Weak impacts of neuropsychological measures on symptoms of attention deficit hyperactivity disorder in university students

OBJECTIVE

Attention deficit hyperactivity disorder (ADHD) is involved in broad neuropsychological domains, including response inhibition, timing, delay aversion, sustained attention, and working memory. This study aimed to examine the relationship between ADHD symptoms and neuropsychological measures in university students.

METHODS

A total of 167 graduate and undergraduate students participated in the study. Neuropsychological characteristics were comprehensively assessed using stop signal, delay discounting, time discrimination, sensorimotor synchronization, continuous performance, and digit span tasks. ADHD symptoms were assessed using the Japanese version of Conners' ADHD Rating Scale.

RESULTS

ADHD symptoms were significantly correlated with some neuropsychological measures, such as the false alarm rate in the continuous performance task; however, these correlations were not strong. In the multiple regression analyses, models including neuropsychological measures were significantly associated with ADHD symptoms, but the coefficients of determination ranged from 0.06 to 0.08. Thus, most of the variance in ADHD symptoms was not explained by neuropsychological measures.

CONCLUSION

These findings suggest that the impact of each neuropsychological measure on ADHD symptoms was weak in university students, and ADHD symptoms cannot be explained by neuropsychological characteristics, which are currently considered core characteristics of ADHD. In addition, ADHD symptoms assessed by self-rating questionnaire in the non-clinical sample might not reflect the degree of real ADHD severity.

Effects of Gaze Cues on Distributive Behavior of the Ultimatum Game in Adults With Attention Deficit Hyperactivity Disorder

ABSTRACT

Adults with attention deficit hyperactivity disorder (ADHD) have difficulty in social decision-making. The ultimatum game (UG) is a popular economic game used to evaluate social decision-making. This study aimed to examine the effects of schematically depicted eyes and ADHD symptoms on UG performance. Thirty adults with ADHD were recruited. The computer screen background was changed among the "eyespots," "neutral," and "flowers" conditions among 30 trials of UG. Through all trials, task performances were recorded, and then compared with 30 typical adults and 30 adults with autism spectrum disorder (ASD). The reaction time was not affected by the background in any group. Although typical adults distributed more money in the "eyespots" condition, a nonsignificant background effect was observed in adults with ADHD or ASD. These results may be associated with reduced attention to social cues in individuals with ADHD, and this ADHD characteristic might lead to difficulty in social decision-making.

Development and field testing of a decision aid to facilitate shared decision making for adults newly diagnosed with attention-deficit hyperactivity disorder

Background

The number of individuals who are diagnosed with attention‐deficit hyperactivity disorder (ADHD) during adulthood has increased in recent years. However, there is still no decision aid (DA) to help adults newly diagnosed with ADHD make decisions regarding further treatments.

Objective

This study aimed to describe the development process of a DA for adults newly diagnosed with ADHD and its field testing during the shared decision‐making (SDM) process in a clinical setting.

Methods

The development process involved the creation of a DA prototype using the International Patient Decision Aid Standards criteria and revision of the prototype through the stakeholders' reviews. The field testing of the DA compared scores before and after the SDM process on the service users' knowledge scale, decisional conflict scale and the Conners Adult ADHD Rating Scales.

Results

The developed DA contained options of watchful waiting with own coping skills and pharmacological treatment, which consisted of several kinds of drug options. Fifteen adults newly diagnosed with ADHD participated in the field testing. The participant decision‐making quality outcomes such as their knowledge and decisional conflict improved after the SDM process. ADHD severity did not change.

Conclusion

A DA for adults with ADHD was systematically developed following the international criteria. Field testing indicated that the DA could serve as a tool to facilitate the SDM process. Further research on this DA is necessary before its routine implementation.

Patient or Public Contribution

During the development process of the DA, the service users who had already been diagnosed with ADHD reviewed the DA prototype and provided feedback, which improved the final version of the DA.

Research protocol for a pragmatic randomized controlled effectiveness and cost effectiveness study of Well Parent Japan (WPJ) for Japanese mothers of children with ADHD: The TRaining And Nurturing Support FOR Mothers TRANSFORM study (Preprint)

Background

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder associated with numerous functional deficits and poor long-term outcomes. Internationally, behavioral interventions are recommended as part of a multimodal treatment approach for children with ADHD. Currently, in Japan, there are limited interventions available to target ADHD. Well Parent Japan (WPJ), a new hybrid parent-training program, provides a culturally acceptable and effective way to help support Japanese children with ADHD and their parents.

Objective

This pragmatic multicenter randomized controlled trial aims to provide preliminary evidence about the effectiveness and cost-effectiveness of WPJ evaluated against treatment as usual (TAU) within routine Japanese mental health services.

Methods

Mothers of children (aged 6-12 years) diagnosed with ADHD were recruited from child and adolescent mental health care services at three hospital sites across Japan (Fukui, Fukuoka, and Okinawa). The mothers were randomized to receive immediate treatment or TAU. The effectiveness and cost-effectiveness of WPJ over TAU at the end of the intervention and at 3-month follow-up will be evaluated. The primary outcome is maternal parent domain stress in the parenting role. The following secondary outcomes will be explored: child behavior, including severity of ADHD symptoms; parenting practices; emotional well-being; and the parent-child relationship and maternal child domain parenting stress. Data analysis will follow intention-to-treat principles with treatment effects quantified through analysis of covariance using multilevel modeling. An incremental cost-effectiveness ratio will be used to analyze the cost-effectiveness of the WPJ intervention.

Results

Study funding was secured through a proof-of-concept grant in July 2018. Approval by the institutional review board for the data collection sites was obtained between 2017 and 2019. Data collection began in August 2019 and was completed in April 2022. Participant recruitment (N=124) was completed in May 2021. Effectiveness and cost-effectiveness analyses are expected to be completed by July 2022 and December 2022, respectively. These timelines are subject to change owing to the COVID-19 pandemic.

Conclusions

This is the first multisite pragmatic trial of WPJ based on the recruitment of children referred directly to routine clinical services in Japan. This multisite randomized trial tests the effectiveness of WPJ in children and families by comparing WPJ directly with the usual clinical care offered for children diagnosed with ADHD in Japan. We also seek to assess and compare the cost-effectiveness of WPJ with TAU in Japan.

Trial Registration

International Standard Randomised Controlled Trial Number ISRCTN66978270; https://www.isrctn.com/ISRCTN66978270

International Registered Report Identifier (IRRID)

DERR1-10.2196/32693