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Whelan M, McGillivray J, Rinehart NJ. Using Life Course Theory to Explore the Association Between Autistic Traits, Child, Family, and School Factors and the Successful Transition to Secondary School. J Autism Dev Disord 2024; 54:2333-2346. [PMID: 37022578 PMCID: PMC11143022 DOI: 10.1007/s10803-022-05845-z] [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: 11/21/2022] [Indexed: 04/07/2023]
Abstract
Life Course Theory contends that school transitions can interrupt academic and wellbeing trajectories, depending on child, family, and school factors. Hierarchical regression analyses examined how autistic traits were associated with school transition outcomes. Autistic traits explained 12% of the variance in Quality of Life (QOL), 24% of the variance in mental health and 9% of the variance in school belonging. When autistic traits were accounted for, gender was a significant predictor of changes in QOL whereas changes in school belonging were predicted by cognitive functioning, parent education, school attendance and school refusal. Changes in mental health after transition were mostly predicted by family factors including family structure, family functioning and parent education but were also significantly predicted by sleep problems.
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Affiliation(s)
- Moira Whelan
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, VIC, Australia.
| | - Jane McGillivray
- Deakin Child Study Centre, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Nicole J Rinehart
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, VIC, Australia
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2
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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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Zendarski N, Mensah F, Hiscock H, Sciberras E. Trajectories of Emotional and Conduct Problems and Their Association With Early High School Achievement and Engagement for Adolescents With ADHD. J Atten Disord 2021; 25:623-635. [PMID: 30832528 DOI: 10.1177/1087054719833167] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: This study aimed to (a) identify longitudinal trajectories of emotional and conduct problems from middle childhood to early adolescence in a sample of 130 adolescents diagnosed with ADHD and (b) examine trajectories in relation to early adolescent academic achievement and engagement. Method: Group-based trajectory models (GBTMs) were constructed from the parent-rated strengths and difficulties questionnaire (SDQ) subscales of emotional and conduct problems at three time points, mean ages 10.7 years, 11.6 years, and 13.7 years. Associations between trajectories and adolescent academic achievement and engagement were examined using multivariate regression. Results: Four distinct trajectories were identified within each domain. High-persistent problem trajectories in each domain were associated with poorer achievement and lower school engagement compared with adolescents following persistent-low problem trajectories. Conclusion: Findings highlight the importance of early assessment and management of comorbid emotional and conduct problems for children with ADHD as they predict school difficulties during early high school. (J. of Att. Dis. XXXX; XX(X) XX-XX).
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Affiliation(s)
- Nardia Zendarski
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The University of Melbourne, Parkville, Victoria, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The University of Melbourne, Parkville, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The University of Melbourne, Parkville, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Emma Sciberras
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The University of Melbourne, Parkville, Victoria, Australia.,Deakin University, Melbourne, Victoria, Australia
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4
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Zavadenko NN, Suvorinova NY. [Attention deficit hyperactivity disorder in children and adolescents]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:29-35. [PMID: 32490615 DOI: 10.17116/jnevro202012004129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the level of adaptive functioning in patients with attention deficit hyperactivity disorder (ADHD). MATERIALS AND METHODS One hundred children and adolescents with ADHD (79 male and 21 female) were examined using M. Weiss functional impairment rating scale (WFIRS). The total score on the ADHD-DSM-IV was at least 24 and ADHD severity was rated as «Moderately ill» or «Markedly ill» on CGI-S-ADHD scale. RESULTS Typical for ADHD difficulties with adaptive functioning in «Family», «Learning and school», «Life skills», «Social activities» domains are more pronounced in «Markedly ill» patients compared to «Moderately ill» and increase during the transition from childhood to adolescence. Comorbid disorders (oppositional defiant disorder and anxiety disorders) lead to a significant increase in adaptive functioning impairments in most domains of daily life, including «Family», «Learning and school», «Child's self concept», «Social activities» and «Risky activities». CONCLUSION It is necessary not only to assess core symptoms in the follow-up of patients with ADHD, but also evaluate comorbid disorders and the level of functional impairment across the main domains of daily life.
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Affiliation(s)
- N N Zavadenko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N Yu Suvorinova
- Pirogov Russian National Research Medical University, Moscow, Russia
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Whelan M, McGillivray J, Rinehart NJ. The Association Between Autism Spectrum Traits and the Successful Transition to Mainstream Secondary School in an Australian School-Based Sample. J Autism Dev Disord 2020; 51:1759-1771. [PMID: 32809171 DOI: 10.1007/s10803-020-04655-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The transition to secondary school is an important educational milestone impacting wellbeing and academic achievement. Students with Autism Spectrum Disorder may be vulnerable during transition however little is known about how Autism Spectrum (AS) traits influence transition outcomes. Generalised estimating equations were used to examine how AS traits were associated with four indicators of successful transition in a school-based sample of 51 students. Higher AS traits were associated with lower quality of life, school belonging and mental health, however the hypothesised decline after school transition was not supported. Characteristics of both the primary and secondary school appeared to be contributing to the wellbeing of students with high AS traits which could be clarified by further investigation with a larger sample.
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Affiliation(s)
- Moira Whelan
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Waterfront Campus, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Jane McGillivray
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Waterfront Campus, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Nicole J Rinehart
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Waterfront Campus, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
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Arruda MA, Arruda R, Guidetti V, Bigal ME. ADHD Is Comorbid to Migraine in Childhood: A Population-Based Study. J Atten Disord 2020; 24:990-1001. [PMID: 28587507 DOI: 10.1177/1087054717710767] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Recurrent headaches and ADHD are prevalent in the pediatric population. Herein, we assess if ADHD is comorbid to headaches overall, to headache subtypes (e.g., migraine), and to headache frequency. Method: Informed consent and analyzable data were obtained for 5,671 children aged 5 to 12 years (65.9% of the target sample). Parents and teachers were interviewed using validated questionnaires based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). Relative risks were modeled using univariate and multivariate analyses. Results: As contrasted to nonheadache controls, the prevalence of ADHD was significantly higher in children with migraine (p < .001) but not in those with tension-type headaches. In children with migraine, risk of ADHD increased as a function of headache frequency (p < .05). Conclusion: Migraine and frequent migraine are comorbid to ADHD. Future studies should focus on the impact of the association on the burden to the children and their families.
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Zendarski N, Sciberras E, Mensah F, Hiscock H. Factors Associated With Educational Support in Young Adolescents With ADHD. J Atten Disord 2020; 24:750-757. [PMID: 30328744 DOI: 10.1177/1087054718804351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: This study aimed to examine patterns of use and factors associated with education support use in students with ADHD during early adolescence. Method: Participants were 130 adolescents (M = 13.7 years, SD = 1.1) with ADHD. Educational support use and the factors associated with use were collected by parent and teacher questionnaires and standardized academic tests during the 2014-2015 school years. Support rates and categories are described. Logistic regression models examine individual, family, and school variables associated with support versus no support. Results: About two thirds of students with ADHD (60%) had accessed education support in the current school year, which included social support (36%), Individualized Educational Plans (IEPs; 22%), Student Support Groups (SSGs; 18%), counseling (17%), mentoring (15%), and homework support (9%). Academic risk (adjusted odds ratio [OR] = 2.30, 95% confidence interval [CI] = [1.03, 5.14], p = .04), behavioral problems (adjusted OR = 1.47, 95% CI = [1.01, 2.14], p = .047), and attending a Catholic school (adjusted OR = 5.10, 95% CI = [1.59, 16.42], p = .006) were associated with receiving support independent of adolescent age, gender, ADHD medication use, and socioeconomic status. Conclusions: Future research needs to determine whether education support makes a difference to long-term outcomes for students with ADHD and to determine why some students at academic risk receive no support.
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Affiliation(s)
- Nardia Zendarski
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Australia
| | - Emma Sciberras
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Australia.,The Royal Children's Hospital, Melbourne, Victoria, Australia.,Deakin University, Burwood, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Australia.,The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Australia.,The Royal Children's Hospital, Melbourne, Victoria, Australia
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Becker SP, Lienesch JA. Nighttime media use in adolescents with ADHD: links to sleep problems and internalizing symptoms. Sleep Med 2018; 51:171-178. [PMID: 30223187 PMCID: PMC6431533 DOI: 10.1016/j.sleep.2018.06.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This study examined nighttime media use in relation to sleep problems and anxiety/depression symptoms in adolescents with attention-deficit/hyperactivity disorder (ADHD). METHODS Participants were 81 adolescents (69% male) ages 13-17 with ADHD. Adolescents completed measures assessing pubertal development, nighttime media use, circadian preference, and daytime sleepiness. Both adolescents and parents completed measures of sleep duration, sleep problems, and internalizing symptoms. RESULTS When summing across media uses (eg, social networking, playing video games, watching television), the average nighttime media use (after 9:00PM) was 5.31 h. Overall, 63% of adolescents reported obtaining less than 8 h of sleep on school nights, and this percentage rose to 77% for parent-reported sleep duration. Moreover, adolescents obtaining less sleep than recommended had more nighttime media use than those obtaining ≥8 h of nightly sleep. Controlling for age, sex, pubertal development, stimulant medication use, and ADHD symptom severity; nighttime media use was associated with shorter sleep duration and increased sleep problems across both adolescent and parent report. Media use was also associated with greater adolescent-reported anxiety and depression, and marginally associated with eveningness circadian preference and greater daytime sleepiness. In considering specific anxiety dimensions, media use was associated with greater adolescent-reported panic symptoms and parent-reported generalized anxiety disorder symptoms. CONCLUSIONS Our findings suggest that nighttime media use may contribute to sleep problems and comorbid internalizing symptoms in adolescents with ADHD, although additional studies are needed to determine causality, potential bidirectional associations, and underlying mechanisms such as using media to (mis)manage negative emotions. Media use is important to assess and monitor and may be a significant intervention target when addressing sleep and internalizing problems, and possible underlying cognitive-emotional processes in adolescents with ADHD.
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Affiliation(s)
- Stephen P Becker
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Center for ADHD, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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Farjam M, Sharafi M, Bahramali E, Rezaei S, Hassanzadeh J, Rezaeian S. Socioeconomic Inequalities in Gastroesophageal Reflux Disorder: Results from an Iranian Cohort Study. Middle East J Dig Dis 2018; 10:180-187. [PMID: 30186582 PMCID: PMC6119839 DOI: 10.15171/mejdd.2018.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/07/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Despite progress in the health indexes in recent years, health inequalities remain as a global challenge within and between regions and countries. This study is the first to quantify the socioeconomic inequity in gastroesophageal reflux disease (GERD) using the concentration index. METHODS In this cross-sectional study, we used baseline data (7012 subjects) from the Fasa Cohort Study (the Southern Iran). The principal component analysis was used to construct socioeconomic status of the participants. The concentration index and concentration curve were used to measure socioeconomic-related inequality in GERD. Decomposition of concentration index was also done to identify the contribution of each explanatory variable to the wealth-related inequality in GERD prevalence. RESULTS The prevalence of GERD was 16.9% (95% CI: 15.9-17.7%). The overall concentration index for GERD was 0.093 (95% CI: 0.062-0.166]. Correspondingly, this figure for men and women were 0.116 (95% CI: 0.062-0.171%) and 0.091 (95% CI: 0.044-0.137%), respectively. The main contributors of socioeconomic-related inequality in GERD prevalence were socioeconomic status (64.4%), alcohol drinking (29%), and age (8.4%). CONCLUSION GERD is significantly more concentrated among richest people. There was significant socioeconomic inequality in GERD according to some individual factors. These inequalities need to be addressed by policy makers to identify the vulnerable subgroups and to reduce the disease burden in the community.
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Affiliation(s)
- Mojtaba Farjam
- Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehdi Sharafi
- Center for Diseases Control and Prevention, Deputy of Health Services, Fasa University of Medical Sciences, Fasa, Iran
| | - Ehsan Bahramali
- Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jafar Hassanzadeh
- Research Centre for Health Sciences, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahab Rezaeian
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Academic Achievement and Risk Factors for Adolescents with Attention-Deficit Hyperactivity Disorder in Middle School and Early High School. J Dev Behav Pediatr 2018; 38:358-368. [PMID: 28604499 DOI: 10.1097/dbp.0000000000000460] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Examine academic achievement of students with attention-deficit hyperactivity disorder (ADHD) during the early high school period and identify potentially modifiable risk factors for low achievement. METHOD Data were collected through surveys (adolescent, parent, and teacher) and direct assessment of Australian adolescents (12-15 yr; n = 130) with ADHD in early high school (i.e., US middle and high school grades). Academic achievement outcomes were measured by linking to individual performance on the National Assessment Program-Literacy and Numeracy (NAPLAN) tests, direct assessment of reading and math, and teacher report of academic competence. Linear regression models examined associations between adolescent, parent/family, and school factors and NAPLAN domain scores. RESULTS Students with ADHD had lower NAPLAN scores on all domains and fewer met minimum academic standards in comparison with state benchmarks. The poorest results were for persuasive writing. Poor achievement was associated with lower intelligence quotient across all academic domains. Adolescent inattention, bullying, poor family management, male sex, and attending a low socioeconomic status school were associated with lower achievement on specific domains. CONCLUSION Students with ADHD are at increased academic risk during the middle school and early high school period. In addition to academic support, interventions targeting modifiable factors including inattention, bullying, and poor family management may improve academic achievement across this critical period.
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Zendarski N, Sciberras E, Mensah F, Hiscock H. Early high school engagement in students with attention/deficit hyperactivity disorder. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2017; 87:127-145. [PMID: 28054712 DOI: 10.1111/bjep.12140] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/26/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Students with attention/deficit hyperactivity disorder (ADHD) continue to languish behind their peers with regard to academic achievement and education attainment. School engagement is potentially modifiable, and targeting engagement may be a means to improve education outcomes. AIMS To investigate school engagement for students with ADHD during the crucial high school transition period and to identify factors associated with low school engagement. SAMPLE Participants are adolescents (12-15 years) in the first and third year of high school with diagnosed ADHD (n = 130). Participants were recruited from 21 paediatric practices. METHODS Cross-sectional study assessing school engagement. Data were collected through direct assessment and child, parent, and teacher surveys. School engagement is measured as student attitudes to school (cognitive and emotional) and suspension rates (behavioural). Multivariable regression analyses examined student, family, and school factors affecting engagement. RESULTS In comparison with state data, students with ADHD in the first year of high school were less motivated (p < .01) and less connected to peers (p < .01). Overall, there was no discordance in third year attitudes. There were high rates of suspension in both years in comparison to state-wide suspensions (21% vs. 6%, p < .01). Explanatory factors for poor attitudes include adolescent depression, poor adolescent supervision, and devaluing education. Conduct problems and increased hyperactivity were related to increased likelihood of being suspended, whilst higher cognitive ability, family socio-economic status, and independent schools reduced risk. CONCLUSIONS Potentially modifiable individual and family factors including adolescent depression, behavioural problems, education values, and family supervision could be targeted to better manage the high school transition for students with ADHD.
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Affiliation(s)
- Nardia Zendarski
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia
| | - Emma Sciberras
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia.,Deakin University, Burwood, Victoria, Australia
| | - Fiona Mensah
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Harriet Hiscock
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia
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Lunsford-Avery JR, Krystal AD, Kollins SH. Sleep disturbances in adolescents with ADHD: A systematic review and framework for future research. Clin Psychol Rev 2016; 50:159-174. [PMID: 27969004 DOI: 10.1016/j.cpr.2016.10.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/15/2016] [Accepted: 10/21/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Biological mechanisms underlying symptom and prognostic heterogeneity in Attention-Deficit/Hyperactivity Disorder (ADHD) are unclear. Sleep impacts neurocognition and daytime functioning and is disrupted in ADHD, yet little is known about sleep in ADHD during adolescence, a period characterized by alterations in sleep, brain structure, and environmental demands as well as diverging ADHD trajectories. METHODS A systematic review identified studies published prior to August 2016 assessing sleep in adolescents (aged 10-19years) with ADHD or participating in population-based studies measuring ADHD symptoms. RESULTS Twenty-five studies were identified (19 subjective report, 6 using actigraphy/polysomnography). Findings are mixed but overall suggest associations between sleep disturbances and 1) ADHD symptoms in the population and 2) poorer clinical, neurocognitive, and functional outcomes among adolescents with ADHD. Common limitations of studies included small or non-representative samples, non-standardized sleep measures, and cross-sectional methodology. CONCLUSIONS Current data on sleep in adolescent ADHD are sparse and limited by methodological concerns. Future studies are critical for clarifying a potential role of sleep in contributing to heterogeneity of ADHD presentation and prognosis. Potential mechanisms by which sleep disturbances during adolescence may contribute to worsened symptom severity and persistence of ADHD into adulthood and an agenda to guide future research are discussed.
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Affiliation(s)
- Jessica R Lunsford-Avery
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road Suite 300, Durham, NC 27705, United States.
| | - Andrew D Krystal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road Suite 300, Durham, NC 27705, United States; Departments of Psychiatry and Neurology, University of California San Francisco School of Medicine, 401 Parnassus Avenue, San Francisco, CA 94143, United States
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road Suite 300, Durham, NC 27705, United States
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