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Bhide S, Efron D, Ukoumunne OC, Anderson V, Nicholson JM, Silk T, Hazell P, Gulenc A, Sciberras E. Family Functioning in Children With ADHD and Subthreshold ADHD: A 3-Year Longitudinal Study. J Atten Disord 2024; 28:480-492. [PMID: 38084374 PMCID: PMC10838481 DOI: 10.1177/10870547231217089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To compare family functioning over time for elementary school children with Attention-Deficit/Hyperactivity Disorder (ADHD; N = 179) and subthreshold ADHD (ST-ADHD; N = 86), to children without ADHD (Control; N = 212). METHOD ADHD was assessed using the Conners 3 ADHD Index and Diagnostic Interview Schedule for Children IV. At baseline, 18-month follow-up and 36-month follow-up, parents completed measures assessing a range of family functioning domains. RESULTS At baseline, the ADHD group reported higher psychological distress, less parenting self-efficacy, less parenting consistency, and more stressful life events; and both groups reported poorer family quality of life (QoL) and greater parenting anger. Trajectories were largely similar to controls (i.e., stable over time), but unlike controls, ADHD and ST-ADHD groups showed lessening parent-partner support and parenting warmth, respectively; and both groups showed worsening aspects of family QoL. CONCLUSION Families of children with ADHD and ST-ADHD report persistently poor or worsening family functioning; highlighting a need for tailored psycho-social supports.
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Affiliation(s)
- Sampada Bhide
- School of Pychology, Deakin University, Geelong, VIC, Australia
- Allied Health - Psychology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Daryl Efron
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Medical School, The University of Melbourne, Parkville, VIC, Australia
- The Royal Children's Hospital, Parkville, VIC, Australia
| | - Obioha C Ukoumunne
- National Institute for Health and Care Research Applied Research Collaboration South West Peninsula, University of Exeter, Exeter, United Kingdom
| | - Vicki Anderson
- Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Medical School, The University of Melbourne, Parkville, VIC, Australia
- The Royal Children's Hospital, Parkville, VIC, Australia
| | - Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Bundoora, VIC, Australia
| | - Tim Silk
- School of Pychology, Deakin University, Geelong, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Philip Hazell
- Discipline of Psychiatry, School of Medicine, The University of Sydney and Westmead Hospital, NSW, Australia
| | - Alisha Gulenc
- Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Emma Sciberras
- School of Pychology, Deakin University, Geelong, VIC, Australia
- Murdoch Children's Research Institute, Parkville, VIC, Australia
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Tsai CS, Hsiao RC, Yen CF. Caregivers' difficulty in managing sleep behaviors of children with attention-deficit/hyperactivity disorder and related factors during the COVID-19 pandemic. Kaohsiung J Med Sci 2023; 39:544-545. [PMID: 36912497 DOI: 10.1002/kjm2.12667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/18/2023] [Accepted: 01/29/2023] [Indexed: 03/14/2023] Open
Affiliation(s)
- Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ray C Hsiao
- Department of Psychiatry, Seattle Children's, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan
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Wang LJ, Kou KC, Tang KS, Lee Y, Chen YC, Lo MH, Lee IK, Chuah SK, Lee CT, Kung CT, Wang CC, Chien SJ. Parental Attitudes, Intentions, Decisions, and Psychological Wellbeing Regarding COVID-19 Vaccination: Preschool, School-Age, and Adolescent Caregivers. Vaccines (Basel) 2022; 10:vaccines10122114. [PMID: 36560524 PMCID: PMC9782239 DOI: 10.3390/vaccines10122114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
The vaccination of all children may be one of the most important public health measures for preventing a wider spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the community. Therefore, the purpose of this study was to investigate the attitude, intention, decision making, and psychological well-being among the caregivers of children who received SARS-CoV-2 vaccination in Taiwan. The caregivers of children (98 preschool children, 191 school-age children, and 154 adolescents) who received COVID-19 vaccination were invited to fill in the following questionnaires: Adopting Self-Protective Behavior Scale, Drivers of COVID-19 Vaccination Acceptance Scale, Impact of Event Scale, Chinese Health Questionnaire, and Parental Bonding Instrument. Compared to the caregivers of adolescents, the caregivers of preschool children exhibited more protective behaviors toward the COVID-19 pandemic. The caregivers of preschool children also displayed a higher emotional impact than those of adolescents and took a greater interest in the family's opinion about vaccination. Finally, we found that COVID-19 ideological invasion and protective parenting style were significantly related to the prevalence of mental illness among caregivers. The results of this study can be used as an important reference for vaccination health care and policy formulation for adolescents with regard to COVID-19.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Kuang-Che Kou
- Division of Pediatric Infection, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Kuo-Shu Tang
- Division of Pediatric Emergency, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Yi-Chun Chen
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Mao-Hung Lo
- Division of Pediatric Cardiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Ing-Kit Lee
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Seng-Kee Chuah
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Chien-Te Lee
- Department of Nephrology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Chia-Te Kung
- Department of Emergency, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Chih-Chi Wang
- Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Correspondence: (C.-C.W.); (S.-J.C.); Tel.: +886-975056193 (S.-J.C.); Fax: +886-7-7338009 (S.-J.C.)
| | - Shao-Ju Chien
- Division of Pediatric Cardiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Correspondence: (C.-C.W.); (S.-J.C.); Tel.: +886-975056193 (S.-J.C.); Fax: +886-7-7338009 (S.-J.C.)
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Lee YC, Chen VCH, Liang SHY, Kelsen BA. Mother-Child Interaction of Boys With ADHD: A Behavioral Observation Study. J Atten Disord 2022; 26:1738-1746. [PMID: 35611550 DOI: 10.1177/10870547221101649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Investigate the quality of mothers' interactions with children with ADHD and a marginal disturbance in socioemotional competence (MDSC). RESEARCH METHODS A total of 49 mother-boy dyads were included, and we observed their communication on neutral and conflict topics for children with ADHD and MDSC, children with ADHD alone, and children with typical development (TD). The Chinese version of the Specific Affect Coding System 20-code was used to examine the affective presentation in communication. RESULTS Mothers of children with ADHD and MDSC had less negative disengagement affect compared with those of children with ADHD alone. Boys with ADHD and MDSC and boys with TD had constant positive engagement between neutral and conflict conditions in parent-child interaction. Boys with ADHD and MDSC had significantly less positive affect and more neutral affect than children with ADHD only. CONCLUSIONS AND IMPLICATIONS Boys with ADHD and MDSC and their mothers had worse quality of observed mother-child communication than children with ADHD only and their mothers.
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Chen CY, Chen JS, Lin CY, Hsiao RC, Tsai CS, Yen CF. Difficulties in Managing Children's Learning among Caregivers of Children with Attention-Deficit/Hyperactivity Disorder during the COVID-19 Pandemic in Taiwan: Association with Worsened Behavioral and Emotional Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13722. [PMID: 36360603 PMCID: PMC9659146 DOI: 10.3390/ijerph192113722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
School closures during the COVID-19 pandemic have interfered with children's learning. The aim of this study was to investigate the difficulties in managing children's learning at home and attending afterschool learning programs and their related factors among caregivers of children with attention-deficit/hyperactivity disorder (ADHD) during the COVID-19 pandemic. In total, 252 caregivers of children with ADHD completed a questionnaire collecting difficulties in managing children's learning, parenting styles, children's worsened symptoms of ADHD, oppositional defiant disorder (ODD) and emotion, and increased Internet use. Multivariate logistic regression models were used to examine the factors related to caregiver difficulties in managing children's learning and children's worsened ADHD, ODD, and emotional symptoms. In total, 85.3% of the caregivers had difficulty in asking their children to learn at home; 28.2% had difficulty in taking children to afterschool learning programs. Children's worsened anger was significantly associated with higher caregiver difficulty in asking children to learn at home, whereas parental overprotection was significantly associated with lower caregiver difficulty in asking children to learn at home. Worsened hyperactivity and opposition were significantly associated with higher caregiver difficulty in taking children to attend afterschool learning programs. Interventions for enhancing caregivers' skills to manage children's learning and children's behavioral and emotional symptoms should take the related factors found in this study into consideration.
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Affiliation(s)
- Chao-Ying Chen
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Internal Medicine/Pediatric, New Taipei City Tucheng Hospital (Chang Gung Medical Foundation), New Taipei City 23652, Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, Kaohsiung 82445, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98295, USA
- Department of Psychiatry, Seattle Children’s, Seattle, WA 98105, USA
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Psychiatry, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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Tsai CS, Wang LJ, Hsiao RC, Yen CF. Second Wave of the Study of Taiwanese Caregivers of Children with ADHD in the COVID-19 Pandemic: Intentions to Vaccinate Their Children for COVID-19, and Related Factors. Vaccines (Basel) 2022; 10:753. [PMID: 35632509 PMCID: PMC9145748 DOI: 10.3390/vaccines10050753] [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: 04/14/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 12/04/2022] Open
Abstract
The second wave of the Study of Taiwanese Caregivers of Children with Attention-Deficit/Hyperactivity Disorder (ADHD) in the COVID-19 Pandemic was conducted at the time of a severe COVID-19 outbreak. The aims of this study were to compare the level of the intentions of caregivers of children with ADHD to vaccinate their children between the first and second waves of study, as well as to examine the COVID-19 pandemic and non-COVID-19 pandemic factors related to caregivers' intentions. In total, 252 caregivers of children with ADHD completed the structured questionnaires, including the Drivers of COVID-19 Vaccination Acceptance Scale; the Risk Perception of the COVID-19 Scale; caregivers' Difficulties in Asking Their Children to Adopt Self-Protective Behavior Scale; the Brief Symptom Rating Scale; the Parental Bonding Instrument; the Swanson, Nolan, and Pelham version IV Scale; and the questionnaires for the intentions to vaccinate their children and child's medication use for treating ADHD. The results demonstrated that 82.5% of caregivers reported their willingness to vaccinate their children definitely or under doctors' recommendation; the level of intentions to vaccinate significantly increased compared with that of caregivers in the first wave of the study. Caregivers' drivers of COVID-19 vaccination uptake, namely, values, impact, and autonomy but not knowledge; being male caregivers; being caregivers of girls; and the older age of the children were positively associated with caregiverscaregivers' intentions. The specific intervention programs for enhancing caregivers' intentions should be specified according to the sex and age of caregivers and of the children with ADHD. The Drivers of COVID-19 Vaccination Uptake should be also the target of intervention for enhancing caregivers' intentions through strengthening caregivers' acceptance of the COVID-19 vaccines' values, positive impact and autonomy to vaccinate their children.
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Affiliation(s)
- Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (C.-S.T.); (L.-J.W.)
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (C.-S.T.); (L.-J.W.)
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry, Children’s Hospital, Seattle, WA 98105, USA;
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
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Lee JI, Hsiao RC, Tsai CS, Yen CF. Caregivers' Difficulty in Managing Smartphone Use of Children with Attention-Deficit/Hyperactivity Disorder during the COVID-19 Pandemic: Relationships with Caregiver and Children Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095194. [PMID: 35564588 PMCID: PMC9104195 DOI: 10.3390/ijerph19095194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/17/2022] [Accepted: 04/24/2022] [Indexed: 02/01/2023]
Abstract
This study examined the difficulty encountered by caregivers of children with attention-deficit/hyperactivity disorder (ADHD) in managing children’s smartphone use during the coronavirus disease 2019 (COVID-19) pandemic and the caregiver- and children-related factors that influence this difficulty. In total, 252 caregivers of children with ADHD were recruited into this study. The caregivers completed a research questionnaire to provide data regarding the difficulty they encountered in managing the smartphone use of children during the COVID-19 pandemic, their general mental health and parenting styles, and the ADHD and oppositional defiant disorder (ODD) symptoms of the children they are caring for. The results indicated that almost 45% of the caregivers of children with ADHD sometimes or often found it difficult to manage the smartphone use of children with ADHD during the COVID-19 pandemic. For the caregivers, a short duration of education, poor general mental health, unaffectionate/uncaring and overprotective parenting styles, older children, and inattention and ODD symptoms were significantly associated with increased difficulty in managing their children’s smartphone use during the COVID-19 pandemic. On the basis of the relevant factors identified in this study, an intervention should be developed to enhance the skills of caregivers of children with ADHD with respect to the management of children’s smartphone use during the COVID-19 pandemic.
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Affiliation(s)
- Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Children’s Hospital, Seattle, WA 98105, USA;
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung 83301, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (C.-S.T.); (C.-F.Y.); Tel.: +886-7-7317123 (ext. 8751) (C.-S.T.); +886-7-3121101 (ext. 6816) (C.-F.Y.); Fax: +886-7-7326817 (C.-S.T.); +886-7-3134761 (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
- Correspondence: (C.-S.T.); (C.-F.Y.); Tel.: +886-7-7317123 (ext. 8751) (C.-S.T.); +886-7-3121101 (ext. 6816) (C.-F.Y.); Fax: +886-7-7326817 (C.-S.T.); +886-7-3134761 (C.-F.Y.)
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Poor Mental Health in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder and Its Relationships with Caregivers' Difficulties in Managing the Children's Behaviors and Worsened Psychological Symptoms during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189745. [PMID: 34574669 PMCID: PMC8470011 DOI: 10.3390/ijerph18189745] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 01/14/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has thrown out a challenge to caregivers of children with attention-deficit/hyperactivity disorder (ADHD). The present study examined the factors related to the poor general mental health state of the caregivers of children with ADHD during the COVID-19 pandemic, including (1) difficulties of caregivers in asking their child to adopt protective behaviors against COVID-19, (2) difficulties of caregivers in managing the child’s daily performance, and (3) worsened psychological symptoms in children. In total, 161 caregivers completed an online questionnaire to provide data regarding their general mental health state and difficulties in asking their child with ADHD to adopt protective behaviors against COVID-19 and in managing the child’s after-school learning, sleep routine, and internet use, as well as worsened psychological symptoms. The results of multivariate logistic regression analysis demonstrated that caregivers’ difficulties in managing ADHD children’s self-protective behaviors and after-school learning and the children’s worsened emotional symptoms were significantly associated with poor caregiver general mental health state. An intervention that enhances the mental health of caregivers of children with ADHD during the COVID-19 pandemic by addressing their difficulties in managing the children’s behaviors and psychological problems is warranted.
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Affiliate Stigma in Caregivers of Children with Attention-Deficit/Hyperactivity Disorder: The Roles of Stress-Coping Orientations and Parental Child-Rearing Styles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179004. [PMID: 34501592 PMCID: PMC8430709 DOI: 10.3390/ijerph18179004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
Affiliate stigma may increase the risks of negative parenting and psychological and depressive problems in caregivers of children with attention-deficit/hyperactivity disorder (ADHD). Evaluating affiliate stigma and determining how to reduce it are crucial to promoting mental health in caregivers and their children with ADHD. The aim of this study was to examine the associations of stress-coping orientations and parental child-rearing styles with the risk of high affiliate stigma in caregivers of children with ADHD in Taiwan. Affiliate stigma, stress-coping orientations, and parental child-rearing styles were assessed. The results of univariate logistic regression analysis indicated that caregivers’ gender, depressive symptoms, four orientations of stress coping, and two parenting styles, and children’s high severities of internalizing, externalizing, and ADHD symptoms were significantly associated with high affiliate stigma. The results of multivariate logistic regression analysis indicated that after controlling for caregivers’ gender, depressive symptoms, and children’s severity of internalizing, externalizing, and ADHD symptoms, caregivers with high orientation of seeking social support were less likely to have high affiliate stigma than those with low orientation of seeking social support; the caregivers with high care and affection parenting were less likely to have high affiliate stigma than those with low care and affection parenting, whereas the caregivers with high overprotection parenting were more likely to have high affiliate stigma than those with low overprotection parenting. Intervention programs targeting caregiver affiliate stigma must consider various coping orientations and parental child-rearing styles in their approach.
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Chang JC, Lai MC, Tai YM, Gau SSF. Mental health correlates and potential childhood predictors for the wish to be of the opposite sex in young autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:146-159. [PMID: 34120486 DOI: 10.1177/13623613211024098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Autistic people/people with autism spectrum disorder are more likely to experience gender dysphoria. However, the possible longitudinal predictors and underlying mechanisms of this co-occurrence are unclear. To fill this knowledge gap, we assessed 88 people with autism spectrum disorder and 42 typically developing individuals at their average ages of 13.0 (baseline, childhood/adolescence) and 20.2 years old (follow-up, adulthood). At follow-up, their endorsement on the item "I wish I was the opposite sex" was used to evaluate gender dysphoric symptoms. We compared mental health symptoms between adults with and without this item endorsement at the follow-up assessment. We explored parent-reported family and autism characteristics-related predictors in childhood/adolescence to this item endorsement in adulthood. We found that more autistic adults reported the wish to be of the opposite sex than did typically developing individuals. Autistic adults who endorsed this item experienced more mental health challenges, more school bullying and cyberbullying, more suicidal ideation, and worse quality of life. Moreover, parent-reported lower family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. More attention and support should be provided to autistic people regarding gender development and related mental health and quality of life impact, especially during the transition period to young adulthood.
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Affiliation(s)
| | - Meng-Chuan Lai
- National Taiwan University Hospital, Taiwan.,Centre for Addiction and Mental Health, Canada.,The Hospital for Sick Children, Canada.,University of Toronto, Canada.,University of Cambridge, UK
| | | | - Susan Shur-Fen Gau
- National Taiwan University Hospital, Taiwan.,Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taiwan
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Liang SHY, Lee YC, Kelsen BA, Chen VCH. Health-related quality of life in mothers of children with attention deficit hyperactivity disorder in Taiwan: The roles of child, parent, and family characteristics. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103944. [PMID: 33836402 DOI: 10.1016/j.ridd.2021.103944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/10/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND No study has examined how child and maternal psychopathological difficulties and family factors contribute to the health-related quality of life (HRQOL) of mothers of children with attention deficit hyperactivity (ADHD). AIMS To investigate the impact of children's diagnosis of ADHD, children's and maternal psychopathology and significant sociodemographic variables of the children, parents and family on HRQOL of mothers of children with ADHD and those of children with typical development (TD) in Taiwan. METHODS AND PROCEDURES Children with ADHD (n = 257) and children with typical development (n = 324) and their mothers were recruited from a psychiatric clinic of a medical center and 10 elementary schools and four high schools in northern Taiwan. Maternal HRQOL was assessed with the World Health Organization Quality of Life - BREF, while the other factors were screened using the Chinese version of the Childhood Autism Spectrum Test for autistic traits, the Swanson, Nolan, and Pelham, version IV scale for ADHD symptoms, the Child Behavior Checklist for behavioral and emotional problems, The Center for Epidemiologic Studies Depression Scale for maternal depression and interpersonal problems, the Adult ADHD Self-report Scale for maternal ADHD symptoms, and the Family APGAR for family support. OUTCOMES AND RESULTS Mothers of children with ADHD had significantly worse HRQOL in all four domains compared with those of children with typical development. Multiple regressions found that factors consistently related to the HRQOL of mothers of children with ADHD and those of children with TD were maternal depression and perceived family support after controlling for several familial, parental and child variables. HRQOL of mothers of children with ADHD and those of children with TD was more closely related to her own and family factors rather than mother- or teacher-rated ADHD symptoms, clinical diagnosis of ADHD or psychopathology of the child. CONCLUSIONS AND IMPLICATIONS Screening for maternal HRQOL, depressive symptoms and family support systems and mental health services for mothers of children with ADHD are warranted based on these findings.
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Affiliation(s)
- Sophie Hsin-Yi Liang
- Section of Department of Child and Adolescent Psychiatry, Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan, Taiwan; Department of Psychiatry, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yi-Chen Lee
- School of Occupational Therapy, National Taiwan University, Taipei, Taiwan.
| | | | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
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Hu HF, Yen CN, Wu YY, Hsiao RC, Yen CF, Cheng CP. Child-Mother Agreement on Experiences of School Bullying Involvement in Children With ADHD. J Atten Disord 2021; 25:44-52. [PMID: 29589796 DOI: 10.1177/1087054718765658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To examine the levels of agreement between the reports of 452 children and their mothers on children's experiences of bullying involvement at school and investigate the factors influencing the levels of agreement in children with ADHD. Method: The levels of agreement between children's and mothers' reports were examined. The influence of age, sex, ADHD symptoms, and psychiatric comorbidities on the levels of agreement was also examined. Results: The results indicated low agreement on the experiences of bullying involvement in child-mother ADHD dyads. Age and hyperactivity-impulsivity, oppositional, depressive, and anxiety symptoms significantly influenced the levels of agreement on the victimization of physical bullying. Age significantly influenced the levels of agreement on the perpetration of physical bullying. Conclusion: Multiple sources of information are required when clinicians assess the experiences of bullying involvement at school in children with ADHD. The factors influencing the levels of agreement should be considered.
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Affiliation(s)
- Huei-Fan Hu
- Department of Psychiatry, Tainan Municipal Hospital, Tainan, Taiwan
| | - Chia-Nan Yen
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Executive Yuan, Tainan, Taiwan
| | - Yu-Yu Wu
- YuNing Psychiatric Clinic, Taiwan
| | | | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Ping Cheng
- Department of Psychology, National Cheng Kung University, Taiwan
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13
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Multidimensional Correlates of Parental Self-Efficacy in Managing Adolescent Internet Use among Parents of Adolescents with Attention-Deficit/Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165768. [PMID: 32784989 PMCID: PMC7460166 DOI: 10.3390/ijerph17165768] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 11/22/2022]
Abstract
Given the growing concerns of problematic Internet use and online safety, it is critical to address parental self-efficacy in managing adolescent Internet use and to examine associated factors, especially in parents of adolescents with attention-deficit/hyperactivity disorder (ADHD). We examined the roles of adolescents’ hyperactivity/impulsivity, inattention and oppositional defiant disorder (ODD) symptoms, parents’ depressive symptoms, parenting behavior (parental care and indifference), and child behavior (Internet addiction) in relation to parental self-efficacy in managing adolescent Internet use. We recruited 237 Taiwanese parents of adolescents with ADHD (ages 11–18). Hierarchical linear regression was performed in four steps to test the study hypotheses. The results indicated that child’s age, ODD symptoms, and Internet addiction of adolescents were negatively associated, and parental care was positively associated with parental self-efficacy in managing adolescent Internet use. The final model was significant and explained 43% of the variance. The present study demonstrated that parenting and child behaviors contribute to parental self-efficacy in managing adolescent Internet use. Moreover, children’s ODD symptoms were identified as the risk factor for reduced parental self-efficacy.
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Shang CY, Shih HH, Pan YL, Lin HY, Gau SSF. Comparative Efficacy of Methylphenidate and Atomoxetine on Social Adjustment in Youths with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2020; 30:148-158. [PMID: 31794244 DOI: 10.1089/cap.2019.0139] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: Although methylphenidate and atomoxetine have positive effects in reducing core symptoms and emotional/behavioral problems of attention-deficit/hyperactivity disorder (ADHD), little is known about their efficacy in improving social adjustment problems among youths with ADHD. Methods: A total of 168 drug-naive youths, 7-16 years of age, with DSM-IV-defined ADHD, were recruited and randomly assigned to osmotic-release oral system methylphenidate (n = 83) and atomoxetine (n = 85) in a 24-week, open-label, head-to-head clinical trial. Efficacy measurement was based on the parent-rated and self-rated Social Adjustment Inventory for Children and Adolescents (SAICA). Evaluation time points were set at baseline and weeks 8, 16, and 24. Results: At week 24, methylphenidate was associated with improvement in school functions (parent report: Cohen d = -0.82; self-report: Cohen d = -0.66) and peer relationships (parent report: Cohen d = -0.50; self-report: Cohen d = -0.25); and atomoxetine was associated with improvement in school functions (parent report: Cohen d = -0.62; self-report: Cohen d = -0.34) and peer relationships (parent report: Cohen d = -0.33; self-report: Cohen d = -0.65). In terms of parent-reported and self-reported ratings, there were no significant differences between the two treatment groups in mean reduction in the severity of school dysfunctions, impaired peer relationships, and behavioral problems at home at week 24. Conclusions: Our findings lend evidence to support that both methylphenidate and atomoxetine were comparably effective in improving social adjustment in youths with ADHD, including school functions and peer relationships.
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Affiliation(s)
- Chi-Yung Shang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsien-Hsueh Shih
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Yun-Ling Branch, Yun-Ling, Taiwan
| | - Yi-Lei Pan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Child and Adolescent Psychiatry, Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Hsiang-Yuan Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Brain and Mind Sciences and Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan
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15
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Fossati M, Negri L, Fianco A, Cocchi MG, Molteni M, Delle Fave A. Resilience as a moderator between Objective and Subjective Burden among parents of children with ADHD. Arch Psychiatr Nurs 2020; 34:53-63. [PMID: 32035590 DOI: 10.1016/j.apnu.2019.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 12/30/2022]
Affiliation(s)
| | - Luca Negri
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Andrea Fianco
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | | | - Massimo Molteni
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Antonella Delle Fave
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy; Department of Pathophysiology and Transplantation, University of Milano, Milano, Italy
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16
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Lin YJ, Gau SSF. Comparison of Neuropsychological Functioning Between Adults With Early- and Late-Onset DSM-5 ADHD. J Atten Disord 2020; 24:29-40. [PMID: 28895460 DOI: 10.1177/1087054717730609] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective: We aimed to compare the visually dependent neuropsychological functioning among adults with Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) ADHD who recalled symptom onset by and after age 7 and non-ADHD controls. Method: We divided the participants, aged 17 to 40 years, into three groups-(a) ADHD, onset <7 years (early-onset, n = 142); (b) ADHD, onset between 7 and <12 years (late-onset, n = 41); (c) non-ADHD controls (n = 148)-and compared their neuropsychological functioning, measured by the Cambridge Neuropsychological Testing Automated Battery. Results: Both ADHD groups had deficits in attention and signal detectability, spatial working memory, and short-term spatial memory, but only the early-onset group showed deficits in alertness, set-shifting, and planning after controlling for age, sex, and psychiatric comorbidities. There was no statistical difference between the two ADHD groups in neuropsychological functioning. Conclusion:DSM-5 criteria for diagnosing adult ADHD are not too lax regarding neuropsychological functioning.
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Affiliation(s)
- Yu-Ju Lin
- Far Eastern Memorial Hospital, New Taipei City, Taiwan.,National Taiwan University, Taipei, Taiwan
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17
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WONG CHIHKAI, CHEN YUMIN, YEN CHENGFANG. Associations of parental bonding and adolescent internet addiction symptoms with depression and anxiety in parents of adolescents with attention deficit/hyperactivity disorder. ARCH CLIN PSYCHIAT 2019. [DOI: 10.1590/0101-60830000000190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | - YU-MIN CHEN
- Kaohsiung Medical University Hospital, Taiwan
| | - CHENG-FANG YEN
- Kaohsiung Medical University Hospital, Taiwan; Kaohsiung Medical University, Taiwan
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18
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Bhide S, Sciberras E, Anderson V, Hazell P, Nicholson JM. Association Between Parenting Style and Socio-Emotional and Academic Functioning in Children With and Without ADHD: A Community-Based Study. J Atten Disord 2019; 23:463-474. [PMID: 27474160 DOI: 10.1177/1087054716661420] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE In a community-based study, we examined parenting style and its relationship to functioning in 6- to 8-year-old children ( n = 391; 66.2% male) with ADHD ( n = 179), compared with non-ADHD controls ( n = 212). METHOD Parenting style was assessed using parent-reported (93.5% female) measures of warmth, consistency, and anger. Child socio-emotional and academic functioning was measured via parent- and teacher-reported scales, and direct academic assessment. RESULTS Parents reported less consistency and more anger in the ADHD group compared with non-ADHD controls, with no differences in warmth. Parenting warmth, consistency, and anger were associated with parent-reported aspects of socio-emotional functioning for children with ADHD and non-ADHD controls, after adjusting for socio-demographic variables, externalizing comorbidities, and ADHD symptom severity. Parenting style was no longer related to academic functioning and most teacher-reported outcomes after adjustment. CONCLUSION Generic parenting interventions that promote warm, consistent, and calm parenting may help alleviate socio-emotional impairments in children with ADHD.
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Affiliation(s)
- Sampada Bhide
- 1 Murdoch Childrens Research Institute, Melbourne, Australia.,2 University of Melbourne, Australia
| | - Emma Sciberras
- 1 Murdoch Childrens Research Institute, Melbourne, Australia.,2 University of Melbourne, Australia.,3 The Royal Childrens Hospital, Melbourne, Australia.,4 Deakin University, Melbourne, Australia
| | - Vicki Anderson
- 1 Murdoch Childrens Research Institute, Melbourne, Australia.,2 University of Melbourne, Australia.,3 The Royal Childrens Hospital, Melbourne, Australia
| | | | - Jan M Nicholson
- 1 Murdoch Childrens Research Institute, Melbourne, Australia.,6 La Trobe University, Melbourne, Australia
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Navab M, Dehghani A, Salehi M. Effect of compassion‐focused group therapy on psychological symptoms in mothers of attention‐deficit hyperactivity disorder children: A pilot study. COUNSELLING & PSYCHOTHERAPY RESEARCH 2019. [DOI: 10.1002/capr.12212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mojgan Navab
- Department of Clinical PsychologyNajafabad BranchIslamic Azad University Najafabad, Isfahan Iran
| | - Akram Dehghani
- Department of Clinical PsychologyNajafabad BranchIslamic Azad University Najafabad, Isfahan Iran
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20
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Cho YJ, Choi R, Park S, Kwon JW. Parental smoking and depression, and attention-deficit hyperactivity disorder in children and adolescents: Korean national health and nutrition examination survey 2005-2014. Asia Pac Psychiatry 2018; 10:e12327. [PMID: 30088339 DOI: 10.1111/appy.12327] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 07/09/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION We aimed to investigate the risk factors associated with attention-deficit hyperactivity disorder (ADHD) in children and adolescents using a nationally representative sample of the Korean population. METHODS Data from children and adolescents aged less than 18 years (n = 23 561) were obtained from the Korean National Health and Nutrition Examination Survey, 2005 to 2014. ADHD was assessed using a self-reported diagnosis of ADHD. We estimated the annual prevalence and number of Korean children and adolescents with physician-diagnosed ADHD from 2005 to 2014. We considered various risk factors including demographics, obesity, and family environment (household income, parental age, depression in adults in the household, and exposure to environmental smoke at home). The relationship between ADHD and the considered risk factors was evaluated using multiple logistic regression. RESULTS The annual prevalence of physician-diagnosed ADHD showed a 4-fold increase (0.35% in 2005 and 1.36% 2014) over the study period. Among ADHD patients, boys and girls constituted 78% and 22%, respectively. Total smoking amounts and depression in adults in the household were significantly associated with children's ADHD. When the analysis was limited to parental effects, only the father's smoking amount and depression were associated with the children's ADHD. DISCUSSION This study identified adults' smoking and depression as family environmental factors associated with children's ADHD. From a public health care perspective, this result illuminates the need for awareness programs emphasizing a parent's conditions that may influence the development of ADHD in children.
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Affiliation(s)
- Youn Joo Cho
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Ran Choi
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Susan Park
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Jin-Won Kwon
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
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21
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Abstract
This study investigated school functioning among unaffected siblings of youths with autistic spectrum disorder (ASD) and identified the correlates for school maladjustment. We recruited 66 youths with a clinical diagnosis of ASD, aged 8-19, their unaffected siblings and 132 typically developing controls (TD). We found that ASD youths had poorer school functions than unaffected siblings and TD. Unaffected siblings had poorer attitude toward schoolwork and more severe behavioral problems at school than TD. Several associated factors for different scholastic functional domains (i.e., academic performance, attitude toward school work, social interactions, behavioral problems) in the siblings included IQ, autistic traits, inattention/oppositional symptoms, sibling relationships, etc. Our findings suggest the need of assessing school functions in unaffected siblings of ASD. TRIAL REGISTRATION Clinical trial registration identifier: NCT01582256.
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Pahlavanzadeh S, Mousavi S, Maghsoudi J. Exploring the Needs of Family Caregivers of Children with Attention Deficit Hyperactivity Disorder: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:149-154. [PMID: 29628964 PMCID: PMC5881233 DOI: 10.4103/ijnmr.ijnmr_16_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is one of the most common chronic childhood disorders that lead to dysfunction and disability in childhood and subsequently be careful. This study aimed to understand the needs of the children's caregivers in Iran. Materials and Methods This qualitative research was conducted in 2016. Using purposive sampling, 27 participants from 20 families of children with ADHD were interviewed. Unstructured interviews were conducted within 6 months in Isfahan. Data gathering continued until no new data were accessed. Data were analyzed using qualitative content analysis. Results The results of this research are shown in three main categories: (1) The caregiver's need for having sufficient information about the disorder, its cause and treatments (pharmacological and nonpharmacological); (2) the need to have enough knowledge about communication problems while caring for a sick child; and (3) the need to improve the performance of care. They were classified under the relevant concept. Conclusions Caregivers of children with ADHD have different needs and problems and assessing them would decrease the child's problems and consequently, the family's problems. It would also increase the sense of control and authority over the child's condition in the caregivers. Since this disorder is chronic and permanent, ignoring the needs of caregivers not only would cut the process of the child's treatment but would also intensify the family's and child's problems. So it is recommended to conduct further studies about each of the resulted concepts in this study and the obstacles for reaching them.
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Affiliation(s)
- Saeid Pahlavanzadeh
- Nursing and Midwifery Care Research Centre, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sharifeh Mousavi
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jahangir Maghsoudi
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Chou WJ, Liu TL, Yang P, Yen CF, Hu HF. Bullying Victimization and Perpetration and Their Correlates in Adolescents Clinically Diagnosed With ADHD. J Atten Disord 2018; 22:25-34. [PMID: 25403369 DOI: 10.1177/1087054714558874] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine the prevalence rates of bullying involvement and their correlates in adolescents diagnosed with ADHD in Taiwan. METHOD Bullying involvement, family and ADHD characteristics, the levels of behavioral inhibition system (BIS) and behavioral approach system (BAS), and psychiatric comorbidity were assessed in 287 adolescents with ADHD. The multiple regression analysis was used to examine the correlate of bullying victimization and perpetration. RESULTS The prevalence rates of the pure victims, pure perpetrators, and victim-perpetrators were 14.6%, 8.4%, and 5.6%, respectively. Young age, a high BIS score, autism spectrum disorders, and low satisfaction with family relationships were associated with severe bullying victimization. A high score of fun seeking on the BAS and low satisfaction with family relationships were associated with severe bullying perpetration. CONCLUSION A high proportion of adolescents with ADHD are involved in bullying. Multiple factors are associated with bullying involvement in adolescents with ADHD.
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Affiliation(s)
- Wen-Jiun Chou
- 1 Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan.,2 College of Medicine, Chang Gung University, Taiwan
| | - Tai-Ling Liu
- 3 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,4 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Pinchen Yang
- 3 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,4 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.,5 Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Cheng-Fang Yen
- 3 Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan.,4 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.,5 Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan
| | - Huei-Fan Hu
- 6 Department of Psychiatry, Tainan Municipal Hospital, Taiwan
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24
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Chou WJ, Wang LJ, Lin CH, Liang SY, Chen VCH, Hou YM, Huang RR, Chou MC, Shang CY, Ho CP, Lai MC. Social adjustment and family function after drug switch from IR-methylphenidate to OROS-methylphenidate in patients with attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat 2018; 14:2783-2791. [PMID: 30425496 PMCID: PMC6205135 DOI: 10.2147/ndt.s176913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This prospective, single-arm, open-label, 8-week, multicenter study investigated the effectiveness of switching from immediate-release methylphenidate (IR-MPH) to osmotic controlled-release methylphenidate (OROS-MPH) in patients with attention-deficit/hyperactivity disorder (ADHD). PATIENTS AND METHODS Overall, 296 patients with ADHD (mean age: 9.5 years) already on IR-MPH treatment were enrolled. Upon enrollment, a flexible dose of OROS-MPH was administered, replacing IR-MPH. Patients were assessed at baseline and weeks 2, 4, and 8 using the Swanson, Nolan, and Pelham version IV scale (SNAP-IV) and the Clinical Global Impression for ADHD symptoms. The Social Adjustment Inventory for Children and Adolescents assessed social functions, and the Chinese Health Questionnaire (CHQ) and Family Adaptation, Partnership, Growth, Affection, and Resolve evaluated parental and family functions. RESULTS Switching from IR-MPH to OROS-MPH yielded significant improvements in all ADHD symptoms, as rated by parents, teachers (SNAP-IV), and study investigators (Clinical Global Impression). CHQ scores and all Social Adjustment Inventory for Children and Adolescents subscores except spare time scores improved significantly. Patients with poor IR-MPH adherence had greater improvements in teacher-rated SNAP-IV and mothers' mental health (CHQ) after switching. CONCLUSION Switching from IR-MPH to OROS-MPH improved patients' behavioral ADHD symptoms and social adjustment, and mental health of patients' mothers. This was most evident in patients who previously exhibited poor IR-MPH adherence.
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Affiliation(s)
- Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung,
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung,
| | - Chien-Ho Lin
- Department of Psychiatry, Chimei Medical Center, Tainan
| | | | | | | | - Rong-Rong Huang
- Department of Child and Adolescent Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung
| | - Miao-Chun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung,
| | - Chi-Yung Shang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chi-Pui Ho
- Department of Child and Adolescent Psychiatry, Kai-Suan Psychiatric Hospital, Kaohsiung
| | - Meng-Chuan Lai
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
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Muñoz-Silva A, Lago-Urbano R, Sanchez-Garcia M, Carmona-Márquez J. Child/Adolescent's ADHD and Parenting Stress: The Mediating Role of Family Impact and Conduct Problems. Front Psychol 2017; 8:2252. [PMID: 29312090 PMCID: PMC5744077 DOI: 10.3389/fpsyg.2017.02252] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/11/2017] [Indexed: 11/30/2022] Open
Abstract
Objective: The demands of parenting are usually associated with some stress, and elevated levels of stress may affect the parent-child relationships and parenting practices. This is especially the case of families where children have special needs conditions or disorders, like Attention Deficit Hyperactivity Disorder (ADHD). Method: This study examined parenting stress among mothers of children and adolescents with ADHD. The sample comprised 126 mothers of girls (36; 29%) and boys (90; 71%) aged 6-17 years old. Results: Mothers reported their own stress levels as well as the children and adolescents' variables (severity of their ADHD symptoms, conduct, and emotional problems) and family-contextual variables (negative impact on family's social life, impact on couple relationship, and perceived social support). Hierarchical multiple regression showed that (a) negative impact on social life and conduct problems were the strongest predictors of mother's stress. Bootstrap mediation analyses revealed that (b) the association between child and adolescent's ADHD and parenting stress was mediated by children's conduct problems and by negative impact on family's social life, and not by children's emotional problems nor by mother's perceived social support. The mediation analysis also suggested (c) a pathway from child/adolescent's ADHD through children's conduct problems and then through their negative impact on family's social life to mother's parenting stress. Conclusion: These results suggest that both child/adolescent's and family factors should be considered in the designing of interventions for reducing parenting stress in families of children and adolescents with ADHD.
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Affiliation(s)
- Alicia Muñoz-Silva
- Department of Social, Developmental and Educational Psychology, University of Huelva, Huelva, Spain
| | | | - Manuel Sanchez-Garcia
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
| | - José Carmona-Márquez
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
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26
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Liu CY, Huang WL, Kao WC, Gau SSF. Influence of Disruptive Behavior Disorders on Academic Performance and School Functions of Youths with Attention-Deficit/Hyperactivity Disorder. Child Psychiatry Hum Dev 2017; 48:870-880. [PMID: 28168530 DOI: 10.1007/s10578-017-0710-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder/conduct disorder (ODD/CD) are associated with negative school outcomes. The study aimed to examine the impact of ADHD and ODD/CD on various school functions. 395 youths with ADHD (244 with ADHD + ODD/CD and 151 with ADHD only) and 156 controls received semi-structured psychiatric interviews. School functions were assessed and compared between each group with a multiple-level model. The results showed that youths with ADHD had poorer performance across different domains of school functioning. Youths with ADHD + ODD/CD had more behavioral problems but similar academic performance than those with ADHD only. The multiple linear regression models revealed that ADHD impaired academic performance while ODD/CD aggravated behavioral problems. Our findings imply that comorbid ODD/CD may specifically contribute to social difficulties in youths with ADHD. Measures of early detection and intervention for ODD/CD should be conducted to prevent adverse outcomes.
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Affiliation(s)
- Chao-Yu Liu
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Douliu, Yun-Lin, Taiwan, Republic of China
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, Republic of China
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Douliu, Yun-Lin, Taiwan, Republic of China
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, Republic of China
- Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Wei-Chih Kao
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Douliu, Yun-Lin, Taiwan, Republic of China
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, Republic of China
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, Republic of China.
- Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.
- Department of Psychology, Graduate Institute of Brain and Mind Sciences, and Graduate Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.
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One-year trajectory analysis for ADHD symptoms and its associated factors in community-based children and adolescents in Taiwan. Child Adolesc Psychiatry Ment Health 2017; 11:28. [PMID: 28580012 PMCID: PMC5452532 DOI: 10.1186/s13034-017-0165-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/18/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Several longitudinal studies have shown the partial symptomatic persistence of attention-deficit hyperactivity disorder (ADHD) in clinic-based samples. However, little is known about the patterns and trajectories of ADHD symptoms in community-based populations. METHODS To differentiate developmental trajectories of ADHD symptoms over 1 year, with a four-wave quarterly follow-up in children and adolescents in the community of Taiwan, we conducted this prospective study in 1281 students in grade 3, 5, and 8. All the students in the regular classes rather than special educational classes were eligible and recruited to the study. Inattention, hyperactivity-impulsivity, and opposition-defiance were rated by parent reports on the Chinese version of the Swanson, Nolan, and Pelham Version IV Scale (SNAP-IV). Group-based trajectory modeling and multivariable regression analyses were used to explore the individual, family and social factors associated with differential trajectories. RESULTS Trajectories were classified as Low (29.9-40.6%), Intermediate (52.5-58.5%) and High (6.9-12.5%) based on the symptom severity of ADHD symptoms assessed by the SNAP-IV. The proportion of children in the high ADHD trajectory might approximately reflect the prevalence of ADHD in Taiwan. The following factors differentiated High from Low trajectories: male gender, more externalizing problems, fewer prosocial behaviors, school dysfunction, more home behavioral problems, and less perceived family support. CONCLUSIONS Our findings that the concurrent conditions of emotional or externalizing problems, as well as impaired school and home function at baseline, might differentiate the high ADHD symptoms trajectory from others could help developing the specific measures for managing high ADHD symptoms over time in a school setting.
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Early maladaptive schemas in adult patients with attention deficit hyperactivity disorder. ACTA ACUST UNITED AC 2016; 9:101-111. [DOI: 10.1007/s12402-016-0211-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 12/15/2016] [Indexed: 11/27/2022]
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Chang JPC, Gau SSF. Mother-Child Relationship in Youths with Attention-Deficit Hyperactivity Disorder and their Siblings. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 45:871-882. [DOI: 10.1007/s10802-016-0218-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Wang LJ, Chou WJ, Chou MC, Gau SSF. The Effectiveness of Aripiprazole for Tics, Social Adjustment, and Parental Stress in Children and Adolescents with Tourette's Disorder. J Child Adolesc Psychopharmacol 2016; 26:442-8. [PMID: 27028456 DOI: 10.1089/cap.2015.0104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Tourette's syndrome (TS) frequently results in a negative impact on multiple functional domains. This prospective open-label study investigated the potential effectiveness of aripiprazole for tics, social adjustment, and parental stress in children and adolescents with TS. METHODS Study participants consisted of 26 patients (mean age 10.4 ± 3.0 years; 22 boys and 4 girls) who were prescribed aripiprazole, with each dose ranging from 2.5 to 15 mg/day. At baseline and 2, 4, and 8 weeks from baseline, tic symptoms, social adjustment, and parenting stress were assessed using the Yale Global Tic Severity Scale (YGTSS), the Social Adjustment Inventory for Children and Adolescents (SAICA), and the Parenting Stress Index (PSI). Aripiprazole could be optionally titrated from 2.5 to 30 mg/day at each visit. RESULTS Of the 26 patients at the initial visit, 22 (84.6%) completed the study. The mean dose of aripiprazole at the endpoint was 8.0 ± 4.0 mg/day. During the 8-week aripiprazole treatment period, motor tics, phonic tics, and impairment on the YGTSS all showed significant improvement. Home behaviors on the SAICA and child domain on the PSI also showed significant improvement. Patients' phonic tics, but not motor tics, showed a positive correlation with their school function and peer relationships. The child domain on the PSI was positively correlated with motor tics, phonic tics, and impairment, as measured by the YGTSS. CONCLUSIONS An 8-week aripiprazole treatment program for children and adolescents with TS was beneficial to their tic symptoms, behaviors at home, and caregivers' stress with regard to fulfilling parenting roles. A long-term placebo-controlled trial with larger samples is warranted to confirm the effectiveness of aripiprazole for social adjustment and parental stress.
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Affiliation(s)
- Liang-Jen Wang
- 1 Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung, Taiwan
| | - Wen-Jiun Chou
- 1 Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung, Taiwan
| | - Miao-Chun Chou
- 1 Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung, Taiwan
| | - Susan Shur-Fen Gau
- 2 Department of Psychiatry, National Taiwan University Hospital and College of Medicine , Taipei, Taiwan
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Chiang HL, Gau SSF. Comorbid psychiatric conditions as mediators to predict later social adjustment in youths with autism spectrum disorder. J Child Psychol Psychiatry 2016; 57:103-111. [PMID: 26251168 DOI: 10.1111/jcpp.12450] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) experience long-term social impairment and their comorbid psychiatric conditions negatively impact adaptive functioning. The aims of the study are to investigate whether comorbid psychopathologies, such as anxiety/depression, inattention, hyperactivity/impulsivity, and oppositional behaviors, mediated the link between autistic symptoms and social maladjustment. METHOD One hundred and twenty-four youths diagnosed with a clinical diagnosis of DSM-IV ASD (mean age, 10.6 ± 3.3 years) participated in this longitudinal study. They were assessed using semistructured diagnostic interviews on ASD and other psychiatric conditions at recruitment. Follow-up interviews took place approximately 3 years later (37.59 ± 15 months) while the parents reported to the Social Adjustment Inventory for Children and Adolescents on their children's social adjustment. Mediation models were used to examine the mediating effect of comorbid psychopathologies on social adjustment. RESULTS Youths with ASD had worse school, peer, and home functions than controls at follow-up assessment. In general, comorbid psychiatric conditions mediated the link between autistic symptoms and different domains of social adjustment, independent of age, sex, and full-scale IQ. Additionally, we found specific mediating effects of anxiety/depression and inattention on school functions; anxiety/depression on peer relationships; and oppositional behaviors on home behaviors. CONCLUSION Early comorbid psychopathologies may further impair later social adjustment in youths with ASD and an early identification and intervention of these comorbid conditions are suggested.
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Affiliation(s)
- Huey-Ling Chiang
- Department of Psychiatry, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Lin YJ, Lo KW, Yang LK, Gau SSF. Validation of DSM-5 age-of-onset criterion of attention deficit/hyperactivity disorder (ADHD) in adults: Comparison of life quality, functional impairment, and family function. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:48-60. [PMID: 26318976 DOI: 10.1016/j.ridd.2015.07.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 07/21/2015] [Accepted: 07/25/2015] [Indexed: 06/04/2023]
Abstract
The newly published Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) elevates the threshold of the ADHD age-of-onset criterion from 7 to 12 years. This study evaluated the quality of life and functional impairment of adults with ADHD who had symptoms onset by or after 7 years and examined the mediation effect of family function and anxiety/depression symptoms between ADHD diagnosis and quality of life and functional impairment. We assessed 189 adults with ADHD and 153 non-ADHD controls by psychiatric interview and self-administered reports on the Adult ADHD Quality of Life Scale, Weiss Functional Impairment Rating Scale, Family APGAR, and Adult Self Report Inventory-4. The ADHD group was divided into early-onset ADHD (onset <7 years, n=147) and late-onset ADHD (onset between 7 and 12 years, n=42). The mediation analysis was conducted to verify the mediating factors from ADHD to functional impairment and quality of life. The late-onset ADHD had more severe functional impairment at work and poorer family support than early-onset ADHD while they had comparable impairment at other domains. Less perceived family support and current anxiety/depressive symptoms partially mediated the link between ADHD diagnosis and quality of life/functional impairment both in early- and late-onset ADHD. Our data support decreased quality of life and increased functional impairment in adult ADHD, regardless of age of onset, and these adverse outcomes may be mediated by family support and anxiety/depression at adulthood. Our findings also imply that the new DSM-5 ADHD criteria do not over-include individuals without impairment.
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Affiliation(s)
- Yu-Ju Lin
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, New Taipei City 220, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
| | - Kuan-Wu Lo
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; School of Medicine, College of Medicine, National Taiwan University, No. 1, Jen-Ai Road Section 1, Taipei 100, Taiwan.
| | - Li-Kuang Yang
- Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, No. 60, Xin-ming Road, Beitou District, Taipei 100, Taiwan.
| | - Susan Shur-Fen Gau
- Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
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Gau SS, Tseng WL, Tseng WYI, Wu YH, Lo YC. Association between microstructural integrity of frontostriatal tracts and school functioning: ADHD symptoms and executive function as mediators. Psychol Med 2015; 45:529-543. [PMID: 25075643 DOI: 10.1017/s0033291714001664] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Deficits in executive function (EF), impaired school functioning and altered white matter integrity in frontostriatal networks have been associated with attention-deficit/hyperactivity disorder (ADHD). However, relationships between impairments in these areas are unclear. Using a sample of youths with and without ADHD, this study examined the association between microstructural integrity of frontostriatal tracts and school dysfunction and the mediating roles of EF and ADHD symptoms in this association. METHOD The sample included 32 Taiwanese youths with ADHD and 32 age-, sex-, handedness- and IQ-matched typically-developing (TD) youths. Participants were assessed using psychiatric interviews, parent reports on ADHD symptoms and school functioning, and EF measures from the Cambridge Neuropsychological Test Automated Battery (CANTAB). The frontostriatal tracts were reconstructed by diffusion spectrum imaging (DSI) tractography and were subdivided into four functionally distinct segments: caudate-dorsolateral, caudate-medial prefrontal, caudate-orbitofrontal and caudate-ventrolateral tracts. RESULTS Youths with ADHD, relative to TD youths, showed altered white matter integrity in all four bilateral pairs of frontostriatal tracts (decreased general fractional anisotropy, GFA), had poor attention, vigilance and response inhibition, and showed impaired school functioning. Altered microstructural integrity in frontostriatal tracts was significantly associated with school dysfunction, which was mediated by EF measures of attention/vigilance and response inhibition in addition to inattention and hyperactivity symptoms. CONCLUSIONS Our findings demonstrate an association between white matter integrity in the frontostriatal networks and school functioning and suggest that EF deficits and ADHD symptoms may be the mediating mechanisms for this association. Future research is needed to test the directionality and specificity of this finding.
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Affiliation(s)
- S S Gau
- Department of Psychiatry,National Taiwan University Hospital and College of Medicine,Taipei,Taiwan
| | - W-L Tseng
- Institute of Child Development,University of Minnesota,Twin Cities, Minnesota, MN,USA
| | - W-Y I Tseng
- Graduate Institute of Brain and Mind Sciences, College of Medicine,National Taiwan University,Taipei,Taiwan
| | - Y-H Wu
- School of Medicine, College of Medicine,National Taiwan University,Taipei,Taiwan
| | - Y-C Lo
- Center for Optoelectronic Medicine, College of Medicine,National Taiwan University,Taipei,Taiwan
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Co-occurrence of attention-deficit hyperactivity disorder symptoms with other psychopathology in young adults: parenting style as a moderator. Compr Psychiatry 2015; 57:85-96. [PMID: 25465651 DOI: 10.1016/j.comppsych.2014.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 10/30/2014] [Accepted: 11/03/2014] [Indexed: 11/23/2022] Open
Abstract
The extent to which parenting styles can influence secondary psychiatric symptoms among young adults with ADHD symptoms is unknown. This issue was investigated in a sample of 2284 incoming college students (male, 50.6%), who completed standardized questionnaires about adult ADHD symptoms, other DSM-IV symptoms, and their parents' parenting styles before their ages of 16. Among them, 2.8% and 22.8% were classified as having ADHD symptoms and sub-threshold ADHD symptoms, respectively. Logistic regression was used to compare the comorbid rates of psychiatric symptoms among the ADHD, sub-threshold ADHD and non-ADHD groups while multiple linear regressions were used to examine the moderating role of gender and parenting styles over the associations between ADHD and other psychiatric symptoms. Both ADHD groups were significantly more likely than other incoming students to have other DSM-IV symptoms. Parental care was negatively associated and parental overprotection/control positively associated with these psychiatric symptoms. Furthermore, significant interactions were found of parenting style with both threshold and sub-threshold ADHD in predicting wide-ranging comorbid symptoms. Specifically, the associations of ADHD with some externalizing symptoms were inversely related to level of paternal care, while associations of ADHD and sub-threshold ADHD with wide-ranging comorbid symptoms were positively related to level of maternal and paternal overprotection/control. These results suggest that parenting styles may modify the effects of ADHD on the risk of a wide range of temporally secondary DSM-IV symptoms among incoming college students, although other causal dynamics might be at work that need to be investigated in longitudinal studies.
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Chou WJ, Liu TL, Yang P, Yen CF, Hu HF. Multi-dimensional correlates of Internet addiction symptoms in adolescents with attention-deficit/hyperactivity disorder. Psychiatry Res 2015; 225:122-128. [PMID: 25466226 DOI: 10.1016/j.psychres.2014.11.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 08/04/2014] [Accepted: 11/03/2014] [Indexed: 12/24/2022]
Abstract
This study examined the associations of the severity of Internet addiction symptoms with reinforcement sensitivity, family factors, Internet activities, and attention-deficit/hyperactivity disorder (ADHD) symptoms among adolescents in Taiwan diagnosed with ADHD. A total of 287 adolescents diagnosed with ADHD and aged between 11 and 18 years participated in this study. Their levels of Internet addiction symptoms, ADHD symptoms, reinforcement sensitivity, family factors, and various Internet activities in which the participants engaged were assessed. The correlates of the severities of Internet addiction symptoms were determined using multiple regression analyses. The results indicated that low satisfaction with family relationships was the strongest factor predicting severe Internet addiction symptoms, followed by using instant messaging, watching movies, high Behavioral Approach System (BAS) fun seeking, and high Behavioral Inhibition System scores. Meanwhile, low paternal occupational SES, low BAS drive, and online gaming were also significantly associated with severe Internet addiction symptoms. Multiple factors are significantly associated with the severity of Internet addiction symptoms among adolescents with ADHD. Clinicians, educational professionals, and parents of adolescents with ADHD should monitor the Internet use of adolescents who exhibit the factors identified in this study.
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Affiliation(s)
- Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center and College of Medicine, Chang Gung University, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung 807, Taiwan
| | - Pinchen Yang
- Department of Psychiatry, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung 807, Taiwan; Department of Psychiatry, School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung 807, Taiwan; Department of Psychiatry, Tainan Municipal Hospital, 670 Chongde Road, East District, Tainan 701, Taiwan.
| | - Huei-Fan Hu
- Department of Psychiatry, Tainan Municipal Hospital, 670 Chongde Road, East District, Tainan 701, Taiwan.
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Chen VCH, Yeh CJ, Lee TC, Chou JY, Shao WC, Shih DH, Chen CI, Lee PC. Symptoms of attention deficit hyperactivity disorder and quality of life of mothers of school-aged children: The roles of child, mother, and family variables. Kaohsiung J Med Sci 2014; 30:631-8. [DOI: 10.1016/j.kjms.2014.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 07/31/2014] [Accepted: 05/07/2014] [Indexed: 11/27/2022] Open
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Kim Y, Kim B, Chang JS, Kim BN, Cho SC, Hwang JW. Parental quality of life and depressive mood following methylphenidate treatment of children with attention-deficit hyperactivity disorder. Psychiatry Clin Neurosci 2014; 68:506-14. [PMID: 24417707 DOI: 10.1111/pcn.12155] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 12/05/2013] [Accepted: 12/20/2013] [Indexed: 11/29/2022]
Abstract
AIM This naturalistic study investigated the associations between quality of life and depressive mood in parents and symptom changes in attention-deficit hyperactivity disorder (ADHD) children. METHODS At baseline and at weeks 4 and 8, the parents evaluated their children, who were receiving treatment with osmotic-release oral system methylphenidate (mean dosage 36.3 ± 15.5 mg/day), using the Swanson, Nolan, and Pelham - Fourth Edition (SNAP-IV-18) scale. The parents evaluated themselves using the Beck Depression Inventory (BDI) and the World Health Organization Quality of Life Assessment, Brief Version (WHOQOL-BREF). RESULTS A significant reduction in SNAP-IV-18 scores and improvements in parental BDI scores and parental WHOQOL-BREF scores were observed. The decrease in BDI scores from baseline to 8 weeks was significantly associated with increases in WHOQOL-BREF sub-domain scores from baseline to 8 weeks, with a greater decrease at 4 weeks and after. The decrease in the SNAP-IV-18 hyperactivity-impulsivity score was significantly associated with increases in WHOQOL social sub-domain scores from baseline to 8 weeks. For those patients who showed a 25% or greater decrease in the SNAP-IV-18 total scores from baseline to 8 weeks, the decreases in the SNAP-IV-18 total score and in the inattention and hyperactivity-impulsivity scores were significantly associated with a decrease in BDI scores from baseline to 8 weeks. CONCLUSION Methylphenidate treatment for ADHD was associated with both symptom alleviation in children with ADHD and improvement in parental depressive mood and quality of life, suggesting that the effects of treatment could go beyond symptom improvement in ADHD.
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Affiliation(s)
- Yeni Kim
- Department of Child Psychiatry, Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, Korea
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Lau WYP, Gau SSF, Chiu YN, Wu YY. Autistic Traits in Couple Dyads as a Predictor of Anxiety Spectrum Symptoms. J Autism Dev Disord 2014; 44:2949-63. [DOI: 10.1007/s10803-014-2151-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chiang HL, Gau SSF. Impact of executive functions on school and peer functions in youths with ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:963-972. [PMID: 24636025 DOI: 10.1016/j.ridd.2014.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 02/10/2014] [Accepted: 02/14/2014] [Indexed: 06/03/2023]
Abstract
Youths with attention-deficit/hyperactivity disorder (ADHD) are more likely to have social dysfunction at school. The authors explored the role of key executive functions (EF, i.e., spatial working memory and spatial planning) on school and peer functions in 511 youths with persistent ADHD according to the DSM-IV diagnostic criteria and 124 non-ADHD controls without any EF deficits. All the participants were assessed by a semi-structured psychiatric interview to confirm their previous and current diagnosis of ADHD and other psychiatric disorders and by the Spatial Working Memory (SWM) and Stocking of Cambridge (SOC) tasks. The participants and their parents reported the participants' school functions and peer relationships. There were three ADHD subgroups: (1) ADHD with deficits in both SWM and SOC tasks (n=121); (2) ADHD with deficit in either SWM or SOC task (n=185); (3) ADHD without deficits in SWM or SOC task (n=205). All the three ADHD groups, regardless of EF deficits, had lower school grade, poorer attitude toward school work, poorer school interactions, more behavioral problems at school, and more severe problems in peer relationships than non-ADHD controls. Multivariate analyses revealed positive associations between deficit in the SWM task and school and peer dysfunctions, and between deficits in the SOC task and impaired peer interactions. Older age and psychiatric comorbidity also contributed to increased risk of school and peer dysfunctions. Our findings suggest that deficits in EF, such as spatial working memory and planning, might be associated with school and peer dysfunctions.
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Affiliation(s)
- Huey-Ling Chiang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine and Graduate Institute of Clinical Medicine, College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan; Department of Psychiatry, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banciao District, New Taipei City, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine and Graduate Institute of Clinical Medicine, College of Medicine, No. 7, Chung-Shan South Road, Taipei, Taiwan; Department of Psychology, Graduate Institute of Epidemiology and Preventive Medicine, and Graduate Institute of Brain and Mind Sciences, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan.
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Lin YH, Gau SSF. Association between morningness-eveningness and the severity of compulsive Internet use: the moderating role of gender and parenting style. Sleep Med 2013; 14:1398-404. [PMID: 24157101 DOI: 10.1016/j.sleep.2013.06.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 06/05/2013] [Accepted: 06/10/2013] [Indexed: 01/28/2023]
Abstract
BACKGROUND Eveningness and Internet addiction are major concerns in adolescence and young adulthood. We investigated the relationship between morningness-eveningness and compulsive Internet use in young adults and explored the moderating effects of perceived parenting styles and family support on such relationships. METHODS The participants consisted of 2731 incoming college students (men, 52.4%; mean age, 19.4±3.6years) from a National University in Taiwan. Each participant completed the questionnaires, which included the Morningness-Eveningness Scale (MES), the Yale-Brown Obsessive Compulsive Scale modified for Internet use (YBOCS-IU), the Parental Bonding Instrument for parenting style, the Family Adaptation, Partnership, Growth, Affection, and Resolve questionnaire (APGAR) for perceived family support, and the Adult Self-Report Inventory-4 (ASRI-4) for psychopathology. The morning (n=459), intermediate (n=1878), and evening (n=394) groups were operationally defined by the MES t scores. RESULTS The results showed that eveningness was associated with greater weekend sleep compensation, increased compulsive Internet use, more anxiety, poorer parenting styles, and less family support; additionally, the most associated variables for increased compulsive Internet use were the tendency of eveningness, male gender, more anxiety symptoms, less maternal affection/care, and a lower level of perceived family support. The negative association between the morning type and compulsive Internet use severity escalated with increased maternal affection/care and decreased with increased perceived family support. The positive association between the evening type and compulsive Internet use severity declined with increased maternal protection. However, the father's parenting style did not influence the relationship between morningness-eveningness and compulsive Internet use severity. CONCLUSIONS Our findings imply that sleep schedule and the parental and family process should be part of specific measures for prevention and intervention of compulsive Internet use.
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Affiliation(s)
- Yu-Hsuan Lin
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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Tseng MCM, Gau SSF, Tseng WL, Hwu HG, Lee MB. Co-Occurring Eating and Psychiatric Symptoms in Taiwanese College Students: Effects of Gender and Parental Factors. J Clin Psychol 2013; 70:224-37. [DOI: 10.1002/jclp.22014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Mei-Chih Meg Tseng
- National Taiwan University Hospital; Taipei Taiwan
- National Taiwan University; Taipei Taiwan
| | - Susan Shur-Fen Gau
- National Taiwan University Hospital; Taipei Taiwan
- National Taiwan University; Taipei Taiwan
| | | | - Hai-Gwo Hwu
- National Taiwan University Hospital; Taipei Taiwan
- National Taiwan University; Taipei Taiwan
| | - Ming-Been Lee
- National Taiwan University Hospital; Taipei Taiwan
- National Taiwan University; Taipei Taiwan
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Gau SSF, Chang JPC. Maternal parenting styles and mother-child relationship among adolescents with and without persistent attention-deficit/hyperactivity disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1581-1594. [PMID: 23475008 DOI: 10.1016/j.ridd.2013.02.002] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 02/01/2013] [Accepted: 02/05/2013] [Indexed: 06/01/2023]
Abstract
We investigated mothering and mother-child interactions in adolescents with and without persistent attention-deficit/hyperactivity disorder (ADHD) in a sample of 190 adolescents with persistent DSM-IV ADHD, 147 without persistent ADHD, and 223 without ADHD. Both participants and their mothers received psychiatric interviews for diagnosis of ADHD and other mental disorders; and reported on the Parental Bonding Instrument about mother's parenting style, the Social Adjustment Inventory for Children and Adolescents for interactions with mothers and home behavioral problems. The mothers also reported on their ADHD and neurotic/depressive symptoms. Our results based on both informants showed that both ADHD groups obtained less affection/care and more overprotection and control from the mothers, and perceived less family support than those without ADHD. Child's inattention and comorbidity, and maternal depression were significantly correlated with decreased maternal affection/care and increased maternal controls; child's hyperactivity-impulsivity and maternal neurotic trait were significantly correlated with maternal overprotection; and child's inattention and comorbidity, and maternal neurotic/depressive symptoms were significantly correlated with impaired mother-child interactions and less family support. Our findings suggested that, regardless of persistence, childhood ADHD diagnosis, particularly inattention symptoms and comorbidity, combining with maternal neurotic/depressive symptoms was associated with impaired maternal process.
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Affiliation(s)
- Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
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Chang LR, Chiu YN, Wu YY, Gau SSF. Father's parenting and father-child relationship among children and adolescents with attention-deficit/hyperactivity disorder. Compr Psychiatry 2013; 54:128-40. [PMID: 22985803 DOI: 10.1016/j.comppsych.2012.07.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Revised: 06/20/2012] [Accepted: 07/09/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE Western literature documents impaired father-child interactions in addition to strong evidence of impaired mother-child interactions in children with attention-deficit/hyperactivity disorder (ADHD). However, the parenting process of fathers and their engagement in the Asian family with children with ADHD remain unexplored. The authors compared fathering and father-child relationships between children with ADHD and those without ADHD and identified the correlates of these paternal measures. METHODS Fathering and father-child relationships were compared between 296 children with attention-deficit/hyperactivity disorder (ADHD) and 229 children without ADHD in Taiwan. All child participants and their parents received psychiatric interviews for the diagnosis of ADHD and other psychiatric disorders of the children, and their fathers were assessed for ADHD, anxiety and depressive symptoms. Both the fathers and children reported on the father's parenting style, father-child interactions, behavioral problems at home, and perceived family support. RESULTS The results showed that children with ADHD received less affection/care and more overprotection and authoritarian control from their fathers. They had less active interactions with their fathers, more severe behavioral problems at home; and perceived less family support than children without ADHD. Correlates for impaired father-child interactions included childhood ADHD symptoms, any comorbidity, age at assessment, and the father's neurotic personality and depressive symptoms. In addition, the children reported more negatively on fathering and father-child interactions than the fathers. CONCLUSIONS Our findings suggest the negative impacts of ADHD on the father's parenting style and father-child interactions. Clinical interventions aimed at improving father-child interactions warrant more attention.
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Affiliation(s)
- Li-Ren Chang
- Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin 64041, Taiwan
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Wu SY, Gau SSF. Correlates for academic performance and school functioning among youths with and without persistent attention-deficit/hyperactivity disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:505-515. [PMID: 23063730 DOI: 10.1016/j.ridd.2012.09.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 09/11/2012] [Indexed: 06/01/2023]
Abstract
Childhood attention-deficit hyperactivity disorder (ADHD) is associated with academic underachievement and school dysfunction. Little is known whether such association varies with the persistence of ADHD symptoms. The authors investigated school functioning among youths with and without persistent ADHD and identified the clinical correlates for school functioning in a large sample of 333 youths with persistent ADHD, 166 with non-persistent ADHD, and 266 without ADHD. The participants and their mothers received structured interviews for diagnosis of ADHD and other psychiatric conditions according to the DSM-IV diagnostic criteria by using the Kiddie epidemiologic version of the Schedule for Affective Disorders and Schizophrenia, and for school functioning by using the Chinese Social Adjustment Inventory for Children and Adolescents. The results showed that both ADHD groups had more impairment in all domains of school functioning than youths without ADHD with a gradient relationship in the order of persistent ADHD, non-persistent ADHD, and non-ADHD. The most consistent correlates for all domains of impaired school functioning were youth- and mother-reported inattention symptoms and increased age. Childhood hyperactivity-impulsivity symptoms also predicted more severe problems in social interactions and school behaviors. Psychiatric comorbid conditions also predicted poorer attitudes toward school works and interactions at school. Our findings indicate that lifetime diagnosis of ADHD, regardless of persistence of ADHD, associate with the impairment of overall school functioning sustaining from childhood into adolescence, and imply that early intervention of childhood inattention may offset school dysfunction at late childhood and adolescence.
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Affiliation(s)
- Szu-Ying Wu
- Department of Psychiatry, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan
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Hsiao MN, Tseng WL, Huang HY, Gau SSF. Effects of autistic traits on social and school adjustment in children and adolescents: the moderating roles of age and gender. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:254-265. [PMID: 22960068 DOI: 10.1016/j.ridd.2012.08.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 07/29/2012] [Accepted: 08/03/2012] [Indexed: 06/01/2023]
Abstract
This study examined the associations between children's and adolescents' autistic-like social deficits and school and social adjustment as well as the moderating roles of age and gender in these associations. The sample consisted of 1321 students (48.7% boys) in Grade 1 to Grade 8 from northern Taiwan. Children's and adolescents' autistic-like social deficits were assessed using the Social Responsiveness Scale (SRS), and their school and social adjustment (i.e., academic performance, negative attitudes toward schoolwork/teachers/classmates, behavioral problems at schools, negative peer relationships, and problems with peers) were assessed using the Social Adjustment Inventory for Children and Adolescents (SAICA). Both measures were completed by the mothers of the participants. Results from the linear mixed models demonstrated that autistic-like social deficits were associated with poor academic performance, negative attitudes toward schoolwork, teachers, and classmates, behavioral problems at schools, negative peer relationships, and problematic peer interactions. Moreover, gender and/or age moderated the associations between autistic-like social deficits and school and social adjustment problems. For example, autistic-like social deficits were more strongly related to negative school attitude, school social problems, and negative peer relationships in boys than in girls. Further, autistic-like social deficits were more strongly related to problems with peers in older girls than in older boys or younger children (regardless of gender). In conclusion, the present study suggests that autistic-like social deficits may place children and adolescents at increased risk for social and school maladjustment and that the extent of maladjustment may vary with the child's age and gender and the domains of adjustment under discussion.
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Affiliation(s)
- Mei-Ni Hsiao
- Department of Psychiatry, National Taiwan University Hospital, No 7 Chung-Shan South Road, Taipei, Taiwan.
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Shang CY, Gau SSF. Improving visual memory, attention, and school function with atomoxetine in boys with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol 2012; 22:353-63. [PMID: 23083022 DOI: 10.1089/cap.2011.0149] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Atomoxetine is efficacious in reducing symptoms of attention- deficit/hyperactivity disorder (ADHD), but its effect on visual memory and attention needs more investigation. This study aimed to assess the effect of atomoxetine on visual memory, attention, and school function in boys with ADHD in Taiwan. METHOD This was an open-label 12 week atomoxetine treatment trial among 30 drug-naíve boys with ADHD, aged 8-16 years. Before administration of atomoxetine, the participants were assessed using psychiatric interviews, the Wechsler Intelligence Scale for Children, 3rd edition (WISC-III), the school function of the Chinese version of the Social Adjustment Inventory for Children and Adolescents (SAICA), the Conners' Continuous Performance Test (CPT), and the tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB) involving visual memory and attention: Pattern Recognition Memory, Spatial Recognition Memory, and Reaction Time, which were reassessed at weeks 4 and 12. RESULTS Our results showed there was significant improvement in pattern recognition memory and spatial recognition memory as measured by the CANTAB tasks, sustained attention and response inhibition as measured by the CPT, and reaction time as measured by the CANTAB after treatment with atomoxetine for 4 weeks or 12 weeks. In addition, atomoxetine significantly enhanced school functioning in children with ADHD. CONCLUSION Our findings suggested that atomoxetine was associated with significant improvement in visual memory, attention, and school functioning in boys with ADHD.
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Affiliation(s)
- Chi-Yung Shang
- Department of Psychiatry, National Taiwan University Hospital & College of Medicine, National Taiwan University, Taipei, Taiwan
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Kawabata Y, Tseng WL, Gau SSF. Symptoms of attention-deficit/hyperactivity disorder and social and school adjustment: the moderating roles of age and parenting. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:177-88. [PMID: 21858455 DOI: 10.1007/s10802-011-9556-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examined the associations between symptoms of attention-deficit/hyperactivity disorder (ADHD) and social and school adjustment (academic performance, peer relationships, school social problems) and the moderating roles of children's age and maternal parenting (affection and overprotection) in these associations. The sample consisted of 2,463 students who were in the first to ninth grade in northern Taiwan. Results from the linear mixed models demonstrated that ADHD symptoms were inversely associated with academic performance and positively associated with social adjustment problems. Further, children's age and maternal parenting moderated the associations between ADHD symptoms and school and social adjustment. For example, maternal overprotection moderated the relation between hyperactivity and negative peer relationships (i.e., difficulty forming and maintaining friendships), such that this relation was stronger for children who experienced higher levels of overprotection than children who did not. Moreover, children's age moderated the association between attention problems and decreased academic performance, such that this association was stronger for older children and adolescents than for younger children. Furthermore, children's age and maternal affection interacted to influence the association between attention problems and school social problems (i.e., bullying, aggression, and peer rejection) with maternal affection acting as a buffer for older children (grades 4-6) only. These findings are discussed from a developmental psychopathology perspective.
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Social adjustment among Taiwanese children with symptoms of ADHD, ODD, and ADHD comorbid with ODD. Child Psychiatry Hum Dev 2011; 42:134-51. [PMID: 20886286 DOI: 10.1007/s10578-010-0204-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined social problems at school and relationships with peers, siblings, mothers, and fathers among children with ADHD only (n = 41), ODD only (n = 14), ADHD + ODD (n = 47), and normal controls (n = 204) from a school-based sample of 2,463 first to ninth graders in Taiwan. ADHD and ODD symptoms were determined by teacher and mother reports on the Conners' Rating Scales and social adjustment problems were assessed by mother reports on the Social Adjustment Inventory for Children and Adolescents. Results indicated that relative to normal controls, children with ADHD + ODD displayed greater levels of social adjustment problems across domains (i.e., school, peers, siblings, and parents) while children with ADHD were significantly more impaired only in social adjustment at schools and children with ODD were more impaired only in social adjustment at home. Some similarities and differences in our findings, in relation to the Western literature, were discussed.
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Al-Sharbati MM, Zaidan ZAJ, Dorvlo ASS, Al-Adawi S. Characteristics of ADHD among Omani schoolchildren using DSM-IV: descriptive study. J Atten Disord 2011; 15:139-46. [PMID: 20071640 DOI: 10.1177/1087054709356175] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is a dearth of studies describing the characteristics of ADHD among schoolchildren attending child psychiatry clinics in the Arab world. Most of the previous quests have focused on community surveys or themes that hampered international comparison. AIM This study screened for the presence of ADHD as well as investigates the psychosocial and educational history relevant for the diagnosis of ADHD among children. METHOD Consecutive schoolchildren attending child psychiatric consultations were screened for the presence of ADHD according to the Diagnostic and Statistical Manual for Mental disorders (DSM) criteria. RESULT A total of 221 schoolchildren suffering from ADHD were identified according to the DSM. The year incidence was 0.16. Males constituted the majority presenting with ADHD. The contribution of consanguinity and a history of acquired brain injury were common features. The majority were attending mainstream education as pharmacotherapy is the only option available for managing ADHD. CONCLUSION This study is one of the few from this part of the world using DSM criteria to diagnose ADHD. The implications of the present findings are discussed in the context of the available literature and the specific situation in Oman.
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Juárez J, Vázquez-Cortés C. Corticosterone treatment before puberty sensitizes the effect of oral methylphenidate on locomotor activity in preadolescence and produces differential effects in adulthood. Brain Res 2010; 1346:195-203. [PMID: 20553877 DOI: 10.1016/j.brainres.2010.05.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 05/14/2010] [Accepted: 05/30/2010] [Indexed: 11/27/2022]
Abstract
UNLABELLED The first objective of this study was to examine the effects of early exposure to methylphenidate and then those of re-exposure in adulthood. The second was to analyze the effect of corticosterone treatment during pre-puberty on oral methylphenidate consumption and, consequently, the effect of this psychostimulant on locomotor activity in preadolescent and adult rats. Experiment 1: from 31 to 39 days of postnatal age (PA), Wistar rats were exposed to either oral methylphenidate or water. Experiment 2: from 24 to 39 days PA, the rats received either corticosterone (2.0 mg/kg/day/subject) or a saline solution. From 31 to 39 days PA, rats were exposed to either methylphenidate or water. During adulthood, all rats in experiments 1 and 2 were exposed to either methylphenidate or water, and subsequently exposed to a free-choice condition of the same two substances. RESULTS Experiment 1. Methylphenidate increased locomotor activity (LA) regardless of age. In adulthood, higher methylphenidate consumption was observed in the group that had not been exposed to this substance, compared to the early methylphenidate-exposed group. Experiment 2. Corticosterone did not affect methylphenidate consumption during preadolescence or adulthood; however, the LA induced by methylphenidate was higher in the preadolescents that had been treated with corticosterone+methylphenidate than in the animals treated only with methylphenidate. In adulthood, methylphenidate produced higher LA in the animals previously treated with corticosterone+methylphenidate than in those that had received previous treatment exclusively with corticosterone. These results suggest that preadolescent corticosterone exposure produced a sensitizing effect of methylphenidate on LA in preadolescence. The differential effect on LA in adulthood depended on whether the corticosterone was administered with or without methylphenidate in preadolescence, which would suggest an enduring effect of the early synergic action between these two substances.
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Affiliation(s)
- Jorge Juárez
- Laboratorio de Farmacología y Conducta, Instituto de Neurociencias, Universidad de Guadalajara, Guadalajara, Jalisco, México.
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