Differences in heterosocial behavior and outcomes of ADHD-symptomatic subtypes in a college sample

The appeal of tai chi and complementary therapies for college students with ADHD

Background:  Developing effective non-pharmacological therapies for Attention Deficit Hyperactivity Disorder (ADHD) is important. We gauged the likelihood that undergraduates would participate in a trial of tai chi as an intervention for ADHD, and evaluated attitudes toward complementary and alternative medicine (CAM). Methods: We collected survey responses from 47 undergraduates with ADHD and 49 healthy controls, measuring their likelihood of participating in trials of tai chi and other non-pharmacological therapies, along with attitudes toward CAM. We examined the relationship between diagnosis, CAM attitudes, and willingness to participate in a trial. Results: Undergraduates with ADHD showed greater acceptance of CAM therapies. Thirty two percent of students with ADHD expressed strong willingness to participate in a tai chi trial. Conclusion: These results support the feasibility of a trial of tai chi as therapy for undergraduates with ADHD, and suggest this population is receptive toward CAM. Future research should examine why interest in CAM is greater among students with ADHD.

Sexual development in ADHD and internet pornography consumption

Development of sexual identity during adolescence is a major process of transition in individual life which in cases of ADHD specifically interacts with other ontogenetic, pathological and psychosocial conditions. According to recent findings growing consumption of internet pornography mainly in male ADHD population is closely related to compulsive sexual behavior and hypersexuality. Recent findings also indicate that consumption of internet pornography in ADHD individuals and other sexual activities may serve as a mood-altering "self-medication" which may help to cope with stressful events and decrease depression and anxiety. Taken together recent findings indicate that internet pornography consumption mainly in ADHD individuals is closely related to stressful experiences, anxiety, depression and identity problems in partnerships which significantly increase their vulnerability to the so-called "problematic pornography use" and other forms of addictive sexual behavior. From this developmental perspective "problematic pornography use" in ADHD individuals represents significant epidemiological problem which requires further research mainly with focus on clinical diagnostics and treatment.

Sexuality in Adults With ADHD: Results of an Online Survey

Establishing a secure sexual identity is a major developmental goal of an individual's transition from childhood to adolescence and the years that follow. Attention deficit/hyperactivity disorder (ADHD) as a neurodevelopmental disorder defined by the core symptoms of inattention, hyperactivity, and impulsivity, but also with emotional dysregulation, oppositional behaviors, or disorganization appearing early in life, can affect several areas of an individual's personal and social development, including sexual health. Yet, the scientific knowledge about the relationship between ADHD and sexual functioning is still scarce. Using an anonymous online survey, we compared different sexual behaviors including risky sexual behaviors, hypersexual behaviors, and sexual dysfunctions between 206 individuals with (n = 139) and without (n = 76) ADHD. Individuals with ADHD reported significantly more hypersexual behaviors than non-ADHD individuals, whereas no differences were found concerning risky sexual behaviors or sexual dysfunctions. In women with ADHD, hypersexual behaviors, sexual risk-taking as well as sexual dysfunctions were closely related to symptoms of emotional dysregulation, impulsivity, and oppositional symptoms. In men with ADHD, the associations between ADHD symptomatology and the sexuality-related measures were less clear, however, signs of emotional dysregulation seemed to be relevant as well. Since individuals with ADHD seem to be at an increased risk of some peculiarities in sexual behavior, sexuality-related issues should be routinely addressed during clinical consultations to provide more holistic treatment in order to enhance individual well-being and quality of life.

Adult ADHD and romantic relationships: What we know and what we can do to help

It has been widely maintained that enduring and healthy romantic relationships are critical to quality of life in adulthood, and can buffer the impact of adversity, including psychological disorder. Unfortunately, much research points toward adults with attention-deficit hyperactivity disorder (ADHD) having short-lived and discordant romantic relationships. Despite this ample evidence, relatively little research has focused on identifying specific factors that may strengthen or explain their relational difficulties, which would have obvious relationship distress prevention and intervention implications. The current study reviews the state of the literature on romantic relationships in adults with ADHD, including differences that have been established between ADHD and non-ADHD populations as well as distal and proximal factors that appear to increase risk of relationship distress of adults with ADHD. Finally, notable gaps in the literature are identified and implications are raised with regards to prevention and intervention efforts designed to address functional impairment in adults with ADHD.

Common Venues in Romantic Relationships of Adults With Symptoms of Autism and Attention Deficit/Hyperactivity Disorder

Introduction: Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) figures among the most common neurodevelopmental disorders. Despite having opposite stereotypes, both ADHD and ASD compromise, though in different ways, skills such as social interactions, communication skills, and social thinking, which may underlie difficulties in romantic relationships. Methods: We evaluated 306 adults about their romantic relationships and the intensity of their love. Participants were from one of four groups:, individuals with ASD-only traits, a group with symptoms of ADHD-only, participants with neither ADHD nor ASD symptoms (control) or from a fourth group of individuals with both ADHD and ASD traits. Results: The ASD traits group had fewer married people and more people who have never been married, while the rate of divorce was higher in the ADHD traits group. Regarding the intensity of love, the mean scores of the ADHD and the ADHD+ASD traits groups were higher in the Passionate Love Scale than the mean score of the control group. Passionate love in the ASD group was no different from the other groups. Small positive correlations were found between passionate love and ADHD and ASD behavioral problems. Conclusion: Marital status was distinct depending on symptoms of a neurodevelopmental disorder in adulthood. Also, ADHD and ASD symptoms were associated with greater passionate love. Therefore, ADHD and ASD behavioral dimensions may impact long-term and short-term experiences of a person's relationship with a significant other in distinct ways. Understanding how people with neurodevelopmental disorders experience love might help us to better clarify the mechanisms associated with their relationship patterns.

Association of ADHD and hypersexuality and paraphilias

Subjects with ADHD suffer from inattention, hyperactivity, and impulsivity. Clinicians often assume that specific symptoms of ADHD are bound to affect sexual desire by increasing the frequency of hypersexuality. There is a lack of knowledge about the comorbidity between ADHD, hypersexuality, and paraphilias. The aim of this article was to provide a review of the literature on the association of ADHD and hypersexuality and paraphilias and to discuss the screening and the management of these syndromes when associated with ADHD. A systematic review of the literature was performed in PubMed, PsychInfo, and Embase databases. The studies reviewed show that some individuals who suffer from ADHD report hypersexuality and paraphilias, but no clear data emerged supporting the idea that hypersexuality and paraphilias are more frequent in an ADHD population. On the other hand, some studies showed a high prevalence of ADHD in hypersexual and paraphilic subjects. This is the first systematic review of hypersexuality and paraphilias in individuals with ADHD. However, the results are limited by differences in the methodology and measurement instruments for hypersexuality and paraphilias as well as by the small number of studies and the small sample sizes of many studies.

Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review

BACKGROUND

The scientific literature on sexuality among mentally ill patients clearly shows a higher prevalence of sexual disorders for many mental disorders, but little is known about sexuality in individuals suffering from ADHD. Clinicians will often assume that specific difficulties of ADHD are bound to affect sexual functioning.

AIM

The aim of this study was to provide a review of the literature to gain better knowledge about sexuality in subjects with ADHD and to discuss screening and management of their potential sexual problems.

METHODS

A systematic review of the literature was performed in Pubmed, PsychInfo, and Embase databases.

MAIN OUTCOME MEASURES

The main outcome measures were sexual function and sexual dysfunctions.

RESULTS

The studies indicated that subjects with ADHD report more sexual desire, more masturbation frequency, less sexual satisfaction, and more sexual dysfunctions than the general population.

CLINICAL IMPLICATIONS

Clinicians working with subjects with ADHD should explore the quality of their sexual life.

STRENGTHS & LIMITATIONS

This is the first systematic review of the sexuality of individuals with ADHD. However, the results are limited by the small number of studies, by the small sample size of many studies, and the potential for bias.

CONCLUSIONS

ADHD is a mental disorder affecting sexual health. Further studies are warranted to learn more about sexuality in subjects with ADHD. Soldati L, Bianchi-Demicheli F, Schockaert P, et al. Sexual Function, Sexual Dysfunctions, and ADHD: A Systematic Literature Review. J Sex Med 2020;17:1653-1664.

Inattention and Hyperactivity-Impulsivity: Their Detrimental Effect on Romantic Relationship Maintenance

OBJECTIVE

The aim of this study is to understand how ADHD symptoms correlate with romantic relationship maintenance and test theoretical pathways by which symptoms of ADHD lead to relationship difficulties.

METHOD

This study involved two phases of data collection, which were identical except for the population. Phase 1 ( n = 172) was a nonclinical sample of romantically involved young adults. Phase 2 ( n = 39) was a clinical sample of romantically involved young adults with ADHD. Participants in both phases reported on their levels of inattention and hyperactivity-impulsivity, their relationship maintenance activities, and their relationship quality.

RESULTS

ADHD symptoms were associated with greater relationship difficulties. In both samples, inattentive symptoms were associated with greater interest in relational alternatives and less constructive responses to partner's bad behaviors, whereas hyperactive-impulsive symptoms were associated with negative responses to bad behavior.

CONCLUSION

The results of this study have implications for developing cognitive-behavioral therapy interventions targeting relationship difficulties in young adults with ADHD.

University students with attention deficit hyperactivity disorder (ADHD): a literature review

OBJECTIVES

To review existing literature about university students with Attention Deficit Hyperactivity Disorder (ADHD).

METHODS

A framework for scoping studies and content analysis were used to source and review selected publications from PubMed, ScienceDirect, Google Scholar and relevant bibliographies.

RESULTS

Seventy-four publications were reviewed and key findings were categorised under six core themes that represent the issues germane to university students with ADHD. These themes are: academic, social and psychological functioning, giftedness, new media technologies, treatment, substance misuse and the non-medical use of prescription stimulants, and malingering.

CONCLUSION

In Ireland and the United Kingdom (UK) young people with ADHD are unlikely to enrol into further education, and of those who do go to university, few will graduate at the same time as their non-ADHD peers. ADHD is associated with poor educational outcomes and it may be a hidden disability within institutions of higher education (e.g. universities). Surprisingly, in this topic area, there is a paucity of research in Ireland and the UK. Most studies originate from North America were research activity in the field has been ongoing since the 1990s. These studies however, tend to use relatively small samples of college (university) students recruited at a single institution. It is difficult to generalise the findings of these studies to student populations in North America, let alone in Ireland and the UK. At the very least, these North American studies provide insights into key areas of concern. This topic area straddles education and psychiatry. This means an inter-disciplinary approach is required to examine, better understand and address the impact of ADHD on the educational outcomes of university students. The philosophies of difference, equity and self-realisation can offer a conceptual framework for conducting further research and/or developing services to deliver more personalised learning support for university students with ADHD.

Stigma and attention-deficit/hyperactivity disorder: negative perceptions and anger emotional reactions mediate the link between active symptoms and social distance

This study aimed to understand the contributions of active ADHD symptoms and the diagnostic label of ADHD in yielding negative attitudes and social distance ratings. Using Amazon's Mechanical Turk (n = 305), respondents were assigned to read a vignette about: (a) a typically developing child, (b) a child with active ADHD symptoms and (c) a child with active ADHD symptoms + diagnostic label. Participants were then asked to answer questions about their beliefs and feelings about the child in the vignette. The active ADHD symptom condition predicted higher levels of social distance, and this link was mediated by negative and animalistic adjective ratings, and by angry emotions felt by the participants after reading the vignettes. Our findings suggest that ADHD symptoms drive negative views and social distance and that an ADHD label may serve as a protective factor to help people overcome biases related to childhood ADHD. ADHD symptom literacy and contact with children with varying levels of ADHD symptoms may be an important target to help reduce negative attitudes.

Risky sexual behavior among adolescents: The role of decision-making, problems from cannabis use and externalizing disorder symptoms

INTRODUCTION

Previous research has demonstrated that externalizing symptoms, cannabis use problems, and poor decision-making abilities are each independently related to risky sexual behavior (RSB). However, few studies have examined the joint effect of these factors on RSB among a sample of adolescents.

METHODS

The current study addresses this gap in the literature by examining how externalizing disorder symptoms, cannabis use, and decision-making abilities interact to predict RSB among a sample of adolescents (n = 204; M_age = 15.5) at-risk for escalation in cannabis use. Poisson regression was used for all analyses, and simple slope difference tests were used for all post-hoc analyses.

RESULTS

A greater number of externalizing symptoms, more problems from cannabis use, and more risk disadvantageous choices on the Cups Task (CT) total trials and more risk disadvantageous choices on the CT-gain trials predicted greater RSB endorsement. Findings also highlight significant interactions between cannabis use problems and CT-total and -gain trial performance, as well as between cannabis use problems and externalizing symptoms in predicting RSB.

CONCLUSION

Current treatment and prevention approaches to reduce RSB among adolescents may benefit from incorporating techniques that improve decision-making skills.

Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students

Prescription stimulant medications are considered a safe and long-term effective treatment for Attention Deficit Hyperactivity Disorder (ADHD). Studies support that stimulants enhance attention, memory, self-regulation and executive function in individuals with ADHD. Recent research, however, has found that many college students without ADHD report misusing prescription stimulants, primarily to enhance their cognitive abilities. This practice raises the question whether stimulants actually enhance cognitive functioning in college students without ADHD. We investigated the effects of mixed-salts amphetamine (i.e., Adderall, 30 mg) on cognitive, autonomic and emotional functioning in a pilot sample of healthy college students without ADHD (n = 13), using a double-blind, placebo-controlled, within-subjects design. The present study was the first to explore cognitive effects in conjunction with mood, autonomic effects, and self-perceptions of cognitive enhancement. Results revealed that Adderall had minimal, but mixed, effects on cognitive processes relevant to neurocognitive enhancement (small effects), and substantial effects on autonomic responses, subjective drug experiences, and positive states of activated emotion (large effects). Overall, the present findings indicate dissociation between the effects of Adderall on activation and neurocognition, and more importantly, contrary to common belief, Adderall had little impact on neurocognitive performance in healthy college students. Given the pilot design of the study and small sample size these findings should be interpreted cautiously. The results have implications for future studies and the education of healthy college students and adults who commonly use Adderall to enhance neurocognition.

The Romantic Relationships of Adolescents With ADHD

OBJECTIVE

This study compared the romantic relationships of adolescents with and without ADHD with regard to romantic involvement, relationship content, and relationship quality.

METHOD

A community sample of 58 participants (30 ADHD, 28 Comparison), ages 13 to 18, completed questionnaires assessing various features of romantic relationships.

RESULTS

Adolescents with ADHD reported having more romantic partners than their typically developing (TD) peers. Females with ADHD were found to have shorter romantic relationships than TD adolescents while males with ADHD reported their age of first intercourse to be nearly 2 years sooner than TD peers. Irrespective of gender, adolescents with ADHD had nearly double the number of lifetime sexual partners. However, the romantic relationships of adolescents with and without ADHD did not differ on levels of aggression or relationship quality.

CONCLUSION

Given the outcomes associated with poor-quality romantic relationships, comprehensive assessments of adolescents with ADHD should include queries into their romantic relationships.

ADHD Symptomology and Social Functioning in College Students

OBJECTIVE

ADHD is no longer considered a disorder that children simply outgrow. Adults experience ADHD at high rates (2.5%-5%) and are impaired in multiple life domains, including social impairment. The purpose of this study was to examine emerging adults with varying degrees of ADHD symptomology in respect to social impairment, state and trait anger, romantic relationship satisfaction, and intimate partner violence (IPV).

METHOD

College students, a subset of emerging adults, were recruited to complete measures online.

RESULTS

Data were analyzed using a series of multiple regressions. Higher levels of ADHD symptomology in college students were related to increased social impairment and higher levels of state and trait anger, but not romantic relationship satisfaction or rates of IPV.

CONCLUSION

Anger management and social skills training may be beneficial treatment components for this group.

Peer Relationships in Undergraduates With ADHD Symptomatology: Selection and Quality of Friendships

OBJECTIVE

This study investigated the relationships between ADHD symptomatology and friendship formation, social skills, and the quality of specific friendships in college students.

METHOD

A total of 156 students, 75 of whom had high self-reported ADHD symptomatology, participated. Friends of 68 participants completed measures of friendship quality.

RESULTS

Students had more positive first impressions of and reported being friends with others whose ADHD symptom severity matched their own. Participants with high ADHD symptoms reported greater difficulty providing emotional support and managing interpersonal conflict than their low-symptom peers. Greater ADHD symptoms in participants and friends were related to reduced quality of specific relationships, but similarity of severity of symptomatology in the dyad benefited the relationship.

CONCLUSION

These findings have implications for the kind of support offered to students with high ADHD symptomatology when they transition to college. Future longitudinal research examining relationships of varying levels of closeness should be conducted.

The Presence of Childhood Attention Deficit/Hyperactivity Disorder May Be Associated With Interpersonal Sensitivity in Patients With Social Anxiety Disorder

The goal of this study was to evaluate a possible association between childhood attention deficit/hyperactivity disorder (ADHD) and interpersonal sensitivity in patients with social anxiety disorder (SAD). The study involved 125 adult outpatients with a primary diagnosis of SAD. To evaluate childhood ADHD, the ADHD module of the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) was used. Clinical and sociodemographic data were collected and clinical rating scales were completed. Mean total scores on the Interpersonal Sensitivity Measure were significantly higher in the group with SAD and ADHD than in the group with SAD without ADHD. Interpersonal Sensitivity Measure total scores were positively correlated with the severity of SAD symptoms and negatively correlated with mean age of onset of SAD. The presence of childhood ADHD may be associated with greater interpersonal sensitivity in patients with SAD.

Attention-Deficit/Hyperactivity Disorder (ADHD) in Adulthood: Concordance and Differences between Self- and Informant Perspectives on Symptoms and Functional Impairment

Attention-deficit/hyperactivity disorder (ADHD) is a severe mental illness, associated with major impairment and a high comorbidity rate. Particularly undiagnosed ADHD in adulthood has serious consequences. Thus, a valid diagnosis is important. In adulthood, the diagnostic process for ADHD is complicated: symptoms may overlap with comorbid disorders, and the onset and progression of the disorder must be reconstructed retrospectively. Guidelines for the diagnostic process recommend the inclusion of additional informant ratings. Research into the relation between self- and informant ratings shows extremely heterogeneous results. The levels of agreement range from low to high. The focus of this study is the concordance and differences between self- and informant ratings on ADHD symptoms and impairments. In this regard, two possible influencing factors (gender and relationship type) are also examined. 114 people participated in this study, 77 with an ADHD diagnosis and 37 without a diagnosis. For all participants, either parents or partners also rated ADHD symptoms and impairments. Small to moderate concordance was found between self- and informant ratings, with females being slightly more concordant than males, particularly for ratings of problems with self-concept. Examination of the consistency within a particular perspective showed that people with ADHD seemed to be unaware of the causal relation between ADHD symptoms and their impairments. A close investigation found almost no influence of gender and relationship type on differences within perspectives. Based on these results, the implications for the diagnostic process are that additional informant information is clearly necessary and helpful.

Emotional symptoms and their contribution to functional impairment in adults with attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is a severe neurodevelopmental disorder beginning in childhood and consisting of the core symptoms of inattention, hyperactivity, and impulsivity. The disorder is often accompanied by functional impairment in daily life. Research showed that severe impairment cannot be fully explained by the core symptoms of ADHD. Accordingly, emotional symptoms in ADHD and their influence on functional impairment have increasingly become the focus of research in recent years. The aim of the current study was to investigate the relationship between ADHD core symptoms, emotional symptoms, and functional impairment. We assumed that emotional symptoms might form part of adult ADHD and that the connection between ADHD core symptoms and functional impairment may be partly mediated by emotional symptoms. Data of 176 participants from an ADHD Special Consultations Unit were included. Of these participants, 146 were diagnosed with ADHD, while 30 received no such diagnosis. We developed a structural equation model which included core symptoms, emotional symptoms, and four domains of daily impairment (family life, social life, work, and organization). As predicted, results indicate that emotional symptoms are directly linked to adult ADHD and bear a strong negative influence on different domains of daily life. The results of different analyses showed a mediation of the relationship between ADHD core symptoms and impairment through emotional symptoms: While the connection between inattention and work and organization was partly mediated, the connections between impulsivity and family life and between inattention and social life were shown to be fully mediated through emotional symptoms.

Online social communication patterns among emerging adult women with histories of childhood attention-deficit/hyperactivity disorder

Little is known about adult women with attention-deficit/hyperactivity disorder (ADHD); however, available evidence suggests that they experience social impairment. Online social networking websites such as Facebook have become endemic outlets through which emerging adults communicate with peers. No study has examined the peer interactions of emerging adults with childhood histories of ADHD in this developmentally relevant online domain. Participants in the current study were an ethnically diverse sample of 228 women, 140 of whom met diagnostic criteria for ADHD in childhood and 88 who composed a matched comparison sample. These women were assessed at 3 time points spanning 10 years (mean age = 9.6 at Wave 1, 14.1 at Wave 2, 19.6 at Wave 3). After statistical control of demographic covariates and comorbidities, childhood ADHD diagnosis predicted, by emerging adulthood, a greater stated preference for online social communication and a greater tendency to have used online methods to interact with strangers. A childhood diagnosis of ADHD also predicted observations of fewer Facebook friends and less closeness and support from Facebook friends in emerging adulthood. These associations were mediated by a composite of face-to-face peer relationship impairment during childhood and adolescence. Intriguingly, women with persistent diagnoses of ADHD from childhood to emerging adulthood differed from women with consistent comparison status in their online social communication; women with intermittent diagnoses of ADHD had scores intermediate between the other 2 groups. Results are discussed within the context of understanding the social relationships of women with childhood histories of ADHD.

ADHD symptomatology, fear of intimacy, and sexual anxiety and behavior among college students in China and the United States

OBJECTIVE

ADHD is marked by an apparent contradiction in social relationships: Those with the disorder have more difficulty establishing close relationships but report increased rates of risky sexual behavior. Two studies examined the relationship between ADHD symptomatology and fear of intimacy, sexual anxiety, and sexual behavior in college students.

METHOD

In the first study, college students in China (n = 300) and the United States (n = 233) completed a series of questionnaires. In the second, 192 American college students completed a follow-up series of measures.

RESULTS

In the first study, those with more ADHD symptoms did not report lower levels of sexual anxiety but did report greater fear of intimacy. In the second, students partially replicated the results of the first study, reporting greater fear of intimacy in those with more symptoms of ADHD. Those with more symptoms also reported lower expectations for the intimacy in their relationships and lower levels of relationship self-competence on one of four domains.

DISCUSSION

ADHD symptomatology, particularly inattention, was related to multiple aspects of risky sexual behavior.

Anxiety in college students With ADHD: relationship to cognitive functioning

OBJECTIVE

This study sought to explore how anxiety impacts college students with ADHD, especially with regard to cognitive functioning.

METHOD

473 college students with ADHD and a control group of 200 college students without ADHD completed self-report measures of anxiety, ADHD symptomatology and tests of cognitive functioning.

RESULTS

Students with ADHD reported significantly more anxiety than students without ADHD. Within the ADHD group, the relationship between anxiety and inattention was similar to the relationship between anxiety and hyperactivity/impulsivity. Students with ADHD reported more anxiety with regard to academics compared to life-in-general. There were no gender differences for anxiety; however, freshman indicated more anxiety than upper-classmen. Anxiety and inattention were found to interact such that students with low levels of inattention but high levels of anxiety performed better on tasks of cognitive ability.

CONCLUSION

Anxiety in college students with ADHD can take many forms, and interventions require a multi-focused approach. There may be some positive aspects to anxiety.

Attention-deficit/hyperactivity disorder symptom levels and romantic relationship quality in college students

OBJECTIVE

The purpose of this study was to examine whether attention-deficit/hyperactivity disorder (ADHD) symptom levels in college undergraduates are associated with poorer romantic relationship quality, and to test whether emotion regulation difficulties, perceived stress, and hostile relationship conflict mediate this association.

PARTICIPANTS

The sample consisted of 189 undergraduate students aged 18 to 25.

METHODS

Self-report measures of ADHD symptoms, relationship quality, and the proposed mediators were collected via online survey from May through August 2011.

RESULTS

Participants who reported clinically significant levels of both hyperactivity-impulsivity and inattentiveness (consistent with ADHD-C) had lower relationship quality than those whose self-reported symptoms indicated no ADHD diagnosis. Further, for women only, both hyperactive-impulsive and inattentive symptom levels were negatively associated with relationship quality. Emotion regulation problems and hostile relationship conflict mediated this association.

CONCLUSION

Findings suggest that ADHD impairs relationship quality among young adults and suggest mechanisms through which this impairment might occur.

Young adult romantic couples' conflict resolution and satisfaction varies with partner's attention-deficit/hyperactivity disorder type

Attention-deficit/hyperactivity disorder (ADHD) has previously been associated with less satisfaction and success in romantic relationships. This study compares conflict resolution and problem-solving behaviors in young adult romantic couples either having one partner with ADHD combined type (C-couples), having one partner identified with ADHD inattentive type (IA-couples), or in which neither partner has an ADHD diagnosis (nondiagnosed [ND] couples). Self-reports of current and childhood ADHD symptoms corroborated diagnostic status and speaker and listener behaviors, coded via the Rapid Couples Interaction Scoring System (Gottman, 1996), were the primary dependent variables. Analyses revealed greater negativity and less positivity in C-couples' behavior during a conflict resolution task, relative to IA and ND couples, and this corresponded with couples' relational satisfaction. IA-couples emitted relational behavior that was largely similar to ND couples. Findings support that relational impairment exists in C-couples, and to some degree, contrast with previous research suggesting that individuals with predominant inattention experience greater social impairment in adulthood than those with other types of ADHD.

Distinct ADHD symptom clusters differentially associated with personality traits

OBJECTIVE

ADHD has been linked to various constructs, yet there is a lack of focus on how its symptom clusters differentially associate with personality, which this study addresses.

METHOD

The current study examines the relationship between impulsive and inattentive ADHD traits and personality, indexed by the Revised NEO Personality Inventory (NEO-PI-R) and the Millon Clinical Multiaxial Inventory (MCMI-III), in a sample of undergraduates.

RESULTS

Impulsivity was associated with NEO-PI-R and MCMI-III traits characterized by emotional distress, interpersonal problems, and disruptive behavior, whereas inattention was associated only with focus-oriented constructs.

CONCLUSION

ADHD-related inattention is a relatively modest predictor of personality traits, as compared with hyperactivity-impulsivity. These findings have implications regarding the distinctiveness and etiology of Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) ADHD types.

Evaluation of a Stress Management Training Program for Adults With ADHD-A Pilot Study

We conducted a pilot study to examine the feasibility, acceptance, and subjective effectiveness of a new stress management training program tailored to the needs of adults with attention deficit hyperactivity disorder (ADHD). After a baseline evaluation of perceived chronic stress and coping strategies, 18 adults with ADHD participated in four sessions of stress management training and completed posttests on chronic stress and additional measures. Participants rated the acceptance and effectiveness of the training as high. Positive effects were found with respect to perceptions of excessive demands at work, chronic worry, and general stress experience. The findings suggest that stress management training is a valuable adjuvant for the treatment of ADHD in adults. Further development and evaluation of the intervention is desirable.

Separate and overlapping relationships of inattention and hyperactivity/impulsivity in children and adolescents with attention-deficit/hyperactivity disorder

There is debate regarding the dimensional versus categorical nature of attention-deficit/hyperactivity disorder (ADHD). This study utilized confirmatory factor analysis to examine this issue. ADHD symptoms rated on interviews and rating scales from a large sample of individuals (ages 3-17, 74 % male, 75 % Caucasian) with ADHD were examined (n = 242). Four potential factor structures were tested to replicate prior findings in a sample with a wide age range and included only participants who met DSM-IV-TR diagnostic criteria for ADHD. Correlations with executive function measures were performed to further assess the separability and validity of the derived factors. The data support a bifactor model with a general ADHD factor and two specific factors, inattention and hyperactivity/impulsivity. Importantly, the individual factors were also differentially correlated with executive functioning measures. This study adds to a growing literature suggesting both a general component to ADHD, as well as dimensional traits of inattention and hyperactivity/impulsivity, associated with distinct executive functioning profiles. The presence of a general underlying factor contraindicates separating the inattentive and combined subtypes of ADHD into distinct disorders.

Stigma in attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a frequently diagnosed disorder in child- and adulthood with a high impact affecting multiple facets of social life. Therefore, patients suffering from ADHD are at high risk to be confronted with stigma, prejudices, and discrimination. A review of the empirical research in the field of ADHD with regard to stigma was performed. The findings of investigations in this field were clustered in different categories, including stigma in children with ADHD, stigma in adults with ADHD, stigma in relatives or in people close to a patient with ADHD, and the influence of stigma on authorities' attitudes toward patients with ADHD. Variables identified to contribute to stigma in ADHD are public's uncertainty concerning the reliability/validity of an ADHD diagnosis and the related diagnostic assessment, public's perceived dangerousness of individuals with ADHD, socio-demographical factors as age, gender, and ethnicity of the respondent or the target individual with ADHD, stigmatization of ADHD treatment, for example public's skepticism toward ADHD medication and disclosure of diagnostic status as well as medication status of the individual with ADHD. The contribution of stigma associated with ADHD can be conceptualized as an underestimated risk factor, affecting treatment adherence, treatment efficacy, symptom aggravation, life satisfaction, and mentally well-being of individuals affected by ADHD. Public as well as health professionals' concepts about ADHD are highly diverse, setting individuals with an ADHD diagnosis at greater risk to get stigmatized.

What do we really know about ADHD in college students?

Research on ADHD in college students began in the 1990s and has been steadily increasing in recent years. Because young adults with ADHD who attend college have experienced greater academic success during high school than many peers with the disorder, which is likely to be associated with better overall functioning, the degree to which they experience similar patterns of adjustment difficulties was not initially known. Accumulating research suggests that college students with ADHD experience less academic success and greater psychological and emotional difficulties than other students and use alcohol and drugs at higher rates. However, conclusions to be drawn from this research are limited by the use of small samples that may not be representative of the wider population of students with ADHD, and a lack of diagnostic rigor in identifying students with ADHD to be included in such research. Studies of the effectiveness of psychosocial treatments, medication treatment, and academic accommodations are extremely limited or nonexistent. Issues particularly germane to college students include feigning ADHD and the misuse and diversion of stimulant medication. Given that at least 25 % of college students with disabilities are diagnosed with ADHD, methodologically sound investigations are clearly needed in order to better understand the impact of ADHD on college students' adjustment and to develop and implement interventions that can enhance students' success.

Sex differences in the manifestation of ADHD in emerging adults

OBJECTIVE

Given the mixed literature in the area, the aim of the current study was to determine whether sex differences exist in inattention, hyperactivity, and impairment in college adults with ADHD.

METHOD

Individuals from three universities were recruited for the study. Participants with (n = 164) and without ADHD (n = 710) completed on-line measures of symptoms and impairment.

RESULTS

College women with ADHD were shown to have higher rates of inattention, hyperactivity, and impairment than college women without ADHD and college men with ADHD. Analyses revealed that women in college who have ADHD experience higher levels of impairment in the following domains: home life, social life, education, money management, and daily life activities.

CONCLUSION

Overall, clear differences emerged between men and women with ADHD. Implications and future directions are discussed.

A systematic review of global publication trends regarding long-term outcomes of ADHD

There is increased global recognition of attention deficit hyperactivity disorder (ADHD) as a serious medical condition with long-term consequences. Although originally conceived of as a childhood disorder, ADHD is being increasingly recognized in adults. Individual geographic regions may have specific interests and objectives for the study of ADHD. A systematic review of long-term outcomes (LTOs) in ADHD was conducted to evaluate research on ADHD LTOs on a global scale. Studies that were at least 2 years in duration were examined. A total of 351 studies were identified in the final analysis. We identified nine outcomes of interest and classified studies by specific geographical regions, age groups studied and study design by region and over time. Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades, with a peak number of 42 publications in 2008. This rise in publications on ADHD LTOs may reflect a rise in global interest and recognition of consequences and impairment associated with ADHD. Although many world regions have published on ADHD LTOs, the majority of studies have emerged from the US and Canada, followed by Europe. While investigators in the US and Canada were predominantly interested in drug addiction as a LTO, European researchers were more interested in antisocial behavior, and Eastern Asian investigators focused on both of these LTOs as well as self-esteem. Geographical differences in the focus of ADHD LTO studies may reflect regional variations in cultural values. Proportionally fewer prospective longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades. Finally, more studies focusing on ADHD in adolescents and adults have been conducted in recent years, and particularly adolescents in Eastern Asia. These changes in basic study design may reflect an increase in the recognition that ADHD is a lifetime chronic disorder. This systematic review analysis of publication trends in ADHD LTOs reflects geographically based interests that change over time.

The role of maternal and child ADHD symptoms in shaping interpersonal relationships

The current study investigated the influence of maternal ADHD symptoms on: (a) mothers' own social functioning; (b) their child's social functioning; and (c) parent-child interactions following a lab-based playgroup involving children and their peers. Participants were 103 biological mothers of children ages 6-10. Approximately half of the children had ADHD, and the remainder were comparison youth. After statistical control of children's ADHD diagnostic status and mothers' educational attainment, mothers' own inattentive ADHD symptoms predicted poorer self-reported social skills. Children with ADHD were reported to have more social problems by parents and teachers, as well as received fewer positive sociometric nominations from playgroup peers relative to children without ADHD. After control of child ADHD status, higher maternal inattention and hyperactivity/impulsivity each predicted children having more parent-reported social problems; maternal inattention predicted children receiving more negative sociometric nominations from playgroup peers. There were interactions between maternal ADHD symptoms and children's ADHD diagnostic status in predicting some child behaviors and parent-child relationship measures. Specifically, maternal inattention was associated with decreased prosocial behavior for children without ADHD, but did not influence the prosocial behavior of children with ADHD. Maternal inattention was associated with mothers' decreased corrective feedback and, at a trend level, decreased irritability toward their children with ADHD, but there was no relationship between maternal inattention and maternal behaviors for children without ADHD. A similar pattern was observed for maternal hyperactivity/impulsivity and mothers' observed irritability towards their children. Treatment implications of findings are discussed.

Subclinical ADHD, stress, and coping in romantic relationships of university students

OBJECTIVE

To examine how the subclinical symptoms of adult ADHD and those of oppositional-defiant disorder (ODD) affect relationship satisfaction and stress and to determine whether different patterns of coping strategies emerge when undergraduates have symptoms of one or both disorders.

METHOD

Participants (N = 497) complete self-report surveys assessing ADHD and ODD symptoms, relationship satisfaction, stress, and coping strategies used in their intimate relationships.

RESULTS

ADHD and ODD symptoms are significantly related to a number of stressors and different patterns of coping strategies. University students with symptoms of both ADHD and ODD display a different pattern of stressors and different patterns of coping than those with symptoms of ADHD only.

CONCLUSION

Screenings for both ADHD and ODD and the provision of services that offer students more constructive coping alternatives to deal with stress in their intimate relationships are needed on university campuses.

The importance of friendship for youth with attention-deficit/hyperactivity disorder

It is well-established that youth with attention-deficit/hyperactivity disorder (ADHD) are often peer-rejected and rated by parents, teachers, and observers to have poor social skills, when compared to typically developing peers. Significantly less research, however, has been devoted to the experiences youth with ADHD have in their close friendships. The aim of this article is to draw attention to friendship as a distinct construct from peer rejection and social skills and to summarize what is known about youth with ADHD in their friendships. The potential for stable, high-quality friendships to buffer the negative outcomes typically conferred by peer rejection in this population is discussed. This article concludes with recommendations for interventions that specifically target improving the close friendships of youth with ADHD as a treatment strategy.

Argentinean adaptation of the Social Skills Inventory IHS-Del-Prette

We present the results of the adaptation of the IHS-Del-Prette (Inventario de Habilidades Sociales, in English, Social Skills Inventory) to a sample of Argentinean college students. Firstly, we addressed the backward translation and carried out an equivalence study of the Portuguese and Spanish versions of the scale. The results showed the two versions were equivalent, as we obtained correlations lower than .50 in only 5 items. Secondly, we performed item analysis by calculating discrimination indexes and item-total correlations. Results indicated that the items are sensitive to differentiate between high and low social-skill groups. Exploratory factor analysis carried out with a sample of 602 college students yielded five factors that explained 26.5% of the total variance, although our data did not completely match the original factor structure. We also obtained moderate alpha values for the subscales, but high reliability for the total scale. Lastly, group differences between males and females are presented to provide evidence of validity. We discuss the implications of the results and present future lines of inquiry.

College students with ADHD: current status and future directions

Approximately 2 to 8% of the college population reports clinically significant levels of ADHD symptomatology and at least 25% of college students with disabilities are diagnosed with ADHD. A comprehensive review of the literature was conducted with findings consistently indicating academic deficits associated with ADHD in college students. It is less clear whether this disorder significantly impacts social, psychological, and neuropsychological functioning. Although several self- and parent-report measures have been developed for this population, very few studies of assessment methods have been conducted. Similarly, no controlled studies of psychopharmacological, psychosocial, or educational interventions have been completed in samples of college students with ADHD. Non-prescribed use (i.e., diversion) of stimulant medication is a growing problem with approximately 7% of college students reporting this behavior. Studies, to date, are limited by lack of controlled investigations, use of small samples, and lack of confirmation of diagnostic status. Comprehensive and methodologically sound investigations are needed, especially regarding treatment, to promote the success of students with ADHD in higher education settings.

College students with attention-deficit/hyperactivity disorder

As more students with attention-deficit/hyperactivity disorder attend college, studies are emerging that reveal problems in psychosocial and academic functioning. Substance use may magnify deficits in self-regulation. Recommendations are made for comprehensive assessment; however, the usual diagnostic categories may not be developmentally relevant. Students who are identified benefit from medication and nonmedication interventions, strategy support, and accommodations.

Social appraisal of adult ADHD: stigma and influences of the beholder's Big Five personality traits

OBJECTIVE

This study investigates social stigma associated with a diagnosis of ADHD in adulthood and whether Big Five personality traits predict appraisals of affected individuals.

METHOD

A sample of 257 undergraduates rate the desirability of targets with ADHD, minor medical problems, and with no appreciable weakness, across several social engagement contexts.

RESULTS

Participants exhibit significantly less desire to engage with those with ADHD (as compared to both controls). Agreeableness, Extraversion, and Conscientiousness are found to predict appraisals of targets with and without ADHD, moderated by sex of the target and the beholder.

CONCLUSION

It is suggested that fairly subtle, negative bias toward ADHD contributes to rejection of individuals with the disorder, particularly in academic and work settings. Findings also suggest peers' personalities do have some effect on appraisals of targets with ADHD