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Schippers LM, Horstman LI, van de Velde H, Pereira RR, Zinkstok J, Mostert JC, Greven CU, Hoogman M. A qualitative and quantitative study of self-reported positive characteristics of individuals with ADHD. Front Psychiatry 2022; 13:922788. [PMID: 36311492 PMCID: PMC9597197 DOI: 10.3389/fpsyt.2022.922788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022] Open
Abstract
Research in Attention-deficit/hyperactivity disorder (ADHD) has had a clear focus on treatment and the dysfunction in specific situation associated with the condition. However, self-report, observational and anecdotal evidence indicates that there are also positive aspects associated with ADHD. Research on the potential positive features in individuals with an ADHD diagnosis is still limited, especially studies with larger representative samples. Here we performed qualitative research to identify positive aspects and strengths associated with ADHD in a large convenience sample from the Dutch organization for people with ADHD, dyslexia and dyscalculia. We sent out open-ended questionnaires to the members of the organization, asking what they consider to be positive aspects of their ADHD. From the responses of individuals with ADHD (n = 206), we extracted 116 codes, which were assigned to thirteen subthemes, which in turn led to five themes. These themes were: Creativity, Being dynamic, Flexibility, Socio-affective skills, and Higher-order cognitive skills. Core symptoms of ADHD such as impulsivity and hyperactivity were also considered positive aspects of ADHD by a minority of participants. After showing our results to a group of additional individuals with ADHD (focus group) they confirmed the identified positive aspects of ADHD. They also helped us with the interpretation of our findings and mentioned certain positive aspects to be a consequence of living with ADHD (being open minded and being honest). In conclusion, experiencing positive aspects seems to be common in ADHD as almost all participants reported positive aspect of ADHD, these aspects cover many different domains. Awareness about ADHD's strengths might help individuals with ADHD and their environment to better cope with, accept or embrace their diagnosis and for example make educational or occupational choices that fit them well. To incorporate these positive aspects in the understanding of ADHD, future research should focus on quantifying strengths in ADHD, and on investigating the link between these aspects and clinical characteristics and how this new knowledge can be implemented in psychoeducation and find its way to education and occupational settings.
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Affiliation(s)
- Lessa M Schippers
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Lisa I Horstman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Hans van de Velde
- ADHD-Europe, Chair Science Committee Adult Patient Organization ADHD, Dyslexia and Dyscalculia, Impuls & Woortblind, Nijkerk, Netherlands
| | - Rob Rodrigues Pereira
- Medical Center Kinderplein, Rotterdam, Netherlands.,Dutch Adult Patient Organization ADHD, Dyslexia and Dyscalculia, Impuls & Woortblind, Nijkerk, Netherlands
| | - Janneke Zinkstok
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Karakter Child and Adolescent Psychiatry University Center, Nijmegen, Netherlands.,Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jeanette C Mostert
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Corina U Greven
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.,Karakter Child and Adolescent Psychiatry University Center, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, Gelderland, Netherlands.,King's College London, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, London, United Kingdom
| | - Martine Hoogman
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.,Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands
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2
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Buitelaar NJL, Posthumus JA, Bijlenga D, Buitelaar JK. The Impact of ADHD Treatment on Intimate Partner Violence in a Forensic Psychiatry Setting. J Atten Disord 2021; 25:1021-1031. [PMID: 31619111 DOI: 10.1177/1087054719879502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective: The current longitudinal impact of treatment of ADHD on intimate partner violence (ITAP) study aims to investigate whether decrease of ADHD symptoms is associated with reduction of intimate partner violence (IPV) frequency in IPV offenders with ADHD in a forensic psychiatry setting. Method: Of n = 209 offenders of IPV with ADHD, frequency of IPV and ADHD symptoms were assessed at the 8th, 16th, 24th, and 52nd weeks of their combined treatment for ADHD and IPV. Results: We observed a significant decrease of self-reported ADHD symptoms (large effect size, d ≥ 0.80) and all IPV outcomes (small, d > 0.20, to large, d > 0.80, effect sizes). The decrease in IPV was mainly associated with the decrease in ADHD symptoms. Conclusion: As IPV treatment alone is not effective in the reduction of IPV in forensic psychiatry, we now have strong indications that the combined treatment of adult ADHD and IPV is more effective in offenders with ADHD.
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Affiliation(s)
- Nannet J L Buitelaar
- De Waag, De Forensische Zorgspecialisten, Utrecht, The Netherlands.,Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Denise Bijlenga
- PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Jan K Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
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3
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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: 115] [Impact Index Per Article: 28.8] [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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4
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Breaux R, Langberg JM. Development and Refinement of the RELAX Intervention, an Intervention Targeting Emotion Dysregulation and Interpersonal Conflict in Adolescents with ADHD: Results from a Pilot Study. ACTA ACUST UNITED AC 2020. [DOI: 10.1080/23794925.2020.1759468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Rosanna Breaux
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Joshua M. Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
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5
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What Differentiates Children with ADHD Symptoms Who Do and Do Not Receive a Formal Diagnosis? Results from a Prospective Longitudinal Cohort Study. Child Psychiatry Hum Dev 2020; 51:138-150. [PMID: 31385105 DOI: 10.1007/s10578-019-00917-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
ADHD diagnoses are increasing worldwide, in patterns involving both overdiagnosis of some groups and underdiagnosis of others. The current study uses data from a national longitudinal study of Irish children (N = 8568) to examine the sociodemographic, clinical and psychological variables that differentiate children with high hyperactivity/inattention symptoms, who had and had not received a diagnosis of ADHD. Analysis identified no significant differences in the demographic characteristics or socio-emotional wellbeing of 9-year-olds with hyperactivity/inattention who had and who had not received a diagnosis of ADHD. However, by age 13, those who had held a diagnosis at 9 years showed more emotional and peer relationship problems, worse prosocial behaviour, and poorer self-concept. Further research is required to clarify the developmental pathways responsible for these effects.
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Arnold LE, Hodgkins P, Kahle J, Madhoo M, Kewley G. Long-Term Outcomes of ADHD: Academic Achievement and Performance. J Atten Disord 2020; 24:73-85. [PMID: 25583985 DOI: 10.1177/1087054714566076] [Citation(s) in RCA: 167] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective: The aim of this study was to synthesize published data regarding long-term effects of ADHD on information learned (measured via achievement tests) and success within the school environment (academic performance). Method: A systematic search identified 176 studies (1980-2012) of long-term (≥2 years) academic outcomes with ADHD. Results: Achievement test outcomes (79%) and academic performance outcomes (75%) were worse in individuals with untreated ADHD compared with non-ADHD controls, also when IQ difference was controlled (72% and 81%, respectively). Improvement in both outcome groups was associated with treatment, more often for achievement test scores (79%) than academic performance (42%), also when IQ was controlled (100% and 57%, respectively). More achievement test and academic performance outcomes improved with multimodal (100% and 67%, respectively) than pharmacological (75% and 33%) or non-pharmacological (75% and 50%) treatment alone. Conclusion: ADHD adversely affects long-term academic outcomes. A greater proportion of achievement test outcomes improved with treatment compared with academic performance. Both improved most consistently with multimodal treatment.
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Affiliation(s)
| | - Paul Hodgkins
- Global Health Economics & Outcomes Research, Shire, Wayne, PA, USA.,Vertex Pharmaceuticals, Boston, MA, USA
| | | | - Manisha Madhoo
- Behavioural Health Medical Strategy, Shire, Wayne, PA, USA
| | - Geoff Kewley
- Learning Assessment & Neurocare Centre, West Sussex, UK
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7
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González RA, Gudjonsson GH, Wells J, Young S. The Role of Emotional Distress and ADHD on Institutional Behavioral Disturbance and Recidivism Among Offenders. J Atten Disord 2016; 20:368-78. [PMID: 23893535 DOI: 10.1177/1087054713493322] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to examine the role of emotional distress as well as ADHD symptomatology in explaining (a) recidivism, (b) behavioral disturbances in prison, and (c) violent and nonviolent offending. METHOD In all, 196 male prisoners from Aberdeen prison completed the Symptom Checklist-90, which examines various clinical symptoms and emotional distress. Current adult symptoms were assessed by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria for ADHD. RESULTS Emotional distress and ADHD explained the variance in prison records of behavioral disturbance above and beyond antisocial personality (ASP) traits; however, much of the effect of emotional distress was mediated by ADHD symptoms. Only ADHD symptoms were significantly associated to history of violent offending, whereas ASP and age mostly explained nonviolent offenses and overall recidivism. CONCLUSION Our results provide support for the conceptual association between ADHD and its related emotional dimension with behavioral disturbance in prison, suggesting a link to reactive violence.
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8
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Thomason KE, Gudjonsson G, German E, Morris R, Young S. Sociomoral Reasoning in Adults with ADHD: A Pilot Study. AIMS Public Health 2014; 1:147-159. [PMID: 29546083 PMCID: PMC5689788 DOI: 10.3934/publichealth.2014.3.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 08/01/2014] [Indexed: 11/18/2022] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is frequently linked with antisocial behaviour, yet less is known about its relationship with sociomoral reasoning, and the possible mediating effect of intelligence. A pilot study was designed to investigate the relationship between antisocial personality traits, intelligence and sociomoral reasoning in adults with ADHD. Twenty two adults with ADHD and 21 healthy controls, matched for age, gender and IQ completed a battery of measures including the National Adult Reading Test, Gough Socialisation Scale and Sociomoral Reflection Measure-Short Form. There was no difference between the groups and levels of sociomoral reasoning, despite the ADHD group reporting greater antisocial personality traits. Sociomoral reasoning was positively correlated with intelligence. Results from a hierarchical multiple regressions indicated that both antisocial traits and IQ were significant predictors of sociomoral reasoning, with IQ proving the most powerful predictor. Whilst antisocial personality traits may explain some of the variance in levels of sociomoral reasoning, a diagnosis of ADHD does not appear to hinder the development of mature moral reasoning. Intellectual functioning appears to facilitate the development of sociomoral reasoning. A further analysis showed that both ADHD and low sociomoral reasoning were significant predictors of antisocial traits. The current findings have important treatment implications.
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Affiliation(s)
| | | | | | - Robin Morris
- King's College London, Institute of Psychiatry, WC2R 2LS, UK
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9
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Deane H, Young S. Navigating adolescence: an epidemiological follow-up of adaptive functioning in girls with childhood ADHD symptoms and conduct disorder. J Atten Disord 2014; 18:44-51. [PMID: 22544385 DOI: 10.1177/1087054712443152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The current study investigated the experience of girls growing up with cognitive and social disorders. METHOD Eight adolescent girls participated in interviews that were transcribed and analyzed using Interpretative Phenomenological Analysis. RESULTS Four of the girls had a history of ADHD symptoms and conduct disorder problems (ADHD/CP), four did not. Three master themes emerged within the domain of "Coping Behaviors": seeking social support, bravado, and avoidance. Three master themes emerged within the domain of "Barriers to Adaptive Functioning": lack of support and guidance, poor negotiation of interpersonal conflict, and victimization. Although all participants experienced developmental barriers, the girls with ADHD/CP coped with these barriers in a less effective way. CONCLUSION The study raises an important developmental concern, the seemingly ineffective coping strategies of ADHD/CP adolescents.
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10
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Epstein JN, Weiss MD. Assessing treatment outcomes in attention-deficit/hyperactivity disorder: a narrative review. Prim Care Companion CNS Disord 2012; 14:PCC.11r01336. [PMID: 23585986 PMCID: PMC3622525 DOI: 10.4088/pcc.11r01336] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 05/11/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To review measures used to assess treatment response in patients with attention-deficit/hyperactivity disorder (ADHD) across the life span. DATA SOURCES Keyword searches of English-language articles in the PubMed database up to and including the May 4, 2011, index date were performed with the search strings (1) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (outcome assessment [MeSH] OR adaptation of life skills OR executive function [MeSH]) and (2) (attention deficit disorder with hyperactivity [MeSH] OR ADHD) AND (function OR functioning OR quality of life [MeSH]). STUDY SELECTION Articles found through this search were then selected based on relevance to the topic area; no specific quality criteria were applied. DATA EXTRACTION Narrative review. RESULTS The vast majority of studies assessing ADHD treatments have measured treatment response using ADHD symptom measures. Additional domains relevant for assessing treatment response among children and adults with ADHD include functional impairment, quality of life, adaptive life skills, and executive function. Validated rating scales exist for assessing these additional domains, but there has been minimal research evaluating the sensitivity of these instruments for detecting treatment response in pediatric and adult samples. CONCLUSIONS Assessment of treatment outcomes in ADHD should move beyond symptom assessment to incorporate measures of functioning, quality of life, adaptive skills, and executive function, especially when assessing long-term treatment response. The authors recommend a potential battery and schedule of measures that could be used to more comprehensively assess treatment response in patients with ADHD.
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Affiliation(s)
- Jeffery N Epstein
- The Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Epstein); and The Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada (Dr Weiss)
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11
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Sciberras E, Ohan J, Anderson V. Bullying and peer victimisation in adolescent girls with Attention-Deficit/Hyperactivity Disorder. Child Psychiatry Hum Dev 2012; 43:254-70. [PMID: 22038319 DOI: 10.1007/s10578-011-0264-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Emerging evidence suggests that adolescent girls with Attention-Deficit/Hyperactivity Disorder (ADHD) are more socially impaired compared with their peers; however, research has yet to elucidate the nature of this impairment. We investigated overt (e.g., physical, such as hitting or kicking or verbal, such as teasing and taunting) and relational (e.g., social manipulation, such as social exclusion) bullying and victimisation in adolescent girls with and without ADHD. Adolescent girls (mean age = 15.11) with (n = 22) and without (n = 20) ADHD and their primary caregivers completed measures of overt/relational bullying and victimisation and social impairment. Adolescent girls with ADHD experienced more social problems and more relational and overt victimisation than adolescent girls without ADHD. Although adolescent girls with ADHD engaged in more overt and relational bullying than adolescent girls without ADHD, this difference was not statistically significant. Oppositional Defiant Disorder symptoms appeared to be more strongly related to bullying behaviour, while victimisation appeared to be more strongly related to ADHD.
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Affiliation(s)
- Emma Sciberras
- Centre for Community Child Health, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, VIC 3052, Australia.
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12
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Biederman J, Petty CR, O’Connor KB, Hyder LL, Faraone SV. Predictors of persistence in girls with attention deficit hyperactivity disorder: results from an 11-year controlled follow-up study. Acta Psychiatr Scand 2012; 125:147-56. [PMID: 22097933 PMCID: PMC3254799 DOI: 10.1111/j.1600-0447.2011.01797.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study sought to examine the age-dependent persistence of attention deficit hyperactivity disorder (ADHD) and its predictors in a large sample of girls with and without ADHD followed prospectively for 11 years into young adulthood. METHOD Participants were girls with (N=96) and without (N=91) ADHD and were 6-17 years old at the baseline assessment (mean age, 11 years) and 15-30 years old at the follow-up assessment (mean: 22 years). Participants were comprehensively and blindly assessed with structured diagnostic interviews and assessments of cognitive, social, school, and family functioning. RESULTS At the 11-year follow-up, 33.3% met full criteria for ADHD, 29.2% showed partial persistence of the disorder, 10.4% had impaired functioning, and 4.2% were remitted but treated (77.1% of the sample). Predictors of persistence were psychiatric comorbidity, family history of psychopathology, and family and school functioning at baseline. CONCLUSION These long-term, prospective, follow-up findings extend to girls findings that ADHD is persistent over the long term and can be predicted from psychosocial adversity and psychiatric comorbidity ascertained 11 years earlier.
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Affiliation(s)
- Joseph Biederman
- Pediatric Psychopharmacology Research Unit, Massachusetts General Hospital, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA
| | - Carter R. Petty
- Pediatric Psychopharmacology Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Katherine B. O’Connor
- Pediatric Psychopharmacology Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Laran L. Hyder
- Pediatric Psychopharmacology Research Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience & Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
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13
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Hodgkins P, Arnold LE, Shaw M, Caci H, Kahle J, Woods AG, Young S. A systematic review of global publication trends regarding long-term outcomes of ADHD. Front Psychiatry 2012; 2:84. [PMID: 22279437 PMCID: PMC3260478 DOI: 10.3389/fpsyt.2011.00084] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 12/29/2011] [Indexed: 01/29/2023] Open
Abstract
There is increased global recognition of attention deficit hyperactivity disorder (ADHD) as a serious medical condition with long-term consequences. Although originally conceived of as a childhood disorder, ADHD is being increasingly recognized in adults. Individual geographic regions may have specific interests and objectives for the study of ADHD. A systematic review of long-term outcomes (LTOs) in ADHD was conducted to evaluate research on ADHD LTOs on a global scale. Studies that were at least 2 years in duration were examined. A total of 351 studies were identified in the final analysis. We identified nine outcomes of interest and classified studies by specific geographical regions, age groups studied and study design by region and over time. Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades, with a peak number of 42 publications in 2008. This rise in publications on ADHD LTOs may reflect a rise in global interest and recognition of consequences and impairment associated with ADHD. Although many world regions have published on ADHD LTOs, the majority of studies have emerged from the US and Canada, followed by Europe. While investigators in the US and Canada were predominantly interested in drug addiction as a LTO, European researchers were more interested in antisocial behavior, and Eastern Asian investigators focused on both of these LTOs as well as self-esteem. Geographical differences in the focus of ADHD LTO studies may reflect regional variations in cultural values. Proportionally fewer prospective longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades. Finally, more studies focusing on ADHD in adolescents and adults have been conducted in recent years, and particularly adolescents in Eastern Asia. These changes in basic study design may reflect an increase in the recognition that ADHD is a lifetime chronic disorder. This systematic review analysis of publication trends in ADHD LTOs reflects geographically based interests that change over time.
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Affiliation(s)
- Paul Hodgkins
- Shire Development Inc., Global Health Economics and Outcomes ResearchWayne, PA, USA
| | - L. Eugene Arnold
- Research Unit on Pediatric Psychopharmacology, Nisonger Center, The Ohio State UniversityColumbus, OH, USA
| | | | - Hervé Caci
- Hôpitaux Pédiatriques de Nice CHU LenvalNice, France
| | | | - Alisa G Woods
- BPS InternationalSan Diego, CA, USA
- Biochemistry and Proteomics Laboratory, Chemistry and Biomolecular Science, Clarkson UniversityPotsdam, NY, USA
| | - Susan Young
- King’s College London, Institute of PsychiatryLondon, UK
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14
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Overbey GA, Snell WE, Callis KE. Subclinical ADHD, stress, and coping in romantic relationships of university students. J Atten Disord 2011; 15:67-78. [PMID: 19815698 DOI: 10.1177/1087054709347257] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine how the subclinical symptoms of adult ADHD and those of oppositional-defiant disorder (ODD) affect relationship satisfaction and stress and to determine whether different patterns of coping strategies emerge when undergraduates have symptoms of one or both disorders. METHOD Participants (N = 497) complete self-report surveys assessing ADHD and ODD symptoms, relationship satisfaction, stress, and coping strategies used in their intimate relationships. RESULTS ADHD and ODD symptoms are significantly related to a number of stressors and different patterns of coping strategies. University students with symptoms of both ADHD and ODD display a different pattern of stressors and different patterns of coping than those with symptoms of ADHD only. CONCLUSION Screenings for both ADHD and ODD and the provision of services that offer students more constructive coping alternatives to deal with stress in their intimate relationships are needed on university campuses.
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Affiliation(s)
- Gail A Overbey
- Department of Psychology-5700, Southeast Missouri State University, Cape Girardeau, MO 63701, USA.
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Abstract
Attention-deficit hyperactivity disorder (ADHD) is recognized to exist in males and females although the literature supports a higher prevalence in males. However, when girls are diagnosed with ADHD, they are more often diagnosed as predominantly inattentive than boys with ADHD. This article provides a review of gender differences noted across the lifespan. Males and females with ADHD are more similar than different, and generally ADHD profiles are not sex specific. Small gender differences have been found: adolescent girls with ADHD have lower self-efficacy and poorer coping strategies than adolescent boys with ADHD; rates of depression and anxiety may be higher, and physical aggression and other externalizing behaviors lower in girls and women with ADHD. Men with ADHD seem to be incarcerated more often than women with ADHD. However, many studies suffer from small sample sizes, referral biases, differences in diagnostic procedures, and possible rater influences. Treatments are reviewed and discussed with reference to the reported gender differences in functioning and the global deficits noted in all samples. The data available so far suggest that treatments are likely to be equally effective in males and females. However, referral bias is a problem, in that females with ADHD are less likely to be referred for treatment than males with ADHD. Future research should include equal representation of both sexes in samples such that sex by treatment analyses can be routinely conducted.
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.
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Wehmeier PM, Schacht A, Dittmann RW, Banaschewski T. Minor differences in ADHD-related difficulties between boys and girls treated with atomoxetine for attention-deficit/hyperactivity disorder. ACTA ACUST UNITED AC 2010; 2:73-85. [DOI: 10.1007/s12402-010-0022-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Accepted: 03/12/2010] [Indexed: 11/28/2022]
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Young S, Amarasinghe JM. Practitioner review: Non-pharmacological treatments for ADHD: a lifespan approach. J Child Psychol Psychiatry 2010; 51:116-33. [PMID: 19891745 DOI: 10.1111/j.1469-7610.2009.02191.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a chronic and pervasive developmental disorder that is not restricted to the childhood years. METHODS This paper reviews non-pharmacological interventions that are available at present for preschoolers, school-age children, adolescents and adults. RESULTS The most appropriate intervention for preschoolers is parent training. For school-age children with moderate impairments there is some evidence to suggest that group parent training programmes and classroom behavioural interventions may suffice as a first-line treatment. For school-age children with severe impairments, interventions are more appropriate when combined with stimulant medication (i.e., integrated treatment packages are likely to be more successful than 'standalone' treatments). Multimodal interventions seem to be best suited for middle school/adolescent children, which most likely reflects that these interventions usually integrate home and school treatment strategies and often include an element of social skills training. Stimulant medication is generally the first line of treatment for adults but CBT has also been found to be effective at addressing the complex needs of this population. CONCLUSION Current research has largely ignored that ADHD is a developmental disorder that spans the preschool to adult years. Most studies focus on young school-age children and outside of this age group there is a dearth of controlled trials that provide conclusive evidence. As children mature the mode and agent of intervention will shift to reflect the developmental needs and circumstances of the individual.
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Affiliation(s)
- Susan Young
- Department of Forensic Mental Health Science, Institute of Psychiatry, King's College London, DeCrespigny Park, London, UK.
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18
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Neuroanatomical abnormalities in adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 2008; 47:1321-8. [PMID: 18827721 PMCID: PMC2644065 DOI: 10.1097/chi.0b013e318185d285] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Several neuroanatomic abnormalities have been reported in patients with attention-deficit/hyperactivity disorder (ADHD). However, findings are not always consistent, perhaps because of heterogeneous subject samples. Studying youths with documented familial ADHD provides an opportunity to examine a more homogeneous population. METHOD Twenty-four youths with a confirmed history of familial ADHD and 10 control youths underwent high-resolution structural magnetic resonance imaging examinations. Archived magnetic resonance imaging scan data from 12 control youths were included in the analysis to increase statistical power. Individually drawn region-of-interest methods were used to examine the frontal lobe gyri and caudate. RESULTS Cerebral total tissue was similar between groups. The volumes of the right caudate and right inferior frontal lobe were larger in the ADHD youths compared with the control youths. Data from a subgroup of the ADHD youths suggest that increasing left caudate volume is associated with decreasing functional activation of this region. CONCLUSIONS Because previous studies have focused primarily on younger subjects or used an extended age range, the present results may reflect neurodevelopmental changes specific to late adolescence in familial ADHD.
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Rucklidge JJ. Gender differences in ADHD: implications for psychosocial treatments. Expert Rev Neurother 2008; 8:643-55. [PMID: 18416665 DOI: 10.1586/14737175.8.4.643] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has now been recognized to exist in both males and females, albeit the literature supports a higher prevalence in males. However, when girls are diagnosed with ADHD, they are more often diagnosed as predominantly inattentive than boys with ADHD. This paper provides a review of gender differences noted across the lifespan in terms of psychosocial functioning, cognitive abilities and psychiatric comorbidities. Males and females with ADHD are more similar than different, and generally symptoms of ADHD are not sex specific. Small gender differences have been found: adolescent girls with ADHD have lower self-efficacy and poorer coping strategies than adolescent boys with ADHD, but these differences tend to disappear by adulthood; rates of depression and anxiety may be higher (especially in adolescence) while physical aggression and other externalizing behaviors may be lower in girls and women with ADHD, although not all studies support these findings (e.g., non-referred samples show similar rates of coexisting psychiatric disorders between boys and girls with ADHD). However, many studies suffer from small sample sizes, referral biases, differences in diagnostic procedures and possible rater influences. Psychosocial treatments are reviewed and discussed with reference to the reported gender differences in functioning as well as the global deficits noted in all samples. Although the data available so far suggest that psychosocial treatments are likely to be equally effective in males and females, this conclusion is based more on the small number of gender differences noted in overall functioning and less on empirical research on treatment by sex effects and the moderating role of sex, an effect only investigated by the Multi-modal Treatment Study of ADHD group, to date. Future research should include equal representation of both sexes in samples such that treatment analyses by gender can be routinely conducted.
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.
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"I have always felt different": the experience of attention-deficit/hyperactivity disorder in childhood. J Pediatr Nurs 2008; 23:49-57. [PMID: 18207047 DOI: 10.1016/j.pedn.2007.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Revised: 07/19/2007] [Accepted: 07/26/2007] [Indexed: 11/21/2022]
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) is one of the most important psychiatric problems of our time. This study examined the experience of childhood ADHD within the contexts that are most significant to this age group--home, school, and friendships. The sample included 16 college-enrolled young adults (ages 18-25) with a self-reported history of ADHD. Participants revealed feelings of difference, misunderstanding, and struggle in all areas of their lives (home, school, and friendships). Nurses can use these findings to improve the care and long-term outcomes of children diagnosed with ADHD.
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Abstract
OBJECTIVE The authors investigate self-reported coping with interpersonal stressors among boys with and without ADHD in two studies and provide initial evidence for effects of different subgroups of ADHD on coping in Study 2. METHOD In Study 1, 20 Austrian adolescents with ADHD were compared to 20 healthy controls. In Study 2, 44 German children and adolescents with ADHD (35 without and 9 with conduct disorders) were compared to 44 healthy controls matched by age and grade level, respectively. RESULTS Increased maladaptive coping was found in both studies. Study 2 revealed heightened maladaptive coping among both subgroups of ADHD, but the subgroup of ADHD with conduct disorders was more affected compared to healthy controls than the subgroup with ADHD alone. CONCLUSION Results suggest an impaired interpersonal coping style in ADHD and point to the potential benefit of stress management and social skills training for boys with ADHD. (
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Affiliation(s)
- Petra Hampel
- Center of Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany.
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Nijmeijer JS, Minderaa RB, Buitelaar JK, Mulligan A, Hartman CA, Hoekstra PJ. Attention-deficit/hyperactivity disorder and social dysfunctioning. Clin Psychol Rev 2007; 28:692-708. [PMID: 18036711 DOI: 10.1016/j.cpr.2007.10.003] [Citation(s) in RCA: 287] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2007] [Revised: 10/05/2007] [Accepted: 10/23/2007] [Indexed: 12/21/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with functional impairments in different areas of daily life. One such area is social functioning. The purpose of this paper is to critically review research on social dysfunctioning in children with ADHD. Children with ADHD often have conflicts with adults and peers, and suffer from unpopularity, rejection by peers, and a lack of friendships, in part as a consequence of their ADHD symptoms. Comorbid oppositional defiant or conduct disorder aggravates these impairments. In some cases the inadequate social behavior of children with ADHD may be phenomenologically and etiologically related to pervasive developmental disorders (PDD). However, the causes and consequences of PDD symptoms in ADHD are understudied. Also, the relative contributions of ADHD, on the one hand, and comorbid disorders, on the other, to the course of social impairments are unknown. Social dysfunctioning in children with ADHD appears to increase their risk of later psychopathology other than ADHD. Thus far effective treatment for social dysfunctioning is lacking. Future research should address the exact nature and long-term consequences of social dysfunctioning in children with ADHD, and focus on development of effective treatment strategies.
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Affiliation(s)
- Judith S Nijmeijer
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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