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Lesica S, Skeel R, Fust BE, Jepsen A. Further validation of the Parent-Reported ADHD Symptom Infrequency Scale (PRASIS) in parents of children with oppositional defiant disorder and anxiety. Child Neuropsychol 2024:1-17. [PMID: 39072667 DOI: 10.1080/09297049.2024.2383701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/18/2024] [Indexed: 07/30/2024]
Abstract
This study aimed to validate a novel parent-report measure of ADHD symptom inflation, the Parent-Reported ADHD Symptom Infrequency Scale (PRASIS), in a clinical sample. The PRASIS is composed of an Infrequency subscale and an ADHD subscale. Online participants were assigned to one of three groups: mothers of children with diagnosed ADHD (n = 110), mothers of children with diagnosed ODD and/or anxiety (n = 116), and mothers of children without ADHD, ODD, or anxiety. The third group was then randomized to either receive instructions to complete the questionnaire honestly (controls, n = 164) or to complete the questionnaire as if they were trying to convince a provider that their child has ADHD (simulators, n = 141). Results indicated good to excellent internal consistency (INF α = .83, ADHD Total α = .93); strong convergent validity of the PRASIS ADHD scale with the ADHD Rating Scale-5 (r(529) = .85, p < .001); excellent group discrimination of the PRASIS Infrequency scale and the PRASIS ADHD scale (η2 = 0.38-0.42); and specificity of 86.7, sensitivity of 67.4%, and an AUC of .86 for the Infrequency scale. Overall, these outcomes supported the utility of the PRASIS in samples including mothers of children with psychiatric diagnoses of ODD and/or anxiety.
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Affiliation(s)
- Sofia Lesica
- Clinical Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Reid Skeel
- Clinical Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | | | - Arianna Jepsen
- Clinical Psychology, Central Michigan University, Mount Pleasant, MI, USA
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Mautone JA, Holdaway A, Chan W, Michel JJ, Guevara JP, Davis A, Desrochers C, Evans E, Gajary Z, Leavy S, Rios D, Tremont KL, Cacia J, Schwartz BS, Jawad AF, Power TJ. Reducing disparities in behavioral health treatment in pediatric primary care: a randomized controlled trial comparing Partnering to Achieve School Success (PASS) to usual ADHD care for children ages 5 to 11 - study protocol. BMC PRIMARY CARE 2024; 25:225. [PMID: 38909215 PMCID: PMC11193903 DOI: 10.1186/s12875-024-02473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/10/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Integrating behavioral health services into pediatric primary care can improve access to care, especially for children marginalized by poverty and racial/ethnic minority status. In primary care, a common presenting concern is attention-deficit/hyperactivity disorder (ADHD). Services in primary care for marginalized children with ADHD typically include medication alone; therapy to improve skills and build relationships is less available. This study evaluates the effectiveness of a behavioral intervention offered through primary care for marginalized families coping with ADHD (Partnering to Achieve School Success, PASS) compared to treatment as usual (TAU). METHOD Three hundred participants will be randomly assigned to PASS or TAU. Participants include children ages 5 to 11 who have ADHD and are from economically marginalized families. PASS is a personalized, enhanced behavioral intervention that includes evidence-based behavior therapy strategies and enhancements to promote family engagement, increase caregiver distress tolerance, and provide team-based care to improve academic and behavioral functioning. TAU includes services offered by primary care providers and referral for integrated behavioral health or community mental health services. Outcomes will be assessed at mid-treatment (8 weeks after baseline), post-treatment (16 weeks), and follow-up (32 weeks) using parent- and teacher-report measures of service use, child academic, behavioral, and social functioning, parenting practices, family empowerment, and team-based care. Mixed effects models will examine between-group differences at post-treatment and follow-up. Analyses will examine the mediating role of parenting practices, family empowerment, and team-based care. Subgroup analyses will examine differential effects of intervention by child clinical characteristics and socioeconomic factors. DISCUSSION This study is unique in targeting a population of children with ADHD marginalized by low socioeconomic resources and examining an intervention designed to address the challenges of families coping with chronic stress related to poverty. TRIAL REGISTRATION This study was registered on clinicaltrials.gov (NCT04082234) on September 5, 2019, prior to enrollment of the first participant. The current version of the protocol and IRB approval date is October 4, 2023. Results will be submitted to ClinicalTrials.gov no later than 30 days prior to the due date for the submission of the draft of the final research report to the Patient-Centered Outcomes Research Institute.
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Affiliation(s)
- Jennifer A Mautone
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA.
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA.
| | - Alex Holdaway
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
| | - Wendy Chan
- Graduate School of Education at University of Pennsylvania, Philadelphia, PA, USA
| | - Jeremy J Michel
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA
| | - James P Guevara
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Colette Desrochers
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Zia Gajary
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA
| | - Siobhan Leavy
- Chester County Intermediate Unit, Downingtown Philadelphia, PA, USA
| | - Danah Rios
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA
| | - Katie L Tremont
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
| | - Jaclyn Cacia
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
| | - Billie S Schwartz
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA
| | - Abbas F Jawad
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas J Power
- Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA, 19146, USA
- Perelman School of Medicine at, University of Pennsylvania, Philadelphia, PA, USA
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Fabiano GA, Lupas K, Merrill BM, Schatz NK, Piscitello J, Robertson EL, Pelham WE. Reconceptualizing the approach to supporting students with attention-deficit/hyperactivity disorder in school settings. J Sch Psychol 2024; 104:101309. [PMID: 38871418 DOI: 10.1016/j.jsp.2024.101309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 09/19/2023] [Accepted: 03/16/2024] [Indexed: 06/15/2024]
Abstract
The long-term academic outcomes for many students with attention-deficit/hyperactivity disorder (ADHD) are strikingly poor. It has been decades since students with ADHD were specifically recognized as eligible for special education through the Other Health Impaired category under the Education for all Handicapped Children Act of 1975, and similarly, eligible for academic accommodations through Section 504 of the 1973 Rehabilitation Act. It is time to acknowledge that these school-policies have been insufficient for supporting the academic, social, and behavioral outcomes for students with ADHD. Numerous reasons for the unsuccessful outcomes include a lack of evidence-based interventions embedded into school approaches, minimizing the importance of the general education setting for promoting effective behavioral supports, and an over-reliance on assessment and classification at the expense of intervention. Contemporary behavioral support approaches in schools are situated in multi-tiered systems of support (MTSS); within this article we argue that forward-looking school policies should situate ADHD screening, intervention, and maintenance of interventions within MTSS in general education settings and reserve special education eligibility solely for students who require more intensive intervention. An initial model of intervention is presented for addressing ADHD within schools in a manner that should provide stronger interventions, more quickly, and therefore more effectively.
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4
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Dodds M, Wanni Arachchige Dona S, Gold L, Coghill D, Le HND. Economic Burden and Service Utilization of Children With Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:247-264. [PMID: 38043710 DOI: 10.1016/j.jval.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/18/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. This study aims to systematically synthesize the literature on service utilization and costs for children with ADHD. METHODS The search included 9 databases for peer-reviewed primary studies in English from 2007 to 2023. Two independent reviewers conducted title/abstract and full-text screenings and quality assessment. Meta-analysis was conducted on direct medical costs. RESULTS Thirty-two studies were included. Children with ADHD have used more pharmaceuticals, mental health, and special education services than children without ADHD (counterparts). Nevertheless, one study found that children with ADHD were twice as likely to have unmet health needs than their counterparts. Annual health system costs per patient were highly varied and higher in children with ADHD ($722-$11 555) than their counterparts ($179-$3646). From a societal perspective, children with ADHD were associated with higher costs ($162-$18 340) than their counterparts ($0-2540). The overall weighted mean direct medical cost was $5319 for children with ADHD compared with $1152 for their counterparts when all studies with different sample sizes were considered together, with the difference being $4167. Limited literature on productivity losses associated with ADHD reported them as a substantial cost. ADHD in children had a "large" effect on the increment of direct medical costs. CONCLUSIONS ADHD was associated with increased service utilization and costs. However, unmet health needs or underuse among children with ADHD was also evident. Governments should endeavor to improve access to effective services for children with ADHD to mitigate the impact of ADHD.
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Affiliation(s)
- Mitchell Dodds
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Sithara Wanni Arachchige Dona
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia.
| | - Lisa Gold
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - David Coghill
- Murdoch Children's Research Institute, Royal Children's Hospital, Victoria, Australia; Departments of Paediatrics and Psychiatry, Faculty of Medicine, The University of Melbourne, Victoria, Australia
| | - Ha N D Le
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
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5
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Morris SSJ, Timmons A, Musser ED. An Individualized, Data-Driven Biological Approach to Attention-Deficit/Hyperactivity Disorder (ADHD) Heterogeneity. Res Child Adolesc Psychopathol 2023; 51:1565-1579. [PMID: 37542616 DOI: 10.1007/s10802-023-01104-6] [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] [Accepted: 07/18/2023] [Indexed: 08/07/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed mental health disorder in childhood, however, there is well-established heterogeneity in both the presentation of ADHD symptoms and secondary characteristics across the literature. Existing Diagnostic and Statistical Manual of Mental Disorders (DSM-5) nosology has been ineffective in explaining such heterogeneity in terms of both pathophysiology and clinical trajectories. The current study investigated ADHD heterogeneity via a biologically-based, data-driven approach (k-Means algorithm). Specifically, unique biological profiles (derived from patterns of parasympathetic and sympathetic functioning) were identified and utilized as predictors of clinical presentations. Two hundred eighty-nine participants (167 youth with ADHD), ages 5 to 13 years, completed an emotion-based task while indexes of parasympathetic (i.e., respiratory sinus arrhythmia [RSA]) and sympathetic (i.e., electrodermal activity [EDA]) activity were obtained. Overall, results suggest that three distinct biological profiles among youth with ADHD are evident, with biological profiles differing in regulation and arousal levels during emotionally evocative contexts: (Profile 1) underregulated, hyperaroused (negative contexts only), (Profile 2) typically regulated, underaroused, and (Profile 3) overregulated (positive contexts only), hyperaroused. Results are supported by several dopaminergic- and reward-based theories, integrating differing concepts across the literature, and adds biological support for existing models. Behaviorally, results may translate into differing clinical presentations, however, further work is needed. In general, youth with ADHD are heterogenous in autonomic functioning, which could have implications for synthesizing across differing theories within the literature, predicting clinical presentations, and developing targeted treatments.
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Affiliation(s)
| | - Adela Timmons
- Department of Psychology, University of Texas at Austin, Austin, USA
| | - Erica D Musser
- Department of Psychology, Florida International University, Miami, USA
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6
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Margherio SM, Evans SW, Monopoli WJ, Langberg JM. Cost-Effectiveness of a Training Intervention for Adolescents with ADHD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:819-833. [PMID: 33630716 DOI: 10.1080/15374416.2021.1875323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to examine the costs and cost-effectiveness of a school-based training intervention delivered at varying levels of intensity with adolescents with attention-deficit/hyperactivity disorder (ADHD). Costs were examined in relation to post-treatment and 6-month follow-up effects of the Challenging Horizons Program (CHP), a training intervention for adolescents with ADHD. METHOD A total of 326 middle-school students (71% male; 77% White) with ADHD were randomized to an after-school version of the CHP (CHP-AS), a less-intensive mentoring version (CHP-M), or routine community care. Detailed time logs were maintained throughout the study and were used to estimate costs associated with each condition. Student grade point average (GPA) and parent-rated ADHD symptoms and organization skills were collected at post-treatment and 6-month follow-up. RESULTS The cost analysis revealed that CHP-AS was more costly per student than CHP-M, both in terms of overall costs and direct expenses to the school. However, CHP-AS was less costly per hour of intervention provided to the youth than CHP-M. Incremental cost-effectiveness ratios revealed that CHP-M may be the more cost-effective option for post-treatment effects, yet CHP-AS may be the more cost-effective option in the long term for sustained gains in organization skills and GPA. CONCLUSIONS This study provides stakeholders important information to make decisions regarding allocation of finite monetary resources to meet their prioritized goals.
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7
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Golson ME, McClain MB, Roanhorse TT, Rodríguez MMD, Galliher RV. The Experience of ADHD as Reported by Racially and Ethnically Minoritized Adolescents: a Survey-Based Phenomenological Investigation. J Racial Ethn Health Disparities 2023; 10:2565-2576. [PMID: 36418737 DOI: 10.1007/s40615-022-01436-x] [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: 08/23/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 11/25/2022]
Abstract
The variety of possible suboptimal long-term outcomes associated with attention-deficit/hyperactivity disorder (ADHD) when left unsupported highlights the importance of timely and accurate identification followed by intervention. Though considerations of race and ethnicity are essential to service delivery, disparities in ADHD identification and intervention persist for racially and ethnically minoritized (REM) youth. This is exacerbated by a lack of research focusing on REM populations. The current study is a phenomenological investigation of REM adolescents' (N = 35) experiences with ADHD. Participant responses to an online phenomenological survey yielded four themes and eleven subthemes related to ADHD symptom experiences, navigating social relationships and school, stigma, and finding positivity in ADHD. Participant experiences corroborate and expand on extant research regarding ADHD symptoms, social isolation, school discipline referrals, and stigma. These findings highlight the importance of including REM participants in research and increased efforts to decrease stigma.
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Affiliation(s)
- Megan E Golson
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA.
| | - Maryellen Brunson McClain
- Department of Counseling and Educational Psychology, Indiana University, 107 S Indiana Ave, Bloomington, IN, 47405, USA
| | - Tyus T Roanhorse
- Department of Counseling and Educational Psychology, Indiana University, 107 S Indiana Ave, Bloomington, IN, 47405, USA
| | | | - Renee V Galliher
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT, 84322, USA
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8
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Lesica S, Skeel R, Fust B. The parent-reported ADHD symptom infrequency scale (PRASIS): a parent report measure of ADHD symptom exaggeration. Child Neuropsychol 2023; 29:255-275. [PMID: 35618325 DOI: 10.1080/09297049.2022.2081676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The present article outlines the development of the parent-reported ADHD symptom infrequency scale (PRASIS), a novel stand-alone questionnaire designed to discriminate between parents exaggerating ratings of ADHD symptoms of their child from parents more accurately reporting symptoms. The PRASIS includes an Infrequency scale (INF) to measure infrequently reported symptoms of ADHD and a clinical scale to measure Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) defined ADHD symptoms (ADHD Total). An initial list of infrequency and clinical items was revised over the course of three studies, each conducted on a different sample of participants (n1 = 154, n2 = 203, n3 = 167) recruited via CloudResearch and consisting of mothers of children 4-12 years old. Analyses on the final version of the measure demonstrated good to excellent internal consistency (INF α = .87 , ADHD Total α = .94) and high convergent validity of the PRASIS ADHD Total scores with ADHD Rating Scale-5 Total scores (r = .87, p < .001). Omnibus ANOVA comparisons demonstrated excellent group discrimination of both the PRASIS Infrequency scale and the PRASIS ADHD scale (Cohen's f = 0.81-0-90). Specificity was above the minimum requirement set a priori (≥.80) and resulting sensitivity was similar or higher than other non-ADHD measures in the symptom validity literature. Specificity and sensitivity are reported for multiple cutoff scores, and positive predictive values (PPV) and negative predictive values (NPV) are presented for several base rates.
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Affiliation(s)
- Sofia Lesica
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Reid Skeel
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Brittany Fust
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
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Danielson ML, Kassab HD, Lee M, Owens JS, Evans SW, Lipton C, Charania S, Young HE, Kubicek LF, Flory K, Cuffe SP. The Utility of the Behavior Assessment System for Children-2 Behavioral and Emotional Screening System and Strengths and Difficulties Questionnaire in Predicting Mental Disorders in the Project to Learn About Youth-Mental Health. PSYCHOLOGY IN THE SCHOOLS 2023; 60:2320-2341. [PMID: 37970221 PMCID: PMC10642258 DOI: 10.1002/pits.22856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023]
Abstract
We examined the predictive utility of the Behavior Assessment System for Children-2 Behavioral and Emotional Screening System (BASC-2-BESS) and Strengths and Difficulties Questionnaire (SDQ) in identifying students with a mental disorder. Data were collected in a two-stage study over 34 months with kindergarten-12th grade (K-12) students (aged 5-19 years) in four U.S. school districts. In Stage 1, teachers completed the BASC-2-BESS and the SDQ. In Stage 2, parents of 1,054 children completed a structured diagnostic interview to determine presence of a mental disorder. Results suggest that teacher versions of the BASC-2-BESS and SDQ have modest utility in identifying children meeting criteria for a mental disorder based on parent report. Area Under the Curve (AUC) statistics representing prediction of any externalizing disorder (.73 for both measures) were higher than the AUCs predicting any internalizing disorder (.58 for both measures). Findings can inform the use of teacher report in mental health screening, specifically the selection of measures when implementing screening procedures.
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Affiliation(s)
- Melissa L Danielson
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta GA
| | | | - Mary Lee
- Department of Psychology, Ohio University, Athens, OH
| | | | | | - Corey Lipton
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta GA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Sana Charania
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta GA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Hayley Elia Young
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta GA
- Rollins School of Public Health, Emory University, Atlanta, GA
| | - Lorraine F Kubicek
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kate Flory
- Department of Psychology, University of South Carolina, Columbia, SC
| | - Steven P Cuffe
- Department of Psychiatry, University of Florida College of Medicine, Jacksonville, FL
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Pfiffner LJ, Dvorsky MR, Friedman LM, Haack LM, Chung S, Charalel JM, Hawkey E, Spiess M. Development of a Web-Based Training Platform for School Clinicians in Evidence-Based Practices for ADHD. SCHOOL MENTAL HEALTH 2022; 15:49-66. [PMID: 36466742 PMCID: PMC9685070 DOI: 10.1007/s12310-022-09556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 11/25/2022]
Abstract
Lack of training for school clinicians in evidence-based practices (EBPs) contributes to underutilization of such services for youth with attention-deficit/hyperactivity disorder (ADHD). Advances in web-based technology and videoconferencing have allowed for expanded access to and optimization of training. We describe the development and outcomes of a novel web-based platform for training school clinicians to gain skills in EBPs for school-age youth with ADHD. The training platform is adapted from an empirically supported, in-person training for a school-home behavioral intervention (Collaborative Life Skills program) and includes skill modules for working with teachers, parents, and students. Training methods include web-accessed manuals/handouts, skill example video clips, automated progress monitoring tools, and consultation/in-session coaching via videoconferencing. We gathered stakeholder qualitative and quantitative feedback during discovery and design phases of the iterative development. We then evaluated the usability, acceptability, fidelity and clinician and student outcomes of the remote training program. Focus group themes and qualitative feedback identified clinician preferences for remote training features (e.g., interactive, brief, role-plays/coaching methods), video tools (recorded samples of skills and therapy sessions), and progress monitoring tools (e.g., clear, easy to use). Clinician usability ratings of the platform were high with most components rated as moderately to very useful/easy to use. Clinician ratings of usability, fidelity implementing the treatment, and their EBP knowledge and confidence following training were favorable. Student's outcomes were similar to those achieved in prior studies of clinician in-person training. Results support the promise of remote, web-based clinician training for the dissemination of evidence-based practices.
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Affiliation(s)
- Linda J. Pfiffner
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Melissa R. Dvorsky
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
- Department of Pediatrics and Psychiatry, Children’s National Hospital, George Washington University School of Medicine, Washington DC, US
| | - Lauren M. Friedman
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
- Department of Psychology, Arizona State University, Tempe, AZ US
| | - Lauren M. Haack
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Sara Chung
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Julia M. Charalel
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Elizabeth Hawkey
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
| | - Madeline Spiess
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, 675 18th St, San Francisco, 94143 CA US
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Merrill BM, Raiker JS, Mattfeld AT, Macphee FL, Ramos MC, Zhao X, Altszuler AR, Schooler JW, Coxe S, Gnagy EM, Greiner AR, Coles EK, Pelham WE. Mind-Wandering and Childhood ADHD: Experimental Manipulations across Laboratory and Naturalistic Settings. Res Child Adolesc Psychopathol 2022; 50:1139-1149. [PMID: 35247108 PMCID: PMC11103794 DOI: 10.1007/s10802-022-00912-6] [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] [Accepted: 02/24/2022] [Indexed: 10/18/2022]
Abstract
The conceptual overlap between mind-wandering and attention-deficit/hyperactivity disorder (ADHD)-related impairments is considerable, yet little experimental research examining this overlap among children is available. The current study aims to experimentally manipulate mind-wandering among children with and without ADHD and examine effects on task performance. Participants were 59 children with ADHD and 55 age-matched controls. Participants completed a novel mind-wandering sustained attention to response task (SART) that included non-self-referential and self-referential stimuli to experimentally increase self-referential mind-wandering, reflected by increases in reaction time variability (RTV) following self-referential stimuli. The ADHD group participated in a classroom study with analogue conditions aimed at encouraging self-referential future-oriented thinking (free play/movie before and after class work) compared to a control condition (newscast) and a cross-over methylphenidate trial. The significant interaction between ADHD status and self-referential stimuli on SART performance indicated that self-referential stimuli led to greater RTV among children with ADHD (within-subject d = 1.29) but not among controls. Methylphenidate significantly reduced RTV among youth with ADHD across self-referential (d = 1.07) and non-self-referential conditions (d = 0.72). In the ADHD classroom study, the significant interaction between mind-wandering condition and methylphenidate indicated that methylphenidate led to higher work completion (ds > 5.00), and the free-play mind-wandering condition had more consistent detrimental effects on productivity (ds ≥ 1.25) than the movie mind-wandering condition. This study is the first to manipulate mind-wandering and assess effects among children with ADHD using a behavioral task. Results provide evidence that children with ADHD are uniquely susceptible to mind-wandering interference.
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Affiliation(s)
- Brittany M Merrill
- Center for Children and Families, Florida International University, Miami, FL, USA.
- Department of Psychology, Florida International University, Miami, FL, USA.
| | - Joseph S Raiker
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Aaron T Mattfeld
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Fiona L Macphee
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Marcela C Ramos
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Xin Zhao
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Amy R Altszuler
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | | | - Stefany Coxe
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Elizabeth M Gnagy
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Andrew R Greiner
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Erika K Coles
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | - William E Pelham
- Center for Children and Families, Florida International University, Miami, FL, USA
- Department of Psychology, Florida International University, Miami, FL, USA
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12
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Laue HE, Karagas MR, Coker MO, Bellinger DC, Baker ER, Korrick SA, Madan JC. Sex-specific relationships of the infant microbiome and early-childhood behavioral outcomes. Pediatr Res 2022; 92:580-591. [PMID: 34732816 PMCID: PMC9065210 DOI: 10.1038/s41390-021-01785-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND A link between the gut microbiome and behavior is hypothesized, but most previous studies are cross-sectional or in animal models. The modifying role of host sex is poorly characterized. We aimed to identify sex-specific prospective associations between the early-life gut microbiome and preschool-age neurobehavior. METHODS In a prospective cohort, gut microbiome diversity and taxa were estimated with 16S rRNA sequencing at 6 weeks, 1 year, and 2 years. Species and gene pathways were inferred from metagenomic sequencing at 6 weeks and 1 year. When subjects were 3 years old, parents completed the Behavioral Assessment System for Children, second edition (BASC-2). A total of 260 children contributed 523 16S rRNA and 234 metagenomics samples to analysis. Models adjusted for sociodemographic characteristics. RESULTS Higher diversity at 6 weeks was associated with better internalizing problems among boys, but not girls [βBoys = -1.86 points/SD Shannon diversity; 95% CI (-3.29, -0.42), pBoys = 0.01, βGirls = 0.22 (-1.43, 1.87), pGirls = 0.8, pinteraction = 0.06]. Among other taxa-specific associations, Bifidobacterium at 6 weeks was associated with Adaptive Skills scores in a sex-specific manner. We observed relationships between functional features and BASC-2 scores, including vitamin B6 biosynthesis pathways and better Depression scores. CONCLUSIONS This study advances our understanding of microbe-host interactions with implications for childhood behavioral health. IMPACT This is one of the first studies to examine the early-life microbiome and neurobehavior, and the first to examine prospective sex-specific associations. Infant and early-childhood microbiomes relate to neurobehavior including anxiety, depression, hyperactivity, and social behaviors in a time- and sex-specific manner. Our findings suggest future studies should evaluate whether host sex impacts the relationship between the gut microbiome and behavioral health outcomes.
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Affiliation(s)
- Hannah E. Laue
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH,Correspondence to: Dr. Hannah E. Laue, One Medical Center Dr, WTRB 700 Lebanon NH 03766, , Phone: 1-603-646-5426
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH
| | - Modupe O. Coker
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH,Oral Biology Department, School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ
| | - David C. Bellinger
- Department of Neurology, Harvard Medical School and Boston Children’s Hospital, Boston, MA
| | - Emily R. Baker
- Department of Obstetrics and Gynecology, Dartmouth Hitchcock Medical Center, Lebanon, NH
| | - Susan A. Korrick
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA,These authors contributed equally
| | - Juliette C. Madan
- Department of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, NH,Departments of Pediatrics and Psychiatry, Children’s Hospital at Dartmouth, Lebanon, NH,These authors contributed equally
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13
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DeFouw ER, Owens JS, Margherio SM, Evans S. Supporting Teachers’ Use of Classroom Management Strategies via Different School-Based Consultation Models: Which Is More Cost-Effective for Whom? SCHOOL PSYCHOLOGY REVIEW 2022. [DOI: 10.1080/2372966x.2022.2087476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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14
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Singh LJ, Gaye F, Cole AM, Chan ES, Kofler MJ. Central executive training for ADHD: Effects on academic achievement, productivity, and success in the classroom. Neuropsychology 2022; 36:330-345. [PMID: 35343732 PMCID: PMC9035079 DOI: 10.1037/neu0000798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Central executive training (CET) is a "Level 2" evidence-based treatment for improving ADHD-related executive dysfunction and behavioral symptoms, but the extent to which these gains extend to the disorder's well-documented academic difficulties is unknown. METHOD Across two clinical trials, 108 children with attention-deficit/hyperactivity disorder (ADHD) 8-13 years old (M = 10.29, SD = 1.50; 32 girls; 75% White/Non-Hispanic) were treated with CET (n = 52), inhibitory control training (ICT; n = 29), or gold-standard behavioral parent training (BPT; n = 27). RESULTS CET was superior to BPT and ICT (d = 0.62-0.88) for improving masked teacher perceptions of academic success, impulse control, and academic productivity at 1-2 months posttreatment. At 2-4-month follow-up, CET (d = 0.76) and ICT (d = 0.54) were superior to BPT for improving objectively-tested academic achievement overall (reading comprehension, math problem-solving, language comprehension), and CET was superior to ICT (d = 0.56) for improving math problem-solving. The significant benefits of CET on academic success, academic productivity, reading comprehension, and math problem-solving replicated across both trials and were clinically significant as evidenced by low number needed to treat estimates (Needed to Treat; NNT = 3-7) and significantly higher proportions of individual cases demonstrating reliable improvements in academic success/productivity (33%-36% vs. 0%-18%) and achievement (38%-72% vs. 18%-54%) across outcomes (all p ≤ .01). CONCLUSIONS Results across the two trials provide strong support for the efficacy of CET for ADHD, and are consistent with model-driven hypotheses that academic difficulties in ADHD are due, in part, to these children's underdeveloped executive functioning abilities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | - Fatou Gaye
- Florida State University, Department of
Psychology
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15
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Fabiano GA, Naylor J, Pelham WE, Gnagy EM, Burrows-MacLean L, Coles E, Chacko A, Wymbs BT, Walker KS, Wymbs F, Garefino A, Mazzant JR, Sastry AL, Tresco KE, Waschbusch DA, Massetti GM, Waxmonsky J. Special Education for Children with ADHD: Services Received and a Comparison to Children with ADHD in General Education. SCHOOL MENTAL HEALTH 2022. [DOI: 10.1007/s12310-022-09514-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Golson ME, Roanhorse TT, McClain MB, Galliher RV, Domenech Rodríguez MM. School‐based ADHD services: Perspectives from racially and ethnically minoritized students. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Megan E. Golson
- Department of Psychology Utah State University Logan Utah USA
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17
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Schein J, Adler LA, Childress A, Cloutier M, Gagnon-Sanschagrin P, Davidson M, Kinkead F, Guerin A, Lefebvre P. Economic burden of attention-deficit/hyperactivity disorder among children and adolescents in the United States: a societal perspective. J Med Econ 2022; 25:193-205. [PMID: 35068300 DOI: 10.1080/13696998.2022.2032097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To provide a comprehensive evaluation of the economic burden associated with attention-deficit/hyperactivity disorder (ADHD) among children and adolescents from a US societal perspective. MATERIALS AND METHODS Direct healthcare costs of children (5-11 years) and adolescents (12-17 years) with ADHD were obtained using claims data from the IBM MarketScan Research Databases (01/01/2017-12/31/2018). Direct non-healthcare and indirect costs were estimated based on literature and government publications. Each cost component was estimated using a prevalence-based approach, with per-patient costs extrapolated to the national level. RESULTS The total annual societal excess costs associated with ADHD were estimated at $19.4 billion among children ($6,799 per child) and $13.8 billion among adolescents ($8,349 per adolescent). Education costs contributed to approximately half of the total excess costs in both populations ($11.6 billion [59.9%] in children; $6.7 billion [48.8%] in adolescents). Other major contributors to the overall burden were direct healthcare costs ($5.0 billion [25.9%] in children; $4.0 billion [29.0%] in adolescents) and caregiving costs ($2.7 billion [14.1%] in children; $1.6 billion [11.5%] in adolescents). LIMITATIONS Cost estimates were calculated based on available literature and/or governmental publications due to the absence of a single data source for all costs associated with ADHD. Thus, the quality of cost estimates is limited by the accuracy of available data as well as the study populations and methodologies used by different studies. CONCLUSION ADHD in children and adolescents is associated with a substantial economic burden that is largely driven by education costs, followed by direct healthcare costs and caregiver costs. Improved intervention strategies and policies may reduce the clinical and economic burden of ADHD in these populations.
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Affiliation(s)
- Jeff Schein
- Otsuka Pharmaceutical Development & Commercialization, Inc., Princeton, NJ, USA
| | | | - Ann Childress
- Center for Psychiatry and Behavioral Medicine, Las Vegas, NV, USA
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18
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Nomura K, Tarumi R, Yoshida K, Sado M, Suzuki T, Mimura M, Uchida H. Cancellation of outpatient appointments in patients with attention-deficit/hyperactivity disorder. PLoS One 2021; 16:e0260431. [PMID: 34797891 PMCID: PMC8604341 DOI: 10.1371/journal.pone.0260431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Regular visit to psychiatric clinic is essential for successful treatment of any psychiatric condition including attention-deficit/hyperactivity disorder (AD/HD). However, cancellation of outpatient appointments in patients with AD/HD, which represents a significant medical loss, has not been systematically investigated to our knowledge. METHODS A systematic chart review was conducted for patients visiting the Shimada Ryoiku medical Center for Challenged Children in Japan at the age of ≤15 years from January to December 2013. The primary outcome measure was the cancellation rate, defined as the number of missed visits divided by the number of scheduled visits. The cancellation rates during 24 months after the first visit were compared between outpatients with AD/HD and other psychiatric disorders, including pervasive developmental disorders (PDD), and developmental coordination disorders and/or communication disorders (DCD-CD). A generalized linear model with binomial distribution was used to examine factors associated with cancellation rates exclusively in the AD/HD group. RESULTS We included 589 patients (mean ± SD age, 5.6 ± 3.4 years; 432 males) in the analysis. The cancellation rate in patients with AD/HD was 12.3% (95% confidence interval [CI]: 10.0-15.1), which was significantly higher than in those with PDD (5.6%, 95% CI: 3.8-8.3) and DCD-CD (5.3%, 95% CI: 3.6-7.8). Prescriptions of osmotic-release oral system-methylphenidate (OROS-MPH) and antipsychotics were associated with fewer cancellations in AD/HD patients (odds ratios: 0.61, 95% CI: 0.39-0.95 and 0.49, 95% CI: 0.25-0.95, respectively), although these significances did not find in the subgroup analysis including only patients with ≥ 6 years old. CONCLUSIONS Patients with AD/HD were more likely to miss appointments compared to those with other psychiatric disorders. The impact of AD/HD medications as well as potential psychiatric symptoms of their parents or caregivers on appointment cancellations needs to be evaluated in more detail in future investigations.
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Affiliation(s)
- Kensuke Nomura
- Department of Child Psychiatry, Shimada Ryoiku Medical Center for Challenged Children, Tokyo, Japan
| | - Ryosuke Tarumi
- Department of Child Psychiatry, Shimada Ryoiku Medical Center for Challenged Children, Tokyo, Japan
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Kazunari Yoshida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Pharmacogenetics Research Clinic, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Mitsuhiro Sado
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takefumi Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- * E-mail:
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Hare MM, Graziano PA. Treatment Response among Preschoolers with Disruptive Behavior Disorders: The Role of Temperament and Parenting. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2021; 50:950-965. [PMID: 33275456 PMCID: PMC8175459 DOI: 10.1080/15374416.2020.1846540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: This study examined associations between temperament (negative affect, effortful control, and surgency) and symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) within a diverse preschool sample. Interactions between temperament and parenting in the prediction of ADHD/ODD symptoms before and after an 8-week early intervention program (i.e., Summer Treatment Program for Pre-kindergartners; STP-PreK) were also examined.Method: The sample included 215 children (Mage = 5.0, 80.9% male, 84.7% Latinx) with a diagnosis of ADHD and/or ODD who completed the STP-PreK. Temperament was measured via parent report while ADHD/ODD symptoms were assessed via combination of parent and teacher report. Positive and negative parenting were assessed via rating scales and a standardized parent-child interaction observation.Results: Higher surgency was associated with greater symptom severity of ADHD/ODD pre- and post-treatment. Higher negative affect was associated with greater symptom severity of ODD pre- and post-treatment, while higher effortful control was only associated with lower symptom severity of inattention pre-treatment. Positive parenting predicted lower symptom severity of ADHD/ODD post-treatment. Moderation analyses indicated that the benefits of low levels of negative parenting only occurred when paired with low temperament risk for symptoms of hyperactivity and ODD. Additionally, only the combination of high surgency and high observed negative parenting resulted in greater symptom severity of ODD. Finally, decreases in inconsistent discipline predicted decreases across all symptom domains post-treatment.Conclusions: Our findings add to the temperament-based model of ADHD/ODD by highlighting temperament's unique prediction of treatment response as well as important interactions with the caregiving environment.
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Affiliation(s)
- Megan M Hare
- Center for Children and Families, Department of Psychology, Florida International University
| | - Paulo A Graziano
- Center for Children and Families, Department of Psychology, Florida International University
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20
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Murray DW, Kuhn LJ, Willoughby MT, LaForett DR, Cavanaugh AM. Outcomes of a Small Group Program for Early Elementary Students with Self-Regulation Difficulties: Limitations of Transportability from Clinic to School. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09480-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Merrill BM, Morrow AS, Sarver D, Sandridge S, Lim CS. Prevalence and Correlates of Attention-Deficit Hyperactivity Disorder in a Diverse, Treatment-Seeking Pediatric Overweight/Obesity Sample. J Dev Behav Pediatr 2021; 42:433-441. [PMID: 34397571 PMCID: PMC8369036 DOI: 10.1097/dbp.0000000000000910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Attention-deficit hyperactivity disorder (ADHD) and obesity are highly prevalent, impairing, and costly conditions, affecting about 10% of children each. Research indicates heightened prevalence of childhood obesity among youth with ADHD. However, more research is needed, examining comorbid ADHD among youth with overweight/obesity (OV/OB) from diverse demographic backgrounds and effects on medically relevant behaviors. The aim of the current study was to examine the prevalence of ADHD in a racially diverse sample of youth in a weight management clinic. Furthermore, we examined the effects of race, rurality, and ADHD on weight status and health behaviors in this under-researched population. METHOD Participants included 1003 patients (Mage = 12.55; 58% female; 67% Black/African American; MBMI Z-Score = 2.54; 98.6% with obesity) in a pediatric weight management clinic serving a rural and urban/suburban area in the southern United States. Parent-reported demographics, ADHD diagnosis, and child health behaviors were recorded. RESULT In total, 17.6% (n = 177) of the sample had an ADHD diagnosis. ADHD status interacted with race to predict standardized body mass index (BMIz), and rurality predicted higher BMIz. Children with comorbid ADHD had significantly more meals per day and fewer active days compared with children with OV/OB without ADHD. CONCLUSION ADHD prevalence was higher in this diverse sample of children seeking obesity treatment (17.6%) compared with the prevalence nationally (9%-10%) and in other obesity samples. Comorbid ADHD was related to higher weight status among racial minority youth and increased engagement in unhealthy lifestyle behaviors often targeted in weight management treatment. It is critical to screen for ADHD in pediatric specialty clinics and assess healthy lifestyle behaviors.
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Affiliation(s)
- Brittany M Merrill
- Center for Children and Families, Department of Psychology, Florida International University, Buffalo, NY
| | - Anne S Morrow
- Mailman Segal Center for Human Development, Nova Southeastern University, Davie, FL
| | - Dustin Sarver
- Division of Psychology, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS
| | - Shanda Sandridge
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS
| | - Crystal S Lim
- Division of Psychology, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS
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22
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Lax Y, Brown SN, Silver M, Brown NM. Associations Between Participation in After-School Activities, Attention-Deficit/Hyperactivity Disorder Severity, and School Functioning. J Dev Behav Pediatr 2021; 42:257-263. [PMID: 33394836 DOI: 10.1097/dbp.0000000000000901] [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: 06/01/2020] [Accepted: 11/01/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the association between after-school activity (ASA) participation, attention-deficit/hyperactivity disorder (ADHD) severity, and school functioning among children with ADHD. METHODS A cross-sectional study was conducted using data from the 2016 National Survey of Children's Health on ADHD severity, ASAs and 2 domains of school functioning among children with ADHD: missed days from school and calls home from school. RESULTS Of 4,049 children with ADHD (weighted N = 5,010,662), 71.8% participated in at least 1 ASA. In multivariable regression analyses, ASA participation was associated with lower odds of moderate-to-severe ADHD [adjusted odds ratio (aOR): 0.62, 95% confidence interval (CI), 0.46-0.85] and lower odds of missed school days (aOR 0.55, 95% CI, 0.41-0.74). We did not find significant associations with calls home from school (aOR 0.79, 95% CI, 0.59-1.07). CONCLUSION After-school activity participation is associated with decreased ADHD severity and reduced school absenteeism. Efforts to optimize ADHD outcomes should consider engaging children and adolescents in ASAs.
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Affiliation(s)
- Yonit Lax
- Division of General Pediatrics, Department of Pediatrics, Maimonides Children's Hospital, Brooklyn, NY
- Department of Pediatrics, SUNY Downstate Medical Center, Brooklyn, NY
- Department of Pediatrics, Maimonides Medical Center, Brooklyn, NY
| | | | - Michael Silver
- Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY
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Chhibber A, Watanabe AH, Chaisai C, Veettil SK, Chaiyakunapruk N. Global Economic Burden of Attention-Deficit/Hyperactivity Disorder: A Systematic Review. PHARMACOECONOMICS 2021; 39:399-420. [PMID: 33554324 DOI: 10.1007/s40273-020-00998-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children and adults. Previous systematic reviews have provided estimates of ADHD-associated costs but were limited to the USA and Europe. OBJECTIVES This study aimed to systematically summarise all global evidence on the economic burden of ADHD. METHODS A systematic search for published studies on costs of ADHD was conducted in EconLit, EMBASE, PubMed, ERIC, and PsycINFO. Additional literature was identified by searching the reference lists of eligible studies. The quality of the studies was assessed using the Larg and Moss checklist. RESULTS This review included 44 studies. All studies were conducted in high-income countries and were limited to North America and Europe except for four studies: two in Asia and two in Australia. Most studies were retrospective and undertook a prevalence-based study design. Analysis revealed a substantial economic impact associated with ADHD. Estimates based on total costs ranged from $US831.38 to 20,538 for per person estimates and from $US356 million to 20.27 billion for national estimates. Estimates based on marginal costs ranged from $US244.15 to 18,751.00 for per person estimates and from $US12.18 million to 141.33 billion for national estimates. Studies that calculated economic burden across multiple domains of direct, indirect, and education and justice system costs for both children and adults with ADHD reported higher costs and translated gross domestic product than did studies that captured only a single domain or age group. CONCLUSIONS Despite the wide variation in methodologies in studies reviewed, the literature suggests that ADHD imposes a substantial economic burden on society. There is a dire need for cost-of-illness research in low- and middle-income countries to better inform the treatment and management of ADHD in these countries. In addition, guidelines on the conduct and reporting of economic burden studies are needed as they may improve standardisation of cost-of-illness studies.
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Affiliation(s)
- Anindit Chhibber
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | | | | | - Sajesh K Veettil
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA.
- School of Pharmacy, Monash University, Subang Jaya, Malaysia.
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Girio-Herrera E, Egan TE, Owens JS, Evans SW, Coles EK, Holdaway AS, Mixon CS, Kassab HD. Teacher Ratings of Acceptability of a Daily Report Card Intervention Prior to and During Implementation: Relations to Implementation Integrity and Student Outcomes. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-020-09400-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Dekkers TJ, Huizenga HM, Bult J, Popma A, Boyer BE. The importance of parental knowledge in the association between ADHD symptomatology and related domains of impairment. Eur Child Adolesc Psychiatry 2021; 30:657-669. [PMID: 32699991 PMCID: PMC8041705 DOI: 10.1007/s00787-020-01579-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 06/17/2020] [Indexed: 11/25/2022]
Abstract
Parents of children with ADHD experience several difficulties while raising their children and report lower levels of knowledge about their children's life and behaviors. A recent study found that low levels of parental knowledge mediated the association between ADHD symptoms and risk-taking behavior (RTB) in adolescents. The current study aimed to investigate this previous finding further by replicating it, by taking peer influence into account as additional social factor of importance and by extending it and also investigate the role of parental knowledge in the association between ADHD symptoms and homework problems. Three studies were performed: study 1 (N=234) replicated previous work on parental knowledge mediating the association between ADHD symptoms and RTB, study 2 (pre-registered, N=313) added peer influence, and study 3 (pre-registered, N=315) assessed whether parental knowledge mediated the association between ADHD symptoms and homework behavior. Parental knowledge consistently mediated the association between ADHD symptoms on one hand and RTB and homework problems on the other, and also predicted stronger resistance to peer influence. Because parental knowledge was repeatedly linked to ADHD-related problems, it seems promising to include parental knowledge in treatment of ADHD-related problems in adolescents, by improving the parent-child relationship. Future studies should test more directly how improvement of the parent-child relationship can be used to optimize parental knowledge, which in its turn reduces ADHD-related problems.
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Affiliation(s)
- Tycho J Dekkers
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS, Amsterdam, The Netherlands.
- Department of Forensic Psychiatry and Complex Behavioral Disorders, De Bascule, Academic Center for Child- and Adolescent Psychiatry, Duivendrecht, The Netherlands.
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
- Department of Child and Adolescent Psychiatry, Free University Medical Center (VUmc), Amsterdam UMC, Amsterdam, The Netherlands.
| | - Hilde M Huizenga
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition Center, University of Amsterdam, Amsterdam, The Netherlands
- Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
| | - Jente Bult
- Veenlanden College, Mijdrecht, The Netherlands
| | - Arne Popma
- Department of Forensic Psychiatry and Complex Behavioral Disorders, De Bascule, Academic Center for Child- and Adolescent Psychiatry, Duivendrecht, The Netherlands
- Department of Child and Adolescent Psychiatry, Free University Medical Center (VUmc), Amsterdam UMC, Amsterdam, The Netherlands
| | - Bianca E Boyer
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS, Amsterdam, The Netherlands
- Psychologenpraktijk Kuin, Haarlem, The Netherlands
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Ros-DeMarize R, Chung P, Stewart R. Pediatric behavioral telehealth in the age of COVID-19: Brief evidence review and practice considerations. Curr Probl Pediatr Adolesc Health Care 2021; 51:100949. [PMID: 33436319 PMCID: PMC8049735 DOI: 10.1016/j.cppeds.2021.100949] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Considerable efforts over the last decade have been placed on harnessing technology to improve access to behavioral health services. These efforts have exponentially risen since the outbreak of the Coronavirus disease 2019 (COVID-19), which has prompted a move to novel systems of care, largely based on telehealth delivery. This article aims to provide a broad review of evidence for telehealth assessment and treatment of externalizing disorders and internalizing disorders in children and discuss practice considerations and established guidelines for telehealth delivery. Existing literature supports the promise of behavioral health interventions including behavioral parent training and combination approaches for externalizing disorders as well as cognitive-behavioral based interventions for internalizing disorders. There is a scarcity of work on assessment via telehealth compared with the available treatment literature. While treatment may be most pressing given the COVID-19 circumstances to continue delivery of care, movement toward establishing evidence-based assessment via telehealth will be of increased importance. Lastly, practice guidelines have been set forth by national associations, professional societies, and supported by the development of national Telehealth Centers of Excellence. These guidelines and practice considerations are discussed within the context of COVID-19.
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Affiliation(s)
| | - Peter Chung
- University of California, Irvine, United States
| | - Regan Stewart
- Medical University of South Carolina, Charleston, SC, United States
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Triece PA, Oddo LE, Hill RM, Pettit JW, Meinzer MC. Investigation of the interpersonal theory of suicide in the context of attention-deficit/hyperactivity disorder symptomatology and suicide ideation. Suicide Life Threat Behav 2020; 50:1198-1204. [PMID: 32770790 DOI: 10.1111/sltb.12683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/05/2020] [Accepted: 06/01/2020] [Indexed: 11/29/2022]
Abstract
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 (Mage = 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.
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Affiliation(s)
| | - Lauren E Oddo
- University of Maryland at College Park, College Park, MD, USA
| | - Ryan M Hill
- Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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Sibley MH, Coxe SJ, Page TF, Pelham WE, Yeguez CE, LaCount PA, Barney S. Four-Year Follow-Up of High versus Low Intensity Summer Treatment for Adolescents with ADHD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 51:750-763. [PMID: 33210938 DOI: 10.1080/15374416.2020.1833734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Despite an emergence of psychosocial treatments for adolescent ADHD, their long-term effects are unknown. METHOD We examine four-year outcomes of a randomized controlled trial (N = 218) comparing high-intensity (HI; 412 h, $4,373 per participant) versus low-intensity (LI; 24 h, $97 per participant) skills-based summer intervention delivered to adolescents with ADHD at two secondary school transitions (6th/9th grade). Quantitative and qualitative analyses evaluated group×time and group×grade×time effects on 4-year outcomes. RESULTS Relative to LI, a single dose of HI had modest but lasting effects on teen organization skills (d =.40) and ADHD symptoms (9th grade only: d =.27 to.31) at 4-year follow-up. There was no long-term incremental effect of HI (vs. LI) for parent-teen conflict, GPA, or parent use of contingency management. Treatment appeared most effective when delivered to older adolescents (i.e., 9th versus 6th grade), suggesting the long-term impact of ADHD treatment may increase with age. Qualitative data corroborated that the primary long-term benefit of HI (vs. LI) treatment was to organization skills; many of the remaining perceived benefits were to parent and teen psychological variables (i.e., increased self-esteem, self-awareness, parental optimism). HI offered no incremental benefit to long-term educational or clinical service utilization or costs. CONCLUSIONS Modest therapeutic benefits of adolescent ADHD treatment are maintained long term. However, HI treatment did not impact outcomes that could defray the intervention's high costs ($4,373) compared to LI treatment ($97).
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Affiliation(s)
- Margaret H Sibley
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute
| | - Stefany J Coxe
- Department of Psychology, Florida International University
| | - Timothy F Page
- Department of Psychology, Florida International University
| | | | | | - Patrick A LaCount
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute
| | - Samantha Barney
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute
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Abstract
The purpose of the study was to estimate the burden to families of raising a child with attention-deficit/hyperactivity disorder (ADHD). Data were drawn from a longitudinal sample recruited in western Pennsylvania. When participants were between 14 and 17 years old, parents completed a questionnaire assessing economic burden over the course of raising their children. Domains of economic burden to families included direct costs related to child's behaviors (excluding treatment expenses) and indirect costs related to caregiver strain. On average, participants with ADHD incurred a total economic burden over the course of child development that was more than five times greater compared to youths without ADHD (ADHD = $15,036 per child, Control = $2,848 per child), and this difference remained significant after controlling for intellectual functioning, oppositional defiant symptoms, or conduct problems. Parents of participants with ADHD were more likely to have changed their job responsibilities or been fired and reported lower work efficiency. The current evaluation of economic burden to individual families extends previous estimates of annual societal cost of illness (COI) of ADHD. Our rough annual estimate of COI for ADHD in children and adolescents is $124.5 billion (2017 US Dollars). Findings underscore the need for interventions to reduce the costly dysfunctional outcomes in families of children with ADHD.
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Sibley MH, Coxe SJ. The ADHD teen integrative data analysis longitudinal (TIDAL) dataset: background, methodology, and aims. BMC Psychiatry 2020; 20:359. [PMID: 32641087 PMCID: PMC7346648 DOI: 10.1186/s12888-020-02734-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Attention Deficit Hyperactivity Disorder (ADHD) Teen Integrative Data Analysis Longitudinal (TIDAL) dataset integrates data from four randomized trials. METHOD Participants with ADHD (N = 854; 72.5% male, 92.5% racial/ethnic minority, ages 10-17) were assessed three times across 12 months. Data includes parent, self, and teacher ratings, observations, and school records. The battery was harmonized using an Integrative Data Analysis (IDA) approach to form variables that assign unique values to all participants. RESULTS The data will be used to investigate: (1) profiles that organize the heterogeneous population into clinically meaningful subgroups, (2) whether these profiles predict treatment response, (3) heterogeneity in treatment response and variables that predict this response, (4) how treatment characteristics and adjunctive supports predict treatment response, and (5) mediators of treatment and whether these mechanisms are moderated by treatment characteristics. CONCLUSIONS The ADHD TIDAL Dataset will be openly shared with the field to maximize its utility.
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Affiliation(s)
- Margaret H Sibley
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle Children's Research Insitute, 2001 8th Ave., Suite 400, Seattle, WA, 98117, USA.
- Department of Psychiatry & Behavioral Health, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
| | - Stefany J Coxe
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA
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31
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Dekkers TJ, Popma A, Sonuga-Barke EJS, Oldenhof H, Bexkens A, Jansen BRJ, Huizenga HM. Risk Taking by Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD): a Behavioral and Psychophysiological Investigation of Peer Influence. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1129-1141. [PMID: 32607755 PMCID: PMC7392932 DOI: 10.1007/s10802-020-00666-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Adolescents with ADHD demonstrate increased risk-taking behavior (RTB) like substance abuse and dangerous traffic conduct. RTB in adolescence is more likely under peer influence. The current investigation (1) tests the hypothesis that adolescents with ADHD are particularly susceptible to such influence and (2) tests whether groups differed in autonomic reactivity to peer influence. Adolescent boys between 12 and 19 years with (n = 81) and without (n = 99) ADHD performed the Balloon Analogue Risk Task twice. In the peer condition, a highly credible virtual peer manipulation that encouraged risk taking was added, in the solo condition this was absent. Autonomic reactivity was indexed by heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA). All adolescents engaged in more risk taking in the peer condition relative to solo condition. Autonomic differences between groups were only found on PEP: a stronger sympathetic response to peer influence was observed in typically developing adolescents relative to adolescents with ADHD. Increased physiological stress (as indexed by PEP) in the peer relative to the solo condition predicted peer-induced risk taking in all adolescents. We conclude that susceptibility to peer influence is not exaggerated in ADHD but rather reflects a general tendency of adolescents. As adolescents experiencing peer influence as stressful are most susceptible to peer influence, we suggest that increasing resistance to peer influence may be an important treatment aim for these adolescents specifically.
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Affiliation(s)
- Tycho J Dekkers
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS, Amsterdam, The Netherlands. .,Department of Forensic Psychiatry and Complex Behavioral Disorders, De Bascule, Academic Center for Child- and Adolescent Psychiatry, Amsterdam, The Netherlands. .,Amsterdam UMC, Department of Child- and Adolescent Psychiatry, Free University Medical Center (VUmc), Amsterdam, The Netherlands.
| | - Arne Popma
- Department of Forensic Psychiatry and Complex Behavioral Disorders, De Bascule, Academic Center for Child- and Adolescent Psychiatry, Amsterdam, The Netherlands.,Amsterdam UMC, Department of Child- and Adolescent Psychiatry, Free University Medical Center (VUmc), Amsterdam, The Netherlands
| | - Edmund J S Sonuga-Barke
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - Helena Oldenhof
- Amsterdam UMC, Department of Child- and Adolescent Psychiatry, Free University Medical Center (VUmc), Amsterdam, The Netherlands
| | - Anika Bexkens
- Department of Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands.,Department of Child and Adolescent Psychiatry, GGZ Delfland, Center for Psychiatry, Delft, The Netherlands
| | - Brenda R J Jansen
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS, Amsterdam, The Netherlands
| | - Hilde M Huizenga
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition Center, University of Amsterdam, Amsterdam, The Netherlands.,Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
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Holdaway AS, Hustus CL, Owens JS, Evans SW, Coles EK, Egan TE, Himawan L, Zoromski AK, Dawson AE, Mixon CS. Incremental Benefits of a Daily Report Card Over Time for Youth with Disruptive Behavior: Replication and Extension. SCHOOL MENTAL HEALTH 2020. [DOI: 10.1007/s12310-020-09375-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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33
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Owens JS, Margherio SM, Lee M, Evans SW, Crowley DM, Coles EK, Mixon CS. Cost-effectiveness of Consultation for a Daily Report Card Intervention: Comparing In-Person and Online Implementation Strategies. JOURNAL OF EDUCATIONAL AND PSYCHOLOGICAL CONSULTATION 2020. [DOI: 10.1080/10474412.2020.1759428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Affiliation(s)
- Russell A. Barkley
- Editor of The ADHD Report and a Clinical professor of Psychiatry at the Virginia Commonwealth University Medical Center in Richmond, VA. He can be contacted by email at:
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35
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Babinski DE, Mazzant JR, Merrill BM, Waschbusch DA, Sibley MH, Gnagy EM, Molina BSG, Pelham WE. Lifetime caregiver strain among mothers of adolescents and young adults with attention-deficit/hyperactivity disorder. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2020; 34:342-352. [PMID: 31750692 PMCID: PMC7102920 DOI: 10.1037/fam0000609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The lifetime maternal caregiver strain (CS) associated with raising a child with attention-deficit/hyperactivity disorder (ADHD) into adolescence and young adulthood was examined in the Pittsburgh ADHD Longitudinal Study (PALS), a longitudinal study of individuals diagnosed with ADHD in childhood and recontacted in adolescence and young adulthood for yearly follow-up. Mothers of adolescents/young adults with (n = 364, 89.6% male; Mage = 19.79) and without childhood ADHD (n = 240, 88.8% male; Mage = 18.97) rated their lifetime maternal CS at Wave 3. Adolescent/young adult (AYA) ADHD and ODD severity measured at Wave 1, AYA delinquency measured at Wave 2, and school disciplinary actions combined from Waves 1 and 2 were explored as mediators of the association between childhood ADHD and lifetime maternal CS at Wave 3 using path analysis. AYA gender and age, parental marital status, maternal depression and ADHD, and highest parental education were included as covariates. Greater lifetime CS was reported among mothers of adolescents/young adults with versus without childhood ADHD. In the mediation model, direct effects of childhood ADHD on AYA ADHD and ODD severity, delinquency, and school discipline problems emerged, and direct effects of AYA ODD severity, delinquency, and school discipline problems on lifetime CS emerged. AYA ODD, delinquency, and school discipline mediated the association between childhood ADHD and lifetime maternal CS. These findings extend research on childhood ADHD to identify AYA sequelae contributing to maternal CS. Future research on the transaction between AYA functional impairment and maternal CS across the transition from adolescence into adulthood is needed to clarify opportunities for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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McLaughlin T, Jong G', Gilpin A, Hepburn CM. Pharmacare in Canada: The paediatric perspective. Paediatr Child Health 2020; 25:113-124. [PMID: 32189975 DOI: 10.1093/pch/pxz176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/20/2019] [Indexed: 11/13/2022] Open
Abstract
Canada's drug insurance system is one of the most expensive in the world, yet millions of Canadians still struggle to access necessary medications. As a result, provincial, territorial, and federal governments are considering public pharmacare policy proposals to ensure that all Canadians can access the medications they need. Pharmacare policies offer an opportunity to prioritize children and youth, whose unique drug needs have long been neglected. Prescription drug use is common in this population, with approximately half of Canadian children and youth requiring at least one prescription in any given year. Drug use remains concentrated, however, among those with complex, chronic, and serious diseases. Children and youth rely heavily on compounded and off-label prescription drugs, which impacts safety, efficacy, palatability, and cost. Reimbursement decision-making bodies do not appropriately value the unique benefits of paediatric drugs, including child-friendly formulations, improved quality of life for children and families, and cost-savings outside the healthcare system. Regardless of the pharmacare model ultimately implemented, ensuring universal, comprehensive, and portable prescription drug coverage for all children and youth is essential. To accomplish this, paediatric drug experts should develop a national, evidence-informed formulary of paediatric drugs. Health Canada should also improve processes to make commercial paediatric drugs and child-friendly formulations more available and accessible. The federal government must also support paediatric drug research and development to this end.
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Affiliation(s)
| | | | - Andrea Gilpin
- Goodman Family Pediatric Formulations Centre, CHU Sainte-Justine, Montreal, Quebec
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37
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Owens JS, Lee M, Kassab H, Evans SW, Coles EC. Motivational Ruler Ratings among Teachers Receiving Coaching in Classroom Management: Measurement and Relationship to Implementation Integrity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 22:769-774. [PMID: 32172406 DOI: 10.1007/s11121-020-01111-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Mary Lee
- Ohio University, Porter Hall 200, Athens, OH, 45701, USA
| | - Hannah Kassab
- Ohio University, Porter Hall 200, Athens, OH, 45701, USA
| | - Steven W Evans
- Ohio University, Porter Hall 200, Athens, OH, 45701, USA
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38
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McLaughlin T, Jong G‘, Gilpin A, Hepburn CM. L’assurance médicaments au Canada : le point de vue de la pédiatrie. Paediatr Child Health 2020. [DOI: 10.1093/pch/pxz177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Résumé
Le système d’assurance médicaments du Canada est l’un des plus coûteux au monde, mais des millions de Canadiens peinent pourtant à accéder aux médicaments dont ils ont besoin. C’est pourquoi les gouvernements fédéral, provinciaux et territoriaux envisagent des propositions de polices d’assurance médicaments publiques pour tous les Canadiens. Les polices d’assurance médicaments permettent de prioriser les enfants et les adolescents, dont les besoins pharmacologiques particuliers ont longtemps été négligés. La prise de médicaments sur ordonnance est courante au sein de cette population, puisqu’environ la moitié des enfants et des adolescents canadiens ont besoin d’au moins une ordonnance au cours d’une année donnée. La prise de médicaments demeure toutefois concentrée au sein des populations atteintes de maladies complexes, chroniques ou graves. Les enfants et les adolescents recourent largement aux préparations magistrales et aux médicaments dans un emploi non conforme à l’étiquette, ce qui a une incidence sur l’innocuité, l’efficacité, la palatabilité et les coûts. Les organes décisionnels en matière de remboursement n’accordent pas toute l’importance qu’ils devraient aux avantages uniques des médicaments pédiatriques, ce qui inclut les formulations adaptées à la pédiatrie, une meilleure qualité de vie pour les enfants et les familles et les économies à l’extérieur du système de santé. Quel que soit le modèle d’assurance médicaments finalement adopté, il est essentiel d’offrir une couverture d’assurance médicaments sur ordonnance complète, universelle et transférable pour tous les enfants et les adolescents. C’est pourquoi les experts des médicaments pédiatriques doivent créer un formulaire national de médicaments pédiatriques fondé sur des données probantes. Santé Canada doit également améliorer les processus pour que les formulations et médicaments commerciaux adaptés à la pédiatrie deviennent plus disponibles et accessibles. À cette fin, le gouvernement fédéral doit également soutenir la recherche-développement des médicaments pédiatriques.
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Affiliation(s)
| | | | - Andrea Gilpin
- Le Centre de formulations pédiatriques de la famille Rosalind et Morris Goodman du CHU Sainte-Justine, Montréal (Québec)
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Zadelaar JN, Dekkers TJ, Huizenga HM. The association between risky decision making and attention‐deficit/hyperactivity disorder symptoms: A preregistered assessment of need for cognition as underlying mechanism. JOURNAL OF BEHAVIORAL DECISION MAKING 2020. [DOI: 10.1002/bdm.2177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
| | - Tycho J. Dekkers
- Department of Psychology University of Amsterdam Amsterdam The Netherlands
- Department of Forensic Psychiatry and Complex Behavioral Disorders De Bascule, Academic Center for Child‐ and Adolescent Psychiatry Amsterdam The Netherlands
- Department of Child and Adolescent Psychiatry Amsterdam UMC, Free University Medical Center (VUmc) Amsterdam The Netherlands
- Department of Psychology University of Central Florida Orlando Florida
| | - Hilde M. Huizenga
- Department of Psychology University of Amsterdam Amsterdam The Netherlands
- Amsterdam Brain and Cognition Center University of Amsterdam Amsterdam The Netherlands
- Research Priority Area Yield University of Amsterdam Amsterdam The Netherlands
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40
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Evans SW, Schultz BK, DeMars CE. High School–Based Treatment for Adolescents With Attention-Deficit/Hyperactivity Disorder: Results From a Pilot Study Examining Outcomes and Dosage. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.1080/02796015.2014.12087444] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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41
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Macphee FL, Merrill BM, Altszuler AR, Ramos MC, Gnagy EM, Greiner AR, Coxe S, Raiker JS, Coles E, Burger L, Pelham WE. The Effect of Weighted Vests and Stability Balls With and Without Psychostimulant Medication on Classroom Outcomes for Children With ADHD. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.17105/spr-2017-0151.v48-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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DuPaul GJ, Evans SW, Mautone JA, Owens JS, Power TJ. Future Directions for Psychosocial Interventions for Children and Adolescents with ADHD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 49:134-145. [DOI: 10.1080/15374416.2019.1689825] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - Jennifer A. Mautone
- Department of Pediatrics, Children’s Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania
| | | | - Thomas J. Power
- Department of Pediatrics, Children’s Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania
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43
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Leve LD, Neiderhiser JM, Ganiban JM, Natsuaki MN, Shaw DS, Reiss D. The Early Growth and Development Study: A Dual-Family Adoption Study from Birth Through Adolescence. Twin Res Hum Genet 2019; 22:716-727. [PMID: 31526412 PMCID: PMC7056588 DOI: 10.1017/thg.2019.66] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The Early Growth and Development Study (EGDS) is a prospective adoption study of birth parents, adoptive parents and adopted children (n = 561 adoptees). The original sample has been expanded to include siblings of the EGDS adoptees who were reared by the birth mother and assessed beginning at age 7 years (n = 217 biological children), and additional siblings in both the birth and adoptive family homes, recruited when the adoptees were 8-15 years old (n = 823). The overall study aims are to examine how family, peer and contextual processes affect child and adolescent adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Adoptive and birth parents were originally recruited through adoption agencies located throughout the USA following the birth of a child. Assessments are ongoing and occurred in 9 month's intervals until the adoptees turned 3 years of age, and in 1 to 2 year intervals thereafter through age 15. Data collection includes the following primary constructs: child temperament, behavior problems, mental health, peer relations, executive functioning, school performance and health; birth and adoptive parent personality characteristics, mental health, health, context, substance use, parenting and marital relations; and the prenatal environment. Findings highlight the power of the adoption design to detect environmental influences on child development and provide evidence of complex interactions and correlations between genetic, prenatal environmental and postnatal environmental influences on a range of child outcomes. The study sample, procedures and an overview of findings are summarized and ongoing assessment activities are described.
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Affiliation(s)
- Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, Oregon, 97403, USA
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, 16802, USA
| | - Jody M. Ganiban
- Center for Family Research, George Washington University, Washington DC, 20037, USA
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, California, 92521, USA
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, 15260, USA
| | - David Reiss
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut, 06519, USA
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Conjoint Behavioral Consultation for Students Exhibiting Symptoms of ADHD: Effects at Post-treatment and One-Year Follow-Up. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09342-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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45
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Merrill BM, Molina BSG, Coxe S, Gnagy EM, Altszuler AR, Macphee FL, Morrow AS, Trucco EM, Pelham WE. Functional Outcomes of Young Adults with Childhood ADHD: A Latent Profile Analysis. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 49:215-228. [PMID: 30689405 DOI: 10.1080/15374416.2018.1547968] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Adults with childhood attention-deficit hyperactivity disorder (ADHD) experience impairment in core functional domains (e.g., educational attainment, occupational status, social relationships, substance abuse, and criminal behavior), but it is currently unclear which impairments co-occur and whether subgroups experience differentiable patterns, none, or all aforementioned functional domains. Latent profile analysis (LPA) was used to characterize patterns of impairment. Data from the Pittsburgh ADHD Longitudinal Study were used. The 317 participants were 25 years old and had childhood ADHD. LPA characterized the variability across substance use (alcohol consumption, cigarette smoking, marijuana use), criminal behavior, peer impairment, educational attainment, maternal relationship, financial dependence, and sexual activity among young adults with childhood ADHD. Childhood predictors of profiles were examined, and ADHD profiles were compared to a matched comparison group without ADHD also followed longitudinally (n = 217). Five profiles were found: prototypic impairment group (54%), high binge-drinking group (17%), high marijuana use group (10%), high criminal activity group (3%), and high cross-domain impairment group (17%). All profiles were impaired compared to non-ADHD young adults. Childhood variables rarely significantly predicted profiles. Young adults with childhood ADHD have differentiable impairment patterns that vary based on substance use, criminal behavior, and number of clinically impaired domains. Nearly all young adult ADHD profiles were impaired in peer, educational, and financial domains, and there was not a nonimpaired ADHD profile. Use of specific substances was elevated among subgroups of, but not all, young adults with ADHD histories. Finally, the high cross-domain impairment profile was impaired in all domains.
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Affiliation(s)
| | | | - Stefany Coxe
- Department of Psychology, Florida International University
| | | | | | | | - Anne S Morrow
- Department of Psychology, Florida International University
| | - Elisa M Trucco
- Department of Psychology, Florida International University
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Mendelsohn AL, Cates CB, Weisleder A, Berkule Johnson S, Seery AM, Canfield CF, Huberman HS, Dreyer BP. Reading Aloud, Play, and Social-Emotional Development. Pediatrics 2018; 141:peds.2017-3393. [PMID: 29632254 PMCID: PMC5914489 DOI: 10.1542/peds.2017-3393] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine impacts on social-emotional development at school entry of a pediatric primary care intervention (Video Interaction Project [VIP]) promoting positive parenting through reading aloud and play, delivered in 2 phases: infant through toddler (VIP birth to 3 years [VIP 0-3]) and preschool-age (VIP 3 to 5 years [VIP 3-5]). METHODS Factorial randomized controlled trial with postpartum enrollment and random assignment to VIP 0-3, control 0 to 3 years, and a third group without school entry follow-up (Building Blocks) and 3-year second random assignment of VIP 0-3 and control 0 to 3 years to VIP 3-5 or control 3 to 5 years. In the VIP, a bilingual facilitator video recorded the parent and child reading and/or playing using provided learning materials and reviewed videos to reinforce positive interactions. Social-emotional development at 4.5 years was assessed by parent-report Behavior Assessment System for Children, Second Edition (Social Skills, Attention Problems, Hyperactivity, Aggression, Externalizing Problems). RESULTS VIP 0-3 and VIP 3-5 were independently associated with improved 4.5-year Behavior Assessment System for Children, Second Edition T-scores, with effect sizes (Cohen's d) ∼-0.25 to -0.30. Receipt of combined VIP 0-3 and VIP 3-5 was associated with d = -0.63 reduction in Hyperactivity (P = .001). VIP 0-3 resulted in reduced "Clinically Significant" Hyperactivity (relative risk reduction for overall sample: 69.2%; P = .03; relative risk reduction for increased psychosocial risk: 100%; P = .006). Multilevel models revealed significant VIP 0-3 linear effects and age × VIP 3-5 interactions. CONCLUSIONS Phase VIP 0-3 resulted in sustained impacts on behavior problems 1.5 years after program completion. VIP 3-5 had additional, independent impacts. With our findings, we support the use of pediatric primary care to promote reading aloud and play from birth to 5 years, and the potential for such programs to enhance social-emotional development.
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Affiliation(s)
- Alan L. Mendelsohn
- Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York
| | - Carolyn Brockmeyer Cates
- Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York
| | - Adriana Weisleder
- Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York;,Department of Communication Sciences and Disorders, Northwestern University, Chicago, Illinois; and
| | - Samantha Berkule Johnson
- Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York
| | - Anne M. Seery
- Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York
| | - Caitlin F. Canfield
- Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York
| | - Harris S. Huberman
- Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Benard P. Dreyer
- Department of Pediatrics, School of Medicine, New York University and Bellevue Hospital Center, New York, New York
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School-Based Interventions for Aggression and Defiance in Youth: A Framework for Evidence-Based Practice. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9269-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Best Practices in School Mental Health for Attention-Deficit/Hyperactivity Disorder: A Framework for Intervention. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9267-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Parents' Preferences for School- and Community-Based Services for Children at Risk for ADHD. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9258-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Evans SW, Owens JS, Wymbs BT, Ray AR. Evidence-Based Psychosocial Treatments for Children and Adolescents With Attention Deficit/Hyperactivity Disorder. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 47:157-198. [DOI: 10.1080/15374416.2017.1390757] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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