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Ruocco L, Zhuang Y, Ng R, Munthali RJ, Hudec KL, Wang AY, Vereschagin M, Vigo DV. A platform for connecting social media data to domain-specific topics using large language models: an application to student mental health. JAMIA Open 2024; 7:ooae001. [PMID: 38250583 PMCID: PMC10799551 DOI: 10.1093/jamiaopen/ooae001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/20/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
Objectives To design a novel artificial intelligence-based software platform that allows users to analyze text data by identifying various coherent topics and parts of the data related to a specific research theme-of-interest (TOI). Materials and Methods Our platform uses state-of-the-art unsupervised natural language processing methods, building on top of a large language model, to analyze social media text data. At the center of the platform's functionality is BERTopic, which clusters social media posts, forming collections of words representing distinct topics. A key feature of our platform is its ability to identify whole sentences corresponding to topic words, vastly improving the platform's ability to perform downstream similarity operations with respect to a user-defined TOI. Results Two case studies on mental health among university students are performed to demonstrate the utility of the platform, focusing on signals within social media (Reddit) data related to depression and their connection to various emergent themes within the data. Discussion and Conclusion Our platform provides researchers with a readily available and inexpensive tool to parse large quantities of unstructured, noisy data into coherent themes, as well as identifying portions of the data related to the research TOI. While the development process for the platform was focused on mental health themes, we believe it to be generalizable to other domains of research as well.
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Affiliation(s)
- Leonard Ruocco
- Data Science Institute, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia V6T 2A1, Canada
| | - Yuqian Zhuang
- Data Science Institute, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia V6T 2A1, Canada
| | - Raymond Ng
- Data Science Institute, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
- Department of Computer Science, University of British Columbia, Vancouver, British Columbia, V6T 1Z4, Canada
| | - Richard J Munthali
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia V6T 2A1, Canada
| | - Kristen L Hudec
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia V6T 2A1, Canada
| | - Angel Y Wang
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia V6T 2A1, Canada
| | - Melissa Vereschagin
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia V6T 2A1, Canada
| | - Daniel V Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia V6T 2A1, Canada
- Department of Global Health and Social Medicine, Harvard University, Boston, MA 02115, United States
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Vereschagin M, Wang AY, Richardson CG, Xie H, Munthali RJ, Hudec KL, Leung C, Wojcik KD, Munro L, Halli P, Kessler RC, Vigo DV. Effectiveness of the Minder Mobile Mental Health and Substance Use Intervention for University Students: Randomized Controlled Trial. J Med Internet Res 2024; 26:e54287. [PMID: 38536225 PMCID: PMC11007604 DOI: 10.2196/54287] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/05/2023] [Accepted: 02/17/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND University attendance represents a transition period for students that often coincides with the emergence of mental health and substance use challenges. Digital interventions have been identified as a promising means of supporting students due to their scalability, adaptability, and acceptability. Minder is a mental health and substance use mobile app that was codeveloped with university students. OBJECTIVE This study aims to examine the effectiveness of the Minder mobile app in improving mental health and substance use outcomes in a general population of university students. METHODS A 2-arm, parallel-assignment, single-blinded, 30-day randomized controlled trial was used to evaluate Minder using intention-to-treat analysis. In total, 1489 participants were recruited and randomly assigned to the intervention (n=743, 49.9%) or waitlist control (n=746, 50.1%) condition. The Minder app delivers evidence-based content through an automated chatbot and connects participants with services and university social groups. Participants are also assigned a trained peer coach to support them. The primary outcomes were measured through in-app self-assessments and included changes in general anxiety symptomology, depressive symptomology, and alcohol consumption risk measured using the 7-item General Anxiety Disorder scale, 9-item Patient Health Questionnaire, and US Alcohol Use Disorders Identification Test-Consumption Scale, respectively, from baseline to 30-day follow-up. Secondary outcomes included measures related to changes in the frequency of substance use (cannabis, alcohol, opioids, and nonmedical stimulants) and mental well-being. Generalized linear mixed-effects models were used to examine each outcome. RESULTS In total, 79.3% (589/743) of participants in the intervention group and 83% (619/746) of participants in the control group completed the follow-up survey. The intervention group had significantly greater average reductions in anxiety symptoms measured using the 7-item General Anxiety Disorder scale (adjusted group mean difference=-0.85, 95% CI -1.27 to -0.42; P<.001; Cohen d=-0.17) and depressive symptoms measured using the 9-item Patient Health Questionnaire (adjusted group mean difference=-0.63, 95% CI -1.08 to -0.17; P=.007; Cohen d=-0.11). A reduction in the US Alcohol Use Disorders Identification Test-Consumption Scale score among intervention participants was also observed, but it was not significant (P=.23). Statistically significant differences in favor of the intervention group were found for mental well-being and reductions in the frequency of cannabis use and typical number of drinks consumed. A total of 77.1% (573/743) of participants in the intervention group accessed at least 1 app component during the study period. CONCLUSIONS In a general population sample of university students, the Minder app was effective in reducing symptoms of anxiety and depression, with provisional support for increasing mental well-being and reducing the frequency of cannabis and alcohol use. These findings highlight the potential ability of e-tools focused on prevention and early intervention to be integrated into existing university systems to support students' needs. TRIAL REGISTRATION ClinicalTrials.gov NCT05606601; https://clinicaltrials.gov/ct2/show/NCT05606601. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/49364.
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Affiliation(s)
- Melissa Vereschagin
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Angel Y Wang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris G Richardson
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Richard J Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kristen L Hudec
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Calista Leung
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Katharine D Wojcik
- Menninger Department of Psychiatry & Behavioural Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Lonna Munro
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Priyanka Halli
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Daniel V Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Wang AY, Vereschagin M, Richardson CG, Xie H, Hudec KL, Munthali RJ, Munro L, Leung C, Kessler RC, Vigo DV. Evaluating the Effectiveness of a Codeveloped e-Mental Health Intervention for University Students: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49364. [PMID: 37647105 PMCID: PMC10500355 DOI: 10.2196/49364] [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] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND University life typically occurs during a period of life transition, where the incidence of mental health and substance use problems and disorders peaks. However, relatively few students obtain effective treatment and support. e-Interventions have proven effective in improving the psychological outcomes of university students and have the potential to provide scalable services that can easily integrate into existing models of care. Minder is a mobile app codeveloped with university students that offers users a collection of evidence-based interventions tailored to help university students maintain their mental health and well-being and manage their substance use. OBJECTIVE This paper describes the protocol for a randomized controlled trial (RCT) that aims to assess the effectiveness of the Minder app in improving the mental health and substance use outcomes of university students. METHODS This study is a 2-arm, parallel assignment, single-blinded, 30-day RCT with 1 intervention group and 1 waitlist control group. Overall, 1496 (748 per trial arm) university students from the University of British Columbia Vancouver Campus (N=54,000) who are aged ≥17 years, have a smartphone with Wi-Fi or cellular data, and speak English will be recruited via a variety of web-based and offline strategies. Participants will be randomized into the intervention or control group after completing a baseline survey. Those randomized into the intervention group will gain immediate access to the Minder app and will be assessed at 2 weeks and 30 days. Those randomized into the control group will be given access to the app content after their follow-up assessment at 30 days. The primary outcomes are measured from baseline to follow-up at 30 days and include changes in general anxiety symptomology, depressive symptomology, and alcohol consumption risk measured by the General Anxiety Disorder 7-Item scale, Patient Health Questionnaire 9-Item scale, and US Alcohol Use Disorders Identification Test-Consumption Scale, respectively. Secondary outcomes include measures related to changes in the frequency of substance use, mental well-being, self-efficacy in managing mental health and substance use, readiness to change, and self-reported use of mental health services and supports (including referral) from baseline to follow-up at 30 days. RESULTS Trial recruitment and data collection began in September 2022, and the completion of data collection for the trial is anticipated by June 2023. As of May 10, 2023, a total of 1425 participants have been enrolled. CONCLUSIONS The RCT described in this protocol paper will assess whether the Minder app is effective in improving the mental health and substance use outcomes of a general population of Canadian university students. Additional secondary outcome research aims to explore additional outcomes of interest for further research and better understand how to support students' general mental well-being. TRIAL REGISTRATION ClinicalTrials.gov NCT05606601; https://clinicaltrials.gov/ct2/show/NCT05606601. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49364.
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Affiliation(s)
- Angel Y Wang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Melissa Vereschagin
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris G Richardson
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Kristen L Hudec
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard J Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lonna Munro
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Calista Leung
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Daniel V Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Jones LB, Judkowicz C, Hudec KL, Munthali RJ, Prescivalli AP, Wang AY, Munro L, Xie H, Pendakur K, Rush B, Gillett J, Young M, Singh D, Todorova AA, Auerbach RP, Bruffaerts R, Gildea SM, McKechnie I, Gadermann A, Richardson CG, Sampson NA, Kessler RC, Vigo DV. The World Mental Health-International College Student (WMH-ICS) Survey in Canada: Protocol for a Mental Health and Substance Use Trend Study (Preprint). JMIR Res Protoc 2021; 11:e35168. [PMID: 35696337 PMCID: PMC9377443 DOI: 10.2196/35168] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 05/13/2022] [Accepted: 06/03/2022] [Indexed: 11/18/2022] Open
Abstract
Background The World Health Organization World Mental Health International College Student (WMH-ICS) initiative aims to screen for mental health and substance use problems among postsecondary students on a global scale as well as to develop and evaluate evidence-based preventive and ameliorative interventions for this population. This protocol paper presents the Canadian version of the WMH-ICS survey, detailing the adapted survey instrument, the unique weekly cross-sectional administration, the multitiered recruitment strategy, and the associated risk mitigation protocols. Objective This paper aims to provide a methodological resource for researchers conducting cross-national comparisons of WMH-ICS data, as well as to serve as a useful guide for those interested in replicating the outlined cross-sectional methodology to better understand how mental health and substance use vary over time among university students. Methods The online survey is based on the WMH-ICS survey instrument, modified to the Canadian context by the addition of questions pertaining to Canadian-based guidelines and the translation of the survey to Canadian French. The survey is administered through the Qualtrics survey platform and is sent to an independent stratified random sample of 350 students per site weekly, followed by two reminder emails. Upon survey closure every week, a random subsample of 70 nonresponders are followed up with via phone or through a personal email in an effort to decrease nonresponder bias. The survey is accompanied by an extensive risk mitigation protocol that stratifies respondents by the level of need and provides tailored service recommendations, including a facilitated expedited appointment to student counseling services for those at increased risk of suicide. The anticipated sample size is approximately 5500 students per site per year. Results In February 2020, the Canadian survey was deployed at the University of British Columbia. This was followed by deployment at Simon Fraser University (November 2020), McMaster University (January 2021), and the University of Toronto (January 2022). Data collection at all 4 sites is ongoing. As of May 6, 2022, 29,503 responses have been collected. Conclusions Based on international collaboration, the Canadian version of the WMH-ICS survey incorporates a novel methodological approach centered on the weekly administration of a comprehensive cross-sectional survey to independent stratified random samples of university students. After 27 months of consecutive survey administration, we have developed and refined a survey protocol that has proven effective in engaging students at four Canadian institutions, allowing us to track how mental health and substance use vary over time using an internationally developed university student survey based on the criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). International Registered Report Identifier (IRRID) RR1-10.2196/35168
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Affiliation(s)
- Laura B Jones
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Carolina Judkowicz
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kristen L Hudec
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard J Munthali
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ana Paula Prescivalli
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Angel Y Wang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lonna Munro
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Krishna Pendakur
- Department of Economics, Simon Fraser University, Burnaby, BC, Canada
| | - Brian Rush
- Social & Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - James Gillett
- Department of Health, Aging & Society, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | - Marisa Young
- Department of Sociology, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | - Diana Singh
- Department of Sociology, Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Sarah M Gildea
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Irene McKechnie
- Okanagan Planning and Institutional Research, University of British Columbia, Kelowna, BC, Canada
| | - Anne Gadermann
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chris G Richardson
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Daniel V Vigo
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Mikami AY, Owens JS, Evans SW, Hudec KL, Kassab H, Smit S, Na JJ, Khalis A. Promoting Classroom Social and Academic Functioning among Children at Risk for ADHD: The MOSAIC Program. J Clin Child Adolesc Psychol 2021; 51:1039-1052. [PMID: 34133243 DOI: 10.1080/15374416.2021.1929250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Social and academic functioning are linked in elementary school, and both are frequently impaired in children with elevated symptoms of attention-deficit/hyperactivity disorder (ADHD). This study evaluated the Making Socially Accepting Inclusive Classrooms (MOSAIC) program, a classroom intervention to support children's social and academic functioning, especially for children at risk for ADHD. Teachers delivered MOSAIC practices to the whole class and applied some strategies more frequently to target children selected for elevated ADHD symptoms and peer impairment.Method: Participants were 34 general education teachers (grades K-5) and 558 children in their classrooms, randomized to MOSAIC or to a typical practice control group for one academic year. In the fall and spring, we assessed (a) peers' sociometric judgments of children, (b) children's self-report of supportive relationships with teachers and peers, and (c) teachers' report of children's social and academic competencies and impairments.Results: Regarding whole class effects, relative to control group children, children in MOSAIC classrooms (target and non-target children) were rated by teachers in spring as having better competencies and lower impairment, after controlling for fall functioning. There were no main effects of MOSAIC on peer sociometrics or child perceptions of supportive relationships. Target status moderated some effects such that, in spring, target children in MOSAIC perceived greater support from their teachers but received poorer sociometrics than did target children in control classrooms.Conclusions: We discuss the difficulty in changing peers' perceptions of children with ADHD symptoms, even in the presence of improvements in other aspects of social and academic functioning.
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Affiliation(s)
| | | | | | | | | | - Sophie Smit
- Department of Psychology, University of British Columbia
| | | | - Adri Khalis
- Department of Psychology, University of British Columbia
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Mikami AY, Normand S, Hudec KL, Guiet J, Na JJ, Smit S, Khalis A, Maisonneuve MF. Treatment of friendship problems in children with attention-deficit/hyperactivity disorder: Initial results from a randomized clinical trial. J Consult Clin Psychol 2020; 88:871-885. [DOI: 10.1037/ccp0000607] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Objective: Children with ADHD display higher rates of sleep problems, and both sleep disorders and ADHD have been shown to affect functioning in childhood. The current study examines the frequency and relationship between sleep problems and ADHD, and their impact on quality of life (QoL) and functional impairment. Method: Parents of 192 children with ADHD (M = 10.23 years) completed measures regarding their child's ADHD symptoms (Swanson, Nolan and Pelham [SNAP]), sleep disorders (Pediatric Sleep Questionnaire [PSQ]), QoL (Child Health Illness Profile [CHIP-PE]), and functioning (Weiss Functional Impairment Rating Scale-Parent Report [WFIRS-P]). Results: Common sleep complaints in participants were insomnia, excessive daytime sleepiness (EDS), and variability in sleep schedule. Regression analysis indicated that sleep problems and ADHD symptoms independently predicted lower levels of QoL (ΔR2 = .12, p < .001) and social functioning (ΔR2 = .12, p < .001). Conclusion: The results suggest that ADHD may coexist with somnolence and that both conditions have a significant impact on a child's functioning and QoL.
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Tarle SJ, Alderson RM, Patros CHG, Lea SE, Hudec KL, Arrington EF. Attention-deficit/hyperactivity disorder and phonological working memory: Methodological variability affects clinical and experimental performance metrics. Neuropsychology 2017; 31:383-394. [PMID: 28277685 DOI: 10.1037/neu0000364] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Despite promising findings in extant research that suggest impaired working memory (WM) serves as a central neurocognitive deficit or candidate endophenotype of attention-deficit/hyperactivity disorder (ADHD), findings from translational research have been relatively underwhelming. This study aimed to explicate previous equivocal findings by systematically examining the effect of methodological variability on WM performance estimates across experimental and clinical WM measures. METHOD Age-matched boys (ages 8-12 years) with (n = 20) and without (n = 20) ADHD completed 1 experimental (phonological) and 2 clinical (digit span, letter-number sequencing) WM measures. RESULTS The use of partial scoring procedures, administration of greater trial numbers, and high central executive demands yielded moderate-to-large between-groups effect sizes. Moreover, the combination of these best-case procedures, compared to worst-case procedures (i.e., absolute scoring, administration of few trials, use of discontinue rules, and low central executive demands), resulted in a 12.5% increase in correct group classification. CONCLUSION Collectively, these findings explain inconsistent ADHD-related WM deficits in previous reports, and highlight the need for revised clinical measures that utilize best-case procedures. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Sarah E Lea
- Department of Psychology, Oklahoma State University
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9
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Patros CHG, Alderson RM, Hudec KL, Tarle SJ, Lea SE. Hyperactivity in boys with attention-deficit/hyperactivity disorder: The influence of underlying visuospatial working memory and self-control processes. J Exp Child Psychol 2016; 154:1-12. [PMID: 27776326 DOI: 10.1016/j.jecp.2016.09.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 06/24/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
Abstract
Changes in motor activity were examined across control and executive function (EF) tasks that differ with regard to demands placed on visuospatial working memory (VS-WM) and self-control processes. Motor activity was measured via actigraphy in 8- to 12-year-old boys with (n=15) and without (n=17) attention-deficit/hyperactivity disorder (ADHD) during the completion of VS-WM, self-control, and control tasks. Results indicated that boys with ADHD, relative to typically developing boys, exhibited greater motor activity across tasks, and both groups' activity was greater during EF tasks relative to control tasks. Lastly, VS-WM performance, relative to self-control performance, accounted for significantly more variance in activity across both VS-WM and self-control tasks. Collectively, findings suggest that ADHD-related hyperactivity is positively related to increased cognitive demands and appears to be better explained by deficient VS-WM rather than insufficient self-control.
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Affiliation(s)
- Connor H G Patros
- Department of Psychology, Oklahoma State University, Stillwater, OK 74078, USA
| | - R Matt Alderson
- Department of Psychology, Oklahoma State University, Stillwater, OK 74078, USA.
| | - Kristen L Hudec
- Department of Psychology, Oklahoma State University, Stillwater, OK 74078, USA
| | - Stephanie J Tarle
- Department of Psychology, Oklahoma State University, Stillwater, OK 74078, USA
| | - Sarah E Lea
- Department of Psychology, Oklahoma State University, Stillwater, OK 74078, USA
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Alderson RM, Patros CHG, Tarle SJ, Hudec KL, Kasper LJ, Lea SE. [Formula: see text]Working memory and behavioral inhibition in boys with ADHD: An experimental examination of competing models. Child Neuropsychol 2015; 23:255-272. [PMID: 26563880 DOI: 10.1080/09297049.2015.1105207] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Working memory (WM) and behavioral inhibition impairments have garnered significant attention as candidate core features, endophenotypes, and/or associated neurocognitive deficits of attention-deficit/hyperactivity disorder (ADHD). The relationship between ADHD-related WM and inhibition deficits remains relatively unclear, however, with inferences about the constructs' directional relationship stemming predominantly from correlational research. The current study utilized a dual-task paradigm to experimentally examine the relationship between ADHD-related WM and behavioral inhibition deficits. A total of 31 boys (15 ADHD and 16 typically developing [TD]) aged 8-12 years completed WM (1-back and 2-back), behavioral inhibition (stop-signal task [SST]), and dual-condition (1-back/SST and 2-back/SST) experimental tasks. Children with ADHD exhibited significant, large-magnitude WM deficits for the 1-back condition but were not significantly different from children in the TD group for the 2-back, 1-back/SST, and 2-back/SST conditions. Children with ADHD also exhibited significant inhibition deficits for the SST, 1-back/SST, and 2-back/SST conditions, but the within-group effect was not significant. The findings suggest that ADHD-related stop-signal demands are upstream, or compete for, resources involved in controlled-focused attention and/or other central executive (CE), WM processes.
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Affiliation(s)
- R Matt Alderson
- a Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Connor H G Patros
- a Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Stephanie J Tarle
- a Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Kristen L Hudec
- a Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Lisa J Kasper
- a Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Sarah E Lea
- a Department of Psychology , Oklahoma State University , Stillwater , OK , USA
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Hudec KL, Alderson RM, Patros CHG, Lea SE, Tarle SJ, Kasper LJ. Hyperactivity in boys with attention-deficit/hyperactivity disorder (ADHD): The role of executive and non-executive functions. Res Dev Disabil 2015; 45-46:103-109. [PMID: 26232202 DOI: 10.1016/j.ridd.2015.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 07/01/2015] [Accepted: 07/13/2015] [Indexed: 06/04/2023]
Abstract
Motor activity of boys (age 8-12 years) with (n=19) and without (n=18) ADHD was objectively measured with actigraphy across experimental conditions that varied with regard to demands on executive functions. Activity exhibited during two n-back (1-back, 2-back) working memory tasks was compared to activity during a choice-reaction time (CRT) task that placed relatively fewer demands on executive processes and during a simple reaction time (SRT) task that required mostly automatic processing with minimal executive demands. Results indicated that children in the ADHD group exhibited greater activity compared to children in the non-ADHD group. Further, both groups exhibited the greatest activity during conditions with high working memory demands, followed by the reaction time and control task conditions, respectively. The findings indicate that large-magnitude increases in motor activity are predominantly associated with increased demands on working memory, though demands on non-executive processes are sufficient to elicit small to moderate increases in motor activity as well.
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Affiliation(s)
- Kristen L Hudec
- Department of Psychology, Oklahoma State University, United States
| | - R Matt Alderson
- Department of Psychology, Oklahoma State University, United States.
| | | | - Sarah E Lea
- Department of Psychology, Oklahoma State University, United States
| | | | - Lisa J Kasper
- Department of Psychology, Oklahoma State University, United States
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Patros CHG, Alderson RM, Lea SE, Tarle SJ, Kasper LJ, Hudec KL. Visuospatial working memory underlies choice-impulsivity in boys with attention-deficit/hyperactivity disorder. Res Dev Disabil 2015; 38:134-144. [PMID: 25576877 DOI: 10.1016/j.ridd.2014.12.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 12/08/2014] [Accepted: 12/09/2014] [Indexed: 06/04/2023]
Abstract
The present study examined the directional relationship between choice-impulsivity and separate indices of phonological and visuospatial working memory performance in boys (aged 8-12 years) with (n=16) and without ADHD (n=19). Results indicated that high ratings of overall ADHD, inattention, and hyperactivity were significantly associated with increased impulsivity and poorer phonological and visuospatial working memory performance. Further, results from bias-corrected bootstrapped mediation analyses revealed a significant indirect effect of visuospatial working memory performance, through choice-impulsivity, on overall ADHD, inattention, and hyperactivity/impulsivity. Collectively, the findings suggest that deficits of visuospatial working memory underlie choice-impulsivity, which in turn contributes to the ADHD phenotype. Moreover, these findings are consistent with a growing body of literature that identifies working memory as a central neurocognitive deficit of ADHD.
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Affiliation(s)
- Connor H G Patros
- Department of Psychology, Oklahoma State University, 116 North Murray, Stillwater, OK 74078-3064, United States
| | - R Matt Alderson
- Department of Psychology, Oklahoma State University, 116 North Murray, Stillwater, OK 74078-3064, United States.
| | - Sarah E Lea
- Department of Psychology, Oklahoma State University, 116 North Murray, Stillwater, OK 74078-3064, United States
| | - Stephanie J Tarle
- Department of Psychology, Oklahoma State University, 116 North Murray, Stillwater, OK 74078-3064, United States
| | - Lisa J Kasper
- Department of Psychology, Oklahoma State University, 116 North Murray, Stillwater, OK 74078-3064, United States
| | - Kristen L Hudec
- Department of Psychology, Oklahoma State University, 116 North Murray, Stillwater, OK 74078-3064, United States
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Alderson RM, Kasper LJ, Patros CHG, Hudec KL, Tarle SJ, Lea SE. Working memory deficits in boys with attention deficit/hyperactivity disorder (ADHD): An examination of orthographic coding and episodic buffer processes. Child Neuropsychol 2014; 21:509-30. [PMID: 24830472 DOI: 10.1080/09297049.2014.917618] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The episodic buffer component of working memory was examined in children with attention deficit/hyperactivity disorder (ADHD) and typically developing peers (TD). Thirty-two children (ADHD = 16, TD = 16) completed three versions of a phonological working memory task that varied with regard to stimulus presentation modality (auditory, visual, or dual auditory and visual), as well as a visuospatial task. Children with ADHD experienced the largest magnitude working memory deficits when phonological stimuli were presented via a unimodal, auditory format. Their performance improved during visual and dual modality conditions but remained significantly below the performance of children in the TD group. In contrast, the TD group did not exhibit performance differences between the auditory- and visual-phonological conditions but recalled significantly more stimuli during the dual-phonological condition. Furthermore, relative to TD children, children with ADHD recalled disproportionately fewer phonological stimuli as set sizes increased, regardless of presentation modality. Finally, an examination of working memory components indicated that the largest magnitude between-group difference was associated with the central executive. Collectively, these findings suggest that ADHD-related working memory deficits reflect a combination of impaired central executive and phonological storage/rehearsal processes, as well as an impaired ability to benefit from bound multimodal information processed by the episodic buffer.
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Affiliation(s)
- R Matt Alderson
- a Department of Psychology , Oklahoma State University , Stillwater , Oklahoma , USA
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Hudec KL, Alderson RM, Kasper LJ, Patros CHG. Working memory contributes to elevated motor activity in adults with ADHD: an examination of the role of central executive and storage/rehearsal processes. J Atten Disord 2014; 18:357-68. [PMID: 23900406 DOI: 10.1177/1087054713497398] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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
OBJECTIVE The relationship between working memory (WM) and objectively measured motor activity was examined in adults with ADHD and healthy controls (HCs). METHOD Thirty-five adults (ADHD = 20, HC = 15) were grouped using self-report and collateral-report measures in addition to a semistructured clinical interview. All participants completed control conditions with minimal WM demands, and separate phonological (PH) and visuospatial (VS) WM tasks with recall demands ranging from four to seven stimuli. RESULTS The ADHD group exhibited significantly more motor activity relative to the HC group, and both groups exhibited greater activity during PH and VS WM tasks, relative to control conditions. Finally, the central executive (CE) and PH storage/rehearsal subsystems were associated with large-magnitude between-group differences in activity. CONCLUSION Findings suggest that increased demands on WM, particularly the CE and PH storage/rehearsal, contribute to ADHD-related hyperactivity, though a portion of excessive motor activity in adults with ADHD may occur independently of WM demands.
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Patros CHG, Hudec KL, Alderson RM, Kasper LJ, Davidson C, Wingate LR. Symptoms of attention-deficit/hyperactivity disorder (ADHD) moderate suicidal behaviors in college students with depressed mood. J Clin Psychol 2013; 69:980-93. [PMID: 23775306 DOI: 10.1002/jclp.21994] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE College students with attention-deficit/hyperactivity disorder-related hyperactive/impulsive (HI) and/or inattentive (IA) symptoms may be at greater risk for suicidal behavior due to core and secondary symptoms that increase their potential to engage in behaviors that put them at risk for suicidal behavior. Consequently, the current study examined the moderating effect of combined HI/IA symptoms, in addition to independent HI and IA symptoms on the relationship between depressed mood and suicidal thoughts and behavior. METHOD A sample of 1,056 undergraduate students (61.5% female, 96.4% aged 18-24 years) provided self-report ratings of mood, suicidal behavior (thoughts, self-harm, attempts, and need for medical attention), and current HI/IA symptoms. RESULTS Significant moderation effects were detected, such that greater HI/IA symptoms were associated with a stronger relationship between depressed mood and suicidal ideation and attempts, but not self-harm. Current HI and IA symptoms significantly moderated the relationship between depressed mood and suicidal thoughts and suicide attempts, but did not moderate the relationship between depressed mood and self-harm and need for medical attention. CONCLUSIONS The current findings suggest that the presence of combined HI/IA symptoms conveys increased suicide risk for depressed college students. Additionally, results suggest a complex relationship between independent HI and IA symptoms and severe suicidal outcomes.
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Alderson RM, Hudec KL, Patros CHG, Kasper LJ. Working memory deficits in adults with attention-deficit/hyperactivity disorder (ADHD): an examination of central executive and storage/rehearsal processes. J Abnorm Psychol 2013; 122:532-41. [PMID: 23421528 DOI: 10.1037/a0031742] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current study was the first to use a regression approach to examine the unique contributions of central executive (CE) and storage/rehearsal processes to working memory (WM) deficits in adults with ADHD. Thirty-seven adults (ADHD = 21, HC = 16) completed phonological (PH) and visuospatial (VS) working memory tasks. While both groups performed significantly better during the PH task relative to the VS task, adults with ADHD exhibited significant deficits across both working memory modalities. Further, the ADHD group recalled disproportionately fewer PH and VS stimuli as set-size demands increased. Overall, the CE and PH storage/rehearsal processes of adults with ADHD were both significantly impaired relative to those of the healthy control adults; however, the magnitude of the CE effect size was much smaller compared to previous studies of children with the disorder. Collectively, results provide support for a lifelong trajectory of WM deficits in ADHD.
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Affiliation(s)
- R Matt Alderson
- Department of Psychology, Oklahoma State University, Stillwater, OK 74078-3064, USA.
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Alderson RM, Kasper LJ, Hudec KL, Patros CHG. Attention-deficit/hyperactivity disorder (ADHD) and working memory in adults: A meta-analytic review. Neuropsychology 2013; 27:287-302. [DOI: 10.1037/a0032371] [Citation(s) in RCA: 166] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Kasper LJ, Alderson RM, Hudec KL. Moderators of working memory deficits in children with attention-deficit/hyperactivity disorder (ADHD): a meta-analytic review. Clin Psychol Rev 2012; 32:605-17. [PMID: 22917740 DOI: 10.1016/j.cpr.2012.07.001] [Citation(s) in RCA: 234] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 07/02/2012] [Accepted: 07/07/2012] [Indexed: 11/16/2022]
Abstract
Working memory has assumed a prominent role as a primary neurocognitive deficit or endophenotype in extant models of attention-deficit/hyperactivity disorder (ADHD). The current study updated previous reviews and employed meta-analytic techniques to examine a broad range of moderating variables of effect size heterogeneity across phonological and visuospatial working memory tasks. Collectively, results revealed large between-group effect sizes across both working memory domains. In addition, several sample (percent female) and task (number of experimental trials, recall vs. recognition tasks, and demands on the central executive) moderating variables explained significant effect size variability among phonological and visuospatial studies. These findings suggest that children with ADHD exhibit statistically significant, large magnitude working memory deficits relative to their typically developing peers.
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Affiliation(s)
- Lisa J Kasper
- Oklahoma State University, Department of Psychology, 116 N. Murray, Stillwater, OK 74078-3064, USA
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Alderson RM, Rapport MD, Hudec KL, Sarver DE, Kofler MJ. Competing Core Processes in Attention-Deficit/Hyperactivity Disorder (ADHD): Do Working Memory Deficiencies Underlie Behavioral Inhibition Deficits? J Abnorm Child Psychol 2010; 38:497-507. [DOI: 10.1007/s10802-010-9387-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [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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