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Zhang W, He T, Hinshaw S, Chi P, Lin X. Longitudinal relationship between oppositional defiant disorder symptoms and attention-deficit/hyperactivity disorder symptoms in Chinese children: insights from cross-lagged panel network analyses. Eur Child Adolesc Psychiatry 2024; 33:2557-2570. [PMID: 38151686 DOI: 10.1007/s00787-023-02347-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 11/29/2023] [Indexed: 12/29/2023]
Abstract
Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common childhood mental disorders, and they have substantial comorbidity. The developmental precursor model has long been widely used to explain the mechanisms of comorbidity between ODD and ADHD, however whether it is equally effective at the symptomatic level is unclear. Therefore, this study aimed to (a) examine the stability of the ODD and ADHD comorbidity network in a longitudinal sample of high-risk children in China; and (b) examine the longitudinal relationship between the ODD and ADHD symptom networks based on a developmental precursor model. Two hundred sixty-three Chinese children aged 6 to 13 years with ODD and/or ADHD were assessed for symptoms of ODD and ADHD in two surveys conducted 1 year apart. We used data from these two time points to construct two cross-sectional networks and a cross-lagged panel network (CLPN) to explore the symptom network for comorbidity of ODD and ADHD. The analysis shows that: (1) the two cross-sectional networks are highly similar in terms of structure, existence of edges, centrality estimates, and the invariance test shows that there is no significant difference between them. The symptoms "follow through", "interrupts/intrudes", "difficulty playing quietly" and "concentration" had the highest expected influence centrality at both time points. (2) Combined with the results of the cross-sectional and cross-lagged networks, we found that "annoy" and "blame" are potential bridge symptoms between the ODD and ADHD symptom networks. The symptom "annoy" forms a reciprocal predictive relationship with "interrupts/intrudes", while "blame" unidirectionally predicts "close attention". In addition, we found that "vindictive" predicted numerous ADHD symptoms, whereas "angry" was predicted by numerous ADHD symptoms. The findings emphasize the broad predictive relationship between ODD and ADHD symptoms with each other, and that ODD symptoms may lead to activation of the ADHD symptom network and vice versa. These findings suggest that the developmental precursor model at the symptom level may partially explain the comorbidity mechanisms of ODD and ADHD, and future studies should further investigate the underlying multiple mechanisms.
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Affiliation(s)
- Wenrui Zhang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Ting He
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China
| | - Stephen Hinshaw
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Peilian Chi
- Department of Psychology, University of Macau, Macau, China
| | - Xiuyun Lin
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China.
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875, China.
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2
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Schwarzlose RF. Superiority and stigma in modern psychology and neuroscience. Trends Cogn Sci 2023; 27:4-6. [PMID: 36207259 PMCID: PMC10367050 DOI: 10.1016/j.tics.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022]
Abstract
Bias in early psychological and neuroscientific research distorted conclusions about women and people of color. Unintentional biases persisting today in studies of older adults and people with stigmatized conditions may perpetuate stigma and hinder scientific discovery. We can combat these biases by changing how we analyze, interpret, and describe differences.
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Affiliation(s)
- Rebecca F Schwarzlose
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
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3
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Salerno L, Becheri L, Pallanti S. ADHD-Gaming Disorder Comorbidity in Children and Adolescents: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101528. [PMID: 36291464 PMCID: PMC9600100 DOI: 10.3390/children9101528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/24/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022]
Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) is a neurobiological condition characterized by developmentally inadequate levels of inattention, hyperactivity, and impulsivity, and a neurobiological disruption in brain neurotransmitters and circuitry causing abnormal responses to rewards. Playing electronic games generates a biological response that activates the neuronal circuits linked to pleasure and reward, and there is a growing attention to this type of activity, which can also turn into a mental health condition. The existence and the boundaries between the functional and the dysfunctional are still a source of debate, with the recognition of 'Internet Gaming Disorder' (IGD) as a condition belonging to the broader area of addiction requiring more in-depth study with respect to the DSM-5, while 'Gaming Disorder' (GD) was officially recognized as a new diagnosis by the World Health Organization (WHO) in the updated revision of the International Classification of Diseases (ICD-11). Notwithstanding, the suggested criteria for the diagnosis of Gaming Disorder are still debated. Since ADHD has been reported as a risk factor for developing addictions, this narrative review aims to provide the current state-of-the art of the knowledge about the comorbidity between ADHD and Gaming Disorder. For this aim, a literature search was conducted using a combination of specific keywords and the results are discussed within the R-Do-C framework and dimensions, and implications for treatment are considered.
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Affiliation(s)
- Luana Salerno
- INS, Istituto di Neuroscienze, 50121 Florence, Italy
| | | | - Stefano Pallanti
- INS, Istituto di Neuroscienze, 50121 Florence, Italy
- Department of Psychiatry, Albert Einstein College of Medicine, Bronx, NY 10461, USA
- Correspondence:
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4
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Rodrigo-Yanguas M, González-Tardón C, Bella-Fernández M, Blasco-Fontecilla H. Serious Video Games: Angels or Demons in Patients With Attention-Deficit Hyperactivity Disorder? A Quasi-Systematic Review. Front Psychiatry 2022; 13:798480. [PMID: 35573357 PMCID: PMC9091561 DOI: 10.3389/fpsyt.2022.798480] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/11/2022] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To carry out a quasi-systematic review of the use of serious video games for health as a cognitive rehabilitative tool in patients diagnosed with attention-deficit hyperactivity disorder. METHOD A quasi-systematic review of serious video games used as an evaluative and rehabilitative tool in patients with ADHD was conducted. It included behavioral patterns in the use of video games and addiction problems in this population. For its elaboration the PRISMA GUIDES were followed. The search was carried out in three PubMed databases, MEDLINE, and PsycInfo using the keywords: [game OR serious game OR computer game) AND (psychotherapy OR rehabilitation OR intervention OR mental disorders) AND (adhd)], [(adhd) AND (Video game addiction)]. All articles written in English, Spanish, or Portuguese from January 1970 to June 2021 were included: those in which reference was made to the use of video games and/or new technologies as a therapeutic and evaluative tool in children and adults diagnosed with ADHD, as well as those that referred to behavioral and clinical patterns in the use of video games. RESULTS We found 605 articles of which 128 were reviewed (44 observational studies, 26 quasi-experimental studies, 26 experimental studies, 8 systematic reviews, 9 narrative texts, 6 case reports, 7 pilot studies, 8 systematic reviews, and 2 meta-analyses). Serious video games can be used to ameliorate ADHD symptoms while improving adherence to treatment. Some serious video games show high accuracy properties assessing ADHD features. CONCLUSION Serious video games for health are increasingly being used as a cognitive rehabilitation tool in patients with attention-deficit hyperactivity disorder (ADHD). SYSTEMATIC REVIEW REGISTRATION [www.crd.york.ac.uk/prospero], identifier [CRD42021247784].
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Affiliation(s)
- María Rodrigo-Yanguas
- Servicio de Psiquiatría, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA)-Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Marcos Bella-Fernández
- Servicio de Psiquiatría, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA)-Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Department of Psychology, Universidad Pontificia de Comillas, Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Servicio de Psiquiatría, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA)-Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.,Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.,Consulting Asistencial Sociosanitario SL, Madrid, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
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5
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Bruya B, Tang YY. Fluid Attention in Education: Conceptual and Neurobiological Framework. Front Psychol 2021; 12:704443. [PMID: 34650472 PMCID: PMC8506156 DOI: 10.3389/fpsyg.2021.704443] [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: 05/04/2021] [Accepted: 07/29/2021] [Indexed: 11/13/2022] Open
Abstract
Attention is indispensable to our learning, performance, relationships, health, and daily life, and yet laboratory studies of attention have only scratched the surface of these lived varieties of attention. In this article, we begin with William James' theory of derived involuntary attention, which has largely been ignored in laboratory research. We then show that there is a gap in our attention vocabulary and the theory that underpins it, which depend on an incomplete voluntary/involuntary dichotomy. The negative effects of this dichotomy stretch beyond laboratory research to clinical diagnosis, influencing how we understand so-called attention deficits. To fill the gap between voluntary and involuntary, we introduce a third kind of attention—fluid attention (also called postvoluntary attention), which is goal-directed and selective, like voluntary attention, but also effortless and drawn to its source, like involuntary attention. Fluid attention is a rediscovery of James' derived involuntary attention. A distinguishing feature of fluid attention is its motivational component, which, we show, neurophysiologically also reveals a gap in the neurocognitive literature on attention. Recognizing fluid attention as fundamentally motivational allows ADHD to be redefined as a motivational rather than an attentional deficit, which we go on to show has significant implications for both special and regular education.
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Affiliation(s)
- Brian Bruya
- Department of History and Philosophy, Eastern Michigan University, Ypsilanti, MI, United States
| | - Yi-Yuan Tang
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States
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6
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Carpita B, Muti D, Nardi B, Benedetti F, Cappelli A, Cremone IM, Carmassi C, Dell’Osso L. Biochemical Correlates of Video Game Use: From Physiology to Pathology. A Narrative Review. Life (Basel) 2021; 11:775. [PMID: 34440519 PMCID: PMC8401252 DOI: 10.3390/life11080775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 12/14/2022] Open
Abstract
In the last few decades, video game playing progressively became a widespread activity for many people, in childhood as well in adulthood. An increasing amount of literature has focused on pathological and non-pathological correlates of video game playing, with specific attention towards Internet Gaming Disorder (IGD). While many neurobiological studies in this field were based on neuroimaging, highlighting structural and functional brain changes among video game users, only a limited number of studies investigated the presence of biochemical correlates of video gaming. The present work aims to summarize and review the available literature about biochemical changes linked to video game use in IGD patients as well as non-pathological users, and the differences in between. Results may shed light on risks and benefits of video games, providing directions for further research on IGD treatment and, on other hand, on the potential role of video games in therapeutic or preventive protocols for specific conditions.
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Affiliation(s)
- Barbara Carpita
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.N.); (F.B.); (A.C.); (I.M.C.); (C.C.); (L.D.)
| | - Dario Muti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (B.N.); (F.B.); (A.C.); (I.M.C.); (C.C.); (L.D.)
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7
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Legault MCB, Liu HZ, Balodis IM. Neuropsychological Constructs in Gaming Disorders: a Systematic Review. Curr Behav Neurosci Rep 2021. [DOI: 10.1007/s40473-021-00230-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Skalski S, Pochwatko G, Balas R. Impact of Motivation on Selected Aspects of Attention in Children with ADHD. Child Psychiatry Hum Dev 2021; 52:586-595. [PMID: 32816140 PMCID: PMC8238702 DOI: 10.1007/s10578-020-01042-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/03/2020] [Accepted: 08/09/2020] [Indexed: 02/06/2023]
Abstract
Earlier reports showed the co-occurrence of a motivation deficit in children with ADHD. The purpose of this study was to assess the impact of extrinsic motivation on selected aspects of attention in children with ADHD, as well as to measure cortical activity and dimensions of motivation as per the self-determination theory. The study included 30 children with ADHD and 30 typically developing (TD) children aged 9-13 years. Children with ADHD exhibited a higher theta/beta power ratio (TBR) in the midline and a lower regional cerebral blood oxygenation (rCBO2) level in prefrontal areas measured using the HEG ratio compared to TD children. Children with ADHD were more likely to undertake activity under the pressure of external stimuli and exhibited attention deficits regarding vigilance, visual search and divided attention. Differences between groups regarding attention decreased in conditions of increased motivation, indicating that motivation can reduce cognitive deficits in children with ADHD.
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Affiliation(s)
- Sebastian Skalski
- Institute of Psychology, Polish Academy of Sciences, 1 Jaracza Street, 00-378, Warsaw, Poland.
| | - Grzegorz Pochwatko
- grid.413454.30000 0001 1958 0162Institute of Psychology, Polish Academy of Sciences, 1 Jaracza Street, 00-378 Warsaw, Poland
| | - Robert Balas
- grid.413454.30000 0001 1958 0162Institute of Psychology, Polish Academy of Sciences, 1 Jaracza Street, 00-378 Warsaw, Poland
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9
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The Development and Psychometric Properties of the Visuospatial Working Memory Assessment (VWMA) for Children. Occup Ther Int 2020; 2020:8736308. [PMID: 32292306 PMCID: PMC7152980 DOI: 10.1155/2020/8736308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/05/2020] [Accepted: 03/02/2020] [Indexed: 11/28/2022] Open
Abstract
The visuospatial working memory plays a crucial role in the occupational performance of children including daily living and academic achievement. Unfortunately, relevant visuospatial working memory tests in the occupational therapy setting are lacking. Therefore, it is of clinical interest to develop new assessment tools in this area. The present study is aimed at summarizing the development of the visuospatial working memory assessment (VWMA) and assessing its psychometric properties. The results revealed that the score of item-objective congruence index (IOC) was 1.0 in overall items of assessment. The Cronbach alpha test confirmed that the internal consistency of VWMA showed good reliability in both types of the assessment, with the total score of computerized tests being .88 and the tabletop tests being .81. The computerized test was found to have excellent test-retest reliability with intraclass correlation coefficient (ICC) values ranging from .88 to .99. The tabletop test was found to have a fair to good test-retest reliability with the ICC values ranging from .51 to .63. As regards construct validity, the results revealed that the tasks in the computerized test identified a significant difference between the control group, normal children, and children with attention deficit/hyperactivity disorder (ADHD) group. The exception to this was the N-back task in which the independent sample t-test of computerized test ranged from 1.61 to 6.23. The results of the tabletop test revealed a significant difference between normal children and the children in the ADHD group over all tasks in which the independent sample t-test ranged from 3.05 to 8.40. In conclusion, good psychometric properties established as regards content validity, internal consistency, test-retest reliability, and construct validity provide evidence to support the position that the new VWMA is appropriate for children.
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10
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Abstract
Objective: The objective of this study was to compare children with ADHD with children without ADHD on frustration tolerance and to examine the role of oppositional defiant disorder (ODD) in frustration tolerance within the sample. Method: Participants included 67 children ages 10 to 14 years-old with (n = 37) and without (n = 30) Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) ADHD who completed the Mirror Tracing Persistence Task (MTPT), a validated computerized behavioral measure of frustration tolerance. Results: Children with ADHD were more likely to quit this task than children without ADHD, demonstrating lower levels of frustration tolerance. There were no differences in frustration tolerance between children with ADHD + ODD and those with ADHD - ODD. Moreover, ODD did not moderate the relationship between ADHD and frustration tolerance. Conclusion: Our results suggest that low frustration tolerance is directly linked to ADHD and not better accounted for by ODD. This research highlights specific behavioral correlates of frustration in children with ADHD.
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11
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Self-directed speech and self-regulation in childhood neurodevelopmental disorders: Current findings and future directions. Dev Psychopathol 2019; 32:205-217. [PMID: 30704545 DOI: 10.1017/s0954579418001670] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Self-directed speech is considered an important developmental achievement as a self-regulatory mediator of thinking and behavior. Atypical self-directed speech is often implicated in the self-regulatory challenges characteristic of children with neurodevelopmental disorders. A growing body of evidence provides snapshots across age-levels and diagnoses, often presenting conflicting results. This systematic review is undertaken to impose clarity on the nature, extent, and self-regulatory implications of self-directed speech interruption in children with developmental language disorder (DLD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD).A rigorous search process of relevant databases (i.e., PsychInfo, PubMed, CINAHL, ERIC) uncovered 19 relevant peer-reviewed articles that investigate self-directed speech in children with neurodevelopmental disorders. Consistent across the research, children with DLD, ASD, and ADHD present with differential development and use of self-directed speech.In its synthesis of findings, this systematic review clearly explicates the differential ontogenesis of self-directed speech in neurodevelopmental disorders and interprets the self-regulatory implications for children with DLD, ASD, and ADHD. Furthermore, the review spotlights important future research directions to better understand the mechanistic relationship between self-directed speech and self-regulation.
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12
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Real and virtual worlds alike: Adolescents' psychopathology is reflected in their videogame virtual behaviors. PLoS One 2017; 12:e0181209. [PMID: 28708879 PMCID: PMC5510843 DOI: 10.1371/journal.pone.0181209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/27/2017] [Indexed: 11/25/2022] Open
Abstract
Current research refers to videogames as a constant variable. However, games today are designed to be highly interactive and versatile: two players may be using the same videogame, but as a result of different using patterns, the game will not necessarily encompass the same content and gameplay. The current study examined the possible relationship between psychopathology and in-game playing patterns. We hypothesized that adolescents would play videogames differently, in a manner that would reflect their particular psychopathologies. We examined 47 male adolescents from three diagnostic groups: those suffering from externalizing psychopathologies, internalizing psychopathologies and controls. We performed a high-resolution examination of their gameplay, using in-game quantitative statistics mechanisms of two fundamentally different games, a structured racing game and an unstructured adventure game. While there was no difference in the groups' using patterns of the structured game, there was a high variability between the groups' using patterns when they were using a non-structured game. These findings suggest that virtual behavior in unstructured games is reflective of adolescent-players psychopathology, and might shed light on an unexplored facet of videogames research. Possible implications are discussed.
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13
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Turgut Turan S, Erdoğan Bakar E, Erden G, Karakaş S. Using Neuropsychometric Measurements in the Differential Diagnosis of Specific Learning Disability. Noro Psikiyatr Ars 2017; 53:144-151. [PMID: 28360787 DOI: 10.5152/npa.2015.10024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 07/08/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of this study was to develop a neuropsychometric battery for the differential diagnosis of specific learning disability (SLD), with specific respect to attention deficit hyperactivity disorder (ADHD), and to help resolve the conflicting results in the literature by an integrative utilization of scores on both the Bannatyne categories and neuropsychological tests. METHODS The sample included 168 primary school boys who were assigned to SLD (n=21), ADHD (n=45), SLD and ADHD (n=57), and control groups (n=45). The exclusion criteria were a neurological or psychiatric comorbidity other than ADHD, a level of anxiety and/or depression above the cutoff score, medication affecting cognitive processes, visual and/or auditory disorders, and an intelligence level outside the IQ range of 85-129. Psychometric scores were obtained from the SLD Battery and Wechsler Intelligence Scale for Children-Revised in the form of Bannatyne category scores. Neuropsychological scores were from the Visual-Aural Digit Span Test-Form B, Serial Digit Learning Test, Judgment of Line Orientation, and Mangina Test. The battery was called the Integrative Battery of SLD. RESULTS The correctness of estimation for classifying cases into the diagnostic dyads (SLD/ADHD, SLD/SLD+ADHD, and SLD+ADHD/ADHD) by an integrative utilization of both the Bannatyne category scores (n=4) and scores from the four neuropsychological tests (n=10) was 92.4%, 81.4%, and 71.8%, respectively. These proportions were generally higher than those obtained using the Bannatyne category scores alone (86.4%, 75.5%, and 73.1%, respectively). The same trend was seen in the classification of children into diagnostic and control groups. However, the proportion of the correctness of estimation was higher than that obtained for the diagnostic dyads. CONCLUSION When conducted using appropriately chosen research designs and statistical techniques and if confounding variables are sufficiently controlled, a neuropsychometric battery that includes capacities that relate to intelligence (Bannatyne categories) and those that relate to neurocognitive processes (neuropsychological tests) can be useful in the differential diagnosis of SLD.
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Affiliation(s)
- Sevil Turgut Turan
- Department of Pediatrics, Akdeniz University School of Medicine, Antalya, Turkey
| | | | - Gülsen Erden
- Department of Psychology, Ankara University School of Medicine, Ankara, Turkey
| | - Sirel Karakaş
- Department of Psychology, Doğuş University, İstanbul, Turkey
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14
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Bakar EE, Taner YI, Soysal AS, Karakas S, Turgay A. Behavioral Rating Inventory and Laboratory Tests Measure Different Aspects of Executive Functioning in Boys: A Validity Study. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20111004014003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | | | | | - Sirel Karakas
- Hacettepe University, KOSGEB Technology Development Center, Ankara-Turkey
| | - Atilla Turgay
- University of Toronto, Department of Family and Community Medicine, Toronto-Canada
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15
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Kim H, Carlson AG, Curby TW, Winsler A. Relations among motor, social, and cognitive skills in pre-kindergarten children with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 53-54:43-60. [PMID: 26852279 DOI: 10.1016/j.ridd.2016.01.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 12/01/2015] [Accepted: 01/24/2016] [Indexed: 06/05/2023]
Abstract
Despite the comorbidity between motor difficulties and certain disabilities, limited research has examined links between early motor, cognitive, and social skills in preschool-aged children with developmental disabilities. The present study examined the relative contributions of gross motor and fine motor skills to the prediction of improvements in children's cognitive and social skills among 2,027 pre-kindergarten children with developmental disabilities, including specific learning disorder, speech/language impairment, intellectual disability, and autism spectrum disorder. Results indicated that for pre-kindergarten children with developmental disabilities, fine motor skills, but not gross motor skills, were predictive of improvements in cognitive and social skills, even after controlling for demographic information and initial skill levels. Moreover, depending on the type of developmental disability, the pattern of prediction of gross motor and fine motor skills to improvements in children's cognitive and social skills differed. Implications are discussed.
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Affiliation(s)
- Helyn Kim
- University of Virginia, Curry School of Education, Center for Advanced Study of Teaching & Learning, PO Box 800784, Charlottesville, VA 22908-0784, USA.
| | - Abby G Carlson
- AppleTree Institute for Education Innovation, Assessment and Evaluation, 415 Michigan Ave. NE, Washington, DC 20017, USA.
| | - Timothy W Curby
- George Mason University, Department of Psychology, 4400 University Dr., MS 3F5, Fairfax, VA 22030-4444, USA.
| | - Adam Winsler
- George Mason University, Department of Psychology, 4400 University Dr., MS 3F5, Fairfax, VA 22030-4444, USA.
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16
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Kofler MJ, Raiker JS, Sarver DE, Wells EL, Soto EF. Is hyperactivity ubiquitous in ADHD or dependent on environmental demands? Evidence from meta-analysis. Clin Psychol Rev 2016; 46:12-24. [PMID: 27131918 DOI: 10.1016/j.cpr.2016.04.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 03/22/2016] [Accepted: 04/11/2016] [Indexed: 12/20/2022]
Abstract
Hyperactivity, or excess gross motor activity, is considered a core and ubiquitous characteristic of ADHD. Alternate models question this premise, and propose that hyperactive behavior reflects, to a large extent, purposeful behavior to cope with environmental demands that interact with underlying neurobiological vulnerabilities. The present review critically evaluates the ubiquity and environmental modifiability of hyperactivity in ADHD through meta-analysis of 63 studies of mechanically measured activity level in children, adolescents, and adults with ADHD relative to typically developing groups. Random effects models corrected for publication bias confirmed elevated gross motor activity in ADHD (d=0.86); surprisingly, neither participant age (child vs. adult) nor the proportion of each ADHD sample diagnosed with the inattentive subtype/presentation moderated this effect. In contrast, activity level assessed during high cognitive load conditions in general (d=1.14) and high executive functioning demands in particular (d=1.39) revealed significantly higher effect sizes than activity level during low cognitive load (d=0.36) and in-class schoolwork (d=0.50) settings. Low stimulation environments, more rigorous diagnostic practices, actigraph measurement of movement frequency and intensity, and ADHD samples that included fewer females were also associated with larger effects. Overall, the results are inconsistent with DSM-5 and ADHD models that a) describe hyperactivity as ubiquitous behavior, b) predict a developmental decline in hyperactivity, or c) differentiate subtypes/presentations according to perceived differences in hyperactive behavior. Instead, results suggest that the presence and magnitude of hyperactive behavior in ADHD may be influenced to a considerable extent by environmental factors in general, and cognitive/executive functioning demands in particular.
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Affiliation(s)
- Michael J Kofler
- Florida State University, Department of Psychology, 1107 W. Call Street, Tallahassee, FL 32306-4301, United States.
| | - Joseph S Raiker
- Florida International University
- Department of Psychology Center for Children and Families 11200 SW 8th St.
- Miami, FL 33199, United States
| | - Dustin E Sarver
- University of Mississippi Medical CenterDepartment of Pediatrics, Division of Child Development Center for Advancement of Youth (CAY) 2500 North State Street Jackson, MS 39216, United States
| | - Erica L Wells
- Florida State University, Department of Psychology, 1107 W. Call Street, Tallahassee, FL 32306-4301, United States
| | - Elia F Soto
- Florida State University, Department of Psychology, 1107 W. Call Street, Tallahassee, FL 32306-4301, United States
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17
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Parsons S, Yuill N, Brosnan M, Good J. Innovative technologies for autism: critical reflections on digital bubbles. ACTA ACUST UNITED AC 2015. [DOI: 10.1108/jat-03-2015-0005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– There is increasing interest from researchers, teachers and other professionals, individuals with autism, and families about the potential for innovative technologies to transform learning experiences and facilitate friendships and social networks. Media accounts have highlighted both the apparently miraculous impacts of technology on supporting communication and learning for people with autism, as well as significant concerns about whether technology use is healthy, safe and socially appropriate for children and young people. Rarely, however, is any evidence reported to support either set of claims. The paper aims to discuss these issues.
Design/methodology/approach
– This short paper reports on an Economic and Social Research Council-funded seminar series in the UK that is critically reviewing and discussing the field with respect to the research evidence base but also the assumptions that are made about where, how and whether innovative technologies may be useful for people with autism and their families.
Findings
– The first seminar in the series focused on whether technologies create a social bubble for people with autism and presented research demonstrating that technology use can be positive, supportive and rewarding.
Originality/value
– This paper offers an up-to-date insight into some of key debates about the benefits and limitations of social technologies for people with autism. Its value lies in raising questions about, and discussing evidence that challenges, some of the negative assumptions that are often perpetuated by the media about the potentially harmful effects of technologies.
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Brown TE, Brams M, Gao J, Gasior M, Childress A. Open-Label Administration of Lisdexamfetamine Dimesylate Improves Executive Function Impairments and Symptoms of Attention-Deficit/Hyperactivity Disorder in Adults. Postgrad Med 2015; 122:7-17. [DOI: 10.3810/pgm.2010.09.2196] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Thomas E. Brown
- Associate Director, Yale Clinic for Attention and Related Disorders, Yale University School of Medicine, New Haven, CT
| | - Matthew Brams
- Principal Investigator, Bayou City Research, Houston, TX
| | - Joseph Gao
- Director, Biostatistics, Clinical Development Operations and Biometrics, Shire Development Inc., Wayne, PA
| | - Maria Gasior
- Clinical Medicine Director, Shire Development Inc., Wayne, PA
| | - Ann Childress
- President, Center for Psychiatry and Behavioral Medicine, Las Vegas, NV
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19
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Strahler Rivero T, Herrera Nuñez LM, Uehara Pires E, Amodeo Bueno OF. ADHD Rehabilitation through Video Gaming: A Systematic Review Using PRISMA Guidelines of the Current Findings and the Associated Risk of Bias. Front Psychiatry 2015; 6:151. [PMID: 26557098 PMCID: PMC4614280 DOI: 10.3389/fpsyt.2015.00151] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 10/09/2015] [Indexed: 11/13/2022] Open
Abstract
Empirical research studies have highlighted the need to investigate whether video game can be useful as a tool within a neuropsychological rehabilitation program for attention deficit hyperactivity disorder (ADHD) patients. However, little is known about the possible gains that this kind of video game-based interventions can produce and even if these gains can be transferred to real life abilities. The present paper aims to uncover key information related to the use of video game in ADHD neuropsychological rehabilitation/intervention by focusing on its gains and its capability to transfer/generalize these gains to real life situation via a systematic review of the empirical literature. The PRISMA guidelines were adopted. Internet-based bibliographic searches were conducted via seven major electronic databases (i.e., PsycARTICLES, PsycINFO, Web of Science, Core Collection BIOSIS Citation Index, MEDLINE, SciELO Citation Index, and PubMed) to access studies examining the association between video game interventions in ADHD patients and behavioral and cognitive outcomes. A total of 14 empirical studies meeting the inclusion criteria were identified. The studies reported the attention, working memory, and the behavioral aspects as the main target of the intervention. Cognitive and behavioral gains were reported after the video game training (VGT). However, many bias related to the choice of outcome instruments, sampling and blindness of assessors, weaken the results power. Additional researches are important to clarify the effects and stability of the VGT programs, and an important effort should be made to construct better methods to assess improvements on everyday cognitive abilities and real world functioning.
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Affiliation(s)
- Thiago Strahler Rivero
- Grupo de Investigação em Memória Humana, Departamento de Psicobiologia, Universidade Federal de São Paulo , São Paulo , Brazil
| | | | - Emmy Uehara Pires
- Departamento de Psicologia, Universidade Federal Rural do Rio de Janeiro , Seropédica , Brazil
| | - Orlando Francisco Amodeo Bueno
- Grupo de Investigação em Memória Humana, Departamento de Psicobiologia, Universidade Federal de São Paulo , São Paulo , Brazil
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20
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Okazaki YO, Horschig JM, Luther L, Oostenveld R, Murakami I, Jensen O. Real-time MEG neurofeedback training of posterior alpha activity modulates subsequent visual detection performance. Neuroimage 2014; 107:323-332. [PMID: 25514519 DOI: 10.1016/j.neuroimage.2014.12.014] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 11/04/2014] [Accepted: 12/05/2014] [Indexed: 11/15/2022] Open
Abstract
It has been demonstrated that alpha activity is lateralized when attention is directed to the left or right visual hemifield. We investigated whether real-time neurofeedback training of the alpha lateralization enhances participants' ability to modulate posterior alpha lateralization and causes subsequent short-term changes in visual detection performance. The experiment consisted of three phases: (i) pre-training assessment, (ii) neurofeedback phase and (iii) post-training assessment. In the pre- and post-training phases we measured the threshold to covertly detect a cued faint Gabor stimulus presented in the left or right hemifield. During magnetoencephalography (MEG) neurofeedback, two face stimuli superimposed with noise were presented bilaterally. Participants were cued to attend to one of the hemifields. The transparency of the superimposed noise and thus the visibility of the stimuli were varied according to the momentary degree of hemispheric alpha lateralization. In a double-blind procedure half of the participants were provided with sham feedback. We found that hemispheric alpha lateralization increased with the neurofeedback training; this was mainly driven by an ipsilateral alpha increase. Surprisingly, comparing pre- to post-training, detection performance decreased for a Gabor stimulus presented in the hemifield that was un-attended during neurofeedback. This effect was not observed in the sham group. Thus, neurofeedback training alters alpha lateralization, which in turn decreases performances in the untrained hemifield. Our findings suggest that alpha oscillations play a causal role for the allocation of attention. Furthermore, our neurofeedback protocol serves to reduce the detection of unattended visual information and could therefore be of potential use for training to reduce distractibility in attention deficit patients, but also highlights that neurofeedback paradigms can have negative impact on behavioral performance and should be applied with caution.
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Affiliation(s)
- Yuka O Okazaki
- Department of Life Sciences, University of Tokyo, Tokyo 153-8902, Japan; Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500HB Nijmegen, the Netherlands.
| | - Jörn M Horschig
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500HB Nijmegen, the Netherlands.
| | - Lisa Luther
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500HB Nijmegen, the Netherlands; Behavioural Science Institute, Radboud University, 6525HR Nijmegen, the Netherlands
| | - Robert Oostenveld
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500HB Nijmegen, the Netherlands
| | - Ikuya Murakami
- Department of Life Sciences, University of Tokyo, Tokyo 153-8902, Japan; Department of Psychology, University of Tokyo, Tokyo 113-0033, Japan.
| | - Ole Jensen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6500HB Nijmegen, the Netherlands.
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21
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van der Oord S, Ponsioen AJGB, Geurts HM, Ten Brink EL, Prins PJM. A pilot study of the efficacy of a computerized executive functioning remediation training with game elements for children with ADHD in an outpatient setting: outcome on parent- and teacher-rated executive functioning and ADHD behavior. J Atten Disord 2014; 18:699-712. [PMID: 22879577 DOI: 10.1177/1087054712453167] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This pilot study tested the short- and long-term efficacy (9 weeks follow-up) of an executive functioning (EF) remediation training with game elements for children with ADHD in an outpatient clinical setting, using a randomized controlled wait-list design. Furthermore, in a subsample, that is, those treated with methylphenidate, additive effects of the EF training were assessed. METHOD A total of 40 children (aged 8-12 years) were randomized to the EF training or wait-list. The training consisted of a 25-session training of inhibition, cognitive flexibility, and working memory. Treatment outcome was assessed by parent- and teacher-rated EF, ADHD, oppositional deviant disorder, and conduct disorder symptoms. RESULTS Children in the EF training showed significantly more improvement than those in the wait-list condition on parent-rated EF and ADHD behavior in the total sample and in the subsample treated with methylphenidate. Effects were maintained at follow-up. CONCLUSION This pilot study shows promising evidence for the efficacy of an EF training with game elements.
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Affiliation(s)
- S van der Oord
- Leuven University, Belgium University of Amsterdam, Netherlands
| | - A J G B Ponsioen
- Lucertis, Outpatient Children's Psychiatric Clinic, Beverwijk/Zaandam, Netherlands
| | | | - E L Ten Brink
- Lucertis, Outpatient Children's Psychiatric Clinic, Beverwijk/Zaandam, Netherlands
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22
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Bioulac S, Lallemand S, Fabrigoule C, Thoumy AL, Philip P, Bouvard MP. Video game performances are preserved in ADHD children compared with controls. J Atten Disord 2014; 18:542-50. [PMID: 22628143 DOI: 10.1177/1087054712443702] [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: 11/17/2022]
Abstract
OBJECTIVE Although ADHD and excessive video game playing have received some attention, few studies have explored the performances of ADHD children when playing video games. The authors hypothesized that performances of ADHD children would be as good as those of control children in motivating video games tasks but not in the Continuous Performance Test II (CPT II). METHOD The sample consisted of 26 ADHD children and 16 control children. Performances of ADHD and control children were compared on three commercially available games, on the repetition of every game, and on the CPT II. RESULTS ADHD children had lower performances on the CPT II than did controls, but they exhibited equivalent performances to controls when playing video games at both sessions and on all three games. CONCLUSION When playing video games, ADHD children present no difference in inhibitory performances compared with control children. This demonstrates that cognitive difficulties in ADHD are task dependent.
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Affiliation(s)
- Stéphanie Bioulac
- Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Bordeaux, France Université Victor Segalen Bordeaux 2, Bordeaux, France
| | | | | | - Anne-Laure Thoumy
- Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Bordeaux, France
| | - Pierre Philip
- Université Victor Segalen Bordeaux 2, Bordeaux, France
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23
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Houghton S, Hunter SC, Trewin T, Glasgow K, Carroll A. The multidimensional anxiety scale for children: a further validation with Australian adolescents with and without ADHD. J Atten Disord 2014; 18:402-11. [PMID: 22427253 DOI: 10.1177/1087054712439100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the factor structure of the Multidimensional Anxiety Scale for Children (MASC) with Australian adolescents with and without ADHD. METHOD The MASC was administered to 210 high school-aged adolescents (109 males, 101 females), 115 of whom were clinically diagnosed as ADHD (86 males, 29 females). The remaining 95 were non-ADHD community comparisons. RESULTS Analyses supported a three-factor model, with a reduced item pool, which combined the Harm Avoidance and Separation Anxiety scales together. This model was invariant across younger and older participants, and across boys and girls. The model was largely invariant across ADHD and non-ADHD groups. The ADHD group had significantly higher Physical Symptom factor scores than the non-ADHD group. CONCLUSION The MASC is useful for assessing anxiety in adolescents with and without ADHD, but items reflecting the Harm Avoidance and Separation Anxiety scales may need revising.
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Affiliation(s)
| | | | - Toby Trewin
- The University of Western Australia, Crawley, Australia
| | - Ken Glasgow
- The University of Western Australia, Crawley, Australia
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24
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Leiner M, Peinado J, Villanos MT, Alvarado LA, Singh N, Dwivedi A. Psychosocial Profile of Mexican American Youths Who Play Aggressive Video Games. HISPANIC JOURNAL OF BEHAVIORAL SCIENCES 2014. [DOI: 10.1177/0739986314538603] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The effects of video games on youths have been subject to debate. Some researchers have linked video games to behavioral and emotional problems, while others have found no adverse effects. The behavioral and emotional problems experienced by some gamers may be linked to certain types of video games. We hypothesized that Mexican American youths with lower socioeconomic status and who play “aggressive” video games have more emotional and behavioral problems than those who do not play such games. We examined a total of 579 youths using the Child Behavior Checklist and analyzing the games played within the last 6 months. Youths who played aggressive video games had higher scores and more emotional and behavioral problems compared with those who did not play aggressive video games.
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Affiliation(s)
- Marie Leiner
- Texas TechUniversityHealthSciences Center, El Paso, USA
| | - Jesus Peinado
- Texas TechUniversityHealthSciences Center, El Paso, USA
| | | | | | - Namrata Singh
- Texas TechUniversityHealthSciences Center, El Paso, USA
| | - Alok Dwivedi
- Texas TechUniversityHealthSciences Center, El Paso, USA
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25
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Forster S, Robertson DJ, Jennings A, Asherson P, Lavie N. Plugging the attention deficit: perceptual load counters increased distraction in ADHD. Neuropsychology 2014; 28:91-7. [PMID: 24219607 PMCID: PMC3906797 DOI: 10.1037/neu0000020] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 07/05/2013] [Accepted: 07/05/2013] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Increased vulnerability to extraneous distraction is a key symptom of Attention-Deficit Hyperactivity Disorder (ADHD), which may have particularly disruptive consequences. Here we apply Load Theory of attention to increase understanding of this symptom, and to explore a potential method for ameliorating it. Previous research in nonclinical populations has highlighted increased perceptual load as a means of improving the ability to focus attention and avoid distraction. The present study examines whether adults with ADHD can also benefit from conditions of high perceptual load to improve their focused attention abilities. METHOD We tested adults with ADHD and age- and IQ-matched controls on a novel measure of irrelevant distraction under load, designed to parallel the form of distraction that is symptomatic of ADHD. During a letter search task, in which perceptual load was varied through search set size, participants were required to ignore salient yet entirely irrelevant distractors (colorful images of cartoon characters) presented infrequently (10% of trials). RESULTS The presence of these distractors produced a significantly greater interference effect on the search RTs for the adults with ADHD compared with controls, p = .005, ηp² = .231. Perceptual load, however, significantly reduced distractor interference for the ADHD group and was as effective in reducing the elevated distractor interference in ADHD as it was for controls. CONCLUSIONS These findings clarify the nature of the attention deficit underlying increased distraction in ADHD, and demonstrate a tangible method for overcoming it.
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Affiliation(s)
- Sophie Forster
- Department of Clinical, Educational, and Health Psychology, University College London
| | - David J Robertson
- Institute of Cognitive Neuroscience and Research Department of Cognitive, Perceptual, and Brain Sciences, University College
| | - Alistair Jennings
- Institute of Cognitive Neuroscience and Research Department of Cognitive, Perceptual, and Brain Sciences, University College
| | - Philip Asherson
- MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London
| | - Nilli Lavie
- Institute of Cognitive Neuroscience and Research Department of Cognitive, Perceptual, and Brain Sciences, University College London
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26
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Adler LA, Dirks B, Deas P, Raychaudhuri A, Dauphin M, Saylor K, Weisler R. Self-Reported quality of life in adults with attention-deficit/hyperactivity disorder and executive function impairment treated with lisdexamfetamine dimesylate: a randomized, double-blind, multicenter, placebo-controlled, parallel-group study. BMC Psychiatry 2013; 13:253. [PMID: 24106804 PMCID: PMC3854089 DOI: 10.1186/1471-244x-13-253] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 09/06/2013] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND This study examined the effects of lisdexamfetamine dimesylate (LDX) on quality of life (QOL) in adults with attention-deficit/hyperactivity disorder (ADHD) and clinically significant executive function deficits (EFD). METHODS This report highlights QOL findings from a 10-week randomized placebo-controlled trial of LDX (30-70 mg/d) in adults (18-55 years) with ADHD and EFD (Behavior Rating Inventory of EF-Adult, Global Executive Composite [BRIEF-A GEC] ≥65). The primary efficacy measure was the self-reported BRIEF-A; a key secondary measure was self-reported QOL on the Adult ADHD Impact Module (AIM-A). The clinician-completed ADHD Rating Scale version IV (ADHD-RS-IV) with adult prompts and Clinical Global Impressions-Severity (CGI-S) were also employed. The Adult ADHD QoL (AAQoL) was added while the study was in progress. A post hoc analysis examined the subgroup having evaluable results from both AIM-A and AAQoL. RESULTS Of 161 randomized (placebo, 81; LDX, 80), 159 were included in the safety population. LDX improved AIM-A multi-item domain scores versus placebo; LS mean difference for Performance and Daily Functioning was 21.6 (ES, 0.93, P<.0001); Impact of Symptoms: Daily Interference was 14.9 (ES, 0.62, P<.0001); Impact of Symptoms: Bother/Concern was 13.5 (ES, 0.57, P=.0003); Relationships/Communication was 7.8 (ES, 0.31, P=.0302); Living With ADHD was 9.1 (ES, 0.79, P<.0001); and General Well-Being was 10.8 (ES, 0.70, P<.0001). AAQoL LS mean difference for total score was 21.0; for subscale: Life Productivity was 21.0; Psychological Health was 12.1; Life Outlook was 12.5; and Relationships was 7.3. In a post hoc analysis of participants with both AIM-A and AAQoL scores, AIM-A multi-item subgroup analysis scores numerically improved with LDX, with smaller difference for Impact of Symptoms: Daily Interference. The safety profile of LDX was consistent with amphetamine use in previous studies. CONCLUSIONS Overall, adults with ADHD/EFD exhibited self-reported improvement on QOL, using the AIM-A and AAQoL scales in line with medium/large ES; these improvements were paralleled by improvements in EF and ADHD symptoms. The safety profile of LDX was similar to previous studies. TRIAL REGISTRATION ClinicalTrials.gov, NCT01101022.
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Affiliation(s)
- Lenard A Adler
- Department of Psychiatry and Child and Adolescent Psychiatry, New York University School of Medicine and Psychiatry Service, New York VA Harbor Healthcare System, New York, NY, USA.
| | - Bryan Dirks
- Clinical Development and Medical Affairs, Shire Development LLC, Wayne, PA, USA
| | - Patrick Deas
- Clinical Development and Medical Affairs, Shire Development LLC, Wayne, PA, USA
| | - Aparna Raychaudhuri
- Clinical Development and Medical Affairs, Shire Development LLC, Wayne, PA, USA
| | - Matthew Dauphin
- Clinical Development and Medical Affairs, Shire Development LLC, Wayne, PA, USA
| | | | - Richard Weisler
- Duke University Medical Center, Durham, NC, USA,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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27
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Garner AA, Mrug S, Hodgens B, Patterson C. Do symptoms of sluggish cognitive tempo in children with ADHD symptoms represent comorbid internalizing difficulties? J Atten Disord 2013; 17:510-8. [PMID: 22366238 DOI: 10.1177/1087054711431456] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Symptoms of sluggish cognitive tempo (SCT) are correlated with inattention and internalizing difficulties. The purpose of the present study was to determine whether symptoms of SCT reflect comorbid internalizing disorder with ADHD or a separate syndrome. METHOD Using a clinical sample of youth evaluated for behavioral and learning difficulties (N = 73), this study examined whether SCT remains associated with symptoms of ADHD after accounting for comorbid symptoms of anxiety and depression reported by children and parents. RESULTS SCT symptoms were correlated with inattention and parent reports of child depression, but not with parent-reported anxiety or child reports of internalizing problems. Inattention (in the absence of hyperactivity/impulsivity) remained uniquely associated with SCT even after accounting for internalizing problems. CONCLUSION The findings confirm SCT as a correlate of inattention and support its construct validity as separate from comorbid internalizing problems. Further research on the clinical utility of SCT is needed.
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28
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Emotional distraction in boys with ADHD: neural and behavioral correlates. Brain Cogn 2013; 83:10-20. [PMID: 23867737 DOI: 10.1016/j.bandc.2013.06.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 06/10/2013] [Accepted: 06/17/2013] [Indexed: 12/18/2022]
Abstract
Although, in everyday life, patients with attention deficit hyperactivity disorder (ADHD) are frequently distracted by goal-irrelevant affective stimuli, little is known about the neural and behavioral substrates underlying this emotional distractibility. Because some of the most important brain responses associated with the sudden onset of an emotional distracter are characterized by their early latency onset and short duration, we addressed this issue by using a temporally agile neural signal capable of detecting and distinguishing them. Specifically, scalp event-related potentials (ERPs) were recorded while 20 boys with ADHD combined type and 20 healthy comparison subjects performed a digit categorization task during the presentation of three types of irrelevant, distracting stimuli: arousing negative (A-), neutral (N) and arousing positive (A+). Behavioral data showed that emotional distracters (both A- and A+) were associated with longer reaction times than neutral ones in the ADHD group, whereas no differences were found in the control group. ERP data revealed that, compared with control subjects, boys with ADHD showed larger anterior N2 amplitudes for emotional than for neutral distracters. Furthermore, regression analyses between ERP data and subjects' emotional ratings of distracting stimuli showed that only in the ADHD group, emotional arousal (ranging from calming to arousing) was associated with anterior N2: its amplitude increased as the arousal content of the visual distracter increased. These results suggest that boys with ADHD are more vulnerable to the distracting effects of irrelevant emotional stimuli than control subjects. The present study provides first data on the neural substrates underlying emotional distractibility in ADHD.
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29
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Cao J, Wang S, Ren Y, Zhang Y, Cai J, Tu W, Shen H, Dong X, Xia Y. Interference control in 6–11 year‐old children with and without ADHD: behavioral and ERP study. Int J Dev Neurosci 2013; 31:342-9. [DOI: 10.1016/j.ijdevneu.2013.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 04/10/2013] [Accepted: 04/26/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Jian Cao
- The Third Affiliated Hospital of SoochowChangzhouChina
- The Fourth Centeral Hospital of Tian JinTianjinChina
| | - Suhong Wang
- The Third Affiliated Hospital of SoochowChangzhouChina
| | - Yanling Ren
- The Third Affiliated Hospital of SoochowChangzhouChina
| | - Yili Zhang
- The Third Affiliated Hospital of SoochowChangzhouChina
| | - Jing Cai
- The Third Affiliated Hospital of SoochowChangzhouChina
| | - Wenjuan Tu
- The Children Hospital of ChangzhouChangzhouChina
| | - Huijuan Shen
- The Children Hospital of ChangzhouChangzhouChina
| | - Xuan Dong
- The Children Hospital of ChangzhouChangzhouChina
| | - Ying Xia
- The University of Texas Medical School at HoustonTXUSA
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30
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Murray GC, McKenzie K. Towards a functional model of mental disorders incorporating the laws of thermodynamics. Med Hypotheses 2013; 80:544-7. [PMID: 23380361 DOI: 10.1016/j.mehy.2013.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 12/24/2012] [Accepted: 01/10/2013] [Indexed: 11/20/2022]
Abstract
The current paper presents the hypothesis that the understanding of mental disorders can be advanced by incorporating the laws of thermodynamics, specifically relating to energy conservation and energy transfer. These ideas, along with the introduction of the notion that entropic activities are symptomatic of inefficient energy transfer or disorder, were used to propose a model of understanding mental ill health as resulting from the interaction of entropy, capacity and work (environmental demands). The model was applied to Attention Deficit Hyperactivity Disorder, and was shown to be compatible with current thinking about this condition, as well as emerging models of mental disorders as complex networks. A key implication of the proposed model is that it argues that all mental disorders require a systemic functional approach, with the advantage that it offers a number of routes into the assessment, formulation and treatment for mental health problems.
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Affiliation(s)
- George C Murray
- Psychological Services, Andrew Lang Unit, Viewfield Lane, Selkirk TD7 4LJ, UK.
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31
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Durkin K, Boyle J, Hunter S, Conti-Ramsden G. Video Games for Children and Adolescents With Special Educational Needs. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2013. [DOI: 10.1027/2151-2604/a000138] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Almost all children play video games at some point and many play regularly. Not only are games ubiquitous in children’s leisure environments but the motivational and skill-enhancing potentialities of this technology are being exploited increasingly in education. Good quality games, which are challenging, instructive, and absorbing, can make learning enjoyable and effective. But is this the case for children who struggle in school? This paper reviews the emerging literature on video game uses by children with special educational needs. With reference to both entertainment games and “serious” games, we consider (i) the implications of developmental and learning disabilities for game play, (ii) the potential of games to address special cognitive and educational needs, and (iii) the social potential of game play. Gaps in current knowledge are identified and directions for future research are outlined.
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Affiliation(s)
- Kevin Durkin
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - James Boyle
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Simon Hunter
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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32
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Fabio RA, Antonietti A. Effects of hypermedia instruction on declarative, conditional and procedural knowledge in ADHD students. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:2028-2039. [PMID: 22750359 DOI: 10.1016/j.ridd.2012.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 04/24/2012] [Accepted: 04/24/2012] [Indexed: 06/01/2023]
Abstract
Two groups of students aged between 12 and 14 years--27 with attention deficit/hyperactivity disorder (ADHD) and 28 with both ADHD and learning problems--were compared to a sample of 29 typically developing students in terms of the acquisition and retention of declarative, conditional and procedural knowledge either in a hypermedia learning or in a traditional instructional setting. Hypermedia instruction produced better learning outcomes than traditional instruction did; the benefits concerned prevalently procedural knowledge and emerged mainly in the retention phase. Hypermedia instruction led ADHD students to reach achievement levels similar to those of typically developing students. Furthermore, hypermedia instruction contrasted the decay of knowledge from the acquisition to the retention phase in both clinical groups. On the basis of these findings, hypermedia instruction is proposed as an approach that may help ADHD learners to overcome attention deficits.
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D'Angiulli A, Lipina SJ, Olesinska A. Explicit and implicit issues in the developmental cognitive neuroscience of social inequality. Front Hum Neurosci 2012; 6:254. [PMID: 22973216 PMCID: PMC3434357 DOI: 10.3389/fnhum.2012.00254] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 08/20/2012] [Indexed: 11/13/2022] Open
Abstract
The appearance of developmental cognitive neuroscience (DCN) in the socioeconomic status (SES) research arena is hugely transformative, but challenging. We review challenges rooted in the implicit and explicit assumptions informing this newborn field. We provide balanced theoretical alternatives on how hypothesized psychological processes map onto the brain (e.g., problem of localization) and how experimental phenomena at multiple levels of analysis (e.g., behavior, cognition and the brain) could be related. We therefore examine unclear issues regarding the existing perspectives on poverty and their relationships with low SES, the evidence of low-SES adaptive functioning, historical precedents of the "alternate pathways" (neuroplasticity) interpretation of learning disabilities related to low-SES and the notion of deficit, issues of "normativity" and validity in findings of neurocognitive differences between children from different SES, and finally alternative interpretations of the complex relationship between IQ and SES. Particularly, we examine the extent to which the available laboratory results may be interpreted as showing that cognitive performance in low-SES children reflects cognitive and behavioral deficits as a result of growing up in specific environmental or cultural contexts, and how the experimental findings should be interpreted for the design of different types of interventions-particularly those related to educational practices-or translated to the public-especially the media. Although a cautionary tone permeates many studies, still, a potential deficit attribution-i.e., low-SES is associated with cognitive and behavioral developmental deficits-seems almost an inevitable implicit issue with ethical implications. Finally, we sketch the agenda for an ecological DCN, suggesting recommendations to advance the field, specifically, to minimize equivocal divulgation and maximize ethically responsible translation.
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Affiliation(s)
- Amedeo D'Angiulli
- Department of Neuroscience, Carleton UniversityOttawa, ON, Canada
- The Institute of Interdisciplinary Studies, Carleton UniversityOttawa, ON, Canada
| | - Sebastian J. Lipina
- Unidad de Neurobiología Aplicada (UNA, CEMIC-CONICET)Argentina
- Centro de Investigaciones Psicopedagógicas Aplicadas (CIPA-UNSAM)Argentina
| | - Alice Olesinska
- Department of Neuroscience, Carleton UniversityOttawa, ON, Canada
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Cameron CE, Brock LL, Murrah WM, Bell LH, Worzalla SL, Grissmer D, Morrison FJ. Fine motor skills and executive function both contribute to kindergarten achievement. Child Dev 2012; 83:1229-44. [PMID: 22537276 PMCID: PMC3399936 DOI: 10.1111/j.1467-8624.2012.01768.x] [Citation(s) in RCA: 195] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study examined the contribution of executive function (EF) and multiple aspects of fine motor skills to achievement on 6 standardized assessments in a sample of middle-socioeconomic status kindergarteners. Three- and 4-year-olds' (n=213) fine and gross motor skills were assessed in a home visit before kindergarten, EF was measured at fall of kindergarten, and Woodcock-Johnson III Tests of Academic Achievement were administered at fall and spring. Correlations indicated that EF and fine motor skills appeared distinct. Further, controlling for background variables, higher levels of both EF and fine motor skills, specifically design copy, predicted higher achievement on multiple subtests at kindergarten entry, as well as improvement from fall to spring. Implications for research on school readiness are discussed.
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Affiliation(s)
- Claire E Cameron
- University of Virginia, Center for Advanced Study of Teaching and Learning, Charlottesville, VA 22903, USA.
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Dovis S, Van der Oord S, Wiers RW, Prins PJM. Can motivation normalize working memory and task persistence in children with attention-deficit/hyperactivity disorder? The effects of money and computer-gaming. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:669-81. [PMID: 22187093 PMCID: PMC3375007 DOI: 10.1007/s10802-011-9601-8] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Visual-spatial Working Memory (WM) is the most impaired executive function in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Some suggest that deficits in executive functioning are caused by motivational deficits. However, there are no studies that investigate the effects of motivation on the visual-spatial WM of children with- and without ADHD. Studies examining this in executive functions other than WM, show inconsistent results. These inconsistencies may be related to differences in the reinforcement used. The effects of different reinforcers on WM performance were investigated in 30 children with ADHD and 31 non-ADHD controls. A visual-spatial WM task was administered in four reinforcement conditions: Feedback-only, 1 euro, 10 euros, and a computer-game version of the task. In the Feedback-only condition, children with ADHD performed worse on the WM measure than controls. Although incentives significantly improved the WM performance of children with ADHD, even the strongest incentives (10 euros and Gaming) were unable to normalize their performance. Feedback-only provided sufficient reinforcement for controls to reach optimal performance, while children with ADHD required extra reinforcement. Only children with ADHD showed a decrease in performance over time. Importantly, the strongest incentives (10 euros and Gaming) normalized persistence of performance in these children, whereas 1 euro had no such effect. Both executive and motivational deficits give rise to visual-spatial WM deficits in ADHD. Problems with task-persistence in ADHD result from motivational deficits. In ADHD-reinforcement studies and clinical practice (e.g., assessment), reinforcement intensity can be a confounding factor and should be taken into account. Gaming can be a cost-effective way to maximize performance in ADHD.
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Affiliation(s)
- Sebastiaan Dovis
- Department of Developmental Psychology, University of Amsterdam, Weesperplein 4, Amsterdam, The Netherlands.
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Chevignard MP, Soo C, Galvin J, Catroppa C, Eren S. Ecological assessment of cognitive functions in children with acquired brain injury: a systematic review. Brain Inj 2012; 26:1033-57. [PMID: 22715895 DOI: 10.3109/02699052.2012.666366] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Childhood acquired brain injury (ABI) often leads to impairment in cognitive functioning, resulting in disabilities in both the home and school environment. Assessing the impact of these cognitive deficits in everyday life using traditional neuropsychological tests has been challenging. This study systematically reviewed ecological measures of cognitive abilities available for children with ABI. METHOD Eight databases were searched (until October 2011) for scales: (1) focused on ecological assessment of cognitive functioning; (2) with published data in an ABI population; (3) applicable to children up to 17;11 years of age; and (4) in English. The title and abstract of all papers were reviewed independently by two reviewers. RESULTS Database searches yielded a total of 12 504 references, of which 17 scales met the inclusion criteria for the review, focusing on executive functions (n = 9), memory (n = 3), general cognitive abilities (n = 2), visuo-spatial skills (n = 2) and attention (n = 1). Four tasks used observation of actual performance in a natural environment, five were proxy-reports and six were functional paper and pencil type tasks, performed in an office. CONCLUSION Overall, few measures were found; eight were still experimental tasks which did not provide norms. Executive functions were better represented in ecological assessment, with relatively more standardized scales available.
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Affiliation(s)
- Mathilde P Chevignard
- Rehabilitation Department for Children with Acquired Brain Injury (INR-A), Hôpitaux de Saint Maurice, Saint Maurice, France.
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37
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Cameron CE, Brock LL, Murrah WM, Bell LH, Worzalla SL, Grissmer D, Morrison FJ. Fine motor skills and executive function both contribute to kindergarten achievement. Child Dev 2012. [PMID: 22537276 DOI: 10.1111/j.1467‐8624.2012.01768.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examined the contribution of executive function (EF) and multiple aspects of fine motor skills to achievement on 6 standardized assessments in a sample of middle-socioeconomic status kindergarteners. Three- and 4-year-olds' (n=213) fine and gross motor skills were assessed in a home visit before kindergarten, EF was measured at fall of kindergarten, and Woodcock-Johnson III Tests of Academic Achievement were administered at fall and spring. Correlations indicated that EF and fine motor skills appeared distinct. Further, controlling for background variables, higher levels of both EF and fine motor skills, specifically design copy, predicted higher achievement on multiple subtests at kindergarten entry, as well as improvement from fall to spring. Implications for research on school readiness are discussed.
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Affiliation(s)
- Claire E Cameron
- University of Virginia, Center for Advanced Study of Teaching and Learning, Charlottesville, VA 22903, USA.
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Brackenridge R, McKenzie K, Murray GC, Quigley A. An examination of the effects of stimulant medication on response inhibition: a comparison between children with and without attention deficit hyperactivity disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:2797-2804. [PMID: 21700419 DOI: 10.1016/j.ridd.2011.05.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 05/13/2011] [Indexed: 05/31/2023]
Abstract
This study investigated whether methylphenidate is effective in improving response inhibition in children with Attention Deficit Hyperactivity Disorder (ADHD). Children with ADHD were compared with normally developing children on measures of response inhibition. Participants with ADHD were compared across two conditions--medicated and unmedicated. There was no significant difference between the inhibitory control of children with and without ADHD. Children with ADHD showed significant improvements in inhibitory control following methylphenidate. The findings of the present study contrast with previous studies which document reduced inhibitory control in ADHD, compared with normally developing children. Reports of methylphenidate improving functioning in children with ADHD are supported. Limitation and implications of the study are discussed.
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Abstract
Children’s use of electronic media, including Internet and video gaming, has increased dramatically to an average in the general population of roughly 3 h per day. Some children cannot control their Internet use leading to increasing research on “internet addiction.” The objective of this article is to review the research on ADHD as a risk factor for Internet addiction and gaming, its complications, and what research and methodological questions remain to be addressed. The literature search was done in PubMed and Psychinfo, as well as by hand. Previous research has demonstrated rates of Internet addiction as high as 25% in the population and that it is addiction more than time of use that is best correlated with psychopathology. Various studies confirm that psychiatric disorders, and ADHD in particular, are associated with overuse, with severity of ADHD specifically correlated with the amount of use. ADHD children may be vulnerable since these games operate in brief segments that are not attention demanding. In addition, they offer immediate rewards with a strong incentive to increase the reward by trying the next level. The time spent on these games may also exacerbate ADHD symptoms, if not directly then through the loss of time spent on more developmentally challenging tasks. While this is a major issue for many parents, there is no empirical research on effective treatment. Internet and off-line gaming overuse and addiction are serious concerns for ADHD youth. Research is limited by the lack of measures for youth or parents, studies of children at risk, and studies of impact and treatment.
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Bourel-Ponchel E, Querné L, Le Moing AG, Delignières A, de Broca A, Berquin P. Maturation of response time and attentional control in ADHD: evidence from an attentional capture paradigm. Eur J Paediatr Neurol 2011; 15:123-30. [PMID: 21185754 DOI: 10.1016/j.ejpn.2010.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 08/30/2010] [Accepted: 08/31/2010] [Indexed: 10/18/2022]
Abstract
Inattention and hyperactivity/impulsivity are the core symptoms of Attention Deficit/Hyperactivity Disorder (ADHD). Slowness, although less known, has been also recently reported in children with ADHD and may contribute to their learning difficulties. Slow response time and greater response time variability have been highlighted by several computerized tasks. The goal of the present work was to evaluate the age-related response time in ADHD children and in a group of matched control children during an attentional capture paradigm. The study population included 75 children with ADHD (aged between 6 and 13) and 75 age- and gender-matched typical developing children (Control group). The children with ADHD made more errors than children on the control group. The response times and the response time variability decreased with age in both groups and were significantly greater in ADHD than in controls. The distractor effect was similar in both groups. The maturation of response times and response time variability with age is quite similar in children with ADHD and typical developing children but whatever the age-class, children with ADHD were slower and exhibited greater response time variability than control children that could explain the variation during day-time of attention capacities in ADHD.
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41
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Turgay A, Ginsberg L, Sarkis E, Jain R, Adeyi B, Gao J, Dirks B, Babcock T, Scheckner B, Richards C, Lasser R, Findling RL. Executive function deficits in children with attention-deficit/hyperactivity disorder and improvement with lisdexamfetamine dimesylate in an open-label study. J Child Adolesc Psychopharmacol 2010; 20:503-11. [PMID: 21186969 PMCID: PMC3005278 DOI: 10.1089/cap.2009.0110] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the effects of lisdexamfetamine dimesylate (LDX) on executive function (EF) behaviors in children with attention-deficit/hyperactivity disorder (ADHD). METHODS This observational, open-label, 7-week, dose-optimization study of LDX (20-70 mg/day) in children with ADHD evaluated efficacy with the ADHD Rating Scale IV; safety measures included adverse events (AEs). EF was assessed with the Behavior Rating Inventory of Executive Function (BRIEF). Post hoc analyses examined BRIEF scores by sex, ADHD subtype, comorbid psychiatric symptoms, and common treatment-emergent AEs (TEAEs). ADHD Rating Scale IV scores were assessed in subjects categorized by baseline BRIEF global executive composite T scores with clinically significant (≥65) or not clinically significant (<65) impairment in EF. RESULTS Mean (standard deviation) change from baseline to endpoint for BRIEF of -17.9 (12.5) for Global Executive Composite, -15.4 (12.6) for Behavioral Regulation Index, and -17.6 (12.3) for Metacognition Index demonstrated improvement with LDX (pooled doses; p < 0.0001 for all). Improvements in BRIEF scores were seen regardless of sex, ADHD subtype, comorbid psychiatric symptoms, common TEAEs, or baseline EF impairment category. TEAEs included decreased appetite, decreased weight, irritability, insomnia, headache, upper abdominal pain, and initial insomnia. CONCLUSIONS Improvements were demonstrated in EF behaviors and ADHD symptoms with LDX. LDX safety profile was consistent with long-acting stimulant use.
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Affiliation(s)
| | | | | | - Rakesh Jain
- R/D Clinical Research, Inc., Lake Jackson, Texas
| | - Ben Adeyi
- Shire Development Inc., Wayne, Pennsylvania
| | - Joseph Gao
- Shire Development Inc., Wayne, Pennsylvania
| | | | | | | | | | | | - Robert L. Findling
- University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
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Prins PJM, Dovis S, Ponsioen A, ten Brink E, van der Oord S. Does computerized working memory training with game elements enhance motivation and training efficacy in children with ADHD? CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2010; 14:115-22. [PMID: 20649448 DOI: 10.1089/cyber.2009.0206] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study examined the benefits of adding game elements to standard computerized working memory (WM) training. Specifically, it examined whether game elements would enhance motivation and training performance of children with ADHD, and whether it would improve training efficacy. A total of 51 children with ADHD aged between 7 and 12 years were randomly assigned to WM training in a gaming format or to regular WM training that was not in a gaming format. Both groups completed three weekly sessions of WM training. Children using the game version of the WM training showed greater motivation (i.e., more time training), better training performance (i.e., more sequences reproduced and fewer errors), and better WM (i.e., higher scores on a WM task) at post-training than children using the regular WM training. Results are discussed in terms of executive functions and reinforcement models of ADHD. It is concluded that WM training with game elements significantly improves the motivation, training performance, and working memory of children with ADHD. The findings of this study are encouraging and may have wide-reaching practical implications in terms of the role of game elements in the design and implementation of new intervention efforts for children with ADHD.
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Affiliation(s)
- Pier J M Prins
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
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Abstract
Young people with developmental disorders experience difficulties with many cognitive and perceptual tasks, and often suffer social impairments. Yet, like typical youth, many appear to enjoy playing videogames. This review considers the appeal of videogames to individuals with autism spectrum disorders, attention deficit hyperactivity disorder, and specific language impairment. It examines how they respond to the various challenges that play entails with particular reference to sensory, cognitive, and social dimensions. It is argued that research into how these young people engage voluntarily with this dynamic and challenging medium offers great potential to extend our empirical and theoretical understanding of the disorders. Many gaps in our current knowledge are identified and several additional themes for possible future research are proposed.
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Affiliation(s)
- Kevin Durkin
- Department of Psychology, University of Strathclyde
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44
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Findling RL, Ginsberg LD, Jain R, Gao J. Effectiveness, safety, and tolerability of lisdexamfetamine dimesylate in children with attention-deficit/hyperactivity disorder: an open-label, dose-optimization study. J Child Adolesc Psychopharmacol 2009; 19:649-62. [PMID: 20035583 DOI: 10.1089/cap.2008.0165] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to assess the effectiveness and safety of lisdexamfetamine dimesylate (LDX) in children with attention-deficit/hyperactivity disorder (ADHD). METHOD This was a 7-week, open-label study evaluating 20, 30, 40, 50, 60, or 70 mg/day LDX in 318 children aged 6-12 years with ADHD. The ADHD Rating Scale IV (ADHD-RS-IV) was the primary efficacy assessment. Secondary measures included the Clinical Global Impressions-Improvement (CGI-I), Expression and Emotion Scale for Children (EESC), and Behavior Rating Inventory of Executive Function (BRIEF). Safety assessments included treatment-emergent adverse events (TEAEs), vital signs, and electrocardiograms. RESULTS At end point, mean (standard deviation [SD]) improvement from baseline in ADHD-RS-IV total score was 28.6 (10.9) (p < 0.0001). Most subjects (89.9%) were rated "improved" (i.e., CGI-I 1 or 2). Improvements from baseline were observed in the EESC total and subscale scores (p < or = 0.0002). LDX treatment resulted in significant improvement on the Global Executive Composite, Behavioral Regulation, and Metacognition indices of the BRIEF (p < 0.0001). TEAEs (incidences > or =10%) were decreased appetite, decreased weight, irritability, insomnia, headache, upper abdominal pain, and initial insomnia. CONCLUSIONS LDX was effective and generally well tolerated with a safety profile consistent with long-acting stimulant use. There was overall improvement in ADHD symptoms and executive function measures and no worsening of emotional expression measures. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00500071.
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Affiliation(s)
- Robert L Findling
- University Hospitals Case Medical Center, Cleveland, Ohio 44106, USA.
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Schmiedeler S, Schwenck C, Schneider W. Die Verarbeitung von Negationen bei Kindern mit ADHS und der Einfluss medikamentöser Behandlung. KINDHEIT UND ENTWICKLUNG 2009. [DOI: 10.1026/0942-5403.18.3.137] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Personen verarbeiten Negationen (z. B. „Tom ist nicht alt“) dann fehlerhaft, wenn nicht ausreichend kognitive Ressourcen verfügbar sind. Wir nehmen an, dass diese kognitive Kapazität von Kindern mit einer Aufmerksamkeitsdefizit- und Hyperaktivitätsstörung (ADHS) besonderer Einschränkung unterliegt, die sich in einer defizitären Negationsverarbeitung äußern sollte. Untersucht wurden 25 Jungen mit ADHS (8 – 14 Jahre) einmal ohne und ein weiteres Mal unter Methylphenidatmedikation in ausbalancierter Reihenfolge sowie 32 klinisch unauffällige Jungen. Zur Erfassung der Negationsverarbeitung wurde ein an Deutsch, Gawronski und Strack (2006) angelehntes Reaktionszeitexperiment verwendet. Die Patienten ohne Medikation wiesen im Vergleich zu den gesunden Kontrollen eine bedeutsam erhöhte Fehleranfälligkeit auf. Sie zeigten jedoch keine Beeinträchtigungen in spezifischen Prozessen der Negationsverarbeitung. Ein signifikanter Effekt der Methylphenidatbehandlung auf die Arbeitsgenauigkeit und -konstanz wurde belegt. Alter und Arbeitsgedächtnis beeinflussten die Informationsverarbeitungsleistung. Die Annahme einer defizitären Negationsverarbeitung bei Kindern mit ADHS konnte nicht bestätigt werden.
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Affiliation(s)
| | - Christina Schwenck
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie der Universität Würzburg
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Desman C, Petermann F, Hampel P. Deficit in response inhibition in children with attention deficit/hyperactivity disorder (ADHD): impact of motivation? Child Neuropsychol 2009; 14:483-503. [PMID: 18982507 DOI: 10.1080/09297040701625831] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To date, neuropsychological and psycho-physiological studies have revealed inconsistent results regarding an executive or motivational deficit explaining the response inhibition deficit in children with attention deficit/hyperactivity disorder (ADHD). Research on differentiating neuropsychological processes in ADHD subtypes is still scarce. Therefore, the motivational impact on response inhibition among boys with ADHD was examined in this study. In the first study, 19 boys with ADHD-combined type (ADHD-C) and 19 age-matched healthy control subjects performed a modified Go/No-Go task with the following experimental conditions: neutral, auditory feedback, reward, response cost, and reward/response cost. Performance and physiological data (heart rate and skin conductance responses) were recorded. In a second study with the modified Go/No-Go task, data for six children with ADHD-C, six with ADHD-inattentive subtype (ADHD-I), and six healthy control subjects were compared. Neither of the two studies revealed group by condition interactions. In study 1, boys with ADHD-C generally made more commissions and omissions compared to the control group. However, feedback significantly improved the response inhibition in all children. The heart rate of all children was increased in the two conditions of reward and reward/response cost. Study 2 revealed that children with ADHD-I responded more slowly and showed increased reaction time variability compared to both other groups. The present study supports an executive rather than a motivational deficit in the response inhibition among children with ADHD-C, though further results also indicate the role of auditory feedback on response inhibition. Additionally, the findings support the differentiation of ADHD-C and ADHD-I, suggesting that ADHD-I children are characterized by a sluggish cognitive tempo.
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Affiliation(s)
- Christiane Desman
- Center of Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
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Chevignard MP, Servant V, Mariller A, Abada G, Pradat-Diehl P, Laurent-Vannier A. Assessment of executive functioning in children after TBI with a naturalistic open-ended task: a pilot study. Dev Neurorehabil 2009; 12:76-91. [PMID: 19340660 DOI: 10.1080/17518420902777019] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Traumatic brain injury (TBI) often leads to executive functions (EF) deficits, resulting in severe longstanding disabilities in daily life activities. The sensitivity and ecological validity of neuropsychological tests have been questioned. The aim of this study was to pilot a novel open-ended naturalistic task and to compare it to other standardized assessments of EF in children post-TBI. METHODS Ten children aged 8-14, with moderate-to-severe TBI, and 18 matched controls participated in the study. The clinical group was assessed using cognitive tests and parent-based questionnaires of EF. An interactive ecological cooking task was designed. RESULTS Analyses indicated mild-to-moderate executive deficits in the cognitive tests in approximately half of the TBI group. For the experimental cooking task, all quantitative and qualitative variables were significantly impaired for the TBI group compared to the control group and failure in the cooking task was associated with lower scores in cognitive tests of EF. The task was able to discriminate the TBI children from the control group. CONCLUSION This pilot study highlights the role of naturalistic assessments, to complement standardized tests in assessing patients' dysexecutive impairments in complex activities of daily living post-childhood TBI.
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Abstract
BACKGROUND There has been research on the use of offline video games for therapeutic purposes but online video game therapy is still fairly under-researched. Online therapeutic interventions have only recently included a gaming component. Hence, this review represents a timely first step toward taking advantage of these recent technological and cultural innovations, particularly for the treatment of special-needs groups such as the young, the elderly and people with various conditions such as ADHD, anxiety and autism spectrum disorders. MATERIAL A review integrating research findings on two technological advances was conducted: the home computer boom of the 1980s, which triggered a flood of research on therapeutic video games for the treatment of various mental health conditions; and the rise of the internet in the 1990s, which caused computers to be seen as conduits for therapeutic interaction rather than replacements for the therapist. DISCUSSION We discuss how video games and the internet can now be combined in therapeutic interventions, as attested by a consideration of pioneering studies. CONCLUSION Future research into online video game therapy for mental health concerns might focus on two broad types of game: simple society games, which are accessible and enjoyable to players of all ages, and online worlds, which offer a unique opportunity for narrative content and immersive remote interaction with therapists and fellow patients. Both genres might be used for assessment and training purposes, and provide an unlimited platform for social interaction. The mental health community can benefit from more collaborative efforts between therapists and engineers, making such innovations a reality.
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Affiliation(s)
- Nathan Wilkinson
- Institute of Health and Social Policy, McGill University, Canada
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49
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Abstract
OBJECTIVE To summarize the literature that has employed visual search tasks to assess automatic and effortful selective visual attention in children with and without ADHD. METHOD Seven studies with a combined sample of 180 children with ADHD (M age = 10.9) and 193 normally developing children (M age = 10.8) are located. RESULTS Using a qualitative approach, the authors find no group difference in automatic search, but results are variable for effortful serial search. Using a novel, graphical approach, the authors find that the ADHD group demonstrated less efficient serial search. This overall effect is explored as a function of search display complexity. Children with ADHD search less efficiently at the lowest and highest levels of display complexity. CONCLUSION Children with ADHD show impairments in aspects of their effortful visual selective attention, as measured by visual search.
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Affiliation(s)
- Jennifer C Mullane
- Department of Psychology, Dalhousie University, Halifax, Nova Scotia, Canada.
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50
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Novel Measures of Response Performance and Inhibition in Children with ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2008; 36:1199-210. [DOI: 10.1007/s10802-008-9243-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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