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Aksu S, Indahlastari A, O'Shea A, Marsiske M, Cohen R, Alexander GE, DeKosky ST, Hishaw GA, Dai Y, Wu SS, Woods AJ. Facilitation of working memory capacity by transcranial direct current stimulation: a secondary analysis from the augmenting cognitive training in older adults (ACT) study. GeroScience 2024; 46:4075-4110. [PMID: 38789832 PMCID: PMC11336148 DOI: 10.1007/s11357-024-01205-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Aging is a public health concern with an ever-increasing magnitude worldwide. An array of neuroscience-based approaches like transcranial direct current stimulation (tDCS) and cognitive training have garnered attention in the last decades to ameliorate the effects of cognitive aging in older adults. This study evaluated the effects of 3 months of bilateral tDCS over the frontal cortices with multimodal cognitive training on working memory capacity. Two hundred ninety-two older adults without dementia were allocated to active or sham tDCS paired with cognitive training. These participants received repeated sessions of bilateral tDCS over the bilateral frontal cortices, combined with multimodal cognitive training. Working memory capacity was assessed with the digit span forward, backward, and sequencing tests. No baseline differences between active and sham groups were observed. Multiple linear regressions indicated more improvement of the longest digit span backward from baseline to post-intervention (p = 0.021) and a trend towards greater improvement (p = 0.056) of the longest digit span backward from baseline to 1 year in the active tDCS group. No significant between-group changes were observed for digit span forward or digit span sequencing. The present results provide evidence for the potential for tDCS paired with cognitive training to remediate age-related declines in working memory capacity. These findings are sourced from secondary outcomes in a large randomized clinical trial and thus deserve future targeted investigation in older adult populations.
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Affiliation(s)
- Serkan Aksu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Steven T DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Yunfeng Dai
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Samuel S Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
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Shepler DK, Callan PD. Differences in executive functioning between adults with ADHD and those diagnosed with other psychiatric diagnoses: Utility of the CTMT and the WAIS-IV. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:984-993. [PMID: 35894662 DOI: 10.1080/23279095.2022.2102923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In this study, the utility of the Comprehensive Trail Making Test (CTMT) and WAIS-IV working memory (WMI) and processing speed (PSI) indices in assessment of ADHD were examined. Using retrospective analysis of data from two private practices, patients were classified as having ADHD, having another psychiatric disorder, or having comorbid ADHD and other psychiatric disorder. Results indicated that significant differences existed in performance across the three groups [F(6, 246) = 3.38, p = .003; Pillai's Trace = 0.152, partial η2 = 0.076] on CTMT scores (p < .05), WMI scores (p ≤ .001) and PSI scores (p < .05). Logistic regression analyses indicated WMI and CTMT trail 5 scores were individually useful indicators in identifying the presence of ADHD. Analysis also indicated minimal increase in correct classification of presence or absence of ADHD through combining CTMT, WMI, and PSI scores. Clinical implications for neuropsychological assessment and differential diagnosis of ADHD are discussed.
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Affiliation(s)
| | - P Douglas Callan
- Clinical Psychology, Michigan School of Psychology, Farmington Hills, MI, USA
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Schiavone N, Virta M, Leppämäki S, Launes J, Vanninen R, Tuulio-Henriksson A, Järvinen I, Lehto E, Hokkanen L. Childhood ADHD and subthreshold symptoms are associated with cognitive functioning at age 40-a cohort study on perinatal birth risks. Front Psychol 2024; 15:1393642. [PMID: 39268376 PMCID: PMC11391087 DOI: 10.3389/fpsyg.2024.1393642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/21/2024] [Indexed: 09/15/2024] Open
Abstract
Introduction In this prospective cohort study over 40 years we investigated the effect of childhood attention-deficit/hyperactivity disorder (ADHD) and subthreshold ADHD on cognitive performance in adulthood. Methods The cohort comprised individuals with mild perinatal risks. Childhood ADHD group (cADHD, n = 39) was compared to a group with subthreshold childhood attention or hyperactivity symptoms (cAP; n = 79), a group with similar perinatal risks but no ADHD symptoms (n = 255), and to controls without ADHD symptoms or perinatal risks (n = 69). The groups were assessed with multiple neuropsychological measures in domains of verbal reasoning, perceptual skills, memory, working memory, attention, executive functions, and speed. Group-level differences and frequencies of deficient functioning were analyzed. Results Overall, the groups' performance differed in all cognitive domains at age 40. Verbal reasoning, perceptual skills, memory, and speed had the largest effect sizes (0.51-0.62). The cADHD group's performance was lower than the other groups' on 13 out of 21 measures. The cAP group performed poorer than controls on five measures. In the cADHD group, 23% had three or more deficient cognitive domains, compared to 4-6% in the other groups. Discussion Childhood ADHD is associated with impaired cognitive functioning in adulthood on several cognitive domains whereas childhood subthreshold ADHD is linked to fewer cognitive deficits. Task complexity was linked to poorer performance within the ADHD group. Our results add to the scarce longitudinal evidence of cognitive outcomes related to childhood ADHD and subthreshold symptoms.
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Affiliation(s)
- Nella Schiavone
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Maarit Virta
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Jyrki Launes
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Ritva Vanninen
- Department of Clinical Radiology, Kuopio University hospital, Kuopio, Finland
- Clinical Radiology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | | | - Ilkka Järvinen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Eliisa Lehto
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Laura Hokkanen
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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Iaia M, Vizzi F, Carlino MD, Turi M, Marinelli CV, Angelelli P. Specific learning disabilities and associated emotional-motivational profiles: a study in Italian university students. Front Psychol 2024; 15:1365980. [PMID: 39171222 PMCID: PMC11337615 DOI: 10.3389/fpsyg.2024.1365980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 07/16/2024] [Indexed: 08/23/2024] Open
Abstract
In this study, we analyzed the emotional and motivational aspects characterizing the profile of university students with Specific Learning Disorders (SLD). We assessed 61 university students, 32 with SLD (age = 23.6) and 29 in the control group (age = 23.00). The results highlighted that individuals with SLD exhibit higher levels of anxiety and depression and lower resilience compared to the control group. The Multidimensional Perfectionism Scale - Short Form, which explores perfectionism, did not reveal differences between the groups. Conversely, lower scores emerged in SLD students for the intrinsic motivation sub-scales of the Academic Motivation Scale. This indicates less engagement in studying out of personal cognitive curiosity. The Self-Regulated Knowledge Scale - University, which measures various cognitive strategies, showed significantly lower scores in the SLD group for knowledge linking, knowledge training, and knowledge critique. This suggests a lower frequency with which SLD students attempt to connect new knowledge with what they already possess, apply their knowledge, ask questions, and critically analyze what they have learned. Therefore, psychological and motivational consequences are evident in this population and can impact well-being and quality of life.
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Affiliation(s)
- Marika Iaia
- Lab of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, Lecce, Italy
| | - Francesca Vizzi
- Lab of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, Lecce, Italy
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Maria Diletta Carlino
- Lab of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, Lecce, Italy
| | - Marco Turi
- Lab of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, Lecce, Italy
- Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | | | - Paola Angelelli
- Lab of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, Lecce, Italy
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Vizzi F, Iaia M, Carlino MD, Marinelli CV, Turi M, Angelelli P. The Enduring Challenge of Literacy Issues in Adulthood: Investigating Spelling Deficits among Dyslexic Italian University Students. Brain Sci 2024; 14:712. [PMID: 39061452 PMCID: PMC11274375 DOI: 10.3390/brainsci14070712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 07/04/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
The issue of literacy challenges among dyslexic adults remains a significant concern. This study investigates spelling deficits among highly educated adults with dyslexia learning a transparent orthography. Thirty-eight Italian dyslexic university students were examined and compared to a group of age- and education-matched typical readers. Firstly, we analyzed spelling performance using a Passage Dictation Test. Additionally, lists of words varying in length and word frequency were dictated under two experimental conditions: a normal condition (NC) and an articulatory suppression condition (ASC). The ASC assessed the participants' ability to spell with interference to the phonological (sublexical) spelling procedure, i.e., the most likely compensated spelling strategy of Italian dyslexic spellers. The results clearly indicated that, in spelling the meaningful passage, dyslexic participants underperformed compared to the controls, with a prevalence of lexical errors, despite the comparison with the normative reference data showing only mild spelling difficulties. In spelling isolated words in normal conditions, dyslexic participants performed within the reference norms and as accurately as control participants across all stimuli (short words, high- and low-frequency words), except for long words, where their spelling difficulties were evident. Articulatory suppression significantly impaired dyslexics' performance on short stimuli, reducing the usual sublexical advantage associated with them, and exacerbated misspellings on long words. Additionally, articulatory suppression disproportionately affected dyslexics' performance on high-frequency words, diminishing the typical lexical advantage associated with these words. Results are discussed in terms of their theoretical, clinical, and educational implications.
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Affiliation(s)
- Francesca Vizzi
- Department of Human and Social Sciences, University of Salento, 73100 Lecce, Italy; (F.V.); (M.I.); (M.D.C.); (M.T.)
- Laboratory of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, 73110 Lecce, Italy
| | - Marika Iaia
- Department of Human and Social Sciences, University of Salento, 73100 Lecce, Italy; (F.V.); (M.I.); (M.D.C.); (M.T.)
- Laboratory of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, 73110 Lecce, Italy
| | - Maria Diletta Carlino
- Department of Human and Social Sciences, University of Salento, 73100 Lecce, Italy; (F.V.); (M.I.); (M.D.C.); (M.T.)
| | - Chiara Valeria Marinelli
- Cognitive and Affective Neuroscience Laboratory, Department of Humanities, University of Foggia, 71122 Foggia, Italy;
| | - Marco Turi
- Department of Human and Social Sciences, University of Salento, 73100 Lecce, Italy; (F.V.); (M.I.); (M.D.C.); (M.T.)
- Laboratory of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, 73110 Lecce, Italy
| | - Paola Angelelli
- Laboratory of Applied Psychology and Intervention, Department of Experimental Medicine, University of Salento, 73110 Lecce, Italy
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Kerdreux E, Fraize J, Garzón P, Chalain E, Etchebarren L, Sitbon D, Maruani A, Boespflug-Tanguy O, Hertz-Pannier L, Noulhiane M, Pinabiaux C, Germanaud D. Questioning cognitive heterogeneity and intellectual functioning in fetal alcohol spectrum disorders from the Wechsler Intelligence Scale for Children. Clin Neuropsychol 2024; 38:1109-1132. [PMID: 37974061 DOI: 10.1080/13854046.2023.2281703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
Introduction: Fetal Alcohol Spectrum Disorders (FASD) are characterized by a variety of multiple cognitive and behavioral impairments, with intellectual, attentional, and executive impairments being the most commonly reported. In populations with multiple neurodevelopmental disorders, the Full Scale Intelligence Quotient (FSIQ) may not be a proper measure of intellectual abilities, rarely interpreted in FASD clinical practice because the heterogeneity of the cognitive profile is deemed too strong. We propose a quantitative characterization of this heterogeneity, of the strengths and weaknesses profile, and a differential analysis between global cognitive (FSIQ) and elementary reasoning abilities in a large retrospective monocentric FASD sample. Methods: Using clinical and cognitive data (Wechsler Intelligence Scale for Children) from 107 children with FASD, we characterized subject heterogeneity (variance and scatter of scaled/composite scores), searched for strengths and weaknesses, and specified intellectual functioning in terms of FSIQ and elementary reasoning (General Abilities Index, Highest Reasoning Scaled Score), in comparison with standardization norms and a Monte-Carlo-simulated sample from normalization data. Results: Performance of children with FASD was lower on all subtests, with a significant weakness in working memory and processing speed. We found no increase in the variance and scatter of the scores, but a discordance between the assessment of global cognitive functioning (28% borderline, 23% deficient) and that of global and elementary reasoning abilities (23-9% borderline, 15-14% deficient). Conclusion: Our results question the notion of WISC profile heterogeneity in FASD and point to working memory and processing speed over-impairment, with global repercussions but most often preserved elementary reasoning abilities.
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Affiliation(s)
- Eliot Kerdreux
- CEA Paris-Saclay, Frederic Joliot Institute, NeuroSpin, UNIACT, Gif-sur-Yvette, France
- Université Paris Cité, Inserm, NeuroDiderot, inDEV, Paris, France
| | - Justine Fraize
- CEA Paris-Saclay, Frederic Joliot Institute, NeuroSpin, UNIACT, Gif-sur-Yvette, France
- Université Paris Cité, Inserm, NeuroDiderot, inDEV, Paris, France
| | - Pauline Garzón
- CEA Paris-Saclay, Frederic Joliot Institute, NeuroSpin, UNIACT, Gif-sur-Yvette, France
- Université Paris Cité, Inserm, NeuroDiderot, inDEV, Paris, France
| | - Esther Chalain
- Genetics Department, Centre of Excellence InovAND, Robert-Debré Hospital, AP-HP, Paris, France
| | - Léa Etchebarren
- Pediatric Neurology Department, Centre of Excellence InovAND, Robert-Debré Hospital, AP-HP, Paris, France
| | - Delphine Sitbon
- Pediatric Neurology Department, Centre of Excellence InovAND, Robert-Debré Hospital, AP-HP, Paris, France
| | - Anna Maruani
- Child and Adolescent Psychiatry Department, Centre of Excellence InovAND, Robert-Debré Hospital, AP-HP, Paris, France
| | | | - Lucie Hertz-Pannier
- CEA Paris-Saclay, Frederic Joliot Institute, NeuroSpin, UNIACT, Gif-sur-Yvette, France
- Université Paris Cité, Inserm, NeuroDiderot, inDEV, Paris, France
| | - Marion Noulhiane
- CEA Paris-Saclay, Frederic Joliot Institute, NeuroSpin, UNIACT, Gif-sur-Yvette, France
- Université Paris Cité, Inserm, NeuroDiderot, inDEV, Paris, France
| | - Charlotte Pinabiaux
- Université Paris Nanterre, Department of Psychology, DysCo Lab, Nanterre, France
| | - David Germanaud
- CEA Paris-Saclay, Frederic Joliot Institute, NeuroSpin, UNIACT, Gif-sur-Yvette, France
- Université Paris Cité, Inserm, NeuroDiderot, inDEV, Paris, France
- Genetics Department, Centre of Excellence InovAND, Robert-Debré Hospital, AP-HP, Paris, France
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Rodriguez VJ, Basurto KS, Finley JCA, Liu Q, Khalid E, Halliburton AM, Tse PKY, Resch ZJ, Soble JR, Ulrich DM. Multidimensional ADHD Symptom Profiles: Associations with Adverse Childhood Experiences. Arch Clin Neuropsychol 2024:acae050. [PMID: 38916192 DOI: 10.1093/arclin/acae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/14/2024] [Accepted: 06/10/2024] [Indexed: 06/26/2024] Open
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are associated with a range of negative health outcomes, including attention-deficit/hyperactivity disorder (ADHD) and neurocognitive deficits. This study identified symptom profiles in adult patients undergoing neuropsychological evaluations for ADHD and examined the association between these profiles and ACEs. METHODS Utilizing unsupervised machine learning models, the study analyzed data from 208 adult patients. RESULTS The Gaussian Mixture Model revealed two distinct symptom profiles: "Severely Impaired" and "Moderately Impaired". The "Severely Impaired" profile, 23.6% of the sample, was characterized by more severe ADHD symptomatology in childhood and worse neurocognitive performance. The "Moderately Impaired" profile, 76.4% of the sample, had scores in the average range for self-reported internalizing and externalizing psychopathology and better neurocognitive performance. There was a greater number of ACEs reported by patients in the Severely Impaired profile than the Moderately Impaired profile (p = .022). Specifically, using an ACEs cutoff of ≥4, 53.1% of patients in the Severely Impaired profile reported four or more ACEs, compared with 34.6% in the Moderately Impaired profile (p = .020). Profiles were not related to clinician-ascribed diagnosis. CONCLUSIONS Findings underscore the association between ACEs and worse symptom profiles marked by impaired neurocognitive function, increased internalizing and externalizing psychopathology, and heightened perceived stress in adults with ADHD. Future research may explore the effect of ACEs on symptom profiles in diverse populations and potential moderators or mediators of these associations. Findings offers valuable insights for clinicians in their assessment and treatment planning.
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Affiliation(s)
| | - Karen S Basurto
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Qimin Liu
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Elmma Khalid
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | | | | | - Zachary J Resch
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
| | - Devin M Ulrich
- Department of Psychiatry, University of Illinois, Chicago, IL, USA
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Tsai CJ, Lin HY, Gau SSF. Correlation of altered intrinsic functional connectivity with impaired self-regulation in children and adolescents with ADHD. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01787-y. [PMID: 38906983 DOI: 10.1007/s00406-024-01787-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/16/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) has a high prevalence of co-occurring impaired self-regulation (dysregulation), exacerbating adverse outcomes. Neural correlates underlying impaired self-regulation in ADHD remain inconclusive. We aimed to investigate the impact of dysregulation on intrinsic functional connectivity (iFC) in children with ADHD and the correlation of iFC with dysregulation among children with ADHD relative to typically developing controls (TDC). METHODS Resting-state functional MRI data of 71 children with ADHD (11.38 ± 2.44 years) and 117 age-matched TDC were used in the final analysis. We restricted our analyses to resting-state networks (RSNs) of interest derived from independent component analysis. Impaired self-regulation was estimated based on the Child Behavioral Checklist-Dysregulation Profile. RESULTS Children with ADHD showed stronger iFC than TDC in the left frontoparietal network, somatomotor network (SMN), visual network (VIS), default-mode network (DMN), and dorsal attention network (DAN) (FWE-corrected alpha < 0.05). After adding dysregulation levels as an extra regressor, the ADHD group only showed stronger iFC in the VIS and SMN. ADHD children with high dysregulation had higher precuneus iFC within DMN than ADHD children with low dysregulation. Angular gyrus iFC within DMN was positively correlated with dysregulation in the ADHD group but negatively correlated with dysregulation in the TDC group. Functional network connectivity showed ADHD had a greater DMN-DAN connection than TDC, regardless of the dysregulation level. CONCLUSIONS Our findings suggest that DMN connectivity may contribute to impaired self-regulation in ADHD. Impaired self-regulation should be considered categorical and dimensional moderators for the neural correlates of altered iFC in ADHD.
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Affiliation(s)
- Chia-Jui Tsai
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsiang-Yuan Lin
- Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Susan Shur-Fen Gau
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan.
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Wilson AC. Cognitive Profile in Autism and ADHD: A Meta-Analysis of Performance on the WAIS-IV and WISC-V. Arch Clin Neuropsychol 2024; 39:498-515. [PMID: 37779387 PMCID: PMC11110614 DOI: 10.1093/arclin/acad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVE Previous research has suggested that neurodevelopmental conditions may be associated with distinctive cognitive profiles on the Wechsler intelligence tests (of which the most recent editions are the WAIS-IV and WISC-V). However, the extent to which a cognitive profile can be reliably identified for individuals meeting criteria for autism or ADHD remains unclear. The present review investigated this issue. METHOD A search was conducted in PsycInfo, Embase, and Medline in October 2022 for papers reporting the performance of children or adults diagnosed with autism or ADHD on the WAIS-IV or the WISC-V. Test scores were aggregated using meta-analysis. RESULTS Scores were analyzed from over 1,800 neurodivergent people reported across 18 data sources. Autistic children and adults performed in the typical range for verbal and nonverbal reasoning, but scored ~1 SD below the mean for processing speed and had slightly reduced scores on working memory. This provides evidence for a "spiky" cognitive profile in autism. Performance of children and adults with ADHD was mostly at age-expected levels, with slightly reduced scores for working memory. CONCLUSION Although the pattern of performance on the Wechsler tests is not sufficiently sensitive or specific to use for diagnostic purposes, autism appears to be associated with a cognitive profile of relative strengths in verbal and nonverbal reasoning and a weakness in processing speed. Attention deficit hyperactivity disorder appears less associated with a particular cognitive profile. Autistic individuals may especially benefit from a cognitive assessment to identify and support with their strengths and difficulties.
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Hong YN, Hwang H, Hong J, Han DH. Correlations between developmental trajectories of brain functional connectivity, neurocognitive functions, and clinical symptoms in patients with attention-deficit hyperactivity disorder. J Psychiatr Res 2024; 173:347-354. [PMID: 38581903 DOI: 10.1016/j.jpsychires.2024.03.021] [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] [Received: 01/13/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/08/2024]
Abstract
Several studies on attention-deficit hyperactivity disorder (ADHD) have suggested a developmental sequence of brain changes: subcortico-subcortical connectivity in children, evolving to subcortico-cortical in adolescence, and culminating in cortico-cortical connectivity in young adulthood. This study hypothesized that children with ADHD would exhibit decreased functional connectivity (FC) between the cortex and striatum compared to adults with ADHD, who may show increased FC in these regions. Seventy-six patients with ADHD (26 children, 26 adolescents, and 24 adults) and 74 healthy controls (25 children, 24 adolescents, and 25 adults) participated in the study. Resting state magnetic resonance images were acquired using a 3.0 T Philips Achieva scanner. The results indicated a gradual decrease in the number of subcategories representing intelligence quotient deficits in the ADHD group with age. In adulthood, the ADHD group exhibited lower working memory compared to the healthy control group. The number of regions showing decreased FC from the cortex to striatum between the ADHD and control groups reduced with age, while regions with increased FC from the default mode network and attention network in the ADHD group increased with age. In adolescents and adults, working memory was positively associated with brain activity in the postcentral gyrus and negatively correlated with ADHD clinical symptoms. In conclusion, the findings suggest that intelligence deficits in certain IQ subcategories may diminish as individuals with ADHD age. Additionally, the study indicates an increasing anticorrelation between cortical and subcortical regions with age in individuals with ADHD.
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Affiliation(s)
- Yu Na Hong
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea.
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea.
| | - Jisun Hong
- Department of Psychiatry, Chung-Ang University Gwang-Myeong Hospital, Gwang-Myeong, Republic of Korea.
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea.
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Lace JW, Sanborn V, Galioto R. Standalone Performance Validity Tests May Be Differentially Related to Measures of Working Memory, Processing Speed, and Verbal Memory in Patients With Multiple Sclerosis. Assessment 2024; 31:732-744. [PMID: 37303186 DOI: 10.1177/10731911231178289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Cognitive functioning may account for minimal levels (i.e., 5%-14%) of variance of performance validity test (PVT) scores in clinical examinees. The present study extended this research twofold: (a) by determining the variance cognitive functioning explains within three distinct PVTs (b) in a sample of patients with multiple sclerosis (pwMS). Seventy-five pwMS (Mage = 48.50, 70.6% female, 80.9% White) completed the Victoria Symptom Validity Test (VSVT), Word Choice Test (WCT), Dot Counting Test (DCT), and three objective measures of working memory, processing speed, and verbal memory as part of clinical neuropsychological assessment. Regression analyses in credible groups (ns ranged from 54 to 63) indicated that cognitive functioning explained 24% to 38% of the variance in logarithmically transformed PVT variables. Variance from cognitive testing differed across PVTs: verbal memory significantly influenced both VSVT and WCT scores; working memory influenced VSVT and DCT scores; and processing speed influenced DCT scores. The WCT appeared least related to cognitive functioning of the included PVTs. Alternative plausible explanations, including the apparent domain/modality specificity hypothesis of PVTs versus the potential sensitivity of these PVTs to neurocognitive dysfunction in pwMS were discussed. Continued psychometric investigations into factors affecting performance validity, especially in multiple sclerosis, are warranted.
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Affiliation(s)
- John W Lace
- Cleveland Clinic Foundation, OH, USA
- Prevea Health, Green Bay, WI, USA
| | - Victoria Sanborn
- Kent State University, OH, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Rachel Galioto
- Cleveland Clinic Foundation, Mellen Center for Multiple Sclerosis, OH, USA
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Dondé C, Coulon N, Turbé H, Andre M, Boyer L, Capdevielle D, Chereau I, Dassing R, Dorey JM, Dubertret C, Leignier S, Llorca PM, Misdrahi D, Passerieux C, Pignon B, Rey R, Schorr B, Schürhoff F, Urbach M, Fond G, Mallet J. Clinical and cognitive characteristics of subjects with schizophrenia and childhood attention-deficit/hyperactivity disorder: Results from the multicentric FACE-SZ cross-sectional dataset. Schizophr Res 2024; 264:105-112. [PMID: 38128341 DOI: 10.1016/j.schres.2023.12.010] [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] [Received: 07/12/2023] [Revised: 08/28/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Childhood Attention-deficit/hyperactivity disorder (C-ADHD) is a neurodevelopmental disorder, associated with an increased risk of subsequent schizophrenia. The objective of the present study was to determine the prevalence of C-ADHD in schizophrenia and the clinical and cognitive characteristics associated with C-ADHD history in schizophrenia. METHODS 569 subjects with schizophrenia (74 % men, mean age 30.8) were included in ten expert centers at a national level and tested with a comprehensive battery of clinician-rated, patient-reported scales and cognitive tests. C-ADHD was assessed with the WURS (Wender Utah Rating Scale) self-report questionnaire. Multivariate, correlation, and principal component analyses (PCA) were conducted. RESULTS Thirty-nine subjects (N = 39, 6.9 %) were classified in the C-ADHD group. Compared to those without C-ADHD, subjects with C-ADHD were more frequently male, had lower education levels, more severe positive clinical symptoms, more subjective cognitive deficits complaints, and lower medication adherence with small to medium effect sizes. Two cognitive components emerged from the PCA, one component including perceptual reasoning and working memory, and another component including visuospatial search and graphomotor speed, cognitive inhibition/flexibility and central executive functioning. Both components were associated with lower performances in the C-ADHD group. CONCLUSIONS C-ADHD is frequent in schizophrenia and associated with more severe positive symptoms and impaired cognitive performances compared to those without C-ADHD. This suggests that the pathophysiological mechanisms contributing to these disorders may lead to the worsening of the cognitive functioning in patients with both disorders. C-ADHD is a relevant clinical marker to discriminate subgroups of schizophrenia with different profiles for a precision-psychiatry approach.
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Affiliation(s)
- Clément Dondé
- Fondation Fondamental, Créteil, France; Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, France; Adult Psychiatry Department CHU Grenoble Alpes, 38000 Grenoble, France; Psychiatry Department, CH Alpes-Isère, F-38000 Saint-Egrève, France.
| | - Nathalie Coulon
- Fondation Fondamental, Créteil, France; Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Hugo Turbé
- Fondation Fondamental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Myrtille Andre
- Fondation Fondamental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Laurent Boyer
- Fondation Fondamental, Créteil, France; AP-HM, Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Delphine Capdevielle
- Fondation Fondamental, Créteil, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chereau
- Fondation Fondamental, Créteil, France; CHU Clermont-Ferrand, Department of Psychiatry, University of Clermont Auvergne, EA 7280 Clermont-Ferrand, France
| | - Romane Dassing
- Fondation Fondamental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Jean-Michel Dorey
- Fondation Fondamental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Caroline Dubertret
- Fondation Fondamental, Créteil, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
| | - Sylvain Leignier
- Fondation Fondamental, Créteil, France; Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France
| | - Pierre-Michel Llorca
- Fondation Fondamental, Créteil, France; University Clermont Auvergne, CMP-B CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France
| | - David Misdrahi
- Centre Expert Schizophrénie, Centre Référent de Réhabilitation Psychosociale et de Remédiation Cognitive (C3R), CH Alpes Isère, France; Department of Adult Psychiatry, Charles Perrens Hospital, Bordeaux, France; University of Bordeaux, Laboratory of Nutrition and Integrative Neurobiology (UMR INRA 1286), France
| | - Christine Passerieux
- Fondation Fondamental, Créteil, France; Versailles Hospital, Department of Adult Psychiatry and Addictology, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines, 94807 Villejuif, France
| | - Baptiste Pignon
- Fondation Fondamental, Créteil, France; Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, Créteil, France
| | - Romain Rey
- Fondation Fondamental, Créteil, France; INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, Université Claude Bernard Lyon 1, Equipe PSYR2, Centre Hospitalier Le Vinatier, Pole Est, 95 bd Pinel, BP 30039, 69678 Bron Cedex, France
| | - Benoît Schorr
- Fondation Fondamental, Créteil, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Franck Schürhoff
- Fondation Fondamental, Créteil, France; Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, Créteil, France
| | - Mathieu Urbach
- Fondation Fondamental, Créteil, France; Versailles Hospital, Department of Adult Psychiatry and Addictology, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; DisAP-DevPsy-CESP, INSERM UMR1018, University of Paris-Saclay, University of Versailles Saint-Quentin-En-Yvelines, 94807 Villejuif, France
| | - Guillaume Fond
- Fondation Fondamental, Créteil, France; AP-HM, Aix-Marseille Univ, School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Jasmina Mallet
- Fondation Fondamental, Créteil, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
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13
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Scorza M, Gontkovsky ST, Puddu M, Ciaramidaro A, Termine C, Simeoni L, Mauro M, Benassi E. Cognitive Profile Discrepancies among Typical University Students and Those with Dyslexia and Mixed-Type Learning Disorder. J Clin Med 2023; 12:7113. [PMID: 38002724 PMCID: PMC10671892 DOI: 10.3390/jcm12227113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/23/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Previous studies have identified areas of cognitive weakness in children diagnosed with Specific Learning Disorder (SLD), in the areas of working memory and processing speed in particular. In adulthood, this literature is still scant, and no studies have compared the cognitive profile of university students with dyslexia (DD) with that of students with Mixed-type SLD. METHOD Thus, in this study, the WAIS-IV was used to examine the cognitive functioning of three groups of university students: students with DD, with Mixed-type SLD, and typical students. Statistical analyses were performed to examine differences in WAIS-IV FSIQ, main, and additional indexes and subtests. RESULTS The results showed strengths in perceptual reasoning and good verbal comprehension abilities in both the DD and Mixed-type SLD group, with weaknesses in working memory and processing speed, leading to a pattern of a better General Ability Index (GAI) than Cognitive Proficiency Index (CPI) in both clinical groups. Thus, discrepancies between GAI and CPI, well documented in children with SLD, still manifest in adulthood in university students. Our findings also revealed worse cognitive performance in university students with mixed learning disorder relative to students with only a reading deficit. CONCLUSIONS The cognitive features and distinctive subtest profiles that emerged should guide the assessment and the definitions of intervention programs, special educational needs, and strategies of compensation.
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Affiliation(s)
- Maristella Scorza
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Reggio Emilia, Italy; (A.C.); (E.B.)
| | | | - Marta Puddu
- Independent Researcher, 40100 Bologna, Italy;
| | - Angela Ciaramidaro
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Reggio Emilia, Italy; (A.C.); (E.B.)
| | - Cristiano Termine
- Department of Medicine and Technological Innovation, University of Insubria, 21100 Varese, Italy;
- Child and Adolescent Neuropsychiatry Unit, ASST dei Sette Laghi, 21100 Varese, Italy;
| | - Loriana Simeoni
- Child and Adolescent Neuropsychiatry Unit, ASST dei Sette Laghi, 21100 Varese, Italy;
| | | | - Erika Benassi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 42121 Reggio Emilia, Italy; (A.C.); (E.B.)
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14
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Roh HJ, Bahn GH, Lee SY, Joung YS, Kim B, Kim EJ, Lee SI, Hong M, Han DH, Lee YS, Yoo HK, Bhang SY. Beyond Attention-Deficit Hyperactivity Disorder: Exploring Psychiatric Comorbidities and Their Neuropsychological Consequences in Adults. Soa Chongsonyon Chongsin Uihak 2023; 34:275-282. [PMID: 37841480 PMCID: PMC10568183 DOI: 10.5765/jkacap.230050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023] Open
Abstract
Objectives This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two boardcertified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.
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Affiliation(s)
- Hyun Jae Roh
- Department of Psychiatry, Nowon Eulji University Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Geon Ho Bahn
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
| | | | - Yoo-Sook Joung
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bongseog Kim
- Department of Psychiatry, Inje University College of Medicine, Seoul, Korea
| | - Eui-Jung Kim
- Department of Psychiatry, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Minha Hong
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea
| | - Young Sik Lee
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hanik K Yoo
- Department of Clinical Psychiatry, Seoul Brain Research Institute, Seoul, Korea
| | - Soo-Young Bhang
- Department of Psychiatry, Nowon Eulji University Hospital, Eulji University School of Medicine, Seoul, Korea
- Nowon Community Addiction Management Center, Seoul, Korea
- Eulji Psychiatry and Medical Science Center, Seoul, Korea
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15
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Finley JCA, Brooks JM, Nili AN, Oh A, VanLandingham HB, Ovsiew GP, Ulrich DM, Resch ZJ, Soble JR. Multivariate examination of embedded indicators of performance validity for ADHD evaluations: A targeted approach. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-14. [PMID: 37703401 DOI: 10.1080/23279095.2023.2256440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
This study investigated the individual and combined utility of 10 embedded validity indicators (EVIs) within executive functioning, attention/working memory, and processing speed measures in 585 adults referred for an attention-deficit/hyperactivity disorder (ADHD) evaluation. Participants were categorized into invalid and valid performance groups as determined by scores from empirical performance validity indicators. Analyses revealed that all of the EVIs could meaningfully discriminate invalid from valid performers (AUCs = .69-.78), with high specificity (≥90%) but low sensitivity (19%-51%). However, none of them explained more than 20% of the variance in validity status. Combining any of these 10 EVIs into a multivariate model significantly improved classification accuracy, explaining up to 36% of the variance in validity status. Integrating six EVIs from the Stroop Color and Word Test, Trail Making Test, Verbal Fluency Test, and Wechsler Adult Intelligence Scale-Fourth Edition was as efficacious (AUC = .86) as using all 10 EVIs together. Failing any two of these six EVIs or any three of the 10 EVIs yielded clinically acceptable specificity (≥90%) with moderate sensitivity (60%). Findings support the use of multivariate models to improve the identification of performance invalidity in ADHD evaluations, but chaining multiple EVIs may only be helpful to an extent.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School, Chicago, IL, USA
| | - Julia M Brooks
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amanda N Nili
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School, Chicago, IL, USA
| | - Alison Oh
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Illinois Institute of Technology Chicago, IL, USA
| | - Hannah B VanLandingham
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Illinois Institute of Technology Chicago, IL, USA
| | - Gabriel P Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Devin M Ulrich
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
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16
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Toffalini E, Buono S, Cornoldi C. The structure, profile, and diagnostic significance of intelligence in children with ADHD are impressively similar to those of children with a specific learning disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 129:104306. [PMID: 35863174 DOI: 10.1016/j.ridd.2022.104306] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 05/21/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
This study examines the structure, profile, and diagnostic significance of intelligence in a group of 948 children diagnosed with attention deficit/hyperactivity disorder (ADHD) assessed with the WISC-IV and compared with children with specific learning disorders (SLDs) and with typically developing children. Based on four indexes, the WISC-IV configuration found in TD resulted applicable to ADHD, but with generally lower loadings on g. The Perceptual Reasoning and Verbal Comprehension indexes not only had higher loadings compared to the other two indexes but also represented the relative strengths of children with ADHD, as previously observed for children with SLD. In fact, the WISC pattern could be successfully used for discriminating between ADHD and TD, but not between ADHD and SLD. The latter result was not due to a co-occurrence of a learning disorder because the presence or absence of an associated diagnosis of SLD negligibly affected the pattern observed in ADHD. We concluded that the characteristics of intelligence in children with ADHD can be relevant for assessing this disorder, and that ADHD and SLDs share largely similar underlying cognitive features.
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Affiliation(s)
| | | | - Cesare Cornoldi
- Department of General Psychology, University of Padua, Italy.
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17
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Association Between Mild Neurocognitive Disorder Due to Alzheimer's Disease and Possible Attention-deficit/Hyperactivity Disorder: A Case Report. J Psychiatr Pract 2022; 28:251-258. [PMID: 35511103 DOI: 10.1097/pra.0000000000000627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent literature concerning attention-deficit/hyperactivity disorder (ADHD) underlines the persistence of this neurodevelopmental illness in older patients. Comorbidity with a neurodegenerative disease is thus possible. However, few studies have investigated this topic. To our knowledge, this is the first case report of such a possible association, which raises important questions about clinical presentation, symptoms, diagnosis, and treatment. A 72-year-old man, without any psychiatric history, presented with depression, subjective memory loss, and attention deficit and anxious symptoms, and was diagnosed with mild neurocognitive disorder due to Alzheimer's disease. However, the patient's attentional symptoms appeared to have been present since childhood. A formalized diagnostic interview assessing for ADHD did not allow for a clear diagnosis, possibly due to recall bias. The patient's anxiety symptoms also did not respond well to cognitive behavioral therapy coupled with different antidepressants. We hypothesized the presence of ADHD, with the symptoms balanced until now by the patient's high cognitive capacities, and we postulated that the onset of a neurogenerative process may have disrupted this balance. In this case report, we discuss symptom dimensionality, the interplay between neurodegenerative and neurodevelopmental diseases, and various treatment options. Attentional deficits and anxiety symptoms are frequent in mild neurocognitive disorders due to neurodegenerative illnesses. It is important to explore the time of onset of such symptoms since neurodegenerative processes can worsen neurodevelopmental conditions. Moreover, identification of a pre-existing neurodevelopmental condition can lead to alternative care and treatment options. In addition, the unexplained worsening of ADHD symptoms should prompt clinicians to assess for a neurodegenerative process.
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18
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Morris NM, Ingram PB, Armistead-Jehle P. Relationship of personality assessment inventory (PAI) over-reporting scales to performance validity testing in a military neuropsychological sample. MILITARY PSYCHOLOGY 2022. [DOI: 10.1080/08995605.2021.2013059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Nicole M. Morris
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Paul B. Ingram
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
- Dwight D. Eisenhower Veteran Affairs Medical Center, Eastern Kansas Veteran Healthcare System, Leavenworth, Kansas, USA
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19
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Hong JS, Lee YS, Hong M, Kim B, Joung YS, Yoo HK, Kim EJ, Lee SI, Bhang SY, Lee SY, Bahn GH, Han DH. Cognitive Developmental Trajectories in Adult ADHD Patients and Controls: A Comparative Study. J Atten Disord 2022; 26:391-407. [PMID: 33472514 DOI: 10.1177/1087054720978548] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE There is an updated conceptualization of whole-lifespan attention-deficit hyperactivity disorder (ADHD), promoted by awareness of probable persistence of impairment into adulthood. We investigated cognition trajectories from adolescence to mid-adulthood in ADHD. METHOD Data of 240 patients with ADHD and 244 healthy controls (HCs) were obtained; clinical symptoms and neuropsychological functions were assessed using the various tests. RESULTS Compared to HCs, patients with ADHD except 35 to 44 age interval showed lower full scale intelligence quotient. They showed decreased verbal comprehensive scores except in the 35 to 44 age interval and working memory scores in all intervals. In the Comprehensive Attention Test, patients with ADHD showed increased working memory error frequencies except in the 15 to 17 age interval and divided attention omission error in all intervals. CONCLUSION Adults with ADHD showed deficits not in simple attention but in complex attention, including divided attention and working memory.
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Affiliation(s)
- Ji Sun Hong
- Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Young Sik Lee
- Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Minha Hong
- Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Bongseog Kim
- Inje University College of Medicine, Seoul, Republic of Korea
| | - Yoo Sook Joung
- Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Hanik K Yoo
- Seoul Brain Research Institute, Seoul, Republic of Korea
| | - Eui-Jung Kim
- Ewha Womans University, Seoul, Republic of Korea
| | - Soyoung Irene Lee
- Soonchunhyang University College of Medicine, Buchun, Republic of Korea
| | - Soo Young Bhang
- Eulji University School of Medicine, Seoul, Republic of Korea
| | - Seung Yup Lee
- Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Geon Ho Bahn
- Kyung Hee University School of Medicine, Seoul, Republic of Korea
| | - Doug Hyun Han
- Chung-Ang University College of Medicine, Seoul, Republic of Korea
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20
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The Impact of School Strategies and the Home Environment on Home Learning Experiences During the COVID-19 Pandemic in Children With and Without Developmental Disorders. J Autism Dev Disord 2022; 53:1642-1672. [PMID: 35013867 PMCID: PMC8747872 DOI: 10.1007/s10803-021-05383-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
Using the Opportunity-Propensity Model (Byrnes in Dev Rev 56:100911, 2020; Byrnes & Miller in Contemp Educ Psychol 32(4);599–629, 2007), the current study investigated which factors helped predicting children’s home learning experiences during the COVID-19 pandemic, thereby examining differences between children with (DD; n = 779) and without (TD; n = 1443) developmental disorders. MANCOVA results indicated more negative experiences for DD children and their parents. SEM-results revealed the alignment between different teachers and autonomous motivation in children as the most important predictors for the outcome variables. Less predictors were significant for DD as compared to TD children which suggests other factors are at play in the DD group. Limitations, strengths and suggestions for future research are being discussed, together with some implications for classroom practices and remote learning approaches.
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21
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Therribout N, Karsinti E, Morel A, Dereux A, Vorspan F, Romo L, Icick R. Feasibility of an Extensive Strategy for Adult Diagnosis of Attention Deficit Hyperactivity Disorder Among Patients Suffering From Substance Use Disorders. Front Psychiatry 2022; 13:803227. [PMID: 35836660 PMCID: PMC9273821 DOI: 10.3389/fpsyt.2022.803227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Attention Deficit Hyperactivity Disorder (ADHD) is found in up to 20% adults with Substance Use Disorder (SUD). ADHD + SUD is associated with a more complex clinical presentation and poorer outcomes than each disorder alone. In the presence of SUD, adult ADHD is particularly difficult to diagnose as both disorders can mimic or hide the symptoms of each other. Our university hospital in Paris recently started an extensive outpatient diagnostic procedure for adult patients with SUD to ascertain or refute ADHD diagnosis and to provide therapeutic guidance. Here, we report the acceptability of the assessment procedure for patients and the preliminary description of the current and lifetime clinical profiles as a function of the final diagnosis "ADHD vs. no ADHD." METHOD Adult SUD patients with suspected ADHD were included in the current pilot study after stating they had no objection that their de-identified data were used for research purposes, according to French ethical procedures. Patients were evaluated for ADHD, comorbid mental disorders, cognitive state and dimensional psychological variables. They were assessed by trained psychologists and psychiatrists using standardized tools over a day. ADHD diagnosis was mainly based on the Diagnostisch Interview Voor ADHD for DSM-5 (DIVA-5). RESULTS Out of 18 eligible patients, 17 were included in the cohort (1 excluded) and none was opposed to using their data. Thirteen (76%) participants were diagnosed with ADHD. All patients appointed for the ADHD diagnostic procedure came, respected schedules and finished the evaluation. All patients were impaired on cognitive functioning and were highly comorbid, but ADHD patients seems to suffer even more from those conditions, especially for cannabis and stimulant use disorders. DISCUSSION Preliminary results show high acceptability of the procedure by ADHD-SUD patients. This result could be explained by all the organization adapted to the psychopathology. Patients' baseline motivation to participate also represents an uncontrolled variable that could promote the ability to follow the procedure. Acceptance results of the protocol are promising and represent a starting point to identify the best procedures to design patient-centered pharmacological and non-pharmacological therapies.
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Affiliation(s)
- Norman Therribout
- Assistance Publique - Hôpitaux de Paris, Hôpital Fernand-Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris Cité, INSERM UMR-S1144, Paris, France.,Laboratoire Clipsyd EA 4430, Université Paris-Nanterre, Nanterre, France.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, France
| | - Emily Karsinti
- Assistance Publique - Hôpitaux de Paris, Hôpital Fernand-Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris Cité, INSERM UMR-S1144, Paris, France.,Laboratoire Clipsyd EA 4430, Université Paris-Nanterre, Nanterre, France.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, France
| | - Alix Morel
- Assistance Publique - Hôpitaux de Paris, Hôpital Fernand-Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris Cité, INSERM UMR-S1144, Paris, France.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, France
| | - Alexandra Dereux
- Assistance Publique - Hôpitaux de Paris, Hôpital Fernand-Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris Cité, INSERM UMR-S1144, Paris, France.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, France
| | - Florence Vorspan
- Assistance Publique - Hôpitaux de Paris, Hôpital Fernand-Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris Cité, INSERM UMR-S1144, Paris, France.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, France
| | - Lucia Romo
- Laboratoire Clipsyd EA 4430, Université Paris-Nanterre, Nanterre, France.,Assistance Publique - Hôpitaux de Paris, Hôpital Raymond-Poincaré, Garches, France.,CESP, U1018 INSERM UPS UVSQ, Villejuif, France
| | - Romain Icick
- Assistance Publique - Hôpitaux de Paris, Hôpital Fernand-Widal, Département Universitaire de Psychiatrie et de Médecine Addictologique, Paris, France.,Université de Paris Cité, INSERM UMR-S1144, Paris, France.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, France
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22
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Leib SI, Keezer RD, Cerny BM, Holbrook LR, Gallagher VT, Jennette KJ, Ovsiew GP, Soble JR. Distinct Latent Profiles of Working Memory and Processing Speed in Adults with ADHD. Dev Neuropsychol 2021; 46:574-587. [PMID: 34743616 DOI: 10.1080/87565641.2021.1999454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the neuropsychological profile of patients with Attention-Deficit/Hyperactivity Disorder (ADHD) based on Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) working memory and processing speed indices. We aimed to establish whether distinct ADHD subtypes emerge based on neuropsychological testing and determine whether ADHD subgroups differ based on neurocognitive and demographic factors in 179 adult patients with ADHD. Latent Profile Analysis (LPA) revealed four discrete latent subgroups within the sample, each with distinct patterns of working memory and processing speed. Classes significantly differed in demographically predicted IQ, education, and self-reported depression and anxiety. Results reveal heterogeneity in cognitive performance in adult ADHD.
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Affiliation(s)
- Sophie I Leib
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, Illinois, USA.,Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Richard D Keezer
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, Illinois, USA.,Department of Psychology, Wheaton College, Wheaton, Illinois, USA
| | - Brian M Cerny
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, Illinois, USA.,Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Lindsey R Holbrook
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, Illinois, USA.,Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | - Virginia T Gallagher
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Kyle J Jennette
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Gabriel P Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, Illinois, USA.,Department of Neurology, University of Illinois College of Medicine, Chicago, Illinois, USA
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23
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Wanderer S, Roessner V, Strobel A, Martini J. WISC-IV performance of children with Chronic Tic Disorder, Obsessive-Compulsive Disorder and Attention-Deficit/Hyperactivity Disorder: results from a German clinical study. Child Adolesc Psychiatry Ment Health 2021; 15:44. [PMID: 34465371 PMCID: PMC8408972 DOI: 10.1186/s13034-021-00392-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 08/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chronic Tic Disorder (CTD), Obsessive-Compulsive Disorder (OCD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are complex neuropsychiatric disorders that frequently co-occur. The aim of this study was to examine WISC-IV performance of a clinical cohort of children with CTD, OCD and/or ADHD. METHODS N = 185 children aged 6 to 17 years from Germany with CTD, OCD and/or ADHD were examined with the WISC-IV that comprises four index scores (VCI: Verbal Comprehension Index, PRI: Perceptual Reasoning Index, WMI: Working Memory Index, PSI: Processing Speed Index) and a Full Scale Intelligence Quotient (FSIQ). WISC-IV profiles of children with CTD-only, OCD-only, ADHD-only, CTD+ADHD, CTD+OCD and CTD+OCD+ADHD were compared with the WISC-IV norm (N = 1650, M = 100 and SD = 15) and among each other. RESULTS Unpaired t-tests revealed that children with ADHD-only showed significant lower PSI scores, whereas children with CTD-only and OCD-only had significant higher VCI scores as compared to the German WISC-IV norm. One-way ANOVA revealed that children with ADHD-only showed significant lower WMI scores as compared to children with CTD+OCD. CONCLUSIONS We were able to confirm previous evidence on WISC-IV profiles in ADHD in a German clinical sample and contribute new findings on cognitive performance in children with (non-)comorbid CTD and OCD that have to be seen in light of the study's limitations.
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Affiliation(s)
- Sina Wanderer
- grid.412282.f0000 0001 1091 2917Department of Child and Adolescent Psychiatry, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Veit Roessner
- grid.412282.f0000 0001 1091 2917Department of Child and Adolescent Psychiatry, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Anja Strobel
- grid.6810.f0000 0001 2294 5505Department of Psychology, Chemnitz University of Technology, Wilhelm-Raabe-Str. 43, 09120 Chemnitz, Germany
| | - Julia Martini
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany. .,Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
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24
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Neufeld J, Hederos Eriksson L, Hammarsten R, Lundin Remnélius K, Tillmann J, Isaksson J, Bölte S. The impact of atypical sensory processing on adaptive functioning within and beyond autism: The role of familial factors. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2341-2355. [PMID: 34340600 DOI: 10.1177/13623613211019852] [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: 11/17/2022]
Abstract
LAY ABSTRACT Individuals diagnosed with autism tend to process sensory information differently than individuals without autism, resulting for instance in increased sensitivity to sounds or smells. This leads to challenges in everyday life and may restrict the individual's daily functioning. How direct this link is, however, is currently unclear. We investigated this question in 289 twins of whom 60 were diagnosed with autism and further 61 were diagnosed with other neurodevelopmental disorders. We looked at the association between unusual sensory processing and adaptive skills, both across individuals and within-twin pairs, testing whether individuals with higher levels of atypical sensory processing showed reduced adaptive skills compared to their twins. Since twins share 50%-100% of their genes and part of their environment (e.g. family background), associations within-twin pairs are free from effects of these familial factors. We found that an increased sensitivity to, as well as the avoiding of, sensory input (hyper-responsiveness) was linked to reduced adaptive skills across individuals-but not within-twin pairs. We also found an association between the degree to which individuals seek for sensory input (sensation seeking) and reduced adaptive skills, but only in individuals diagnosed with autism. The results suggest that sensory hyper-responsiveness has negative effects on individuals' general ability to function, but that this link is influenced by familial factors and hence not direct. In addition, sensation seeking behaviors might have a negative impact on adaptive skills specifically in autistic individuals.
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Affiliation(s)
| | | | | | | | | | - Johan Isaksson
- Karolinska Institutet, Sweden.,Uppsala University, Sweden
| | - Sven Bölte
- Karolinska Institutet, Sweden.,Region Stockholm, Sweden.,Curtin University, Australia
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25
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Anker E, Ogrim G, Heir T. Verbal working memory and processing speed: Correlations with the severity of attention deficit and emotional dysregulation in adult ADHD. J Neuropsychol 2021; 16:211-235. [PMID: 34218514 PMCID: PMC9290636 DOI: 10.1111/jnp.12260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/18/2021] [Indexed: 12/02/2022]
Abstract
Objectives The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), emphasizes symptoms severity with regard to the diagnosis of attention deficit hyperactivity disorder (ADHD). Many clinicians use neuropsychological test results as objective measures of cognitive functions as part of the diagnostic work‐up. The aim of this study was to investigate whether the psychometric test results regarding verbal working memory and processing speed are useful as indicators of the severity of attention deficits and emotional dysregulation in adults with ADHD. Methods This observational cross‐sectional clinical study included 418 adults diagnosed with ADHD according to the DSM‐5. Attention deficit severity was defined based on the inattentive subscale of the Adult ADHD Self‐Report Scale. Emotional dysregulation was assessed with the Deficient Emotional Self‐Regulation scale. Verbal working memory was measured with the Working Memory Index (WMI), and processing speed was measured with the Processing Speed Index (PSI) from the Wechsler Adult Intelligence Scale, third edition. Results The full‐scale intelligence quotients of the participants were in the normal range, with expected reductions in verbal working memory and processing speed. Only processing speed was associated with attention deficits (β = −.056, p = .003). The association between the psychometric test result for verbal working memory and processing speed and that between the severity of attention deficits and emotional dysregulation were weak (R2 < .1) and mostly non‐significant. Conclusion The psychometric index scores for verbal working memory (WMI) and processing speed (PSI) seem to have limited utility as indicators of the severity of attention deficits and emotional dysregulation in adult ADHD patients.
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Affiliation(s)
| | - Geir Ogrim
- Østfold Hospital Trust, Norway.,Gillberg Neuropsychiatry Centre, University of Gothenburg, Sweden
| | - Trond Heir
- Institute of clinical Medicine, University of Oslo, Norway
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26
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Jang JH, Chung SJ, Choi A, Lee JY, Kim B, Park M, Park S, Choi JS. Association of General Cognitive Functions with Gaming Use in Young Adults: A Comparison among Excessive Gamers, Regular Gamers and Non-Gamers. J Clin Med 2021; 10:jcm10112293. [PMID: 34070386 PMCID: PMC8197560 DOI: 10.3390/jcm10112293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to examine the relationship of general cognitive function with gaming use, and to identify elements of intelligence predicting increased gaming use. In total, 160 young adults participated in this study. Two clinical groups (n = 97) were defined: excessive gaming users diagnosed with internet gaming disorder (IGD) (n = 64) and the high-risk users (n = 33). The control group (n = 63) was also divided into regular gamers (n = 14) and non-gamers (n = 49). Participants completed the Wechsler Adult Intelligence Scale-IV and self-reported questionnaires regarding IGD severity and gaming hours. The IGD group had significantly lower Full Scale Intelligence Quotient (FSIQ), Verbal Comprehension Index (VCI), and Processing Speed Index (PSI) scores, compared with regular gamers and non-gamers. The IGD group also exhibited lower Working Memory Index (WMI) scores, compared with non-gamers. The high-risk group demonstrated significantly lower PSI score, compared with non-gamers. Furthermore FSIQ, VCI, WMI, and PSI scores were significant predictors of gaming hours in the IGD group. For the high-risk group, FSIQ, WMI, and VCI scores were negatively associated with gaming hours. Our study demonstrates the need to address the importance of enhancing working memory and verbal ability, thus, preventing the development of gaming addiction among individuals at high-risk gamers.
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Affiliation(s)
- Joon Hwan Jang
- Department of Psychiatry, Seoul National University Health Service Center, Seoul 08826, Korea; (J.H.J.); (S.P.)
- Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Sun Ju Chung
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (S.J.C.); (A.C.); (J.Y.L.); (B.K.); (M.P.)
| | - Aruem Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (S.J.C.); (A.C.); (J.Y.L.); (B.K.); (M.P.)
| | - Ji Yoon Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (S.J.C.); (A.C.); (J.Y.L.); (B.K.); (M.P.)
| | - Bomi Kim
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (S.J.C.); (A.C.); (J.Y.L.); (B.K.); (M.P.)
| | - Minkyung Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (S.J.C.); (A.C.); (J.Y.L.); (B.K.); (M.P.)
| | - Susan Park
- Department of Psychiatry, Seoul National University Health Service Center, Seoul 08826, Korea; (J.H.J.); (S.P.)
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul 07061, Korea; (S.J.C.); (A.C.); (J.Y.L.); (B.K.); (M.P.)
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-870-3461
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27
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Brydges CR, Ozolnieks KL, Roberts G. Working Memory and Intraindividual Variability in Response Time Mediate Fluid Intelligence Deficits Associated With ADHD Symptomology. J Atten Disord 2021; 25:63-72. [PMID: 29708000 DOI: 10.1177/1087054718772143] [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: 12/12/2022]
Abstract
Objective: To determine if decreased fluid intelligence was associated with ADHD, and was mediated by deficits in working memory and intraindividual variability in motor responding. Method: The present study tested 142 young adults from the general population on a range of working memory, response time, and fluid intelligence tasks, and an ADHD self-report symptoms questionnaire. Results: Total and hyperactive ADHD symptoms correlated significantly and negatively with fluid intelligence, but this association was fully mediated by both working memory and intraindividual variability in response time. However, inattentive symptoms were not associated with fluid intelligence. Conclusion: These results have important implications for clinicians using speeded psychometric tests as part of their assessment battery, working memory interventions for ADHD patients that focus on performance improvement without controlling for response consistency, and also demonstrate potential differences in the neuropsychological profiles of ADHD subtypes.
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Affiliation(s)
- Christopher R Brydges
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia.,School of Psychology and Exercise Science, Murdoch University, Murdoch, Western Australia, Australia
| | - Krista L Ozolnieks
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Western Australia, Australia
| | - Gareth Roberts
- School of Psychology, University of Sydney, Camperdown, New South Wales, Australia
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28
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Baggio S, Hasler R, Deiber MP, Heller P, Buadze A, Giacomini V, Perroud N. Associations of executive and functional outcomes with full-score intellectual quotient among ADHD adults. Psychiatry Res 2020; 294:113521. [PMID: 33161177 DOI: 10.1016/j.psychres.2020.113521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 10/17/2020] [Indexed: 12/31/2022]
Abstract
Associations between executive and functional impairment, intelligence, and attention deficit hyperactivity disorder (ADHD) have been scarcely investigated among adult populations and lead to inconsistent results. This study tested the impact of intellectual level on executive and functional impairment in a clinical sample of adults diagnosed with ADHD. Participants were recruited in a specialized center for the diagnosis and treatment of ADHD (n=66, mean age=27.9 ± 10.8). Measures included intellectual quotient (IQ, Wechsler Adult Intelligence Scale) categorized as ≤110 or >110, the continuous performance test (CPT3TM), grade retention, educational attainment, and having an activity (job or studies). Participants with a higher IQ had significantly better functional outcomes than participants with a standard IQ: higher educational attainment, lower grade retention, and often having an activity. Participants with higher IQ performed significantly better on all CPT variables assessing executive functioning. Intelligence seemed to work as a protective factor for executive and functional outcomes in a clinical population of ADHD adults and might reduce long-lasting detrimental consequences in life.
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Affiliation(s)
- Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; Office of Corrections, Canton Zurich, Zurich, Switzerland.
| | - Roland Hasler
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Marie-Pierre Deiber
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Patrick Heller
- Division of Prison Health, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Anna Buadze
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Véronique Giacomini
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Geneva, Switzerland
| | - Nader Perroud
- Department of Mental Health and Psychiatry, Service of Psychiatric Specialties, University Hospitals of Geneva, Geneva, Switzerland; Department of Psychiatry, University of Geneva, Geneva, Switzerland; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
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29
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Differential Efficacy of an Intelligent Tutoring System for University Students: A Case Study with Learning Disabilities. SUSTAINABILITY 2020. [DOI: 10.3390/su12219184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Computer-Based Learning Environments (CBLEs) have emerged as an almost limitless source of education, challenging not only students but also education providers; teaching and learning in these virtual environments requires greater self-regulation of learning. More research is needed in order to assess how self-regulation of learning strategies can contribute to better performance. This study aims to report how an Intelligent Tutoring System can help students both with and without learning difficulties to self-regulate their learning processes. A total of 119 university students with and without learning difficulties took part in an educational experiment; they spent 90 min learning in a CBLE specifically designed to assess and promote self-regulated learning strategies. Results show that as a consequence of the training, the experimental group applied more self-regulation strategies than the control group, not only as a response to a system prompt but also self-initiated. In addition, there were some differences in improvement of learning processes in students with and without learning difficulties. Our results show that when students with learning difficulties have tools that facilitate applying self-regulated learning strategies, they do so even more than students without learning difficulties.
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30
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Molavi P, Nadermohammadi M, Salvat Ghojehbeiglou H, Vicario CM, Nitsche MA, Salehinejad MA. ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference. BMC Psychiatry 2020; 20:502. [PMID: 33046041 PMCID: PMC7549239 DOI: 10.1186/s12888-020-02887-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is a major neurodevelopmental disorder with heterogeneous symptoms, subtypes, and cognitive deficits. Cognitive deficits are central to ADHD pathophysiology and one potential source of heterogeneity in ADHD. Subtype-specific cognitive correlates are not, however, well-studied. We explored cognitive correlates of ADHD subtypes based on the Wechsler Intelligence Scale for Children (WISC-IV) scores. We also assessed subtype-specific self-esteem rating in ADHD subtypes and explored its association with cognitive correlates. METHODS One hundred thirty-nine children with ADHD (80.6% boy, 19.4% girl) were categorized into the predominantly "hyperactive (ADHD-H)", "inattentive (ADHD-I)" and "combined (ADHD-C)" subtype based on their symptoms and scores on the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) and Conners Parent-Rating Scale (CPRS-RS). They were then individually administrated the WISC-IV and completed a self-esteem inventory. Group differences in the WISC-IV indices and their predictability in discriminating ADHD subtypes were analyzed. RESULTS We found a quantitative differentiation of cognitive abilities among ADHD subtypes with "working memory" as the most compromised cognitive domain. ADHD-I had the poorest cognitive profile while ADHD-H scored highest in all cognitive domains. Importantly, cognitive abilities were negatively correlated with inattention and positively correlated with hyperactive symptoms. Moreover, self-esteem ratings were positively correlated with the cognitive domains and were rated differently based on the subtypes. ADHD-H, with the highest cognitive strength, reported the highest level of self-esteem among all subtypes. CONCLUSIONS ADHD subtype-specific symptoms, cognitive deficits, and self-esteem problems should be considered for precise diagnosis and effective and personalized treatment in ADHD in light of further supporting evidence and assessments. Cognitive interventions might be more compatible with and effective in inattentive and combined subtypes of ADHD. Working memory improving-based interventions can benefit all ADHD subtypes. A supportive educational system in school and providing adjunct supportive interventions should be considered for children with ADHD as well.
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Affiliation(s)
- Parviz Molavi
- grid.411426.40000 0004 0611 7226Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehriar Nadermohammadi
- Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Habibeh Salvat Ghojehbeiglou
- grid.411426.40000 0004 0611 7226Department of Psychiatry, Fatemi Hospital, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Carmelo M. Vicario
- grid.10438.3e0000 0001 2178 8421Department of Scienze Cognitive della Formazione e degli Studi Culturali, University of Messina, Messina, Italy
| | - Michael A. Nitsche
- grid.419241.b0000 0001 2285 956XDepartment of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany. .,International Graduate School of Neuroscience, Ruhr-University Bochum, Bochum, Germany. .,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran.
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31
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Differentiating depression and ADHD without depression in adults with processing-speed measures. Acta Neuropsychiatr 2020; 32:237-246. [PMID: 32338233 DOI: 10.1017/neu.2020.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We evaluated processing-speed and shift-cost measures in adults with depression or attention-deficit hyperactivity disorder (ADHD) and monitored the effects of treatment. We hypothesised that cognitive-speed and shift-cost measures might differentiate diagnostic groups. METHODS Colour, form, and colour-form stimuli were used to measure naming times. The shift costs were calculated as colour-form-naming time minus the sum of colour- and form-naming times. Measurements were done at baseline and end point for 42 adults with depression and 42 with ADHD without depression. Patients with depression were treated with transcranial pulsed electromagnetic fields and patients with ADHD with methylphenidate immediate release. RESULTS During depression treatment, reductions in naming times were recorded weekly. One-way analysis of variance indicated statistical between-group differences, with effect sizes in the medium range for form and colour-form. In both groups, naming times were longer before than after treatment. For the ADHD group, shift costs exceeded the average-normal range at baseline but were in the average-normal range after stabilisation with stimulant medication. For the depression group, shift costs were in the average-normal range at baseline and after treatment. Baseline colour-form-naming times predicted reductions in naming times for both groups, with the largest effect size and index of forecasting efficiency for the ADHD group. CONCLUSIONS The cognitive-processing-speed (colour-form) and shift-cost measures before treatment proved most sensitive in differentiating patients with depression and ADHD. Reductions in naming times for the depression group were suggested to reflect improved psychomotor skills rather than improved cognitive control.
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Egeland J, Follesø K. Offering alphabet support in the Trail Making Test: Increasing validity for participants with insufficient automatization of the alphabet. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:478-485. [PMID: 32546072 DOI: 10.1080/23279095.2020.1774377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Insufficient automatization of the alphabet may falsely impair performance on the Trail Making Test among persons with dyslexia or persons not accustomed to the Latin alphabet. We analyze whether writing the alphabet on top of the test sheet changes performance in these risk groups, and whether alphabet support reduces the complexity of the set-shifting task.One-hundred and seventy patients referred to neuropsychological assessment participated and were given both a TMT-version offering alphabet support and the D-KEFS TMT. The discrepancy between the D-KEFS subtask where lines are drawn successively between numbers only, and the task where lines are drawn between letters only, was operationalized as measuring insufficient alphabet automatization.Both the possible dyslexia group, and persons taught to read with another alphabet, had a larger discrepancy score than the remaining sample. Regression analyses showed that the discrepancy scores explained 3.4% of the variance beyond age and speed when giving alphabet support. The corresponding percentage for the D-KEFS Switching task was 17.5%. The findings indicate that alphabet support alleviated effects of non-automatization. The TMT-B-NR: TMT-A ratio score was equivalent to what is found when not applying alphabet support, showing that alphabet support did not contaminate the test as a EF-measure.
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Affiliation(s)
- Jens Egeland
- Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway.,Institute of Psychology, University of Oslo, Oslo, Norway
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Kim Y, Koh MK, Park KJ, Lee HJ, Yu GE, Kim HW. WISC-IV Intellectual Profiles in Korean Children and Adolescents with Attention Deficit/Hyperactivity Disorder. Psychiatry Investig 2020; 17:444-451. [PMID: 32321204 PMCID: PMC7265020 DOI: 10.30773/pi.2019.0312] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/28/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to compare the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) profiles of children with attention deficit/hyperactivity disorder (ADHD) and typically-developing children (TC) in Korea. METHODS The Korean version of the WISC-IV and the Advanced Test of Attention (ATA) were administered to 377 children and adolescents: 224 with ADHD (age 8.2±2.1 years, 182 boys) and 153 TC (age 8.7±2.4 years, 68 boys). Partial correlation and an analysis of covariance were used to investigate the relationship between the scores of the WISC-IV and the ATA. RESULTS The mean score of the full-scale intelligence quotient was lower in ADHD children than in TC (p<0.001). In analyses controlling for gender and with the full-scale intelligence quotient as a covariate, the working memory index (WMI) (p<0.001) and values of the Digit span subtest (p=0.001) of the WISC-IV were lower in the ADHD group than in TC. The WMI (r=-0.26, p<0.001) and its subtest Arithmetic scores (r=-0.25, p<0.001) were negatively correlated with Commission errors on the auditory ATA. CONCLUSION Children with ADHD have significantly lower WMI scores, which were clinically correlated with Commission errors on the auditory task of the ATA. Thus, the WMI is an indicator of attention deficit in children with ADHD.
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Affiliation(s)
- Yangsik Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min Kyung Koh
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kee Jeong Park
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun-Jeong Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Go Eun Yu
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyo-Won Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Takeda T, Nakashima Y, Tsuji Y. Discrepancies in Wechsler Adult Intelligent Scale III profile in adult with and without attention-deficit hyperactivity disorder. Neuropsychopharmacol Rep 2020; 40:166-174. [PMID: 32333645 PMCID: PMC7722665 DOI: 10.1002/npr2.12106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/17/2019] [Accepted: 01/31/2020] [Indexed: 11/25/2022] Open
Abstract
Aim The Wechsler Adult Intelligent Scale (WAIS) is the most frequently administered cognitive assessment for adult Attention‐deficit hyperactivity disorder (ADHD); therefore, identifying discrepancies in WAIS profile in patients and comparing with matched controls would be clinically and diagnostically beneficial. Methods The WAIS‐III profiles of 50 adults with ADHD were compared to an age‐matched typical development (TD) group. Results The adult ADHD group exhibited significantly lower WAIS‐III working memory (WM) and processing speed (PS) indices. However, these differences disappeared when intelligence quotient (IQ), Beck Depression Inventory (BDI) score, or Autism Quotient (AQ) score was included as a covariate. The adult ADHD group also demonstrated significantly lower scores in several WM‐ and PS‐domain subscales, while crystallized abilities were comparatively preserved. Additionally, only a small portion of participants in both groups lacked any significant gaps between WAIS‐III verbal and performance IQ scores (VIQ–PIQ) or associated indices. Discussion This study confirms previous findings that adult ADHD patients have deficits in WM and PS. However, it is highly likely that comorbidities such as depression and autism spectrum disorder contribute to lower WM and PS scores in adult ADHD. Unexpectedly, a “flat profile” is uncommon even in TD adults. Therefore, clinician should assess how WAIS deficits affect daily life rather than merely considering an uneven WAIS profile when diagnosing and treating adult ADHD. Although attention‐deficit hyperactivity disorder adults have lower scores of WM and PS in WAIS‐III, the comorbidities such as depression considerably contribute to these findings. Significant discrepancies in VIQ‐PIA and among index scores are common even in TD adults.![]()
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Affiliation(s)
- Toshinobu Takeda
- Department of Clinical Psychology, Ryukoku University, Kyoto, Japan
| | - Youta Nakashima
- Rakuwakai Otowa Hospital Department of Clinical Psychology, Kyoto, Japan
| | - Yui Tsuji
- Graduate School of Psychological Science, Health Science University of Hokkaido, Sapporo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
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Early Attentional Modulation by Working Memory Training in Young Adult ADHD Patients during a Risky Decision-Making Task. Brain Sci 2020; 10:brainsci10010038. [PMID: 31936483 PMCID: PMC7017173 DOI: 10.3390/brainsci10010038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/17/2019] [Accepted: 01/03/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Working memory (WM) deficits and impaired decision making are among the characteristic symptoms of patients affected by attention deficit/hyperactivity disorder (ADHD). The inattention associated with the disorder is likely to be due to functional deficits of the neural networks inhibiting irrelevant sensory input. In the presence of unnecessary information, a good decisional process is impaired and ADHD patients tend to take risky decisions. This study is aimed to test the hypothesis that the level of difficulty of a WM training (WMT) is affecting the top-down modulation of the attentional processes in a probabilistic gambling task. Methods: Event-related potentials (ERP) triggered by the choice of the amount wagered in the gambling task were recorded, before and after WMT with a the dual n-back task, in young ADHD adults and matched controls. For each group of participants, randomly assigned individuals were requested to perform WMT with a fixed baseline level of difficulty. The remaining participants were trained with a performance-dependent adaptive n-level of difficulty. Results: We compared the ERP recordings before and after 20 days of WMT in each subgroup. The analysis was focused on the time windows with at least three recording sites showing differences before and after training, after Bonferroni correction ( p < 0.05 ). In ADHD, the P1 wave component was selectively affected at frontal sites and its shape was recovered close to controls' only after adaptive training. In controls, the strongest contrast was observed at parietal level with a left hemispheric dominance at latencies near 900 ms, more after baseline than after adaptive training. Conclusion: Partial restoration of early selective attentional processes in ADHD patients might occur after WMT with a high cognitive load. Modified frontal sites' activities might constitute a neural marker of this effect in a gambling task. In controls, conversely, an increase in late parietal negativity might rather be a marker of an increase in transfer effects to fluid intelligence.
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36
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Kennedy RJ, Quinlan DM, Brown TE. Comparison of Two Measures of Working Memory Impairments in 220 Adolescents and Adults With ADHD. J Atten Disord 2019; 23:1838-1843. [PMID: 27485506 DOI: 10.1177/1087054716661232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: This study tests the hypotheses that (a) adolescents and adults with ADHD score lower on two normed measures of verbal working memory, relative to their overall verbal abilities, than the general population and (b) a specific story memory test is a more sensitive and relevant measure of working memory impairment than a numerically based test. Method: Scores on normed story memory and numerical memory tests of 220 adolescents and adults with ADHD were corrected for the individual's verbal abilities and compared with each other and national norms. Results: Participants with ADHD scored significantly below their verbal ability measure on both verbal and numerically based memory tests in comparison with national norms. Scores on verbal memory test were lower than scores for numerically based memory tests. Conclusion: This story memory test is a more sensitive measure of working memory impairments in adolescents and adults with ADHD than measures based on recall of numerical data.
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Affiliation(s)
| | | | - Thomas E Brown
- Keck School of Medicine of University of Southern California, Los Angeles, USA.,Brown Clinic for Attention & Related Disorders, Hamden, CT, USA
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37
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Merz ZC, Lace JW, Eisenstein AM, Grant AF. Examination of Wechsler adult Intelligence Scale-Fourth Edition short-form IQ estimations in an outpatient psychoeducational sample. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:707-716. [PMID: 31747821 DOI: 10.1080/23279095.2019.1687480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The Wechsler Adult Intelligence Scale, 4th edition (WAIS-IV) is a commonly utilized cognitive battery across many clinical settings. However, due to various patient variables, an abbreviated assessment of intellectual abilities, may be clinically advantageous to allow for a more thorough assessment of other cognitive domains. The current study represents an attempt to propose additional short-form IQ estimations in an outpatient clinical sample. METHODS We examined archival data from 318 concurrent psychological/psychoeducational evaluations performed within a university clinic (Mage = 28.67; 53.8% women). Thirty-six unique 4-subtest short-form IQ combinations were created to ensure that each WAIS-IV index score was represented by a single subtest. RESULTS Complete data for the ten core subtests and FSIQ were available for 192 cases. Stepwise regression analyses revealed three short-form combinations that significantly accounted for unique variance in true FSIQ scores in the final model (R2 = .981, F[3, 188] = 3257.597, p < .001). Regression-based and prorated FSIQ estimates were calculated, and both methods revealed that approximately 70-75% of participants' FSIQ estimates fell within five Standard Score points of true FSIQ. CONCLUSION Results suggest the utility of three derived 4-subtest short-form IQ estimations for use within a clinical sample.
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Affiliation(s)
- Zachary C Merz
- Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John W Lace
- Psychology, Saint Louis University, St. Louis, MO, USA
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Abstract
Zusammenfassung. Die Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) gehört zu den besonders häufigen psychischen Störungen des Kindes- und Jugendalters. Traditionelle Ansätze der Diagnostik und Behandlung weisen erhebliche Defizite auf, wodurch vielfältige Forschungsaktivitäten begründet sind. Die Bedeutung von kognitiven (neuropsychologischen) Aspekten der ADHS wurde jahrelang kritisch diskutiert. Mittlerweile liegen jedoch überzeugende Argumente dafür vor, diese Sichtweise im Rahmen der Diagnostik und Therapie stärker zu berücksichtigen. Vor allem kommt der Erfassung der Exekutivfunktionen eine größere Bedeutung zu. Neue Ansätze in diesem Bereich werden diskutiert.
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Affiliation(s)
- Ulrike Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Moura O, Costa P, Simões MR. WISC-III Cognitive Profiles in Children with ADHD: Specific Cognitive Impairments and Diagnostic Utility. The Journal of General Psychology 2019; 146:258-282. [PMID: 30729871 DOI: 10.1080/00221309.2018.1561410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This study aimed to investigate the presence of specific cognitive impairments and the diagnostic utility of the WISC-III in children with ADHD. Ninety-eight children with ADHD and 81 children without ADHD matched by age and gender (control group), between the ages of 6 and 12 years, participated in the study. Children with ADHD revealed the most pronounced deficits in the subtests tapping working memory and processing speed. Freedom from Distractibility was the cognitive profile most impaired and that showed the highest diagnostic accuracy to discriminate children with ADHD. The optimal cutoff scores of the most common WISC-III cognitive profiles revealed greater diagnostic accuracy than the traditional approach of full or partial profiles. Taken together, these results suggested that in the context of a comprehensive psychological assessment, the WISC may provide knowledge about the specific cognitive strengths and weaknesses that characterize this disorder and may be useful in the decision-making process relative to ADHD diagnosis.
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40
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Wallinius M, Nordholm J, Wagnström F, Billstedt E. Cognitive functioning and aggressive antisocial behaviors in young violent offenders. Psychiatry Res 2019; 272:572-580. [PMID: 30616126 DOI: 10.1016/j.psychres.2018.12.140] [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] [Received: 06/07/2018] [Revised: 12/19/2018] [Accepted: 12/26/2018] [Indexed: 11/15/2022]
Abstract
Studies have shown that offenders have impaired cognitive abilities yet it is unclear if cognitive dysfunction per se contributes to aggressive antisocial behaviors. Our aims were to (1) determine associations between cognitive functioning and different forms of aggressive antisocial behaviors, (2) describe prevalence of, and covariates to, uneven intellectual profiles, and (3) investigate associations between cognitive functioning and age at onset of aggressive antisocial behaviors. A cohort (n = 269) of 18-25 years old male violent offenders were assessed for general intellectual functioning with the Wechsler Adult Intelligence Scales-third edition, and for executive functions with the Cambridge Neuropsychological Test Automated Battery. Only one measure of cognitive functioning - slower reaction times in a response inhibition test - was significantly correlated with higher occurrence of aggressive, but not exclusively antisocial, behaviors. Furthermore, offenders with even intellectual profiles showed more aggressive antisocial behaviors than offenders with uneven intellectual profiles. Finally, increased errors in tests of cognitive flexibility and slower reaction times in a response inhibition test were associated with a younger age at onset of general, but not exclusively violent, criminality. Overall, effect sizes were small. The findings emphasize the need of research investigating how cognitive functioning in offenders affects susceptibility to treatment interventions.
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Affiliation(s)
- Märta Wallinius
- Lund University, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden; Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Regional Forensic Psychiatric Clinic Växjö, Sweden.
| | - Johannes Nordholm
- General Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fredrik Wagnström
- Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
| | - Eva Billstedt
- Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden
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41
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Pauls F, Daseking M, Jacobs C, Werpup L, Petermann F. Intelligenzdiagnostik bei Kindern und Jugendlichen mit ADHS. KINDHEIT UND ENTWICKLUNG 2018. [DOI: 10.1026/0942-5403/a000256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Zusammenfassung. Mit seiner neuartigen Indexstruktur bietet die Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V; Wechsler, 2014 , 2017 ) eine differenzierte Messung kognitiver Fähigkeiten. Es wurden die Leistungen von Kindern und Jugendlichen mit ADHS (n = 103) in der WISC-V mit einer parallelisierten Kontrollgruppe verglichen. Zusätzlich zur Analyse der Leistungen auf signifikante Gruppenunterschiede wurden für alle fünf Indexwerte, den Gesamt-IQ sowie die entsprechenden Untertests Effektgrößen bestimmt und miteinander verglichen. Für die Kinder mit ADHS zeigten sich auf allen fünf Indizes und dem Gesamt-IQ signifikant niedrigere Leistungen, wobei die größten Effekte in den Bereichen Arbeitsgedächtnis, Fluides Schlussfolgern und Gesamt-IQ gefunden wurden. Spezifische Minderleistungen bei ADHS ließen sich auch auf Untertestebene identifizieren. Die Ergebnisse der vorliegenden Studie bestätigen, dass die WISC-V als valides und sensibles Instrument zur Erfassung kognitiver Defizite bei Kindern mit Aufmerksamkeitsstörungen angesehen werden kann. In der klinischen Praxis kann die WISC-V-Profilanalyse wichtige Informationen zu einer vorab diagnostizierten ADHS liefern.
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Affiliation(s)
- Franz Pauls
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Monika Daseking
- Helmut-Schmidt-Universität/Universität der Bundeswehr, Hamburg
| | | | - Lina Werpup
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
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Calamia M, Hill BD, Musso MW, Pella RD, Gouvier WD. Factor structure and clinical correlates of the 61-item Wender Utah Rating Scale (WURS). ACTA ACUST UNITED AC 2018; 10:177-188. [PMID: 29427262 DOI: 10.1007/s12402-018-0251-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 02/02/2018] [Indexed: 12/14/2022]
Abstract
The objective of this study was to assess the factor structure and clinical correlates of a 61-item version of the Wender Utah Rating Scale (WURS), a self-report retrospective measure of childhood problems, experiences, and behavior used in ADHD assessment. Given the currently mostly widely used form of the WURS was derived via a criterion-keyed approach, the study aimed to use latent variable modeling of the 61-item WURS to potentially identify more and more homogeneous set of items reflecting current conceptualizations of ADHD symptoms. Exploratory structural equation modeling was used to generate factor scores which were then correlated with neuropsychological measures of intelligence and executive attention as well as a broad measure of personality and emotional functioning. Support for a modified five-factor model was found: ADHD, disruptive mood and behavior, negative affectivity, social confidence, and academic problems. The ADHD factor differed somewhat from the traditional 25-item WURS short form largely through weaker associations with several measures of personality and psychopathology. This study identified a factor more aligned with DSM-5 conceptualization of ADHD as well as measures of other types of childhood characteristics and symptoms which may prove useful for both research and clinical practice.
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Affiliation(s)
| | | | - Mandi W Musso
- Our Lady of the Lake Regional Medical Center, Baton Rouge, LA, USA
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Geffen J, Forster K. Treatment of adult ADHD: a clinical perspective. Ther Adv Psychopharmacol 2018; 8:25-32. [PMID: 29344341 PMCID: PMC5761907 DOI: 10.1177/2045125317734977] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/21/2017] [Indexed: 12/22/2022] Open
Abstract
Adult attention deficit/hyperactivity disorder (ADHD) has moved from the blurred edge of clinical focus to clear recognition as a prevalent and significant disorder in its own right. It is a relatively common comorbidity which if identified and treated may open the door to better outcomes for hard-to-treat patients. Conversely, failure to identify and treat adult ADHD is linked to negative outcomes. The recognition of the importance of adult ADHD in a subset of our patients challenges us to overcome our anxiety about this diagnosis and prevent the societal marginalization of vulnerable patients. Adult ADHD responds well to integrated pharmacological and psychotherapeutic intervention. Its treatment responsiveness reduces disability and allows the comorbidity which is typically present to be addressed. Mastering this challenge can make the diagnosis and treatment of adult ADHD a rewarding experience.
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Affiliation(s)
- Josh Geffen
- Toowong Specialist Clinic, 2/54 Jephson St, Toowong, Brisbane, Queensland, 4066, Australia
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44
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van Dongen LCM, Wingbermühle E, Oomens W, Bos-Roubos AG, Ockeloen CW, Kleefstra T, Egger JIM. Intellectual Profiles in KBG-Syndrome: A Wechsler Based Case-Control Study. Front Behav Neurosci 2017; 11:248. [PMID: 29311865 PMCID: PMC5742227 DOI: 10.3389/fnbeh.2017.00248] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 12/06/2017] [Indexed: 12/18/2022] Open
Abstract
KBG syndrome is a neurodevelopmental disorder (NDD) caused by loss-of-function of the ANKRD11 gene. The core phenotype comprises developmental delay (DD)/ intellectual disability (ID) and several specific facial dysmorphisms. In addition, both ADHD- and ASD-related symptoms have been mentioned. For the correct understanding of these developmental and behavioral characteristics however, it is of great importance to apply objective measures, which seldom has been done in patients with KBG syndrome. In this study, intelligence profiles of patients with KBG syndrome (n = 18) were compared with a control group comprising patients with NDD caused by various other genetic defects (n = 17), by means of the Wechsler scales. These scales were also used to measure speed of information processing, working memory, verbal comprehension and perceptual reasoning. No significant differences were found in the global level of intelligence of patients with KBG syndrome as compared to the patient genetic control group. The same was true for Wechsler subtest results. Hence, behavioral problems associated with KBG syndrome cannot directly be related to or explained by a specific intelligence profile. Instead, specific assessment of neurocognitive functions should be performed to clarify the putative behavioral problems as observed in this syndrome.
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Affiliation(s)
- Linde C M van Dongen
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands.,Department of Human Genetics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Ellen Wingbermühle
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Wouter Oomens
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Anja G Bos-Roubos
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Charlotte W Ockeloen
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Tjitske Kleefstra
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands.,Department of Human Genetics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Jos I M Egger
- Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands.,Department of Human Genetics, Radboud University Medical Centre, Nijmegen, Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
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Brunner D, Abramovitch A, Etherton J. A yoga program for cognitive enhancement. PLoS One 2017; 12:e0182366. [PMID: 28783749 PMCID: PMC5544241 DOI: 10.1371/journal.pone.0182366] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 07/17/2017] [Indexed: 12/17/2022] Open
Abstract
Background Recent studies suggest that yoga practice may improve cognitive functioning. Although preliminary data indicate that yoga improves working memory (WM), high-resolution information about the type of WM subconstructs, namely maintenance and manipulation, is not available. Furthermore, the association between cognitive enhancement and improved mindfulness as a result of yoga practice requires empirical examination. The aim of the present study is to assess the impact of a brief yoga program on WM maintenance, WM manipulation and attentive mindfulness. Methods Measures of WM (Digit Span Forward, Backward, and Sequencing, and Letter-Number Sequencing) were administered prior to and following 6 sessions of yoga (N = 43). Additionally, the Mindfulness Attention Awareness Scale was administered to examine the potential impact of yoga practice on mindfulness, as well as the relationships among changes in WM and mindfulness. Results Analyses revealed significant improvement from pre- to post- training assessment on both maintenance WM (Digit Span Forward) and manipulation WM (Digit Span Backward and Letter-Number Sequencing). No change was found on Digit Span Sequencing. Improvement was also found on mindfulness scores. However, no correlation was observed between mindfulness and WM measures. Conclusions A 6-session yoga program was associated with improvement on manipulation and maintenance WM measures as well as enhanced mindfulness scores. Additional research is needed to understand the extent of yoga-related cognitive enhancement and mechanisms by which yoga may enhance cognition, ideally by utilizing randomized controlled trials and more comprehensive neuropsychological batteries.
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Affiliation(s)
- Devon Brunner
- Department of Psychology, Texas State University, San Marcos, Texas, United States of America
- * E-mail:
| | - Amitai Abramovitch
- Department of Psychology, Texas State University, San Marcos, Texas, United States of America
| | - Joseph Etherton
- Department of Psychology, Texas State University, San Marcos, Texas, United States of America
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Carlozzi NE, Kirsch NL, Kisala PA, Tulsky DS. An examination of the Wechsler Adult Intelligence Scales, Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate and Severe traumatic brain injury (TBI). Clin Neuropsychol 2015; 29:21-37. [PMID: 25646823 DOI: 10.1080/13854046.2015.1005677] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined the clinical utility of the Wechsler Adult Intelligence Scales-Fourth Edition (WAIS-IV) in individuals with complicated mild, moderate or severe TBI. One hundred individuals with TBI (n = 35 complicated mild or moderate TBI; n = 65 severe TBI) and 100 control participants matched on key demographic variables from the WAIS-IV normative dataset completed the WAIS-IV. Univariate analyses indicated that participants with severe TBI had poorer performance than matched controls on all index scores and subtests (except Matrix Reasoning). Individuals with complicated mild/moderate TBI performed more poorly than controls on the Working Memory Index (WMI), Processing Speed Index (PSI), and Full Scale IQ (FSIQ), and on four subtests: the two processing speed subtests (SS, CD), two working memory subtests (AR, LN), and a perceptual reasoning subtest (BD). Participants with severe TBI had significantly lower scores than the complicated mild/moderate TBI on PSI, and on three subtests: the two processing speed subtests (SS and CD), and the new visual puzzles test. Effect sizes for index and subtest scores were generally small-to-moderate for the group with complicated mild/moderate and moderate-to-large for the group with severe TBI. PSI also showed good sensitivity and specificity for classifying individuals with severe TBI versus controls. Findings provide support for the clinical utility of the WAIS-IV in individuals with complicated mild, moderate, and severe TBI.
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Affiliation(s)
- Noelle E Carlozzi
- a Department of Physical Medicine and Rehabilitation , University of Michigan , Ann Arbor , Michigan 48109-2800 , USA
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Connectivity supporting attention in children with attention deficit hyperactivity disorder. NEUROIMAGE-CLINICAL 2014; 7:68-81. [PMID: 25610768 PMCID: PMC4299959 DOI: 10.1016/j.nicl.2014.11.011] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 11/04/2014] [Accepted: 11/14/2014] [Indexed: 01/15/2023]
Abstract
Intra-subject variability (ISV) is the most consistent behavioral deficit in Attention Deficit Hyperactivity Disorder (ADHD). ISV may be associated with networks involved in sustaining task control (cingulo-opercular network: CON) and self-reflective lapses of attention (default mode network: DMN). The current study examined whether connectivity supporting attentional control is atypical in children with ADHD. Group differences in full-brain connection strength and brain–behavior associations with attentional control measures were examined for the late-developing CON and DMN in 50 children with ADHD and 50 typically-developing (TD) controls (ages 8–12 years). Children with ADHD had hyper-connectivity both within the CON and within the DMN. Full-brain behavioral associations were found for a number of between-network connections. Across both groups, more anti-correlation between DMN and occipital cortex supported better attentional control. However, in the TD group, this brain–behavior association was stronger and occurred for a more extensive set of DMN–occipital connections. Differential support for attentional control between the two groups occurred with a number of CON–DMN connections. For all CON–DMN connections identified, increased between-network anti-correlation was associated with better attentional control for the ADHD group, but worse attentional control in the TD group. A number of between-network connections with the medial frontal cortex, in particular, showed this relationship. Follow-up analyses revealed that these associations were specific to attentional control and were not due to individual differences in working memory, IQ, motor control, age, or scan motion. While CON–DMN anti-correlation is associated with improved attention in ADHD, other circuitry supports improved attention in TD children. Greater CON–DMN anti-correlation supported better attentional control in children with ADHD, but worse attentional control in TD children. On the other hand, greater DMN–occipital anti-correlation supported better attentional control in TD children. Children with ADHD are hyper-connected within both the CON and DMN. More DMN–Visual antagonism supports better attention, particularly in controls. More DMN–CON antagonism supports better attention only in children with ADHD. CON–DMN compensation for attention may be due to stimulant medication use.
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