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Haza B, Gosling CJ, Ciminaghi F, Conty L, Pinabiaux C. Research Review: Social cognition and everyday social skills in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analysis of case-control studies. J Child Psychol Psychiatry 2024; 65:1245-1254. [PMID: 38860431 DOI: 10.1111/jcpp.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Previous studies that have assessed social cognition in Attention-Deficit/Hyperactivity Disorder (ADHD) have produced inconsistent findings. To summarize these data and shed light upon moderators that may explain observed inconsistencies, we conducted a systematic review and meta-analysis exploring social cognition (Theory of Mind (ToM), Empathy, Facial and Non-Facial Emotion Recognition) and Everyday Social Skills in children and adolescents with ADHD. METHODS The current meta-analysis involved 142 studies including 652 effect sizes. These studies compared children and adolescents with ADHD (n = 8,300) and with typical development (n = 7,983). RESULTS Participants with ADHD exhibited moderate to very large deficits in ToM (SMD = 0.84, 95% CI = 0.68-0.99), Facial Emotion Recognition (SMD = 0.63, 95% CI = 0.46-0.81), and Everyday Social Skills (SMD = 1.23, 95% CI = 1.08-1.37). The magnitude of these impairments was similar when considering effect sizes adjusted for some covariates and the methodological quality of the studies. Few studies have investigated Empathy and Non-Facial Emotion Recognition, which precludes definitive conclusions. CONCLUSIONS Children and adolescents with ADHD experience robust impairments in ToM, Facial Emotion Recognition and Everyday Social Skills. Future studies should explore whether these deficits are a consequence of difficulties in other areas of cognition (e.g., executive functioning). We have made all our raw data open access to facilitate the use of the present work by the community (e.g., clinicians looking for tools, assessing social impairments, or researchers designing new studies).
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Affiliation(s)
- Belen Haza
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
| | - Corentin J Gosling
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
- Laboratory of Psychopathology and Health Process, Université Paris Cité, Boulogne Billancourt, France
- Faculty of Environmental and Life Sciences, School of Psychology, Centre for Innovation in Mental Health (CIMH), University of Southampton, Southampton, UK
| | - Flavia Ciminaghi
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
| | - Laurence Conty
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
| | - Charlotte Pinabiaux
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
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Novak L, Malinakova K, Trnka R, Mikoska P, Sverak T, Kiiski H, Tavel P, van Dijk JP. Neural bases of social deficits in ADHD: A systematic review. Does the Theory of Mind matter? Brain Res Bull 2024; 215:111011. [PMID: 38906229 DOI: 10.1016/j.brainresbull.2024.111011] [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: 03/01/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION The Attention Deficit Hyperactivity Disorder (ADHD) causes serious interpersonal problems from childhood to adulthood, one of them being problematic social functioning. This phenomenon in ADHD should be associated with impairments in the Theory of Mind (ToM). Therefore, understanding the neural correlates of the ToM could be crucial for helping individuals with ADHD with their social functioning. Thus, we aimed to review published literature concerning neuroanatomical and functional correlates of ToM deficits in children and adolescents with ADHD. METHODS We reviewed studies published between 1970 and 2023. In accordance with PRISMA guidelines, after data from three databases were collected, two authors (LN and PM) independently screened all relevant records (n=638) and consequently, both authors did the data extraction. The quality of the included studies (n=5) was measured by a modified version of The Newcastle-Ottawa Scale and by measures specific for our study. This systematic review was registered on PROSPERO (CRD42020139847). RESULTS Results indicated that impairments in performing of the ToM tasks were negatively associated with the grey matter volume in the bilateral amygdala and hippocampus in both, ADHD and control group. In EEG studies, a significantly greater electrophysiological activity during ToM tasks was observed in the, frontal, temporal, parietal and occipital lobes in participants with ADHD as compared to healthy subjects. CONCLUSION More research is needed to explore the ToM deficits in children with ADHD. Future research might focus on the neural circuits associated with attention and inhibition, which deficits seems to contribute to the ToM deficits in children and adolescents with ADHD.
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Affiliation(s)
- Lukas Novak
- Olomouc University Social Health Institute, Palacký University Olomouc, Olomouc, Czech Republic; Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Klara Malinakova
- Olomouc University Social Health Institute, Palacký University Olomouc, Olomouc, Czech Republic
| | - Radek Trnka
- Olomouc University Social Health Institute, Palacký University Olomouc, Olomouc, Czech Republic; Prague College of Psychosocial Studies, Prague, Czech Republic
| | - Petr Mikoska
- Olomouc University Social Health Institute, Palacký University Olomouc, Olomouc, Czech Republic
| | - Tomas Sverak
- Department of Psychiatry, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Hanni Kiiski
- Trinity Institute of Neuroscience and School of Psychology, Trinity College Dublin, Ireland
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacký University Olomouc, Olomouc, Czech Republic
| | - Jitse P van Dijk
- Olomouc University Social Health Institute, Palacký University Olomouc, Olomouc, Czech Republic; Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Graduate School Kosice Institute for Society and Health, P.J. Safarik University in Kosice, Kosice, Slovak Republic
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Austgulen A, Posserud MB, Hysing M, Haavik J, Lundervold AJ. Deliberate self-harm in adolescents screening positive for attention-deficit / hyperactivity disorder: a population-based study. BMC Psychiatry 2024; 24:564. [PMID: 39160455 PMCID: PMC11334607 DOI: 10.1186/s12888-024-06008-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 08/08/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Adolescents with attention-deficit / hyperactivity disorder (ADHD) have an increased risk of self-harm. The risk of self-harm among adolescents who display an elevated level of ADHD symptoms, but without a formal diagnosis, is not well-studied and understood. OBJECTIVE To investigate the relationship between self-reported symptoms of ADHD and self-harm in a population-based sample of adolescents. METHODS Adolescents in the population-based youth@hordaland study were invited to complete the Adult ADHD Self-Report Scale (ASRS) and the Short Mood and Feelings Questionnaire (SMFQ). They were asked whether they ever deliberately have taken an overdose or tried to harm themselves on purpose, once or multiple times, defined according to the code used in the Child and Adolescent Self-harm in Europe (CASE) Study. Adolescents reporting severe problems on ≥ four of six selected items on the ASRS-v 1.1 screener were defined as ADHD-screen positive (ADHD-SC+), and the remaining sample as ADHD-screen negative (ADHD-SC-). SMFQ score ≥ 12 was used to define a high level of depressive symptoms. RESULTS A total of 9692 adolescents (mean age 17.4 years, 53.1% females) participated in the study, of which 2390 (24.7%) screened positive on the ASRS. ADHD-SC+ adolescents engaged in self-harm more often than the ADHD-SC- group (14.6% vs. 5.4%, OR = 3.02, 95%CI [2.57-3.24]). This remained significant after adjustment for demographic variables, SMFQ score ≥ 12, symptoms of conduct disorder and familial history of self-harm and suicide attempts (OR = 1.58, 95%CI [1.31-1.89]). They were also more likely to report an overdose as their method of self-harm (OR = 1.52, 95%CI [1.05-2.23]). Within the ADHD-SC+ group female sex, high levels of inattention and hyperactivity/impulsivity symptoms, SMFQ score ≥ 12, symptoms indicating conduct disorder and familial history of self-harm and suicide attempts increased the likelihood of engaging in deliberate self-harm. CONCLUSION Adolescents who screened positive for ADHD had increased risk of engaging in self-harm. Clinicians should consider the increased risk of such engagement in adolescents who present with high level of ADHD symptoms, even in the absence of a clinical ADHD diagnosis.
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Affiliation(s)
- Amalie Austgulen
- Department of Biomedicine, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Maj-Britt Posserud
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Jan Haavik
- Department of Biomedicine, Faculty of Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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Frost-Karlsson M, Capusan AJ, Olausson H, Boehme R. Altered somatosensory processing in adult attention deficit hyperactivity disorder. BMC Psychiatry 2024; 24:558. [PMID: 39138461 PMCID: PMC11323665 DOI: 10.1186/s12888-024-06002-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 08/06/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Tactile sensitivity and sensory overload in ADHD are well-documented in clinical-, self-, and parent- reports, but empirical evidence is scarce and ambiguous and focuses primarily on children. Here, we compare both empirical and self-report tactile sensitivity and ADHD symptomatology in adults with ADHD and neurotypical controls. We evaluate whether tactile sensitivity and integration is more prevalent in ADHD and whether it is related to ADHD symptom severity. METHODS Somatosensory evoked potential (SEP) amplitudes were measured in 27 adults with ADHD and 24 controls during four conditions (rest, stroking of the own arm, stroking of the arm by a researcher, and stroking of an object). Participants also filled out questionnaires on tactile sensitivity and ADHD symptoms and performed a Qb-test as an objective measure of ADHD symptom severity. RESULTS Participants with ADHD self-reported greater tactile sensitivity and ADHD symptom severity than controls and received higher scores on the Qb-test. These values correlated with one another. ADHD participants showed lower tolerable threshold for electrical radial nerve stimulus, and greater reduction in cortical SEP amplitudes during additional tactile stimuli which was correlated with ADHD symptoms. CONCLUSIONS We find that ADHD symptomatology and touch sensitivity are directly linked, using both self-reports and experimental measures. We also find evidence of tactile sensory overload in ADHD, and an indication that this is linked to inattention specifically. Tactile sensitivity and sensory overload impact the functioning and life quality of many people with ADHD, and clinicians should consider this when treating their patients.
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Affiliation(s)
- Morgan Frost-Karlsson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience (CSAN), Linköping University Hospital, Tinnerbäckshuset Floor 14, Linköping, S-581 83, Sweden.
| | - Andrea Johansson Capusan
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Psychiatry in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Håkan Olausson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Rebecca Boehme
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Medical Imaging Visualization (CMIV), Linköping University, Linköping, Sweden
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Inci Izmir SB, Aktan ZD, Ercan ES. The Comparison of Psychological Factors and Executive Functions of Children with Attention Deficit Hyperactivity Disorder and Cognitive Disengagement Syndrome to ADHD and ADHD Comorbid with Oppositional Defiant Disorder. J Atten Disord 2024:10870547241267379. [PMID: 39092505 DOI: 10.1177/10870547241267379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
OBJECTIVE The study aims to examine family functionality, emotion regulation difficulties, preference for loneliness, social exclusion, internalizing and externalizing disorders, and executive functions in children with Attention Deficit Hyperactivity Disorder (ADHD) and Cognitive Disengagement Syndrome (CDS) and compare with ADHD, and ADHD+ Oppositional Defiant Disorder (ODD). METHOD This study included 842 children aged 8-12 years. The subjects were categorized according to DSM-V as ADHD (n = 246), ADHD + ODD (n = 212), ADHD + CDS (n = 176), and Control group (n = 207). The solitude and social exclusion, difficulties in emotion dysregulation and Barkley SCT scales, Child Behavior Checklist, family assessment device, and Central Vital Signs (CNSVS) test were used. RESULTS According to the study, children with ADHD + CDS had higher rates of internalizing disorders. They also preferred being alone and experienced more difficulty communicating with their parents and solving problems within the family. Additionally, these children had difficulty recognizing and understanding the emotional reactions of others. The ADHD + ODD group presented a poorer performance on CNSVS domain tests except for the psychomotor speed test than other groups. Also, ADHD + CDS children had the lowest psychomotor speed scores and lower scores on reaction time and cognitive flexibility than pure ADHD children. CONCLUSION This study will contribute to the etiology, treatment, and clinical discrimination of ADHD + CDS.
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Narvekar N, Carter Leno V, Pasco G, Begum Ali J, Johnson MH, Charman T, Jones EJH. The roles of sensory hyperreactivity and hyporeactivity in understanding infant fearfulness and emerging autistic traits. J Child Psychol Psychiatry 2024; 65:1022-1036. [PMID: 38172076 DOI: 10.1111/jcpp.13941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Existing evidence indicates that atypical sensory reactivity is a core characteristic of autism, and has been linked to both anxiety (and its putative infant precursor of fearfulness) and repetitive behaviours. However, most work has used cross-sectional designs and not considered the differential roles of hyperreactivity and hyporeactivity to sensory inputs, and is thus limited in specificity. METHODS 161 infants with and without an elevated likelihood of developing autism and attention-deficit hyperactivity disorder (ADHD) were followed from 10 to 36 months of age. Parents rated an infant precursor of later anxiety (fearfulness) using the Infant Behaviour Questionnaire at 10 and 14 months, and the Early Childhood Behavioural Questionnaire at 24 months, and sensory hyperreactivity and hyporeactivity at 10, 14 and 24 months using the Infant Toddler Sensory Profile. Domains of autistic traits (restrictive and repetitive behaviours; RRB, and social communication interaction, SCI) were assessed using the parent-rated Social Responsiveness Scale at 36 months. Cross-lagged models tested (a) paths between fearfulness and hyperreactivity at 10-24 months, and from fearfulness and hyperreactivity to later autism traits, (b) the specificity of hyperreactivity effects by including hyporeactivity as a correlated predictor. RESULTS Hyperreactivity at 14 months was positively associated with fearfulness at 24 months, and hyperreactivity at 24 months was positively associated with SCI and RRB at 36 months. When hyporeactivity was included in the model, paths between hyperreactivity and fearfulness remained, but paths between hyperreactivity and autistic traits became nonsignificant. CONCLUSIONS Our findings indicate that alterations in early sensory reactivity may increase the likelihood of showing fearfulness in infancy, and relate to later social interactions and repetitive behaviours, particularly in individuals with a family history of autism or ADHD.
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Affiliation(s)
- Nisha Narvekar
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Virginia Carter Leno
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Greg Pasco
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Mark H Johnson
- Centre for Brain and Cognitive Development, Birkbeck, London, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Tony Charman
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily J H Jones
- Centre for Brain and Cognitive Development, Birkbeck, London, UK
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Jepsen IB, Brynskov C, Thomsen PH, Rask CU, Jensen de López K, Lambek R. The Role of Language in the Social and Academic Functioning of Children With ADHD. J Atten Disord 2024:10870547241266419. [PMID: 39077785 DOI: 10.1177/10870547241266419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
OBJECTIVE To provide an in-depth examination of whether pragmatic, expressive, receptive, and narrative language are associated with the social and academic functioning of children with ADHD. METHOD Children with ADHD (n = 46) and neurotypical comparison (NC) children (n = 40) aged 7 to 11 years completed tasks measuring expressive, receptive, and narrative language, while parents rated pragmatic language and social- and academic functioning. RESULTS Children with ADHD differed significantly from NC children on pragmatic language, expressive language, receptive language, and narrative coherence. An examination of indirect effects revealed that a significant proportion of the association between ADHD and social functioning was shared with pragmatic language, while a significant proportion of the association between ADHD and academic difficulties was shared with pragmatic language as well as with expressive language. CONCLUSION This preliminary study supports the clinical relevance of language in relation to the academic- and social functioning of children with ADHD.
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Affiliation(s)
| | | | - Per Hove Thomsen
- Aarhus University, Denmark
- Aarhus University Hospital Psychiatry, Denmark
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Lee YS, Sprong ME, Shrestha J, Smeltzer MP, Hollender H. Trajectory Analysis for Identifying Classes of Attention Deficit Hyperactivity Disorder (ADHD) in Children of the United States. Clin Pract Epidemiol Ment Health 2024; 20:e17450179298863. [PMID: 39130191 PMCID: PMC11311732 DOI: 10.2174/0117450179298863240516070510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/12/2024] [Accepted: 04/30/2024] [Indexed: 08/13/2024]
Abstract
Background Attention Deficit Hyperactivity Disorder (ADHD) is a mental health disorder that affects attention and behavior. People with ADHD frequently encounter challenges in social interactions, facing issues, like social rejection and difficulties in interpersonal relationships, due to their inattention, impulsivity, and hyperactivity. Methods A National Longitudinal Survey of Youth (NLSY) database was employed to identify patterns of ADHD symptoms. The children who were born to women in the NLSY study between 1986 and 2014 were included. A total of 1,847 children in the NLSY 1979 cohort whose hyperactivity/inattention score was calculated when they were four years old were eligible for this study. A trajectory modeling method was used to evaluate the trajectory classes. Sex, baseline antisocial score, baseline anxiety score, and baseline depression score were adjusted to build the trajectory model. We used stepwise multivariate logistic regression models to select the risk factors for the identified trajectories. Results The trajectory analysis identified six classes for ADHD, including (1) no sign class, (2) few signs since preschool being persistent class, (3) few signs in preschool but no signs later class, (4) few signs in preschool that magnified in elementary school class, (5) few signs in preschool that diminished later class, and (6) many signs since preschool being persistent class. The sensitivity analysis resulted in a similar trajectory pattern, except for the few signs since preschool that magnified later class. Children's race, breastfeeding status, headstrong score, immature dependent score, peer conflict score, educational level of the mother, baseline antisocial score, baseline anxious/depressed score, and smoking status 12 months prior to the birth of the child were found to be risk factors in the ADHD trajectory classes. Conclusion The trajectory classes findings obtained in the current study can (a) assist a researcher in evaluating an intervention (or combination of interventions) that best decreases the long-term impact of ADHD symptoms and (b) allow clinicians to better assess as to which class a child with ADHD belongs so that appropriate intervention can be employed.
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Affiliation(s)
- Yu-Sheng Lee
- School of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois at Springfield, Illinois, United States
| | - Matthew Evan Sprong
- School of Public Management and Policy, College of Public Affairs and Education, University of Illinois at Springfield, llinois, United States
| | - Junu Shrestha
- School of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois at Springfield, Illinois, United States
| | - Matthew P. Smeltzer
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Tennessee, United States
| | - Heaven Hollender
- School of Health and Human Sciences, Indiana University Indianapolis, Indiana, United States
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Kochhar P, Arora I, Bellato A, Ropar D, Hollis C, Groom M(MJ. A comparison of visual attention to pictures in the Autism Diagnostic Observation Schedule in children and adolescents with ADHD and/or autism. Front Psychiatry 2024; 15:1378593. [PMID: 38742132 PMCID: PMC11089217 DOI: 10.3389/fpsyt.2024.1378593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
Background Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are neurodevelopmental conditions which frequently co-occur. The Autism Diagnostic Observation Schedule (ADOS) is commonly used to aid with diagnostic assessment of ASD but was not originally designed for use in those with comorbid ADHD. Visual attention to social stimuli has been often studied in ASD using eye-tracking, to obtain quantitative indices of how attention is deployed to different parts of a social image/scene. As the ADOS includes tasks that rely on attending to and processing images of social scenes, these measures of visual attention could provide useful additional objective measurement alongside ADOS scores to enhance the characterisation of autistic symptoms in those with ADHD. Methods Children with ASD, comorbid ASD and ADHD, ADHD and Neurotypical (NT) controls were recruited (n=84). Visual attention was measured using eye-tracking during free viewing of social scenes selected from the ADOS. The full ADOS was then administered. Stimulant medication was temporarily withdrawn during this assessment. Research diagnoses were based on the Development and Wellbeing Assessment (DAWBA), ADOS, Social Communication Questionnaire (SCQ, a measure of ASD severity) and Conners' Rating Scales (CRS-3, a measure of ADHD severity) following clinical consensus. Results Using factorial ANOVAs to model ADHD, Autism and their interaction, we found that fixation duration to faces was reduced in those with ASD (ASD and ASD+ADHD) compared to those without ASD (ADHD and NT). Reduced visual attention to faces in the whole sample was associated with Autism symptom severity (SCQ subscale scores) but not ADHD symptom severity (CRS-3 scores). Discussion Our findings provide preliminary evidence in support of implementing visual attention measurement during assessment of ASD in the context of comorbidity with ADHD. For example, if a child with ADHD was found to reduce attention to faces in ADOS pictures this may suggest additive difficulties on the autism spectrum. Replication across a larger sample would be informative. This work has future potential in the clinic to help with complex cases, including those with co-occurring ADHD and ASD.
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Affiliation(s)
- Puja Kochhar
- Neurodevelopmental Specialist Service, Nottinghamshire Healthcare National Health Service (NHS) Foundation Trust, Nottingham, United Kingdom
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Iti Arora
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Alessio Bellato
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Danielle Ropar
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Chris Hollis
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- National Institute for Health and Care Research (NIHR) MindTech Medtech Co-operative, Institute of Mental Health, UK NIHR, Nottingham, United Kingdom
- Nottingham Biomedical Research Centre, Institute of Mental Health, Nottingham, United Kingdom
| | - Madeleine (Maddie) J. Groom
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- National Institute for Health and Care Research (NIHR) MindTech Medtech Co-operative, Institute of Mental Health, UK NIHR, Nottingham, United Kingdom
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Ruchkin V, Wallonius M, Odekvist E, Kim S, Isaksson J. Memory training with the method of loci for children and adolescents with ADHD-A feasibility study. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:137-145. [PMID: 36344263 DOI: 10.1080/21622965.2022.2141120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to investigate if training with the memory technique Method of Loci (MoL) is feasible for children and adolescents with ADHD. Twelve children (aged 9-17 years) with ADHD participated. Training with MoL was done using a mobile application, memorizing a sequence of 20-80 pictures, intended to be carried out five times per week for 4 weeks. Feasibility was assessed with pre- and post-intervention ratings, and with interviews after the training. Qualitative data were analyzed with content analysis. Those who trained with MoL performed better on memory test and reported fewer ADHD symptoms after completing the training, as compared to their baseline levels. All of these children would recommend the training to peers but the duration of training varied considerably. The participants and their parents reported that the MoL training was easy and fun to use, although lack of motivation, distractions in every-day life, and lack of routines created challenges. We conclude that training with MoL was considered feasible by most of the participants. Future research should try to make the intervention more acceptable by motivating the participants and limiting potential distractions and involving larger study groups and controls to study the efficacy of the training.
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Affiliation(s)
- Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Marwin Wallonius
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Emma Odekvist
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Sharmeen Kim
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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Quiñones-Labernik P, Blocklinger KL, Bruce MR, Ferri SL. Excess neonatal testosterone causes male-specific social and fear memory deficits in wild-type mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.10.18.562939. [PMID: 37905064 PMCID: PMC10614869 DOI: 10.1101/2023.10.18.562939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Neurodevelopmental disorders (ND) disproportionately affect males compared to females, and Autism Spectrum Disorder (ASD) in particular exhibits a 4:1 male bias. The biological mechanisms of this female protection or male susceptibility have not been identified. There is some evidence to suggest that fetal/neonatal gonadal hormones, which play pivotal roles in many aspects of development, may contribute. Here, we investigate the role of testosterone administration during a critical period of development, and its effects on social approach and fear learning in C57BL/6J wildtype mice. Male, but not female mice treated with testosterone on the day of birth (PN0) exhibited deficits in both social behavior and contextual fear conditioning, whereas mice treated with the same dose of testosterone on postnatal day 18 (PN18) did not display such impairments. Testosterone administration did not induce anxiogenic effects or lead to changes in body weight compared to the vehicle-treated group. These impairmeants are relevant to ND and may help identify novel treatment targets.
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Affiliation(s)
| | | | | | - Sarah L Ferri
- Department of Pediatrics, University of Iowa, Iowa City, IA, United States
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12
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Flynn LT, Bouras NN, Migovich VM, Clarin JD, Gao WJ. The "psychiatric" neuron: the psychic neuron of the cerebral cortex, revisited. Front Hum Neurosci 2024; 18:1356674. [PMID: 38562227 PMCID: PMC10982399 DOI: 10.3389/fnhum.2024.1356674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Nearly 25 years ago, Dr. Patricia Goldman-Rakic published her review paper, "The 'Psychic' Neuron of the Cerebral Cortex," outlining the circuit-level dynamics, neurotransmitter systems, and behavioral correlates of pyramidal neurons in the cerebral cortex, particularly as they relate to working memory. In the decades since the release of this paper, the existing literature and our understanding of the pyramidal neuron have increased tremendously, and research is still underway to better characterize the role of the pyramidal neuron in both healthy and psychiatric disease states. In this review, we revisit Dr. Goldman-Rakic's characterization of the pyramidal neuron, focusing on the pyramidal neurons of the prefrontal cortex (PFC) and their role in working memory. Specifically, we examine the role of PFC pyramidal neurons in the intersection of working memory and social function and describe how deficits in working memory may actually underlie the pathophysiology of social dysfunction in psychiatric disease states. We briefly describe the cortico-cortical and corticothalamic connections between the PFC and non-PFC brain regions, as well the microcircuit dynamics of the pyramidal neuron and interneurons, and the role of both these macro- and microcircuits in the maintenance of the excitatory/inhibitory balance of the cerebral cortex for working memory function. Finally, we discuss the consequences to working memory when pyramidal neurons and their circuits are dysfunctional, emphasizing the resulting social deficits in psychiatric disease states with known working memory dysfunction.
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Affiliation(s)
- L. Taylor Flynn
- Department of Neurobiology, Drexel University College of Medicine, Philadelphia, PA, United States
- Drexel University College of Medicine, Philadelphia, PA, United States
| | - Nadia N. Bouras
- Department of Neurobiology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Volodar M. Migovich
- Department of Neurobiology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Jacob D. Clarin
- Department of Neurobiology, Drexel University College of Medicine, Philadelphia, PA, United States
| | - Wen-Jun Gao
- Department of Neurobiology, Drexel University College of Medicine, Philadelphia, PA, United States
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13
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Glad DM, Pardej SK, Olszewski E, Klein-Tasman BP. Pilot study of the effectiveness of a telehealth group for improving peer relationships for adolescents with neurofibromatosis type 1. Orphanet J Rare Dis 2024; 19:115. [PMID: 38475852 DOI: 10.1186/s13023-024-03093-1] [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: 09/26/2023] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Interventions for social difficulties have not been investigated in the neurofibromatosis type 1 (NF1) population despite observations of elevated rates of social difficulties. In this pilot study, the effectiveness of a 14-week telehealth PEERS® intervention with nineteen adolescents with NF1 (Mage=13.79 years, SD = 1.32) with social skills difficulties was examined. Measures of social outcomes were completed at three timepoints (before, immediately after, and at 14-week follow-up). RESULTS Caregiver-reported social-emotional skills, social impairment, caregiver-reported number of adolescent get-togethers, and teen social knowledge showed significant improvement following the intervention. CONCLUSIONS The PEERS® intervention is promising to support the social and friendship skills of adolescents with NF1 who have social difficulties.
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Affiliation(s)
- Danielle M Glad
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA.
| | - Sara K Pardej
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
| | - Ellen Olszewski
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
| | - Bonita P Klein-Tasman
- Department of Psychology, University of Wisconsin- Milwaukee, 2441 E Hartford Ave, Wisconsin, 53211, Milwaukee, USA
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14
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Bozkurt A, Yıldırım Demirdöğen E, Kolak Çelik M, Akıncı MA. An assessment of dynamic facial emotion recognition and theory of mind in children with ADHD: An eye-tracking study. PLoS One 2024; 19:e0298468. [PMID: 38329958 PMCID: PMC10852339 DOI: 10.1371/journal.pone.0298468] [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: 09/30/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Deficits in social cognition in attention deficit hyperactivity disorder (ADHD) have been associated with difficulties in functioning. Since recognizing emotional facial expressions is essential for developing the perceptual components of the theory of mind (ToM), it is important to assess this relationship in children with ADHD. This study therefore compared the recognition of emotional stimuli and gaze patterns between children with ADHD and healthy children using eye-tracking with dynamic facial images. It also examined the relationship between facial emotion recognition accuracy, gaze patterns, ToM scores, and ADHD symptoms. Children with ADHD aged 8-13 (n = 47) and a control group (n = 38) completed a facial emotion recognition test, ToM tests, and the Conners' Parent Rating Scale. Participants' gaze patterns in response to dynamic facial emotion expressions were recorded using eye-tracking technology. Children with ADHD exhibited significantly lower accuracy in the recognition of the facial expressions of disgust and anger. The percentage fixation in the eye region was also significantly lower for happy, angry, sad, disgusted, and neutral emotions in the children with ADHD compared to the control group. No relationship was determined between the percentage of fixations on facial areas of interests and ADHD symptoms or ToM tests. This study provides evidence that children with ADHD experience deficits in visual attention to emotional cues. In addition, it suggests that facial emotion recognition deficits in children with ADHD represent a separate domain of social cognition that develops independently of ToM skills and core symptoms. Understanding and treating the social difficulties of individuals with ADHD may help improve their social functioning.
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Affiliation(s)
- Abdullah Bozkurt
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
| | | | - Müberra Kolak Çelik
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
| | - Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
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15
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Bullard CC, Roberts DK, Tatsuki MO, Sullivan MA, Kofler MJ, Alderson RM. Social functioning in children with ADHD: an examination of inhibition, self-control, and working memory as potential mediators. Child Neuropsychol 2024:1-23. [PMID: 38269494 PMCID: PMC11269528 DOI: 10.1080/09297049.2024.2304375] [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: 04/18/2023] [Accepted: 11/24/2023] [Indexed: 01/26/2024]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) experience a host of social problems, in addition to significant impairments in behavioral inhibition, working memory, and self-control. Behavioral inhibition and working memory difficulties have been linked with social functioning deficits, but to date, most studies have examined these neurocognitive problems either in isolation or as an aggregate measure in relation to social problems, and none has considered the role of self-control. Thus, it remains unclear whether all of these executive functions are linked with social problems or if the link can be more parsimoniously explained by construct overlap. Fifty-eight children with ADHD and 63 typically developing (TD) children completed tests assessing self-control, behavioral inhibition, and working memory; parents and teachers rated children's social functioning. Examination of potential indirect effects with the bootstrapping procedure indicated that working memory mediated the relation between group membership (ADHD, TD) and child social functioning based on teacher but not parent ratings. Behavioral inhibition and self-control did not have direct relations with either parent- or teacher-rated social functioning. These findings point to important differences regarding how executive functioning difficulties manifest at school compared to home, as well as the specific executive function components that predict ADHD-related social difficulties.
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Affiliation(s)
| | - Delanie K. Roberts
- Oklahoma State University, Department of Psychology
- Children’s Hospital of Los Angeles
| | - Miho O. Tatsuki
- Oklahoma State University, Department of Psychology
- Florida State University, Department of Psychology
| | | | | | - R. Matt Alderson
- Oklahoma State University, Department of Psychology
- Posthumous author
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16
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Uono S, Egashira Y, Hayashi S, Takada M, Ukezono M, Okada T. Reduced gaze-cueing effect with neutral and emotional faces in adults with attention deficit/hyperactivity disorder. J Psychiatr Res 2023; 168:310-317. [PMID: 37949042 DOI: 10.1016/j.jpsychires.2023.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
This study examined whether gaze shift of neutral and emotional faces triggers reflexive attention orienting in 45 adults with attention deficit/hyperactivity disorder (ADHD) and 45 age-, sex-, and intelligence quotient-matched typically developing (TD) adults. The cues changed from neutral to anger, fearful, or happy expressions under the emotional face condition. Participants were asked to detect a target that appeared to the left or right of the cue stimuli, as rapidly and accurately as possible. The results revealed a gaze-cueing effect, where the reaction time to the target was shorter under the "gaze-at-target" condition than under the "non-gaze-at-target" condition in both groups. Facial expressions did not modulate the gaze-cueing effect in either group. However, the magnitude of the gaze-cueing effect was smaller in the ADHD group than in the TD group. Contrary to our expectations, a larger gaze-cueing effect was observed in individuals with ADHD who exhibited more severe inattention. Our results suggest that adults with ADHD ineffectively orient their attention toward another's gaze. Moreover, difficulty with sustained and selective attention may be associated with a larger influence of gaze direction; this difficulty may play a role in social interaction problems.
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Affiliation(s)
- Shota Uono
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8553, Japan; Division of Disability Sciences, Institute of Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8572, Japan.
| | - Yuka Egashira
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Sayuri Hayashi
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Miki Takada
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8553, Japan; Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-0856, Japan
| | - Masatoshi Ukezono
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Takashi Okada
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8553, Japan
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17
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Koncz P, Demetrovics Z, Takacs ZK, Griffiths MD, Nagy T, Király O. The emerging evidence on the association between symptoms of ADHD and gaming disorder: A systematic review and meta-analysis. Clin Psychol Rev 2023; 106:102343. [PMID: 37883910 DOI: 10.1016/j.cpr.2023.102343] [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: 09/27/2022] [Revised: 06/27/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023]
Abstract
The co-existence of gaming disorder (GD) with other mental health problems has been widely reported. Despite the growing research interest in the comorbidity of GD with attention-deficit/hyperactivity disorder (ADHD), to date, no quantitative synthesis has been performed. The present study comprised a systematic literature search using Scopus, Science Direct, Web of Science, and PubMed databases. Three types of studies were included in the analyses: studies reporting (i) correlation coefficients between the symptoms of GD and ADHD, (ii) means, and standard deviations for comparison of GD severity between ADHD/non-ADHD individuals, and (iii) comparison of ADHD severity between GD/non-GD individuals. The results indicated a moderate relationship between GD and ADHD symptom severity when both subdomains of ADHD were combined (r = 0.296), and also when only inattention (r = 0.306) or hyperactivity (r = 0.266) symptoms were analyzed, which was also confirmed in a structural equation model meta-analysis. Studies showed a large average difference comparing the GD symptom severity of ADHD and non-ADHD individuals (g = 0.693), or ADHD symptom severity of GD and non-GD individuals (g = 0.854). In some cases, higher estimates of association were reported among studies that (i) had a higher proportion of males, (ii) assessed problematic internet use among predominantly videogame player samples rather than assessing only GD, and (iii) had been more recently published. The present review shows that this is an emerging field demonstrating significant results in cross-sectional correlational studies. However, future research should apply more rigorous methodologies to investigate the relationship further (e.g., longitudinal studies and studies using professional/clinical ratings and diagnosis). These results suggest that screening and treatment for ADHD among individuals with gaming disorder is necessary, and individuals with ADHD should be made aware of their higher susceptibility to gaming disorder.
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Affiliation(s)
- Patrik Koncz
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar.
| | - Zsofia K Takacs
- School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Tamás Nagy
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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18
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Ging-Jehli NR, Arnold LE, Van Zandt T. Cognitive-attentional mechanisms of cooperation-with implications for attention-deficit hyperactivity disorder and cognitive neuroscience. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:1545-1567. [PMID: 37783876 DOI: 10.3758/s13415-023-01129-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/04/2023]
Abstract
People's cooperativeness depends on many factors, such as their motives, cognition, experiences, and the situation they are in. To date, it is unclear how these factors interact and shape the decision to cooperate. We present a computational account of cooperation that not only provides insights for the design of effective incentive structures but also redefines neglected social-cognitive characteristics associated with attention-deficit hyperactivity disorder (ADHD). Leveraging game theory, we demonstrate that the source and magnitude of conflict between different motives affected the speed and frequency of cooperation. Integrating eye-tracking to measure motivation-based information processing during decision-making shows that participants' visual fixations on the gains of cooperation rather than its costs and risks predicted their cooperativeness on a trial-by-trial basis. Using Bayesian hierarchical modeling, we find that a situation's prosociality and participants' past experience each bias the decision-making process distinctively. ADHD characteristics explain individual differences in responsiveness across contexts, highlighting the clinical importance of experimentally studying reactivity in social interactions. We demonstrate how the use of eye-tracking and computational modeling can be used to experimentally investigate social-cognitive characteristics in clinical populations. We also discuss possible underlying neural mechanisms to be investigated in future studies.
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Affiliation(s)
- Nadja R Ging-Jehli
- Department of Psychology, The Ohio State University, Columbus, OH, USA.
- Department of Cognitive, Linguistic, & Psychological Sciences, Carney Institute for Brain Science, Brown University, Providence, RI, USA.
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, The Ohio State University, Nisonger Center UCEDD, Columbus, OH, USA
| | - Trish Van Zandt
- Department of Psychology, The Ohio State University, Columbus, OH, USA
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19
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Wu X, Guo Y, Xue J, Dong Y, Sun Y, Wang B, Xiang J, Liu Y. Abnormal and Changing Information Interaction in Adults with Attention-Deficit/Hyperactivity Disorder Based on Network Motifs. Brain Sci 2023; 13:1331. [PMID: 37759932 PMCID: PMC10526475 DOI: 10.3390/brainsci13091331] [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: 07/31/2023] [Revised: 08/27/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Network motif analysis approaches provide insights into the complexity of the brain's functional network. In recent years, attention-deficit/hyperactivity disorder (ADHD) has been reported to result in abnormal information interactions in macro- and micro-scale functional networks. However, most existing studies remain limited due to potentially ignoring meso-scale topology information. To address this gap, we aimed to investigate functional motif patterns in ADHD to unravel the underlying information flow and analyze motif-based node roles to characterize the different information interaction methods for identifying the abnormal and changing lesion sites of ADHD. The results showed that the interaction functions of the right hippocampus and the right amygdala were significantly increased, which could lead patients to develop mood disorders. The information interaction of the bilateral thalamus changed, influencing and modifying behavioral results. Notably, the capability of receiving information in the left inferior temporal and the right lingual gyrus decreased, which may cause difficulties for patients in processing visual information in a timely manner, resulting in inattention. This study revealed abnormal and changing information interactions based on network motifs, providing important evidence for understanding information interactions at the meso-scale level in ADHD patients.
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Affiliation(s)
- Xubin Wu
- College of Computer Science and Technology, Taiyuan University of Technology, Taiyuan 030024, China; (X.W.); (J.X.); (Y.D.); (Y.S.); (B.W.)
| | - Yuxiang Guo
- School of Software, Taiyuan University of Technology, Taiyuan 030024, China;
| | - Jiayue Xue
- College of Computer Science and Technology, Taiyuan University of Technology, Taiyuan 030024, China; (X.W.); (J.X.); (Y.D.); (Y.S.); (B.W.)
| | - Yanqing Dong
- College of Computer Science and Technology, Taiyuan University of Technology, Taiyuan 030024, China; (X.W.); (J.X.); (Y.D.); (Y.S.); (B.W.)
| | - Yumeng Sun
- College of Computer Science and Technology, Taiyuan University of Technology, Taiyuan 030024, China; (X.W.); (J.X.); (Y.D.); (Y.S.); (B.W.)
| | - Bin Wang
- College of Computer Science and Technology, Taiyuan University of Technology, Taiyuan 030024, China; (X.W.); (J.X.); (Y.D.); (Y.S.); (B.W.)
| | - Jie Xiang
- College of Computer Science and Technology, Taiyuan University of Technology, Taiyuan 030024, China; (X.W.); (J.X.); (Y.D.); (Y.S.); (B.W.)
| | - Yi Liu
- Department of Anesthesiology, Shanxi Province Cancer Hospital, Taiyuan 030013, China
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20
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Poznyak E, Samson JL, Barrios J, Rafi H, Hasler R, Perroud N, Debbané M. Mentalizing in Adolescents and Young Adults with Attention Deficit Hyperactivity Disorder: Associations with Age and Attention Problems. Psychopathology 2023; 57:91-101. [PMID: 37586353 PMCID: PMC10997248 DOI: 10.1159/000531512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/23/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Growing, albeit heterogenous evidence questions whether attention deficit/hyperactivity disorder (ADHD) is associated with socio-cognitive impairments, especially beyond childhood. This study focuses on mentalizing - the socio-cognitive ability to attribute and reason in terms of mental states. We aimed to characterize mentalizing performance in terms of correct scores and types of errors in adolescents and young adults with ADHD. METHODS Forty-nine adolescents and adults with ADHD and 49 healthy controls matched for age and gender completed a computerized naturalistic mentalizing task, the Movie for Assessment of Social Cognition (MASC). Repeated measures analyses of variance examined the effects of age group and ADHD diagnosis on MASC performance. Additionally, associations between mentalizing scores, the severity of attention problems, and the presence of comorbidity were explored in the ADHD group. RESULTS Results showed an increased prevalence of hypomentalizing errors in adolescents with ADHD. Lower mentalizing scores in adolescents with ADHD were correlated with indices of inattentiveness, impulsivity, and vigilance problems. Hypomentalizing errors in adolescents showed to be particularly associated with inattentiveness, after controlling for age and comorbidity. In contrast, adults with ADHD performed similarly to controls and their scores on the mentalizing task were not correlated to attention problems. CONCLUSION These findings highlight potential developmental differences in mentalizing abilities in ADHD youths and their association with attentional impairments.
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Affiliation(s)
- Elena Poznyak
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Jessica Lee Samson
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Juan Barrios
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Halima Rafi
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Roland Hasler
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Geneva, Switzerland
| | - Nader Perroud
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Spender K, Chen YWR, Wilkes-Gillan S, Parsons L, Cantrill A, Simon M, Garcia A, Cordier R. The friendships of children and youth with attention-deficit hyperactivity disorder: A systematic review. PLoS One 2023; 18:e0289539. [PMID: 37549157 PMCID: PMC10406331 DOI: 10.1371/journal.pone.0289539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/20/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Children with attention-deficit hyperactivity disorder (ADHD) experience substantial difficulty maintaining meaningful friendships, which has implications for social functioning and mental health. No systematic review has investigated their friendship difficulties. OBJECTIVES To systematically review and methodologically appraise the quality of existing studies reporting on friendships of children with ADHD. To compare their friendships to typically-developing children, and examine associations between friendship and children's social-emotional wellbeing and mental health. METHOD Six databases were searched. The methodological quality of studies was assessed using the QualSyst appraisal tool and the Appraisal tool for Cross-Sectional Studies. Aspects of friendships measured were charted, along with comparisons between children with ADHD and typically-developing children and the associations between friendships and social-emotional wellbeing and mental health. RESULTS Twenty-three cross-sectional studies and one longitudinal follow-up study were included. Studies included 1509 participants with ADHD, with 1197 typically-developing participants used as a companion in 19 of the 24 studies. Friendship quantity was the most investigated aspect of friendship. Children and youth with ADHD had significantly fewer friends, lower quality friendships and poorer friendship interactions. There were mixed findings from studies investigating the role or impact of friendship on social-emotional wellbeing and mental health. Twenty-two had strong methodological quality. CONCLUSION Limited longitudinal studies, small sample sizes and variability in measurement restrict the interpretations of friendship over time and the causal impact of friendship on social and emotional outcomes. Further research should investigate the role and impact of friendships on the social-emotional wellbeing of children and youth with ADHD.
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Affiliation(s)
- Katherine Spender
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Yu-Wei Ryan Chen
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Wilkes-Gillan
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lauren Parsons
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Alycia Cantrill
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Megan Simon
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Abbygale Garcia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Reinie Cordier
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, University of Northumbria, Newcastle upon Tyne, United Kingdom
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22
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Gillies D, Leach MJ, Perez Algorta G. Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev 2023; 4:CD007986. [PMID: 37058600 PMCID: PMC10103546 DOI: 10.1002/14651858.cd007986.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a major problem in children and adolescents, characterised by age-inappropriate levels of inattention, hyperactivity, and impulsivity, and is associated with long-term social, academic, and mental health problems. The stimulant medications methylphenidate and amphetamine are the most frequently used treatments for ADHD, but these are not always effective and can be associated with side effects. Clinical and biochemical evidence suggests that deficiencies of polyunsaturated fatty acids (PUFA) could be related to ADHD. Research has shown that children and adolescents with ADHD have significantly lower plasma and blood concentrations of PUFA and, in particular, lower levels of omega-3 PUFA. These findings suggest that PUFA supplementation may reduce the attention and behaviour problems associated with ADHD. This review is an update of a previously published Cochrane Review. Overall, there was little evidence that PUFA supplementation improved symptoms of ADHD in children and adolescents. OBJECTIVES To compare the efficacy of PUFA to other forms of treatment or placebo in treating the symptoms of ADHD in children and adolescents. SEARCH METHODS We searched 13 databases and two trials registers up to October 2021. We also checked the reference lists of relevant studies and reviews for additional references. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials that compared PUFA with placebo or PUFA plus alternative therapy (medication, behavioural therapy, or psychotherapy) with the same alternative therapy alone in children and adolescents (aged 18 years and under) diagnosed with ADHD. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcome was severity or improvement of ADHD symptoms. Our secondary outcomes were severity or incidence of behavioural problems; quality of life; severity or incidence of depressive symptoms; severity or incidence of anxiety symptoms; side effects; loss to follow-up; and cost. We used GRADE to assess the certainty of evidence for each outcome. MAIN RESULTS We included 37 trials with more than 2374 participants, of which 24 trials were new to this update. Five trials (seven reports) used a cross-over design, while the remaining 32 trials (52 reports) used a parallel design. Seven trials were conducted in Iran, four each in the USA and Israel, and two each in Australia, Canada, New Zealand, Sweden, and the UK. Single studies were conducted in Brazil, France, Germany, India, Italy, Japan, Mexico, the Netherlands, Singapore, Spain, Sri Lanka, and Taiwan. Of the 36 trials that compared a PUFA to placebo, 19 used an omega-3 PUFA, six used a combined omega-3/omega-6 supplement, and two used an omega-6 PUFA. The nine remaining trials were included in the comparison of PUFA to placebo, but also had the same co-intervention in the PUFA and placebo groups. Of these, four trials compared a combination of omega-3 PUFA plus methylphenidate to methylphenidate. One trial each compared omega-3 PUFA plus atomoxetine to atomoxetine; omega-3 PUFA plus physical training to physical training; and an omega-3 or omega-6 supplement plus methylphenidate to methylphenidate; and two trials compared omega-3 PUFA plus dietary supplement to dietary supplement. Supplements were given for a period of between two weeks and six months. Although we found low-certainty evidence that PUFA compared to placebo may improve ADHD symptoms in the medium term (risk ratio (RR) 1.95, 95% confidence interval (CI) 1.47 to 2.60; 3 studies, 191 participants), there was high-certainty evidence that PUFA had no effect on parent-rated total ADHD symptoms compared to placebo in the medium term (standardised mean difference (SMD) -0.08, 95% CI -0.24 to 0.07; 16 studies, 1166 participants). There was also high-certainty evidence that parent-rated inattention (medium-term: SMD -0.01, 95% CI -0.20 to 0.17; 12 studies, 960 participants) and hyperactivity/impulsivity (medium-term: SMD 0.09, 95% CI -0.04 to 0.23; 10 studies, 869 participants) scores were no different compared to placebo. There was moderate-certainty evidence that overall side effects likely did not differ between PUFA and placebo groups (RR 1.02, 95% CI 0.69 to 1.52; 8 studies, 591 participants). There was also moderate-certainty evidence that medium-term loss to follow-up was likely similar between groups (RR 1.03, 95% CI 0.77 to 1.37; 13 studies, 1121 participants). AUTHORS' CONCLUSIONS Although we found low-certainty evidence that children and adolescents receiving PUFA may be more likely to improve compared to those receiving placebo, there was high-certainty evidence that PUFA had no effect on total parent-rated ADHD symptoms. There was also high-certainty evidence that inattention and hyperactivity/impulsivity did not differ between PUFA and placebo groups. We found moderate-certainty evidence that overall side effects likely did not differ between PUFA and placebo groups. There was also moderate-certainty evidence that follow-up was similar between groups. It is important that future research addresses the current weaknesses in this area, which include small sample sizes, variability of selection criteria, variability of the type and dosage of supplementation, and short follow-up times.
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Affiliation(s)
- Donna Gillies
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Matthew J Leach
- School of Nursing & Midwifery, University of South Australia, Adelaide, Australia
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McKay E, Kirk H, Martin R, Cornish K. Social difficulties in adolescent attention deficit hyperactivity disorder: Social motivation, social anxiety and symptom severity as contributing factors. J Clin Psychol 2023; 79:1113-1129. [PMID: 36413514 DOI: 10.1002/jclp.23462] [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: 02/28/2022] [Accepted: 11/12/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many interventions have been developed to address the social difficulties commonly experienced by adolescents with attention-deficit/hyperactivity disorder (ADHD), yet they are largely ineffective. OBJECTIVE This study examined social impairment among adolescents with and without ADHD, determining whether gender, social anxiety, age, and ADHD symptom type (inattention and hyperactivity/impulsivity) and severity are associated with social impairment. METHOD Parents and primary caregivers of adolescents (aged 13-17) with (n = 76) and without ADHD (n = 36) completed the Strengths and Weaknesses of ADHD and Normal Behavior, Social Responsiveness Scale 2nd Edition, and Spence Children's Anxiety Scale. RESULTS Adolescents with ADHD scored significantly higher than TD adolescents across social impairment domains. ADHD symptoms were associated with severity of impairment in all domains excluding Social Motivation. Hyperactivity/impulsivity and social anxiety predicted social impairment, whereas gender did not. CONCLUSION Adolescents with ADHD are more likely to experience social impairment than TD adolescents, and interventions targeting symptom reduction and social anxiety may improve these social impairments.
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Affiliation(s)
- Erin McKay
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Hannah Kirk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Rachael Martin
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Kim Cornish
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Koerts J, Bangma DF, Mette C, Tucha L, Tucha O. Strengths and Weaknesses of Everyday Financial Knowledge and Judgment Skills of Adults with ADHD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4656. [PMID: 36901665 PMCID: PMC10001631 DOI: 10.3390/ijerph20054656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Adequate financial capability is crucial in everyday life. This capability might, however, not be given to adults with ADHD. The present study aims to determine strengths and weaknesses regarding everyday financial knowledge and judgment skills in adults with ADHD. In addition, the impact of income is explored. Forty-five adults with ADHD (Mage = 36.6, SDage = 10.2) and 47 adults without ADHD (Mage = 38.5, SDage = 13.0) were included and were assessed with the Financial Competence Assessment Inventory. Adults with ADHD showed decreased scores regarding awareness of the arrival of bills, knowledge of own income, having a reserve fund for unexpected expenses, the ability to state long-term financial goals, own preferences for estate management, understanding of assets, legal action for debt, access to financial advice/counseling, and the ability to compare medical insurance plans as compared with adults without ADHD (all p < 0.001). However, no effect of income was found. In conclusion, adults with ADHD have difficulties with many aspects of everyday financial knowledge and skills, which might result in a plethora of personal and legal consequences. It is, therefore, of the utmost importance that professionals who support adults with ADHD proactively ask about everyday financial functioning so that assessment, financial support, and coaching can be provided.
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Affiliation(s)
- Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
| | - Dorien F. Bangma
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
- Novicare, 3542 AB Utrecht, The Netherlands
| | - Christian Mette
- Department of Social Work and Education, Protestant University of Applied Sciences Bochum, 44803 Bochum, Germany
- LVR Hospital Essen, 45147 Essen, Germany
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, 45147 Essen, Germany
| | - Lara Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, 18147 Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, 18147 Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, W23 F2K8 Maynooth, Ireland
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25
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Hall CL, Partlett C, Valentine AZ, Pearcey S, Sayal K. Understanding the Impact of Home Confinement on Children and Young People with ADHD and ASD During the COVID-19 Pandemic. Child Psychiatry Hum Dev 2023:10.1007/s10578-022-01490-w. [PMID: 36633768 PMCID: PMC9835738 DOI: 10.1007/s10578-022-01490-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2022] [Indexed: 01/13/2023]
Abstract
To understand whether the mental health of children and young people (CYP) with and without attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) were differentially affected by COVID-19. We analysed data (n = 6507) from the Co-Space study, a UK web-based longitudinal survey. CYP with ADHD (n = 160;2.5%), ASD (n = 465;7%), and ADHD + ASD (n = 155;2.4%) were compared with a reference group (n = 5727;88%) using parent-completed questionnaires [Strengths and Difficulties Questionnaire (SDQ) & Pandemic Anxiety Scale (PAS)]. Baseline to 1-month follow-up differences were compared using linear regression models. CYP with ADHD and/or ASD had higher scores at baseline than other CYP. At follow-up, CYP with ASD showed small but significant improvements in symptoms (SDQ), compared with the reference group. CYP with ASD experienced a worsening of disease anxiety (PAS) and CYP with ADHD a deterioration in functional impairment. These findings indicate a mixed pattern of pandemic-related impact for CYP with ADHD and/or ASD.
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Affiliation(s)
- Charlotte L Hall
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, Mental Health & Clinical Neurosciences, University of Nottingham, Innovation Park, Triumph Road, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Institute of Mental Health, Mental Health & Clinical Neurosciences, University of Nottingham, Innovation Park, Triumph Road, Nottingham, UK.
| | - Christopher Partlett
- Nottingham Clinical Trials Unit, School of Medicine, Applied Health Research Building, University Park, Nottingham, UK
| | - Althea Z Valentine
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, School of Medicine, Mental Health & Clinical Neurosciences, University of Nottingham, Innovation Park, Triumph Road, Nottingham, UK
| | - Samantha Pearcey
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Kapil Sayal
- Institute of Mental Health, School of Medicine, Mental Health & Clinical Neurosciences, University of Nottingham, Innovation Park, Triumph Road, Nottingham, UK
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Sacco L, Morellini L, Cerami C. Editorial: The diagnosis and the therapy of social cognition deficits in adults affected by ADHD and MCI. Front Neurol 2023; 14:1162510. [PMID: 36937525 PMCID: PMC10018807 DOI: 10.3389/fneur.2023.1162510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Leonardo Sacco
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
- *Correspondence: Leonardo Sacco
| | - Lucia Morellini
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
- Faculty of Biomedical Sciences, Universitá della Svizzera italiana, Lugano, Switzerland
| | - Chiara Cerami
- IUSS Cognitive Neuroscience (ICoN) Center, University School for Advanced Studies IUSS-Pavia, Pavia, Italy
- Cognitive Computational Neuroscience Research Unit, Mondino Foundation IRCCS, Pavia, Italy
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Zhang K, Yuan J, Pei X, Fu Z, Zhao Y, Hu N, Wang Y, Yang L, Cao Q. Cerebral blood flow characteristics of drug-naïve attention-deficit/hyperactivity disorder with social impairment: Evidence for region-symptom specificity. Front Neurosci 2023; 17:1149703. [PMID: 37025372 PMCID: PMC10070692 DOI: 10.3389/fnins.2023.1149703] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/03/2023] [Indexed: 04/08/2023] Open
Abstract
Background Social deficits are among the most important functional impairments in attention-deficit/hyperactivity disorder (ADHD). However, the relationship between social impairment and ADHD core symptoms as well as the underlying cerebral blood flow (CBF) characteristics remain unclear. Methods A total of 62 ADHD subjects with social deficits (ADHD + SD), 100 ADHD subjects without social deficits (ADHD-SD) and 81 age-matched typically developing controls (TDC) were enrolled. We first examined the correlation between the Social Responsiveness Scale (SRS-1) and ADHD core symptoms (inattention, hyperactivity, and impulsion) and then explored categorical and dimensional ADHD-related regional CBF by arterial spin labeling (ASL). For the categorical analysis, a voxel-based comparison of CBF maps between the ADHD + SD, ADHD-SD, and TDC groups was performed. For the dimensional analysis, the whole-brain voxel-wise correlation between CBF and ADHD symptoms (inattention, hyperactivity/impulsivity, and total scores) was evaluated in three groups. Finally, correlations between the SRS-1 and ADHD-related regional CBF were investigated. We applied Gaussian random field (GRF) for the correction of multiple comparisons in imaging results (voxel-level P < 0.01, and cluster-level P < 0.05). Results The clinical characteristics analysis showed that social deficits positively correlated with ADHD core symptoms, especially in social communication and autistic mannerisms domains. In the categorical analysis, we found that CBF in the left middle/inferior temporal gyrus in ADHD groups was higher than TDCs and was negatively correlated with the social motivation scores. Moreover, in dimensional analysis, we found that CBF in the left middle frontal gyrus was negatively correlated with the inattention scores, SRS total scores and autistic mannerisms scores in ADHD + SD subjects. Conclusion The present study shows that inattention, hyperactivity, and impulsivity may be responsible for the occurrence of social deficits in ADHD, with autistic traits being another significant contributing factor. Additionally, CBF in the left middle/inferior temporal gyrus and the left middle frontal gyrus might represent the corresponding physiological mechanisms underlying social deficits in ADHD.
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Hall MB, Willis DE, Rodriguez EL, Schwarz JM. Maternal immune activation as an epidemiological risk factor for neurodevelopmental disorders: Considerations of timing, severity, individual differences, and sex in human and rodent studies. Front Neurosci 2023; 17:1135559. [PMID: 37123361 PMCID: PMC10133487 DOI: 10.3389/fnins.2023.1135559] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/13/2023] [Indexed: 05/02/2023] Open
Abstract
Epidemiological evidence suggests that one's risk of being diagnosed with a neurodevelopmental disorder (NDD)-such as autism, ADHD, or schizophrenia-increases significantly if their mother had a viral or bacterial infection during the first or second trimester of pregnancy. Despite this well-known data, little is known about how developing neural systems are perturbed by events such as early-life immune activation. One theory is that the maternal immune response disrupts neural processes important for typical fetal and postnatal development, which can subsequently result in specific and overlapping behavioral phenotypes in offspring, characteristic of NDDs. As such, rodent models of maternal immune activation (MIA) have been useful in elucidating neural mechanisms that may become dysregulated by MIA. This review will start with an up-to-date and in-depth, critical summary of epidemiological data in humans, examining the association between different types of MIA and NDD outcomes in offspring. Thereafter, we will summarize common rodent models of MIA and discuss their relevance to the human epidemiological data. Finally, we will highlight other factors that may interact with or impact MIA and its associated risk for NDDs, and emphasize the importance for researchers to consider these when designing future human and rodent studies. These points to consider include: the sex of the offspring, the developmental timing of the immune challenge, and other factors that may contribute to individual variability in neural and behavioral responses to MIA, such as genetics, parental age, the gut microbiome, prenatal stress, and placental buffering.
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Hayashi W, Hanawa Y, Saga N, Nakamura D, Iwanami A. ASD symptoms in adults with ADHD: a comparative study using ADOS-2. Eur Arch Psychiatry Clin Neurosci 2022; 272:1481-1494. [PMID: 34993599 DOI: 10.1007/s00406-021-01362-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022]
Abstract
In this study, we examined autism spectrum disorder (ASD) symptoms in adults with attention-deficit hyperactivity disorder (ADHD) in comparison with normal controls using the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Sixty-three adults with ADHD (mean age, 35.3 years; 38 men) and 31 controls (mean age, 38.7 years; 17 men) completed Module 4 of the ADOS-2, Autism Spectrum Quotient, Conners' Adult ADHD Rating Scale, and Wechsler Adult Intelligence Scale, Third Edition. Adults with ADHD were not clinically diagnosed with ASD, and their ADHD diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Between-group comparisons on the scoring patterns revealed significant ASD symptoms present in adults with ADHD, which was congruent with our previous study. Further, item level and correlation analyses showed the possibility that ASD symptoms in adult ADHD comprised of two distinct mechanisms, one qualitatively similar to ASD and the other arising from ADHD characteristics, highlighting the complex nature of ADHD-ASD symptom overlaps.
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Affiliation(s)
- Wakaho Hayashi
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.
| | - Yoichi Hanawa
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Nobuyuki Saga
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Dan Nakamura
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Akira Iwanami
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
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Alkalay S, Dan O. Effect of short-term methylphenidate on social impairment in children with attention deficit/hyperactivity disorder: systematic review. Child Adolesc Psychiatry Ment Health 2022; 16:93. [PMID: 36443766 PMCID: PMC9706974 DOI: 10.1186/s13034-022-00526-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/14/2022] [Indexed: 11/30/2022] Open
Abstract
Attention Deficit/Hyperactivity disorder (ADHD) is one of the most common disorders in school-age children. In addition to learning difficulties associated with the disorder's core symptoms of inattention and hyperactivity, children with ADHD display substantial social impairments. Methylphenidate (MPH) in formulations such as Ritalin or Concerta mitigates inattention and hyperactivity, but the effects of the therapy on social behavior in children with ADHD are not clear. This review aims to determine the effectiveness of short term (up to 6 months) MPH treatment on three domains of social skills in children aged 6-14 with ADHD: (i) Recognition of nonverbal emotional expressions, which are a marker of inherent (unlearned) social understanding, (ii) theory of mind (ToM) components that relate to learned cognition and social communication, and (iii) social competence in everyday environments. 15 relevant studies were identified based on inclusion/exclusion criteria. The results show mixed effects: the overall social performance as evaluated by parents, teachers or peers, and some components of ToM, were found to improve following a weeks-long course of MPH treatment. However, the effects of the medication are less clear when evaluating momentary/nonverbal social responses such as reactions to emotional facial expressions. While the findings of this review indicate that an MPH medication regime of order weeks to months could improve, to a degree, social impairment in children with ADHD, more studies are required to identify the medications' mechanism and confirm such a conclusion.
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Affiliation(s)
- Sarit Alkalay
- Department of Psychology, The Center for Psychobiological Research, Max Stern Jezreel Valley Academic College, P.O.B. 72, 10806, Sede Nahum, Israel.
| | - Orrie Dan
- Department of Psychology, The Center for Psychobiological Research, Max Stern Jezreel Valley Academic College, P.O.B. 72, 10806 Sede Nahum, Israel
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31
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Dekkers TJ, van Hoorn J. Understanding Problematic Social Media Use in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD): A Narrative Review and Clinical Recommendations. Brain Sci 2022; 12:brainsci12121625. [PMID: 36552085 PMCID: PMC9776226 DOI: 10.3390/brainsci12121625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is consistently associated with a host of social problems, such as victimization and difficulties in maintaining close friendships. These problems are not limited to offline relations but also manifest in the online social world, as previous research shows that ADHD is associated with problematic use of social media. Given the ubiquitous nature of social media, the goal of the current review is to understand why adolescents with ADHD demonstrate more problematic social media use than their typically developing peers. To this end, we provide a narrative review on the evidence for the link between ADHD and social media use, and consequently present an integrative framework, which encompasses neurobiological mechanisms (i.e., imbalance theory of brain development and dual pathway model of ADHD) and social mechanisms, including influences from peers and parents. We conclude that empirical work shows most consistent evidence for the link between problematic social media use and ADHD (symptoms), while intensity of social media use is also associated with several other behaviors and outcomes. Finally, we hypothesize how existing interventions for ADHD may work on the identified mechanisms and provide at-hand clinical recommendations for therapists working with adolescents with ADHD who exhibit problematic social media use.
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Affiliation(s)
- Tycho J. Dekkers
- University Medical Center Groningen, Department of Child and Adolescent Psychiatry, University of Groningen, 9723 HE Groningen, The Netherlands
- Accare Child Study Center, 9713 GZ Groningen, The Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry, 1105 AZ Amsterdam, The Netherlands
- Amsterdam University Medical Center (AUMC), Department of Child and Adolescent Psychiatry, 1100 DD Amsterdam, The Netherlands
- Correspondence:
| | - Jorien van Hoorn
- Levvel, Academic Center for Child and Adolescent Psychiatry, 1105 AZ Amsterdam, The Netherlands
- Department of Developmental and Educational Psychology, Leiden University, 2311 EZ Leiden, The Netherlands
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Lavigne-Cerván R, Sánchez-Muñoz de León M, Juárez-Ruiz de Mier R, Romero-González M, Gamboa-Ternero S, Rodríguez-Infante G, Romero-Pérez JF. Proposal for an Integrative Cognitive-Emotional Conception of ADHD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15421. [PMID: 36430140 PMCID: PMC9691192 DOI: 10.3390/ijerph192215421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
Although numerous efforts have been made to deepen our understanding of the etiology of Attention Deficit Hyperactivity Disorder (ADHD), no explanation of its origins, nor of its consequences, has yet found a consensus within the scientific community. This study performs a theoretical review of various research studies and provides a reflection on the role of emotions in the origin of the disorder, at the neuroanatomical and functional level. To this end, theoretical models (single and multiple origin) and applied studies are reviewed in order to broaden the perspective on the relevance of the executive system in ADHD; it is suggested that this construct is not only composed and activated by cognitive processes and functions, but also includes elements of an emotional and motivational nature. Consequently, it is shown that ADHD is involved in social development and in a person's ability to adapt to the environment.
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Affiliation(s)
- Rocío Lavigne-Cerván
- Department of Developmental and Educational Psychology, University of Malaga, 29071 Malaga, Spain
| | | | | | - Marta Romero-González
- Department of Developmental and Educational Psychology, University of Malaga, 29071 Malaga, Spain
| | - Sara Gamboa-Ternero
- Department of Developmental and Educational Psychology, University of Alicante, 03690 Alicante, Spain
| | - Gemma Rodríguez-Infante
- Department of Developmental and Educational Psychology, University of Malaga, 29071 Malaga, Spain
| | - Juan F. Romero-Pérez
- Department of Developmental and Educational Psychology, University of Malaga, 29071 Malaga, Spain
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Morellini L, Ceroni M, Rossi S, Zerboni G, Rege-Colet L, Biglia E, Morese R, Sacco L. Social Cognition in Adult ADHD: A Systematic Review. Front Psychol 2022; 13:940445. [PMID: 35898990 PMCID: PMC9311421 DOI: 10.3389/fpsyg.2022.940445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/09/2022] [Indexed: 01/16/2023] Open
Abstract
The aim of this systematic review was to collect and align the research on social cognition impairments in adults with Attention-deficit/hyperactivity disorder (ADHD). In particular, we selected and analyzed papers on emotion recognition and processing, Theory of Mind (TOM), empathy, and other facets of social cognition as decision making. We identified 16 papers published between 2012 and 2022 which meet inclusion criteria. Papers search, selection, and extraction followed the PRISMA guidelines. In order to summarize data from papers, we used a narrative synthesis approach. Results show different evidence of impairment in social cognition domains in adults with ADHD. Our systematic review suggests the importance of promoting more research on this topic because it is essential to keep in mind that social cognition plays a central role in socialization and social relationships.
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Affiliation(s)
- Lucia Morellini
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
- *Correspondence: Lucia Morellini
| | - Martino Ceroni
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Stefania Rossi
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Giorgia Zerboni
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Laura Rege-Colet
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Elena Biglia
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Rosalba Morese
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
- Rosalba Morese
| | - Leonardo Sacco
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
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Zuberer A, Schwarz L, Kreifelts B, Wildgruber D, Erb M, Fallgatter A, Scheffler K, Ethofer T. Neural Basis of Impaired Emotion Recognition in Adult Attention-Deficit/Hyperactivity Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:680-687. [PMID: 33551283 DOI: 10.1016/j.bpsc.2020.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Deficits in emotion recognition have been repeatedly documented in patients diagnosed with attention-deficit/hyperactivity disorder (ADHD), but their neural basis is unknown so far. METHODS In the current study, adult patients with ADHD (n = 44) and healthy control subjects (n = 43) underwent functional magnetic resonance imaging during explicit emotion recognition of stimuli expressing affective information in face, voice, or face-voice combinations. The employed experimental paradigm allowed us to delineate areas for processing audiovisual information based on their functional activation profile, including the bilateral posterior superior temporal gyrus/middle temporal gyrus, amygdala, medial prefrontal cortex, and precuneus, as well as the right posterior thalamus. RESULTS As expected, unbiased hit rates for correct classification of the expressed emotions were lower in patients with ADHD than in healthy control subjects irrespective of the presented sensory modality. This deficit at a behavioral level was accompanied by lower activation in patients with ADHD versus healthy control subjects in the cortex adjacent to the right superior temporal gyrus/middle temporal gyrus and the right posterior thalamus, which represent key areas for processing socially relevant signals and their integration across modalities. A cortical region adjacent to the right posterior superior temporal gyrus was the only brain region that showed a significant correlation between brain activation and emotion identification performance. CONCLUSIONS Altogether, these results provide the first evidence for a potential neural substrate of the observed impairments in emotion recognition in adults with ADHD.
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Affiliation(s)
- Agnieszka Zuberer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany; Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
| | - Lena Schwarz
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Benjamin Kreifelts
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Andreas Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Klaus Scheffler
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany; Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Thomas Ethofer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany; Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
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Abdel Fattah NR, Yousef AM, Mohamed AE, Amin SI. Behavioral symptoms among children and adolescents with attention deficit hyperactivity disorder during COVID-19 outbreak: a retrospective prospective cohort study. MIDDLE EAST CURRENT PSYCHIATRY 2022. [PMCID: PMC9068252 DOI: 10.1186/s43045-022-00198-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental conditions in children, and with the coronavirus pandemic, ADHD children now pose obvious challenges. This retrospective prospective cohort study was conducted on 150 ADHD children and adolescents that had previously attended the child unit of the Psychiatry Department, Zagazig University Hospitals, Sharkia, Egypt, and diagnosed as ADHD patients using the research diagnostic criteria of DSM-5 which administrated by experienced psychiatrists and evaluated by The Arabic version of Conner’s Parent Rating Scale Revised-short version (CPRS-48) before the onset of COVID-19 pandemic. We collected the other data of the study by applying an Arabic language questionnaire which included the data related to the COVID -19 pandemic and the Arabic version of CPRS-48 by which we reevaluated the behavioral symptoms of the subjects who participated in the study during COVID-19 pandemic. This research aimed to evaluate the behavioral symptoms among ADHD children and adolescents and detect the change in these symptoms during the COVID-19 pandemic by comparing them before and during the pandemic. Results One hundred fifty ADHD children were included in the study with a mean age of 10 years old. The male gender was predominant and represented 76.7% of the sample. Ninety percent were living in urban areas with more low social class (50%), 84.7% of parents were married, 60% of the family member of our subjects had COVID-19 while 12% lost one or more of their relative by the pandemic (64.7%). The fathers continued working as normal, while 40.7% of the mothers stopped working because of COVID-19. 62.7% of the parents were verbally and physically abusive to their children. Unfortunately, 100% of the subjects stopped attending their behavioral therapy center, 96.0% stopped their Follow up with a psychiatrist, and 55% stopped complying with their medications. As we presumed, we found a statistically significant change in the behavioral and psychological symptoms measured by Conner’s Parent Rating Scale Revised-short version (CPRS-48) during the COVID-19 pandemic compared to the period before. The worsening of the symptoms was associated with age, sex, residency, social class, father and mother present working and couple status, having positive cases or losses of COVID-19 among family members, and patient maltreatment. Conclusions To conclude, this study suggests that the lockdown caused by the COVID-19 pandemic has worsened symptoms in a significant number of children and adolescents with ADHD, which needs clinical attention. Moreover, the patients’ psychiatric follow-up and compliance with their medications were markedly affected. Additionally, the lockdown has also led to an increase in the abusive behavior of the parents towards their children.
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Ladicha LS, Altemeyer KM, Ramsauer B. Die klinische Validierung des diagnostischen Elterninterviews „Diagnostic Infant and Preschool Assessment“ (DIPA). DIAGNOSTICA 2022. [DOI: 10.1026/0012-1924/a000286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Da Klein- und Vorschulkinder bereits unter psychischen Auffälligkeiten leiden können, ist ein valides Diagnoseinstrument erforderlich. Das Diagnostic Infant and Preschool Assessment (DIPA) ist ein Elterninterview zur klinischen Diagnostik im Kleinkind- und Vorschulalter. Die deutsche DIPA-Version wurde auf ihre psychometrischen Eigenschaften untersucht. Mit N = 109 Eltern klinisch vorgestellter Kinder (Alter: 0 bis 6 Jahre) wurde das DIPA durchgeführt und die Ergebnisse mit der CBCL / 1½-5 und der C-TRF / 1½-5 verglichen. Die Kinder erhielten durchschnittlich zwei DIPA-Diagnosen, wobei die Störung mit Oppositionellem Trotzverhalten am häufigsten vorkam. Es zeigten sich zufriedenstellende Beurteilerübereinstimmungen. Zwischen den nach Anzahl der DIPA-Diagnosen eingeteilten Gruppen zeigten sich signifikante Unterschiede in den CBCL-Ergebnissen. Erhöhte CBCL-Problemwerte konnten das Vorliegen von DIPA-Diagnosen vorhersagen. Die Ergebnisse sprechen für eine zufriedenstellende Konstruktvalidität des DIPA. Es kann im klinischen Alltag eingesetzt werden, da es die 15 wichtigsten DSM-5-Diagnosen des Vorschulalters umfasst und valide, benutzerfreundlich sowie effizient ist und auch für die Forschung vielfältige Möglichkeiten liefert.
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Affiliation(s)
- Lina S. Ladicha
- Klinik für Kinder- und Jugendpsychiatrie, -psychosomatik und -psychotherapie, Universitätsklinikum Münster, Westfälische Wilhelms-Universität Münster
| | - Klara-Maria Altemeyer
- Klinik für Kinder- und Jugendpsychiatrie, -psychosomatik und -psychotherapie, Universitätsklinikum Münster, Westfälische Wilhelms-Universität Münster
| | - Brigitte Ramsauer
- Fakultät Medizin, MSH Medical School Hamburg University of Applied Sciences and Medical University, Hamburg
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Hayashi W, Hanawa Y, Yuriko I, Aoyagi K, Saga N, Nakamura D, Iwanami A. ASD symptoms in adults with ADHD: a preliminary study using the ADOS-2. Eur Arch Psychiatry Clin Neurosci 2022; 272:217-232. [PMID: 33751200 DOI: 10.1007/s00406-021-01250-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/03/2021] [Indexed: 10/25/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has long been regarded as disparate and mutually exclusive to autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III-R and DSM-IV. However, this idea has become obsolete due to a growing body of evidence suggesting numerous phenotypic and genetic similarities between ADHD and ASD. ASD symptoms or autistic traits in individuals with ADHD have been examined; however, most studies were conducted on children and relied on self- or parent- reports. ASD symptoms assessed with more direct, objective measures, such as the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in adults with ADHD, remain understudied. In the present study, we used the ADOS-2 to evaluate ASD symptoms in adults with ADHD who were not clinically diagnosed with ASD. Fifty-six adults (mean age 33.9 years, 35 males, intelligence quotient ≥ 85), who were diagnosed with ADHD based on the DSM-5 criteria, completed Module 4 of the ADOS-2. Autism Spectrum Quotient (AQ), Conners' Adult ADHD Rating Scale (CAARS), and Wechsler Adult Intelligence Scale (WAIS)-III were also administered to assess self-rated ASD symptoms, ADHD symptoms, and intelligence, respectively. Overall, 23.3% of participants met the ASD diagnostic classification on the ADOS-2. Social reciprocal interaction scores tended to be higher, while restricted and repetitive behavior scores were low. The scoring patterns and possible overlapping and differing phenotypic characteristics of ADHD and ASD are discussed.
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Affiliation(s)
- Wakaho Hayashi
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan. .,Department of Psychiatry, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.
| | - Yoichi Hanawa
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Iwami Yuriko
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Keisuke Aoyagi
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Nobuyuki Saga
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Dan Nakamura
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Akira Iwanami
- Department of Psychiatry, Showa University School of Medicine, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.,Department of Psychiatry, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
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38
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Silverman MR, Bennett R, Feuerstahler L, Stadterman J, Dick AS, Graziano P, Roy AK. Measuring Emotion Dysregulation in Children With Attention-Deficit/Hyperactivity Disorder: Revisiting the Factor Structure of the Emotion Regulation Checklist. Behav Ther 2022; 53:196-207. [PMID: 35227398 PMCID: PMC9162246 DOI: 10.1016/j.beth.2021.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/13/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
Emotion dysregulation (ED) is prevalent among youth with Attention-Deficit/Hyperactivity Disorder (ADHD) and significantly impacts functioning. Nuanced measurement of ED is central to understanding its role in this disorder and informing treatment approaches. The present study examined the factor structure of the Emotion Regulation Checklist (ERC) among children with ADHD with and without Oppositional Defiant Disorder (ODD). Exploratory factor analysis (EFA) conducted in a sample of 328 youth (mean age = 6.08) with ADHD indicated a four-factor solution, comprised of the following factors: Negative Emotion Lability, Positive Emotion Lability, Socially Appropriate Affect, and Socially Incongruent Affect. The Negative and Positive Emotion Lability subscales assess the reactivity of negatively and positively valenced emotions, respectively. The Socially Appropriate and Socially Incongruent Affect subscales provide an assessment of social-emotional functioning. All subscales discriminated between children with ADHD only and ADHD with co-morbid ODD, such that children with ODD had greater emotional lability and social-emotional difficulties. This revised factor structure of the ERC facilitates a uniquely brief, yet multifaceted and specific, assessment of emotional difficulties in children with ADHD that can inform treatment planning and operationalize emotional reactivity and social-emotional functioning in future research efforts.
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Affiliation(s)
- Melanie R. Silverman
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY USA
| | - Randi Bennett
- Hassenfeld Children’s Hospital, NYU Langone, 1 Park Avenue, New York, NY USA
| | - Leah Feuerstahler
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY USA
| | - Jill Stadterman
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY USA
| | - Anthony Steven Dick
- Department of Psychology, Florida International University, 11200 SW 8 Street, Miami, FL USA
| | - Paulo Graziano
- Department of Psychology, Florida International University, 11200 SW 8 Street, Miami, FL USA
| | - Amy Krain Roy
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY USA,Hassenfeld Children’s Hospital, NYU Langone, 1 Park Avenue, New York, NY USA
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Hoorn J, Water E, Dekkers TJ, Pollak Y, Popma A, Jansen BRJ, Huizenga HM, Duijvenvoorde ACK. Peer feedback decreases impulsive choice in adolescents with and without attention‐deficit/hyperactivity disorder. JCPP ADVANCES 2022. [DOI: 10.1002/jcv2.12065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Jorien Hoorn
- Institute of Psychology, Department of Developmental and Educational Psychology Leiden University Leiden The Netherlands
- Leiden Institute for Brain and Cognition Leiden The Netherlands
- Levvel Academic Center for Child‐ and Adolescent Psychiatry Amsterdam The Netherlands
| | | | - Tycho J. Dekkers
- Levvel Academic Center for Child‐ and Adolescent Psychiatry Amsterdam The Netherlands
- Department of Psychology University of Amsterdam Amsterdam The Netherlands
- Department of Child‐ and Adolescent Psychiatry University Medical Center Groningen Groningen The Netherlands
- Department of Child‐ and Adolescent Psychiatry Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Yehuda Pollak
- Seymour Fox School of Education Hebrew University of Jerusalem Jerusalem Israel
| | - Arne Popma
- Levvel Academic Center for Child‐ and Adolescent Psychiatry Amsterdam The Netherlands
- Department of Child‐ and Adolescent Psychiatry Amsterdam University Medical Centers Amsterdam The Netherlands
| | - Brenda R. J. Jansen
- Department of Psychology University of Amsterdam Amsterdam The Netherlands
- Amsterdam Brain and Cognition Center Amsterdam The Netherlands
- Research Priority Area Yield Amsterdam The Netherlands
| | - Hilde M. Huizenga
- Department of Psychology University of Amsterdam Amsterdam The Netherlands
- Amsterdam Brain and Cognition Center Amsterdam The Netherlands
- Research Priority Area Yield Amsterdam The Netherlands
| | - Anna C. K. Duijvenvoorde
- Institute of Psychology, Department of Developmental and Educational Psychology Leiden University Leiden The Netherlands
- Leiden Institute for Brain and Cognition Leiden The Netherlands
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40
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ADHD patients with DIRAS2 risk allele need more thalamic activation during emotional face-voice recognition. Psychiatry Res 2022; 308:114355. [PMID: 34990989 DOI: 10.1016/j.psychres.2021.114355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
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41
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Hai T, Climie EA. Positive Child Personality Factors in Children with ADHD. J Atten Disord 2022; 26:476-486. [PMID: 33666141 DOI: 10.1177/1087054721997562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder. While previous studies have shown substantial impact of ADHD across multiple domains, relatively little attention has been devoted to studying positive personality factors in individuals with ADHD. To address this, the current study examined strength-based factors in children with ADHD in relation to their social skills. METHOD Sixty-four children (aged 8-12 years) with ADHD completed questionnaires related to their social skills and strength-based factors (e.g., optimism, resilience, self-concept, and coping skills). RESULTS Findings indicated significant differences between different levels of social skills in children with ADHD, with children with higher social skills reporting higher levels of resiliency, greater behavioral competence, and greater prosocial attitudes than those with lower social skills. CONCLUSIONS The results highlight the importance of fostering strong social skills in children with ADHD, leading them to perceive themselves as competent and resilient.
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Affiliation(s)
- Tasmia Hai
- University of Alberta, Edmonton, AB, Canada
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42
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Anderman EM, Gilman R, Liu X, Ha SY. The relations of inattention and hyperactivity to academic cheating in adolescents with executive functioning problems. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eric M. Anderman
- Department of Educational Studies, College of Education and Human Ecology The Ohio State University Columbus Ohio USA
| | | | - Xingfeiyue Liu
- Department of Educational Studies, College of Education and Human Ecology The Ohio State University Columbus Ohio USA
| | - Seung Yon Ha
- Department of Educational Studies, College of Education and Human Ecology The Ohio State University Columbus Ohio USA
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Abstract
Attention-Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition associated with impaired function and increased risk of poor outcomes in children, young people and adults with the condition. Currently approved pharmacological treatments for ADHD include a range of stimulant (methylphenidate, amphetamine) and nonstimulant (atomoxetine, guanfacine, clonidine) medications. All have been shown to be effective in treating the symptoms of ADHD and improving other functional outcomes including quality of life, academic performance, rates of accidents and injuries, and do not appear to be associated with significant adverse outcomes or side effects. In this chapter, we review medications for ADHD by summarising the mechanisms of action of each of the two main classes of compounds (stimulants and nonstimulants), the formulations of the most commonly prescribed medications within each class, their efficacy in treating ADHD symptoms and other outcomes, and other factors that influence treatment decisions including side effects and tolerability, comorbidities and medical history. We conclude with a summary of the treatment decisions made by clinicians and suggest some next steps for research. Further research is needed to understand the mechanisms of action of these medications and how exactly they improve symptoms, and to examine their effects on commonly occurring comorbidities.
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Affiliation(s)
- Madeleine J Groom
- Academic Unit of Mental Health and Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK.
| | - Samuele Cortese
- Faculty of Environmental and Life Sciences, Center for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, Nottingham, UK
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Facial emotion recognition impairment predicts social and emotional problems in children with (subthreshold) ADHD. Eur Child Adolesc Psychiatry 2022; 31:715-727. [PMID: 33415471 PMCID: PMC9142461 DOI: 10.1007/s00787-020-01709-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/19/2020] [Indexed: 12/28/2022]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) symptoms often experience social and emotional problems. Impaired facial emotion recognition has been suggested as a possible underlying mechanism, although impairments may depend on the type and intensity of emotions. We investigated facial emotion recognition in children with (subthreshold) ADHD and controls using a novel task with children's faces of emotional expressions varying in type and intensity. We further investigated associations between emotion recognition accuracy and social and emotional problems in the ADHD group. 83 children displaying ADHD symptoms and 30 controls (6-12 years) completed the Morphed Facial Emotion Recognition Task (MFERT). The MFERT assesses emotion recognition accuracy on four emotions using five expression intensity levels. Teachers and parents rated social and emotional problems on the Strengths and Difficulties Questionnaire. Repeated measures analysis of variance revealed that the ADHD group showed poorer emotion recognition accuracy compared to controls across emotions (small effect). The significant group by expression intensity interaction (small effect) showed that the increase in accuracy with increasing expression intensity was smaller in the ADHD group compared to controls. Multiple regression analyses within the ADHD group showed that emotion recognition accuracy was inversely related to social and emotional problems, but not prosocial behavior. Not only children with an ADHD diagnosis, but also children with subthreshold ADHD experience impairments in facial emotion recognition. This impairment is predictive for social and emotional problems, which may suggest that emotion recognition may contribute to the development of social and emotional problems in these children.
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Which factors determine clinicians' policy and attitudes towards medication and parent training for children with Attention-Deficit/Hyperactivity Disorder? Eur Child Adolesc Psychiatry 2022; 31:483-493. [PMID: 33585968 PMCID: PMC8940866 DOI: 10.1007/s00787-021-01735-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/31/2021] [Indexed: 01/19/2023]
Abstract
Behavioral parent and teacher training and stimulant medication are recommended interventions for children with attention-deficit/hyperactivity disorder (ADHD). However, not all children with ADHD receive this evidence-based care, and the aim of the current study was to find out why. More specifically, we investigated clinicians' policy, guideline use, and attitudes towards medication and parent training when treating children with ADHD, as well as several factors that could affect this. A total of 219 Dutch clinicians (mainly psychologists, psychiatrists and educationalists) completed a survey. Clinicians were likely to recommend medication more often than parent training, and clinicians' policy to recommend medication and parent training was positively associated with their attitudes towards these interventions. Less experienced clinicians and those with a non-medical background reported lower rates of guideline use, whereas clinicians with a medical background reported less positive attitudes towards parent training. Furthermore, a substantial portion of the clinicians based their decision to recommend parent training on their clinical judgement (e.g., prior estimations of efficacy, perceived low abilities/motivation of parents), and many clinicians reported barriers for referral to parent training, such as waiting lists or a lack of skilled staff. To achieve better implementation of evidence-based care for children with ADHD, guidelines should be communicated better towards clinicians. Researchers and policy-makers should further focus on barriers that prevent implementation of parent training, which are suggested by the discrepancy between clinicians' overall positive attitude towards parent training and the relatively low extent to which clinicians actually advise parent training.
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Aiello S, Vagni D, Cerasa A, Leonardi E, Carrozza C, Famà F, Campisi A, Marino F, Siracusano R, Alquino MA, Mainiero F, Germano E, Tartarisco G, Pioggia G, Gagliano A, Ruta L. Autistic Traits and Empathy in Children With Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder and Co-occurring Attention Deficit Hyperactivity Disorder/Autism Spectrum Disorder. Front Neurosci 2021; 15:734177. [PMID: 34887721 PMCID: PMC8649805 DOI: 10.3389/fnins.2021.734177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD) are two of the most represented neurodevelopmental conditions in childhood. The diagnostic shift introduced by the DSM-5, allowing a combined diagnosis of ADHD and ASD, poses different clinical challenges related to diagnostic overshadowing, accuracy of clinical judgment and potential delay in an ASD diagnosis in children presenting with ADHD. Here we tried to disentangle the clinical phenotype and specificity of the two co-occurring conditions in relation to autism traits and empathy, by comparing children with ASD with and without comorbid ADHD with children presenting ADHD only and children with typical development. The child versions of the Autism Quotient (C-AQ) and Empathy Quotient (C-EQ) were administered to a total sample of 198 male children between 6 and 14 years old with age appropriate language skills and normal intelligence. Univariate analysis demonstrated no significant differences in the C-AQ total and subscale scores as well as the C-EQ between children with ASD and children with ASD + ADHD, while children with ADHD alone presented an intermediate phenotype between ASD and TD. Furthermore, a receiver operating characteristic (ROC) analysis was applied to discriminate among the different phenotypes. We found that the C-AQ and C-EQ were accurate at distinguishing with satisfactory reliability between: (a) ASD vs. non- ASD (N-ASD) groups comprising both ADHD and TD children (Area Under the Curve AUC 88% for C-AQ and 81% for C-EQ); (b) ASD and TD (AUC 92% for C-AQ and 95% for C-EQ); (c) ASD and ADHD (AUC 80% for C-AQ and 68% for C-EQ). Our data confirm the reliability of the C-AQ and C-EQ as behavioral markers to differentiate ASD (regardless of comorbid ADHD) from an ADHD condition and TD. Interestingly, in our sample an ADHD condition does not increase the severity of the clinical phenotype in terms of autism traits distribution and empathy, suggesting that the psychological measures detected by the two quantitative instruments are independent of ADHD traits. This evidence will contribute to the translational efforts in developing better tailored treatments and preventive strategies.
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Affiliation(s)
- Stefania Aiello
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - David Vagni
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy.,S. Anna Institute, Crotone, Italy.,Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, Arcavacata, Italy
| | - Elisa Leonardi
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Cristina Carrozza
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Francesca Famà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Agrippina Campisi
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Rosamaria Siracusano
- Division of Child Neurology and Psychiatry, Federico II University Hospital Naples, Naples, Italy
| | - Maria Ausilia Alquino
- Division of Child Neurology and Psychiatry, Department of the Adult and Developmental Age Human Pathology, University of Messina, Messina, Italy
| | - Francesco Mainiero
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Eva Germano
- Division of Child Neurology and Psychiatry, Department of the Adult and Developmental Age Human Pathology, University of Messina, Messina, Italy
| | - Gennaro Tartarisco
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Antonella Gagliano
- Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Liliana Ruta
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
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Mehren A, Thiel CM, Bruns S, Philipsen A, Özyurt J. Unimpaired social cognition in adult patients with ADHD: brain volumetric and behavioral results. Soc Cogn Affect Neurosci 2021; 16:1160-1169. [PMID: 33959774 PMCID: PMC8599175 DOI: 10.1093/scan/nsab060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 04/20/2021] [Accepted: 05/05/2021] [Indexed: 11/14/2022] Open
Abstract
The present study aimed to investigate whether adult patients with attention deficit hyperactivity disorder (ADHD) show deficits in social cognition and to identify the structural neural correlates of social cognitive skills in ADHD. Twenty-six adult patients with ADHD and 26 matched healthy control participants performed the Movie for the Assessment of Social Cognition and underwent a structural magnetic resonance imaging scan. We compared theory of mind (ToM) performance between ADHD patients and healthy controls. Using voxel-based morphometry, we further compared gray matter volumes in regions that are critical for social cognition between the two groups and examined whether ToM performance was correlated with brain morphometry measures. We did not observe any between-group differences in ToM abilities or regional gray matter volumes. Across both groups, performance on affective aspects of ToM correlated positively with gray matter volumes in the medial part of the superior frontal gyri, which is typically involved in social cognition. This study is the first to relate brain structure to social cognitive abilities in adult patients with ADHD. Although our sample was small and heterogeneous, with half of the patients showing mild-to-moderate psychiatric comorbidities, our results may encourage longitudinal studies that relate social cognitive development in childhood and adolescence to brain maturation of ADHD patients.
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Affiliation(s)
- Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn 53127, Germany
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
| | - Christiane Margarete Thiel
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
- Cluster of Excellence ‘Hearing4all’, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
| | - Swantje Bruns
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn 53127, Germany
| | - Jale Özyurt
- Biological Psychology Lab, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg 26129, Germany
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48
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Glenn DE, Michalska KJ, Lee SS. Social skills moderate the time-varying association between aggression and peer rejection among children with and without ADHD. Aggress Behav 2021; 47:659-671. [PMID: 34426990 PMCID: PMC10155268 DOI: 10.1002/ab.21991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 07/26/2021] [Accepted: 08/03/2021] [Indexed: 11/10/2022]
Abstract
Although childhood aggression is typically associated with peer rejection, some children concurrently employ coercive and socially skilled behavior and successfully avoid negative peer outcomes. However, research on children's dual use of coercive and social behavior has largely employed cross-sectional designs with nonclinical populations and, as a result, little is known about the covariation of aggression with social skills, particularly among high-risk samples. We directly addressed this limitation by testing childhood aggression and social skills as separate time-varying predictors of prospective change in peer rejection in a sample of children with and without attention-deficit/hyperactivity disorder (ADHD). Two hundred and two 5-10-year-old children (M = 7.9 years, SD = 1.2) with and without ADHD were followed prospectively for 6 years. Key constructs, including children's overt aggression, social skills, and peer rejection, were collected at each of the three waves using multiple methods and informants. Controlling for demographic factors and time-varying ADHD symptoms, longitudinal change in child-, parent-, and teacher-reported aggression positively predicted prospective change in parent- and teacher-reported peer rejection. Importantly, predictions were moderated by parent- and teacher-reported social skills, such that aggression inversely predicted peer rejection for children with high social skills. These results demonstrate that social skills meaningfully alter trajectories of peer rejection predicted from cross-time variation in aggression. We discuss the theoretical and empirical implications of these findings within a developmental psychopathology framework, including recommendations for directions for future research.
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Affiliation(s)
- Dana E. Glenn
- Department of Psychology University of California Riverside California USA
| | | | - Steve S. Lee
- Department of Psychology University of California Los Angeles California USA
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Fantozzi P, Sesso G, Muratori P, Milone A, Masi G. Biological Bases of Empathy and Social Cognition in Patients with Attention-Deficit/Hyperactivity Disorder: A Focus on Treatment with Psychostimulants. Brain Sci 2021; 11:1399. [PMID: 34827398 PMCID: PMC8615705 DOI: 10.3390/brainsci11111399] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 12/16/2022] Open
Abstract
In recent years, there has been growing interest in investigating the effect of specific pharmacological treatments for ADHD not only on its core symptoms, but also on social skills in youths. This stands especially true for ADHD patients displaying impulsive aggressiveness and antisocial behaviors, being the comorbidity with Disruptive Behavior Disorders, one of the most frequently observed in clinical settings. This systematic review aimed to synthesize research findings on this topic following PRISMA guidelines and to identify gaps in current knowledge, future directions, and treatment implications. Search strategies included the following terms: ADHD; methylphenidate and other ADHD drugs; empathy, theory of mind and emotion recognition. Full-text articles were retrieved and data from individual studies were collected. Thirteen studies were finally included in our systematic review. Ten studies assessing changes in empathy and/or theory of mind in patients with ADHD treated after pharmacological interventions were identified. Similarly, seven partially overlapping studies assessing changes in emotion recognition were retrieved. Despite a great heterogeneity in the methodological characteristics of the included studies, most of them reported an improvement in emphatic and theory of mind abilities in youths with ADHD treated with psychostimulants and nonstimulant drugs, as well as positive but less consistent results about emotion recognition performances.
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Affiliation(s)
- Pamela Fantozzi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Pietro Muratori
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Annarita Milone
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
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50
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Abstract
Although autism spectrum disorder (ASD) is the prototypical psychiatric disorder of social impairment, several if not most psychiatric disorders are characterized by prominent impairments in social functioning. A challenge in clinically assessing and describing social impairment is that it has been variably defined and can be difficult to measure. In this article we consider the psychiatric differential diagnosis of social impairment within the DSM-5 framework. We describe the features of social impairment in 13 DSM-5 disorders from a developmental perspective and highlight diagnostic factors that differentiate among the disorders, including the main features of social impairment, verbal communication, nonverbal communication, course of social impairment, social cognition, and key features of accompanying neuropsychiatric symptoms. We conclude by describing an approach for assessing social impairment across the lifespan.
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