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Ferrin M, Häge A, Swanson J, Wong KHTW, Dittmann RW, Banaschewski T, Coghill D, Santosh PJ, Romanos M, Simonoff E, Buitelaar JK. Medication adherence and persistence in children and adolescents with attention deficit hyperactivity disorder (ADHD): a systematic review and qualitative update. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02538-z. [PMID: 39105823 DOI: 10.1007/s00787-024-02538-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 07/15/2024] [Indexed: 08/07/2024]
Abstract
Low medication-adherence and persistence may reduce the effectiveness of ADHD-medication. This preregistered systematic review (PROSPERO CRD42020218654) on medication-adherence and persistence in children and adolescents with ADHD focuses on clinically relevant questions and extends previous reviews by including additional studies. We included a total of n = 66 studies. There was a lack of consistency in the measurement of adherence/persistence between studies. Pooling the medication possession ratios (MPR) and using the most common adherence definition (MPR ≥ 80%) indicated that only 22.9% of participants had good adherence at 12-month follow-up. Treatment persistence on medication measured by treatment duration during a 12-month follow-up averaged 170 days (5.6 months). Our findings indicate that medication-adherence and persistence among youth with ADHD are generally poor and have not changed in recent years. Clinicians need to be aware that various factors may contribute to poor adherence/persistence and that long-acting stimulants and psychoeducational programs may help to improve adherence/persistence. However, the evidence to whether better adherence/persistence contributes to better long-term outcomes is limited and requires further research.
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Affiliation(s)
- Maite Ferrin
- Child and Adolescent Mental Health Service, Barnet Enfield and Haringey NHS Trust, London, UK.
- ReCognition Health, London, UK.
| | - Alexander Häge
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - James Swanson
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Kirstie H T W Wong
- Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China
- Research Department of Practice and Policy, UCL School of Pharmacy, Mezzanine Floor, BMA House, Tavistock Square, London, WC1H 9JP, UK
| | - Ralf W Dittmann
- Paediatric Psychopharmacology, Dept of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Heidelberg, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - David Coghill
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Paramala J Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, UK
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Center of Mental Health, University Hospital Wuerzburg, Würzburg, Germany
| | - Emily Simonoff
- Institute of Psychiatry, Psychology and Neuroscience and Maudsley NIHR Biomedical Research Centre, King's College London, London, UK
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
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Wilkes-Gillan S, Parsons L, Parsons D, Mahoney N, Hancock N, Cordier R, Lincoln M, Chen YWR, Bundy A. An evaluation of intervention appropriateness from the perspective of parents: A peer-mediated, play-based intervention for children with ADHD. Aust Occup Ther J 2024. [PMID: 39032070 DOI: 10.1111/1440-1630.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 07/03/2024] [Accepted: 07/04/2024] [Indexed: 07/22/2024]
Abstract
INTRODUCTION A peer-mediated, play-based intervention has been developed to address social participation challenges experienced by children with ADHD. To facilitate implementation into clinical practice, interventions should be evaluated for appropriateness to the end-user, as well as effectiveness. Previous research demonstrated the approach is effective for improving children's social play skills. This study aimed to evaluate the appropriateness of the intervention for children with ADHD and their families. METHODS Parents of children with ADHD who participated in the play-based intervention were interviewed 1 month after completion. Parents were asked about their perspective of parent and children's experiences of the intervention, the perceived benefits for children and parents, the logistics of participating, and recommended adaptations to the intervention. Interviews were analysed thematically, and themes were mapped to the elements of the adopted definition of appropriateness to understand whether parents supported the appropriateness of the intervention for their families. CONSUMER AND COMMUNITY INVOLVEMENT Consumers were not directly involved in the decisions made about this study. FINDINGS One core theme, 'collaborative efforts', emerged from the data. Major themes comprising the core theme were 'on the same page', 'therapeutic relationship', and 'getting the job done'. Three sub-themes of 'engagement and motivation', 'the effort was worth it for the reward', and 'Rome wasn't built in a day' were nested within the major themes. CONCLUSION Parents largely supported the appropriateness of the intervention, indicating it addressed an important goal for their child, participation was a positive experience, and they perceived the intervention to be beneficial. Future adaptions of the intervention are needed to increase its ecological validity and to generalise the strategies to other social environments and playmates, such as peers at school. PLAIN LANGUAGE SUMMARY This study looked at an intervention that uses play with peers to help children with ADHD develop their play skills. The researchers wanted to know if parents thought the intervention was a good fit for their families and if it helped their children. Parents gave an interview a month after the intervention ended. They were asked about their thoughts on the intervention, how it helped their children and themselves, how easy it was to take part, and what changes could be made to make the intervention better. After analysing parents' answers, the researchers found parents mostly agreed that the intervention was a good fit. They said it helped their children to play with their peers, and they had a good time doing it. Parents thought the intervention was helpful, they liked that it was a joint effort between them and the occupational therapist, and they felt it was worth the effort. However, they also suggested some changes. They wanted the intervention to fit into other real-life social situations, such as school, so their children could use the skills they learned in other places. Overall, parents thought the intervention was helpful and suitable for their children and themselves, but some changes might make it more helpful.
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Affiliation(s)
- Sarah Wilkes-Gillan
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lauren Parsons
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Dave Parsons
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Natasha Mahoney
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Nicola Hancock
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Reinie Cordier
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Department of Social Work, Education and Community Wellbeing, Faculty of Health and Life Sciences, University of North Umbria, Newcastle upon Tyne, UK
| | - Michelle Lincoln
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Yu-Wei Ryan Chen
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Anita Bundy
- Department of Occupational Therapy, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado, USA
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Fabiano GA, Lupas K, Merrill BM, Schatz NK, Piscitello J, Robertson EL, Pelham WE. Reconceptualizing the approach to supporting students with attention-deficit/hyperactivity disorder in school settings. J Sch Psychol 2024; 104:101309. [PMID: 38871418 PMCID: PMC11331420 DOI: 10.1016/j.jsp.2024.101309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 09/19/2023] [Accepted: 03/16/2024] [Indexed: 06/15/2024]
Abstract
The long-term academic outcomes for many students with attention-deficit/hyperactivity disorder (ADHD) are strikingly poor. It has been decades since students with ADHD were specifically recognized as eligible for special education through the Other Health Impaired category under the Education for all Handicapped Children Act of 1975, and similarly, eligible for academic accommodations through Section 504 of the 1973 Rehabilitation Act. It is time to acknowledge that these school-policies have been insufficient for supporting the academic, social, and behavioral outcomes for students with ADHD. Numerous reasons for the unsuccessful outcomes include a lack of evidence-based interventions embedded into school approaches, minimizing the importance of the general education setting for promoting effective behavioral supports, and an over-reliance on assessment and classification at the expense of intervention. Contemporary behavioral support approaches in schools are situated in multi-tiered systems of support (MTSS); within this article we argue that forward-looking school policies should situate ADHD screening, intervention, and maintenance of interventions within MTSS in general education settings and reserve special education eligibility solely for students who require more intensive intervention. An initial model of intervention is presented for addressing ADHD within schools in a manner that should provide stronger interventions, more quickly, and therefore more effectively.
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Rattay K, Robinson LR. Identifying Risk Factors for Attention-Deficit/Hyperactivity Disorder (ADHD): a Public Health Concern and Opportunity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:195-202. [PMID: 38598041 PMCID: PMC11315233 DOI: 10.1007/s11121-024-01667-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with significant individual and societal negative impacts of the disorder continuing into adulthood (Danielson et al. in Journal of Clinical Child and Adolescent Psychology, in press; Landes and London in Journal of Attention Disorders 25:3-13, 2021). Genetic and environmental risk (e.g., modifiable exposures such as prenatal tobacco exposure and child maltreatment) for ADHD is likely multifactorial (Faraone et al. in Neuroscience & Biobehavioral Reviews 128:789-818, 2021). However, the evidence for potentially modifiable contextual risks is spread across studies with different methodologies and ADHD criteria limiting understanding of the relationship between early risk factors and later childhood ADHD. Using common methodology across six meta-analyses (Bitsko et al. in Prevention Science, 2022; Claussen et al. in Prevention Science 1-23, 2022; Dimitrov et al. in Prevention Science, 2023; Maher et al. in Prevention Science, 2023; Robinson, Bitsko et al. in Prevention Science, 2022; So et al. in Prevention Science, 2022) examining 59 risk factors for childhood ADHD, the papers in this special issue use a public health approach to address prior gaps in the literature. This introductory paper provides examples of comprehensive public health approaches focusing on policy, systems, and environmental changes across socio-ecological contexts to improve health and wellbeing through prevention, early intervention, and support across development using findings from these meta-analyses. Together, the findings from these studies and a commentary by an author independent from the risk studies have the potential to minimize risk conditions, prioritize prevention efforts, and improve the long-term health and wellbeing of children and adults with ADHD.
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Affiliation(s)
- Karyl Rattay
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Lara R Robinson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention, Atlanta, GA, USA
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Weigard A, McCurry KL, Shapiro Z, Martz ME, Angstadt M, Heitzeg MM, Dinov ID, Sripada C. Generalizable prediction of childhood ADHD symptoms from neurocognitive testing and youth characteristics. Transl Psychiatry 2023; 13:225. [PMID: 37355620 PMCID: PMC10290685 DOI: 10.1038/s41398-023-02502-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/23/2023] [Accepted: 06/01/2023] [Indexed: 06/26/2023] Open
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) symptoms are believed to result from disrupted neurocognitive development. However, evidence for the clinical and predictive value of neurocognitive assessments in this context has been mixed, and there have been no large-scale efforts to quantify their potential for use in generalizable models that predict individuals' ADHD symptoms in new data. Using data drawn from the Adolescent Brain Cognitive Development Study (ABCD), a consortium that recruited a diverse sample of over 10,000 youth (ages 9-10 at baseline) across 21 U.S. sites, we develop and test cross-validated machine learning models for predicting youths' ADHD symptoms using neurocognitive abilities, demographics, and child and family characteristics. Models used baseline demographic and biometric measures, geocoded neighborhood data, youth reports of child and family characteristics, and neurocognitive tests to predict parent- and teacher-reported ADHD symptoms at the 1-year and 2-year follow-up time points. Predictive models explained 15-20% of the variance in 1-year ADHD symptoms for ABCD Study sites that were left out of the model-fitting process and 12-13% of the variance in 2-year ADHD symptoms. Models displayed high generalizability across study sites and trivial loss of predictive power when transferred from training data to left-out data. Features from multiple domains contributed meaningfully to prediction, including neurocognition, sex, self-reported impulsivity, parental monitoring, and screen time. This work quantifies the information value of neurocognitive abilities and other child characteristics for predicting ADHD symptoms and provides a foundational method for predicting individual youths' symptoms in new data across contexts.
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Affiliation(s)
| | | | - Zvi Shapiro
- Department of Psychology, Emory University, Atlanta, USA
| | - Meghan E Martz
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
| | - Ivo D Dinov
- Departments of Computational Medicine and Bioinformatics, and Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, USA
| | - Chandra Sripada
- Department of Psychiatry, University of Michigan, Ann Arbor, USA
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Zhao X, Hayes T, Timmons AC, Wu W, Frazier SL. Unpacking Inequities in ADHD Diagnosis: Examining Individual-Level Race/Ethnicity and State-Level Online Information-Seeking Patterns. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023:10.1007/s10488-023-01259-w. [PMID: 36929270 PMCID: PMC10020073 DOI: 10.1007/s10488-023-01259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 03/18/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent, persistent, and costly mental health condition. The internet is an increasingly popular source for information related to ADHD. With a nationally representative sample (2018 NSCH), we aimed to separate individual- and state-level effects to examine inequities in ADHD diagnoses. We extracted state-level relative search volumes using "ADHD," "ADHD treatment," "ADHD medication," and "ADHD therapy" from Google Trends, and sociodemographic and clinical variables from the 2018 National Survey of Children's Health (N = 26,835). We examined state variation in ADHD-related information-seeking and applied multilevel modeling to examine associations among individual-level race/ethnicity, state-level information-seeking patterns, and ADHD diagnoses. Online information seeking related to ADHD varies by state and search term. Individual-level racial/ethnic background and state-level information-seeking patterns were associated with ADHD diagnoses; however, their cross-level interaction was not significant. This study adds to the strong body of evidence documenting geographical variation and diagnostic disparity in mental health and the growing literature on the impact of the digital divide on population health, indicating an urgent need for addressing inequities in mental health care. Increasing public interest in and access to empirically supported online information may increase access to care, especially among people of color.
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Affiliation(s)
- Xin Zhao
- Department of Medicine, University of California at Irvine, Irvine, USA.
| | - Timothy Hayes
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, Miami, USA
| | - Adela C Timmons
- Department of Psychology, College of Liberal Arts, University of Texas at Austin, Austin, USA
| | - Wensong Wu
- Department of Mathematics and Statistics, College of Arts, Sciences, & Education, Florida International University, Miami, USA
| | - Stacy L Frazier
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, Miami, USA
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Español-Martín G, Pagerols M, Prat R, Rivas C, Ramos-Quiroga JA, Casas M, Bosch R. The impact of attention-deficit/hyperactivity disorder and specific learning disorders on academic performance in Spanish children from a low-middle- and a high-income population. Front Psychiatry 2023; 14:1136994. [PMID: 37124266 PMCID: PMC10130398 DOI: 10.3389/fpsyt.2023.1136994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Past research has demonstrated that attention-deficit/hyperactivity disorder (ADHD), specific learning disorders (SLD), and socioeconomic status (SES) affect a host of educational outcomes. However, there are no studies examining whether SES moderates the association between these neurodevelopmental disorders (ND) and the academic achievement of children and adolescents. The present investigation examined the impact of ADHD and SLD on academic performance in 1,287 Spanish students aged 5-17 from a low-middle (LM)- and a high-income population, when adjusted for comorbidity and demographic factors that may influence educational functioning. Methods Parents completed a questionnaire regarding demographic data along with the Strengths and Difficulties Questionnaire. Additionally, teachers provided information on learning difficulties trough the Protocol for Detection and Management of Dyslexia. Teacher's Version. Academic performance across multiple domains (i.e., first language, foreign language, mathematics) was obtained from school records. ND were determined using standardized diagnostic methods based on the Diagnostic and Statistical Manual of Mental Disorders criteria. To examine the effects of ADHD and SLD on academic achievement and the potential moderating role of SES, a series of ordinal logistic regressions were conducted. Results Emotional/behavioral problems, learning difficulties, and ND were more frequent among individuals from the LM-income population. After controlling for gender, age, parental divorce/separation, grade retention, frequency of screen use, and daily meals, both ADHD and SLD were associated with worse educational outcomes. Lower SES also increased the risk for academic impairment, although the interactions with ADHD or SLD were not significant. Conclusion These findings indicate that ADHD and SLD exert a pervasive impact on academic performance across different socioeconomic backgrounds. Therefore, early detection and effective intervention strategies aimed at students with these ND are crucial to improve their educational functioning and mitigate the negative consequences related to academic problems.
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Affiliation(s)
- Gemma Español-Martín
- Servei de Psiquiatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- Grup de Psiquiatria, Salut Mental i Addiccions, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Mireia Pagerols
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Unitat de Farmacologia, Departament de Fonaments Clínics, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Barcelona, Spain
- *Correspondence: Mireia Pagerols,
| | - Raquel Prat
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Centre for Health and Social Care Research (CEES), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain
| | - Cristina Rivas
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Josep Antoni Ramos-Quiroga
- Servei de Psiquiatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain
- Grup de Psiquiatria, Salut Mental i Addiccions, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Barcelona, Spain
- Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Miquel Casas
- Departament de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Rosa Bosch
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Programa MIND Escoles, Hospital Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
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Piscitello J, Altszuler AR, Mazzant JR, Babinski DE, Gnagy EM, Page TF, Molina BSG, Pelham WE. The Impact of ADHD on Maternal Quality of Life. Res Child Adolesc Psychopathol 2022; 50:1275-1288. [PMID: 35648330 PMCID: PMC9613519 DOI: 10.1007/s10802-022-00935-z] [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] [Accepted: 05/11/2022] [Indexed: 11/24/2022]
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) is associated with substantial burden to caregiver quality of life (QoL). However, a paucity of work has focused on quantifying QoL among caregivers of adolescents with a history of ADHD. The purpose of the current study was (1) to quantify maternal QoL in a sample of mothers of adolescents with and without childhood ADHD; and (2) to examine predictors (i.e., parent and child characteristics and behavior) associated with maternal QoL. Participants included mothers of adolescents with (N = 110) and without ADHD (N = 90) ranging in age from 13 to 18 (M = 16.09, 92% male). The Quality Adjusted Life-Year (QALY) was used to calculate maternal QoL using two health domains (i.e., anxiety/depression and disruption in daily activities) commonly impacted by raising youth with ADHD. QALYs are valued monetarily to estimate disease burden. Mothers of adolescents with childhood ADHD experienced significantly worse QoL relative to mothers in the comparison group. Maternal depression, as well as adolescent age, ADHD status, and discipline problems significantly predicted lower levels of maternal QALY health status index, with ADHD being the strongest predictor. This is equal to a reduction in 1.96 QALYs when summed over the course of a child's lifetime and is associated with a loss of $98,000 to $196,000. Results of the investigation help to further elucidate the health impacts incurred by families of adolescents with ADHD and have important public health implications. Further, parental QoL should be considered when conceptualizing the financial and negative health impact of ADHD.
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Affiliation(s)
- Jennifer Piscitello
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US.
| | - Amy R Altszuler
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US
| | - Jessica Robb Mazzant
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US
| | - Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, US
| | - Elizabeth M Gnagy
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US
| | - Timothy F Page
- Department of Management, H. Wayne Huizenga College of College of Business and Entrepreneurship, Nova Southeastern University, Davie, FL, US
| | - Brooke S G Molina
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, US
| | - William E Pelham
- Center for Children and Families, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, US
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de Vries S, Verheij R. Residential green space associated with the use of attention deficit hyperactivity disorder medication among Dutch children. Front Psychol 2022; 13:948942. [PMID: 36118499 PMCID: PMC9479333 DOI: 10.3389/fpsyg.2022.948942] [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] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/08/2022] [Indexed: 11/24/2022] Open
Abstract
Several studies have observed an inverse relationship between attention deficit hyperactivity disorder (ADHD)-related behavior of children, as reported by parents or teachers, and the amount of green space in their residential environment. Research using other, more objective measures to determine ADHD prevalence is scarce and could strengthen the evidence base considerably. In this study, it is investigated whether a similar beneficial association will be observed if the use of ADHD-related medication is selected as an outcome measure. More specifically, registry data from a health insurance company on the reimbursement of ADHD-related medication in 2011 were available for 248,270 children between 5 and 12 years of age. Amounts of green space within 250 and 500 m of the home address were calculated. Multilevel logistic regression analyses for the prevalence of use were conducted, including the following covariates: sex, age, urbanity of the neighborhood, neighborhood socioeconomic status (SES), and percentage of people with a non-Western migration background in the neighborhood population. Results showed that the amount of green space was inversely related to the prevalence of use of ADHD medication. Moreover, the relationship was strongest among children living in the least wealthy neighborhoods and absent among those living in the wealthiest neighborhoods. Results also show that in less wealthy neighborhoods, there is, on average, less green space available nearby: children who are likely to benefit most from nearby green space tend to have the least of it.
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Affiliation(s)
- Sjerp de Vries
- Wageningen Environmental Research, Wageningen University and Research, Wageningen, Netherlands
- Cultural Geography Chairgroup, Wageningen University and Research, Wageningen, Netherlands
| | - Robert Verheij
- Netherlands Institute for Health Services Research (Nivel), Utrecht, Netherlands
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
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Fioravante I, Lozano-Lozano JA, Martella D. Attention deficit hyperactivity disorder: A pilot study for symptom assessment and diagnosis in children in Chile. Front Psychol 2022; 13:946273. [PMID: 35992438 PMCID: PMC9387654 DOI: 10.3389/fpsyg.2022.946273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric disorders among school-age children and is characterized by varying degrees of inattention, hyperactivity, and impulsivity. Diagnosis, which currently relies on the DSM-V criteria, is complex. This research proposes an integrated procedure for ADHD diagnosis in children, improving the diagnostic process and scientific research on etiopathology. Materials and methods We conducted a clinical report on ADHD diagnosis in children (n = 92) between the ages of 8 and 13, based on the results of the application of different scales to parents of school-age children in Chile. The children were divided into two groups, those with an ADHD diagnosis (n = 44) and those without (n = 48) (24% females). Results The results revealed statistically significant differences between groups for scales EDAH y SDQ-Cas, Conners Comprehensive Behavior Scale, Conners Parent Scale and the criteria according to the DSM-V and its dimensions, with the exception of inattention. Conclusion The findings indicate the importance of appropriate criteria and procedures to establish a diagnosis and implement effective interventions in ADHD.
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Affiliation(s)
- Isabella Fioravante
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José Antonio Lozano-Lozano
- Instituto de Ciencias Biomédicas, Instituto Iberoamericano Desarrollo Sostenible, Claustro Académico del Doctorado en Ciencias Sociales, Universidad Autónoma de Chile, Santiago, Chile
| | - Diana Martella
- Departamento de Psicología, Universidad Loyola de Andalucía, Sevilla, Spain
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Fuller-Thomson E, Rivière RN, Carrique L, Agbeyaka S. The Dark Side of ADHD: Factors Associated With Suicide Attempts Among Those With ADHD in a National Representative Canadian Sample. Arch Suicide Res 2022; 26:1122-1140. [PMID: 33345733 DOI: 10.1080/13811118.2020.1856258] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIM This study investigated the prevalence and odds of suicide attempts among adults with attention deficit hyperactivity disorder (ADHD) compared to those without and identified factors associated with suicide attempts among adults with ADHD. METHODS Secondary analysis of the nationally representative Canadian Community Health Survey-Mental Health (CCHS-MH) (n = 21,744 adults, of whom 529 had ADHD). Respondents were asked whether they received an ADHD diagnosis from a health care professional. Lifetime suicide attempt was based on self-report. RESULTS Adults with ADHD were much more likely to have attempted suicide than those without (14.0% vs. 2.7%). One in four women with ADHD have attempted suicide. Sixty percent of the association between ADHD and attempted suicide was attenuated when lifetime history of depression and anxiety disorders were taken into account. Female gender, lower education attainment, substance abuse, lifetime history of depression, and childhood exposure to chronic parental domestic violence were found to be independent correlates of lifetime suicide attempts among those with ADHD. CONCLUSION These findings can inform targeted screening and outreach to the most vulnerable adults with ADHD.
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12
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Fabiano GA, Tower D, Valente M, Rejman E, Rodriguez Z. An Observational Study of the Morning and Evening Behavior of Individuals With and Without Attention-Deficit/Hyperactivity Disorder. J Atten Disord 2022; 26:1199-1211. [PMID: 34911376 DOI: 10.1177/10870547211063644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Evidence of ADHD symptoms and impairments were documented in the morning and evening hours for individuals diagnosed with ADHD. These results illustrate additional areas in need of attention in the refinement of treatments for adults with ADHD.
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Affiliation(s)
| | - Devon Tower
- Florida International University, Buffalo, NY, USA
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13
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O'Dell SM, Gormley MJ, Schlieder V, Klinger T, DeHart K, Kettlewell PW, Kulchak Rahm A. Perspectives of Rural Primary Care Clinicians on Pediatric Attention-Deficit/Hyperactivity Disorder Care. J Dev Behav Pediatr 2022; 43:273-282. [PMID: 35353792 DOI: 10.1097/dbp.0000000000001056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/15/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Despite efficacious treatments, evidence-based guidelines, and increased availability of integrated behavioral health care, youth coping with attention-deficit/hyperactivity disorder (ADHD) receive suboptimal care. More research is needed to understand and address care gaps, particularly within rural health systems that face unique challenges. We conducted a qualitative study within a predominantly rural health system with a pediatric-integrated behavioral health care program to address research gaps and prepare for quality improvement initiatives, including primary care clinician (PCC) trainings and clinical decision support tools in the electronic health record (EHR). METHOD Semistructured interviews were conducted with 26 PCCs representing clinics within the health system. Interview guides were based on the Practical Robust Implementation and Sustainability Model to elicit PCC views regarding determinants of current practices and suggestions to guide quality improvement efforts. We used thematic analysis to identify patterns of responding that were common across participants. RESULTS PCCs identified several internal and external contextual factors as determinants of current practices. Of note, PCCs recommended increased access to continuing education trainings held in clinic over lunch and delivered in less than 30 minutes. Suggested improvements to the EHR included incorporating parent and teacher versions of the Vanderbilt Rating Scale into the EHR, documentation templates aligned with evidence-based guidelines, and alerts and suggestions to aid medication management during appointments. CONCLUSION Future research to identify implementation strategies to help rural PCCs adopt innovations are needed given the increased responsibility for managing ADHD care and intractable gaps in access to behavioral health care in rural regions.
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Affiliation(s)
- Sean M O'Dell
- Departments of Population Health Sciences
- Psychiatry and Behavioral Health, Geisinger, Danville, PA
| | - Matthew J Gormley
- Psychiatry and Behavioral Health, Geisinger, Danville, PA
- Department of Educational Psychology, University of Nebraska-Lincoln, Lincoln, NE
| | | | - Tracey Klinger
- Investigator Initiated Research Operations, Geisinger, Danville, PA
| | - Kathy DeHart
- Department of Pediatrics, Geisinger, Danville, PA
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14
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Di Lonardo Burr SM, LeFevre JA, Arnold LE, Epstein JN, Hinshaw SP, Molina BSG, Hechtman L, Hoza B, Jensen PS, Vitiello B, Pelham WE, Howard AL. Paths to postsecondary education enrollment among adolescents with and without childhood attention-deficit/hyperactivity disorder (ADHD): A longitudinal analysis of symptom and academic trajectories. Child Dev 2022; 93:e563-e580. [PMID: 35635061 DOI: 10.1111/cdev.13807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We examined developmental trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms, standardized achievement, and school performance for adolescents with and without ADHD who did and did not enroll in postsecondary education (PSE; N = 749; 79% boys; 63% White, 17% non-Hispanic Black, 10% Hispanic, and 10% other ethnicities). In a multisite study (recruitment based in New York, North Carolina, Pennsylvania, California, and Quebec), participants were originally enrolled between 1994 and 1998 at ages 7 to 9.9 and followed up through 2012 (Mage = 25 at final follow-up). Adolescents who eventually enrolled in PSE had less severe symptoms, but differences were modest and trajectories were similar over time. For all adolescents, standardized achievement trajectories declined up to two thirds of a standard deviation from ages 9 to 17. By the end of high school, the average GPA of adolescents with ADHD was three quarters of a point higher for those who eventually enrolled in PSE compared to those who did not. Overall, school performance mattered more than academic achievement for understanding eventual enrollment of adolescents with ADHD.
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Affiliation(s)
- Sabrina M Di Lonardo Burr
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Cognitive Science, Carleton University, Ottawa, Ontario, Canada
| | - Jo-Anne LeFevre
- Department of Cognitive Science, Carleton University, Ottawa, Ontario, Canada.,Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, Ohio, USA
| | - Jeffrey N Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, California, USA
| | - Brooke S G Molina
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lily Hechtman
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Betsy Hoza
- Department of Psychological Science, University of Vermont, Burlington, Vermont, USA
| | - Peter S Jensen
- The REACH Institute, New York, New York, USA.,Department of Psychiatry, University of Arkansas for the Medical Sciences, Little Rock, Arkansas, USA
| | - Benedetto Vitiello
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - William E Pelham
- College of Arts, Sciences, and Education, Florida International University, Miami, Florida, USA
| | - Andrea L Howard
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
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15
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von Wirth E, Breuer D, Mandler J, Schürmann S, Döpfner M. Prediction of Educational Attainment and Occupational Functioning in Young Adults With a Childhood Diagnosis of ADHD: Results from the Cologne Adaptive Multimodal Treatment (CAMT) Study. J Atten Disord 2022; 26:1018-1032. [PMID: 34697953 DOI: 10.1177/10870547211045740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This longitudinal study examined early predictors of educational attainment and occupational functioning in adults with a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD). METHOD Participants (n = 70) of the Cologne Adaptive Multimodal Treatment (CAMT) Study were diagnosed with ADHD and received adaptive multimodal ADHD treatment during childhood. They were then followed through adolescence into adulthood. RESULTS Hierarchical regression analysis revealed that poor reading skill and externalizing behaviors in childhood were early predictors of educational and occupational difficulties in adulthood. The use of stimulant medication in childhood predicted lower high school achievement, probably because medication use was confounded by indication. The regression models improved when intelligence scores and/or externalizing behaviors, especially delinquency, assessed in adolescence were considered as additional predictors. CONCLUSION Children with ADHD, who continue to show reading difficulties and externalizing behavior problems after initial treatment, are at risk for educational and occupational difficulties and may need additional support.
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Affiliation(s)
- Elena von Wirth
- University of Cologne, Faculty of Medicine and University Hospital Cologne, School for Child and Asolescent Cognitive Behavior Therapy (AKiP), Cologne, Germany
| | - Dieter Breuer
- University of Cologne, Faculty of Medicine and University Hospital Cologne, School for Child and Asolescent Cognitive Behavior Therapy (AKiP), Cologne, Germany
| | - Janet Mandler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, School for Child and Asolescent Cognitive Behavior Therapy (AKiP), Cologne, Germany
| | - Stephanie Schürmann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, School for Child and Asolescent Cognitive Behavior Therapy (AKiP), Cologne, Germany
| | - Manfred Döpfner
- University of Cologne, Faculty of Medicine and University Hospital Cologne, School for Child and Asolescent Cognitive Behavior Therapy (AKiP), Cologne, Germany
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16
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Dickson KS, Sklar M, Chen SZ, Kim B. Characterization of multilevel influences of mental health care transitions: a comparative case study analysis. BMC Health Serv Res 2022; 22:437. [PMID: 35366865 PMCID: PMC8976965 DOI: 10.1186/s12913-022-07748-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Mental health care transitions are increasingly prioritized given their potential to optimize care delivery and patient outcomes, especially those focused on the transition from inpatient to outpatient mental health care. However, limited efforts to date characterize such mental health transition practices, especially those spanning multiple service setting contexts. Examination of key influences of inpatient to outpatient mental health care transitions across care contexts is needed to inform ongoing and future efforts to improve mental health care transitions. The current work aims to characterize multilevel influences of mental health care transitions across three United States-based mental health system contexts. METHODS A comparative multiple case study design was used to characterize transition practices within the literature examining children's, non-VA adult, and VA adult service contexts. Andersen's (1995) Behavioral Health Service Use Model was applied to identify and characterize relevant distinct and common domains of focus in care transitions across systems. RESULTS Several key influences to mental health care transitions were identified spanning the environmental, individual, and health behavior domains, including: community capacity or availability, cross-system or agency collaboration, provider training and experience related to mental health care transitions, client care experience and expectations, and client clinical characteristics or complexity. CONCLUSIONS Synthesis illustrated several common factors across system contexts as well as unique factors for further consideration. Our findings inform key considerations and recommendations for ongoing and future efforts aiming to plan, expand, and better support mental health care transitions. These include timely information sharing, enhanced care coordination and cross setting and provider communication, continued provider/client education, and appropriate tailoring of services to improve mental health care transitions.
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Affiliation(s)
- Kelsey S. Dickson
- Department of Child and Family Development, San Diego State University, San Diego, CA USA
- Child and Adolescent Services Research Center, San Diego, CA USA
| | - Marisa Sklar
- Child and Adolescent Services Research Center, San Diego, CA USA
- Department of Psychiatry, University of California, San Diego, San Diego, CA USA
- UC San Diego ACTRI Dissemination and Implementation Science Center, San Diego, CA USA
| | - Serena Z. Chen
- Harvard South Shore Psychiatry Residency Training Program, Harvard Medical School / VA Boston Healthcare System, Boston, MA USA
- Department of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Bo Kim
- Harvard South Shore Psychiatry Residency Training Program, Harvard Medical School / VA Boston Healthcare System, Boston, MA USA
- Department of Psychiatry, Harvard Medical School, Boston, MA USA
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA USA
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17
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Campez M, Raiker JS, Little K, Altszuler AR, Merrill BM, Macphee FL, Gnagy EM, Greiner AR, Musser ED, Coles EK, Pelham WE. An evaluation of the effect of methylphenidate on working memory, time perception, and choice impulsivity in children with ADHD. Exp Clin Psychopharmacol 2022; 30:209-219. [PMID: 33475395 PMCID: PMC8406432 DOI: 10.1037/pha0000446] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) consistently exhibit a stronger preference for immediate rewards than for larger rewards available following a delay on tasks measuring choice impulsivity (CI). Despite this, however, there remains a dearth of studies examining the impact of stimulant treatment on CI as well as associated higher order (e.g., working memory [WM]) and perceptual (e.g., time perception) cognitive processes. The present study examines the effect of osmotic release oral system methylphenidate (OROS-MPH) on CI, WM and time perception processes as well as the relation among these processes before and after taking a regimen of OROS-MPH. Thirty-five children (aged 7-12 years) with a diagnosis of ADHD participating in a concurrent stimulant medication study were recruited to complete computerized assessments of CI, WM, and time perception. Children completed the assessments after administration of a placebo as well as their lowest effective dose of OROS-MPH following a 2-week titration period. The results from one-sample t-tests indicated that OROS-MPH improves both CI and WM in youth with ADHD but does not impact time perception. Further, results revealed no significant association among the various indices of cognitive performance while taking placebo or OROS-MPH. Overall, the findings suggest that while OROS-MPH improves both CI and WM in youth with ADHD, improvements in CI as a result of OROS-MPH are unlikely to be associated with the improvements in WM given the lack of association among the two. Future studies should consider alternate cognitive, emotional, and motivational mechanisms that may account for the impact of OROS-MPH on CI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Mileini Campez
- Florida International University, Center for Children and Families
| | - Joseph S. Raiker
- Florida International University, Center for Children and Families
| | | | - Amy R. Altszuler
- Florida International University, Center for Children and Families
| | | | - Fiona L. Macphee
- Florida International University, Center for Children and Families
| | | | | | - Erica D. Musser
- Florida International University, Center for Children and Families
| | - Erika K. Coles
- Florida International University, Center for Children and Families
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18
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Chuang YC, Wang CY, Huang WL, Wang LJ, Kuo HC, Chen YC, Huang YJ. Two meta-analyses of the association between atopic diseases and core symptoms of attention deficit hyperactivity disorder. Sci Rep 2022; 12:3377. [PMID: 35232975 PMCID: PMC8888762 DOI: 10.1038/s41598-022-07232-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/09/2022] [Indexed: 02/06/2023] Open
Abstract
Studies in the field of neuroscience and psychology have hypothesized that a causal association exists between atopic diseases and attention-deficit/hyperactivity disorder (ADHD). Previous systematic reviews and meta-analyses have reported a higher risk of ADHD in children with atopic diseases; however, the relationship between ADHD symptoms and atopic diseases remains unclear. We systematically reviewed observational cross-sectional and longitudinal studies to investigate the relationship between atopic diseases and ADHD symptom severity (hyperactivity/impulsivity and inattention). The majority of studies showed a statistically significant association between atopic diseases and both ADHD symptoms, with substantial heterogeneity in the outcome of hyperactivity/impulsivity. Remarkably decreased heterogeneity and statistical significance were observed in the second meta-analysis of ADHD-related behavior symptoms in atopic patients without ADHD. Our study indicated that atopic diseases not only associated with ADHD but also ADHD symptoms severity. This association was even observed in children with subthreshold ADHD, indicating that atopic diseases may play a role in the spectrum of ADHD symptom severity. Trial registration: This study was registered on PROSPERO (registration ID: CRD42020213219).
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Affiliation(s)
- Yu-Chieh Chuang
- Department of General Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Ching-Yun Wang
- Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Jui Huang
- Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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19
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Cherkasova MV, Roy A, Molina BSG, Scott G, Weiss G, Barkley RA, Biederman J, Uchida M, Hinshaw SP, Owens EB, Hechtman L. Review: Adult Outcome as Seen Through Controlled Prospective Follow-up Studies of Children With Attention-Deficit/Hyperactivity Disorder Followed Into Adulthood. J Am Acad Child Adolesc Psychiatry 2022; 61:378-391. [PMID: 34116167 DOI: 10.1016/j.jaac.2021.05.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/28/2021] [Accepted: 06/01/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To describe adult outcome of people with attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood and its several key predictors via a review of 7 North American controlled prospective follow-up studies: Montreal, New York, Milwaukee, Pittsburgh, Massachusetts General Hospital (MGH), Berkeley, and 7-site Multimodal Treatment Study of Children With ADHD (MTA). METHOD All studies were prospective and followed children with a diagnosis of ADHD and an age- and gender-matched control group at regular intervals from childhood (6-12 years of age) through adolescence into adulthood (20-40 years of age), evaluating symptom and syndrome persistence, functional outcomes, and predictors of these outcomes. RESULTS The rates of ADHD syndrome persistence ranged from 5.7% to 77%, likely owing to varying diagnostic criteria and the source of information (self-report vs informant report) across the studies. However, all studies observed high rates of symptomatic persistence ranging from 60% to 86%. The 7 studies were largely consistent in finding that relative to control groups, research participants with childhood-diagnosed ADHD had significant impairments in the areas of educational functioning, occupational functioning, mental health, and physical health as well as higher rates of substance misuse, antisocial behavior, and unsafe driving. The most consistently observed predictors of functional outcomes included ADHD persistence and comorbidity, especially with disruptive behavior disorders. CONCLUSION Childhood ADHD has high rates of symptomatic persistence, which is associated with negative functional outcomes. Characteristics that predict these negative outcomes, such as comorbid disruptive behavior disorders, may be important targets for intervention.
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Affiliation(s)
| | | | | | | | - Gabrielle Weiss
- McGill University, Montreal, and the University of British Columbia, Vancouver, Canada
| | | | | | - Mai Uchida
- Massachusetts General Hospital, Harvard Medical School, Boston
| | - Stephen P Hinshaw
- University of California Berkeley and the University of California San Francisco, California
| | | | - Lily Hechtman
- McGill University Health Center, Montreal, Quebec, Canada; Division of Child Psychiatry, McGill University, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
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20
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Fuller-Thomson E, Carrique L, MacNeil A. Generalized anxiety disorder among adults with attention deficit hyperactivity disorder. J Affect Disord 2022; 299:707-714. [PMID: 34799150 DOI: 10.1016/j.jad.2021.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research has identified a link between Attention-Deficit Hyperactivity Disorder (ADHD) and Generalized Anxiety Disorder (GAD). The aims of this study were to investigate the relationship between ADHD and GAD, and to identify significant correlates of GAD among those with ADHD. METHODS Data were derived from the nationally representative 2012 Canadian Community Health Survey-Mental Health. The sample included 6,989 respondents aged 20-39, of whom 682 had GAD. Bivariate and logistic regression analyses were conducted to determine the degree to which the association between ADHD and GAD was attenuated by demographics, socioeconomic status, social support, spirituality, childhood adversities, depression, and substance abuse/dependence. Additional analyses were conducted using the subsample of those diagnosed with ADHD (n = 272) to determine factors associated with GAD. RESULTS 1 in 9 respondents with GAD had ADHD, in comparison to 1 in 33 of those without GAD. The age-sex-race adjusted odds of GAD were four-fold for those with ADHD in comparison to those without ADHD. After adjusting for all covariates, the odds of GAD were still more than double for those with ADHD. Factors associated with GAD among those with ADHD include being female, having an income <$40,000, having fewer close relationships, and having a lifetime history of depression. LIMITATIONS Cross-sectional design prohibits causal inferences. CONCLUSION The high co-morbidity between ADHD and GAD emphasizes the need for targeted intervention to support these often overlapping disorders.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada; Department of Family and Community Medicine & Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
| | - Lauren Carrique
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
| | - Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada; Institute for Life Course and Aging, University of Toronto, Toronto, ON, Canada
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21
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Rhodes JD, Kennedy TM, Walther CA, Gnagy EM, Pelham WE, Molina BS. Smoking-Specific Risk Factors in Early Adulthood That Mediate Risk of Daily Smoking by Age 29 for Children with ADHD. J Atten Disord 2022; 26:525-536. [PMID: 33769107 PMCID: PMC9747070 DOI: 10.1177/10870547211003664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To test whether smoking-specific risk factors in early adulthood mediate prediction to daily smoking from childhood ADHD. METHODS Participants were 237 with and 164 without childhood ADHD. A smoking risk profile score comprising smoking-specific factors measured between ages 18 to 25 (e.g., craving severity) and age of initiation was tested as mediator of the association between childhood ADHD and age 29 daily smoking. RESULTS Childhood ADHD predicted age 29 smoking (β = -.15, p = .019), 35% of ADHD versus 17% of nonADHD, and the profile score (β = -.07, p = .004), which in turn mediated prediction to age 29 daily smoking (β = -.03; p = .007). When tested individually, three profile variables (# cigarettes/day, difficulty concentrating during abstinence, and nicotine dependence) were significant mediators (ps = 0.005-0.038), above and beyond early adult smoking, ADHD persistence, and delinquency. CONCLUSIONS These behavioral smoking characteristics help explain later daily cigarette smoking for adults with ADHD histories and may need to be targeted in intervention.
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22
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Ludyga S, Ishihara T. Brain structural changes and the development of interference control in children with ADHD: The predictive value of physical activity and body mass index. NEUROIMAGE: CLINICAL 2022; 35:103141. [PMID: 36002962 PMCID: PMC9421503 DOI: 10.1016/j.nicl.2022.103141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/15/2022] [Accepted: 08/01/2022] [Indexed: 11/29/2022] Open
Abstract
Children with ADHD show deficits in interference control during preadolescence. Abnormalities in gray-white matter ratio contributed contribute to these deficits. Higher physical activity and lower body mass index predict higher interference control. Gray-white matter ratio underlies the predictive value of body mass index. Brain structure does not explain the predictive value of physical activity.
Background Children with ADHD face deficits in interference control due to abnormalities in brain structure. A low body mass index and high physical activity are factors promoting brain health and may have the potential to reduce ADHD-related cognitive deficits. We aimed to investigate the predictive values of ADHD, body mass index and physical activity for interference control and the potential mediation of these associations by brain structure. Method At 9 and 11 years, 4576 children with ADHD and neurotypical peers from the ABCD-cohort completed a Flanker task, anthropometric assessments and reported physical activity. Additionally, T1- and T2-weighted magnet resonance images were collected at both measurement time points. Results ADHD, lower physical activity and higher body mass index at baseline predicted lower interference control. Gray matter volume, surface area and gray-white matter ratio contributed to interference control. The longitudinal association between body mass index and interference control was mediated by gray-white-matter ratio. This mediating effect was stronger for children with ADHD than neurotypical peers and mainly restricted to regions associated with cognitive control. Conclusion The maintenance of a lower body mass index contributes to interference control by a tendency to normalize regional alterations in grey-white-matter ratio. Being compliant with physical activity also promises higher interference control, but brain structure does not seem to underlie this association.
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23
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Babinski DE, Sibley MH. Family-based treatments for attention-deficit/hyperactivity disorder: A review of family functioning outcomes in randomized controlled trials from 2010 to 2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:83-106. [PMID: 34779516 DOI: 10.1111/jmft.12572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/31/2021] [Indexed: 06/13/2023]
Abstract
This review details advances in randomized controlled trials of family-based treatments for attention-deficit/hyperactivity disorder (ADHD) conducted in the United States from 2010 to 2019, and the impact of these treatments on the domain of family functioning. Twenty-two studies were included in the review and three types of family treatments, integrated parent-child treatments, parent-directed treatments, and youth treatments with adjunctive parent involvement, were identified for children and adolescents. Studies point to considerable advancements in consideration of understudied and diverse populations, and results of the review show all three types of family interventions for ADHD should be considered well-established interventions addressing family functioning. Practical guidelines are offered, and future directions for research are discussed.
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Affiliation(s)
- Dara E Babinski
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Margaret H Sibley
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
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24
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Baweja R, Soutullo CA, Waxmonsky JG. Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care. World J Psychiatry 2021; 11:1206-1227. [PMID: 35070771 PMCID: PMC8717033 DOI: 10.5498/wjp.v11.i12.1206] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/20/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common and impairing behavioral health disorder, impacting over 5% of children worldwide. There are multiple evidence-based pharmacological and psychosocial treatments for ADHD, and greater service utilization is associated with improved acute and long-term outcomes. However, long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely. This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers. Families face a variety of structural and attitudinal barriers, ranging from cost and access to stigma and low self-efficacy to successfully implement change. There are multiple interventions that may enhance engagement with ADHD care including psychoeducation, integration of behavioral services in general medical settings, telehealth as well as specific adaptations to existing ADHD treatments, such as the use of motivational interviewing or shared decision making. Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers. Adding motivational interviewing, shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes. However, little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.
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Affiliation(s)
- Raman Baweja
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA 17033, United States
| | - Cesar A Soutullo
- Louis A. Faillace, MD Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77054, United States
| | - James G Waxmonsky
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA 17033, United States
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Zhao X, Kennedy TM, Hayes T, Gnagy EM, Pelham WE, Molina BSG. A measure of functioning in adults With ADHD: Psychometric properties of the general life functioning scale-parent version. J Clin Psychol 2021; 77:2894-2914. [PMID: 34862602 PMCID: PMC8767958 DOI: 10.1002/jclp.23285] [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: 01/22/2021] [Revised: 10/10/2021] [Accepted: 11/12/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The General Life Functioning Scale (GLF) was developed to provide a complementary alternative to existing measures of impairment. We examined the psychometric properties of the GLF-Parent version (GLF-P), given the known value of informant ratings. METHODS The GLF-P was administered to parents of adults with attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood and a nonADHD comparison group in the Pittsburgh ADHD Longitudinal Study. GLF-P ratings described 334 participants (ADHD = 186; comparison = 148) rated at age 25 (Mage = 24.80 years, SDage = 0.46, range = 24-26) and 401 participants (ADHD = 237; comparison = 164) rated at age 30 (Mage = 29.30, SDage = 0.64, range = 28-33). Exploratory (EFA) and confirmatory (CFA) factor analyses were used. RESULTS EFAs suggested and CFAs confirmed a five-factor solution. We found measurement invariance across diagnostic and age groups, satisfactory internal consistency, construct validity, and known-group validity. CONCLUSION Psychometric results suggest the GLF-P as a helpful adjunctive measure of functioning. Further research is needed to determine the utility of the GLF across diverse settings.
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Affiliation(s)
- Xin Zhao
- Center for Children and Families, Florida International University, Miami, Florida, USA
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Traci M. Kennedy
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Timothy Hayes
- Center for Children and Families, Florida International University, Miami, Florida, USA
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Elizabeth M. Gnagy
- Center for Children and Families, Florida International University, Miami, Florida, USA
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - William E. Pelham
- Center for Children and Families, Florida International University, Miami, Florida, USA
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Brooke S. G. Molina
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
- Department of Psychology, Pediatrics, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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White matter abnormalities associated with ADHD outcomes in adulthood. Mol Psychiatry 2021; 26:6655-6665. [PMID: 34035475 PMCID: PMC8613296 DOI: 10.1038/s41380-021-01153-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/24/2021] [Accepted: 04/29/2021] [Indexed: 02/04/2023]
Abstract
It remains unclear if previously reported structural abnormalities in children with ADHD are present in adulthood regardless of clinical outcome. In this study, we examined the extent to which focal-rather than diffuse-abnormalities in fiber collinearity of 18 major white matter tracts could distinguish 126 adults with rigorously diagnosed childhood ADHD (ADHD; mean age [SD] = 34.3 [3.6] years; F/M = 12/114) from 58 adults without ADHD histories (non-ADHD; mean age [SD] = 33.9 [4.1] years; F/M = 5/53) and if any of these abnormalities were greater for those with persisting ADHD symptomatology. To this end, a tract profile approach was used. After accounting for age, sex, handedness, and comorbidities, a MANCOVA revealed a main effect of group (ADHD < non-ADHD; F[18,155] = 2.1; p = 0.007) on fractional anisotropy (FA, a measure of fiber collinearity and/or integrity), in focal portions of white matter tracts involved in visuospatial processing and memory (i.e., anterior portion of the left inferior longitudinal fasciculus, and middle portion of the left and right cingulum angular bundle). Only abnormalities in the anterior portion of the left inferior longitudinal fasciculus distinguished probands with persisting versus desisting ADHD symptomatology, suggesting that abnormalities in the cingulum angular bundle might reflect "scarring" effects of childhood ADHD. To our knowledge, this is the first study using a tract profile approach to identify focal or widespread structural abnormalities in adults with ADHD rigorously diagnosed in childhood.
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Combined Treatment for Children with Attention-Deficit/Hyperactivity Disorder: Brief History, the Multimodal Treatment for Attention-Deficit/Hyperactivity Disorder Study, and the Past 20 Years of Research. J Dev Behav Pediatr 2021; 41 Suppl 2S:S88-S98. [PMID: 31996571 DOI: 10.1097/dbp.0000000000000777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Decades of research support 3 interventions for youth with attention-deficit/hyperactivity disorder (ADHD): behavioral intervention, stimulant medication, and their combination. However, professional organizations have long disagreed regarding the best approach for implementing evidence-based interventions for ADHD in practice. The accompanying Society of Developmental and Behavioral Pediatrics guidelines for complex ADHD provide a framework for initiating treatment with behavioral intervention and adding stimulant medication as necessary, resulting in combined/multimodal treatment for many, if not most, children. In this special article, we review the extant literature on combined treatment, with special emphasis on the past 15 years of research that have led to the recommendation for this approach. Specifically, we review the literature on dosing and sequencing of multimodal treatment for youth with ADHD and the impact of multimodal interventions on areas of functional impairment. The extant research provides clear support for a psychosocial-first approach in treating youth with complex ADHD.
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Zhao X, Coxe SJ, Timmons AC, Frazier SL. Mental Health Information Seeking Online: A Google Trends Analysis of ADHD. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:357-373. [PMID: 34553276 DOI: 10.1007/s10488-021-01168-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 01/03/2023]
Abstract
Health information influences consumer decision making to seek, select, and utilize services. Online searching for mental health information is increasingly common, especially by adolescents and parents. We examined historical trends and factors that may influence population-level patterns in information seeking for attention-deficit/hyperactivity disorder (ADHD). We extracted Google Trends data from January 2004 to February 2020. Keywords included "ADHD," "ADHD treatment," "ADHD medication," and "ADHD therapy." We examined trends (systematic change over time) and seasonality (repeating pattern of change) via time-series analyses and graphics. We also used interrupted time-series analyses to examine the impact of celebrity and pharmaceutical events. Queries of "ADHD medication" increase, while queries for "ADHD therapy" remain relatively low despite a positive linear trend. Searches for "ADHD treatment" displayed a downward trend in more recent years. Analyses on seasonality revealed that holiday breaks coincided with a decrease in search interest, while post-break periods illustrated a rise, and the ADHD Awareness Month (October) coincided with a rise of public interest in all four search terms. Celebrity effects were more prominent in earlier years; the "Own It" pharmaceutical campaign may have increased ADHD awareness and the specificity of searches for "ADHD medication." The anonymous, accessible, and low-cost nature of seeking information online makes search engines like Google important sources of mental health information. Changing search patterns in response to seasonal, advocacy, and media events highlight internet-based opportunities for raising awareness and disseminating empirically supported information.
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Affiliation(s)
- Xin Zhao
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, 11200 SW 8th Street, Miami, USA.
| | - Stefany J Coxe
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, 11200 SW 8th Street, Miami, USA
| | - Adela C Timmons
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, 11200 SW 8th Street, Miami, USA
| | - Stacy L Frazier
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, 11200 SW 8th Street, Miami, USA
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DuPaul GJ, Evans SW, Owens JS, Cleminshaw CL, Kipperman K, Fu Q, Benson K. School-based intervention for adolescents with attention-deficit/hyperactivity disorder: Effects on academic functioning. J Sch Psychol 2021; 87:48-63. [PMID: 34303447 DOI: 10.1016/j.jsp.2021.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/24/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
Multi-component training interventions such as the Challenging Horizons Program (CHP) improve organization skills and academic functioning of middle school students with attention-deficit/hyperactivity disorder (ADHD); however, few studies have investigated treatment for high school students. We explored the extent to which CHP adapted for high school would improve proximal (e.g., organization skills, homework performance) and distal (e.g., report card grades) academic outcomes through 6-month follow-up relative to a community care (CC) condition. Participants included 186 adolescents who were randomly assigned to CHP (n = 92; 80% male; M age = 15.0; SD = 0.8) or CC (n = 94; 78% male; M age = 15.1; SD = 0.9) with CHP delivered over one school year. Parent, teacher, and self-report ratings of organization skills and academic performance, report card grades, and achievement tests were collected across multiple occasions. Intent-to-treat analyses using hierarchical linear modeling revealed significant improvements of small to medium magnitude (d range = 0.32 to 0.58) for parent-rated organization skills, homework performance, and academic functioning at 6-month follow-up. CHP effect on grades was small, but associated with a less steep decline than that found for CC. No statistically significant effects on teacher or self-report ratings were obtained. CHP appears efficacious for ameliorating organization skills and homework performance deficits exhibited by high school students with ADHD and can protect against decline in report card grades experienced by these students. CHP may require supplementation with academic skills instruction for some students and may need implementation beyond one school year to produce durable effects.
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30
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Using Fidget Spinners to Improve On-Task Classroom Behavior for Students With ADHD. Behav Anal Pract 2021; 15:454-465. [DOI: 10.1007/s40617-021-00588-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/26/2022] Open
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Camp A, Pastrano A, Gomez V, Stephenson K, Delatte W, Perez B, Syas H, Guiseppi-Elie A. Understanding ADHD: Toward an Innovative Therapeutic Intervention. Bioengineering (Basel) 2021; 8:56. [PMID: 34062853 PMCID: PMC8147268 DOI: 10.3390/bioengineering8050056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 11/21/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a pervasive condition affecting persons across all age groups, although it is primarily diagnosed in children. This neurological condition affects behavior, learning, and social adjustment and requires specific symptomatic criteria to be fulfilled for diagnosis. ADHD may be treated with a combination of psychological or psychiatric therapeutic interventions, but it often goes unattended. People with ADHD face societal bias challenges that impact how they manage the disorder and how they view themselves. This paper summarizes the present state of understanding of this disorder, with particular attention to early diagnosis and innovative therapeutic intervention. Contemporary understanding of the mind-brain duality allows for innovative therapeutic interventions based on neurological stimulation. This paper introduces the concept of neurostimulation as a therapeutic intervention for ADHD and poses the question of the relationship between patient adherence to self-administered therapy and the aesthetic design features of the neurostimulation device. By fabricating devices that go beyond safety and efficacy to embrace the aesthetic preferences of the patient, it is proposed that there will be improvements in patient adherence to a device intended to address ADHD.
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Affiliation(s)
- Allyson Camp
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Amanda Pastrano
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Valeria Gomez
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Kathleen Stephenson
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - William Delatte
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Brianna Perez
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Hunter Syas
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Anthony Guiseppi-Elie
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
- Houston Methodist Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Ave., Houston, TX 77030, USA
- Department of Electrical and Computer Engineering, College of Engineering, Anderson University, Anderson, SC 29621, USA
- ABTECH Scientific, Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, VA 23219, USA
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Chhibber A, Watanabe AH, Chaisai C, Veettil SK, Chaiyakunapruk N. Global Economic Burden of Attention-Deficit/Hyperactivity Disorder: A Systematic Review. PHARMACOECONOMICS 2021; 39:399-420. [PMID: 33554324 DOI: 10.1007/s40273-020-00998-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children and adults. Previous systematic reviews have provided estimates of ADHD-associated costs but were limited to the USA and Europe. OBJECTIVES This study aimed to systematically summarise all global evidence on the economic burden of ADHD. METHODS A systematic search for published studies on costs of ADHD was conducted in EconLit, EMBASE, PubMed, ERIC, and PsycINFO. Additional literature was identified by searching the reference lists of eligible studies. The quality of the studies was assessed using the Larg and Moss checklist. RESULTS This review included 44 studies. All studies were conducted in high-income countries and were limited to North America and Europe except for four studies: two in Asia and two in Australia. Most studies were retrospective and undertook a prevalence-based study design. Analysis revealed a substantial economic impact associated with ADHD. Estimates based on total costs ranged from $US831.38 to 20,538 for per person estimates and from $US356 million to 20.27 billion for national estimates. Estimates based on marginal costs ranged from $US244.15 to 18,751.00 for per person estimates and from $US12.18 million to 141.33 billion for national estimates. Studies that calculated economic burden across multiple domains of direct, indirect, and education and justice system costs for both children and adults with ADHD reported higher costs and translated gross domestic product than did studies that captured only a single domain or age group. CONCLUSIONS Despite the wide variation in methodologies in studies reviewed, the literature suggests that ADHD imposes a substantial economic burden on society. There is a dire need for cost-of-illness research in low- and middle-income countries to better inform the treatment and management of ADHD in these countries. In addition, guidelines on the conduct and reporting of economic burden studies are needed as they may improve standardisation of cost-of-illness studies.
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Affiliation(s)
- Anindit Chhibber
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | | | | | - Sajesh K Veettil
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, School of Pharmacy, University of Utah, Salt Lake City, UT, USA.
- School of Pharmacy, Monash University, Subang Jaya, Malaysia.
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Koerts J, Bangma DF, Fuermaier ABM, Mette C, Tucha L, Tucha O. Financial judgment determination in adults with ADHD. J Neural Transm (Vienna) 2021; 128:969-979. [PMID: 33709182 PMCID: PMC8295146 DOI: 10.1007/s00702-021-02323-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/01/2021] [Indexed: 11/27/2022]
Abstract
ADHD has a debilitating influence on everyday functioning, including the capability to make financial decisions. The capability to make financial decisions is a multidimensional construct that includes financial knowledge, financial judgment, financial performance and related contextual factors. So far, the majority of studies in adults with ADHD focused on financial performance, while the other aspects of financial capability were less explored. The current study aims to partly bridge this gap by examining the ability of financial judgment in adults with ADHD. Thirty-nine adults with ADHD and 83 adults without ADHD were included. All participants were assessed with the Financial Competence Assessment Inventory (FCAI) and Financial Decision-Making Interview (FDMI) which both assess the four abilities of financial judgment, i.e., understanding, appreciation, reasoning and communication. The results show that adults with ADHD, compared to adults without ADHD, obtained significantly lower scores on understanding (according to the FCAI and FDMI). Furthermore, adults with ADHD showed a significantly lower appreciation, reasoning and communication (according to the FCAI) than adults without ADHD. In conclusion, adults with ADHD have difficulties with financial judgment especially with the ability to understand information that is relevant for a financial situation or transaction. Furthermore, adults with ADHD were found to have problems with appreciating, reasoning and communicating about practical information that partly relates to their own financial situation (as assessed with the FCAI). A careful assessment of financial capability in adults with ADHD, therefore, appears warranted in clinical practice.
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Affiliation(s)
- Janneke Koerts
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Dorien F Bangma
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
| | - Christian Mette
- Department of Social Work and Education, Protestant University of Applied Sciences Bochum, Bochum, Germany
- LVR Hospital Essen, Essen, Germany
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Duisburg-Essen, Germany
| | - Lara Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
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Kennedy TM, Walther CAP, Pedersen SL, McKone KMP, Gnagy EM, Pelham WE, Molina BSG. Beers with Peers: Childhood ADHD and Risk for Correlated Change in Perceived Peer and Personal Alcohol Use Across Young Adulthood. Alcohol Clin Exp Res 2020; 44:2350-2360. [PMID: 32966613 PMCID: PMC7680395 DOI: 10.1111/acer.14467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 09/14/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND ADHD poses risk for problematic alcohol use through adulthood. Perceived peer alcohol use, one of the strongest correlates of individuals' own alcohol use, is especially salient for adolescents with ADHD. The extent to which this risk extends into young adulthood is unknown, as well as how change in these constructs is associated throughout young adulthood. METHODS In the Pittsburgh ADHD Longitudinal Study, 358 individuals with childhood-diagnosed ADHD and 239 without were prospectively followed from ages 18 to 29. Piecewise, bivariate longitudinal growth modeling was used to examine the change in both peer alcohol use and individuals' heavy drinking (binge-drinking frequency), their between-person associations, and differences by ADHD group. The addition of structured residuals probed within-person year-to-year change in peer and personal alcohol use and their prospective associations. RESULTS Perceived peer alcohol use and individuals' heavy drinking frequencies changed together over time concurrently-from ages 18 to 21 (piece 1) and 21 to 29 (piece 2). Prospectively, individuals who increased the most in heavy drinking from ages 18 to 21 reported more friends using alcohol at age 29, regardless of ADHD history. Within-person increases in personal alcohol use likewise predicted increased perceived peer use the subsequent year within each age group (piece), regardless of ADHD history. However, while decreasing perceived peer use from ages 21 to 29 was related to more frequent heavy drinking at age 29 for those without ADHD, increasing perceived peer use from ages 18 to 21 predicted more frequent heavy drinking at age 29 for those with ADHD. CONCLUSIONS Young adult heavy drinking changes in tandem with perceived peer alcohol use across individuals and predicts selection of alcohol-using peers from year to year within individuals, further into adulthood than previously documented. Findings suggest the centrality of relationships with alcohol-consuming friends in relation to one's heavy drinking, especially for young adults with ADHD histories, through the twenties.
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Affiliation(s)
- Traci M Kennedy
- From the, University of Pittsburgh, (TMK, SLP, KMPM, BSGM), Pittsburgh, Pennsylvania, USA
| | | | - Sarah L Pedersen
- From the, University of Pittsburgh, (TMK, SLP, KMPM, BSGM), Pittsburgh, Pennsylvania, USA
| | - Kirsten M P McKone
- From the, University of Pittsburgh, (TMK, SLP, KMPM, BSGM), Pittsburgh, Pennsylvania, USA
| | | | - William E Pelham
- Florida International University, (EMG, WEP), Miami, Florida, USA
| | - Brooke S G Molina
- From the, University of Pittsburgh, (TMK, SLP, KMPM, BSGM), Pittsburgh, Pennsylvania, USA
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35
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Martella D, Aldunate N, Fuentes LJ, Sánchez-Pérez N. Arousal and Executive Alterations in Attention Deficit Hyperactivity Disorder (ADHD). Front Psychol 2020; 11:1991. [PMID: 32903419 PMCID: PMC7434859 DOI: 10.3389/fpsyg.2020.01991] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/17/2020] [Indexed: 12/27/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in childhood and can significantly affect a child's personal and social development and academic achievement. Taking into account the model of attentional networks proposed by Posner et al., the aim of the present study was to review the literature regarding two main explicative models of ADHD, i.e., the inhibition model and the cognitive-energetic model, by discussing behavioral and neurological evidence of both models and the limitations of each model. The review highlights evidence that favors the energetic model and points to an unstable arousal as a potential pathogenetic factor in ADHD.
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Affiliation(s)
- Diana Martella
- Facultad de Ciencias Sociales y Humanidades, Instituto de Estudios Sociales y Humanísticos, Universidad Autónoma de Chile, Santiago, Chile
| | - Nerea Aldunate
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis J. Fuentes
- Departamento de Psicología Básica y Metodología, Facultad de Psicología, Universidad de Murcia, Murcia, Spain
| | - Noelia Sánchez-Pérez
- Departamento de Psicología y Sociología, Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain
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