Eating competence is related to executive function skills in college students

PURPOSE

This study aimed to determine the relationship between eating competence (EC) and executive function (EF) skills in college students.

METHODS

This cross-sectional study was part of a larger study in which an online survey was administered during autumn quarter 2020 to undergraduate students at a northwestern U.S. public university. Sociodemographic data were collected, along with measures of EC (16-item Satter Eating Competence Inventory, ecSI-2.0™) and EF skills (27-item Executive Function Index, EFI). Multiple linear regression was used to examine the ecSI-2.0™ total score and its four domain scores with each of the five EF skills.

RESULTS

Of the 1996 respondents included in the final analyses, 40.2 % were eating competent (total ecSI-2.0™ ≥32). The mean ecSI-2.0™ score among participants was 28.7. Gender distribution was 72.0 % women, 23.3 % men, and 4.7 % trans-and-gender non-conforming (TGNC) or preferred not to answer. EFI scores were higher among women (70.9) than among men (68.2) and TGNC (64.9). Both total ecSI-2.0™ score and the contextual skills domain were significantly associated with four of the EFI subscales. Internal regulation was related to impulse control and motivational drive. Further significant associations were found with other domains of ecSI-2.0™ and specific EFI subscales.

CONCLUSION

EF skills are associated with EC in college students, particularly skills related to food management and internal regulation. Since both EF and EC can be developed, this study offers promise for future research in an increasingly gender-diverse and neurodiverse college population during a time of increasing independence and autonomy.

Perceptions of Academic Performance, Impairment, and Mental Health in University Students With and Without ADHD

OBJECTIVE

This study aims to investigate the impact of positive illusory bias (PIB) on the relationship between ADHD symptoms and functioning in college students, with a focus on gender differences.

METHOD

The sample consisted of 195 college students, including 148 with ADHD and 47 without ADHD. Measures of ADHD symptomatology, life satisfaction, affect, gender identity, and impairment were collected, along with cumulative grade point average.

RESULTS

ADHD symptomatology was inversely linked to subjective well-being, with PIB acting as a significant moderator. Functional impairment was predicted by ADHD symptoms and subjective well-being, while social impairment and academic functioning were predicted by PIB and well-being. Significant gender differences were found, particularly in the interaction between PIB and ADHD symptoms for non-binary individuals.

CONCLUSION

This study suggests that PIB is relevant for emerging adults with ADHD enrolled in higher education. Subjective well-being and PIB act as buffers against the detrimental functional and social effects of ADHD symptoms in emerging adult college students. The study highlights the importance of considering gender-specific approaches in understanding and supporting the mental health of this population.

Exploring the impact of probiotics on adult ADHD management through a double-blind RCT

Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric condition often persisting into adulthood, characterized by inattention, impulsivity, and hyperactivity. Emerging research suggests a connection between ADHD and gut microbiota, highlighting probiotics as potential therapeutic agents. This study involved a double-blind, randomized controlled trial where college students with ADHD received either a multi-strain probiotic supplement or a placebo daily for three months. ADHD symptoms were evaluated using a computerized performance test (MOXO) and the MATAL questionnaire. Academic records provided performance data. Additionally, eating and sleeping habits, gastrointestinal symptoms, and anthropometrics were assessed through questionnaires before and after the intervention. Fingernail cortisol concentrations (FCC) measured the long-term activity of the hypothalamic-pituitary-adrenal axis. The findings indicated that the probiotic significantly decreased hyperactivity, improved gastrointestinal symptoms, and enhanced academic performance. A multivariate analysis identified age as a significant predictor, with younger participants experiencing greater overall benefits from the intervention. There was also a negative correlation between FCC and symptoms of attention and impulsivity. Furthermore, higher academic grades were associated with lower levels of hyperactivity and impulsivity. These results suggest a beneficial impact of probiotics on ADHD symptoms and lay the groundwork for further studies to evaluate the effects of various probiotic strains on clinical outcomes in ADHD.

Attention Deficit Hyperactivity Disorder Misdiagnosis: Why Medical Evaluation Should Be a Part of ADHD Assessment

INTRODUCTION

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that interferes with multiple aspects of daily functioning and is associated with impairments in several domains. It may affect academic, educational, vocational, social, emotional, interpersonal, and health domains, and worsen risks to health outcomes.

OBJECTIVE

To identify and discuss medical conditions that commonly present with symptoms resembling ADHD.

METHOD

This review is selective and not systematic. It is conducted through a focused literature search through PubMed, Google Scholar, and EMBASE. Search term included "ADHD misdiagnosis", "medical conditions with ADHD like symptoms", "ADHD AND medical problems".

EXCLUSION

giftedness, high IQ, and any article that does not list medical conditions. The limits applied were the following: the work must have been published in the past 20 years, be on humans, and be in the English language.

RESULTS

There are several medical conditions that can be misdiagnosed as ADHD and may show a similar presentation to ADHD, particularly with inattentive symptoms. Examples include, but are not limited to, absence seizure disorder, diabetes, thyroid dysfunction, sleep deprivation, post-concussion states, inflammatory bowel disease, iron deficiency states and anemia, and disordered breathing.

CONCLUSIONS

Our review suggests that a thorough medical evaluation should be conducted prior to the diagnosis of ADHD. Allied health professionals and psychologists who diagnose ADHD should seek medical clearance from a physician prior to making the ADHD diagnosis in order to reduce misdiagnosis rates and improve patient outcomes. ADHD diagnosis should follow guidelines and be carried out under a systematic standardized approach. A full medical evaluation should be conducted to assess for medical conditions that may look like ADHD or be associated with ADHD.

Is practice good enough? Retrieval benefits students with ADHD but does not compensate for poor encoding in unmedicated students

Introduction

A significant proportion of currently enrolled college students receive support for attention deficit/hyperactivity disorder (ADHD) and these students are often at risk of academic failure. Retrieval practice or self-testing is an effective, accessible, and affordable tool for improving academic performance. Three recent studies found conflicting results with regards to the effectiveness of retrieval practice in this population.

Methods

The present study compared 36 individuals with ADHD to 36 controls. Participants studied Swahili-English word pairs that varied in difficulty. Half of the pairs were repeatedly studied, and the other half repeatedly tested.

Results

On a final test, all participants showed a benefit of retrieval practice relative to restudy and participant status did not moderate the effect. However, unmedicated individuals with ADHD performed worse overall, both during the encoding phase and on the final test, whereas medicated participants were not significantly different from controls.

Discussion

An examination of self-reported encoding strategies found unmedicated participants used fewer deep strategies at encoding, consistent with prior work on ADHD and memory. Although retrieval practice is effective in this group, improved strategy use may be necessary to ensure performance that is fully equivalent to that of students without ADHD.

Functional Impairments Associated With ADHD in Adulthood and the Impact of Pharmacological Treatment

OBJECTIVE

Among untreated adults, functional impairments associated with ADHD are widespread and cumulative, and can include social, educational, and professional impairments, increased risk of accidents and mortality, and reduced quality of life. Here, we review the most prominent functional impairments in adults with ADHD and summarize evidence describing the potential role of medication in improving outcomes.

METHOD

Articles related to the search terms "ADHD," "adult," and functional impairments were identified through Google Scholar and PubMed and selected for inclusion based on four criteria: strength of evidence, relevance to current challenges in adult ADHD, impact on the field, and recency of the results.

RESULTS

We identified 179 papers to support the conclusions on the relationship between ADHD and functional impairments, and the impact of pharmacological therapy on functional impairments.

CONCLUSION

This narrative review provides evidence that pharmacological treatment can be effective in minimizing not only the symptoms of ADHD, but its functional consequences as well.

Childhood School Performance in Adults Diagnosed with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

Children with ADHD often tend to underperform in school. This partial study aimed to find out if the school experience of adults with higher ADHD symptomatology differs from those with lower and no ADHD symptomatology.

METHOD

Based on the results of ASRS questionnaires, the respondents were divided into three groups (low, medium, and high) according to the manifested ADHD symptomatology. We explored their school experiences by looking at their grades for behavior at school, notes regarding their attendance, school expulsion, and other school experiences.

RESULTS

Children with higher ADHD symptomatology were significantly more likely to be expelled, receive notes for bad behavior, disturbing or forgetting as well as receive reprimands from teachers.

CONCLUSION

Our results show that children with increased ADHD symptomatology experience more difficulties with school behavior, they are frequently reprimanded, and they do receive more negative feedback regarding their attendance and tardiness from teachers.

Self-devised assistive techniques by university students with learning disabilities

Background

Access to assistive technology for disabilities is limited in low-resource settings. Therefore, existing research focuses on accessibility challenges. This article focuses on how students with learning disabilities manage learning in the absence of assistive technology, a subject that receives less scholarly attention.

Objectives

This article aims to provide insights on how students with learning disabilities manage learning in the face of limited access to assistive technology. It explores conversion factors that influence access to assistive technology.

Method

This qualitative study used semistructured interviews to collect data from students with learning disabilities and respective university staff members who were recruited using convenience and snowballing techniques. Data were analysed thematically and supported by thick descriptions of experiences.

Results

This study established that students have limited access to assistive technology, and they manage learning through self-devised means that are more socially than technologically or scientifically inspired such as self-affirmation, animal therapy, family support and prayer. Conversion factors, which affect ability by either enabling or constraining access to assistive technology, were identified at personal and institutional or environmental levels.

Conclusion

The article concludes that even though students with learning disabilities devise unconventional assistive ways to manage learning, failure to access assistive technology is a capability deprivation that promotes inequalities.

Contribution

This article provides insights that shift perspectives that students with disabilities are passive recipients of support; rather, they can be active agents who innovate nontechnological ways to manage learning in the absence of assistive technology.

Road-Crossing Behavior in Complex Traffic Situations: A Comparison of Children With and Without ADHD

All children are vulnerable to pedestrian injuries, but previous research suggests children diagnosed with ADHD may have elevated risk. Child pedestrian injury risk also increases with increasing traffic volume and speed. The current study examined three hypotheses: (a) Pedestrian behavior of children with ADHD is riskier than that of typically-developing children; (b) Children's pedestrian behavior is riskier with increased traffic complexity; and (c) Pedestrian behavior of children with ADHD is influenced more by complex traffic situations than behavior of typically-developing children. A sample of 38 children ages 8-12 years, 45% diagnosed with ADHD, completed 21 virtual street-crossings, 7 in each of three levels of traffic complexity. Outcome measures included unsafe crossings, ratio of looking at traffic by time, start-delay to enter the road, time to contact with oncoming vehicles, and time waiting to cross. A repeated measure MANOVA and follow-up tests showed that all children had more unsafe crossings, shorter start-delays and shorter TTCs when exposed to increased traffic complexity compared to lighter traffic. Children with ADHD had more unsafe crossings than typically-developing children. Further, compared to typically-developing children, ADHD children had comparatively more unsafe crossings, lower time to contact and longer wait-time in more complex traffic environments. Executive function deficits among children with ADHD likely influence their behavior in complex traffic environments. Implications of the results for policy-making and preventive strategies are discussed.

The impact of psychological theory on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults: A scoping review

Psychological theory and interpretation of research are key elements influencing clinical treatment development and design in Attention Deficit Hyperactivity Disorder (ADHD). Research-based treatment recommendations primarily support Cognitive Behavioural Therapy (CBT), an extension of the cognitive behavioural theory, which promotes a deficit-focused characterisation of ADHD and prioritises symptom reduction and cognitive control of self-regulation as treatment outcomes. A wide variety of approaches have developed to improve ADHD outcomes in adults, and this review aimed to map the theoretical foundations of treatment design to understand their impact. A scoping review and analysis were performed on 221 documents to compare the theoretical influences in research, treatment approach, and theoretical citations. Results showed that despite variation in the application, current treatments characterise ADHD from a single paradigm of cognitive behavioural theory. A single theoretical perspective is limiting research for effective treatments for ADHD to address ongoing issues such as accommodating context variability and heterogeneity. Research into alternative theoretical characterisations of ADHD is recommended to provide treatment design opportunities to better understand and address symptoms.

Motivational interviewing plus behavioral activation for alcohol misuse in college students with ADHD

Objective: College is a high-risk period for the initiation and escalation of problem alcohol use. College students with attention-deficit/hyperactivity disorder (ADHD) are at particularly high risk for experiencing alcohol-related negative consequences relative to typically developing peers. Despite this, the best therapeutic approach for addressing alcohol problems in college students with ADHD has not been identified. Behavioral activation (BA) may augment the effects of gold-standard College drinking interventions [i.e., brief motivational intervention (BMI)] for students with ADHD who are engaging in problem drinking. Method: 113 college students with ADHD (Mean age = 19.87, SD = 1.44; 49.1% male) were randomized to either BMI + BA or BMI plus supportive counseling (BMI + SC). Both groups received ADHD psychoeducation delivered in MI style. Outcomes were assessed using the Brief Young Adult Alcohol Consequences Questionnaire, Daily Drinking Questionnaire, Barkley Functional Impairment Scale, and Beck Depression Inventory. Results: There were no significant differences in outcomes for the sample as a whole; in both conditions, participants showed significant reductions in their alcohol-related negative consequences, alcohol use, and depressive symptoms at 1- and 3-month follow-ups. Exploratory moderation analyses revealed that participants with elevated depressive symptoms at baseline evidenced greater reductions in alcohol-related negative consequences in the BMI + BA condition compared to BMI + SC at the 3-month follow-up. Those low in depressive symptoms evidenced greater reductions of alcohol-related negative consequences in BMI + SC compared to BMI + BA. Conclusions: For college students with ADHD who reported elevated baseline depressive symptoms, the inclusion of BA with BMI resulted in significantly greater decreases in alcohol-related negative consequences, compared to BMI + SC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Self-reported functional impairment in college students: relationship to noncredible reporting, ADHD, psychological disorders, and other psychological factors

INTRODUCTION

Both symptoms and functional impairment should be assessed in college students seeking evaluations for Attention Deficit Hyperactivity Disorder (ADHD). However, impairment is not specific to ADHD. Although it is well documented that self-reported symptoms can be reported noncredibly, there is less research examining credibility of self-reported impairment, and few clinicians rule out alternative causes for impairment.

METHOD

Participants (N = 428) completed self-report measures of functional impairment, sleep, perceived stress, and in an ADHD symptom measure with embedded validity indicators.

RESULTS

Noncredible reporters endorsed greater functional impairment than credible reporters in several domains, but impairment was reported at a high rate even in credible responders (N = 323) in several domains. Participants who reported prior ADHD and participants who reported prior psychiatric diagnoses reported greater impairment and higher rates of clinically significant impairment than those who reported no prior diagnoses. Few differences in reported impairment emerged between those who reported ADHD and psychiatric diagnoses. Sleep and stress accounted for significant variance in impairment, and the ADHD group reported greater impairment than the psychiatric diagnosis and no diagnosis groups after controlling for these variables.

CONCLUSIONS

Results reinforce the importance of considering the validity of, and alternative sources for, self-reported impairment in college students with ADHD concerns.

Sport Concussion Assessment Tool Symptom Inventory: Healthy and Acute Postconcussion Symptom Factor Structures

CONTEXT

Previous researchers have examined factor structures for common concussion symptom inventories. However, they failed to discriminate between the acute (<72 hours) and subacute (3 days-3 months) periods after concussion. The Sport Concussion Assessment Tool (SCAT) is an acute assessment that, when compared with other concussion symptom inventories, includes or excludes symptoms that may result in different symptom factors.

OBJECTIVE

The primary purpose was to investigate the symptom factor structure of the 22-item SCAT symptom inventory in healthy, uninjured and acutely concussed high school and collegiate athletes. The secondary purpose was to document the frequency of the unique SCAT symptom inventory items.

DESIGN

Case series.

SETTING

High school and college.

PATIENTS OR OTHER PARTICIPANTS

A total of 1334 healthy, uninjured and 200 acutely concussed high school and collegiate athletes.

MAIN OUTCOME MEASURE(S)

Healthy, uninjured participants completed the SCAT symptom inventory at a single assessment. Participants in the acutely concussed sample completed the SCAT symptom inventory within 72 hours after concussion. Two separate exploratory factor analyses (EFAs) using a principal component analysis and varimax extraction method were conducted.

RESULTS

A 3-factor solution accounted for 48.1% of the total variance for the healthy, uninjured sample: cognitive-fatigue (eg, feeling "in a fog" and "don't feel right"), migraine (eg, neck pain and headache), and affective (eg, more emotional and sadness) symptom factors. A 3-factor solution accounted for 55.0% of the variance for the acutely concussed sample: migraine-fatigue (eg, headache and "pressure in the head"), affective (eg, sadness and more emotional), and cognitive-ocular (eg, difficulty remembering and balance problems) symptom factors.

CONCLUSIONS

The inclusion of unique SCAT symptom inventory items did not alter the symptom factor structure for the healthy, uninjured sample. For the acutely concussed sample, all but 1 unique SCAT symptom inventory item (neck pain) loaded onto a factor.

Do ADHD Symptoms, Executive Function, and Study Strategies Predict Temporal Reward Discounting in College Students with Varying Levels of ADHD Symptoms? A Pilot Study

The purpose of this study was to examine the relationship between temporal reward discounting and attention deficit hyperactivity disorder (ADHD) symptoms in college students. Additionally, we examined whether temporal reward discounting was associated with executive functioning in daily life and with learning and study strategies in this group. Thirty-nine college students (19 with ADHD and 20 controls) participated after meeting criteria for ADHD or non-ADHD based on standardized assessment. Strong preferences for small immediate rewards were specifically associated with the ADHD symptom domain hyperactivity–impulsivity. Additionally, these preferences were associated with daily life executive function problems and with weak learning and study strategies. This suggests that steep temporal discounting may be a key mechanism playing a role in the daily life challenges that college students with ADHD symptoms face. If these findings are replicated in larger samples, then intervention strategies may profitably be developed to counteract this strong preference for small immediate rewards in college students with ADHD symptoms.

Psychometric Properties of the Weiss Functional Impairment Rating Scale: Evidence for Utility in Research, Assessment, and Treatment of ADHD in Emerging Adults

Objective: The current study examines psychometric properties of the Weiss Functional Impairment Rating Scale (WFIRS), a measure of adult ADHD-related impairment. It is a self-report questionnaire that provides a metric of overall life impairment and domain-specific dysfunction. Method: Using data from a large (N = 2,093), multi-institution sample of college students and including a subsample of collateral informants (n = 262), a series of analyses were conducted. Results: The WFIRS demonstrated robust internal reliability, cross-informant agreement on par or superior to other measures of ADHD symptomatology and impairment, and concurrent validity. The WFIRS was not shown to be uniquely associated with ADHD, as internalizing symptoms also associated with the total and domain scores. Conclusion: The use of the WFIRS in identifying ADHD-related impairment in emerging adults appears to be psychometrically supported, and will prove useful to clinicians and researchers.

Perceived stress partially accounts for the association between Attention Deficit Hyperactivity Disorder (ADHD) symptoms and suicidal ideation among students

The association between Attention Deficit Hyperactivity Disorder (ADHD) and suicidal ideation has been the focus of recent research interest among youths and young adults. However, the role perceived stress plays in this association is unclear. We investigated whether perceived stress accounts for the association between ADHD and subsequent suicidal ideation among French students enrolled in the i-Share cohort. The associations between ADHD symptoms, perceived stress at baseline, and suicidal ideation during follow-up were investigated using logistic regression models, and Structural Equation Modeling was used to estimate the indirect effect via perceived stress. In total 4333 participants (median age: 20.3 years; [interquartile range: 18.7-21.8]) were included in the main analyses. ADHD was associated with suicidal ideation (adjusted Odds Ratio = 1.15 [95% Confidence Interval: 1.04-1.26]). Perceived stress partially accounts for the association between ADHD and suicidal ideation (proportion explained 49%). Our study suggests that ADHD and perceived stress represent mental health targets for suicide prevention programs.

The relation between ADHD symptoms, perceived stress and binge drinking in college students

Binge drinking is a major public health problem associated with various negative short-term and long-term clinical and social outcomes. If there is evidence to suggest a relationship between ADHD and alcohol use in college students, no study has investigated the role of ADHD symptomatology in binge drinking. Thus, this research was designed to explore the relative contributions of inattention and hyperactivity/impulsivity symptoms to binge drinking in a sample of French college students while controlling for effects of perceived stress. Participants (N = 7011; mean age = 20.9; 74.9% of females) completed self-report surveys assessing ADHD symptoms, perceived stress, sociodemographic characteristics, and binge drinking frequency. Multinomial logistic regression revealed significant associations between higher levels of ADHD symptoms in general, but not perceived stress, and increasing frequency of binge drinking. Moreover, higher levels of inattention and hyperactivity/impulsivity symptoms were independently associated with greater frequency of binge drinking. The association was stronger between high rates of binge drinking and inattention than for hyperactivity/impulsivity. These findings, which remained statistically significant after adjusting for a range of potential confounders (including perceived stress), suggest that the presence of ADHD symptoms may be an important factor related to binge drinking.

ADHD and SCT Symptomatology in Relation to College Students' Use of Self-Regulated Learning Strategies

Objective: The present study examined the relation between self-regulated learning (SRL) strategies and ADHD and sluggish cognitive tempo (SCT) symptomatology. Method: Participants were 303 college students, aged 18 to 25 (M = 20.04, SD = 1.45), from a Midwestern university who completed the Barkley Adult ADHD Rating Scale-IV (BAARS-IV), and a shortened, generalized version of the Motivated Strategies for Learning Questionnaire (MSLQ). Results: Among college students, inattention symptomatology was consistently predictive of deficits in use of value, expectancy, and self-regulation strategies, while SCT symptomatology was only predictive of deficits in the use of self-regulation strategies. Conclusion: This study is the first to examine the relation between SCT symptomatology and SRL strategy use in college students. The findings revealed that SRL strategy use differs between college students exhibiting ADHD or SCT symptomatology. Remediation focusing on these deficits would likely increase academic achievement. Clinical implications, limitations, and suggestions for future research are discussed.

Predictors and Moderators of Quality of Life Among College Students With ADHD

Objective: The current study examines (a) whether ADHD among college students is associated with differences in perceptions of quality of life (QoL); (b) the moderating roles of comorbidity, drug use, psychopharmacological treatment, and psychosocial treatment; and (c) the total impact of these variables on QoL. Method: Participants were college students with and without ADHD (N = 372) in a longitudinal study. Results: College students with ADHD were more likely to assert negative global QoL evaluations relative to non-ADHD peers. The relationship between ADHD and QoL was not altered as a function of medication treatment, comorbid psychopathology, psychosocial treatment, or drug use. Conclusion: College students with ADHD behave similarly to other adults with ADHD in that they make lower subjective global evaluations of their QoL relative to their non-ADHD agemates. Other factors associated with ADHD and QoL do not appear to moderate this relationship.

Explaining the Relationship Between ADHD Symptomatology and Amotivation in the Undergraduate Population: The Role of Basic Psychological Need Frustration

Recent research has shown that undergraduate students who experience both clinical and subclinical attention-deficit/hyperactivity disorder (ADHD) struggle academically. Furthermore, these students have cited academic amotivation as a factor in their academic difficulties. Self-determination theory (SDT) posits that a lack of motivation—known as amotivation—may be the result of the frustration of the basic psychological needs—autonomy, competence, and relatedness. For this reason, the current study examined whether basic psychological need frustration mediated the relationship between ADHD symptomatology and academic amotivation. A sample of undergraduate students completed an online questionnaire about their university experience. Data were analyzed using a mediational structural equation model. Results suggested significant relationships between all of the variables. Moreover, basic psychological need frustration fully mediated the relationship between ADHD symptomatology and academic amotivation. These results demonstrate the importance of fulfilling the basic psychological needs of undergraduate students experiencing ADHD symptomatology, as it may increase their academic motivation, and, subsequently, reduce their academic difficulties.

University students with attention deficit hyperactivity disorder (ADHD): a literature review

OBJECTIVES

To review existing literature about university students with Attention Deficit Hyperactivity Disorder (ADHD).

METHODS

A framework for scoping studies and content analysis were used to source and review selected publications from PubMed, ScienceDirect, Google Scholar and relevant bibliographies.

RESULTS

Seventy-four publications were reviewed and key findings were categorised under six core themes that represent the issues germane to university students with ADHD. These themes are: academic, social and psychological functioning, giftedness, new media technologies, treatment, substance misuse and the non-medical use of prescription stimulants, and malingering.

CONCLUSION

In Ireland and the United Kingdom (UK) young people with ADHD are unlikely to enrol into further education, and of those who do go to university, few will graduate at the same time as their non-ADHD peers. ADHD is associated with poor educational outcomes and it may be a hidden disability within institutions of higher education (e.g. universities). Surprisingly, in this topic area, there is a paucity of research in Ireland and the UK. Most studies originate from North America were research activity in the field has been ongoing since the 1990s. These studies however, tend to use relatively small samples of college (university) students recruited at a single institution. It is difficult to generalise the findings of these studies to student populations in North America, let alone in Ireland and the UK. At the very least, these North American studies provide insights into key areas of concern. This topic area straddles education and psychiatry. This means an inter-disciplinary approach is required to examine, better understand and address the impact of ADHD on the educational outcomes of university students. The philosophies of difference, equity and self-realisation can offer a conceptual framework for conducting further research and/or developing services to deliver more personalised learning support for university students with ADHD.

Utility of the Personality Assessment Inventory in detecting feigned Attention-Deficit/Hyperactivity Disorder (ADHD): The Feigned Adult ADHD index

Objective

The high potential for secondary gain among college students presenting for Attention-Deficit/Hyperactivity Disorder (ADHD) evaluations highlights the need for psychometrically sound embedded validity indicators. The purpose of this study was to develop new validity indicators specific to feigned ADHD for the Personality Assessment Inventory (PAI) and compare them to preexisting imbedded PAI validity measures.

Method

PAI scales that were theoretically related to feigned ADHD were evaluated. A binomial (ADHD simulators, n = 138, and genuine ADHD, n = 142) logistic regression was conducted with selected PAI scales and subscales. Classification rates were compared between the new and existing validity scales. A similar approach was used for item-level data in a second study in a subgroup of the original sample.

Results

The derived PAI scale-based logistic regression had a sensitivity of 54% and specificity of 92%. This algorithm accurately identified 97% of healthy controls as not feigning ADHD and correctly identified 98% of a no diagnosis group and 75% of a mood/anxiety disorders group. Classification accuracy of the new index was superior to the majority of existing PAI validity scales across groups. An item-level PAI algorithm had a sensitivity of 85% and specificity of 97% for identifying feigned ADHD.

Conclusions

New validity measures were compared to existing PAI validity indicators and performed better than many of them in this study. The algorithms developed in this study of ADHD simulators and genuine ADHD cases have adequate sensitivity and good specificity and appear to function differently than other PAI symptom validity scales.

An experimental paradigm examining the influence of frustration on risk-taking behavior

The present study examined the impact of frustration on risk-taking in college students with low and high ADHD symptomatology (L-ADHD and H-ADHD). Participants completed the Balloon Analogue Risk Task (BART) following induced frustration from a mood manipulation task (experimental session) and following no mood manipulation (control session). A manipulation check revealed a significant three-way interaction where the H-ADHD group reported higher frustration levels compared to the L-ADHD group, particularly in response to the frustration induction in the experimental condition. Primary results revealed that the L-ADHD group exploded significantly fewer balloons in the experimental condition compared to the control condition; there was a nonsignificant difference of balloon explosions across conditions for the H-ADHD group. The study provides initial laboratory-based support for the impact of frustration on the risk behavior of those with low and high levels of ADHD, with potential implications for future studies and ultimately for intervention.

Mind wandering perspective on attention-deficit/hyperactivity disorder

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder associated with a range of mental health, neurocognitive and functional problems. Although the diagnosis is based on descriptions of behaviour, individuals with ADHD characteristically describe excessive spontaneous mind wandering (MW). MW in individuals with ADHD reflects constant mental activity which lacks topic stability and content consistency. Based on this review of the neural correlates of ADHD and MW, we outline a new perspective on ADHD: the MW hypothesis. We propose that altered deactivation of the default mode network, and dysfunctional interaction with the executive control network, leads to excessive and spontaneous MW, which underpins symptoms and impairments of ADHD. We highlight that processes linked to the normal neural regulation of MW (context regulation, sensory decoupling, salience thresholds) are deficient in ADHD. MW-related measures could serve as markers of the disease process, as MW can be experimentally manipulated, as well as measured using rating scales, and experience sampling during both cognitive tasks and daily life. MW may therefore be a potential endophenotype.

Factor structure and clinical correlates of the 61-item Wender Utah Rating Scale (WURS)

The objective of this study was to assess the factor structure and clinical correlates of a 61-item version of the Wender Utah Rating Scale (WURS), a self-report retrospective measure of childhood problems, experiences, and behavior used in ADHD assessment. Given the currently mostly widely used form of the WURS was derived via a criterion-keyed approach, the study aimed to use latent variable modeling of the 61-item WURS to potentially identify more and more homogeneous set of items reflecting current conceptualizations of ADHD symptoms. Exploratory structural equation modeling was used to generate factor scores which were then correlated with neuropsychological measures of intelligence and executive attention as well as a broad measure of personality and emotional functioning. Support for a modified five-factor model was found: ADHD, disruptive mood and behavior, negative affectivity, social confidence, and academic problems. The ADHD factor differed somewhat from the traditional 25-item WURS short form largely through weaker associations with several measures of personality and psychopathology. This study identified a factor more aligned with DSM-5 conceptualization of ADHD as well as measures of other types of childhood characteristics and symptoms which may prove useful for both research and clinical practice.

A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for College Students With ADHD

OBJECTIVE

Between 2% and 8% of college students meet criteria for ADHD, with increased incidence in recent decades. There are very few clinical trials conducted on the meaningful intervention of ADHD in college. Mindfulness-based cognitive therapy (MBCT) effectively treats college students with ADHD and could be more feasibly applied in college mental health clinics.

METHOD

Fifty-four undergraduates with ADHD between ages 19 and 24 were randomized to receive either MBCT or wait-list (WL) during a 6-week intervention phase. ADHD symptoms, neuropsychological performance, and related outcomes were assessed at pre-treatment, post-treatment, and 3-month follow-up.

RESULTS

Participants receiving MBCT group showed greater treatment response rates (57%-71% vs. 23%-31%) and experience less anxiety and depression, and greater levels of mindfulness; MBCT participants show greater improvement on neuropsychological performance.

CONCLUSION

MBCT may be a useful intervention for college students with ADHD, improving participants' ADHD symptoms, mindfulness, and sustained attention.

Efficacy of an Organizational Skills Intervention for College Students With ADHD Symptomatology and Academic Difficulties

OBJECTIVE

We sought to elucidate the effects of an organization, time management, and planning (OTMP) skills training intervention for college students reporting elevated levels of ADHD symptomatology and academic impairment.

METHOD

Undergraduate participants enrolled in either the intervention ( n = 22) or comparison ( n = 15) condition in exchange for psychology course credit. Those in the intervention condition attended three weekly group meetings designed to improve organizational skills. Treatment effectiveness was evaluated by comparing pre- and postmeasurements of academic impairment, inattention, hyperactivity/impulsivity, and OTMP skills utilization.

RESULTS

Intervention group participants improved significantly on ratings of inattention, hyperactivity/impulsivity, and academic impairment, relative to the comparison group. Intervention group participants also improved in their use of OTMP skills, relative to their baseline ratings.

CONCLUSION

This study suggests an organizational skills intervention has the potential to ameliorating ADHD symptomatology and academic impairment among college students.

Self-Monitoring by College Students With ADHD: The Impact on Academic Performance

OBJECTIVE

There is a lack of empirically supported treatments for college students with ADHD and academic deficits. The current study evaluated self-monitoring, an intervention that may improve academics in children with ADHD, with a college sample diagnosed with ADHD.

METHOD

Fifty-three participants were recruited, 41 of which completed the study and are included in the analyses. Participants were randomly assigned to a group that received study skills instruction, goal setting, and self-monitoring instruction (SM+ group; n = 22) or a group that received only study skills and goal setting (SM- group; n = 19).

RESULTS

Participants in the SM+ group demonstrated significant improvement in their ADHD symptoms, academic behavior, grade point averages (GPAs), and goal attainment. These improvements were not significant for the SM- group.

CONCLUSION

These findings suggest that self-monitoring might be used to improve academic performance in college students with ADHD.

Positive alcohol expectancies mediate associations between ADHD behaviors and alcohol-related problems among college students

An increasing percentage of college students report being affected by ADHD behaviors, and this population is at increased risk of experiencing negative consequences associated with alcohol consumption. However, specific factors motivating alcohol consumption and contributing to negative outcomes among these individuals are not well understood. Recent work suggests alcohol expectancies may interact with ADHD behaviors to influence negative drinking-related outcomes among those with elevated inattention and/or hyperactivity-impulsivity. Seven-hundred-forty emerging adults (M age = 19.13 [SD = 2.25] years; 72.1% female; 85.8% Caucasian) enrolled in two public universities in the Southeast and Midwest USA completed the Brief Comprehensive Effects of Alcohol Survey (B-CEOA) and provided self-reports of ADHD symptoms and drinking-related outcomes. Multiple mediation analyses were conducted to evaluate effects of ADHD behaviors (i.e., hyperactivity-impulsivity, and inattention) and related impairment in major life domains (e.g., social interactions, occupational and educational activities, fulfillment of daily responsibilities) on drinking-related outcomes via positive and negative alcohol expectancies, controlling for sex, age, co-occurring oppositional behaviors, and data collection site. Inattention, hyperactivity-impulsivity, and impairment directly predicted both personal and social problems consequent to alcohol use. Effects of ADHD behaviors and impairment on drinking-related personal and social problems were partially mediated by positive expectancies. Findings are consistent with and extend prior work supporting a role of positive alcohol expectancies in alcohol-related negative outcomes among college students experiencing mild to moderate symptoms of ADHD.

Neuropsychological functioning in college students with and without ADHD

OBJECTIVE

Increasing numbers of students with attention-deficit/hyperactivity disorder (ADHD) are attending college; however, little empirical information is available concerning the functional impairment experienced by these students. Although preliminary studies suggest that college students with ADHD are more likely to experience a variety of psychosocial and academic difficulties compared to their peers without the disorder, findings regarding neuropsychological functioning have been inconsistent with some studies reporting that college students with ADHD perform more poorly on various cognitive and neuropsychological tasks while others report no differences compared to their peers without ADHD.

METHOD

The purposes of the present study, the Trajectories Related to ADHD in College project, a longitudinal study following the 4-year outcomes of college students with and without ADHD, were to (a) examine the performance of 436 first-year college students with and without ADHD (51.6% female) on measures of executive function (EF) and intelligence and (b) investigate the association of self-reported use of stimulant medication and neuropsychological performance in students with ADHD. Participant data from their first year of involvement in the study were analyzed.

RESULTS

Participants with ADHD performed more poorly on task-based and self-report EF measures relative to the comparison group. In contrast, no significant group differences were found with respect to intellectual performance. Within the ADHD group, use of prescription stimulant medication was associated with improved performance on some, but not all, neuropsychological tasks. Additional analyses also revealed significant group differences in EF based on clinical diagnostic status.

CONCLUSION

College students with ADHD demonstrated poorer EF than their peers without ADHD and psychostimulant medication was associated with improved EF performance. No group differences were found with respect to intellectual functioning, Lastly, having one or more comorbid psychiatric diagnoses in addition to ADHD was associated with poorer EF outcomes. (PsycINFO Database Record

Evidence-Based Considerations and Recommendations for Athletic Trainers Caring for Patients With Attention-Deficit/Hyperactivity Disorder

CONTEXT

Patients with attention-deficit/hyperactivity disorder (ADHD) can be noncompliant, impulsive, and disruptive in an athletic training or physical rehabilitation facility. Athletic trainers (ATs) are valuable and essential health care providers for active patients with ADHD. However, for a patient with ADHD to have a successful outcome in a busy athletic training environment, the AT or health care provider must tailor the treatment setting to the patient's needs.

OBJECTIVE

To educate and raise awareness among ATs about patients with ADHD and to provide ATs with strategies and tools that will allow them to treat patients with ADHD more effectively.

DATA SOURCES

We retrieved and reviewed articles from PubMed, PsychINFO, and Ovid without date restrictions. Search words were attention deficit hyperactivity disorder plus 1 of the following topics or search words: athletic training, athletics, coaching, sport, or sport psychology.

STUDY SELECTION

Any ADHD articles that were not applicable or translatable in good faith to athletic training, physical rehabilitation, or sport and exercise were excluded.

DATA EXTRACTION

Nonpharmacologic interventions were reviewed and amassed into categories from which the recommendations were created. No statistical analyses were conducted for this review.

DATA SYNTHESIS

We identified 1241 articles, and 86 met the inclusion criteria. Five groups of evidence were observed: (1) goal setting and coaching, (2) reinforcements and outcomes, (3) routines and treatment timing, (4) simplified feedback and instructions, and (5) environmental control. Reliable evidence suggests that these techniques can be translated and applied within an athletic training and physical rehabilitation setting.

CONCLUSIONS

Athletic trainers are a vital component in providing health care for patients with ADHD. Using goal contagion creates a structured environment and positive reinforcements that accommodate patients with ADHD. Furthermore, ATs may use the evidence-based recommendations in this review to create a treatment and physical rehabilitation program and space that are tailored to the needs of the ADHD patient to increase the chance of a successful outcome.

Attention Functioning Among Adolescents With Multiple Learning, Attentional, Behavioral, and Emotional Difficulties

Attention-deficit/hyperactivity disorder (ADHD) is characterized by high levels of inattention, hyperactivity, and impulsivity; however, these symptoms can result from a variety of reasons. To obtain a comprehensive understanding of the various difficulties of individuals with ADHD, especially when co-occurrence difficulties are present, it is essential to combine neuropsychological and subjective assessment tools. In the present field study the authors investigated a group of adolescents with multiple deficits (MD) using neuropsychological and subjective measures. Teachers' ratings verified extremely high levels of symptoms of oppositional behavior, inattention, hyperactivity-impulsivity, social problems, and emotional problems in this group. As expected, MD group participants showed decreased abilities to maintain attention on task for a long period of time, focus attention and effectively inhibit adjacent distractors, and resist conflicting irrelevant information. Importantly, although significant differences in the attention measures were observed at the group level, not all MD participants displayed deviant performance. Thus, we conclude that the heterogeneous group of adolescents with MD comprises individuals with primary attention deficits as well as those with other nonattentional deficits that show equivalent behavioral symptoms. Using neuropsychological tools can be useful in differentiating between different core deficits and in guiding appropriate interventions.

Mediating effect of anxiety and depression on the relationship between Attention-deficit/hyperactivity disorder symptoms and smoking/drinking

Attention-deficit/hyperactivity disorder (ADHD) has been often found to be comorbid with other disorders, including anxiety, depression, and unhealthy behaviors such as drinking alcohol and smoking. These factors were often discussed separately, and the mediating effects of mental health on substance use are unknown. To study the mediating effects of anxiety and depression on the relationship between ADHD and drinking/smoking behaviors, we conducted a cross-sectional study of 1870 college students from Shanghai, China. The Adult ADHD Self-Report Scale (ASRS-v1.1) and Wender Utah Rating Scale (WURS) were used to identify the current and past ADHD. Structural Equation Modeling was carried out to clarify the mediating effect of anxiety and depression on the relationship between core ADHD symptoms and smoking/drinking behaviors. We found that inattention as one of the core symptoms of ADHD was associated with an increased risk of depression as a direct effect, as well as slightly increased risk of smoking/drinking behaviors by an indirect effect of depression. Hyperactivity-impulsivity, as another core symptom of ADHD had a robust impact on smoking and drinking behaviors, while being mediated by anxiety and depression. In conclusion, anxiety and depression was associated with further increased risk behaviors of smoking/drinking alcohol among those students with ADHD.

Postsecondary ADHD Documentation Requirements: Common Practices in the Context of Clinical Issues, Legal Standards, and Empirical Findings

OBJECTIVE

To evaluate the information postsecondary institutions require when determining disability service eligibility for students with reported ADHD.

METHOD

ADHD documentation requirements of 200 U.S. institutions were surveyed by reviewing guidelines posted on disability services websites.

RESULTS

Whereas virtually all institutions required documentation, findings revealed significant variability in requirements across institutions. Required variables most often included a qualified evaluator (80%), diagnostic statement (75%), and identification of substantial limitations (73%), but only 5 of 46 evaluated variables were required by at least 50% of institutions. Supportive data such as diagnostic criteria, standardized assessment results, and rationale for accommodations were rarely required.

CONCLUSION

The majority of institutions required little to verify ADHD as a disability. Furthermore, there was little agreement on what components are essential for verification. When integrated with research, a large portion of guidelines failed to address identified weaknesses in ADHD diagnosis and disability determination.

The Relation Between ADHD Symptoms and Alcohol Use in College Students

OBJECTIVE

Although there is evidence to suggest an association between ADHD and alcohol use in college students, results are inconclusive primarily because studies have failed to control for related variables. Thus, this study was designed to systematically compare the relative contributions of inattention and hyperactivity/impulsivity to alcohol use and alcohol-related problems in a sample of college students while controlling for effects of antisocial behaviors.

METHOD

A total of 192 undergraduate college students from a rural Midwestern university received class credit for participating in the study. They completed measures of alcohol use, ADHD symptoms, and antisocial behavior.

RESULTS

Hierarchical regressions revealed inattention, but not hyperactivity/impulsivity, was related to alcohol-related problems even when controlling for antisocial behavior. However, neither inattention nor hyperactivity/impulsivity was related to alcohol use regardless of whether current antisocial behavior was controlled.

CONCLUSION

Inattention may be an important factor related to alcohol-related problems in college students.

Repercussões do Transtorno de Déficit de Atenção/Hiperatividade (TDAH) na Experiência Universitária

Buscou-se verificar de que forma o diagnóstico do Transtorno de Déficit de Atenção/Hiperatividade (TDAH), ou a presença dos sintomas do transtorno, interfere na vida acadêmica de estudantes universitários. Realizou-se uma revisão sistemática de literatura com os descritores estudantes universitários/college students e TDAH/ADHD nas bases de dados Scielo Brasil, Index Psi, Redalyc, Medline, ePsycARTICLES no período de 2004 a 2014. Foram encontrados 53 artigos e, destes, 15 foram analisados. Os trabalhos visavam apontar as semelhanças e as diferenças entre estudantes universitários com e sem sintomas ou diagnóstico de TDAH quanto a variáveis que podem afetar a experiência universitária, bem como descrever o transtorno nessa população. Os jovens com e sem TDAH tendem a ser semelhantes no que se refere ao autoconceito e ao bem-estar psicológico, mas diferentes quanto à adaptação à universidade e às preocupações com o desempenho acadêmico. Esta revisão oferece um panorama sobre o que já se sabe sobre TDAH em estudantes universitários e sobre a forma como os estudos com esse público têm sido realizados.

Mental health status of patients with mild traumatic brain injury admitted to shahid beheshti hospital of kashan, iran

Background:

Planning for providing mental health services to the mentally patients due to brain injury need awareness of mental health status of the patient.

Objectives:

This study aimed to assess the mental health of patients with mild TBI.

Patients and Methods:

The descriptive cross-sectional study was performed on 286 patients with mild TBI who were admitted to department of neurosurgery of Shahid Beheshti Hospital, Kashan, Iran, during the first eight months of 2013. Enrolled patients were 15 to 70 years old who able to respond to questionnaires. The Brief Symptom Inventory (BSI) questionnaire is used to assess the mental health status of the patients. The data were presented using logistic regression and descriptive statistics.

Results:

A total of 286 patients, 79.7% males and 20.3% females with male to female ratio of 4:1, completed the study. Female had significantly higher Global Severity Index (GSI) compared to males. There was a significant association between, psychologic disorders’ symptoms and age (P = 0.00). The mean (SD) of GSI on the Symptom Checklist-90 (SCL-90) was 1.39 (0.58).

Conclusions:

This study showed that 36% of the patients with mild TBI symptoms had mental health problems. Given the high rates of psychologic disorders among patients with mild TBI, it is necessary to reduce the factors that caused the disorder.

Disinhibition mediates the relationship between ADHD and problematic alcohol use in college students

OBJECTIVE

High-risk alcohol use among college students has received substantial attention in recent years, and intervention and prevention efforts have increased dramatically. The current study examined ADHD as a risk factor for problematic drinking among college students. Trait disinhibition and difficulty stopping a drinking session were examined as potential mechanisms through which ADHD is associated with alcohol-related problems.

METHOD

Participants included 100 full-time undergraduate students with (n = 48) and without (n = 52) Diagnostic and Statistical Manual of Mental Disorders (4th ed.) ADHD.

RESULTS

Students with ADHD had higher rates of alcohol-related problems and alcohol-use disorders across multiple measures. Both disinhibition and difficulty stopping a drinking session independently mediated the relationship between ADHD and negative consequences of alcohol use.

CONCLUSION

These findings indicate that college students with ADHD are at increased risk for alcohol-related problems. Trait disinhibition and difficulty stopping a drinking session represent mechanisms of high-risk alcohol use among college students with ADHD.

Aberrant Monoaminergic System in Thyroid Hormone Receptor-β Deficient Mice as a Model of Attention-Deficit/Hyperactivity Disorder

BACKGROUND

Thyroid hormone receptors are divided into 2 functional types: TRα and TRβ. Thyroid hormone receptors play pivotal roles in the developing brain, and disruption of thyroid hormone receptors can produce permanent behavioral abnormality in animal models and humans.

METHODS

Here we examined behavioralchanges, regional monoamine metabolism, and expression of epigenetic modulatory proteins, including acetylated histone H3 and histone deacetylase, in the developing brain of TRα-disrupted (TRα (0/0) ) and TRβ-deficient (TRβ (-/-) ) mice. Tissue concentrations of dopamine, serotonin (5-hydroxytryptamine) and their metabolites in the mesocorticolimbic pathway were measured.

RESULTS

TRβ (-/-) mice, a model of attention-deficit/hyperactivity disorder, showed significantly high exploratory activity and reduced habituation, whereas TRα (0/0) mice showed normal exploratory activity. The biochemical profiles of dopamine and 5-hydroxytryptamine showed significantly low dopamine metabolic rates in the caudate putamen and nucleus accumbens and overall low 5-hydroxytryptamine metabolic rates in TRβ (-/-) mice, but not in TRα (0/0) mice. Furthermore, the expression of acetylated histone H3 was low in the dorsal raphe of TRβ (-/-) mice, and histone deacetylase 2/3 proteins were widely increased in the mesolimbic system.

CONCLUSIONS

These findings suggest that TRβ deficiency causes dysfunction of the monoaminergic system, accompanied by epigenetic disruption during the brain maturation process.