Co-occurrence of attention-deficit hyperactivity disorder symptoms with other psychopathology in young adults: parenting style as a moderator

The relationship between perceived parenting styles and anxiety in adolescents

Adolescence is a crucial period of growth and the best time to recognize, rebuild, and improve different psychological and social aspects of a person's life. Anxiety is one of the variables that affect a person's mental health. Also, there is a connection between parenting styles and mental health during adolescence. The purpose of this study was to determine the relationship between perceived parenting styles and anxiety of adolescents in Isfahan (Iran). This descriptive-analytical study was conducted with the participation of 197 teenagers in the age group of 12-18 years in Isfahan, Iran. The participants were selected by cluster random sampling. The Parenting Styles Questionnaire (PSQ) and March Children's Anxiety Questionnaire were used to collect information. Data were analyzed using descriptive and analytical statistics through SPSS 26. The mean and standard deviation of anxiety in adolescents were 45.96 and 16.51, respectively (at a low level). The participants evaluated their parenting style in order as permissive (32%), authoritative (24.9%), neglectful (21.8%), and authoritarian (21.3%). A significant difference was observed between the anxiety level of adolescents and their parenting style (p < 0.001). In this way, the highest anxiety was related to the children of permissive parents, and the most minor anxiety was associated with the authoritarian parents (p < 0.001). The findings of this research indicate that there is a significant difference between the perceived parenting styles in terms of the level of children's anxiety. Therefore, considering the importance of parenting styles on children's psychological characteristics, It is recommended to educate parents about the importance of their parenting style on their children's health.

Correlation Between Life Satisfaction and Symptoms of ADHD in Dental Students: The Mediation of Resilience

OBJECTIVE

This study explores the correlation between life satisfaction and ADHD symptoms. It also discusses whether resilience mediates the correlation between ADHD symptoms and life satisfaction.

METHOD

We surveyed 297 dental students. A total of 291 completed a self-report scale consisting of the Adult ADHD Self-Report Scale, Wender Utah Rating Scale, Life Satisfaction Scale, and Conner-Davidson Resilience Scale. The study used hierarchical linear regression analysis, resampling, and asymptotic strategies for data processing.

RESULTS

The ADHD screening results of the self-report scale were positive for 6.87% of the students. This positive rate differed among participants of diverse ages and varying paternal education levels. ADHD symptoms were negatively correlated with life satisfaction and resilience. Life satisfaction was observably positively associated with resilience. Resilience serves as a mediating role between life satisfaction and the two symptoms of ADHD.

CONCLUSION

Resilience intervention programs can enhance the life satisfaction of dental students, especially those with positive ADHD symptoms screening.

Relationship between attention deficit hyperactive disorders with life satisfaction among medical students in city of Hail, KSA

BACKGROUND

Attention deficit hyperactive disorder (ADHD) begins in childhood, and its symptoms persist into adulthood. Students with ADHD symptoms will be at increased risk of antisocial behavior, depression, and loss of inhibition. This study determines the relationship between ADHD and life satisfaction level among medical students in the city of Hail, KSA.

MATERIALS AND METHODS

This is a cross-sectional study that was conducted in a public-sector medical college. A total of 200 students were recruited through stratified cluster sampling. Validated, structured scales of ADHD and life satisfaction were used, and known psychiatric disorders among students were excluded from the study. Correlation and linear regression analyses were used to determine the relationship between ADHD and life satisfaction and identify the determinants of ADHD. P value < 0.05 was considered statistically significant.

RESULT

The prevalence rate of ADHD among medical students was 33.3%. Female gender, third-year academic year student, and 21-26-year-old age group were the high-risk groups of ADHD. Inattention (r = -0.263, P value -0.000) and hyperactivity (r = -0.260, P value 0.000) were significantly correlated with life satisfaction level, with 92% of the variability in life satisfaction determined by inattention and hyperactivity.

CONCLUSION

The burden of ADHD is high among medical students, and it negatively correlates with life satisfaction level. Students' academic and social functioning was affected due to ADHD. There is a need to address this issue with early diagnosis and management of this disorder.

Longer screen time utilization is associated with the polygenic risk for Attention-deficit/hyperactivity disorder with mediation by brain white matter microstructure

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) has been reported to be associated with longer screen time utilization (STU) at the behavioral level. However, whether there are shared neural links between ADHD symptoms and prolonged STU is not clear and has not been explored in a single large-scale dataset.

METHODS

Leveraging the genetics, neuroimaging and behavioral data of 11,000+ children aged 9-11 from the Adolescent Brain Cognitive Development cohort, this study investigates the associations between the polygenic risk and trait for ADHD, STU, and white matter microstructure through cross-sectionally and longitudinal analyses.

FINDINGS

Children with higher polygenic risk scores for ADHD tend to have longer STU and more severe ADHD symptoms. Fractional anisotropy (FA) values in several white matter tracts are negatively correlated with both the ADHD polygenic risk score and STU, including the inferior frontal-striatal tract, inferior frontal-occipital fasciculus, superior longitudinal fasciculus and corpus callosum. Most of these tracts are linked to visual-related functions. Longitudinal analyses indicate a directional effect of white matter microstructure on the ADHD scale, and a bi-directional effect between the ADHD scale and STU. Furthermore, reduction of FA in several white matter tracts mediates the association between the ADHD polygenic risk score and STU.

INTERPRETATION

These findings shed new light on the shared neural overlaps between ADHD symptoms and prolonged STU, and provide evidence that the polygenic risk for ADHD is related, via white matter microstructure and the ADHD trait, to STU.

FUNDING

This study was mainly supported by NSFC and National Key R&D Program of China.

Perceived parenting attitudes in relation to ADHD symptoms and aggressive behaviors in a sample of Egyptian children with ADHD

Background

Externalizing behaviors are common in children with attention-deficit hyperactivity disorder (ADHD). This study was aiming to investigate the perceived parenting attitudes in children with ADHD and their correlates to the severity of symptoms and associated aggressive behaviors in those children. Accordingly, 140 children with ADHD were assessed using Mini International Neuropsychiatric Interview for Children; Conners’ Parent Rating Scale-Revised, Long Version; the problem scale of the Child Behavior Checklist for ages 4–18; and the Perceived Parenting Attitude Scale.

Results

Assessment of associated behavioral problems in the participants revealed the presence of significant aggressive and externalizing problems. The participants perceived a similar attitude between their mothers and fathers. No significant association is found between severity of ADHD symptoms and perceived parenting attitudes, while consistency in parenting in both mothers and fathers was positively correlated to the aggressive behaviors of the participants.

Conclusions

Aggression is a common symptom associated with ADHD that should be identified and addressed. Although the current study has revealed that consistency in parenting is positively correlated to the aggression in ADHD children, yet children with ADHD might have a positive illusory bias in their social self-perceptions making it difficult to account for the reliability of their perceived parenting attitudes; hence, it remains to be clarified whether perceived parents’ attitudes are attributed to children’s aggression or to children’s perception caused by the previously mentioned illusory bias. For future research, it is highly recommended to assess parenting from the parents’ and their children’s points of view.

Practical considerations for the evaluation and management of Attention Deficit Hyperactivity Disorder (ADHD) in adults

Attention deficit with or without hyperactivity disorder (ADHD) is one of the most frequent neuropsychiatric disorders, and affects 2-4% of adults. In contrast with many European countries, the identification and management of adult ADHD remains underdeveloped in France, and a subject of controversy. This review provides a practical update on current knowledge about ADHD in adults for French-speaking professionals who have to detect or manage adult patients with ADHD. ADHD is classified as a neurodevelopmental disorder in the recent update of the international diagnostic classification. While symptoms and impairment due to ADHD are frequently severe during childhood, they often evolve as children grow older, with frequent persistent disabilities in adulthood. In adulthood, the clinical presentation, as in childhood, involves the symptom triad of inattention, hyperactivity and impulsivity. However, differences are noted: hyperactivity is more often internalized, symptoms of inattention may be masked by anxiety symptoms or obsessive-like compensation strategies. ADHD is often diagnosed during childhood, but it is not rare for the diagnosis to be made later. Failure to recognise symptoms resulting in misdiagnosis, or alternatively well-developed compensation factors could be two underlying reasons for the long delay until diagnosis. Other symptoms, such as emotional deregulation or executive function-related symptoms are also usually observed in adults. In addition, in adults, ADHD is often associated with other psychiatric disorders (in 80% of cases); this makes the diagnosis even more difficult. These disorders encompass a broad spectrum, from mood disorders (unipolar or bipolar), to anxiety disorders, and other neurodevelopmental disorders and personality disorders, especially borderline and antisocial personality disorder. Substance-use disorders are very common, either as a consequence of impulsivity and emotional dysregulation or as an attempt at self-treatment. Sleep disorders, especially restless leg syndrome and hypersomnolence, could share common pathophysiological mechanisms with ADHD. ADHD and comorbidity-related symptoms are responsible for serious functional impairment, in various domains, leading to academic, social, vocational, and familial consequences. The impact on other psychiatric disorders as an aggravating factor should also be considered. The considerable disability and the poorer quality of life among adults with ADHD warrant optimal evaluation and management. The diagnostic procedure for ADHD among adults should be systematic. Once the positive diagnosis is made, the evaluation enables characterisation of the levels of severity and impairment at individual level. A full examination should also assess medical conditions associated with ADHD, to provide personalized care. In recent years, a growing number of assessment tools have been translated and validated in French providing a wide range of structured interviews and standardized self-report questionnaires for the evaluation of core and associated ADHD symptoms, comorbidities and functional impairment. The treatment of ADHD in adults is multimodal, and aims to relieve the symptoms, limit the burden of the disease, and manage comorbidities. The most relevant and validated psychological approaches are psycho-education, cognitive-behavioural therapy and "third wave therapies" with a specific focus on emotional regulation. Cognitive remediation and neurofeedback are promising strategies still under evaluation. Medications, especially psychostimulants, are effective for alleviating ADHD symptoms with a large effect size. Their safety and tolerance are satisfactory, although their long-term clinical benefit is still under discussion. In France, methylphenidate is the only stimulant available for the treatment of ADHD. Unfortunately, there is no authorization for its use among adults except in continuation after adolescence. Hence the prescription, which is subject to the regulations on narcotics, is off-label in France. This article aims to provide practical considerations for the management of ADHD and associated disorders in adults, in this particular French context.

Parenting practices among parents of children with attention-deficit/hyperactivity disorder: Gender-related differences

OBJECTIVE

Further research is needed on parenting practices among parents of children with attention-deficit/hyperactivity disorder (ADHD), as these practices impact children's development and outcomes. This study analyzes these practices, distinguishing between parents' and children's gender.

METHOD

Parental warmth (affection-communication and criticism-rejection responses) and control (inductive, strict, and indulgent discipline styles) were assessed in both parents of 81 children diagnosed with ADHD (aged 6-17 years).

RESULTS

Mothers reported greater affection-communication responses and use of inductive disciplinary practices than fathers. Higher use of maternal strict practices was associated with female children, regardless of their age, subtype, medication, or comorbidities. However, parental practices used with male children were affected by children's age and subtype.

CONCLUSIONS

Warmth levels and discipline styles used by parents of children with ADHD may differ depending on the gender of both parents and children. The implications of these findings for understanding gender differences associated with ADHD are discussed.

Psychiatric comorbid patterns in adults with attention-deficit hyperactivity disorder: Treatment effect and subtypes

Psychiatric comorbidities are common in individuals with attention-deficit/hyperactivity disorder (ADHD). In this study, we sought to evaluate the effects of medication and childhood ADHD subtypes on psychiatric comorbidities among adults with ADHD as compared to healthy adult controls. We assessed 121 drug-naïve adults with ADHD, 93 treated adults with ADHD, and 145 healthy controls (age 18-36 years) using semi-structured psychiatric interviews, intelligence tests, and medical records. Drug-naïve adults with ADHD had more comorbidities than treated adults with ADHD and controls. Childhood ADHD-combined subtype, relative to ADHD-inattentive subtype, was associated with higher risks of comorbidities. Current medication treatment was associate with a higher risk for anxiety disorders, and longer treatment duration was associated with lower risks of mood disorders and sleep disorders. Our results indicate that no medication treatment, short treatment duration, and childhood ADHD-combined subtype are associated with increased risks for psychiatric comorbidities among adults with ADHD.

Associations between symptoms of attention-deficit/ hyperactivity disorder and life satisfaction in medical students: the mediating effect of resilience

BACKGROUND

Research on symptoms of attention-deficit/hyperactivity disorder (ADHD) in medical students is rather scant. Studying the disorder in this population, especially its associations with positive psychological constructs can further the understanding of mental health in future physicians. The objectives of the present study were to investigate the prevalence of ADHD symptoms in medical students, to examine the relationships between ADHD symptoms and life satisfaction, and to explore the mediating role of resilience on the associations.

METHODS

This cross-sectional study was carried out at one medical university in China, in June 2016. Self-reported questionnaires consisting of Adult ADHD Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Conner-Davidson Resilience Scale (CD-RISC), Satisfaction With Life Scale (SWLS), and socio-demographic characteristics, were distributed to the students. Hierarchical linear regression analyses were used to examine the effects of ADHD symptoms on life satisfaction, and asymptotic and resampling strategies were used to explore the mediating role of resilience.

RESULTS

A total number of 521 medical students became final subjects. Based on the cutoffs of the scales, 1.54% of the medical students were highly likely to have ADHD, and 6.91% of the students were likely to have ADHD. Only inattention was negatively correlated with life satisfaction in the students. Resilience functioned as a mediator in the relationship between inattention and life satisfaction.

CONCLUSIONS

The prevalence of ADHD symptoms among Chinese medical students could be relatively high. Inattention is significantly related to life satisfaction among the students. Early identification of medical students with ADHD symptoms should be warranted. Resilience intervention programs might be undertaken to enhance life satisfaction in medical students, especially for those with inattention symptoms.

Can parenting practices predict externalizing behavior problems among children with hearing impairment?

OBJECTIVE

To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices.

METHODS

The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls.

RESULTS

Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%.

CONCLUSION

Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.

Monoamine Oxidase-A Genetic Variants and Childhood Abuse Predict Impulsiveness in Borderline Personality Disorder

Objective

Impulsivity is a core feature of borderline personality disorder (BPD) and antisocial personality disorder (ASPD) that likely arises from combined genetic and environmental influences. The interaction of the low activity variant of the monoamine oxidase-A (MAOA-L) gene and early childhood adversity has been shown to predict aggression in clinical and non-clinical populations. Although impulsivity is a risk factor for aggression in BPD and ASPD, little research has investigated potential gene-environment (G×E) influences impacting its expression in these conditions. Moreover, G×E interactions may differ by diagnosis.

Methods

Full factorial analysis of variance was employed to investigate the influence of monoamine oxidase-A (MAO-A) genotype, childhood abuse, and diagnosis on Barratt Impulsiveness Scale-11 (BIS-11) scores in 61 individuals: 20 subjects with BPD, 18 subjects with ASPD, and 23 healthy controls.

Results

A group×genotype×abuse interaction was present (F(2,49)=4.4, p=0.018), such that the interaction of MAOA-L and childhood abuse predicted greater BIS-11 motor impulsiveness in BPD. Additionally, BPD subjects reported higher BIS-11 attentional impulsiveness versus ASPD participants (t(1,36)=2.3, p=0.025).

Conclusion

These preliminary results suggest that MAOA-L may modulate the impact of childhood abuse on impulsivity in BPD. Results additionally indicate that impulsiveness may be expressed differently in BPD and ASPD.

Association between childhood and adult attention deficit hyperactivity disorder symptoms in Korean young adults with Internet addiction

Background and aims Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric comorbidities of Internet addiction (IA); however, the possible mechanisms that contribute to this high comorbidity are still under debate. This study aims to analyze these possible mechanisms by comparing the effect of IA severity and childhood ADHD on inattention, hyperactivity, and impulsivity in young adults with IA. We hypothesized that IA might have associations with ADHD-like cognitive and behavior symptoms aside from childhood ADHD. Methods Study participants consisted of 61 young male adults. Participants were administered a structured interview. The severity of IA, childhood and current ADHD symptoms, and psychiatry comorbid symptoms were assessed through self-rating scales. The associations between the severity of IA and ADHD symptoms were examined through hierarchical regression analyses. Results Hierarchical regression analyses showed that the severity of IA significantly predicted most dimensions of ADHD symptoms. By contrast, childhood ADHD predicted only one dimension. Discussion The high comorbidity of inattention and hyperactivity symptoms in IA should not solely be accounted by an independent ADHD disorder but should consider the possibility of cognitive symptoms related to IA. Functional and structural brain abnormalities associated with excessive and pathologic Internet usage might be related to these ADHD-like symptoms. Conclusion Inattention and hyperactivity in young adults with IA are more significantly associated with the severity of IA than that of childhood ADHD.

Comorbidity of Personality Disorders and Adult Attention Deficit Hyperactivity Disorder (ADHD)--Review of Recent Findings

Children suffering from attention deficit hyperactivity disorder (ADHD) may remit until adulthood. But, more than 60-80% have persisting ADHD symptoms. ADHD as an early manifesting neurodevelopmental disorder is considered a major risk factor for the development of comorbid psychiatric disorders in later life. Particularly, personality disorders are oftentimes observed in adult patients suffering from ADHD. If ADHD and personality disorders share common etiological mechanisms and/or if ADHD as a severely impairing condition influences psychological functioning and learning and leads to unfavorable learning histories is unclear. The development of inflexible and dysfunctional beliefs on the basis of real and perceived impairments or otherness due to the core symptoms of ADHD is intuitively plausible. Such beliefs are a known cause for the development of personality disorders. But, why some personality disorders are more frequently found in ADHD patients as for example antisocial and borderline personality disorder remains subject of debate. Because of the high prevalence of ADHD and the high impact of personality disorders on daily functioning, it is important to take them into account when treating patients with ADHD. Research on the developmental trajectories leading to personality disorders in adult ADHD patients might open the door for targeted interventions to prevent impairing comorbid clinical pictures.

Attachment and parental reflective functioning features in ADHD: enhancing the knowledge on parenting characteristics

Attention-Deficit/Hyperactivity Disorder (ADHD) is a disorder characterized by a chronic, pervasive, and developmentally inappropriate levels of impulsivity and in attention. It is associated with adverse academic and social functions and stress to families. Studies provide evidence that family variables are correlated with this disorder and that parenting styles play an important role in its complexity. However, a thorough investigation of the impact of parental affective and relational aspects on the ADHD child's areas of functioning is still needed. In designing future research on ADHD, we suggest to investigate parenting characteristics to a greater extent by adopting an attachment perspective with a focus on parental reflective functioning as it pertains to the child's ADHD clinical condition.