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Rojas-Navarro S, Alarcón-Arcos S, Tabilo-Prieto I. Spectralities of ADHD: hauntological diagnosis amidst agency, politics and pedagogies. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2024; 33:89-103. [PMID: 38373414 DOI: 10.1080/14461242.2024.2316736] [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: 06/27/2023] [Accepted: 02/06/2024] [Indexed: 02/21/2024]
Abstract
Hauntology has become an increasingly alluring concept in social sciences to reflect upon everyday life and how subjects dwell upon scenarios pervaded not only by the potency of the actual but also the haunting of the past and the virtual. Drawing on the concept of 'hauntology', we inquire about recurring temporalities and spectrality themes concerning the 'controversial' diagnosis of attention deficit hyperactivity disorder (ADHD) in Chile. Using participant observation and in-depth interviews with health practitioners, teachers, school staff, diagnosed children, and their peers from 3-year-long research, we examine how the performance of the diagnosis by clinicians at times can produce a modification of the temporality of the diagnosed children from that moment forth. Amidst tension created by educational policies, ideas of well-being, pedagogical practices, and everyday living, the diagnosis keeps repeating its agentic capacity while resisting its decay, becoming ever-present and actual. Once cast, the diagnosis acts as a repeating force that can shape every experience, cancelling the possibility for the child to become different by unfolding out of the diagnosis.
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Affiliation(s)
- Sebastián Rojas-Navarro
- Faculty of Education and Social Sciences, Universidad Andrés Bello, Santiago, Chile
- Millennium Institute for Care Research (MICARE), Santiago, Chile
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Gonzalez C, Finley JCA, Khalid E, Basurto KS, VanLandingham HB, Frick LA, Brooks JM, Ellison RL, Ulrich DM, Soble JR, Resch ZJ. The Impact of Adverse Childhood Experiences on Symptom and Performance Validity Tests Among a Multiracial Sample Presenting for ADHD Evaluation. Arch Clin Neuropsychol 2024:acae006. [PMID: 38366222 DOI: 10.1093/arclin/acae006] [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: 09/04/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are commonly reported in individuals presenting for attention-deficit hyperactivity disorder (ADHD) evaluation. Performance validity tests (PVTs) and symptom validity tests (SVTs) are essential to ADHD evaluations in young adults, but extant research suggests that those who report ACEs may be inaccurately classified as invalid on these measures. The current study aimed to assess the degree to which ACE exposure differentiated PVT and SVT performance and ADHD symptom reporting in a multi-racial sample of adults presenting for ADHD evaluation. METHOD This study included 170 adults referred for outpatient neuropsychological ADHD evaluation who completed the ACE Checklist and a neurocognitive battery that included multiple PVTs and SVTs. Analysis of variance was used to examine differences in PVT and SVT performance among those with high (≥4) and low (≤3) reported ACEs. RESULTS Main effects of the ACE group were observed, such that high ACE group reporting demonstrated higher scores on SVTs assessing ADHD symptom over-reporting and infrequent psychiatric and somatic symptoms on the Minnesota Multiphasic Personality Inventory-2-Restructured Form. Conversely, no significant differences emerged in total PVT failures across ACE groups. CONCLUSIONS Those with high ACE exposure were more likely to have higher scores on SVTs assessing over-reporting and infrequent responses. In contrast, ACE exposure did not affect PVT performance. Thus, ACE exposure should be considered specifically when evaluating SVT performance in the context of ADHD evaluations, and more work is needed to understand factors that contribute to different patterns of symptom reporting as a function of ACE exposure.
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Affiliation(s)
- Christopher Gonzalez
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elmma Khalid
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Karen S Basurto
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Hannah B VanLandingham
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Lauren A Frick
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, Wheaton College, Wheaton, 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
| | - Rachael L Ellison
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Devin M Ulrich
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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Lewczuk K, Marcowski P, Wizła M, Gola M, Nagy L, Koós M, Kraus SW, Demetrovics Z, Potenza MN, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Briken P, Burkauskas J, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chen L, Ciocca G, Corazza O, Csako RI, Fernandez DP, Fujiwara H, Fernandez EF, Fuss J, Gabrhelík R, Gewirtz-Meydan A, Gjoneska B, Grubbs JB, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez MC, Jurin T, Kalina O, Klein V, Költő A, Lee SK, Lin CY, Lin YC, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Miller DJ, Orosová O, Orosz G, Ponce FP, Quintana GR, Quintero Garzola GC, Ramos-Diaz J, Rigaud K, Rousseau A, Tubino Scanavino MD, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Ünsal BC, Vaillancourt-Morel MP, Claire Van Hout M, Bőthe B. Cross-Cultural Adult ADHD Assessment in 42 Countries Using the Adult ADHD Self-Report Scale Screener. J Atten Disord 2024; 28:512-530. [PMID: 38180045 DOI: 10.1177/10870547231215518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVE We analyzed adult ADHD symptoms in a cross-cultural context, including investigating the occurrence and potential correlates of adult ADHD and psychometric examination of the Adult ADHD Self-Report Scale (ASRS) Screener. METHOD Our analysis is based on a large-scale research project involving 42 countries (International Sex Survey, N=72,627, 57% women, Mage=32.84; SDage=12.57). RESULTS The ASRS Screener demonstrated good reliability and validity, along with partial invariance across different languages, countries, and genders. The occurrence of being at risk for adult ADHD was relatively high (21.4% for women, 18.1% for men). The highest scores were obtained in the US, Canada, and other English-speaking Western countries, with significantly lower scores among East Asian and non-English-speaking European countries. Moreover, ADHD symptom severity and occurrence were especially high among gender-diverse individuals. Significant associations between adult ADHD symptoms and age, mental and sexual health, and socioeconomic status were observed. CONCLUSIONS Present results show significant cross-cultural variability in adult ADHD occurrence as well as highlight important factors related to adult ADHD. Moreover, the importance of further research on adult ADHD in previously understudied populations (non-Western countries) and minority groups (gender-diverse individuals) is stressed. Lastly, the present analysis is consistent with previous evidence showing low specificity of adult ADHD screening instruments and contributes to the current discussion on accurate adult ADHD screening and diagnosis.
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Affiliation(s)
- Karol Lewczuk
- Cardinal Stefan Wyszynski University, Warsaw, Poland
| | | | | | - Mateusz Gola
- University of California, San Diego, USA
- Institute of Psychology, Polish Academy of Sciences, Poland
| | - Léna Nagy
- ELTE Eötvös Loránd University, Budapest, Hungary
| | - Mónika Koós
- ELTE Eötvös Loránd University, Budapest, Hungary
| | | | - Zsolt Demetrovics
- ELTE Eötvös Loránd University, Budapest, Hungary
- University of Gibraltar, Gibraltar
| | - Marc N Potenza
- Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | | | | | - Sophie Bergeron
- Université de Montréal, Canada
- Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles (CRIPCAS), Canada
| | - Joël Billieux
- University of Lausanne, Switzerland
- Lausanne University Hospitals, Switzerland
| | - Peer Briken
- University Medical Centre Hamburg-Eppendorf, Germany
| | - Julius Burkauskas
- Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
| | | | | | | | | | | | | | | | | | - Hironobu Fujiwara
- Kyoto University, Kyoto, Japan
- RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
- The General Research Division, Osaka University Research Center on Ethical, Legal and Social Issues, Osaka, Japan
| | | | | | - Roman Gabrhelík
- Charles University, Prague, Czech Republic
- General University Hospital in Prague, Czech Republic
| | | | - Biljana Gjoneska
- Macedonian Academy of Sciences and Arts, Republic of North Macedonia
| | | | | | - Md Saiful Islam
- Jahangirnagar University, Savar, Dhaka, Bangladesh
- Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, Bangladesh
| | | | - Martha C Jiménez-Martínez
- Universidad Pedagógica y Tecnológica de Colombia, Colombia
- Grupo de Investigación Biomédica y de Patología, Colombia
| | | | | | | | | | - Sang-Kyu Lee
- Hallym University Chuncheon Sacred Heart Hospital, South Korea
- Chuncheon Addiction Management Center, South Korea
| | - Chung-Ying Lin
- National Cheng Kung University, Tainan
- University of Religions and Denominations, Qom, Iran
| | | | | | | | | | | | | | - Oľga Orosová
- Pavol Jozef Safarik University in Kosice, Slovakia
| | | | | | | | | | | | | | | | - Marco De Tubino Scanavino
- Western University, St. Joseph's Health Care London and London Health Sciences Centre, London, Canada
- Lawson Health Research Institute, London, Canada
- Universidade de São Paulo, Brazil
| | | | - Pratap Sharan
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Sheikh Shoib
- Department of Health Services, Srinagar, India
- Sharda University, Greater Noida, India
- Psychosis Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | | | | | - Vesta Steibliene
- Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
| | - Dan J Stein
- University of Cape Town, Rondebosch, South Africa
- South African Medical Research Council, South Africa
| | - Berk C Ünsal
- ELTE Eötvös Loránd University, Budapest, Hungary
| | - Marie-Pier Vaillancourt-Morel
- Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles (CRIPCAS), Canada
- Université du Québec à Trois-Rivières, Canada
| | | | - Beáta Bőthe
- Université de Montréal, Canada
- Centre de Recherche Interdisciplinaire sur les Problèmes Conjugaux et les Agressions Sexuelles (CRIPCAS), Canada
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Banaschewski T, Häge A, Hohmann S, Mechler K. Perspectives on ADHD in children and adolescents as a social construct amidst rising prevalence of diagnosis and medication use. Front Psychiatry 2024; 14:1289157. [PMID: 38250274 PMCID: PMC10796544 DOI: 10.3389/fpsyt.2023.1289157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024] Open
Abstract
The diagnosis of attention-deficit hyperactivity disorder (ADHD) is based on the presence of pervasive, persistent symptoms of inattention and/or hyperactivity/impulsivity typically emerging early in life and resulting in significant functional impairment. In contrast to a worldwide epidemiological prevalence of approximately 5% in children and 2-3% in adults, there are significant variations in the prevalence of administrative ADHD diagnoses and medication use. We assert that in order to explore the underlying dynamics of this phenomenon, a thorough understanding of the construct ADHD is necessary. We contend that ADHD is not a natural entity that unfolds within an individual and can be understood independent from societal and environmental factors, but rather that ADHD as a diagnosis can better be conceptualized as a valid and pragmatically useful social construct. Decisions to diagnose and treat ADHD should follow a person-centered approach and be focused on functional impairment within a socially constructed, context-dependent and environmentally contingent model.
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Affiliation(s)
- Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexander Häge
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Konstantin Mechler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Pham D, Lin A, Rosenthal H, Milanaik R. ADHD Diagnosis in Children of Non-US-Born Parents: A Cross-Sectional Analysis. J Atten Disord 2024; 28:3-13. [PMID: 37694890 DOI: 10.1177/10870547231197242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
OBJECTIVE(S) To assess the likelihood of ADHD diagnosis in children of non-US-born caregivers relative to children of US-born caregivers. METHOD Cross-sectional analysis of a combined 2016 to 2019 National Survey of Children's Health dataset (n = 109,881) was performed to identify associations between caregiver's birth outside the U.S. and child's ADHD diagnosis. Logistic regression models adjusted for potential sociodemographic confounders. RESULTS Children with one or two non-US-born caregivers were less likely to be diagnosed with ADHD (aOR = 0.58, p < .001; aOR = 0.59, p < .001, respectively). Likelihood of a diagnosis increased as non-US-born caregivers spent more time in the US. After a diagnosis, children of two non-US-born caregivers were less likely to be treated with medication. CONCLUSION The lower likelihood of ADHD diagnosis in children with non-US-born caregivers may reflect an increasing need for public health education to raise awareness about ADHD among this population and the development of culturally sensitive ADHD identification methodologies.
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Affiliation(s)
- Duy Pham
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, USA
| | - Allison Lin
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, USA
| | - Hannah Rosenthal
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, USA
| | - Ruth Milanaik
- Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
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Jacobs D. Experiences of children and adolescents with attention-deficit/hyperactivity disorder taking methylphenidate. Dev Med Child Neurol 2023; 65:1587-1595. [PMID: 37154566 DOI: 10.1111/dmcn.15636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/07/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023]
Abstract
To improve clinical counselling for adolescents about the use of stimulant medication, it is crucial to understand the experiences of young people diagnosed with attention-deficit/hyperactivity disorder (ADHD) who are taking such treatment. For this narrative review, five databases were searched for studies investigating the personal experiences of control issues in adolescents diagnosed with ADHD taking methylphenidate. We extracted the data using NVivo 12 and interpretatively synthesized them according to the procedures of thematic analysis. Interviewed youngsters spontaneously put forward self-experiences about self-esteem and sense of control, although these issues were rarely explicitly addressed in the research question. The overarching theme in these studies was 'improving the self'. Two subthemes emerged: (1) medication sometimes delivered on its promise to improve the self, but regularly it did not; and (2) youngsters felt pressurized to conform to behavioural norms and comply with the medication use that adults had decided on. To genuinely involve youngsters diagnosed with ADHD for whom stimulant medication is prescribed in the shared decision-making process, we recommend to specifically involve them in a dialogue on the medication's potential effects on their self-experiences. This will allow them to feel at least partly in control of their body and life, and less pressurized to conform to others' norms.
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Affiliation(s)
- Delphine Jacobs
- Psychiatrie Infanto-Juvénile, Cliniques universitaires Saint-Luc, Bruxelles, Belgium
- UCLouvain, Institut de Recherche Santé et Société, Bruxelles, Belgium
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Grønneberg SV, Engebretsen E, Torp Løkkeberg S. When ADHD knocks on the door - discourse theory as a frame to explore subject positions and mental wellbeing before diagnosis. Int J Qual Stud Health Well-being 2023; 18:2209964. [PMID: 37155151 PMCID: PMC10167886 DOI: 10.1080/17482631.2023.2209964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
PURPOSE Attention deficit hyperactivity disorder (ADHD) is currently the most prevalent childhood psychiatric diagnosis. This article reports how 10 young adults in Norway positioned themselves before they were diagnosed with ADHD either during early childhood or adolescence. A central theme is how these subject-positions relate to societal norms and mental well-being. METHOD Individual interviews were conducted, and the transcriptions of the interviews were analysed according to discourse theory. RESULT Six central subject positions were identified which in turn related to two major positions: 1) failure with schoolwork and 2) struggle in social interaction. The findings indicated specific emotional and environmental needs and that individuals were confronted with societal norms related to the criteria for ADHD prior to and regardless of whether one had received a formal diagnosis. CONCLUSION We argue that analysing subject positions provides important knowledge regarding ADHD that is useful for individuals, parents, teachers, practitioners, policymakers, and helping professionals in the field of mental health and education when it comes to interventions that support children who possess different temperaments.
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Affiliation(s)
- Siv Vea Grønneberg
- Faculty of Health, Welfare and Organisation, Østfold University College, Fredrikstad, Norway
| | | | - Stine Torp Løkkeberg
- Faculty of Health, Welfare and Organisation, Østfold University College, Fredrikstad, Norway
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Fraiman YS, Guyol G, Acevedo-Garcia D, Beck AF, Burris H, Coker TR, Tiemeier H. A Narrative Review of the Association between Prematurity and Attention-Deficit/Hyperactivity Disorder and Accompanying Inequities across the Life-Course. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1637. [PMID: 37892300 PMCID: PMC10605109 DOI: 10.3390/children10101637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
Preterm birth is associated with an increased risk of neurodevelopmental and neurobehavioral impairments including attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioral disorder of childhood. In this narrative review, we examine the known associations between prematurity and ADHD and highlight the impact of both prematurity and ADHD on multiple domains across the pediatric life-course. We develop a framework for understanding the health services journey of individuals with ADHD to access appropriate services and treatments for ADHD, the "ADHD Care Cascade". We then discuss the many racial and ethnic inequities that affect the risk of preterm birth as well as the steps along the "ADHD Care Cascade". By using a life-course approach, we highlight the ways in which inequities are layered over time to magnify the neurodevelopmental impact of preterm birth on the most vulnerable children across the life-course.
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Affiliation(s)
- Yarden S. Fraiman
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Genevieve Guyol
- Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02218, USA
| | - Dolores Acevedo-Garcia
- Heller School of Social Policy and Management, Brandeis University, Waltham, MA 02453, USA
| | - Andrew F. Beck
- Cincinnati Children’s, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Heather Burris
- Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tumaini R. Coker
- Seattle Children’s, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Henning Tiemeier
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Storebø OJ, Storm MRO, Pereira Ribeiro J, Skoog M, Groth C, Callesen HE, Schaug JP, Darling Rasmussen P, Huus CML, Zwi M, Kirubakaran R, Simonsen E, Gluud C. Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Cochrane Database Syst Rev 2023; 3:CD009885. [PMID: 36971690 PMCID: PMC10042435 DOI: 10.1002/14651858.cd009885.pub3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed and treated psychiatric disorders in childhood. Typically, children and adolescents with ADHD find it difficult to pay attention and they are hyperactive and impulsive. Methylphenidate is the psychostimulant most often prescribed, but the evidence on benefits and harms is uncertain. This is an update of our comprehensive systematic review on benefits and harms published in 2015. OBJECTIVES To assess the beneficial and harmful effects of methylphenidate for children and adolescents with ADHD. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, three other databases and two trials registers up to March 2022. In addition, we checked reference lists and requested published and unpublished data from manufacturers of methylphenidate. SELECTION CRITERIA We included all randomised clinical trials (RCTs) comparing methylphenidate versus placebo or no intervention in children and adolescents aged 18 years and younger with a diagnosis of ADHD. The search was not limited by publication year or language, but trial inclusion required that 75% or more of participants had a normal intellectual quotient (IQ > 70). We assessed two primary outcomes, ADHD symptoms and serious adverse events, and three secondary outcomes, adverse events considered non-serious, general behaviour, and quality of life. DATA COLLECTION AND ANALYSIS Two review authors independently conducted data extraction and risk of bias assessment for each trial. Six review authors including two review authors from the original publication participated in the update in 2022. We used standard Cochrane methodological procedures. Data from parallel-group trials and first-period data from cross-over trials formed the basis of our primary analyses. We undertook separate analyses using end-of-last period data from cross-over trials. We used Trial Sequential Analyses (TSA) to control for type I (5%) and type II (20%) errors, and we assessed and downgraded evidence according to the GRADE approach. MAIN RESULTS We included 212 trials (16,302 participants randomised); 55 parallel-group trials (8104 participants randomised), and 156 cross-over trials (8033 participants randomised) as well as one trial with a parallel phase (114 participants randomised) and a cross-over phase (165 participants randomised). The mean age of participants was 9.8 years ranging from 3 to 18 years (two trials from 3 to 21 years). The male-female ratio was 3:1. Most trials were carried out in high-income countries, and 86/212 included trials (41%) were funded or partly funded by the pharmaceutical industry. Methylphenidate treatment duration ranged from 1 to 425 days, with a mean duration of 28.8 days. Trials compared methylphenidate with placebo (200 trials) and with no intervention (12 trials). Only 165/212 trials included usable data on one or more outcomes from 14,271 participants. Of the 212 trials, we assessed 191 at high risk of bias and 21 at low risk of bias. If, however, deblinding of methylphenidate due to typical adverse events is considered, then all 212 trials were at high risk of bias. PRIMARY OUTCOMES methylphenidate versus placebo or no intervention may improve teacher-rated ADHD symptoms (standardised mean difference (SMD) -0.74, 95% confidence interval (CI) -0.88 to -0.61; I² = 38%; 21 trials; 1728 participants; very low-certainty evidence). This corresponds to a mean difference (MD) of -10.58 (95% CI -12.58 to -8.72) on the ADHD Rating Scale (ADHD-RS; range 0 to 72 points). The minimal clinically relevant difference is considered to be a change of 6.6 points on the ADHD-RS. Methylphenidate may not affect serious adverse events (risk ratio (RR) 0.80, 95% CI 0.39 to 1.67; I² = 0%; 26 trials, 3673 participants; very low-certainty evidence). The TSA-adjusted intervention effect was RR 0.91 (CI 0.31 to 2.68). SECONDARY OUTCOMES methylphenidate may cause more adverse events considered non-serious versus placebo or no intervention (RR 1.23, 95% CI 1.11 to 1.37; I² = 72%; 35 trials 5342 participants; very low-certainty evidence). The TSA-adjusted intervention effect was RR 1.22 (CI 1.08 to 1.43). Methylphenidate may improve teacher-rated general behaviour versus placebo (SMD -0.62, 95% CI -0.91 to -0.33; I² = 68%; 7 trials 792 participants; very low-certainty evidence), but may not affect quality of life (SMD 0.40, 95% CI -0.03 to 0.83; I² = 81%; 4 trials, 608 participants; very low-certainty evidence). AUTHORS' CONCLUSIONS The majority of our conclusions from the 2015 version of this review still apply. Our updated meta-analyses suggest that methylphenidate versus placebo or no-intervention may improve teacher-rated ADHD symptoms and general behaviour in children and adolescents with ADHD. There may be no effects on serious adverse events and quality of life. Methylphenidate may be associated with an increased risk of adverse events considered non-serious, such as sleep problems and decreased appetite. However, the certainty of the evidence for all outcomes is very low and therefore the true magnitude of effects remain unclear. Due to the frequency of non-serious adverse events associated with methylphenidate, the blinding of participants and outcome assessors is particularly challenging. To accommodate this challenge, an active placebo should be sought and utilised. It may be difficult to find such a drug, but identifying a substance that could mimic the easily recognised adverse effects of methylphenidate would avert the unblinding that detrimentally affects current randomised trials. Future systematic reviews should investigate the subgroups of patients with ADHD that may benefit most and least from methylphenidate. This could be done with individual participant data to investigate predictors and modifiers like age, comorbidity, and ADHD subtypes.
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Affiliation(s)
- Ole Jakob Storebø
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
- Child and Adolescent Psychiatric Department, Region Zealand, Roskilde, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | | | | | - Maria Skoog
- Clinical Study Support, Clinical Studies Sweden - Forum South, Lund, Sweden
| | - Camilla Groth
- Pediatric Department, Herlev University Hospital, Herlev, Denmark
| | | | | | | | | | - Morris Zwi
- Islington Child and Adolescent Mental Health Service, Whittington Health, London, UK
| | - Richard Kirubakaran
- Cochrane India-CMC Vellore Affiliate, Prof. BV Moses Centre for Evidence Informed Healthcare and Health Policy, Christian Medical College, Vellore, India
| | - Erik Simonsen
- Research Unit, Mental Health services, Region Zealand Psychiatry, Roskilde, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital ─ Rigshospitalet, Copenhagen, Denmark
- Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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10
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Tan TX, Zhou Y. Screen Time and ADHD Behaviors in Chinese Children: Findings From Longitudinal and Cross-Sectional Data. J Atten Disord 2022; 26:1725-1737. [PMID: 35575422 DOI: 10.1177/10870547221098181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Research suggests that screen exposure presents a risk for ADHD behaviors in young children. However, the operationalization of screen exposure remains murky and longitudinal data is scarce. In this paper, we examined the relations between better operationalized daily screen time and behaviors of inattention and behaviors of hyperactivity/impulsivity in three cohorts of community samples of young Chinese children. METHOD Study 1 was longitudinal and included 111 children who were 3.6 years old (Range = 2.4-4.9; SD = 0.4) at Baseline and 4.8 years old (Range = 3.9-6.0; SD = 0.4) at Follow-Up. Study 2 was cross-sectional and included 172 children aged 4.9 years (Range = 3.0-7.1; SD = 1.0). Study 3 was also cross-sectional and included 313 children who were 6.9 years old (Range = 5.7-8.3; SD = 0.4). In each study, the parents reported how much time that their children spent daily on iPad/tablet, smart phone, and online games and watching TV in the previous week, and their children's behaviors of inattention (I/A) and hyperactivity/impulsivity (H/I). RESULTS Regression analysis revealed that in Study 1, controlling for child demographics, mother's education, family SES, and corresponding I/A or H/I scores at Baseline, screen time at Baseline predicted I/A scores (β = .27, p < .01) and H/I scores (β = .32, p < .001) at Follow-Up. Similarly, controlling for covariates, screen time predicted I/A scores (β = .25, p < .01) and H/I scores (β = .25, p < .01) in Study 2; I/A scores (β = 0.16, p < .01) and H/I scores (β = .15, p < .05) in Study 3. CONCLUSION Screen exposure was a risk for inattention and hyperactivity/impulsivity behaviors in urban Chinese children.
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Affiliation(s)
| | - Yi Zhou
- Independent Researcher, Beijing, China
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11
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Scott S. Debate: 'A rose by any other name' would smell as sweet - myths peddled about the ills of diagnosing conduct disorders. Child Adolesc Ment Health 2022; 27:302-304. [PMID: 35880324 DOI: 10.1111/camh.12589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
Using a diagnosis of ODD/CD enables the clinician to apply a huge amount of helpful information about what has caused the concerns and then to offer effective treatment. More often than not, they do not use a diagnostic label with the family; the point is for the clinician to share the expertise. Myths about the nature of psychiatric diagnosis and the harms of a label of ODD/CD are debunked in this article. It is society who stigmatises these individuals because of their antisocial behaviour, and withholding skilfully applied benefits of the accumulated knowledge of the condition is cruel and especially harmful to disadvantaged groups in society where ODD/CD is far more prevalent.
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Affiliation(s)
- Stephen Scott
- Institute of Psychiatry, Kings College London, London, UK
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12
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Hinshaw SP, Nguyen PT, O'Grady SM, Rosenthal EA. Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. J Child Psychol Psychiatry 2022; 63:484-496. [PMID: 34231220 DOI: 10.1111/jcpp.13480] [Citation(s) in RCA: 71] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 01/13/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) - and its underlying behavioral dimensions of inattention and hyperactivity-impulsivity - have been understudied in females. We first cover the conceptual issues of prevalence, diagnostic practices, diversity, comorbidity, and causal factors, plus forces limiting awareness of ADHD in females. After a narrative review of cross-sectional and longitudinal findings, we conclude the following. (a) Girls meet diagnostic criteria for ADHD at just under half the rates of boys, a ratio that becomes much closer to equal by adulthood. (b) Girls and women with ADHD show a predominance of inattention and associated internalizing problems; boys and men display greater levels of hyperactive-impulsive symptoms and associated externalizing problems. (c) Sex differences in ADHD symptoms and related outcomes depend heavily on the clinical versus nonreferred nature of the samples under investigation. (d) Females with ADHD experience, on average, serious impairments, with a particularly heightened risk for problems in close relationships and engagement in self-harm. (e) Clinicians may overlook symptoms and impairments in females because of less overt (but still impairing) symptom manifestations in girls and women and their frequent adoption of compensatory strategies. Our review of predictors and mediators of adult outcomes highlights (a) the potential for heterotypically continuous pathways in females with childhood ADHD and (b) developmental progressions to self-harm, intimate partner violence, unplanned pregnancy, and comorbid psychopathology. Focusing on ADHD in females is necessary to characterize causal and maintaining mechanisms with accuracy and to foster responsive interventions, as highlighted in our closing list of clinical implications and research priorities.
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Affiliation(s)
- Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Phuc T Nguyen
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Sinclaire M O'Grady
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Emily A Rosenthal
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
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13
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Gascon A, Gamache D, St-Laurent D, Stipanicic A. Do we over-diagnose ADHD in North America? A critical review and clinical recommendations. J Clin Psychol 2022; 78:2363-2380. [PMID: 35322417 DOI: 10.1002/jclp.23348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 02/18/2022] [Accepted: 03/01/2022] [Indexed: 11/09/2022]
Abstract
There has been a marked increase in the prevalence of attention-deficit/hyperactivity disorder (ADHD) in the last 25 years in North America. Some see this trend as positive and believe that it reflects a better identification of ADHD and even think that the disorder is still under-diagnosed. Others, however, contend that ADHD is over-diagnosed. To help mental health clinicians to maintain an informed and nuanced perspective on this debate, this critical review aims to (1) summarize empirical results on factors that might contribute to increase the number of ADHD diagnoses and (2) propose clinical recommendations coherent with these findings to improve clinical practices for ADHD assessment and treatment. We conclude that artifactual factors such as current formulation of diagnostic criteria, clinical practices, and inordinate focus on performance, which is rampant in North America, likely contribute to inflated prevalence rates.
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Affiliation(s)
- Abigaëlle Gascon
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Center for Interdisciplinary Studies on Child Development and the Family, Trois-Rivières, Quebec, Canada
| | - Dominick Gamache
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,CERVO Brain Research Centre, Quebec City, Quebec, Canada.,Interdisciplinary Research Centre on Intimate Relationship Problems and Sexual Abuse, Montreal, Quebec, Canada
| | - Diane St-Laurent
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Center for Interdisciplinary Studies on Child Development and the Family, Trois-Rivières, Quebec, Canada
| | - Annie Stipanicic
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.,Center for Interdisciplinary Studies on Child Development and the Family, Trois-Rivières, Quebec, Canada.,University Institute for Intellectual Disability and Autism Spectrum Disorder, Trois-Rivières, Quebec, Canada
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14
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Abstract
This chapter focusses on the benefits and limitations of stimulant medications in the treatment of ADHD. We highlight the key similarities and differences between the different stimulants used to treat ADHD and briefly discuss mechanisms of action, pharmacokinetics, and pharmacodynamics. We will discuss some of the political, ethical, and moral discussions about the use of stimulants including a consideration of the treatment of subsyndromal ADHD and the use of stimulants as cognitive enhancers. We review the comparative efficacy and effectiveness between stimulants and non-pharmacological treatments for ADHD, between stimulant classes and formulations and between stimulant and non-stimulant medications. We discuss the effects on core symptoms, common associated symptoms, cognition, and more distal outcomes including quality of life and functioning and issues related to tolerance, tolerability and adverse effects. Looking at the clinical implications of these findings, we discuss the importance of measurement-based care in the treatment of ADHD. Finally, we will look at the benefits and limitations of stimulants across several different populations and clinical subgroups.
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Affiliation(s)
- David Coghill
- Financial Markets Foundation Chair of Developmental Mental Health, Departments of Paediatrics and Psychiatry, School of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia.
- Murdoch Children's Research Institute, Parkville, VIC, Australia.
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15
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Koi P. Demarcation, instantiation, and individual traits: Realist social ontology for mental disorders. PHILOSOPHICAL PSYCHOLOGY 2021. [DOI: 10.1080/09515089.2021.2016674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Polaris Koi
- Philosophy, University of Turku, Turku, Finland
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16
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Swanepoel A. Fifteen-minute consultation: To prescribe or not to prescribe in ADHD, that is the question. Arch Dis Child Educ Pract Ed 2021; 106:322-325. [PMID: 33033075 DOI: 10.1136/archdischild-2020-318866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 09/09/2020] [Accepted: 09/16/2020] [Indexed: 11/03/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is fraught with controversy. Some clinicians believe it is a biological neurodevelopmental disorder which should be treated with medication. Others are adamant that ADHD is a social construct in which children, who have suffered developmental trauma, are medicalised. Evolutionary science may help us find a solution to this dichotomy by seeing ADHD as an example of an evolutionary mismatch in which children with ADHD are caught in a school environment that does not suit their natures. By considering how to improve the 'goodness of fit' between the child and their environment, clinicians can be more flexible in finding solutions that are ethically sound.
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17
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Fox V, Sheffield JM, Woodward ND. Attention-deficit/hyperactivity disorder in youth with psychosis spectrum symptoms. Schizophr Res 2021; 237:141-147. [PMID: 34530253 PMCID: PMC8582016 DOI: 10.1016/j.schres.2021.08.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Childhood attention deficit-hyperactivity disorder (ADHD) is common in psychotic disorders. However, prevalence estimates vary widely and the impact of ADHD on the severity of psychotic symptoms and associated features is unclear. We used the Philadelphia Neurodevelopmental Cohort (PNC; n = 9498 youth age 8-21), which includes a comprehensive structured interview of clinical symptoms and the Penn Computerized Neurocognitive Battery (CNB), to clarify the prevalence of ADHD in psychosis spectrum (PS) youth and determine if comorbid ADHD is associated with severity of psychotic symptoms and cognitive impairment. METHODS Prevalence of ADHD among PS youth was established by comparing PS youth to all other youth in the PNC cohort. Cognition was compared between four groups: typically developing (TD), ADHD, PS without ADHD (PS-ADHD), and PS with ADHD (PS+ADHD). To evaluate the impact of ADHD on psychosis symptomatology, severity of positive and negative psychotic symptoms was compared between PS-ADHD and PS+ADHD groups. RESULTS ADHD was more prevalent in PS youth compared to non-PS youth (45% vs. 20%). Cognition was significantly impaired in PS youth compared to TD youth, but the presence of ADHD in PS youth was not associated with greater cognitive impairment. Co-morbid ADHD was, however, associated with more severe psychosis symptoms in PS youth. CONCLUSION ADHD is more common among PS youth compared to youth without PS symptoms and is associated with more severe psychotic symptoms, but not severity of cognitive impairment. The association between ADHD and psychotic disorders may be mediated by psychosis symptoms in youth and may manifest a more stable cognitive impairment.
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Affiliation(s)
- Victoria Fox
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, United States of America
| | - Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, United States of America
| | - Neil D Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN, United States of America.
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18
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Koi P. Genetics on the neurodiversity spectrum: Genetic, phenotypic and endophenotypic continua in autism and ADHD. STUDIES IN HISTORY AND PHILOSOPHY OF SCIENCE 2021; 89:52-62. [PMID: 34365317 DOI: 10.1016/j.shpsa.2021.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
How we ought to diagnose, categorise and respond to spectrum disabilities such as autism and Attention Deficit/Hyperactivity Disorder (ADHD) is a topic of lively debate. The heterogeneity associated with ADHD and autism is described as falling on various continua of behavioural, neural, and genetic difference. These continua are varyingly described either as extending into the general population, or as being continua within a given disorder demarcation. Moreover, the interrelationships of these continua are likewise often vague and subject to diverse interpretations. In this paper, I explore geneticists' and self-advocates' perspectives concerning autism and ADHD as continua. These diagnoses are overwhelmingly analysed as falling on a continuum or continua of underlying traits, which supports the notion of "the neurodiversity spectrum", i.e., a broader swath of human neural and behavioural diversity on which some concentrations of different functioning are diagnosed. I offer a taxonomy of conceptions of the genetic, phenotypic, and endophenotypic dimensionality within and beyond these diagnostic categories, and suggest that the spectrum of neurodiversity is characteristically endophenotypic.
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Affiliation(s)
- Polaris Koi
- Philosophy Unit, University of Turku, FI-20014 Turun Yliopisto, Finland.
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19
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Beyond controversies in child mental health: negotiating autism and ADHD diagnosis in France and Brazil. BIOSOCIETIES 2021. [DOI: 10.1057/s41292-021-00234-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Peter S. An (un)happy marriage: child psychotherapy with children who are medicated for ADHD. JOURNAL OF CHILD PSYCHOTHERAPY 2021. [DOI: 10.1080/0075417x.2021.1945657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sarah Peter
- Anna Freud National Centre for Children and Families, London, UK
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21
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Tan TX, Liu Y, Damjanovic V, Ledford E, Li G, Li Y. Inattention, hyperactivity/impulsivity, and academic competence: Findings from three cohorts. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2021; 92:82-104. [PMID: 34184249 DOI: 10.1111/bjep.12439] [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] [Received: 01/03/2021] [Revised: 06/09/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is a risk for learning. Because ADHD commonly includes behaviours of inattention and behaviours of hyperactivity/impulsivity, how the two types of behaviours independently affect children's academic competence remains poorly understood. AIMS To investigate the impact of behaviours of inattention and behaviours of hyperactivity/impulsivity on Chinese students' academic competence. SAMPLES Parents of 167 preschoolers (Cohort 1), parents of 313 first graders (Cohort 2), and 1,003 high school students (Cohort 3). METHODS The ADHD-RS-IV Preschool version (Cohort 1), ADHD-RS-IV Home version (Cohort 2), and BASC-SRP (Cohort 3) were used to measure behaviours of inattention and hyperactivity/impulsivity. Academic competence was operationalized as school readiness (Cohort 1), math and language arts scores at two time points provided by school (Cohort 2), and self-reported academic performance (Cohort 3). Multiple regressions were performed to investigate the relationship between academic performance and behaviours of inattention alone (Step 1), and behaviours of hyperactivity/impulsivity alone (Step 2), and behaviours of inattention together with behaviours of hyperactivity/impulsivity (Step 3). RESULTS For each cohort, both types of behaviours were negatively correlated with academic competence. However, regression analyses showed that in Step 3, behaviours of hyperactivity/impulsivity either failed to predict academic competence or predicted better academic competence. Overall, behaviours of inattention alone accounted for a similar amount of variance in academic competence as did behaviours of inattention and hyperactivity/impulsivity combined. CONCLUSIONS Behaviours of inattention presented a risk for academic competence but the effect of behaviours of hyperactivity/impulsivity varied. Implications for instructional strategies for behaviours of inattention were discussed.
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Affiliation(s)
- Tony Xing Tan
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, Florida, USA
| | - Yanhong Liu
- Department of Counseling & Human Services, School of Education, Syracuse University, New York, USA
| | - Victoria Damjanovic
- Department of Teaching and Learning, College of Education, University of South Florida, Tampa, Florida, USA
| | - Elyse Ledford
- Department of Teaching and Learning, College of Education, University of South Florida, Tampa, Florida, USA
| | - Gen Li
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, Florida, USA
| | - Yanzheng Li
- Department of Sociology, College of Humanities and Laws, Hebei University of Science and Technology, Shijiazhuang, Hebei, China
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22
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Shi Y, Hunter Guevara LR, Dykhoff HJ, Sangaralingham LR, Phelan S, Zaccariello MJ, Warner DO. Racial Disparities in Diagnosis of Attention-Deficit/Hyperactivity Disorder in a US National Birth Cohort. JAMA Netw Open 2021; 4:e210321. [PMID: 33646315 PMCID: PMC7921900 DOI: 10.1001/jamanetworkopen.2021.0321] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE There are limited data on the racial disparities in the incidence of attention-deficit/hyperactivity disorder (ADHD) diagnosis in children at the national level. OBJECTIVE To explore differences in rates of diagnosis of ADHD and use of treatment among children by race and ethnicity. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study assessed insurance claims data of children born in the US between January 1, 2006, and December 31, 2012, who had continuous insurance coverage for at least 4 years. The last date of follow-up included in the cohort was June 30, 2019. Race/ethnicity designations were based on self-report and included non-Hispanic White, Black, Hispanic, and Asian. Data were analyzed between October 2019 and December 2020. EXPOSURES Race and ethnicity. MAIN OUTCOMES AND MEASURES ADHD diagnosis as defined by International Classification of Diseases codes (ninth or tenth editions) and treatment within 1 year of diagnosis, including medication and behavior therapy as defined by billing codes. Data on ADHD diagnosis and treatment were adjusted for sex, region, and household income in a multivariate Cox regression model. RESULTS Among 238 011 children in the cohort (116 093 [48.8%] girls; 15 183 [6.7%] Asian, 14 792 [6.2%] Black, 23 358 [9.8%] Hispanic, and 173 082 [72.7%] White children), 11 401 (4.8%) were diagnosed with ADHD. The cumulative incidence at age 12 was 13.12% (95% CI, 12.79%-13.46%). In multivariate Cox regression adjusting for sex, region, and household income, the hazard ratio for Asian children was 0.48 (95% CI, 0.43-0.53); Black children, 0.83 (95% CI, 0.77-0.90); and Hispanic children, 0.77 (95% CI, 0.72, 0.82) compared with White children. In the first year after diagnosis, 516 preschool children (19.4%) received behavioral therapy only, 860 (32.4%) had medications only, 505 (19.0%) had both, and 774 (29.2%) had no claims associated with either option. A higher percentage of school-aged children (2904 [65.6%]) were prescribed medications, and fewer had therapy only (639 [14.4%]) or no treatment at all (884 [20.0%]). Compared with other groups, White children were more likely to receive some kind of treatment. Asian children had the highest odds of receiving no treatment (odds ratio compared with White children, 0.54; 95% CI, 0.42-0.70). CONCLUSIONS AND RELEVANCE Racial and ethnic disparities in the diagnosis and treatment of ADHD are evident. Future study is needed to elucidate the mechanism behind these disparities, with special attention to Asian children. Clinicians should provide racially sensitive care in the evaluation and treatment of ADHD.
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Affiliation(s)
- Yu Shi
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Hayley J. Dykhoff
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Lindsey R. Sangaralingham
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
- OptumLabs, Cambridge, Massachusetts
| | - Sean Phelan
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | - David O. Warner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
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Batstra L, Foget L, van Haeringen C, Te Meerman S, Thoutenhoofd ED. What children and young people learn about ADHD from youth information books: A text analysis of nine books on ADHD available in Dutch. Scand J Child Adolesc Psychiatr Psychol 2021; 8:1-9. [PMID: 33520773 PMCID: PMC7685495 DOI: 10.21307/sjcapp-2020-001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is not a singular concept. For the purposes of this study, understandings of ADHD are assumed also to spread along a conceptual dimension that includes some combination of biomedical and psychosocial knowledge. Biomedically, ADHD may be considered a somatic affliction causing inattention and hyperactivity, amenable to pharmaceutical treatment. Psychosocially, ADHD ranks among adverse behaviour patterns that are amenable to psychosocial and pedagogical intervention. Considering both biomedical and psychosocial factors are associated with the ADHD construct, it seems self-evident that young people should be offered information that gives equal consideration to both ways of addressing ADHD, but the question is just how balanced the information available to young people is. This study investigated nine information books on ADHD available in the Netherlands in Dutch, aimed at children and young people up to age 17. Thirteen perspective-dependent text elements were identified in qualitative content analysis. Eight attributes associate with a biomedical view: ADHD as cause, biological factors, clinical diagnosis, brain abnormality, medication, neurofeedback, heritability and persistence. Five text elements associate with a psychosocial view: ADHD as perceived behaviour, environmental factors, descriptive diagnosis, behavioural intervention and normalisation. The most frequent text passages encountered describe ADHD as a brain abnormality, along with medical and behavioural treatment. Providing the main focus for information in eight out of nine books, biomedical information about ADHD predominates in the available youth information books, while psychosocial information about ADHD is far less well covered.
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Affiliation(s)
- Laura Batstra
- Faculty of Behavioral and Social Sciences, The University of Groningen, Groningen, The Netherlands
| | - Linda Foget
- Faculty of Behavioral and Social Sciences, The University of Groningen, Groningen, The Netherlands
| | - Caroline van Haeringen
- Faculty of Behavioral and Social Sciences, The University of Groningen, Groningen, The Netherlands
| | - Sanne Te Meerman
- Youth, Education and Society, Centre of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, The Netherlands
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Ho HY, Wong CK, Wu SY, Hsiao RC, Chen YL, Yen CF. Increased Alopecia Areata Risk in Children with Attention-Deficit/Hyperactivity Disorder and the Impact of Methylphenidate Use: A Nationwide Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031286. [PMID: 33535410 PMCID: PMC7908272 DOI: 10.3390/ijerph18031286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022]
Abstract
Alopecia areata (AA) is an autoimmune disease that causes sudden hair loss. Although few studies have reported the association between AA and attention-deficit/hyperactivity disorder (ADHD), the impact of methylphenidate (MPH) on AA has not been examined. This study examined whether AA risk is higher in children with ADHD than in those without ADHD as well as the impact of MPH use on AA risk in children with ADHD. From the Taiwan Maternal and Child Health Database, we enrolled all 1,750,456 newborns from 2004 to 2017 in Taiwan. Of them, 90,016 children received a diagnosis of ADHD whereas the remaining 1,660,440 did not. To compare AA risk in ADHD and the impact of MPH treatment on it, multiple Cox regression with adjustments for covariates (i.e., age, sex, and psychiatric comorbidities) was performed. The results indicated that 88 (0.098%) children with ADHD and 1191 (0.072%) children without ADHD had AA. Nevertheless, after adjustment for the covariates, AA risk was higher in children with ADHD than in those without ADHD (adjusted hazard ratio [aHR]: 1.30, 95% confidence interval [CI]: 1.04–1.64). Our data indicated a considerable reduction in AA risk (aHR: 0.64) among children with ADHD who received MPH than among those who did not receive MPH; however, this difference was nonsignificant, indicated by a wide 95% CI (0.32–1.25). In conclusion, ADHD and AA may share some underlying mechanisms.
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Affiliation(s)
- Hsing-Ying Ho
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan; (H.-Y.H.); (S.-Y.W.)
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
| | - Chih-Kai Wong
- Department of Dermatology, MacKay Memorial Hospital, Taipei 10449, Taiwan;
| | - Szu-Yuan Wu
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan; (H.-Y.H.); (S.-Y.W.)
- Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 26546, Taiwan
- Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 26546, Taiwan
- Graduate Institute of Business Administration, Fu Jen Catholic University, Taipei 24205, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine and Children’s Hospital, Seattle, WA 98105, USA;
| | - Yi-Lung Chen
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan; (H.-Y.H.); (S.-Y.W.)
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-23323456 (ext. 20106) (Y.-L.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-23323456 (ext. 20106) (Y.-L.C.); +886-7-3121101 (ext. 6822) (C.-F.Y.)
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Young S, Asherson P, Lloyd T, Absoud M, Arif M, Colley WA, Cortese S, Cubbin S, Doyle N, Morua SD, Ferreira-Lay P, Gudjonsson G, Ivens V, Jarvis C, Lewis A, Mason P, Newlove-Delgado T, Pitts M, Read H, van Rensburg K, Zoritch B, Skirrow C. Failure of Healthcare Provision for Attention-Deficit/Hyperactivity Disorder in the United Kingdom: A Consensus Statement. Front Psychiatry 2021; 12:649399. [PMID: 33815178 PMCID: PMC8017218 DOI: 10.3389/fpsyt.2021.649399] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Despite evidence-based national guidelines for ADHD in the United Kingdom (UK), ADHD is under-identified, under-diagnosed, and under-treated. Many seeking help for ADHD face prejudice, long waiting lists, and patchy or unavailable services, and are turning to service-user support groups and/or private healthcare for help. Methods: A group of UK experts representing clinical and healthcare providers from public and private healthcare, academia, ADHD patient groups, educational, and occupational specialists, met to discuss shortfalls in ADHD service provision in the UK. Discussions explored causes of under-diagnosis, examined biases operating across referral, diagnosis and treatment, together with recommendations for resolving these matters. Results: Cultural and structural barriers operate at all levels of the healthcare system, resulting in a de-prioritization of ADHD. Services for ADHD are insufficient in many regions, and problems with service provision have intensified as a result of the response to the COVID-19 pandemic. Research has established a range of adverse outcomes of untreated ADHD, and associated long-term personal, social, health and economic costs are high. The consensus group called for training of professionals who come into contact with people with ADHD, increased funding, commissioning and monitoring to improve service provision, and streamlined communication between health services to support better outcomes for people with ADHD. Conclusions: Evidence-based national clinical guidelines for ADHD are not being met. People with ADHD should have access to healthcare free from discrimination, and in line with their legal rights. UK Governments and clinical and regulatory bodies must act urgently on this important public health issue.
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Affiliation(s)
- Susan Young
- Psychology Services Limited, London, United Kingdom.,Department of Psychology, Reykjavik University, Reykjavik, Iceland.,ADHD Foundation, Liverpool, United Kingdom
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Tony Lloyd
- ADHD Foundation, Liverpool, United Kingdom
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.,King's Health Partners Academic Health Science Centre, London, United Kingdom.,Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Muhammad Arif
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | | | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences & Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Solent NHS Trust, Southampton, United Kingdom.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, United States
| | - Sally Cubbin
- The ADHD Clinic, Manor Hospital, Oxford, United Kingdom
| | - Nancy Doyle
- Genius Within, Plumpton Green, United Kingdom.,Department of Organizational Psychology, Birkbeck College, University of London, London, United Kingdom
| | - Susan Dunn Morua
- AADD-United Kingdom, Bristol, United Kingdom.,Bristol Adult ADHD Support Group, Bristol, United Kingdom
| | - Philip Ferreira-Lay
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, United Kingdom
| | - Gisli Gudjonsson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | | | - Alexandra Lewis
- Cambridge & Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Peter Mason
- ADHD Foundation, Liverpool, United Kingdom.,ADHD and Psychiatry Services Limited, Liverpool, United Kingdom.,Cheshire and Wirral Partnership NHS Foundation Trust, Chester, United Kingdom
| | | | - Mark Pitts
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Helen Read
- ADHD Consultancy Limited, London, United Kingdom
| | - Kobus van Rensburg
- Adult ADHD and Asperger's Team & Children and Young People's ADHD and ASD Service, Northamptonshire Healthcare NHS Foundation Trust, Kettering, United Kingdom
| | - Bozhena Zoritch
- ADDmire Clinic, West Byfleet, United Kingdom.,Epsom and St. Helier University Hospital, Epsom, United Kingdom
| | - Caroline Skirrow
- Cambridge Cognition, Cambridge, United Kingdom.,Psychological Sciences, University of Bristol, Bristol, United Kingdom
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Olashore AA, Paruk S, Ogunjumo JA, Ogundipe RM. Attention-deficit hyperactivity disorder in school-age children in Gaborone, Botswana: Comorbidity and risk factors. S Afr J Psychiatr 2020; 26:1525. [PMID: 33240552 PMCID: PMC7670025 DOI: 10.4102/sajpsychiatry.v26i0.1525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/05/2020] [Indexed: 11/12/2022] Open
Abstract
Background Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. Its occurrence and pattern of presentation are unknown in Botswana. Aim To determine the prevalence of attention-deficit hyperactivity disorder (ADHD), associated comorbid conditions and risk factors amongst school-age children in Botswana. Setting Primary schools in Gaborone, Botswana. Methods This study used a cross-sectional design. A two-stage random sampling technique was utilised to select learners from 25 out of the 29 public schools in the city. The Vanderbilt ADHD Diagnostic Rating Scale (VADRS), teacher and parent versions, was administered. Results Of the 1737 children, 50.9% (n = 884) were male, and their mean age was 9.53 years (s.d. = 1.97). The prevalence of ADHD was 12.3% (n = 213). The most prevalent presentation was the predominantly inattentive, 7.2% (n = 125). A family history of mental illness (odds ratio [OR] = 6.59, 95% CI: 1.36–32.0) and perinatal complications (OR = 2.16, 95% CI: 1.08–4.29) emerged as the independent predictors of ADHD. Conclusions The prevalence of ADHD in Botswana is slightly higher than that reported in the literature, but the pattern of presentations and comorbidities is similar. A positive family history of mental illness and perinatal complications independently predicted ADHD. Mental health screening amongst families of the affected individuals and improved perinatal care should be considered as health care priorities in Botswana.
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Affiliation(s)
- Anthony A Olashore
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Saeeda Paruk
- Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban South Africa
| | - John A Ogunjumo
- Department of Family Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Radiance M Ogundipe
- Department of Family Medicine, Faculty of Medicine, University of Botswana, Gaborone, Botswana
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Meyer BJ, Stevenson J, Sonuga-Barke EJS. Sex Differences in the Meaning of Parent and Teacher Ratings of ADHD Behaviors: An Observational Study. J Atten Disord 2020; 24:1847-1856. [PMID: 28800718 DOI: 10.1177/1087054717723988] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To test explanations for the underrecognition of female ADHD by examining differences in adult ratings of boys and girls matched for levels of directly observed ADHD behaviors. Method: In a secondary analysis of a population-based sample, 3- to 4-year-olds (n = 153, 79 male) and 8- to 9-year-olds (n = 144, 75 male) were grouped according to levels of directly observed ADHD behaviors (low/moderate/high). Groups were then compared with parent/teacher ADHD ratings. Results: There were no sex differences in levels of directly observed ADHD behaviors within groups. For preschoolers, parents' ratings of males, but not females, significantly increased across groups-mirroring levels of observed behaviors. For older children, both parent and teacher mean ratings were significantly higher for males than females across groups. Conclusion: Identified differences in adult ratings of males and females matched for directly observed behaviors may contribute to understanding the substantial ADHD underrecognition in females.
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Prevalence of attention-deficit/hyperactivity disorder in older adults: A systematic review and meta-analysis. Neurosci Biobehav Rev 2020; 118:282-289. [DOI: 10.1016/j.neubiorev.2020.07.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/26/2022]
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Evidence for a Higher-Order ESEM Structure of ADHD in a Sample of Chinese Children. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09837-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Xing Tan T, Teng Y. Behaviors of ADHD and Peer Relationship Difficulties in Chinese and American Youths: Role of Co-Occurring Behaviors of Depression and Anxiety. The Journal of Genetic Psychology 2020; 181:391-404. [PMID: 32672133 DOI: 10.1080/00221325.2020.1788499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The co-occurrence of behaviors of attention-deficit/hyperactivity disorder (ADHD) with behaviors of anxiety or behaviors of depression is the norm, but little is known on how the co-occurrence accounted for youths' peer relations. The authors report results on difficult peer relations in relation to behaviors of ADHD, co-occurring behaviors of depression, and behaviors of anxiety from three studies on 862 youths in China and in the United States. Study 1 included 313 ethnically and socioeconomically diverse American youths; Study 2 included 250 youths who were adopted out of Chinese orphanages by American parents; and Study 3 included 299 youths from Beijing, China. Data on difficult peer relations and behaviors of ADHD, depression, and anxiety were collected with the third edition of Behavior Assessment System for Children-Self Report of Personality. In all three studies, each type of problems alone significantly predicted difficult peer relations, but behaviors of ADHD were not significant when co-occurring behaviors of depression or co-occurring behaviors of anxiety were considered. Despite that the youths in our study had different cultural and personal backgrounds, there was no evidence that behaviors of ADHD were detrimental to youths' peer relations when behaviors of depression or anxiety were considered. Implications for intervention were discussed.
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Affiliation(s)
- Tony Xing Tan
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, Florida, USA
| | - Yuejia Teng
- Department of Psychology, College of Arts and Sciences, University of South Florida, Tampa, Florida, USA
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Slobodin O, Masalha R. Challenges in ADHD care for ethnic minority children: A review of the current literature. Transcult Psychiatry 2020; 57:468-483. [PMID: 32233772 DOI: 10.1177/1363461520902885] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
While attention deficit hyperactivity disorder (ADHD) has been extensively studied in the past decades, the role of social and cultural practices in its assessment, diagnosis, and treatment has been often overlooked. This selective review provides an overview of research that explores social and cultural influences on help-seeking behavior in ethnic minority children with ADHD. Studies were selected that address cultural diversity in three areas of ADHD help-seeking: problem recognition, access to mental health services, and treatment. Special attention was given to studies of treatment selection and adherence in minority groups. Findings suggested that cultural disparities in ADHD care among ethnic minority children occur in the early stages of problem recognition, through service selection, and in the quality of treatment. Ethnic minority children were less likely than their nonminority counterparts to be diagnosed with ADHD and its comorbid conditions and less likely to be prescribed and adhere to stimulant drug treatment. These differences reflect cultural diversity in norms and attitudes towards mental health issues (e.g., fear of social stigma) as well as limited access to qualified health care. Paradoxically, cultural, racial, and language bias may also lead to the overidentification of ethnic minority children as disabled and to higher ratings of ADHD symptoms. This review highlights the importance of sociocultural factors in understanding developmental psychopathology and help-seeking behavior. In addition, it further supports calls for increasing cultural competence in communications during clinical assessment, diagnosis, and treatment in minority communities. Clinical, theoretical, and methodological considerations for future research are discussed.
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Affiliation(s)
- Ortal Slobodin
- Education Department, Ben-Gurion University, Be'er Sheva, Israel
| | - Rafik Masalha
- Faculty of Health Sciences, Ben-Gurion University, Be'er Sheva, Israel
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2019 PIF Essay Competition winning entry: Not just "normal": the life-changing magic of going beyond "healthy". Australas Psychiatry 2020; 28:368-369. [PMID: 32538166 DOI: 10.1177/1039856220926601c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cunial KJ, Casey LM, Bell C, Kebbell MR. Investigative interviewing of youth with ADHD - recommendations for detective training. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2020; 27:797-814. [PMID: 33833610 PMCID: PMC8009112 DOI: 10.1080/13218719.2020.1742241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) in youth can lead to a trajectory of early and repeated contact with the criminal justice system (CJS), where such youth face significant challenges due to the nature of their diagnosis and the lack of specialized detective training in this area. This article reviews Australian detectives' perceptions regarding contact with ADHD-affected youth, ongoing contact of such youth with the CJS, and the impact of ADHD on interviewing time efficiency and quality of information gathered. It explores detectives' perceived impact of ADHD on components of the Cognitive Interview (CI). It overviews detectives' perceptions regarding their own skill/ability, training availability and future training preferences regarding the interviewing of ADHD-affected youth. The authors highlight best practice in specialized detective training, as well as in working with ADHD-affected youth. Recommendations are made regarding the design features of a potential specialized training programme for detectives interviewing ADHD-affected youth.
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Affiliation(s)
| | - Leanne M. Casey
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Clare Bell
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Mark R. Kebbell
- School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
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Suggestive diagnosis of attention-deficit/hyperactivity disorder in indigenous children and adolescents from the Brazilian Amazon. Eur Child Adolesc Psychiatry 2020; 29:373-384. [PMID: 31165277 PMCID: PMC7056679 DOI: 10.1007/s00787-019-01356-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 05/23/2019] [Indexed: 11/11/2022]
Abstract
The prevalence of attention-deficit/hyperactivity disorder (ADHD) symptoms has been scarcely studied in indigenous cultures that preserve ancestral cultural characteristics. The objective of the study is to estimate the prevalence of suggestive diagnosis of ADHD among indigenous children and adolescents from villages in the Amazon. This is an analytical cross-sectional study using instruments to track ADHD symptoms (the Child Behaviour Checklist for ages 6-18: CBCL/6-18 and the teacher report form for ages 6-18: TRF/6-18) and to investigate their negative impact on the patients (using the Strengths and Difficulties Questionnaire-SDQ). The prevalence of a suggestive ADHD diagnosis according to the CBCL/TRF DSM-IV ADHD subscale without and with negative impact as assessed by the SDQ was 4.3% and 1.1%, respectively. Comorbid oppositional-defiant, conduct problems and anxious symptoms were present in all cases screening positive for ADHD. We also presented a case report as an illustration of the observed clinical presentation. ADHD is a recognizable disorder even in a culture that preserves millennial characteristics. Furthermore, the presence of ADHD symptoms was associated with significant impairment.
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Dauman N, Haza M, Erlandsson S. Liberating parents from guilt: a grounded theory study of parents' internet communities for the recognition of ADHD. Int J Qual Stud Health Well-being 2019; 14:1564520. [PMID: 30696381 PMCID: PMC6352942 DOI: 10.1080/17482631.2018.1564520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 11/06/2022] Open
Abstract
PURPOSE This study presents a qualitative analysis of information posted on the Internet by two communities of French parents promoting the recognition of ADHD in the context of current health and school practices. METHOD Grounded Theory (Strauss & Corbin's approach) was applied to the posted messages, with the aim to discover the main concern and common theme through a constant comparison analysis. RESULTS Liberating parents from feeling responsible for their child's misconduct was found to be the core category. From this perspective, we account for the commitment of the digital communities to formalize the child's conduct as a consequence of a neurodevelopmental disorder. This approach helps to account for the promotion of behavioural expertise and conditioning strategies (e.g., positive reinforcement) for handling the child's so-called disorder as appropriate parental responses. Giving evidence for parenting struggles was the third main concern of the communities, in the face of perceived skepticism from professionals towards ADHD as a medical condition. CONCLUSIONS By using examples from countries that are found to have a more pro-medical approach to ADHD, the communities aim at improving such medical practices in France. Issues surrounding the claim that ADHD would require a specific style of parenting are also discussed.
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Affiliation(s)
- Nicolas Dauman
- Department of Psychology, University of Poitiers, Poitiers, France
| | - Marion Haza
- Department of Psychology, University of Poitiers, Poitiers, France
| | - Soly Erlandsson
- Centre for Child and Youth Studies, University West, Trollhättan, Sweden
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Izzo VA, Donati MA, Novello F, Maschietto D, Primi C. The Conners 3-short forms: Evaluating the adequacy of brief versions to assess ADHD symptoms and related problems. Clin Child Psychol Psychiatry 2019; 24:791-808. [PMID: 31074289 DOI: 10.1177/1359104519846602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Conners' Rating Scales are widely used to assess attention deficit/hyperactivity disorder (ADHD) and related difficulties in children and adolescents. A short form of the scales is available, which, along with the several advantages of brief versions, also displays good psychometric properties. Nonetheless, no studies have confirmed them in cultural contexts different from the original one. The present study examined the psychometric properties of the Self-Report, Parent, and Teacher Conners 3-Short Forms in terms of reliability and validity in an Italian sample. Analyses were performed on 591 children and adolescents, 631 parents' ratings, and 325 teachers' ratings. To test for discriminative validity, ADHD clinical samples of 55 youth, 63 parents, and 15 teachers were compared to gender- and age-matched groups. Findings confirmed the original multidimensional structures and supported the Conners 3-Short Form scales as reliable and valid tools to assess ADHD and its main comorbid conditions.
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Affiliation(s)
- Viola Angela Izzo
- NEUROFARBA Department, Section of Psychology, University of Florence, Italy
| | - Maria Anna Donati
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | | | | | - Caterina Primi
- NEUROFARBA Department, Section of Psychology, University of Florence, Italy
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Sutoko S, Monden Y, Tokuda T, Ikeda T, Nagashima M, Funane T, Sato H, Kiguchi M, Maki A, Yamagata T, Dan I. Exploring attentive task-based connectivity for screening attention deficit/hyperactivity disorder children: a functional near-infrared spectroscopy study. NEUROPHOTONICS 2019; 6:045013. [PMID: 31853459 PMCID: PMC6917048 DOI: 10.1117/1.nph.6.4.045013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/20/2019] [Indexed: 06/10/2023]
Abstract
Connectivity impairment has frequently been associated with the pathophysiology of attention-deficit/hyperactivity disorder (ADHD). Although the connectivity of the resting state has mainly been studied, we expect the transition between baseline and task may also be impaired in ADHD children. Twenty-three typically developing (i.e., control) and 36 disordered (ADHD and autism-comorbid ADHD) children were subjected to connectivity analysis. Specifically, they performed an attention task, visual oddball, while their brains were measured by functional near-infrared spectroscopy. The results of the measurements revealed three key findings. First, the control group maintained attentive connectivity, even in the baseline interval. Meanwhile, the disordered group showed enhanced bilateral intra- and interhemispheric connectivities while performing the task. However, right intrahemispheric connectivity was found to be weaker than those for the control group. Second, connectivity and activation characteristics might not be positively correlated with each other. In our previous results, disordered children lacked activation in the right middle frontal gyrus. However, within region connectivity of the right middle frontal gyrus was relatively strong in the baseline interval and significantly increased in the task interval. Third, the connectivity-based biomarker performed better than the activation-based biomarker in terms of screening. Activation and connectivity features were independently optimized and cross validated to obtain the best performing threshold-based classifier. The effectiveness of connectivity features, which brought significantly higher training accuracy than the optimum activation features, was confirmed (88% versus 76%). The optimum screening features were characterized by two trends: (1) strong connectivities of right frontal, left frontal, and left parietal lobes and (2) weak connectivities of left frontal, left parietal, and right parietal lobes in the control group. We conclude that the attentive task-based connectivity effectively shows the difference between control and disordered children and may represent pathological characteristics to be feasibly implemented as a supporting tool for clinical screening.
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Affiliation(s)
- Stephanie Sutoko
- Hitachi, Ltd., Center for Exploratory Research, Research and Development Group, Hatoyama, Saitama, Japan
- Chuo University, Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Bunkyo-ku, Tokyo, Japan
| | - Yukifumi Monden
- Jichi Medical University, Department of Pediatrics, Shimotsuke, Tochigi, Japan
- International University of Health and Welfare Hospital, Department of Pediatrics, Nasushiobara, Tochigi, Japan
| | - Tatsuya Tokuda
- Chuo University, Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Bunkyo-ku, Tokyo, Japan
| | - Takahiro Ikeda
- Jichi Medical University, Department of Pediatrics, Shimotsuke, Tochigi, Japan
| | - Masako Nagashima
- Jichi Medical University, Department of Pediatrics, Shimotsuke, Tochigi, Japan
| | - Tsukasa Funane
- Hitachi, Ltd., Center for Exploratory Research, Research and Development Group, Hatoyama, Saitama, Japan
| | - Hiroki Sato
- Hitachi, Ltd., Center for Exploratory Research, Research and Development Group, Hatoyama, Saitama, Japan
| | - Masashi Kiguchi
- Hitachi, Ltd., Center for Exploratory Research, Research and Development Group, Hatoyama, Saitama, Japan
| | - Atsushi Maki
- Hitachi, Ltd., Center for Exploratory Research, Research and Development Group, Hatoyama, Saitama, Japan
| | - Takanori Yamagata
- Jichi Medical University, Department of Pediatrics, Shimotsuke, Tochigi, Japan
| | - Ippeita Dan
- Chuo University, Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Bunkyo-ku, Tokyo, Japan
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Regnart J, Truter I, Zingela Z, Meyer A. A pilot study: Use of the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale in a South African patient population. S Afr J Psychiatr 2019; 25:1326. [PMID: 31205781 PMCID: PMC6556992 DOI: 10.4102/sajpsychiatry.v25i0.1326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 03/13/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder which typically presents in childhood. This diagnosis may often be overlooked in adulthood, particularly in psychiatric populations. The Adult ADHD Self-Report Scale (ASRS) is an internationally used and reliable screener; however, studies investigating its use in African populations are limited. AIM To investigate the application of the ASRS in a South African setting. SETTING A patient population in Port Elizabeth, South Africa, was identified as representing a developing or low- and middle-income country population. METHODS A convenience sample of acutely presenting psychiatric participants admitted for stabilisation was used. Fieldworkers administered the ASRS; collected information relating to demographics, differential diagnoses, substance use disorder (SUD) presence and substance consumption; and prescribed medication relating to current or historical treatment of ADHD. RESULTS The study sample included 30 participants, with black people representing the majority of participants. Adult ADHD Self-Report Scale completion revealed the rate of ADHD within the study population to be 43.3%, a contrast to the initially presumed prevalence of 6.7% which was based on reported methylphenidate therapy. A difference in SUD prevalence was identified between subjects screening positively and negatively for ADHD with a greater tendency towards SUDs seen for ASRS-positive individuals. Significant differences were identified in relation to cannabis- and polysubstance use for ASRS-positive individuals. CONCLUSION Despite limitations related to the sample used and challenges in ASRS administration, investigation findings support recommendations for ADHD screening inclusion in acute inpatient settings in South Africa and ASRS translation into indigenous African languages.
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Affiliation(s)
- Judith Regnart
- Department of Pharmacy, Nelson Mandela University, Port Elizabeth, South Africa
| | - Ilse Truter
- Department of Pharmacy, Nelson Mandela University, Port Elizabeth, South Africa
| | - Zukiswa Zingela
- Department of Psychiatry and Behavioural Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Anneke Meyer
- Department of Psychology, Nelson Mandela University, Port Elizabeth, South Africa
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The powerless or the empowered? Stakeholders' experiences of diagnosis and treatment for attention-deficit hyperactivity disorder in Ireland. Ir J Psychol Med 2019; 35:203-212. [PMID: 30124187 DOI: 10.1017/ipm.2018.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
IntroductionIn Ireland, attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed condition in Child and Adolescent Mental Health Services (CAMHS). However, little is known about the experiences of stakeholders affected by ADHD in their pathways through care, especially in Ireland. OBJECTIVES The aim of this stakeholder voice study was to explore stress and coping among parents and Children and Young People (C/YP) affected by ADHD in an Irish context, in order to contribute to knowledge about what works and what needs to change in practice from a service user perspective. METHODS In total, 15 C/YP (7-18 years) with ADHD and their parents participated in semi-structured interviews, which were triangulated using other sources (e.g. visual methods), to contribute to a highly contextualised understanding of lived experiences. Transcribed interviews were analysed using a deductive approach to Thematic Analysis informed by a theoretical framework of stress and coping theory and Bronfenbrenner's bio-ecological model. RESULTS Some degree of difficulty in their pathway through care was identified by participants in all case studies. Findings identified barriers to diagnosis, including delays in diagnosis, such as scepticism, stigma, and label avoidance from gatekeepers; poor multiagency working; and misdiagnosis. Once received, diagnosis may serve as an access to empowerment, providing knowledge, understanding, and support. However, C/YP and their parents also reported distressing experiences and a sense of powerlessness within CAMHS and with treatment; such as tensions around medical management, stigma, and a lack of child- and family-centred practice. CONCLUSIONS Despite the professionals and the systematic supports available, stakeholders did not feel that they were fully understood, listened to, or participants in accessing diagnosis and care planning.
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A systematic review of mindfulness based interventions for children and young people with ADHD and their parents. ACTA ACUST UNITED AC 2019. [DOI: 10.2478/gp-2019-0007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract
Objective
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent disorders in childhood, which may pose risks in later life such as academic underachievement and anti-social behaviour. It has been suggested that mindfulness-based interventions (MBI) may contribute to positive outcomes with child and adult populations. In this article, we aim to systematically review the literature regarding the effectiveness of MBI on both children with ADHD and their parents.
Method
Seven databases were searched using the PRISMA criteria and included peer-reviewed journals and grey literature.
Results
Ten studies met the inclusion criteria. Findings suggested that MBI had positive results in addressing attention deficits in children with ADHD, but in terms of hyperactivity, the evidence was conflicting. MBI interventions also appear to effectively address parental stress and family functioning. However, the rating from the quality assessment showed several methodological limitations.
Discussion
The current evidence on the impact of MBI on ADHD symptoms is non-conclusive. However, promising data indicated the potential for MBI in addressing parental stress and family functioning. Further research is recommended to overcome the current methodological limitations.
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Uribe P, Abarca-Brown G, Radiszcz E, López-Contreras E. ADHD and Gender: subjective experiences of children in Chile. SAUDE E SOCIEDADE 2019. [DOI: 10.1590/s0104-12902019181144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Although research on ADHD has tended to ignore gender differentials, recent contributions produced mainly from epidemiology have revealed that this diagnostic category seems to be strongly related to gender. However, these contributions seem to limit their scope to the study of the symptoms as well as cognitive, affective and social functioning of children, leaving aside subjective aspects associated with the ADHD practices of diagnosis and treatment. Thus, this article aims to explore how the gender dimension crosses the subjective experience of children diagnosed with ADHD. Based on open interviews conducted with children between the ages of 7 and 13, we show general trends that articulate gender and characteristics associated with the ADHD diagnosis, while at the same time, with children’s experiences that dislocate such trends. The findings were grouped according to four emerging axes: (1) locations, (2) abilities, (3) approches, (4) interactions. Thus, we will show how the experience of boys and girls is multiple in relation to the diagnosis and it is not possible to be reduced to a gender binary perspective.
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Reyes P, Cottet P, Jimenez A, Jauregui G. Rethinking medicalization: discursive positions of children and their caregivers on the diagnosis and treatment of ADHD in Chile. SAUDE E SOCIEDADE 2019. [DOI: 10.1590/s0104-12902019181141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract The debates around the diagnosis and pharmacological treatment of Attention Deficit and Hyperactivity Disorder (ADHD) have traditionally been approached from the perspective of the “medicalization processes” of children’s behaviour. However, this perspective tends to overlook the meanings of diagnosis and treatment of ADHD for children and their caregivers. The purpose of this article is to describe the discursive positions of children and their caregivers on the diagnosis and treatment of ADHD. In-depth interviews were conducted with seven Chilean children and their caregivers. The material was analysed following the procedures of the discourse structure analysis. A discursive structure was identified that configures four emerging realities: the myth of origin of the child’s behaviour and learning problems; the ambivalences in/of medicalization; the process of identity (dis)stabilization under diagnosis and treatment; and the subversion of medicalization. It is observed that the subjective experience of the diagnosis and treatment of ADHD is not homogeneous, since different discursive positions, family and institutional understandings that enter into conflict cross it. The experiences of ADHD are shaped by discursive structures that condition the meanings of this experience. The medicalization process is not univocal, but can take different forms and have consequences on children’s experiences and social trajectories.
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Affiliation(s)
| | - Pablo Cottet
- Universidad de Chile, Chile; Universidad Academia de Humanismo Cristiano, Chile
| | - Alvaro Jimenez
- Universidad de Chile, Chile; Universidad de Chile, Chile
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Tanaka Y, Brod M, Lane JR, Upadhyaya H. What Is a Clinically Relevant Improvement in Quality of Life in Adults With ADHD? J Atten Disord 2019; 23:65-75. [PMID: 25876607 DOI: 10.1177/1087054715580395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To estimate a minimal clinically important difference (MCID) on the adult ADHD Quality of Life (AAQoL) scale. METHOD The MCID was determined from data from short-term ( N = 537) and long-term ( N = 440), placebo-controlled atomoxetine trials in adults with ADHD. For the anchor-based approach, change in clinician-rated Clinical Global Impressions-ADHD-Severity (CGI-ADHD-S) scores was used to derive MCID. For the distribution-based approach, baseline-to-endpoint mean ( SD) changes in AAQoL scores corresponding to 0.5 SD were computed. RESULTS The MCID was similar (approximately 8-point difference) between the short-term and the long-term treatment groups when either the anchor-based or distribution-based approach was used. CONCLUSION These results suggest that approximately 8 points in the change from baseline on the AAQoL is a MCID.
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Affiliation(s)
- Yoko Tanaka
- 1 Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA
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Abstract
The diagnosis of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents has increased considerably over the past decades. Scholars and health professionals alike have expressed concern about the role of screen media in the rise in ADHD diagnosis. However, the extent to which screen media use and ADHD are linked remains a point of debate. To understand the current state of the field and, ultimately, move the field forward, we provide a systematic review of the literature on the relationship between children and adolescents' screen media use and ADHD-related behaviors (i.e., attention problems, hyperactivity, and impulsivity). Using the Differential Susceptibility to Media effects Model as a theoretical lens, we systematically organize the existing literature, identify potential shortcomings in this literature, and provide directions for future research. The available evidence suggests a statistically small relationship between media and ADHD-related behaviors. Evidence also suggests that individual child differences, such as gender and trait aggression, may moderate this relationship. There is a clear need for future research that investigates causality, underlying mechanisms, and differential susceptibility to the effects of screen media use on ADHD-related behaviors. It is only through a richer empirical body that we will be able to fully understand the media-ADHD relationship.
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Reale L, Bonati M. ADHD prevalence estimates in Italian children and adolescents: a methodological issue. Ital J Pediatr 2018; 44:108. [PMID: 30185215 PMCID: PMC6126024 DOI: 10.1186/s13052-018-0545-2] [Citation(s) in RCA: 23] [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: 06/07/2018] [Accepted: 08/14/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is recognized as the most common, and most studied, developmental age disorder. Basic information, such as the most appropriate case definition and the best way to evaluate the disorder's prevalence rate, however, remains an open issue. METHODS A comprehensive meta-analysis on the epidemiology of ADHD in Italy, which was lacking from the literature, was therefore performed to attempt to estimate the actual prevalence rate of ADHD, highlighting conceptual and quantitative differences between clinical-diagnosis and survey-based symptoms studies. The Medline, Embase, and PsycINFO databases, and the grey literature, were searched up to January 2018. The review was laid out in three main sections: an overall prevalence estimate, an epidemiological profile of ADHD symptoms, and an attempt to define the actual rate of ADHD diagnosis, as emerged from Italian studies. RESULTS A total of 15 unique studies were included. These contributed to estimating the prevalence of ADHD in 67,838 subjects aged 5-17, representing 9 of the 20 regions (45%) of Italy. Overall, the pooled prevalence of ADHD was 2.9% (range: 1.1-16.7%). When distinguishing studies based on case definition, however, we found an average prevalence estimate, based on symptoms criteria, of 5.9% (range: 1.4 to 16.7%) and a best-estimate prevalence rate of 1.4% (range: 1.1 to 3.1%). CONCLUSIONS Following the case definition for epidemiological studies of ADHD, counting only subjects with an ADHD diagnosis performed and confirmed by clinical assessment would reduce the wide variability in prevalence estimates, and, above all, would both describe the real rate of subjects suffering from ADHD disorder and avoid misdiagnosis.
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Affiliation(s)
- Laura Reale
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via G. La Masa 19, 20156, Milan, Italy
| | - Maurizio Bonati
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via G. La Masa 19, 20156, Milan, Italy.
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Abstract
We are delighted to dedicate an edition of the Irish Journal of Psychological Medicine to the topic of attention-deficit hyperactivity disorder (ADHD). ADHD accounts for the majority of clinical presentations to Child and Adolescent Mental Health Services, both in terms of new assessments and ongoing attendances. Papers presented in this edition reflect on the evolving construct of ADHD, drawing from science, clinical practice and public opinion. Current and evidenced-based assessment and treatment practice guidelines are reviewed. International longitudinal studies allow us to understand the personal and societal cost, which can persist for many years post-diagnosis. Despite continuation to adulthood in many young people, follow on adult services are lacking. It is fitting that submissions, by way of personal reflections and opinion pieces, are also included from adult colleagues as they reflect on their experiences in this area. Given the recent development of a national clinical programme in ADHD in Ireland, coupled with a growing evidence for effective interventions, it is hoped that this special edition will highlight the need for appropriate and accessible ADHD treatments across the lifespan.
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Swanepoel A, Music G, Launer J, Reiss MJ. How evolutionary thinking can help us to understand ADHD. BJPSYCH ADVANCES 2018. [DOI: 10.1192/apt.bp.116.016659] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummaryWe argue that current debates about attention-deficit hyperactivity disorder (ADHD) can be considered afresh using an evolutionary lens. We show how the symptoms of ADHD can often be considered adaptive to their specific environment. We suggest that, from an evolutionary point of view, ADHD symptoms might be understood to result from an ‘evolutionary mismatch’, in which current environmental demands do not fit with what evolution has prepared us to cope with. For example, in our ancestral environment of evolutionary adaptedness (EEA), children were not expected to sit still and concentrate on academic tasks for many hours a day. Understanding ADHD in terms of such a ‘mismatch’ raises significant issues regarding the management of childhood ADHD, including ethical ones. An approach based on the concept of mismatch could provide an alternative to current debates on whether ADHD results from nature or nurture and whether it is under- or over-diagnosed. It would allow clinicians and policy makers to take both the child and the environment into account and consider what might be desirable and feasible, both in society and for specific children, to lessen the mismatch.LEARNING OBJECTIVES•Grasp the concept of ADHD as an ‘evolutionary mismatch’•Understand the issues raised by this perspective, including ethical ones•Appreciate how a transparent discussion of these issues might inform decisions about management, medication and schooling
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Abstract
Cultural psychiatry as a clinical specialty sprung mainly from Europe and North America, in order to respond to growing concerns of ethnic minorities in high-income countries. Academic psychiatrists pursuing comparative international studies on mental health, together with medical anthropologists conducting clinical ethnographies, contributed to its theoretical basis (Kleinman, 1987; Littlewood, 1990). What at first appeared to be a marginal specialty is no longer so. For example, the UK alone has witnessed a steady growth of the field, as evidenced by its mandatory inclusion in mental health training curricula, and the existence of several taught masters courses, academic positions in universities and three dedicated journals, as well as, more recently, lead papers in mainstream publications that have debated the cultural position of ‘biology’ itself (Timimi & Taylor, 2004). Additionally, with a proliferation of clinical jobs for ‘ethnic minority’ services in hospital trusts across the country, there is ample scope for employment. The overall evidence indicates that ‘cultural psychiatry’ in the UK is now a specialty in its own right.
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Weeland J, van Aar J, Overbeek G. Dutch Norms for the Eyberg Child Behavior Inventory: Comparisons with other Western Countries. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017; 40:224-234. [PMID: 29937620 PMCID: PMC5978845 DOI: 10.1007/s10862-017-9639-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The Eyberg Child Behavior Inventory (ECBI) is one of the most widely used and well-validated parent rating scales for children's disruptive behavior. This screening instrument is a short, targetted and easy to implement inventory with good psychometric properties and is normed for different countries, among which the United States, Spain, Sweden and Norway. The ECBI has been successfully used for research and clinical purposes, in several countries including The Netherlands. To date, Dutch studies have relied on Scandinavian or US norm scores. However, this may be problematic because of cross-cultural differences in the degree to which certain behaviors are seen as problematic by parents. The main goal of this paper therefore was to obtain norm scores for The Netherlands among 6462 Dutch children aged 4 to 8 years (Mage = 6.37 years; SD = 1.32; 50.6% boys). In line with previous research, we found small differences on the mean sum scores across children of different ages (intensity scale) and gender (intensity and problem scale). Therefore, Dutch norm scores were provided age- and gender specific. Our results showed that disruptive behavior of children in the most rural areas was reported as occurring less frequently and was seen as less problematic by parents compared to the disruptive behavior of children in less rural areas. Finally, we found that Dutch norm scores on the ECBI were significantly lower than US norm scores, and significantly higher on the intensity scale (but not the problem scale) than Norwegian and Swedish norm scores.
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Affiliation(s)
- Joyce Weeland
- Forensic Child and Youth Care, Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Jolien van Aar
- Preventive Youth Care, Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Geertjan Overbeek
- Preventive Youth Care, Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
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Vargas Rodríguez ÁM, Parales Quenza CJ. La Construcción Social de la Hiperactividad. REVISTA COLOMBIANA DE PSICOLOGÍA 2017. [DOI: 10.15446/rcp.v26n2.59891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El trastorno por déficit de atención e hiperactividad (tdah)es una afección frecuente, con alta variabilidad en su preva-lencia a través de contextos, y de interés por la repercusión que tiene sobre el desempeño escolar de quienes la padecen. Se exploraron las construcciones simbólicas que hacen diferentes actores acerca de niños diagnosticados con TDAH. Con tal fin se realizaron entrevistas abiertas de tipo semántico y episódico a 31 participantes bogotanos, distribuidos en grupos de maestros, padres y niños. Estas entrevistas fueron abordadas desde una perspectiva de análisis de discurso. Los resultados mostraron que el tdahse reconstruye, a partir de la perspectiva del observador y del contexto, en términos de problema hereditario y de fallas en las prácticas de crianza. Por su parte, para los niños, el diagnóstico es un evento importante en la construcción de su subjetividad.
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