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Bucherbeam TR, Lovett BJ, Harrison AG. ADHD and Anxiety Symptoms: Does Construct or Assessment Type Matter More? J Atten Disord 2024; 28:1152-1157. [PMID: 38323532 DOI: 10.1177/10870547231220905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
OBJECTIVE This study examined the relationships between self-reported ADHD symptoms, self-reported anxiety, and continuous performance test (CPT) performance. METHOD 128 postsecondary students referred for clinical evaluation for possible ADHD and related conditions completed the Conners Adult ADHD Rating Scale, the Behavior Assessment Scale for Children, Third Edition, and either of two CPTs. RESULTS Multiple regression models found that when self-reported anxiety and CPT performance were used to simultaneously predict self-reported ADHD symptoms, CPT performance was not a significant predictor, whereas self-reported anxiety was. This finding was replicated across two different subsamples that took different CPTs. CONCLUSION Self-reported anxiety and ADHD symptoms are strongly related, but neither of these variables is significantly related to CPT performance. Implications for clinical practice and future research are discussed.
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Gilbert M, Boecker M, Reiss F, Kaman A, Erhart M, Schlack R, Westenhöfer J, Döpfner M, Ravens-Sieberer U. Gender and Age Differences in ADHD Symptoms and Co-occurring Depression and Anxiety Symptoms Among Children and Adolescents in the BELLA Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01622-w. [PMID: 37851158 DOI: 10.1007/s10578-023-01622-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/19/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most diagnosed neurodevelopmental disorders of childhood. Current studies addressing gender and age differences in ADHD are lacking. The present study aims to fill this research gap by dimensionally evaluating gender and age differences in ADHD symptoms, as measured by a DSM-5-based parent rating scale, in children and adolescents who participated in the two-year follow-up of the community-based BELLA study (n = 1326). Associations between ADHD symptoms and depression symptoms and anxiety symptoms were also examined. Multiple linear regressions revealed significant associations between gender and all ADHD symptoms. Age was significantly associated with hyperactive/impulsive symptoms. Additional multiple linear regressions demonstrated significant positive associations between depression and anxiety symptoms and ADHD symptoms. Further, female gender was found to be positively associated with both depression and anxiety symptoms. These findings may suggest a need for more gender-specific approaches to ADHD diagnosis and treatment, as well as more research into the intersections of ADHD and depression and anxiety symptoms in children and adolescents.
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Affiliation(s)
- Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Erhart
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Alice Salomon University of Applied Sciences, Berlin, Germany
- Apollon University of Applied Sciences, Bremen, Germany
| | - Robert Schlack
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Joachim Westenhöfer
- Department of Health Sciences, Faculty of Life Sciences, Competence Center Health, Hamburg University of Applied Sciences, Hamburg, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Section "Child Public Health", University Medical Center Hamburg-Eppendorf, Martinistraße 52, W 29, 20246, Hamburg, Germany.
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Vizgaitis AL, Bottini S, Polizzi CP, Barden E, Krantweiss AR. Self-Reported Adult ADHD Symptoms: Evidence Supporting Cautious Use in an Assessment-Seeking Sample. J Atten Disord 2023:10870547231172764. [PMID: 37158158 DOI: 10.1177/10870547231172764] [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: 05/10/2023]
Abstract
OBJECTIVE Self-report symptom inventories are commonly used in adult ADHD assessment, and research indicates they should be interpreted with caution. This study investigated one self-report symptom inventory for adult ADHD in a clinical sample. METHOD Archival data were used to evaluate diagnostic utility of the Conners Adult ADHD Rating Scale-Self-Report: Long Version (CAARS-S:L) in a sample of 122 adults seeking ADHD assessment. RESULTS Overall, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) estimates for the ADHD Index and other CAARS-S:L scales demonstrated weak accuracy. Anxiety and depression were the most common diagnoses present when a false positive on the ADHD Index was observed. PPV and specificity for the ADHD Index were higher in males compared to females. CONCLUSION The CAARS-S:L may be useful for screening purposes in some cases, but should not be the main method used for diagnostic purposes. Clinical implications of findings are discussed.
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Affiliation(s)
| | | | | | - Eileen Barden
- Boston University School of Medicine, MA, USA
- State University of New York at Binghamton, NY, USA
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4
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Maffly-Kipp J, Morey LC. Detecting Attention Deficit Hyperactivity Disorder and its feigning using the Personality Assessment Inventory. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-10. [PMID: 37155738 DOI: 10.1080/23279095.2023.2207215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Attention Deficit Hyperactivity Disorder is a relatively common and often disabling disorder in adults. However, feigning ADHD symptomatology is both easy and potentially common. We explored the most effective strategies for A) identifying individuals who had been diagnosed with ADHD based on existing PAI symptom indicators, and B), discriminating between feigned and genuine ADHD symptoms using PAI negative distortion indicators. Our sample consisted of 463 college aged participants who had been diagnosed with ADHD (n = 60), were asked to feign ADHD (n = 71), and a control group (n = 333). Self-reported diagnosis and successful feigning were corroborated by the CAARS-S: E scale. We first compared two PAI-derived ADHD indicators to determine which best differentiated between our ADHD and Control groups. Next, we compared seven negative distortion indicators to determine which could best distinguish between real and feigned ADHD symptoms. Our results revealed that the PAI-ADHD scale was the most effective symptom indicator. Further, the Negative Distortion Scale (NDS) and the Item-FAA scale were the most effective for identifying feigners. When assessing ADHD based on the PAI, the PAI-ADHD scale appears promising as an indicator of symptomatology, while the NDS and Item-FAA appear useful to rule-out feigning.
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Affiliation(s)
- Joseph Maffly-Kipp
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Leslie C Morey
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
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Evidence-Based Accommodations for Postsecondary Students with Disabilities: Beware the Base Rate Fallacy. PSYCHOLOGICAL INJURY & LAW 2023. [DOI: 10.1007/s12207-023-09471-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Harrison AG, Armstrong I. Accommodation Decision-Making for Postsecondary Students with ADHD: Treating the Able as Disabled. PSYCHOLOGICAL INJURY & LAW 2022; 15:367-384. [PMID: 36068830 PMCID: PMC9437389 DOI: 10.1007/s12207-022-09461-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/23/2022] [Indexed: 11/26/2022]
Abstract
Students with attention-deficit/hyperactivity disorder (ADHD) may be entitled to academic accommodations in postsecondary education. Disability Services Offices (DSOs) in Canada say that objective evidence of functional impairment is required prior to providing academic accommodations. This study set out to determine if postsecondary disability service providers use objective, third-party data when making accommodation decisions. Providers were asked if they would grant extra time accommodations to a fictitious prospective student. The student self-reported attention and academic problems that emerged during COVID restrictions, and that extra time helped her earn better grades and reduced her anxiety. While her neuropsychological report suggested superficial similarity to ADHD and contained accommodation recommendations, it lacked any objective evidence supporting either an ADHD diagnosis or functional impairments that would support extra time accommodation. Despite the lack of current or historical functional impairment, 100% of all DSO decision makers confirmed that they would grant extra time accommodations to this student. Results suggest that DSOs’ accommodation decisions are not based on evidence of functional impairment but rely mainly on student self-report and the recommendations of a professional. As such, the current system of determining reasonable accommodations is flawed and inequitable, offering non-impaired individuals access to supports and services that may privilege them over their similarly abled peers. Postsecondary institutions must either develop more defensible methods of disability determination or provide all students with access to accommodations to create a more equitable learning environment.
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7
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Shim SH, Woo YS, Kim JS, Heo IS, Yoon HJ, Sung HM, Lee J, Bahk WM. Comparison between Atomoxetine and OROS Methylphenidate as an Adjunctive to SSRIs in Attention-deficit/Hyperactivity Disorder Adults with Comorbid Partially Responsive Major Depressive Disorder: A Head-to-head, 12-week, Randomized, Rater-blinded Clinical Trial. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:143-153. [PMID: 35078957 PMCID: PMC8813317 DOI: 10.9758/cpn.2022.20.1.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 12/28/2022]
Abstract
Objective This study aimed to compare the efficacy and safety of atomoxetine (ATX) and OROS methylphenidate (MPH) as adjunctive to selective serotonin reuptake inhibitors (SSRIs) in adults with attention-deficit hyperactivity disorder (ADHD) with comorbid partially responsive major depressive disorder (MDD). Methods Sixty Korean adults with ADHD and comorbid partially responsive MDD were recruited in a 12-week, randomized, rater-blinded, active-controlled trial and were evenly randomized to ATX or OROS MPH treatment. Results Depressive symptoms measured using the Hamilton Depression Rating Scale and Clinically Useful Depression Outcome Scale, and ADHD symptoms measured using the Adult ADHD Self-Report Scale, as well as the Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and the Sheehan Disability Scale scores were significantly improved in both groups during the 12 weeks of treatment. The changes in all outcome measures during the 12-week treatment were not significantly different between the two groups (all p > 0.05). No serious adverse events were reported and there were no significant differences in systolic and diastolic blood pressure, pulse rate, weight, or body mass index between the ATX and MPH groups. Conclusion Our findings suggest that ATX and MPH can be used as adjunctive treatments in adults with ADHD and comorbid partially responsive MDD. The efficacy and tolerability of ATX and MPH in adults with ADHD did not differ significantly. Further studies should be conducted to draw a definitive conclusion.
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Affiliation(s)
- Se-hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Young Sup Woo
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Sun Kim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - In Soo Heo
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | | | - Hyung Mo Sung
- Department of Psychiatry, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Jonghun Lee
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Krauss A, Schellenberg C. ADHD Symptoms and Health-Related Quality of Life of Adolescents and Young Adults. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2022. [DOI: 10.1027/2512-8442/a000104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Background: Adolescence and young adulthood present particularly challenging periods for individuals affected by attention-deficit hyperactivity disorder (ADHD) symptoms. However, unlike childhood ADHD, ADHD among adolescents and young adults has been studied less frequently. A concept that can be used to characterize the experiences of individuals with ADHD symptoms is health-related quality of life (HRQoL), which encompasses well-being in various dimensions. Aims: The present study used a school-based sample in the German-speaking part of Switzerland to investigate the association between ADHD symptoms and HRQoL of adolescents and young adults. Method: A total of 907 individuals aged 14–24 years ( M = 17.69; SD = 1.66; 58.9% female) were surveyed regarding ADHD symptoms and HRQoL. Results: Multiple hierarchical regression analyses disclosed that ADHD symptoms were negatively related to all subdimensions of HRQoL. Moreover, adolescents with clinically significant or subclinical ADHD symptoms showed lower values in all examined dimensions – physical, emotional, self-esteem, family, friends/peers, and school/education – than adolescents with unremarkable ADHD symptoms. An exception was the well-being concerning friends/peers. Limitations: The present study used a cross-sectional design and a selective sample of school classes. ADHD symptoms were assessed using self-reports without any diagnostic judgment. Conclusion: The results illustrate the comprehensive effects of ADHD symptoms on well-being during adolescence and young adulthood. They highlight the importance of focusing more on ADHD during these stages of age, also considering individuals with symptoms in the subclinical range.
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Affiliation(s)
- Annette Krauss
- Institute for Educational Support for Behaviour, Social-Emotional, and Psychomotor Development, University of Teacher Education in Special Needs (HfH), Zurich, Switzerland
| | - Claudia Schellenberg
- Institute for Educational Support for Behaviour, Social-Emotional, and Psychomotor Development, University of Teacher Education in Special Needs (HfH), Zurich, Switzerland
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Mohamed SMH, Börger NA, van der Meere JJ. Executive and Daily Life Functioning Influence the Relationship Between ADHD and Mood Symptoms in University Students. J Atten Disord 2021; 25:1731-1742. [PMID: 31971050 PMCID: PMC8404724 DOI: 10.1177/1087054719900251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Many studies have indicated a close relationship between ADHD and mood symptoms in university students. In the present study, we explore the role of daily functional impairments and executive functioning in the ADHD-mood relationship. Method: A total of 343 adults (126 males) filled out (a) the Conners' Adult ADHD Rating Scale, (b) the Depression Anxiety and Stress Scale, (c) the Weiss Functional Impairment Rating Scale, and (d) the Executive Function Index Scale. Results: The correlation between mood symptoms and ADHD was .48 (moderate correlation) and dropped to .15 (weak correlation) when controlling for functional problems and executive functioning. Hierarchical regression analyses showed that both functional impairments and executive functioning significantly explained 42% to 53% of the variance of mood symptoms. The addition of ADHD symptoms to the model slightly increased the explained mood variance by only 1%. Conclusion: These findings underline the role of experienced difficulties in triggering mood symptoms in ADHD symptomatology.
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Affiliation(s)
- Saleh M. H. Mohamed
- University of Groningen, The Netherlands,Saleh M. H. Mohamed, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands.
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10
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Di Lonardo Burr SM, LeFevre JA. The subject matters: relations among types of anxiety, ADHD symptoms, math performance, and literacy performance. Cogn Emot 2021; 35:1334-1349. [PMID: 34253140 DOI: 10.1080/02699931.2021.1955243] [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] [Indexed: 10/20/2022]
Abstract
In this study, we extended a model of the relations among ADHD symptoms, anxiety, and academic performance. Undergraduates (N = 515) completed self-report measures of anxiety (i.e. trait, test, math, and literacy) and ADHD symptoms. During the study, they completed math and literacy measures and reported their current (i.e. state) anxiety three times. There were significant correlations among ADHD symptoms and all measures of anxiety. However, neither ADHD symptoms nor trait anxiety were correlated with math or literacy performance. Test-anxious students reported increasing state anxiety as the study progressed. In contrast, math-anxious students reported increased state anxiety following the math tasks but not the literacy tasks and literacy-anxious students reported increased state anxiety following the literacy tasks but not the math tasks. With respect to performance, math-anxious students had worse math performance and literacy-anxious students had worse literacy performance whereas test anxiety was not directly related to performance on either math or literacy tasks. Patterns of relations did not differ for men and women, but, except for literacy anxiety, women reported higher levels of all types of anxiety. These results could help educators understand how affective responses are related to university students' academic performance.
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Affiliation(s)
| | - Jo-Anne LeFevre
- Department of Cognitive Science, Carleton University, Ottawa, Canada.,Department of Psychology, Carleton University, Ottawa, Canada
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11
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Paucke M, Stibbe T, Huang J, Strauss M. Differentiation of ADHD and Depression Based on Cognitive Performance. J Atten Disord 2021; 25:920-932. [PMID: 31409195 DOI: 10.1177/1087054719865780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: The aim of this study was to assess whether self-report scales and neuropsychological tests used for adult patients with ADHD can help to distinguish between ADHD-specific and depressive symptoms. Method: In a cross-sectional design, differences in self-report questionnaires and neuropsychological tests among clinical subgroups and healthy controls (HC) were evaluated. Patients in clinical groups were diagnosed with major depressive disorder (MDD) or ADHD with or without depressive symptoms according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) guidelines. Results: The Hyperactivity subscales of the Conners' Adult ADHD Rating Scale (CAARS) differed between MDD and ADHD, whereas self-concept and inattention scales even distinguished comorbidity subgroups within the ADHD population. A reduced alertness and higher variations in reaction times measured by performance tests indicated problems in sustained attention in ADHD patients compared with HC. Conclusion: The diagnostic process of ADHD, and thereby the distinction from other symptom-overlapping, comorbid mental disorders, might be improved by utilizing ADHD-specific self-report questionnaires and neuropsychological tests, which are short, cost-effective, and standardized screening methods.
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Weis R, Hombosky ML, Schafer KK, Shulman D, Tull JK. Accommodation decision-making for postsecondary students with ADHD: Implications for neuropsychologists. J Clin Exp Neuropsychol 2021; 43:370-383. [PMID: 33899673 DOI: 10.1080/13803395.2021.1918645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Neuropsychologists are often asked to evaluate students for attention-deficit/hyperactivity disorder (ADHD) and to provide documentation to support their requests for academic accommodations in college. Research points to the importance of multi-method, multi-informant data when evaluating ADHD and determining the need for accommodations. However, the Association on Higher Education and Disability (AHEAD) directs disability service providers to give primacy to students' self-reports and their own impressions of students' narratives over objective, third-party data when rendering accommodation decisions. The organization asserts that in many cases information from parents, teachers, and psychologists is not needed to confirm the existence of a disability or students' need for accommodations. In this article, we describe the way disability service providers are directed to evaluate accommodation requests, the limitations of these procedures, and the dangers of well-intentioned, but indiscriminate accommodation-granting. We then provide recommendations for neuropsychologists who conduct ADHD evaluations for college students in light of these professional guidelines.
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Affiliation(s)
- Robert Weis
- Department of Psychology, Denison University, Granville, OH, USA
| | | | - Kendra K Schafer
- Department of Psychology, Denison University, Granville, OH, USA
| | - Darcy Shulman
- Department of Psychology, Denison University, Granville, OH, USA
| | - Jessica K Tull
- Department of Psychology, Denison University, Granville, OH, USA
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Gomez R, Stavropoulos V, Zarate D, Griffiths M. ADHD symptoms, the current symptom scale, and exploratory structural equation modeling: A psychometric study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103850. [PMID: 33549934 DOI: 10.1016/j.ridd.2020.103850] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/18/2020] [Accepted: 12/26/2020] [Indexed: 06/12/2023]
Abstract
The aim of the study was to use exploratory structural equation modelling (ESEM) to investigate support for an ADHD factor model with group factors for inattention (IA), hyperactivity (HY), and impulsivity (IM), as proposed in in ICD-10. A total of 202 adults (121 females and 81 males), aged between 18 and 35 years, from the general community, completed the Current Symptoms Scale (CSS). The results for the model showed good global fit, good convergent and divergent validities. However, the IA and IM factors, but not the HY factor, were clearly defined and demonstrated acceptable reliabilities. Taken together, these finding indicate that a revised ESEM model without the HY factor (i.e. with only the IA and IM symptoms) is an appropriate structure for modeling adult ratings of the ADHD behaviors described in the CSS. The taxonomic, theoretical and clinical implications of the findings for ADHD in general are discussed.
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Di Lonardo Burr SM, LeFevre JA. Confidence is key: Unlocking the relations between ADHD symptoms and math performance. LEARNING AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.lindif.2019.101808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Harrison AG, Harrison KA, Armstrong IT. Discriminating malingered attention Deficit Hyperactivity Disorder from genuine symptom reporting using novel Personality Assessment Inventory validity measures. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 29:10-22. [PMID: 31852281 DOI: 10.1080/23279095.2019.1702043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
It is now widely understood that ADHD can be feigned easily and convincingly. Despite this, almost no methods exist to assist clinicians in identifying when such behavior occurs. Recently, new validity indicators specific to feigned ADHD were reported for the Personality Assessment Inventory (PAI). Derived from a logistic regression, these algorithms are said to have excellent specificity and good sensitivity in identifying feigned ADHD. However, these authors compared those with genuine ADHD only to nonclinical undergraduate students (asked to respond honestly or asked to simulate ADHD); no criterion group of definite malingerers was included. We therefore investigated these new validity indicators with 331 postsecondary students who underwent assessment for possible ADHD and compared scores of those who were eventually diagnosed with ADHD (n = 111) to those who were not [Clinical controls (66), Definite malingerers (36); No diagnosis (117)]. The two proposed PAI algorithms were found to have poor positive predictive value (.19 and .17). Self-report validity measures from the Connors' Adult Attention Rating Scale, and the Negative Impression Management scale on the PAI returned more positive results. Overall, more research is needed to better identify noncredible ADHD presentation, as the PAI-based methods proposed by Aita et al. appear inadequate as symptom validity measures.
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Affiliation(s)
- Allyson G Harrison
- Department of Psychology, Queen's University (Regional Assessment and Resource Centre), Kingston, Canada
| | - Kathleen A Harrison
- Department of Psychology, Queen's University (Regional Assessment and Resource Centre), Kingston, Canada
| | - Irene T Armstrong
- Department of Psychology, Queen's University (Regional Assessment and Resource Centre), Kingston, Canada
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Harrison AG, Nay S, Armstrong IT. Diagnostic Accuracy of the Conners' Adult ADHD Rating Scale in a Postsecondary Population. J Atten Disord 2019; 23:1829-1837. [PMID: 26794674 DOI: 10.1177/1087054715625299] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Clinicians frequently rely upon the results of self-report rating scales when making the diagnosis of ADHD; however, little research exists regarding the ability of self-report measures to accurately differentiate ADHD from other disorders. Method: This present study investigated the ability of the Conners' Adult ADHD Rating Scale (CAARS) to discriminate between 249 postsecondary students with carefully diagnosed ADHD and 507 clinical controls. Results: The overall discriminant validity of the CAARS was 69%, and it had an unacceptably high false positive and false negative rate. At lower prevalence rates, a high score on the CAARS has only a 22% chance of accurately identifying individuals with ADHD. Conclusion: Although the CAARS is an adequate screening measure, it should not be the main method by which a diagnosis is made, as it frequently misidentifies individuals with other psychological complaints as having ADHD. Implications for clinical practice are discussed.
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Affiliation(s)
| | - Sylvia Nay
- Queens University, Kingston, Ontario, Canada
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17
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Nankoo MMA, Palermo R, Bell JA, Pestell CM. Examining the Rate of Self-Reported ADHD-Related Traits and Endorsement of Depression, Anxiety, Stress, and Autistic-Like Traits in Australian University Students. J Atten Disord 2019; 23:869-886. [PMID: 29502467 DOI: 10.1177/1087054718758901] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the rate of ADHD-related traits among young adults in an Australian university, and to examine whether higher endorsement of ADHD-related symptoms is associated with self-reported symptoms of depression, anxiety, distress, and autistic-like traits. METHOD In total, 1,002 students aged 17 to 25 years completed the Conners' Adult ADHD Rating Scale (CAARS), the Depression, Anxiety, and Stress Scale (DASS), and the Autism Quotient (AQ). RESULTS About 17.3% of students reported "at-risk" levels of ADHD-related symptoms. Regression analyses revealed that CAARS scores explained unique variance in self-reported levels of depression, anxiety, stress, and autism-related traits. CONCLUSION The rate of self-reported ADHD symptoms is higher in Australian undergraduate students than that reported in previous studies using the CAARS to investigate rates of diagnosed students. Problems with self-concept accounted for the most unique variance in DASS subscale scores. Hyperactivity/restlessness and inattention/memory problems accounted for the most unique variance in AQ-Social and AQ-Attention-to-Detail scores, respectively.
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Affiliation(s)
| | - Romina Palermo
- 1 The University of Western Australia, Crawley, Australia
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18
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Han DH, McDuff D, Thompson D, Hitchcock ME, Reardon CL, Hainline B. Attention-deficit/hyperactivity disorder in elite athletes: a narrative review. Br J Sports Med 2019; 53:741-745. [DOI: 10.1136/bjsports-2019-100713] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2019] [Indexed: 01/29/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common brain developmental disorder in the general population that may be even more prevalent in elite athletes in certain sports. General population studies of ADHD are extensive and have reported on prevalence, symptoms, therapeutic and adverse effects of treatment and new clinical and research findings. However, few studies have reported on prevalence, symptoms and treatments of ADHD in elite athletes. This narrative review summarises the literature on symptoms, comorbidities, effects of ADHD on performance and management options for elite athletes with ADHD. The prevalence of ADHD in student athletes and elite athletes may be 7%–8%. The symptoms and characteristics of ADHD play a role in athletes’ choice of a sport career and further achieving elite status. Proper management of ADHD in elite athletes is important for safety and performance, and options include pharmacologic and psychosocial treatments.
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Weis R, Till CH, Erickson CP. ADHD Assessment in College Students: Psychologists’ Adherence to DSM-5 Criteria and Multi-Method/Multi-Informant Assessment. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2017. [DOI: 10.1177/0734282917735152] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The evidence-based assessment of attention-deficit/hyperactivity disorder (ADHD) depends on adherence to Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) diagnostic criteria and reliance on multi-method/multi-informant data. Although nearly all psychologists endorse these practices, college students with ADHD may lack documentation supporting their diagnoses. We reviewed the documentation submitted by 214 undergraduates diagnosed with ADHD and receiving academic accommodations for this condition. Their clinicians also completed a checklist that described their assessment procedures. Relatively few psychologists assessed all DSM-5 criteria, based on either the psychologist’s self-reported assessment procedures (23.4%), written documentation (14.0%), or multi-method/multi-informant data (10.3%) such as educational/medical records, results of rating scales, or interviews with other informants. Psychologists were least likely to assess students’ areas of impairment or to rule out alternative causes for students’ self-reported symptoms. This lack of adherence to DSM-5 criteria and overreliance on students’ self-reports can threaten the reliability of diagnosis and the appropriateness of medication and accommodations that follow.
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Abbott D, Shirali Y, Haws JK, Lack CW. Biobehavioral assessment of the anxiety disorders: Current progress and future directions. World J Psychiatry 2017; 7:133-147. [PMID: 29043151 PMCID: PMC5632598 DOI: 10.5498/wjp.v7.i3.133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/08/2017] [Accepted: 07/03/2017] [Indexed: 02/05/2023] Open
Abstract
It is difficult to accurately assess and differentially diagnose the anxiety disorders. The current system of assessment relies heavily on the subjective measures of client self-report, clinical observation, and clinical judgment. Fortunately, recent technological advances may enable practitioners to utilize objective, biobehavioral measures of assessment in a clinical setting. The current body of literature on two of these biobehavioral tools (eye-tracking and electrocardiogram devices) is promising, but more validation and standardization research is needed to maximize the utility of these devices. Eye-tracking devices are uniquely capable of providing data that can be used to differentially diagnose anxiety disorders from both other commonly comorbid and misdiagnosed disorders. Both eye-tracking and electrocardiogram devices are able to provide change-sensitive assessment information. This objective, real-time feedback can assist clinicians and researchers in assessing treatment efficacy and symptom fluctuation. Recently developed wearable and highly portable electrocardiogram devices, like the wearable fitness and behavior tracking devices used by many consumers, may be particularly suited for providing this feedback to clinicians. Utilizing these biobehavioral devices would supply an objective, dimensional component to the current categorical diagnostic assessment system. We posit that if adequate funding and attention are directed at this area of research, it could revolutionize diagnostic and on-going assessment practices and, in doing so, bring the field of diagnosis out of the 20th century.
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Affiliation(s)
- Deah Abbott
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - Yasmin Shirali
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - J Kyle Haws
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
| | - Caleb W Lack
- Department of Psychology, University of Central Oklahoma, Edmond, OK 73134, United States
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Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry 2017; 17:302. [PMID: 28830387 PMCID: PMC5567978 DOI: 10.1186/s12888-017-1463-3] [Citation(s) in RCA: 281] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 08/11/2017] [Indexed: 12/11/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management.The prevalence of ADHD in the general adult population is 2.5% and it is associated with substantial personal and individual burden. The most frequent comorbid psychopathologies include mood and anxiety disorders, substance use disorders, and personality disorders. There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. The overlapping symptoms between ADHD and comorbid psychopathologies represent challenges for diagnosis and treatment. Guidelines recommend that when ADHD coexists with other psychopathologies in adults, the most impairing condition should generally be treated first.Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. The use of validated assessment scales and high-yield clinical questions can help identify adults with ADHD who could potentially benefit from evidence-based management strategies.
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Affiliation(s)
- Martin A. Katzman
- START Clinic for Mood and Anxiety Disorders, 32 Park Road, Toronto, ON M4W 2N4 Canada ,Adler Graduate Professional School, Toronto, ON Canada ,0000 0001 0687 7127grid.258900.6Northern Ontario School of Medicine, Laurentian and Lakehead University, Thunder Bay, ON Canada ,0000 0001 0687 7127grid.258900.6Department of Psychology, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1 Canada
| | - Timothy S. Bilkey
- Ontario Bilkey ADHD Clinics, 400 Bayfield Street, Suite 245, Barrie, ON L4M 5A1 Canada
| | - Pratap R. Chokka
- Chokka Center for Integrative Health, 2603 Hewes Way NW #201, Edmonton, Alberta T6L 6W6 Canada ,grid.17089.37University of Alberta, 1E1 Walter Mackenzie Centre, Edmonton, AB T6G 2R7 Canada
| | - Angelo Fallu
- Clinique Woodward, 717 rue Woodward, DIEX Research Inc., Sherbrooke, Quebec, J1G 1W4 Canada
| | - Larry J Klassen
- Eden Mental Health Centre, 1500 Pembina Ave, Winkler, MB R6W 1T4 Canada
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Neuroticism and the Overlap Between Autistic and ADHD Traits: Findings From a Population Sample of Young Adult Australian Twins. Twin Res Hum Genet 2017; 20:319-329. [DOI: 10.1017/thg.2017.38] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neuroticism, a ‘Big Five’ personality trait, has been associated with sub-clinical traits of both autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The objective of the current study was to examine whether causal overlap between ASD and ADHD traits can be accounted for by genetic and environmental risk factors that are shared with neuroticism. We performed twin-based structural equation modeling using self-report data from 12 items of the Neo Five-Factor Inventory Neuroticism domain, 11 Social Responsiveness Scale items, and 12 Adult ADHD Self-Report Scale items obtained from 3,170 young adult Australian individual twins (1,081 complete pairs). Univariate analysis for neuroticism, ASD, and ADHD traits suggested that the most parsimonious models were those with additive genetic and unique environmental components, without sex limitation effects. Heritability of neuroticism, ASD, and ADHD traits, as measured by these methods, was moderate (between 40% and 45% for each respective trait). In a trivariate model, we observed moderate phenotypic (between 0.45 and 0.62), genetic (between 0.56 and 0.71), and unique environmental correlations (between 0.37and 0.55) among neuroticism, ASD, and ADHD traits, with the highest value for the shared genetic influence between neuroticism and self-reported ASD traits (rg = 0.71). Together, our results suggest that in young adults, genetic, and unique environmental risk factors indexed by neuroticism overlap with those that are shared by ASD and ADHD.
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Gallagher CE, Watt MC, Weaver AD, Murphy KA. “I fear, therefore, I shop!” exploring anxiety sensitivity in relation to compulsive buying. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.07.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kwan MY, Arbour-Nicitopoulos KP, Duku E, Faulkner G. Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis. Health Promot Chronic Dis Prev Can 2016; 36:163-70. [PMID: 27556920 PMCID: PMC5215183 DOI: 10.24095/hpcdp.36.8.03] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. METHODS Undergraduate students (n = 837; mean age = 21 years) from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep). RESULTS A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671) = 7.26, p < .01). CONCLUSION Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed.
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Affiliation(s)
- M Y Kwan
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, Niagara Regional Campus, McMaster University, St. Catharines, Ontario, Canada
| | - K P Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - E Duku
- Department of Psychiatry and Behavioural Neurosciences and Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - G Faulkner
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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Harrison AG, Armstrong IT. Development of a symptom validity index to assist in identifying ADHD symptom exaggeration or feigning. Clin Neuropsychol 2016; 30:265-83. [DOI: 10.1080/13854046.2016.1154188] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mohamed SMH, Börger NA, Geuze RH, van der Meere JJ. Brain lateralization and self-reported symptoms of ADHD in a population sample of adults: a dimensional approach. Front Psychol 2015; 6:1418. [PMID: 26441789 PMCID: PMC4585266 DOI: 10.3389/fpsyg.2015.01418] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 09/07/2015] [Indexed: 11/13/2022] Open
Abstract
Many clinical studies reported a compromised brain lateralization in patients with Attention-Deficit/Hyperactivity Disorder (ADHD) without being conclusive about whether the deficit existed in the left or right hemisphere. It is well-recognized that studying ADHD dimensionally is more controlled for comorbid problems and medication effects, and provides more accurate assessment of the symptoms. Therefore, the present study applied the dimensional approach to test the relationship between brain lateralization and self-reported ADHD symptoms in a population sample. Eighty-five right-handed university students filled in the Conners' Adult ADHD Rating Scales and performed a lateralization reaction time task. The task consists of two matching conditions: one condition requires nominal identification for letters tapping left hemisphere specialization (Letter Name-Identity condition) and the other one requires physical and visuospatial identification for shapes tapping right hemisphere specialization (Shape Physical-Identity condition). The letters or shapes to be matched are presented in left or right visual field of a fixation cross. For both task conditions, brain lateralization was indexed as the difference in mean reaction time between left and right visual field. Linear regression analyses, controlled for mood symptoms reported by a depression, anxiety, and stress scale, showed no relationship between the variables. These findings from a population sample of adults do not support the dimensionality of lateralized information processing deficit in ADHD symptomatology. However, group comparison analyses showed that subjects with high level of inattention symptoms close to or above the clinical cut-off had a reduced right hemisphere processing in the Shape Physical-Identity condition.
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Affiliation(s)
- Saleh M H Mohamed
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen Groningen, Netherlands ; Department of Psychology, Beni-Suef University Beni-Suef, Egypt
| | - Norbert A Börger
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen Groningen, Netherlands
| | - Reint H Geuze
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen Groningen, Netherlands
| | - Jaap J van der Meere
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen Groningen, Netherlands
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Self-Reported ADHD Symptoms and Interhemispheric Interaction in Adults: A Dimensional Approach. Behav Neurol 2015; 2015:254868. [PMID: 26089596 PMCID: PMC4452317 DOI: 10.1155/2015/254868] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 05/04/2015] [Accepted: 05/07/2015] [Indexed: 11/17/2022] Open
Abstract
The present study applied the dimensional approach to test whether self-reported symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) in adults are associated with the speed of interhemispheric interaction. A sample of first grade students (N = 112) completed Conners' Adult ADHD Rating Scales and letter matching reaction time tasks. In the tasks, participants had to match a single target letter displayed below the fixation cross, either on left or right visual field, with one of two letters displayed above the fixation cross, one letter on each visual field. For each task, identical letters were presented either within the same visual field (within hemisphere condition) or across visual fields (across hemisphere condition). Interhemispheric interaction was indexed as the difference in mean reaction time between within and across hemisphere conditions. Comorbid problems such as depression, anxiety, and stress may affect task performance and are controlled for in this study. Findings indicated that self-reported ADHD symptomology, especially hyperactivity, in the presence of stress was weakly but significantly associated with fast interhemispheric interaction.
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Zheng F, Gao P, He M, Li M, Wang C, Zeng Q, Zhou Z, Yu Z, Zhang L. Association between mobile phone use and inattention in 7102 Chinese adolescents: a population-based cross-sectional study. BMC Public Health 2014; 14:1022. [PMID: 25273315 PMCID: PMC4190308 DOI: 10.1186/1471-2458-14-1022] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 09/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The dramatic growth of mobile phone (MP) use among young people has increased interest in its possible health hazards in this age group. The aim of this cross-sectional study was to investigate the association between MP use and inattention in adolescents. METHODS A total of 7720 middle school students were involved in this cross-sectional study. Inattention was assessed as defined for the Attention Deficit component of Attention deficit/Hyperactivity disorder (ADHD) by the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. [DSM-IV-TR]). The demographic characteristics and information on MP use were included in the questionnaire. Chi-square tests and logistic regression models were used to analyze the data. RESULTS In total, 7102 (91.99%) valid questionnaires were obtained. After adjusted for confounders, inattention in adolescents was significantly associated with MP ownership, the time spent on entertainment on MP per day, the position of the MP during the day and the mode of the MP at night. The strongest association between inattention and the time spent on the MP was among students who spent more than 60 minutes per day playing on their MP. CONCLUSIONS Our study shows some associations between MP use and inattention in Chinese adolescents. Decreasing MP usage to less than 60 minutes per day may help adolescents to stay focused and centered.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lei Zhang
- Department of Occupational Health, Key Laboratory of Medical Protection for Electromagnetic Radiation, Ministry of Education, Third Military Medical University, NO, 30 Gaotanyan Street, Chongqing 400038, People's Republic of China.
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Beezhold BL, Johnston CS, Nochta KA. Sodium benzoate-rich beverage consumption is associated with increased reporting of ADHD symptoms in college students: a pilot investigation. J Atten Disord 2014; 18:236-41. [PMID: 22538314 DOI: 10.1177/1087054712443156] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sodium benzoate, a common additive in popular beverages, has recently been linked to ADHD. This research examined the relationship between sodium benzoate-rich beverage ingestion and symptoms related to ADHD in college students. METHOD College students (N = 475) completed an anonymous survey in class in fall 2010. The survey assessed recent intake of a noninclusive list of sodium benzoate-rich beverages and ADHD-related symptoms using a validated screener. RESULTS Sodium benzoate-rich beverage intake was significantly associated with ADHD-related symptoms (p = .001), and significance was retained after controlling for covariates. Students scoring ≥4 on the screener (scores that may be consistent with ADHD; n = 67) reported higher intakes (34.9 ± 4.4 servings/month) than the remainder of the sample (16.7 ± 1.1 servings/month). CONCLUSION These data suggest that a high intake of sodium benzoate-rich beverages may contribute to ADHD-related symptoms in college students and warrants further investigation.
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Higher Reported Levels of Depression, Stress, and Anxiety Are Associated With Increased Endorsement of ADHD Symptoms by Postsecondary Students. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2013. [DOI: 10.1177/0829573513480616] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined the extent to which postsecondary students endorse symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) and whether experienced level of stress, depression, or anxiety are associated with higher reporting of ADHD symptoms. Students attending a combined health and counseling service completed the Conners Adult ADHD Rating Scale (CAARS), the Depression Anxiety and Stress Scale (DASS), and the Life Experiences Survey (LES). A subset also completed the Brown Attention Deficit Disorder Scale (BADDS). Findings demonstrate that the BADDS had weak specificity; 35% of never-diagnosed postsecondary students were classified as probably or very probably having ADHD based on their BAADS score. Lower false positive rates were found on the CAARS. Misdiagnosis of ADHD seems especially likely in students experiencing high levels of stress, depression, or anxiety, as these psychological conditions were associated with elevated reporting of ADHD symptoms; such conditions must therefore be considered when assessing for possible ADHD in young adults.
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