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Alacha HF, Walbridge FC, Harton HC, Vasko JM, Bodalski EA, Rother Y, Lefler EK. Cognitive emotion regulation and learning effectiveness in college students with ADHD symptoms. ANXIETY, STRESS, AND COPING 2024:1-17. [PMID: 39021066 DOI: 10.1080/10615806.2024.2379986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND College students with ADHD have difficulties with emotion regulation and have poorer academic skills than peers without ADHD; however, less is known regarding the relation between ADHD symptoms, maladaptive cognitive emotion regulation strategies (CERS), and learning effectiveness. OBJECTIVES We examined whether maladaptive CERS predicted learning effectiveness, and whether this relation was moderated by ADHD symptoms. DESIGN A cross-sectional online survey. METHODS College students (N = 4,183; Mage = 19.24; 70.1% female) at eight universities completed a battery as part of a larger study. RESULTS College students in our elevated ADHD group used significantly more maladaptive CERS and performed worse in three domains of learning effectiveness (i.e., Academic Self-Efficacy [ASE], Organization and Attention to Study [OAS], Stress and Time Press [STP]) than college students in our non-ADHD group. Further, ADHD symptoms moderated the relation between maladaptive CERS and OAS, such that individuals with the highest levels of ADHD symptoms were less impacted by maladaptive CERS. CONCLUSION Increased use of maladaptive CERS is unique to ADHD rather than lack of adaptive CERS. Also, maladaptive CERS and low ADHD symptoms interact to predict poor OAS. Interventions for college students, regardless of ADHD status, should incorporate emotion regulation components to improve learning effectiveness.
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Affiliation(s)
- Helena F Alacha
- Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Fayth C Walbridge
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Helen C Harton
- Department of Psychology, University of Northern Iowa, Cedar Falls, Iowa, USA
| | - John M Vasko
- Department of Wyoming, University of Wyoming, Laramie, Wyoming, USA
| | - Elizabeth A Bodalski
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Yvette Rother
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
| | - Elizabeth K Lefler
- Department of Psychology, University of Northern Iowa, Cedar Falls, Iowa, USA
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2
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Roberts DK, Sarver DE, Cash AR, Walker BH, Lim CS. Understanding health behaviors that modify the risk for obesity in ADHD. J Pediatr Psychol 2024; 49:372-381. [PMID: 38516857 DOI: 10.1093/jpepsy/jsae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE Research provides support for the associated risk of inadequate sleep duration, limited physical activity, and excessive media use in attention-deficit/hyperactivity disorder (ADHD) and obesity. The present study aims to (1) examine the association between ADHD and overweight or obese status (OW/OB); (2) comprehensively examine sleep duration, physical activity, and media use as potential moderators of OW/OB; and (3) examine the moderating effects of these health behaviors cross-sectionally by comparing medicated youth with ADHD, unmedicated youth with ADHD, and youth without ADHD. METHODS Data were acquired from the 2018 and 2019 National Survey of Children's Health, a nationally representative survey of caregivers conducted across the United States. The current study used data for youth 11-17 years old with a final sample size of 26,644. Hours of sleep, physical activity, and media use per day were dichotomized based on national recommendation guidelines for each health behavior (i.e., either meeting or not meeting guidelines). RESULTS The OW/OB prevalence rate was 7% greater among unmedicated youth with ADHD than among medicated youth with ADHD. Medicated youth with ADHD and peers without ADHD had similar OW/OB rates. Among medicated youth with ADHD, physical activity, sleep duration, and media use did not contribute to OW/OB risk after controlling for family poverty level. However, among unmedicated youth with ADHD, meeting sleep duration guidelines was linked to a lower OW/OB risk. CONCLUSION Overall, findings suggest that clinical providers and parents may wish to prioritize improved sleep duration in the management of OW/OB risk in youth with ADHD.
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Affiliation(s)
- Delanie K Roberts
- Department of Psychology, Children's Hospital of Los Angeles, Los Angeles, CA, United States
| | - Dustin E Sarver
- Department of Psychiatry and Human Behavior, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, United States
- Department of Pediatrics, Center for Advancement of Youth, University of Mississippi Medical Center, Jackson, MS, United States
| | - Annah R Cash
- Department of Psychology, Child Study Center, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Benjamin H Walker
- Department of Population Health, University of Mississippi Medical Center, Jackson, MS, United States
| | - Crystal S Lim
- Department of Health Psychology, University of Missouri, Columbia, MO, United States
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3
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Kaur S, Morales-Hidalgo P, Voltas N, Canals-Sans J. Cluster analysis of teachers report for identifying symptoms of autism spectrum and/or attention deficit hyperactivity in school population: EPINED study. Autism Res 2024; 17:1027-1040. [PMID: 38641914 DOI: 10.1002/aur.3138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/08/2024] [Indexed: 04/21/2024]
Abstract
An early detection of Neurodevelopmental Disorders (NDDs) is crucial for their prognosis; however, the clinical heterogeneity of some disorders, such as autism spectrum disorder (ASD) or attention-deficit hyperactivity disorder (ADHD) is an obstacle to accurate diagnoses in children. In order to facilitate the screening process, the current study aimed to identify symptom-based clusters among a community-based sample of preschool and school-aged children, using behavioral characteristics reported by teachers. A total of 6894 children were assessed on four key variables: social communication differences, restricted behavior patterns, restless-impulsiveness, and emotional lability (pre-schoolers) or inattention and hyperactivity-impulsivity (school-aged). From these behavioral profiles, four clusters were identified for each age group. A cluster of ASD + ADHD and others including children with no pathology was clearly identified, whereas two other clusters were characterized by subthreshold ASD and/or ADHD symptoms. In the school-age children, the presence of ADHD was consistently observed with ASD patterns. In pre-schoolers, teachers were more proficient at identifying children who received a diagnosis for either ASD and/or ADHD from an early stage. Considering the significance of early detection and intervention of NDDs, teachers' insights are important. Therefore, promptly identifying subthreshold symptoms in children can help to minimize consequences in social and academic functioning.
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Affiliation(s)
- Sharanpreet Kaur
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, Spain
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Paula Morales-Hidalgo
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, Spain
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
- Department of Psychology and Education Studies, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Núria Voltas
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, Spain
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
- Department of Psychology, Universitat Rovira i Virgili, Serra Húnter Fellow, Tarragona, Spain
| | - Josefa Canals-Sans
- Nutrition and Mental Health (NUTRISAM) Research Group, Universitat Rovira i Virgili, Spain
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
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4
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Martin J. Why are females less likely to be diagnosed with ADHD in childhood than males? Lancet Psychiatry 2024; 11:303-310. [PMID: 38340761 DOI: 10.1016/s2215-0366(24)00010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
ADHD is less likely to be diagnosed in females than males, especially in childhood. Females also typically receive the diagnosis later than males and are less likely to be prescribed ADHD medication. Understanding why these sex differences in clinical care and treatment for ADHD occur is key to improving timely diagnosis in people affected by ADHD. This Personal View is a conceptual review synthesising literature on this topic. This publication considers potential biological explanations (eg, genetic factors), influence of diagnostic practices (eg, criteria suitability, diagnostic overshadowing, and sex-specific diagnostic thresholds), and sociocultural explanations (eg, sex differences in presentation and compensatory behaviours), for the observed sex differences in ADHD clinical practice. This Personal View also outlines future research directions for improving understanding of sex differences in recognition and diagnosis of ADHD.
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Affiliation(s)
- Joanna Martin
- Centre for Neuropsychiatric Genetics and Genomics and Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK.
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5
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Aitken M, Plamondon A, Krzeczkowski J, Kil H, Andrade BF. Systematic Integration of Multi-Informant Externalizing Ratings in Clinical Settings. Res Child Adolesc Psychopathol 2024; 52:635-644. [PMID: 37787879 DOI: 10.1007/s10802-023-01119-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 10/04/2023]
Abstract
Best practice clinical assessment of externalizing problems often necessitates collection of information from parents, youth themselves, and teachers. The present study tested the predictive validity of a psychometrically-driven scoring procedure to integrate multi-informant, dimensional ratings of externalizing problems. Participants were 2264 clinic-referred youth ages 6-18. Parents, teachers, and youth completed questionnaire ratings of externalizing problems (hyperactivity-inattention, conduct problems, and oppositionality-defiance) prior to an initial clinical appointment. The predictive validity of simple (highest informant rating; and all informant ratings separately) and more complex (latent S-1 bifactor model with specific informant factors; and moderated nonlinear factor analysis accounting for child age and sex) methods of informant integration was tested in predicting impairment, comorbidity, and number of clinical encounters. A simple model, in which all informant ratings were included, showed the best predictive validity across outcomes, performing as well or better than the use of the highest informant ratings or more complex latent variable models. The addition of child age and sex as moderators in the factor model did not improve predictive validity. Each informant (parent, teacher, and youth) contributes important information to the prediction of clinically-relevant outcomes. There is insufficient evidence at present to suggest that complex latent variable models should be favored over simpler models that preserve each informant's ratings.
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Affiliation(s)
- Madison Aitken
- Centre for Addiction and Mental Health, Toronto, Canada.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
- Department of Psychology, York University, Toronto, Canada.
| | - André Plamondon
- Département des Fondements et Pratiques en Éducation, Université Laval, Québec, Canada
| | - John Krzeczkowski
- Department of Health Sciences, Brock University, Saint Catherine's, Canada
| | - Hali Kil
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Brendan F Andrade
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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6
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Garcia-Rosales A, Cortese S, Vitoratou S. Measurement invariance of Attention Deficit/Hyperactivity Disorder symptom criteria as rated by parents and teachers in children and adolescents: A systematic review. PLoS One 2024; 19:e0293677. [PMID: 38394179 PMCID: PMC10889893 DOI: 10.1371/journal.pone.0293677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/17/2023] [Indexed: 02/25/2024] Open
Abstract
This systematic review aimed to establish the extent to which each Attention Deficit/Hyperactivity Disorder (ADHD) symptom criterion is being assessed without being influenced (biased) by factors such as informant, sex/gender, and age. Measurement invariance (MI) testing using confirmatory factor analysis (CFA) is the prime statistical method to ascertain how these factors may affect the measurement and colour the perception or interpretation of symptom criteria. Such effects (non-invariance) can be operationalised in the form of altered association of a symptom criterion with the measured trait (expressed via variations in CFA loadings which represent the weight of each symptom criterion) due to the factor(s) and/or artificially alter the probability of endorsement of a particular symptom criterion (expressed via variations in the CFA threshold(s) representing how mild or severe a given symptom is). Based on a pre-registered protocol (CRD42022276105), we searched PubMed, Global Health, Embase and PsycInfo up to 21-02-23 for studies that included MI assessments on specific ADHD symptom criteria in individuals aged 0-18 years old, using parental and/or teacher report. Self-reports were excluded, given the poor reliability of self-report in ADHD. All included studies met specific COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria. Results were synthesised in tabular form, grouping results by factors (e.g. informant) from 44 studies retained. Most comparisons indicated both metric (same loadings) and scalar invariance (same thresholds) with regard to informant, gender, age, temporal (repeated assessments) and co-morbidity. Therefore, the available evidence supports the current diagnostic criteria. However, findings could have been improved by systematic reporting of the direction of bias and its effect size. There appears to be a bias towards reporting MI instead of non-invariance. More studies in the literature are needed where the amalgamation of information provided by different informs and the association of specific symptoms with comorbidity are analysed.
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Affiliation(s)
- Alexandra Garcia-Rosales
- MRC Social Genetic Developmental and Psychiatry Centre, King’s College London, Institute of Psychiatry, Psychology, and Neurosciences, London, United Kingdom
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neurosciences, King’s College, London, United Kingdom
- Universidad Autónoma de Madrid, Madrid, Spain
- Kensington & Chelsea Child and Adolescent Mental Health Service, Central and North West London NHS Foundation Trust, London, United Kingdom
| | - Samuele Cortese
- School of Psychology, Centre for Innovation in Mental Health (CIMH), Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
- Hassenfeld Children’s Hospital at NYU Langone, New York University Child Study Center, New York, New York, United States of America
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Horizon Centre, CAMHS West, Solent NHS Trust, Southampton, United Kingdom
| | - Silia Vitoratou
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology, and Neurosciences, King’s College, London, United Kingdom
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7
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Shepard E, Sweeney C, Thompson L, Jacobs S, Grimm J, Weyandt LL. Effectiveness of executive functioning training among heterogeneous adolescent samples: A systematic review. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:327-343. [PMID: 35914534 DOI: 10.1080/21622965.2022.2106436] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of the present systematic review was to discuss the reported efficacy of executive functioning training techniques among adolescents. A systematic review of the literature was conducted to retrieve and consolidate findings from articles evaluating executive functioning training techniques among adolescents. A total of 26 articles were located that examined the role of executive functioning training techniques among adolescents (age 10-19 years). Articles retrieved enabled comparison across psychiatric and medical diagnoses including attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), as well as adolescents with physical health concerns. Results revealed that among typically developing adolescents, executive functioning training was non-significant or yielded small effect size improvements in executive functioning as measured by behavioral and neuroimaging tasks among 62.5% of studies reviewed. In contrast, in those with medical conditions, ASD, ADHD, and conduct disorder, all but two studies reviewed yielded a medium to large effect size, supporting the effectiveness of EF training. Future research is needed to identify the long-term efficacy of these treatments, as well as their generalizability to real-world conditions.
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Affiliation(s)
- Emily Shepard
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Caroline Sweeney
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Lauren Thompson
- Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, Rhode Island, USA
| | - Sophie Jacobs
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Jessica Grimm
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Lisa L Weyandt
- Department of Psychology, Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, Rhode Island, USA
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Monopoli WJ, Allan DM, Everly EL, Evans SW, Mikami AY, Owens JS. An Exploration of the Psychometric Properties of the Social Experiences Questionnaire: Replication and Extension. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-022-09553-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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9
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Hatch B, Kadlaskar G, Miller M. Diagnosis and treatment children and adolescents with autism and ADHD. PSYCHOLOGY IN THE SCHOOLS 2022; 60:295-311. [PMID: 37065905 PMCID: PMC10092654 DOI: 10.1002/pits.22808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/11/2022] [Accepted: 09/11/2022] [Indexed: 11/12/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and autism are neurodevelopmental disorders that emerge in childhood. There is increasing recognition that ADHD and autism frequently co-occur. Yet, questions remain among clinicians regarding the best ways to evaluate and treat co-occurring autism and ADHD. This review outlines issues relevant to providing evidence-based practice to individuals and families who may be experiencing difficulties associated with co-occurring autism and ADHD. After describing the complexities of the co-occurrence of autism and ADHD, we present practical considerations for best practice assessment and treatment of co-occurring autism and ADHD. Regarding assessment, this includes considerations for interviewing parents/caregivers and youth, using validated parent and teacher rating scales, conducting cognitive assessments, and conducting behavior observations. Regarding treatment, consideration is given to behavioral management, school-based interventions, social skills development, and the use of medications. Throughout, we note the quality of evidence that supports a particular component of assessment or treatment, highlighting when evidence is most relevant to those with co-occurring autism and ADHD across stages of development. In light of the current evidence for assessment and treatment of co-occurring autism and ADHD, we conclude by outlining practical implications for clinical and educational practice.
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Affiliation(s)
- Burt Hatch
- School of Psychology Victoria University of Wellington Wellington New Zealand
| | - Girija Kadlaskar
- Department of Psychiatry & Behavioral Sciences and MIND Institute University of California Davis California USA
| | - Meghan Miller
- Department of Psychiatry & Behavioral Sciences and MIND Institute University of California Davis California USA
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Tourjman V, Louis-Nascan G, Ahmed G, DuBow A, Côté H, Daly N, Daoud G, Espinet S, Flood J, Gagnier-Marandola E, Gignac M, Graziosi G, Mansuri Z, Sadek J. Psychosocial Interventions for Attention Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis by the CADDRA Guidelines Work GROUP. Brain Sci 2022; 12:brainsci12081023. [PMID: 36009086 PMCID: PMC9406006 DOI: 10.3390/brainsci12081023] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 12/10/2022] Open
Abstract
Multiple psychosocial interventions to treat ADHD symptoms have been developed and empirically tested. However, no clear recommendations exist regarding the utilization of these interventions for treating core ADHD symptoms across different populations. The objective of this systematic review and meta-analysis by the CADDRA Guidelines work Group was to generate such recommendations, using recent evidence. Randomized controlled trials (RCT) and meta-analyses (MA) from 2010 to 13 February 2020 were searched in PubMed, PsycINFO, EMBASE, EBM Reviews and CINAHL. Studies of populations with significant levels of comorbidities were excluded. Thirty-one studies were included in the qualitative synthesis (22 RCT, 9 MA) and 24 studies (19 RCT, 5 MA) were included in the quantitative synthesis. Using three-level meta-analyses to pool results of multiple observations from each RCT, as well as four-level meta-analyses to pool results from multiples outcomes and multiple studies of each MA, we generated recommendations using the GRADE approach for: Cognitive Behavioral Therapy; Physical Exercise and Mind–Body intervention; Caregiver intervention; School-based and Executive intervention; and other interventions for core ADHD symptoms across Preschooler, Child, Adolescent and Adult populations. The evidence supports a recommendation for Cognitive Behavioral Therapy for adults and Caregiver intervention for Children, but not for preschoolers. There were not enough data to provide recommendations for the other types of psychosocial interventions. Our results are in line with previous meta-analytic assessments; however, they provide a more in-depth assessment of the effect of psychosocial intervention on core ADHD symptoms.
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Affiliation(s)
- Valerie Tourjman
- Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada; (V.T.); (G.L.-N.); (A.D.); (H.C.)
| | - Gill Louis-Nascan
- Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada; (V.T.); (G.L.-N.); (A.D.); (H.C.)
- Department of Psychology, Université du Québec à Montréal, Montreal, QC H2X 3P2, Canada
| | - Ghalib Ahmed
- Departments of Family Medicine and Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Anaïs DuBow
- Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada; (V.T.); (G.L.-N.); (A.D.); (H.C.)
| | - Hubert Côté
- Department of Psychiatry, Université de Montréal, Montreal, QC H3T 1J4, Canada; (V.T.); (G.L.-N.); (A.D.); (H.C.)
| | - Nadia Daly
- Department of Psychiatry, Harvard University, Boston, MA 02115, USA;
- Boston Children’s Hospital, Harvard University, Boston, MA 02115, USA;
| | - George Daoud
- Department of Psychiatry, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
| | - Stacey Espinet
- CADDRA—Canadian ADHD Resource Alliance, Toronto, ON M5A 3X9, Canada;
| | - Joan Flood
- Department of Psychiatry, The Shoniker Clinic, Scarborough, ON M1E 4B9, Canada;
| | | | - Martin Gignac
- Child and Adolescent Psychiatry Division, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Gemma Graziosi
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada;
| | - Zeeshan Mansuri
- Boston Children’s Hospital, Harvard University, Boston, MA 02115, USA;
| | - Joseph Sadek
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Correspondence:
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11
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Wexler D, Salgado R, Gornik A, Peterson R, Pritchard A. What's race got to do with it? Informant rating discrepancies in neuropsychological evaluations for children with ADHD. Clin Neuropsychol 2022; 36:264-286. [PMID: 34238112 PMCID: PMC8985113 DOI: 10.1080/13854046.2021.1944671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate race-based discrepancies in informant ratings and in rates of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnosis among a clinically referred sample of Black and White children. METHOD Demographic information and ratings of inattention, hyperactivity/impulsivity, and conduct were collected from caregivers and teachers as part of neuropsychological evaluations at an outpatient clinic. The final sample included 3,943 children (6-18 years), of which 70% were White and 30% were Black. RESULTS Teachers, but not caregivers, endorsed more inattentive symptoms and conduct problems for Black than for White children, irrespective of ADHD diagnostic status and socioeconomic status (SES), and after controlling for child sex, child age, and learning difficulties. Teachers endorsed more hyperactive/impulsive symptoms for Black children with ADHD of lower SES than for White children with these characteristics. Caregivers of Black children of higher SES reported fewer hyperactive/impulsive symptoms than caregivers of White children of higher SES. Despite differences in teachers' ratings by race, diagnostic rates of ADHD in the context of neuropsychological evaluations were comparable for Black and White children. CONCLUSIONS Consistent with previous literature, teachers endorsed more ADHD and conduct problems in Black children. Within our clinically referred sample, this may reflect teacher bias rather than actual prevalence differences by rafce, given that Black caregivers endorsed fewer or similar numbers of symptoms relative to White caregivers. This lack of racial disparities in rates of ADHD diagnosis is inconsistent with findings in community- and population-based samples, and reflectspossible benefit of the use of neuropsychological evaluations in diagnostic decision-making for ADHD.
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Affiliation(s)
- Danielle Wexler
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rod Salgado
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Allison Gornik
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rachel Peterson
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alison Pritchard
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA;,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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12
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Langwerden RJ, Thompson MG, Wagner EF. Multidimensional conceptualization of identity and psychopathology: Assessing mental health disparities from an intersectional and dimensional framework. Personal Ment Health 2021; 15:293-308. [PMID: 34132042 DOI: 10.1002/pmh.1519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 11/12/2022]
Abstract
Black, Indigenous, and People of Color (BIPOC) currently constitute 40% of the US population and will become the majority by 2045. Current mental health systems have not sufficiently accounted for disparities, inequities, and social determinants impacting BIPOC lives. We outline several advances that could improve mental health disparities research. Research on BIPOC requires mental health assessment accurately capturing multiple facets of one's identity, taking into account the complexities of multifaceted historical oppression. Assessing (personality) psychopathology in a dimensional and hierarchical manner could provide greater insight into mental health disparities between diverse identity individuals. We encourage studying moderators that are protective assets for BIPOC-such as resiliency and community factors-as opposed to deficit-dominant, category-based, and majority-dominant assessments.
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Affiliation(s)
- Robbert J Langwerden
- Community-Based Research Institute, Florida International University, Miami, Florida, USA.,Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Michelle G Thompson
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eric F Wagner
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
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13
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Martel MM, Goh PK, Lee CA, Karalunas SL, Nigg JT. Longitudinal attention-deficit/hyperactivity disorder symptom networks in childhood and adolescence: Key symptoms, stability, and predictive validity. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:562-574. [PMID: 34472891 PMCID: PMC8480395 DOI: 10.1037/abn0000661] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The current study visualized attention-deficit/hyperactivity disorder (ADHD) symptom networks in a longitudinal sample of participants across childhood and adolescence with exploratory examination of age and gender effects. Eight hundred thirty-six children ages 7-13 years were followed annually for 8 years in total. Across parent and teacher report, results suggested "is easily distracted" and "difficulties sustaining attention" as central symptoms across three testing points (i.e., Year 1, Year 3, and Years 5-8 collapsed). "Difficulties following instructions" and "intrudes/interrupts" also emerged as parent-reported central symptoms. Assessment of network structure across the three testing points suggested global robustness of relations among ADHD symptoms from midchildhood into early adolescence. However, relations among symptoms that cause problems in school settings (i.e., being easily distracted) were stronger in teacher-reported than parent-reported networks. When aggregated into a sum score, central symptoms during Year 1 predicted total difficulties related to mental health problems 5 years later just as well as all 18 symptoms. Central symptoms of ADHD may be useful as screeners of future emotional and behavioral difficulties. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Jungersen CM, Lonigan CJ. Do Parent and Teacher Ratings of ADHD Reflect the Same Constructs? A Measurement Invariance Analysis. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021; 43:778-792. [DOI: 10.1007/s10862-021-09874-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pelsser L, Frankena K, Toorman J, Rodrigues Pereira R. Retrospective Outcome Monitoring of ADHD and Nutrition (ROMAN): The Effectiveness of the Few-Foods Diet in General Practice. Front Psychiatry 2020; 11:96. [PMID: 32226397 PMCID: PMC7081264 DOI: 10.3389/fpsyt.2020.00096] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/06/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Double-blind placebo-controlled studies investigating the effect of a few-foods diet (FFD) on attention-deficit/hyperactivity disorder (ADHD) have provided consistent evidence that ADHD can be triggered by foods, indicating the existence of a food-induced ADHD subtype. In 2001 the "few-foods" approach was included in an ADHD treatment protocol. This approach consists of (a) determining, by means of an FFD, whether food is a trigger of ADHD; (b) reintroducing, in FFD responders, foods to assess which foods are incriminated; (c) finally composing a personalised diet eliminating the involved foods only. In the Netherlands the few-foods approach is applied in practice. We aimed to retrospectively assess its effectiveness on ADHD and oppositional defiant disorder (ODD) in real life. METHODS Data from all children who started the few-foods approach in three specialised healthcare facilities during three consecutive months were included. Behavior was assessed at start and end of the 5-week FFD, using the ADHD Rating Scale and a structured psychiatric interview. Clinical responders (behavioral improvements ≥40%) proceeded with the reintroduction phase. RESULTS Data of 57 children, 27 taking medication and 15 following some elimination diet at start, were available. No differences were noted between parental scores of children with and without medication or some elimination diet at start. 21/27 (78%) children stopped taking medication during the FFD. 34/57 (60%) children were ADHD responders, 20/29 (65%) children meeting ODD criteria were ODD responders. 26/34 (76%) ADHD responders started the reintroduction phase; 14/26 (54%) still participated at six months. Teacher data were available of 18/57 (32%) children. 9/18 (50%) children were ADHD responders. CONCLUSION The FFD, if applied by trained specialists, may lead to clinically relevant reduction of ADHD and ODD symptoms in general practice, and a concomitant decrease of ADHD medication. These results corroborate the existence of an ADHD subgroup with food-induced ADHD. Defining and eliminating the incriminated foods, i.e. the underlying causal triggers, may result in secondary prevention of food-induced ADHD. Research into underlying mechanism(s) is of vital importance: finding an easier method or biomarkers for diagnosing food-induced ADHD and ascertaining the incriminated foods may lead to redundancy of the few-foods approach.
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Affiliation(s)
| | - Klaas Frankena
- Adaptation Physiology group, Wageningen University & Research, Wageningen, Netherlands
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