1
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Botkin TN, Wiggs K, Kipp HL, Lindstrom RA, Joseph HM, Kolko DJ, Pedersen SL, Molina BSG. Highly Involved Parenting of Adolescents With ADHD: Examination of the Psychometric Properties of a Measure of "Helicopter Parenting". J Atten Disord 2024:10870547241258879. [PMID: 38859688 DOI: 10.1177/10870547241258879] [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: 06/12/2024]
Abstract
OBJECTIVE The concept of the "helicopter parent" was popularized in the 2000s and 2010s by Western culture, and it has recently begun to be examined by researchers to describe parental over-involvement and intrusive behavior that impedes transition into adulthood. Research has yet to investigate the viability of this construct for adolescents when parenting is needed to facilitate the development of autonomy. The present study examined the psychometric structure of a modified "helicopter parenting" measure adapted for use in a sample with increased likelihood of highly involved parenting: adolescents with ADHD. METHODS Adolescents (n = 333; age 13-18 years; 25% female) and their parents (n = 341, 91% female) completed a survey for a study on provider training in stimulant diversion prevention in 2016 and 2017. We modified a previously validated measure of "helicopter parenting" for young adults. Other previously established parenting measures were included. We conducted principal component analysis for both informants' reports of the modified measure. We examined associations between the components and informants' demographic characteristics and parenting measures to begin to examine convergent and discriminant validity. RESULTS Two components were identified for adolescent and parent reports and labeled parental Intervention and Day-to-day Monitoring and Planning. These components were differentially associated with demographic characteristics and other measures of parenting. For example, across reporters, parents exhibited less Day-to-Day Monitoring and Planning for older adolescents. Racially/ethnically minoritized parents and male adolescents reported more Intervention parenting. Modest-sized statistically significant associations were found between these indicators of highly involved parenting and the other measures of parenting. CONCLUSION Findings provide initial evidence of construct validity. Future work with more heterogeneous samples should examine if this measure captures adaptive parenting, or behaviors that interfere with developing independence, for adolescents with ADHD and neurotypically developing adolescents.
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Affiliation(s)
| | | | - Heidi L Kipp
- University of Pittsburgh School of Medicine, PA, USA
| | | | | | - David J Kolko
- University of Pittsburgh School of Medicine, PA, USA
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2
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Kennedy TM, Molina BSG, Pedersen SL. Change in Adolescents' Perceived ADHD Symptoms Across 17 Days of Ecological Momentary Assessment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:397-412. [PMID: 35882042 PMCID: PMC9877248 DOI: 10.1080/15374416.2022.2096043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To test whether adolescents' perceived ADHD symptoms may improve while monitoring them throughout the day. METHOD In a sample of 90 adolescents (Mage = 14.7; 66% boys, 34% girls; 76.7% White, 13.3% Black or African American, 8.9% more than one race, 1.1% "other") treated for ADHD by their pediatricians, this study examined: (1) whether self-rated ADHD symptoms decreased across 17 days of 4 times daily ecological momentary assessment (EMA) of symptoms and (2) whether completing versus missing an EMA survey was associated with lower self-rated ADHD symptoms in the subsequent hours. RESULTS Multilevel regression analyses showed that, on average, adolescents' perceived ADHD symptoms (inattention, hyperactivity, impulsivity, and total across domains) decreased across 17 days of EMA. Within person, symptoms were lower following completed versus missed EMA surveys. Significant moderating effects showed that the effect of completing the prior EMA survey weakened across the day and over the course of the 17 days. CONCLUSIONS This study is the first to document acute improvements in self-rated ADHD symptoms using EMA in adolescents' naturalistic environments. Symptom monitoring throughout the day may help adolescents improve their day-to-day ADHD, at least acutely, and holds promise as one component of mobile-health ADHD interventions.
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Howe CG, Laue HE. Invited Perspective: Studying Metal Impacts on Neurobehavior during the Critical but Challenging Window of Adolescence. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:21303. [PMID: 38363633 PMCID: PMC10871113 DOI: 10.1289/ehp14303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Caitlin G. Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Hannah E. Laue
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
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4
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Kennedy TM, Molina BSG. Translating the nuanced risk for substance use among adolescents treated for attention-deficit/hyperactivity disorder (ADHD) into clinical practice: a commentary on McCabe et al. (2023). J Child Psychol Psychiatry 2024; 65:112-115. [PMID: 37669753 DOI: 10.1111/jcpp.13888] [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] [Accepted: 08/13/2023] [Indexed: 09/07/2023]
Abstract
In their recent examination of the Monitoring the Future (MTF) data, McCabe et al. (Journal of Child Psychology and Psychiatry, 2023) address the complex, longstanding, and clinically valuable questions of whether and how stimulant medication treatment for adolescents with ADHD relates to their risk for substance use. Here, we expand on the authors' interpretations of their nuanced findings of increased risk for illicit stimulant use and non-prescribed stimulant medication use for youth with later age of medication treatment initiation and shorter treatment duration. We particularly focus on highlighting tangible clinical implications, and we recommend ways future research can build on the authors' findings to further clarify this important issue.
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5
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Connaughton M, O’Hanlon E, Silk TJ, Paterson J, O’Neill A, Anderson V, Whelan R, McGrath J. The Limbic System in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder: A Longitudinal Structural Magnetic Resonance Imaging Analysis. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:385-393. [PMID: 38298776 PMCID: PMC10829648 DOI: 10.1016/j.bpsgos.2023.10.005] [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: 07/03/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 02/02/2024] Open
Abstract
Background During childhood and adolescence, attention-deficit/hyperactivity disorder (ADHD) is associated with changes in symptoms and brain structures, but the link between brain structure and function remains unclear. The limbic system, often termed the "emotional network," plays an important role in a number of neurodevelopmental disorders, yet this brain network remains largely unexplored in ADHD. Investigating the developmental trajectories of key limbic system structures during childhood and adolescence will provide novel insights into the neurobiological underpinnings of ADHD. Methods Structural magnetic resonance imaging data (380 scans), emotional regulation (Affective Reactivity Index), and ADHD symptom severity (Conners 3 ADHD Index) were measured at up to 3 time points between 9 and 14 years of age in a sample of children and adolescents with ADHD (n = 57) and control children (n = 109). Results Compared with the control group, the ADHD group had lower volume of the amygdala (left: β standardized [β_std] = -0.38; right: β_std = -0.34), hippocampus (left: β_std = -0.44; right: β_std = -0.34), cingulate gyrus (left: β_std = -0.42; right: β_std = -0.32), and orbitofrontal cortex (right: β_std = -0.33) across development (9-14 years). There were no significant group-by-age interactions in any of the limbic system structures. Exploratory analysis found a significant Conners 3 ADHD Index-by-age interaction effect on the volume of the left mammillary body (β_std = 0.17) in the ADHD group across the 3 study time points. Conclusions Children and adolescents with ADHD displayed lower volume and atypical development in limbic system structures. Furthermore, atypical limbic system development was associated with increased symptom severity, highlighting a potential neurobiological correlate of ADHD severity.
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Affiliation(s)
- Michael Connaughton
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Erik O’Hanlon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Timothy J. Silk
- Department of Developmental Neuroimaging, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Centre for Social and Early Emotional Development and School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Julia Paterson
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Aisling O’Neill
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Vicki Anderson
- Department of Developmental Neuroimaging, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Psychology, Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Robert Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Jane McGrath
- Department of Psychiatry, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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6
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Iines R. P, Sami J. M, Vesa M. N, Hannu K. S. ADHD symptoms and maladaptive achievement strategies: the reciprocal prediction of academic performance beyond the transition to middle school. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2023. [DOI: 10.1080/13632752.2023.2189404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Affiliation(s)
- Palmu Iines R.
- Department of Education, University of Jyväskylä, Jyvaskyla, Finland
- Valteri National Centre for Learning and Support, Finland
| | | | - Närhi Vesa M.
- Department of Education, University of Jyväskylä, Jyvaskyla, Finland
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7
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Di Lonardo Burr SM, LeFevre JA, Arnold LE, Epstein JN, Hinshaw SP, Molina BSG, Hechtman L, Hoza B, Jensen PS, Vitiello B, Pelham WE, Howard AL. Paths to postsecondary education enrollment among adolescents with and without childhood attention-deficit/hyperactivity disorder (ADHD): A longitudinal analysis of symptom and academic trajectories. Child Dev 2022; 93:e563-e580. [PMID: 35635061 DOI: 10.1111/cdev.13807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We examined developmental trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms, standardized achievement, and school performance for adolescents with and without ADHD who did and did not enroll in postsecondary education (PSE; N = 749; 79% boys; 63% White, 17% non-Hispanic Black, 10% Hispanic, and 10% other ethnicities). In a multisite study (recruitment based in New York, North Carolina, Pennsylvania, California, and Quebec), participants were originally enrolled between 1994 and 1998 at ages 7 to 9.9 and followed up through 2012 (Mage = 25 at final follow-up). Adolescents who eventually enrolled in PSE had less severe symptoms, but differences were modest and trajectories were similar over time. For all adolescents, standardized achievement trajectories declined up to two thirds of a standard deviation from ages 9 to 17. By the end of high school, the average GPA of adolescents with ADHD was three quarters of a point higher for those who eventually enrolled in PSE compared to those who did not. Overall, school performance mattered more than academic achievement for understanding eventual enrollment of adolescents with ADHD.
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Affiliation(s)
- Sabrina M Di Lonardo Burr
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Cognitive Science, Carleton University, Ottawa, Ontario, Canada
| | - Jo-Anne LeFevre
- Department of Cognitive Science, Carleton University, Ottawa, Ontario, Canada.,Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, Ohio, USA
| | - Jeffrey N Epstein
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, California, USA
| | - Brooke S G Molina
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lily Hechtman
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Betsy Hoza
- Department of Psychological Science, University of Vermont, Burlington, Vermont, USA
| | - Peter S Jensen
- The REACH Institute, New York, New York, USA.,Department of Psychiatry, University of Arkansas for the Medical Sciences, Little Rock, Arkansas, USA
| | - Benedetto Vitiello
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - William E Pelham
- College of Arts, Sciences, and Education, Florida International University, Miami, Florida, USA
| | - Andrea L Howard
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
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Park S, Chang H. Developmental Trajectory of Inattention and Its Association With Depressive Symptoms in Adolescence: Peer Relationships as a Mediator. Front Psychol 2022; 12:736840. [PMID: 35178006 PMCID: PMC8845459 DOI: 10.3389/fpsyg.2021.736840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/16/2021] [Indexed: 11/21/2022] Open
Abstract
This study investigated the developmental trajectory of inattention symptoms as a predictor of later depressive symptoms in adolescence, and examined potential mediating role of peer relationships in this process. Participants were adolescents who were part of the large longitudinal panel study on Korean Youths, Korean Children & Youth Panel Survey 2010 (KCYPS 2010) of the National Youth Policy Institute (NYPI). Specifically, data were drawn from two cohorts of KCYPS that differed in participant age (Panel 1: 2003 birth cohort, n = 2,342, 48.2% girls; Panel 2: 2000 birth cohorts, n = 2,378, 40.0% girls). We analyzed data collected from 2010 to 2016 when children in panel 1 were 6-7 to 12-13 years old, and children in panel 2 were 9-10 to 15-16 years old. Results of latent growth modeling (LGM) were as follows. In Panel 1, the inattention symptoms increased from 9-10 to 12-13 years. Otherwise, the inattention symptoms decreased from 11-12 to 15-16 years in panel 2. Additionally, in both panels, initial status and slope of inattention significantly predicted later levels of depressive symptoms, and peer relationships partly mediated the association between inattention trajectory and depressive symptoms. The findings are discussed with respect to considering the growth of inattention and the quality of peer relationships as promising targets for early identification and intervention of depression in adolescents.
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Affiliation(s)
| | - Hyein Chang
- Department of Psychology, Sungkyunkwan University, Seoul, South Korea
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9
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Sibley MH, Arnold LE, Swanson JM, Hechtman LT, Kennedy TM, Owens E, Molina BS, Jensen PS, Hinshaw SP, Roy A, Chronis-Tuscano A, Newcorn JH, Rohde LA. Variable Patterns of Remission From ADHD in the Multimodal Treatment Study of ADHD. Am J Psychiatry 2022; 179:142-151. [PMID: 34384227 PMCID: PMC8810708 DOI: 10.1176/appi.ajp.2021.21010032] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE It is estimated that childhood attention deficit hyperactivity disorder (ADHD) remits by adulthood in approximately 50% of cases; however, this conclusion is typically based on single endpoints, failing to consider longitudinal patterns of ADHD expression. The authors investigated the extent to which children with ADHD experience recovery and variable patterns of remission by adulthood. METHODS Children with ADHD (N=558) in the Multimodal Treatment Study of ADHD (MTA) underwent eight assessments over follow-ups ranging from 2 years (mean age, 10.44 years) to 16 years (mean age, 25.12 years) after baseline. The authors identified participants with fully remitted, partially remitted, and persistent ADHD at each time point on the basis of parent, teacher, and self-reports of ADHD symptoms and impairment, treatment utilization, and substance use and mental disorders. Longitudinal patterns of remission and persistence were identified that considered context and timing. RESULTS Approximately 30% of children with ADHD experienced full remission at some point during the follow-up period; however, a majority of them (60%) experienced recurrence of ADHD after the initial period of remission. Only 9.1% of the sample demonstrated recovery (sustained remission) by study endpoint, and only 10.8% demonstrated stable ADHD persistence across study time points. Most participants with ADHD (63.8%) had fluctuating periods of remission and recurrence over time. CONCLUSIONS The MTA findings challenge the notion that approximately 50% of children with ADHD outgrow the disorder by adulthood. Most cases demonstrated fluctuating symptoms between childhood and young adulthood. Although intermittent periods of remission can be expected in most cases, 90% of children with ADHD in MTA continued to experience residual symptoms into young adulthood.
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Affiliation(s)
- Margaret H. Sibley
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle Children’s Research Institute
| | - L. Eugene Arnold
- Department of Psychiatry and Behavioral Health, Ohio State University, Nisonger Center, Columbus Ohio
| | - James M. Swanson
- Child Development Center, School of Medicine, University of California, Irvine
| | - Lily T. Hechtman
- Division of Child Psychiatry, McGill University, Montreal Children’s Hospital, Montreal, Quebec, Canada
| | - Traci M. Kennedy
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | - Elizabeth Owens
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | | | | | - Stephen P. Hinshaw
- Department of Psychology, University of California, Berkeley, Department of Psychiatry & Behavioral Sciences, University of California, San Francisco
| | | | | | - Jeffrey H. Newcorn
- Department of Psychiatry & Pediatrics, Icahn School of Medicine at Mount Sinai
| | - Luis A. Rohde
- ADHD and Developmental Psychiatry Programs, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul
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10
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Ceroni M, Rossi S, Zerboni G, Biglia E, Soldini E, Izzo A, Morellini L, Sacco L. Attentive-executive functioning and compensatory strategies in adult ADHD: A retrospective case series study. Front Psychol 2022; 13:1015102. [PMID: 36312151 PMCID: PMC9606327 DOI: 10.3389/fpsyg.2022.1015102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adults with ADHD exhibit a neuropsychological profile that may present deficits in many cognitive domains, particularly attention and executive functions (EFs). However, some authors do not consider executive disfunction as an important part of the clinical profile of the syndrome; this could be related to the use of inappropriate neuropsychological tests, probably not adapted and not sufficiently ecological. Moreover, new data are required on specific correlation of attentive-executive symptoms with socio-demographic factors. Therefore, the aim of this study is to analyze the neuropsychological performance of a group of adults with ADHD, also evaluating the influence of gender, age and education level. Methods We retrospectively collected health-related personal data of 40 adult ADHD patients, clinically diagnosed and evaluated via a battery of 4 neuropsychological tests and 1 self-administered questionnaire. Gender, age and years of education differences were assessed. Results Attention and EFs deficits have been highlighted mainly on the d2-R and 5-point neuropsychological tests, which therefore seem to be more sensitive in measuring the attention-executive dysfunction in an adult ADHD population, than TAP Go/No-go and ROCFT. ADHD patients also manifested subjective behavioral impulsivity disorders on BIS-11. There were no statistically significant gender differences in cognitive performance. On the contrary, younger patients performed worse on subscales TAP Go/No-go errors and 5-points number of drawings, while participants with a higher education level performed better on subscales d2-R speed of execution and d2-R errors. This supports a reduction in the number of errors and the execution time as a function of older age and a higher level of education. Finally, patients with higher education also self-reported greater impulsivity in planning. Conclusion Our preliminary findings suggest that adult ADHD is not a lifelong stable disorder, but it may change over time. Moreover, attention-executive deficits may be influenced and partially counterbalanced by experience (i.e., advancing age) and a higher level of education. This could underlie the development of specific psycho-behavioral and cognitive compensatory strategies. The use of self-administered questionnaires is therefore recommended to highlight attentional and executive difficulties that may not result in neuropsychological tests.
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Affiliation(s)
- Martino Ceroni
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
| | - Stefania Rossi
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
| | - Giorgia Zerboni
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
| | - Elena Biglia
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
| | - Emiliano Soldini
- Competence Centre for Healthcare Practices and Policies, Department of Business Economics, Health, and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Alessia Izzo
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Lucia Morellini
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- *Correspondence: Lucia Morellini,
| | - Leonardo Sacco
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
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11
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Zendarski N, Guo S, Sciberras E, Efron D, Quach J, Winter L, Bisset M, Middeldorp CM, Coghill D. Examining the Educational Gap for Children with ADHD and Subthreshold ADHD. J Atten Disord 2022; 26:282-295. [PMID: 33317376 DOI: 10.1177/1087054720972790] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The present study examined the impact of Attention Deficit Hyperactivity Disorder (ADHD) on core educational outcomes in two large community cohorts of Australian school children. METHOD Academic (reading and numeracy) and non-academic (school engagement, attendance, peer victimization, and parental expectations) outcomes were compared between children with ADHD, subthreshold ADHD, and controls when children were in grade 5 (M age = 10.5). Data were drawn from the Longitudinal Study of Australian Children birth cohort (LSAC; N = 3,540) and the Children's Attention Project (CAP; N = 356). RESULTS Both subthreshold ADHD and ADHD groups had poorer outcomes on all measures, with medium effects sizes. Differences were not evident between subthreshold ADHD and ADHD groups. CONCLUSIONS Educational outcomes examined in this study highlight the educational risk for upperprimary school children with ADHD or subthreshold ADHD, in comparison to their peers. Monitoring these outcomes is necessary to inform policy, practice, and intervention.
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Affiliation(s)
- Nardia Zendarski
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Shuaijun Guo
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Emma Sciberras
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia.,Deakin University, Geelong, Australia
| | - Daryl Efron
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia.,Department General Medicine, Royal Children's Hospital, Melbourne Australia
| | - Jon Quach
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Matthew Bisset
- Murdoch Children's Research Institute, Melbourne, Australia.,Deakin University, Geelong, Australia
| | - Christel M Middeldorp
- The University of Queensland, Brisbane, Australia.,Children's Health Queensland Hospital and Health Service, Brisbane Australia
| | - David Coghill
- The University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
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12
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Evans SW, Allan D, Xiang J, Margherio SM, Owens JS, Langberg JM. Organization interventions as a mediator of change in grades in the Challenging Horizons Program. J Sch Psychol 2021; 87:18-27. [PMID: 34303445 DOI: 10.1016/j.jsp.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 02/28/2021] [Accepted: 05/14/2021] [Indexed: 12/28/2022]
Abstract
This study evaluated whether an organization intervention was a mediator of change for grade point average (GPA) in a randomized clinical trial of a school-based treatment program for adolescents with attention deficit hyperactivity disorder (ADHD). A demographically diverse sample of 148 participants (105 males) with a diagnosis of ADHD were recruited from nine middle schools. Comprehensive diagnostic evaluations were completed and participants were randomized into one of three conditions (two active treatment conditions, one control condition) for a randomized clinical trial that lasted an entire school year. The results of the trial are reported elsewhere (Evans et al., 2016; Schultz et al., 2017); in this study we evaluated four of the criteria for determining mediation as reported by Kazdin (2007) to determine whether response to the organization intervention in this school-based treatment program mediated the relationship between dosage and GPA beyond previous GPA. The results provided evidence that response to the organization intervention mediated the relationship between intervention dosage and change in GPA.
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Affiliation(s)
- Steven W Evans
- Ohio University, Department of Psychology, Athens, OH 45701, United States.
| | - Darcey Allan
- Ohio University, Department of Psychology, Athens, OH 45701, United States.
| | - Joe Xiang
- Ohio University, Department of Psychology, Athens, OH 45701, United States.
| | | | - Julie Sarno Owens
- Ohio University, Department of Psychology, Athens, OH 45701, United States.
| | - Joshua M Langberg
- Virginia Commonwealth University, Department of Psychology, Richmond, VA 23284, United States.
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13
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Sibley MH, Ortiz M, Gaias LM, Reyes R, Joshi M, Alexander D, Graziano P. Top problems of adolescents and young adults with ADHD during the COVID-19 pandemic. J Psychiatr Res 2021; 136:190-197. [PMID: 33610946 PMCID: PMC8009847 DOI: 10.1016/j.jpsychires.2021.02.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/25/2021] [Accepted: 02/08/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE ADHD symptom severity appears to be exacerbated during the COVID-19 pandemic. The present study surveyed top problems experienced by adolescents and young adults (A/YAs) with ADHD during the COVID-19 pandemic to identify possible reasons for symptom escalation and potential targets for intervention. We also explored perceived benefits of the pandemic for A/YAs with ADHD. METHOD At the outbreak of the COVID-19 pandemic (April-June 2020), we administered self and parent ratings about current and pre-pandemic top problem severity and benefits of the pandemic to a sample of convenience (N = 134 A/YAs with ADHD participating in a prospective longitudinal study). RESULTS The most common top problems reported in the sample were social isolation (parent-report: 26.7%; self-report: 41.5%), difficulties engaging in online learning (parent-report: 23.3%, self-report: 20.3%), motivation problems (parent-report: 27.9%), and boredom (self-report: 21.3%). According to parent (d = 0.98) and self-report (d = 1.33), these top problems were more severe during the pandemic than in prior months. Contrary to previous speculation, there was no evidence that pandemic-related changes mitigated ADHD severity. Multi-level models indicated that A/YAs with higher IQs experienced severer top problems exacerbations at the transition to the COVID-19 pandemic. CONCLUSIONS For A/YAs with ADHD, several risk factors for depression and school dropout were incurred during the early months of the COVID-19 pandemic. A/YAs with ADHD should be monitored for school disengagement and depressive symptoms during the COVID-19 pandemic. Recommended interventions attend to reducing risk factors such as increasing social interaction, academic motivation, and behavioral activation among A/YAs with ADHD.
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Affiliation(s)
- Margaret H Sibley
- University of Washington, 1410 Campus Parkway, Seattle, WA, USA; Seattle Children's Research Institute, 1900 9th Avenue, Seattle, WA, USA.
| | - Mercedes Ortiz
- Seattle Children's Research Institute, 1900 9th Avenue, Seattle, WA, USA
| | - Larissa M Gaias
- University of Massachusetts Lowell, 220 Pawtucket St, Lowell, MA, USA
| | - Rosemary Reyes
- University of Washington, 1410 Campus Parkway, Seattle, WA, USA
| | - Mahima Joshi
- University of Washington, 1410 Campus Parkway, Seattle, WA, USA
| | - Dana Alexander
- University of Washington, 1410 Campus Parkway, Seattle, WA, USA
| | - Paulo Graziano
- Florida International University, 11200 SW 8th Street, Miami, FL, USA
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14
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Examination of developmental pathways from preschool temperament to early adolescent ADHD symptoms through initial responsiveness to reward. Dev Psychopathol 2021; 34:841-853. [PMID: 33722319 DOI: 10.1017/s0954579420002199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
To identify sources of phenotypic heterogeneity in attention-deficit/hyperactivity disorder (ADHD) accounting for diversity in developmental/ pathogenic pathways, we examined, in a large sample of youth (N = 354), (a) associations between observed temperamental emotionality at age 3, an electrocortical index (i.e., reward positivity [RewP]) of initial responsiveness to reward at age 9, and ADHD symptoms at age 12, and (b) whether the association between emotionality and ADHD symptoms is mediated by initial responsiveness to reward. Bivariate analyses indicated greater positive emotionality (PE) was associated with enhanced RewP, lower age-9ADHD and lower age-12 inattention (IA). Negative emotionality (NE) was not associated with RewP or ADHD. Mediation analyses revealed the association between PE and hyperactivity/impulsivity (H/I) was mediated by RewP; enhanced RewP was associated with greater H/I. Greater PE was associated with enhanced RewP at a trend level. These effects held accounting for age-9 ADHD, age-12 IA and age-12 oppositional defiant and conduct disorder symptoms. As such, preschool emotionality is associated with adolescent ADHD-H/I symptoms through late childhood initial responsiveness to reward. These relations indicate that individual differences in emotionality and reward responsiveness may be informative for personalizing ADHD interventions.
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15
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von Wirth E, Mandler J, Breuer D, Döpfner M. The Accuracy of Retrospective Recall of Childhood ADHD: Results from a Longitudinal Study. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09852-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AbstractAttention-deficit/hyperactivity disorder (ADHD) is a childhood-onset condition that may continue into adulthood. When assessing adult patients, clinicians usually rely on retrospective reports of childhood symptoms to evaluate the age-of-onset criterion. Since inaccurate symptom recall may impede the diagnosis and treatment of ADHD, knowledge about the factors influencing retrospective reports is needed. This longitudinal study investigated (a) the accuracy of retrospective symptom ratings by adult participants with a childhood diagnosis of ADHD (self-ratings) and parents or significant others (proxy ratings), and (b) the influence of current ADHD symptom severity and ADHD-associated impairments on retrospective symptom ratings. Participants (N = 55) were members of the Cologne Adaptive Multimodal Treatment (CAMT) study who had been referred and treated for ADHD in childhood and were reassessed in adulthood (average age 27 years). Participants’ retrospective self-ratings were substantially lower than, and did not correlate with, parents’ ADHD symptom ratings provided at study entry, while retrospective symptom ratings provided by proxy respondents correlated moderately with parents’ childhood ratings. In addition, participants were more likely to underreport childhood symptoms (79%) and more frequently denied the presence of three or more childhood symptoms (17%) compared to proxy respondents (65% underreporting, 10% false-negative recall). Proxy respondents’ symptom recall was best predicted by childhood ADHD, while participants’ symptom recall was best predicted by current ADHD symptom severity. ADHD-associated impairments were not correlated with symptom recall after controlling for childhood ADHD. Together, these findings suggest a recall bias in adult patients and question the validity of retrospective reports, even in clinical samples.
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16
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Nigg JT, Sibley MH, Thapar A, Karalunas SL. Development of ADHD: Etiology, Heterogeneity, and Early Life Course. ANNUAL REVIEW OF DEVELOPMENTAL PSYCHOLOGY 2020; 2:559-583. [PMID: 34368774 PMCID: PMC8336725 DOI: 10.1146/annurev-devpsych-060320-093413] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
ADHD represents a powerful entry point for developmental approaches to psychopathology due to its major role in early emergence of major life problems. One key issue concerns the role of early environmental risks in etiology and maintenance in the context of genetic liability. Here, psychosocial aspects of development need more attention. A second key issue is that phenotypic heterogeneity requires better resolution if actionable causal mechanisms are to be effectively identified. Here, the interplay of cognition and emotion in the context of a temperament lens is one helpful way forward. A third key issue is the poorly understood yet somewhat striking bifurcation of developmental course in adolescence, when a subgroup seem to have largely benign outcomes, while a larger group continue on a problematic path. A final integrative question concerns the most effective conceptualization of the disorder in relation to broader dysregulation. Key scientific priorities are noted.
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Affiliation(s)
- Joel T Nigg
- Oregon Health & Science University, Portland OR, USA
| | - Margaret H Sibley
- University of Washington and Seattle Children's Research Institute, Seattle WA, USA
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17
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Nigg JT, Sibley MH, Thapar A, Karalunas SL. Development of ADHD: Etiology, Heterogeneity, and Early Life Course. ANNUAL REVIEW OF DEVELOPMENTAL PSYCHOLOGY 2020. [PMID: 34368774 DOI: 10.1146/annurev-devpsych-060320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
ADHD represents a powerful entry point for developmental approaches to psychopathology due to its major role in early emergence of major life problems. One key issue concerns the role of early environmental risks in etiology and maintenance in the context of genetic liability. Here, psychosocial aspects of development need more attention. A second key issue is that phenotypic heterogeneity requires better resolution if actionable causal mechanisms are to be effectively identified. Here, the interplay of cognition and emotion in the context of a temperament lens is one helpful way forward. A third key issue is the poorly understood yet somewhat striking bifurcation of developmental course in adolescence, when a subgroup seem to have largely benign outcomes, while a larger group continue on a problematic path. A final integrative question concerns the most effective conceptualization of the disorder in relation to broader dysregulation. Key scientific priorities are noted.
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Affiliation(s)
- Joel T Nigg
- Oregon Health & Science University, Portland OR, USA
| | - Margaret H Sibley
- University of Washington and Seattle Children's Research Institute, Seattle WA, USA
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18
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Sibley MH, Coxe SJ, Page TF, Pelham WE, Yeguez CE, LaCount PA, Barney S. Four-Year Follow-Up of High versus Low Intensity Summer Treatment for Adolescents with ADHD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 51:750-763. [PMID: 33210938 DOI: 10.1080/15374416.2020.1833734] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Despite an emergence of psychosocial treatments for adolescent ADHD, their long-term effects are unknown. METHOD We examine four-year outcomes of a randomized controlled trial (N = 218) comparing high-intensity (HI; 412 h, $4,373 per participant) versus low-intensity (LI; 24 h, $97 per participant) skills-based summer intervention delivered to adolescents with ADHD at two secondary school transitions (6th/9th grade). Quantitative and qualitative analyses evaluated group×time and group×grade×time effects on 4-year outcomes. RESULTS Relative to LI, a single dose of HI had modest but lasting effects on teen organization skills (d =.40) and ADHD symptoms (9th grade only: d =.27 to.31) at 4-year follow-up. There was no long-term incremental effect of HI (vs. LI) for parent-teen conflict, GPA, or parent use of contingency management. Treatment appeared most effective when delivered to older adolescents (i.e., 9th versus 6th grade), suggesting the long-term impact of ADHD treatment may increase with age. Qualitative data corroborated that the primary long-term benefit of HI (vs. LI) treatment was to organization skills; many of the remaining perceived benefits were to parent and teen psychological variables (i.e., increased self-esteem, self-awareness, parental optimism). HI offered no incremental benefit to long-term educational or clinical service utilization or costs. CONCLUSIONS Modest therapeutic benefits of adolescent ADHD treatment are maintained long term. However, HI treatment did not impact outcomes that could defray the intervention's high costs ($4,373) compared to LI treatment ($97).
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Affiliation(s)
- Margaret H Sibley
- Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute
| | - Stefany J Coxe
- Department of Psychology, Florida International University
| | - Timothy F Page
- Department of Psychology, Florida International University
| | | | | | - Patrick A LaCount
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute
| | - Samantha Barney
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute
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19
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Wagner NJ, Holochwost S, Danko C, Propper CB, Coffman JL. Observed Peer Competence Moderates Links between Children's Self-Regulation Skills and Academic Performance. EARLY CHILDHOOD RESEARCH QUARTERLY 2020; 54:286-293. [PMID: 33162669 PMCID: PMC7641505 DOI: 10.1016/j.ecresq.2020.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study focuses on the relations between observed measures of children's self-regulation and academic achievement, as well as the extent to which observations of children's peer competence in preschool moderates these links. Data were drawn from 102 students (male = 48; M age = 4.82 years, SD age = 0.46 years) enrolled in pre-kindergarten classrooms. A series of linear path models was used to test study hypotheses, and the nature of significant interactions was elucidated by examining simple slopes and regions of significance. Children's self-regulation, but not peer competence, significantly predicted both reading and math performance assessed using the Woodcock Johnson III, β = .43, p < .001 and β = .39, p < .001, respectively. Tests of moderation effects revealed that the association between children's poor self-regulation and poor math performance, but not reading performance, β = -.28, p = .022 and β = -.11, p = .23, was negated for children with average to high peer competence. These results demonstrate the protective quality of peer competence for academic performance using observational methods collected in preschools.
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20
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Genc S, Malpas CB, Gulenc A, Sciberras E, Efron D, Silk TJ, Seal ML. Longitudinal patterns of white matter fibre density and morphology in children are associated with age and pubertal stage. Dev Cogn Neurosci 2020; 45:100853. [PMID: 32932204 PMCID: PMC7498759 DOI: 10.1016/j.dcn.2020.100853] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/31/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022] Open
Abstract
The pubertal period involves dynamic white matter development. This period also corresponds with rapid gains in higher cognitive functions including attention, as well as increased risk of developing mental health difficulties. This longitudinal study comprised children aged 9-13 years (n = 130). Diffusion magnetic resonance imaging (dMRI) data were acquired (b = 2800s/mm2, 60 directions) at two time-points. We derived measures of fibre density and morphology using the fixel-based analysis framework and performed a tract-based mixed-effects modelling analysis to understand patterns of white matter development with respect to age, sex, pubertal stage, and the change in pubertal stage. We observed significant increases in apparent fibre density across a large number of white matter pathways, including major association and commissural pathways. We observed a linear relationship between pubertal stage and fibre density and morphology in the right superior longitudinal fasciculus, and fibre morphology in the right inferior longitudinal fasciculus. Finally, we report a significant interaction between the change in pubertal stage and age in the development of fibre density, for left-lateralised association tracts. Overall, white matter development across ages 9-13 years involves the expansion of major white matter fibre pathways, with key association pathways linked with pubertal stage.
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Affiliation(s)
- Sila Genc
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK; Developmental Imaging, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia.
| | - Charles B Malpas
- Developmental Imaging, Murdoch Children's Research Institute, Parkville, Australia; Clinical Outcomes Research Unit (CORe), Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Alisha Gulenc
- Population Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Emma Sciberras
- Department of Paediatrics, University of Melbourne, Parkville, Australia; Population Health, Murdoch Children's Research Institute, Parkville, Australia; School of Psychology, Deakin University, Geelong, Australia
| | - Daryl Efron
- Population Health, Murdoch Children's Research Institute, Parkville, Australia; The Royal Children's Hospital, Parkville, Australia
| | - Timothy J Silk
- Developmental Imaging, Murdoch Children's Research Institute, Parkville, Australia; School of Psychology, Deakin University, Geelong, Australia
| | - Marc L Seal
- Developmental Imaging, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
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21
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Hustus CL, Evans SW, Owens JS, Benson K, Hetrick AA, Kipperman K, DuPaul GJ. An Evaluation of 504 and Individualized Education Programs for High School Students With Attention Deficit Hyperactivity Disorder. SCHOOL PSYCHOLOGY REVIEW 2020. [DOI: 10.1080/2372966x.2020.1777830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Chiorean A, Savoy C, Beattie K, El Helou S, Silmi M, Van Lieshout RJ. Childhood and adolescent mental health of NICU graduates: an observational study. Arch Dis Child 2020; 105:684-689. [PMID: 31974300 DOI: 10.1136/archdischild-2019-318284] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 01/07/2020] [Accepted: 01/12/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the mental health of children and adolescents admitted to neonatal intensive/special care units (NICUs) in infancy. METHODS This cross-sectional study used a provincially representative cohort from the 2014 Ontario Child Health Study. Parents provided data on psychiatric disorders using the MINI International Neuropsychiatric Interview for Children and Adolescents in 3141 children aged 4-11 years (NICU n=389; control n=2752) and in 2379 children aged 12-17 years (NICU n=298; control n=2081). Additionally, 2235 adolescents aged 12-17 years completed the interview themselves (NICU n=285; control n=1950). Odds of psychiatric disorder were compared in those admitted and controls. RESULTS Based on parent reports, NICU graduates aged 4-11 years had increased adjusted ORs (95% CI) of 1.78 (1.39 to 2.28) for any psychiatric disorder, with a marginal prevalence of 32.4% in NICU participants and 27.6% in controls. At this age, NICU graduates also had increased ORs of 1.74 (1.25 to 2.40) for psychiatric comorbidity, 1.48 (1.04 to 2.11) for oppositional defiant disorder, 1.61 (1.19 to 2.19) for attention-deficit hyperactivity disorder, 4.11 (2.33 to 7.25) for separation anxiety disorder and 2.13 (1.37 to 3.31) for specific phobia. At 12-17 years, 40.5% and 30.5% of NICU graduates and 30.6% and 17.9% of controls had any psychiatric disorder as reported by parents and self-report, respectively. Parents and adolescents, respectively, reported increased adjusted ORs (95% CI) of 1.63 (1.18 to 2.26) and 1.55 (1.13 to 2.11) for any disorder, 1.64 (1.06 to 2.54) and 1.74 (1.11 to 2.73) for psychiatric comorbidity, and 1.89 (1.22 to 2.93) and 3.17 (2.03 to 4.95) for oppositional defiant disorder. CONCLUSIONS NICU graduates are at increased risk for psychiatric disorders during childhood and adolescence.
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Affiliation(s)
- Andreea Chiorean
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Calan Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Beattie
- Division of Rheumatology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Salhab El Helou
- Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton, Ontario, Canada
| | - Maysoon Silmi
- Division of Neonatology, Department of Pediatrics, McMaster University Children's Hospital, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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23
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Mahajnah M, Sharkia R, Shorbaji N, Zelnik N. The Clinical Characteristics of ADHD Diagnosed in Adolescents in Comparison With Younger Children. J Atten Disord 2020; 24:1125-1131. [PMID: 28367712 DOI: 10.1177/1087054717696768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The aim of this study is to identify the clinical characteristics in adolescents newly diagnosed with ADHD. Method: Data of patients aged 7 to 17 years diagnosed with ADHD were collected and analyzed. The patients were divided into adolescents aged 13 to 17 years (Group I) and children aged 7 to 12 years (Group II): 592 males and 231 females. Group I consists of 450 participants, and Group II consists of 373 participants. Results: Adolescents were predominantly inattentive (63.8%); most of Group II patients had combined or hyperactive ADHD (70.8%). Learning disorders were more common in adolescents (51.2% vs. 39.7%) and treated mainly with long-acting methylphenidate (MPH), and Group II patients were treated mainly with short- and medium-acting MPH. Newly diagnosed adolescents were less likely to exhibit behavioral comorbidities. Headache and insomnia were reported more in adolescents, and stimulant rebound effect was more in younger children. Conclusion: Although the biological nature of ADHD is similar in both age groups, the primary symptomatology and associated comorbidities are prone to age-dependent changes.
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Affiliation(s)
- Muhammad Mahajnah
- Hillel Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Rajech Sharkia
- The Triangle Regional Research and Development Center, Kfar Qara, Israel.,Beit Berl Academic College, Israel
| | - Nadeem Shorbaji
- Hillel Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Nathanel Zelnik
- Hillel Yaffe Medical Center, Hadera, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel.,Haifa District and Carmel Medical Center, Israel
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24
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Sibley MH, Ortiz M, Graziano P, Dick A, Estrada E. Metacognitive and motivation deficits, exposure to trauma, and high parental demands characterize adolescents with late-onset ADHD. Eur Child Adolesc Psychiatry 2020; 29:537-548. [PMID: 31388765 DOI: 10.1007/s00787-019-01382-w] [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] [Received: 12/13/2018] [Accepted: 07/26/2019] [Indexed: 11/30/2022]
Abstract
The objective of this study is to evaluate support for three hypotheses about the etiology of adolescent-onset ADHD symptoms: (1) a "cool" cognitive load hypothesis, (2) a "hot" rewards processing hypothesis, and (3) a trauma exposure hypothesis. Participants (N = 50) were drawn from two public high schools in a culturally diverse metropolitan area. A detailed procedure for identifying and confirming late-onset ADHD cases is described. Adolescents with late-onset ADHD (n = 15) were identified and compared to childhood-onset (n = 17) and non-ADHD classmates (n = 18). Adolescents and parents completed measures of neurocognition, rewards' processing, clinical profile, and environmental demands. Late-onset cases were clinically and neurocognitively indistinguishable from childhood-onset cases; however, they experienced higher demands from parents (d = 1.09). Compared to the non-ADHD group, late-onset cases showed significant deficits in metacognition (d = 1.25) and academic motivation (d = 0.80), as well as a pronounced history of multiple trauma exposure (OR 11.82). At 1-year follow-up, ADHD persisted in 67.7% of late-onset cases. Late-onset cases (26.7%) were more likely than childhood-onset cases (0.0%) to transfer to alternative schools by 1-year follow-up. Multiple factors may contribute to adolescent-onset ADHD. Adolescents with metacognition and motivation deficits may be at greatest risk for the late-onset ADHD phenotype, particularly in highly demanding environments. Exposure to traumatic stress may play a key role in the exacerbation of existing deficits or onset of new symptoms. Late-onset ADHD was persistent in most cases and associated with higher risk for school disengagement than childhood-onset ADHD. Further work is needed to better understand the etiologies of late-onset ADHD symptoms.
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Affiliation(s)
- Margaret H Sibley
- Florida International University, Miami, USA. .,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Center for Child Health, Behavior, and Development, Seattle Children's Hospital, 2001 8th Ave., Suite 400, Seattle, WA, 98121, USA.
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25
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Langberg JM, Epstein JN, Becker SP, Girio-Herrera E, Vaughn AJ. Evaluation of the Homework, Organization, and Planning Skills (HOPS) Intervention for Middle School Students with Attention Deficit Hyperactivity Disorder as Implemented by School Mental Health Providers. SCHOOL PSYCHOLOGY REVIEW 2019. [DOI: 10.1080/02796015.2012.12087514] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Joshua M. Langberg
- Virginia Commonwealth University and Cincinnati Children's Hospital Medical Center
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26
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Sibley MH, Coxe SJ, Campez M, Morley C, Olson S, Hidalgo-Gato N, Gnagy E, Greiner A, Coles EK, Page T, Pelham WE. High versus Low Intensity Summer Treatment for ADHD Delivered at Secondary School Transitions. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 47:248-265. [PMID: 29498550 DOI: 10.1080/15374416.2018.1426005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Spikes in symptom severity are noted for adolescents with attention deficit/hyperactivity disorder (ADHD) at the transitions to middle and high school that are attributed to developmental maladjustment. This study evaluated the effectiveness of high-intensity (HI; 412 hr, $4,373 per participant) versus low-intensity (LI; 24 hr, $97 per participant) skills-based summer intervention delivered to adolescents with ADHD by local school district staff. Participants were 325 ethnically diverse rising sixth and ninth graders with ADHD randomized to HI versus LI (n = 218) or recruited into an untreated comparison group (n = 107). Group × Time 1-year outcome trajectories were compared using linear mixed models. Both interventions possessed high fidelity and were viewed by families as enjoyable and beneficial. Youth attendance was higher for HI (~80%) versus LI (~45%). Parent training attendance was uniform across groups (~50%). Parent and student attendance did not impact trajectories. Primary benefits of HI over LI were to note taking (d = .50), parent contingency management (d = .43), and parent-rated ADHD symptoms (d = .40-.46; ninth grade only). Secondary analyses suggested that HI may produce additional benefits compared to no treatment for home organization skills (HI vs. untreated d = .54), parent-teen conflict (HI vs. untreated d = .39), and grade point average (HI vs. untreated d = .47, ninth grade only). Summer HI treatment was superior to LI in engagement and uptake of certain skills. However, the extent to which these medium benefits on a limited number of outcomes justify high costs compared to LI remains an open question. Delivering treatment during the summer instead of school year may limit generalizability.
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Affiliation(s)
- Margaret H Sibley
- a Department of Psychiatry & Behavioral Health , Florida International University
| | - Stefany J Coxe
- b Department of Psychology, Florida International University
| | - Mileini Campez
- b Department of Psychology, Florida International University
| | - Candance Morley
- c Center for Children and Families, Florida International University
| | - Sandra Olson
- c Center for Children and Families, Florida International University
| | - Nick Hidalgo-Gato
- c Center for Children and Families, Florida International University
| | - Elizabeth Gnagy
- c Center for Children and Families, Florida International University
| | - Andrew Greiner
- c Center for Children and Families, Florida International University
| | - Erika K Coles
- b Department of Psychology, Florida International University
| | - Timothy Page
- d Department of Health Policy and Management, Florida International University
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27
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Attention-deficit/hyperactivity disorder: An integrated developmental psychopathology and Research Domain Criteria (RDoC) approach. Compr Psychiatry 2019; 90:65-72. [PMID: 30743139 PMCID: PMC6913174 DOI: 10.1016/j.comppsych.2018.12.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 12/12/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is characterized by heterogeneous behaviors and symptoms, developmental trajectories, and treatment response. Isolating intermediate phenotypes that are superior to current DSM-based nosology in order to explain such heterogeneity is integral to enhancing etiological theory, improving clinical assessment, predicting treatment response, and developing tailored treatments. To this end, this review provides an integrated developmental psychopathology and National Institute of Mental Health Research Domain Criteria (RDoC) approach to ADHD. In particular, associations between ADHD and RDoC domains of cognition (specifically working memory) and positive valence (reward anticipation/delay/receipt) are discussed. These domains are examined across behavioral and neurocircuitry levels of analysis and placed within a developmental context via examining associations among RDoC domains, relevant features of ADHD, and environmental correlates implicated across development. Limitations of the existing literature and proposed future directions are explored. Importantly, future work should focus on novel approaches that account for developmental shifts in functioning of relevant RDoC domains over time, as well as further examination of the interaction across RDoC domains and levels of analysis.
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28
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Ciesielski H, Tamm L, Vaughn A, Cyran J, Epstein J. Academic Skills Groups for Middle School Children With ADHD in the Outpatient Mental Health Setting: An Open Trial. J Atten Disord 2019; 23:409-417. [PMID: 25926629 PMCID: PMC4626438 DOI: 10.1177/1087054715584055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To conduct an open trial assessing the initial efficacy of an intervention focusing on increasing skills related to academic performance (planning, organization, studying, and homework behaviors) for middle school children diagnosed with ADHD. The intervention is modeled on evidence-based interventions but designed for administration in the outpatient setting. METHOD Parents and their children diagnosed with ADHD attended seven weekly group sessions targeting academic, organizational, and homework skills. Parents completed the Homework Problem Checklist and Impairment Rating Scale pre- and post-treatment. RESULTS Following intervention, significant improvements in homework completion and management, as well as reductions in academic impairment and improvements in parent confidence and family relations, were reported. CONCLUSION Despite limitations including small sample size and lack of a control group, our results demonstrate initial efficacy of an academic skills intervention designed for use in the outpatient setting with middle school children diagnosed with ADHD on clinically relevant outcome measures.
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Affiliation(s)
| | - Leanne Tamm
- Cincinnati Children’s Hospital Medical Center
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29
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The Rey-Osterrieth Complex Figure: a Useful Measure of Organizational Skills for Adolescents with ADHD? JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2018. [DOI: 10.1007/s40817-018-0055-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Dvorsky MR, Langberg JM, Becker SP, Evans SW. Trajectories of Global Self-Worth in Adolescents with ADHD: Associations with Academic, Emotional, and Social Outcomes. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:765-780. [PMID: 29714502 DOI: 10.1080/15374416.2018.1443460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Resilience models suggest that there are likely to be multiple trajectories of self-worth and that despite experiencing impairment, some youth with attention deficit/hyperactivity disorder (ADHD) may maintain a positive self-worth, which could buffer them against negative outcomes. The present study used a cohort-sequential longitudinal design to evaluate developmental trajectories of global self-worth in a sample of 324 middle-school-age adolescents (71% male) diagnosed with ADHD between ages 11 and 14 in predicting outcomes at age 15. Sex, medication status, and ADHD/oppositional defiant disorder symptom severity were included as covariates in the models. Using growth mixture modeling, 3 distinct self-worth trajectory groups were identified: (a) high and increasing (44.4% of participants), (b) moderate and decreasing (48.8%), and (c) low and decreasing (6.8%). Participants with high and increasing global self-worth were less likely to exhibit co-occurring depressive symptoms and had better social functioning and higher grades at age 15 relative to those in either decreasing trajectory. Implications of these findings for monitoring and supporting positive global self-worth for adolescents with ADHD are discussed.
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Affiliation(s)
- Melissa R Dvorsky
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and Virginia Commonwealth University
| | | | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and University of Cincinnati
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Bourchtein E, Langberg JM, Owens JS, Evans SW, Perera RA. Is the Positive Illusory Bias Common in Young Adolescents with ADHD? A Fresh Look at Prevalence and Stability Using Latent Profile and Transition Analyses. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:1063-1075. [PMID: 28004285 DOI: 10.1007/s10802-016-0248-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The goal of this study was to use novel approaches that do not require the use of arbitrary cut-points (i.e., latent profile/transition analysis) to evaluate the prevalence and stability of the positive illusory bias (PIB) in young adolescents with attention-deficit/hyperactivity disorder (ADHD). Participants were 326 middle-school students diagnosed with ADHD (Mage = 12.26 years, 71% male, 77% Caucasian). The Self-Perception Profile for Children (SPPC) was completed by participants and their parents at baseline and again 12 and 18 months later. Cross-sectional results revealed four subgroups based on SPPC responses. Only a small subset (18.4%) of youth with ADHD exhibited a global PIB, across the behavioral, scholastic, and social domains, with an additional 29% displaying a PIB in the scholastic domain only. Additionally, average parent/adolescent-rated competence within each subgroup was in line with an objective measure of scholastic competence (i.e., grades). When examined longitudinally, only a PIB in the social domain was stable across the 18-month study period and only for half of the sample. These findings suggest that the PIB is not ubiquitous in youth with ADHD, with many young adolescents rating themselves accurately relative to their parents and their grades. Further, when stability across time is considered, the PIB may be specific to social functioning, as opposed to a global, cross-domain phenomenon. Implications for the future measurement of the PIB are discussed.
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Affiliation(s)
- Elizaveta Bourchtein
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, 23284-2018, USA.
| | - Joshua M Langberg
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, 23284-2018, USA
| | - Julie S Owens
- Ohio University, 200 Porter Hall, Athens, OH, 45701, USA
| | - Steven W Evans
- Ohio University, 200 Porter Hall, Athens, OH, 45701, USA
| | - Robert A Perera
- Virginia Commonwealth University, 806 W. Franklin Street, P.O. Box 842018, Richmond, VA, 23284-2018, USA
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Bunford N, Evans SW, Langberg JM. Emotion Dysregulation Is Associated With Social Impairment Among Young Adolescents With ADHD. J Atten Disord 2018; 22:66-82. [PMID: 24681899 DOI: 10.1177/1087054714527793] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate aspects of emotion dysregulation (ED) that characterize young adolescents with ADHD, examine the effects of subtype and comorbidity, and determine the extent to which ED is related to aggression and rule-breaking and social impairment. METHOD We examined which aspects of ED are most relevant to ADHD in 180 young adolescents (75% boys), as well as whether ED differs across ADHD subtypes or comorbid oppositional defiant disorder (ODD) status. We also examined the association between ED and aggression, rule-breaking, and social impairment. RESULTS Young adolescent females and males with ADHD exhibited various manifestations of ED, including behavioral dyscontrol in the presence of strong emotions and inflexibility/slow return to emotional baseline. ED did not differ as a function of ADHD subtype or comorbid ODD. Three aspects of ED, namely, low threshold for emotional excitability/impatience, behavioral dyscontrol in the face of strong emotions, and inflexibility/slow return to baseline, predicted three of six measured indices of parent- and self-reported social impairment, above and beyond comorbid ODD. CONCLUSIONS ED is associated with ADHD among young adolescents, does not differ based on ADHD subtype or ODD status, and is associated with social impairment.
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Musser ED, Willoughby MT, Wright S, Sullivan EL, Stadler DD, Olson BF, Steiner RD, Nigg JT. Maternal prepregnancy body mass index and offspring attention-deficit/hyperactivity disorder: a quasi-experimental sibling-comparison, population-based design. J Child Psychol Psychiatry 2017; 58:240-247. [PMID: 27901266 PMCID: PMC5787386 DOI: 10.1111/jcpp.12662] [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] [Accepted: 09/22/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND High maternal prepregnancy body mass index (BMI) has been associated with increased risk of offspring attention-deficit/hyperactivity disorder (ADHD). However, whether this effect is attributable to maternal or familial level confounds has been little examined. METHODS The present study sought to examine these associations, utilizing data from the medical records of a health care system which treats 350,000 patients annually and a sibling-comparison design in a sample of 4,682 children born to 3,645 mothers. RESULTS When examining the overall maternal effect, a linear association was observed between maternal prepregnancy BMI and child ADHD [b = 0.04, 95% confidence interval (95% CI) = 0.02-0.06, p = .0003], such that a one-unit (i.e. 1 kg/m2 ) increase in prepregnancy BMI was associated with a 4% increase in the odds of ADHD (exp b = 1.04). However, when the model was reparameterized to take full advantage of the sibling design to allow for the examination of both maternal and child-specific effects, the child-specific prepregnancy BMI effect was not reliably different from zero (b = -0.08, 95% CI = -0.23 to 0.06, p = .24). In contrast, at the maternal-level, average prepregnancy BMI was a reliably non-zero predictor of child ADHD (b = 0.04, 95% CI = 0.02-0.06, p < .0001) with each one-unit increase in maternal prepregnancy BMI associated with a 4.2% increase in the odds of ADHD (exp b = 1.04, 95% CI = 1.02-1.06). CONCLUSIONS The association between maternal prepregnancy BMI and offspring ADHD may be better accounted for by familial or maternal confounds rather than a direct causal effect of BMI.
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Affiliation(s)
- Erica D. Musser
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Michael T. Willoughby
- Education & Workforce Development, RTI International, Research Triangle Park, NC, USA
| | | | - Elinor L. Sullivan
- Division of Neuroscience, Oregon National Primate Research Center, Beaverton, OR, USA
- Department of Biology, University of Portland, Portland, OR, USA
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Diane D. Stadler
- Department of Medicine, Section of Health Promotion & Sports Medicine, Graduate Programs in Human Nutrition, Oregon Health & Science University, Portland, OR, USA
| | - Brent F. Olson
- Marshfield Clinic Research Foundation, Marshfield, WI, USA
| | | | - Joel T. Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
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Musser ED, Karalunas SL, Dieckmann N, Peris TS, Nigg JT. Attention-deficit/hyperactivity disorder developmental trajectories related to parental expressed emotion. JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 125:182-195. [PMID: 26854504 DOI: 10.1037/abn0000097] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
UNLABELLED In the transition from childhood to adolescence, attention-deficit/hyperactivity disorder (ADHD) developmental trajectories diverge. Family environment, as indexed by parental expressed emotion, may moderate these trajectories. 388 children with ADHD and 127 controls were assessed using multi-informant, multimethod diagnostic procedures at up to 3 time points 1 year apart in an accelerated longitudinal design spanning ages 7-13 years. Latent-class growth analysis was used to identify developmental trajectories for parent- and teacher-rated ADHD and oppositional-defiant disorder (ODD) symptoms within the ADHD sample. Parental expressed emotion, criticism, and emotional overinvolvement were coded from a 5-min speech sample at 2 time points, 1 year apart, for 208 of these children and compared among ADHD trajectory groups. RESULTS Parent-rated hyperactivity yielded a 4-class trajectory solution in latent-class growth analysis; teacher-rated inattention yielded a 3-trajectory solution. Teacher-rated ODD also yielded 3-trajectory solution. A parent-rated high persistent hyperactive group was more likely than the other ADHD groups to have parents with stable high criticism (34.6%, p < .001), with ODD symptoms controlled. A teacher-identified high ODD-worsening group was more likely to experience high criticism, particularly the initial time point; (87.5%, p < .001), with hyperactivity controlled. Parental criticism, an index of the family environment, is uniquely associated with divergent developmental trajectories among children with ADHD in addition to those associated with ODD symptoms. Lay summary: For many children, ADHD symptoms decrease as they transition to adolescence. Family environmental factors, such as parental criticism, may help explain for whom symptom remission is less likely.
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Affiliation(s)
- Erica D Musser
- Department of Psychology, Florida International University
| | | | - Nathan Dieckmann
- School of Nursing, Department of Psychiatry, Oregon Health & Science University
| | - Tara S Peris
- Department of Psychiatry & Biobehavioral Science, Semel Institute, University of California, Los Angeles
| | - Joel T Nigg
- Departments of Behavioral Neuroscience and Psychiatry, Oregon Health & Science University
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Lee SJ, Park SH, Jeong A, Chae H, Oh K. Temperamental predictors of developmental trajectories of inattention and hyperactivity-impulsivity problems in schoolchildren. Integr Med Res 2017; 6:33-40. [PMID: 28462142 PMCID: PMC5395674 DOI: 10.1016/j.imr.2016.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/17/2016] [Accepted: 11/18/2016] [Indexed: 11/30/2022] Open
Abstract
Background The current study aimed to examine the temperamental predictors of developmental trajectory subgroups of children's inattention and hyperactivity–impulsivity problems through a short-term longitudinal study. Methods Children (n = 1344) were divided into younger (age 6–8 years) and older (age 9–11 years) groups in order to observe changes in inattention and hyperactivity–impulsivity problems. Inattention and hyperactivity–impulsivity problems were measured three times at 5-month intervals and Cloninger's four temperaments (novelty seeking, harm avoidance, reward dependence, and persistence) were examined on the first occasion only. A cohort sequential design and growth mixture model were used for investigating trajectory subgroups and multiple logistic regression analysis to examine the temperamental predictors. Results Developmental trajectories of inattention and hyperactivity–impulsivity showed different subgroupings depending on the age group of children. Temperament (high score on novelty seeking and low score on persistence as well as high score on reward dependence) and gender predicted the likelihood of belonging to high-risk versus low-risk subgroups. Conclusion Suggestions taking into account the predictors of developmental trajectories in inattention and hyperactivity–impulsivity problems for future research are discussed along with the limitations of the current study.
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Affiliation(s)
- Soo Jin Lee
- Department of Psychotherapy, Kyungil University, Gyeongsan, Korea
| | - Soo-Hyun Park
- Department of Psychology, Yonsei University, Seoul, Korea
| | - Ansuk Jeong
- Department of Psychology, University of Utah Asia Campus, Incheon, Korea
| | - Han Chae
- School of Korean Medicine, Pusan National University, Busan, Korea
| | - Kyungja Oh
- Department of Psychology, Yonsei University, Seoul, Korea
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Zendarski N, Sciberras E, Mensah F, Hiscock H. Early high school engagement in students with attention/deficit hyperactivity disorder. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2017; 87:127-145. [PMID: 28054712 DOI: 10.1111/bjep.12140] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/26/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Students with attention/deficit hyperactivity disorder (ADHD) continue to languish behind their peers with regard to academic achievement and education attainment. School engagement is potentially modifiable, and targeting engagement may be a means to improve education outcomes. AIMS To investigate school engagement for students with ADHD during the crucial high school transition period and to identify factors associated with low school engagement. SAMPLE Participants are adolescents (12-15 years) in the first and third year of high school with diagnosed ADHD (n = 130). Participants were recruited from 21 paediatric practices. METHODS Cross-sectional study assessing school engagement. Data were collected through direct assessment and child, parent, and teacher surveys. School engagement is measured as student attitudes to school (cognitive and emotional) and suspension rates (behavioural). Multivariable regression analyses examined student, family, and school factors affecting engagement. RESULTS In comparison with state data, students with ADHD in the first year of high school were less motivated (p < .01) and less connected to peers (p < .01). Overall, there was no discordance in third year attitudes. There were high rates of suspension in both years in comparison to state-wide suspensions (21% vs. 6%, p < .01). Explanatory factors for poor attitudes include adolescent depression, poor adolescent supervision, and devaluing education. Conduct problems and increased hyperactivity were related to increased likelihood of being suspended, whilst higher cognitive ability, family socio-economic status, and independent schools reduced risk. CONCLUSIONS Potentially modifiable individual and family factors including adolescent depression, behavioural problems, education values, and family supervision could be targeted to better manage the high school transition for students with ADHD.
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Affiliation(s)
- Nardia Zendarski
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia
| | - Emma Sciberras
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia.,Deakin University, Burwood, Victoria, Australia
| | - Fiona Mensah
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Harriet Hiscock
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
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Hautmann C, Rothenberger A, Döpfner M. Daily Symptom Profiles of Children With ADHD Treated With Modified-Release Methylphenidate. J Atten Disord 2017; 21:120-128. [PMID: 24062276 DOI: 10.1177/1087054713502233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim was to identify subgroups of patients with ADHD with different daily symptom profiles and to characterize their response to modified-release methylphenidate (MR MPH) treatment, using data from the observational trial OBSEER. METHOD OBSEER included patients aged 6 to 17 years receiving MR MPH under routine care. To detect subgroups, a latent class cluster analysis was applied. Sex, age, MR MPH dose, and emotional symptoms were considered predictors of response. RESULTS The analysis included 637 patients (81.3% male), with a mean age (standard deviation) of 10.1 (2.5) years. A two-class solution best fit the data, identifying a high-severity group (49.8%) with pronounced symptom reduction, and a low-severity group (50.2%) with minor changes throughout the day. Younger age, male sex, and higher MPH doses were predictive of the high-severity class. CONCLUSION Children with ADHD treated with MR MPH are heterogeneous, and subgroups with differential treatment response can be identified.
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Abstract
Individuals with attention-deficit/hyperactivity disorder (ADHD) experience impairments in a number of functional domains. Although current evidence-based treatments for ADHD reduce symptoms and improve academic and behavioral functioning, they have minimal impact on social functioning or on risky behaviors (see Evans et al. in J Clin Child Adolesc Psychol, 43:527-551, 2014 for review). Preliminary evidence indicates that emotion dysregulation (ED) is associated with impairments across the developmental spectrum, such as social impairment and risky behaviors, and that its relative absence/presence is differentially associated with treatment response. It thus stands to reason that by incorporating a focus on ED in interventions targeting social impairment and risky behaviors, we may be able to increase the number of youth who respond to such interventions and decrease the prevalence or degree of these impairments and behaviors among youth and adults with ADHD. However, a number of questions remain unaddressed about the association between ADHD and ED, such as the portion of individuals with ADHD who experience ED, the extent to which ED is associated with the above impairments and behaviors, and whether or not ED is malleable. To begin addressing these questions, we summarize and critically evaluate the literature on the association between ADHD and ED and make recommendations for future basic, translational, and treatment outcome research.
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Sibley MH, Mitchell JT, Becker SP. Method of adult diagnosis influences estimated persistence of childhood ADHD: a systematic review of longitudinal studies. Lancet Psychiatry 2016; 3:1157-1165. [PMID: 27745869 DOI: 10.1016/s2215-0366(16)30190-0] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/14/2016] [Accepted: 07/15/2016] [Indexed: 11/30/2022]
Abstract
Several studies have questioned the stability of attention-deficit hyperactivity disorder (ADHD) from childhood to adulthood. This systematic review illustrates how variability in diagnostic methods influences adult ADHD persistence estimates. Systematic database searches identified studies reporting adult ADHD persistence rates that were published in English between Jan 1, 1992, and May 31, 2016. Study inclusion criteria were systematic childhood diagnosis of attention-deficit disorder, ADHD, or a research diagnostic protocol that matched DSM-III, DSM-III-R, or DSM-IV standards; mean childhood age of younger than 12·0 years with no participants older than 18·0 years; and mean adult age of 18·0 years or older with no participants younger than 17·0 years. Across 12 included samples, we identified 41 estimates of ADHD persistence, which ranged from 4·0% to 77·0%. Methods of diagnosing ADHD in adulthood varied widely with respect to source of information, diagnostic instruments (eg, rating scales, interviews), diagnostic symptom threshold, and whether impairment was required for diagnosis. Sole reliance on self reports and a strict threshold of six DSM symptoms led to very low persistence estimates. To minimise false-negative and false-positive classifications, recommended methods for determining adult persistence of ADHD include collecting self and informant ratings, requiring the presence of impairment, and using an age-appropriate symptom threshold. Very few persistence estimates utilised these methods, but those that did indicated persistence rates of 40-50%.
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Affiliation(s)
- Margaret H Sibley
- Department of Psychiatry and Behavioral Health, Center for Children and Families, Florida International University, Miami, FL, USA.
| | - John T Mitchell
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Adolescent Perceptions of Outgrowing Childhood Attention-Deficit Hyperactivity Disorder: Relationship to Symptoms and Quality of Life. J Dev Behav Pediatr 2016; 37:196-204. [PMID: 26950341 DOI: 10.1097/dbp.0000000000000279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Parental and self-perceptions about outgrowing attention-deficit hyperactivity disorder (ADHD) likely impact treatment decisions; however, little is known about these perceptions. The aim of this study was to assess adolescent and parent perceptions of outgrowing childhood ADHD and evaluate how these perceptions relate to ADHD symptoms and quality of life (QoL). METHOD Cross-sectional survey of adolescents (13-18 years) with a childhood diagnosis of ADHD and their parents. Participants were contacted by mail and completed questionnaires about: perceptions of outgrowing ADHD, current ADHD symptoms (the Conners' Scales), and QoL (PedsQL). ANCOVAs were conducted to assess the relationship between the perception of outgrowing ADHD and: (1) current ADHD symptoms and (2) QoL, controlling for co-morbidities and medication use. RESULTS 115 adolescent-parent dyads were enrolled. Mean age was 15.5 ± 1.7 years, 73% were male, and 63% were taking ADHD medication. Only 16% of adolescents and 9% of parents reported outgrowing ADHD, with little correlation between parent and adolescent responses (kappa 0.3). Adolescents who reported Yes or Don't Know to outgrowing ADHD, compared to those who reported No, had lower scores on the inattention (IA) and hyperactivity (H) scales of both parent report and adolescent self-report Conners' scales and higher scores on the adolescent self-report PedsQL. CONCLUSION A majority of adolescents do not endorse outgrowing their ADHD diagnosis, but those that do demonstrate fewer ADHD symptoms and better QoL than those who don't, suggesting that adolescents have insight about their level of impairment and should have a valued role in making treatment decisions.
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Silk TJ, Genc S, Anderson V, Efron D, Hazell P, Nicholson JM, Kean M, Malpas CB, Sciberras E. Developmental brain trajectories in children with ADHD and controls: a longitudinal neuroimaging study. BMC Psychiatry 2016; 16:59. [PMID: 26969310 PMCID: PMC4787204 DOI: 10.1186/s12888-016-0770-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 03/03/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The symptom profile and neuropsychological functioning of individuals with Attention Deficit/Hyperactivity Disorder (ADHD), change as they enter adolescence. It is unclear whether variation in brain structure and function parallels these changes, and also whether deviations from typical brain development trajectories are associated with differential outcomes. This paper describes the Neuroimaging of the Children's Attention Project (NICAP), a comprehensive longitudinal multimodal neuroimaging study. Primary aims are to determine how brain structure and function change with age in ADHD, and whether different trajectories of brain development are associated with variations in outcomes including diagnostic persistence, and academic, cognitive, social and mental health outcomes. METHODS/DESIGN NICAP is a multimodal neuroimaging study in a community-based cohort of children with and without ADHD. Approximately 100 children with ADHD and 100 typically developing controls will be scanned at a mean age of 10 years (range; 9-11years) and will be re-scanned at two 18-month intervals (ages 11.5 and 13 years respectively). Assessments include a structured diagnostic interview, parent and teacher questionnaires, direct child cognitive/executive functioning assessment and magnetic resonance imaging (MRI). MRI acquisition techniques, collected at a single site, have been selected to provide optimized information concerning structural and functional brain development. DISCUSSION This study will allow us to address the primary aims by describing the neurobiological development of ADHD and elucidating brain features associated with differential clinical/behavioral outcomes. NICAP data will also be explored to assess the impact of sex, ADHD presentation, ADHD severity, comorbidities and medication use on brain development trajectories. Establishing which brain regions are associated with differential clinical outcomes, may allow us to improve predictions about the course of ADHD.
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Affiliation(s)
- Timothy J. Silk
- Murdoch Childrens Research Institute, Melbourne, Australia ,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Sila Genc
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Childrens Research Institute, Melbourne, Australia ,The Royal Children’s Hospital, Melbourne, Australia
| | - Daryl Efron
- Murdoch Childrens Research Institute, Melbourne, Australia ,The Royal Children’s Hospital, Melbourne, Australia ,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Philip Hazell
- Discipline of Psychiatry, University of Sydney, Sydney, Australia
| | - Jan M. Nicholson
- Murdoch Childrens Research Institute, Melbourne, Australia ,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Michael Kean
- Murdoch Childrens Research Institute, Melbourne, Australia ,The Royal Children’s Hospital, Melbourne, Australia
| | | | - Emma Sciberras
- Murdoch Childrens Research Institute, Melbourne, Australia ,The Royal Children’s Hospital, Melbourne, Australia ,Department of Paediatrics, University of Melbourne, Melbourne, Australia ,School of Psychology, Deakin University, Melbourne, Australia
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Zendarski N, Sciberras E, Mensah F, Hiscock H. A longitudinal study of risk and protective factors associated with successful transition to secondary school in youth with ADHD: prospective cohort study protocol. BMC Pediatr 2016; 16:20. [PMID: 26822230 PMCID: PMC4730730 DOI: 10.1186/s12887-016-0555-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 01/21/2016] [Indexed: 11/25/2022] Open
Abstract
Background Attention-Deficit/Hyperactivity Disorder (ADHD) has a significant impact on child and adolescent development, especially in relation to school functioning and academic outcomes. Despite the transition to high school being a potentially critical period for children with ADHD, most research in this period has focused on academic outcomes. This study aims to extend previous research by describing academic, school engagement, behaviour and social-emotional outcomes for young people with ADHD in the first and third years of high school and to identify risk and protective factors predictive of differing outcomes across these four domains. Methods and design The Moving Up study is a longitudinal, prospective cohort study of children with ADHD as they transition and adjust to high school (age 12–15 years). Data are collected through direct assessment and child, parent and teacher surveys. The primary outcome is academic achievement, obtained by linking to standardised test results. Secondary outcomes include measures of behaviour, ADHD symptoms, school engagement (attitudes and attendance), and social and emotional functioning, including depressive symptoms. The mean performance of the study cohort on each outcome measure will be compared to the population mean for same aged children, using t-tests. Risk and protective factors to be examined using multiple regression include a child, family and school factors know to impact academic and school functioning. Discussion The Moving up study is the first Australian study prospectively designed to measure a broad range of student outcomes for children with ADHD during the high school transition period. Examining both current (cross sectional) and earlier childhood (longitudinal) factors gives us the potential to learn more about risk and protective factors associated with school functioning in young people with ADHD. The richness and depth of this information could lead to more targeted and effective interventions that may alter academic and wellbeing trajectories for young people at risk of poor outcomes. The study is approved by The Royal Children’s Hospital Melbourne Human Research Ethics Committee (33206). Findings will be disseminated through peer-reviewed journals and conference presentations.
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Affiliation(s)
- Nardia Zendarski
- Department of Paediatrics, University of Melbourne, Parkville, 3052, VIC, Australia. .,Community Health Services Research, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, 3052, VIC, Australia. .,Centre for Community Child Health, The Royal Children's Hospital, 5th floor Flemington Rd, Parkville, 3052, VIC, Australia.
| | - Emma Sciberras
- Department of Paediatrics, University of Melbourne, Parkville, 3052, VIC, Australia. .,Community Health Services Research, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, 3052, VIC, Australia. .,Centre for Community Child Health, The Royal Children's Hospital, 5th floor Flemington Rd, Parkville, 3052, VIC, Australia. .,School of Psychology, Deakin University, Burwood, 3125, VIC, Australia.
| | - Fiona Mensah
- Department of Paediatrics, University of Melbourne, Parkville, 3052, VIC, Australia. .,Community Health Services Research, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, 3052, VIC, Australia. .,Centre for Community Child Health, The Royal Children's Hospital, 5th floor Flemington Rd, Parkville, 3052, VIC, Australia.
| | - Harriet Hiscock
- Department of Paediatrics, University of Melbourne, Parkville, 3052, VIC, Australia. .,Community Health Services Research, Murdoch Childrens Research Institute, The Royal Children's Hospital, Flemington Rd, Parkville, 3052, VIC, Australia. .,Centre for Community Child Health, The Royal Children's Hospital, 5th floor Flemington Rd, Parkville, 3052, VIC, Australia.
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Langberg JM, Dvorsky MR, Molitor SJ, Bourchtein E, Eddy LD, Smith Z, Schultz BK, Evans SW. Longitudinal evaluation of the importance of homework assignment completion for the academic performance of middle school students with ADHD. J Sch Psychol 2016; 55:27-38. [PMID: 26931065 DOI: 10.1016/j.jsp.2015.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 08/26/2015] [Accepted: 12/16/2015] [Indexed: 10/22/2022]
Abstract
The primary goal of this study was to longitudinally evaluate the homework assignment completion patterns of middle school age adolescents with ADHD, their associations with academic performance, and malleable predictors of homework assignment completion. Analyses were conducted on a sample of 104 middle school students comprehensively diagnosed with ADHD and followed for 18 months. Multiple teachers for each student provided information about the percentage of homework assignments turned in at five separate time points and school grades were collected quarterly. Results showed that agreement between teachers with respect to students assignment completion was high, with an intraclass correlation of .879 at baseline. Students with ADHD were turning in an average of 12% fewer assignments each academic quarter in comparison to teacher-reported classroom averages. Regression analyses revealed a robust association between the percentage of assignments turned in at baseline and school grades 18 months later, even after controlling for baseline grades, achievement (reading and math), intelligence, family income, and race. Cross-lag analyses demonstrated that the association between assignment completion and grades was reciprocal, with assignment completion negatively impacting grades and low grades in turn being associated with decreased future homework completion. Parent ratings of homework materials management abilities at baseline significantly predicted the percentage of assignments turned in as reported by teachers 18 months later. These findings demonstrate that homework assignment completion problems are persistent across time and an important intervention target for adolescents with ADHD.
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Affiliation(s)
| | | | | | | | | | - Zoe Smith
- Virginia Commonwealth University, USA
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Kofler MJ, Larsen R, Sarver DE, Tolan PH. Developmental trajectories of aggression, prosocial behavior, and social-cognitive problem solving in emerging adolescents with clinically elevated attention-deficit/hyperactivity disorder symptoms. JOURNAL OF ABNORMAL PSYCHOLOGY 2015; 124:1027-42. [PMID: 26595479 DOI: 10.1037/abn0000103] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Middle school is a critical yet understudied period of social behavioral risks and opportunities that may be particularly difficult for emerging adolescents with attention-deficit/hyperactivity disorder (ADHD) given their childhood social difficulties. Relatively few ADHD studies have examined social behavior and social-cognitive problem solving beyond the elementary years, or examined aspects of positive (prosocial) behavior. The current study examined how middle school students with clinically elevated ADHD symptoms differ from their non-ADHD peers on baseline (6th grade) and age-related changes in prosocial and aggressive behavior, and the extent to which social-cognitive problem solving strategies mediate these relations. Emerging adolescents with (n = 178) and without (n = 3,806) clinically elevated, teacher-reported ADHD-combined symptoms were compared longitudinally across 6th through 8th grades using parallel process latent growth curve modeling, accounting for student demographic characteristics, oppositional-defiant disorder (ODD) symptoms, deviant peer association, school climate, and parental monitoring. Sixth graders with elevated ADHD symptoms engaged in somewhat fewer prosocial behaviors (d = -0.44) and more aggressive behavior (d = 0.20) relative to their peers. These small social behavioral deficits decreased but were not normalized across the middle school years. Contrary to hypotheses, social-cognitive problem solving was not impaired in the ADHD group after accounting for co-occurring ODD symptoms and did not mediate the association between ADHD and social behavior during the middle school years. ADHD and social-cognitive problem solving contributed independently to social behavior, both in 6th grade and across the middle school years; the influence of social-cognitive problem solving on social behavior was highly similar for the ADHD and non-ADHD groups.
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Affiliation(s)
| | - Ross Larsen
- Department of Instructional Psychology and Technology, Brigham Young University
| | - Dustin E Sarver
- Department of Pediatrics, University of Mississippi Medical Center
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Lambert MC, Reid R, Prosser B, Bussing R. A Survival Analysis of Psychostimulant Prescriptions in New South Wales from 1990 to 2010. J Child Adolesc Psychopharmacol 2015. [PMID: 26218772 DOI: 10.1089/cap.2014.0151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Psychostimulant medication is considered a mainstay in the treatment of attention-deficit/hyperactivity disorder (ADHD); however, research suggests that the typical duration of medication treatment for children and youth may be <3 years. The purpose of this study was to evaluate the psychostimulant treatment persistence for children and adolescents in New South Wales, Australia. METHODS This study used survival analysis to assess duration of medication treatment on a large administrative database of children and youth from New South Wales, Australia. Several models were fit to evaluate differences in survival rates among decades (1990-1999 vs. 2000-2010), gender, and age. RESULTS Results showed that: 1) Overall median treatment time (i.e., median survival time) was 1.96 years (99% CI=1.93, 1.99); 2) there were small, but significant changes over time in duration of treatment; 3) females had shorter treatment duration than males; and 4) there were relatively large differences in treatment duration across age groups. CONCLUSIONS These results indicate that the majority of children and youth receive medication treatment for only a small portion of childhood/adolescence, and that there are differential patterns in treatment duration across age groups.
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Affiliation(s)
- Matthew C Lambert
- 1 Department of Special Education and Communication Disorders, University of Nebraska , Lincoln, Nebraska
| | - Robert Reid
- 1 Department of Special Education and Communication Disorders, University of Nebraska , Lincoln, Nebraska
| | - Brenton Prosser
- 2 Faculty of Health, University of Canberra , Canberra, Australian Capital Territory, Australia
| | - Regina Bussing
- 3 Department of Psychiatry, University of Florida , Gainesville, Florida
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Howard AL, Molina BSG, Swanson JM, Hinshaw SP, Belendiuk KA, Harty SC, Arnold LE, Abikoff HB, Hechtman L, Stehli A, Greenhill LL, Newcorn JH, Wigal T. Developmental progression to early adult binge drinking and marijuana use from worsening versus stable trajectories of adolescent attention deficit/hyperactivity disorder and delinquency. Addiction 2015; 110:784-95. [PMID: 25664657 PMCID: PMC4398637 DOI: 10.1111/add.12880] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/17/2014] [Accepted: 02/03/2015] [Indexed: 11/26/2022]
Abstract
AIMS To examine the association between developmental trajectories of inattention, hyperactivity-impulsivity and delinquency through childhood and adolescence (ages 8-16 years) and subsequent binge drinking and marijuana use in early adulthood (age 21 years). DESIGN Prospective naturalistic follow-up of children with attention deficit/hyperactivity disorder (ADHD) previously enrolled in a randomized controlled trial (RCT). Treatment-phase assessments occurred at 3, 9 and 14 months after randomization; follow-up assessments occurred at 24 months, 36 months, and 6, 8 and 12 years after randomization. SETTING Secondary analysis of data from the Multimodal Treatment Study of ADHD (MTA), a multi-site RCT comparing the effects of careful medication management, intensive behavior therapy, their combination, and referral to usual community care. PARTICIPANTS A total of 579 children with DSM-IV ADHD combined type, aged 7.0 and 9.9 years at baseline (mean = 8.5, SD = 0.80). MEASUREMENTS Ratings of inattention, hyperactivity-impulsivity and delinquency were collected from multiple informants at baseline and through the 8-year follow-up. Self-reports of binge drinking and marijuana use were collected at the 12-year follow-up (mean age 21 years). FINDINGS Trajectories of worsening inattention symptoms and delinquency (and less apparent improvement in hyperactivity-impulsivity) were associated with higher rates of early adult binge drinking and marijuana use, compared with trajectories of stable or improving symptoms and delinquency (of 24 comparisons, all P-values <0.05), even when symptom levels in stable trajectories were high. CONCLUSIONS Worsening inattention symptoms and delinquency during adolescence are were associated with higher levels of early adult substance use; this pattern may reflect a developmental course of vulnerability to elevated substance use in early adulthood.
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Affiliation(s)
- Andrea L. Howard
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Brooke S. G. Molina
- Departments of Psychology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Stephen P. Hinshaw
- Department of Psychology, University of California, Berkeley, CA, USA and Department of Psychiatry, University of California, San Francisco, CA, USA
| | | | - Seth C. Harty
- Department of Psychology, Chatham University, Pittsburgh, PA, USA
| | - L. Eugene Arnold
- Department of Psychiatry, Ohio State University, Columbus, OH, USA
| | | | - Lily Hechtman
- Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Annamarie Stehli
- Child Development Center, University of California, Irvine, CA, USA
| | | | - Jeffrey H. Newcorn
- Division of Child and Adolescent Psychiatry, Mount Sinai Medical Center, New York, NY, USA
| | - Timothy Wigal
- Child Development Center, University of California, Irvine, CA, USA
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Sibley MH, Altszuler AR, Morrow AS, Merrill BM. Mapping the academic problem behaviors of adolescents with ADHD. SCHOOL PSYCHOLOGY QUARTERLY : THE OFFICIAL JOURNAL OF THE DIVISION OF SCHOOL PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION 2014; 29:422-437. [PMID: 24933215 PMCID: PMC4261004 DOI: 10.1037/spq0000071] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study possessed 2 aims: (a) to develop and validate a clinician-friendly measure of academic problem behavior that is relevant to the assessment of adolescents with attention deficit/hyperactivity disorder (ADHD) and (b) to better understand the cross-situational expression of academic problem behaviors displayed by these youth. Within a sample of 324 adolescents with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision diagnosed ADHD (age M = 13.07, SD = 1.47), parent, teacher, and adolescent self-report versions of the Adolescent Academic Problems Checklist (AAPC) were administered and compared. Item prevalence rates, factorial validity, interrater agreement, internal consistency, and concurrent validity were evaluated. Findings indicated the value of the parent and teacher AAPC as a psychometrically valid measure of academic problems in adolescents with ADHD. Parents and teachers offered unique perspectives on the academic functioning of adolescents with ADHD, indicating the complementary roles of these informants in the assessment process. According to parent and teacher reports, adolescents with ADHD displayed problematic academic behaviors in multiple daily tasks, with time management and planning deficits appearing most pervasive. Adolescents with ADHD display heterogeneous academic problems that warrant detailed assessment prior to treatment. As a result, the AAPC may be a useful tool for clinicians and school staff conducting targeted assessments with these youth.
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Affiliation(s)
- Margaret H Sibley
- Department of Psychiatry and Behavioral Health, Center for Children and Families, Florida International University
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The developmental course of childhood inattention symptoms uniquely predicts educational attainment: a 16-year longitudinal study. Psychiatry Res 2014; 219:707-9. [PMID: 25017615 DOI: 10.1016/j.psychres.2014.06.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 01/30/2014] [Accepted: 06/17/2014] [Indexed: 02/02/2023]
Abstract
In this 16-year longitudinal study, a new trajectory estimation approach was used to verify whether the developmental course of childhood inattention significantly predicted functional impairment. A rising childhood inattention trajectory significantly predicted graduation failure (OR: 1.76 [1.32-2.34]) independently of averaged inattention levels. Rising inattention is, in itself, important for prognosis.
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Swift KD, Sayal K, Hollis C. ADHD and transitions to adult mental health services: a scoping review. Child Care Health Dev 2014; 40:775-86. [PMID: 24164052 DOI: 10.1111/cch.12107] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 11/29/2022]
Abstract
There is increased awareness that attention deficit hyperactivity disorder (ADHD) continues into adulthood. Thus, health services are faced with a new challenge in providing a 'smooth' transition to adult services appropriate for young people with ADHD. This scoping review sought to identify the literature addressing transition for young people with ADHD to adult mental health services (AMHS). A scoping review, in which the search terms 'ADHD' and 'Transition' or 'Transfer' were entered into eight healthcare publication databases facilitated by NHS Evidence to identify both published and unpublished papers between 2000 and June 2013. Additional informal searches were also undertaken. Twenty-three papers were selected for this review. This review confirms the lack of research explicitly tracking transition from Paediatrics/Child and Adolescent Mental Health Services (CAMHS) to AMHS for young people with ADHD. Only four papers directly studying transition for ADHD patients were identified. Three further studies surveyed clinician perspectives. Taken together, the studies address a number of issues in relation to transition, including the developmental course of ADHD symptoms, appropriate adult care, knowledge and communication, unmet need, comorbidities, environmental demands and medication cessation/dosage during the transition period. While literature surrounding transition exists, the scope of the evidence showing successful and unsuccessful transition activity from Paediatric and CAMHS to AMHS for young people with ADHD is limited. Future quality research in the form of audits, longitudinal tracking studies and service evaluations are required if we are truly to understand and identify what is needed and currently available for successful transition to an appropriate adult service for ADHD patients.
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Affiliation(s)
- K D Swift
- Child and Adolescent Mental Health Services (CAMHS), Nottinghamshire Healthcare NHS Trust, Nottingham, UK
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Measurement of Behavioral and Emotional Outcomes of Youth in Foster Care: Investigation of the Roles of Age and Placement Type. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014; 37:422-431. [PMID: 26478653 DOI: 10.1007/s10862-014-9464-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Behavioral Assessment System for Children-2 (BASC-2) is used to assess behavioral and emotional outcomes for youth. Research providing evidence for use of the BASC-2 parent-report form historically has included biological parents reporting on their children (Reynolds and Kamphaus 2004). For youth residing in out-of-home placements through enrollment in foster care, caregivers reporting on their functioning may include foster parents or residential staff. Given the significant adverse mental health outcomes for youth in foster care and the need to adequately assess adjustment in foster care, the purpose of the study was to evaluate the measurement properties of caregivers' report on the parent report form (PRS) of the BASC-2 in foster care youth. Using 479 respondents, a measurement model was fit to the data demonstrating adequate fit across Internalizing Problems, Externalizing Problems, and Adaptive Skills. Further, a comparison of measurement properties across child and adolescent groups and groups of youth residing in residential facilities versus foster homes was conducted. Factorial invariance and latent means also were assessed. The BASC-2 PRS was found to be an adequate assessment of psychological outcomes for youth in foster care when completed by foster parents or residential facility staff.
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