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Falemban R, Wilmut K, Hurst H, Purcell C. Roadside experiences of parents of children with developmental coordination disorder and/or attention deficit hyperactivity disorder. Front Hum Neurosci 2024; 18:1339043. [PMID: 38660013 PMCID: PMC11039856 DOI: 10.3389/fnhum.2024.1339043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/11/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Pedestrians are a vulnerable group at the roadside and previous research has identified that children with DCD and ADHD are at a heightened risk of pedestrian injuries. Despite this, limited research has explored parental perspectives of the pedestrian risks faced by children with DCD and/or ADHD. Understanding parents' perspectives provides a unique insight into the challenges children face every day and the concerns that parents perceive regarding their children's safety as pedestrians. Therefore, the aim of this study was to explore parents' perspectives of the pedestrian risks faced by their children with DCD and/or ADHD. Methods Semi-structured interviews were conducted with 14 parents of primary school and early secondary school aged children with age range 7-17. The participants were divided into three groups based on their children's conditions: DCD group (10-17 years, n = 3), ADHD group (7-13 years, n = 5), and co-occurring group (7-16 years, n = 6). All parents confirmed an existing diagnosis and completed the SNAP-IV and DCDQ as screening tools. The interviews explored parents' perspectives regarding their children's pedestrian behaviors, parents' concerns and preventative measures taken to improve the pedestrian safety of their children with DCD and/or ADHD. Reflexive thematic analysis was undertaken to analyze the interviews, from which three themes were developed. Results The first theme related to the challenges experienced by children at the roadside; parents emphasized the significance of structured and controlled pedestrian crossing sites, underlining their preference for designated crossings as safer options due to their heightened perceptions of risk associated with other road-crossing locations. The second theme: parental concerns and influences on children's road safety referred to their children's performance and safety at the roadside, leading to increased monitoring and a more protective approach to road crossing. The third theme: road safety education related to various strategies parents implemented to mitigate risks, while balancing independence and prioritizing their safety. Discussion While there were commonalities in the challenges faced by children with DCD and/or ADHD at the roadside, there were also notable differences. Parents of children with DCD discussed challenges with spatial awareness and motor skills, whereas parents of children with ADHD discussed challenges with impulsivity and inattention. Parents of children with co-occurring DCD and ADHD described a complex interplay of these challenges. It is evident from the interviews that children with DCD and/or ADHD require a distinct approach to develop their pedestrian skills effectively and parents reported specific strategies they used to address the risks associated with their children's roadside behavior. Promoting pedestrian safety for children with DCD and/or ADHD necessitates collaboration among parents, schools and local authorities to implement comprehensive measures ensuring their safety. These findings contribute to understanding parental experiences and needs, providing valuable guidance for targeted interventions and policies to enhance the road safety of children with DCD and/or ADHD.
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Affiliation(s)
- Rayan Falemban
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al-Qura University,, Makkah, Saudi Arabia
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Kate Wilmut
- Centre for Psychological Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
| | - Heather Hurst
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Catherine Purcell
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
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Moran RN, Guin R, Louis M, Rhodes K. Baseline Evaluation of Concussion-Like Symptoms and Modifying Factors in Collegiate Club-Sport Athletes. J Athl Train 2023; 58:974-980. [PMID: 36735634 PMCID: PMC10784891 DOI: 10.4085/1062-6050-0645.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Collegiate club-sport athletes participate in a variety of competitive sports and have been understudied in the concussion literature. Baseline performance measures are warranted to better understand assessment and management. OBJECTIVE To quantify normative values and the effects of modifying factors sex, concussion history, diagnosed attention disabilities (attention-deficit/hyperactivity disorder [ADHD]), and sport type on baseline symptom evaluation among collegiate club-sport athletes. DESIGN Cross-sectional study. SETTING Retrospective chart review. PATIENTS OR OTHER PARTICIPANTS A total of 1034 collegiate club-sport athletes (N = 649 males, 62.7%) from 29 sports at a single institution. MAIN OUTCOME MEASURE(S) Chart reviews were conducted for club-sport athletes who completed athlete background and symptom information on the Sport Concussion Assessment Tool-5th edition as a baseline concussion assessment during a single academic year. Demographics (eg, age, sex, sport), background medical information (eg, concussion history, ADHD), and symptom evaluation, consisting of individual 22-item symptom reports, the total number of symptoms, symptom severity scores, and symptom factors (eg, physical, cognitive, insomnia, and emotional), were analyzed. RESULTS On baseline symptom reporting, 68% of club-sport athletes were asymptomatic, with mild symptoms described by 3% to 12% and moderate or severe symptoms by ≤4%. Modifier groups differed with a higher total number of symptoms and symptom severity in females (P < .001), individuals reporting a history of concussion (P < .001), and those with ADHD (total number P = .04, symptom severity P = .02). Similar significant findings were noted for females and the history of concussion group on all 4 symptom factors; however, those in collision or contact sports also indicated greater cognitive (P = .03) and insomnia (P = .02) factors. Those with ADHD endorsed more cognitive (P < .001) factors. CONCLUSIONS Normative symptoms for a collegiate club-sport sample revealed approximately 70% were asymptomatic. Higher total number of symptoms and symptom severity were demonstrated by females and those with a history of concussion. Cognitive-specific symptoms were greater in those diagnosed with ADHD and those who participated in collision or contact sports.
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Abed M, Mansureh HH, Masoud GAL, Elaheh H, Mohammad-Hossein NHK, Yamin BD, Abdol-Hossein V. Construction of Meta-Thinking Educational Program Based on Mental-Brain Simulation ( MTMBS) and Evaluating its Effectiveness on Executive Functions, Emotion Regulation, and Impulsivity in Children With ADHD: A Resting-State Functional MRI Study. J Atten Disord 2023; 27:1223-1251. [PMID: 36843348 DOI: 10.1177/10870547231155436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE The aim of present research was to make a Meta-Thinking educational program based on mental-brain simulation and to evaluate its effectiveness on executive functions, emotion regulation and impulsivity in children with ADHD. METHODS The research method was Embedded Design: Embedded Experimental Model. The research sample included 32 children with ADHD who were randomly assigned to two experimental and control groups. The intervention was implemented for eight sessions of 1.5 hr for the experimental group, and fMRI images were taken from them, while the control group didn't receive any treatment. Finally, using semi-structured interviews, coherent information was collected from the parents of the experimental group about the changes made. Data were analyzed with SPSS-24, MAXQDA, fMRIprep, and FSL software. RESULTS The Meta-Thinking Educational Program had effect on performance of ADHD children and suppressed brain regions related to DMN. CONCLUSION The Implementation of this educational program plays a vital role in improving psychological problems of children with ADHD.
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van Hal R, Geurts D, van Eijndhoven P, Kist J, Collard RM, Tendolkar I, Vrijsen JN. A transdiagnostic view on MDD and ADHD: shared cognitive characteristics? J Psychiatr Res 2023; 165:315-324. [PMID: 37556964 DOI: 10.1016/j.jpsychires.2023.07.028] [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: 11/21/2022] [Revised: 06/23/2023] [Accepted: 07/20/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Major Depressive disorder (MDD) and Attention Deficit Hyperactivity Disorder (ADHD) are prevalent mental disorders that often co-occur. There is overlap in symptomatology between MDD and ADHD that complicates diagnostics and treatment selection. Hence, to aid diagnostics of single and comorbid disorders, we aimed to examine the discriminative power of common symptom measures and cognitive dysfunction to differentiate between participants diagnosed with MDD, ADHD, ADHD and comorbid MDD and without a mental disorder. METHODS Four diagnosed groups were compared: MDD (n = 103), ADHD (n = 78), comorbid MDD + ADHD (n = 29), healthy controls (HC; n = 123). We examined between-group differences and discriminative functions of clinically validated self-report symptom questionnaires, as well as task-based and self-report measures of cognitive dysfunction. RESULTS Based on the between group comparisons, all patient groups were characterized by clinically relevant levels of ADHD-symptomatology, executive dysfunction, and diminished cognitive performances in the domain of attention; even the MDD-only group. In addition, based on self-reported symptoms of MDD, ADHD, and executive dysfunction, discriminant function analysis classified all HC correctly (100%) and patients diagnosed with ADHD or MDD relatively well (resp. 85% and 82%). Comorbid MDD + ADHD was poorly differentiated from single MDD or ADHD by the commonly used self-report symptom questionnaires for MDD and ADHD (0% correct predictions), which substantially improved by incorporating the questionnaire on executive functioning (42% correct predictions). CONCLUSIONS In both MDD and ADHD, clinical levels of attentional and executive dysfunction were found, while these clinical groups differed in cognitive flexibility, initiating, inhibition and meta-cognition. Comorbid MDD + ADHD was poorly distinguishable from non-comorbid MDD and ADHD based on self-reported symptoms of depression and ADHD. Addition of subjective executive function in the discrimination models resulted in increased discriminative power. Our findings indicate that executive functioning measure can improve the diagnostic process of ADHD and MDD.
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Affiliation(s)
- Rianne van Hal
- Radboud University Medical Center, Department of Psychiatry, Nijmegen, the Netherlands.
| | - Dirk Geurts
- Radboud University Medical Center, Department of Psychiatry, Nijmegen, the Netherlands; Donders Institute, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Philip van Eijndhoven
- Radboud University Medical Center, Department of Psychiatry, Nijmegen, the Netherlands; Donders Institute, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Joosje Kist
- Radboud University Medical Center, Department of Psychiatry, Nijmegen, the Netherlands; Donders Institute, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rose M Collard
- Radboud University Medical Center, Department of Psychiatry, Nijmegen, the Netherlands
| | - Indira Tendolkar
- Radboud University Medical Center, Department of Psychiatry, Nijmegen, the Netherlands; Donders Institute, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Janna N Vrijsen
- Radboud University Medical Center, Department of Psychiatry, Nijmegen, the Netherlands; Donders Institute, Radboud University Medical Center, Nijmegen, the Netherlands; Pro Persona Mental Health Care, Depression Expertise Center, Nijmegen, the Netherlands
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Brancati GE, De Rosa U, De Dominicis F, Petrucci A, Nannini A, Medda P, Schiavi E, Perugi G. History of Childhood/Adolescence Referral to Speciality Care or Treatment in Adult Patients with Attention-Deficit/Hyperactivity Disorder: Mutual Relations with Clinical Presentation, Psychiatric Comorbidity and Emotional Dysregulation. Brain Sci 2023; 13:1251. [PMID: 37759852 PMCID: PMC10526193 DOI: 10.3390/brainsci13091251] [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: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that only rarely remits in adulthood. While several studies underlined differences between child and adult ADHD, the relationship between adult clinical presentation and early referral/treatment has been rarely investigated. In our study, 100 adults with ADHD were recruited and subdivided according to a history of referral to speciality care or treatment with methylphenidate (MPH) during childhood/adolescence. The early referral was associated with a history of disruptive behaviors during childhood/adolescence. Current ADHD symptoms were more pronounced in patients first referred during childhood/adolescence but never treated with MPH. Early MPH treatment was associated with lower rates of mood disorders and lower severity of emotional dysregulation at the time of assessment. Negative emotionality mediated the relationship between MPH treatment and mood disorders comorbidity. ADHD patients first referred during childhood/adolescence are characterized by more externalizing features than those first referred in adulthood. MPH treatment during the developmental age may have a role in preventing mood disorders in patients with ADHD, possibly by reducing emotional dysregulation.
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Affiliation(s)
- Giulio Emilio Brancati
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Ugo De Rosa
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | | | - Alessandra Petrucci
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Alessandro Nannini
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Pierpaolo Medda
- Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy; (P.M.)
| | - Elisa Schiavi
- Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy; (P.M.)
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
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Brancati GE, Acierno D, Barbuti M, Elefante C, Gemignani S, Raia A, Perugi G. Revisiting stimulant use for emotional dysregulation in attention-deficit/hyperactivity disorder (ADHD). Expert Rev Neurother 2023; 23:981-994. [PMID: 37747111 DOI: 10.1080/14737175.2023.2263645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/22/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION Emotional dysregulation (ED) symptoms are present in a considerable portion of patients with attention-deficit/hyperactivity disorder (ADHD). In recent years, an increasing number of studies investigated the effects of stimulant medications on ED in patients with ADHD. AREAS COVERED A narrative review of the literature on stimulant treatment for ED is provided, including controlled and observational clinical studies conducted on pediatric and adult samples and neurobiological investigations. Positive effects of stimulants on irritability have been demonstrated in children. Comorbidity with disruptive behavior disorders (DBD) and disruptive mood dysregulation disorder does not prevent stimulant effectiveness. Methylphenidate has also been found to reduce temper problems, affective instability, and emotional over-reactivity in adults with ADHD, although with variable effect sizes. A variety of adverse emotional effects have been reported, especially at high doses and in special populations. However, several possible confounders of treatment-emergent ED have been highlighted. Finally, according to neuroimaging studies, stimulants may mitigate emotional processing anomalies associated with ADHD. EXPERT OPINION The findings are consistent with models including ED within the core features of ADHD. Stimulant treatment should be prioritized over antipsychotics in ADHD-DBD. It remains to be elucidated whether other medications may be more effective in specific populations with ADHD and/or ED.
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Affiliation(s)
- Giulio Emilio Brancati
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Donatella Acierno
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Margherita Barbuti
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Camilla Elefante
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Samuele Gemignani
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Accursio Raia
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Giulio Perugi
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
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Yoon J, Yu H, Jang Y, Lee D, Park YS, Ihm HK, Ryoo HA, Cho N, Lee J, Kim Y, Park J, Kang HS, Ha TH, Myung W. Validation of the Short Form of the Mood Instability Questionnaire-Trait (MIQ-T-SF) in the Korean General Population. Psychiatry Investig 2023; 20:408-417. [PMID: 37253466 DOI: 10.30773/pi.2022.0275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/30/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE Mood instability (MI) is a clinically significant trait associated with psychiatric disorders. However, there are no concise measurements to evaluate MI. The initial Mood Instability Questionnaire-Trait (MIQ-T) was developed to fill this gap. The current study aimed to create a short form of MIQ-T (MIQ-T-SF) that measures MI with high validity and reliability in the Korean general population. METHODS Of the 59 items in the MIQ-T, 17 items were chosen for the MIQ-T-SF following the factor analysis process. In total, 540 participants completed the MIQ-T-SF. Cronbach's alpha and McDonald's omega were used to evaluate reliability. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to determine construct validity. Concurrent validity was confirmed via comparisons with Personality Assessment Inventory-Borderline Features Scale. Measurement invariance across gender and age groups was confirmed before analyzing differences in scores using Kruskal-Wallis test. RESULTS The MIQ-T-SF displayed expected correlations and high internal consistency (α=0.71-0.90, Ωt=0.72-0.92). Using EFA and CFA, a five-factor structure was confirmed. Measurement invariance was supported, and gender differences were observed. CONCLUSION The MIQ-T-SF is an accurate and reliable method to detect MI in the Korean general population. The study's results offer new perspectives for future studies on MI.
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Affiliation(s)
- Joohyun Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeona Yu
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yoonjeong Jang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Daseul Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yun Seong Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hong Kyu Ihm
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyun A Ryoo
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Nayoung Cho
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jakyung Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yeoju Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jungkyu Park
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Hyo Shin Kang
- Department of Psychology, Kyungpook National University, Daegu, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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Agapoff JA, Chong Z, Meek M, van Schalkwyk GI. Pharmacologic and Non-Pharmacologic Interventions for Emotional Lability: A Meta-Analysis. Neurosci Biobehav Rev 2023; 149:105184. [PMID: 37085024 DOI: 10.1016/j.neubiorev.2023.105184] [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: 12/14/2022] [Revised: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 04/23/2023]
Abstract
Emotional Lability (EL) is a common symptom dimension in a variety of psychiatric disorders. However, as it is not typically a diagnosis in its own right, it lacks a consistently applied clinical definition and treatment approach. Therefore, in this review we performed a meta-analysis to determine the effect size for treatments of EL across diagnostic categories. We then conducted subgroup analyses to compare effect sizes for pharmacologic (MED) and behavioral (BEH) treatments, according to underlying diagnosis, and according to medication class. We found that pharmacologic and non-pharmacologic treatments are effective for EL, and that the effect sizes were similar - a finding with implications for clinical practice. Our finding also supports future research which approaches EL as an important construct independent of underlying diagnosis.
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Affiliation(s)
- Jame A Agapoff
- Assistant Clinical Professor of Psychiatry, John A Burns School of Medicine, University of Hawai'i, 1356 Lusitana St. 4(th) Fl, Honolulu, HI, 96813.
| | - Zhang Chong
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Health Sciences, Salt Lake City, UT 84113.
| | - Matthew Meek
- Department of Pediatrics, University of Utah, and Intermountain Healthcare. Mario Capecchi Dr., Salt Lake City, UT 84113.
| | - Gerrit I van Schalkwyk
- Department of Pediatrics, University of Utah, and Intermountain Healthcare. Mario Capecchi Dr., Salt Lake City, UT 84113.
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Long Y, Pan N, Ji S, Qin K, Chen Y, Zhang X, He M, Suo X, Yu Y, Wang S, Gong Q. Distinct brain structural abnormalities in attention-deficit/hyperactivity disorder and substance use disorders: A comparative meta-analysis. Transl Psychiatry 2022; 12:368. [PMID: 36068207 PMCID: PMC9448791 DOI: 10.1038/s41398-022-02130-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/09/2022] Open
Abstract
As two common mental disorders during the period of adolescence that extend to early adulthood, attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) have considerable diagnostic co-occurrence and shared neuropsychological impairments. Our study aimed to identify overlapping and distinct brain structural abnormalities associated with ADHD and SUDs among adolescents and young adults. A systematic literature search on voxel-based morphometry (VBM) studies of ADHD and SUDs was conducted in PubMed and Web of Science. Data were extracted and analyzed to identify brain abnormalities using Seed-based d-Mapping software. Data-driven functional decoding was conducted to identify the psychophysiological functioning associated with brain alterations. 13 and 14 VBM studies for ADHD (619 patients and 483 controls) and SUDs (516 patients and 413 controls), respectively, were included. Patterns of decreased gray matter volume (GMV) were found in the left precentral gyrus, bilateral superior frontal gyri, and left inferior frontal gyrus in the ADHD group compared to the control group. In contrast, individuals with SUDs, relative to controls, were characterized by increased GMV in the left putamen and insula. Comparative analysis indicated larger regional GMV in the right inferior parietal lobule and smaller volumes in the left putamen and left precentral gyrus in the ADHD group than in the SUDs group. Dissociable brain structural abnormalities in adolescents and young adults with ADHD and SUDs potentially implicate different pathogeneses and provide a reference for differential diagnosis and early detection for shared symptomology and comorbidity.
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Affiliation(s)
- Yajing Long
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Nanfang Pan
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Shiyu Ji
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China ,grid.21107.350000 0001 2171 9311Department of Biochemistry and Molecular Biology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Kun Qin
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China ,grid.24827.3b0000 0001 2179 9593Department of Psychiatry, University of Cincinnati, Cincinnati, OH USA
| | - Ying Chen
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Xun Zhang
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Min He
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Xueling Suo
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Yifan Yu
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China ,grid.506261.60000 0001 0706 7839Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China ,grid.412901.f0000 0004 1770 1022Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China. .,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China. .,Functional & Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China. .,Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
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10
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Hindley G, O'Connell KS, Rahman Z, Frei O, Bahrami S, Shadrin A, Høegh MC, Cheng W, Karadag N, Lin A, Rødevand L, Fan CC, Djurovic S, Lagerberg TV, Dale AM, Smeland OB, Andreassen OA. The shared genetic basis of mood instability and psychiatric disorders: A cross-trait genome-wide association analysis. Am J Med Genet B Neuropsychiatr Genet 2022; 189:207-218. [PMID: 35841185 PMCID: PMC9541703 DOI: 10.1002/ajmg.b.32907] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/12/2022] [Accepted: 05/28/2022] [Indexed: 12/30/2022]
Abstract
Recent genome-wide association studies of mood instability (MOOD) have found significant positive genetic correlation with major depression (DEP) and weak correlations with other psychiatric disorders. We investigated the polygenic overlap between MOOD and psychiatric disorders beyond genetic correlation to better characterize putative shared genetic determinants. GWAS summary statistics for schizophrenia (SCZ, n = 105,318), bipolar disorder (BIP, n = 413,466), DEP (n = 450,619), attention-deficit hyperactivity disorder (ADHD, n = 53,293), and MOOD (n = 363,705) were analyzed using the bivariate causal mixture model and conjunctional false discovery rate methods. MOOD correlated positively with all psychiatric disorders, but with wide variation in strength (rg = 0.10-0.62). Of 10.4 K genomic variants influencing MOOD, 4 K-9.4 K influenced psychiatric disorders. Furthermore, MOOD was jointly associated with DEP at 163 loci, SCZ at 110, BIP at 60 and ADHD at 25. Fifty-three jointly associated loci were overlapping across two or more disorders, seven of which had discordant effect directions on psychiatric disorders. Genes mapped to loci associated with MOOD and all four disorders were enriched in a single gene-set, "synapse organization." The extensive polygenic overlap indicates shared molecular underpinnings across MOOD and psychiatric disorders. However, distinct patterns of genetic correlation and effect directions may relate to differences in the core clinical features of each disorder.
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Affiliation(s)
- Guy Hindley
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
| | - Kevin S O'Connell
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Zillur Rahman
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Oleksandr Frei
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway
| | - Shahram Bahrami
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Alexey Shadrin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Margrethe C Høegh
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Weiqiu Cheng
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Naz Karadag
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Aihua Lin
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Linn Rødevand
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Chun C Fan
- Department of Radiology, University of California San Diego, La Jolla, California, USA.,Multimodal Imaging Laboratory, University of California San Diego, La Jolla, California, USA.,Department of Cognitive Science, University of California San Diego, La Jolla, California, USA
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.,NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.,KG Jebsen Centre for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
| | - Trine V Lagerberg
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anders M Dale
- Department of Radiology, University of California San Diego, La Jolla, California, USA.,Multimodal Imaging Laboratory, University of California San Diego, La Jolla, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, California, USA.,Department of Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Olav B Smeland
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,KG Jebsen Centre for Neurodevelopmental disorders, University of Oslo, Oslo, Norway
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11
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Carmassi C, Conti L, Gravina D, Nardi B, Dell'Osso L. Emotional dysregulation as trans-nosographic psychopathological dimension in adulthood: A systematic review. Front Psychiatry 2022; 13:900277. [PMID: 36104987 PMCID: PMC9464828 DOI: 10.3389/fpsyt.2022.900277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Emotional dysregulation (ED) is characterized by inappropriate emotional reactions related to environmental or cognitive stimuli. In most recent years, increasing interest has been devoted to its definition and detection across mental disorders for its detrimental role progressively highlighted in both neurodevelopment and adult mental disorders, with implications on the severity of clinical manifestations. The aim of this systematic review was to evaluate and gather the scientific evidence about ED in adult psychiatric population to elucidate the concept of ED as trans-nosographic entity. Methods The electronics databases PubMed, Scopus and Web of Science was reviewed to identify studies in accordance with the PRISMA guidelines; at the end of the selection process a total of 29 studies (N = 709; N = 658; N = 1,425) was included. All studies included assessed the presence of ED symptoms, by means of a validate scale in adult (>18 years of age), in clinically diagnosed patients as well as healthy control participants. Results Our results suggest ED as a trans-diagnostic factor across multiple mental disorders, such as bipolar disorder, attention deficit hyperactivity disorder, autism spectrum disorder, personality disorders; a better definition of this concept could be helpful to interpret and clarify many clinical cases and improve their diagnostic and therapeutic management.
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Affiliation(s)
| | - Lorenzo Conti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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12
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Sedgwick-Müller JA, Müller-Sedgwick U, Adamou M, Catani M, Champ R, Gudjónsson G, Hank D, Pitts M, Young S, Asherson P. University students with attention deficit hyperactivity disorder (ADHD): a consensus statement from the UK Adult ADHD Network (UKAAN). BMC Psychiatry 2022; 22:292. [PMID: 35459116 PMCID: PMC9027028 DOI: 10.1186/s12888-022-03898-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is associated with poor educational outcomes that can have long-term negative effects on the mental health, wellbeing, and socio-economic outcomes of university students. Mental health provision for university students with ADHD is often inadequate due to long waiting times for access to diagnosis and treatment in specialist National Health Service (NHS) clinics. ADHD is a hidden and marginalised disability, and within higher education in the UK, the categorisation of ADHD as a specific learning difference (or difficulty) may be contributing to this. AIMS This consensus aims to provide an informed understanding of the impact of ADHD on the educational (or academic) outcomes of university students and highlight an urgent need for timely access to treatment and management. METHODS The UK Adult ADHD Network (UKAAN) convened a meeting of practitioners and experts from England, Wales, and Scotland, to discuss issues that university students with ADHD can experience or present with during their programme of studies and how best to address them. A report on the collective analysis, evaluation, and opinions of the expert panel and published literature about the impact of ADHD on the educational outcomes of university students is presented. RESULTS A consensus was reached that offers expert advice, practical guidance, and recommendations to support the medical, education, and disability practitioners working with university students with ADHD. CONCLUSIONS Practical advice, guidance, and recommendations based on expert consensus can inform the identification of ADHD in university students, personalised interventions, and educational support, as well as contribute to existing research in this topic area. There is a need to move away from prevailing notions within higher education about ADHD being a specific learning difference (or difficulty) and attend to the urgent need for university students with ADHD to have timely access to treatment and support. A multimodal approach can be adapted to support university students with ADHD. This approach would view timely access to treatment, including reasonable adjustments and educational support, as having a positive impact on the academic performance and achievement of university students with ADHD.
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Affiliation(s)
- Jane A. Sedgwick-Müller
- grid.13097.3c0000 0001 2322 6764Health and Community Services, Government of Jersey, St Helier, Jersey. Social, Genetic & Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN) & Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care (FNFNM), King’s College London, London, UK
| | - Ulrich Müller-Sedgwick
- grid.5335.00000000121885934Adult Neurodevelopmental Service, Health and Community Services, Government of Jersey, St Helier, Jersey. Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Marios Adamou
- grid.15751.370000 0001 0719 6059School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Marco Catani
- grid.13097.3c0000 0001 2322 6764Natbrainlab, Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, UK
| | - Rebecca Champ
- grid.15751.370000 0001 0719 6059School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
| | - Gísli Gudjónsson
- grid.13097.3c0000 0001 2322 6764Psychology Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, UK
| | - Dietmar Hank
- grid.439418.3Adult ADHD Service, Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
| | - Mark Pitts
- grid.37640.360000 0000 9439 0839Adult ADHD and Autism Outpatient Service, South London & Maudsley NHS Foundation Trust, London, UK
| | - Susan Young
- grid.9580.40000 0004 0643 5232Psychology Services Limited, Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | - Philip Asherson
- grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, UK
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13
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Graziano PA, Landis T, Maharaj A, Ros-Demarize R, Hart KC, Garcia A. Differentiating Preschool Children with Conduct Problems and Callous-Unemotional Behaviors through Emotion Regulation and Executive Functioning. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:170-182. [PMID: 31618114 PMCID: PMC7509846 DOI: 10.1080/15374416.2019.1666399] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Callous-unemotional (CU) traits are important characteristics for identifying severe patterns of conduct problems (CP). The current study focused on (a) identifying subgroups of young children displaying a combination of CP and CU behaviors and (b) examining the extent to which executive functioning (EF) and emotion regulation (ER) are associated with CU behaviors. Participants included 249 preschoolers (N = 249, 78% boys, Mage = 4.95 years; 81% Latino/Hispanic) referred to treatment because of externalizing behavior problems. CU behaviors and CP were measured via a combination of teacher/parent rating scales. A multimethod approach was used to measure EF and ER including parent/teacher rating scales, neuropsychological, and observational tasks. Poorer ER as rated by parents/teachers and observed was associated with greater levels of CU behaviors. Latent profile analyses identified three subgroups of children displaying (a) low CU/low CP, (b) moderate CU/moderate CP, and (c) high CU/high CP. Children in the high CU/high-CP group were rated as having significantly poorer rated ER compared to all other groups and poorer observed ER compared to the low-CU/low-CP group. Exploratory analyses found that children in the high-CU/high-CP group displayed marginally lower levels of rated ER but significantly better EF performance on standardized neuropsychological tasks compared to children in a low-CU/high-CP group.Children with higher levels of reported CU behaviors and CP display poorer ER yet may display relatively better EF performance compared to children with lower levels of CU behaviors and CP.
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Affiliation(s)
- Paulo A Graziano
- Center for Children and Families, Department of Psychology, Florida International University
| | - Taylor Landis
- Center for Children and Families, Department of Psychology, Florida International University
| | - Andre Maharaj
- Center for Children and Families, Department of Psychology, Florida International University
| | - Rosmary Ros-Demarize
- Center for Children and Families, Department of Psychology, Florida International University
| | - Katie C Hart
- Center for Children and Families, Department of Psychology, Florida International University
| | - Alexis Garcia
- Center for Children and Families, Department of Psychology, Florida International University
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14
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McLoughlin G, Gyurkovics M, Aydin Ü. What Has Been Learned from Using EEG Methods in Research of ADHD? Curr Top Behav Neurosci 2022; 57:415-444. [PMID: 35637406 DOI: 10.1007/7854_2022_344] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Electrophysiological recording methods, including electroencephalography (EEG) and magnetoencephalography (MEG), have an unparalleled capacity to provide insights into the timing and frequency (spectral) composition of rapidly changing neural activity associated with various cognitive processes. The current chapter provides an overview of EEG studies examining alterations in brain activity in ADHD, measured both at rest and during cognitive tasks. While EEG resting state studies of ADHD indicate no universal alterations in the disorder, event-related studies reveal consistent deficits in attentional and inhibitory control and consequently inform the proposed cognitive models of ADHD. Similar to other neuroimaging measures, EEG research indicates alterations in multiple neural circuits and cognitive functions. EEG methods - supported by the constant refinement of analytic strategies - have the potential to contribute to improved diagnostics and interventions for ADHD, underlining their clinical utility.
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Affiliation(s)
- Gráinne McLoughlin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Máté Gyurkovics
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ümit Aydin
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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15
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Ben-Dor Cohen M, Eldar E, Maeir A, Nahum M. Emotional dysregulation and health related quality of life in young adults with ADHD: a cross sectional study. Health Qual Life Outcomes 2021; 19:270. [PMID: 34930314 PMCID: PMC8691086 DOI: 10.1186/s12955-021-01904-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Attention Deficit Hyperactivity Disorder (ADHD) is associated with emotional dysregulation (ED) and impaired health related quality of life (HRQoL). However, the role of ED in explaining the relationship between ADHD and HRQoL is unclear. The purpose of the present study was to do so in a sample of non-referred young adults with and without ADHD. Method The study design was cross-sectional. A non-clinical sample of 63 young adults with ADHD (mean age = 24.86 years, SD = 3.25, 78% university students) and 69 gender-matched controls (mean age = 23.84 years, SD = 2.59, 89% university students) were recruited. The Adult ADHD Quality-of-Life scale was used to measure HRQoL; The Self-Report Wender–Reimherr Adult Attention Deficit Disorder Scale and the Difficulties in Emotion Regulation Scale were used to measure ED. Group differences on all measures were tested using univariate and multivariate analyses of covariance, while controlling for age. Finally, a moderation analysis was used in order to examine the impact of ED on HRQoL beyond that accounted for by ADHD symptoms. Results Both HRQoL and ED were significantly worse for the ADHD group compared to the control group. The medication status of the ADHD group participants had no significant effect on the level of ADHD symptoms, ED or HRQoL. ED moderated the effect of ADHD symptoms on HRQoL for the ADHD group. Conclusion The findings support the centrality of ED in ADHD and its crucial influence on HRQoL. Young adults with ADHD and high levels of ED are at risk for aversive impact on their well-being regardless of their ADHD symptoms level. Young adults with Attention Deficit Hyperactivity Disorder (ADHD) struggle with poor quality of life (QoL). Emotional regulation is one’s ability to modify their emotional state to promote adaptive, goal-oriented behaviors. Emotional dysregulation is a common yet neglected feature of people with ADHD. Our results show that young adults with ADHD are twice more likely to suffer from emotional dysregulation then their peers. Moreover, higher levels of emotional dysregulation predicted lower levels of QoL. These findings support the centrality of ED in ADHD and their crucial influence on everyday QoL. These findings are important not only on the theoretical level, but may also contribute to the design of interventions that aim to promote quality of life.
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Affiliation(s)
- Maayan Ben-Dor Cohen
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Eran Eldar
- Psychology Department, Faculty of Social Sciences, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Cognitive Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adina Maeir
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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16
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Callahan BL, Shammi P, Taylor R, Ramakrishnan N, Black SE. Longitudinal Cognitive Performance of Older Adults With ADHD Presenting to a Cognitive Neurology Clinic: A Case Series of Change Up to 21 Years. Front Aging Neurosci 2021; 13:726374. [PMID: 34867269 PMCID: PMC8634492 DOI: 10.3389/fnagi.2021.726374] [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] [Received: 06/16/2021] [Accepted: 10/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: The neuropsychological features of older adults with ADHD are largely unknown. This retrospective chart review aims to elucidate their cognitive trajectories using a case series of six older adults with ADHD presenting with memory complaints to a cognitive neurology clinic, whom we argue are a particularly relevant group to study due to their potential to mimic neurodegenerative syndromes. Methods: Participants were included if they were age 40 or older at intake, had ADHD based on DSM-5 criteria, and had cognitive data collected prior to 2014 with follow-up at least 5 years later. Results: Five men and one woman were included (M = 53.8 years at intake) and had an average of 135.0 months of follow-up data available. Despite notable between- and within-subject variability, cognition generally improved or remained stable across visits. Two participants experienced notable memory decline, but a global consideration of their performance in other domains suggests these deficits may be frontally-mediated. Conclusion: In this small sample, cognition remained generally unchanged across 5–21 years. Isolated impairments likely reflect substantial intra-individual variability across time and measures.
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Affiliation(s)
- Brandy L Callahan
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Prathiba Shammi
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rebecca Taylor
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sandra E Black
- Dr. Sandra Black Centre for Brain Resilience, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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17
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Cardinale EM, Freitag GF, Brotman MA, Pine DS, Leibenluft E, Kircanski K. Phasic Versus Tonic Irritability: Differential Associations With Attention-Deficit/Hyperactivity Disorder Symptoms. J Am Acad Child Adolesc Psychiatry 2021; 60:1513-1523. [PMID: 33440203 PMCID: PMC9073575 DOI: 10.1016/j.jaac.2020.11.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/18/2020] [Accepted: 01/04/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Irritability is a multifaceted construct in pediatric psychopathology. It has been conceptualized as having a phasic dimension and a tonic dimension. Disruptive mood dysregulation disorder is defined by the presence of both dimensions. Severe irritability, or disruptive mood dysregulation disorder, is highly comorbid with attention-deficit/hyperactivity disorder (ADHD). However, it is unknown whether the presence of ADHD modulates the expression of phasic and tonic irritability. METHOD A data-driven, latent variable approach was used to examine irritability and ADHD symptoms in a transdiagnostic pediatric sample (N = 489) with primary disruptive mood dysregulation disorder, ADHD, subclinical irritability symptoms, or no diagnosis. Using latent profile analyses, we identified 4 classes: high levels of both irritability and ADHD symptoms, high levels of irritability and moderate levels of ADHD symptoms, moderate levels of irritability and high levels of ADHD symptoms, and low levels of both irritability and ADHD symptoms. Confirmatory factor analysis operationalized phasic irritability and tonic irritability. RESULTS As expected, the 2 latent classes characterized by high overall irritability exhibited the highest levels of both phasic and tonic irritability. However, between these 2 high irritability classes, highly comorbid ADHD symptoms were associated with significantly greater phasic irritability than were moderately comorbid ADHD symptoms. In contrast, the 2 high irritability groups did not differ on levels of tonic irritability. CONCLUSION These findings suggest that phasic, but not tonic, irritability has a significant association with ADHD symptoms and that phasic and tonic might be distinct, though highly related, irritability dimensions. Future research should investigate potential mechanisms underlying this differential association.
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18
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Zhang J, Li W, Zhang H, Wilson A, Shuai L, Xia W, Wang Z, Qiu M, Wang Y. Callous-unemotional traits in Chinese preschool children with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatry Ment Health 2021; 15:35. [PMID: 34246300 PMCID: PMC8272896 DOI: 10.1186/s13034-021-00388-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/01/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Children with early onset of Callous-Unemotional (CU) traits are at a higher risk for long-term, persistent psychosocial problems. The current study aimed to explore the characteristics of CU in preschool children with Attention Deficit Hyperactivity Disorder (ADHD) and the diagnostic significance of CU traits in ADHD. METHODS A total of 176 preschool children (89 with ADHD and 87 Typically Developing Children [TDC]) aged 4-5 years old were recruited to the study. The participants were assessed for CU traits, emotional and behavioral problems, and how their executive functioning was associated with ADHD using multiple assessment scales. Multiple linear regression analysis was performed to assess the incremental validity of the Inventory of Callous-Unemotional Traits (ICU), adjusting for possible covariates by child's sex, conduct problems, and oppositional defiant symptoms. RESULTS The results showed that there was a significant difference of ICU scores between the ADHD and TDC groups (F = 30.12, P < 0.001). In terms of callousness, ADHD + Oppositional Defiant Disorder (ODD) group showed a significant high score, and the ADHD only group scored significantly higher than the TDC group (F = 20.42, P < 0.001). The ICU was negatively associated with the prosocial behaviour subscale (γ = - 0.57, P < 0.01) and showed low to moderate positive correlations with emotional and behavioural problems, as well as executive function (γ = 0.24-0.67, P < 0.05). The ICU scores explained 6% of the incremental validity in ADHD symptoms. The diagnostic value of the ICU for ADHD was medium and acceptable. CONCLUSIONS The current study indicated that early identification of CU traits may help clinicians better understand symptoms and behavioural problems in children with ADHD. CU traits therefore could be considered as a useful assessment tool for ADHD.
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Affiliation(s)
- Jinsong Zhang
- Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China. .,Ministry of Education and Shanghai Key Laboratory of Children's Environment Health, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Wei Li
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China ,Ministry of Education and Shanghai Key Laboratory of Children’s Environment Health, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Huifeng Zhang
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China ,Ministry of Education and Shanghai Key Laboratory of Children’s Environment Health, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Amanda Wilson
- grid.48815.300000 0001 2153 2936Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Lan Shuai
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Weiping Xia
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Zhouye Wang
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Meihui Qiu
- grid.412987.10000 0004 0630 1330Department of Medical Psychology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China
| | - Yuanyuan Wang
- grid.48815.300000 0001 2153 2936Department of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
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19
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Perpetration of and Victimization in Cyberbullying and Traditional Bullying in Adolescents with Attention-Deficit/Hyperactivity Disorder: Roles of Impulsivity, Frustration Intolerance, and Hostility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136872. [PMID: 34206834 PMCID: PMC8297231 DOI: 10.3390/ijerph18136872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/20/2021] [Accepted: 06/24/2021] [Indexed: 01/23/2023]
Abstract
Victimization and perpetration of cyberbullying and traditional bullying are prevalent among adolescents with attention-deficit/hyperactivity disorder (ADHD). This study examined the associations of impulsivity, frustration discomfort, and hostility with victimization and with the perpetration of cyberbullying and traditional bullying in adolescents with ADHD. Self-reported involvement in cyberbullying and traditional bullying was assessed in 195 adolescents with a clinical diagnosis of ADHD. Adolescents also completed questionnaires for impulsivity, frustration discomfort, and hostility. Caregivers completed the Child Behavior Checklist for adolescents’ ADHD, internalization, oppositional defiance, and problems with conduct. The associations of impulsivity, frustration discomfort, and hostility with victimization and perpetration of cyberbullying and traditional bullying were examined using logistic regression analysis. The results demonstrated that after the effects of demographic characteristics and behavioral problems were controlled for, frustration intolerance increased the risks of being cyberbullying victims and perpetrators whereas hostility increased the risks of being the victims and perpetrators of traditional bullying. Impulsivity was not significantly associated with any type of bullying involvement. Prevention and intervention programs should alleviate frustration intolerance and hostility among adolescents with ADHD.
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Comparison of Emotional Dysregulation Features in Cyclothymia and Adult ADHD. ACTA ACUST UNITED AC 2021; 57:medicina57050489. [PMID: 34066126 PMCID: PMC8151096 DOI: 10.3390/medicina57050489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 01/16/2023]
Abstract
Background and Objectives: Emotional dysregulation is central to the problem of the overlap between attention-deficit/hyperactivity disorder (ADHD) and cyclothymia. The aim of the study was to evaluate comorbidity rates between ADHD and cyclothymic disorder and to explore demographic and clinical differences among the groups, focusing on affective temperament and emotional dysregulation. Materials and Methods: One hundred sixty-five outpatients attending the Second Psychiatry Unit at the Santa Chiara University Hospital (Pisa) were consecutively recruited: 80 were diagnosed with ADHD, 60 with cyclothymic disorder, and 25 with both conditions. Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-M) and the 40-item version of Reactivity, Intensity, Polarity, and Stability questionnaire (RI-PoSt-40) were administered. Results: Cyclothymic patients were more frequently female and older with respect to the ADHD groups. Both comorbid and non-comorbid ADHD patients showed significantly lower educational attainment and more frequently had substance use disorders. Panic disorder was common in non-comorbid cyclothymic patients, who showed significantly higher rates of familial panic disorder, major depressive disorder and suicide attempts in comparison with patients only diagnosed with ADHD. Cyclothymic patients without ADHD were also characterized by fewer hyperthymic temperamental traits, higher depressive and anxious dispositions, and a greater negative emotionality. No significant differences among groups were observed for cyclothymic temperament and overall negative emotional dysregulation, but comorbid patients with both conditions scored the highest in these subscales. This group also showed significantly higher affective instability with respect to ADHD patients without cyclothymia and was less frequently diagnosed with bipolar disorder type II than patients from both the other groups. Conclusions: ADHD and cyclothymia often co-occur and show similar levels of emotional dysregulation. However, cyclothymic patients may be more prone to negative emotionality in clinical settings. Subjects with “sunny” cyclothymic features might escape the attention of clinicians unless ADHD is present.
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Paucke M, Stibbe T, Huang J, Strauss M. Differentiation of ADHD and Depression Based on Cognitive Performance. J Atten Disord 2021; 25:920-932. [PMID: 31409195 DOI: 10.1177/1087054719865780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: The aim of this study was to assess whether self-report scales and neuropsychological tests used for adult patients with ADHD can help to distinguish between ADHD-specific and depressive symptoms. Method: In a cross-sectional design, differences in self-report questionnaires and neuropsychological tests among clinical subgroups and healthy controls (HC) were evaluated. Patients in clinical groups were diagnosed with major depressive disorder (MDD) or ADHD with or without depressive symptoms according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) guidelines. Results: The Hyperactivity subscales of the Conners' Adult ADHD Rating Scale (CAARS) differed between MDD and ADHD, whereas self-concept and inattention scales even distinguished comorbidity subgroups within the ADHD population. A reduced alertness and higher variations in reaction times measured by performance tests indicated problems in sustained attention in ADHD patients compared with HC. Conclusion: The diagnostic process of ADHD, and thereby the distinction from other symptom-overlapping, comorbid mental disorders, might be improved by utilizing ADHD-specific self-report questionnaires and neuropsychological tests, which are short, cost-effective, and standardized screening methods.
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Yalvaç EBK, Gaynor K. Emotional dysregulation in adults: The influence of rumination and negative secondary appraisals of emotion. J Affect Disord 2021; 282:656-661. [PMID: 33445088 DOI: 10.1016/j.jad.2020.12.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/30/2020] [Accepted: 12/26/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Emotional dysregulation is commonly discussed as a transdiagnostic factor in clinical populations. The present study aims to investigate cognitive factors (rumination and negative appraisals of emotion) in the maintenance of emotional dysregulation in a normative sample in order to partially validate a cognitive model of emotional dysregulation and to examine the potential clinical relevance of addressing cognitive factors in the treatment of emotional dysregulation. METHODS People who were 18 or older were asked to participate via a university research system and social media. Participants (N = 216) were asked to fill out online surveys regarding emotional dysregulation, rumination and negative secondary appraisals of emotion. RESULTS People who had higher emotional dysregulation levels displayed a greater tendency to ruminate and were more prone to negative secondary appraisals of emotion. There was a positive association between rumination and negative secondary appraisals of emotion, and this association was mediated by emotional dysregulation. LIMITATIONS The present study was solely based on self-report measurements and the collected data were cross-sectional. CONCLUSIONS The present study showed that a wide spectrum of experiences of emotional dysregulation occurred in a normative sample. The significant mediation highlighted the maintaining role of rumination and negative appraisals in emotional dysregulation. These data highlight the importance of addressing cognitive factors in emotional dysregulation.
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Affiliation(s)
| | - Keith Gaynor
- School of Psychology, University College Dublin, Ireland.
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Do Childhood Emotional Lability and ADHD Symptoms Have Shared Neuropsychological Roots? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-020-09859-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Soares LS, Alves ALC, Costa DDS, Malloy-Diniz LF, de Paula JJ, Romano-Silva MA, de Miranda DM. Common Venues in Romantic Relationships of Adults With Symptoms of Autism and Attention Deficit/Hyperactivity Disorder. Front Psychiatry 2021; 12:593150. [PMID: 34220561 PMCID: PMC8249738 DOI: 10.3389/fpsyt.2021.593150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) figures among the most common neurodevelopmental disorders. Despite having opposite stereotypes, both ADHD and ASD compromise, though in different ways, skills such as social interactions, communication skills, and social thinking, which may underlie difficulties in romantic relationships. Methods: We evaluated 306 adults about their romantic relationships and the intensity of their love. Participants were from one of four groups:, individuals with ASD-only traits, a group with symptoms of ADHD-only, participants with neither ADHD nor ASD symptoms (control) or from a fourth group of individuals with both ADHD and ASD traits. Results: The ASD traits group had fewer married people and more people who have never been married, while the rate of divorce was higher in the ADHD traits group. Regarding the intensity of love, the mean scores of the ADHD and the ADHD+ASD traits groups were higher in the Passionate Love Scale than the mean score of the control group. Passionate love in the ASD group was no different from the other groups. Small positive correlations were found between passionate love and ADHD and ASD behavioral problems. Conclusion: Marital status was distinct depending on symptoms of a neurodevelopmental disorder in adulthood. Also, ADHD and ASD symptoms were associated with greater passionate love. Therefore, ADHD and ASD behavioral dimensions may impact long-term and short-term experiences of a person's relationship with a significant other in distinct ways. Understanding how people with neurodevelopmental disorders experience love might help us to better clarify the mechanisms associated with their relationship patterns.
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Affiliation(s)
- Lorrayne Stephane Soares
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Luiza Costa Alves
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Danielle de Souza Costa
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Leandro Fernandes Malloy-Diniz
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Mental Health, Universidade Federal de Minas, Belo Horizonte, Brazil
| | - Jonas Jardim de Paula
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Psychology, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Marco Aurélio Romano-Silva
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Mental Health, Universidade Federal de Minas, Belo Horizonte, Brazil
| | - Débora Marques de Miranda
- Programa de Pós-Graduação em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Miovský M, Lukavská K, Rubášová E, Šťastná L, Šefránek M, Gabrhelík R. Attention Deficit Hyperactivity Disorder among Clients Diagnosed with a Substance Use Disorder in the Therapeutic Communities: Prevalence and Psychiatric Comorbidity. Eur Addict Res 2021; 27:87-96. [PMID: 32781442 DOI: 10.1159/000508571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/04/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Most severe substance use disorders (SUDs) are connected with attention deficit hyperactivity disorder (ADHD) and other mental health problems. Therapeutic communities (TCs) provide a suitable option for the treatment of severe SUDs. The relationship between ADHD, the severity of the SUD, and other comorbidities in residential TCs is unknown. OBJECTIVE To estimate the prevalence of ADHD among clients with an SUD in residential rehab, and to compare the mental health of clients with and without ADHD. METHODS A cohort study was conducted in 5 residential TCs (N = 180, 76.7% male, 53.9% 25-34 years, 79.2% diagnosed with methamphetamine use disorder). We assessed ADHD symptoms, substance use, mental health problems, and psychiatric symptoms. RESULTS ADHD was found in 51% of the clients who showed significantly higher scores for their psychiatric status composite score (ASI-PSY) (F = 9.08, p < 0.001; t = 5.05, p < 0.001), the positive psychiatric symptoms total (SCL-PST) (F = 3.36, p < 0.05; t = 3.15, p < 0.01), and the global severity index (SCL-GSI) (F = 3.27, p < 0.05; t = 3.18, p < 0.01). The ASI-PSY and SCL correlated significantly with the symptoms of attention deficit disorder (Pearson's r's = 0.30-0.42, p's < 0.001) and the symptoms of hyperactivity disorder (r's = 0.24-0.30, p's < 0.01). Even when severity of substance use was accounted for, ADHD was confirmed as a significant predictor of ASI-PSY (B= 0.14, p < 0.001 for combined disorder; B = 0.20, p < 0.001 for attention disorder) and partially of SCL-PST (B = 8.12, p < 0.05 for attention disorder). CONCLUSIONS The ADHD prevalence in TCs was nearly 10-fold compared to the globally recorded values. ADHD diagnostic procedures and interventions should become an integral part of the standard diagnostic and treatment process.
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Affiliation(s)
- Michal Miovský
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia,
| | - Kateřina Lukavská
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Eva Rubášová
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Lenka Šťastná
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Martin Šefránek
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
| | - Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
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26
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Monopoli WJ, Evans SW, Benson K, Allan NP, Owens JS, DuPaul GJ, Bunford N. Assessment of a conceptually informed measure of emotion dysregulation: Evidence of construct validity vis a vis impulsivity and internalizing symptoms in adolescents with ADHD. Int J Methods Psychiatr Res 2020; 29:1-14. [PMID: 32898309 PMCID: PMC7723178 DOI: 10.1002/mpr.1826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/06/2020] [Accepted: 03/29/2020] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Despite advances in understanding associations among attention-deficit hyperactivity disorder (ADHD), emotion dysregulation (ED), and related outcomes, there is incongruity between ADHD-relevant conceptualizations of ED and available measures of ED. To assess the psychometric properties of a parent-report questionnaire of ED conceptualized as deficits in the ability to modulate the (a) speed/degree of emotion escalation; (b) expression intensity; and (c) speed/degree of de-escalation. METHODS Participants were 209 adolescents with ADHD (78% male; 13.5-17.8 years old [M = 15.2 SD = 0.91]). Questionnaire items were selected from parent-report scales of ED and oppositional defiant disorder and subjected to exploratory factor analysis (EFA) and validity analyses. RESULTS The EFA revealed two factors, with speed/degree of escalation combined with intensity as factor one, and speed/degree of de-escalation as factor two. Factor one scores were related to ADHD impulsivity symptoms but not to anxiety and depression symptoms and they remained predictors of impulsivity even in the presence of self-report ED, evincing convergent, discriminant, and incremental validity. Factor two scores were related to anxiety and depression but not impulsivity, evincing convergent and discriminant validity. CONCLUSION These results inform our understanding of ADHD-relevant ED in adolescence and offer avenues for future research in measurement development, as well as for understanding ED and ADHD-related impairment.
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Affiliation(s)
- W John Monopoli
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Steven W Evans
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | - Kari Benson
- Department of Psychology, Ohio University, Athens, Ohio, USA
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Nóra Bunford
- 'Lendület' Developmental and Translational Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
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27
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Leaberry KD, Rosen PJ, Fogleman ND, Walerius DM, Slaughter KE. Comorbid Internalizing and Externalizing Disorders Predict Lability of Negative Emotions Among Children With ADHD. J Atten Disord 2020; 24:1989-2001. [PMID: 28992752 DOI: 10.1177/1087054717734647] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: A subset of children with ADHD experience more frequent, sudden, and intense shifts toward negative emotions. The current study utilized ecological momentary assessment (EMA) to provide a valid assessment of the impact of comorbid internalizing and externalizing disorders on negative emotional lability (EL) among children with ADHD. Method: Parents of 58, 8- to 12-year-old children with ADHD were administered a diagnostic interview to assess for ADHD and for the presence of comorbid disorders. Parents completed EMA-based ratings of their child's negative emotions three times daily for a total of 28 days. Results: Children with a comorbid internalizing disorder or children with comorbid oppositional defiant disorder (ODD) experienced significantly greater EMA-derived negative EL than children without comorbid disorders over time. Children with multiple comorbidities experienced greater EL than children with single comorbidities. Conclusion: Overall, this study suggested that both comorbid ODD and comorbid internalizing disorders contribute to negative EL among children with ADHD.
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28
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Assessment and treatment of substance use in adults with ADHD: a psychological approach. J Neural Transm (Vienna) 2020; 128:1099-1108. [PMID: 33211196 DOI: 10.1007/s00702-020-02277-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/05/2020] [Indexed: 10/22/2022]
Abstract
Over half of young people and adults diagnosed with Attention Deficit Hyperactivity Disorder [ADHD] also have substance use disorder [SUD]. Their use of substances may arise from an attempt to self-medicate and/or to cope with their difficulties. This manuscript reviews key research in the literature and identifies that traditional SUD psychological interventions are an effective treatment for those presenting with a dual diagnosis of ADHD and SUD. However, typically, this is only available to those presenting to specialist SUD services for treatment of harmful use and/or dependency. This misses an opportunity to intervene much earlier, before drug use escalates to these levels. The manuscript aims to provide practical guidance for healthcare practitioners, by detailing a psychological framework for earlier assessment and intervention of problematic drug use in young people and adults with ADHD. Specific techniques are outlined drawing on psychoeducation, motivational interviewing and cognitive behavioural therapy in a phased approach to address factors that motivate initial use of substances and those that maintain use.
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Abbass K, Corbisiero S, Stieglitz RD. Development and psychometric properties of the ADHD-SCL-90-R screening scale for adult ADHD. J Clin Psychol 2020; 77:1428-1442. [PMID: 33188720 DOI: 10.1002/jclp.23088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 10/06/2020] [Accepted: 10/25/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Adult attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder with serious impairments, but it often remains undetected. The aim of the study was to develop an ADHD screening scale from the Symptom Check-List-90-R (SCL-90-R) and describe its psychometric properties. The item selection was based on the ADHD-specific Conners' Adult ADHD Rating Scale (CAARS-S:L). METHOD In total, 412 subjects of an ADHD Special Consultations Unit were investigated, who completed the SCL-90-R, CAARS-S:L, and ADHD Self-Rating Behavior Questionnaire. RESULTS The ADHD-SCL-90-R Screening Scale consisted of 16 items with a four-factor structure, including Inattention/Memory Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Lability, and Problems with Self-Concept. It showed excellent internal consistency (Cronbachs α = .90) and good convergent validity (r = .57-.59). Sensitivity was 78%, specificity was 56%, and the discriminatory power was acceptable (area under the curve = 0.74). CONCLUSION The newly developed ADHD-SCL-90-R Screening Scale showed good psychometric properties, and it has a versatile application in clinical practice.
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Affiliation(s)
- Karen Abbass
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Salvatore Corbisiero
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland
| | - Rolf-Dieter Stieglitz
- Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel, Basel, Switzerland.,Psychiatric Clinics, University of Basel, Basel, Switzerland
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30
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Young S, Hollingdale J, Absoud M, Bolton P, Branney P, Colley W, Craze E, Dave M, Deeley Q, Farrag E, Gudjonsson G, Hill P, Liang HL, Murphy C, Mackintosh P, Murin M, O'Regan F, Ougrin D, Rios P, Stover N, Taylor E, Woodhouse E. Guidance for identification and treatment of individuals with attention deficit/hyperactivity disorder and autism spectrum disorder based upon expert consensus. BMC Med 2020; 18:146. [PMID: 32448170 PMCID: PMC7247165 DOI: 10.1186/s12916-020-01585-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals with co-occurring hyperactivity disorder/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can have complex presentations that may complicate diagnosis and treatment. There are established guidelines with regard to the identification and treatment of ADHD and ASD as independent conditions. However, ADHD and ASD were not formally recognised diagnostically as co-occurring conditions until the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) was published in 2013. Hence, awareness and understanding of both conditions when they co-occur is less established and there is little guidance in the clinical literature. This has led to uncertainty among healthcare practitioners when working with children, young people and adults who present with co-existing ADHD and ASD. The United Kingdom ADHD Partnership (UKAP) therefore convened a meeting of professional experts that aimed to address this gap and reach expert consensus on the topic that will aid healthcare practitioners and allied professionals when working with this complex and vulnerable population. METHOD UK experts from multiple disciplines in the fields of ADHD and ASD convened in London in December 2017. The meeting provided the opportunity to address the complexities of ADHD and ASD as a co-occurring presentation from different perspectives and included presentations, discussion and group work. The authors considered the clinical challenges of working with this complex group of individuals, producing a consensus for a unified approach when working with male and female, children, adolescents and adults with co-occurring ADHD and ASD. This was written up, circulated and endorsed by all authors. RESULTS The authors reached a consensus of practical recommendations for working across the lifespan with males and females with ADHD and ASD. Consensus was reached on topics of (1) identification and assessment using rating scales, clinical diagnostic interviews and objective supporting assessments; outcomes of assessment, including standards of clinical reporting; (2) non-pharmacological interventions and care management, including psychoeducation, carer interventions/carer training, behavioural/environmental and Cognitive Behavioural Therapy (CBT) approaches; and multi-agency liaison, including educational interventions, career advice, occupational skills and training, and (3) pharmacological treatments. CONCLUSIONS The guidance and practice recommendations (Tables 1, 4, 5, 7, 8 and 10) will support healthcare practitioners and allied professionals to meet the needs of this complex group from a multidisciplinary perspective. Further research is needed to enhance our understanding of the diagnosis, treatment and management of individuals presenting with comorbid ADHD and ASD.
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Affiliation(s)
| | - Jack Hollingdale
- South London & Maudsley NHS Foundation Trust, Service for Complex Autism and Associated Neurodevelopmental Disorders, London, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Women & Children's Health, King's College, London, UK
| | - Patrick Bolton
- South London & Maudsley NHS Foundation Trust, Service for Complex Autism and Associated Neurodevelopmental Disorders, London, UK
| | | | | | - Emily Craze
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | - Mayuri Dave
- Positive Behaviour, Learning Disability, Autism and Mental Health Service (PALMS) Hertfordshire Communication Disorders Clinics, Hertfordshire Community NHS Trust, St Albans, UK
| | - Quinton Deeley
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | - Emad Farrag
- South London & Maudsley NHS Foundation Trust, Maudsley Health, Abu Dhabi, UAE
| | - Gisli Gudjonsson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Clodagh Murphy
- Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, National Adult Autism and ADHD Service, South London and Maudsley Foundation NHS Trust, London, UK.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peri Mackintosh
- South London & Maudsley NHS Foundation Trust, National Autism Unit, Kent, UK
| | | | | | - Dennis Ougrin
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Patricia Rios
- Diagnostic Assessments and Treatment Services (DATS), Hertfordshire, UK
| | | | - Eric Taylor
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Woodhouse
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Asherson P, Stes S, Nilsson Markhed M, Berggren L, Svanborg P, Kutzelnigg A, Deberdt W. The effects of atomoxetine on emotional control in adults with ADHD: An integrated analysis of multicenter studies. Eur Psychiatry 2020; 30:511-20. [DOI: 10.1016/j.eurpsy.2014.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 12/17/2014] [Accepted: 12/21/2014] [Indexed: 12/12/2022] Open
Abstract
AbstractPurpose:To investigate the effects of atomoxetine on emotional control in adults with ADHD.Methods:We performed an integrated analysis using individual patient data pooled from three Eli Lilly-sponsored studies. An integrated analysis can be viewed as a meta-analysis of individual patient-level data, rather than study-level summary data.Results:Two populations were identified: a large sample of patients with pre-treatment baseline data (the “overall population”; n = 2846); and a subset of these patients with placebo-controlled efficacy data from baseline to 10 or 12 weeks after initiating treatment (the “placebo-controlled population”; n = 829). At baseline, in the overall population, ∼50% of ADHD patients had BRIEF-AS (Behavior Rating Inventory of Executive Function-Adult Version Self-Report) Emotional control subscores between 21 and 30, compared with ∼10% of normative subjects in the BRIEF-A manual. At endpoint, in the placebo-controlled population, atomoxetine led to a small (effect size 0.19) but significant (P = 0.013) treatment effect for emotional control. The effect size was 0.32 in patients with BRIEF-AS Emotional control scores > 20 at baseline. Improvements in emotional control correlated with improvements in the core ADHD symptoms and quality-of-life.Discussion:As deficient emotional control is associated with impaired social, educational and occupational functioning over and above that explained by core ADHD symptoms alone, improvements in emotional control may be clinically relevant.Conclusion:At baseline, adults with ADHD were more likely to have impaired emotional control than normative subjects. In the adult ADHD patients, atomoxetine treatment was associated with improvements in emotional control, as well as in core ADHD symptoms and quality-of-life.
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32
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Nigg JT, Karalunas SL, Gustafsson HC, Bhatt P, Ryabinin P, Mooney MA, Faraone SV, Fair DA, Wilmot B. Evaluating chronic emotional dysregulation and irritability in relation to ADHD and depression genetic risk in children with ADHD. J Child Psychol Psychiatry 2020; 61:205-214. [PMID: 31605387 PMCID: PMC6980250 DOI: 10.1111/jcpp.13132] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND A central nosological problem concerns the etiological relationship of emotional dysregulation with ADHD. Molecular genetic risk scores provide a novel method for informing this question. METHODS Participants were 514 community-recruited children of Northern European descent age 7-11 defined as ADHD or non-ADHD by detailed research evaluation. Parents-rated ADHD on standardized ratings and child temperament on the Temperament in Middle Childhood Questionnaire (TMCQ) and reported on ADHD and comorbid disorders by semi-structured clinical interview. Categorical and dimensional variables were created for ADHD, emotional dysregulation (implicating disruption of regulation of both anger-irritability and of positive valence surgency-sensation seeking), and irritability alone (anger dysregulation). Genome-wide polygenic risk scores (PRS) were computed for ADHD and depression genetic liability. Structural equation models and computationally derived emotion profiles guided analysis. RESULTS The ADHD PRS was associated in variable-centered analyses with irritability (β = .179, 95% CI = 0.087-0.280; ΔR2 = .034, p < .0002), but also with surgency/sensation seeking (B = .146, 95%CI = 0.052-0.240, ΔR2 =.022, p = .002). In person-centered analysis, the ADHD PRS was elevated in the emotion dysregulation ADHD group versus other ADHD children (OR = 1.44, 95% CI = 1.03-2.20, Nagelkerke ΔR2 = .013, p = .033) but did not differentiate irritable from surgent ADHD profiles. All effects were independent of variation in ADHD severity across traits or groups. The depression PRS was related to oppositional defiant disorder but not to ADHD emotion dysregulation. CONCLUSIONS Irritability-anger and surgency-sensation seeking, as forms of negative and positively valenced dysregulated affect in ADHD populations, both relate principally to ADHD genetic risk and not mood-related genetic risk.
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Affiliation(s)
- Joel T. Nigg
- Department of Psychiatry, Oregon Health & Science University, Portland, OR,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
| | - Sarah L. Karalunas
- Department of Psychiatry, Oregon Health & Science University, Portland, OR,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
| | | | - Priya Bhatt
- Department of Psychiatry, Oregon Health & Science University, Portland, OR
| | - Peter Ryabinin
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Michael A. Mooney
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
| | - Stephen V. Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY,Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Damien A. Fair
- Department of Psychiatry, Oregon Health & Science University, Portland, OR,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
| | - Beth Wilmot
- Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR
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Helfer B, Cooper RE, Bozhilova N, Maltezos S, Kuntsi J, Asherson P. The effects of emotional lability, mind wandering and sleep quality on ADHD symptom severity in adults with ADHD. Eur Psychiatry 2020; 55:45-51. [DOI: 10.1016/j.eurpsy.2018.09.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 11/29/2022] Open
Abstract
AbstractMind wandering, emotional lability and sleep quality are currently mostly independently investigated but are all interlinked and play a major role is adult attention-deficit/ hyperactivity disorder (ADHD). Emotional lability is a core feature of the disorder, excessive mind wandering has recently been linked to symptoms and impairments of ADHD and poor sleep quality is experienced by a clear majority of adults with ADHD. All three phenomena lead to functional impairment in ADHD, however their relationship to each other and to ADHD symptom severity is not well understood. Here we used serial multiple mediation models to examine the influence of mind wandering, sleep quality and emotional lability on ADHD symptom severity. 81 adults diagnosed with ADHD participated in this study. We found that mind wandering and emotional lability predicted ADHD symptom severity and that mind wandering, emotional lability and sleep quality were all linked and significantly contributed to the symptomatology of adult ADHD. Mind wandering was found to lead to emotional lability which in turn lead to ADHD symptom severity; and poor sleep quality was found to exacerbate mind wandering leading to ADHD symptoms. Future research should employ objective on-task measures of mind wandering, sleepiness and emotional lability to investigate the neural basis of these impairing deficits in ADHD.
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Şair YB, Sevinçok D, Kutlu A, Çakaloz B, Sevinçok L. The affective temperament traits and pregnancy-related depression in mothers may constitute risk factors for their children with attention deficit and hyperactivity disorder. J OBSTET GYNAECOL 2019; 40:1079-1084. [PMID: 31814479 DOI: 10.1080/01443615.2019.1679741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We investigated whether the affective temperaments of mothers and maternal depression before and during the index pregnancy are related to the development of Attention-Deficit Hyperactivity Disorder (ADHD) in their children. One hundred and twenty children were screened for the diagnosis of ADHD. After exclusion and inclusion criteria were applied for children and their mothers, we compared the mothers of children with (n = 63) and without ADHD (n = 60) in terms of affective temperament traits, depression before and during the index pregnancy, and some environmental risk factors. The rate of boys were significantly higher among children with ADHD compared to healthy controls. The mothers of children with ADHD had significantly lower education levels, more cigarette consumption during pregnancy, and more depression rates before the pregnancy than those of healthy children. Male gender (p = .002), Hamilton Depression Rating Scale (HDRS) (p = .002), cyclothymic (p = .022), irritable (p = .035) and anxious temperament scores (p = .016) significantly predicted the association between the mothers and their children with ADHD. Our findings might suggest that male child gender, the severity of depression at index pregnancy, higher cyclothymic, irritable, and anxious temperament scores in mothers may constitute as important risk factors for the development of ADHD in their children.Impact statementWhat is already known on this subject? Although the effects of maternal depression on ADHD were extensively investigated, the relationship between affective temperament traits of mothers and ADHD in their children has not been sufficiently examined. To investigate the roles of maternal affective temperament traits and pregnancy-related depression on offspring ADHD would help us to understand the etiopathogenic bases of ADHD.What do the results of this study add? Cyclothymic, irritable and anxious temperaments of mothers were significantly associated with the offspring ADHD after adjusting for the gender, maternal smoking, prepartum and antenatal depression.What are the implications of these findings for clinical practice and/or further research? These findings might demonstrate that some maternal affective temperaments and depression during pregnancy are suggestive of an inherited predisposition to ADHD in offsprings. Longitudinal studies are required to demonstrate the relationship between maternal affective temperament features and the development of affective illness in children with ADHD.
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Affiliation(s)
- Yaşan Bilge Şair
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Doğa Sevinçok
- Department of Child and Adolescent Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Ayşe Kutlu
- Department of Child and Adolescent Psychiatry, Dr.Behcet Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Burcu Çakaloz
- Department of Child and Adolescent Psychiatry, Pamukkale University, Denizli, Turkey
| | - Levent Sevinçok
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
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Kim H, Kim B. Affective Factors That Contribute to the Quality of Life of Juvenile Inmates with Attention-Deficit/Hyperactivity Disorder: A Focus on Items from the Korean Youth Self Report. Soa Chongsonyon Chongsin Uihak 2019; 30:161-167. [PMID: 32595337 PMCID: PMC7298911 DOI: 10.5765/jkacap.190021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/13/2019] [Accepted: 07/17/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study investigated quality of life in Korean juvenile inmates with attention-deficit/hyperactivity disorder (ADHD) and the impact of behavioral and emotional problems on quality of life. METHODS In total, 200 inmates were evaluated using the Korean version of the Mini-International Neuropsychiatric Interview (K-MINI) and the Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (K-SADS-PL-K). We extracted the inmates with ADHD and evaluated their quality of life, behavioral problems, and emotional problems with the Pediatric Quality of Life Inventory (PedsQL) and the Korean Youth Self Report (K-YSR) scale. Descriptive statistics, Pearson correlation analysis, and multiple regression analysis were conducted. RESULTS Among the 200 total inmates, 68 were diagnosed with ADHD by the K-SADS-PL-K. Most of the correlations between PedsQL scores and K-YSR items were significant. Multiple regression analysis showed that PedsQL could be predicted by affective problems (among the DSM-oriented scales of the K-YSR) and attention problems (among the syndrome scales of the K-YSR). CONCLUSION Our results demonstrate that, among juvenile inmates with ADHD, quality of life was negatively correlated with most behavioral and emotional problems. Meanwhile, the significant influence of affective and attention problems on inmates' quality of life suggests the necessity of comprehensive treatments for this group.
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Affiliation(s)
- Hyesoon Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Bongseog Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Brancati GE, Barbuti M, Pallucchini A, Cotugno B, Schiavi E, Hantouche EG, Perugi G. Reactivity, Intensity, Polarity and Stability questionnaire (RIPoSt-40) assessing emotional dysregulation: Development, reliability and validity. J Affect Disord 2019; 257:187-194. [PMID: 31301622 DOI: 10.1016/j.jad.2019.07.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/06/2019] [Accepted: 07/04/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Emotional dysregulation (ED) is a heterogenous construct with great relevance in psychiatric research and clinical practice. In the present study, we validated a 40-items version of the Reactivity, Intensity, Polarity and Stability questionnaire (RIPoSt-40), a self-report measure of ED. METHODS A non-clinical sample (N = 396) and two clinical samples of patients with cyclothymia (N = 120) and ADHD (N = 54) were recruited. Items were selected and subscales were derived based on inter-item correlations and PCA with promax rotation in the non-clinical sample. Test-retest reliability was assessed in a subsample (N = 60). Internal consistency and concurrent validity with TEMPS-M factors were evaluated in each sample. The three groups results were compared to ascertain discriminant validity. RESULTS Four subscales were identified as measures of affective instability, emotional impulsivity, negative and positive emotionality. The first three subscales also sum up to a negative ED score comprising thirty items. Measures of reliability (test-retest r = 0.71-0.84) and internal consistency (Cronbach's α = 0.72-0.95) were generally high. Concurrent validity was supported by correlations with TEMPS-M factors. Discriminant validity was significant (p < 0.001) with cyclothymic and ADHD patients showing higher scores for each subscale, except for positive emotionality. LIMITATIONS The non-clinical sample was recruited through a web-survey and mainly included young and highly educated subjects. Mood and anxiety comorbidity of the clinical samples were not taken into consideration. CONCLUSION RIPoSt-40 questionnaire has proved to be a valid, reliable and useful tool to assess ED both in clinical and non-clinical contexts.
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Affiliation(s)
- Giulio E Brancati
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Sant'Anna School of Advanced Studies, Pisa, Italy.
| | - Margherita Barbuti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Biagio Cotugno
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Schiavi
- Azienda Ospedaliera Universitaria Pisana, Pisa Italy
| | - Elie G Hantouche
- Centre des Troubles Anxieux et de l'Humeur, Anxiety & Mood Center, 89 Boulevard de Courcelles 75008, Paris, France
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Gisbert L, Richarte V, Corrales M, Ibáñez P, Bosch R, Bellina M, Fadeuilhe C, Casas M, Ramos-Quiroga JA. The Relationship Between Neuropsychological Deficits and Emotional Lability in Adults With ADHD. J Atten Disord 2019; 23:1514-1525. [PMID: 29890879 DOI: 10.1177/1087054718780323] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The objective of this study was to investigate the extent to which neuropsychological performance parameters implicated in ADHD might mediate the relationship between emotional lability (EL) and this disorder. Method: Eight hundred twelve adult patients with ADHD were examined. EL was assessed using the EL subscale of Conners' Adult ADHD Rating Scales (CAARS). To assess cognitive and executive functions, a battery of neuropsychological tests was performed in 262 patients with ADHD and high EL symptomatology and 550 patients with ADHD and low EL symptomatology. Results: Several differences between groups were found regarding neuropsychological performance; however, nearly all significant differences disappeared when the effect of gender, inattention, and hyperactive symptoms and psychiatric comorbidities were taken into account. Conclusion: Our results do not support the hypothesis that neuropsychological deficits are associated with EL in adults with ADHD.
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Affiliation(s)
- Laura Gisbert
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Vanesa Richarte
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Montserrat Corrales
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Pol Ibáñez
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain
| | - Rosa Bosch
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Mariano Bellina
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain
| | - Christian Fadeuilhe
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain
| | - Miquel Casas
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- 1 Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Biomedical Network Research Center on Mental Health, Barcelona, Spain.,3 Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Spain
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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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Vatansever D, Bozhilova NS, Asherson P, Smallwood J. The devil is in the detail: exploring the intrinsic neural mechanisms that link attention-deficit/hyperactivity disorder symptomatology to ongoing cognition. Psychol Med 2019; 49:1185-1194. [PMID: 30514410 DOI: 10.1017/s0033291718003598] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a developmental condition that profoundly affects quality of life. Although mounting evidence now suggests uncontrolled mind-wandering as a core aspect of the attentional problems associated with ADHD, the neural mechanisms underpinning this deficit remains unclear. To that extent, competing views argue for (i) excessive generation of task-unrelated mental content, or (ii) deficiency in the control of task-relevant cognition. METHODS In a cross-sectional investigation of a large neurotypical cohort (n = 184), we examined alterations in the intrinsic brain functional connectivity architecture of the default mode (DMN) and frontoparietal (FPN) networks during resting state functional magnetic resonance imaging in relation to ADHD symptomatology, which could potentially underlie changes in ongoing thought within variable environmental contexts. RESULTS The results illustrated that ADHD symptoms were linked to lower levels of detail in ongoing thought while the participants made more difficult, memory based decisions. Moreover, greater ADHD scores were associated with lower levels of connectivity between the DMN and right sensorimotor cortex, and between the FPN and right ventral visual cortex. Finally, a combination of high levels of ADHD symptomology with reduced FPN connectivity to the visual cortex was associated with reduced levels of detail in thought. CONCLUSIONS The results of our study suggest that the frequent mind-wandering observed in ADHD may be an indirect consequence of the deficient control of ongoing cognition in response to increasing environmental demands, and that this may partly arise from dysfunctions in the intrinsic organisation of the FPN at rest.
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Affiliation(s)
| | - Natali S Bozhilova
- Social, Genetic and Developmental Psychiatry Centre, Psychology and Neuroscience, Institute of Psychiatry, King's College London,London,UK
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Psychology and Neuroscience, Institute of Psychiatry, King's College London,London,UK
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Valero S, Bosch R, Corominas M, Barrau V, Ramos-Quiroga JA, Casas M. Remittance or persistence of attention deficit-hyperactivity disorder (ADHD) and its impact on recidivism in risky driving behaviors. TRAFFIC INJURY PREVENTION 2018; 19:701-707. [PMID: 30485128 DOI: 10.1080/15389588.2018.1505043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/22/2018] [Accepted: 07/22/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Recent data regarding the persistence or remittance of attention deficit-hyperactivity disorder (ADHD) diagnosis into adulthood raise the question of its possible role in crucial public health issues, including road safety, especially when neurocognitive capacities are challenged. METHODS The study included 611 participants with serious traffic violations. The Spanish version of the Mini International Neuropsychiatric Interview (M.I.N.I.) was used to assess psychopathology. They were grouped into 3 diagnostic conditions: non-ADHD, persistent ADHD (ADHD-P), and remittent ADHD (ADHD-R). Several risky driving behaviors were analyzed. RESULTS Although participants with ADHD have more driving violations relative to non-ADHD, ADHD-R, and ADHD-P drivers have similar profiles. ADHD-R and ADHD-P drivers are more prone to perform risky and recidivistic behaviors relative to non-ADHD counterparts (P = .044 and P = .047, respectively); ADHD-R and ADHD-P participants are statistically comparable in this proneness (P = .772). CONCLUSION These results suggest that the underlying core deficits of ADHD-attention and other executive disabilities-persist despite the fact that some people no longer reach the threshold for clinical diagnosis.
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Affiliation(s)
- S Valero
- a Group of Psychiatry, Mental Health and Addiction , Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
| | - R Bosch
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - M Corominas
- a Group of Psychiatry, Mental Health and Addiction , Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
| | - V Barrau
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - J A Ramos-Quiroga
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
| | - M Casas
- b Department of Psychiatry , Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
- c Biomedical Network Research Center on Mental Health (CIBERSAM) , Madrid , Spain
- d Instituto para el Desarrollo de Estudios y Terapias Avanzadas en Neurociencias (IDETAN)
- e Department of Psychiatry and Legal Medicine , Universitat Autònoma de Barcelona , Barcelona , Catalonia , Spain
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Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry 2018; 56:14-34. [DOI: 10.1016/j.eurpsy.2018.11.001] [Citation(s) in RCA: 201] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 12/17/2022] Open
Abstract
AbstractBackground Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
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Individual differences in tendencies to attention-deficit/hyperactivity disorder and emotionality: empirical evidence in young healthy adults from Germany and China. ACTA ACUST UNITED AC 2018; 11:167-182. [DOI: 10.1007/s12402-018-0266-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/27/2018] [Indexed: 11/26/2022]
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Jensen DA, Høvik MF, Monsen NJN, Eggen TH, Eichele H, Adolfsdottir S, Plessen KJ, Sørensen L. Keeping Emotions in Mind: The Influence of Working Memory Capacity on Parent-Reported Symptoms of Emotional Lability in a Sample of Children With and Without ADHD. Front Psychol 2018; 9:1846. [PMID: 30333774 PMCID: PMC6176092 DOI: 10.3389/fpsyg.2018.01846] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/10/2018] [Indexed: 11/13/2022] Open
Abstract
Emotional lability (EL) often co-occurs with attention-deficit/hyperactivity disorder (ADHD) in children. However, difficulties of regulating intense emotions in ADHD are still poorly understood. We investigated the potential role of working memory (WM) as a protective factor against EL in children with ADHD by building on models describing the close relationship between WM and regulation of emotions. The parents of 41 children with ADHD and 34 typically developing children (TDC) filled out the emotional control scale (ECS) from the Behavior Rating Inventory of Executive Functioning and the child behavior checklist (CBCL). The children themselves completed the backward conditions of the digit span (DS) and spatial span (SS) tasks as well as the letter-umber sequencing (LNS) task. The results of a stepwise regression analysis confirmed the negative relationship between parent reported EL measured using the ECS and scores on the LNS, when controlling for symptoms of ADHD and oppositional defiant disorder (ODD). WM thus seems to be important for the ability of the children to express emotions in an adaptive and flexible way. We therefore suggest that a poorer WM capacity, which is often found in children with ADHD, may be a predictor of high levels of EL.
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Affiliation(s)
- Daniel André Jensen
- The Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway
- Betanien District Psychiatric Center (DPS), Bergen, Norway
| | - Marie Farstad Høvik
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - Thale Hegdahl Eggen
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Heike Eichele
- The Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Steinunn Adolfsdottir
- The Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Kerstin Jessica Plessen
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway
- Child and Adolescent Mental Health Center, Copenhagen, Denmark
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Lin Sørensen
- The Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway
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Tamm L, Epstein JN, Becker SP. A preliminary investigation of reaction time variability in relation to social functioning in children evaluated for ADHD. Child Neuropsychol 2018; 25:885-898. [PMID: 30246598 DOI: 10.1080/09297049.2018.1523379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Reaction time variability (RTV) is a ubiquitous phenomenon in Attention-Deficit/Hyperactivity Disorder (ADHD). Few studies have examined RTV in relation to functional outcomes such as social impairment in children with ADHD. In this exploratory study, we investigated whether RTV is associated with social functioning in children at risk for ADHD. Specifically, we explored the association between RTV (tau derived from correct go trials of a Stop-Signal task) and social functioning in 198 children ages 7-12 years referred for an ADHD evaluation. Social functioning measures included child and/or parent ratings of social competence, aggression, social problems, and impairment in relationships. In regression analyses that also included Oppositional Defiant Disorder symptoms and sex, higher RTV was significantly associated with lower ratings of social competence, and higher proactive/reactive aggression ratings on the child self-report measures. RTV was not significantly associated with parent report of social functioning or relationship impairment. This study provides preliminary evidence that RTV may be associated with social functioning in children at risk for ADHD. We propose that lapses of attention affecting cognitive control may also negatively impact social information processing thereby affecting social functioning. Replication is warranted and longitudinal studies are needed to investigate whether RTV predicts social dysfunction in ADHD.
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Affiliation(s)
- Leanne Tamm
- a Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Jeffery N Epstein
- a Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center , University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Stephen P Becker
- a Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center , University of Cincinnati College of Medicine , Cincinnati , OH , USA
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Bozhilova NS, Michelini G, Kuntsi J, Asherson P. Mind wandering perspective on attention-deficit/hyperactivity disorder. Neurosci Biobehav Rev 2018; 92:464-476. [PMID: 30036553 PMCID: PMC6525148 DOI: 10.1016/j.neubiorev.2018.07.010] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/19/2018] [Accepted: 07/19/2018] [Indexed: 11/29/2022]
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder associated with a range of mental health, neurocognitive and functional problems. Although the diagnosis is based on descriptions of behaviour, individuals with ADHD characteristically describe excessive spontaneous mind wandering (MW). MW in individuals with ADHD reflects constant mental activity which lacks topic stability and content consistency. Based on this review of the neural correlates of ADHD and MW, we outline a new perspective on ADHD: the MW hypothesis. We propose that altered deactivation of the default mode network, and dysfunctional interaction with the executive control network, leads to excessive and spontaneous MW, which underpins symptoms and impairments of ADHD. We highlight that processes linked to the normal neural regulation of MW (context regulation, sensory decoupling, salience thresholds) are deficient in ADHD. MW-related measures could serve as markers of the disease process, as MW can be experimentally manipulated, as well as measured using rating scales, and experience sampling during both cognitive tasks and daily life. MW may therefore be a potential endophenotype.
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Affiliation(s)
- Natali S Bozhilova
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, Denmark Hill, De Crespigny Park, SE5 8AF, United Kingdom.
| | - Giorgia Michelini
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, Denmark Hill, De Crespigny Park, SE5 8AF, United Kingdom
| | - Jonna Kuntsi
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, Denmark Hill, De Crespigny Park, SE5 8AF, United Kingdom
| | - Philip Asherson
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, Denmark Hill, De Crespigny Park, SE5 8AF, United Kingdom.
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46
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Van Liefferinge D, Sonuga-Barke E, Danckaerts M, Fayn K, Van Broeck N, van der Oord S. Measuring child and adolescent emotional lability: How do questionnaire-based ratings relate to experienced and observed emotion in everyday life and experimental settings? Int J Methods Psychiatr Res 2018; 27:e1720. [PMID: 29845690 PMCID: PMC6877123 DOI: 10.1002/mpr.1720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/12/2018] [Accepted: 04/09/2018] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Emotional lability (EL) is an important trans-diagnostic concept that is associated with significant functional impairment in childhood and adolescence. EL is typically measured with questionnaires, although little is known about the ecological validity of these ratings. In this paper, we undertook 2 studies addressing this issue by examining the relationship between rating-based measures of EL and directly measured emotional expressions and experiences. Furthermore, the associations between directly measured emotional expressions and experiences and attention-deficit/hyperactivity disorder (ADHD) symptomatology were also examined, given the clear association of EL with ADHD in former research. METHODS In Study 1, we examined the relationship between parental report of children's EL and ADHD, and children's emotional expressions in an experimental context (N = 67). In Study 2, we examined the relationship between parental ratings and real-time measures of emotional experiences in daily life in adolescents (N = 65). RESULTS EL ratings were associated with different elements of real-time emotional experiences and expressions. Elements of emotional expressions but not emotional experiences were also associated with ADHD symptom reports. CONCLUSIONS These studies provide evidence for the ecological validity of EL ratings. Furthermore, they add evidence for the associations between EL and ADHD.
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Affiliation(s)
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,UK Institute for Disorders of Impulse and Attention, University of Southampton, Southampton, UK
| | - Marina Danckaerts
- Department of Neurosciences, Child and Adolescent Psychiatry, Leuven, Belgium.,University Psychiatric Centre, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Kirill Fayn
- Research Group Quantitative Psychology and Individual Differences, Leuven, Belgium
| | - Nady Van Broeck
- Research Group Clinical Psychology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Saskia van der Oord
- Research Group Clinical Psychology, Katholieke Universiteit Leuven, Leuven, Belgium.,Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands.,Centre for Cognitive Science, University of Amsterdam, Amsterdam, The Netherlands
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47
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Efron D, Furley K, Gulenc A, Sciberras E. Maternal ADHD symptoms, child ADHD symptoms and broader child outcomes. Arch Dis Child 2018; 103:841-846. [PMID: 29317442 DOI: 10.1136/archdischild-2017-313936] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/31/2017] [Accepted: 12/04/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study investigated the associations between maternal symptoms of attention deficit hyperactivity disorder (ADHD) and child functional outcomes in a community-based sample of children with and without ADHD. DESIGN AND SETTING In this cohort study, children with ADHD and healthy controls were recruited through schools in Melbourne, Australia, using a combined screening (Conners 3 ADHD Index) and case confirmation (Diagnostic Interview Schedule for Children Version IV) procedure. PATIENTS 117 children with ADHD and 149 control children were included in the analyses. MAIN OUTCOME MEASURES Maternal ADHD symptoms (Conners Adult ADHD Rating Scale) and child outcomes (ADHD severity, quality of life (QoL), academic competence, social-emotional functioning) were measured at a mean child age of 8.9 years. RESULTS Mothers of children with ADHD had clinically elevated ADHD symptoms compared with mothers of control children (adjusted analysis: 18.0% vs 2.0%, P<0.001). Elevated maternal ADHD symptoms were associated with greater child ADHD symptom severity and lower QoL by maternal report for children with (severity P=0.01; QoL P=0.003) and without (severity P=0.003; QoL P=0.003) ADHD. Elevated maternal ADHD symptoms were additionally associated with increased parent-rated emotional problems, peer problems and total impairment scores in children without ADHD (all P<0.01). CONCLUSIONS Maternal ADHD symptoms are associated with increased ADHD symptom severity and reduced QoL by maternal report in offspring with or without ADHD, and have broader negative associations with emotional and social functioning in children without ADHD. In the evaluation of the referred children, maternal ADHD symptoms should be considered and referral made to adult services where indicated.
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Affiliation(s)
- Daryl Efron
- Community Child Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Kirsten Furley
- General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Alisha Gulenc
- Community Child Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Emma Sciberras
- Community Child Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,School of Psychology, Deakin University, Geelong, Victoria, Australia
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48
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King JB, Anderson JS, Yurgelun-Todd DA, Subramaniam P, Ehrler MR, Lopez-Larson MP. Decreased anterior cingulate activation in a motor task in youths with bipolar disorder. J Child Psychol Psychiatry 2018; 59:900-907. [PMID: 29451300 PMCID: PMC6041159 DOI: 10.1111/jcpp.12875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bipolar disorder (BP) is characterized by abnormal shifts in mood between episodes of mania and severe depression, both of which have been linked with psychomotor disturbances. This study compares brain activation patterns in motor networks between euthymic youths with BP and healthy controls (HC) during the completion of a simple motor task. METHODS Thirty-five youths with BP and 35 HC (aged 10-19) completed a self-paced sequential bilateral finger-tapping task, consisting of a 4-minute scan block with alternating 20-second periods of either the tapping task (six blocks) or rest (six blocks), while undergoing functional magnetic resonance imaging. Clinical and behavioral symptoms were assessed using the Child Behavior Checklist (CBCL). A between-group whole-brain analysis compared activation pattern differences while controlling for effects of age and sex. Clusters meeting whole-brain false discovery rate (FDR) correction (qFDR < .05) were considered statistically significant. Post hoc analyses evaluating comorbid attention-deficit/hyperactivity disorder (ADHD) in the BP group were also conducted. RESULTS Significantly decreased activation was found in the anterior cingulate cortex (ACC) in youths with BP compared to HC. Furthermore, ACC activation was negatively correlated with CBCL mood dysregulation profile scores in the BP group. No significant differences in functional activation patterns were found between youths with BP and comorbid ADHD and those with only BP. CONCLUSIONS These findings suggest a potential common mechanism of impaired ACC modulation between emotion dysregulation and motor processing in youths with BP.
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Affiliation(s)
- Jace B. King
- Department of Radiology, University of Utah, Salt Lake City, UT, USA,Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA,Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA,Correspondence: Jace B. King, University of Utah, Imaging and Neurosciences Center, 729 Arapeen Drive, Salt Lake City, UT, 84108, USA; Phone: 801-585-9667;
| | - Jeffrey S. Anderson
- Department of Radiology, University of Utah, Salt Lake City, UT, USA,Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA,School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Deborah A. Yurgelun-Todd
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA,Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA,School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Punitha Subramaniam
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, UT, USA,Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA
| | | | - Melissa P. Lopez-Larson
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT USA,School of Medicine, University of Utah, Salt Lake City, UT, USA
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49
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Adler LA, Silverstein MJ. Emotional Dysregulation in Adult ADHD. Psychiatr Ann 2018. [DOI: 10.3928/00485713-20180607-01] [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: 11/20/2022]
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50
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Attention-deficit/hyperactivity disorder symptoms and happiness among adults in the general population. Psychiatry Res 2018; 265:317-323. [PMID: 29778053 DOI: 10.1016/j.psychres.2018.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/13/2018] [Accepted: 05/01/2018] [Indexed: 01/10/2023]
Abstract
Despite an increasing focus on the role of mood and emotions in attention-deficit/hyperactivity disorder (ADHD), as yet, there has been comparatively little research on positive emotions. To address this research gap, the current study examined the association between ADHD symptoms and happiness using data from the 2007 Adult Psychiatric Morbidity Survey. The analytic sample comprised 7274 adults aged 18 and above residing in private households in England. Information was collected on ADHD symptoms using the Adult ADHD Self-Report Scale (ASRS) Screener, while happiness was assessed with a single (3-point) measure. Multivariable ordinal logistic regression analysis and a mediation analysis were performed to examine associations. Greater ADHD symptom severity was associated with higher odds for feeling less happy. Mood instability (percentage mediated 37.1%), anxiety disorder (35.6%) and depression (29.9%) were all important mediators of the association between ADHD and happiness. Given that happiness has been linked to a number of beneficial outcomes, the results of this study highlight the importance of diagnosing ADHD in adults and also of screening for and treating any comorbid psychiatric disorders in these individuals.
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