Assessing adult attention-deficit/hyperactivity disorder: a Turkish version of the current symptoms scale

Turkish adaptation of the Smartphone Distraction Scale (SDS)

The aim of this study is to adapt the Smartphone Distraction Scale to Turkish and to examine its psychometric properties. The participants of the study consisted of a community sample of 399 people, 288 (72.2%) women and 111 (27.8%) men, aged between 18-60 (27.14±10.89). In data collection, Sociodemographic Form (SF), Smartphone Distraction Scale-Turkish Version (SDS), Bergen Social Media Scale (BSMS), Emotion Regulation Questionnaire (ERQ), Current Symptoms Scale (CSS), and Perceived Multitasking Scale (PMS) were used. The data were analyzed through Cronbach alpha internal consistency coefficient, Pearson product-moment correlation test, item-total score correlation coefficients, confirmatory factor analysis to estimate the construct validity of the scale. Considering the internal consistency reliability of the scale, the Cronbach alpha reliability coefficient was found to be .88 for attention/impulsivity, .80 for alertness, .76 for multitasking, and .76 for emotion regulation. The item and total score correlation coefficients of the scale items were found to be between 0.49 and 0.76. Confirmatory factor analysis supported the 16-item and four-factor structure of the scale. The correlation of SDS with BSMAS, ERQ, CSS, and PMS was found to be statistically significant. The results of the research show that the SDS adapted to Turkish culture is a valid and reliable measurement tool that can be used in academic studies and clinical settings.

A measure of cognitions specific to seasonal depression: Development and validation of the Seasonal Beliefs Questionnaire

We introduce the Seasonal Beliefs Questionnaire (SBQ), a self-report inventory of maladaptive thoughts about the seasons, light availability, and weather conditions, proposed to constitute a unique cognitive vulnerability to winter seasonal affective disorder (SAD; Rohan, Roecklein, & Haaga, 2009). Potential items were derived from a qualitative analysis of self-reported thoughts during SAD-tailored cognitive-behavioral therapy (CBT-SAD) and subsequently refined based on qualitative feedback from 48 SAD patients. In the psychometric study (N = 536 college students), exploratory and confirmatory factor analyses pruned the items to a 26-item scale with a 5-factor solution, demonstrating good internal consistency, convergent and divergent validity, and 2-week test-retest reliability. In a known groups comparison, the SBQ discriminated SAD patients (n = 86) from both nonseasonal major depressive disorder (MDD) patients (n = 30) and healthy controls (n = 110), whereas a generic measure of depressogenic cognitive vulnerability (the Dysfunctional Attitudes Scale [DAS]) discriminated MDD patients from the other groups. In a randomized clinical trial comparing CBT-SAD with light therapy (N = 177), SBQ scores improved at twice the rate in CBT-SAD than in light therapy. Greater change in SBQ scores during CBT-SAD, but not during light therapy, was associated with a lower risk of depression recurrence 2 winters later. In contrast, DAS scores improved comparably during CBT-SAD and light therapy, and DAS change was unrelated to recurrence following either treatment. These results support using the SBQ as a brief assessment tool for a SAD-specific cognitive vulnerability and as a treatment target in CBT-SAD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Impact of In-Person and Virtual World Mindfulness Training on Symptoms of Post-Traumatic Stress Disorder and Attention Deficit and Hyperactivity Disorder

Mindfulness meditation training has been shown to reduce stress and improve short-term memory for military personnel. However, no studies have investigated the effects of in-person and virtual world (VW) mindfulness training on Post-Traumatic Stress Disorder (PTSD) or Attention Deficit Hyperactivity Disorder (ADHD) symptoms. In this study, U.S. military active duty service members and veterans were pseudo-randomized into two mindfulness training groups: in-person (IP) and online via a VW, and a wait-list control group. Volunteers answered a demographic questionnaire, and completed the PTSD Checklist-Military Version (PCL-M) and ADHD Current Symptoms Scale before and after training. The results showed practical and clinically relevant reductions in PTSD symptoms, particular for the IP group, but did not show statistical relevance with hypothesis testing. Results also showed post-training reductions in ADHD symptoms for both IP and VW groups, but no change for the control group. To investigate the effects of initial ADHD symptoms, IP and VW groups were combined into a single Mindfulness Training group. Those with high-initial ADHD symptoms attending training showed improvements, but the control group did not. These results expand research on the mindfulness training, and suggest that IP mindfulness training, rather than VW training, may be of greater benefit for those with PTSD symptoms, while either delivery system appears adequate for reducing attentional symptoms.

Attention deficit hyperactivity disorder in the European adult population: prevalence, disease awareness, and treatment guidelines

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological disorder with childhood onset and persistence into adolescence and adulthood.

METHODS

Our literature review reports scientific publications and guidelines on the treatment of adult ADHD, with a particular focus on European countries, identified by literature searches in Medline and Embase. The final literature search was performed in July 2012, incorporating literature from 1974 to 2012. The primary research parameters were 'Europe' (including single European countries), 'ADHD', 'attention deficit disorder', 'attention deficit', 'attention disorder', and 'hyperactivity'. Secondary search parameters were 'comorbid', 'epidemiology' or 'prevalence', 'disease management', 'drug therapy', or 'therapy'. The main searches were also limited to adults and English language publications. The papers identified by this literature review were selected for inclusion by consensus of the authors based on clinical relevance.

RESULTS

Appropriate resources for the diagnosis and treatment of adult ADHD in Europe are scarce, and many cases go untreated, particularly because of the frequent presence of psychiatric comorbidities. Apart from atomoxetine, and an extended-release form of methylphenidate in Germany, no other medications have been approved for starting treatment in adult ADHD patients in the European Union. However, a variety of stimulant and non-stimulant medications are used off-label, and a number of studies have confirmed that these medications are well tolerated and effective in adult patients with ADHD.

CONCLUSIONS

Our results emphasize the need for broader access to effective treatments for adult ADHD patients in Europe.

The relationship between the presence of ADHD and certain candidate gene polymorphisms in a Turkish sample

Due to the high heritability of attention-deficit hyperactivity disorder (ADHD), parents of children with ADHD appear to represent a good sample group for investigating the genetics of the disorder. The aim of this study was to investigate the association between ADHD and six polymorphisms in five candidate genes [5-HT2A (rs6311), NET1 (rs2242447), COMT (rs4818), NTF3 (rs6332), SNAP-25 (rs3746544) and (rs1051312)]. We included 228 parents of children diagnosed with ADHD and 109 healthy parents as the control group. The polymorphisms were genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) assays and analyzed using the chi-square test and the multinomial logit model. SNAP-25 (rs3746544) polymorphism was associated with loading for ADHD, while 5-HT2A (rs6311) and NET1 (rs2242447) polymorphisms were associated with ADHD. On the other hand, there was no significant association between the SNAP-25 (rs1051312), NTF3 (rs6332), or COMT (rs4818) gene polymorphisms and ADHD. In addition, we found that even if variation in the SNAP-25 gene alone does not affect the phenotype, it may nevertheless lead to the emergence of a clinical ADHD picture in the presence of other genetic factors. Our findings suggest that a combination of NET1 (rs2242447) and SNAP-25 (rs3746544) is a risk factor for ADHD. Problems associated with the noradrenergic and serotonergic systems and SNAP-25 may play a role, both alone and in interaction with one another, in the pathophysiological mechanisms of ADHD.

Neuropsychological weaknesses in adult ADHD; cognitive functions as core deficit and roles of them in persistence to adulthood

Prior investigations have shown that individuals with attention deficit hyperactivity disorder (ADHD) have impaired neuropsychological functions. This study had two aims, first to investigate weakened cognitive functions in adult ADHD (aADHD), and second, to investigate difference between persisters (those having persistently ongoing ADHD diagnosis in adulthood), and remitters (those having ADHD diagnosis only in childhood and not in adulthood), in terms of cognitive deficits. We evaluated performance on a comprehensive neuropsychological battery in three groups including 34 persisters, 35 remitters, and 35 healthy control group (absence of childhood and adulthood ADHD diagnosis). Our findings showed that adults with ADHD have inefficient attention, interference control and set-shifting functions, which may be revealed on neuropsychological tests that require greater cognitive demand. Given the finding that interference control deficit exists across the lifespan in people with ADHD, we suggest that interference control-associated functional weakness may be a core deficit for ADHD. (JINS, 2012, 18, 1-8).

Disentangling child and family influences on maternal expressed emotion toward children with attention-deficit/hyperactivity disorder

OBJECTIVE

We used multi-level modelling of sibling-pair data to disentangle the influence of proband-specific and more general family influences on maternal expressed emotion (MEE) toward children and adolescents with attention-deficit/hyperactivity disorder (ADHD).

METHOD

MEE was measured using the Five Minute Speech Sample (FMSS) for 60 sibling pairs (aged 5 through 17 years) each comprising one proband with ADHD and one child without ADHD. Questionnaire measures were used to assess child and adolescent conduct and emotional problems and maternal depression and ADHD. Multi-level models partitioned the effects of five MEE components (initial statement [IS], relationship [REL], warmth [WAR], critical comments [CC], and positive comments [PC]) into proband-specific and general family effects.

RESULTS

Significant proband-specific effects were confirmed for all MEE components, with higher levels of MEE expressed toward probands with ADHD than siblings without ADHD. For REL, PC, and CC, this effect was explained by comorbid child conduct problems rather than ADHD. Only low WAR was associated with child ADHD itself. Furthermore, only low WAR was related to variations in more general family characteristics, especially levels of maternal depression.

CONCLUSIONS

MEE toward children with ADHD was influenced by proband-specific factors. For most components, these were driven by comorbid symptoms of conduct problems rather than ADHD itself. WAR was different; it was influenced by both child-specific and more general characteristics of the family. Further studies utilising a longitudinal design are required to establish the direction of causation and extend our understanding of the relationship between EE components and ADHD.

Scales for the identification of adults with attention deficit hyperactivity disorder (ADHD): a systematic review

Attention deficit hyperactivity disorder (ADHD) is prevalent in the adult population. The associated co-morbidities and impairments can be relieved with treatment. Therefore, several rating scales have been developed to identify adults with ADHD who may benefit from treatment. No systematic review has yet sought to evaluate these scales in more detail. The present systematic review was undertaken to describe the properties, including psychometric statistics, of the currently available adult ADHD rating scales and their scoring methods, along with the procedure for development. Descriptive synthesis of the data is presented and study quality has been assessed by an objective quality assessment tool. The properties of each scale are discussed to make judgements about their validity and usefulness. The literature search retrieved 35 validation studies of adult ADHD rating scales and 14 separate scales were identified. The majority of studies were of poor quality and reported insufficient detail. Of the 14 scales, the Conners' Adult ADHD Rating scale and the Wender Utah Rating Scale (short version) had more robust psychometric statistics and content validity. More research into these scales, with good quality studies, is needed to confirm the findings of this review. Future studies of ADHD rating scales should be reported in more detail so that further reviews have more support for their findings.

ADHD symptomatology and adjustment to college in China and the United States

This study examined ADHD symptomatology and college adjustment in 420 participants--147 from the United States and 273 from China. It was hypothesized that higher levels of ADHD symptoms in general and the inattentive symptom group in particular would be related to decreased academic and social adjustment, career decision-making self-efficacy, and poorer study skills in both countries. Results generally supported the hypotheses, indicating that the difficulties associated with inattention are cross-cultural and not specific to the United States.

Comorbidity of adult attention-deficit hyperactivity disorder and bipolar disorder: prevalence and clinical correlates

The aim of this study was to determine the frequency of adult attention deficit hyperactivity disorder (ADHD) comorbidity with lifetime bipolar disorder, and the influence of this comorbidity on various demographic and clinical variables in patients. Patients (n=159) with a previous diagnosis of bipolar disorder (79 female, 80 male) were included in this study. All patients were interviewed for the presence of current adult and childhood ADHD diagnosis and other axis I psychiatric disorder comorbidities using the structured clinical interview for DSM-IV (SCID) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL). The subjects also completed a Wender Utah rating scale (WURS-25) and a Current Symptoms Scale for ADHD symptoms. In particular, patients' clinical characteristics, the age of onset of bipolar disorder, and the number of episodes were noted. Twenty-six of the 159 bipolar patients (16.3%) were diagnosed with adult ADHD, while another subgroup of patients (n=17, 10.7%) received a diagnosis of childhood ADHD but did not fulfill criteria for adult ADHD. Both of these two subgroups (patients with adult ADHD, and patients with only childhood ADHD) had an earlier age of onset of the disease and a higher number of previous total affective or depressive episodes than those without any lifetime ADHD comorbidity. However only bipolar patients with adult ADHD comorbidity had higher lifetime comorbidity rates for axis I psychiatric disorders, such as panic disorder and alcohol abuse/dependence, compared to patients without lifetime ADHD. Bipolar patients with comorbid adult ADHD did not differ from bipolar patients with comorbid childhood ADHD in terms of any demographic or clinical variables except for adult ADHD scale scores. In conclusion, ADHD is a common comorbidity in bipolar patients, and it adversely affects the course of the disease and disrupts the social adjustment of the patients. Regular monitoring of ADHD will help to prevent problems and complications that could arise in the course of the disease, particularly in patients with early onset bipolar disorder.

Self-reported symptoms of ADHD among college students in China and the United States

OBJECTIVE

The present study examined ADHD symptoms among college students in China and the United States.

METHOD

A total of 283 (45%) American and 343 (55%) Chinese students completed the Wender Utah Rating Scale (WURS) and the Current Symptoms Scale (CSS), in addition to other measures.

RESULTS

Both of the ADHD measures appear to be reliable and valid, with good internal consistency, similar factor structures, and predicted relationships with other variables, such as depression and self-esteem. However, differences exist between the cultures in gender and overall reported symptom severity.

CONCLUSION

ADHD symptomatology is present among college students in China in a pattern similar to that found in American college students. The WURS and the CSS appear to be effective screening measures for the disorder in China, although further research on gender and cultural differences is necessary.

Epidemiology of attention problems among Turkish children and adolescents: a national study

OBJECTIVE

To evaluate the epidemiology of attention problems using parent, teacher, and youth informants among a nationally representative Turkish sample.

METHOD

The children and adolescents, 4 to 18 years old, were selected from a random household survey. Attention problems derived from the Child Behavior Checklist (CBCL) (N = 4,488), Teacher Report Form (TRF) (N = 2,360), and the Youth Self Report (YSR) (N = 2,206) were examined.

RESULTS

The CBCL and TRF attention problems scores were higher among young male children, whereas the YSR reported scores were higher among older adolescents without a gender effect. The CBCL and YSR scores were also higher by urban residence.

CONCLUSION

Compared with other European samples, our national sample had higher mean attention problems scores than the Scandinavian but lower mean scores than the former Soviet Union samples. In addition to elucidating the profile of attention problems in Turkey, our results also contribute to understanding the comparative global epidemiology of attention problems.

Maternal Inattention and Impulsivity and Parenting Behaviors

This study extends previous research by examining whether maternal inattention, impulsivity, and hyperactivity are associated with different parenting behaviors. Ninety-six mother-son dyads participated in the study, and the boys ranged between 4 and 8 years of age. Maternal inattention was uniquely and positively associated with mothers' use of inconsistent discipline and lower involvement with the child after controlling for impulsivity and the control variables of child age, maternal depression and hostility, family socioeconomic status, and child behavior problems. Maternal impulsivity was uniquely and negatively associated with mothers' use of positive reinforcement after similar controls. Possible reasons for the different patterns of associations between maternal inattention and impulsivity, and parenting and the clinical implications of the findings are discussed.

When personality and culture clash: the psychological distress of allocentrics in an individualist culture and idiocentrics in a collectivist culture

Because humans need both autonomy and interdependence, persons with either an extreme collectivist orientation (allocentrics) or extreme individualist values (idiocentrics) may be at risk for possession of some features of psychopathology. Is an extreme personality style a risk factor primarily when it conflicts with the values of the surrounding society? Individualism-collectivism scenarios and a battery of clinical and personality scales were administered to nonclinical samples of college students in Boston and Istanbul. For students residing in a highly individualistic society (Boston), collectivism scores were positively correlated with depression, social anxiety, obsessive-compulsive disorder and dependent personality. Individualism scores, particularly horizontal individualism, were negatively correlated with these same scales. A different pattern was obtained for students residing in a collectivist culture, Istanbul. Here individualism (and especially horizontal individualism) was positively correlated with scales for paranoid, schizoid, narcissistic, borderline and antisocial personality disorder. Collectivism (particularly vertical collectivism) was associated with low report of symptoms on these scales. These results indicate that having a personality style which conflicts with the values of society is associated with psychiatric symptoms. Having an orientation inconsistent with societal values may thus be a risk factor for poor mental health.

CSF oligoclonal bands in MS include antibodies against Chlamydophila antigens

BACKGROUND

Considerable evidence suggests the role of an infectious agent in MS. The presence of Chlamydophila pneumoniae in CSF from patients with MS was shown earlier; to further examine this association the reactivity of the oligoclonal antibody response in the CSF of patients with MS to C pneumoniae antigens was determined and compared with other antigens.

METHODS

Seventeen patients with MS and 14 control subjects with other neurologic disease were studied. Affinity-driven immunoblot studies and solid-phase adsorption of CSF oligoclonal bands by elementary body antigens of C pneumoniae, viral antigens (measles and herpes simplex virus-1), bacterial antigen (Escherichia coli and Staphylococcus aureus), and heat shock protein-60 were performed.

RESULTS

Affinity-driven immunoblot studies demonstrated reactivity of oligoclonal bands in CSF samples from 16 patients with MS against elementary body antigens of C pneumoniae. None of the control subjects showed a prominent reactivity to elementary body antigens of C pneumoniae. In 14 of 17 patients with MS examined, oligoclonal bands were adsorbed either partially or completely from the CSF by elementary body antigens of C pneumoniae, but not by myelin basic protein, heat shock protein-60, or bacterial or viral antigens. In three patients with subacute sclerosing panencephalitis, adsorption of oligoclonal bands was seen with measles virus antigens but not with elementary body antigens of C pneumoniae.

CONCLUSIONS

Oligoclonal bands in CSF of patients with MS include antibodies against Chlamydophila antigens.