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Yılmaz Y, Bahadır E. Cognitive disengagement syndrome and attention deficit hyperactivity disorder: An examination of relationships with alexithymia and emotion regulation difficulties. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-7. [PMID: 39087375 DOI: 10.1080/23279095.2024.2385444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Cognitive disengagement syndrome (CDS) and ADHD are considered distinct but interrelated constructs. This study aimed to investigate the prevalence of elevated CDS symptoms and increased ADHD risk in the general population, and their relationships with emotion regulation difficulty (ERD) and alexithymia. Out of 1166 participants, 142 with known psychiatric conditions were excluded, resulting in 1024 participants. Participants completed various scales including Adult ADHD Self-Report Screening Scale for DSM-5 (ASRS-5), Barkley Adult Sluggish Cognitive Tempo (SCT) Scale, Difficulties in Emotion Regulation Scale-Short Form (DERS-16), and the Toronto Alexithymia Scale (TAS-20). Four groups were formed based on Barkley and ASRS-5 scores: Group 1) No elevated CDS symptoms and Low risk of ADHD, Group 2) No elevated CDS symptoms and Increased risk of ADHD, Group 3) Elevated CDS symptoms and Low risk of ADHD, Group 4) Elevated CDS symptoms and Increased risk of ADHD. Elevated CDS symptoms was found in 10% of participants, and increased ADHD risk in 9.2%. Among probable ADHD cases, 40% had elevated CDS symptoms, while 60% of elevated CDS symptoms cases had increased ADHD risk. Group 4 (elevated CDS symptoms and increased risk of ADHD) had the highest ERD and alexithymia scores, while Group 1(no elevated CDS symptoms and low risk of ADHD) had the lowest. Regression analyses showed that CDS scores predicted ERD (47%) and alexithymia (32%) better than ADHD scores (ERD: 36%, alexithymia: 23%). CDS and ADHD appear as significant concepts that could be involved in the etiology of ERD and alexithymia.
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Affiliation(s)
- Yavuz Yılmaz
- Department of Psychiatry, Sivas Cumhuriyet University, Faculty of Medicine, Sivas, Turkey
| | - Erdi Bahadır
- Departmant of Psychiatry, Hackalı Baba State Hospital, Trabzon, Turkey
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2
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Muscò A, Martini D, Digregorio M, Broccoli V, Andreazzoli M. Shedding a Light on Dark Genes: A Comparative Expression Study of PRR12 Orthologues during Zebrafish Development. Genes (Basel) 2024; 15:492. [PMID: 38674426 PMCID: PMC11050278 DOI: 10.3390/genes15040492] [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: 03/16/2024] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Haploinsufficiency of the PRR12 gene is implicated in a human neuro-ocular syndrome. Although identified as a nuclear protein highly expressed in the embryonic mouse brain, PRR12 molecular function remains elusive. This study explores the spatio-temporal expression of zebrafish PRR12 co-orthologs, prr12a and prr12b, as a first step to elucidate their function. In silico analysis reveals high evolutionary conservation in the DNA-interacting domains for both orthologs, with significant syntenic conservation observed for the prr12b locus. In situ hybridization and RT-qPCR analyses on zebrafish embryos and larvae reveal distinct expression patterns: prr12a is expressed early in zygotic development, mainly in the central nervous system, while prr12b expression initiates during gastrulation, localizing later to dopaminergic telencephalic and diencephalic cell clusters. Both transcripts are enriched in the ganglion cell and inner neural layers of the 72 hpf retina, with prr12b widely distributed in the ciliary marginal zone. In the adult brain, prr12a and prr12b are found in the cerebellum, amygdala and ventral telencephalon, which represent the main areas affected in autistic patients. Overall, this study suggests PRR12's potential involvement in eye and brain development, laying the groundwork for further investigations into PRR12-related neurobehavioral disorders.
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Affiliation(s)
- Alessia Muscò
- Cell and Developmental Biology Unit, University of Pisa, 56126 Pisa, Italy (D.M.)
| | - Davide Martini
- Cell and Developmental Biology Unit, University of Pisa, 56126 Pisa, Italy (D.M.)
| | - Matteo Digregorio
- Cell and Developmental Biology Unit, University of Pisa, 56126 Pisa, Italy (D.M.)
| | - Vania Broccoli
- Stem Cell and Neurogenesis Unit, Division of Neuroscience, San Raffaele Scientific Institute, 20132 Milan, Italy
- CNR Institute of Neuroscience, 20132 Milan, Italy
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Blume F, Buhr L, Kühnhausen J, Köpke R, Weber LA, Fallgatter AJ, Ethofer T, Gawrilow C. Validation of the Self-Report Version of the German Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Scale (SWAN-DE-SB). Assessment 2024:10731911241236699. [PMID: 38523357 DOI: 10.1177/10731911241236699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Adults with attention-deficit/hyperactivity disorder (ADHD) experience impairing levels of inattention and/or hyperactivity-impulsivity, while individuals without ADHD experience these symptoms to a lesser extent. Yet, ADHD self-report scales so far hardly captured continuous distributions across the general population. In addition, they focused on weaknesses and ignored strengths. To address these shortcomings, we present here the Strengths and Weaknesses of ADHD and Normal-Behavior Scale Self-Report (SWAN-DE-SB). The normal distribution of the data collected and the scale's internal consistency, and factorial and convergent validity were assessed using data from a general population sample. Its clinical utility was evaluated by comparing scores from a clinical sample and a sample of individuals without ADHD and by calculating optimal cut-off values for specificity and sensitivity. The SWAN-DE-SB demonstrated normal distribution of the data collected, high internal consistency, and factorial and convergent validity. It reliably discriminated individuals with and without ADHD, with high specificity and sensitivity. It should therefore be considered a psychometrically convincing measure to assess strengths and weaknesses of ADHD symptoms and normal behavior in clinical and general population samples.
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Affiliation(s)
- Friederike Blume
- DIPF | Leibniz Institute for Research and Information in Education, Frankfurt/Main, Germany
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt/Main, Germany
- University of Tübingen, LEAD Graduate School & Research Network, Germany
| | - Lilly Buhr
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt/Main, Germany
- University of Tübingen, LEAD Graduate School & Research Network, Germany
- University of Tübingen, Department of Psychology, School Psychology, Germany
| | - Jan Kühnhausen
- University of Tübingen, LEAD Graduate School & Research Network, Germany
- University Hospital Tübingen, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Germany
| | - Rieke Köpke
- University of Tübingen, Department of Psychology, School Psychology, Germany
| | - Lydia A Weber
- University Hospital Tübingen, Department of Psychiatry and Psychotherapy, Germany
| | - Andreas J Fallgatter
- University of Tübingen, LEAD Graduate School & Research Network, Germany
- University Hospital Tübingen, Department of Psychiatry and Psychotherapy, Germany
- German Center for Mental Health (DZPG), partner site Tübingen, Germany
| | - Thomas Ethofer
- University Hospital Tübingen, Department of Psychiatry and Psychotherapy, Germany
- German Center for Mental Health (DZPG), partner site Tübingen, Germany
| | - Caterina Gawrilow
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt/Main, Germany
- University of Tübingen, LEAD Graduate School & Research Network, Germany
- University of Tübingen, Department of Psychology, School Psychology, Germany
- German Center for Mental Health (DZPG), partner site Tübingen, Germany
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McEnaney E, Ryan C. Improving the Objective Measurement of Alexithymia Using a Computer-Scored Alexithymia Provoked Response Questionnaire with an Online Sample. J Pers Assess 2024:1-11. [PMID: 38422394 DOI: 10.1080/00223891.2024.2320417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
The study and measurement of alexithymia - a trait marked by difficulty identifying and describing feelings - can be improved by incorporating objective measures to supplement self-report scales. The Alexithymia Provoked Response Questionnaire (APRQ) is an observer-rated alexithymia tool that shows promise yet can be time-consuming to administer. The present study aimed to assess the feasibility of computer administration and scoring of the APRQ. Further, the APRQ's association with verbal IQ and emotional vocabulary use was examined, as was the relationship between the APRQ and the self-report Bermond-Vorst Alexithymia Questionnaire-B (BVAQ-B). Adult participants (n = 366), including a proportion gathered through purposive sampling, participated in an online study. Inter-rater reliability measures indicated that computerized scoring of the APRQ is as reliable as human scoring, making the measure scalable for use with large samples. Alexithymia levels were independent of two measures of verbal IQ. Correlational analyses indicated overlap in alexithymia as measured by the APRQ and most of the subscales of the BVAQ-B. The APRQ, as an objective measure, may capture deficits in emotional awareness independent of self-insight.
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Affiliation(s)
- Emma McEnaney
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Christian Ryan
- School of Applied Psychology, University College Cork, Cork, Ireland
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5
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Bozkurt A, Yıldırım Demirdöğen E, Kolak Çelik M, Akıncı MA. An assessment of dynamic facial emotion recognition and theory of mind in children with ADHD: An eye-tracking study. PLoS One 2024; 19:e0298468. [PMID: 38329958 PMCID: PMC10852339 DOI: 10.1371/journal.pone.0298468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Deficits in social cognition in attention deficit hyperactivity disorder (ADHD) have been associated with difficulties in functioning. Since recognizing emotional facial expressions is essential for developing the perceptual components of the theory of mind (ToM), it is important to assess this relationship in children with ADHD. This study therefore compared the recognition of emotional stimuli and gaze patterns between children with ADHD and healthy children using eye-tracking with dynamic facial images. It also examined the relationship between facial emotion recognition accuracy, gaze patterns, ToM scores, and ADHD symptoms. Children with ADHD aged 8-13 (n = 47) and a control group (n = 38) completed a facial emotion recognition test, ToM tests, and the Conners' Parent Rating Scale. Participants' gaze patterns in response to dynamic facial emotion expressions were recorded using eye-tracking technology. Children with ADHD exhibited significantly lower accuracy in the recognition of the facial expressions of disgust and anger. The percentage fixation in the eye region was also significantly lower for happy, angry, sad, disgusted, and neutral emotions in the children with ADHD compared to the control group. No relationship was determined between the percentage of fixations on facial areas of interests and ADHD symptoms or ToM tests. This study provides evidence that children with ADHD experience deficits in visual attention to emotional cues. In addition, it suggests that facial emotion recognition deficits in children with ADHD represent a separate domain of social cognition that develops independently of ToM skills and core symptoms. Understanding and treating the social difficulties of individuals with ADHD may help improve their social functioning.
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Affiliation(s)
- Abdullah Bozkurt
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
| | | | - Müberra Kolak Çelik
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
| | - Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
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Connolly RD, Lamont A, Speed D. Perceived Social Support on the Relationship Between ADD/ADHD and Both Anxious and Depressive Symptoms Among Canadian Adults. J Atten Disord 2023; 27:283-293. [PMID: 36415889 PMCID: PMC9850397 DOI: 10.1177/10870547221136227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The primary goal of the present research was to examine whether the relationships that social support demonstrates with both anxiety and depression varied between adults with and without ADD/ADHD in a Canadian sample. METHOD Data were obtained from the 2012 Canadian Community Health Survey-Mental Health (N ≥ 16,354). Presence of social support, diagnosis of generalized anxiety disorder (GAD), and experience of major depressive episodes (MDEs) were estimated in the self-report ADD/ADHD and non-ADD/ADHD groups. RESULTS Although social support was negatively associated with having GAD or experiencing an MDE, and self-report ADD/ADHD was positively associated with these outcomes. Presence of self-report ADD/ADHD did not significantly modify the relationships between social support and GAD or MDE. CONCLUSION Social support may be a protective factor against symptoms of anxiety and depression in the general Canadian population, for adults with and without ADHD.
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Affiliation(s)
- Ross D. Connolly
- Memorial University of Newfoundland,
St. John’s, Canada,Ross D. Connolly, Student Wellness and
Counselling Centre, Memorial University of Newfoundland, St. John’s, NL A1C 5S7,
Canada.
| | | | - David Speed
- University of New Brunswick, Saint
John, Canada
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Soler-Gutiérrez AM, Pérez-González JC, Mayas J. Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. PLoS One 2023; 18:e0280131. [PMID: 36608036 PMCID: PMC9821724 DOI: 10.1371/journal.pone.0280131] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder, with an onset in childhood, that accompanies the person throughout their life, with prevalence between 3 and 5% in adults. Recent studies point towards a fourth core symptom of the disorder related to the emotional information processing that would explain the repercussions that ADHD has on the social, academic, and professional life of the people affected. This review aims to describe emotion dysregulation features as well as the brain activity associated in adults with ADHD. A search of the scientific literature was launched in specialized databases: PsycInfo, Medline, Eric, PsycArticle, Psicodoc and Scopus, following PRISMA guidelines. Twenty-two articles met the inclusion criteria: (a) an ADHD clinical diagnosis, (b) participants over 18 years old, (c) emotion regulation measurement, (d) empirical studies, and (c) in English. Due to the heterogeneity of the studies included, they were classified into three sections: measures and features of emotion regulation (ER) in people with ADHD, neurological and psychophysiological activity related to ER, and treatments. The studies found that meet the selection criteria are scarce and very heterogeneous both in aims and in sample features. Adults with ADHD show a more frequent use of non-adaptive emotion regulation strategies compared to people without ADHD symptoms. Moreover, emotion dysregulation was associated with symptom severity, executive functioning, psychiatric comorbidities, and even with criminal conviction. Different patterns of brain activity were observed when people with and without ADHD were compared. These results may suggest that psychopharmacological treatments as well as behavioral therapies could be useful tools for improving emotional difficulties in adult ADHD.
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Affiliation(s)
- Ana-María Soler-Gutiérrez
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- Escuela Internacional de Doctorado de la UNED (EIDUNED), Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Julia Mayas
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- * E-mail:
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8
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Turjeman-Levi Y, Kluger AN. Sensory-processing sensitivity versus the sensory-processing theory: Convergence and divergence. Front Psychol 2022; 13:1010836. [PMID: 36533027 PMCID: PMC9752870 DOI: 10.3389/fpsyg.2022.1010836] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/11/2022] [Indexed: 08/08/2023] Open
Abstract
Two individual-difference theories focus on sensory sensitivity: one emanating from psychology-sensory-processing-sensitivity (SPS); and one from occupational therapy-sensory processing theory (SP). Each theory is coupled with its measure: the highly-sensitive-person scale (HSPS) and the adolescent adult sensory profile (ASP). The constructs of both theories were claimed to be independent of neuroticism. To assess the convergence of these measures, we recruited participants from a general population and a Facebook Group dedicated to people high in SPS. The participants, N = 1,702 M age = 26.9 (66.7% female), answered the HSPS, ASP, and neuroticism questionnaires. We subjected the HSPS and the APS to exploratory graph analysis. To assess the divergence of these measures from neuroticism, we performed meta-analyses. We also used a subsample obtained in an unrelated study, N = 490, to correlate HSPS and APS with the Big Five and additional measures. The results suggested that (a) the latent structure of these measures conforms to the theories only partially, (b) some of the sub-scales of these two measures correlated highly, r = 0.63, but low enough to suggest divergence, (c) both differentially predict membership in a Facebook group, and (d) both are not isomorphic with neuroticism. We concluded that HSPS primarily measures the emotional reaction to sensory stimulation, whereas ASP the behavioral reactions. We offer shorter yet reliable measures for both theories.
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Affiliation(s)
- Yaara Turjeman-Levi
- The Hebrew University Business School, The Hebrew University of Jerusalem, Jerusalem, Israel
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9
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Hilton DC, Canu WH, Jarrett MA. The importance of executive functioning for social skills in college students: a relative weights analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-8. [PMID: 35930391 DOI: 10.1080/07448481.2022.2109038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/13/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
STATEMENT OF RELEVANCE Social interaction is one of the most important things that humans do on a day-to-day basis, impacting both mental and physical wellness. College is a particularly important period where social interaction becomes increasingly important as well as complex. While there is no currently agreed upon cognitive basis of social interaction, the executive function (EF) system is believed to play a central role. The current study provides further evidence of the role of the EF system across different social skills in addition to highlighting the complexity of these relationships.
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Affiliation(s)
- Dane C Hilton
- Department of Psychology, Wofford College, Spartanburg, South Carolina, USA
| | - Will H Canu
- Department of Psychology, Appalachian State University, Boone, North Carolina, USA
| | - Matthew A Jarrett
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA
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Einziger T, Berger A. Individual differences in sensitivity to positive home environment among children "at risk" for attention-deficit/hyperactivity disorder: A review. Front Psychiatry 2022; 13:927411. [PMID: 35935437 PMCID: PMC9353058 DOI: 10.3389/fpsyt.2022.927411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/04/2022] [Indexed: 12/02/2022] Open
Abstract
Although the evidence for the genetic basis of attention-deficit/hyperactivity disorder (ADHD) is strong, environmental factors, such as the quality of parenting or the home environment, may moderate such genetic liability. The plausible negative effect of a low-quality home environment and negative parenting on child outcomes is well-established; however, the positive effect of a high-quality environment and positive parenting remained largely uninvestigated. Due to the presence of genetic, temperamental, or physiological factors, children who were traditionally considered at-risk for ADHD may be more sensitive to aspects of their environment compared to children who are not at such risk. Therefore, they would be more affected by their environmental experience, either for good or bad. Under supportive environmental conditions, such at-risk individuals might actually outperform their non-vulnerable peers, suggesting that these individual factors might be considered susceptibility factors rather than risk factors. Little is known regarding the positive effect of the environment in the ADHD literature, but it has been demonstrated in cognitive functions that are closely associated with ADHD, such as executive functions (EF). We review this literature and examine the extant empirical support for sensitivity to aspects of the home environment and parenting in the case of ADHD and EF. Moreover, we review factors that could help identify the specific aspects of the home environment and parenting that these children might be more susceptible to. Such knowledge could be valuable when designing preventive interventions and identifying those children that are especially sensitive and could benefit from such interventions. Recommendations for future studies are discussed as well.
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Affiliation(s)
- Tzlil Einziger
- Department of Behavioral Sciences, Ruppin Academic Center, Emek Hefer, Israel
| | - Andrea Berger
- Department of Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel
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11
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Bemmouna D, Weibel S, Kosel M, Hasler R, Weiner L, Perroud N. The utility of the autism-spectrum quotient to screen for autism spectrum disorder in adults with attention deficit/hyperactivity disorder. Psychiatry Res 2022; 312:114580. [PMID: 35523029 DOI: 10.1016/j.psychres.2022.114580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
The co-occurrence of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) has been reported to be highly prevalent in adults. However, very few studies have assessed the usefulness of screening instruments to detect this co-occurrence, particularly when screening for ASD in the context of ADHD. Our study aimed at assessing the utility of the autism-spectrum quotient (AQ) as a screening tool of ASD in a sample of 153 adults referred for ADHD assessment. Our results showed that the AQ is of limited use in this context as its positive predictive value was low (47%). Particularly, the more severe the attentional deficits the more likely individuals with ADHD were to be misclassified as having a co-occurring ASD based on the AQ. However, the "imagination" subscale of the AQ was able to discriminate those who met ASD criteria from those who did not, suggesting that targeting imagination impairments might be useful when assessing for the ADHD+ASD co-occurrence in clinical settings.
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Affiliation(s)
- Doha Bemmouna
- Department of Psychology, University of Strasbourg, 12 Rue Goethe, Strasbourg 67000, France.
| | - Sébastien Weibel
- Inserm U1114, 1 Place de l'Hôpital, Strasbourg 67000, France; Psychiatry Department, University Hospitals of Strasbourg, 1 Place de l'Hôpital, Strasbourg 67000, France
| | - Markus Kosel
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospital of Geneva, 20 rue de Lausanne, Geneva 1201, Switzerland
| | - Roland Hasler
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospital of Geneva, 20 rue de Lausanne, Geneva 1201, Switzerland
| | - Luisa Weiner
- Department of Psychology, University of Strasbourg, 12 Rue Goethe, Strasbourg 67000, France; Psychiatry Department, University Hospitals of Strasbourg, 1 Place de l'Hôpital, Strasbourg 67000, France
| | - Nader Perroud
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospital of Geneva, 20 rue de Lausanne, Geneva 1201, Switzerland
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12
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Ryan C, Cogan S. Eliciting Expressions of Emotion: An Exploratory Analysis of Alexithymia in Adults with Autism Utilising the APRQ. J Autism Dev Disord 2022; 53:2499-2513. [PMID: 35394243 DOI: 10.1007/s10803-022-05508-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 11/28/2022]
Abstract
This study examined alternative methods for detecting alexithymia to the Toronto Alexithymia Scale-20 (TAS-20) by comparing the emotional linguistic performance of ASD and NT samples (n = 32 in each) on the Alexithymia Provoked Responses Questionnaire (APRQ). We utilised both the LIWC and tidytext approaches to linguistic analysis. The results indicate the ASD sample used significantly fewer affective words in response to emotionally stimulating scenarios and had less emotional granularity. Affective word use was correlated with ASD symptomatology but not with TAS-20 scores, suggesting that some elements of alexithymia are not well detected by the TAS-20 alone. The APRQ, in combination with the tidytext package, offers significant potential for sophisticated exploration of emotional expression in ASD.
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Affiliation(s)
- Christian Ryan
- School of Applied Psychology, University College Cork, Distillery House, North Mall, Cork, T23 TK30, Ireland.
| | - Stephen Cogan
- Aspect, Cork Association for Autism, Carrigtwohill, Cork, Ireland
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13
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Schlag F, Allegrini AG, Buitelaar J, Verhoef E, van Donkelaar M, Plomin R, Rimfeld K, Fisher SE, St Pourcain B. Polygenic risk for mental disorder reveals distinct association profiles across social behaviour in the general population. Mol Psychiatry 2022; 27:1588-1598. [PMID: 35228676 PMCID: PMC9095485 DOI: 10.1038/s41380-021-01419-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/26/2021] [Accepted: 12/01/2021] [Indexed: 12/16/2022]
Abstract
Many mental health conditions present a spectrum of social difficulties that overlaps with social behaviour in the general population including shared but little characterised genetic links. Here, we systematically investigate heterogeneity in shared genetic liabilities with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders (ASD), bipolar disorder (BP), major depression (MD) and schizophrenia across a spectrum of different social symptoms. Longitudinally assessed low-prosociality and peer-problem scores in two UK population-based cohorts (4-17 years; parent- and teacher-reports; Avon Longitudinal Study of Parents and Children(ALSPAC): N ≤ 6,174; Twins Early Development Study(TEDS): N ≤ 7,112) were regressed on polygenic risk scores for disorder, as informed by genome-wide summary statistics from large consortia, using negative binomial regression models. Across ALSPAC and TEDS, we replicated univariate polygenic associations between social behaviour and risk for ADHD, MD and schizophrenia. Modelling variation in univariate genetic effects jointly using random-effect meta-regression revealed evidence for polygenic links between social behaviour and ADHD, ASD, MD, and schizophrenia risk, but not BP. Differences in age, reporter and social trait captured 45-88% in univariate effect variation. Cross-disorder adjusted analyses demonstrated that age-related heterogeneity in univariate effects is shared across mental health conditions, while reporter- and social trait-specific heterogeneity captures disorder-specific profiles. In particular, ADHD, MD, and ASD polygenic risk were more strongly linked to peer problems than low prosociality, while schizophrenia was associated with low prosociality only. The identified association profiles suggest differences in the social genetic architecture across mental disorders when investigating polygenic overlap with population-based social symptoms spanning 13 years of child and adolescent development.
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Affiliation(s)
- Fenja Schlag
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Wundtlaan 1, 6525 XD, Nijmegen, The Netherlands
| | - Andrea G Allegrini
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Memory Ln, Camberwell, London, SE5 8AF, London, UK
- Psychology and Language Sciences, University College London, 26 Bedford Way, Bloomsbury, London, WC1H 0AP, London, UK
| | - Jan Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Geert Grooteplein 21, 6525 EZ, Nijmegen, The Netherlands
| | - Ellen Verhoef
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Wundtlaan 1, 6525 XD, Nijmegen, The Netherlands
| | - Marjolein van Donkelaar
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Wundtlaan 1, 6525 XD, Nijmegen, The Netherlands
| | - Robert Plomin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Memory Ln, Camberwell, London, SE5 8AF, London, UK
| | - Kaili Rimfeld
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Memory Ln, Camberwell, London, SE5 8AF, London, UK
| | - Simon E Fisher
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Wundtlaan 1, 6525 XD, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands
| | - Beate St Pourcain
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Wundtlaan 1, 6525 XD, Nijmegen, The Netherlands.
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Kapittelweg 29, 6525 EN, Nijmegen, The Netherlands.
- MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
- Population Health Sciences, University of Bristol, 5 Tyndall Avenue, Bristol, BS8 1UD, UK.
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Wang J, Jin S, Fu W, Liang Y, Yang Y, Xu X. Pubertal exposure to bisphenol-A affects social recognition and arginine vasopressin in the brain of male mice. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 226:112843. [PMID: 34601267 DOI: 10.1016/j.ecoenv.2021.112843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 06/13/2023]
Abstract
Social recognition is an ability of animals to identify and distinguish conspecifics, which is essential for nearly all social species to establish social relationships. Social recognition provides the basis for a variety of social behaviors. Because of modulated by gonadal hormones, it is possible that social cognition is affected by environmental endocrine disruptors (EEDs). In the present study, after being pubertal exposed to bisphenol A (BPA, 0.04, 0.4, and 4 mg/kg) for 18 days, adult male mice did not show significant dishabituation to a novel female stimulus in habituation-dishabituation task. The capacity for discriminating the odors between familiar and novel female urine or between male and female urine was suppressed in BPA-exposed male. In addition, BPA (0.4, 4 mg/kg) decreased the number of immunoreaction of AVP (AVP-ir) neurons in both the bed nucleus of the stria terminalis (BNST) and the medial amygdala (MeA), and BPA (0.04, 0.4, 4 mg/kg) reduced the level of V1αR in the lateral septum (LS) of adult male. Further, BPA decreased the levels of testosterone (T) in the brain and androgens receptor (AR) in the LS, the amygdala, and BNST, as well the levels of estrogen receptor α and β (ERα/β) in the amygdala and BNST. These results indicate that pubertal exposure to BPA affected the actions of both androgens and estrogens in the brain and inhibited AVP system of social circuits, and these alterations may be associated with impaired social recognition of adult male mice.
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Affiliation(s)
- Jinshan Wang
- Chemistry and Life Sciences College, Key Laboratory of Wildlife Biotechnology and Conservation and Utilization of Zhejiang Province, Zhejiang Provincial Key Laboratory of Ecology, Zhejiang Normal University, PR China
| | - Shizhen Jin
- Chemistry and Life Sciences College, Key Laboratory of Wildlife Biotechnology and Conservation and Utilization of Zhejiang Province, Zhejiang Provincial Key Laboratory of Ecology, Zhejiang Normal University, PR China
| | - Wenshuang Fu
- Chemistry and Life Sciences College, Key Laboratory of Wildlife Biotechnology and Conservation and Utilization of Zhejiang Province, Zhejiang Provincial Key Laboratory of Ecology, Zhejiang Normal University, PR China
| | - Yufeng Liang
- Chemistry and Life Sciences College, Key Laboratory of Wildlife Biotechnology and Conservation and Utilization of Zhejiang Province, Zhejiang Provincial Key Laboratory of Ecology, Zhejiang Normal University, PR China
| | - Yani Yang
- Chemistry and Life Sciences College, Key Laboratory of Wildlife Biotechnology and Conservation and Utilization of Zhejiang Province, Zhejiang Provincial Key Laboratory of Ecology, Zhejiang Normal University, PR China
| | - Xiaohong Xu
- Chemistry and Life Sciences College, Key Laboratory of Wildlife Biotechnology and Conservation and Utilization of Zhejiang Province, Zhejiang Provincial Key Laboratory of Ecology, Zhejiang Normal University, PR China.
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Brewer R, Murphy J, Bird G. Atypical interoception as a common risk factor for psychopathology: A review. Neurosci Biobehav Rev 2021; 130:470-508. [PMID: 34358578 PMCID: PMC8522807 DOI: 10.1016/j.neubiorev.2021.07.036] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/09/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.
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Affiliation(s)
- Rebecca Brewer
- Department of Psychology, Royal Holloway, University of London, United Kingdom
| | - Jennifer Murphy
- Department of Psychology, Royal Holloway, University of London, United Kingdom.
| | - Geoffrey Bird
- Department of Experimental Psychology, University of Oxford, United Kingdom; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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16
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Cohen A, Asraf K, Saveliev I, Dan O, Haimov I. The effects of sleep deprivation on the processing of emotional facial expressions in young adults with and without ADHD. Sci Rep 2021; 11:14241. [PMID: 34244583 PMCID: PMC8271007 DOI: 10.1038/s41598-021-93641-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022] Open
Abstract
The ability to recognize emotions from facial expressions is essential to the development of complex social cognition behaviors, and impairments in this ability are associated with poor social competence. This study aimed to examine the effects of sleep deprivation on the processing of emotional facial expressions and nonfacial stimuli in young adults with and without attention-deficit/hyperactivity disorder (ADHD). Thirty-five men (mean age 25.4) with (n = 19) and without (n = 16) ADHD participated in the study. During the five days preceding the experimental session, the participants were required to sleep at least seven hours per night (23:00/24:00–7:00/9:00) and their sleep was monitored via actigraphy. On the morning of the experimental session, the participants completed a 4-stimulus visual oddball task combining facial and nonfacial stimuli, and repeated it after 25 h of sustained wakefulness. At baseline, both study groups had poorer performance in response to facial rather than non-facial target stimuli on all indices of the oddball task, with no differences between the groups. Following sleep deprivation, rates of omission errors, commission errors and reaction time variability increased significantly in the ADHD group but not in the control group. Time and target type (face/non-face) did not have an interactive effect on any indices of the oddball task. Young adults with ADHD are more sensitive to the negative effects of sleep deprivation on attentional processes, including those related to the processing of emotional facial expressions. As poor sleep and excessive daytime sleepiness are common in individuals with ADHD, it is feasible that poor sleep quality and quantity play an important role in cognitive functioning deficits, including the processing of emotional facial expressions that are associated with ADHD.
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Affiliation(s)
- Ami Cohen
- Psychology Department, Center for Psychobiological Research, Emek Yezreel, Max Stern Yezreel Valley College, Afula, Israel.
| | - Kfir Asraf
- Psychology Department, Center for Psychobiological Research, Emek Yezreel, Max Stern Yezreel Valley College, Afula, Israel
| | - Ivgeny Saveliev
- Psychology Department, Center for Psychobiological Research, Emek Yezreel, Max Stern Yezreel Valley College, Afula, Israel
| | - Orrie Dan
- Psychology Department, Center for Psychobiological Research, Emek Yezreel, Max Stern Yezreel Valley College, Afula, Israel
| | - Iris Haimov
- Psychology Department, Center for Psychobiological Research, Emek Yezreel, Max Stern Yezreel Valley College, Afula, Israel
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17
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Ryan C, Cogan S, Phillips A, O'Connor L. Objective and Subjective Measurement of Alexithymia in Adults with Autism. J Autism Dev Disord 2021; 51:2019-2028. [PMID: 32888165 DOI: 10.1007/s10803-020-04665-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
High rates of alexithymia, a condition characterised by difficulties identifying and describing emotions, are frequently reported in both children and adults with autism spectrum disorder (ASD). However, the dilemma of measuring alexithymia via self-report has rarely been addressed. In this study, we compared objective and subjective measures of alexithymia in adults with ASD and typically developing adults. We found significantly higher levels of alexithymia in the ASD sample as measured by both self-report on the Toronto Alexithymia Scale (TAS-20) and by the observer rated Alexithymia Provoked Response Scale (APRQ). However, the two measures did not correlate with each other. We explore the different facets of the alexithymia construct that these two measures may be distinguishing.
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Affiliation(s)
- Christian Ryan
- School of Applied Psychology, University College Cork, Distillery House, North Mall, Cork, T23 TK30, Ireland.
| | | | - Ailish Phillips
- School of Applied Psychology, University College Cork, Distillery House, North Mall, Cork, T23 TK30, Ireland
| | - Lorraine O'Connor
- School of Applied Psychology, University College Cork, Distillery House, North Mall, Cork, T23 TK30, Ireland
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18
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Sodano SM, Tamulonis JP, Fabiano GA, Caserta AM, Hulme KF, Hulme KL, Stephan GR, Tronci F. Interpersonal Problems of Young Adults With and Without Attention-Deficit/Hyperactivity Disorder. J Atten Disord 2021; 25:562-571. [PMID: 30614417 DOI: 10.1177/1087054718821728] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective:Interpersonal functioning is a core area of impairment for young adults with Attention-Deficit/Hyperactivity Disorder (ADHD), yet the assessment of their interpersonal problems has not been approached using a comprehensive model of interpersonal behaviors. Method: Interpersonal problems of young adults with ADHD (n = 24) were compared to non-ADHD peers (n = 26) by self- and collateral-report using the Inventory of Interpersonal Problems-Circumplex-Item Response Theory (IIP-C-IRT). Results: Both self- and collateral-reports yielded significantly higher scores across interpersonal problem domains, except for self-reported Hostile-Dominant (HD) interpersonal problems. Discrepancy scores between self- and collateral-report supported larger differences in the ADHD versus non-ADHD groups for HD problems. Large correlations between collateral-reported family relationship impairments and HD problems were found only for the ADHD group. Conclusion: Young adults with ADHD have higher levels of interpersonal problems relative to their non-ADHD peers, but also appear to underreport HD interpersonal problems relative to non-ADHD peers, suggesting the presence of a bias. (J. of Att. Dis. XXXX; XX[X] XX-XX).
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Affiliation(s)
- Sandro M Sodano
- University at Buffalo, The State University of New York, USA
| | | | | | | | - Kevin F Hulme
- University at Buffalo, The State University of New York, USA
| | - Karen L Hulme
- University at Buffalo, The State University of New York, USA
| | - Gina R Stephan
- University at Buffalo, The State University of New York, USA
| | - Federica Tronci
- University at Buffalo, The State University of New York, USA
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19
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Lee HS, Kim S, Kim HJ, Ko YG. Encoding differences in posed negative emotional expressions between prosocials and proselfs. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-018-9986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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ERP evidence for emotional sensitivity in social anxiety. J Affect Disord 2021; 279:361-367. [PMID: 33099050 DOI: 10.1016/j.jad.2020.09.111] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/08/2020] [Accepted: 09/26/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Emotional sensitivity involves the ability to recognize and interpret facial expressions. This is very important for interpersonal communication. Previous studies found differences in emotional sensitivity between high social anxiety (HSA) individuals and low social anxiety (LSA) individuals. However, the underlying neural mechanisms are still unclear. The present study explored the effects of expression intensity and social anxiety on emotional sensitivity and their neural mechanisms. METHODS The HSA group (n = 20) and the LSA group (n = 20) were asked to recognize anger expressions with different intensities in an emotion recognition task. The hit rate, reaction time, early time window (P1, N170), and late time window (LPP) were recorded. RESULTS The results showed that individuals with HSA had a significantly higher hit rate and shorter reaction time than individuals with LSA (p < 0.01). Event-related potential (ERP) results showed that, compared to the LSA group, the HSA group exhibited significantly enhanced N170 and LPP amplitude (p < 0.01). However, the difference in P1 amplitude was not significant (p > 0.05). LIMITATIONS The participants in this study were a subclinical social anxiety sample, and the effects of other mood disorders were not excluded, partially limiting the generalizability of the results. CONCLUSIONS Our findings suggest that, compared to LSA individuals, HSA individuals are more sensitive to all presented faces. The ERP results indicated that HSA individuals' high sensitivity to threatening expressions is related to stronger structural encoding and fine processing.
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21
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Parks KMA, Cardy JEO, Woynaroski TG, Sehl CG, Stevenson RA. Investigating the Role of Inattention and/or Hyperactivity/impulsivity in Language and Social Functioning Using a Dimensional Approach. JOURNAL OF COMMUNICATION DISORDERS 2021; 89:106036. [PMID: 33249356 PMCID: PMC8862713 DOI: 10.1016/j.jcomdis.2020.106036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 06/12/2023]
Abstract
The current study parsed out the distinct components of attention-deficit/hyperactivity disorder (ADHD) symptomatology to examine differential relations with language and social ability. Using a research domain criteria (RDoC) framework, we administered standardized tests and previously developed and validated questionnaires to assess levels of inattention and/or hyperactivity/impulsivity symptomatology, language, social responsivity and social competency in 98 young adults. Those with higher inattention and/or hyperactivity/impulsivity symptomatology had reduced language comprehension, social responsivity, and social competency. Inattention and hyperactivity/impulsivity both predicted language comprehension, but not language production. Interestingly, inattention uniquely contributed to social responsiveness and social competency, but hyperactivity/impulsivity did not. Findings suggest that inattention and/or hyperactivity/impulsivity symptoms, inattention in particular, may be especially important for social skills programs geared towards individuals with attention limitations.
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Affiliation(s)
- Kaitlyn M A Parks
- Western University, Department of Psychology, 1151 Richmond St London, N6A 3K7 London, ON, Canada; Western University, Brain and Mind Institute, 1151 Richmond St, London, ON, N6A 3K7, Canada.
| | - Janis E Oram Cardy
- Western University, Brain and Mind Institute, 1151 Richmond St, London, ON, N6A 3K7, Canada; Western University, School of Communication Sciences and Disorders, 1151 Richmond St, London, ON, N6A 3K7, Canada; Western University, Program in Neuroscience, 1151 Richmond St, London, ON, N6A 3K7, Canada.
| | - Tiffany G Woynaroski
- Vanderbilt University Medical Center, Department of Hearing & Speech Sciences, 2201 West End Ave, Nashville, 377235, TN, USA; Vanderbilt Kennedy Center, 2201 West End Ave, Nashville, 377235, TN, USA; Vanderbilt Brain Institute, 2201 West End Ave, Nashville, 377235, TN, USA.
| | - Claudia G Sehl
- Western University, Department of Psychology, 1151 Richmond St London, N6A 3K7 London, ON, Canada; Western University, Brain and Mind Institute, 1151 Richmond St, London, ON, N6A 3K7, Canada; University of Waterloo, Department of Psychology, 200 University Ave W, Waterloo, ON, N2L 3GL, Canada.
| | - Ryan A Stevenson
- Western University, Department of Psychology, 1151 Richmond St London, N6A 3K7 London, ON, Canada; Western University, Brain and Mind Institute, 1151 Richmond St, London, ON, N6A 3K7, Canada; Western University, Program in Neuroscience, 1151 Richmond St, London, ON, N6A 3K7, Canada; Western University, Department of Psychiatry, 1151 Richmond St, London, ON, N6A 3K7, Canada; York University, Centre for Vision Research, 4700 Keele St, Toronto, ON, M3J 1P3, Canada.
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22
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Single-dose pharmacokinetics of amphetamine extended-release tablets compared with amphetamine extended-release oral suspension. CNS Spectr 2020; 25:774-781. [PMID: 31964449 DOI: 10.1017/s1092852919001676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Evaluate the relative bioavailability of single-dose amphetamine extended-release tablet (AMPH ER TAB) 20 mg, swallowed whole or chewed, and amphetamine extended-release oral suspension (AMPH EROS) 2.5 mg/mL; evaluate food effect on AMPH ER TAB. METHODS Healthy volunteers (18-55 years) were randomized to 1 dose of AMPH ER TAB 20 mg swallowed (fasted), chewed (fed/fasted), or 20 mg AMPH EROS (fasted). A crossover study design was used. Plasma samples were collected each period predose and at time points to 60 hours postdose. d- and l-amphetamine were measured and pharmacokinetic (PK) was calculated (90% confidence intervals of the ratios of the plasma levels) for AUC0-t, AUC0-∞, and Cmax. Comparative relative bioavailability between formulations was determined when ratios were within 80% and 125%. Safety was also assessed. RESULTS Thirty-two subjects completed the study. AMPH ER TAB swallowed versus AMPH EROS (fasted): for d- and l-amphetamine, the total and peak exposure was similar: d: AUC0-t: 100.68% to 108.08%, AUC0-∞: 101.47% to 109.52%, Cmax: 98.10% to 103.17%; l: AUC0-t: 100.31% to 108.57%, AUC0-∞: 101.27% to 111.09%, Cmax: 98.2% to 103.37%. For d- and l-amphetamine when the tablet is swallowed whole, Tmax was 5.00 hours (with a range of 2.00-9.00 hours). AMPH ER TAB chewed versus AMPH EROS (fasted): for d- and l-amphetamine, the total and peak exposure was similar: d: AUC0-t: 99.23% to 106.62%, AUC0-∞: 99.58% to 107.59%, Cmax: 99.91% to 105.14%; l: AUC0-t: 98.16% to 106.35%, AUC0-∞: 98.44% to 108.11%, Cmax: 99.53% to 104.75%. For d- and l-amphetamine when the tablet has been chewed, Tmax was 5.00 hours (with a range of 3.00-7.00 hours). PK results were similar for patients in the fasted and fed groups, indicative of no presence of food effect. No serious adverse events (AEs) were reported, overall AE profiles between the tablet and oral suspension were comparable without any unanticipated safety concerns. CONCLUSIONS Single doses of AMPH ER TAB for both d- and l-amphetamine demonstrated comparable bioavailability to a 20 mg dose of AMPH EROS, 2.5 mg/mL under fasted conditions when chewed and swallowed whole, and demonstrated equivalent peak and overall exposure without apparent food effect. AMPH ER TAB was well-tolerated and consistent with adverse events noted in other amphetamine formulations.
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23
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Recognition of emotional facial expressions in adolescents with attention deficit/hyperactivity disorder. J Adolesc 2020; 82:1-10. [PMID: 32442797 DOI: 10.1016/j.adolescence.2020.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 03/21/2020] [Accepted: 04/26/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Attention Deficit/Hyperactivity Disorder (ADHD) is associated with impaired social competencies, due in part to an inability to determine emotional states through facial expressions. Social interactions are a critical component of adolescence, which raises the question of how do adolescents with ADHD cope with this impairment. Yet, previous reviews do not distinguish between children and adolescents. This review focuses on the ability of adolescents (defined by the World Health Organization as 10-19 years old) with ADHD to recognize emotional facial expressions, when compared to their typically-developing peers. METHODS Comprehensive database search and analysis yielded 9 relevant studies published between 2008 and 2018. RESULTS The studies reviewed here examined recognition of emotional facial expressions in adolescents with ADHD. Behavioral measures (reaction time, reaction time variance and recognition accuracy) show no statistically significant differences between adolescents with ADHD and their typically-developing peers. However, neural responses as recorded using functional Magnetic Resonance Imaging (fMRI) or Event Related Potentials (ERP) find differences in brain activity and the temporal evolution of the reaction between the two groups. CONCLUSIONS Studies of children and of adults with ADHD find deficiencies in the recognition of emotional facial expressions. However, this review shows that adolescents with ADHD perform comparably to their peers on accuracy and rate, although their neural processing is different. This suggests that the methodologies employed by the ADHD and typically-developing adolescents to asses facial expressions are different. Further study is needed to determine what these may be.
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Eddy LD, Jones HA, Snipes D, Karjane N, Svikis D. Associations Between ADHD Symptoms and Occupational, Interpersonal, and Daily Life Impairments Among Pregnant Women. J Atten Disord 2019; 23:976-984. [PMID: 28043206 DOI: 10.1177/1087054716685839] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Past research links symptoms of depression and anxiety with functional impairments among pregnant women. However, no prior research has examined the impact of ADHD symptoms among this population. The current study examines associations between ADHD symptoms and impairment in several life domains. METHOD Self-report measures of ADHD symptoms, impairment, and demographic information were collected from 250 pregnant women at an urban women's health clinic in the Southeast. Data were assessed using multivariate path analysis. RESULTS Inattentive symptoms were significant predictors of professional life impairment, daily life impairment, and relationship impairment. Impulsivity uniquely predicted variability in professional life impairment and relationship impairment. Hyperactivity was not a significant predictor. CONCLUSION Future research should focus on the mechanisms by which inattention and impulsivity affect daily functioning in pregnant women, in addition to investigating potential interventions. Health care professionals should assess for impulsivity and inattention among pregnant women.
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Affiliation(s)
- Laura D Eddy
- 1 Virginia Commonwealth University, Richmond, USA
| | | | | | | | - Dace Svikis
- 1 Virginia Commonwealth University, Richmond, USA
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25
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Elias R, White SW. Autism Goes to College: Understanding the Needs of a Student Population on the Rise. J Autism Dev Disord 2019; 48:732-746. [PMID: 28255760 DOI: 10.1007/s10803-017-3075-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Understanding the needs of adolescents and emerging adults with Autism Spectrum Disorder (ASD) with respect to transition to postsecondary education is critical to development of user-informed transition programming. Parents of adolescents and emerging adults with ASD (n = 52) and ADHD (n = 47) completed an online survey. Social interaction training and independent living training were services frequently requested by parents in the ASD group. Additionally, parents of postsecondary students with ASD endorsed distinct challenges with self-advocacy, managing emotions, and managing personal/adaptive skills relative to postsecondary students with ADHD. The profile of parent-reported difficulties and needed services compared to transition to postsecondary education for students with ASD is distinguishable from that for ADHD, suggesting individualized transition planning and in-college supports.
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Affiliation(s)
- Rebecca Elias
- Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall (0436), Blacksburg, VA, 24060, USA.
| | - Susan W White
- Department of Psychology, Virginia Polytechnic Institute and State University, 109 Williams Hall (0436), Blacksburg, VA, 24060, USA
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26
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Schönenberg M, Schneidt A, Wiedemann E, Jusyte A. Processing of Dynamic Affective Information in Adults With ADHD. J Atten Disord 2019; 23:32-39. [PMID: 25823741 DOI: 10.1177/1087054715577992] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE ADHD has been repeatedly linked to problems in social functioning. Although some theories assume that the emotion recognition deficits are explained by general attentional deficits, mounting evidence suggests that they may actually constitute a distinct impairment. However, it remains unclear whether the deficient processing affects specific emotional categories or may generalize to all basic emotions. The present study aims to investigate these questions by assessing the sensitivity to all six basic emotions in adults with ADHD. METHOD The participants judged the emotion onset in animated morph clips displaying facial expressions that slowly changed from neutral to emotional. RESULTS ADHD participants exhibited an impaired recognition of sad and fearful facial expressions. CONCLUSION The present findings indicate that ADHD is possibly associated with a specific deficit in the recognition of facial emotions signaling negative social feedback.
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27
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McVey AJ, Schiltz HK, Haendel AD, Dolan BK, Willar KS, Pleiss SS, Karst JS, Carlson M, Krueger W, Murphy CC, Casnar CL, Yund B, Van Hecke AV. Social difficulties in youth with autism with and without anxiety and ADHD symptoms. Autism Res 2018; 11:1679-1689. [PMID: 30475451 PMCID: PMC6311999 DOI: 10.1002/aur.2039] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/31/2018] [Accepted: 10/02/2018] [Indexed: 12/28/2022]
Abstract
Social difficulties inherent to autism spectrum disorder are often linked with co-occurring symptoms of anxiety and attention deficit hyperactivity disorder (ADHD). The present study sought to examine the relation between such co-occurring symptoms and social challenges. Parents of adolescents with autism (N = 113) reported upon social challenges via the social responsiveness scale (SRS) and anxiety and ADHD symptomatology via the Child Behavior Checklist. Results revealed differences in SRS scores across co-occurring symptom subgroups (Anxiety, ADHD, Both, Neither)-namely, adolescents with autism and anxiety as well as those with autism, anxiety, and ADHD showed greater scores on the SRS than the other groups. Implications for research and clinical practice are discussed and recommendations are offered. Autism Research 2018, 11: 1679-1689. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Anxiety and attention deficit hyperactivity disorder (ADHD) symptoms are related to greater social challenges for adolescents with autism spectrum disorder. The present study found that autism with anxiety and autism with anxiety and ADHD, was related to greater social difficulties than autism alone. Findings provide further support for the intertwined nature of anxiety and ADHD symptoms in autism. What this may mean for research and clinical practice is considered and recommendations are suggested.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Christina L Casnar
- Alpert Medical School of Brown University, Clinical Psychology Training Consortium, Providence, Rhode Island
| | - Brianna Yund
- University of Wisconsin - Milwaukee, Milwaukee, Wisconsin
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Abstract
OBJECTIVE The present study investigated differences in emotional face processing between adolescents (age 15-18) with ADHD-Combined type (ADHD-CT) and typically developing controls. METHOD Participants completed a visual emotional task in which they were asked to rate the degree of negativity/positivity of four facial expressions (taken from the NimStim face stimulus set). RESULTS Participants' ratings, ratings' variability, response times (RTs), and RTs' variability were analyzed. Results showed a significant interaction between group and the type of presented stimuli. Adolescents with ADHD-CT discriminated less between positive and negative emotional expressions compared with those without ADHD. In addition, adolescents with ADHD-CT exhibited greater variability in their RTs and in their ratings of facial expressions when compared with controls. CONCLUSION The present results lend further support to the existence of a specific deficit or alteration in the processing of emotional face stimuli among adolescents with ADHD-CT.
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Affiliation(s)
- Orrie Dan
- 1 Yezreel Valley College, Emeck Yezreel, Israel
| | - Sivan Raz
- 1 Yezreel Valley College, Emeck Yezreel, Israel.,2 Psychology Department, Tel-Hai College, Israel
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29
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Aduen PA, Day TN, Kofler MJ, Harmon SL, Wells EL, Sarver DE. Social Problems in ADHD: Is it a Skills Acquisition or Performance Problem? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018; 40:440-451. [PMID: 30287981 DOI: 10.1007/s10862-018-9649-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Recent models suggest that social skills training's inefficacy for children with ADHD may be due to target misspecification, such that their social problems reflect inconsistent performance rather than knowledge/skill gaps. No study to date, however, has disentangled social skills acquisition from performance deficits in children with ADHD. Children ages 8-12 with ADHD (n=47) and without ADHD (n=23) were assessed using the well-validated social behavioral analysis framework to quantify cross-informant social skills acquisition deficits, performance deficits, and strengths. Results provided support for the construct and predictive validities of this Social Skills Improvement System (SSIS) alternate scoring method, including expected magnitude and valence relations with BASC-2 social skills and ADHD symptoms based on both parent and teacher report. Acquisition deficits were relatively rare and idiosyncratic for both the ADHD and Non-ADHD groups, whereas children with ADHD demonstrated cross-informant social performance deficits (d=0.82-0.99) on several specific behaviors involving attention to peer directives, emotion regulation, and social reciprocity. Relative to themselves, children with ADHD were perceived by parents and teachers as exhibiting more social strengths than social acquisition deficits; however, they demonstrated significantly fewer social strengths than the Non-ADHD group (d = -0.71 to -0.89). These findings are consistent with recent conceptualizations suggesting that social problems in ADHD primarily reflect inconsistent performance rather than a lack of social knowledge/skills. Implications for refining social skills interventions for ADHD are discussed.
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Affiliation(s)
| | - Taylor N Day
- Florida State University, Department of Psychology
| | | | | | | | - Dustin E Sarver
- University of Mississippi Medical Center, Department of Pediatrics, Center for Advancement of Youth
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30
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Moulin F, Chollet A, Ramos-Quiroga JA, Bouvard M, Melchior M, Galéra C. Prevalence and Psychosocial Correlates of ADHD Symptoms in Young Adulthood: A French Population-Based Study. J Atten Disord 2018; 22:167-181. [PMID: 28490216 DOI: 10.1177/1087054717706758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The scientific literature suggests that ADHD in adulthood is associated with a considerable psychosocial burden. However, most knowledge in this area relies on studies conducted in the United States or in North European nations, thereby limiting generalization to other countries. METHOD We assessed the psychosocial correlates of ADHD symptoms in a French community-based sample. Data came from 1,214 community-based young adults (18-35 years) and their parents (Trajectoires Epidémiologiques en Population and GAZEL studies). ADHD symptoms and socioeconomic and psychosocial correlates were assessed in a telephone interview. Logistic regression analyses were conducted to assess associations. RESULTS A total of 7.1% of the sample presented high levels of ADHD symptoms. Parental history of anxiety, dissatisfaction with love life, and consumption of tobacco were associated with the highest odds ratios. CONCLUSION This study confirms the high functional impairment associated with adult ADHD symptoms in a French community sample. It extends the existing literature to family risk correlates and individual well-being correlates.
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Affiliation(s)
| | - Aude Chollet
- 2 Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonnes Université, Paris, France.,3 Institut National de la Santé et de la Recherche Médicale (INSERM), UMR_S_1136, Paris, France
| | | | - Manuel Bouvard
- 1 Bordeaux University Hospital, France.,5 Child Psychiatry Department, Charles Perrens Hospital, Bordeaux, France
| | - Maria Melchior
- 2 Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonnes Université, Paris, France.,3 Institut National de la Santé et de la Recherche Médicale (INSERM), UMR_S_1136, Paris, France
| | - Cédric Galéra
- 1 Bordeaux University Hospital, France.,5 Child Psychiatry Department, Charles Perrens Hospital, Bordeaux, France
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31
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Hesson J, Fowler K. Prevalence and Correlates of Self-Reported ADD/ADHD in a Large National Sample of Canadian Adults. J Atten Disord 2018; 22:191-200. [PMID: 25749874 DOI: 10.1177/1087054715573992] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to examine the prevalence and correlates of self-reported attention deficit disorder (ADD)/ADHD in Canadian adults. METHOD Prevalence of self-reported ADD/ADHD was examined in a large national sample of Canadians ( n = 16,957). Demographic variables, lifetime, and current psychiatric comorbidities were then compared in a group of adults with self-reported ADD/ADHD ( n = 488) and an age- and gender-matched control group ( n = 488). RESULTS The prevalence of self-reported ADD/ADHD was 2.9%. Significantly higher lifetime and current prevalence rates of major depressive disorder, bipolar I and II disorders, generalized anxiety disorder, and substance use disorders were observed in the ADD/ADHD group compared with the control group. Within the ADD/ADHD group, lifetime and 12-month prevalence rates of major depressive disorder and generalized anxiety disorder were significantly higher in women, whereas lifetime and current rates of some substance use disorders were significantly higher in men. CONCLUSION In a national sample of Canadian adults, self-reported ADD/ADHD was associated with significant psychiatric comorbidity. Gender differences were also noted.
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Affiliation(s)
| | - Ken Fowler
- 1 Memorial University of Newfoundland, St. John's, Canada
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Jusyte A, Gulewitsch MD, Schönenberg M. Recognition of peer emotions in children with ADHD: Evidence from an animated facial expressions task. Psychiatry Res 2017; 258:351-357. [PMID: 28917441 DOI: 10.1016/j.psychres.2017.08.066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 07/14/2017] [Accepted: 08/23/2017] [Indexed: 10/19/2022]
Abstract
A growing body of literature suggests that ADHD is associated with emotion recognition impairments that may be linked to deficient interpersonal functioning. However, our understanding of the mechanisms underlying these recognition impairments is extremely limited. Here, we used dynamic stimuli to investigate whether impaired emotion recognition in children with ADHD may be associated with impairments in perceptual sensitivity. Participants (ADHD: N = 26; Controls: N = 26) viewed video sequences of neutral faces slowly developing into one of the six basic emotional expressions (angry, happy, fearful, sad, disgusted and surprised) and were instructed to indicate via a button press the precise moment at which they were able to correctly recognize the emotional expression. The results showed that compared to controls, children with ADHD exhibited lower accuracy rates across all emotional expressions while there was no evidence for impaired perceptual sensitivity. Thus, the study provides evidence for a generalized categorization impairment across all emotional categories and is consistent with developmental delay accounts of ADHD. Future studies are needed in order to further investigate the developmental course of social cognition deficits in ADHD.
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Affiliation(s)
- Aiste Jusyte
- LEAD Graduate School & Research Network, University of Tübingen, Germany.
| | | | - Michael Schönenberg
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany
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33
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Canela C, Buadze A, Dube A, Eich D, Liebrenz M. Skills and compensation strategies in adult ADHD - A qualitative study. PLoS One 2017; 12:e0184964. [PMID: 28953946 PMCID: PMC5617155 DOI: 10.1371/journal.pone.0184964] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 09/04/2017] [Indexed: 12/31/2022] Open
Abstract
Objective The primary objectives of this study were to investigate how adult patients with ADHD coped with their symptoms prior to diagnosis and treatment, what skills and compensation strategies they had developed and what their self-perceptions of these strategies were. Methods We used a qualitative approach to analyze interviews with 32 outpatients of a specialty care unit at a university hospital. Results Patients reported frequent use of diverse compensatory strategies with varying degrees of effectiveness. These were classified into five categories (organizational, motoric, attentional, social, psychopharmacological). In certain circumstances, ADHD symptoms were even perceived as useful. Conclusion Before diagnosis and treatment, patients with ADHD may develop a variety of skills to cope with their symptoms. Several of these skills are perceived as helpful. Knowledge of self-generated coping strategies may help better understand patients and their histories and thus facilitate patient cooperation. Moreover, knowing ways in which such patients cope with their symptoms may help elucidate reasons for late or under-diagnosing of the disorder.
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Affiliation(s)
- Carlos Canela
- Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
- * E-mail:
| | - Anna Buadze
- Division of ADHD Research, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Anish Dube
- Santa Barbara Child & Family Services, Santa Barbara, County of Santa Barbara, California
| | - Dominique Eich
- Division of ADHD Research, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Michael Liebrenz
- Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland
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34
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Kara H, Bodur Ş, Çetinkaya M, Kara K, Tulacı ÖD. Assessment of relationship between comorbid oppositional defiant disorder and recognition of emotional facial expressions in children with attention-deficit/hyperactivity disorder. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1367566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Halil Kara
- Department of Child and Adolescent Psychiatry, Mental Health Hospital, Elazig, Turkey
| | - Şahin Bodur
- Department of Child and Adolescent Psychiatry, Dr Sami Ulus Maternity and Child Health Hospital, Ankara, Turkey
| | - Miray Çetinkaya
- Department of Child and Adolescent Psychiatry, Dr Munif Islamoglu Kastamonu State Hospital, Kastamonu, Turkey
| | - Koray Kara
- Department of Child and Adolescent Psychiatry, Gulhane Military Medical Academy, Ankara, Turkey
| | - Özge Demircan Tulacı
- Department of Child and Adolescent Psychiatry, Gulhane Military Medical Academy, Ankara, Turkey
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35
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Thompson MJJ, Au A, Laver-Bradbury C, Lange AM, Tripp G, Shimabukuro S, Zhang JS, Shuai L, Thompson CE, Daley D, Sonuga-Barke EJ. Adapting an attention-deficit hyperactivity disorder parent training intervention to different cultural contexts: The experience of implementing the New Forest Parenting Programme in China, Denmark, Hong Kong, Japan, and the United Kingdom. Psych J 2017; 6:83-97. [PMID: 28371554 DOI: 10.1002/pchj.159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/02/2017] [Accepted: 01/05/2017] [Indexed: 11/07/2022]
Abstract
The New Forest Parenting Programme (NFPP) is a parenting program developed for parents who have a child with attention-deficit hyperactivity disorder (ADHD). It is a manualized program that is delivered in a parent's home over 8 weeks, or in a group format, or through a self-help manual. Three randomized controlled trials have been carried out in the United Kingdom. The NFPP group has adapted the program according to feedback from parents and therapists, and for use with different populations, both within the United Kingdom and internationally. The first international trial took place in New York, United States. Trials in Denmark, Hong Kong, and Japan followed. More recently, a trial of the self-help manual has been carried out in mainland China. This paper will outline the adaptions that were needed in order to be able to deliver the program in different countries with their own expectations of parenting, culture, and language. Training had to be differently focused; manuals and handouts had to be revised, translated and back-translated; and supervision had to be delivered at a distance to maintain the fidelity of the program. The international group will outline their experience of running trials in their own countries with the NFPP in a face-to-face format (Denmark), a group format (Hong Kong and Japan), and a self-help format (mainland China).
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Affiliation(s)
- Margaret J J Thompson
- Academic Unit of Psychology, University of Southampton, Southampton, UK.,CAMHS, Solent NHS Trust, Better Care Centre, Southampton, UK
| | - Alma Au
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | | | - Anne-Mette Lange
- Centre for Child & Adolescent Psychiatry, Research Department, Aarhus University Hospital, Risskov, Denmark
| | - Gail Tripp
- Human Developmental Neurobiology Research Unit, Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Shizuka Shimabukuro
- Human Developmental Neurobiology Research Unit, Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Jin S Zhang
- Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lan Shuai
- Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - David Daley
- Division of Psychiatry and Applied Psychology, School of Medicine & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan & NIHR MindTech Health Care Technology Cooperative, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Edmund J Sonuga-Barke
- Academic Unit of Psychology, University of Southampton, Southampton, UK.,Centre for Child & Adolescent Psychiatry, Research Department, Aarhus University Hospital, Risskov, Denmark.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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36
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Cortez-Carbonell I, Cerić F. Emotion recognition of facial expressions in adults with attention deficit hyperactivity disorder / Reconocimiento de emociones de expresiones faciales en adultos con trastorno de hiperactividad con déficit de atención. STUDIES IN PSYCHOLOGY 2017. [DOI: 10.1080/02109395.2016.1268387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Ni HC, Lin YJ, Gau SSF, Huang HC, Yang LK. An Open-Label, Randomized Trial of Methylphenidate and Atomoxetine Treatment in Adults With ADHD. J Atten Disord 2017; 21:27-39. [PMID: 23475825 DOI: 10.1177/1087054713476549] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To directly compare the efficacy of methylphenidate and atomoxetine in improving symptoms, social functions, and quality of life among adults with ADHD. METHOD This was an 8-to-10-week, open-label, head-to-head, randomized clinical trial with two treatment arms: immediate-release methylphenidate (IR-methylphenidate; n = 31) and atomoxetine once daily ( n = 32). The outcome measures included ADHD symptom severity, quality of life, and functional impairments. RESULTS We found a significant reduction in overall ADHD symptoms and improvement in social functions and quality of life for both groups at Weeks 4 to 5 and Weeks 8 to 10. There was no significant difference in the slope of improvements over time except that atomoxetine was superior to IR-methylphenidate in reducing hyperactive/impulsive symptoms at Weeks 4 to 5. There was no significant group difference in the rates of adverse effects. CONCLUSION Both IR-methylphenidate and atomoxetine are well tolerated and efficacious in ethnic Chinese adults with ADHD.
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Affiliation(s)
- Hsing-Chang Ni
- 1 National Taiwan University Hospital, Taipei, Taiwan
- 2 National Taiwan University College of Medicine, Taipei, Taiwan
- 3 Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Yu-Ju Lin
- 1 National Taiwan University Hospital, Taipei, Taiwan
- 2 National Taiwan University College of Medicine, Taipei, Taiwan
- 4 Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- 1 National Taiwan University Hospital, Taipei, Taiwan
- 2 National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hui-Chun Huang
- 5 National Cheng Kung University Hospital, Tainan, Taiwan
| | - Li-Kuang Yang
- 1 National Taiwan University Hospital, Taipei, Taiwan
- 2 National Taiwan University College of Medicine, Taipei, Taiwan
- 6 Beitou Armed Forces Hospital, Taipei, Taiwan
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38
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Ryan J, Ross S, Reyes R, Kosmerly S, Rogers M. Social functioning among college students diagnosed with ADHD and the mediating role of emotion regulation. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2016. [DOI: 10.1080/13632752.2016.1235329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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39
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Pollock BE, Khaddouma A, Huet-Cox K, Fillauer JP, Bolden J. Emotional Intelligence, Relationship Satisfaction, and the Moderating Effect of ADHD Symptomatology. JOURNAL OF ADULT DEVELOPMENT 2016. [DOI: 10.1007/s10804-016-9242-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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40
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Crundwell RMA. An Initial Investigation of the Impact of Self-Regulation and Emotionality on Behavior Problems in Children With ADHD. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2016. [DOI: 10.1177/0829573506295458] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children with attention-deficit hyperactivity disorder (ADHD) are reported to have more difficulties with self-regulation and emotional regulation. Current ADHD models suggest a primary deficit in behavioral inhibition causes secondary deficits in executive functions, impacting on emotional regulation. This study examined the relationship of regulation and emotionality on behavior problems in children with ADHD and the relationship between ADHD symptoms and emotional regulation and emotionality. Mothers of 32 male children between the ages of 6 and 11 diagnosed as ADHD combined type or predominantly hyperactive-impulsive type completed questionnaires assessing self-control and emotionality. Results indicated that ADHD boys who showed greater emotionality in terms of anger/frustration and less self-control and inhibition were rated as having more behavioral difficulties. Children with symptoms of hyperactivity and impulsivity were rated as lower in self-control and inhibition and higher in emotionality. Results of the study are discussed with respect to current theoretical models of ADHD.
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41
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Tureck K, Matson JL, Cervantes P, Turygin N. Autism severity as a predictor of inattention and impulsivity in toddlers. Dev Neurorehabil 2016; 18:285-9. [PMID: 23869975 DOI: 10.3109/17518423.2013.807884] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Evaluate how severity of autism spectrum disorder (ASD) symptoms predicts attention-deficit/hyperactivity disorder (ADHD) symptoms in atypically developing toddlers. METHOD Parents/caregivers of 2300 atypically developing toddlers' ages 18-37 months were assessed about their children's behaviours using the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT) Part 1 and the inattention/impulsivity subscale of the BISCUIT-Part 2. RESULTS ASD symptom severity was positively and significantly correlated with inattention/impulsivity, indicating that children with more severe symptoms of ASD tended to have higher scores on the measure of inattention/impulsivity, R(2) = 0.49, F (1, 2298) = 2234.72, p < 0.001. Additionally, ASD symptom severity significantly predicted inattention/impulsivity, β = 0.70, t (2298) = 47.27, p < 0.001. CONCLUSIONS ASD symptom severity predicts rates of ADHD symptoms in atypically developing toddlers. The implications of these findings are discussed in the context of other research.
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Affiliation(s)
- Kim Tureck
- a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA
| | - Johnny L Matson
- a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA
| | - Paige Cervantes
- a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA
| | - Nicole Turygin
- a Department of Psychology , Louisiana State University , Baton Rouge , LA , USA
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Kang T, Kim JW, Bahn GH, Song SH, Kim J, Kim JH, Kim YJ, Kim EJ, Kim TH, Yang SJ, Yang J, Lee SI, Park JH, Choi J, Han DH. Development of Korean Adult ADHD Rating Scale. Soa Chongsonyon Chongsin Uihak 2015. [DOI: 10.5765/jkacap.2015.26.4.295] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Taewoong Kang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Won Kim
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Geon Ho Bahn
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sook Hyung Song
- Department of Psychiatry, Yong-In Mental Hospital, Yongin, Korea
| | - Junwon Kim
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Ji-Hoon Kim
- Department of Neuropsychiatry, Pusan National University Yangsan Hospital, Busan, Korea
| | | | - Eui-Jung Kim
- Department of Psychiatry, Ewha Womans University School of Medicine, Seoul, Korea
| | - Tae-Ho Kim
- Department of Psychiatry, College of Medicine, Konkuk University, Chungju, Korea
| | - Su-Jin Yang
- Jeju Special Self-Governing Provincial Office of Education, Jeju, Korea
| | - Jaewon Yang
- KAIST Clinic, Korea Advanced Institute of Science and Technology (KAIST, Daejeon, Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Joon-Ho Park
- Department of Industrial and Advertising Psychology, Daejeon University, Daejeon, Korea
| | - Jeewook Choi
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Daejeon St. Mary’s Hospital, Daejeon, Korea
| | - Doug-Hyun Han
- Department of Psychiatry, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea
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Surman CBH, Biederman J, Spencer T, Miller CA, Petty CR, Faraone SV. Neuropsychological Deficits Are Not Predictive of Deficient Emotional Self-Regulation in Adults With ADHD. J Atten Disord 2015; 19:1046-53. [PMID: 23503813 DOI: 10.1177/1087054713476548] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate whether neuropsychological deficits account for the association between deficient emotional self-regulation (DESR) and ADHD. METHOD DESR was identified in adults with and without ADHD who reported extreme frequency of items from the Barkley Current Behavior Scale (>95th percentile of control participants). A neuropsychological battery and structured diagnostic interview were administered to 113 adults with ADHD and DESR, 93 adults with ADHD without DESR, and 119 participants without ADHD or DESR. RESULTS Relative to adults with ADHD without DESR, adults with ADHD and DESR demonstrated lower scores on Wechsler Adult Intelligence Scale (WAIS) arithmetic but no other significant differences in neuropsychological performance. Relative to adults without ADHD, both ADHD groups demonstrated lower scores across several measures of executive function. CONCLUSION Our findings do not support the hypothesis that neuropsychological deficits are linked to DESR in adults with ADHD. This finding is consistent with the hypothesis that DESR could be a manifestation of ADHD, but further study of alternate hypotheses is necessary to support this conclusion.
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Affiliation(s)
| | | | | | | | | | - Stephen V Faraone
- State University of New York Upstate Medical University, Syracuse, NY, USA
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Mörstedt B, Corbisiero S, Bitto H, Stieglitz RD. Attention-Deficit/Hyperactivity Disorder (ADHD) in Adulthood: Concordance and Differences between Self- and Informant Perspectives on Symptoms and Functional Impairment. PLoS One 2015; 10:e0141342. [PMID: 26529403 PMCID: PMC4631342 DOI: 10.1371/journal.pone.0141342] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/07/2015] [Indexed: 01/07/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a severe mental illness, associated with major impairment and a high comorbidity rate. Particularly undiagnosed ADHD in adulthood has serious consequences. Thus, a valid diagnosis is important. In adulthood, the diagnostic process for ADHD is complicated: symptoms may overlap with comorbid disorders, and the onset and progression of the disorder must be reconstructed retrospectively. Guidelines for the diagnostic process recommend the inclusion of additional informant ratings. Research into the relation between self- and informant ratings shows extremely heterogeneous results. The levels of agreement range from low to high. The focus of this study is the concordance and differences between self- and informant ratings on ADHD symptoms and impairments. In this regard, two possible influencing factors (gender and relationship type) are also examined. 114 people participated in this study, 77 with an ADHD diagnosis and 37 without a diagnosis. For all participants, either parents or partners also rated ADHD symptoms and impairments. Small to moderate concordance was found between self- and informant ratings, with females being slightly more concordant than males, particularly for ratings of problems with self-concept. Examination of the consistency within a particular perspective showed that people with ADHD seemed to be unaware of the causal relation between ADHD symptoms and their impairments. A close investigation found almost no influence of gender and relationship type on differences within perspectives. Based on these results, the implications for the diagnostic process are that additional informant information is clearly necessary and helpful.
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Affiliation(s)
- Beatrice Mörstedt
- Department of Psychology, Div. of Clinical Psychology & Psychiatry, University of Basel, Basel, Switzerland
- * E-mail:
| | | | - Hannes Bitto
- Department of Psychology, Div. of Clinical Psychology & Psychiatry, University of Basel, Basel, Switzerland
| | - Rolf-Dieter Stieglitz
- Department of Psychology, Div. of Clinical Psychology & Psychiatry, University of Basel, Basel, Switzerland
- University of Basel Psychiatric Clinics, Basel, Switzerland
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45
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Steinhoff KW. Special Issues in the Diagnosis and Treatment of ADHD in Adolescents. Postgrad Med 2015; 120:60-8. [DOI: 10.3810/pgm.2008.09.1908] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Cheung KKW, Wong ICK, Ip P, Chan PKL, Lin CHY, Wong LYL, Chan EW. Experiences of adolescents and young adults with ADHD in Hong Kong: treatment services and clinical management. BMC Psychiatry 2015; 15:95. [PMID: 25927845 PMCID: PMC4459071 DOI: 10.1186/s12888-015-0478-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 04/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Specialist services for the treatment of attention deficit hyperactivity disorder (ADHD) in adulthood in Hong Kong are yet to be developed. This study aims to explore the experiences of adolescents and young adults with ADHD in accessing treatment and services, coping with ADHD-related impairment, and their expectations of future treatment in Hong Kong. METHOD Qualitative interviews were conducted with a semi-structured guide. Forty young adult patients aged between 16 and 23 were included in the study. The interview recordings were transcribed verbatim and anonymised. Data were analysed with a thematic approach based on key principles of Grounded Theory. RESULTS Four meta-themes were developed: Accessing ADHD diagnosis and treatment services; ADHD-related impairment; Experience of ADHD treatments; and Attitudes and expectations of future ADHD treatment. The role of parents and schools were highly significant in accessing services for patients diagnosed with ADHD in childhood. In general, ADHD affected every aspect of patients' lives including academic outcome, employment, family and social relationships. Medications were the principal treatment for ADHD amongst the interviewees and were reported to be generally effective. Half of the patients received non-pharmacological treatments in childhood but these effects were reported to be temporary. There was general consensus that the needs of patients with ADHD could not be met by the current service. In particular, there is a lack of specialist service for adults with ADHD, follow-up by different clinicians, and insufficient provision of non-pharmacological treatments. CONCLUSION The findings suggest that further development of specialist ADHD services and non-pharmacological options for young adults are essential to meet their diverse needs with a holistic approach.
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Affiliation(s)
- Kerry K W Cheung
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
| | - Ian C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong, China.
| | - Phyllis K L Chan
- Department of Psychiatry, Child and Adolescent Psychiatric Team, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong, China.
| | - Candy H Y Lin
- Department of Psychiatry, Child and Adolescent Psychiatric Team, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong, China.
| | - Lisa Y L Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
| | - Esther W Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China.
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Koemans RG, van Vroenhoven S, Karreman A, Bekker MHJ. Attachment and autonomy problems in adults with ADHD. J Atten Disord 2015; 19:435-46. [PMID: 22956713 DOI: 10.1177/1087054712453170] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Attachment security and autonomy were examined in adults with ADHD. Insecure attachment and autonomy problems were expected to be negatively associated with general psychological functioning. METHOD Questionnaires were administered (Relationship Questionnaire, Autonomy-Connectedness Scale, Brief Symptom Inventory) in 84 late-diagnosed adults with ADHD. RESULTS Only 18% of participants were securely attached, as opposed to 59% in the normal population. Concerning autonomy, participants scored below average on self-awareness, above average on sensitivity to others, and average on capacity to manage new situations compared with the normal population. The preoccupiedly attached group reported more problems in psychological functioning than the secure and dismissive group. Sensitivity to others and capacity to manage new situations were associated with psychological functioning; self-awareness was not. Attachment security and autonomy contributed to general psychological functioning. CONCLUSION Attachment and autonomy problems do exist in adults with ADHD and contribute negatively to their psychological functioning.
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Mao AR, Brams M, Babcock T, Madhoo M. A Physician's Guide to Helping Patients with ADHD Find Success in the Workplace. Postgrad Med 2015; 123:60-70. [DOI: 10.3810/pgm.2011.09.2460] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Raz S, Dan O. Altered event-related potentials in adults with ADHD during emotional faces processing. Clin Neurophysiol 2015; 126:514-23. [DOI: 10.1016/j.clinph.2014.06.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 06/01/2014] [Accepted: 06/03/2014] [Indexed: 12/21/2022]
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Köchel A, Schöngaßner F, Feierl-Gsodam S, Schienle A. Processing of affective prosody in boys suffering from attention deficit hyperactivity disorder: A near-infrared spectroscopy study. Soc Neurosci 2015; 10:583-91. [PMID: 25721229 DOI: 10.1080/17470919.2015.1017111] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Neurobiological studies on facial affect recognition have demonstrated reduced response amplitudes to anger cues in patients suffering from attention deficit hyperactivity disorder (ADHD). It is still unclear whether a similar deficit exists in the auditory domain. Therefore, this near-infrared spectroscopy study focused on neuronal correlates of affective prosody processing. Fourteen boys suffering from ADHD and fourteen healthy boys were exposed to emotionally intoned, standardized sentences of the categories anger, sadness, happiness, and to affectively neutral sentences. Relative to controls, the patients displayed a diminished activation of the right superior temporal gyrus (STG) when processing anger prosody, which was correlated with aggressive behavior. There were no group differences for the other emotions. Additionally, the ADHD group showed increased supramarginal gyrus (SMG) activation in the anger condition. This might mirror compensatory attention allocation. In summary, we identified a selectively lowered STG activation to auditory anger cues in ADHD patients. Consequently, STG recruitment during anger exposure might be used for evaluation of psychotherapy effects.
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Affiliation(s)
- Angelika Köchel
- a Department of Clinical Psychology , University of Graz , Graz , Austria
| | | | | | - Anne Schienle
- a Department of Clinical Psychology , University of Graz , Graz , Austria
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