Severity of symptoms and quality of life in medical students with ADHD

Medical education: Accommodating students with ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects a significant number of medical students worldwide. It is poorly recognised by educators, and therefore inadequately accommodated for in educational strategies. In order to investigate this further, a literature review and pilot survey were conducted. Health educators employed by The University of Newcastle, Australia, completed a short online survey, which focused on their understanding of, and ability to recognise and adapt teaching strategies for students with ADHD. The results of the survey informed the development of a resource that provided evidence-based strategies for supporting the learning of tertiary students with ADHD. In addition, the results of this pilot study may form the basis for further research in this domain. Given the prevalence and potential impact of ADHD on higher education, it is important to gain deeper insight into how medical educators can best engage and support students with ADHD. This knowledge may potentially reduce the negative impacts of this neurodiversity on students and support their learning and well-being throughout their medical career. Ultimately this may help doctors to achieve their full potential, especially in clinical decision-making.

The freedom to teach (at the best)

Over the past decades, biomedical education has changed considerably, mostly by the introduction of novel didactic strategies, as well as the addition of technology. As a consequence, the centuries-old lecture-style presentation has come under criticism for providing only a one-directional transfer of information. However, the delivery of traditional lectures has also seen considerable changes such as the use of Microsoft PowerPoint slides which can be projected and serve as lecture handouts to learners. Electronic technologies and the internet now allow for the permanent recording of lectures and the distribution of video recordings to students who are unable or choose not to attend lectures in person. This off-site consumption of lecture presentations can either be synchronous or, if the recorded videos are made available online, asynchronous. At the beginning of the Covid-19 pandemic, most schools were forced to change all lecture-style instruction to an online format. With students returning to classroom teaching, schools, and educators have to make a decision whether to offer online lecture recordings permanently, reintroduce in-person lecture presentations, or compromise on a combination of both. Each solution has its own advantages and disadvantages, some of which are discussed in this article. However, there appears to be no single 'best solution' to serve all learners, educators, and educational needs.

Associated predictors of functional impairment among adolescents with ADHD-a cross-sectional study

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) in adolescence is associated with functional impairment in several domains of life. To enable development of interventions that more effectively target functional impairment in this age group, the associations between clinical characteristics and impairment need to be clarified. The aim of this study was to investigate the associations between ADHD and functional impairment, if they varied by sex, and the potential impact of comorbid psychiatric symptoms on the associations.

METHODS

This was a cross-sectional study including adolescents with ADHD (n = 164) and a reference group of adolescents without ADHD (n = 106). Self-ratings and parental ratings of functional impairment in different life domains were used as outcomes in all analyses. Differences between groups were investigated with comparative analyses. General linear models (GLMs) were used to explore associations between ADHD symptoms and functional impairment in adolescents with ADHD, while adjusting for of comorbid symptoms, sex, and medication.

RESULTS

Adolescents with ADHD displayed higher levels of functional impairment than peers without ADHD, and girls with ADHD rated higher impairment than their male counterparts. The combined ADHD presentation was associated with the highest levels of self-reported impairment, while parental ratings indicated comparable levels of overall impairment across presentations. In the adjusted GLMs, symptoms of inattention were strongly associated with self- and parent-rated impairment in school, but symptoms of hyperactivity/impulsivity were not, whereas symptoms of both inattention and hyperactivity/impulsivity were modestly associated with self-rated impairment with friends. Further, both emotional and conduct problems were associated with impairment in daily life.

CONCLUSIONS

Our results suggest that attention difficulties, in particular, seem to impair academic functioning in adolescents with ADHD, and interventions targeting such difficulties are warranted. In addition, comorbid symptoms need to be assessed and treated, and self-reports of functioning should be included in research and clinical practice involving adolescents.

One size doesn’t fit all: framework and resources for individualized interventions for struggling medical students

When helping struggling medical students, a “one size fits all” approach is often ineffective, as many different factors affect academic success. In our experience, these factors may overlap or be distinct for each student, and thus require individualized interventions based on student needs. We recommend an individualized model of academic support includes an intake interview, assessment, individualized interventions, and follow up to assess progress. This paper provides a recommended framework of resources for medical school faculty and staff who work with struggling students. Different issues that lead students to struggle are categorized in the main domains of Bloom’s taxonomy: cognitive, affective, and psychomotor. A discussion of the impact of the factors in each domain includes detailed tables with corresponding manifestations, assessments, and support strategies literature for each issue. An application of a proposed framework is presented on a case example. Individualized approaches to improving medical student success are presented to address the complex and interrelated areas of academic success, wellbeing, quality of life, career potential, and satisfaction with medical school.

Effectiveness of Online Mindfulness-Based Intervention (iMBI) on Inattention, Hyperactivity-Impulsivity, and Executive Functioning in College Emerging Adults with Attention-Deficit/Hyperactivity Disorder: A Study Protocol

Attention-deficit/hyperactivity disorder (ADHD), a common neurodevelopmental disorder, often persists into adulthood. In Malaysia, the prevalence rate of hyperactivity symptoms is highest among Chinese Malaysians. There are limited evidence-based treatment options targeting the core symptoms of ADHD, as well as executive functioning. In addition, conventional psychotherapeutic approaches for adults with ADHD have been found to be highly labor-intensive. The present study will evaluate the effectiveness of an online mindfulness-based intervention to reduce inattention and hyperactivity–impulsivity and improve executive functioning among Chinese Malaysian college emerging adults with ADHD. Informed by established literature, we will design an 8-week online mindfulness-based intervention (i.e., iMBI). We will conduct a two-arm randomized controlled trial comparing an iMBI plus treatment-as-usual group (n = 54) and an enhanced treatment-as-usual control group (n = 54). Outcome measures of inattention, hyperactivity–impulsivity, and executive functioning will be collected at baseline, immediately post-intervention, and 1-month post-intervention. The findings of the present study will not only demonstrate the implementation of iMBI as a new treatment modality but also inform practitioners on the effectiveness of iMBI in reducing the burden of adults living with ADHD.

Factors associated with positive mental health in young adults with a neurodevelopmental disorder

BACKGROUND

Positive dimension of mental health has gained less attention in previous research on individuals with neurodevelopmenal disorders. However, knowledge on factors associated with mental well-being is crucial for planning effective interventions for this target group.

AIMS

The aim of the study was to investigate the determinants of positive mental health among young adults with neurodevelopmental disorders.

METHODS AND PROCEDURES

The study sample consisted of 171 young adults (18-35 years, mean age 25 years, SD 4.35) with a diagnosis of Autism Spectrum Disorder (ASD) or ADHD/ADD. The data were collected with questionnaires.

RESULTS

The mean score of SWEMWBS was 20.98 (n = 168, ranging 14.75-35.00, SD = 3.55). Provisions of social relationships, functional capacity and self-rated state of health associated independently with positive mental health.

CONCLUSION AND IMPLICATIONS

The level of positive mental health of study participants was relatively low compared with previous studies in other clinical settings or general populations. Promotion of social competence and social relationship should be included in rehabilitation programmes targeted at individuals with neurodevelopmental disorder. This may be beneficial in reaching also other goals set for the rehabilitation, such as increasing capacity to work or study.

Attention-Deficit/Hyperactivity Disorder Symptoms and Life Satisfaction in a Representative Adolescent and Adult Sample

Although it is well documented that attention-deficit/hyperactivity disorder (ADHD) is associated with reduced life satisfaction, the mechanisms that might explain this co-occurrence are unclear. We examined the correlation of ADHD symptoms with life satisfaction and whether this association is mediated by (lacking) social support and depressive symptoms. Self-reported ADHD symptoms, life satisfaction, social support, and depressive symptoms were assessed in a representative, predominantly adult sample from the general population (14-91 years, N = 2517). Attention-deficit/hyperactivity disorder symptoms correlated negatively with life satisfaction (r = -0.41, p < 0.01), even after demographic factors (gender, age, income) and common risk factors (not being in a relationship, being unemployed) were controlled for (r = -0.39, p < 0.01). Social support mediated up to 23% and depressive symptoms up to 44% in the association between ADHD symptoms and life satisfaction. Counteracting problems with social relationships and treating depressive symptoms may help to increase life satisfaction in adults with ADHD symptoms.

Health, Dietary Habits, and Achievement Motivation in College Students With Self-Reported ADHD Diagnosis

OBJECTIVE

The present study aimed to investigate aspects of health and motivation in a subpopulation of college students with ADHD.

METHOD

Seventy-seven college students with self-reported ADHD (49 women; M age = 25.82, SD = 4.62) and 120 college students without ADHD (65 women; M age = 25.17, SD = 5.41) participated in an online survey assessing their health, dietary habits, and achievement motivation.

RESULTS

College students with ADHD showed impairment in psychological functioning, impairment in their mental health, and reported more ambition and less self-control. Furthermore, we found gender differences: Women with ADHD reported worse psychological functioning, and the gender differences in obsessive-compulsive behavior and compensatory effort were mediated by the timing of diagnosis.

CONCLUSION

College students, especially women, with ADHD struggle with health-related issues. Some of these gender differences might be due to under diagnosis of girls in childhood. Differences in achievement motivation might indicate compensatory mechanisms.

Impairments, diagnosis and treatments associated with attention-deficit/hyperactivity disorder (ADHD) in UK adults: results from the lifetime impairment survey

AIM

The Lifetime Impairment Survey assessed how ADHD impairs everyday life, identifying areas most affected.

METHODS

This opinion-based survey evaluated experiences, diagnosis and treatment of lifetime impairment in adults with (n=89) and without (n=94) ADHD. Groups were compared using impairment and symptoms scales; higher scores indicate greater impairment.

RESULTS

Mean (standard deviation) age at diagnosis was 18.2 (11.5) years; 47.1% were taking prescription medication for ADHD. Adults with ADHD reported greater impairments than those without for all scales (p<0.001) except the involvement scale.

CONCLUSION

Greater impairments in adults with than without ADHD suggest a continued impact throughout their daily lives.