Stress Accounts for the Association Between ADHD Symptoms and Suicide Ideation When Stress-Reactive Rumination Is High

Excessive mind wandering, rumination, and mindfulness mediate the relationship between ADHD symptoms and anxiety and depression in adults with ADHD

BACKGROUND

Persistent mind-wandering processes are associated with negative emotions; however, mindful states exhibit an anticorrelation with mind-wandering patterns. The aim of this study is to investigate the mediating role of excessive mind wandering (EMW), rumination, and trait mindfulness between attention-deficit hyperactivity disorder (ADHD) symptoms and the severity of anxiety/depression in adults with ADHD.

METHODS

Medication-free 159 adults diagnosed with ADHD completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale, Hospital Anxiety Depression Scale, Mind Excessively Wandering Scale, Ruminative Response Scale, and Freiburg Mindfulness Inventory after the diagnostic examination according to the Structured Clinical Interview for DSM-5-Clinician Version (SCID-5).

RESULTS

ADHD symptoms exhibited an indirect, but not a direct, association with the severity of anxiety and depression, mediated by increased excessive mind wandering and rumination, as well as decreased trait mindfulness.

LIMITATIONS

This study was carried out within a clinical population using a cross-sectional design. While diagnostic assessments were conducted using SCID-5, psychiatric symptoms were evaluated through self-report measures.

CONCLUSIONS

Coping with EMW and rumination and promoting mindfulness ability may be promising targets in treating comorbid conditions in adults with ADHD. These findings have highlighted the effects of mentation processes on depression and anxiety, which are common comorbidities with ADHD in adults; however, longitudinal studies are needed.

Alarmingly high prevalence and lack of gender differences in ADHD among high school students: Screening for ADHD with ASRS among adolescents and working adults

Introduction: The aim was to examine the psychometric properties of the Polish version of the Adult ADHD Self-Report Scale (ASRS) among adolescents and adult working populations of different genders, the prevalence of ADHD, and its relationship to stress.

Materials and methods: A sample of 723 professionally active people and 1744 high school students participated in the study. Part A of the Adult ADHD Self-Report Scale (ASRS) was used to measure ADHD and the 4-item Perceived Stress Scale (PSS-4) was used to measure stress.

Results: Confirmatory factor analyses showed that the original 6-item two-factor solution of ASRS Part A had a satisfactory fit and showed basic measurement invariance between age groups and genders. Inattention and hyperactivity were related mostly similarly to stress in all groups. The prevalence of ADHD among adolescents was much higher than in previous reports, and no gender differences were found. About every fifth high school student and every tenth adult showed a risk of ADHD. The potential cause of the difference in the prevalence in the studied groups can be generation change.

Conclusions: ASRS is a well-functioning screening measure with good psychometric properties. It is a convenient option for large-scale epidemiological surveys necessary to understand potential generational changes in the prevalence of ADHD and the lack of gender differences among adolescents.

The role of self-compassion in the mental health of adults with ADHD

OBJECTIVE

Evidence suggests that the poorer mental health associated with attention deficit hyperactivity Disorder (ADHD) is partially explained by adverse psychosocial correlates of the condition. As recent studies show that self-compassion is negatively associated with ADHD, this study investigates if levels of self-compassion may explain the mental health outcomes in people with ADHD compared to people without ADHD.

METHOD

A total of 543 adults with ADHD (62.72% female, 18-67 years), and 313 adults without ADHD (66.45% female, 18-82 years) completed questionnaires online to measure levels of self-compassion and mental health. A Structural Equation Model assessed the mediating effect of self-compassion on the relationships between ADHD and well-being (psychological, emotional, and social), and ADHD and ill-being (depression, anxiety, and stress).

RESULTS

Findings suggest that low self-compassion contributes to poorer mental health in adults with ADHD compared to adults without ADHD.

CONCLUSIONS

Thus, self-compassion may be a potential target to improve mental health in this population.

PUBLIC HEALTH SIGNIFICANCE

This study shows that self-compassion is an important factor in the mental health of adults with ADHD and provides preliminary evidence for the use of self-compassion interventions to improve mental health outcomes in adults with ADHD.

Interactions between the neural correlates of dispositional internally directed thought and visual imagery

Cognition is not always directed to the events in the here and now and we often self-generate thoughts and images in imagination. Important aspects of these self-generated experiences are associated with various dispositional traits. In this study, we explored whether these psychological associations relate to a common underlying neurocognitive mechanism. We acquired resting state functional magnetic resonance imaging data from a large cohort of participants and asked them to retrospectively report their experience during the scan. Participants also completed questionnaires reflecting a range of dispositional traits. We found thoughts emphasizing visual imagery at rest were associated with dispositional tendency towards internally directed attention (self-consciousness and attentional problems) and linked to a stronger correlation between a posterior parietal network and a lateral fronto-temporal network. Furthermore, decoupling between the brainstem and a lateral visual network was associated with dispositional internally directed attention. Critically, these brain-cognition associations were related: the correlation between parietal-frontal regions and reports of visual imagery was stronger for individuals with increased connectivity between brainstem and visual cortex. Our results highlight neural mechanisms linked to the dispositional basis for patterns of self-generated thought, and suggest that accounting for dispositional traits is important when exploring the neural substrates of self-generated experience (and vice versa). This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.

Investigation of the interpersonal theory of suicide in the context of attention-deficit/hyperactivity disorder symptomatology and suicide ideation

OBJECTIVE

The current study examines components of the Interpersonal Theory of Suicide as mediators of the association between attention-deficit/hyperactivity disorder (ADHD) symptoms and suicide ideation in college students with elevated depressive symptoms. Specifically, indirect effects of perceived burdensomeness and thwarted belongingness were simultaneously evaluated on the association between self-reported ADHD symptoms and suicide ideation, controlling for gender and levels of depression.

METHOD

Participants were 217 college students with elevated depressive symptoms (M_age  = 20.72 years old; SD = 3.74) who participated in a larger study on mood and well-being. The sample was predominantly female (77.9% female) and Hispanic (72.7%).

RESULTS

In a multivariate mediation model controlling for gender and depressive symptoms, there were significant indirect effects of perceived burdensomeness and thwarted belongingness on the association between self-reported ADHD symptoms and suicide ideation.

CONCLUSION

Perceived burdensomeness and thwarted belongingness may represent promising targets for preventing suicide ideation in individuals with elevated ADHD symptoms.

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.

Sluggish cognitive tempo and ADHD symptoms in relation to task-unrelated thought: Examining unique links with mind-wandering and rumination

Recent theoretical and empirical evidence highlights associations between attention-deficit/hyperactivity disorder (ADHD) symptoms and task-unrelated thought, including mind-wandering and rumination. However, it has been hypothesized that sluggish cognitive tempo (SCT), characterized by daydreaming and staring behaviors, may uniquely relate to task-unrelated thought. The purpose of the present study was to test whether SCT symptoms are associated with greater mind-wandering and rumination, and whether this association remains when controlling for ADHD and internalizing symptoms. Participants (N = 4679; 18-29 years; 69% female; 80.9% White) enrolled in six universities in the United States completed measures of SCT, ADHD symptoms, internalizing symptoms, and rumination, as well as two scales used to assess mind-wandering. Although ADHD symptoms were correlated with greater self-reported mind-wandering and rumination, relations with mind-wandering on the daydreaming frequency scale, reflective rumination, and brooding rumination were attenuated when controlling for SCT and internalizing symptoms. Above and beyond other psychopathology dimensions, SCT symptoms were uniquely associated with greater self-reported mind-wandering and both reflective and brooding rumination. Additionally, SCT symptoms were more strongly associated than other psychopathology dimensions with the mind-wandering measure of daydreaming frequency. Results provide the first empirical support for unique and robust associations between SCT symptoms and task-unrelated thought, while suggesting that the link between ADHD and mind-wandering may be less robust than previously suggested.

Relational impairments, sluggish cognitive tempo, and severe inattention are associated with elevated self-rated depressive symptoms in adolescents with ADHD

This study examines how ADHD-related symptoms and impairments interact to predict depression symptoms in young adolescents with ADHD. A sample of 342 adolescents (71% male, mean age = 13 years old) with DSM-IV-TR diagnosed ADHD completed baseline clinical assessments upon entry to a psychosocial treatment study for ADHD. Ratings of ADHD and sluggish cognitive tempo (SCT) symptoms, and social and academic impairment were obtained from parents, while ratings of depressive symptoms and conflict with parents were obtained from youth. Among adolescents with ADHD, elevated depressive symptoms were associated with higher SCT symptom severity, lower hyperactive/impulsive (HI) symptom severity, higher social impairments, higher conflict with parents, and lower academic problems. Interaction effects indicated that clinically significant depressive symptoms were most likely to occur when high levels of parent-youth conflict were present along with high inattentive (IN) symptoms, high SCT, and/or low HI. Among children and adolescents with ADHD, depression prevention efforts might target IN/SCT symptom management, as well as improving interpersonal relationships with parents and peers. Future work is needed to verify these findings longitudinally.