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Lee K, Fung HW. The mediated model of PTSD between ADHD symptoms and alcohol abuse in a population of college students in Taiwan. J Formos Med Assoc 2024:S0929-6646(24)00359-0. [PMID: 39209668 DOI: 10.1016/j.jfma.2024.08.008] [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: 01/23/2024] [Revised: 06/28/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE Impulsivity, inattention, childhood trauma, PTSD, and depressive symptoms were the high-risk factors of alcohol abuse in ADHD symptoms. There is a lack of a comprehensive framework of trauma and PTSD in ADHD symptoms with alcohol abuse to explain why ADHD college students become problematic alcohol drinking. METHOD 521 college students were recruited from online platforms (e.g., Facebook, LINE, or Google) after informed consent (females, 67.9%, n = 354; averaged age = 20.34, S.D. = 1.98). All of them completed the questionnaires, which included symptoms of ADHD, inattention and impulsivity, depressive symptoms, childhood trauma, PTSD symptoms, and problematic alcohol drinking. One-way ANOVA and path analysis were applied to examine the significance of eight paths. RESULTS Our results supported the mediating effects of childhood trauma and PTSD symptoms in ADHD symptoms with problematic alcohol drinking. DISCUSSION The effect of complex PTSD between impulsivity and problematic alcohol drinking is still unclear. In addition to impulsivity and inattention to ADHD symptoms with problematic alcohol drinking, the impact of hyperactivity also needs to be considered. CONCLUSIONS Effective treatment for ADHD symptoms with alcohol abuse could focus on self-control training and emotional regulation in the future.
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Affiliation(s)
- Kunhua Lee
- Department of Educational Psychology and Counseling, National Tsing Hua University, Taiwan.
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong.
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Navarro-Soria I, Rico-Juan JR, Juárez-Ruiz de Mier R, Lavigne-Cervan R. Prediction of attention deficit hyperactivity disorder based on explainable artificial intelligence. APPLIED NEUROPSYCHOLOGY. CHILD 2024:1-14. [PMID: 38593762 DOI: 10.1080/21622965.2024.2336019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Accurate assessment of Attention Deficit Hyperactivity Disorder (ADHD) is crucial for the effective treatment of affected individuals. Traditionally, psychometric tests such as the WISC-IV have been utilized to gather evidence and identify patterns or factors contributing to ADHD diagnosis. However, in recent years, the use of machine learning (ML) models in conjunction with post-hoc eXplainable Artificial Intelligence (XAI) techniques has improved our ability to make precise predictions and provide transparent explanations. The objective of this study is twofold: firstly, to predict the likelihood of an individual receiving an ADHD diagnosis using ML algorithms, and secondly, to offer interpretable insights into the decision-making process of the ML model. The dataset under scrutiny comprises 694 cases collected over the past decade in Spain, including information on age, gender, and WISC-IV test scores. The outcome variable is the professional diagnosis. Diverse ML algorithms representing various learning styles were rigorously evaluated through a stratified 10-fold cross-validation, with performance assessed using key metrics, including accuracy, area under the receiver operating characteristic curve, sensitivity, and specificity. Models were compared using both the full set of initial features and a well-suited wrapper-type feature selection algorithm (Boruta). Following the identification of the most suitable model, Shapley additive values were computed to assign weights to each predictor based on their additive contribution to the outcome and to elucidate the predictions. Strikingly, a reduced set of 8 out of the initial 20 variables produced results comparable to using the full feature set. Among the ML models tested, the Random Forest algorithm outperformed others on most metrics (ACC = 0.90, AUC = 0.94, Sensitivity = 0.91, Specificity = 0.92). Notably, the principal predictors, ranked by importance, included GAI - CPI, WMI, CPI, PSI, VCI, WMI - PSI, PRI, and LN. Individual case examples exhibit variations in predictions depending on unique characteristics, including instances of false positives and negatives. Our ML model adeptly predicted ADHD diagnoses in 90% of cases, with potential for further enhancement by expanding our database. Furthermore, the use of XAI techniques enables the elucidation of salient factors in individual cases, thereby aiding inexperienced professionals in the diagnostic process and facilitating comparison with expert assessments. It is important to note that this tool is designed to support the ADHD diagnostic process, where the medical professional always has the final say in decision-making.
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Affiliation(s)
- Ignasi Navarro-Soria
- Department of Developmental and Educational Psychology, University of Alicante, San Vicente, Spain
| | - Juan Ramón Rico-Juan
- Department of Software and Computing Systems, University of Alicante, San Vicente, Spain
| | | | - Rocío Lavigne-Cervan
- Department of Developmental and Educational Psychology, University of Malaga, Malaga, Spain
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3
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DeRosa J, Rosch KS, Mostofsky SH, Nikolaidis A. Developmental deviation in delay discounting as a transdiagnostic indicator of risk for child psychopathology. J Child Psychol Psychiatry 2024; 65:148-164. [PMID: 37524685 PMCID: PMC10828118 DOI: 10.1111/jcpp.13870] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND The tendency to prefer smaller, immediate rewards over larger, delayed rewards is known as delay discounting (DD). Developmental deviations in DD may be key in characterizing psychiatric and neurodevelopmental disorders. Recent work empirically supported DD as a transdiagnostic process in various psychiatric disorders. Yet, there is a lack of research relating developmental changes in DD from mid-childhood to adolescence to psychiatric and neurodevelopmental disorders. Additionally, examining the interplay between socioeconomic status/total household income (THI) and psychiatric symptoms is vital for a more comprehensive understanding of pediatric pathology and its complex relationship with DD. METHODS The current study addresses this gap in a robust psychiatric sample of 1843 children and adolescents aged 5-18 (M = 10.6, SD = 3.17; 1,219 males, 624 females). General additive models (GAMs) characterized the shape of age-related changes in monetary and food reward discounting for nine psychiatric disorders compared with neurotypical youth (NT; n = 123). Over 40% of our sample possessed a minimum of at least three psychiatric or neurodevelopmental disorders. We used bootstrap-enhanced Louvain community detection to map DD-related comorbidity patterns. We derived five subtypes based on diagnostic categories present in our sample. DD patterns were then compared across each of the subtypes. Further, we evaluated the effect of cognitive ability, emotional and behavioral problems, and THI in relation to DD across development. RESULTS Higher discounting was found in six of the nine disorders we examined relative to NT. DD was consistently elevated across development for most disorders, except for depressive disorders, with age-specific DD differences compared with NTs. Community detection analyses revealed that one comorbidity subtype consisting primarily of Attention-Deficit/Hyperactivity Disorder (ADHD) Combined Presentation and anxiety disorders displayed the highest overall emotional/behavioral problems and greater DD for the food reward. An additional subtype composed mainly of ADHD, predominantly Inattentive Presentation, learning, and developmental disorders, showed the greatest DD for food and monetary rewards compared with the other subtypes. This subtype had deficits in reasoning ability, evidenced by low cognitive and academic achievement performance. For this ADHD-I and developmental disorders subtype, THI was related to DD across the age span such that participants with high THI showed no differences in DD compared with NTs. In contrast, participants with low THI showed significantly worse DD trajectories than all others. Our results also support prior work showing that DD follows nonlinear developmental patterns. CONCLUSIONS We demonstrate preliminary evidence for DD as a transdiagnostic marker of psychiatric and neurodevelopmental disorders in children and adolescents. Comorbidity subtypes illuminate DD heterogeneity, facilitating the identification of high-risk individuals. Importantly, our findings revealed a marked link between DD and intellectual reasoning, with children from lower-income households exhibiting lower reasoning skills and heightened DD. These observations underscore the potential consequences of compromised self-regulation in economically disadvantaged individuals with these disorders, emphasizing the need for tailored interventions and further research to support improved outcomes.
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Affiliation(s)
- Jacob DeRosa
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Keri S Rosch
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aki Nikolaidis
- Center for the Developing Brain, Child Mind Institute, New York, NY, USA
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4
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Young JL, Powell RN, Zabel C, Saal J, Welling LLM, Fortain J, Ceresnie A. Development and validation of the ADHD Symptom and Side Effect Tracking - Baseline Scale (ASSET-BS): a novel short screening measure for ADHD in clinical populations. BMC Psychiatry 2023; 23:806. [PMID: 37932675 PMCID: PMC10629079 DOI: 10.1186/s12888-023-05295-6] [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: 05/23/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVE The aim was to develop and test a novel screen of adult ADHD, with a specific focus on clinical use. We designed a series of three studies to accomplish this aim. METHOD Study One (n = 155) and Study Two (n = 591) collected data via surveys to conduct exploratory and confirmatory factor analyses, respectively. Study Three analyzed the scale's psychometrics in a clinical sample (n = 151). RESULTS Study One and Study Two identified a 10-item scale with a two-factor structure. Study Three found good discriminant validity, sensitivity = 80.0%, specificity = 80.2%, and convergent validity with both the Brown Executive Function/Attention Scales, r (131) = .76, p < .001, and the Conner's Adult ADHD Rating Scales r (131) = .71, p < .001. CONCLUSION The scale demonstrated effectiveness in screening for ADHD in a psychiatric outpatient population. Its results may be used to identify patients that may benefit from thorough ADHD diagnostic procedures.
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Affiliation(s)
- Joel L Young
- Rochester Center for Behavioral Medicine, 441 South Livernois, Suite 100, Rochester Hills, MI, 48307, USA
- School of Medicine - Wayne State University, Detroit, USA
| | - Richard N Powell
- Rochester Center for Behavioral Medicine, 441 South Livernois, Suite 100, Rochester Hills, MI, 48307, USA.
| | | | - Jaime Saal
- Rochester Center for Behavioral Medicine, 441 South Livernois, Suite 100, Rochester Hills, MI, 48307, USA
| | | | - Jillian Fortain
- Rochester Center for Behavioral Medicine, 441 South Livernois, Suite 100, Rochester Hills, MI, 48307, USA
| | - Ashley Ceresnie
- Rochester Center for Behavioral Medicine, 441 South Livernois, Suite 100, Rochester Hills, MI, 48307, USA
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5
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Pan MR, Zhang SY, Chen CL, Qiu SW, Liu L, Li HM, Zhao MJ, Dong M, Si FF, Wang YF, Qian QJ. Bidirectional associations between maladaptive cognitions and emotional symptoms, and their mediating role on the quality of life in adults with ADHD: a mediation model. Front Psychiatry 2023; 14:1200522. [PMID: 37547201 PMCID: PMC10400449 DOI: 10.3389/fpsyt.2023.1200522] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Background/objectives Adults with attention-deficit/hyperactivity disorder (ADHD) have more maladaptive cognitions, emotional problems and a poorer quality of life (QoL). A verification of the psychological model in clinical samples is needed for a better understanding of the mechanisms of ADHD diagnosis on QoL via maladaptive cognitions, emotional symptoms, and their interactions. Methods 299 ADHD participants and 122 healthy controls were recruited. ADHD core symptoms, maladaptive cognitions, emotional symptoms and psychological QoL were rated. Pearson's correlation and structural equation modeling were analyzed to explore the relationship and influence of ADHD diagnosis on QoL. Results More maladaptive cognitions, emotional symptoms, and poorer QoL were found in the ADHD group, and the dysfunctional attitudes were on par between ADHD with or without medication (p = 0.368). Moderate to strong correlations were found between emotional symptoms, maladaptive cognitions and QoL, and ADHD core symptoms presented correlations among the above scores (r = 0.157 ~ 0.416, p < 0.01) in ADHD participants. The influence of ADHD diagnosis on QoL was mediated through maladaptive cognitions, emotional symptoms, and their bidirectional interactions (p < 0.05), especially those with stable medication. Conclusion Our study is the first to verify the psychological model in adults with ADHD in China. The findings determined the direct influence of ADHD diagnosis on QoL and the indirect influence through maladaptive cognitions, emotional symptoms, and their interactions, emphasizing the importance of interventions for emotional symptoms and maladaptive cognitions for ADHD patients both with or without medication for a better QoL outcome.
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Affiliation(s)
- Mei-Rong Pan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Shi-Yu Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Cai-Li Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Sun-Wei Qiu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lu Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hai-Mei Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Meng-Jie Zhao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Min Dong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Fei-Fei Si
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yu-Feng Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Qiu-Jin Qian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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6
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Orm S, Øie MG, Fossum IN, Fjermestad K, Andersen PN, Skogli EW. Predictors of Quality of Life and Functional Impairments in Emerging Adults With and Without ADHD: A 10-Year Longitudinal Study. J Atten Disord 2023; 27:458-469. [PMID: 36779541 DOI: 10.1177/10870547231153962] [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: 02/14/2023]
Abstract
OBJECTIVE We tested the hypotheses that (1) a diagnosis of ADHD in childhood or adolescence is associated with reduced quality of life (QoL) and everyday functioning in emerging adulthood, and (2) executive function (EF) deficits, internalizing difficulties, and ADHD symptoms predict reduced QoL and more functional impairments. METHOD We assessed 85 children and adolescents with ADHD and 50 typically developing (TD) peers at baseline (Mage = 11.6 years, 58% males), 2-year follow-up, and 10-year follow-up with neuropsychological tests of EF and self-reports. RESULTS Individuals with ADHD reported lower QoL and functional impairments in emerging adulthood compared to TD peers. More internalizing difficulties and ADHD symptoms at baseline and 2-year follow-up significantly predicted lower QoL and more functional impairments at the 10-year follow-up. CONCLUSION ADHD and internalizing difficulties in childhood or adolescence have a negative impact on QoL and everyday functioning in emerging adulthood.
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Affiliation(s)
- Stian Orm
- Innlandet Hospital Trust, Lillehammer, Norway.,University of Oslo, Norway
| | - Merete Glenne Øie
- Innlandet Hospital Trust, Lillehammer, Norway.,University of Oslo, Norway
| | | | | | | | - Erik Winther Skogli
- Innlandet Hospital Trust, Lillehammer, Norway.,Inland Norway University of Applied Sciences, Hamar, Norway
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Connolly RD, Lamont A, Speed D. Perceived Social Support on the Relationship Between ADD/ADHD and Both Anxious and Depressive Symptoms Among Canadian Adults. J Atten Disord 2023; 27:283-293. [PMID: 36415889 PMCID: PMC9850397 DOI: 10.1177/10870547221136227] [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] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The primary goal of the present research was to examine whether the relationships that social support demonstrates with both anxiety and depression varied between adults with and without ADD/ADHD in a Canadian sample. METHOD Data were obtained from the 2012 Canadian Community Health Survey-Mental Health (N ≥ 16,354). Presence of social support, diagnosis of generalized anxiety disorder (GAD), and experience of major depressive episodes (MDEs) were estimated in the self-report ADD/ADHD and non-ADD/ADHD groups. RESULTS Although social support was negatively associated with having GAD or experiencing an MDE, and self-report ADD/ADHD was positively associated with these outcomes. Presence of self-report ADD/ADHD did not significantly modify the relationships between social support and GAD or MDE. CONCLUSION Social support may be a protective factor against symptoms of anxiety and depression in the general Canadian population, for adults with and without ADHD.
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Affiliation(s)
- Ross D. Connolly
- Memorial University of Newfoundland,
St. John’s, Canada,Ross D. Connolly, Student Wellness and
Counselling Centre, Memorial University of Newfoundland, St. John’s, NL A1C 5S7,
Canada.
| | | | - David Speed
- University of New Brunswick, Saint
John, Canada
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8
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Hargitai LD, Livingston LA, Waldren LH, Robinson R, Jarrold C, Shah P. Attention-deficit hyperactivity disorder traits are a more important predictor of internalising problems than autistic traits. Sci Rep 2023; 13:31. [PMID: 36646771 PMCID: PMC9842645 DOI: 10.1038/s41598-022-26350-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 12/13/2022] [Indexed: 01/18/2023] Open
Abstract
Autism Spectrum Disorder (ASD) and Attention-Deficit Hyperactivity Disorder (ADHD) are both linked to internalising problems like anxiety and depression. ASD and ADHD also often co-occur, making their individual statistical contributions to internalising disorders difficult to investigate. To address this issue, we explored the unique associations of self-reported ASD traits and ADHD traits with internalising problems using a large general population sample of adults from the United Kingdom (N = 504, 49% male). Classical regression analyses indicated that both ASD traits and ADHD traits were uniquely associated with internalising problems. Dominance and Bayesian analyses confirmed that ADHD traits were a stronger, more important predictor of internalising problems. However, brief depression and anxiety measures may not provide a comprehensive index of internalising problems. Additionally, we focused on recruiting a sample that was representative of the UK population according to age and sex, but not ethnicity, a variable that may be linked to internalising disorders. Nevertheless, our findings indicate that while ASD and ADHD uniquely predict internalising problems, ADHD traits are a more important statistical predictor than ASD traits. We discuss potential mechanisms underlying this pattern of results and the implications for research and clinical practice concerning neurodevelopmental conditions.
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Affiliation(s)
- Luca D. Hargitai
- grid.7340.00000 0001 2162 1699Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Lucy A. Livingston
- grid.5600.30000 0001 0807 5670Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK ,grid.13097.3c0000 0001 2322 6764Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Lucy H. Waldren
- grid.7340.00000 0001 2162 1699Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Ross Robinson
- grid.7340.00000 0001 2162 1699Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Christopher Jarrold
- grid.5337.20000 0004 1936 7603School of Psychological Science, University of Bristol, Bristol, BS8 1TU UK
| | - Punit Shah
- grid.7340.00000 0001 2162 1699Department of Psychology, University of Bath, Bath, BA2 7AY UK
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9
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Karalunas SL, Antovich D, Miller N, Nigg JT. Prospective prediction of developing internalizing disorders in ADHD. J Child Psychol Psychiatry 2022; 64:768-778. [PMID: 36464786 DOI: 10.1111/jcpp.13731] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Clinical course in attention-deficit/hyperactivity disorder (ADHD) is highly heterogeneous with respect to both core symptoms and associated features and impairment. Onset of comorbid anxiety and mood disorders during later childhood and adolescence is one critical aspect of divergent outcomes in ADHD. Characterizing heterogeneity in onset of anxiety and depression and identifying prospective predictors of these divergent courses may facilitate early identification of the children most at risk. METHODS A total of 849 children recruited for a case-control study of ADHD development, aged 7-12 years at baseline, completed up to six annual waves of comprehensive clinical and cognitive assessment, including multi-informant behavior ratings, parent semi-structured clinical diagnostic interviews, and measures of executive function (EF). Latent class growth curve analyses (LCGAs) characterized patterns of anxiety and depression over time. Trajectories were predicted from baseline parent-rated child temperament, lab-measured child EF, coded parental criticism, and child-reported self-blame for inter-parental conflict. RESULTS Latent class growth curve analyses separately identified three trajectories for anxiety and three for depression: persistently high, persistently low, and increasing. Temperamental fear/sadness and irritability were independent predictors that interacted with family characteristics. Baseline parental criticism and self-blame for inter-parental conflict exerted influence but only in the context of low temperamental risk. Better baseline child working memory was associated with delayed onset of depression. CONCLUSIONS The interaction of baseline child emotional features with EF or family environment predicted divergent courses of both anxiety and depression from middle-childhood to mid-adolescence. Results suggest modifiable risk factors associated with prospective differences in long-term outcomes.
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Affiliation(s)
| | - Dylan Antovich
- Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| | - Natalie Miller
- Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
| | - Joel T Nigg
- Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, USA
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10
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Porter BM, Douglas IJ, Larguinho TL, Aristizabal M, Mitchell ME, Roe MA, Church JA. Examination of Pre-pandemic Measures on Youth Well-being During Early Stages of the COVID-19 Pandemic. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:252-260. [PMID: 34549203 PMCID: PMC8446746 DOI: 10.1016/j.bpsgos.2021.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected our lives in numerous ways. How youth have been impacted by the pandemic and which preexisting factors best relate to COVID-19 responses are of high importance for effective identification and treatment of those most vulnerable. Youth with pre-pandemic mental health difficulties such as attention-deficit/hyperactivity disorder (ADHD) could be at risk for worse well-being during and after the pandemic. METHODS The current study tested potential risk factors (i.e., pre-pandemic mental health, age, and parental education) and their relationship to family experiences during early months of the COVID-19 pandemic. Participants were previously enrolled in an ongoing, yearly longitudinal study examining the relationship between mental health and executive functions in youth. Families with 1-4 annual pre-pandemic lab visits filled out an online COVID-19 survey in May-July 2020 to assess how the pandemic impacted their well-being (n = 135 youth). RESULTS Youth pre-pandemic mental health difficulties, especially ADHD symptoms, related to worse well-being during the early pandemic. Trajectories of recent ADHD symptoms over time also predicted cognitive difficulties during the pandemic. We found that youth age was a strong predictor of pandemic response, with younger youth showing fewer negative responses. Parental education level buffered family economic impact during early COVID-19. Families showed synchrony in their pandemic responses. CONCLUSIONS Pre-pandemic ADHD severity and slope, youth age, and parental education (a proxy for socioeconomic status) were risk factors that influenced youth or family well-being early in the COVID-19 pandemic; this information can help identify those who may need more community and educational support.
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Affiliation(s)
- Blaire M. Porter
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Ian J. Douglas
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Tyler L. Larguinho
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | | | - Mackenzie E. Mitchell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mary Abbe Roe
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Jessica A. Church
- Department of Psychology, The University of Texas at Austin, Austin, Texas
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11
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Oguchi M, Takahashi T, Nitta Y, Kumano H. The Moderating Effect of Attention-Deficit Hyperactivity Disorder Symptoms on the Relationship Between Procrastination and Internalizing Symptoms in the General Adult Population. Front Psychol 2021; 12:708579. [PMID: 34764902 PMCID: PMC8575693 DOI: 10.3389/fpsyg.2021.708579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The symptoms of attention-deficit hyperactivity disorder (ADHD) are known to exacerbate the effect of cognitive-behavioral impairments on emotional burden. Although adults with ADHD frequently experience procrastination and internalizing symptoms such as depression and anxiety, few studies have examined whether the association between procrastination and internalizing symptoms differs by ADHD symptoms. Objective: This study aimed to examine the moderating effect of ADHD symptoms on the association between procrastination and internalizing symptoms. Method: A cross-sectional survey was conducted among 470 adults (mean age=26.57, standard deviation=2.93) using self-reported questionnaires: Adult ADHD Self-Report Scale, General Procrastination Scales, Patient Health Questionnaire-9, and State-Trait Anxiety Inventory. Conclusion: Participants with more substantial ADHD symptoms experienced more procrastination and internalizing symptoms than those with the less substantial ADHD symptoms. Therefore, procrastination constitutes the treatment target for those suffering from ADHD and comorbid internalizing symptoms. Alternatively, there was no enhancing effect of ADHD symptoms on the association between procrastination and internalizing symptoms. It is necessary to examine more precise and valid hypotheses and underlying mechanisms of procrastination in high and low ADHD symptom groups.
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Affiliation(s)
- Mana Oguchi
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Toru Takahashi
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Yusuke Nitta
- Graduate School of Human Sciences, Waseda University, Tokorozawa, Japan
| | - Hiroaki Kumano
- Faculty of Human Sciences, Waseda University, Tokorozawa, Japan
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12
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Adult ADHD, executive function, depressive/anxiety symptoms, and quality of life: A serial two-mediator model. J Affect Disord 2021; 293:97-108. [PMID: 34175595 DOI: 10.1016/j.jad.2021.06.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 05/08/2021] [Accepted: 06/13/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Adult attention-deficit/hyperactivity disorder (ADHD) is associated with impaired executive function (EF), depressive/anxiety symptoms, and poor quality of life (QoL). In this study, we aimed to investigate correlations among these variables and to build a simple or serial mediation model for exploring the mechanisms between adult ADHD and QoL. METHODS This was a cross-sectional study. The sample included 223 participants with ADHD and 54 healthy volunteers. Participants were required to complete the following scales: ADHD Rating Scale (ADHD-RS), Brief Version of the World Health Organization Quality of Life Scale (WHOQOL-BREF), Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS). Correlations among EF, depressive/anxiety symptoms and QoL were analyzed using Pearson correlation. The simple and serial mediation models were analyzed using PROCESS (version 3.3). RESULTS The correlations between EF and QoL, depressive/anxiety symptoms and QoL, and depressive/anxiety symptoms and EF were statistically significant. In ADHD adults with comorbidities, the correlation coefficients were between -0.19 and -0.47, -0.20 and -0.62, 0.28 and 0.50, respectively. In simple mediation models, EF and depressive/anxiety symptoms were significant mediators respectively between ADHD and QoL, respectively. In a serial two-mediator model, ADHD could affect QoL indirectly via EF and then via depressive/anxiety symptoms significantly. LIMITATIONS The average age was young, the degree of education was high, and only self-reported scales were relied on. CONCLUSIONS There is a mutual effect between EF and emotional symptoms. This was the first study to build a serial two-mediator model between ADHD and QoL, suggesting the importance of EF and depressive/anxiety symptoms.
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Relationship between Bullying Victimization and Quality of Life in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) in Taiwan: Mediation of the Effects of Emotional Problems and ADHD and Oppositional Defiant Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189470. [PMID: 34574409 PMCID: PMC8470640 DOI: 10.3390/ijerph18189470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022]
Abstract
This cross-sectional study investigated the mediating effects of emotional problems including depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD) symptoms on the association between bullying victimization and quality of life (QoL) among adolescents with ADHD in Taiwan. A total of 171 adolescents diagnosed as having ADHD participated in this study. Adolescents completed the School Bullying Experience Questionnaire, the Taiwanese Quality of Life Questionnaire for Adolescents, the Taiwanese version of the Children’s Depression Inventory and the Multidimensional Anxiety Scale for Children. Caregivers completed the Chinese version of the Swanson, Nolan, and Pelham Version IV Scale. Structural equation modeling (SEM) was used to examine the relationships among the variables. The results of SEM revealed that bullying victimization indirectly correlated with QoL through the mediation of emotional problems in adolescents with ADHD, whereas ADHD and ODD symptoms did not mediate the association between bullying victimization and QoL. Bullying victimization should be actively prevented and intervened on to ensure better QoL in adolescents with ADHD. Moreover, emotional problems should be alleviated among adolescents with ADHD with bullying victimization experience to maintain their QoL.
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Hsieh MH, Chien YL, Gau SSF. Mismatch negativity and P3a in drug-naive adults with attention-deficit hyperactivity disorder. Psychol Med 2021; 52:1-11. [PMID: 33706818 PMCID: PMC9772912 DOI: 10.1017/s0033291720005516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/15/2020] [Accepted: 01/04/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Individuals with attention-deficit hyperactivity disorder (ADHD) often display over-response to stimuli that are irrelevant to the ongoing task, and their attentional abilities disproportionately worsen in the presence of competing stimuli. Auditory event-related potentials (ERPs) such as mismatch negativity (MMN) and P3a using the passive oddball paradigm have been studied in children and adolescents with ADHD. Still, there is no such data for adults with ADHD. This study aimed to compare the MMN and P3a and their clinical and neurocognitive correlations between drug-naive adults with ADHD and control adults. METHODS We recruited 52 adults with ADHD (26.5 ± 6.2 years), and 62 age-matched controls (25.6 ± 5.6 years). They received the psychiatric interviews, auditory ERP, the Conners' continuous performance test (CCPT), and the Cambridge gambling test (CGT). They also completed the questionnaires about ADHD symptoms and real-world executive functions. MMN and P3a were assessed during a passive duration-deviant auditory oddball paradigm from the midline electrodes Cz. RESULTS Adults with ADHD demonstrated smaller Cz MMN amplitude, more severe ADHD symptoms, poorer attention profiles (CCPT), and a wide range of executive dysfunctions than controls. As for the correlates, Cz peak amplitude of MMN correlated with inattention symptoms, executive dysfunctions, attentional vigilance (CCPT), and decision-making (CGT) in ADHD adults but only with decision-making in controls. CONCLUSIONS Our findings that smaller amplitude of MMN and its differential associated pattern with inattention, real-world executive dysfunction, and decision-making, in drug-naive adults with ADHD from adult controls, provide evidence to support the potential electrophysiological biomarker for adult ADHD.
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Affiliation(s)
- Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, and Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Quintero J, Morales I, Vera R, Zuluaga P, Fernández A. The Impact of Adult ADHD in the Quality of Life Profile. J Atten Disord 2019; 23:1007-1016. [PMID: 28974134 DOI: 10.1177/1087054717733046] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In this multicenter, cross-sectional study, we aimed to investigate the quality of life (QoL) and the neuropsychological and clinical characteristics of adults with ADHD with different developmental pathways. METHOD Our study sample included 25 control (healthy) participants, 31 patients with newly diagnosed ADHD without comorbidities (ADHD-C-D), 31 with newly diagnosed ADHD with comorbidities (ADHD+C-D), and 29 with previously diagnosed ADHD with comorbidities (ADHD+C+D). RESULTS Compared with controls, ADHDs had little differences in the attentional performance but showed higher impulsivity, more severe symptoms of depression and anxiety, and lower QoL. The ADHD+C-D group showed more severe symptoms of depression and anxiety than the ADHD+C+D group ( p = .037 and p = .008, respectively), and poorer QoL in the psychological health sphere ( p = .003). CONCLUSION Differences between ADHD and control subjects were particularly remarkable in mood symptoms and QoL. Previous diagnosis might have a positive impact on mood symptoms and QoL in ADHD adults.
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Affiliation(s)
- Javier Quintero
- 1 Hospital Universitario Infanta Leonor, Madrid, Spain.,2 Complutense University of Madrid, Spain
| | | | - Rosa Vera
- 2 Complutense University of Madrid, Spain
| | | | - Alberto Fernández
- 2 Complutense University of Madrid, Spain.,4 Technical University of Madrid, Spain
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Hwang-Gu SL, Lin HY, Chen YC, Tseng YH, Hsu WY, Chou MC, Chou WJ, Wu YY, Gau SSF. Symptoms of ADHD Affect Intrasubject Variability in Youths with Autism Spectrum Disorder: An Ex-Gaussian Analysis. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:455-468. [PMID: 29847154 DOI: 10.1080/15374416.2018.1452151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Increased intrasubject variability in reaction times (RT-ISV) is frequently found in individuals with autism spectrum disorder (ASD). However, how dimensional attention deficit/hyperactivity disorder (ADHD) symptoms impact RT-ISV in individuals with ASD remains elusive. We assessed 97 high-functioning youths with co-occurring ASD and ADHD (ASD+ADHD), 124 high-functioning youths with ASD only, 98 youths with ADHD only, and 249 typically developing youths, 8-18 years of age, using the Conners Continuous Performance Test (CCPT). We compared the conventional CCPT parameters (omission errors, commission errors, mean RT and RT standard error (RTSE) as well as the ex-Gaussian parameters of RT (mu, sigma, and tau) across the four groups. We also conducted regression analyses to assess the relationships between RT indices and symptoms of ADHD and ASD in the ASD group (i.e., the ASD+ADHD and ASD-only groups). The ASD+ADHD and ADHD-only groups had higher RT-ISV than the other two groups. RT-ISV, specifically RTSE and tau, was significantly associated with ADHD symptoms rather than autistic traits in the ASD group. Regression models also revealed that sex partly accounted for RT-ISV variance in the ASD group. A post hoc analysis showed girls with ASD had higher tau and RTSE values than their male counterparts. Our results suggest that RT-ISV is primarily associated with co-occurring ADHD symptoms/diagnosis in children and adolescents with ASD. These results do not support the hypothesis of response variability as a transdiagnostic phenotype for ASD and ADHD and warrant further validation at a neural level.
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Affiliation(s)
- Shoou-Lian Hwang-Gu
- a Graduate Institute of Behavioral Sciences, College of Medicine , Chang Gung University , Tao-Yuan.,b Department of Child Psychiatry , Chang Gung Memorial Hospital Linkou Branch
| | - Hsiang-Yuan Lin
- c Department of Psychiatry , National Taiwan University Hospital and College of Medicine
| | - Yu-Chi Chen
- d Graduate Institute of Behavioral Sciences, College of Medicine , Chang Gung University
| | | | - Wen-Yau Hsu
- f Department of Psychology and Research Center for Mind, Brain and Learning , National Chengchi University
| | - Miao-Chun Chou
- g Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center , Chang Guang University, College of Medicine
| | - Wen-Jun Chou
- g Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center , Chang Guang University, College of Medicine
| | - Yu-Yu Wu
- b Department of Child Psychiatry , Chang Gung Memorial Hospital Linkou Branch
| | - Susan Shur-Fen Gau
- b Department of Child Psychiatry , Chang Gung Memorial Hospital Linkou Branch.,c Department of Psychiatry , National Taiwan University Hospital and College of Medicine
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Matthies S, Sadohara-Bannwarth C, Lehnhart S, Schulte-Maeter J, Philipsen A. The Impact of Depressive Symptoms and Traumatic Experiences on Quality of Life in Adults With ADHD. J Atten Disord 2018; 22:486-496. [PMID: 27590436 DOI: 10.1177/1087054716654568] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE We assessed factors influencing quality of life (QoL) in adults with ADHD. METHOD QoL, traumatic childhood experiences, and depression were assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Childhood Trauma Questionnaire (CTQ), and Beck Depression Inventory (BDI), respectively, in 60 adult ADHD outpatients and 60 age- and gender-matched controls. RESULTS Emotional neglect or abuse had occurred significantly more often during childhood in adults with ADHD. Depressive symptoms were rated significantly higher by ADHD patients. QoL was significantly lower in adults with ADHD, and the variables depression, ADHD symptom severity, and traumatic load, accounted for ~60% of variance in overall QoL. CONCLUSION QoL is significantly reduced in adult ADHD patients. Depressive symptoms and traumatic childhood experiences influence QoL. Treatment for adult ADHD patients should take the high interdependence of depressive symptoms, childhood trauma, and QoL into consideration.
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Maternal and Family Processes in Different Subgroups of Youth with Autism Spectrum Disorder. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 47:177-194. [DOI: 10.1007/s10802-018-0404-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Torrente F, López P, Lischinsky A, Cetkovich-Bakmas M, Manes F. Depressive symptoms and the role of affective temperament in adults with attention-deficit/hyperactivity disorder (ADHD): A comparison with bipolar disorder. J Affect Disord 2017; 221:304-311. [PMID: 28688349 DOI: 10.1016/j.jad.2017.06.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/10/2017] [Accepted: 06/17/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the characteristics of depressive symptoms and the influence of affective temperament in adults with attention-deficit/hyperactivity disorder (ADHD), in comparison with bipolar disorder (BD) patients and healthy controls (HCs). METHOD Sixty patients with ADHD, 50 patients with BD, and 30 HCs were assessed with instruments for measuring depressive symptoms (Beck Depression Inventory-II), and affective temperaments (Temperament Scale of Memphis, Pisa and San Diego, self-administered version; TEMPS-A). In addition, participants were evaluated with scales for measuring ADHD symptoms, impulsiveness, anxiety, executive dysfunction, and quality of life. RESULTS ADHD patients showed levels of depressive symptoms similar to BD patients and higher than HCs. Only neurovegetative symptoms of depression differentiated ADHD and BD groups (BD > ADHD). Depressive symptoms in ADHD patients correlated positively with core ADHD, impulsivity, anxiety, and dysexecutive symptoms and negatively with quality of life. Thirty-eight percent of patients with ADHD scored above the cutoff for at least one affective temperament. Cyclothymic was the more common affective temperament (25%). ADHD patients with affective temperamental traits were more depressed and impulsive than patients without those traits and showed a symptomatic profile analogous to BD patients. LIMITATIONS The small size of resultant samples when ADHD group was stratified by the presence of affective temperament. In addition, results may not generalize to less severe ADHD patients from the community. CONCLUSIONS Concomitant depressive symptoms constitute a common occurrence in adults with ADHD that carries significant psychopathological and functional consequences. The concept of affective temperaments may be an interesting link for explaining depressive symptomatology and emotional impulsivity in a subgroup of patients with ADHD, beyond the classic idea of comorbidity.
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Affiliation(s)
- Fernando Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
| | - Pablo López
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Alicia Lischinsky
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Marcelo Cetkovich-Bakmas
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Facundo Manes
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
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Attention-Deficit/Hyperactivity Disorder Symptoms and Life Satisfaction in a Representative Adolescent and Adult Sample. J Nerv Ment Dis 2017; 205:720-724. [PMID: 28609313 DOI: 10.1097/nmd.0000000000000700] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although it is well documented that attention-deficit/hyperactivity disorder (ADHD) is associated with reduced life satisfaction, the mechanisms that might explain this co-occurrence are unclear. We examined the correlation of ADHD symptoms with life satisfaction and whether this association is mediated by (lacking) social support and depressive symptoms. Self-reported ADHD symptoms, life satisfaction, social support, and depressive symptoms were assessed in a representative, predominantly adult sample from the general population (14-91 years, N = 2517). Attention-deficit/hyperactivity disorder symptoms correlated negatively with life satisfaction (r = -0.41, p < 0.01), even after demographic factors (gender, age, income) and common risk factors (not being in a relationship, being unemployed) were controlled for (r = -0.39, p < 0.01). Social support mediated up to 23% and depressive symptoms up to 44% in the association between ADHD symptoms and life satisfaction. Counteracting problems with social relationships and treating depressive symptoms may help to increase life satisfaction in adults with ADHD symptoms.
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Hurford DP, Fender AC, Boux JL, Swigart CC, Boydston PS, Butts SR, Cox CL, Becker TA, Pike ME. Examination of the Effects of Intelligence on the Test of Variables of Attention for Elementary Students. J Atten Disord 2017; 21:929-937. [PMID: 25270566 DOI: 10.1177/1087054714550480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the performance differences on the Test of Variables of Attention (TOVA) among different IQ level groups. METHOD The present study examined the results of the TOVA with 138 elementary students aged 6 to 10 years who were assigned to one of four different groups based on their scores from the Wechsler Nonverbal Scale of Ability (WNV; low average: IQ < 90, average: IQ between 90 and 109, high average: IQ between 110 and 119, superior: IQ between 120 and 129, and very superior: IQ > 129). The latter two groups were combined. RESULTS On all TOVA measures (response time, response time variability, errors of omission and commission, and ADHD scores), intellectual functioning significantly influenced performance. CONCLUSION The results of the present study indicate that performance on the TOVA was affected by intellectual functioning.
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Chien YL, Chou MC, Chiu YN, Chou WJ, Wu YY, Tsai WC, Gau SSF. ADHD-related symptoms and attention profiles in the unaffected siblings of probands with autism spectrum disorder: focus on the subtypes of autism and Asperger's disorder. Mol Autism 2017; 8:37. [PMID: 28770037 PMCID: PMC5526322 DOI: 10.1186/s13229-017-0153-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/19/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The presence of attention-deficit/hyperactive disorder (ADHD) symptoms and impaired attention performance are commonly noted in individuals with autism spectrum disorder (ASD). However, little is known about attention performance in their unaffected siblings. This study aimed to investigate the ADHD-related traits and attention performance in unaffected siblings of probands with autism and Asperger syndrome (AS), as well as the clinical correlates of ADHD-related traits. METHODS We assessed the intention, hyperactivity-impulsivity, and oppositional symptoms, and attention profiles of 199 probands with a diagnosis of ASD (122 autism, 77 AS), their unaffected siblings, and 196 typically developing controls (TD) by their parents' reports on the ADHD-related symptoms and the Connors' Continuous Performance Test (CCPT), respectively. RESULTS Compared to TD, unaffected siblings of ASD probands were more hyperactive/impulsive and oppositional, particularly unaffected siblings of AS probands. In CCPT, unaffected siblings of AS have intermediate levels of performance between probands with AS and TD on focused attention and sustained attention but were not statistically different from AS probands or TD in these attention profiles. In contrast, unaffected siblings of autism probands have significantly better CCPT performance when compared to autism probands but not to TD. In addition, stereotyped behaviors predicted ADHD-related traits in both sibling groups, but distinctive patterns of other correlates for ADHD-related traits were found between the two sibling groups. CONCLUSIONS This work suggested that unaffected siblings of AS, but not autism, have more hyperactive/impulsive traits and a trend of pervasive attention deficits assessed by CCPT which might serve as potential endophenotypes for genetic studies in AS. TRIAL REGISTRATION ClinicalTrials.gov, NCT01582256.
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Affiliation(s)
- Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No.7, Chung-Shan South Road, Taipei, 10002 Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Miao-Chun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Yen-Nan Chiu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No.7, Chung-Shan South Road, Taipei, 10002 Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Yu-Yu Wu
- Department of Psychiatry, Chang Gung Memorial Hospital- Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No.7, Chung-Shan South Road, Taipei, 10002 Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No.7, Chung-Shan South Road, Taipei, 10002 Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Regnart J, Truter I, Meyer A. Critical exploration of co-occurring Attention-Deficit/Hyperactivity Disorder, mood disorder and Substance Use Disorder. Expert Rev Pharmacoecon Outcomes Res 2017; 17:275-282. [DOI: 10.1080/14737167.2017.1351878] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Judith Regnart
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
| | - Anneke Meyer
- Department of Psychology, Nelson Mandela Metropolitan University, Port Elizabeth, South Africa
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Fan LY, Chou TL, Gau SSF. Neural correlates of atomoxetine improving inhibitory control and visual processing in Drug-naïve adults with attention-deficit/hyperactivity disorder. Hum Brain Mapp 2017; 38:4850-4864. [PMID: 28657141 DOI: 10.1002/hbm.23683] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/22/2017] [Accepted: 05/29/2017] [Indexed: 11/09/2022] Open
Abstract
Atomoxetine improves inhibitory control and visual processing in healthy volunteers and adults with attention-deficit/hyperactivity disorder (ADHD). However, little is known about the neural correlates of these two functions after chronic treatment with atomoxetine. This study aimed to use the counting Stroop task with functional magnetic resonance imaging (fMRI) and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to investigate the changes related to inhibitory control and visual processing in adults with ADHD. This study is an 8-week, placebo-controlled, double-blind, randomized clinical trial of atomoxetine in 24 drug-naïve adults with ADHD. We investigated the changes of treatment with atomoxetine compared to placebo-treated counterparts using the counting Stroop fMRI and two CANTAB tests: rapid visual information processing (RVP) for inhibitory control and delayed matching to sample (DMS) for visual processing. Atomoxetine decreased activations in the right inferior frontal gyrus and anterior cingulate cortex, which were correlated with the improvement in inhibitory control assessed by the RVP. Also, atomoxetine increased activation in the left precuneus, which was correlated with the improvement in the mean latency of correct responses assessed by the DMS. Moreover, anterior cingulate activation in the pre-treatment was able to predict the improvements of clinical symptoms. Treatment with atomoxetine may improve inhibitory control to suppress interference and may enhance the visual processing to process numbers. In addition, the anterior cingulate cortex might play an important role as a biological marker for the treatment effectiveness of atomoxetine. Hum Brain Mapp 38:4850-4864, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Li-Ying Fan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.,Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Tai-Li Chou
- Department of Psychology, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.,Department of Psychology, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
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One-year trajectory analysis for ADHD symptoms and its associated factors in community-based children and adolescents in Taiwan. Child Adolesc Psychiatry Ment Health 2017; 11:28. [PMID: 28580012 PMCID: PMC5452532 DOI: 10.1186/s13034-017-0165-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/18/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Several longitudinal studies have shown the partial symptomatic persistence of attention-deficit hyperactivity disorder (ADHD) in clinic-based samples. However, little is known about the patterns and trajectories of ADHD symptoms in community-based populations. METHODS To differentiate developmental trajectories of ADHD symptoms over 1 year, with a four-wave quarterly follow-up in children and adolescents in the community of Taiwan, we conducted this prospective study in 1281 students in grade 3, 5, and 8. All the students in the regular classes rather than special educational classes were eligible and recruited to the study. Inattention, hyperactivity-impulsivity, and opposition-defiance were rated by parent reports on the Chinese version of the Swanson, Nolan, and Pelham Version IV Scale (SNAP-IV). Group-based trajectory modeling and multivariable regression analyses were used to explore the individual, family and social factors associated with differential trajectories. RESULTS Trajectories were classified as Low (29.9-40.6%), Intermediate (52.5-58.5%) and High (6.9-12.5%) based on the symptom severity of ADHD symptoms assessed by the SNAP-IV. The proportion of children in the high ADHD trajectory might approximately reflect the prevalence of ADHD in Taiwan. The following factors differentiated High from Low trajectories: male gender, more externalizing problems, fewer prosocial behaviors, school dysfunction, more home behavioral problems, and less perceived family support. CONCLUSIONS Our findings that the concurrent conditions of emotional or externalizing problems, as well as impaired school and home function at baseline, might differentiate the high ADHD symptoms trajectory from others could help developing the specific measures for managing high ADHD symptoms over time in a school setting.
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Pan PY, Yeh CB. Impact of depressive/anxiety symptoms on the quality of life of adolescents with ADHD: a community-based 1-year prospective follow-up study. Eur Child Adolesc Psychiatry 2017; 26:659-667. [PMID: 27990556 DOI: 10.1007/s00787-016-0929-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 12/05/2016] [Indexed: 01/27/2023]
Abstract
Adolescents with attention-deficit/hyperactivity disorder (ADHD) often exhibit functional impairment even those having less visible symptoms. Therefore, it is of great clinical importance to identify ADHD symptoms among adolescents in the community. Furthermore, little is known regarding the role of internalizing symptoms in their quality of life. Thus, this study aimed to screen ADHD in a sample of high school students using the Adult ADHD Self-report Scale (ASRS) and to investigate the impact of internalizing symptoms on their well-being. In the first year, adolescents aged 15-17 years old from a senior high school (N = 1947) completed the Adult ADHD Self-rating Scale (ASRS), Wender Utah Rating Scale, Impulsiveness Scale, Beck's Depression Inventory and Beck's Anxiety Inventory. In the second year, the World Health Organization Quality of Life-BREF was applied for the measurement of their psychosocial outcomes. Results showed that adolescents with higher ASRS scores manifested more severe concurrent depressive and anxiety symptoms. ADHD symptoms among these adolescents were significantly associated with poorer quality of life 1 year later (p < 0.001). And both depressive and anxiety symptoms were mediators in the relationship between ADHD symptoms and quality of life. The finding of this study supports that the concurrent internalizing symptoms may underlie the negative relations between ADHD symptoms and quality of life in adolescents in the community. The application of ASRS in adolescents may help clinicians in early intervention for their ADHD problems as well as emotional symptoms.
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Affiliation(s)
- Pei-Yin Pan
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Neihu Dist., Taipei City, 11490, Taiwan
| | - Chin-Bin Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Neihu Dist., Taipei City, 11490, Taiwan.
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Caye A, Spadini AV, Karam RG, Grevet EH, Rovaris DL, Bau CHD, Rohde LA, Kieling C. Predictors of persistence of ADHD into adulthood: a systematic review of the literature and meta-analysis. Eur Child Adolesc Psychiatry 2016; 25:1151-1159. [PMID: 27021056 DOI: 10.1007/s00787-016-0831-8] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 02/11/2016] [Indexed: 11/25/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is traditionally conceptualized as a neurodevelopmental disorder that continues into adulthood in up to half of diagnosed cases. In light of current evidence, factors associated with the course of the disorder remain unknown. We performed a systematic review of the literature searching for risk markers from childhood that predicted the persistence of ADHD into adulthood. We reviewed 26,168 abstracts and selected 72 for full-text review. We identified data from 16 studies, comprising 6 population-based retrospective samples and 10 clinical follow-ups. We performed meta-analyses of factors evaluated by at least three studies. Severity of ADHD (OR 2.33, 95 % CI = 1.6-3.39, p < 0.001), treatment for ADHD (OR 2.09, 95 % CI = 1.04-4.18, p = 0.037), comorbid conduct disorder (OR 1.85, 95 % CI = 1.06-3.24, p = 0.030), and comorbid major depressive disorder (OR 1.8, 95 % CI = 1.1-2.95, p = 0.019) emerged as predictors already presented in childhood for ADHD persistence into adulthood. Further, we suggest that cohort studies should be designed to clarify such an important question for research and clinical practice.
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Affiliation(s)
- Arthur Caye
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Alex V Spadini
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Rafael G Karam
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Eugenio H Grevet
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
| | - Diego L Rovaris
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Claiton H D Bau
- Department of Genetics, Instituto de Biociências, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Luis A Rohde
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, Porto Alegre, Brazil
| | - Christian Kieling
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Rua Ramiro Barcelos, 2530-400 N., Porto Alegre, RS, 90035-009, Brazil.
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Shang CY, Yan CG, Lin HY, Tseng WY, Castellanos FX, Gau SS. Differential effects of methylphenidate and atomoxetine on intrinsic brain activity in children with attention deficit hyperactivity disorder. Psychol Med 2016; 46:3173-3185. [PMID: 27574878 DOI: 10.1017/s0033291716001938] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Methylphenidate and atomoxetine are commonly prescribed for treating attention deficit hyperactivity disorder (ADHD). However, their therapeutic neural mechanisms remain unclear. METHOD After baseline evaluation including cognitive testing of the Cambridge Neuropsychological Test Automated Battery (CANTAB), drug-naive children with ADHD (n = 46), aged 7-17 years, were randomly assigned to a 12-week treatment with methylphenidate (n = 22) or atomoxetine (n = 24). Intrinsic brain activity, including the fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo), was quantified via resting-state functional magnetic resonance imaging at baseline and week 12. RESULTS Reductions in inattentive symptoms were related to increased fALFF in the left superior temporal gyrus and left inferior parietal lobule for ADHD children treated with methylphenidate, and in the left lingual gyrus and left inferior occipital gyrus for ADHD children treated with atomoxetine. Hyperactivity/impulsivity symptom reductions were differentially related to increased fALFF in the methylphenidate group and to decreased fALFF in the atomoxetine group in bilateral precentral and postcentral gyri. Prediction analyses in the atomoxetine group revealed negative correlations between pre-treatment CANTAB simple reaction time and fALFF change in the left lingual gyrus and left inferior occipital gyrus, and positive correlations between pre-treatment CANTAB simple movement time and fALFF change in bilateral precentral and postcentral gyri and left precuneus, with a negative correlation between movement time and the fALFF change in the left lingual gyrus and the inferior occipital gyrus. CONCLUSIONS Our findings suggest differential neurophysiological mechanisms for the treatment effects of methylphenidate and atomoxetine in children with ADHD.
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Affiliation(s)
- C Y Shang
- Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan
| | - C G Yan
- Nathan Kline Institute for Psychiatric Research,Orangeburg, NY,USA
| | - H Y Lin
- Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan
| | - W Y Tseng
- Graduate Institute of Brain and Mind Sciences,Taipei,Taiwan
| | - F X Castellanos
- Nathan Kline Institute for Psychiatric Research,Orangeburg, NY,USA
| | - S S Gau
- Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan
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Ni HC, Hwang Gu SL, Lin HY, Lin YJ, Yang LK, Huang HC, Gau SSF. Atomoxetine could improve intra-individual variability in drug-naïve adults with attention-deficit/hyperactivity disorder comparably with methylphenidate: A head-to-head randomized clinical trial. J Psychopharmacol 2016; 30:459-67. [PMID: 26905919 DOI: 10.1177/0269881116632377] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Intra-individual variability in reaction time (IIV-RT) is common in individuals with attention-deficit/hyperactivity disorder (ADHD). It can be improved by stimulants. However, the effects of atomoxetine on IIV-RT are inconclusive. We aimed to investigate the effects of atomoxetine on IIV-RT, and directly compared its efficacy with methylphenidate in adults with ADHD. METHODS An 8-10 week, open-label, head-to-head, randomized clinical trial was conducted in 52 drug-naïve adults with ADHD, who were randomly assigned to two treatment groups: immediate-release methylphenidate (n=26) thrice daily (10-20 mg per dose) and atomoxetine once daily (n=26) (0.5-1.2 mg/kg/day). IIV-RT, derived from the Conners' continuous performance test (CCPT), was represented by the Gaussian (reaction time standard error, RTSE) and ex-Gaussian models (sigma and tau). Other neuropsychological functions, including response errors and mean of reaction time, were also measured. Participants received CCPT assessments at baseline and week 8-10 (60.4±6.3 days). RESULTS We found comparable improvements in performances of CCPT between the immediate-release methylphenidate- and atomoxetine-treated groups. Both medications significantly improved IIV-RT in terms of reducing tau values with comparable efficacy. In addition, both medications significantly improved inhibitory control by reducing commission errors. CONCLUSION Our results provide evidence to support that atomoxetine could improve IIV-RT and inhibitory control, of comparable efficacy with immediate-release methylphenidate, in drug-naïve adults with ADHD. Shared and unique mechanisms underpinning these medication effects on IIV-RT awaits further investigation.
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Affiliation(s)
- Hsing-Chang Ni
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Shoou-Lian Hwang Gu
- Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Hsiang-Yuan Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Ju Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hui-Chun Huang
- Department of Child and Adolescent Psychiatry, Taoyaun Psychiatric Center, Ministry of Health and Welfare, Taoyuan County, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan
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Chiang HL, Chen YJ, Shang CY, Tseng WYI, Gau SSF. Different neural substrates for executive functions in youths with ADHD: a diffusion spectrum imaging tractography study. Psychol Med 2016; 46:1225-1238. [PMID: 26744120 DOI: 10.1017/s0033291715002767] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The relationship between white-matter tracts and executive functions (EF) in attention deficit hyperactivity disorder (ADHD) has not been well studied and previous studies mainly focused on frontostriatal (FS) tracts. The authors explored the microstructural property of several fibre tracts hypothesized to be involved in EF, to correlate their microstructural property with EF, and to explore whether such associations differ between ADHD and typically developing (TD) youths. METHOD We assessed 45 youths with ADHD and 45 individually matched TD youths with a computerized test battery for multiple dimensions of EF. From magnetic resonance imaging, FS tract, superior longitudinal fasciculus (SLF), arcuate fasciculus (AF) and cingulum bundle (CB) were reconstructed by diffusion spectrum imaging tractography. The generalized fractional anisotropy (GFA) values of white-matter tracts were computed to present microstructural property of each tract. RESULTS We found lower GFA in the left FS tract, left SLF, left AF and right CB, and poorer performance in set-shifting, sustained attention, cognitive inhibition and visuospatial planning in ADHD than TD. The ADHD and TD groups demonstrated different association patterns between EF and fibre tract microstructural property. Most of the EF were associated with microstructural integrity of the FS tract and CB in TD youths, while with that of the FS tract, SLF and AF in youths with ADHD. CONCLUSIONS Our findings support that the SLF, AF and CB also involve in a wide range of EF and that the main fibre tracts involved in EF are different in youths with ADHD.
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Affiliation(s)
- H-L Chiang
- Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan
| | - Y-J Chen
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine,Taipei,Taiwan
| | - C-Y Shang
- Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan
| | - W-Y I Tseng
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine,Taipei,Taiwan
| | - S S-F Gau
- Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan
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Lin YJ, Lo KW, Yang LK, Gau SSF. Validation of DSM-5 age-of-onset criterion of attention deficit/hyperactivity disorder (ADHD) in adults: Comparison of life quality, functional impairment, and family function. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:48-60. [PMID: 26318976 DOI: 10.1016/j.ridd.2015.07.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 07/21/2015] [Accepted: 07/25/2015] [Indexed: 06/04/2023]
Abstract
The newly published Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) elevates the threshold of the ADHD age-of-onset criterion from 7 to 12 years. This study evaluated the quality of life and functional impairment of adults with ADHD who had symptoms onset by or after 7 years and examined the mediation effect of family function and anxiety/depression symptoms between ADHD diagnosis and quality of life and functional impairment. We assessed 189 adults with ADHD and 153 non-ADHD controls by psychiatric interview and self-administered reports on the Adult ADHD Quality of Life Scale, Weiss Functional Impairment Rating Scale, Family APGAR, and Adult Self Report Inventory-4. The ADHD group was divided into early-onset ADHD (onset <7 years, n=147) and late-onset ADHD (onset between 7 and 12 years, n=42). The mediation analysis was conducted to verify the mediating factors from ADHD to functional impairment and quality of life. The late-onset ADHD had more severe functional impairment at work and poorer family support than early-onset ADHD while they had comparable impairment at other domains. Less perceived family support and current anxiety/depressive symptoms partially mediated the link between ADHD diagnosis and quality of life/functional impairment both in early- and late-onset ADHD. Our data support decreased quality of life and increased functional impairment in adult ADHD, regardless of age of onset, and these adverse outcomes may be mediated by family support and anxiety/depression at adulthood. Our findings also imply that the new DSM-5 ADHD criteria do not over-include individuals without impairment.
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Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, New Taipei City 220, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
| | - Kuan-Wu Lo
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; School of Medicine, College of Medicine, National Taiwan University, No. 1, Jen-Ai Road Section 1, Taipei 100, Taiwan.
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, No. 60, Xin-ming Road, Beitou District, Taipei 100, Taiwan.
| | - Susan Shur-Fen Gau
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
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Duda TA, Casey JE, McNevin N. Development of graphomotor fluency in adults with ADHD: Evidence of attenuated procedural learning. Hum Mov Sci 2015; 44:1-10. [PMID: 26296142 DOI: 10.1016/j.humov.2015.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 07/25/2015] [Accepted: 08/09/2015] [Indexed: 01/03/2023]
Abstract
PURPOSE The present study sought to determine if adults with ADHD demonstrate reduced graphomotor learning relative to controls. METHOD Twenty-eight control adults (n=14) and adults with ADHD (n=14) were recruited and wrote a novel grapheme on a digitizing tablet 30 times. Participants with ADHD were counterbalanced on and off stimulant medication. RESULTS Control participants, F(1,13)=13.786, p=.003, ω(2)partial=.460, and participants with ADHD on medication, F(1,13)=10.462, p=.007, ω(2)partial=.387, demonstrated significant improvement in graphomotor fluency with equivalent practice whereas participants with ADHD off medication did not, F(1,12)=0.166, NS. CONCLUSIONS Results indicate that graphomotor program learning in adults with ADHD may occur more slowly than typically developing peers. Findings have implications for providing accommodations to adults with ADHD, potential benefits of stimulant medication, and using digitizing technology as a neuropsychological assessment instrument.
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Affiliation(s)
- Thomas A Duda
- University of Windsor, 401 Sunset Avenue, Windsor, Ontario N9B 3P4, Canada.
| | - Joseph E Casey
- University of Windsor, 401 Sunset Avenue, Windsor, Ontario N9B 3P4, Canada
| | - Nancy McNevin
- University of Windsor, 401 Sunset Avenue, Windsor, Ontario N9B 3P4, Canada
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The subjective well-being of individuals diagnosed with comorbid intellectual disability and attention deficit hyperactivity disorders. Qual Life Res 2015; 24:1875-86. [PMID: 25676860 DOI: 10.1007/s11136-015-0936-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE The present study's aim was to empirically explore subjective well-being (SWB) and its correlates among adults diagnosed with comorbid intellectual disability (ID) and attention deficit hyperactivity disorder (ADHD). This exploration was guided by the Theory of SWB Homeostasis as a conceptual framework for examining determinants and processes underlying the SWB of this understudied population. METHOD A total of 246 adults receiving residential support completed questionnaires measuring their SWB, ADHD symptomatology, functional limitations, and individual internal (self-determination) and external (financial resources, and social support) resources. RESULTS The participants' SWB was found to be within the normative range. ADHD symptomatology directly predicted reductions in SWB; however, according to the theory, this effect was fully mediated by the individual's internal and external resources. CONCLUSIONS The main findings support the applicability of the SWB Homeostasis theory for understanding the SWB of individuals with comorbid ID and ADHD. The study findings shed light on the psychosocial determinants of SWB and highlight the importance of psychosocial resources as buffers of the effect of health and environmental conditions.
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Co-occurrence of attention-deficit hyperactivity disorder symptoms with other psychopathology in young adults: parenting style as a moderator. Compr Psychiatry 2015; 57:85-96. [PMID: 25465651 DOI: 10.1016/j.comppsych.2014.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/30/2014] [Accepted: 11/03/2014] [Indexed: 11/23/2022] Open
Abstract
The extent to which parenting styles can influence secondary psychiatric symptoms among young adults with ADHD symptoms is unknown. This issue was investigated in a sample of 2284 incoming college students (male, 50.6%), who completed standardized questionnaires about adult ADHD symptoms, other DSM-IV symptoms, and their parents' parenting styles before their ages of 16. Among them, 2.8% and 22.8% were classified as having ADHD symptoms and sub-threshold ADHD symptoms, respectively. Logistic regression was used to compare the comorbid rates of psychiatric symptoms among the ADHD, sub-threshold ADHD and non-ADHD groups while multiple linear regressions were used to examine the moderating role of gender and parenting styles over the associations between ADHD and other psychiatric symptoms. Both ADHD groups were significantly more likely than other incoming students to have other DSM-IV symptoms. Parental care was negatively associated and parental overprotection/control positively associated with these psychiatric symptoms. Furthermore, significant interactions were found of parenting style with both threshold and sub-threshold ADHD in predicting wide-ranging comorbid symptoms. Specifically, the associations of ADHD with some externalizing symptoms were inversely related to level of paternal care, while associations of ADHD and sub-threshold ADHD with wide-ranging comorbid symptoms were positively related to level of maternal and paternal overprotection/control. These results suggest that parenting styles may modify the effects of ADHD on the risk of a wide range of temporally secondary DSM-IV symptoms among incoming college students, although other causal dynamics might be at work that need to be investigated in longitudinal studies.
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Pehlivanidis A, Papanikolaou K, Spyropoulou AC, Papadimitriou GN. Comorbid attention-deficit/hyperactivity disorder in adult psychiatric outpatients with depressive or anxiety disorders. Int J Psychiatry Clin Pract 2014; 18:265-71. [PMID: 24998681 DOI: 10.3109/13651501.2014.941878] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There are very few studies reporting on the prevalence and the contribution of not previously diagnosed ADHD in the clinical picture of other psychiatric disorders. The aim of our study is to determine the prevalence and clinical correlates of comorbid attention deficit/hyperactivity disorder (ADHD) in adult psychiatric outpatients with depressive or anxiety disorders. METHODS During a 6-month period, 114 outpatients with depressive or anxiety disorders were evaluated for ADHD diagnosis. Assessment included interviews with both patient and relatives/friends and the use of a daily diary. Moreover, the patients completed the self-report scales Beck Depression Inventory (BDI), Spielberger's Anxiety Inventory (STAI), and the Symptom Checklist-90-R Rating Scale (SCL-90-R). RESULTS A total of 22 out of 114 patients (19.3%) received an ADHD diagnosis for the first time in their life. Comorbid ADHD compared to non ADHD patients scored significantly higher (p < 0.05) for depression (BDI), state and trait anxiety (STAI) and in the following SCL-90-R factors: Positive Symptoms Distressing Index, Positive Symptoms Index, Somatization, Obsessive Compulsive, Depression, Anxiety, and Hostility. CONCLUSIONS ADHD might go unrecognized among psychiatric outpatients. Patients with depressive or anxiety disorder reporting more severe symptomatology should be carefully screened for possible comorbid adult ADHD.
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Affiliation(s)
- Artemios Pehlivanidis
- 1st Department of Psychiatry, Athens University Medical School, Eginition Hospital , Athens , Greece
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Abstract
BACKGROUND AND PURPOSE Hyperactive behavior pattern (such as attention deficit hyperactivity disorder (ADHD)) is proposed to be present in individuals with Legg-Calvé-Perthes disease (LCPD). We investigated whether individuals with LCPD have a higher risk of ADHD, depression, and mortality. SUBJECTS AND METHODS We identified 4,057 individuals with LCPD in Sweden during the period 1964-2011. 40,570 individuals without LCPD were randomly selected from the Swedish general population and matched by year of birth, sex, and region (control group). We used Cox proportional hazard regression to estimate the relative risks. RESULTS Compared to the control group, individuals with LCPD had a raised hazard ratio (HR) of 1.5 (95% CI: 1.2-1.9) for ADHD. The risks were higher for female individuals (HR = 2.1, CI: 1.3-3.5) than for male individuals (HR = 1.4, CI: 1.1-1.8). Individuals with LCPD had a modestly higher hazard ratio for depression (HR = 1.3, CI: 1.1-1.5) than the control group. Furthermore, individuals with LCPD had a slightly higher mortality risk than the control group (HR = 1.2, CI: 1.0-1.4) INTERPRETATION: Individuals with LCPD have a higher risk of ADHD. Hyperactivity could expose the femoral head to higher mechanical stress and contribute to the etiology of LCPD. The higher risk of depression may be due to the burden of LCPD itself or could reflect neurobehavioral aspects of ADHD changing into depression later in life. Individuals with LCPD have a higher mortality risk, with higher risk of suicide and cardiovascular diseases.
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Affiliation(s)
- Yasmin D Hailer
- Department of Orthopedics, Uppsala University Hospital, Uppsala, Sweden.
| | - Olle Nilsson
- Department of Orthopedics, Uppsala University Hospital, Uppsala, Sweden.
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Lau WYP, Gau SSF, Chiu YN, Wu YY. Autistic Traits in Couple Dyads as a Predictor of Anxiety Spectrum Symptoms. J Autism Dev Disord 2014; 44:2949-63. [DOI: 10.1007/s10803-014-2151-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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