Cognitive Control Deficits in Children With Subthreshold Attention-Deficit/Hyperactivity Disorder

Stochastic resonance is not required for pink noise to have beneficial effects on ADHD-related performance? The moderate brain arousal model challenged

OBJECTIVE

Random noise, such as white or pink noise, has been shown to have beneficial effects on the performance of individuals with (elevated traits of) ADHD. Both the state regulation deficit (SRD) account and the moderate brain arousal (MBA) model argue that this effect is due to enhanced cognitive arousal. The MBA model specifically attributes this to random noise affecting dopaminergic (DA) transmission via stochastic resonance (SR). However, he requirement of SR and the role of DA have not yet been properly examined. To test this, proper control conditions are needed.

METHOD

To examine the requirement of SR, 60 neurotypical adults with varying levels of ADHD traits performed a slow two-choice reaction time (S1-S2) task in three auditory conditions: pink (random) noise, a pure 100 Hz tone (non-random noise), and silence. All participants also completed the Attention Network Test (ANT) in two conditions (pink noise and silence) to inspect the effect on executive network efficiency which may serve as a proxy measure of DA. ADHD traits were assessed via self-report.

RESULTS

Auditory stimulation improved performance on the S1-S2 task in participants with elevated ADHD traits, however this was the case for both pink noise and the pure tone. Pink noise did not affect executive network efficiency, irrespective of ADHD traits.

CONCLUSIONS

Our results suggest that stochastic resonance is not required for pink noise to have a beneficial effect on ADHD-related performance. Pink noise did not affect our DA proxy measure, however this negative finding should be interpreted with caution. Our results cast doubt on the tenets of the MBA model, warranting further research.

Contrasting presentations of children with ADHD and subthreshold ADHD

BACKGROUND

We aimed to explore the differences and relationships in body composition, social function, and comorbidities between children with attention-deficit/hyperactivity disorder (ADHD) and subthreshold ADHD.

METHODS

A case-control study was conducted to analyze the differences between children with ADHD and subthreshold ADHD. Logistic regression models were used to analyze the factors influencing social functional impairments and comorbidities.

RESULTS

Children with ADHD and subthreshold ADHD had a higher fat mass index than healthy children (p < 0.05). The scores of all six social functional domains were higher in the subthreshold ADHD and ADHD groups than in the control group (p < 0.05). The prevalence of comorbidity was higher in children with subthreshold ADHD and ADHD compared to the control group (p < 0.05). Inattention and comorbid anxiety/depression increased the risk of functional impairments in children with ADHD (full syndrome/subthreshold), whereas a higher fat-free mass index reduced the risk. The severity of hyperactivity was associated with a higher risk of comorbidity in children with ADHD (full syndrome/subthreshold).

CONCLUSION

Children with subthreshold ADHD and ADHD had more fat mass and higher rates of social functional impairments and comorbidities than healthy children. There were clinical correlations between body composition, social functional impairments, and comorbidities in ADHD.

IMPACT

1. Children with subthreshold ADHD and ADHD had higher fat mass levels than normal children. 2. The social function impairments and comorbidities of children with subthreshold ADHD were similar to those with ADHD. 3. Inattentiveness and anxiety/depression increased the risk of functional impairments in children with ADHD (full syndrome/subthreshold), while a higher fat-free mass index and skeletal muscle-to-body fat ratio reduced the risk.

Patterns of Physical Activity of Adolescents With ADHD in the School Context: A Cross-Sectional Study for Clinical Practice

OBJECTIVES

To describe the daily Physical Activity (PA) patterns of adolescents with Attention-deficit/hyperactivity disorder (ADHD), to analyze the differences in terms of PA patterns between adolescents with ADHD and those without ADHD, and to study the factors associated with achieving the daily PA recommendations.

METHODS

The sample was composed of 778 adolescents who provided complete information on their PA patterns through the Physical Activity Questionnaire for Adolescents (PAQ-A). Of these, 97 had ADHD according to DSM-5 criteria.

RESULTS

The results show that being a girl or being of foreign origin and having ADHD have an impact on the achievement of the recommended amount of daily PA.

CONCLUSIONS

When promoting PA in adolescents with ADHD within the school environment, it is necessary to consider different domains and specific contexts of a school day, paying special attention to girls and adolescents with ADHD of immigrant origin.

Impact of "intensive parenting attitude" on children's social competence via maternal parenting behavior

"Intensive parenting" is a tendency to invest parents' time, money, and energy in their child. This also includes some gender bias concerning a mother being the best person to primarily raise her children. Some psychology scholars have pointed out that this attitude causes much stress, anxiety, depression, and a sense of guilt among mothers. However, its effects on children have yet to be revealed using an extensive survey, and this indicates the need to investigate any possible impact of an intensive parenting attitude on children. The aim of this study was to elucidate a link between a maternal intensive parenting attitude and their children's social competence through maternal parenting behavior. This was based on collecting data from 675 Japanese women who were mothers of preschoolers using the Japanese version of the Intensive Parenting Attitude Questionnaire, the Positive and Negative Parenting Scale, and the Strength and Difficulties Questionnaire. The results showed that the "Essentialism," "Fulfillment," and "Child-centered" components of intensive parenting attitude influenced the "involvement and monitoring" and "positive responsivity" of parenting behavior. Furthermore, these two parenting behaviors affected children's prosocial behavior and hyperactivity/inattention. These findings suggest that an intensive parenting attitude has some impact on children as well as mothers, both positively and negatively, pointing to a serious effect on society.

Attention deficit in primary-school-age children with attention deficit hyperactivity disorder measured with the attention network test: a systematic review and meta-analysis

Objective

To review and meta-analyze patterns of attention deficit in primary-school-age children with ADHD measured with the neuropsychological attention network test (ANT).

Methods

Six electronic databases were searched to 5.05.2022. Selection criteria included prospective cohort and intervention studies; ANT used; primary-school-age; diagnosis of ADHD/at high risk.

Results

Seven studies met inclusion criteria (N = 3,826). Compared with controls, children with ADHD had higher scores for Reaction Time (Hedges' g = 0.433; 95% CI: 0.135-0.731), Reaction Time Variability (Hedges' g = 0.334; 95% CI: 0.012-0.657), and Alerting Network (Hedges' g = 0.235; 95% CI: 0.021-0.449) while children at high risk had higher Alerting Network scores (Hedges' g = 0.176; 95% CI: 0.003-0.349) and Correctness scores (Hedges' g = 1.956; 95% CI: 0.020-3.892).

Conclusions

Children with ADHD and at risk of ADHD had different ANT results from children without ADHD only for the alerting network. There were no significant differences for executive and orienting outcomes. Children at risk of ADHD also made more errors (commission and omission) measured with the ANT compared with children without ADHD. Reaction time was longer and reaction time variability higher in children with ADHD than in children without ADHD, and in children at risk of ADHD compared with children without ADHD.

Preregistration

A protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42021249768).

The Clinical Manifestation, Executive Dysfunction, and Caregiver Strain in Subthreshold Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

Subthreshold attention-deficit/hyperactivity disorder (ADHD) has been suggested to be a "morbid condition" which also needs medical attention.

METHODS

The present study recruited 89 children with subthreshold ADHD (sADHD), 115 children with diagnosed ADHD (cADHD), and 79 healthy controls (HC) to explore the clinical manifestation, executive functions (EFs) of sADHD, and the caregiver strain. The clinical manifestation was evaluated through clinical interviews and parent-reports. Executive functions were assessed both experimentally and ecologically. Caregiver strain was measured by a parent-reported questionnaire.

RESULTS

For the clinical manifestation, both sADHD and cADHD indicated impairments when compared with HC. The comorbidities and the scaled symptoms indicated that the externalizing behaviors were relatively less serious in sADHD than cADHD, whereas the internalizing behaviors between two groups were comparable. For ecological EFs, sADHD scored between cADHD and HC in inhibition and working memory. For experimental EFs, sADHD was comparable to cADHD in inhibition, shifting, and was worse than cADHD in verbal working memory. For the caregiver strain, all scores of sADHD were between that in cADHD and that in HC.

CONCLUSION

Our present findings supported the suggestion of subthreshold ADHD as "morbid condition," which should be treated with caution in clinical practice, especially for the internalizing behaviors and some key components of EFs.