's conceptualization of behaviorally-oriented diagnostic criteria. This assumption that the DSM-5's method for identifying ADHD is the gold standard underlies the research base that evaluates the incremental validity of measures and methods for diagnosing it. That is, when evaluating whether a measure is useful in the identification of ADHD, the 'right answer' is based on the DSM-5's behaviorally-oriented definition. An alternative model for considering the fact that ADHD is a neurodevelopmental disorder, with its roots in executive dysfunction, is proposed. Using neuropsychological and cognitive tests to identify executive functioning problems can be combined with rating scales and interviews to diagnose ADHD in a way that does not ascribe entirely to a behavioral definition of the disorder.
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105
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Murray AL, Speyer LG, Hall HA, Valdebenito S, Hughes C. A Longitudinal and Gender Invariance Analysis of the Strengths and Difficulties Questionnaire Across Ages 3, 5, 7, 11, 14, and 17 in a Large U.K.-Representative Sample. Assessment 2021; 29:1248-1261. [PMID: 33874786 PMCID: PMC9301174 DOI: 10.1177/10731911211009312] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Developmental invariance is important for making valid inferences about child
development from longitudinal data; however, it is rarely tested. We evaluated
developmental and gender invariance for one of the most widely used measures of
child mental health: the parent-reported Strengths and Difficulties
Questionnaire (SDQ). Using data from the large U.K. population-representative
Millennium Cohort Study (N = 10,207; with data at ages 3, 5, 7,
11, 14, and 17 years), we tested configural, metric, scalar, and residual
invariance in emotional problems, conduct problems, hyperactivity/inattention,
prosociality, and peer problems. We found that the SDQ showed poor fit at age 3
in both males and females and at age 17 in males; however, it fit reasonably
well and its scores were measurement invariant up to the residual level across
gender at ages 5, 7, 11, and 14 years. Scores were also longitudinally
measurement invariant across this age range up to the partial residual level.
Results suggest that the parent-reported SDQ can be used to estimate
developmental trajectories of emotional problems, conduct problems,
hyperactivity/inattention, prosociality, and peer problems and their gender
differences across the age range 5 to 14 years using a latent model.
Developmental differences outside of this range may; however, partly reflect
measurement differences.
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106
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Tahıllıoğlu A, Bilaç Ö, Uysal T, Ercan ES. Who predict ADHD with better diagnostic accuracy?: Parents or teachers? Nord J Psychiatry 2021; 75:214-223. [PMID: 33612071 DOI: 10.1080/08039488.2020.1867634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The objectives of the study were to determine which parents or teachers predict attention-deficit/hyperactivity disorder (ADHD) better in children and adolescents, and to detect both diagnostical and symptomatological agreement levels across informant reports. METHOD A total of 417 cases aged 6-14 from a non-referred community sample were assessed by a semi-structured interview, parent- and teacher-rated ADHD Rating Scale-IV. Also, impairment criteria were taken into account to ensure the gold standard diagnosis for ADHD. The measures of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated in each categorical sample. Besides, the agreement between parent and teacher reports of ADHD was investigated. RESULTS Parents and teachers had similar diagnostic accuracy for predicting ADHD. Both parents and teachers predicted ADHD in similar accuracy in both boys and girls, separately. However, girls were found to be more predictable by both parents and teachers compared to boys. Parents with lower education levels had worse diagnostic accuracy than both parents with higher education levels and teachers. Low to moderate agreement and correlations between parent and teacher ADHD reports were detected. CONCLUSION In general, parents and teachers seem to predict ADHD in similar accuracy. Nevertheless, child gender and parental education level may alter the predictability power for ADHD. The findings can guide for clinicians that how to evaluate observation reports of parents and teachers to make accurate ADHD diagnosis in patients.
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Affiliation(s)
- Akın Tahıllıoğlu
- Department of Child and Adolescent Psychiatry, Ege University, Izmir, Turkey
| | - Öznur Bilaç
- Department of Child and Adolescent Psychiatry, Manisa Celal Bayar University, Manisa, Turkey
| | - Taciser Uysal
- Department of Child and Adolescent Psychiatry, İstanbul Okmeydanı Education and Research Hospital, Istanbul, Turkey
| | - Eyüp Sabri Ercan
- Department of Child and Adolescent Psychiatry, Ege University, Izmir, Turkey
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107
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London AS, Landes SD. Cohort Change in the Prevalence of ADHD Among U.S. Adults: Evidence of a Gender-Specific Historical Period Effect. J Atten Disord 2021; 25:771-782. [PMID: 31189421 DOI: 10.1177/1087054719855689] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To document inter- and intra-cohort changes in adult ADHD and examine whether changes vary by gender. Method: We analyze data from the 2007 and 2012 U.S. National Health Interview Survey. Results: The prevalence of ADHD among adults aged 18 to 64 years increased from 3.41% in 2007 to 4.25% in 2012. As expected, patterns of inter- and intra-cohort change varied by gender. At younger ages, inter-cohort gender differences are more distinct due to a spike in prevalence among boys/men born in or after 1980. Consistent with a gender-specific historical period effect, recent intra-cohort increases among women have narrowed the gender gap. Conclusion: The gender gap in the prevalence of ADHD among adults decreased by 31.1% from 2007 to 2012 due to increased prevalence among adult women of all ages. We discuss these results in relation to diagnostic practice, adult health and well-being, data limitations and needs, and directions for future research.
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108
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Assessing reading and online research comprehension: Do difficulties in attention and executive function matter? LEARNING AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.lindif.2021.101985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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109
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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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110
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Kahle S, Mukherjee P, Dixon JF, Leibenluft E, Hinshaw SP, Schweitzer JB. Irritability Predicts Hyperactive/Impulsive Symptoms Across Adolescence for Females. Res Child Adolesc Psychopathol 2021; 49:185-196. [PMID: 33294965 PMCID: PMC8202810 DOI: 10.1007/s10802-020-00723-7] [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: 10/11/2020] [Indexed: 10/22/2022]
Abstract
Irritability is common in Attention-Deficit Hyperactivity Disorder (ADHD), but little is known about whether irritability predicts the course of ADHD symptoms over time. Adolescence is a dynamic period of emotional development as well as shifts in ADHD symptoms; an important goal is to identify youth at risk of increasing or persisting symptoms. We examined irritability as a longitudinal predictor of change in adolescents' ADHD symptoms, as well as how this link may differ in females versus males. The sample included 108 youth (72 males) age 12-16 years (M = 14.21 years, SD = 1.44 years), 62 of whom met criteria for ADHD. Approximately 18 months later, 80 participants (48 males) were followed up at Time 2. A dimensional approach was used to examine changes over time in parent-reported inattentive and hyperactive/impulsive symptoms. Longitudinal path analysis revealed that irritability at Time 1 predicted higher relative hyperactive/impulsive symptoms at Time 2 after controlling for age and longitudinal stability in all variables. A multiple-group analysis examining moderation by sex/gender revealed that this association was significant only for females. These results suggest that irritability may play a key role in the persistence and worsening of hyperactive/impulsive symptoms across adolescence for females, with potential implications for the diagnosis and treatment of females with ADHD.
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Affiliation(s)
- Sarah Kahle
- MIND Institute, University of California, Davis, CA, USA
| | | | - J Faye Dixon
- MIND Institute, University of California, Davis, CA, USA
| | | | - Stephen P Hinshaw
- University of California, Berkeley, CA, USA
- University of California, San Francisco, CA, USA
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111
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Zhang KA, Markon KE. Age and Gender Measurement Noninvariance of the Adult ADHD Self-Report Scale Screener. J Atten Disord 2021; 25:403-413. [PMID: 30449230 DOI: 10.1177/1087054718808059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The nature and form of demographics-related differences in ADHD self-reported symptoms across adulthood is currently poorly understood. This study explored the psychometrics of the Adult ADHD Self-Report Scale Screener (ASRS-6), including its age- and gender-related measurement invariance. Method: Structural equation models were used to analyze adult data-aged 16 to 95 years-from the 2007 British Adult Psychiatric Morbidity Survey. Results: The three-factor model (disorganization, inattention, hyperactivity) outperformed one- and two-factor models. Self-reported attentional deficits may be more pathognomonic of overall self-reported ADHD in adults than other symptoms. All items exhibited age measurement noninvariance while only a subset exhibited gender measurement noninvariance. Individuals who are male and younger tend to have lower thresholds for endorsement for ASRS-6 items than individuals who are female and older. Conclusion: The ASRS-6 does not appear to be unidimensional, and self-reported ASRS-6 symptomatology changes in meaning with age.
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Affiliation(s)
- K Anne Zhang
- The University of Iowa, Iowa City, USA.,Indiana University, Bloomington, USA
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112
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Doidge JL, Flora DB, Toplak ME. A Meta-Analytic Review of Sex Differences on Delay of Gratification and Temporal Discounting Tasks in ADHD and Typically Developing Samples. J Atten Disord 2021; 25:540-561. [PMID: 30596297 DOI: 10.1177/1087054718815588] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: To examine whether males and females with ADHD differ in their preferences for delayed rewards, since there is some evidence that suggests a sex difference with typically developing (TD) samples. Method: We used meta-analyses to examine sex differences on delay of gratification and temporal discounting tasks in both TD and ADHD samples. We identified 28 papers with 52 effect sizes for children and adults, and calculated the average effect size for sex comparisons within TD and ADHD samples. Results: The estimated mean difference between TD males and TD females was negligible, but males with ADHD were more likely to choose the larger delayed rewards than females with ADHD. Meta-regressions indicated that task type, age, and reward type did not significantly predict sex differences. Conclusion: These findings suggest that females referred for ADHD may make less adaptive choices by preferring smaller immediate rewards over larger delayed rewards more often than males with ADHD. Implications of our findings are discussed.
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113
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Lau TWI, Lim CG, Acharryya S, Lim-Ashworth N, Tan YR, Fung SSD. Gender differences in externalizing and internalizing problems in Singaporean children and adolescents with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatry Ment Health 2021; 15:3. [PMID: 33482840 PMCID: PMC7825195 DOI: 10.1186/s13034-021-00356-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/11/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Studies on gender differences in attention-deficit/hyperactivity disorder (ADHD) comorbidities in the Asian populations have been limited and previous studies have shown inconclusive findings. Singapore is a city-state country in Southeast Asia with a population of 5.7 million. This study examined gender differences in internalizing and externalizing problems in Singaporean children and adolescents with ADHD. The plausible social factors underlying the gender differences were discussed. METHODS A total of 773 participants (aged 6 to 18, 88% males) newly diagnosed with ADHD were recruited from the largest public child and adolescent psychiatric center in Singapore. Their internalizing and externalizing problems were assessed using the Child Behavioral Checklist and Teacher's Report Form by parents and teachers respectively. Demographics and relevant social factors were collected using parent questionnaires. RESULTS Females with ADHD were reported to have less delinquent and aggressive behavior but more depressive symptoms than their male counterparts, similar to findings in the Western literature. Gender remained a significant predictor of externalizing problem after controlling for other factors. Lower socioeconomic status and parental use of physical punishment were significant predictors of both internalizing and externalizing problems. CONCLUSIONS Gender differences in ADHD comorbidities do exist in the Asian clinical population. The lack of externalizing symptoms in females with ADHD has made timely referral and diagnosis challenging. More research is needed in understanding the gender differences in ADHD and the biopsychosocial mechanism underlying the differences in order to improve the detection of ADHD in females.
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Affiliation(s)
- Tsz Wing Ivy Lau
- The Institute of Mental Health, Buangkok Green Medical Park 10 Buangkok View, Singapore, 539747, Singapore
| | - Choon Guan Lim
- The Institute of Mental Health, Buangkok Green Medical Park 10 Buangkok View, Singapore, 539747, Singapore
| | | | - Nikki Lim-Ashworth
- The Institute of Mental Health, Buangkok Green Medical Park 10 Buangkok View, Singapore, 539747, Singapore
| | - Yi Ren Tan
- The Institute of Mental Health, Buangkok Green Medical Park 10 Buangkok View, Singapore, 539747, Singapore
| | - Shuen Sheng Daniel Fung
- The Institute of Mental Health, Buangkok Green Medical Park 10 Buangkok View, Singapore, 539747, Singapore.
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114
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Shen Y, Wang L, Huang C, Guo J, De Leon SA, Lu J, Luo X, Zhang XY. Sex differences in prevalence, risk factors and clinical correlates of internet addiction among chinese college students. J Affect Disord 2021; 279:680-686. [PMID: 33190119 DOI: 10.1016/j.jad.2020.10.054] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/09/2020] [Accepted: 10/25/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Internet addiction(IA) is now very common. However, few studies have explored the sex differences in risk factors for IA, especially among Chinese college students. This study aimed to investigate the sex differences in prevalence, risk factors and clinical correlates of IA among Chinese college students. METHODS A total of 8098 college students from Hunan province were recruited using a cross-sectional design and a convenience sampling method. Each student filled out the survey online anonymously, which collected their information on their socio-demographics, internet addiction(Revised Chinese internet addiction scale;CIAS-R), ADHD(Wender Utah Rating Scale and World Health Organization (WHO) Adult ADHD Self-Report Scale v 1.1 Symptom Checklist), depression(Self-reporting Depression Scale;SDS), insomnia(Athens Insomnia Scale;AIS), anxiety(Self-Rating Anxiety Scale;SAS) and suicidal behaviors through WeChat. RESULTS Overall, the prevalence of IA in males and females was 7.21%(259/3592) and 8.17%(368/4506), respectively. Multivariate logistic regression analysis revealed that suicidal ideation[odds ratio (OR),1.557;95% confidence interval (CI),1.083-2.240], suicide attempts(OR,2.081;95%CI:1.271-3.409), ADHD(OR,6.487;95%CI,4.697-8.959) and insomnia(OR,2.596;95%CI,1.910-3.529) were independent risk factors for male IA after controlling for confounding variables. Nationality(OR,1.507;95%CI,1.058-2.145), suicidal ideation(OR,2.012;95%CI,1.532-2.641), depression(OR,1.771;95%CI:1.071-2.930), ADHD(OR,4.497; 95%CI,3.285-6.158) and insomnia(OR,2.356;95%CI,1.813-3.061) were independent risk factors for female IA. LIMITATION No causal relationships could be drawn due to the cross-sectional design. CONCLUSIONS This study shows IA is common among both sexes. IA is significantly associated with ADHD, insomnia and suicidal behaviors in both male and female students, indicating the importance of screening IA and addressing ADHD, insomnia and suicidal behaviors to improve the mental health of college students and better prevent suicide in both sexes.
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Affiliation(s)
- Yanmei Shen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Lu Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Chunxiang Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Jimin Guo
- Department of Internal Medicine, Molecular Medicine, University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - Sara Arenas De Leon
- Department of Biochemistry and Molecular Biology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131, USA
| | - JianPing Lu
- Department of Child and Adolescent Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), 16 Lincui Road, Chaoyang District, Beijing 100101, China.
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115
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Lineweaver TT, Kercood S, Gabor AJ, Cervantes J, Laine A, Baker E. The effect of medication and question wording on self-reported symptoms and their accuracy in young adults with attention-deficit/hyperactivity disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 60:252-269. [PMID: 33393098 DOI: 10.1111/bjc.12276] [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] [Received: 06/05/2020] [Revised: 12/06/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study examined the effect of whether participants were on or off their medications and the effect of questionnaire wording on self-reported symptoms in young adults with ADHD. Additionally, this research evaluated the relationships between these self-reported symptoms and objective performance on measures of working memory. DESIGN This experimental study utilized a mixed factorial design with one between-subjects factor (whether participants were unmedicated or medicated at the time they completed their assessment) and one within-subjects factor (whether participants reported their on-medication or off-medication symptoms when describing their ADHD subjective symptomatology). METHODS Forty-five young adults with ADHD (ages 18-23) completed a brief neuropsychological evaluation and several self-report questionnaires. RESULTS Although being medicated or unmedicated while completing the questionnaires did not directly affect self-reported symptoms or their accuracy, questionnaire wording exerted a statistically significant effect on subjective symptomatology; participants described themselves as substantially more symptomatic at times when they are off than at times when they are on their medications. More importantly, their general self-perceptions (symptoms when medication state was not specified) of their Inattention/Memory Problems and their Hyperactivity/Restlessness aligned with their descriptions of their off-medication symptoms, whereas their general self-perceptions of their Impulsivity/Emotional Lability and Problems with Self-Concept related to both their self-reported off-medication and on-medication symptoms. CONCLUSIONS These results highlight the necessity of specifying medication state when asking patients to report their current symptomatology. Failing to do so risks an over-reporting of symptoms from patients who are typically on medications as they may describe the extent of their unmedicated, rather than medicated, symptomatology. PRACTITIONER POINTS Being medicated or unmedicated while completing questionnaires about subjective symptomatology did not directly affect self-reported symptoms of young adults with ADHD or the accuracy of these self-reports. When medication state was not specified on a questionnaire, young adults with ADHD reported symptoms similar to those they experience when they are not medicated. These results highlight the importance of specifying medication state when asking young adults with ADHD to report their current symptomatology. Failing to do so risks an over-reporting of symptoms from patients who are typically on medications. These findings open the door for further research with larger and more diverse and representative samples of adults with ADHD to evaluate the accuracy of their subjective symptomatology relative to their objective abilities. Future studies should also examine whether gender affects subjective symptoms, their accuracy, or the influence of question wording and medications on self-reported symptomatology of adults with ADHD, as the current study was unable to address this important issue.
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Affiliation(s)
- Tara T Lineweaver
- Department of Psychology, Butler University, Indianapolis, Indiana, USA
| | - Suneeta Kercood
- College of Education, Butler University, Indianapolis, Indiana, USA
| | - Alexandra J Gabor
- Department of Psychology, Butler University, Indianapolis, Indiana, USA
| | - Jhovana Cervantes
- Department of Psychology, Butler University, Indianapolis, Indiana, USA
| | - Abigail Laine
- Department of Psychology, Butler University, Indianapolis, Indiana, USA
| | - Ellen Baker
- Department of Psychology, Butler University, Indianapolis, Indiana, USA
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Katzenmajer-Pump L, Farkas BF, Varga BA, Jansma JM, Balázs J. Low Level of Perfectionism as a Possible Risk Factor for Suicide in Adolescents With Attention-Deficit/Hyperactivity Disorder. Front Psychiatry 2021; 12:707831. [PMID: 34589006 PMCID: PMC8473605 DOI: 10.3389/fpsyt.2021.707831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/17/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: Suicide is one of the leading causes of death among adolescents. Although it is known that both perfectionism and attention-deficit/hyperactivity disorder ('ADHD') are important risk factors for suicide, there are no studies that have investigated the relationship between suicidal behavior and perfectionism among people with ADHD. Aim: The current study investigates the association between perfectionism and suicide in adolescents with ADHD. Method: Subjects included 88 adolescents with ADHD and 96 non-clinical control adolescents. We used the Multidimensional Perfectionism Scale to evaluate perfectionism as well as its separate traits, and the Mini International Neuropsychologic Interview Kid to evaluate psychiatric disorders and suicidal behavior. Differences between the groups were statistically evaluated using t-tests, a Poisson regression analysis with suicide as a discrete variable, and a logistic regression analysis with suicide as a binary variable. Results: Compared to the control group, the ADHD group showed a significantly lower level on the adaptive 'Organization' trait of perfectionism, but not on any other trait, and a significantly higher level of suicidal behavior. Logistic regression results indicated a significant association for perfectionism in general (OR = 0.93, p = 0.003), and for the 'Personal Standards' trait (OR: 0.82, p = 0.039). Poisson regression analysis also showed a significant association with perfectionism in general (IRR = 0.90; p < 0.001) and with the 'Personal standards' trait model (IRR = 0.81, p = 0.019). Discussion: Our results indicate that a low level of perfectionism, in particular 'Personal standards', may be a risk factor for suicidal behavior in adolescents with ADHD. We recommend that psychoeducation and therapy of adolescents with ADHD should consider focusing on adaptive perfection as a possible risk factor for suicide as well.
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Affiliation(s)
- Luca Katzenmajer-Pump
- Institute of Psychology, Eötvös Loránd University, Doctoral School of Psychology, Budapest, Hungary
| | | | - Balázs András Varga
- Institute of Psychology, Eötvös Loránd University, Doctoral School of Psychology, Budapest, Hungary
| | - Johan M Jansma
- Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, UMC Utrecht, Utrecht, Netherlands
| | - Judit Balázs
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Department of Psychology, Bjørknes University College, Oslo, Norway
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117
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Zou H, Yang J. Exploring the Brain Lateralization in ADHD Based on Variability of Resting-State fMRI Signal. J Atten Disord 2021; 25:258-264. [PMID: 30520697 DOI: 10.1177/1087054718816170] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: In this study, we investigate the brain lateralization in ADHD patients. Furthermore, we also explore the difference between male and female patients, and the difference among distinct ADHD subtypes, that is, ADHD-inattentive (ADHD-IA) and ADHD-combined (ADHD-C). Method: We employed the standard deviation to quantify the variability of resting-state functional magnetic resonance imaging (fMRI) signal and measure the lateralization index (LI). Results: ADHD patients showed significantly increased rightward lateralization in the inferior frontal gyrus (opercular), precuneus, and paracentral lobule, and decreased rightward lateralization in the insula. Compared with male patients, female patients showed significantly rightward lateralization in the putamen and lobule VII of cerebellar hemisphere. ADHD-C patients exhibited increased rightward lateralization in the inferior frontal gyrus (opercular), and decreased rightward lateralization in the inferior temporal gyrus, as compared with ADHD-IA. The LI was also found to be related to inattentive and hyper/impulsive scores. Conclusion: These key findings may aid in understanding the pathology of ADHD.
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Affiliation(s)
| | - Jian Yang
- Nanjing University of Science & Technology, China
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118
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Fluyau D, Revadigar N, Pierre CG. Systematic Review and Meta-Analysis: Treatment of Substance Use Disorder in Attention Deficit Hyperactivity Disorder. Am J Addict 2020; 30:110-121. [PMID: 33289928 DOI: 10.1111/ajad.13133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/20/2020] [Accepted: 11/22/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Treating substance use disorder (SUD) in patients with co-occurring attention deficit hyperactivity disorder (ADHD) and SUD may lower medical, psychiatric, and social complications. We conducted a systematic review with meta-analysis to investigate the clinical benefits of pharmacological interventions to treat SUD in patients with ADHD. METHODS Articles were searched on Cochrane Central Register of Controlled Trials, PubMed, EBSCO, Google Scholar, Embase, Web of Science, and Ovid MEDLINE from 1971 to 2020. Data for SUD treatment as primary study endpoints and ADHD symptoms management as secondary outcomes were synthesized using random-effects model meta-analysis. Studies (N = 17) were included. The principal measure of effect size was the standardized mean difference (SMD). PROSPERO registration: CRD42020171646. RESULTS The pooled effect of pharmacological interventions compared with placebo was small for the reduction in substance use (SMD = 0.405, 95% confidence interval [CI]: [0.252, 0.557], P < .001), abstinence (SMD = 0.328, 95% CI: [0.149, 0.507], P < .001), craving (SMD = 0.274, 95% CI: [0.103, 0.446], P = .002), and the reduction in the frequency of ADHD symptoms (SMD = 0.420, 95% CI: [0.259, 0.582], P < .001). The pooled effect was moderate for the management of withdrawal symptoms (SMD = 0.577, 95% CI: [0.389, 0.764], P = .001]) and the decrease in the severity of ADHD symptoms (SMD = 0.533, 95% CI: [0.393, 0.672], P < .001). CONCLUSION AND SCIENTIFIC SIGNIFICANCE The magnitude of benefits for pharmacological interventions varies. Despite some limitations, it was positive. This meta-analysis is the first to appraise the benefits of medications to treat SUD in ADHD. It is the groundwork for treatment and risk mitigation. (Am J Addict 2020;00:00-00).
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Affiliation(s)
- Dimy Fluyau
- Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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119
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Monopoli WJ, Evans SW, Benson K, Allan NP, Owens JS, DuPaul GJ, Bunford N. Assessment of a conceptually informed measure of emotion dysregulation: Evidence of construct validity vis a vis impulsivity and internalizing symptoms in adolescents with ADHD. Int J Methods Psychiatr Res 2020; 29:1-14. [PMID: 32898309 PMCID: PMC7723178 DOI: 10.1002/mpr.1826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/06/2020] [Accepted: 03/29/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Despite advances in understanding associations among attention-deficit hyperactivity disorder (ADHD), emotion dysregulation (ED), and related outcomes, there is incongruity between ADHD-relevant conceptualizations of ED and available measures of ED. To assess the psychometric properties of a parent-report questionnaire of ED conceptualized as deficits in the ability to modulate the (a) speed/degree of emotion escalation; (b) expression intensity; and (c) speed/degree of de-escalation. METHODS Participants were 209 adolescents with ADHD (78% male; 13.5-17.8 years old [M = 15.2 SD = 0.91]). Questionnaire items were selected from parent-report scales of ED and oppositional defiant disorder and subjected to exploratory factor analysis (EFA) and validity analyses. RESULTS The EFA revealed two factors, with speed/degree of escalation combined with intensity as factor one, and speed/degree of de-escalation as factor two. Factor one scores were related to ADHD impulsivity symptoms but not to anxiety and depression symptoms and they remained predictors of impulsivity even in the presence of self-report ED, evincing convergent, discriminant, and incremental validity. Factor two scores were related to anxiety and depression but not impulsivity, evincing convergent and discriminant validity. CONCLUSION These results inform our understanding of ADHD-relevant ED in adolescence and offer avenues for future research in measurement development, as well as for understanding ED and ADHD-related impairment.
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Affiliation(s)
- W John Monopoli
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Steven W Evans
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Kari Benson
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Nóra Bunford
- 'Lendület' Developmental and Translational Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
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120
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Meyer BJ, Stevenson J, Sonuga-Barke EJS. Sex Differences in the Meaning of Parent and Teacher Ratings of ADHD Behaviors: An Observational Study. J Atten Disord 2020; 24:1847-1856. [PMID: 28800718 DOI: 10.1177/1087054717723988] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To test explanations for the underrecognition of female ADHD by examining differences in adult ratings of boys and girls matched for levels of directly observed ADHD behaviors. Method: In a secondary analysis of a population-based sample, 3- to 4-year-olds (n = 153, 79 male) and 8- to 9-year-olds (n = 144, 75 male) were grouped according to levels of directly observed ADHD behaviors (low/moderate/high). Groups were then compared with parent/teacher ADHD ratings. Results: There were no sex differences in levels of directly observed ADHD behaviors within groups. For preschoolers, parents' ratings of males, but not females, significantly increased across groups-mirroring levels of observed behaviors. For older children, both parent and teacher mean ratings were significantly higher for males than females across groups. Conclusion: Identified differences in adult ratings of males and females matched for directly observed behaviors may contribute to understanding the substantial ADHD underrecognition in females.
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121
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Murray AL, Eisner M, Obsuth I, Ribeaud D. Identifying Early Markers of "Late Onset" Attention Deficit and Hyperactivity/Impulsivity Symptoms. J Atten Disord 2020; 24:1796-1806. [PMID: 28440106 DOI: 10.1177/1087054717705202] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: In recent years, there has been an increased focus on "late onset" ADHD, referring to the onset of symptoms beyond childhood, into adolescence and adulthood. We aimed to identify childhood predictors of ADHD symptom increases over development. Method: We used growth mixture modeling to evaluate predictors of a "late onset" symptom trajectories in a longitudinal cohort study of youth measured at eight points from ages 7 to 15. Results: Individuals with high levels of sensation seeking at age 7 were more likely to show a trajectory of ADHD symptoms characterized by increasing levels from age 7 than persistently low symptom levels. Conclusion: The late versus early onset distinction may align with the distinction between deficits in "bottom-up" versus "top-down" processes previously discussed in relation to ADHD. Results also raise the possibility that later onset symptoms could be predicted based on characteristics in childhood.
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122
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Janssens A, Eke H, Price A, Newlove-Delgado T, Blake S, Ani C, Asherson P, Beresford B, Emmens T, Hollis C, Logan S, Paul M, Sayal K, Young S, Ford T. The transition from children’s services to adult services for young people with attention deficit hyperactivity disorder: the CATCh-uS mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Attention deficit hyperactivity disorder was previously seen as a childhood developmental disorder, so adult mental health services were not set up to support attention deficit hyperactivity disorder patients who became too old for child services. To our knowledge, this is the first in-depth study of the transition of attention deficit hyperactivity disorder patients from child to adult health services in the UK.
Objectives
Our objectives were to explore how many young people with attention deficit hyperactivity disorder are in need of services as an adult, what adult attention deficit hyperactivity disorder services are available and how attention deficit hyperactivity disorder stakeholders experience transition from child to adult services.
Design
An interactive mixed-method design was adopted with three study streams: (1) a 12-month surveillance study with 9-month follow-up to find out how many young people required ongoing medication when they were too old for child services (929 surveys completed by children’s clinicians); (2) a mapping study to identify and describe services for young adults with attention deficit hyperactivity disorder (2686 respondents to online surveys for patients and health workers and freedom of information requests to service providers and commissioners); and (3) a qualitative study to explore key stakeholders’ experiences of transition from child to adult services (144 interviews with 64 attention deficit hyperactivity disorder patients, 28 parents and 52 health clinicians; 38 working in child or adult secondary health services and 14 general practitioners). Members of the public advised at each stage of the study.
Results
When corrected for non-response and case ascertainment, the annual number of young people with an ongoing need for medication for attention deficit hyperactivity disorder lies between 270 and 599 per 100,000 people aged 17–19 years. Among 315 individuals eligible for transition, 64% were accepted, but only 22% attended their first adult services appointment. Our interactive map describes 294 unique services for adults with attention deficit hyperactivity disorder across the UK, of which 44 are ‘dedicated’ attention deficit hyperactivity disorder services. Few services provide the full range of recommended provision; most focus on diagnosis and medication. Services are unevenly distributed across the UK, with nearly all ‘dedicated’ services being in England. Exploring stakeholders’ experiences revealed how invested the stakeholders are in continuing attention deficit hyperactivity disorder treatment and how the architecture of services affects transition. An association between attention deficit hyperactivity disorder, education and continuance of medication into young adulthood, plus parent involvement and feeling prepared for transition and adult life with attention deficit hyperactivity disorder, influenced investment. However, even with investment, how accessible adult services are, how patient needs fit with the remit of the adult service and the level of patient information available affect transition outcomes. The results also highlight how general practitioners can end up as care co-ordinators during transition by default.
Limitations
Transition estimates were based on those who want medication, so these indicate a minimum level of need.
Conclusions
Few of those who need ongoing support for attention deficit hyperactivity disorder successfully transfer to adult services, and a small proportion of those who transfer experience optimal transitional care. Adult attention deficit hyperactivity disorder service provision is patchy. Even among ‘dedicated’ services, few provide the whole range of National Institute for Health and Care Excellence-recommended treatments.
Future work
We need to evaluate various models of transitional care and adult attention deficit hyperactivity disorder provision, as well as develop and evaluate psychosocial interventions for young people and adults with attention deficit hyperactivity disorder.
Trial registration
Current Controlled Trials ISRCTN12492022.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 42. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Astrid Janssens
- Child Health Research Group, University of Exeter Medical School, University of Exeter, Exeter, UK
- User Perspectives, University of Southern Denmark, Odense, Denmark
| | - Helen Eke
- Child Health Research Group, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Anna Price
- Child Health Research Group, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Tamsin Newlove-Delgado
- Child Health Research Group, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Sharon Blake
- Child Health Research Group, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Cornelius Ani
- Division of Psychiatry, Faculty of Medicine, Imperial College London, London, UK
- Surrey and Borders Partnership NHS Foundation Trust, Chertsey, UK
| | - Philip Asherson
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | | | - Chris Hollis
- School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- National Institute for Health Research MindTech MedTech Co-operative and National Institute for Health Research Biomedical Research Centre, Mental Health Theme, Institute of Mental Health, Nottingham, UK
| | - Stuart Logan
- Child Health Research Group, University of Exeter Medical School, University of Exeter, Exeter, UK
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, Exeter, UK
| | - Moli Paul
- Warwick Medical School, University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Kapil Sayal
- School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | | | - Tamsin Ford
- Child Health Research Group, University of Exeter Medical School, University of Exeter, Exeter, UK
- University of Cambridge, Cambridge, UK
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Lion-François L, Herbillon V, Peyric E, Mercier C, Gérard D, Ginhoux T, Coutinho V, Kemlin I, Kassai B, Desportes V, Michael GA. Attention and Executive Disorders in Neurofibromatosis 1: Comparison Between NF1 With ADHD Symptomatology (NF1 + ADHD) and ADHD Per Se. J Atten Disord 2020; 24:1807-1823. [PMID: 28587546 DOI: 10.1177/1087054717707579] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: To compare children with Neurofibromatosis type 1 and associated ADHD symptomatology (NF1 + ADHD) with children having received a diagnosis of ADHD without NF1. The idea was that performance differences in tasks of attention between these two groups would be attributable not to the ADHD symptomatology, but to NF1 alone. Method: One group of children with NF1 + ADHD (N = 32), one group of children with ADHD (N = 31), and one group of healthy controls (N = 40) participated in a set of computerized tasks assessing intensive, selective, and executive aspects of attention. Results: Differences were found between the two groups of patients in respect of several aspects of attention. Children with NF1 + ADHD did not always perform worse than children with ADHD. Several double dissociations can be established between the two groups of patients. Conclusion: ADHD symptomatology in NF1 does not contribute to all attention deficits, and ADHD cannot account for all attention impairments in NF1.
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Affiliation(s)
- Laurence Lion-François
- Hospices Civils de Lyon, Service de Neurologie pédiatrique, Hôpital Femme Mère Enfant, Lyon, France
| | - Vania Herbillon
- Hospices Civils de Lyon, Epilepsie, sommeil et explorations fonctionnelles neuropédiatriques, Hôpital Femme Mère Enfant, Lyon, France
| | - Emeline Peyric
- Hospices Civils de Lyon, Service de Neurologie pédiatrique, Hôpital Femme Mère Enfant, Lyon, France
| | - Catherine Mercier
- Laboratoire Biostatistique-Santé, UMR CNRS 5558, Université de Lyon, France
| | - Daniel Gérard
- Service de Psychiatrie infantile, Hôpital Pierre Wertheimer, Lyon, France
| | | | - Virginie Coutinho
- Service de Neuropédiatrie, Hôpital Trousseau La Roche-Guyon, Hôpitaux Universitaires Est Parisien, Paris, France
| | - Isabelle Kemlin
- Service de Neuropédiatrie, Hôpital Trousseau La Roche-Guyon, Hôpitaux Universitaires Est Parisien, Paris, France
| | - Behrouz Kassai
- Service de Pharmacologie Clinique, Inserm EPICIME-CIC 1407, CHU Lyon, Bron, France.,Laboratoire de Biométrie et Biologie Evolutive, CNRS, UMR 5558, Université Lyon 1, Villeurbanne, France
| | - Vincent Desportes
- Hospices Civils de Lyon, Service de Neurologie pédiatrique, Hôpital Femme Mère Enfant, Lyon, France
| | - George A Michael
- Laboratoire d'Étude des Mécanismes Cognitifs, EA 3082, Université de Lyon, Université Lumière-Lyon 2, Lyon, France
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124
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Stibbe T, Huang J, Paucke M, Ulke C, Strauss M. Gender differences in adult ADHD: Cognitive function assessed by the test of attentional performance. PLoS One 2020; 15:e0240810. [PMID: 33057383 PMCID: PMC7561166 DOI: 10.1371/journal.pone.0240810] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/05/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction The aim of this study was to assess cognitive differences between male and female adults with Attention Deficit Hyperactivity Disorder (ADHD). Methods Patients with an ADHD diagnosis according to the DSM-IV guidelines were included in a cross-sectional study evaluating cognitive measures. 28 women and 41 men from ages 19 to 56 completed self-report questionnaires and performed a computer-based test of attentional performance (TAP). The TAP assesses cognitive functions highly affected in ADHD patients, including working memory, alertness and attention as well as behavioral control and response inhibition. Results There were no measurable differences in self-report scales assessing current symptomology between the sexes, however men scored higher on the scale for childhood symptoms. Performance measures for general wakefulness were comparable between men and women, while working memory and behavioral control test results differed. Females reacted significantly slower and more unstable for both the TAP Go/NoGo paradigm and working memory subtest, while also making more errors in the latter. Conclusions We found gender-specific effects regarding working memory and behavioral control in this sample of adult patients with ADHD. Further studies are warranted, examining whether these differences relate to differences in clinical presentation and comorbidity patterns between men and women.
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Affiliation(s)
- Tina Stibbe
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Jue Huang
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Madlen Paucke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Christine Ulke
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
| | - Maria Strauss
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Saxony, Germany
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125
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Erdogan Bakar E, Karakaş S. Spontaneous age-related changes of attention in unmedicated boys with attention deficit hyperactivity disorder. Clin Neuropsychol 2020; 36:664-698. [PMID: 32954923 DOI: 10.1080/13854046.2020.1801846] [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: 10/23/2022]
Abstract
OBJECTIVE Neuropsychological, neuroanatomical, and electrophysiological studies have reported a steady increase in the different attention types until the age of 10 years. Moreover, differences between healthy control (HC) boys and those with attention deficit hyperactivity disorder (ADHD) become nonsignificant in late childhood. This cross-sectional study aimed to perform a comparative analysis of attentional processing in boys with ADHD and HC in the 6:00-10:11 years age range. Methods: Age-related changes in attentional processing were compared between Caucasian Turkic boys (72-131 months of age) with ADHD (n = 144) and HC (n = 112). Selective, focused, and inhibitory attention were measured using the Stroop Test (5 scores); sustained attention was measured using the Cancellation Test (3 scores); and attention span was measured using the Visual Aural Digit Span Test-Revised (6 scores). Results: At the age of 6 years, the ADHD group had a significantly lower performance for all attention types. By the age of 10 years, there were no significant between-group differences. However, the component structure of the neuropsychological test scores in the ADHD group differed from that in the HC group and previous studies. Conclusions: Attentional processing in boys with ADHD changes within the age-range of 6:00-10:00 years where it finally becomes similar to that in HC boys. This delayed maturation is consistent with the maturational lag model of ADHD. However, there was a between-group difference in the component structure of attentional processing, which is consistent with the maturational deviance model of ADHD.
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Affiliation(s)
| | - Sirel Karakaş
- Department of Psychology, Doğuş University, İstanbul, Turkey.,Neurometrika Medical Technologies Research and Development Limited Liability Company, Ankara, Turkey
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126
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Kok FM, Groen Y, Fuermaier ABM, Tucha O. The female side of pharmacotherapy for ADHD-A systematic literature review. PLoS One 2020; 15:e0239257. [PMID: 32946507 PMCID: PMC7500607 DOI: 10.1371/journal.pone.0239257] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 09/02/2020] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE This comprehensive review examined sex differences in prescription rates and efficacy or effectiveness of pharmacotherapy treatment in girls and women with attention deficit hyperactivity disorder (ADHD), while identifying gaps in the scientific knowledge on this topic. METHOD A rigorous electronic database search was carried out in order to identify all published studies on female-specific effects of stimulants and non-stimulants in the treatment of ADHD. In total, 2672 studies were screened of which 21 studies (seven on prescription rates, 14 on effects of pharmacotherapy) met the inclusion criteria and were included for analysis. RESULTS In all seven studies on ADHD prescription rates, girls received significantly less prescriptions than boys, a difference however no longer seen in adults with the exception of one study. Each of the 14 studies on effectiveness / efficacy found at least one sex-difference in the effects of ADHD pharmacotherapy. CONCLUSION Several sex-differences are demonstrated in the prescription, usage and efficacy /effectiveness of both stimulant and non-stimulant ADHD pharmacotherapy. A single daily use of MPH may possibly not be optimal for girls with ADHD and ATX may be a promising medication for girls and women with ADHD. The robustness of this result requires further investigation.
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Affiliation(s)
- Francien M. Kok
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Yvonne Groen
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Anselm B. M. Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
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Evidence for a Higher-Order ESEM Structure of ADHD in a Sample of Chinese Children. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09837-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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128
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Shih P, Huang CC, Pan SC, Chiang TL, Guo YL. Hyperactivity disorder in children related to traffic-based air pollution during pregnancy. ENVIRONMENTAL RESEARCH 2020; 188:109588. [PMID: 32504847 DOI: 10.1016/j.envres.2020.109588] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/31/2020] [Accepted: 04/23/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders in childhood globally. Between the two components of ADHD, hyperactivity disorder is more prevalent than inattention during early childhood. Although some investigations have implied a relationship between childhood ADHD and gestational exposure to air pollution, the evidence is limited. The aim of this study was to investigate the association between gestational exposure to air pollution exposure and hyperactivity disorder in childhood in a population-based birth cohort. METHODS The Taiwan Birth Cohort Study started from all deliveries of Taiwan in 2005 by the birth registry, and recruited representative 12% of all mother-infant pairs by two-stage stratified sampling. At age of 8 years in each child, their main caretaker was inquired whether the child had ever received a hyperactivity diagnosis from a physician or other specialist, like special needs educator. Exposure to air pollutants during gestation was estimated through ordinary kriging based on data from air monitoring stations of Environmental Protection Administration, Taiwan. Logistic regression was used to determine adjusted odds ratios (aORs) of hyperactivity disorder in relation to air pollutants. RESULTS A total of 16,376 mother-infant pairs were included in the final analysis; 374 (2.3%) of the children had received a diagnosis of hyperactivity before 8 years of age. The occurrence of hyperactivity was significantly related to prenatal nitrogen oxide (NOx), but not to particulate matter 10 μm or less in diameter or sulfur dioxide. Further analysis to separate effects by nitrogen dioxide (NO2) and/or nitric oxide (NO) showed that only NO was significantly related to hyperactivity [aOR per interquartile range (3.14 ppb): 1.26, 95% confidence interval: 1.09-1.46]. CONCLUSIONS In conclusion, our study found childhood hyperactivity disorder to be positively associated with prenatal NO exposure. Further confirmation on potential hazardous effects of NO and investigation on potential mechanisms are warranted.
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Affiliation(s)
- Ping Shih
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ching-Chun Huang
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Chun Pan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
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129
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Isaksson J, Ruchkin V, Lindblad F. Unseen and Stressed? Gender Differences in Parent and Teacher Ratings of ADHD Symptoms and Associations With Perceived Stress in Children With ADHD. J Atten Disord 2020; 24:1565-1569. [PMID: 27401240 DOI: 10.1177/1087054716658381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: In this study, we investigate the differences between parent and teacher ADHD ratings, and how these ratings relate to perceived stress in children with ADHD. Method: Ratings by parents and teachers with the Swanson, Nolan and Pelham ADHD symptom rating scale (SNAP-IV) were collected from children with a clinical diagnosis of ADHD (n = 137). Also, information on medication was collected. Children (≥11 years of age; n = 64) were invited to complete the Pressure-Activation-Stress scale. Results: Among girls, but not boys, teacher ratings were significantly lower than parental ratings on all symptom scales. Lower teacher ratings on hyperactivity symptoms were associated with higher levels of perceived stress. Conclusion: The findings suggest a potential gender bias in ratings among teachers. Underrated, and hence underidentified, ADHD problems in the school setting seem to increase the perception of stress in the sense of pressure for both girls and boys.
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Affiliation(s)
- Johan Isaksson
- Uppsala University, Sweden.,Karolinska Institutet, Stockholm, Sweden
| | - Vladislav Ruchkin
- Uppsala University, Sweden.,Yale University, New Haven, CT, USA.,Säter Psychiatric Clinic, Sweden
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130
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Rigoni M, Blevins LZ, Rettew DC, Kasehagen L. Symptom Level Associations Between Attention-Deficit Hyperactivity Disorder and School Performance. Clin Pediatr (Phila) 2020; 59:874-884. [PMID: 32441129 DOI: 10.1177/0009922820924692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is associated with reduced school performance. To determine which ADHD symptoms and subtypes have the strongest association, we used type and frequency of symptoms on the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (NS-DATA) to create symptom scores for inattention and hyperactivity-impulsivity and define subtypes (ADHD-Inattentive [ADHD-I], ADHD-Hyperactive-Impulsive, ADHD-Combined [ADHD-C]). Regression methods were used to examine associations between symptoms and subtype and a composite measure of school performance. Children with ADHD-C and ADHD-I had higher adjusted odds of having reduced overall school performance (ADHD-C = 5.8, 95% confidence interval [CI] = 3.1-10.9; ADHD-I = 5.5, 95% CI = 3.1-10.1) compared with children without ADHD. All inattentive symptoms were significantly related to reduced school performance in reading, writing, and handwriting, while 6 of 9 symptoms were significantly associated in mathematics. Children with ADHD-I were significantly more likely than children with other ADHD subtypes to receive a school-based Individualized Education Program or 504 Plan. ADHD-I symptoms may be broadly linked to reduced school performance.
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Affiliation(s)
- Megan Rigoni
- Vermont Department of Health, Burlington, VT, USA
| | | | - David C Rettew
- University of Vermont, Larner College of Medicine, Burlington, VT, USA.,Vermont Department of Mental Health, Waterbury, VT, USA
| | - Laurin Kasehagen
- Vermont Department of Health, Burlington, VT, USA.,University of Vermont, Larner College of Medicine, Burlington, VT, USA.,Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Field Support Branch, MCH Epidemiology Program Team, Atlanta, GA, USA
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131
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Young S, Adamo N, Ásgeirsdóttir BB, Branney P, Beckett M, Colley W, Cubbin S, Deeley Q, Farrag E, Gudjonsson G, Hill P, Hollingdale J, Kilic O, Lloyd T, Mason P, Paliokosta E, Perecherla S, Sedgwick J, Skirrow C, Tierney K, van Rensburg K, Woodhouse E. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry 2020; 20:404. [PMID: 32787804 PMCID: PMC7422602 DOI: 10.1186/s12888-020-02707-9] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. METHODS The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. RESULTS A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. CONCLUSIONS This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.
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Affiliation(s)
- Susan Young
- Psychology Services Limited, PO 1735, Croydon, London, CR9 7AE, UK.
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.
| | - Nicoletta Adamo
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
- Service for Complex Autism and Associated Neurodevelopmental Disorders, South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, London, UK
| | | | | | | | | | | | - Quinton Deeley
- National Autism Unit, Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Emad Farrag
- South London & Maudsley NHS Foundation Trust, Maudsley Health, Abu Dhabi, UAE
| | - Gisli Gudjonsson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Peter Hill
- Independent Consultant in Child and Adolescent Psychiatry, Private Practice, London, UK
| | - Jack Hollingdale
- Michael Rutter Centre, South London and Maudsley Hospital, London, UK
| | | | | | - Peter Mason
- ADHD and Psychiatry Services Limited, Liverpool, UK
| | | | | | - Jane Sedgwick
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
- Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Caroline Skirrow
- Cambridge Cognition, Cambridge, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Kevin Tierney
- Neuropsychiatry Team, National Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kobus van Rensburg
- Adult ADHD and AS Team & CYP ADHD and ASD Service in Northamptonshire, Northampton, UK
| | - Emma Woodhouse
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
- Compass, London, UK
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132
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Silva D, Colvin L, Glauert R, Stanley F, Srinivas Jois R, Bower C. Literacy and Numeracy Underachievement in Boys and Girls With ADHD. J Atten Disord 2020; 24:1392-1402. [PMID: 26689936 DOI: 10.1177/1087054715613438] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To determine literacy and numeracy outcomes, among children with and without ADHD by gestational age and gender. Method: De-identified linked population data from the Western Australian Monitoring of Drug Dependence Systems, Western Australian Literacy and Numeracy Assessment database, and the Midwives Notification System used information on 6,819 children with ADHD compared with 14,451 non-ADHD children. Results: Twenty-three percent of boys and 28% of girls with ADHD had numeracy scores below the benchmark in School Year 3, compared with 11% of children without ADHD. These differences were also evident in reading, writing, and spelling through primary school. Children with ADHD and reduced gestational age were at a greater risk of not meeting numeracy and reading benchmarks, compared with children born at term. Conclusion: Children with ADHD are disadvantaged from an early age in key areas of learning, and this risk increased with reduction in gestational age at birth.
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Affiliation(s)
- Desiree Silva
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia.,School of Paediatrics and Child Health, University of Western Australia.,Joondalup Health Campus, Joondalup, Western Australia
| | - Lyn Colvin
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia
| | - Rebecca Glauert
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia
| | - Fiona Stanley
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia.,School of Paediatrics and Child Health, University of Western Australia
| | | | - Carol Bower
- Telethon Kids Institute, University of Western Australia, Perth , Western Australia
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133
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Zaso MJ, Park A, Antshel KM. Treatments for Adolescents With Comorbid ADHD and Substance Use Disorder: A Systematic Review. J Atten Disord 2020; 24:1215-1226. [PMID: 25655767 PMCID: PMC4666815 DOI: 10.1177/1087054715569280] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Comorbid ADHD and substance use disorder (SUD) presents frequently in adolescence, a developmental period that may promote the emergence of substance misuse among individuals with ADHD. Comorbid ADHD and SUD in adolescence results in significant and unique treatment challenges, necessitating examination into effective interventions. Method: This systematic review examined existing research into the treatment of comorbid adolescent ADHD and SUD. Results: Findings from a small number of pharmacological intervention studies suggest potential efficacy of extended-release stimulant and nonstimulant medications. Efficacy of psychotherapeutic interventions has not been systematically examined. Conclusion: Current research on treatments for comorbid ADHD and SUD in adolescence is limited. Future placebo-controlled clinical trials using large samples are needed to examine the efficacy of psychotherapeutic interventions, the heightened risk of prescription stimulant misuse, and the long-term maintenance of treatment gains in this population. Clinical guidelines for the treatment of comorbid ADHD and SUD are discussed.
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Affiliation(s)
- Michelle J. Zaso
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Aesoon Park
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Kevin M. Antshel
- Department of Psychology, Syracuse University, Syracuse, NY, USA
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134
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Silva D, Colvin L, Glauert R, Stanley F, Srinivasjois R, Bower C. Literacy and Numeracy Underachievement in Boys and Girls With ADHD. J Atten Disord 2020; 24:1305-1316. [PMID: 26290485 DOI: 10.1177/1087054715596575] [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] [Indexed: 11/16/2022]
Abstract
Objective: The aim was to determine literacy and numeracy outcomes, among children with and without ADHD by gestational age and gender. Method: De-identified linked population data from the Western Australian Monitoring of Drugs of Dependence System and Western Australian Literacy and Numeracy Assessment databases, and the Midwives Notification System used information on 6,819 children with ADHD compared with 14,451 non-ADHD children. Results: A total of 23% of boys and 28% of girls with ADHD had numeracy scores below the benchmark in School Year 3, compared with 11% of children without ADHD. These differences were also evident for reading, writing, and spelling through primary school. Children with ADHD and reduced gestational age were at a greater risk of not meeting numeracy and reading benchmarks, compared with children born at term. Conclusion: Children with ADHD are disadvantaged from an early age in key areas of learning, and this risk increased with reduction in gestational age at birth.
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Affiliation(s)
- Desiree Silva
- Telethon Kids Institute, University of Western Australia, Perth, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Australia.,Joondalup Health Campus, University of Western Australia, Perth, Australia
| | - Lyn Colvin
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Rebecca Glauert
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Fiona Stanley
- Telethon Kids Institute, University of Western Australia, Perth, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Australia
| | | | - Carol Bower
- Telethon Kids Institute, University of Western Australia, Perth, Australia
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135
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Yoo SJ, Joo H, Kim D, Lim MH, Kim E, Ha M, Kwon HJ, Paik KC, Kim KM. Associations between Exposure to Bisphenol A and Behavioral and Cognitive Function in Children with Attention-deficit/Hyperactivity Disorder: A Case-control Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:261-269. [PMID: 32329307 PMCID: PMC7242102 DOI: 10.9758/cpn.2020.18.2.261] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 12/23/2022]
Abstract
Objective Bisphenol A (BPA) is a widely produced synthetic chemical used to manufacture polycarbonate plastics and epoxy resins. We aimed to investigate the association between exposure to BPA and behavioral and cognitive function in children with attention-deficit/hyperactivity disorder (ADHD) and healthy controls. Methods The study included 444 children aged from 6 to 10 years. The ADHD and control groups included 195 and 249 children, respectively. BPA levels were assessed via urinalysis, while behavior was assessed using the Korean version of the ADHD Rating Scale (K-ARS) and the Behavior Assessment System for Children (BASC-2). Cognitive function was assessed using the Continuous Performance Test (i.e., ADHD Diagnostic System [ADS]). Participants were categorized into tertile groups based on urinary BPA concentration. Results Scores on the K-ARS and the hyperactivity, aggression, anxiety, and depression subscales of the BASC-2 were significantly different among tertile groups for urinary BPA levels. Scores on visual omission error, commission error, response time variability, and auditory commission error of the ADS were significantly different among three BPA groups. Subgroup analysis revealed that these differences of behavior and cognition among three BPA groups were observed in only boys and normal controls. Conclusion Exposure to BPA was associated with unfavorable behavioral and cognitive outcomes. Our study extends the findings of previous studies regarding the association between BPA exposure and behavior/cognitive function by including children with ADHD. Further studies are required to determine the mechanisms underlying sex- and group-based differences in these associations.
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Affiliation(s)
- Seung-Jin Yoo
- Environmental Health Center, Dankook University Medical Center
| | - Hyunjoo Joo
- Department of Preventive Medicine, Dankook University College of Medicine
| | - Dohyun Kim
- Department of Psychiatry, Dankook University Hospital
| | - Myung Ho Lim
- Environmental Health Center, Dankook University Medical Center.,Department of Psychology, College of Public Human Resources, Dankook University
| | - Eunjung Kim
- Environmental Health Center, Dankook University Medical Center
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine
| | - Ho-Jang Kwon
- Environmental Health Center, Dankook University Medical Center.,Department of Preventive Medicine, Dankook University College of Medicine
| | - Ki Chung Paik
- Environmental Health Center, Dankook University Medical Center.,Department of Psychiatry, Dankook University College of Medicine, Cheonan, Korea
| | - Kyoung Min Kim
- Environmental Health Center, Dankook University Medical Center.,Department of Psychiatry, Dankook University College of Medicine, Cheonan, Korea
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136
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Young S, Hollingdale J, Absoud M, Bolton P, Branney P, Colley W, Craze E, Dave M, Deeley Q, Farrag E, Gudjonsson G, Hill P, Liang HL, Murphy C, Mackintosh P, Murin M, O'Regan F, Ougrin D, Rios P, Stover N, Taylor E, Woodhouse E. Guidance for identification and treatment of individuals with attention deficit/hyperactivity disorder and autism spectrum disorder based upon expert consensus. BMC Med 2020; 18:146. [PMID: 32448170 PMCID: PMC7247165 DOI: 10.1186/s12916-020-01585-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals with co-occurring hyperactivity disorder/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can have complex presentations that may complicate diagnosis and treatment. There are established guidelines with regard to the identification and treatment of ADHD and ASD as independent conditions. However, ADHD and ASD were not formally recognised diagnostically as co-occurring conditions until the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) was published in 2013. Hence, awareness and understanding of both conditions when they co-occur is less established and there is little guidance in the clinical literature. This has led to uncertainty among healthcare practitioners when working with children, young people and adults who present with co-existing ADHD and ASD. The United Kingdom ADHD Partnership (UKAP) therefore convened a meeting of professional experts that aimed to address this gap and reach expert consensus on the topic that will aid healthcare practitioners and allied professionals when working with this complex and vulnerable population. METHOD UK experts from multiple disciplines in the fields of ADHD and ASD convened in London in December 2017. The meeting provided the opportunity to address the complexities of ADHD and ASD as a co-occurring presentation from different perspectives and included presentations, discussion and group work. The authors considered the clinical challenges of working with this complex group of individuals, producing a consensus for a unified approach when working with male and female, children, adolescents and adults with co-occurring ADHD and ASD. This was written up, circulated and endorsed by all authors. RESULTS The authors reached a consensus of practical recommendations for working across the lifespan with males and females with ADHD and ASD. Consensus was reached on topics of (1) identification and assessment using rating scales, clinical diagnostic interviews and objective supporting assessments; outcomes of assessment, including standards of clinical reporting; (2) non-pharmacological interventions and care management, including psychoeducation, carer interventions/carer training, behavioural/environmental and Cognitive Behavioural Therapy (CBT) approaches; and multi-agency liaison, including educational interventions, career advice, occupational skills and training, and (3) pharmacological treatments. CONCLUSIONS The guidance and practice recommendations (Tables 1, 4, 5, 7, 8 and 10) will support healthcare practitioners and allied professionals to meet the needs of this complex group from a multidisciplinary perspective. Further research is needed to enhance our understanding of the diagnosis, treatment and management of individuals presenting with comorbid ADHD and ASD.
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Affiliation(s)
| | - Jack Hollingdale
- South London & Maudsley NHS Foundation Trust, Service for Complex Autism and Associated Neurodevelopmental Disorders, London, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Women & Children's Health, King's College, London, UK
| | - Patrick Bolton
- South London & Maudsley NHS Foundation Trust, Service for Complex Autism and Associated Neurodevelopmental Disorders, London, UK
| | | | | | - Emily Craze
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | - Mayuri Dave
- Positive Behaviour, Learning Disability, Autism and Mental Health Service (PALMS) Hertfordshire Communication Disorders Clinics, Hertfordshire Community NHS Trust, St Albans, UK
| | - Quinton Deeley
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | - Emad Farrag
- South London & Maudsley NHS Foundation Trust, Maudsley Health, Abu Dhabi, UAE
| | - Gisli Gudjonsson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Clodagh Murphy
- Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, National Adult Autism and ADHD Service, South London and Maudsley Foundation NHS Trust, London, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peri Mackintosh
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | | | | | - Dennis Ougrin
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Patricia Rios
- Diagnostic Assessments and Treatment Services (DATS), Hertfordshire, UK
| | | | - Eric Taylor
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Woodhouse
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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137
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Higgins GA, Silenieks LB, MacMillan C, Thevarkunnel S, Parachikova AI, Mombereau C, Lindgren H, Bastlund JF. Characterization of Amphetamine, Methylphenidate, Nicotine, and Atomoxetine on Measures of Attention, Impulsive Action, and Motivation in the Rat: Implications for Translational Research. Front Pharmacol 2020; 11:427. [PMID: 32390829 PMCID: PMC7193984 DOI: 10.3389/fphar.2020.00427] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/19/2020] [Indexed: 12/18/2022] Open
Abstract
Amphetamine (AMP), methylphenidate (MPH), and atomoxetine (ATX) are approved treatments for ADHD, and together with nicotine (NIC), represent pharmacological agents widely studied on cognitive domains including attention and impulsive action in humans. These agents thus represent opportunities for clinical observation to be reinvestigated in the preclinical setting, i.e., reverse translation. The present study investigated each drug in male, Long Evans rats trained to perform either (1) the five-choice serial reaction time task (5-CSRTT), (2) Go/NoGo task, or (3) a progressive ratio (PR) task, for the purpose of studying each drug on attention, impulsive action and motivation. Specific challenges were adopted in the 5-CSRTT designed to tax attention and impulsivity, i.e., high frequency of stimulus presentation (sITI), variable reduction in stimulus duration (sSD), and extended delay to stimulus presentation (10-s ITI). Initially, performance of a large (> 80) cohort of rats in each task variant was conducted to examine performance stability over repeated challenge sessions, and to identify subgroups of "high" and "low" attentive rats (sITI and sSD schedules), and "high" and "low" impulsives (10-s ITI). Using an adaptive sequential study design, the effects of AMP, MPH, ATX, and NIC were examined and contrasting profiles noted across the tests. Both AMP (0.03-0.3 mg/kg) and MPH (1-6 mg/kg) improved attentional performance in the sITI but not sSD or 10-s ITI condition, NIC (0.05-0.2 mg/kg) improved accuracy across all conditions. ATX (0.1-1 mg/kg) detrimentally affected performance in the sITI and sSD condition, notably in "high" performers. In tests of impulsive action, ATX reduced premature responses notably in the 10-s ITI condition, and also reduced false alarms in Go/NoGo. Both AMP and NIC increased premature responses in all task variants, although AMP reduced false alarms highlighting differences between these two measures of impulsive action. The effect of MPH was mixed and appeared baseline dependent. ATX reduced break point for food reinforcement suggesting a detrimental effect on motivation for primary reward. Taken together these studies highlight differences between AMP, MPH, and ATX which may translate to their clinical profiles. NIC had the most reliable effect on attentional accuracy, whereas ATX was reliably effective against all tests of impulsive action.
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Affiliation(s)
- Guy A Higgins
- Intervivo Solutions, Toronto, ON, Canada.,Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | | | | | | | | | | | - Hanna Lindgren
- Discovery Research, H. Lundbeck A/S, Copenhagen, Denmark
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138
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Cueli M, Rodríguez C, Cañamero LM, Núñez JC, González-Castro P. Self-Concept and Inattention or Hyperactivity-Impulsivity Symptomatology: The Role of Anxiety. Brain Sci 2020; 10:brainsci10040250. [PMID: 32340167 PMCID: PMC7226128 DOI: 10.3390/brainsci10040250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 11/16/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has been associated with low levels of self-concept (academic, emotional, social or physical), although this association can differ in the function of the inattention or hyperactivity-impulsivity symptomatology. Furthermore, the relation between ADHD and self-concept can be mediated or moderated by the levels of anxiety. This work is aimed to examine the differential effect of inattention symptomatology and hyperactivity-impulsivity symptomatology on academic, emotional, social and physical self-concept and the mediating or moderating role of anxiety in this relationship. A total of 167 students (70.7% boys and 29.3% girls) aged between 11 and 16 participated in this study. Students' ADHD symptomatology, self-concept in four areas (academic, emotional, social and physical self-concept) and trait anxiety were measured with the State-Trait Anxiety Inventory for Children. The results indicate that trait anxiety mediates the relationship between inattention and emotional, social and physical self-concept but does not moderate this relationship. Trait anxiety does not mediate or moderate the relationship between hyperactivity-impulsivity symptoms and self-concept. When inattention symptomatology increases, academic self-concept decreases directly, but students' emotional, social and physical self-concept decreases indirectly through trait anxiety.
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139
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Leopold DR, Christopher ME, Olson RK, Petrill SA, Willcutt EG. Invariance of ADHD Symptoms Across Sex and Age: a Latent Analysis of ADHD and Impairment Ratings from Early Childhood into Adolescence. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:21-34. [PMID: 29691720 DOI: 10.1007/s10802-018-0434-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A population-based longitudinal sample of 489 twin pairs was assessed at six time points over ten years to examine the measurement invariance and stability of attention-deficit/hyperactivity disorder (ADHD) symptoms, as well as the developmental relations between inattention (IN), hyperactivity-impulsivity (HI), and multiple aspects of functional impairment. Parent ratings of ADHD symptoms and functional impairment were obtained in preschool and after the completion of kindergarten, first, second, fourth, and ninth grades. Results of the temporal and sex invariance models indicated that parent ratings of the 18 ADHD symptoms function in the same manner for females and males from early childhood into adolescence. In addition to establishing this prerequisite condition for the interpretation of longitudinal and between-sex differences in the IN and HI symptom dimensions, cross-lagged models indicated that both IN and HI were associated with increased risk for both concurrent and future overall, social, and recreational impairment, whereas only IN was uniquely associated with later academic impairment. Taken together, the current results demonstrate that IN and HI are highly stable from preschool through ninth grade, invariant between females and males, and indicative of risk for impairment in multiple areas, thereby providing strong support for the validity of the symptom dimensions among both sexes.
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Affiliation(s)
- Daniel R Leopold
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB 345, Boulder, CO, 80309-0345, USA.
| | - Micaela E Christopher
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB 345, Boulder, CO, 80309-0345, USA
| | - Richard K Olson
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB 345, Boulder, CO, 80309-0345, USA
| | - Stephen A Petrill
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Erik G Willcutt
- Department of Psychology and Neuroscience, University of Colorado Boulder, UCB 345, Boulder, CO, 80309-0345, USA
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140
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Sex Differences in Externalizing and Internalizing Symptoms in ADHD, Autism, and General Population Samples. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09798-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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141
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Coe JL, Micalizzi L, Josefson B, Parade SH, Seifer R, Tyrka AR. Sex Differences in Associations between Early Adversity, Child Temperament, and Behavior Problems. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2020; 44:490-504. [PMID: 33707801 DOI: 10.1177/0165025420912012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Early adversity is associated with both internalizing and externalizing problems among children, and effects of adversity on dimensions of child temperament may underlie these links. However, very little is known about the role of child sex in these processes. The current study examined if there are indirect effects of early adversity on behavior problems through dimensions of child temperament and if these indirect effects vary across child sex. Participants in this multimethod (parent-report survey, semi-structured interview, child protection records) study included 274 preschool-aged children (M age = 50.86 months; 52% with documented case of moderate-severe maltreatment) and their primary caregivers assessed at two time-points spaced 6 months apart. Results of multi-group path analyses revealed that while anger mediated associations between lifetime stress and behavior problems for the full sample, inhibitory control and appropriate attentional allocation were significant intermediary mechanisms of lifetime stress for boys, but not for girls. Inhibitory control mediated associations between maltreatment and behavior problems for the full sample, but appropriate attentional allocation mediated these associations for boys only. Results suggest that early adversity influences child behavior problems through child temperament, particularly for boys. This work supports the perspective that temperament is influenced by characteristics of the early rearing environment, and the indirect effects of adversity on behavior problems through temperament vary across sex.
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Affiliation(s)
- Jesse L Coe
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA
| | - Lauren Micalizzi
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Brittney Josefson
- Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA
| | - Stephanie H Parade
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA
| | - Ronald Seifer
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, East Providence, RI, USA
| | - Audrey R Tyrka
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Mood Disorders Research Program and Laboratory for Clinical and Translational Neuroscience, Butler Hospital, Providence, RI, USA
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142
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Beheshti A, Chavanon ML, Christiansen H. Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis. BMC Psychiatry 2020; 20:120. [PMID: 32164655 PMCID: PMC7069054 DOI: 10.1186/s12888-020-2442-7] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/13/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Emotional symptoms are increasingly considered a core feature of attention deficit/hyperactivity disorder (ADHD). We aimed to quantify the evidence of emotional dysregulation and its respective facets in individuals with adult ADHD compared to healthy controls using meta-analysis. METHODS Two electronic databases (PubMed, PsycINFO) were reviewed to identify studies. Studies were eligible for inclusion that had reports on any measure of emotion (dys) regulation in adults (> 18 years of age) in clinically diagnosed patients with ADHD as well as healthy control participants. We included a total of 13 studies (N = 2535) to assess (1) the standardized mean difference in emotion dysregulation (ED) as a general factor and its specific facets (i.e., emotional lability, negative emotional responses, and emotion recognition) between adults with ADHD and healthy controls; and (2) the association between ADHD symptom severity and ED. RESULTS Compared to healthy controls, adults with ADHD revealed significantly higher levels of general ED (Hedges' g = 1.17, p < 0.001; Hedges' g is the adjusted effect size). With regard to intermediate dimensions of ED, emotional lability exhibited the strongest weighted effect (Hedges' g = 1.20, CI [0.57, 1.83], p < 0.001). Furthermore, symptom severity and general ED correlated significantly (r = 0.54, p < 0.001). Regarding intermediate dimensions of ED, negative emotional responses correlated closely with ADHD symptom severity (r = 0.63, p < 0.001) and emotional lability (r = 0.52, p < 0.001). CONCLUSIONS Our findings support ED symptoms as a core feature of ADHD's psychopathology. With respect to dimensions of ED, emotional lability, and negative emotional responses play a more definitive role in the psychopathology of adults with ADHD. Due to insufficient statistical reports in the included studies, we could not perform meta-regressions to control the role of moderator variables.
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Affiliation(s)
- Ashkan Beheshti
- Department of Psychology, Child and Adolescent Clinical Psychology Group, Marburg University, Gutenbergstr.18, 35037 Marburg, Germany
| | - Mira-Lynn Chavanon
- Department of Psychology, Child and Adolescent Clinical Psychology Group, Marburg University, Gutenbergstr.18, 35037 Marburg, Germany
| | - Hanna Christiansen
- Department of Psychology, Child and Adolescent Clinical Psychology Group, Marburg University, Gutenbergstr.18, 35037 Marburg, Germany
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143
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Kohls G, Baumann S, Gundlach M, Scharke W, Bernhard A, Martinelli A, Ackermann K, Kersten L, Prätzlich M, Oldenhof H, Jansen L, van den Boogaard L, Smaragdi A, Gonzalez-Madruga K, Cornwell H, Rogers JC, Pauli R, Clanton R, Baker R, Bigorra A, Kerexeta-Lizeaga I, Sesma-Pardo E, Aguirregomoscorta-Menéndez F, Siklósi R, Dochnal R, Kalogerakis Z, Pirlympou M, Papadakos L, Dikeos D, Hervas A, Herpertz-Dahlmann B, Fernández-Rivas A, Popma A, Stadler C, De Brito SA, Blair JR, Freitag CM, Fairchild G, Konrad K. Investigating Sex Differences in Emotion Recognition, Learning, and Regulation Among Youths With Conduct Disorder. J Am Acad Child Adolesc Psychiatry 2020; 59:263-273. [PMID: 31026574 DOI: 10.1016/j.jaac.2019.04.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 03/27/2019] [Accepted: 04/17/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Conduct disorder (CD) is a serious neurodevelopmental disorder marked by notably higher prevalence rates for boys than girls. Converging evidence suggests that CD is associated with impairments in emotion recognition, learning, and regulation. However, it is not known whether there are sex differences in the relationship between CD and emotion dysfunction. Prior studies on emotion functioning in CD have so far been underpowered for investigating sex differences. Therefore, our primary aim was to characterize emotion processing skills in a large sample of girls and boys with CD compared to typically developing controls (TDCs) using a comprehensive neuropsychological test battery. METHOD We included 542 youths with CD (317 girls) and 710 TDCs (479 girls), 9 to 18 years of age, from a European multisite study (FemNAT-CD). Participants completed three experimental tasks assessing emotion recognition, learning, and regulation, respectively. Data were analyzed to test for effects of group and sex, and group-by-sex interactions, while controlling for potentially confounding factors. RESULTS Relative to TDCs, youths with CD showed impaired emotion recognition (that was related to more physical and proactive aggression, and higher CU traits), emotional learning (specifically from punishment), and emotion regulation. Boys and girls with CD, however, displayed similar impairments in emotion processing. CONCLUSION This study provides compelling evidence for a relationship between CD and deficient neurocognitive functioning across three emotional domains that have previously been linked to CD etiology. However, there was no support for sex-specific profiles of emotion dysfunction, suggesting that current neurocognitive models of CD apply equally to both sexes.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Martin Prätzlich
- Psychiatric University Clinics and University of Basel, Switzerland
| | | | - Lucres Jansen
- VU University Medical Center, Amsterdam, The Netherlands
| | | | | | | | | | | | - Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Roberta Clanton
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Rosalind Baker
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - Aitana Bigorra
- Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Barcelona, Spain
| | | | - Eva Sesma-Pardo
- Psychiatric Service, Basurto University Hospital, Bilbao, Spain
| | | | - Réka Siklósi
- Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | - Roberta Dochnal
- Pediatrics and Child Health Center, University of Szeged, Szeged, Hungary
| | | | | | | | | | - Amaia Hervas
- Child and Adolescent Mental Health Unit, University Hospital Mutua Terrassa, Barcelona, Spain
| | | | | | - Arne Popma
- VU University Medical Center, Amsterdam, The Netherlands
| | | | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, UK
| | - James R Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE
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144
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Kita Y, Ashizawa F, Inagaki M. Prevalence estimates of neurodevelopmental disorders in Japan: A community sample questionnaire study. Psychiatry Clin Neurosci 2020; 74:118-123. [PMID: 31657492 DOI: 10.1111/pcn.12950] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/21/2019] [Indexed: 11/29/2022]
Abstract
AIM Prevalence estimates of neurodevelopmental disorders have been calculated by questionnaire surveys scored by a single rater, which introduces inherent rater biases. The present study aimed to estimate the prevalence and comorbidity rates of four neurodevelopmental disorders based on both parent and teacher rating scales. METHODS We performed a community sample survey recruiting 3852 children aged 6 to 9 years. Parents and teachers evaluated clinical conditions in children using questionnaire-style scales. These scales with cut-off values were used to estimate the prevalence and comorbidity rates of attention deficit hyperactive disorder, autism spectrum disorder, specific learning disorder (or developmental dyslexia), and developmental coordination disorder. RESULTS The prevalence estimates were separately confirmed according to the raters. Some estimates were higher than those in previous studies conducted in other countries. We also found a large disagreement between the parent and teacher rating scores. Moreover, the degree of agreement between two raters varied depending on the severity of the child's clinical condition. CONCLUSION These estimates are the first findings based on evaluating children by two different raters. The prevalence and comorbidity estimates are informative for researchers and clinicians of pediatric neurology. The disagreements between two different raters raise questions about previous estimates of neurodevelopmental disorders.
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Affiliation(s)
- Yosuke Kita
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Cognitive Brain Research Unit (CBRU), Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Fumiko Ashizawa
- Day-Care Service 'Tsukushi', Tokyo Kasei University, Sayama, Japan
| | - Masumi Inagaki
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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145
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Trends in incidence rates of diagnosed attention-deficit/hyperactivity disorder (ADHD) over 12 years in Taiwan: A nationwide population-based study. Psychiatry Res 2020; 284:112792. [PMID: 31981938 DOI: 10.1016/j.psychres.2020.112792] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/07/2020] [Accepted: 01/12/2020] [Indexed: 11/22/2022]
Abstract
We investigated time trends in the incidence rate (IR) of attention-deficit/hyperactivity disorder (ADHD) across the lifespan and potential factors affecting them using a Taiwanese population-based database. IR per 10,000 person-years (PY) of newly diagnosed ADHD based on ICD-9-CM was calculated annually for the total population, gender, 5 age groups, and 3 ADHD subtypes from 2000 to 2011. Among the 265,932 patients, IR increased from 7.92 to 13.92; the male-to-female ratio decreased from 3.61 to 2.90. The largest increase in IR was noted in young adults (19-30 years), followed by preschoolers (0-6 years), while the smallest increase was in adults (>31 years). The IR trends showed a more prominent increase in males than females among children, adolescents, and young adults, yet a reserved relationship existed among adults, with a more prominent increase in women. The combined type of ADHD exhibited a prominently increasing trend in the child/adolescent group (age≦18) and the inattentive type ADHD in the adult group (age>18). In conclusion, the ADHD IR is increasing with distinct differences among age, sex, and subtypes. The diminishing gap between those who need treatment and those actually treated might partly contribute to this trend, especially among young adults, preschoolers, and females.
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146
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Bishop SA, Okagbue HI, Odukoya JA. Statistical analysis of childhood and early adolescent externalizing behaviors in a middle low income country. Heliyon 2020; 6:e03377. [PMID: 32072060 PMCID: PMC7013197 DOI: 10.1016/j.heliyon.2020.e03377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/09/2019] [Accepted: 02/04/2020] [Indexed: 02/07/2023] Open
Abstract
The article show the pattern of externalizing behavior across age, gender, school type, and school level, with reference to aggression, delinquency, and hyperactivity. The study samples were primary school pupils and secondary school students from three selected Local Government Areas (LGA) in Ogun State, Nigeria [Ado-Odo/Ota, Ifo, and Yewa South]. Their ages ranged from 10 to 20 years. The student/pupil sample was 1770 in all. The instrument used was an adapted version of Achenbach's child behavior checklist and youth self-report. Basic descriptive statistics like frequency, percentage, mean, standard deviation, as well as non-parametric statistics like Phi-coefficient, Chi-square, Goodman and Kruskal's gamma, Mann Whitney U test and Kruskal Wallis H test were utilized. Inferential parametric statistics like Pearson r, analysis of variance and simple regression were also utilized. Four major findings were reported. Firstly, the private schools irrespective of age, gender and level, scored higher than the public school in aggression, delinquency, and hyperactivity. Secondly, aggression is higher in secondary schools, while delinquency and hyperactivity are more prevalent in primary schools. Thirdly, school level and school type are the strongest predictors of externalizing behavior. Lastly, correspondence analysis showed a similar behavioral pattern for the three behaviors and three distinct behavioral patterns. i). Respondents aged 10 and below and those in primary schools (ii). Male, public and between 16 and 20. iii). Private, secondary, female and between 11 and 15. Implications of the study are discussed.
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147
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Barbarini TDA. CORPOS, “MENTES”, EMOÇÕES: UMA ANÁLISE SOBRE TDAH E SOCIALIZAÇÃO INFANTIL. PSICOLOGIA & SOCIEDADE 2020. [DOI: 10.1590/1807-0310/2020v32173058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este artigo problematiza o Transtorno de Déficit de Atenção e Hiperatividade (TDAH), entendendo que sua delimitação clínica e social se orienta por normas de conduta que configuram o processo de socialização infantil. Trata de questões emergentes de dois trabalhos de campo, realizados em um ambulatório de psiquiatria infantil (dissertação de mestrado da autora deste artigo) e em escolas brasileiras (tese de doutorado), nos períodos de 2009-2011 e 2012-2016, respectivamente. Parte-se da questão de gênero suscitada pela prevalência do transtorno para analisar algumas dessas normas de conduta social - sobretudo aquelas relacionadas ao controle da corporalidade e das emoções -, e do estigma sofrido por crianças diagnosticadas para compreender a legitimação de intervenções especializadas bem como a produção de identidades. Almeja-se explorar a conjuntura da sociedade contemporânea, que articula o domínio sobre o corpo, a “mente” e as emoções para conferir sentido às condutas, crenças e desejos coletivos e individuais.
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148
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Levelink B, Feron FJM, Dompeling E, van Zeben-van de Aa DMCB. Children With ADHD Symptoms: Who Can Do Without Specialized Mental Health Care? J Atten Disord 2020; 24:104-112. [PMID: 29471702 PMCID: PMC6935830 DOI: 10.1177/1087054718756194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: A new Dutch Child and Youth Act should reduce specialized mental health care for children with symptoms of ADHD. Characteristics of children referred to a specialized ADHD clinic are explored to give direction to this intention. Method: Data of 261 children who underwent a multidisciplinary best practice evaluation (including rating scales, and demographic, psychological, and somatic findings) were analyzed. Univariable and multivariable logistic regression models were used to find predictive variables for the need of specialized mental health care. Results: Collected data were heterogeneous. (Sub)clinical total scores on the Teacher Report Form (TRF) and Child Behavior Checklist (CBCL) were predictive variables for specialized mental health care. Also children with divorced parents were more often referred to specialized care. Conclusion: (Sub)clinical scores on the CBCL and TRF increased the need for specialized care, but comprehensive assessment of every child with ADHD symptoms was necessary to differentiate between levels of care.
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149
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Slobodin O, Davidovitch M. Gender Differences in Objective and Subjective Measures of ADHD Among Clinic-Referred Children. Front Hum Neurosci 2019; 13:441. [PMID: 31920599 PMCID: PMC6923191 DOI: 10.3389/fnhum.2019.00441] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 12/02/2019] [Indexed: 11/25/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD), one of the most prevalent childhood disorders today, is generally more likely to be diagnosed and treated in boys than in girls. However, gender differences in ADHD are currently poorly understood, partly because previous research included only a limited proportion of girls and relied mainly on subjective measures of ADHD, which are highly vulnerable to reporter's bias. To further examine gender differences in ADHD and to address some of the shortcomings of previous studies, this study examined gender differences in subjective and objective measures of ADHD among clinic-referred children with ADHD. Participants were 204 children aged 6-17 years-old with ADHD (129 boys, 75 girls). A retrospective analysis was conducted using records of a clinical database. Obtained data included parent and teacher forms of the Conners ADHD rating scales, Child Behavior Checklist (CBCL), Teacher's Report Form (TRF), and child's continuous performance test (CPT) scores. Results showed that according to parents' and teachers' reports of ADHD-related symptoms (Conners ADHD rating scales), girls had more inattention problems than boys, but no differences were identified in the level of hyperactivity and impulsivity symptoms. CPT data, however, revealed higher impulsivity among boys. We did not find gender differences in the level of distractibility during CPT performance. Specifically, the effects of distractors type (visual environmental stimuli, auditory stimuli, or a combination of them) and distractors load (one or two distracting stimuli at a time) on CPT performance did not differ between boys and girls with ADHD. These findings suggest that gender effects on ADHD symptoms may differ between subjective and objective measures. Understanding gender differences in ADHD may lead to improved identification of girls with the disorder, helping to reduce the gender gap in diagnosis and treatment.
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Affiliation(s)
- Ortal Slobodin
- Department of Education, Ben-Gurion University, Beer-Sheva, Israel
| | - Michael Davidovitch
- Medical Department and Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel
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150
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Cohen R, Cohen-Kroitoru B, Halevy A, Aharoni S, Aizenberg I, Shuper A. Handwriting in children with Attention Deficient Hyperactive Disorder: role of graphology. BMC Pediatr 2019; 19:484. [PMID: 31823772 PMCID: PMC6902409 DOI: 10.1186/s12887-019-1854-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/22/2019] [Indexed: 11/18/2022] Open
Abstract
Background Handwriting difficulties are common in children with attention deficient hyperactive disorder (ADHD). The aim of our study was to find distinctive characteristics of handwriting in children with ADHD by using graphology to analyze physical characteristics and patterns, and to evaluate whether graphological analysis is an effective ADHD diagnostic tool for clinicians. Method The cohort included 49 children aged 13–18 years attending a tertiary neurology and epilepsy center in 2016–2017; 22 had a previous DSM-IV/V diagnosis of ADHD. The children were asked to write a 10–12-line story in Hebrew on a blank sheet of paper with a blue pen over a 20-min period. The samples were analyzed by a licensed graphologist blinded to the clinical details of the children against a predetermined handwriting profile of individuals with ADHD. Each ADHD characteristic identified in each sample was accorded 1 point, up to a total of 15 points. Patients with a graphology score of 9–15 were considered to have ADHD. Results There were 21 boys (43%) and 28 girls (57%) in the cohort; 15 boys (71.4%) and 7 girls (25%) had a DSM-IV/V diagnosis of ADHD. The mean graphology score was significantly higher in the children who had a DSM-IV/V diagnosis of ADHD than in the children who did not (9.61 + 3.49 vs. 5.79 + 4.01, p = 0.002, respectfully). Using a score of 9 as the cutoff, in the girls, graphology had a specificity of 80% (95% CI 59.2–92.8) and a of sensitivity 71.4% for predicting ADHD. Corresponding values in the boys were 75.0 and 76.2%. Conclusion The handwriting of children with ADHD has specific characteristics. Graphology may serve as a clinically useful tool in the diagnosis of ADHD.
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Affiliation(s)
- Rony Cohen
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children's Medical Center of Israel, Petach Tikva, Tikva, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Meuhedet Health Services, North District, Jerusalem, Israel.
| | - Batia Cohen-Kroitoru
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children's Medical Center of Israel, Petach Tikva, Tikva, Israel.,Institute of Applied Graphology, Meitar, Jerusalem, Israel
| | - Ayelet Halevy
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children's Medical Center of Israel, Petach Tikva, Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Aharoni
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children's Medical Center of Israel, Petach Tikva, Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Avinoam Shuper
- Department of Pediatric Neurology and Epilepsy Center, Schneider Children's Medical Center of Israel, Petach Tikva, Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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