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Liu X, Yang Y, Ye Z, Wang F, Zeng K, Sun Y, Huang Y, Dai L. The effect of digital interventions on attention deficit hyperactivity disorder (ADHD): A meta-analysis of randomized controlled trials. J Affect Disord 2024; 365:563-577. [PMID: 39191306 DOI: 10.1016/j.jad.2024.08.156] [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: 03/08/2024] [Revised: 08/18/2024] [Accepted: 08/23/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity. Individuals with ADHD often encounter heightened emotional and behavioral challenges. This study aims to conduct a meta-analysis of the efficacy of digital interventions in improving symptoms of ADHD. METHODS This study searched 6 databases for English articles from database construction until December 4, 2023. Randomized controlled trials employing digital interventions for ADHD were gathered. Following the Cochrane Collaboration criteria, Review Manager 5.3 software was utilized to evaluate the risk of bias present in the included papers. Mean differences for post-intervention and follow-up data were standardized using Stata 18.0 software. Subgroup analysis was employed to investigate the sources of heterogeneity. The study adhered to the PRISMA guidelines and was registered on the PROSPERO platform (CRD42024504134). RESULTS This review included a total of 25 randomized controlled trials (RCTs). The combined study population comprised 1780 cases. In the digital intervention groups, there was a significant decrease in overall ADHD symptoms (SMD = -0.33; 95 % CI = [-0.51, -0.16]) compared to the control groups. Furthermore, there was a significant reduction in inattention symptoms (SMD = -0.31; 95 % CI = [-0.46, -0.15]) and hyperactivity/impulsivity symptoms (SMD = -0.15; 95 % CI = [-0.29, -0.02]) within the digital intervention groups. CONCLUSION The digital interventions proved beneficial for individuals with ADHD by alleviating symptoms of ADHD, inattention, and hyperactivity/impulsivity.
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Affiliation(s)
- Xin Liu
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Yawen Yang
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Zhiyu Ye
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Fang Wang
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Kuan Zeng
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Ye Sun
- Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Ying Huang
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lisha Dai
- School of Education Research, China University of Geosciences, Wuhan, China; Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Psychosomatic Department, Wuhan Mental Health Center, Wuhan, China; Psychosomatic Department, Wuhan Hospital for Psychotherapy, Wuhan, China.
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Dentz A, Soelch CM, Fahim C, Torsello A, Parent V, Ponsioen A, Guay MC, Bioulac-Rogier S, Clément C, Bader M, Romo L. Non-pharmacological treatment of Attention Deficit Disorder with or without Hyperactivity (ADHD). Overview and report of the first international symposium on the non-pharmacological management of ADHD. L'ENCEPHALE 2024; 50:309-328. [PMID: 38326137 DOI: 10.1016/j.encep.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/24/2023] [Indexed: 02/09/2024]
Abstract
Attention Deficit Disorder with or without Hyperactivity (ADHD is a neurodevelopmental disorder which affects the day-to-day functioning of children and adults with this condition. Pharmacological treatment can reduce the symptoms associated with ADHD, but it has some limitations. The objective of this symposium is to determine the effects of non-pharmacological approaches on ADHD symptoms. Results indicate that the following intervention are promising approaches: cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), yoga, cognitive and metacognitive intervention, neurofeedback and parental training programs. Current research advocates multimodal approaches in conjunction with school or work accommodations integrating innovative technologies.
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Affiliation(s)
- Amélie Dentz
- Université de Fribourg, Département de Psychologie, rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland.
| | - Chantal Martin Soelch
- Université de Fribourg, Département de Psychologie, rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland
| | - Cherine Fahim
- Université de Fribourg, Département de Psychologie, rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland
| | - Alexandra Torsello
- Université de Fribourg, Département de Psychologie, rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland
| | | | | | | | | | - Céline Clément
- Laboratoire Interuniversitaire des Sciences de l'Education et de la Communication (EA 2310), Université de Strasbourg, Strasbourg, France
| | - Michel Bader
- Unité de Recherche, Service de Psychiatrie de l'Enfant et de l'adolescent (SUPEA - DP CHUV), Lausanne, Switzerland
| | - Lucia Romo
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre Université, Nanterre, France
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3
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Guo N, Fuermaier ABM, Koerts J, Tucha O, Scherbaum N, Müller BW. Networks of Neuropsychological Functions in the Clinical Evaluation of Adult ADHD. Assessment 2023; 30:1719-1736. [PMID: 36031877 PMCID: PMC10363951 DOI: 10.1177/10731911221118673] [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] [Indexed: 11/16/2022]
Abstract
This study applied network analysis to explore the relations between neuropsychological functions of individuals in the clinical evaluation of attention-deficit/hyperactivity disorder (ADHD) in adulthood. A total of 319 participants from an outpatient referral context, that is, 173 individuals with ADHD (ADHD group) and 146 individuals without ADHD (n-ADHD group), took part in this study and completed a comprehensive neuropsychological assessment. A denser network with stronger global connectivity was observed in the ADHD group compared to the n-ADHD group. The strongest connections were consistent in both networks, that is, the connections between selective attention and vigilance, and connections between processing speed, fluency, and flexibility. Further centrality estimation revealed attention-related variables to have the highest expected influence in both networks. The observed relationships between neuropsychological functions, and the high centrality of attention, may help identify neuropsychological profiles that are specific to ADHD and optimize neuropsychological assessment and treatment planning of individuals with cognitive impairment.
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Affiliation(s)
- Nana Guo
- University of Groningen, The Netherlands
| | | | | | - Oliver Tucha
- University of Groningen, The Netherlands
- University Medical Center Rostock, Germany
- Maynooth University, Ireland
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Mette C. Time Perception in Adult ADHD: Findings from a Decade-A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3098. [PMID: 36833791 PMCID: PMC9962130 DOI: 10.3390/ijerph20043098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Time perception is impaired in adult ADHD. Since the term time perception subsumes different constructs, including time estimation, time reproduction, time production, and duration discrimination, it remains open whether certain domains are more affected than other domains in adult ADHD. The aim of this explorative review is to present the current state of research on time perception in adult ADHD by analysing studies from the past 10 years. A review of the literature addressing adult ADHD time perception, time estimation, and time reproduction was performed. The search strategy was conducted by using the databases "PubMed", "Medline", and "PSYNDEX". The results of the present review indicate that the number of studies on time perception in adult ADHD is very scarce. Moreover, the main investigated domains of time perception in the past decade were time estimation, time reproduction and time management. Whereas some of the found studies were able to demonstrate a distinct deficit in time estimation, time reproduction and time management other studies were unable to demonstrate a clear association between ADHD and time estimation and time reproduction deficits. However, the diagnostic protocols, study design, and methodology varied between studies. Further studies on time estimation and time reproduction need to be carried out.
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Affiliation(s)
- Christian Mette
- Department of Psychology, Immanuel-Kant-Str. 18-20, Protestant University of Applied Sciences, 44809 Bochum, Germany
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5
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Surman CBH, Walsh DM. Do ADHD Treatments Improve Executive Behavior Beyond Core ADHD Symptoms in Adults? Evidence From Systematic Analysis of Clinical Trials. J Clin Pharmacol 2023; 63:640-653. [PMID: 36731171 DOI: 10.1002/jcph.2209] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/26/2023] [Indexed: 02/04/2023]
Abstract
We sought to understand the effect of current treatments for attention deficit hyperactivity disorder (ADHD) on executive functioning deficits, which are often comorbid with ADHD, via a systematic analysis of adult ADHD treatment studies evaluating change in behavioral measures beyond the core symptoms of Diagnostic and Statistical Manual of Mental Disorders ADHD. The standardized mean difference for behavioral measures of executive functioning was determined from controlled trials of adults with ADHD and compared with effects on core ADHD symptoms. Several studies of atomoxetine revealed small to large standardized mean differences. Nonreplicated studies revealed small to medium effects for triple-bead mixed amphetamine salts, lisdexamfetamine, and forms of cognitive behavioral therapy. Proportional effect versus core ADHD symptoms ranged from 0.78 to 1.16 for atomoxetine, and from 0.65 to 1.44 across all the studies. ADHD treatments have effects on executive functioning behavior beyond core ADHD symptoms in adults. Clinicians can measure and treat this morbidity using available clinical tools.
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Affiliation(s)
- Craig B H Surman
- Clinical and Research Program in ADHD and Related Disorders, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Daniel M Walsh
- Clinical and Research Program in ADHD and Related Disorders, Massachusetts General Hospital, Boston, Massachusetts, USA
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6
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Scholz L, Werle J, Philipsen A, Schulze M, Collonges J, Gensichen J. Effects and feasibility of psychological interventions to reduce inattention symptoms in adults with ADHD: a systematic review. J Ment Health 2023; 32:307-320. [PMID: 32954909 DOI: 10.1080/09638237.2020.1818189] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Adult ADHD is common, highly comorbid, and restricts daily functioning. However, only a minority of patients receive appropriate treatment. AIMS Primary objective: To identify psychological interventions that diminish inattention symptoms in adults with ADHD. Secondary objective: To evaluate feasibility aspects. METHODS A search in PubMed, Cochrane Library, PsycInfo, PSYNDEX, and Eric was conducted. Interventions were grouped in: ADHD coaching, neuro feedback, cognitive training, psychoeducation, and behavioral therapy. Inattention symptoms were evaluated using standardized mean differences. Study quality was rated with the Cochrane Risk of Bias tool. Feasibility was assessed by number and time of sessions, setting, and qualification of the provider. RESULTS A total of N = 2229 results were identified, 19 randomized controlled studies were included in the analysis. Behavioral therapy showed effects on inattention symptoms [SMD: 0.44-1.71] when compared to inactive controls. In terms of feasibility, longer interventions did not outperform shorter ones and individual sessions were not superior to group sessions. No effects were given for neuro feedback, cognitive training, and psychoeducation in comparison to controls. CONCLUSION For adults with ADHD behavioral therapy seems an effective intervention to reduce inattention symptoms. In terms of feasibility, brief interventions may be valuable for a primary care setting.
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Affiliation(s)
- Lisanne Scholz
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Jana Werle
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Marcel Schulze
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | | | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Munich, Germany
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7
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Selaskowski B, Asché LM, Wiebe A, Kannen K, Aslan B, Gerding TM, Sanchez D, Ettinger U, Kölle M, Lux S, Philipsen A, Braun N. Gaze-based attention refocusing training in virtual reality for adult attention-deficit/hyperactivity disorder. BMC Psychiatry 2023; 23:74. [PMID: 36703134 PMCID: PMC9879564 DOI: 10.1186/s12888-023-04551-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is characterized by substantial interindividual heterogeneity that challenges the systematic assessment and treatment. Considering mixed evidence from previous neurofeedback research, we present a novel feedback system that relies on gaze behavior to detect signs of inattention while performing a neuropsychological attention task in a virtual seminar room. More specifically, an audiovisual feedback was given whenever participants averted their gaze from the given task. METHODS Eighteen adults with ADHD and 18 healthy controls performed a continuous performance task (CPT) in virtual reality under three counterbalanced conditions in which either gaze-based feedback, sham feedback, or no feedback was provided. In all conditions, phases of high and low virtual distraction alternated. CPT errors and reaction times, proportions of gaze dwell times (e.g., task focus or distraction focus), saccade characteristics, EEG theta/beta ratios, head movements, and an experience sampling of ADHD symptoms were analyzed. RESULTS While patients can be discriminated well from healthy controls in that they showed more omission errors, higher reaction times, higher distraction-related dwell times, and more head movements, the feedback did not immediately improve task performance. It was also indicated that sham feedback was rather associated with an aggravation of symptoms in patients. CONCLUSIONS Our findings demonstrate sufficient suitability and specificity for this holistic ADHD symptom assessment. Regarding the feedback, a single-session training was insufficient to achieve learning effects based on the proposed metacognitive strategies. Future longitudinal, multi-session trials should conclusively examine the therapeutic efficacy of gaze-based virtual reality attention training in ADHD. TRIAL REGISTRATION drks.de (identifier: DRKS00022370).
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Affiliation(s)
- Benjamin Selaskowski
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Marie Asché
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Annika Wiebe
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Kyra Kannen
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Behrem Aslan
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Thiago Morano Gerding
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Dario Sanchez
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Ulrich Ettinger
- grid.10388.320000 0001 2240 3300Department of Psychology, University of Bonn, Bonn, Germany
| | - Markus Kölle
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Silke Lux
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- grid.15090.3d0000 0000 8786 803XDepartment of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany.
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8
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Zhang DW. Perspectives on heterogeneity-informed cognitive training for attention-deficit/hyperactivity disorder. Front Psychiatry 2023; 13:1100008. [PMID: 36713921 PMCID: PMC9878183 DOI: 10.3389/fpsyt.2022.1100008] [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: 11/16/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (AD/HD) is a heterogeneous neurodevelopmental condition, posing a severe threat to quality of life. Pharmacological therapies are the front-line treatment; however, their shortages encourage the development of alternative treatments for AD/HD. One promising method of developing alternative treatments is cognitive training (CT). A CT-based therapy was recently approved by the US Food and Drug Administration. However, due to heterogeneity in AD/HD, a CT protocol is unlikely to provide a one-size-fits-all solution for all patients with AD/HD. Therefore, this article highlights key aspects that need to be considered to further develop CT protocols for AD/HD, regarding training content, timing, suitability, and delivery mode. The perspectives presented here contribute to optimizing CT as an alternative option for treating AD/HD.
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Affiliation(s)
- Da-Wei Zhang
- Department of Psychology and Center for Place-Based Education, Yangzhou University, Yangzhou, China
- Department of Psychology, Monash University Malaysia, Bandar Sunway, Malaysia
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9
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Champ RE, Adamou M, Tolchard B. The impact of psychological theory on the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults: A scoping review. PLoS One 2021; 16:e0261247. [PMID: 34932573 PMCID: PMC8691636 DOI: 10.1371/journal.pone.0261247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 11/25/2021] [Indexed: 12/12/2022] Open
Abstract
Psychological theory and interpretation of research are key elements influencing clinical treatment development and design in Attention Deficit Hyperactivity Disorder (ADHD). Research-based treatment recommendations primarily support Cognitive Behavioural Therapy (CBT), an extension of the cognitive behavioural theory, which promotes a deficit-focused characterisation of ADHD and prioritises symptom reduction and cognitive control of self-regulation as treatment outcomes. A wide variety of approaches have developed to improve ADHD outcomes in adults, and this review aimed to map the theoretical foundations of treatment design to understand their impact. A scoping review and analysis were performed on 221 documents to compare the theoretical influences in research, treatment approach, and theoretical citations. Results showed that despite variation in the application, current treatments characterise ADHD from a single paradigm of cognitive behavioural theory. A single theoretical perspective is limiting research for effective treatments for ADHD to address ongoing issues such as accommodating context variability and heterogeneity. Research into alternative theoretical characterisations of ADHD is recommended to provide treatment design opportunities to better understand and address symptoms.
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Affiliation(s)
- Rebecca E. Champ
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Marios Adamou
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
| | - Barry Tolchard
- School of Health and Life Sciences, Teeside University, Middlesbrough, United Kingdom
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10
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Halperin JM, Marks DJ, Chacko A, Bedard AC, O'Neill S, Curchack-Lichtin J, Bourchtein E, Berwid OG. Training Executive, Attention, and Motor Skills (TEAMS): a Preliminary Randomized Clinical Trial of Preschool Youth with ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:375-389. [PMID: 31834588 DOI: 10.1007/s10802-019-00610-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This preliminary randomized controlled trial compared Training Executive, Attention and Motor Skills (TEAMS), a played-based intervention for preschool children with attention-deficit/hyperactivity disorder (ADHD), to an active comparison intervention consisting of parent education and support (ClinicalTrials.gov Identifier: NCT01462032). The primary aims were to gauge preliminary efficacy and assist in further development of TEAMS. Four- and 5-year-old children with ADHD were randomly assigned to receive TEAMS (N = 26) or the comparison intervention (N = 26) with blinded assessments by parents, teachers and clinicians ascertained pretreatment, post-treatment, and 1- and 3-months post-treatment. Changes in ADHD severity, impairment, parenting factors, and neuropsychological functioning over time as a function of treatment condition were assessed using the PROC MIXED procedure in SAS. Across most measures, significant main effects for Time emerged; both treatments were associated with reduced ADHD symptoms that persisted for three months post-treatment. There were no significant Treatment effects or Time x Treatment interactions on symptom and impairment measures, suggesting that the magnitude of improvement did not differ between the two interventions. However, significant correlations emerged between the magnitude of behavioral change, as assessed by parents and clinicians, and the amount of time families engaged in TEAMS-related activities during treatment. Across a wide array of parenting and neuropsychological measures, there were few significant group differences over time. TEAMS and other psychosocial interventions appear to provide similar levels of benefit. Play-based interventions like TEAMS represent a potentially viable alternative/addition to current ADHD treatments, particularly for young children, but more research and further development of techniques are necessary.
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Affiliation(s)
- Jeffrey M Halperin
- Psychology Department, Queens College and the Graduate Center, City University of New York, 65-30 Kissena Boulevard, Flushing, New York, 11367, USA.
| | | | - Anil Chacko
- New York University - Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
| | - Anne-Claude Bedard
- Ontario Institute for Studies in Education, the University of Toronto, Toronto, Canada
| | - Sarah O'Neill
- The City College and the Graduate Center, City University of New York, New York, NY, USA
| | | | | | - Olga G Berwid
- York College, City University of New York, New York, NY, USA
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Who benefits from computerized cognitive training? Lower processing speed predicts greater cognitive improvement. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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12
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Bleich-Cohen M, Gurevitch G, Carmi N, Medvedovsky M, Bregman N, Nevler N, Elman K, Ginou A, Zangen A, Ash EL. A functional magnetic resonance imaging investigation of prefrontal cortex deep transcranial magnetic stimulation efficacy in adults with attention deficit/hyperactive disorder: A double blind, randomized clinical trial. Neuroimage Clin 2021; 30:102670. [PMID: 34215144 PMCID: PMC8102620 DOI: 10.1016/j.nicl.2021.102670] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/19/2021] [Accepted: 04/08/2021] [Indexed: 02/09/2023]
Abstract
ADHD is one of the most prevalent neurocognitive disorders. Deep Transcranial Magnetic Stimulation (dTMS) is a non-invasive neuromodulation tool that holds promise in treatment of neurocognitive disorders. Hypoactivity of the prefrontal cortex (PFC) has been observed in ADHD. This study examined the clinical, cognitive, and neural effects of dTMS to the PFC in adults with ADHD by using functional magnetic resonance imaging (fMRI). High frequency repetitive dTMS was applied to either the right or left PFC in 62 adults with ADHD in a randomized, double blind, placebo controlled protocol with 3 study groups: 2 treatment arms (rPFC, or lPFC) and a Sham arm. The study included 15 dTMS/cognitive training treatment sessions. Clinical effects were assessed with the Conners Adult ADHD Rating Scale (CAARS) self-report and the Clinical Global Impression score (CGI) as primary outcome measures. Self-report/observer questionnaires and computerized cognitive testing were also performed to assess clinical and cognitive effects. Neural effects were assessed with fMRI using working-memory (WM) and resting-state paradigms. While the study did not show improvement in the primary endpoints, significant improvements were observed in the CAARS (self-report) inattention/memory sub-scale, as well as increased activations in the rDLPFC, right parietal-cortex and right insula/IFG during WM conditions after treatment in the right stimulation group. Increased rDLPFC activation was associated with larger symptom improvement in the right stimulation group. This study indicates that dTMS is effective in modulating attention related brain networks, and is a feasible technique that may improve attention symptoms in adults with ADHD.
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Affiliation(s)
- Maya Bleich-Cohen
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; Brainsway Ltd, Jerusalem 9777518, Israel.
| | - Guy Gurevitch
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Noa Carmi
- Sagol Brain Institute, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Mordekhay Medvedovsky
- Department of Neurology, Agnes Ginges Center of Neurogenetics, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel
| | - Noa Bregman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Naomi Nevler
- Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Karin Elman
- Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Amit Ginou
- Brainsway Ltd, Jerusalem 9777518, Israel
| | - Abraham Zangen
- Brain Stimulation and Behavior Lab, The Zlotowski Center for Neuroscience, Ben Gurion University, Beer Sheva 8410501, Israel
| | - Elissa L Ash
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
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13
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Lee TL, Yeung MK, Sze SL, Chan AS. Eye-Tracking Training Improves Inhibitory Control in Children with Attention-Deficit/Hyperactivity Disorder. Brain Sci 2021; 11:314. [PMID: 33801559 PMCID: PMC8002197 DOI: 10.3390/brainsci11030314] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/23/2022] Open
Abstract
Disinhibition is a common sign among children with attention-deficit/hyperactivity disorder (ADHD). The present study examined the effect of computerized eye-tracking training to improve inhibitory control in ADHD children. Thirty-two ADHD children (mean age = 8.4 years) were recruited. Half of the participants underwent 240 min of eye-tracking training over two weeks (i.e., experimental group), while the other half did not receive any training (i.e., control group). After training, the experimental group exhibited significant improvements in neuropsychological tests of inhibition, such as faster reaction time in the incongruent condition of the Flanker test, more unique designs in the Category Fluency and Five-Point Tests, and a faster completion time in Trail 2 of the Children's Color Trail Test. The control group did not show significant changes in any of these tests. Our findings support the use of eye-tracking training to improve the inhibitory control of ADHD children.
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Affiliation(s)
- Tsz Lok Lee
- Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China; (T.L.L.); (S.L.S.)
| | - Michael K. Yeung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Sophia L. Sze
- Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China; (T.L.L.); (S.L.S.)
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Agnes S. Chan
- Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China; (T.L.L.); (S.L.S.)
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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Testing the Mechanism of Action of Computerized Cognitive Training in Young Adults with Depression: Protocol for a Blinded, Randomized, Controlled Treatment Trial. ACTA ACUST UNITED AC 2020; 5. [PMID: 32743079 PMCID: PMC7394311 DOI: 10.20900/jpbs.20200014] [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] [Indexed: 11/20/2022]
Abstract
Background: Depression is associated with a broad range of cognitive deficits, including processing speed (PS) and executive functioning (EF). Cognitive symptoms commonly persist with the resolution of affective symptoms and increase risk of relapse and recurrence. The cognitive control network is comprised of brain areas implicated in EF and mood regulatory functions. Prior research has demonstrated the effectiveness of computerized cognitive training (CCT) focused on PS and EF in mitigating both cognitive and affective symptoms of depression. Methods: Ninety participants aged 18–29 with a current diagnosis of major depressive disorder or persistent depressive disorder, or a Hamilton Depression Rating Scale score ≥12, will be randomized to either PS/EF CCT, verbal CCT, or waitlist control. Participants in the active groups will complete 15 min of training 5 days/week for 8 weeks. Clinical and neuropsychological assessments will be completed at baseline, week 4, week 8, and 3-month follow-up. Structural and functional magnetic resonance imaging (fMRI) will be completed at baseline and week 8. We will compare changes in mood, cognition, daily functioning, and fMRI data. We will explore cognitive control network functioning using resting-state and task-based fMRI. Results: Recruitment began in October 2019; we expect to finish recruitment by April 2022 and subsequently begin data analysis. Conclusions: This study is innovative in that it will include both active and waitlist control conditions and will explore changes in neural activation. Identifying the neural networks associated with improvements following CCT will allow for the development of more precise and effective interventions. Trial Registration: ClinicalTrials.govNCT03869463; https://clinicaltrials.gov/ct2/show/NCT03869463.
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Psychological Treatments in Adult ADHD: A Systematic Review. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09794-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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16
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Gutman SA, Balasubramanian S, Herzog M, Kim E, Swirnow H, Retig Y, Wolff S. Effectiveness of a Tailored Intervention for Women With Attention Deficit Hyperactivity Disorder (ADHD) and ADHD Symptoms: A Randomized Controlled Study. Am J Occup Ther 2020; 74:7401205010p1-7401205010p11. [PMID: 32078512 DOI: 10.5014/ajot.2020.033316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Women with attention deficit hyperactivity disorder (ADHD) and ADHD symptoms may experience difficulty carrying out desired life roles and activities. OBJECTIVE To determine whether a 7-wk tailored occupation-based intervention can reduce perceived stress and ADHD symptoms and enhance perceived performance of and satisfaction with daily roles and activities among women with ADHD. DESIGN Randomization to intervention (n = 11) and control (n = 12) groups. SETTING Home and community. PARTICIPANTS Twenty-three participants ages 20-55 yr, English speaking, and with a self-reported diagnosis of ADHD. INTERVENTION The intervention was administered for 7 wk in individual 1-hr sessions and addressed routine establishment, organization, time management, stress management, and sensory regulation in the home and community. OUTCOMES AND MEASURES Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Perceived Stress Scale, and Canadian Occupational Performance Measure. RESULTS At 1-wk postintervention, statistically significant differences were found between intervention and control groups in perceived stress (Z = -3.838, p < .000, d = -2.66), ADHD symptoms (Z = -3.605, p < .000, d = -2.17), and COPM Performance (Z = -4.074, p < .000, d = 3.04) and Satisfaction change scores (Z = -3.759, p < .000, d = 2.82). CONCLUSION AND RELEVANCE A 7-wk tailored intervention reduced perceived stress and ADHD symptoms and enhanced perceived performance of and satisfaction with desired occupational roles and activities in a sample of women with ADHD. Further research is warranted to determine whether the intervention can be useful to women with ADHD beyond the present sample. WHAT THIS ARTICLE ADDS This intervention may offer an effective nonpharmacological option for women with ADHD symptoms.
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Affiliation(s)
- Sharon A Gutman
- Sharon A. Gutman, PhD, OTR, FAOTA, is Professor, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York;
| | - Sheetala Balasubramanian
- Sheetala Balasubramanian, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Maya Herzog
- Maya Herzog, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Elizabeth Kim
- Elizabeth Kim, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Hannah Swirnow
- Hannah Swirnow, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Yudis Retig
- Yudis Retig, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
| | - Samantha Wolff
- Samantha Wolff, MS, OTR, is Occupational Therapist, Programs in Occupational Therapy, Rehabilitation and Regenerative Medicine, Columbia University, New York
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Nimmo-Smith V, Merwood A, Hank D, Brandling J, Greenwood R, Skinner L, Law S, Patel V, Rai D. Non-pharmacological interventions for adult ADHD: a systematic review. Psychol Med 2020; 50:529-541. [PMID: 32036811 DOI: 10.1017/s0033291720000069] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a common developmental disorder, often persisting into adulthood. Whilst medication is first-line treatment for ADHD, there is a need for evidence-based non-pharmacological treatment options for adults with ADHD who are either still experiencing significant symptoms or for those who have made the informed choice not to start medication. METHODS We systematically searched PsycINFO, MEDLINE (Ovid), EMBASE, CINAHL and CENTRAL for randomised controlled trials of non-pharmacological treatments for ADHD in adults. After screening of titles and abstracts, full text articles were reviewed, data extracted and bias assessed using a study proforma. RESULTS There were 32 eligible studies with the largest number of studies assessing cognitive behavioural therapy (CBT). CBT consisted of either group, internet or individual therapy. CONCLUSIONS The majority found an improvement in ADHD symptoms with CBT treatment. Additionally, mindfulness and cognitive remediation have evidence as effective interventions for the core symptoms of ADHD and there is evidence for the use of group dialectical behavioural therapy and hypnotherapy. However, evidence for these is weaker due to small numbers of participants and limitations due to the lack of suitable control conditions, and a high risk of bias.
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Affiliation(s)
- Victoria Nimmo-Smith
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Andrew Merwood
- Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Dietmar Hank
- Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | | | - Rosemary Greenwood
- Research and Innovation, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Lara Skinner
- Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Sarah Law
- Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | | | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Avon & Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
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Alyagon U, Shahar H, Hadar A, Barnea-Ygael N, Lazarovits A, Shalev H, Zangen A. Alleviation of ADHD symptoms by non-invasive right prefrontal stimulation is correlated with EEG activity. NEUROIMAGE-CLINICAL 2020; 26:102206. [PMID: 32062566 PMCID: PMC7021642 DOI: 10.1016/j.nicl.2020.102206] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 01/21/2020] [Accepted: 02/03/2020] [Indexed: 12/13/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a prevalent disorder with effective pharmacological treatment that benefits most patients. However, about one-third fail to benefit while others search non-pharmacological alternatives, and for those options are scarce. One alternative treatment option is to alter abnormal right prefrontal cortex (rPFC) activity, given that rPFC abnormality has been repeatedly implicated in ADHD neurophathology. Here, we evaluated whether targeting the rPFC with multiple sessions of repetitive transcranial magnetic stimulation (rTMS), which can modulate neuronal excitability, activity, and plasticity in a non-invasive manner, will affect clinical symptoms in adults suffering from ADHD. Concomitantly, we used EEG to characterize electrophysiological alterations induced by treatment and to search for correlation between baseline neuronal activity and clinical response. Forty-three drug free adults with ADHD were randomized to receive either Real, Active Control, or Sham treatment (13 females, age ranging 21-46; n = 15, 14, 14, respectively), and underwent three weeks of daily high-frequency (18 Hz) stimulation sessions. We found that Real treatment was safe and resulted in significant improvement of symptoms (η2p = 0.34; Cohen's d(against Sham) = 0.96; Cohen's d(against AC) = 0.68; p = 0.00085). Furthermore, based on EEG recorded within the first treatment session we established a novel biomarker, composed of the Alpha and Low-gamma power, which highly correlated the magnitude of the clinical outcome (r = 0.92, p = 0.0001). Taken together, the results of this pilot study indicate safety and effectiveness of rTMS directed to the rPFC for treatment of adult ADHD patients. The biomarker is suggested to reflect the responsiveness of the cortex to this rTMS intervention. Following validation of the results in larger samples, this study may represent a step towards a non-pharmacological treatment for adults with ADHD using EEG-based selection of optimal candidates for treatment.
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Affiliation(s)
- Uri Alyagon
- Department of Life Sciences and the Zlotowski Centre for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hamutal Shahar
- Department of Life Sciences and the Zlotowski Centre for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aviad Hadar
- Department of Life Sciences and the Zlotowski Centre for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Noam Barnea-Ygael
- Department of Life Sciences and the Zlotowski Centre for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Avi Lazarovits
- Department of Life Sciences and the Zlotowski Centre for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hadar Shalev
- Psychiatry Department, Soroka Medical Center, Beer-Sheva, Israel
| | - Abraham Zangen
- Department of Life Sciences and the Zlotowski Centre for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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López-Pinar C, Martínez-Sanchís S, Carbonell-Vayá E, Sánchez-Meca J, Fenollar-Cortés J. Efficacy of Nonpharmacological Treatments on Comorbid Internalizing Symptoms of Adults With Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review. J Atten Disord 2020; 24:456-478. [PMID: 31189374 DOI: 10.1177/1087054719855685] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is highly comorbid in adulthood. This meta-analysis was aimed at ascertaining the efficacy of different psychotherapies in improving comorbid internalizing symptoms in adults with ADHD. Method: Twenty randomized controlled trials and 12 uncontrolled pretest-posttest studies were included and combined using the inverse variance method. Risk of bias and heterogeneity assessment and moderator analyses were performed. Results: Cognitive-behavioral therapy (CBT) improved quality of life (QoL), emotional dysregulation (ED), depression, and anxiety symptoms, particularly at follow-up, which was predicted by core symptoms reduction. A significant between-group effect was obtained only on QoL, ED, and self-esteem for dialectical behavior therapy (DBT), mindfulness-based therapies (MBTs), and neurofeedback, respectively. Conclusion: Results support CBT efficacy for treating comorbid internalizing symptoms. More research is needed to determine the effectiveness of DBT, MBT, and neurofeedback. The small number of studies evaluating some therapies and the high risk of bias observed might limit these results.
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20
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Givon Shaham N, Sternberg S, Rand D. Executive Functioning of Older Adults Correlates with Performance of Touchscreen App-Based Puzzles. Games Health J 2018; 7:271-276. [PMID: 30106643 DOI: 10.1089/g4h.2017.0118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The use of touchscreen tablets has become common in healthcare. This technology has the potential to be used as a motivational tool for cognitive training. Age-related decline in executive functioning (EF) and dexterity may lead to poor performance using tablet applications (apps), but the impact on performance of app-based puzzles has not been studied. OBJECTIVES (1) To characterize and compare the experience performance of playing tablet apps of older and younger adults, (2) To determine if EF and dexterity contribute to performance of app-based puzzles. MATERIALS AND METHODS We performed a cross-sectional study of community-dwelling healthy older (n = 35) and younger adults (n = 34). EF was measured by the Trail Making Test (part B) (TMT-B) and the Weekly Calendar Planning Activity. Dexterity was assessed using the Nine-Hole Peg Test. Participants played three unfamiliar app-based puzzles requiring EF and filled out the short feedback questionnaire. RESULTS All participants succeeded in playing the apps and reported enjoyment, however, older adults perceived less success and control. Significant differences in EF, dexterity, and performance were found between groups. EF of older adults (TMT-B) accounted for 17.7%-36.8% (P < 0.05) of the total variance of performance. CONCLUSION These findings have implications for the use of tablet apps for older adults. Longer instruction and training periods may be required for training EF among older adults.
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Affiliation(s)
- Noa Givon Shaham
- 1 Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Shelley Sternberg
- 2 Department of Geriatric Services, Ministry of Health , Jerusalem, Israel
| | - Debbie Rand
- 1 Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
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Effectiveness of Neurofeedback on Executive Functions and Tendency Toward High-Risk Behaviors in Adolescents with Attention Deficit Hyperactivity Disorder. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS AND ADDICTION 2018. [DOI: 10.5812/ijhrba.82012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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De Crescenzo F, Ziganshina LE, Yudina EV, Kaplan YC, Ciabattini M, Wei Y, Hoyle CHV. Noradrenaline reuptake inhibitors (NRIs) for attention deficit hyperactivity disorder (ADHD) in adults. Hippokratia 2018. [DOI: 10.1002/14651858.cd013044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Franco De Crescenzo
- Catholic University of the Sacred Heart; Institute of Psychiatry and Psychology; L.go A. Gemelli 8 Rome Italy 00168
| | - Liliya Eugenevna Ziganshina
- Kazan (Volga region) Federal University; Research & Education Centre for Evidence-Based Medicine Cochrane Russia; 18 Kremlevskaya Street, 420008 14-15 Malaya Krasnaya Street, 420015 Kazan Tatarstan Russian Federation
- Kazan (Volga region) Federal University; Department of Basic and Clinical Pharmacology; Kazan Russian Federation
| | - Ekaterina V Yudina
- Kazan (Volga region) Federal University; Research & Education Centre for Evidence-Based Medicine Cochrane Russia; 18 Kremlevskaya Street, 420008 14-15 Malaya Krasnaya Street, 420015 Kazan Tatarstan Russian Federation
- Kazan (Volga region) Federal University; Department of Basic and Clinical Pharmacology; Kazan Russian Federation
| | - Yusuf Cem Kaplan
- Izmir Katip Celebi University School of Medicine; Department of Pharmacology; Izmir Turkey 35360
| | | | - Yinghui Wei
- University of Plymouth; Centre for Mathematical Sciences, School of Computing, Electronics and Mathematics; Plymouth UK
| | - Charles HV Hoyle
- Kazan (Volga region) Federal University; Research & Education Centre for Evidence-Based Medicine Cochrane Russia; 18 Kremlevskaya Street, 420008 14-15 Malaya Krasnaya Street, 420015 Kazan Tatarstan Russian Federation
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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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Computerized Progressive Attention Training (CPAT) vs. Active Control in Adults with ADHD. JOURNAL OF COGNITIVE ENHANCEMENT 2017. [DOI: 10.1007/s41465-017-0056-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Brydges CR, Ozolnieks KL, Roberts G. Working memory - not processing speed - mediates fluid intelligence deficits associated with attention deficit/hyperactivity disorder symptoms. J Neuropsychol 2015; 11:362-377. [DOI: 10.1111/jnp.12096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 12/01/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Christopher R. Brydges
- School of Psychology & Exercise Science; Murdoch University; Perth Western Australia Australia
- Laboratory of Neuropsychology; University of the Balearic Islands; Palma de Mallorca Spain
| | - Krista L. Ozolnieks
- School of Psychology & Exercise Science; Murdoch University; Perth Western Australia Australia
| | - Gareth Roberts
- School of Psychology & Exercise Science; Murdoch University; Perth Western Australia Australia
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