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Sinha C, Lecavalier L, Johnson CR, Taylor C, Mulligan A, Buckley D, Alder ML, Scahill L. Qualitative Exploration Toward the Development of a Parent-Rated Scale for Insomnia in Children with Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-022-05865-9. [PMID: 36856915 DOI: 10.1007/s10803-022-05865-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 03/02/2023]
Abstract
Toward the development of a new parent-rating for insomnia, this multi-site qualitative study explored sleep problems and related impacts in children with autism spectrum disorder (ASD) and their families. To ensure content validity of the measure, we conducted six focus groups with caregivers (N = 25) of 24 children (age 3 to 18 years) with ASD. Based on parent report, all children had a history of mild or greater insomnia. The focus group transcripts were systematically coded to identify major themes. Verbatim comments from caretakers were used to generate 134 candidate items. Further review by the research team and an expert panel followed by individual cognitive interviews with 12 parents reduced the item bank to 40. The thematic analysis of focus group transcripts identified 7 categories: (1) Trouble falling asleep; (2) trouble staying asleep; (3) early morning waking; (4) bedtime routines; (5) parental strategies for bedtime management; (6) impact of sleep problems on the child; and (7) impact of sleep problems on the family. The Flesch Kincaid Grade Level of the 40-item version was 7.2 (seventh grade reading level). Insomnia in children with ASD shares features in common with insomnia in the general pediatric population. However, perhaps owing to autistic features such as insistence on sameness, sensory sensitivities, communication impairments, insomnia in children with ASD appears to have unique behavioral manifestations. Content validity and item clarity of the 40-item bank were supported by expert panel review and cognitive interviews with caregivers of children with ASD.
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Affiliation(s)
- C Sinha
- Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA, 30307, USA
| | - L Lecavalier
- The Ohio State University Nisonger Center and Department of Psychology, 1581 Dodd Drive, Columbus, OH, 43210, USA
| | - C R Johnson
- Cleveland Clinic Children's Center for Autism, Lerner College of Medicine at Case Western Reserve University, 2801 Martin Luther King Jr. Dr., Cleveland, OH, 44104, USA
| | - C Taylor
- The Ohio State University, 306A Atwell Hall, 453 W. 10th Ave., Columbus, OH, 43210, USA
| | - A Mulligan
- The Ohio State University Nisonger Center, 1581 Dodd Drive, Columbus, OH, 43210, USA
| | - D Buckley
- Marcus Autism Center, Emory University School of Medicine, 1920 Briarcliff Rd. NE, Atlanta, GA, 30307, USA
| | - M L Alder
- Marcus Autism Center, Emory University School of Medicine, 1920 Briarcliff Rd. NE, Atlanta, GA, 30307, USA
| | - L Scahill
- Marcus Autism Center, Emory University School of Medicine, 1920 Briarcliff Rd. NE, Atlanta, GA, 30307, USA.
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Machida K, Barry E, Mulligan A, Gill M, Robertson IH, Lewis FC, Green B, Kelly SP, Bellgrove MA, Johnson KA. Which Measures From a Sustained Attention Task Best Predict ADHD Group Membership? J Atten Disord 2022; 26:1471-1482. [PMID: 35253511 DOI: 10.1177/10870547221081266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Difficulty with sustaining attention to a task is a hallmark of ADHD. It would be useful to know which measures of sustained attention best predict a diagnosis of ADHD. Participants were 129 children with a diagnosis of ADHD and 129 matched controls who completed the fixed Sustained Attention to Response Task (SART). The number of commission and omission errors, standard deviation of response time (SDRT), tau, fast and slow frequency variability, d-prime, and mu were able to successfully classify children with and without ADHD. The mean response time, criterion, and sigma were not able to classify participants. The best classifiers were d-prime (0.75 Area Under the Receiver Operated Characteristic), tau (.74), SDRT (0.74), omission errors (0.72), commission errors (0.71), and SFAUS (0.70). This list of the best classifier measures derived from the SART may prove useful for the planning of future studies.
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Affiliation(s)
| | | | | | | | | | | | - Benita Green
- The University of Melbourne, Parkville, VIC, Australia
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3
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Mulligan A, Sresthaporn N, Mulroy S, Rudd T, Coffey A, Joyce M, Gadancheva V, Glancy C. Development, preliminary validation and reliability of the colourful 'My Feelings Form' self-report for young children. Child Adolesc Ment Health 2022; 28:299-306. [PMID: 35614029 DOI: 10.1111/camh.12566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Patient-reported outcome measures place the patient at the centre of his/her care. There are calls to introduce child-reported outcome measures to mental health services. We aimed to (a) develop an age-appropriate patient-reported outcome measure for children's mental health, and (b) validate this in a primary school and Child and Adolescent Mental Health Service (CAMHS). METHODS A list of items to measure children's mental health was proposed (Draft 1) and revised to 14 items following focus group and user consultation (Draft 2). A colourful, cartoon and emoji version was created in consultation with children (Draft 3); a professional cartoon artist created the final 'My Feelings Form' (MFF), with usability feedback (Draft 4). The MFF was tested by 317 children aged 4-13 years from one mixed-gender primary school at two time points in 1 day, and 25 children aged 4-13 years from CAMHS. Results were analysed using test-retest reliability and exploratory factor analysis; a receiver operator characteristic curve was constructed. RESULTS The CAMHS group scored significantly higher than the school group for the mean total score (23.5 ± 11.3 vs. 16.1 ± 6.2) and for 10 items. Test-retest reliability was acceptable (correlation = 0.74, p < .001). Exploratory factor analysis using 10 informative items identified two factors - emotional factor (Cronbach's alpha = 0.74) and function factor (Cronbach's alpha = 0.59). The revised 10-item form has a Cronbach's alpha of 0.77; a cut-off of 12 has a sensitivity of 80% and specificity of 60%, indicating that it correctly identified 80% of those who were attending CAMHS and gave 60% of the schoolchildren a negative result. CONCLUSIONS The colourful MFF was co-produced with children, and preliminary data suggest that it is a useful patient-reported outcome measure for children's mental health.
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Affiliation(s)
- Aisling Mulligan
- Department of Child and Adolescent Psychiatry, School of Medicine, University College Dublin, Dublin, Ireland.,Dublin North City and County Child and Adolescent Mental Health Service, Dublin, Ireland
| | | | - Sinead Mulroy
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Tara Rudd
- Dublin North City and County Child and Adolescent Mental Health Service, Dublin, Ireland
| | - Anne Coffey
- Department of Psychotherapy, University College Dublin, Dublin, Ireland
| | - Maria Joyce
- Department of Psychotherapy, University College Dublin, Dublin, Ireland
| | - Veselina Gadancheva
- Dublin North City and County Child and Adolescent Mental Health Service, Dublin, Ireland
| | - Caoimhe Glancy
- School of Medicine, University College Dublin, Dublin, Ireland
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Gilligan C, Sresthaporn N, Mulligan A. COVID-19 and mental health of primary school children: Comparison of 2019 and 2020. Child Care Health Dev 2022; 48:891-894. [PMID: 35297078 PMCID: PMC9111544 DOI: 10.1111/cch.13001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 02/28/2022] [Accepted: 03/06/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION It is believed that the COVID-19 pandemic and associated global school closures may have an adverse effect on children's mental health. METHODS We performed repeated measures of the mental health of children attending one primary school in Ireland before and during the quarantine phase of the first wave of the pandemic. We used the 'My Feelings Form', which is a 14-item colourful self-report measure which was completed in the classroom in 2019 and via postal survey in 2020. RESULTS We had an 87% response rate in 2019 and a 35% response rate via postal return in 2020. We found no evidence of a change in mean measures of mental health between 2019 and 2020, in the 35% who responded in 2020. CONCLUSION There is a cohort of children who were not adversely affected by the first wave of COVID-19 pandemic and associated school closures in Ireland.
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Affiliation(s)
- Colin Gilligan
- School of MedicineUniversity College DublinDublinIreland
| | | | - Aisling Mulligan
- Department of Child and Adolescent Psychiatry, School of Medicine, Catherine McAuley Education and Research CentreUniversity College DublinDublinIreland
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Appadurai V, Chamberlain R, Edwards NFA, Mulligan A, Platts D, Hamilton-Craig C, Chan J, Scalia GM. The long term prognostic value of peak left atrial strain in cardiac transplant patients. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Left atrial (LA) dysfunction is associated with poorer outcomes in many disease processes. Left atrial strain (LAS) is a novel two-dimensional (2D) quantitative analysis of LA function. Cardiac transplantation directly involves the LA during implantation of the donor heart. Traditional echocardiographic indices after transplantation have demonstrated value in correlating with acute cellular rejection (ACR), morbidity and mortality over short- and long-term follow-up. The prognostic value of LA strain has not been previously investigated in this cohort.
Purpose
We hypothesized that incrementally impaired LA strain in post cardiac transplant patients with varying degrees of ACR may be prognostic of poorer outcomes on long term follow-up.
Methods
87 Heart transplant patients, assessed between 2009 and 2015, underwent transthoracic echocardiography and endomyocardial biopsy. 2D strain analysis on the LV and LA were performed along with traditional echocardiographic parameters. Patients were grouped according to peak LAS (PALS) tertiles and rejection burden history was assessed and grouped according to ACR burden at a median of 12 (±5.4) months post transplantation. The primary endpoint was all-cause mortality at follow-up.
Results
12 patients met the primary endpoint over a median follow-up of 66 ± 51 months. The mean LA PALS was significantly different across the tertiles (lowest tertile 12.29 ± 2.5% vs middle tertile 17.89 ± 1.1% vs highest tertile 24.54 ± 4.2%; p <0.0001). LA strain dispersion was also significantly different between the tertiles (61.03 ± 25.8ms vs 41.8 ± 15.8ms vs 44.8 ± 18.8ms; p <0.001). All other clinical and echocardiographic parameters were non-significant between the tertiles however, there was a trend towards a lower PALS in the higher rejection burden group. Kaplan Meier curves demonstrated that survival over follow-up was significantly worse in the lower tertile LA PALS group compared to the highest tertiles LA PALS group (Log-rank test = p < 0.0001). The lowest LA PALS tertile had a significantly higher risk of reaching the primary endpoint compared with patients in the highest LA PALS tertile (hazard ratio [HR] 9.802; 95% CI 1.832-52.45; p <0.008). Higher LA PALS and LV GLS (LA PALS HR 0.610 95% CI 0.401-0.926; p 0.02; LV GLS HR 0.638 95% CI 0.418-0.972; p 0.037) were significantly associated with a reduction in reaching the primary endpoint in a multi-variate regression model including clinically relevant traditional and strain-based echocardiographic parameters.
Conclusions
Lower LA PALS is significantly associated with poorer long-term outcomes in cardiac transplant patients with ACR. Non-invasive LA PALS may be a useful predictor of long-term outcome in patients post cardiac transplantation. Abstract Figure. Survival curves for LA PALS tertiles
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Affiliation(s)
- V Appadurai
- The Prince Charles Hospital, Brisbane, Australia
| | | | - NFA Edwards
- The Prince Charles Hospital, Brisbane, Australia
| | - A Mulligan
- The Prince Charles Hospital, Brisbane, Australia
| | - D Platts
- The Prince Charles Hospital, Brisbane, Australia
| | | | - J Chan
- The Prince Charles Hospital, Brisbane, Australia
| | - GM Scalia
- The Prince Charles Hospital, Brisbane, Australia
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Mulligan A, Burrage M, Savage M, Black P, Scalia G. Prevalence of Disproportionate RV Filling Pressures to LV Filling Pressures. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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7
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Braito I, Rudd T, Buyuktaskin D, Ahmed M, Glancy C, Mulligan A. Review: systematic review of effectiveness of art psychotherapy in children with mental health disorders. Ir J Med Sci 2021; 191:1369-1383. [PMID: 34231158 PMCID: PMC9135848 DOI: 10.1007/s11845-021-02688-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/09/2021] [Indexed: 12/02/2022]
Abstract
Art therapy and art psychotherapy are often offered in Child and Adolescent Mental Health services (CAMHS). We aimed to review the evidence regarding art therapy and art psychotherapy in children attending mental health services. We searched PubMed, Web of Science, and EBSCO (CINHAL®Complete) following PRISMA guidelines, using the search terms (“creative therapy” OR “art therapy”) AND (child* OR adolescent OR teen*). We excluded review articles, articles which included adults, articles which were not written in English and articles without outcome measures. We identified 17 articles which are included in our review synthesis. We described these in two groups—ten articles regarding the treatment of children with a psychiatric diagnosis and seven regarding the treatment of children with psychiatric symptoms, but no formal diagnosis. The studies varied in terms of the type of art therapy/psychotherapy delivered, underlying conditions and outcome measures. Many were case studies/case series or small quasi-experimental studies; there were few randomised controlled trials and no replication studies. However, there was some evidence that art therapy or art psychotherapy may benefit children who have experienced trauma or who have post-traumatic stress disorder (PTSD) symptoms. There is extensive literature regarding art therapy/psychotherapy in children but limited empirical papers regarding its use in children attending mental health services. There is some evidence that art therapy or art psychotherapy may benefit children who have experienced trauma. Further research is required, and it may be beneficial if studies could be replicated in different locations.
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Affiliation(s)
- Irene Braito
- School of Medicine, University College Dublin, Dublin, Ireland.,Paediatric Medicine, Great North Children's Hospital, United Kingdom, UK
| | - Tara Rudd
- Dublin North City and County Child and Adolescent Mental Health Service, Dublin, Ireland
| | - Dicle Buyuktaskin
- School of Medicine, University College Dublin, Dublin, Ireland.,Department of Child and Adolescent Psychiatry, Cizre Dr. Selahattin Cizrelioglu State Hospital, Cizre, Sirnak, Turkey
| | - Mohammad Ahmed
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Caoimhe Glancy
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Aisling Mulligan
- Dublin North City and County Child and Adolescent Mental Health Service, Dublin, Ireland. .,Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland.
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Bayat MK, Chan W, Javorsky G, Platts D, Dashwood A, Wong Y, Mulligan A, Tesar P, Prahbu A, Thomson B, Lavana J, McKenzie S. Acute Compartment Syndrome Following Heart Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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9
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Challa A, Maddicks-Law J, Mulligan A, Prabhu A, Wong Y. High Pre-Donation Vasoactive Inotropic Score (VIS) May Be Associated with Increased Risk of Primary Graft Dysfunction in Cardiac Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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10
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Eapen V, McPherson S, Karlov L, Nicholls L, Črnčec R, Mulligan A. Social communication deficits and restricted repetitive behavior symptoms in Tourette syndrome. Neuropsychiatr Dis Treat 2019; 15:2151-2160. [PMID: 31440054 PMCID: PMC6666375 DOI: 10.2147/ndt.s210227] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/01/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Autism spectrum disorders (ASD) have been found to occur more frequently in individuals with Tourette syndrome (TS) than in the general population. Similarities exist between ASD and TS clinically, which suggests a potential relationship between the two conditions. Purpose: The purpose of this study was to explore the occurrence of autism-related features in ASD and TS, focusing on areas of overlap and difference. Patients and methods: This study examined the nature and extent of autistic traits as measured by the Social Communication Questionnaire (SCQ) in a sample with a diagnosis of TS, a sample diagnosed to have ASD, and a normative general population sample. Results: The TS sample had significantly higher mean SCQ scores than the general population, but generally lower scores than the ASD sample. The group differences in mean SCQ scores between the TS and ASD sample were significant except in the domain of restricted repetitive behaviours (RRB). Conclusion: This suggests that ASD traits occur commonly in the TS population, with a significant overlap in certain clinical features. This was especially the case for complex movements or repetitive behaviours, which may represent either: i) a shared phenotype which is subclinical, ii) a phenocopy where some clinical symptoms mimic each other, or iii) a co-morbidity. Awareness of this association can be useful in identifying these symptoms as part of the comprehensive assessment of TS and addressing these to improve the overall clinical outcomes in these patients.
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Affiliation(s)
- Valsamma Eapen
- School of Psychiatry , University of New South Wales, Sydney, NSW, Australia
| | - Sarah McPherson
- Medical Oncology, The Canberra Hospital, Canberra, ACT, Australia
| | - Lisa Karlov
- School of Psychiatry , University of New South Wales, Sydney, NSW, Australia
| | - Laura Nicholls
- School of Psychiatry , University of New South Wales, Sydney, NSW, Australia
| | - Rudi Črnčec
- Penrith Therapy Centre, Penrith, NSW, Australia
| | - Aisling Mulligan
- Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Dublin North City and County Child and Adolescent Mental Health Service, Health Services Executive, Dublin, Ireland
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Moriswala R, Antoo A, Scholes E, Seman M, Simons K, Mulligan A, Cox N, Neil C. Predictors of Congestive Readmission Within 6 Months Following Acute Decompensated Heart Failure. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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12
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Lai WW, O'Mahony M, Mulligan A. The Home Observation Measure of the Environment is associated with symptoms of ADHD and oppositionality in a CAMHS sample. Clin Child Psychol Psychiatry 2018; 23:503-513. [PMID: 29262691 DOI: 10.1177/1359104517740712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Severe early deprivation has a causal role in attention-deficit/hyperactivity disorder (ADHD). Adversity in the home is associated with increased ADHD and oppositional symptoms in children with ADHD. We aimed to replicate this in an independent clinic sample. METHODS A total of 247 sequential families with a child referred to child and adolescent mental health services (CAMHS) were invited to participate; 100 families completed the study. The Home Observation Measure of the Environment (HOME) assessment was completed in the family home; parents completed the Conners' Rating Scale. RESULTS A less supportive home was associated with more symptoms of inattention ( r = .33, p = .001), hyperactivity/impulsivity ( r = -.22, p = .028) and oppositionality ( r = -.48, significant at p < .000001). CONCLUSION The HOME correlates with ADHD and oppositional symptom severity in a clinic sample; more research is required to ascertain whether this is a causal association and the direction of causation. If causal, then the modification of the home environment may be a treatment strategy for ADHD.
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Affiliation(s)
- Wai Wai Lai
- 1 School of Medicine, University College Dublin, Ireland.,2 Dublin North City and County Child & Adolescent Mental Health Service, Health Services Exective, Dublin 1, Ireland
| | | | - Aisling Mulligan
- 2 Dublin North City and County Child & Adolescent Mental Health Service, Health Services Exective, Dublin 1, Ireland.,3 Department of Child & Adolescent Psychiatry and Catherine McAuley Education & Research Centre, School of Medicine, University College Dublin, Ireland
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13
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Haji K, Pathan F, Wong C, Neil C, Cox N, Mulligan A, Oreto M, Wright L, Marwick T. P5633Handheld ultrasound: a way to reduce requests for inappropriate echocardiograms. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Haji
- Western Hospital, Cardiology, Melbourne, Australia
| | - F Pathan
- Menzies Research Institute, Hobart, Australia
| | - C Wong
- Western Hospital, Cardiology, Melbourne, Australia
| | - C Neil
- Western Hospital, Cardiology, Melbourne, Australia
| | - N Cox
- Western Hospital, Cardiology, Melbourne, Australia
| | - A Mulligan
- Western Hospital, Cardiology, Melbourne, Australia
| | - M Oreto
- Western Hospital, Cardiology, Melbourne, Australia
| | - L Wright
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - T Marwick
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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14
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McCarthy H, Stanley J, Piech R, Skokauskas N, Mulligan A, Donohoe G, Mullins D, Kelly J, Johnson K, Fagan A, Gill M, Meaney J, Frodl T. Childhood-Diagnosed ADHD, Symptom Progression, and Reversal Learning in Adulthood. J Atten Disord 2018; 22:561-570. [PMID: 27507767 DOI: 10.1177/1087054716661233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE ADHD persists in up to 60% into adulthood, and the reasons for persistence are not fully understood. The objective of this study was to characterize the neurofunctional basis of decision making in those with a childhood diagnosis of ADHD with either persistent or remitted symptoms in adulthood versus healthy control participants. METHOD Thirty-two adults diagnosed with ADHD as children were split into persistent ( n = 18) or remitted ( n = 14) ADHD groups. Their neural activity and neurofunctional connectivity during a probabilistic reversal learning task were compared with 32 healthy controls. RESULTS Remitters showed significantly higher neural connectivity in final reversal error and probabilistic error conditions, and persisters depict higher neural connectivity in reversal errors than controls at a family-wise error (FWE) corrected whole-brain corrected threshold. CONCLUSION Remitters may have utilized higher neural connectivity than controls to make successful decisions. Also, remitters may have utilized compensatory strategies to override any potential underlying ADHD deficits.
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Affiliation(s)
| | | | | | - Norbert Skokauskas
- 1 Trinity College Dublin, Ireland.,3 Norwegian University of Science and Technology, Trondheim, Norway
| | - Aisling Mulligan
- 4 Children's University Hospital, Dublin, Ireland.,5 Mater Child and Adolescent Mental Health Service, Dublin, Ireland
| | | | | | | | - Katherine Johnson
- 1 Trinity College Dublin, Ireland.,6 University of Melbourne, Victoria, Australia
| | - Andrew Fagan
- 1 Trinity College Dublin, Ireland.,7 St. James's Hospital, Dublin, Ireland
| | - Michael Gill
- 1 Trinity College Dublin, Ireland.,7 St. James's Hospital, Dublin, Ireland
| | | | - Thomas Frodl
- 1 Trinity College Dublin, Ireland.,8 Otto von Guericke University of Magdeburg, Germany
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Coşkunlu A, Tanıl E, Coffey A, Büyüktaşkın D, Mulligan A. The Vasarhelyi method of child art psychotherapy: an adjunctive treatment in childhood depression. Psychoanalytic Psychotherapy 2018. [DOI: 10.1080/02668734.2017.1334150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Aynur Coşkunlu
- Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Department of Psychology, Fatih Sultan Mehmet Vakıf University, Istanbul, Turkey
| | - Ezgi Tanıl
- Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Department of Psychology, Fatih Sultan Mehmet Vakıf University, Istanbul, Turkey
| | - Anne Coffey
- Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Department of Child Art Psychotherapy, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Dicle Büyüktaşkın
- Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Department of Child and Adolescent Psychiatry, Gazi University School of Medicine, Ankara, Turkey
| | - Aisling Mulligan
- Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Dublin North City and County Child and Adolescent Mental Health Service, Health Services Executive, Ireland
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Haji K, Wong C, Pathan F, Neil C, Cox N, Mulligan A, Oreto M, Wright L, Marwick T. Using Handheld Ultrasound to Reduce Rarely Appropriate Echocardiograms. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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17
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Mulligan A, Moriswala R, Scholes E, Zammit C, Cox N, Neil C. Effectiveness of Unit Education Regarding Guideline Changes in a Single Centre: Iron Replacement in Heart Failure. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Al-mukhtar O, Noaman S, Cheng Y, Seman M, Mulligan A, Cox N, Chan W. Pollen Count Association With Coronary Artery Disease in Patients Undergoing Percutaneous Coronary Intervention in Melbourne. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mulligan A, Moriswala R, Scholes E, Zammit C, Cox N, Neil C. Absolute and Functional Iron Deficiency in Hospitalised Patients with Heart Failure: Effect on All-Cause Readmission. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Al-Mukhtar O, Mulligan A, Noaman S, Goh C, Seman M, Neil C. A Systematic Review of Palliative Intent Medical Interventions for Patients with Advanced Heart Failure: A Best Evidence Synthesis Approach. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Al-mukhtar O, Noaman S, Lim M, Goh C, Seman M, Mulligan A, Chan W, Cox N. Predictors of Short-Term Readmissions in Patients with Coronary Artery Disease Treated with Percutaneous Coronary Intervention. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mulligan A, Seman M, Abramowski R, Mulkhtar AO, Zammit C, Scholes E, Long C, Neil C, Cox N. A ‘Cardiogeriatric Model’ of Care in Acute Decompensated Heart Failure: Implementation of a Multidisciplinary Approach Impacting 12-Month Readmissions in Complex Patients. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Saba L, Byrne A, Mulligan A. Child art psychotherapy in CAMHS: Which cases are referred and which cases drop out? Springerplus 2016; 5:1816. [PMID: 27812453 PMCID: PMC5069233 DOI: 10.1186/s40064-016-3509-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/11/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The Vasarhelyi method of child art psychotherapy (CAP) is offered at certain Child and Adolescent Mental Health Services. Children attend three introductory sessions, and then choose to continue weekly CAP or conclude the sessions. AIMS This study aims to identify the clinical disorders and characteristics of patients referred to CAP, and to determine who engages with the therapy. METHODS A retrospective review of the clinical records of 67 children who attended CAP in DNCC/Mater CAMHS over 13 years was performed. The data was analysed using Microsoft Excel 12.0 and SPSS version 20. RESULTS 67 children (57 % male and 43 % female) aged 5-17 years participated in CAP with an average age of 10.6 years. Children attended an average of 14 sessions of CAP, with a range of 1-61 sessions (mean of 13.8 ± 12.9 sessions). Anxiety disorder (28 %), behaviour disorder/ODD (25 %), and ADHD (21 %) are the most common diagnoses referred. These diagnoses along with autism spectrum disorder (ASD) had the highest overall engagement, while those with depression engaged the least. Children with ADHD and with ASD attended high numbers of sessions (with a mean of 23 and 19 respectively). Those who experienced acute life events or difficulties in the home engaged well (60 and 40 % respectively). There was no significant difference found in the percentage of appointments attended by males in comparison to females. CONCLUSION CAP is generally acceptable to children, with a high average attendance rate. It was noted that children with ADHD and with ASD engaged well with the therapy for prolonged periods, whereas children with depression did not engage so well. We suggest that CAMHS clinics should consider referring children diagnosed with ADHD and children diagnosed with ASD to CAP as an adjunct to other therapies. We suggest that individuals with depression should be referred initially to other therapeutic services as the engagement with CAP was relatively poor.
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Affiliation(s)
- Leslie Saba
- Department of Child and Adolescent Psychiatry, University College Dublin, Belfield, Dublin 4, Ireland
| | - Alison Byrne
- Department of Child Art Psychotherapy, Mater Miserircordiae University Hospital, Dublin 7, Ireland
| | - Aisling Mulligan
- Department of Child and Adolescent Psychiatry, University College Dublin, Belfield, Dublin 4, Ireland
- HSE Dublin North City and County Child and Adolescent Mental Health Service, James Joyce St., Dublin 1, Ireland
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Jeyaseelan L, Chandrashekar S, Mulligan A, Bosman HA, Watson AJS. Correction of moderate to severe hallux valgus with combined proximal opening wedge and distal chevron osteotomies: a reliable technique. Bone Joint J 2016; 98-B:1202-7. [PMID: 27587521 DOI: 10.1302/0301-620x.98b9.35984] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 04/19/2016] [Indexed: 11/05/2022]
Abstract
AIMS The mainstay of surgical correction of hallux valgus is first metatarsal osteotomy, either proximally or distally. We present a technique of combining a distal chevron osteotomy with a proximal opening wedge osteotomy, for the correction of moderate to severe hallux valgus. PATIENTS AND METHODS We reviewed 45 patients (49 feet) who had undergone double osteotomy. Outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) and the Short Form (SF) -36 Health Survey scores. Radiological measurements were undertaken to assess the correction. The mean age of the patients was 60.8 years (44.2 to 75.3). The mean follow-up was 35.4 months (24 to 51). RESULTS The mean AOFAS score improved from 54.7 to 92.3 (p < 0.001) and the mean SF-36 score from 59 to 86 (p < 0.001). The mean hallux valgus and intermetatarsal angles were improved from 41.6(o) to 12.8(o) (p < 0.001) and from 22.1(o) to 7.1(o), respectively (p < 0.001). The mean distal metatarsal articular angle improved from 23(o) to 9.7(o). The mean sesamoid position, as described by Hardy and Clapham, improved from 6.8 to 3.5. The mean length of the first metatarsal was unchanged. The overall rate of complications was 4.1% (two patients). CONCLUSION These results suggest that a double osteotomy of the first metatarsal is a reliable, safe technique which, when compared with other metatarsal osteotomies, provides strong angular correction and excellent outcomes with a low rate of complications. Cite this article: Bone Joint J 2016;98-B:1202-7.
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Affiliation(s)
- L Jeyaseelan
- Princess Alexandra Hospital, Hamstel Rd, Harlow CM20 1QX, UK
| | - S Chandrashekar
- Princess Alexandra Hospital, Hamstel Rd, Harlow CM20 1QX, UK
| | - A Mulligan
- Barts and the London NHS Trust, Whitechapel Rd, London, Whitechapel E1 1BB, UK
| | - H A Bosman
- Homerton NHS Trust, Homerton Row, London E9, UK
| | - A J S Watson
- Princess Alexandra Hospital, Hamstel Rd, Harlow CM20 1QX, UK
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Noaman S, Goh C, Al-Mukhtar O, Seman M, Mulligan A, Zakhem B, Brazzale A, Walton A, Stub D, Cox N, Chan W. Comparison of Short-term Clinical Outcomes of Proximal Versus Distal Culprit Lesions in ST-Elevation Myocardial Infarction. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mulligan A, Seman M, Francke M, Long C, Wong C, Cox N, Neil C. Prevalence and Impact of Anaemia and Iron Deficiency in Elderly Hospitalised Heart Failure Patients: Effect on Length of Stay and Hospital Free Survival. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mulligan A, Seman M, Abramowski R, Zammit C, Scholes E, Long C, Janus E, Cowie K, Cox N, Neil C. A ‘Cardiogeriatric Model’ of Care in Acute Decompensated Heart Failure: Implementation of a Multidisciplinary Approach, Impacting 30-Day Hospital Readmission. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lai WW, O'Mahony M, Mulligan A. A telephone interview version of the middle childhood HOME Observation Measurement of the Environment. Child Care Health Dev 2015; 41:1152-60. [PMID: 26424127 DOI: 10.1111/cch.12281] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 06/26/2015] [Accepted: 07/15/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Home Observation Measurement of the Environment (HOME) is a 59-item observation and interview tool used to measure how suitable a child's home is for a child of his or her developmental age and has been used extensively in research. The HOME is usually performed in the child's home, which has cost implications. We wished to develop a telephone version of the HOME. METHODS We developed a 54-item telephone interview version of the HOME and used it to measure the home environment in 77 children aged 6-10 years inclusive attending a child and adolescent mental health clinic, followed by a home visit and HOME assessment. The results of the telephone home assessment were then compared with the results of the original HOME. RESULTS Our sample had a mean HOME score of 47.6, standard deviation (SD) = 5.5 and a mean telephone home score of 42.6, SD = 5.1. No difference was found in comparison of the subscale mean scores of the HOME with the telephone home assessment. The agreement of 54 items in common between the HOME and telephone home assessment ranged from 73% agreement to 100% agreement. Forty-three of 50 items had moderate to almost perfect agreement using kappa analysis (kappa = 0.41-0.99); three had 100% agreement. CONCLUSIONS The telephone version of the HOME compares favourably with the HOME.
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Affiliation(s)
- W W Lai
- Child and Adolescent Mental Health Service, Mater Misericordiae University Hospital, Dublin, Ireland
| | - M O'Mahony
- Child and Adolescent Mental Health Service, Mater Misericordiae University Hospital, Dublin, Ireland
| | - A Mulligan
- Child and Adolescent Mental Health Service, Mater Misericordiae University Hospital, Dublin, Ireland.,Department of Psychiatry and Mental Health, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
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Wetterling F, McCarthy H, Tozzi L, Skokauskas N, O'Doherty JP, Mulligan A, Meaney J, Fagan AJ, Gill M, Frodl T. Impaired reward processing in the human prefrontal cortex distinguishes between persistent and remittent attention deficit hyperactivity disorder. Hum Brain Mapp 2015; 36:4648-63. [PMID: 26287509 DOI: 10.1002/hbm.22944] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Revised: 07/23/2015] [Accepted: 08/06/2015] [Indexed: 11/08/2022] Open
Abstract
Symptoms of attention deficit hyperactivity disorder (ADHD) in children often persist into adulthood and can lead to severe antisocial behavior. However, to-date it remains unclear whether neuro-functional abnormalities cause ADHD, which in turn can then provide a marker of persistent ADHD. Using event-related functional magnetic resonance imaging (fMRI), we measured blood oxygenation level dependent (BOLD) signal changes in subjects during a reversal learning task in which choice of the correct stimulus led to a probabilistically determined 'monetary' reward or punishment. Participants were diagnosed with ADHD during their childhood (N=32) and were paired with age, gender, and education matched healthy controls (N=32). Reassessment of the ADHD group as adults resulted in a split between either persistent (persisters, N=17) or remitted ADHDs (remitters, N=15). All three groups showed significantly decreased activation in the medial prefrontal cortex (PFC) and the left striatum during punished correct responses, however only remitters and controls presented significant psycho-physiological interaction between these fronto-striatal reward and outcome valence networks. Comparing persisters to remitters and controls showed significantly inverted responses to punishment (P<0.05, family-wise error corrected) in left PFC region. Interestingly, the decreased activation shown after punishment was located in different areas of the PFC for remitters compared with controls, suggesting that remitters might have learned compensation strategies to overcome their ADHD symptoms. Thus, fMRI helps understanding the neuro-functional basis of ADHD related behavior differences and differentiates between persistent and remittent ADHD.
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Affiliation(s)
- Friedrich Wetterling
- Department of Psychiatry, School of Medicine, Trinity College, the University of Dublin, Dublin 2, Ireland
| | - Hazel McCarthy
- Department of Psychiatry, School of Medicine, Trinity College, the University of Dublin, Dublin 2, Ireland
| | - Leonardo Tozzi
- Department of Psychiatry, School of Medicine, Trinity College, the University of Dublin, Dublin 2, Ireland
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - John P O'Doherty
- Division of the Humanities and Social Sciences and Computation and Neural Systems Program, California Institute of Technology, Pasadena, California
| | - Aisling Mulligan
- Department of Psychiatry, School of Medicine, Trinity College, the University of Dublin, Dublin 2, Ireland
| | - James Meaney
- Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College, the University of Dublin, Dublin 8, Ireland
| | - Andrew J Fagan
- Centre for Advanced Medical Imaging (CAMI), St. James's Hospital/School of Medicine, Trinity College, the University of Dublin, Dublin 8, Ireland
| | - Michael Gill
- Department of Psychiatry, School of Medicine, Trinity College, the University of Dublin, Dublin 2, Ireland
| | - Thomas Frodl
- Department of Psychiatry, School of Medicine, Trinity College, the University of Dublin, Dublin 2, Ireland.,Department of Psychiatry, University Hospital, Otto Von Guericke University Magdeburg, Germany
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McCarthy H, Skokauskas N, Mulligan A, Donohoe G, Mullins D, Kelly J, Johnson K, Fagan A, Gill M, Meaney J, Frodl T. Attention network hypoconnectivity with default and affective network hyperconnectivity in adults diagnosed with attention-deficit/hyperactivity disorder in childhood. JAMA Psychiatry 2013; 70:1329-37. [PMID: 24132732 DOI: 10.1001/jamapsychiatry.2013.2174] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The neurobiological underpinnings of attention-deficit/hyperactivity disorder (ADHD) and particularly those associated with the persistence of ADHD into adulthood are not yet well understood. The correlation patterns in spontaneous neural fluctuations at rest are known as resting-state functional connectivity (RSFC) and could characterize ADHD-specific connectivity changes. OBJECTIVE To determine the specific location of possible ADHD-related differences in RSFC between adults diagnosed as having ADHD in childhood and control subjects. DESIGN Using resting-state functional magnetic resonance imaging, we calculated and compared functional connectivity from attention, affective, default, and cognitive control networks involved in the psychopathology of ADHD between the ADHD and control groups. SETTING University psychiatric service and magnetic resonance imaging research center. PARTICIPANTS Sixteen drug-free adults (5 women and 11 men; mean age, 24.5 years) diagnosed with combined-type ADHD in childhood and 16 healthy controls matched for age (mean age, 24.4 years), sex, handedness, and educational level recruited from the community. INTERVENTION Functional magnetic resonance imaging. MAIN OUTCOMES AND MEASURES Connectivity data from ventral and dorsal attention, affective, default, and cognitive control networks and ADHD symptoms derived from ADHD-specific rating instruments. RESULTS Adults with ADHD showed significantly decreased RSFC within the attention networks and increased RSFC within the affective and default mode and the right lateralized cognitive control networks compared with healthy controls (P < .01, familywise error for whole-brain cluster correction). Lower RSFC in the ventral and dorsal attention network was significantly correlated with higher levels of ADHD symptoms (P < .001). CONCLUSIONS AND RELEVANCE These RSFC findings might underpin a biological basis for adult ADHD and are functionally related to persistent inattention, disturbance in cognitive control, and emotional dysregulation in adults with ADHD. These findings need to be understood in the context of all aspects of brain function in ADHD.
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Affiliation(s)
- Hazel McCarthy
- Neuroimaging Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland2Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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O'Dwyer V, Bonham S, Mulligan A, O'Connor C, Farah N, Kennelly MM, Turner MJ. Antenatal rubella immunity in Ireland. Ir Med J 2013; 106:232-235. [PMID: 24282891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The objective of the study was to identify those women attending for antenatal care who would have benefited from prepregnancy rubella vaccination. It was a population-based observational study of women who delivered a baby weighing < or = 500 g in 2009 in the Republic of Ireland. The woman's age, parity, nationality and rubella immunity status were analysed using data collected by the National Perinatal Reporting System. Of the 74,810 women delivered, the rubella status was known in 96.7% (n = 72,333). Of these, 6.4% (n = 4,665) women were not immune. Rubella seronegativity was 8.0% (n = 2425) in primiparous women compared with 5.2% (n = 2239) in multiparous women (p < 0.001), 14.7% (n = 10653) in women < 25 years old compared with 5.0% (n = 3083) in women < or = 25 years old (p < 0.001), and 11.4% (n = 780) in women born outside the 27 European Union (EU27) countries compared with 5.9% (n = 3886) in women born inside the EU27 countries (p < 0.001). Based on our findings we recommend that to prevent Congenital Rubella Syndrome, the health services in Ireland should focus on women who are young, nulliparous and born outside the EU.
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Affiliation(s)
- V O'Dwyer
- UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork St, Dublin 8
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Mulligan A, Anney R, Butler L, O’Regan M, Richardson T, Tulewicz EM, Fitzgerald M, Gill M. Home environment: association with hyperactivity/impulsivity in children with ADHD and their non-ADHD siblings. Child Care Health Dev 2013; 39:202-12. [PMID: 22168816 PMCID: PMC3307872 DOI: 10.1111/j.1365-2214.2011.01345.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE We wished to ascertain if there is an association between symptoms of attention-deficit/hyperactivity disorder (ADHD) and home environment in children with ADHD and non-ADHD siblings, controlling for other environmental measures. METHODS 96 children with ADHD combined type (ADHD-CT) and their siblings participated in the study. Parent and teacher Conners' rating scales were completed and home environment was assessed using the middle childhood and early adolescent Home Observation for Measurement of the Environment (HOME). ADHD symptoms were assessed for correlation with HOME in children with ADHD-CT and non-ADHD siblings and multiple regression analysis was used to control for gender, socio-economic status, exposure to nicotine, exposure to alcohol in utero, birth weight, gestational age, pregnancy and perinatal risk factors. The presence of oppositional disorders was assessed for association with HOME score in those with ADHD-CT. The multiple regression analysis was repeated controlling for environmental factors and for oppositional disorders in those with ADHD-CT. Oppositional symptoms were assessed for correlation with HOME score in non-ADHD siblings. RESULTS Teacher-rated hyperactive/impulsive scores correlated with HOME (r=-0.27, P < 0.01) in children with ADHD-CT. This association remained significant when other environmental factors and oppositional disorders were controlled for. Environmental factors and gender contributed to 30% of the variance of ADHD symptoms in ADHD-CT. Parent-rated hyperactive/impulsive scores also correlated with HOME (r=-0.28, P < 0.05) for non-ADHD siblings. An association between HOME and diagnosis of oppositional defiant disorder or conduct disorder was found for children with ADHD-CT and between HOME and oppositional symptoms in non-ADHD siblings. CONCLUSIONS The home environment has a small but significant association with hyperactive/impulsive symptoms in children with ADHD-CT and non-ADHD siblings. This association remained when other environmental factors were taken into account. Oppositional symptoms are associated with home environment in ADHD-CT and in non-ADHD siblings.
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Affiliation(s)
- Aisling Mulligan
- Department of Psychiatry, Trinity College Dublin, Ireland
- School of Medicine and Medical Science, University College Dublin, Ireland
| | - Richard Anney
- Department of Psychiatry, Trinity College Dublin, Ireland
| | - Louise Butler
- Department of Psychiatry, Trinity College Dublin, Ireland
| | - Myra O’Regan
- Department of Statistics, Trinity College Dublin, Ireland
| | - Thomas Richardson
- Department of Psychiatry, Trinity College Dublin, Ireland
- Mental Health Research and Development Unit, University of Bath, U.K
| | | | | | - Michael Gill
- Department of Psychiatry, Trinity College Dublin, Ireland
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Swann R, Perkins A, Velentzis L, Mulligan A, Woodside J, Cantwell M, Dutton S, Leathem A, Robertson C, Dwek M. 893 The DietCompLyf Study – a Prospective Longitudinal Study of Breast Cancer Survival. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Perkins K, Swann R, Woodside J, Robertson C, Dutton S, Mulligan A, Velentzis L, Keshtgar M, Leathem A, Dwek M. 1171 DietCompLyf Study – a Multi-centre UK Study on Breast Cancer – What Are the Dietary and Lifestyle Changes Following Diagnosis? Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71766-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Uebel H, Albrecht B, Asherson P, Börger NA, Butler L, Chen W, Christiansen H, Heise A, Kuntsi J, Schäfer U, Andreou P, Manor I, Marco R, Meidad S, Miranda A, Mulligan A, Oades RD, van der Meere J, Faraone SV, Rothenberger A, Banaschewski T. Performance variability, impulsivity errors and the impact of incentives as gender-independent endophenotypes for ADHD. J Child Psychol Psychiatry 2010; 51:210-8. [PMID: 19929943 PMCID: PMC2921046 DOI: 10.1111/j.1469-7610.2009.02139.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is one of the most common and highly heritable child psychiatric disorders. There is strong evidence that children with ADHD show slower and more variable responses in tasks such as Go/Nogo tapping aspects of executive functions like sustained attention and response control which may be modulated by motivational factors and/or state-regulation processes. The aim of this study was (1) to determine if these executive functions may constitute an endophenotype for ADHD; (2) to investigate for the first time whether known modulators of these executive functions may also be familial; and (3) to explore whether gender has an impact on these measures. METHODS Two hundred and five children with ADHD combined type, 173 nonaffected biological siblings and 53 controls with no known family history of ADHD were examined using a Go/Nogo task in the framework of a multi-centre study. Performance-measures and modulating effects of event-rate and incentives were examined. Shared familial effects on these measures were assessed, and the influence of gender was tested. RESULTS Children with ADHD responded more slowly and variably than nonaffected siblings or controls. Nonaffected siblings showed intermediate scores for reaction-time variability, false alarms and omission errors under fast and slow event-rates. A slower event-rate did not lead to reduced performance specific to ADHD. In the incentive condition, mean reaction-times speeded up and became less variable only in children with ADHD and their nonaffected siblings, while accuracy was improved in all groups. Males responded faster, but also committed more false alarms. There were no interactions of group by gender. CONCLUSIONS Reaction-time variability and accuracy parameters could be useful neuropsychological endophenotypes for ADHD. Performance-modulating effects of incentives suggested a familially driven motivational dysfunction which may play an important role on etiologic pathways and treatment approaches for ADHD. The effects of gender were independent of familial effects or ADHD-status, which in turn suggests that the proposed endophenotypes are independent of gender.
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Affiliation(s)
- Henrik Uebel
- Child & Adolescent Psychiatry, University of Göttingen, von Siebold-Strasse 5, Göttingen, Germany.
| | - Björn Albrecht
- Child & Adolescent Psychiatry, University of Göttingen, Germany
| | - Philip Asherson
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, UK
| | - Norbert A. Börger
- Laboratory of Clinical and Developmental Psychology, Groningen, Netherlands
| | - Louise Butler
- ADHD Unit, Geha Mental Health Centre, Petach-Tikva, Israel
| | - Wai Chen
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, UK
| | - Hanna Christiansen
- Department of Clinical Psychology, Philipps University of Marburg, Germany
| | - Alexander Heise
- Child & Adolescent Psychiatry, University of Göttingen, Germany
| | - Jonna Kuntsi
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, UK
| | - Ulrike Schäfer
- Child and Adolescent Psychiatrist in Private Practice, Göttingen, Germany
| | - Penny Andreou
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, UK
| | - Iris Manor
- Department of Psychiatry, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland
| | - Rafaela Marco
- Department of Developmental and Educational Psychology, University of Valencia, Spain
| | - Sheera Meidad
- ADHD Unit, Geha Mental Health Centre, Petach-Tikva, Israel
| | - Ana Miranda
- Department of Developmental and Educational Psychology, University of Valencia, Spain
| | - Aisling Mulligan
- Department of Psychiatry, Trinity Centre for Health Sciences, St. James’s Hospital, Dublin, Ireland
| | - Robert D. Oades
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Germany
| | - Jaap van der Meere
- Laboratory of Clinical and Developmental Psychology, Groningen, Netherlands
| | - Stephen V. Faraone
- Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY USA
| | | | - Tobias Banaschewski
- Child & Adolescent Psychiatry, University of Göttingen, Germany, Central Institute of Mental Health, Department of Child and Adolescent Psychiatry and Psychotherapy, Mannheim, Germany
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Johnson KA, Dáibhis A, Tobin CT, Acheson R, Watchorn A, Mulligan A, Barry E, Bradshaw JL, Gill M, Robertson IH. Right-sided spatial difficulties in ADHD demonstrated in continuous movement control. Neuropsychologia 2009; 48:1255-64. [PMID: 20043932 DOI: 10.1016/j.neuropsychologia.2009.12.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 12/15/2009] [Accepted: 12/17/2009] [Indexed: 11/25/2022]
Abstract
Children with Attention Deficit Hyperactivity Disorder (ADHD) often show spatial attentional deficits, exhibiting a subtle rightwards bias, possibly due to dysfunction within the right hemisphere fronto-parietal network. Approximately 50% of children with ADHD also show signs of movement dysfunction. The nature of this movement dysfunction and possible interactions with spatial attention difficulties has not been clearly described. This study compared 31 children with and 31 children without ADHD on a movement kinematic task that tested hand-drawing movement precision. Participants used an electronic pen on a digitizing tablet. The pen tip position was sampled as X and Y coordinates at 200Hz. The task was to join targets of either 10 or 20mm diameter that were separated by a distance of 62.5 or 125 mm. Constant error in the X and Y planes, peak absolute velocity and acceleration, movement time, the number of pauses and pause time were analysed. Apart from a significantly increased rate of acceleration across all conditions, the children with ADHD demonstrated no temporal difficulties with the task; rather they showed subtle spatial difficulties, possibly suggestive of cerebellar involvement. The children with ADHD showed difficulties in accuracy of movement towards the right. They were less accurate in the X plane when moving towards the right-sided targets over the long distance. Greater variability in target accuracy was shown when moving towards the small target on the right side. The children with ADHD made significantly more pauses on the left target, when preparing the right movement, than the control group. These results suggest that the subtle spatial bias towards the right that has been demonstrated in ADHD in spatial attention also extends into the continuous movement domain.
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Affiliation(s)
- K A Johnson
- School of Psychology and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland.
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Slimani N, Deharveng G, Southgate DAT, Biessy C, Chajès V, van Bakel MME, Boutron-Ruault MC, McTaggart A, Grioni S, Verkaik-Kloosterman J, Huybrechts I, Amiano P, Jenab M, Vignat J, Bouckaert K, Casagrande C, Ferrari P, Zourna P, Trichopoulou A, Wirfält E, Johansson G, Rohrmann S, Illner AK, Barricarte A, Rodríguez L, Touvier M, Niravong M, Mulligan A, Crowe F, Ocké MC, van der Schouw YT, Bendinelli B, Lauria C, Brustad M, Hjartåker A, Tjønneland A, Jensen AM, Riboli E, Bingham S. Contribution of highly industrially processed foods to the nutrient intakes and patterns of middle-aged populations in the European Prospective Investigation into Cancer and Nutrition study. Eur J Clin Nutr 2009; 63 Suppl 4:S206-25. [DOI: 10.1038/ejcn.2009.82] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Bellgrove MA, Johnson KA, Barry E, Mulligan A, Hawi Z, Gill M, Robertson I, Chambers CD. Dopaminergic haplotype as a predictor of spatial inattention in children with attention-deficit/hyperactivity disorder. ACTA ACUST UNITED AC 2009; 66:1135-42. [PMID: 19805704 DOI: 10.1001/archgenpsychiatry.2009.120] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT A distinct pattern of selective attention deficits in attention-deficit/hyperactivity disorder (ADHD) has been difficult to identify. Heterogeneity may reflect differences in underlying genetics. OBJECTIVE To document an objective deficit of selective attention in a large sample of children with and without ADHD using spatial orienting paradigms. By stratifying samples according to the gene dosage of a risk haplotype of the dopamine transporter gene (DAT1), we could determine whether genetic factors predict spatial inattention in ADHD. DESIGN A case-control design was used. SETTING Children with ADHD were recruited from clinics or support groups in Ireland. Typically developing children were recruited from schools in and around Dublin, Ireland. PARTICIPANTS One hundred fifteen children were recruited (ADHD = 50, control = 65). Groups were matched for age but differed in estimated intelligence. INTERVENTION Two versions of a visual spatial orienting task in which attention was directed by valid, neutral, or invalid cues to target locations. Sudden-onset peripheral cues (exogenous) and centrally presented predictive cues (endogenous) were used. MAIN OUTCOME MEASURES To isolate an attention deficit in ADHD, groups were first compared using analysis of variance on the spatial orienting tasks. Multiple regression was used to assess the main effect of DAT1 haplotype status (heterozygous vs homozygous) and the interaction of diagnosis and genotype on those variables that discriminated children with and without ADHD. RESULTS Children with ADHD displayed deficits in reorienting attention from invalidly cued spatial locations, particularly for targets in the left visual field. DAT1 haplotype status predicted spatial reorienting deficits for left visual field targets (P = .007) but there was also a significant interaction of diagnosis and genotype (P = .02), which revealed the greatest impairment in children with ADHD homozygous for the DAT1 haplotype. CONCLUSION Heterogeneity in selective attention in ADHD can be explained by a replicated genetic risk factor for ADHD, the 10/3 DAT1 haplotype.
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Affiliation(s)
- Mark A Bellgrove
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia 4072.
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Marco R, Miranda A, Schlotz W, Melia A, Mulligan A, Müller U, Andreou P, Butler L, Christiansen H, Gabriels I, Medad S, Albrecht B, Uebel H, Asherson P, Banaschewski T, Gill M, Kuntsi J, Mulas F, Oades R, Roeyers H, Steinhausen HC, Rothenberger A, Faraone SV, Sonuga-Barke EJS. Delay and reward choice in ADHD: an experimental test of the role of delay aversion. Neuropsychology 2009; 23:367-80. [PMID: 19413450 DOI: 10.1037/a0014914] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Children with attention deficit/hyperactivity disorder (ADHD) choose smaller sooner (SS) over larger later (LL) rewards more than controls. Here we assess the contributions of impulsive drive for immediate rewards (IDIR) and delay aversion (DAv) to this pattern. We also explore the characteristics of, and the degree of familiality in, ADHD SS responders. We had 360 ADHD probands; 349 siblings and 112 controls (aged between 6 to 17 years) chose between SS (1 point after 2 s) and LL reward (2 points after 30 s) outcomes on the Maudsley Index of Delay Aversion (Kuntsi, Oosterlaan, & Stevenson, 2001): Under one condition SS choice led to less overall trial delay under another it did not. ADHD participants chose SS more than controls under both conditions. This effect was larger when SS choice reduced trial delay. ADHD SS responders were younger, had lower IQ, more conduct disorder and had siblings who were more likely to be SS responders themselves. The results support a dual component model in which both IDIR and DAv contribute to SS choice in ADHD. SS choice may be a marker of an ADHD motivational subtype.
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Affiliation(s)
- Rafaela Marco
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
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Braet W, Johnson KA, Tobin CT, Acheson R, McDonnell C, Hawi Z, Barry E, Mulligan A, Gill M, Bellgrove MA, Robertson IH, Garavan H. Increased fMRI activation during response inhibition, and decreased activation during error processing is associated with possession of the 10-repeat allele of the DAT1 gene: a genetic imaging study investigating the role of the DAT1 gene in Attention Deficit Hyperactivity disorder. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)71700-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Xu X, Duman EA, Anney R, Brookes K, Franke B, Zhou K, Buschgens C, Chen W, Christiansen H, Eisenberg J, Gabriëls I, Manor I, Marco R, Müller U, Mulligan A, Rommelse N, Thompson M, Uebel H, Banaschewski T, Buitelaar J, Ebstein R, Gill M, Miranda A, Mulas F, Oades R, Roeyers H, Rothenberger A, Sergeant J, Sonuga-Barke E, Steinhausen HC, Taylor E, Faraone S, Asherson P. No association between two polymorphisms of the serotonin transporter gene and combined type attention deficit hyperactivity disorder. Am J Med Genet 2009. [DOI: 10.1002/ajmg.b.30921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Mulligan A, McAuley C. Thrombosis and psychosis--possible association with the antiphospholipid syndrome and anticardiolipin antibodies. Ir Med J 2009; 102:61-62. [PMID: 19405326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Mulligan A, Anney RJL, O'Regan M, Chen W, Butler L, Fitzgerald M, Buitelaar J, Steinhausen HC, Rothenberger A, Minderaa R, Nijmeijer J, Hoekstra PJ, Oades RD, Roeyers H, Buschgens C, Christiansen H, Franke B, Gabriels I, Hartman C, Kuntsi J, Marco R, Meidad S, Mueller U, Psychogiou L, Rommelse N, Thompson M, Uebel H, Banaschewski T, Ebstein R, Eisenberg J, Manor I, Miranda A, Mulas F, Sergeant J, Sonuga-Barke E, Asherson P, Faraone SV, Gill M. Autism symptoms in Attention-Deficit/Hyperactivity Disorder: a familial trait which correlates with conduct, oppositional defiant, language and motor disorders. J Autism Dev Disord 2009; 39:197-209. [PMID: 18642069 DOI: 10.1007/s10803-008-0621-3] [Citation(s) in RCA: 165] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2008] [Accepted: 07/02/2008] [Indexed: 11/27/2022]
Abstract
It is hypothesised that autism symptoms are present in Attention-Deficit/Hyperactivity Disorder (ADHD), are familial and index subtypes of ADHD. Autism symptoms were compared in 821 ADHD probands, 1050 siblings and 149 controls. Shared familiality of autism symptoms and ADHD was calculated using DeFries-Fulker analysis. Autism symptoms were higher in probands than siblings or controls, and higher in male siblings than male controls. Autism symptoms were familial, partly shared with familiality of ADHD in males. Latent class analysis using SCQ-score yielded five classes; Class 1(31%) had few autism symptoms and low comorbidity; Classes 2-4 were intermediate; Class 5(7%) had high autism symptoms and comorbidity. Thus autism symptoms in ADHD represent a familial trait associated with increased neurodevelopmental and oppositional/conduct disorders.
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Xu X, Duman E, Anney R, Brookes K, Franke B, Zhou K, Buschgens C, Chen W, Christiansen H, Eisenberg J, Gabriëls I, Manor I, Marco R, Müller U, Mulligan A, Rommelse N, Thompson M, Uebel H, Banaschewski T, Buitelaar J, Ebstein R, Gill M, Miranda A, Mulas F, Oades R, Roeyers H, Rothenberger A, Sergeant J, Sonuga-Barke E, Steinhausen HC, Taylor E, Faraone S, Asherson P. No association between two polymorphisms of the serotonin transporter gene and combined type attention deficit hyperactivity disorder. Am J Med Genet 2009. [DOI: 10.1002/ajmg.b.30892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lai W, O'Mahony M, Mulligan A. Development of an Interview Version of the HOME Assessment Tool. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)71169-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Aims:To develop an interview version of the HOME assessment tool and compare the interview version of the HOME with the home visit version.Methods:Families whose child under 10 years of age attending the Mater CAMHS, with first attendance in the past two years were contacted. 100 of the 247 contacted agreed to participate and consented to a family visit. The study had prior ethics approval. A brief interview version of the HOME devised by substituting questions for the observer rated part of the HOME questionnaire was administered prior to the home-visit, where the home-based version of the HOME was performed. Both interviews were then compared and statistically analysed.Results:The mean score for the home visit HOME was 46.93 ± SD. The comparison of the telephone data with the home visit data suggested that there is a small significant difference between total score for the telephone and the home visit HOME score, with a difference of 0.96 - 3.20 (95% CI), when each of the assessments were scored out of 100. Bell- curves and T-Pairing scores of subscales and individual questions of both interviews suggest similarity.Conclusion:These results suggest that an interview version of the HOME assessment can be administered in the clinic or by telephone.
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Anney RJL, Lasky-Su J, O'Dúshláine C, Kenny E, Neale BM, Mulligan A, Franke B, Zhou K, Chen W, Christiansen H, Arias-Vásquez A, Banaschewski T, Buitelaar J, Ebstein R, Miranda A, Mulas F, Oades RD, Roeyers H, Rothenberger A, Sergeant J, Sonuga-Barke E, Steinhausen H, Asherson P, Faraone SV, Gill M. Conduct disorder and ADHD: evaluation of conduct problems as a categorical and quantitative trait in the international multicentre ADHD genetics study. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:1369-78. [PMID: 18951430 DOI: 10.1002/ajmg.b.30871] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is typically characterized by inattention, excessive motor activity, impulsivity, and distractibility. Individuals with ADHD have significant impairment in family and peer relations, academic functioning, and show high co-morbidity with a wide range of psychiatric disorders including oppositional defiant disorder (ODD), conduct disorder (CD), anxiety disorder, depression, substance abuse, and pervasive developmental disorder (PDD). Family studies suggest that ADHD + CD represents a specific subtype of the ADHD disorder with familial risk factors only partly overlapping with those of ADHD alone. We performed a hypothesis-free analysis of the GAIN-ADHD sample to identify markers and genes important in the development of conduct problems in a European cohort of individuals with ADHD. Using the Family-Based Association Test (FBAT) package we examined three measures of conduct problems in 1,043,963 autosomal markers. This study is part of a series of exploratory analyses to identify candidate genes that may be important in ADHD and ADHD-related traits, such as conduct problems. We did not find genome-wide statistical significance (P < 5 x 10(-7)) for any of the tested markers and the three conduct problem traits. Fifty-four markers reached strong GWA signals (P < 10(-5)). We discuss these findings in the context of putative candidate genes and the implications of these findings in the understanding of the etiology of ADHD + CD. We aimed to achieve insight into the genetic etiology of a trait using a hypothesis-free study design and were able to identify a number of biologically interesting markers and genes for follow-up studies.
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Affiliation(s)
- Richard J L Anney
- Department of Neuropsychiatric Genetics, Trinity College Dublin, Ireland.
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Chen W, Zhou K, Sham P, Franke B, Kuntsi J, Campbell D, Fleischman K, Knight J, Andreou P, Arnold R, Altink M, Boer F, Boholst MJ, Buschgens C, Butler L, Christiansen H, Fliers E, Howe-Forbes R, Gabriëls I, Heise A, Korn-Lubetzki I, Marco R, Medad S, Minderaa R, Müller UC, Mulligan A, Psychogiou L, Rommelse N, Sethna V, Uebel H, McGuffin P, Plomin R, Banaschewski T, Buitelaar J, Ebstein R, Eisenberg J, Gill M, Manor I, Miranda A, Mulas F, Oades RD, Roeyers H, Rothenberger A, Sergeant J, Sonuga-Barke E, Steinhausen HC, Taylor E, Thompson M, Faraone SV, Asherson P. DSM-IV combined type ADHD shows familial association with sibling trait scores: a sampling strategy for QTL linkage. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:1450-60. [PMID: 18189238 DOI: 10.1002/ajmg.b.30672] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a discrete clinical syndrome characterized by the triad of inattention, hyperactivity, and impulsivity in the context of marked impairments. Molecular genetic studies have been successful in identifying genetic variants associated with ADHD, particularly with DSM-IV inattentive and combined subtypes. Quantitative trait locus (QTL) approaches to linkage and association mapping have yet to be widely used in ADHD research, although twin studies investigating individual differences suggest that genetic liability for ADHD is continuously distributed throughout the population, underscoring the applicability of quantitative dimensional approaches. To investigate the appropriateness of QTL approaches, we tested the familial association between 894 probands with a research diagnosis of DSM-IV ADHD combined type and continuous trait measures among 1,135 of their siblings unselected for phenotype. The sibling recurrence rate for ADHD combined subtype was 12.7%, yielding a sibling recurrence risk ratio (lambda(sib)) of 9.0. Estimated sibling correlations around 0.2-0.3 are similar to those estimated from the analysis of fraternal twins in population twin samples. We further show that there are no threshold effects on the sibling risk for ADHD among the ADHD probands; and that both affected and unaffected siblings contributed to the association with ADHD trait scores. In conclusion, these data confirm the main requirement for QTL mapping of ADHD by demonstrating that narrowly defined DSM-IV combined type probands show familial association with dimensional ADHD symptom scores amongst their siblings.
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Affiliation(s)
- Wai Chen
- MRC Social Genetic Developmental and Psychiatry Centre, Institute of Psychiatry, London, United Kingdom
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Anney RJL, Hawi Z, Sheehan K, Mulligan A, Pinto C, Brookes KJ, Xu X, Zhou K, Franke B, Buitelaar J, Vermeulen SH, Banaschewski T, Sonuga-Barke E, Ebstein R, Manor I, Miranda A, Mulas F, Oades RD, Roeyers H, Rommelse N, Rothenberger A, Sergeant J, Steinhausen HC, Taylor E, Thompson M, Asherson P, Faraone SV, Gill M. Parent of origin effects in attention/deficit hyperactivity disorder (ADHD): analysis of data from the international multicenter ADHD genetics (IMAGE) program. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:1495-500. [PMID: 18163388 DOI: 10.1002/ajmg.b.30659] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
There are conflicting reports suggesting that the parental origin of transmitted risk alleles may play a role in the etiology of attention deficit/hyperactivity disorder (ADHD). A recent report by Hawi and colleagues observed a generalized paternal over-transmission of alleles associated with ADHD. This was not replicated in more recent studies. Using data from a large multicenter study we examined the overall and gene-specific parent of origin effect in 554 independent SNPs across 47 genes. Transmission disequilibrium and explicit parent of origin test were performed using PLINK. Overall parent of origin effect was tested by Chi-square. There was no overall parent of origin effect in the IMAGE sample (chi(1)(2) = 1.82, P = 0.117). Five markers in three genes, DDC, TPH2, and SLC6A2 showed nominal association (P < 0.01) with ADHD combined subtype when restricted to maternal or paternal transmission only. Following the initial report by Hawi and co-workers three studies, including this one, found no evidence to support an overall parent of origin effect for markers associated with ADHD. We cannot however, exclude gene-specific parent of origin effect in the etiology ADHD.
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Affiliation(s)
- Richard J L Anney
- Department of Psychiatry, Trinity College Dublin, St. James's Hospital, Dublin, Ireland.
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