Science.gov

Sample records for adult attention deficit

  1. Approach to attention deficit disorder in adults

    PubMed Central

    Matas, Manuel

    2006-01-01

    OBJECTIVE To review the etiology, diagnosis, and management of attention deficit disorder (ADD) in adults. SOURCES OF INFORMATION PsycINFO, PubMed, and Psychiatry 24x7.com were searched. Several books on ADD in adults were reviewed. I also drew on my own clinical experience assessing and treating adults with ADD for more than 20 years. MAIN MESSAGE The classic triad of ADD symptoms are inattention, impulsiveness, and hyperactivity or restlessness. Although ADD is a well established brain disorder, the diagnosis remains controversial. Attention deficit disorder has been called a fad, not a legitimate diagnosis, but it is a well established, well documented, medical condition that can cause much suffering if left untreated. At one time we thought children would outgrow ADD at puberty, but we now know that many will continue to have residual symptoms throughout adolescence and adulthood. If left untreated, ADD can interfere with relationships, employment, and self-esteem. Treatment with stimulants and adjunctive care is often effective. CONCLUSION Attention deficit disorder in adults represents a substantial burden of illness. It can be diagnosed and treated successfully. PMID:17273498

  2. Adults with Attention Deficit Hyperactivity Disorder (ADHD). ERIC Digest.

    ERIC Educational Resources Information Center

    Wasserstein, Jeanette; Wasserstein, Adella; Wolf, Lorraine E.

    This digest examines attention deficit hyperactivity disorder (ADHD) in adults and symptoms of the disability. Pertinent adult problems include: (1) substance abuse, antisocial behaviors, and criminality, all of which can occur in adults with ADHD; (2) poor social skills or deficits in self-awareness are also frequent; (3) occurrence of ADHD with…

  3. Sustained and Focused Attention Deficits in Adult ADHD

    ERIC Educational Resources Information Center

    Marchetta, Natalie D. J.; Hurks, Petra P. M.; De Sonneville, Leo M. J.; Krabbendam, Lydia; Jolles, Jelle

    2008-01-01

    Objective: To examine the specificity of deficits in focused attention and sustained attention in adults with ADHD and to evaluate the effect of comorbidity. Method: Twenty-eight adults with ADHD without comorbidity were compared with 28 ADHD outpatients with comorbidity. Two control groups were used: 68 adults referred for ADHD but with another…

  4. Adults with Dyslexia Demonstrate Attentional Orienting Deficits

    ERIC Educational Resources Information Center

    Buchholz, Judy; Davies, Anne Aimola

    2008-01-01

    Alerting, orienting and executive control of attention are investigated in five adult cases of dyslexia. In comparison with a control group, alerting and executive control were found to be generally intact for each case. Two spatial cueing tasks were employed. For the task requiring target detection, orienting difficulties were evident only in…

  5. Attentional Lapses of Adults with Attention Deficit Hyperactivity Disorder in Tasks of Sustained Attention.

    PubMed

    Gmehlin, Dennis; Fuermaier, Anselm B M; Walther, Stephan; Tucha, Lara; Koerts, Janneke; Lange, Klaus W; Tucha, Oliver; Weisbrod, Matthias; Aschenbrenner, Steffen

    2016-06-01

    Adults with attention deficit hyperactivity disorder (ADHD) show attentional dysfunction such as distractibility and mind-wandering, especially in lengthy tasks. However, fundamentals of dysfunction are ambiguous and relationships of neuropsychological test parameters with self-report measures of ADHD symptoms are marginal. We hypothesize that basic deficits in sustaining attention explain more complex attentional dysfunction in persons with ADHD and relate to ADHD symptoms. Attentional function was analyzed by computing ex-Gaussian parameters for 3 time Blocks in a 20 min test of sustained alertness. Changes in performance across these blocks were analyzed by comparing adult persons with ADHD (n = 24) with healthy matched controls (n = 24) and correlated with neuropsychological measures of selective and divided attention as well as self-report measures of ADHD symptoms. We found a significantly steeper increase in the number of slow responses (ex-Gaussian parameter τ) in persons with ADHD with time on task in basic sustained alertness. They also performed significantly worse in tasks of sustained selective and divided attention. However, after controlling for an increase in τ during the alertness task, significant differences between groups disappeared for divided and partly selective attention. Increases in τ in the sustained alertness task correlated significantly with self-report measures of ADHD symptoms. Our results provide evidence that very basic deficits in sustaining attention in adults with ADHD are related to infrequent slow responses (=attentional lapses), with changes over time being relevant for more complex attentional function and experienced ADHD symptoms in everyday life. PMID:27193369

  6. Treatment of adults with attention-deficit/hyperactivity disorder

    PubMed Central

    Kolar, Dusan; Keller, Amanda; Golfinopoulos, Maria; Cumyn, Lucy; Syer, Cassidy; Hechtman, Lily

    2008-01-01

    This review focuses on the treatment of attention deficit hyperactivity disorder (ADHD) in adults. It briefly addresses prevalence, diagnostic and differential diagnostic issues specific to adults. Stimulant medication, non-stimulant medication, and psychosocial treatments are thoroughly reviewed. For each class of medication possible mechanism of action, efficacy and side effects are summarized. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, stimulant medications are most effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD. PMID:18728745

  7. Treatment of adults with attention-deficit/hyperactivity disorder

    PubMed Central

    Kolar, Dusan; Keller, Amanda; Golfinopoulos, Maria; Cumyn, Lucy; Syer, Cassidy; Hechtman, Lily

    2008-01-01

    This review focuses on the treatment of attention deficit hyperactivity disorder (ADHD) in adults. It briefly addresses prevalence, diagnostic and differential diagnostic issues specific to adults. Stimulant medication, non-stimulant medication, and psychosocial treatments are thoroughly reviewed. For each class of medication possible mechanism of action, efficacy and side effects are summarized. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, stimulant medications are most effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD. PMID:18728812

  8. Treatment of attention deficit hyperactivity disorder in adults.

    PubMed

    Greenfield, Brian; Hechman, Lily

    2005-01-01

    A number of medication and psychologic treatment options for adults with attention deficit hyperactivity disorder have become available during the past 5 years, while others are under investigation. This review describes the safety and effectiveness of the stimulants (i.e., methylphenidate and dexedrine), and particularly the newer long-acting stimulants (i.e., Concerta) and Adderall XR) in the treatment of this population. Some nonstimulant/nonantidepressants, particularly atomoxetine, have also been shown to improve attention deficit hyperactivity disorder symptoms. Combination treatment of stimulants and antidepressants require more study with regard to safety and efficacy. Psychosocial interventions (e.g., cognitive behavioral therapy, mindfulness training and cognitive remediation) can also benefit adults with attention deficit hyperactivity disorder. Cognitive behavioral therapy combined with medication is more effective than either intervention alone, especially for addressing the emotional and functional aspects of peoples lives and thus improving occupational, interpersonal and emotional outcomes. PMID:15853481

  9. Attention Deficit Hyperactivity Disorder and adult mortality.

    PubMed

    London, Andrew S; Landes, Scott D

    2016-09-01

    This study examines the relationship between self-reported ADHD and adult mortality over a four-year period, and whether ADHD is associated with underlying cause of death (accidents versus all others). If ADHD increases mortality risk through accidents, then interventions may be designed and implemented to reduce risk and prevent premature death. We estimate descriptive statistics and multivariate logistic regression models using data from the 2007 U.S. National Health Interview Survey (NHIS) Sample Adult File linked to National Death Index (NDI) data through 2011 (N=23,352). Analyses are weighted and standard errors are adjusted for the complex sampling design. We find that the odds of dying are significantly higher among those with ADHD than among those without ADHD net of exogenous sociodemographic controls (adjusted odds ratio=1.78, 95% confidence interval=1.01, 3.12). Although marginally non-significant, accidental death is more common among those with ADHD than among those without ADHD (13.2% versus 4.3%, p=0.052). Few population-representative studies examine the relationship between ADHD and adult mortality due to data limitations. Using NHIS data linked to the NDI, we are only able to observe a few deaths among adults with ADHD. However, ADHD is associated with significantly higher odds of dying for adults and results suggest that accidents may be an underlying cause of death more often for decedents with ADHD. Future research should further examine the mechanisms linking ADHD to adult mortality and the extent to which mortality among persons with ADHD is preventable. Regular measurement of ADHD among adults in the NHIS is warranted. PMID:27343403

  10. [Assessment of the attention-deficit hyperactivity disorder in adults].

    PubMed

    Gross, J; Blocher, D; Trott, G E; Rösler, M

    1999-01-01

    The attention-deficit hyperactivity disorder (ADHD) is one of the most common disorders in childhood and adolescence with a prevalence of app. 5%. The importance of ADHD in childhood as a factor of vulnerability for psychiatric disorders in adults is becoming a focus of discussion. It was shown that there is a comorbidity in adults with substance abuse, delinquency and personality disorders. There is a growing evidence that ADHD will persist in a significant number of patients during adulthood. This is the first german study to evaluate this interdependence. We examined 164 adult inpatients and 48 healthy volunteers with the Wender Utah Rating Scale (WURS), a retrospective self-evaluation scale for the diagnosis of ADHD in childhood, and the Eysenck impulsiveness questionnaire I7. It could be shown that the WURS and the I7 are suitable instruments for the evaluation of the ADHD in adults especially concerning the aspects of attention deficits and impulsiveness. PMID:10087514

  11. Psychotherapy of Adults With Attention-Deficit Disorder

    PubMed Central

    BEMPORAD, JULES; ZAMBENEDETTI, MAURIZIO

    1996-01-01

    The multimodal treatment of adults with attention-deficit disorder (ADD) is described as consisting of a sequence of overlapping therapeutic measures. The initial objective is symptom amelioration through adequate pharmacotherapy. Once this has been accomplished, a period of psychoeducational therapy is recommended to teach the individual to live successfully with a chronic disorder. These two aspects of treatment may suffice for some ADD adults, but many others may require an additional course of psychotherapy to deal with dysfunctional personality characteristics resulting from having grown up with ADD. Among these are modes of defenses against painful affects, resistances to treatment, and inaccurate estimations and expectations of the self and others. PMID:22700291

  12. Emotion perception in adult attention-deficit hyperactivity disorder.

    PubMed

    Bisch, Jeanne; Kreifelts, Benjamin; Bretscher, Johannes; Wildgruber, Dirk; Fallgatter, Andreas; Ethofer, Thomas

    2016-08-01

    This study examined identification of emotional information in facial expression, prosody, and their combination in 23 adult patients with combined attention deficit-hyperactivity disorder (ADHD) versus 31 healthy controls (HC) matched for gender, age, and education. We employed a stimulus set which was carefully balanced for valence as well as recognizability of the expressed emotions as determined in an independent sample of HC to avoid potential biases due to different levels of task difficulty. ADHD patients were characterized by impaired recognition of all employed categories (neutral, happiness, eroticism, disgust, anger). Basic cognitive functions as assessed by neuropsychological testing, such as sustained attention, constancy of alertness, and verbal intelligence partially explained lower recognition rates. Removal of the correlated variance by means of regression analyses did not abolish lower performance in ADHD indicating deficits in social cognition independent of these neuropsychological factors (p < 0.05). Lower performance correlated with self-rated emotional intelligence (r = 0.38, p < 0.05) indicating that adults with ADHD are aware of their problems in emotion perception. ADHD patients could partly compensate their deficit in unimodal emotion perception by audiovisual integration as revealed by larger gains in emotion recognition accuracy during bimodal presentation (p < 0.05) as compared to HC. These behavioral results can serve as foundation for future neuroimaging studies and point rather towards sensory-specific regions than audiovisual integration areas in perception of emotional information in adult ADHD. PMID:26850439

  13. Is Adult Attention-Deficit Hyperactivity Disorder Being Overdiagnosed?

    PubMed Central

    Paris, Joel; Bhat, Venkat; Thombs, Brett

    2015-01-01

    This review offers a perspective on the question as to whether attention-deficit hyperactivity disorder (ADHD) is being overdiagnosed in adults. Considering underlying causes as well as consequences, we conclude that the diagnosis of adult ADHD should be made cautiously, making use of multiple sources of information, including self-report, clinical interviews, collateral information, childhood documentation, and neuropsychological testing. Routine screening with symptom checklists is insufficient, and stimulant response is diagnostically uninformative. The causes of overdiagnosis may include changes in diagnostic thresholds, poor diagnostic practices, and advertising by the pharmaceutical industry. Overdiagnosis leads to overtreatment, and dramatic increases in prescriptions for adult ADHD during the last decade should arouse concern. PMID:26175391

  14. Adult attention-deficit hyperactivity disorder: key conceptual issues.

    PubMed

    Asherson, Philip; Buitelaar, Jan; Faraone, Stephen V; Rohde, Luis A

    2016-06-01

    For many years, attention-deficit hyperactivity disorder (ADHD) was thought to be a childhood-onset disorder that has a limited effect on adult psychopathology. However, the symptoms and impairments that define ADHD often affect the adult population, with similar responses to drugs such as methylphenidate, dexamphetamine, and atomoxetine, and psychosocial interventions, to those seen in children and adolescents. As a result, awareness of ADHD in adults has rapidly increased and new clinical practice has emerged across the world. Despite this progress, treatment of adult ADHD in Europe and many other regions of the world is not yet common practice, and diagnostic services are often unavailable or restricted to a few specialist centres. This situation is remarkable given the strong evidence base for safe and effective treatments. Here we address some of the key conceptual issues surrounding the diagnosis of ADHD relevant to practising health-care professionals working with adult populations. We conclude that ADHD should be recognised in the same way as other common adult mental health disorders, and that failure to recognise and treat ADHD is detrimental to the wellbeing of many patients seeking help for common mental health problems. PMID:27183901

  15. Adult Attention Deficit Hyperactivity Disorder and Parenting Styles.

    PubMed

    Karbalaei Sabagh, Ali; Khademi, Mojgan; Noorbakhsh, Simasadat; Razjooyan, Katayoon; Arabgol, Fariba

    2016-03-01

    The aim of the present study was to compare the parenting styles in parents with and without adult attention deficit hyperactivity disorder (ADHD) who had children with ADHD. It was a case-control study with convenience sampling strategy. Participants were recruited from the parents of previously diagnosed children with ADHD referred to Imam Hossein Hospital, Tehran/ Iran. Ninety parents with adult ADHD and 120 normal parents were chosen by Conner's Adult ADHD Screening Scale (CAARS) and psychiatrist interview. Using Baumrind Parenting Styles Questionnaire and Arnold Parenting Scale, parenting styles were assessed in both the groups. Results from independent samples t-test indicated that Authoritarian parenting style (F = 0.576, p 0.022) and Over reacting style (F = 7.976, p 0.045) were significantly higher in cases. On the other hand, controls were using Permissive style (F = 0.131, p 0.044) more than cases. The results are consistent with prior studies; these findings can improve the content of parent training for children with ADHD, who have adult ADHD themselves. PMID:26264632

  16. Measurement of Stigmatization towards Adults with Attention Deficit Hyperactivity Disorder

    PubMed Central

    Fuermaier, Anselm B. M.; Tucha, Lara; Koerts, Janneke; Mueller, Anna K.; Lange, Klaus W.; Tucha, Oliver

    2012-01-01

    Objectives In general, assessment tools for stigma in mental disorders such as attention deficit hyperactivity disorder (ADHD) are lacking. Moreover, misbeliefs and misconceptions about ADHD are common, in particular with regard to the adult form of ADHD. The aim of the present study was to develop a questionnaire measuring stigma in adults with ADHD and to demonstrate its sensitivity. Methods A questionnaire initially containing 64 items associated with stigma in adults with ADHD was developed. A total number of 1261 respondents were included in the analyses. The psychometric properties were investigated on a sample of 1033 participants. The sensitivity of the questionnaire was explored on 228 participants consisting of teachers, physicians and control participants. Results Thirty-seven items were extracted due to exploratory factor analysis (EFA) and the internal consistency of items. Confirmatory factor analysis (CFA) revealed good psychometric properties of a 6-factor structure. Teachers and physicians differed significantly in their stigmatizing attitudes from control participants. Conclusions The present data shed light on various dimensions of stigma in adult ADHD. Reliability and Social Functioning, Malingering and Misuse of Medication, Ability to Take Responsibility, Norm-violating and Externalizing Behavior, Consequences of Diagnostic Disclosure and Etiology represent critical aspects associated with stigmatization. PMID:23284760

  17. Mindfulness Meditation Improves Mood, Quality of Life, and Attention in Adults with Attention Deficit Hyperactivity Disorder

    PubMed Central

    Bueno, Viviane Freire; Kozasa, Elisa H.; da Silva, Maria Aparecida; Alves, Tânia Maria; Louzã, Mario Rodrigues; Pompéia, Sabine

    2015-01-01

    Objective. Adults with attention deficit hyperactivity disorder (ADHD) display affective problems and impaired attention. Mood in ADHD can be improved by mindful awareness practices (MAP), but results are mixed regarding the enhancement of attentional performance. Here we evaluated MAP-induced changes in quality of life (QoL), mood, and attention in adult ADHD patients and controls using more measures of attention than prior studies. Methods. Twenty-one ADHD patients and 8 healthy controls underwent 8 weekly MAP sessions; 22 similar patients and 9 controls did not undergo the intervention. Mood and QoL were assessed using validated questionnaires, and attention was evaluated using the Attentional Network Test (ANT) and the Conners Continuous Performance Test (CPT II), before and after intervention. Results. MAP enhanced sustained attention (ANT) and detectability (CPT II) and improved mood and QoL of patients and controls. Conclusion. MAP is a complementary intervention that improves affect and attention of adults with ADHD and controls. PMID:26137496

  18. Career Beliefs and Job Satisfaction in Adults with Symptoms of Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Painter, Carol A.; Prevatt, Frances; Welles, Theresa

    2008-01-01

    The authors evaluated dysfunctional career beliefs and subsequent low job satisfaction in adults reporting significant symptoms of attention-deficit/hyperactivity disorder (ADHD). Participants (N = 81) completed the Adult Attention Deficit Disorders Evaluation Scale (S. B. McCarney & P. D. Anderson, 1996), the Career Thoughts Inventory (J. P.…

  19. Malondialdehyde levels in adult attention-deficit hyperactivity disorder

    PubMed Central

    Bulut, Mahmut; Selek, Salih; Gergerlioglu, H. Serdar; Savas, Haluk A.; Yilmaz, H. Ramazan; Yuce, Murat; Ekici, Giyasettin

    2007-01-01

    Objective To evaluate the biochemical basis of adult attention-deficit hyperactivity disorder (A-ADHD), we compared lipid peroxidation status in the plasma of A-ADHD patients, and that of control subjects without A-ADHD by quantifying the levels of malondialdehyde (MDA), an end product of fatty acid oxidation. We aimed to examine the association between MDA and A-ADHD. Method The study comprised 20 A-ADHD patients from Gaziantep University Sahinbey Research Hospital Psychiatry Clinic, diagnosed by 2 psychiatrists (H.A.S. and S.S.) according to the Turkish version of the adult ADD/ADHD DSM-IV-Based Diagnostic Screening and Rating Scale, and 21 healthy volunteers. Malondialdehyde levels were measured in plasma samples of both study groups. Results The mean (standard deviation [SD]) MDA levels in patients (2.44 [0.84] nmol/mL) were significantly higher than those of control subjects (0.36 [0.20] nmol/mL) (t = 11.013, df = 39, p < 0.01). MDA levels were correlated with overall number of criteria met (n = 20, p = 0.01, Ro = 0.56) and total hyperactivity/impulsivity score (n = 20, p = 0.02, Ro = 0.51). Conclusion The fact that MDA levels were increased in A-ADHD could be an indication of increased oxidative stress in this disease. We suggest that such changes may have a pathological role in A-ADHD. This is the first study evaluating the MDA levels in A-ADHD, and our findings may provide a scientific guide for the further clinical enzymologic and biochemical studies on this disorder. PMID:18043768

  20. Parenting in adults with attention-deficit/hyperactivity disorder (ADHD).

    PubMed

    Johnston, Charlotte; Mash, Eric J; Miller, Natalie; Ninowski, Jerilyn E

    2012-06-01

    Although the validity of adult ADHD is well established and research has identified a variety of impairments associated with the condition in adults, study of how ADHD impacts an adult's ability to parent has been relatively neglected. Parenting is a particularly important domain of functioning given the familial nature of the disorder and emerging evidence that parenting behaviors play a role in the development or maintenance of child ADHD symptoms, comorbid psychopathologies, and other associated difficulties. In this paper, we focus on three broad categories of cognitive dysfunction proposed across models of ADHD - cognitive processes (e.g., working memory, planning, and inhibitory control), self-regulation deficits (e.g., self-monitoring of performance to detect errors or the need for regulation of behavior and/or emotions), and motivational or arousal difficulties (e.g., response to incentives, delay aversion). We consider how these deficits may lead to impairments in the parenting behaviors of effective behavioral control and emotional responsiveness, and review the available evidence regarding parenting in adults with ADHD symptoms. We conclude by noting the limitations in existing studies, and argue for further research that is theoretically grounded in how core deficits of ADHD may be related to dimensions of parenting. The implications of an improved understanding of how ADHD impacts parenting for the development of early intervention or prevention programs are outlined. PMID:22459785

  1. Attentional Control and Subjective Executive Function in Treatment-Naive Adults with Attention Deficit Hyperactivity Disorder

    PubMed Central

    Grane, Venke Arntsberg; Endestad, Tor; Pinto, Arnfrid Farbu; Solbakk, Anne-Kristin

    2014-01-01

    We investigated performance-derived measures of executive control, and their relationship with self- and informant reported executive functions in everyday life, in treatment-naive adults with newly diagnosed Attention Deficit Hyperactivity Disorder (ADHD; n = 36) and in healthy controls (n = 35). Sustained attentional control and response inhibition were examined with the Test of Variables of Attention (T.O.V.A.). Delayed responses, increased reaction time variability, and higher omission error rate to Go signals in ADHD patients relative to controls indicated fluctuating levels of attention in the patients. Furthermore, an increment in NoGo commission errors when Go stimuli increased relative to NoGo stimuli suggests reduced inhibition of task-irrelevant stimuli in conditions demanding frequent responding. The ADHD group reported significantly more cognitive and behavioral executive problems than the control group on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). There were overall not strong associations between task performance and ratings of everyday executive function. However, for the ADHD group, T.O.V.A. omission errors predicted self-reported difficulties on the Organization of Materials scale, and commission errors predicted informant reported difficulties on the same scale. Although ADHD patients endorsed more symptoms of depression and anxiety on the Achenbach System of Empirically Based Assessment (ASEBA) than controls, ASEBA scores were not significantly associated with T.O.V.A. performance scores. Altogether, the results indicate multifaceted alteration of attentional control in adult ADHD, and accompanying subjective difficulties with several aspects of executive function in everyday living. The relationships between the two sets of data were modest, indicating that the measures represent non-redundant features of adult ADHD. PMID:25545156

  2. Attentional control and subjective executive function in treatment-naive adults with Attention Deficit Hyperactivity Disorder.

    PubMed

    Grane, Venke Arntsberg; Endestad, Tor; Pinto, Arnfrid Farbu; Solbakk, Anne-Kristin

    2014-01-01

    We investigated performance-derived measures of executive control, and their relationship with self- and informant reported executive functions in everyday life, in treatment-naive adults with newly diagnosed Attention Deficit Hyperactivity Disorder (ADHD; n = 36) and in healthy controls (n = 35). Sustained attentional control and response inhibition were examined with the Test of Variables of Attention (T.O.V.A.). Delayed responses, increased reaction time variability, and higher omission error rate to Go signals in ADHD patients relative to controls indicated fluctuating levels of attention in the patients. Furthermore, an increment in NoGo commission errors when Go stimuli increased relative to NoGo stimuli suggests reduced inhibition of task-irrelevant stimuli in conditions demanding frequent responding. The ADHD group reported significantly more cognitive and behavioral executive problems than the control group on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). There were overall not strong associations between task performance and ratings of everyday executive function. However, for the ADHD group, T.O.V.A. omission errors predicted self-reported difficulties on the Organization of Materials scale, and commission errors predicted informant reported difficulties on the same scale. Although ADHD patients endorsed more symptoms of depression and anxiety on the Achenbach System of Empirically Based Assessment (ASEBA) than controls, ASEBA scores were not significantly associated with T.O.V.A. performance scores. Altogether, the results indicate multifaceted alteration of attentional control in adult ADHD, and accompanying subjective difficulties with several aspects of executive function in everyday living. The relationships between the two sets of data were modest, indicating that the measures represent non-redundant features of adult ADHD. PMID:25545156

  3. The Readiness of Adults with Attention Deficit Hyperactivity Disorder for Self-Directed Learning

    ERIC Educational Resources Information Center

    Wright, Melissa Sue

    2011-01-01

    This study investigated the readiness for self-directed learning of adults with Attention Deficit Hyperactivity Disorder (ADHD), as well as their overall educational experiences. Using Guglielmino's Self-Directed Learning Readiness Scale for Adults (SDLRS-A), the researcher investigated whether the following factors were significantly related to…

  4. Scales for the Identification of Adults with Attention Deficit Hyperactivity Disorder (ADHD): A Systematic Review

    ERIC Educational Resources Information Center

    Taylor, Abigail; Deb, Shoumitro; Unwin, Gemma

    2011-01-01

    Attention deficit hyperactivity disorder (ADHD) is prevalent in the adult population. The associated co-morbidities and impairments can be relieved with treatment. Therefore, several rating scales have been developed to identify adults with ADHD who may benefit from treatment. No systematic review has yet sought to evaluate these scales in more…

  5. Adults with Attention-Deficit/ Hyperactivity Disorder: Assessment and Treatment Strategies

    ERIC Educational Resources Information Center

    Wadsworth, John S.; Harper, Dennis C.

    2007-01-01

    Attention-deficit/hyperactivity disorder (ADHD) among adults is characterized by inattentiveness and impulsivity. This article provides counselors with information about the etiology, assessment, and treatment of adult ADHD. The identification of the genetic and neurological features of ADHD has led to improvements in evaluation and treatment.…

  6. Children and Adults with Attention-Deficit/Hyperactivity Disorder

    MedlinePlus

    ... All Rights Reserved. Press Privacy Attention Magazine Archives Advertise with CHADD Contact Us Site Map Report a Problem For help call: 800-233-4050 Follow CHADD on Facebook Follow CHADD on Twitter

  7. Cortisol Response to Stress in Adults with Attention Deficit Hyperactivity Disorder

    PubMed Central

    Palomar, Gloria; Ferrer, Roser; Real, Alberto; Nogueira, Mariana; Corrales, Montserrat; Casas, Miguel; Ramos-Quiroga, Josep Antoni

    2015-01-01

    Background: Differences in the cortisol response have been reported between children exhibiting the inattentive and hyperactive/impulsive subtypes of attention deficit hyperactivity disorder. However, there is no such information about adults. The aim of the present study was to determine the possible differences between the combined and inattentive subtypes in the cortisol response to stress. Methods: Ninety-six adults with attention deficit hyperactivity disorder, 38 inattentive and 58 combined, without any medical or psychiatric comorbidities and 25 healthy controls were included. The Trier Social Stress Test was used to assess physiological stress responses. Clinical data and subjective stress levels, including the Perceived Stress Scale, were also recorded. Results: No significant differences in the cortisol response to the Trier Social Stress Test were found between patients and controls. However, albeit there were no basal differences, lower cortisol levels at 15 (P=.015), 30 (P=.015), and 45 minutes (P=.045) were observed in the combined compared with the inattentive subtype after the stress induction; these differences disappeared 60 minutes after the stress. In contrast, the subjective stress responses showed significant differences between attention deficit hyperactivity disorder patients and controls (P<.001), but no differences were seen between attention deficit hyperactivity disorder subtypes. In turn, subjective stress measures, such as the Perceived Stress Scale, positively correlated with the whole cortisol stress response (P<.027). Conclusions: Both the combined and inattentive attention deficit hyperactivity disorder adults exhibited a normal cortisol response to stress when challenged. Nevertheless, the inattentive patients displayed a higher level of cortisol after stress compared with the combined patients. Despite the differences in the cortisol response, adults with attention deficit hyperactivity disorder reported high levels of subjective

  8. Adults' versus Children's Perceptions of a Child with Autism or Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Harnum, Marsha; Duffy, Jim; Ferguson, Duncan A.

    2007-01-01

    The present study examined public perceptions toward children with autism or with attention deficit hyperactivity disorder (ADHD). A convenience sample was used consisting of 30 children (7-12-year-olds) and 30 adults. Participants read a stereotyped scenario featuring either a child with autism, a child with ADHD, or a normal child. Child…

  9. Self-Reported Adult Attention-Deficit/Hyperactivity Disorder Symptoms among College Students

    ERIC Educational Resources Information Center

    Garnier-Dykstra, Laura M.; Pinchevsky, Gillian M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; Arria, Amelia M.

    2010-01-01

    Objective: Report the distribution of scores from the Adult ADHD Self-Report Scale (ASRS) and estimate the prevalence of self-reported attention-deficit/hyperactivity disorder (ADHD) symptoms as compared to clinical diagnoses. Participants: Participants were 1,080 college students, divided into 3 groups: (1) no ADHD diagnosis (n = 972), (2)…

  10. Adult Dyslexia and Attention Deficit Disorder in Finland--Project DyAdd: WAIS-III Cognitive Profiles

    ERIC Educational Resources Information Center

    Laasonen, Marja; Leppamaki, Sami; Tani, Pekka; Hokkanen, Laura

    2009-01-01

    The project Adult Dyslexia and Attention Deficit Disorder in Finland (Project DyAdd) compares adults (n = 119, 18-55 years) with dyslexia, attention-deficit/hyperactivity disorder (ADHD), dyslexia together with ADHD (comorbid), and healthy controls with neuropsychological, psychophysical, and biological methods. The focus of this article is on the…

  11. Attention deficit hyperactivity disorder symptoms in adults with autism spectrum disorders.

    PubMed

    Johnston, Kate; Dittner, Antonia; Bramham, Jessica; Murphy, Clodagh; Knight, Anya; Russell, Ailsa

    2013-08-01

    Features of attention deficit hyperactivity disorder (ADHD) and impairments on neuropsychological, tests of attention have been documented in children with autism spectrum disorders (ASDs). To date, there has been a lack of research comparing attention in adults with ASD and adults with ADHD. In study 1, 31 adults with ASD and average intellectual function completed self-report measures of ADHD symptoms. These were compared with self-report measures of ADHD symptoms in 38 adults with ADHD and 29 general population controls. In study 2, 28 adults with a diagnosis of ASD were compared with an age- and intelligence quotient-matched sample of 28 adults with ADHD across a range of measures of attention. Study 1 showed that 36.7% of adults with ASD met Diagnostic and Statistical Manual-IV criteria for current ADHD "caseness" (Barkley Current self-report scores questionnaire). Those with a diagnosis of pervasive developmental disorder-not otherwise specified were most likely to describe ADHD symptoms. The ASD group differed significantly from both the ADHD and control groups on total and individual symptom self-report scores. On neuropsychological testing, adults with ASD and ADHD showed comparable performance on tests of selective attention. Significant group differences were seen on measures of attentional switching; adults with ADHD were significantly faster and more inaccurate, and individuals with Asperger's syndrome showed a significantly slower and more accurate response style. Self-reported rates of ADHD among adults with ASD are significantly higher than in the general adult population and may be underdiagnosed. Adults with ASD have attentional difficulties on some neuropsychological measures. PMID:23788522

  12. Attention Deficit Hyperactivity Disorder

    MedlinePlus

    ... us to find out more about ADHD. Share Attention Deficit Hyperactivity Disorder (Easy-to-Read) Download PDF Download ePub Order ... attention deficit/hyperactivity disorder , or ADHD . What is attention deficit/hyperactivity disorder, or ADHD? ADHD is a common mental disorder ...

  13. Attention-deficit/hyperactivity disorder (ADHD) symptoms, anxiety symptoms, and executive functioning in emerging adults.

    PubMed

    Jarrett, Matthew A

    2016-02-01

    The current study examined attention-deficit/hyperactivity disorder (ADHD) and anxiety symptoms in relation to self-reported executive functioning deficits in emerging adults. College students (N = 421; ages 17-25; 73.1% female) completed self-reports of ADHD, anxiety, and executive functioning in a laboratory setting. Structural equation modeling analyses revealed that self-reported executive functioning deficits were significantly related to all 3 symptom domains. Executive functioning deficits were most strongly related to inattention followed by hyperactivity/impulsivity and anxiety. Analyses based on clinical groups revealed that groups with ADHD and comorbid anxiety showed greater deficits on self-regulation of emotion and self-organization/problem solving than those with ADHD only or anxiety only. Groups with ADHD showed greater deficits with self-motivation and self-restraint than those with anxiety only. All clinical groups differed from a control group on executive functioning deficits. Overall, anxiety symptoms appear to be associated with college students' self-reported executive functioning deficits above and beyond relationships with ADHD symptomatology. Further, those with ADHD and anxiety appear to show increased difficulties with self-regulation of emotion and self-organization/problem solving, a domain which appears to overlap substantially with working memory. Future studies should seek to replicate our findings with a clinical population, utilize both report-based and laboratory task measures of executive functioning, and integrate both state and trait anxiety indices into study designs. Finally, future studies should seek to determine how executive functioning deficits can be best ameliorated in emerging adults with ADHD and anxiety. (PsycINFO Database Record PMID:26121381

  14. Attention-deficit/hyperactivity disorder in adults: evidence-based recommendations for management.

    PubMed

    Rostain, Anthony L

    2008-09-01

    Attention-deficit/hyperactivity disorder (ADHD) is associated with impairments in educational, occupational, neuropsychological, and social functioning in adults. Successful diagnosis and treatment of the disorder in adults can be a challenge because recent and integrative clinical guidelines are lacking and diagnostic criteria are based on making a retrospective diagnosis of childhood-onset ADHD. To develop evidence-based recommendations for the treatment of ADHD in adults, the scientific literature was reviewed, including primary clinical studies, meta-analyses, and available clinical guidelines. Studies show that stimulant therapy is highly effective and safe in the management of ADHD in adults, with similar response rates to those reported in children at doses that are equivalent on a mg/kg basis. Long-acting stimulants, such as OROS methylphenidate (OROS MPH, Concerta), dexmethylphenidate (d-MPH, Focalin), and mixed amphetamine salts extended release (MAS XR, Adderall XR), have durations of action of up to 10 to 12 hours, which permit once-daily dosing. For adults with ADHD who do not respond to stimulant therapy or who have a comorbid condition in which a stimulant is contraindicated, the nonstimulant atomoxetine (Strattera) may be an appropriate alternative. For many adults, cognitive-behavioral therapy in addition to pharmacotherapy may improve treatment response. Attention-deficit/hyperactivity disorder medications may increase blood pressure and heart rate in adults, so patients should be monitored. PMID:18824823

  15. Overcoming Attention Deficit Disorders in Children, Adolescents, and Adults. Fourth Edition

    ERIC Educational Resources Information Center

    Jordan, Dale R.

    2006-01-01

    Previously published as "Attention Deficit Disorder: ADHD and ADD Syndromes," this popular book is now in its fourth edition. It provides up-to-date research and more complete explanations of how Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) interfere with classroom learning, behavior at home, job…

  16. GUTI: a measure of urgent task involvement among adults with attention-deficit hyperactivity disorder.

    PubMed

    Glickman, M M; Dodd, D K

    1998-04-01

    Attention-deficit hyperactivity disorder (ADHD) has been proposed to represent adaptive responding to highly urgent situations as in primitive hunting. In the present study, 31 adults with self-reported ADHD were compared with 33 normal adults on a newly developed, 10-item measure of urgent task involvement. The internal consistency of the scale was suitable, and the group with ADHD scored significantly higher than the control group, as predicted. Validation and further development of this scale is required for it to become a tool for the study of performance of highly urgent tasks. PMID:9621734

  17. Neurocognitive correlates of adult attention-deficit/hyperactivity disorder in a Turkish sample.

    PubMed

    Aycicegi-Dinn, Ayse; Dervent-Ozbek, Sevinc; Yazgan, Yanki; Bicer, Duygu; Dinn, Wayne M

    2011-03-01

    We established a neuropsychological testing profile among Turkish adults presenting with ADHD controlling for general intelligence and comorbid psychiatric conditions. Adults with ADHD frequently present with comorbid conditions (e.g., mood and substance use/abuse disorders) that may have a detrimental impact on neurocognitive function. Hence, we excluded patients with ADHD meeting criteria for comorbid psychiatric syndromes. A comprehensive neuropsychological test battery was administered to adults with ADHD attending a general psychiatry clinic in Istanbul, Turkey, and healthy control participants. Adults with ADHD demonstrated performance deficits on tests of attention, information processing speed, and general and working memory. Patients with ADHD also reported a significantly greater number of symptoms associated with frontal lobe syndromes (i.e., dysexecutive symptoms and disinhibition). Patients with ADHD demonstrated rather striking deficits on tests of verbal and nonverbal memory. Once information was encoded, however, patients with ADHD do not demonstrate significant information loss. Patients with ADHD and healthy controls did not differ on tests of alternation learning, inhibitory control (error rates), and ToM skills. Findings support the contention that dorsal-prefrontal (rather than ventral-prefrontal) dysfunction is associated with adult ADHD. Unexpectedly, groups did not differ on executive control and fluency tasks. Yet patients with ADHD obtained substantially higher scores on a self-report measure of executive dysfunction. This suggests that dysexecutive symptoms among patients with ADHD in the current study do not reflect set-shifting or organizational deficits. Rather, symptoms may reflect attentional and working memory deficits as well as diminished information processing speed. PMID:21432617

  18. Understanding Attention Deficit Disorders.

    ERIC Educational Resources Information Center

    Villegas, Orlando; And Others

    This booklet provides basic information regarding attention deficit hyperactivity disorders (ADHD), in their separate modalities, with hyperactivity, impulsivity, and inattention. Explanations are offered concerning short attention span, impulsive behavior, hyperactivity, and beginning new activities before completing the previous one. Theories…

  19. Attention deficit hyperactivity disorder

    MedlinePlus

    Attention deficit hyperactivity disorder (ADHD) is a problem caused by the presence of 1 or more of ... of these behaviors. INATTENTIVE SYMPTOMS Doesn't pay attention to details or makes careless mistakes in schoolwork ...

  20. Screening for attention-deficit/hyperactivity disorder in adult inpatients with psychiatric disorders.

    PubMed

    Kumar, Geetha; Faden, Justin; Steer, Robert A

    2011-06-01

    The purpose was to assess the effectiveness of the adult ADHD Module from the MINI International Neuropsychiatric Interview (MINI) and the Conners' Adult ADHD Rating Scales: Screening Version DSM-IV ADHD Symptoms Total Scale (CAARS-S:SV) in screening for attention-deficit/hyperactivity (ADHD) disorder in patients hospitalized for other psychiatric disorders. Assessment measures were administered to 55 (50%) female and 55 (50%) male adult (>18 yr. old) inpatients. Only six (5%) of the 110 inpatients had been diagnosed with comorbid ADHD according to medical charts. In contrast, 55 (50%) patients met criteria for ADHD according to the MINI, and 39 (36%) patients met criteria on the CAARS-S:SV. The higher rates of prevalence for the MINI and the CAARS-S:SV were attributable to symptom criteria for ADHD being similar to those shared with comorbid disorders. PMID:21879629

  1. Executive Functioning Differences between Adults with Attention Deficit Hyperactivity Disorder and Autistic Spectrum Disorder in Initiation, Planning and Strategy Formation

    ERIC Educational Resources Information Center

    Bramham, Jessica; Ambery, Fiona; Young, Susan; Morris, Robin; Russell, Ailsa; Xenitidis, Kiriakos; Asherson, Philip; Murphy, Declan

    2009-01-01

    Executive functioning deficits characterize the neuropsychological profiles of the childhood neurodevelopmental disorders of attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD). This study sought to determine whether similar impairments exist in adults with ADHD (N = 53) and ASD (N = 45) in comparison with a…

  2. Shared polygenic contribution between childhood attention-deficit hyperactivity disorder and adult schizophrenia†

    PubMed Central

    Hamshere, Marian L.; Stergiakouli, Evangelia; Langley, Kate; Martin, Joanna; Holmans, Peter; Kent, Lindsey; Owen, Michael J.; Gill, Michael; Thapar, Anita; O’Donovan, Mick; Craddock, Nick

    2013-01-01

    Background There is recent evidence of some degree of shared genetic susceptibility between adult schizophrenia and childhood attention-deficit hyperactivity disorder (ADHD) for rare chromosomal variants. Aims To determine whether there is overlap between common alleles conferring risk of schizophrenia in adults with those that do so for ADHD in children. Method We used recently published Psychiatric Genome-wide Association Study (GWAS) Consortium (PGC) adult schizophrenia data to define alleles over-represented in people with schizophrenia and tested whether those alleles were more common in 727 children with ADHD than in 2067 controls. Results Schizophrenia risk alleles discriminated ADHD cases from controls (P = 1.04×10–4, R2 = 0.45%); stronger discrimination was given by alleles that were risk alleles for both adult schizophrenia and adult bipolar disorder (also derived from a PGC data-set) (P = 9.98×10–6, R2 = 0.59%). Conclusions This increasing evidence for a small, but significant, shared genetic susceptibility between adult schizophrenia and childhood ADHD highlights the importance of research work across traditional diagnostic boundaries. PMID:23703318

  3. Cognitive heterogeneity in adult attention deficit/hyperactivity disorder: A systematic analysis of neuropsychological measurements.

    PubMed

    Mostert, Jeanette C; Onnink, A Marten H; Klein, Marieke; Dammers, Janneke; Harneit, Anais; Schulten, Theresa; van Hulzen, Kimm J E; Kan, Cornelis C; Slaats-Willemse, Dorine; Buitelaar, Jan K; Franke, Barbara; Hoogman, Martine

    2015-11-01

    Attention Deficit/Hyperactivity Disorder (ADHD) in childhood is associated with impaired functioning in multiple cognitive domains: executive functioning (EF), reward and timing. Similar impairments have been described for adults with persistent ADHD, but an extensive investigation of neuropsychological functioning in a large sample of adult patients is currently lacking. We systematically examined neuropsychological performance on tasks measuring EF, delay discounting, time estimation and response variability using univariate ANCOVA's comparing patients with persistent ADHD (N=133, 42% male, mean age 36) and healthy adults (N=132, 40% male, mean age 36). In addition, we tested which combination of variables provided the highest accuracy in predicting ADHD diagnosis. We also estimated for each individual the severity of neuropsychological dysfunctioning. Lastly, we investigated potential effects of stimulant medication and a history of comorbid major depressive disorder (MDD) on performance. Compared to healthy adults, patients with ADHD showed impaired EF, were more impulsive, and more variable in responding. However, effect sizes were small to moderate (range: 0.05-0.70) and 11% of patients did not show neuropsychological dysfunctioning. The best fitting model predicting ADHD included measures from distinct cognitive domains (82.1% specificity, 64.9% sensitivity). Furthermore, patients receiving stimulant medication or with a history of MDD were not distinctively impaired. To conclude, while adults with ADHD as a group are impaired on several cognitive domains, the results confirm that adult ADHD is neuropsychologically heterogeneous. This provides a starting point to investigate individual differences in terms of impaired cognitive pathways. PMID:26336867

  4. [Adult attention deficit/hyperactivity disorder, associated symptoms and comorbid psychiatric disorders: diagnosis and pharmacological treatment].

    PubMed

    Paslakis, G; Schredl, M; Alm, B; Sobanski, E

    2013-08-01

    Adult attention deficit/hyperactivity disorder (ADHD) is characterised by inattention and/or hyperactivity and impulsivity and is a frequent psychiatric disorder with childhood onset. In addition to core symptoms, patients often experience associated symptoms like emotional dysregulation or low self-esteem and suffer from comorbid disorders, particularly depressive episodes, substance abuse, anxiety or sleep disorders. It is recommended to include associated symptoms and comorbid psychiatric disorders in the diagnostic set-up and in the treatment plan. Comorbid psychiatric disorders should be addressed with disorder-specific therapies while associated symptoms also often improve with treatment of the ADHD core symptoms. The most impairing psychiatric disorder should be treated first. This review presents recommendations for differential diagnosis and treatment of adult ADHD with associated symptoms and comorbid psychiatric disorders with respect to internationally published guidelines, clinical trials and expert opinions. PMID:23864520

  5. Attention-deficit/hyperactivity disorder and adverse health outcomes in adults.

    PubMed

    Spencer, Thomas J; Faraone, Stephen V; Tarko, Laura; McDermott, Katie; Biederman, Joseph

    2014-10-01

    Whereas the adverse impact of attention-deficit/hyperactivity disorder (ADHD) on emotional and psychosocial well-being has been well investigated, its impact on physical health has not. The main aim of this study was to assess the impact of ADHD on lifestyle behaviors and measures of adverse health risk indicators. Subjects were 100 untreated adults with ADHD and 100 adults without ADHD of similar age and sex. Unhealthy lifestyle indicators included assessments of bad health habits, frequency of visits to healthcare providers, and follow through with recommended prophylactic tests. Assessments of adverse health risk indicators included measurements of cardiovascular and metabolic parameters, weight, body mass index, and waist circumference. No differences were identified in health habits between subjects with and without ADHD, but robust differences were found in a wide range of adverse health risk indicators. ADHD is associated with an adverse impact in health risk indicators well known to be associated with high morbidity and mortality. PMID:25211634

  6. Structured group psychotherapy in adults with attention deficit hyperactivity disorder: results of an open multicentre study.

    PubMed

    Philipsen, Alexandra; Richter, Harald; Peters, Julia; Alm, Barbara; Sobanski, Esther; Colla, Michael; Münzebrock, Mirka; Scheel, Corinna; Jacob, Christian; Perlov, Evgeniy; Tebartz van Elst, Ludger; Hesslinger, Bernd

    2007-12-01

    Attention deficit hyperactivity disorder (ADHD) is a serious mental disorder that often persists in adulthood. In a pilot study, a structured skills training group program for adult ADHD led to significant symptomatic improvements. The present study evaluated the program's effectiveness, feasibility, and patient acceptability in a multicenter setting. Seventy-two adult ADHD patients were assigned to 13 two-hour weekly sessions at 4 different therapy sites. The therapy was well tolerated and led to significant improvements of ADHD, depressive symptoms, and personal health status (p < 0.001). The factors treatment site and medication did not contribute to the overall improvement. Patients regarded the program topics "behavioral analyses," "mindfulness," and "emotion regulation" as the most helpful. In this multicenter study, the therapy program showed therapist-independent effects and seemed to be disorder-specific. This warrants the effort of organizing further controlled studies. PMID:18091195

  7. Attention deficit hyperactivity disorder.

    PubMed

    Thapar, Anita; Cooper, Miriam

    2016-03-19

    Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder with a prevalence of 1·4-3·0%. It is more common in boys than girls. Comorbidity with childhood-onset neurodevelopmental disorders and psychiatric disorders is substantial. ADHD is highly heritable and multifactorial; multiple genes and non-inherited factors contribute to the disorder. Prenatal and perinatal factors have been implicated as risks, but definite causes remain unknown. Most guidelines recommend a stepwise approach to treatment, beginning with non-drug interventions and then moving to pharmacological treatment in those most severely affected. Randomised controlled trials show short-term benefits of stimulant medication and atomoxetine. Meta-analyses of blinded trials of non-drug treatments have not yet proven the efficacy of such interventions. Longitudinal studies of ADHD show heightened risk of multiple mental health and social difficulties as well as premature mortality in adult life. PMID:26386541

  8. Baseline Omega-3 Index Correlates with Aggressive and Attention Deficit Disorder Behaviours in Adult Prisoners

    PubMed Central

    Meyer, Barbara J.; Byrne, Mitchell K.; Collier, Carole; Parletta, Natalie; Crawford, Donna; Winberg, Pia C.; Webster, David; Chapman, Karen; Thomas, Gayle; Dally, Jean; Batterham, Marijka; Farquhar, Ian; Martin, Anne-Marie; Grant, Luke

    2015-01-01

    Background There is emerging evidence that the supplementation of omega-3 contributes to a decrease in aggressive behaviour in prison populations. A challenge of such research is achieving statistical power against effect sizes which may be affected by the baseline omega-3 index. There are no published data on the blood omega-3 index with studies of this kind to assess the variability of the blood omega-3 index in conjunction with aggression and attention deficit assessments. Objective To determine if the variance of the omega-3 index is correlated with aggressive and attention deficit behaviour in a prison population. Design 136 adult male prisoners were recruited from South Coast Correctional Centre (SCCC), NSW Australia. A 7 point categorisation was used to quantify levels of aggressive behaviour (4 weeks) from individual SCCC case notes, whereby higher scores correspond to increasingly aggressive behaviour. Study participants completed the Aggression Questionnaire (AQ) and the Brown’s Attention Deficit Disorder Scales (BADDS), provided a blood sample for erythrocyte fatty acid analysis using gas chromatography and the omega-3 index was calculated. Results The baseline omega-3 index ranged from 2.3% to 10.3%, indicating that some participants already had substantial omega-3 intake, however a median of 4.7% indicated a lower overall omega-3 intake than the general Australian population. Assessment of aggressive and attention deficit behaviour shows that there were negative correlations between baseline omega-3 index and baseline aggression categorisation scores (r = −0.21, P = 0.016); total AQ score (r = −0.234, P = 0.011); Anger (r = -0.222 p = 0.016); Hostility AQ (r = −0.239, P = 0.009); indirect aggression (r = −0.188 p = 0.042); total BADDS (r = −0.263, p = 0.005); Activation (r = −0.224, p = 0.016); Attention (r = −0.192, p = 0.043); Effort (r = −0.253, p = 0.007); Affect (r = −0.330, p = 0.000) and Memory (r = −0.240, p = 0

  9. Attention Deficit Hyperactivity Disorder

    MedlinePlus

    ... finish things? If so, your child may have attention deficit hyperactivity disorder (ADHD). Nearly everyone shows some of these behaviors at times, but ADHD lasts more than 6 months and causes problems ...

  10. Underdiagnosis of Attention-Deficit/Hyperactivity Disorder in Adult Patients: A Review of the Literature

    PubMed Central

    Quintero, Javier; Anand, Ernie; Casillas, Marta; Upadhyaya, Himanshu P.

    2014-01-01

    Objective: To raise awareness of attention-deficit/hyperactivity disorder (ADHD) as an underdiagnosed, undertreated, often comorbid, and debilitating condition in adults. Data Sources: PubMed was searched using combinations of keywords, including ADHD, adult, diagnosis, identify, prevalence, and comorbid, to find articles published between 1976 and 2013. Study Selection: In total, 99 articles were selected for inclusion on the basis of their relevance to the objective and importance to and representation of ADHD research, including international guidelines for adults with ADHD. Results: In a large proportion of children with ADHD, symptoms persist into adulthood. However, although adults with ADHD often experience chaotic lifestyles, with impaired educational and vocational achievement and higher risks of substance abuse and imprisonment, many remain undiagnosed and/or untreated. ADHD is usually accompanied by other psychiatric comorbidities (such as major depressive disorder, anxiety disorder, and alcohol abuse). Indeed, adults with ADHD are more likely to present to a psychiatric clinic for treatment of their comorbid disorders than for ADHD, and their ADHD symptoms are often mistaken for those of their comorbidities. Untreated ADHD in adults with psychiatric comorbidities leads to poor clinical and functional outcomes for the patient even if comorbidities are treated. Effective treatment of adults’ ADHD improves symptoms, emotional lability, and patient functioning, often leading to favorable outcomes (eg, safer driving, reduced criminality). A few medications have now been approved for use in adults with ADHD, while a multimodal approach involving psychotherapy has also shown promising results. Conclusions General psychiatrists should familiarize themselves with the symptoms of ADHD in adults in order to diagnose and manage ADHD and comorbidities appropriately in these patients. PMID:25317367

  11. The impact of distractions on young adult drivers with attention deficit hyperactivity disorder (ADHD).

    PubMed

    Reimer, Bryan; Mehler, Bruce; D'Ambrosio, Lisa A; Fried, Ronna

    2010-05-01

    Young adults with attention deficit hyperactivity disorder (ADHD) are at higher risk for being involved in automobile crashes. Although driving simulators have been used to identify and understand underlying behaviors, prior research has focused largely on single-task, non-distracted driving. However, in-vehicle infotainment and communications systems often vie for a driver's attention, potentially increasing the risk of collision. This paper explores the impact of secondary tasks on individuals with and without ADHD, a medical condition known to affect the regulation of attention. Data are drawn from a validated driving simulation representing periods before, during, and after participation in a secondary cognitive task. A hands-free phone task was employed in a high stimulus, urban setting and a working memory task during low stimulus, highway driving. Drivers with ADHD had more difficulty on the telephone task, yet did not show an increased decrement in driving performance greater than control participants. In contrast, participants with ADHD showed a larger decline in driving performance than controls during a secondary task in a low demand setting. The results suggest that the interaction of the nature of the driving context and the secondary task has a significant influence on how drivers with ADHD allocate attention and, in-turn, on the relative impact on driving performance. Drivers with ADHD appear particularly susceptible to distraction during periods of low stimulus driving. PMID:20380911

  12. Adult attention deficit hyperactivity symptoms and psychosis: Epidemiological evidence from a population survey in England.

    PubMed

    Marwaha, Steven; Thompson, Andrew; Bebbington, Paul; Singh, Swaran P; Freeman, Daniel; Winsper, Catherine; Broome, Matthew R

    2015-09-30

    Despite both having some shared features, evidence linking psychosis and adult attention deficit hyperactivity disorder (ADHD) is sparse and inconsistent. Hypotheses tested were (1) adult ADHD symptoms are associated with auditory hallucinations, paranoid ideation and psychosis (2) links between ADHD symptoms and psychosis are mediated by prescribed ADHD medications, use of illicit drugs, and dysphoric mood. The Adult Psychiatric Morbidity Survey 2007 (N=7403) provided data for regression and multiple mediation analyses. ADHD symptoms were coded from the ADHD Self-Report Scale (ASRS). Higher ASRS total score was significantly associated with psychosis, paranoid ideation and auditory hallucinations despite controlling for socio-demographic variables, verbal IQ, autism spectrum disorder traits, childhood conduct problems, hypomanic and dysphoric mood. An ASRS score indicating probable ADHD diagnosis was also significantly associated with psychosis. The link between higher ADHD symptoms and psychosis, paranoia and auditory hallucinations was significantly mediated by dysphoric mood, but not by use of amphetamine, cocaine or cannabis. In conclusion, higher levels of adult ADHD symptoms and psychosis are linked and dysphoric mood may form part of the mechanism. Our analyses contradict the traditional clinical view that the main explanation for people with ADHD symptoms developing psychosis is illicit drugs. PMID:26235475

  13. Unwanted intrusive and worrisome thoughts in adults with Attention Deficit\\Hyperactivity Disorder.

    PubMed

    Abramovitch, Amitai; Schweiger, Avraham

    2009-08-15

    Attention Deficit/Hyperactivity Disorder (ADHD) is associated with deficient motor and cognitive inhibitory mechanisms. The aim of this article is to examine two symptoms associated with cognitive disinhibition, namely: intrusive unwanted thoughts, worrisome thoughts and their suppression. Thirty-seven college students diagnosed with ADHD and 23 healthy college students were compared on the Distressing Thoughts Questionnaire and on the Anxious Thoughts Inventory. Results show that in comparison to the control group, participants with ADHD experienced significantly higher ratings on all intrusive thoughts scales, and three worrisome thoughts scales. Our results suggest that worrisome intrusive thoughts are an important phenotypical expression of adults with ADHD. A neurobiological explanation for this phenomenon is suggested, and clinical implications are discussed. PMID:19570581

  14. Current Status of Cognitive Behavioral Therapy for Adult Attention-Deficit Hyperactivity Disorder

    PubMed Central

    Knouse, Laura E.; Safren, Steven A.

    2010-01-01

    Synopsis Attention-deficit / hyperactivity disorder (ADHD) is a valid and impairing psychological disorder that persists into adulthood in a majority of cases and is associated with chronic functional impairment and increased rates of comorbidity. Cognitive-behavioral therapy (CBT) approaches for this disorder have emerged relatively recently, and available evidence from open and randomized controlled trials suggests that these approaches are promising in producing significant symptom reduction. A conceptual model of how CBT may work for ADHD is reviewed along with existing efficacy studies. A preliminary comparison of effect sizes across intervention packages suggests that targeted learning and practice of specific behavioral compensatory strategies may be a critical “active ingredient” in CBT for adult ADHD. The article concludes with a discussion of future directions and critical questions that must be addressed in this area of clinical research. PMID:20599129

  15. A controlled study of a simulated workplace laboratory for adults with attention deficit hyperactivity disorder.

    PubMed

    Fried, Ronna; Surman, Craig; Hammerness, Paul; Petty, Carter; Faraone, Stephen; Hyder, Laran; Westerberg, Diana; Small, Jacqueline; Corkum, Lyndsey; Claudat, Kim; Biederman, Joseph

    2012-12-30

    Despite an extant literature documenting that adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for significant difficulties in the workplace, there is little documentation of the underlying factors associated with these impairments. The main aim of this study was to examine specific deficiencies associated with ADHD on workplace performance in a simulated workplace laboratory relative to controls. Participants were 56 non-medicated young adults with DSM-IV ADHD and 63 age- and sex-matched controls without ADHD. Participants spent 10h in a workplace simulation laboratory. Areas assessed included: (1) simulated tasks documented in a government report (SCANS) often required in workplace settings (taxing vigilance; planning; cooperation; attention to detail), (2) observer ratings, and (3) self-reports. Robust findings were found in the statistically significant differences on self-report of ADHD symptoms found between participants with ADHD and controls during all workplace tasks and periods of the workday. Task performance was found to be deficient in a small number of areas, and there were a few statistically significant differences identified by observer ratings. Symptoms reported by participants with ADHD in the simulation including internal restlessness, intolerance of boredom and difficulty maintaining vigilance were significant and could adversely impact workplace performance over the long-term. PMID:22608823

  16. A controlled study of a simulated workplace laboratory for adults with attention deficit hyperactivity disorder

    PubMed Central

    Fried, Ronna; Surman, Craig; Hammerness, Paul; Petty, Carter; Faraone, Stephen; Hyder, Laran; Westerberg, Diana; Small, Jacqueline; Corkum, Lyndsey; Claudat, Kim; Biederman, Joseph

    2012-01-01

    Despite an extant literature documenting that adults with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for significant difficulties in the workplace, there is little documentation of the underlying factors associated with these impairments. The main aim of this study was to examine specific deficiencies associated with ADHD on workplace performance in a simulated workplace laboratory relative to controls. Participants were 56 non-medicated young adults with DSM-IV ADHD and 63 age and sex matched controls without ADHD. Participants spent 10 hours in a workplace simulation laboratory. Areas assessed included: 1) simulated tasks documented in a government report (SCANS) often required in workplace settings (taxing vigilance; planning; cooperation; attention to detail), 2)observer ratings, and 3)self-reports. Robust findings were found in the statistically significant differences on self-report of ADHD symptoms found between participants with ADHD and controls during all workplace tasks and periods of the workday. Task performance was found to be deficient in a small number of areas and there were few statistically significant differences identified by observer ratings. Symptoms reported by participants with ADHD in the simulation including internal restlessness, intolerance of boredom and difficulty maintaining vigilance were significant and could adversely impact workplace performance over the long-term. PMID:22608823

  17. Response Inhibition in Adults with Autism Spectrum Disorder Compared to Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Johnston, Kate; Madden, Anya K.; Bramham, Jessica; Russell, Ailsa J.

    2011-01-01

    Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are hypothesised to involve core deficits in executive function. Previous studies have found evidence of a double dissociation between the disorders on specific executive functions (planning and response inhibition). To date most research has been conducted with…

  18. Visual function and color vision in adults with Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Kim, Soyeon; Chen, Samantha; Tannock, Rosemary

    2013-01-01

    Purpose Color vision and self-reported visual function in everyday life in young adults with Attention-Deficit/Hyperactivity Disorder (ADHD) were investigated. Method Participants were 30 young adults with ADHD and 30 controls matched for age and gender. They were tested individually and completed the Visual Activities Questionnaire (VAQ), Farnsworth-Munsell 100 Hue Test (FMT) and A Quick Test of Cognitive Speed (AQT). Results The ADHD group reported significantly more problems in 4 of 8 areas on the VAQ: depth perception, peripheral vision, visual search and visual processing speed. Further analyses of VAQ items revealed that the ADHD group endorsed more visual problems associated with driving than controls. Color perception difficulties on the FMT were restricted to the blue spectrum in the ADHD group. FMT and AQT results revealed slower processing of visual stimuli in the ADHD group. Conclusion A comprehensive investigation of mechanisms underlying visual function and color vision in adults with ADHD is warranted, along with the potential impact of these visual problems on driving performance. PMID:24646898

  19. Clinical assessment and treatment of attention deficit hyperactivity disorder in adults.

    PubMed

    Asherson, Philip

    2005-07-01

    Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder that frequently persists into adulthood, with significant levels of inattentive, hyperactive and impulsive behavior. Impairments associated with adult ADHD include distress from the symptoms, impaired ability to function in work and academic settings, and problems sustaining stable relationships. The disorder is commonly associated with volatile moods, antisocial behavior, and drug and alcohol misuse. There is an increased risk of developing comorbid anxiety, depression, personality disorders, and drug and alcohol dependence. Despite the proven effectiveness of drugs such as methylphenidate, dexamphetamine and atomoxetine, few cases of ADHD are recognized and treated in the UK. The reasons for this are unclear, since most psychiatrists working with children and adolescents are aware that ADHD commonly persists into adult life and they also see the disorder affecting parents of children with ADHD. Issues of transition from the care of child to adult psychiatry and the need to refer adult relatives of children with ADHD to suitable psychiatric services are a major concern. Furthermore, many cases of adult ADHD go unrecognized or are seen by mental health teams that are not familiar with the subtleties of the adult presentation. As a result, misdiagnosis and treatment for conditions such as atypical depression, mixed affective disorder, cyclothymia, and borderline and unstable emotional personality disorders is not uncommon. There is therefore a requirement for further training in this area. This review will describe the common clinical presentation and provide guidelines for the diagnosis and treatment of ADHD in adults. Any psychiatrically trained physician using standard psychiatric assessment procedures can perform clinical evaluations for adult ADHD. As with other psychiatric disorders in adulthood, ADHD has its own characteristic onset, course and psychopathology. Symptoms of ADHD are

  20. Association Between Adult Attention Deficit/Hyperactivity Disorder and Obesity in the US Population

    PubMed Central

    Pagoto, S. L.; Curtin, C.; Lemon, S. C.; Bandini, L. G.; Schneider, K. L.; Bodenlos, J. S.; Ma, Y.

    2011-01-01

    Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder that affects approximately 2.9%–4.7% of US adults. Studies have revealed high rates of ADHD (26 – 61%) in patients seeking weight loss treatment suggesting an association between ADHD and obesity. The objective of the present study was to test the association between ADHD and overweight and obesity in the US population. Cross-sectional data from the Collaborative Psychiatric Epidemiology Surveys were used. Participants were 6,735 U.S. residents (63.9% Caucasian; 51.6% female) aged 18 to 44. A retrospective assessment of childhood ADHD and a self-report assessment of adult ADHD were administered. Diagnosis was defined by three categories: never met diagnostic criteria, met full childhood criteria with no current symptoms, and met full childhood criteria with current symptoms. The prevalence of overweight and obesity was 33.9% and 29.4%, respectively, among adults with ADHD, and 28.8% and 21.6%, respectively, among persons with no history of ADHD. Adult ADHD was associated with greater likelihood of overweight, [odds ratio (OR)=1.58; 95% confidence interval (CI)=1.05, 2.38] and obesity (OR=1.81; 95% CI=1.14, 2.64). Results were similar when adjusting for demographic characteristics and depression. Mediation analyses suggest that binge eating disorder, but not depression, partially mediates the associations between ADHD and both overweight and obesity. Results suggest that adult ADHD is associated with overweight and obesity. PMID:19131944

  1. Psychometric evaluation of the Sheehan Disability Scale in adult patients with attention-deficit/hyperactivity disorder.

    PubMed

    Coles, Theresa; Coon, Cheryl; DeMuro, Carla; McLeod, Lori; Gnanasakthy, Ari

    2014-01-01

    Inattention and impulsivity symptoms are common among adults with attention-deficit/hyperactivity disorder (ADHD), which can lead to difficulty concentrating, restlessness, difficulty completing tasks, disorganization, impatience, and impulsiveness. Many adults with ADHD find it difficult to focus and prioritize. Resulting outcomes, such as missed deadlines and forgotten engagements, may ultimately impact the ability to function at work, school, home, or in a social environment. The European Medicines Agency guidelines for evaluating medicinal products for ADHD recommend inclusion of both functional outcomes, such as school, social, or work functioning, and outcomes related to symptoms of ADHD in clinical studies of novel medication primary efficacy endpoints. Due to its performance in other disease areas and the relevance of its items as evidenced by content validity analyses, the Sheehan Disability Scale (SDS) was chosen to assess functional impairment in ADHD. The aim of this study was to investigate the psychometric properties of the SDS, used as a brief measure of functional impairment in a number of psychiatric disorders, in adult patients with ADHD. To the authors' knowledge, this is the first study to evaluate the reliability of the SDS (based on Cronbach's coefficient alpha and test-retest reliability), its validity (construct and known-groups validity), and its ability to detect change in this patient population. This study also established a preliminary responder definition for the SDS in this study population to determine when change can be considered clinically beneficial in a clinical trial setting. The psychometric results support the use of the SDS subscales (items 1-3) and total score (sum of items 1-3) in an ADHD population. In addition, the evaluation provides evidence for a three-point preliminary responder definition for the SDS and further evidence of its responsiveness in adults with ADHD. Altogether, the results indicate that the SDS is a

  2. White matter microstructure and the variable adult outcome of childhood attention deficit hyperactivity disorder.

    PubMed

    Shaw, Philip; Sudre, Gustavo; Wharton, Amy; Weingart, Daniel; Sharp, Wendy; Sarlls, Joelle

    2015-02-01

    Changes in cerebral cortical anatomy have been tied to the clinical course of attention deficit hyperactivity disorder (ADHD). We now ask if alterations in white matter tract microstructure are likewise linked with the adult outcome of childhood ADHD. Seventy-five young adults, 32 with ADHD persisting from childhood and 43 with symptom remission were contrasted against 74 never-affected comparison subjects. Using diffusion tensor imaging, we defined fractional anisotropy, a metric related to white matter microstructure, along with measures of diffusion perpendicular (radial) and parallel (axial) to the axon. Analyses were adjusted for head motion, age and sex, and controlled for multiple comparisons and medication history. Tract-based analyses showed that greater adult inattention, but not hyperactivity-impulsivity, was associated with significantly lower fractional anisotropy in the left uncinate (standardized β=-0.37, t=3.28, p=0.002) and inferior fronto-occipital fasciculi (standardized β=-0.37, t=3.29, p=0.002). The ADHD group with symptoms persisting into adulthood had significantly lower fractional anisotropy than the never-affected controls in these tracts, differences associated with medium to large effect sizes. By contrast, the ADHD group that remitted by adulthood did not differ significantly from controls. The anomalies were found in tracts that connect components of neural systems pertinent to ADHD, such as attention control (inferior fronto-occipital fasciculus) and emotion regulation and the processing of reward (the uncinate fasciculus). Change in radial rather than axial diffusivity was the primary driver of this effect, suggesting pathophysiological processes including altered myelination as future targets for pharmacological and behavioral interventions. PMID:25241803

  3. White Matter Microstructure and the Variable Adult Outcome of Childhood Attention Deficit Hyperactivity Disorder

    PubMed Central

    Shaw, Philip; Sudre, Gustavo; Wharton, Amy; Weingart, Daniel; Sharp, Wendy; Sarlls, Joelle

    2015-01-01

    Changes in cerebral cortical anatomy have been tied to the clinical course of attention deficit hyperactivity disorder (ADHD). We now ask if alterations in white matter tract microstructure are likewise linked with the adult outcome of childhood ADHD. Seventy-five young adults, 32 with ADHD persisting from childhood and 43 with symptom remission were contrasted against 74 never-affected comparison subjects. Using diffusion tensor imaging, we defined fractional anisotropy, a metric related to white matter microstructure, along with measures of diffusion perpendicular (radial) and parallel (axial) to the axon. Analyses were adjusted for head motion, age and sex, and controlled for multiple comparisons and medication history. Tract-based analyses showed that greater adult inattention, but not hyperactivity–impulsivity, was associated with significantly lower fractional anisotropy in the left uncinate (standardized β=−0.37, t=3.28, p=0.002) and inferior fronto-occipital fasciculi (standardized β=−0.37, t=3.29, p=0.002). The ADHD group with symptoms persisting into adulthood had significantly lower fractional anisotropy than the never-affected controls in these tracts, differences associated with medium to large effect sizes. By contrast, the ADHD group that remitted by adulthood did not differ significantly from controls. The anomalies were found in tracts that connect components of neural systems pertinent to ADHD, such as attention control (inferior fronto-occipital fasciculus) and emotion regulation and the processing of reward (the uncinate fasciculus). Change in radial rather than axial diffusivity was the primary driver of this effect, suggesting pathophysiological processes including altered myelination as future targets for pharmacological and behavioral interventions. PMID:25241803

  4. Does Response Variability Predict Distractibility among Adults with Attention-Deficit/Hyperactivity Disorder?

    ERIC Educational Resources Information Center

    Adams, Zachary W.; Roberts, Walter M.; Milich, Richard; Fillmore, Mark T.

    2011-01-01

    Increased intraindividual variability in response time (RTSD) has been observed reliably in attention-deficit/hyperactivity disorder (ADHD) and has often been used as a measure of inattention. RTSD is assumed to reflect attentional lapses and distractibility, though evidence for the validity of this connection is lacking. We assessed whether RTSD…

  5. Diminished testing benefits in young adults with attention-deficit hyperactivity disorder.

    PubMed

    Dudukovic, Nicole M; Gottshall, Jackie L; Cavanaugh, Patricia A; Moody, Christine T

    2015-01-01

    Memory retrieval has been shown to enhance the long-term retention of tested material; however, recent research suggests that limiting attention during retrieval can decrease the benefits of testing memory. The present study examined whether testing benefits are reduced in young adults with attention-deficit hyperactivity disorder (ADHD). College students with and without ADHD read three short prose passages, each followed by a free recall test, a restudy period or a distractor task. Two days later participants recalled the passages. Although participants without ADHD did not show a significant benefit of testing over restudying, testing did produce recall benefits relative to not taking a test. These testing benefits were diminished in participants with ADHD, who did not show any advantage of testing over either restudying or no test. The absence of testing benefits in the ADHD group is likely due in part to decreased recall on the initial test. These findings have implications for improving educational practices among individuals with ADHD and also speak to the need to examine individual differences in the effectiveness of testing as a learning strategy. PMID:25385006

  6. Comorbidity of Personality Disorders and Adult Attention Deficit Hyperactivity Disorder (ADHD)--Review of Recent Findings.

    PubMed

    Matthies, Swantje; Philipsen, Alexandra

    2016-04-01

    Children suffering from attention deficit hyperactivity disorder (ADHD) may remit until adulthood. But, more than 60-80% have persisting ADHD symptoms. ADHD as an early manifesting neurodevelopmental disorder is considered a major risk factor for the development of comorbid psychiatric disorders in later life. Particularly, personality disorders are oftentimes observed in adult patients suffering from ADHD. If ADHD and personality disorders share common etiological mechanisms and/or if ADHD as a severely impairing condition influences psychological functioning and learning and leads to unfavorable learning histories is unclear. The development of inflexible and dysfunctional beliefs on the basis of real and perceived impairments or otherness due to the core symptoms of ADHD is intuitively plausible. Such beliefs are a known cause for the development of personality disorders. But, why some personality disorders are more frequently found in ADHD patients as for example antisocial and borderline personality disorder remains subject of debate. Because of the high prevalence of ADHD and the high impact of personality disorders on daily functioning, it is important to take them into account when treating patients with ADHD. Research on the developmental trajectories leading to personality disorders in adult ADHD patients might open the door for targeted interventions to prevent impairing comorbid clinical pictures. PMID:26893231

  7. Living in Chaos and Striving for Control: How Adults with Attention Deficit Hyperactivity Disorder Deal with Their Disorder

    ERIC Educational Resources Information Center

    Toner, Michele; O'Donoghue, Thomas; Houghton, Stephen

    2006-01-01

    This article reports a Grounded Theory of "Living in Chaos and Striving for Control" developed in response to the central research question of how adults diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) deal with their disorder. Semi-structured interviews were conducted with 10 males diagnosed with ADHD in adulthood. "Chaos" emerged…

  8. [Awareness of adult attention-deficit/hyperactivity disorder (ADHD) in Greece].

    PubMed

    Pehlivanidis, A

    2012-06-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopment disorder of childhood that persists into adulthood in the majority of cases. In adults, the clinical picture of ADHD is complex and comorbidity with other psychiatric disorders is the rule. The documentation that the disorder had a childhood onset and the various comorbid symptomatologies present both in childhood and adult life represent the most influential obstacles for the accurate clinical diagnosis of the disorder. In 75% of cases with adult ADHD there is at least one coexisting comorbid disorder, with anxiety and mood disorders as well as substance abuse and impulse control disorders being the most prevalent ones. Adult psychiatrists have limited experience in the diagnosis, treatment and overall management of the disorder. Greece is a member of the European Network Adult ADHD (ENAA), founded in 2003, aiming to increase awareness of the disorder and to improve knowledge and patient care for adults with ADHD across Europe. A clinic where diagnosis as well as treatment recommendations are given after a thorough assessment of adult ADHD patients, is hosted at the First Department of Psychiatry of the Athens National and Kapodistian University. The clinic is in close collaboration with ENAA. The diagnosis of ADHD is given after a detailed evaluation of the patient, based on history taken, self-administered questionnaires and a specific psychiatric interview. The reliable trace of the symptoms' onset back in early childhood, current symptomatology, as well as its impact on at least two major areas of functioning (school, home, work or personal relationships) are pivotal for the assessment procedure. Special attention should be paid in the distinction of symptoms often coexisting with the core symptoms of the ADHD, such as emotional liability, incessant mental activity, avoidance of situations like queuing, especially when there is also frustration, from those indicating a comorbid

  9. Methylphenidate in Adults with Attention Deficit Hyperactivity Disorder and Substance Use Disorders.

    PubMed

    Simon, Nicolas; Rolland, Benjamin; Karila, Laurent

    2015-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopment disorder occurring during childhood. However, ADHD persists into adulthood in 45.7% of cases. The global prevalence of adult ADHD is estimated to 5.3%, with no difference between Europe and North America. ADHD is often comorbid with substance use disorder (SUD), with Odds Ratio ranges from 1.5 to 7.9, depending on the substance and the dependence level. Conversely, the prevalence of ADHD among patients with SUD is 10.8%, versus 3.8% for patients without SUD. Methylphenidate (MPH) alleviates ADHD symptoms and, as such, is currently considered as a first choice medication. MPH blocks the dopamine and norepinephrine transporters leading to an increase in extracellular dopamine. It should be noted that its subjective effects are highly dependent on the pharmacokinetic and especially on the rate of input, which highlights the importance of choosing a sustained-release formulation. Meanwhile, prescribing MPH to patients with comorbid SUD has always been challenging for clinicians. The aim of this review is to address the benefits and pitfalls of using MPH in adults with ADHD comorbid SUD, depending on each of the following types of SUD: amphetamine, cocaine, nicotine, alcohol, cannabis and opiates. Overall, due to the prevalence of ADHD in SUD and to the benefits of MPH observed in this population, and considering the mild or low side effects observed, the response to MPH treatment should be evaluated individually in adults with comorbid ADHD and SUD. The choice of the formulation should favor sustained- release MPH over immediate release MPH. Cardiovascular parameters also have to be monitored during long-term use. PMID:26088112

  10. Emotional bias of cognitive control in adults with childhood attention-deficit/hyperactivity disorder.

    PubMed

    Schulz, Kurt P; Bédard, Anne-Claude V; Fan, Jin; Clerkin, Suzanne M; Dima, Danai; Newcorn, Jeffrey H; Halperin, Jeffrey M

    2014-01-01

    Affect recognition deficits found in individuals with attention-deficit/hyperactivity disorder (ADHD) across the lifespan may bias the development of cognitive control processes implicated in the pathophysiology of the disorder. This study aimed to determine the mechanism through which facial expressions influence cognitive control in young adults diagnosed with ADHD in childhood. Fourteen probands with childhood ADHD and 14 comparison subjects with no history of ADHD were scanned with functional magnetic resonance imaging while performing a face emotion go/no-go task. Event-related analyses contrasted activation and functional connectivity for cognitive control collapsed over face valence and tested for variations in activation for response execution and inhibition as a function of face valence. Probands with childhood ADHD made fewer correct responses and inhibitions overall than comparison subjects, but demonstrated comparable effects of face emotion on response execution and inhibition. The two groups showed similar frontotemporal activation for cognitive control collapsed across face valence, but differed in the functional connectivity of the right dorsolateral prefrontal cortex, with fewer interactions with the subgenual cingulate cortex, inferior frontal gyrus, and putamen in probands than in comparison subjects. Further, valence-dependent activation for response execution was seen in the amygdala, ventral striatum, subgenual cingulate cortex, and orbitofrontal cortex in comparison subjects but not in probands. The findings point to functional anomalies in limbic networks for both the valence-dependent biasing of cognitive control and the valence-independent cognitive control of face emotion processing in probands with childhood ADHD. This limbic dysfunction could impact cognitive control in emotional contexts and may contribute to the social and emotional problems associated with ADHD. PMID:24918067

  11. Psychometric evaluation of the Sheehan Disability Scale in adult patients with attention-deficit/hyperactivity disorder

    PubMed Central

    Coles, Theresa; Coon, Cheryl; DeMuro, Carla; McLeod, Lori; Gnanasakthy, Ari

    2014-01-01

    Inattention and impulsivity symptoms are common among adults with attention-deficit/hyperactivity disorder (ADHD), which can lead to difficulty concentrating, restlessness, difficulty completing tasks, disorganization, impatience, and impulsiveness. Many adults with ADHD find it difficult to focus and prioritize. Resulting outcomes, such as missed deadlines and forgotten engagements, may ultimately impact the ability to function at work, school, home, or in a social environment. The European Medicines Agency guidelines for evaluating medicinal products for ADHD recommend inclusion of both functional outcomes, such as school, social, or work functioning, and outcomes related to symptoms of ADHD in clinical studies of novel medication primary efficacy endpoints. Due to its performance in other disease areas and the relevance of its items as evidenced by content validity analyses, the Sheehan Disability Scale (SDS) was chosen to assess functional impairment in ADHD. The aim of this study was to investigate the psychometric properties of the SDS, used as a brief measure of functional impairment in a number of psychiatric disorders, in adult patients with ADHD. To the authors’ knowledge, this is the first study to evaluate the reliability of the SDS (based on Cronbach’s coefficient alpha and test-retest reliability), its validity (construct and known-groups validity), and its ability to detect change in this patient population. This study also established a preliminary responder definition for the SDS in this study population to determine when change can be considered clinically beneficial in a clinical trial setting. The psychometric results support the use of the SDS subscales (items 1–3) and total score (sum of items 1–3) in an ADHD population. In addition, the evaluation provides evidence for a three-point preliminary responder definition for the SDS and further evidence of its responsiveness in adults with ADHD. Altogether, the results indicate that the SDS

  12. Normal Neurochemistry in the Prefrontal and Cerebellar Brain of Adults with Attention-Deficit Hyperactivity Disorder

    PubMed Central

    Endres, Dominique; Perlov, Evgeniy; Maier, Simon; Feige, Bernd; Nickel, Kathrin; Goll, Peter; Bubl, Emanuel; Lange, Thomas; Glauche, Volkmar; Graf, Erika; Ebert, Dieter; Sobanski, Esther; Philipsen, Alexandra; Tebartz van Elst, Ludger

    2015-01-01

    Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. In an attempt to extend earlier neurochemical findings, we organized a magnetic resonance spectroscopy (MRS) study as part of a large, government-funded, prospective, randomized, multicenter clinical trial comparing the effectiveness of specific psychotherapy with counseling and stimulant treatment with placebo treatment (Comparison of Methylphenidate and Psychotherapy Study). We report the baseline neurochemical data for the anterior cingulate cortex (ACC) and the cerebellum in a case–control setting. For the trial, 1,480 adult patients were contacted for participation, 518 were assessed for eligibility, 433 were randomized, and 187 were potentially eligible for neuroimaging. The control group included 119 healthy volunteers. Single-voxel proton MRS was performed. In the patient group, 113 ACC and 104 cerebellar spectra fulfilled all quality criteria for inclusion in statistical calculations, as did 82 ACC and 78 cerebellar spectra in the control group. We did not find any significant neurometabolic differences between the ADHD and control group in the ACC (Wilks’ lambda test: p = 0.97) or in the cerebellum (p = 0.62). Thus, we were unable to replicate earlier findings in this methodologically sophisticated study. We discuss our findings in the context of a comprehensive review of other MRS studies on ADHD and a somewhat skeptical neuropsychiatric research perspective. As in other neuropsychiatric disorders, the unclear nosological status of ADHD might be an explanation for false-negative findings. PMID:26441572

  13. Associations of Attention-Deficit Hyperactivity Disorder Symptom Dimensions with Smoking Deprivation Effects in Adult Smokers

    PubMed Central

    Bidwell, L. Cinnamon; Ameringer, Katherine J.; Leventhal, Adam M.

    2014-01-01

    Identifying relations of Attention-Deficit Hyperactivity Disorder (ADHD) symptom dimensions to individual facets of the tobacco withdrawal syndrome could elucidate the mechanisms linking ADHD and regular smoking. This study examined the unique relations of inattention (IN) and hyperactivity-impulsivity (HI) symptom dimensions of ADHD to a variety of tobacco withdrawal symptoms. 132 community-dwelling adult smokers recruited without regard to ADHD status completed a self-report measure of ADHD symptoms experienced over the past 6 months at a baseline visit. At two subsequent experimental sessions (one following overnight tobacco deprivation and one nondeprived; order counterbalanced), participants completed measures of tobacco withdrawal symptoms, mood, and desire to smoke. Preliminary analyses showed that higher levels of IN and HI symptoms were both associated with higher levels of negative affect and concentration difficulties during nondeprived (“baseline”) states (Ps < .01). Over and above nondeprived ratings, higher levels of HI symptoms were associated with larger deprivation-induced increases in negative affect, concentration problems, and desire to smoke, particularly for negative affect relief, during deprived states (Ps < .01). ADHD symptoms, particularly HI symptoms, are associated with more severe exacerbations in abstinence-induced withdrawal symptoms, which could be an important mechanism of ADHD-smoking comorbidity. These findings suggest the need for clinical studies examining the role of these unique and potentially more severe withdrawal profiles experienced by smokers with high-levels of ADHD symptoms in smoking reinstatement and cessation outcomes. PMID:24731115

  14. Association of VAMP-2 and Syntaxin 1A Genes with Adult Attention Deficit Hyperactivity Disorder

    PubMed Central

    Kenar, Aẙe Nur Inci; Ay, Özlem İzci; Erdal, Mehmet Emin

    2014-01-01

    Objective The etiology of attention deficit hyperactivity disorder (ADHD) has not been entirely clarified yet. Structural and metabolic differences at the prefrontal striatal cerebellary system and the interaction of gene and environment are the main factors that thought to play roles in the etiology. Genetic investigations are performed especially about the dopamine pathways and receptors. In this study; it was aimed to investigate the association of the synaptobrevin-2 (VAMP-2) gene Ins/Del polymorphism and syntaxin 1A gene intron 7 polymorphism, which take place in encoding presynaptic protein, with adult ADHD. Methods One hundred thirty-nine patients, having ADHD aging between 18 and 60 years and 106 healthy people as controls were included into the study. DNA samples were extracted from whole blood and genetic analysis were performed. Results A significant difference was determined between ADHD and VAMP-2 Ins/Del polymorphism and syntaxin 1A intron 7 polymorphism according to the control group. These polymorphisms were found not to be associated with subtypes of ADHD. Conclusion It is supposed that synaptic protein genes together with dopaminergic genes might have roles in the etiology of ADHD. PMID:24605127

  15. Childhood Attention Deficit Hyperactivity Disorder, Substance Use, and Adult Functioning Among Incarcerated Women

    PubMed Central

    Hennessey, Kathleen A.; Stein, Michael D.; Rosengard, Cynthia; Rose, Jennifer S.; Clarke, Jennifer G.

    2016-01-01

    Objective To estimate prevalence of childhood Attention Deficit Hyperactivity Disorder (ADHD) among incarcerated females and determine its association with substance use and adult functioning. Method 192 female participants were recruited from the Department of Corrections in Rhode Island. Childhood ADHD was defined as scoring >46 on the Wender Utah Rating Scale. Results 46% met criteria for childhood ADHD. Multivariate analysis revealed that women meeting WURS criteria were more likely to be inconsistently employed (OR = 0.23, 95% CI = 0.10 – 0.54), recently homeless (OR = 2.09, 95% CI = 1.02 – 4.30), lifetime incarceration of more than 90 days (OR = 3.00, 95% CI = 1.37 – 6.57), current smokers (OR = 2.99, 95% CI = 1.24 – 7.20) and ever used marijuana regularly (OR = 3.47, 95% CI = 1.61 – 7.45). Conclusion Among incarcerated females, childhood ADHD is associated with negative social and health behaviors. PMID:19773601

  16. Priming Sentence Production in Adolescents and Adults with Attention-Deficit/Hyper-Activity Disorder

    ERIC Educational Resources Information Center

    Engelhardt, Paul E.; Ferreira, Fernanda; Nigg, Joel T.

    2009-01-01

    Theoretical accounts of attention-deficit/hyperactivity disorder (ADHD) posit a prominent role for problems in response inhibition (Nigg 2006). A key avenue for impulsivity in children with ADHD is inappropriate language expression. In this study, we sought to determine whether poor inhibitory control affects language production in adolescents and…

  17. Economic Impact of Childhood and Adult Attention-Deficit/Hyperactivity Disorder in the United States

    ERIC Educational Resources Information Center

    Doshi, Jalpa A.; Hodgkins, Paul; Kahle, Jennifer; Sikirica, Vanja; Cangelosi, Michael J.; Setyawan, Juliana; Erder, M. Haim; Neumann, Peter J.

    2012-01-01

    Objective: Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent mental disorders in children in the United States and often persists into adulthood with associated symptomatology and impairments. This article comprehensively reviews studies reporting ADHD-related incremental (excess) costs for children/adolescents and…

  18. Contribution of organizational strategy to verbal learning and memory in adults with attention-deficit/hyperactivity disorder.

    PubMed

    Roth, Robert M; Wishart, Heather A; Flashman, Laura A; Riordan, Henry J; Huey, Leighton; Saykin, Andrew J

    2004-01-01

    Statistical mediation modeling was used to test the hypothesis that poor use of a semantic organizational strategy contributes to verbal learning and memory deficits in adults with attention-deficit/hyperactivity disorder (ADHD). Comparison of 28 adults with ADHD and 34 healthy controls revealed lower performance by the ADHD group on tests of verbal learning and memory, sustained attention, and use of semantic organization during encoding. Mediation modeling indicated that state anxiety, but not semantic organization, significantly contributed to the prediction of both learning and delayed recall in the ADHD group. The pattern of findings suggests that decreased verbal learning and memory in adult ADHD is due in part to situational anxiety and not to poor use of organizational strategies during encoding. PMID:14744190

  19. Adults with Dyslexia Show Deficits on Spatial Frequency Doubling and Visual Attention Tasks

    ERIC Educational Resources Information Center

    Buchholz, Judy; McKone, Elinor

    2004-01-01

    We examine the visual processing of high-functioning adults with developmental dyslexia (mean Performance IQ=126.5) and current phonological problems. In comparison to an age- and IQ-matched control group, the group with dyslexia showed deficits in two tasks associated with magnocellular/dorsal pathway function. For the "frequency doubling"…

  20. Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder: Attrition and Change During Long-term Treatment.

    PubMed

    Gift, Thomas E; Reimherr, Frederick W; Marchant, Barrie K; Steans, Tammy A; Wender, Paul H

    2016-05-01

    Personality disorders (PDs) are commonly found in adults with attention-deficit/hyperactivity disorder (ADHD) and are associated with increased ADHD symptoms and psychosocial impairment. To assess the impact of PDs or personality traits on retention rates in ADHD trials and whether treating ADHD affects the expression of PD, data were analyzed from 2 methylphenidate trials. Assessment of PDs and personality traits included using the Wisconsin Personality Disorders Inventory IV and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Personality Disorders. Attention-deficit/hyperactivity disorder symptoms were evaluated using the Wender-Reimherr Adult Attention Deficit Disorder Scale. Major findings were that subjects with cluster A, cluster B, passive-aggressive, or more than 1 PD showed more attrition. Subjects dropping out also had more schizoid and narcissistic traits. Attention-deficit/hyperactivity disorder symptoms (p < 0.001) and all personality traits (range, p = 0.03 to p = 0.001) improved, but there was almost no correlation between changes on these 2 measures. Conversely, of 11 Wisconsin Personality Disorders Inventory IV items that improved most, 8 resembled ADHD or oppositional defiant disorder symptoms. PMID:27082828

  1. Validating the measurement of executive functions in an occupational context for adults with attention deficit hyperactivity disorder.

    PubMed

    Stern, Adi; Maeir, Adina

    2014-01-01

    OBJECTIVE. The objectives of this study were to better understand the cognitive profile of adults with attention deficit hyperactivity disorder (ADHD), their occupational performance, and their quality of life (QoL) and to examine the validity of a cognitive-functional evaluation (CFE) battery for these adults. METHOD. Eighty-one adults with ADHD and 58 without ADHD completed ADHD symptom ratings, the Behavior Rating Inventory of Executive Function-Adult Version, and the Adult ADHD Quality-of-Life Scale. An occupational performance interview was administered to the ADHD group. RESULTS. A broad range of occupational concerns were reported. We found significant differences between groups on all measures. In the ADHD group, we found medium significant correlations among the measures. CONCLUSION. Adults with ADHD experience cognitive and functional difficulties in their daily lives associated with QoL. The results support the use of a CFE battery that has been shown to be sensitive and specific for these adults. PMID:25397767

  2. Attention Deficit Hyperactivity Disorder Basics

    MedlinePlus

    ... us to find out more about ADHD. Share Attention Deficit Hyperactivity Disorder Basics Download PDF Download ePub Order a free ... attention deficit/hyperactivity disorder , or ADHD . What is attention deficit/hyperactivity disorder, or ADHD? ADHD is a common mental disorder ...

  3. Adult attention-deficit hyperactivity disorder, risky behaviors, and motorcycle injuries: a case-control study

    PubMed Central

    Sadeghi-Bazargani, Homayoun; Abedi, Leili; Mahini, Minoo; Amiri, Shahrokh; Khorasani-Zavareh, Davoud

    2015-01-01

    Background The aim of this study was to assess the association of motorcycle traffic injuries with motorcycle riding behavior and subtypes of attention-deficit hyperactivity disorder (ADHD) while controlling for individual correlates of motorcycle traffic injuries. Methods A case-control study was carried out in 298 patients with motorcycle trauma along with 151 control patients admitted to the Shohada and Imam Reza university hospitals as the two referral specialty centers in the East Azarbyjan Province of Iran in 2013. The Persian version of the Motorcycle Riding Behavior Questionnaire and the Persian version of Conner’s Adult ADHD Rating Scales (the self-report short version) were used to assess riding behavior and screen for adult ADHD, respectively. The scale has four subscales, comprising subscale A (inattention), subscale B (hyperactivity, impulsivity), subscale C (A + C), and subscale D (ADHD index). The statistical analysis was done using Stata version 11. Results All subjects were male and aged 13–79 years. Approximately 54% of the participants were married and 13% had academic education. Approximately 18% of the motorcycle riders stated that their motorcycle riding was only for fun purposes. More than two thirds of the participants did not have a motorcycle riding license. Variables found to be significantly associated with motorcycle injuries in bivariate analysis included age, marital status, educational level, having a motorcycle riding license, using a helmet while riding, daily amount of riding, riding just for fun, riding behavior score, and ADHD scale scores. It was found in multivariate analysis that if the ADHD index (subscale D) score was used to assess the association of ADHD with motorcycle injuries, a protective role for ADHD was observed. However, the two other subscales showed a different predictive pattern for subscale A versus subscale B, with only subscale B increasing the likelihood of motorcycle traffic injuries. The score based

  4. Parenting in adults with attention-deficit/hyperactivity disorder (ADHD)☆

    PubMed Central

    Johnston, Charlotte; Mash, Eric J.; Miller, Natalie; Ninowski, Jerilyn E.

    2013-01-01

    Although the validity of adult ADHD is well established and research has identified a variety of impairments associated with the condition in adults, study of how ADHD impacts an adult’s ability to parent has been relatively neglected. Parenting is a particularly important domain of functioning given the familial nature of the disorder and emerging evidence that parenting behaviors play a role in the development or maintenance of child ADHD symptoms, comorbid psychopathologies, and other associated difficulties. In this paper, we focus on three broad categories of cognitive dysfunction proposed across models of ADHD — cognitive processes (e.g., working memory, planning, and inhibitory control), self-regulation deficits (e.g., self-monitoring of performance to detect errors or the need for regulation of behavior and/or emotions), and motivational or arousal difficulties (e.g., response to incentives, delay aversion). We consider how these deficits may lead to impairments in the parenting behaviors of effective behavioral control and emotional responsiveness, and review the available evidence regarding parenting in adults with ADHD symptoms. We conclude by noting the limitations in existing studies, and argue for further research that is theoretically grounded in how core deficits of ADHD may be related to dimensions of parenting. The implications of an improved understanding of how ADHD impacts parenting for the development of early intervention or prevention programs are outlined. PMID:22459785

  5. Dissociations between developmental dyslexias and attention deficits

    PubMed Central

    Lukov, Limor; Friedmann, Naama; Shalev, Lilach; Khentov-Kraus, Lilach; Shalev, Nir; Lorber, Rakefet; Guggenheim, Revital

    2014-01-01

    We examine whether attention deficits underlie developmental dyslexia, or certain types of dyslexia, by presenting double dissociations between the two. We took into account the existence of distinct types of dyslexia and of attention deficits, and focused on dyslexias that may be thought to have an attentional basis: letter position dyslexia (LPD), in which letters migrate within words, attentional dyslexia (AD), in which letters migrate between words, neglect dyslexia, in which letters on one side of the word are omitted or substituted, and surface dyslexia, in which words are read via the sublexical route. We tested 110 children and adults with developmental dyslexia and/or attention deficits, using extensive batteries of reading and attention. For each participant, the existence of dyslexia and the dyslexia type were tested using reading tests that included stimuli sensitive to the various dyslexia types. Attention deficit and its type was established through attention tasks assessing sustained, selective, orienting, and executive attention functioning. Using this procedure, we identified 55 participants who showed a double dissociation between reading and attention: 28 had dyslexia with normal attention and 27 had attention deficits with normal reading. Importantly, each dyslexia with suspected attentional basis dissociated from attention: we found 21 individuals with LPD, 13 AD, 2 neglect dyslexia, and 12 surface dyslexia without attention deficits. Other dyslexia types (vowel dyslexia, phonological dyslexia, visual dyslexia) also dissociated from attention deficits. Examination of 55 additional individuals with both a specific dyslexia and a certain attention deficit found no attention function that was consistently linked with any dyslexia type. Specifically, LPD and AD dissociated from selective attention, neglect dyslexia dissociated from orienting, and surface dyslexia dissociated from sustained and executive attention. These results indicate that

  6. Postural sway and regional cerebellar volume in adults with attention-deficit/hyperactivity disorder

    PubMed Central

    Hove, Michael J.; Zeffiro, Thomas A.; Biederman, Joseph; Li, Zhi; Schmahmann, Jeremy; Valera, Eve M.

    2015-01-01

    Objective Motor abnormalities, including impaired balance and increased postural sway, are commonly reported in children with ADHD, but have yet to be investigated in adults with ADHD. Furthermore, although these abnormalities are thought to stem from cerebellar deficits, evidence for an association between the cerebellum and these motor deficits has yet to be provided for either adults or children with ADHD. Method In this study, we measured postural sway in adults with ADHD and controls, examining the relationship between sway and regional cerebellar gray matter volume. Thirty-two ADHD and 28 control participants completed various standing-posture tasks on a Wii balance board. Results Postural sway was significantly higher for the ADHD group compared to the healthy controls. Higher sway was positively associated with regional gray matter volume in the right posterior cerebellum (lobule VIII/IX). Conclusion These findings show that sway abnormalities commonly reported in children with ADHD are also present in adults, and for the first time show a relationship between postural control atypicalities and the cerebellum in this group. Our findings extend the literature on motor abnormalities in ADHD and contribute to our knowledge of their neural substrate. PMID:26106567

  7. The Validity of a Battery of Phonemic and Orthographic Awareness Tasks for Adults with and without Dyslexia and Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Gregg, Noel; Bandalos, Deborah L.; Coleman, Chris; Davis, J. Mark; Robinson, Kelly; Blake, Jamilia

    2008-01-01

    The vast majority of adults with learning disabilities are those with deficits affecting reading decoding, reading and writing fluency, and spelling. Many adults with Attention Deficit/Hyperactivity Disorder (AD/HD) also demonstrate problems with reading and writing. Documenting the underlying reasons for reading underachievement among these…

  8. Attention deficit hyperactivity disorder.

    PubMed

    Kulkarni, Madhuri

    2015-03-01

    Attention Deficit Hyperactivity Disorder (ADHD) is a common behavioral disorder in children. It is characterized by motor hyperactivity, impulsivity and inattention inappropriate for the age. Approximately 5-10 % of school age children are diagnosed to have ADHD. The affected children show significant impairment in social behavior and academic performance. The DSM-5 criteria are useful in diagnosing three subtypes of ADHD based on presence of symptoms described in 3 domains viz ., inattention, hyperactivity and impulsivity. Co-morbidities like specific learning disability, anxiety disorder, oppositional defiant disorder are commonly associated with ADHD.Education of parents and teachers, behavioral therapy and medication are main components of management. Methylphenidate and Atomoxetine are effective in controlling symptoms of ADHD in most children. Research studies estimated that 30-60 % of children continue to show symptoms of ADHD in adulthood. The general practitioner can play an important role in early diagnosis, appropriate assessment and guiding parents for management of children with ADHD. PMID:25186567

  9. Attention Deficit Hyperactivity Disorder

    PubMed Central

    Matthews, Marguerite; Nigg, Joel T.

    2014-01-01

    Over the last two decades, there have been numerous technical and methodological advances available to clinicians and researchers to better understand attention deficit hyperactivity disorder (ADHD) and its etiology. Despite the growing body of literature investigating the disorder’s pathophysiology, ADHD remains a complex psychiatric disorder to characterize. This chapter will briefly review the literature on ADHD, with a focus on its history, the current genetic insights, neurophysiologic theories, and the use of neuroimaging to further understand the etiology. We address some of the major concerns that remain unclear about ADHD, including subtype instability, heterogeneity, and the underlying neural correlates that define the disorder. We highlight that the field of ADHD is rapidly evolving; the descriptions provided here will hopefully provide a sturdy foundation for which to build and improve our understanding of the disorder. PMID:24214656

  10. Inhibition in adults with attention deficit/hyperactivity disorder: event-related potentials in the stop task.

    PubMed

    MacLaren, Vance V; Taukulis, Harald K; Best, Lisa A

    2007-12-01

    The core deficit in Attention Deficit/Hyperactivity Disorder (ADHD) may be a deficiency in executive functions, particularly the processes that are associated with the inhibition of predominant responses. To test this notion in the adult population, healthy undergraduate volunteers and students with ADHD symptoms performed a visual Stop Signal Task (Logan et al. J Exp Psychol: Hum Percept Perform 10:276-291, 1984) while Event-Related brain Potentials were recorded. The two groups did not differ on behavioral measures of performance, but there was a significant difference in the N2-P3 component. These results underline the robustness of an N2-P3 difference between healthy adults and people with ADHD symptoms that have persisted into young adulthood. PMID:17922184

  11. Cognitive complaints and neuropsychological functioning in adults with and without attention-deficit hyperactivity disorder referred for multidisciplinary assessment.

    PubMed

    In de Braek, Dymphie; Dijkstra, Jeanette B; Jolles, Jelle

    2011-04-01

    The present study aims to gain insight into the clinical presentation (viz., self-reported complaints and neuropsychological functioning) of adults referred for an attention-deficit hyperactivity disorder (ADHD) diagnosis. The investigation evaluated group differences between an ADHD and a non-ADHD sample (n = 30 and n = 42, respectively), all of which had been clinically referred for multidisciplinary assessment of ADHD. Forty-two percent of all referred patients were diagnosed with adult ADHD. Adults with ADHD made significantly more errors on a verbal learning task than the non-ADHD control group, which could indicate an impairment of the self-monitoring function in adult ADHD. The ADHD group reported more problems than the control group in the domains of executive functioning but not in the domains of attention and hyperactivity. More attention should be paid to executive complaints and functioning (present and past) when referring adults suspected of ADHD for multidisciplinary assessment. Also, characteristics that are thought to be striking symptoms of adult ADHD, such as problems with concentration and hyperactive behavior, are in fact not distinctive symptoms of ADHD at all. PMID:21660764

  12. [Attention deficit hyperactivity disorder].

    PubMed

    Cunill, Ruth; Castells, Xavier

    2015-04-20

    Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders and can persist into the adulthood. ADHD has important social, academic and occupational consequences. ADHD diagnosis is based on the fulfillment of several clinical criteria, which can vary depending on the diagnostic system used. The clinical presentation can show great between-patient variability and it has been related to a dysfunction in the fronto-striatal and meso-limbic circuits. Recent investigations support a model in which multiple genetic and environmental factors interact to create a neurobiological susceptibility to develop the disorder. However, no clear causal association has yet been identified. Although multimodal treatment including both pharmacological and psychosocial interventions is usually recommended, no convincing evidence exists to support this recommendation. Pharmacological treatment has fundamentally shown to improve ADHD symptoms in the short term, while efficacy data for psychosocial interventions are scarce and inconsistent. Yet, drug treatment is increasingly popular and the last 2 decades have witnessed a sharp increase in the prescription of anti-ADHD medications coinciding with the marketing of new drugs to treat ADHD. PMID:24787685

  13. Preparatory neural networks are impaired in adults with attention-deficit/hyperactivity disorder during the antisaccade task☆

    PubMed Central

    Hakvoort Schwerdtfeger, Rebecca M.; Alahyane, Nadia; Brien, Donald C.; Coe, Brian C.; Stroman, Patrick W.; Munoz, Douglas P.

    2012-01-01

    Adults with attention-deficit/hyperactivity disorder (ADHD) often display executive function impairments, particularly in inhibitory control. The antisaccade task, which measures inhibitory control, requires one to suppress an automatic prosaccade toward a salient visual stimulus and voluntarily make an antisaccade in the opposite direction. ADHD patients not only have longer saccadic reaction times, but also make more direction errors (i.e., a prosaccade was executed toward the stimulus) during antisaccade trials. These deficits may stem from pathology in several brain areas that are important for executive control. Using functional MRI with a rapid event-related design, adults with combined subtype of ADHD (coexistence of attention and hyperactivity problems), who abstained from taking stimulant medication 20 h prior to experiment onset, and age-match controls performed pro- and antisaccade trials that were interleaved with pro- and anti-catch trials (i.e., instruction was presented but no target appeared, requiring no response). This method allowed us to examine brain activation patterns when participants either prepared (during instruction) or executed (after target appearance) correct pro or antisaccades. Behaviorally, ADHD adults displayed several antisaccade deficits, including longer and more variable reaction times and more direction errors, but saccade metrics (i.e., duration, velocity, and amplitude) were normal. When preparing to execute an antisaccade, ADHD adults showed less activation in frontal, supplementary, and parietal eye fields, compared to controls. However, activation in these areas was normal in the ADHD group during the execution of a correct antisaccade. Interestingly, unlike controls, adults with ADHD produced greater activation than controls in dorsolateral prefrontal cortex during antisaccade execution, perhaps as part of compensatory mechanisms to optimize antisaccade production. Overall, these data suggest that the saccade deficits

  14. Psychotherapy of attention deficit hyperactivity disorder in adults--a pilot study using a structured skills training program.

    PubMed

    Hesslinger, Bernd; Tebartz van Elst, Ludger; Nyberg, Elisabeth; Dykierek, Petra; Richter, Harald; Berner, Michael; Ebert, Dieter

    2002-08-01

    In clinical practice many adult patients with attention deficit hyperactivity disorder (ADHD) ask for an additional psychotherapeutic intervention besides the medical therapy. In this paper we present a structured skill training program particularly tailored for adult patients with ADHD. The program is based on the principles of cognitive-behavioral treatment for borderline personality disorder developed by M. Linehan. It was modified to suit the special needs of adult patients with ADHD. In this exploratory pilot study we tested this program in a group setting. The following elements were presented: neurobiology of ADHD, mindfulness, chaos and control, behavior analysis, emotion regulation, depression, medication in ADHD, impulse control, stress management, dependency, ADHD in relationship and self respect. In an open study design patients were assessed clinically using psychometric scales (Attention Deficit Hyperactivity Disorder Checklist according to DSM-IV, 16 items of the SCL-90-R, Beck-Depression Inventory, visual analogue scale) prior to and following group therapy. This treatment resulted in positive outcomes in that patients improved on all psychometric scales. PMID:12242579

  15. Adult Attention Deficit Hyperactivity Disorder Symptoms, Perceived Stress, and Well-Being: The Role of Early Maladaptive Schemata.

    PubMed

    Miklósi, Mónika; Máté, Orsolya; Somogyi, Klára; Szabó, Marianna

    2016-05-01

    Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent chronic neuropsychiatric disorders, severely affecting the emotional well-being of children as well as of adults. It has been suggested that individuals who experience symptoms of ADHD develop maladaptive schemata of failure, impaired self-discipline, social isolation, and shame. These schemata may then contribute to impaired emotional well-being by increasing unhelpful responses to stressful life events. However, to date, no empirical research has tested this theoretical proposition. In a sample of 204 nonclinical adults, we conducted a serial multiple mediator analysis, which supported the proposed model. More severe ADHD symptoms were associated with higher levels of perceived stress both directly and indirectly through stronger maladaptive schemata, which, in turn, were related to lower levels of emotional well-being. Results suggest that identifying and modifying maladaptive schemata may be an important addition to psychotherapy for adult ADHD patients. PMID:26825377

  16. A Controlled Study of Autonomic Nervous System Function in Adults with Attention-Deficit/Hyperactivity Disorder Treated with Stimulant Medications: Results of a Pilot Study

    ERIC Educational Resources Information Center

    Schubiner, Howard; Hassunizadeh, Bischan; Kaczynski, Richard

    2006-01-01

    Objective: Despite the fact that autonomic nervous system (ANS) abnormalities are commonly found in adults and predict increased cardiovascular mortality, no studies have assessed ANS function in adults with attention-deficit/hyperactivity disorder (ADHD) taking stimulants. Method: This pilot study evaluated ANS function in adults with ADHD in…

  17. Methylphenidate enhances cognitive performance in adults with poor baseline capacities regardless of attention-deficit/hyperactivity disorder diagnosis.

    PubMed

    Agay, Nirit; Yechiam, Eldad; Carmel, Ziv; Levkovitz, Yechiel

    2014-04-01

    We compare the view that the effect of methylphenidate (MPH) is selective to individuals with attention-deficit/hyperactivity disorder (ADHD) with an alternative approach suggesting that its effect is more prominent for individuals with weak baseline capacities in relevant cognitive tasks. To evaluate theses 2 approaches, we administered sustained attention, working memory, and decision-making tasks to 20 ADHD adults and 19 control subjects, using a within-subject placebo-controlled design. The results demonstrated no main effects of MPH in the decision-making tasks. In the sustained attention and working-memory tasks, MPH enhanced performance of both ADHD and non-ADHD adults to a similar extent compared with placebo. Hence, the effect of MPH was not selective to ADHD adults. In addition, those benefitting most from MPH in all 3 task domains tended to be individuals with poor task performance. However, in most tasks, individuals whose performance was impaired by MPH were not necessarily better (or worse) performers. The findings suggest that the administration of MPH to adults with ADHD should consider not only clinical diagnosis but also their functional (performance-based) profile. PMID:24525641

  18. Driving impairments in teens and adults with attention-deficit/hyperactivity disorder.

    PubMed

    Barkley, Russell A

    2004-06-01

    Available research provides compelling evidence that ADHD is associated with significantly increased risks for various adverse outcomes while driving, including increased traffic citations (particularly speeding), motor vehicle crashes for which the driver is at fault, repeated crash occurrences,and more severe crashes as determined from dollar damage and likelihood of bodily injuries from the crash. Not surprisingly, teens and adults with ADHD are more likely to have their licenses suspended and even fully revoked. Research further suggests that these driving risks cannot be accounted for by the comorbid disorders likely to be associated with ADHD, such as ODD, conduct disorder (CD), depression, or anxiety, or by lower than normal levels of intelligence. Recent attempts to study the processes or mechanisms involved in driving in adults with ADHD offer some explanation of how the disorder conveys such increased risks. Driving can be conceptualized usefully as involving at least three or more dimensions or levels, including basic cognitive abilities necessary for driving (operational), actual skills for maneuvering the vehicle in traffic (tactical), and the more executive, goal-directed aspects of driving(strategic). The findings of studies indicate that ADHD interferes with the basic operational components of driving by means of the impairments it produces in attention, resistance to distraction, response inhibition, slower and more variable reaction time, and the capacity to follow rules that may compete with ongoing sensory information. Accumulating evidence also points to a problem in the tactical level of driving, such that those with ADHDrate themselves and are rated by others as employing less safe driving habits during their normal operation of a vehicle than are adults in community control groups. Although this has been more elusive to demonstrate through the use of simple laboratory-based driving simulators. more modern virtual reality driving platforms

  19. Sex-specific attentional deficits in adult vitamin D deficient BALB/c mice.

    PubMed

    Groves, Natalie J; Burne, Thomas H J

    2016-04-01

    Epidemiological studies have shown an association between vitamin D deficiency and cognitive impairment. However, there is a paucity of preclinical data showing that vitamin D deficiency is a causal factor for impaired cognitive processing. The aim of this study was to assess two cognitive tasks, the 5 choice-serial reaction task and the 5 choice-continuous performance task in adult vitamin D (AVD) deficient BALB/c mice. Ten-week old male and female BALB/c mice were fed a control or vitamin D deficient diet for 10 weeks prior to, and during behavioural testing. We found sex-dependent impairments in attentional processing and showed that male AVD-deficient mice were less accurate, took longer to respond when making a correct choice and were more likely to make an omission, without a change in the motivation to collect reward. By contrast, female AVD-deficient mice had a reduced latency to collect reward, but no changes on any other measures compared to controls. Therefore, we have shown that in otherwise healthy adult mice, vitamin D deficiency led to mild cognitive impairment in male but not female mice and therefore this model will be useful for future investigations into unravelling the mechanism by which vitamin D affects the adult brain and cognitive function. PMID:26836278

  20. Supplementary guanfacine hydrochloride as a treatment of attention deficit hyperactivity disorder in adults: A double blind, placebo-controlled study.

    PubMed

    Butterfield, Max E; Saal, Jaime; Young, Benjamin; Young, Joel L

    2016-02-28

    The purpose of this study was to examine the efficacy of an extended release guanfacine hydrochloride supplement relative to a placebo supplement in adults (19-62) with ADHD and a sub-optimal response to a stimulant-only treatment program. The study's primary outcome measures were the Attention Deficit Hyperactivity Disorder Rating Scale and the Clinical Global Impression - Severity. Twenty-six adults who met criteria for attention deficit hyperactivity disorder and sub-optimal functioning were randomly assigned to supplement their existing psychostimulant treatment regimen with either a titrated dose (1-6mg) of extended release guanfacine hydrochloride or a matching placebo for a 10-week trial. The data were analyzed with standard mixed model analysis of variance procedures, and participants in both the investigational agent group and the placebo group showed statistically significant improvement in their symptoms and functioning over the course of the trial. The treatments did not differ in terms of their efficacy, safety, or tolerability. Although these results do suggest that both treatments were associated with clinical improvement, the possible impacts of socially desirable responding and regression to the mean on these results are discussed. PMID:26730446

  1. Treatment outcomes after methylphenidate in adults with attention-deficit/hyperactivity disorder treated with lisdexamfetamine dimesylate or atomoxetine

    PubMed Central

    Joseph, Alain; Cloutier, Martin; Guérin, Annie; Nitulescu, Roy; Sikirica, Vanja

    2016-01-01

    Purpose To compare treatment adherence, discontinuation, add-on, and daily average consumption (DACON) among adults with attention-deficit/hyperactivity disorder receiving second-line lisdexamfetamine dimesylate (LDX) or atomoxetine (ATX), following methylphenidate. Patients and methods A retrospective cohort study using US commercial claims databases (Q2/2009–Q3/2013). Results At month 12, the LDX cohort (N=2,718) had a higher adherence level (proportion of days covered: 0.48 versus 0.30, P<0.001) and was less likely to discontinue (Kaplan–Meier estimate: 63% versus 85%, P<0.001) than the ATX cohort (N=674). There were no statistical differences in treatment add-on rates between cohorts (Kaplan–Meier estimate: 26% versus 25%, P=0.297). The LDX cohort had a lower DACON (1.10 versus 1.31, P<0.001) and was less likely to have a DACON >1 (adjusted odds ratio: 0.20, 95% confidence interval: 0.15–0.25, P<0.001) than the ATX cohort. Conclusion Adults with attention-deficit/hyperactivity disorder treated with LDX following methylphenidate had a higher treatment adherence and lower discontinuation and DACON relative to those treated with ATX following methylphenidate. PMID:27069357

  2. Diminished prefrontal brain function in adults with psychopathology in childhood related to attention deficit hyperactivity disorder.

    PubMed

    Fallgatter, Andreas J; Ehlis, Ann-Christine; Rösler, Michael; Strik, Werner K; Blocher, Detlev; Herrmann, Martin J

    2005-02-28

    The aim of the present study was to investigate prefrontal brain function and cognitive response control in patients with personality disorders who either suffered or did not suffer from psychopathology related to attention deficit hyperactivity disorder (ADHD) during childhood. For this purpose, 36 psychiatric out-patients with personality disorders--24 of whom showed ADHD-related psychopathology during childhood assessed by the German short form of the Wender Utah Rating Scale--and 24 healthy controls were investigated electrophysiologically by means of a cued Go-NoGo task (Continuous Performance Test). Topographical analyses were conducted to individually quantify the NoGo anteriorisation (NGA), a neurophysiological correlate of prefrontal response control that has been suggested to reflect activation of the anterior cingulate cortex. ADHD patients exhibited a significantly reduced mean NGA and diminished amplitudes of the Global Field Power, as well as a reduced increase of fronto-central P300 amplitudes, in NoGo-trials compared with the healthy controls, whereas patients with personality disorders alone did not differ from the control group in any of the electrophysiological parameters. The results indicate that ADHD-related psychopathology is associated with prefrontal brain dysfunction, probably related to processes of response inhibition and/or cognitive response control. PMID:15766638

  3. Deviant white matter structure in adults with attention-deficit/hyperactivity disorder points to aberrant myelination and affects neuropsychological performance.

    PubMed

    Onnink, A Marten H; Zwiers, Marcel P; Hoogman, Martine; Mostert, Jeanette C; Dammers, Janneke; Kan, Cornelis C; Vasquez, Alejandro Arias; Schene, Aart H; Buitelaar, Jan; Franke, Barbara

    2015-12-01

    Attention-deficit/hyperactivity disorder (ADHD) in childhood is characterized by gray and white matter abnormalities in several brain areas. Considerably less is known about white matter microstructure in adults with ADHD and its relation with clinical symptoms and cognitive performance. In 107 adult ADHD patients and 109 gender-, age- and IQ-matched controls, we used diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS) to investigate whole-skeleton changes of fractional anisotropy (FA) and mean, axial, and radial diffusivity (MD, AD, RD). Additionally, we studied the relation of FA and MD values with symptom severity and cognitive performance on tasks measuring working memory, attention, inhibition, and delay discounting. In comparison to controls, participants with ADHD showed reduced FA in corpus callosum, bilateral corona radiata, and thalamic radiation. Higher MD and RD were found in overlapping and even more widespread areas in both hemispheres, also encompassing internal and external capsule, sagittal stratum, fornix, and superior lateral fasciculus. Values of FA and MD were not associated with symptom severity. However, within some white matter clusters that distinguished patients from controls, worse inhibition performance was associated with reduced FA and more impulsive decision making was associated with increased MD. This study shows widespread differences in white matter integrity between adults with persistent ADHD and healthy individuals. Changes in RD suggest aberrant myelination as a pathophysiological factor in persistent ADHD. The microstructural differences in adult ADHD may contribute to poor inhibition and greater impulsivity but appear to be independent of disease severity. PMID:25956761

  4. Temperament and Character as Endophenotype in Adults with Autism Spectrum Disorders or Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Sizoo, Bram B.; van der Gaag, Rutger Jan; van den Brink, Wim

    2015-01-01

    Autism spectrum disorder and attention deficit/hyperactivity disorder overlap in several ways, raising questions about the nature of this comorbidity. Rommelse et al. published an innovative review of candidate endophenotypes for autism spectrum disorder and attention deficit/hyperactivity disorder in cognitive and brain domains. They found that…

  5. Attention-Deficit Hyperactivity Disorder.

    ERIC Educational Resources Information Center

    Barkley, Russell A.

    1998-01-01

    Attention deficit hyperactivity disorder (ADHD) may arise when key brain circuits do not develop properly, perhaps due to an altered gene or genes. Describes ADHD in detail and introduces a psychological model of ADHD. (ASK)

  6. Whole-brain structural topology in adult attention-deficit/hyperactivity disorder: Preserved global - disturbed local network organization.

    PubMed

    Sidlauskaite, Justina; Caeyenberghs, Karen; Sonuga-Barke, Edmund; Roeyers, Herbert; Wiersema, Jan R

    2015-01-01

    Prior studies demonstrate altered organization of functional brain networks in attention-deficit/hyperactivity disorder (ADHD). However, the structural underpinnings of these functional disturbances are poorly understood. In the current study, we applied a graph-theoretic approach to whole-brain diffusion magnetic resonance imaging data to investigate the organization of structural brain networks in adults with ADHD and unaffected controls using deterministic fiber tractography. Groups did not differ in terms of global network metrics - small-worldness, global efficiency and clustering coefficient. However, there were widespread ADHD-related effects at the nodal level in relation to local efficiency and clustering. The affected nodes included superior occipital, supramarginal, superior temporal, inferior parietal, angular and inferior frontal gyri, as well as putamen, thalamus and posterior cerebellum. Lower local efficiency of left superior temporal and supramarginal gyri was associated with higher ADHD symptom scores. Also greater local clustering of right putamen and lower local clustering of left supramarginal gyrus correlated with ADHD symptom severity. Overall, the findings indicate preserved global but altered local network organization in adult ADHD implicating regions underpinning putative ADHD-related neuropsychological deficits. PMID:26640763

  7. Faststats: Attention Deficit Hyperactivity Disorder (ADHD)

    MedlinePlus

    ... this? Submit What's this? Submit Button NCHS Home Attention Deficit Hyperactivity Disorder (ADHD)* Recommend on Facebook Tweet Share Compartir Data ... attention deficit disorder (ADD)" is used rather than "attention deficit hyperactivity disorder (ADHD)" in some data sources. More data Association ...

  8. Pharmacological and clinical dilemmas of prescribing in co-morbid adult attention-deficit/hyperactivity disorder and addiction

    PubMed Central

    Pérez de los Cobos, José; Siñol, Núria; Pérez, Víctor; Trujols, Joan

    2014-01-01

    The present article reviews whether available efficacy and safety data support the pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD) in patients with concurrent substance use disorders (SUD). Arguments for and against treating adult ADHD with active SUD are discussed. Findings from 19 large open studies and controlled clinical trials show that the use of atomoxetine or extended-release methylphenidate formulations, together with psychological therapy, yield promising though inconclusive results about short term efficacy of these drugs in the treatment of adult ADHD in patients with SUD and no other severe mental disorders. However, the efficacy of these drugs is scant or lacking for treating concurrent SUD. No serious safety issues have been associated with these drugs in patients with co-morbid SUD-ADHD, given their low risk of abuse and favourable side effect and drug–drug interaction profile. The decision to treat adult ADHD in the context of active SUD depends on various factors, some directly related to SUD-ADHD co-morbidity (e.g. degree of diagnostic uncertainty for ADHD) and other factors related to the clinical expertise of the medical staff and availability of adequate resources (e.g. the means to monitor compliance with pharmacological treatment). Our recommendation is that clinical decisions be individualized and based on a careful analysis of the advantages and disadvantages of pharmacological treatment for ADHD on a case-by-case basis in the context of active SUD. PMID:23216449

  9. Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

    PubMed Central

    Park, Bo-yong; Park, Hyunjin

    2016-01-01

    Attention deficit hyperactivity disorder (ADHD) is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients. PMID:26981099

  10. Driving in young adults with attention deficit hyperactivity disorder: knowledge, performance, adverse outcomes, and the role of executive functioning.

    PubMed

    Barkley, Russell A; Murphy, Kevin R; Dupaul, George I; Bush, Tracie

    2002-07-01

    Past studies find that attention deficit hyperactivity disorder (ADHD) creates a higher risk for adverse driving outcomes. This study comprehensively evaluated driving in adults with ADHD by comparing 105 young adults with the disorder (age 17-28) to 64 community control (CC) adults on five domains of driving ability and a battery of executive function tasks. The ADHD group self-reported significantly more traffic citations, particularly for speeding, vehicular crashes, and license suspensions than the CC group, with most of these differences corroborated in the official DMV records. Cognitively, the ADHD group was less attentive and made more errors during a visual reaction task under rule-reversed conditions than the CC group. The ADHD group also obtained lower sceres on a test of driving rules and decision-making but not on a simple driving simulator. Both self- and other-ratings showed the CC group employed safer routine driving habits than the ADHD group. Relationships between the cognitive and driving measures and the adverse outcomes were limited or absent, calling into question their use in screening ADHD adults for driving risks. Several executive functions also were significantly yet modestly related to accident frequency and total traffic violations after controlling for severity of ADHD. These results are consistent with earlier studies showing significant driving problems are associated with ADHD. This study found that these driving difficulties were not a function of comorbid oppositional defiant disorder, depression, anxiety, or frequency of alcohol or illegal drug use. Findings to date argue for the development of interventions to reduce driving risks among adults with ADHD. PMID:12164675

  11. Naming Speed of Adolescents and Young Adults with Attention Deficit Hyperactivity Disorder: Differences in Alphanumeric Versus Color/Object Naming.

    PubMed

    Whipple, Brittany D; Nelson, Jason M

    2016-02-01

    This study investigated the performance of adolescents and young adults with Attention Deficit Hyperactivity Disorder (ADHD), Reading Disorder (RD), and ADHD/RD on measures of alphanumeric and nonalphanumeric naming speed and the relationship between naming speed and academic achievement. The sample (N = 203) included students aged 17-28 years diagnosed with ADHD (n = 83), RD (n = 71), or ADHD/RD (n = 49). Individuals with ADHD performed significantly faster on measures of alphanumeric naming compared with RD and comorbid groups and, within group, demonstrated significantly quicker naming of letters/digits compared with colors/objects. Both alphanumeric rapid naming scores and processing speed scores variably predicted academic achievement scores across groups, whereas nonalphanumeric rapid naming only predicted reading comprehension scores within the ADHD group. Results support findings that older individuals with ADHD show relative weakness in rapid naming of objects and colors. Implications of these findings in regard to assessment of older individuals for ADHD are discussed. PMID:26471216

  12. Adherence to medication in adults with attention deficit hyperactivity disorder and pro re nata dosing of psychostimulants: a systematic review.

    PubMed

    Caisley, H; Müller, U

    2012-07-01

    Adherence to a regular medication regimen may be challenging for adults with attention deficit hyperactivity disorder (ADHD). Some report taking psychostimulants on a pro re nata (PRN) basis. This review aims to establish the rate of adherence, and reasons for and consequences of non-adherence to medication for ADHD in adults, and to review literature on PRN dosing of psychostimulants in these patients. A systematic literature search was conducted. Four primary research studies have investigated the rate of adherence to medication in adults with ADHD. Mean adherence rate in two studies ranged from 52% to 87%. A number of possible reasons for poor adherence have been suggested. Prospective studies are needed to further define the rate of adherence and causes of poor adherence. Evidence examining whether differences in adherence affect clinical outcomes is equivocal. Therefore, caution should be applied to the assumption that maximising adherence to regular medication regimens will improve clinical outcomes. Two articles acknowledge that patients take medication on a PRN basis. Studies comparing the effectiveness of a regular and PRN regimen of psychostimulants are needed. If PRN dosing is as effective as a regular regimen, advantages might include enhanced doctor-patient communication, reduced side effects and cost savings. PMID:22521805

  13. Attention-deficit hyperactivity disorder in adults: A systematic review and meta-analysis of genetic, pharmacogenetic and biochemical studies.

    PubMed

    Bonvicini, C; Faraone, S V; Scassellati, C

    2016-07-01

    The adult form of attention-deficit/hyperactivity disorder has a prevalence of up to 5% and is the most severe long-term outcome of this common disorder. Family studies in clinical samples as well as twin studies suggest a familial liability and consequently different genes were investigated in association studies. Pharmacotherapy with methylphenidate (MPH) seems to be the first-line treatment of choice in adults with attention-deficit hyperactive disorder (ADHD) and some studies were conducted on the genes influencing the response to this drug. Finally some peripheral biomarkers were identified in ADHD adult patients. We believe this work is the first systematic review and meta-analysis of candidate gene association studies, pharmacogenetic and biochemical (metabolomics) studies performed in adults with ADHD to identify potential genetic, predictive and peripheral markers linked specifically to ADHD in adults. After screening 5129 records, we selected 87 studies of which 61 were available for candidate gene association studies, 5 for pharmacogenetics and 21 for biochemical studies. Of these, 15 genetic, 2 pharmacogenetic and 6 biochemical studies were included in the meta-analyses. We obtained an association between adult ADHD and the gene BAIAP2 (brain-specific angiogenesis inhibitor 1-associated protein 2), even after Bonferroni correction, with any heterogeneity in effect size and no publication bias. If we did not apply the Bonferroni correction, a trend was found for the carriers allele 9R of dopamine transporter SLC6A3 40 bp variable tandem repeat polymorphism (VNTR) and for 6/6 homozygotes of SLC6A3 30 bp VNTR. Negative results were obtained for the 9-6 haplotype, the dopamine receptor DRD4 48 bp VNTR, and the enzyme COMT SNP rs4680. Concerning pharmacogenetic studies, no association was found for the SLC6A3 40 bp and response to MPH with only two studies selected. For the metabolomics studies, no differences between ADHD adults and controls were

  14. Learning Disabilities and Attention-Deficit/Hyperactivity Disorder in Intelligent Well Educated Adults

    ERIC Educational Resources Information Center

    Guyer, Kenneth E.; Guyer, Barbara P.; Banks, Steven R.

    2008-01-01

    This retrospective study examined scores for 111 adult participants on the Wechsler Adult Intelligence Scale-Revised, the Wide Range Achievement Test-III and the Nelson-Denny Reading Test. All participants were referred to a university clinic for learning problems. The participants were diagnosed with a learning disability, an…

  15. Lifetime Prevalence of Attention-Deficit Hyperactivity Disorder in Young Adults: Examining Variations in the Socioeconomic Gradient

    PubMed Central

    Yallop, Lauren; Brownell, Marni; Chateau, Dan; Walker, John; Warren, Michelle; Bailis, Dan; LeBow, Michael

    2015-01-01

    Objective: It has only recently been accepted that attention-deficit hyperactivity disorder (ADHD) persists into adulthood. Accordingly, less is known about adult diagnostic and treatment prevalence. We aimed to determine the lifetime prevalence of ADHD diagnosis and psychostimulant prescriptions for young adults in the province of Manitoba and to explore how diagnosis differs according to sociodemographic characteristics and age at diagnosis; and to investigate whether a socioeconomic gradient exists within young adults with a lifetime ADHD diagnosis, as well as the variables that moderate the gradient. Methods: Using the Manitoba Population Health Research Data Repository, our cross-sectional analysis used 24 fiscal years of data (1984/85 to 2008/09) and included all adults aged 18 to 29 during 2007/08 to 2008/09 in Manitoba (n = 207 544) who had a lifetime diagnosis of ADHD (n = 14 762). Regression analyses tested for differences in rates by sex, region, age, age at diagnosis, and socioeconomic status. Results: Lifetime prevalence for ADHD diagnosis (7.11%) and psychostimulant prescriptions (3.09%) differed according to sex, region, and age. In contrast to previous Manitoban research on childhood ADHD, the socioeconomic gradient for ADHD diagnosis was not found in young adulthood. When region was accounted for, a small negative gradient in the urban population and a positive gradient in the rural population were evident. People from the highest income quintile were significantly less likely to be diagnosed before age 18, compared with other income quintiles. Conclusions: Given the high lifetime prevalence of ADHD in Manitoban young adults and significant socioeconomic correlates for diagnosis, further investigation into the trajectory of this relatively unexplored population is recommended. PMID:26720190

  16. Effect of Symptoms of Adult Attention Deficit Hyperactivity Disorder on Symptoms of Post Traumatic Stress Disorder in Korean Conscripts

    PubMed Central

    Lee, Dong-Yun; Park, Chul-Soo; Kim, Bong-Jo; Cha, Bo-Seok; Lee, So-Jin; Bhang, Soo Young

    2012-01-01

    Objective This study is conducted to investigate the effect of symptoms of Attention Deficit and Hyperactivity Disorder (ADHD) on symptoms of Posttraumatic Stress Disorder (PTSD) among 224 conscripts during 5 weeks of military basic training. Methods Total number of subject is 224 conscripts. We evaluated past and present symptoms of ADHD with Korean-Wender Utah rating scale (K-WURS) and Korean adult attention -deficit/hyperactivity disorder scale (K-AADHDS) and stress and symptoms of PTSD with Brief Encounter Psychosocial Instrument-K (BEPSI-K), the Korean version of the Impact of Event Scale-Revised (IES-R-K) on 1 week and 5 weeks later of basic military training. Pearson correlation analysis and multivariate logistic regression analysis were performed to evaluate risk factors of PTSD using SPSS program and Path analysis also was used to find relationship between past and present ADHD and PTSD simultaneously using AMOS program. Results Present symptoms of ADHD (OR=1.145, CI=1.054-1.245, p=0.001) and Past symptoms of ADHD (OR=1.049, CI=1.005-1.095, p=0.028) were significant risk factor of PTSD symptoms on 1st week of basic military training. The symptoms of PTSD on fist week was also significant risk factor of PTSD after 5weeks of basic military training (OR=1.073, CI=1.020-1.129, p=0.006). Using path analysis, we could found confirm these relations between past and present ADHD symptoms and symptoms of PTSD. Conclusion The result suggests that past and present symptoms of ADHD are the risk factor of symptoms of PTSD on first week. And the symptoms of PTSD on first week are also risk factor of PTSD symptoms on last weeks in Korean conscripts. The symptoms of ADHD might make an important role in vulnerability of the symptoms of PTSD in Korean conscripts. PMID:22707966

  17. Factors Associated With Adherence to Methylphenidate Treatment in Adult Patients With Attention-Deficit/Hyperactivity Disorder and Substance Use Disorders.

    PubMed

    Skoglund, Charlotte; Brandt, Lena; Almqvist, Catarina; DʼOnofrio, Brian M; Konstenius, Maija; Franck, Johan; Larsson, Henrik

    2016-06-01

    Adherence to treatment is one of the most consistent factors associated with a favorable addiction treatment outcome. Little is known about factors associated with treatment adherence in individuals affected with comorbid attention-deficit/hyperactivity disorder and substance use disorders (SUD). This study aimed to explore whether treatment-associated factors, such as the prescribing physician's (sub)specialty and methylphenidate (MPH) dose, or patient-related factors, such as sex, age, SUD subtype, and psychiatric comorbidity, were associated with adherence to MPH treatment. Swedish national registers were used to identify adult individuals with prescriptions of MPH and medications specifically used in the treatment of SUD or a diagnosis of SUD and/or coexisting psychiatric diagnoses. Primary outcome measure was days in active MPH treatment in stratified dose groups (≤36 mg, ≥37 mg to ≤54 mg, ≥55 mg to ≤72 mg, ≥73 mg to ≤90 mg, ≥91 mg to ≤108 mg, and ≥109 mg). Lower MPH doses (ie, ≤36 mg day 100) were associated with treatment discontinuation between days 101 and 830 (HR≤36 mg, 1.67; HR37-54mg, 1.37; HR55-72mg, 1.36; HR73-90mg, 1.19; HR≥108mg, 1.09). The results showed a linear trend (P < 0.0001) toward decreased risk of treatment discontinuation along with increase of MPH doses. In conclusion, this study shows that higher MPH doses were associated with long-term treatment adherence in individuals with attention-deficit/hyperactivity disorder and SUD. PMID:27043119

  18. Attention Deficits, Attention-Deficit Hyperactivity Disorder, and Intellectual Disabilities

    ERIC Educational Resources Information Center

    Deutsch, Curtis K.; Dube, William V.; McIlvane, William J.

    2008-01-01

    Attention-Deficit Hyperactivity Disorder (ADHD) and its earlier nosologic classifications have been extensively investigated since the 1960s, with PubMed listings alone exceeding 13,000 entries. Strides have been made in the diagnosis and treatment of ADHD in individuals with intellectual function in the normal range, as described in companion…

  19. Multicomponent attention deficits in attention deficit hyperactivity disorder.

    PubMed

    Kiliç, Birim Günay; Sener, Sahnur; Koçkar, Aylin Ilden; Karakaş, Sirel

    2007-04-01

    The aim of this study was to examine the specific aspects of attention, such as selective attention, sustained attention, and short-term memory in children with attention deficit hyperactivity disorder, combined subtype (ADHD-C). A total of 40 children with a diagnosis of ADHD from the 4th edition of the Diagnostic and Statistical Manual, aged 6-11 years old were compared with 40 controls matched for age and gender on a battery of tests. Short-term memory span and attention was measured by Visual Aural Digit Span Test-Revised. Stroop test and the Turkish version of Cancellation Test were used to assess selective and sustained attention, respectively. In order to check for factor structure in two groups on the test scores, principal component analysis was conducted for both groups separately. Relative to the comparison children, children with ADHD showed significant deficits on tests that are related to different aspects of attention. The results are consistent with the theories explaining the biological basis of ADHD by scattered attention networks in the brain, which have reciprocal dynamic interactions. Further comparative studies are needed to elucidate whether the cognitive processes that are known to be assessed by these tests are specific to ADHD. PMID:17362431

  20. Methylphenidate significantly improves driving performance of adults with attention-deficit hyperactivity disorder: a randomized crossover trial.

    PubMed

    Verster, Joris C; Bekker, Evelijne M; de Roos, Marlise; Minova, Anita; Eijken, Erik J E; Kooij, J J Sandra; Buitelaar, Jan K; Kenemans, J Leon; Verbaten, Marinus N; Olivier, Berend; Volkerts, Edmund R

    2008-05-01

    Although patients with attention-deficit hyperactivity disorder (ADHD) have reported improved driving performance on methylphenidate, limited evidence exists to support an effect of treatment on driving performance and some regions prohibit driving on methylphenidate. A randomized, crossover trial examining the effects of methylphenidate versus placebo on highway driving in 18 adults with ADHD was carried out. After three days of no treatment, patients received either their usual methylphenidate dose (mean: 14.7 mg; range: 10-30 mg) or placebo and then the opposite treatment after a six to seven days washout period. Patients performed a 100 km driving test during normal traffic, 1.5 h after treatment administration. Standard deviation of lateral position (SDLP), the weaving of the car, was the primary outcome measure. Secondary outcome measurements included the standard deviation of speed and patient reports of driving performance. Driving performance was significantly better in the methylphenidate than in the placebo condition, as reflected by the SDLP difference (2.3 cm, 95% CI = 0.8-3.8, P = 0.004). Variation in speed was similar on treatment and on placebo (-0.05 km/h, 95% CI = -0.4 to 0.2, P = 0.70). Among adults with ADHD, with a history of a positive clinical response to methylphenidate, methylphenidate significantly improves driving performance. PMID:18308788

  1. Increased Neural Responses to Reward in Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder and Their Unaffected Siblings

    PubMed Central

    von Rhein, Daniel; Cools, Roshan; Zwiers, Marcel P.; van der Schaaf, Marieke; Franke, Barbara; Luman, Marjolein; Oosterlaan, Jaap; Heslenfeld, Dirk J.; Hoekstra, Pieter J.; Hartman, Catharina A.; Faraone, Stephen V.; van Rooij, Daan; van Dongen, Eelco V.; Lojowska, Maria; Mennes, Maarten; Buitelaar, Jan

    2015-01-01

    Objective Attention-deficit/hyperactivity disorder (ADHD) is a heritable neuropsychiatric disorder associated with abnormal reward processing. Limited and inconsistent data exist about the neural mechanisms underlying this abnormality. Furthermore, it is unknown whether reward processing is abnormal in unaffected siblings of participants with ADHD. Method We used event-related functional magnetic resonance imaging (fMRI) to investigate brain responses during reward anticipation and receipt with an adapted monetary incentive delay task in a large sample of adolescents and young adults with ADHD (n=150), their unaffected siblings (n=92), and control participants (n=108), all of the same age. Results Participants with ADHD showed, relative to control participants, increased responses in the anterior cingulate, anterior frontal cortex, and cerebellum during reward anticipation, and in the orbitofrontal, occipital cortex, and ventral striatum during reward receipt. Responses of unaffected siblings were increased in these regions as well, except for the cerebellum during anticipation and the orbitofrontal cortex during receipt. Conclusion ADHD in adolescents and young adults is associated with enhanced neural responses in frontostriatal circuitry to anticipation and receipt of reward. The findings support models emphasizing aberrant reward processing in ADHD and suggest that processing of reward is subject to familial influences. Future studies using standard monetary incentive delay task parameters have to replicate our findings. PMID:25901776

  2. A candidate gene investigation of methylphenidate response in adult attention-deficit/hyperactivity disorder patients: results from a naturalistic study.

    PubMed

    Hegvik, Tor-Arne; Jacobsen, Kaya Kvarme; Fredriksen, Mats; Zayats, Tetyana; Haavik, Jan

    2016-08-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common childhood onset neuropsychiatric disorder with a complex and heterogeneous symptomatology. Persistence of ADHD symptoms into adulthood is common. Methylphenidate (MPH) is a widely prescribed stimulant compound that may be effective against ADHD symptoms in children and adults. However, MPH does not exert satisfactory effect in all patients. Several genetic variants have been proposed to predict either treatment response or adverse effects of stimulants. We conducted a literature search to identify previously reported variants associated with MPH response and additional variants that were biologically plausible candidates for MPH response. The response to MPH was assessed by the treating clinicians in 564 adult ADHD patients and 20 genetic variants were successfully genotyped. Logistic regression was used to test for association between these polymorphisms and treatment response. Nominal associations (p < 0.05) were meta-analysed with published data from previous comparable studies. In our analyses, rs1800544 in the ADRA2A gene was associated with MPH response at a nominal significance level (OR 0.560, 95 % CI 0.329-0.953, p = 0.033). However, this finding was not affirmed in the meta-analysis. No genetic variants revealed significant associations after correction for multiple testing (p < 0.00125). Our results suggest that none of the studied variants are strong predictors of MPH response in adult ADHD as judged by clinician ratings, potentially except for rs1800544. Consequently, pharmacogenetic testing in routine clinical care is not supported by our analyses. Further studies on the pharmacogenetics of adult ADHD are warranted. PMID:27091191

  3. Multimodal Magnetic Resonance Imaging Study of Treatment-Naïve Adults with Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Chaim, Tiffany M.; Zhang, Tianhao; Zanetti, Marcus V.; da Silva, Maria Aparecida; Louzã, Mário R.; Doshi, Jimit; Serpa, Mauricio H.; Duran, Fabio L. S.; Caetano, Sheila C.; Davatzikos, Christos; Busatto, Geraldo F.

    2014-01-01

    Background Attention-Deficit/Hiperactivity Disorder (ADHD) is a prevalent disorder, but its neuroanatomical circuitry is still relatively understudied, especially in the adult population. The few morphometric magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) studies available to date have found heterogeneous results. This may be at least partly attributable to some well-known technical limitations of the conventional voxel-based methods usually employed to analyze such neuroimaging data. Moreover, there is a great paucity of imaging studies of adult ADHD to date that have excluded patients with history of use of stimulant medication. Methods A newly validated method named optimally-discriminative voxel-based analysis (ODVBA) was applied to multimodal (structural and DTI) MRI data acquired from 22 treatment-naïve ADHD adults and 19 age- and gender-matched healthy controls (HC). Results Regarding DTI data, we found higher fractional anisotropy in ADHD relative to HC encompassing the white matter (WM) of the bilateral superior frontal gyrus, right middle frontal left gyrus, left postcentral gyrus, bilateral cingulate gyrus, bilateral middle temporal gyrus and right superior temporal gyrus; reductions in trace (a measure of diffusivity) in ADHD relative to HC were also found in fronto-striatal-parieto-occipital circuits, including the right superior frontal gyrus and bilateral middle frontal gyrus, right precentral gyrus, left middle occipital gyrus and bilateral cingulate gyrus, as well as the left body and right splenium of the corpus callosum, right superior corona radiata, and right superior longitudinal and fronto-occipital fasciculi. Volumetric abnormalities in ADHD subjects were found only at a trend level of significance, including reduced gray matter (GM) in the right angular gyrus, and increased GM in the right supplementary motor area and superior frontal gyrus. Conclusions Our results suggest that adult ADHD is associated with

  4. Attention deficit hyperactivity disorder across the lifespan: the child, adolescent, and adult.

    PubMed

    Greydanus, Donald E; Pratt, Helen D; Patel, Dilip R

    2007-02-01

    Management of a child, adolescent, college student, or adult with ADD/ADHD (ADHD) is reviewed with emphasis on pharmacologic approaches in the adult. Psychological treatment includes psychotherapy, cognitive-behavior therapy, support groups, parent training, biofeedback, meditation, and social skills training. Medications are reviewed that research has revealed can improve the core symptomatology of a child or adolescent with ADHD. These medications include stimulants (psychostimulants), antidepressants, alpha-2 agonists, and a norepinephrine reuptake inhibitor. Psychopharmacology approved and/or used in pediatric patients are also used in adults with ADHD, though most are not officially FDA-approved. It is emphasized that ADHD management should include a multi-modal approach, involving appropriate educational interventions, appropriate psychological management of the patient of any age, and judicious use of medications. Such an approach is recommended to benefit those with ADHD achieve their maximum potential across the human life span. PMID:17386306

  5. The circadian rhythm in adult attention-deficit/hyperactivity disorder: current state of affairs.

    PubMed

    Kooij, J J Sandra; Bijlenga, Denise

    2013-10-01

    Adults with ADHD often have sleep problems that are caused by a delay of their internal circadian rhythm system. Such individuals are often typified as 'evening' or 'night' persons. This review focuses on the link between ADHD symptoms and the evening typology through multiple pathways. Etiology of the internal circadian rhythm system, the genetic basis for evening typology, overlap between ADHD symptoms and evening preference and risk factors for various chronic health conditions, including metabolic syndrome and cancer, are discussed. The treatment perspectives to reset the delayed rhythm in adults with ADHD involve psychoeducation on sleep hygiene, melatonin in the afternoon or evening and bright light therapy in the morning. PMID:24117273

  6. Childhood Attention Deficit Hyperactivity Disorder, Substance Use, and Adult Functioning among Incarcerated Women

    ERIC Educational Resources Information Center

    Hennessey, Kathleen A.; Stein, Michael D.; Rosengard, Cynthia; Rose, Jennifer S.; Clarke, Jennifer G.

    2010-01-01

    Objective: To estimate prevalence of childhood ADHD among incarcerated women and determine its association with substance use and adult functioning. Method: 192 female participants are recruited from the Department of Corrections in Rhode Island. Childhood ADHD is defined as scoring >46 on the Wender Utah Rating Scale. Results: The findings…

  7. Management of attention deficit disorder.

    PubMed

    Delcau, C M

    1984-10-01

    Attention deficit disorder occurs in 5% to 10% of school-aged children. Retrospective studies have shown an increased incidence of academic and social failure in untreated children. This paper reviews the natural course of the disorder and describes some therapeutic interventions. PMID:6484648

  8. Deaf Adults without Attention Deficit Hyperactivity Disorder Display Reduced Perceptual Sensitivity and Elevated Impulsivity on the Test of Variables of Attention (T.O.V.A.)

    ERIC Educational Resources Information Center

    Parasnis, Ila; Samar, Vincent J.; Berent, Gerald P.

    2003-01-01

    The Test of Variables of Attention (T.O.V.A.; R. A. Leark, T. R. Dupuy, L. M. Greenberg, C. L. Corman, & C. L. Kindeschi, 1996) is a continuous performance test used widely to help diagnose attention deficit hyperactivity disorder (ADHD) in both hearing and deaf people. The T.O.V.A. previously has been normed only on the hearing population. The…

  9. Online Social Communication Patterns among Young Adult Women with Histories of Childhood Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Mikami, Amori Yee; Szwedo, David E.; Ahmad, Shaikh I.; Samuels, Andrea Stier; Hinshaw, Stephen P.

    2015-01-01

    Little is known about adult women with Attention-Deficit/Hyperactivity Disorder (ADHD), however available evidence suggests that they experience social impairment. Online social networking websites such as Facebook have become endemic outlets through which emerging adults communicate with peers. No study has examined the peer interactions of emerging adults with childhood histories of ADHD in this developmentally relevant online domain. Participants in the current study were an ethnically diverse sample of 228 women, 140 of whom met diagnostic criteria for ADHD in childhood and 88 who composed a matched comparison sample. These women were assessed at three time points spanning 10 years (mean age = 9.6 at Wave 1, 14.1 at Wave 2, 19.6 at Wave 3). After statistical control of demographic covariates and comorbidites, childhood ADHD diagnosis predicted, by emerging adulthood, a greater stated preference for online social communication and a greater tendency to have used online methods to interact with strangers. A childhood diagnosis of ADHD also predicted observations of fewer Facebook friends and less closeness and support from Facebook friends in emerging adulthood. These associations were mediated by a composite of face-to-face peer relationship impairment during childhood and adolescence. Intriguingly, women with persistent diagnoses of ADHD from childhood to emerging adulthood differed from women with consistent comparison status in their online social communication; women with intermittent diagnoses of ADHD had scores intermediate between the other two groups. Results are discussed within the context of understanding the social relationships of women with childhood histories of ADHD. PMID:25894439

  10. Online social communication patterns among emerging adult women with histories of childhood attention-deficit/hyperactivity disorder.

    PubMed

    Mikami, Amori Yee; Szwedo, David E; Ahmad, Shaikh I; Samuels, Andrea Stier; Hinshaw, Stephen P

    2015-08-01

    Little is known about adult women with attention-deficit/hyperactivity disorder (ADHD); however, available evidence suggests that they experience social impairment. Online social networking websites such as Facebook have become endemic outlets through which emerging adults communicate with peers. No study has examined the peer interactions of emerging adults with childhood histories of ADHD in this developmentally relevant online domain. Participants in the current study were an ethnically diverse sample of 228 women, 140 of whom met diagnostic criteria for ADHD in childhood and 88 who composed a matched comparison sample. These women were assessed at 3 time points spanning 10 years (mean age = 9.6 at Wave 1, 14.1 at Wave 2, 19.6 at Wave 3). After statistical control of demographic covariates and comorbidities, childhood ADHD diagnosis predicted, by emerging adulthood, a greater stated preference for online social communication and a greater tendency to have used online methods to interact with strangers. A childhood diagnosis of ADHD also predicted observations of fewer Facebook friends and less closeness and support from Facebook friends in emerging adulthood. These associations were mediated by a composite of face-to-face peer relationship impairment during childhood and adolescence. Intriguingly, women with persistent diagnoses of ADHD from childhood to emerging adulthood differed from women with consistent comparison status in their online social communication; women with intermittent diagnoses of ADHD had scores intermediate between the other 2 groups. Results are discussed within the context of understanding the social relationships of women with childhood histories of ADHD. PMID:25894439

  11. Nicotine-induced behavioral sensitization in an adult rat model of attention deficit/hyperactivity disorder (ADHD).

    PubMed

    Watterson, Elizabeth; Spitzer, Alexander; Watterson, Lucas R; Brackney, Ryan J; Zavala, Arturo R; Olive, M Foster; Sanabria, Federico

    2016-10-01

    Attention deficit hyperactivity disorder (ADHD) is associated with increased risk of tobacco dependence. Nicotine, the main psychoactive component of tobacco, appears to be implicated in ADHD-related tobacco dependence. However, the behavioral responsiveness to nicotine of the prevalent animal model of ADHD, the spontaneously hypertensive rat (SHR), is currently underinvestigated. The present study examined the activational effects of acute and chronic nicotine on the behavior of adult male SHRs, relative to Wistar Kyoto (WKY) controls. Experiment 1 verified baseline strain differences in open-field locomotor activity. Experiment 2 tested for baseline strain differences in rotational behavior using a Rotorat apparatus. Adult SHR and WKY rats were then exposed to a 7-day regimen of 0.6mg/kg/d s.c. nicotine, or saline, prior to each assessment. A separate group of SHRs underwent similar training, but was pre-treated with mecamylamine, a cholinergic antagonist. Nicotine sensitization, context conditioning, and mecamylamine effects were then tested. Baseline strain differences were observed in open-field performance and in the number of full rotations in the Rotorat apparatus, but not in the number of 90° rotations or direction changes. In these latter measures, SHRs displayed weaker nicotine-induced rotational suppression than WKYs. Both strains expressed nicotine-induced sensitization of rotational activity, but evidence for strain differences in sensitization was ambiguous; context conditioning was not observed. Mecamylamine reversed the effects of nicotine on SHR performance. These findings are consistent with the hypothesis that a reduced aversion to nicotine (expressed in rats as robust locomotion) may facilitate smoking among adults with ADHD. PMID:27363925

  12. Nonstimulant therapies for attention-deficit hyperactivity disorder (ADHD) in children and adults.

    PubMed

    Waxmonsky, James G

    2005-01-01

    While stimulant medications are the primary pharmacological treatment for ADHD across the lifespan, a subset of patients with ADHD do not experience significant symptom relief from stimulants or can not tolerate effective stimulant doses. Psychosocial therapies, particularly behavioral modification techniques, should be considered for children with ADHD and oppositional behaviors, while Cognitive Behavioral Therapy (CBT) may be a helpful adjunct for adolescents and adults with ADHD. Among the nonstimulant medications, atomoxetine (Strattera) is the only the FDA approved option. It has been found to be efficacious for the entire spectrum of ADHD symptoms in both children and adults. However, daily compliance is essential, and it may take several weeks to achieve full therapeutic effect. Other nonstimulants that have been used to treat ADHD include bupropion (Wellbutrin), the alpha-2 agonists guanfacine (Tenex) and clonidine (Catapres) as well as the tricylic antidepressants. Modafinil (Provigil) is actively being studied for the treatment of pediatric ADHD, and there has been some preliminary studies assessing the efficacy of cholinergic agents for ADHD. Recently, there has been increasing interest in combining nonstimulant therapies with stimulants to further enhance treatment effects. However, more controlled data on the safety and efficacy of combining pharmacological therapies are needed. PMID:16222911

  13. Alternative treatments for adults with attention-deficit hyperactivity disorder (ADHD).

    PubMed

    Arnold, L E

    2001-06-01

    A previous review of alternative treatments (Tx) of ADHD--those other than psychoactive medication and behavioral/psychosocial Tx--was supplemented with an additional literature search focused on adults with ADHD. Twenty-four alternative Tx were identified, ranging in scientific documentation from discrediting controlled studies through mere hypotheses to positive controlled double-blind clinical trials. Many of them are applicable only to a specific subgroup. Although oligoantigenic (few-foods) diets have convincing double-blind evidence of efficacy for a properly selected subgroup of children, they do not appear promising for adults. Enzyme-potentiated desensitization, relaxation/EMG biofeedback, and deleading also have controlled evidence of efficacy. Iron supplementation, magnesium supplementation, Chinese herbals, EEG biofeedback, massage, meditation, mirror feedback, channel-specific perceptual training, and vestibular stimulation all have promising prospective pilot data, many of these tests reasonably controlled. Single-vitamin megadosage has some intriguing pilot trial data. Zinc supplementation is hypothetically supported by systematic case-control data, but no systematic clinical trial. Laser acupuncture has promising unpublished pilot data and may be more applicable to adults than children. Essential fatty acid supplementation has promising systematic case-control data, but clinical trials are equivocal. RDA vitamin supplementation, non-Chinese herbals, homeopathic remedies, and antifungal therapy have no systematic data in ADHD. Megadose multivitamin combinations are probably ineffective for most patients and are possibly dangerous. Simple sugar restriction seems ineffective. Amino acid supplementation is mildly effective in the short term, but not beyond 2-3 months. Thyroid treatment is effective in the presence of documented thyroid abnormality. Some alternative Tx of ADHD are effective or probably effective, but mainly for certain patients. In some

  14. Association Between Adult Attention Deficit Hyperactivity Disorder and Helmet Use Among Motorcycle Riders

    PubMed Central

    Safiri, Saeid; Haghdoost, Ali Akbar; Hashemi, Fatemeh; Amiri, Shahrokh; Raza, Owais; Sadeghi-Bazargani, Homayoun

    2016-01-01

    Background Use of helmets plays a major role in preventing injuries or decreasing injury severity among motorcycle riders. Use of helmets may depend on personal factors such as psychological factors. Objectives The aim of this study was to independently assess the association between helmet use among motorcycle riders and ADHD scores, with controlling the accident history and was taken more sensitive measures if helmet use was different between motorcycle riders, according to their ADHD scores. Patients and Methods A cross-sectional study was done on 205 motorcycle riders referred to Kerman Referral Injury Hospital after a motorcycle traffic accident. Friends and family members possessing motorcycles who visited the patient in this facility were included in our sample. The Persian version of the Conner’s Adult ADHD Rating Scale (CAARS) self-report (screening version) was used in order to screen for adult ADHD. CAARS scores were compared between those who usually used helmets and those who did not. Results Univariable analysis showed the mean of the age variable was significantly higher in the helmeted group, 26.94 ± 7.72 vs. 23.08 ± 7.7.32, (P < 0.001). The majority of the non-helmeted group was single (P < 0.001). Subjects with secondary educational level were more often in the helmeted group (P = 0.007). Daily and weekly driving hours were higher in the non-helmeted group (P = 0.002 and P = 0.004). Most of the subjects in the helmeted group had a driving license in comparison with the other group (P < 0.001). There was not a significant association between SES and having hyperactive children and helmet use (P = 0.159). In all ADHD subscales, a significant association was found and scores were higher in the non-helmeted group (P < 0.05). Nevertheless, multivariable analysis did not confirm the association of the ADHD screening score with helmet use. Conclusions The result of this study did not find an independent association between ADHD and helmet use. PMID

  15. Micronutrients reduce stress and anxiety in adults with Attention-Deficit/Hyperactivity Disorder following a 7.1 earthquake.

    PubMed

    Rucklidge, Julia; Johnstone, Jeanette; Harrison, Rachel; Boggis, Anna

    2011-09-30

    The role of good nutrition for resilience in the face of stress is a topic of interest, but difficult to study. A 7.1 earthquake took place in the midst of research on a micronutrient treatment for Attention-Deficit/Hyperactivity Disorder (ADHD), providing a unique opportunity to examine whether individuals with ADHD taking micronutrients demonstrated more emotional resilience post-earthquake than individuals with ADHD not taking micronutrients. Thirty-three adults with ADHD were assessed twice following the earthquake using a measure of depression, anxiety and stress also completed at some point pre-earthquake (baseline). Seventeen were not taking micronutrients at the time of the earthquake (control group), 16 were (micronutrient group). While there were no between-group differences one week post-quake (Time 1), at two weeks post-quake (Time 2), the micronutrient group reported significantly less anxiety and stress than the controls (effect size 0.69). These between group differences could not be explained by other variables, such as pre-earthquake measures of emotions, demographics, psychiatric status, and personal loss or damage following the earthquake. The results suggest that micronutrients may increase resilience to ongoing stress and anxiety associated with a highly stressful event in individuals with ADHD and are consistent with controlled studies showing benefit of micronutrients for mental health. PMID:21802745

  16. Gambling behaviors and psychopathology related to Attention-Deficit/Hyperactivity Disorder (ADHD) in problem and non-problem adult gamblers.

    PubMed

    Fatseas, Melina; Alexandre, Jean-Marc; Vénisse, Jean-Luc; Romo, Lucia; Valleur, Marc; Magalon, David; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Guilleux, Alice; Groupe Jeu; Challet-Bouju, Gaëlle; Grall-Bronnec, Marie

    2016-05-30

    Previous studies showed that Pathological Gambling and Attention Deficit/Hyperactivity Disorder (ADHD) often co-occur. The aim of this study was to examine whether ADHD is associated with specific severity patterns in terms of gambling behavior, psychopathology and personality traits. 599 problem and non-problem-gamblers were recruited in addiction clinics and gambling places in France. Subjects were assessed with the Wender-Utah Rating Scale-Child, the Adult ADHD Self-Report Scale, the Mini International Neuropsychiatric Interview, the Temperament and Character Inventory, the South Oaks Gambling Screen and questionnaires assessing gambling related cognitive distortions and gambling habits. 20.7% (n=124) of gamblers were screened positive for lifetime or current ADHD. Results from the multivariate analysis showed that ADHD was associated with a higher severity of gambling-related problems and with more psychiatric comorbidity. Among problem gamblers, subjects with history of ADHD were also at higher risk for unemployment, psychiatric comorbidity and specific dysfunctional personality traits. This study supports the link between gambling related problems and ADHD in a large sample of problem and non-problem gamblers, including problem-gamblers not seeking treatment. This points out the necessity to consider this disorder in the prevention and in the treatment of pathological gambling. PMID:27031593

  17. Factors predicting treatment adherence in patients with adult attention-deficit/hyperactivity disorder: a preliminary study.

    PubMed

    Semerci, Bengi; Taskıran, Sarper; Tufan, Evren; Şanlı, Işın

    2016-09-01

    This study aimed to elicit patient- and treatment-related factors that can potentially predict treatment adherence in adult ADHD. Subjects who were over 18 and received a diagnosis of ADHD were included in the study. Chart review data of 102 subjects regarding demographics, medications, comorbidities, concomitant medications and domains of functional impairment were collected, and predictors were assessed using a binominal logistical regression model. One hundred and two patients (78.4 % male) with a mean age of 28.8 (SD = 9.8, range = 18-55) years were enrolled in the study. Childhood diagnosis of ADHD, agents used for treatment (MPH or atomoxetine), individual domains of dysfunction and use of additional psychotropic drugs were not found to be related to treatment adherence. Patients with a university education and those referred for family history of ADHD were more likely to adhere to treatment (p = 0.05 and 0.03, respectively). On the other hand, reasons for referral other than ADHD were significantly more frequently related to non-adherence (p = 0.02). Treatment noncompliance remains a significant problem despite therapeutic effects of medications. Identification of predictors of non-adherence can lead to heightened awareness of special populations at risk. We have found that prior awareness on ADHD (via past history/media/friends) leading to self/clinician referral to rule out ADHD and pervasiveness of symptoms across functional domains led to better compliance in our sample. Future research with prospective design utilizing objective tools for adherence is required. PMID:27056071

  18. Functional Properties of Rare Missense Variants of Human CDH13 Found in Adult Attention Deficit/Hyperactivity Disorder (ADHD) Patients

    PubMed Central

    Mavroconstanti, Thegna; Johansson, Stefan; Winge, Ingeborg; Knappskog, Per M.; Haavik, Jan

    2013-01-01

    The CDH13 gene codes for T-cadherin, a GPI-anchored protein with cell adhesion properties that is highly expressed in the brain and cardiovascular system. Previous studies have suggested that CDH13 may be a promising candidate gene for Attention Deficit/Hyperactivity Disorder (ADHD). The aims of this study were to identify, functionally characterize, and estimate the frequency of coding CDH13 variants in adult ADHD patients and controls. We performed sequencing of the CDH13 gene in 169 Norwegian adult ADHD patients and 63 controls and genotyping of the identified variants in 641 patients and 668 controls. Native and green fluorescent protein tagged wild type and variant CDH13 proteins were expressed and studied in CHO and HEK293 cells, respectively. Sequencing identified seven rare missense CDH13 variants, one of which was novel. By genotyping, we found a cumulative frequency of these rare variants of 2.9% in controls and 3.2% in ADHD patients, implying that much larger samples are needed to obtain adequate power to study the genetic association between ADHD and rare CDH13 variants. Protein expression and localization studies in CHO cells and HEK293 cells showed that the wild type and mutant proteins were processed according to the canonical processing of GPI-anchored proteins. Although some of the mutations were predicted to severely affect protein secondary structure and stability, no significant differences were observed between the expression levels and distribution of the wild type and mutant proteins in either HEK293 or CHO cells. This is the first study where the frequency of coding CDH13 variants in patients and controls is reported and also where the functional properties of these variants are examined. Further investigations are needed to conclude whether CDH13 is involved in the pathogenesis of ADHD or other conditions. PMID:23936508

  19. Functional properties of rare missense variants of human CDH13 found in adult attention deficit/hyperactivity disorder (ADHD) patients.

    PubMed

    Mavroconstanti, Thegna; Johansson, Stefan; Winge, Ingeborg; Knappskog, Per M; Haavik, Jan

    2013-01-01

    The CDH13 gene codes for T-cadherin, a GPI-anchored protein with cell adhesion properties that is highly expressed in the brain and cardiovascular system. Previous studies have suggested that CDH13 may be a promising candidate gene for Attention Deficit/Hyperactivity Disorder (ADHD). The aims of this study were to identify, functionally characterize, and estimate the frequency of coding CDH13 variants in adult ADHD patients and controls. We performed sequencing of the CDH13 gene in 169 Norwegian adult ADHD patients and 63 controls and genotyping of the identified variants in 641 patients and 668 controls. Native and green fluorescent protein tagged wild type and variant CDH13 proteins were expressed and studied in CHO and HEK293 cells, respectively. Sequencing identified seven rare missense CDH13 variants, one of which was novel. By genotyping, we found a cumulative frequency of these rare variants of 2.9% in controls and 3.2% in ADHD patients, implying that much larger samples are needed to obtain adequate power to study the genetic association between ADHD and rare CDH13 variants. Protein expression and localization studies in CHO cells and HEK293 cells showed that the wild type and mutant proteins were processed according to the canonical processing of GPI-anchored proteins. Although some of the mutations were predicted to severely affect protein secondary structure and stability, no significant differences were observed between the expression levels and distribution of the wild type and mutant proteins in either HEK293 or CHO cells. This is the first study where the frequency of coding CDH13 variants in patients and controls is reported and also where the functional properties of these variants are examined. Further investigations are needed to conclude whether CDH13 is involved in the pathogenesis of ADHD or other conditions. PMID:23936508

  20. Long-Term Pharmacotherapy of Adults With Attention Deficit Hyperactivity Disorder: A Literature Review and Clinical Study.

    PubMed

    Fredriksen, Mats; Peleikis, Dawn E

    2016-01-01

    This MiniReview reports and discusses the main findings of the author's thesis including a literature study of long-term pharmacological treatment of adults with attention deficit hyperactivity disorder (ADHD), and a clinical study of 1-year medication. Electronic databases were systematically reviewed for original studies on pharmacotherapy of the defined duration, 24 weeks or more. Although few trials were found with limitations such as excluding comorbidities, treatment with stimulants and atomoxetine was reported tolerated and effective compared to non-treatment. The clinical study of the thesis was conducted on 250 medication-naïve patients with ADHD referred to a specialized outpatient clinic. Comorbid psychiatric disorders were diagnosed among 75% of the patients. About 56% had not completed secondary school, and 51% had been unable to work the preceding year. Persisting inattentive symptoms and comorbid mental disorders in adulthood were related to long-term work disability. In the prospective observational study of the thesis, patients were treated with methylphenidate as first-line drug and atomoxetine or dexamphetamine as second-line drugs, according to current treatment guidelines. At 12-month follow-up, 232 patients completed evaluation and 70% persisted on medication. About 80% of these used methylphenidate. Sustained improvement of symptoms and functioning was related to continued medication. Comorbid mental disorders and side effects were related to lower effectiveness and adherence, and 12% stopped medication due to side effects. Summing up the MiniReview, treatment with stimulants and atomoxetine of adults with ADHD has long-term beneficial effects and is tolerated but more longitudinal studies should be performed. With stated limitations, the findings of the thesis should contribute to a relevant guidance for clinical practice. PMID:26404187

  1. Dysfunctional Career Thoughts and Attitudes as Predictors of Vocational Identity among Young Adults with Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Dipeolu, Abiola; Sniatecki, Jessica L.; Storlie, Cassandra A.; Hargrave, Stephanie

    2013-01-01

    This study examined dysfunctional career thoughts and attitudes as predictors of vocational identity among high school students with Attention Deficit Hyperactivity Disorder (ADHD). Regression analysis results indicated that dysfunctional career thoughts and attitudes were significant predictors of vocational identity, accounting for 42% of the…

  2. Does mindfulness meditation improve attention in attention deficit hyperactivity disorder?

    PubMed Central

    Modesto-Lowe, Vania; Farahmand, Pantea; Chaplin, Margaret; Sarro, Lauren

    2015-01-01

    Attention deficit hyperactivity disorder (ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperactivity declines over time, inattention and executive function difficulties persist, leading to functional deficits. Adolescents and adults with ADHD have pervasive impairment in interpersonal and family relationships. They may develop addiction, delinquent behavior and comorbid psychiatric disorders. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. Mindfulness training, derived from Eastern meditation practices, may improve self-regulation of attention. It may also be a useful strategy to augment standard ADHD treatments and may be used as a potential tool to reduce impairments in patients with residual symptoms of ADHD. Clinically, this would manifest by an increased ability to suppress task-unrelated thoughts and distractions resulting in improved attention, completion of tasks and potential improvement in occupational and social function. PMID:26740931

  3. Does mindfulness meditation improve attention in attention deficit hyperactivity disorder?

    PubMed

    Modesto-Lowe, Vania; Farahmand, Pantea; Chaplin, Margaret; Sarro, Lauren

    2015-12-22

    Attention deficit hyperactivity disorder (ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperactivity declines over time, inattention and executive function difficulties persist, leading to functional deficits. Adolescents and adults with ADHD have pervasive impairment in interpersonal and family relationships. They may develop addiction, delinquent behavior and comorbid psychiatric disorders. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. Mindfulness training, derived from Eastern meditation practices, may improve self-regulation of attention. It may also be a useful strategy to augment standard ADHD treatments and may be used as a potential tool to reduce impairments in patients with residual symptoms of ADHD. Clinically, this would manifest by an increased ability to suppress task-unrelated thoughts and distractions resulting in improved attention, completion of tasks and potential improvement in occupational and social function. PMID:26740931

  4. Delayed sleep timing and symptoms in adults with attention-deficit/hyperactivity disorder: a controlled actigraphy study.

    PubMed

    Gamble, Karen L; May, Roberta S; Besing, Rachel C; Tankersly, Amelia P; Fargason, Rachel E

    2013-05-01

    Patients with attention-deficit/hyperactivity disorder (ADHD) often exhibit disrupted sleep and circadian rhythms. Determination of whether sleep disturbance and/or circadian disruption are differentially associated with symptom severity is necessary to guide development of future treatment strategies. Therefore, we measured sleep and ADHD symptoms in participants aged 19-65 who met the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) criteria for ADHD and insomnia without psychiatric comorbidities by monitoring actigraphy and daily sleep logs for 2 wks, as well as the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), the ADHD Rating Scale (ADHD-RS), and a clinic-designed sleep behavior questionnaire. Principal components analysis identified correlated circadian- and sleep-related variables in all participants with ADHD who completed the study (n = 24). The identified components were entered into a backwards stepwise linear regression analysis, which indicated that delayed sleep timing and increased sleepiness (ESS) (but not sleep duration or sleep efficiency) significantly predicted greater severity of both hyperactive-impulsive and inattentive ADHD symptoms (p < .05 for partial regression coefficients). In addition, combined subtypes had the most impaired age-adjusted sleep quality (PSQI scores; p < .05 compared with healthy controls; n = 13), and 91.7% of them reported going to bed late due to being "not tired/too keyed up to sleep" compared with 57.2% and 50% of inattentive and symptom-controlled participants, respectively (p < .05). In conclusion, the results of this study suggest that ADHD symptom severity correlates with delayed sleep timing and daytime sleepiness, suggesting that treatment interventions aimed at advancing circadian phase may improve daytime sleepiness. In addition, ADHD adults with combined hyperactive-impulsive and inattentive symptoms have decreased sleep quality as well

  5. Response to methylphenidate by adult and pediatric patients with attention-deficit/hyperactivity disorder: the Spanish multicenter DIHANA study

    PubMed Central

    Valdizán-Usón, JR; Cánovas-Martínez, A; De Lucas-Taracena, MT; Díaz-Atienza, F; Eddy-Ives, LS; Fernández-Jaén, A; Fernández-Pérez, M; García-Giral, M; García-Magán, P; Garraus-Oneca, M; Idiazábal-Alecha, MA; López-Benito, M; Lorenzo-Sanz, G; Martínez-Antón, J; Martínez-Granero, MA; Montañés-Rada, F; Mulas-Delgado, F; Ochando-Perales, G; Ortega-García, E; Pelaz-Antolín, A; Ramos-Quiroga, JA; Ruiz-Sanz, FC; Vaquerizo-Madrid, J; Yusta-Izquierdo, A

    2013-01-01

    Background: The purpose of this multicenter Spanish study was to evaluate the response to immediate-release methylphenidate by children and adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), as well as to obtain information on current therapy patterns and safety characteristics. Methods: This multicenter, observational, retrospective, noninterventional study included 730 patients aged 4–65 years with a diagnosis of ADHD. Information was obtained based on a review of medical records for the years 2002–2006 in sequential order. Results: The ADHD predominantly inattentive subtype affected 29.7% of patients, ADHD predominantly hyperactive-impulsive was found in 5.2%, and the combined subtype in 65.1%. Overall, a significant lower Clinical Global Impression (CGI) score and mean number of DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision) symptoms by subtype were found after one year of treatment with immediate-release methylphenidate; CGI decreased from 4.51 to 1.69, symptoms of inattention from 7.90 to 4.34, symptoms of hyperactivity from 6.73 to 3.39, and combined subtype symptoms from 14.62 to 7.7. Satisfaction with immediate-release methylphenidate after one year was evaluated as “very satisfied” or “satisfied” by 86.90% of the sample; 25.75% of all patients reported at least one adverse effect. At the end of the study, 41.47% of all the patients treated with immediate-release methylphenidate were still receiving it, with a mean time of 3.80 years on therapy. Conclusion: Good efficacy and safety results were found for immediate-release methylphenidate in patients with ADHD. PMID:23430373

  6. Treatment Approaches to Attention Deficit Hyperactivity Disorder.

    PubMed

    Antai-Otong, Deborah; Zimmerman, Michele L

    2016-06-01

    Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children, adolescents, and adults, with a prevalence estimated from 5% to 7% across cultures and approximately 2% to 5% in adults. This lifelong disorder challenges nurses to understand the basis of ADHD, analyze symptoms, differentiate coexisting disorders, gather health information from varied sources, and implement person-centered multimodal treatment. Nurses are poised to plan, and work with patients, families, and teachers in the community and school systems to optimize academic and occupational performance and improve quality of life. Pharmacotherapy, psychoeducation, and behavioral therapies are strong components of multimodal treatment planning. PMID:27229276

  7. The Adult ADHD Self-Report Scale (ASRS): utility in college students with attention-deficit/hyperactivity disorder.

    PubMed

    Gray, Sarah; Woltering, Steven; Mawjee, Karizma; Tannock, Rosemary

    2014-01-01

    Background. The number of students with Attention Deficit/Hyperactivity Disorder (ADHD) enrolled in colleges and universities has increased markedly over the past few decades, giving rise to questions about how best to document symptoms and impairment in the post-secondary setting. The aim of the present study was to investigate the utility and psychometric properties of a widely-used rating scale for adults with ADHD, the Adult ADHD Self-Report Scale (ASRS-V1.1), in a sample of post-secondary students with ADHD. Methods. A total of 135 college students (mean age = 24, 42% males) with ADHD were recruited from Student Disability Services in post-secondary institutions. We compared informant responses on the ASRS administered via different modalities. First, students' self-report was ascertained using the ASRS Screener administered via telephone interview, in which they were asked to provide real-life examples of behavior for each of the six items. Next, students self-reported symptoms on the 18-item paper version of the ASRS Symptom Checklist administered about 1-2 weeks later, and a collateral report using an online version of the 18-item ASRS Symptom Checklist. Students also completed self-report measures of everyday cognitive failure (CFQ) and executive functioning (BDEFS). Results. Results revealed moderate to good congruency between the 18-item ASRS-Self and ASRS-Collateral reports (correlation = .47), and between student self-report on the 6-item telephone-based and paper versions of the ASRS, with the paper version administered two weeks later (correlation = .66). The full ASRS self-report was related to impairment, such as in executive functioning (correlation = .63) and everyday cognitive failure (correlation = .74). Executive functioning was the only significant predictor of ASRS total scores. Discussion. Current findings suggest that the ASRS provides an easy-to-use, reliable, and cost-effective approach for gathering information about current symptoms of

  8. Confirmatory Factor Analysis of the Behavior Rating Inventory of Executive Function-Adult Version in Healthy Adults and Application to Attention-Deficit/Hyperactivity Disorder

    PubMed Central

    Roth, Robert M.; Lance, Charles E.; Isquith, Peter K.; Fischer, Adina S.; Giancola, Peter R.

    2013-01-01

    The Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) is a questionnaire measure designed to assess executive functioning in everyday life. Analysis of data from the BRIEF-A standardization sample yielded a two-factor solution (labeled Behavioral Regulation and Metacognition). The present investigation employed confirmatory factor analysis (CFA) to evaluate four alternative models of the factor structure of the BRIEF-A self-report form in a sample of 524 healthy young adults. Results indicated that a three-factor model best fits the data: a Metacognition factor, a Behavioral Regulation factor consisting of the Inhibit and Self-Monitor scales, and an Emotional Regulation factor composed of the Emotional Control and Shift scales. The three factors contributed 14%, 19%, and 24% of unique variance to the model, respectively, and a second-order general factor accounted for 41% of variance overall. This three-factor solution is consistent with recent CFAs of the Parent report form of the BRIEF. Furthermore, although the Behavioral Regulation factor score in the two-factor model did not differ between adults with attention-deficit/hyperactivity disorder and a matched healthy comparison group, greater impairment on the Behavioral Regulation factor but not the Emotional Regulation factor was found using the three-factor model. Together, these findings support the multidimensional nature of executive function and the clinical relevance of a three-factor model of the BRIEF-A. PMID:23676185

  9. Attention-deficit hyperactivity disorder.

    PubMed

    Wolraich, Mark L

    2006-12-01

    Attention-deficit hyperactivity disorder (ADHD) is a challenging condition to diagnose and treat. For diagnosis, the clinician needs to establish the presence of ADHD on Diagnostic and Statistical Manual of Mental Disorders criteria requiring information from parents and teachers and considering both alternative diagnoses and co-occurring conditions. In the treatment of ADHD as a chronic illness, the clinician needs to educate the family about the condition and partner with them about treatment decisions. The 2 treatments with demonstrated efficacy for ADHD are medications (stimulant medications and a selective norepinephrine reuptake inhibiter) and behavior-modification programs. PMID:17178358

  10. Extended-Release Mixed Amphetamine Salts vs Placebo for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cocaine Use Disorder

    PubMed Central

    Levin, Frances R.; Mariani, John J.; Specker, Sheila; Mooney, Marc; Mahony, Amy; Brooks, Daniel J.; Babb, David; Bai, Yun; Eberly, Lynn E.; Nunes, Edward V.; Grabowski, John

    2015-01-01

    IMPORTANCE Adult attention-deficit/hyperactivity disorder (ADHD) is prevalent but often unrecognized, in part because it tends to co-occur with other disorders such as substance use disorders. Cocaine use disorder is one such disorder with high co-occurrence of ADHD. OBJECTIVE To examine whether treatment of co-occurring ADHD and cocaine use disorder with extended-release mixed amphetamine salts is effective at both improving ADHD symptoms and reducing cocaine use. DESIGN, SETTING, AND PARTICIPANTS Thirteen-week, randomized, double-blind, 3-arm, placebo-controlled trial of participants meeting DSM-IV-TR criteria for both ADHD and cocaine use disorder conducted between December 1, 2007, and April 15, 2013, at 2 academic health center substance abuse treatment research sites. One hundred twenty-six adults diagnosed as having comorbid ADHD and cocaine use disorder were randomized to extended-release mixed amphetamine salts or placebo. Analysis was by intent-to-treat population. INTERVENTIONS Participants received extended-release mixed amphetamine salts (60 or 80 mg) or placebo daily for 13 weeks and participated in weekly individual cognitive behavioral therapy. MAIN OUTCOMES AND MEASURES For ADHD, percentage of participants achieving at least a 30% reduction in ADHD symptom severity, measured by the Adult ADHD Investigator Symptom Rating Scale; for cocaine use, cocaine-negative weeks (by self-report of no cocaine use and weekly benzoylecgonine urine screens) during maintenance medication (weeks 2–13) and percentage of participants achieving abstinence for the last 3 weeks. RESULTS More patients achieved at least a 30% reduction in ADHD symptom severity in the medication groups (60 mg: 30 of 40 participants [75.0%]; odds ratio [OR] = 5.23; 95% CI, 1.98–13.85; P < .001; and 80 mg: 25 of 43 participants [58.1%]; OR = 2.27; 95% CI, 0.94–5.49; P = .07) compared with placebo (17 of 43 participants [39.5%]). The odds of a cocaine-negative week were higher in the 80

  11. Attention-deficit/hyperactivity disorder.

    PubMed

    Shaywitz, B A; Fletcher, J M; Shaywitz, S E

    1997-01-01

    In this chapter we have reviewed the diagnosis and management of attention deficit disorder, focusing particularly on the role of stimulant therapy in ADHD. Hisorical review suggests that ADHD has roots that extend back almost a century. The definition of ADHD is based on inclusion and exclusion criteria that are established by history and reflect behavioral concerns. Attention-deficit/hyperactivity disorder is a chronic disorder affecting the child's home, school, and community life. The primary symptoms of the disorder manifest a developmental pattern: activity diminishes while attentional deficits persist. Major sources of concern are the secondary and often more resistant problems of learning difficulties, behavioral problems, lack of peer acceptance, and low self-esteem. An often frustrating and perplexing characteristic of the disorder is its marked variability-over time, across situations, and within the same child and similar situations. Educational management represents an important priority and often forms the cornerstone of all other therapies, nonpharmacologic or pharmacologic. Cognitive-behavioral therapies represent the most widely used alternative to pharmacotherapy. Although the effects of CBT alone are disappointing, recent studies suggest that such therapies may provide a useful adjunct to pharmacotherapy and may be helpful when children are tapered off medication. Psychotherapy, or a combination of psychotherapy and medication (termed multimodality therapy), may also be useful. Pharmacotherapy for ADHD originated almost 60 years ago, and at this time the ameliorative effects of medications in ADHD are well established. The general skepticism of experienced clinicians, coupled with a climate where parents are reluctant to medicare children, serves to limit their use except where indicated. Although the effects of stimulants on attention and activity seem well established, effects on cognition, conduct, and social behavior are more controversial

  12. Attention-Deficit/Hyperactivity Disorder.

    PubMed

    Bokor, Gyula; Anderson, Peter D

    2014-08-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurobiological condition of childhood onset with the hallmarks of inattention, impulsivity, and hyperactivity. Inattention includes excessive daydreaming, disorganization, and being easily distracted. Impulsivity manifests as taking an action before fully thinking of the consequences. Hyperactivity includes an excessive rate of speech and motor activity. Complications of ADHD include academic failure, low self-esteem, poor work performance, substance abuse, criminal justice issues, and social problems. ADHD is predominately due to decreased activity in the frontal lobe. Dopamine and norepinephrine are the main neurotransmitters involved in the pathophysiology of ADHD. Pharmacological treatment of ADHD includes psychostimulants, norepinephrine reuptake inhibitors, α2 agonists, bupropion, and monoamine oxidase inhibitors. The most effective medications are the psychostimulants. Nonpharmacological treatment of ADHD includes coaching, providing structure, academic accommodations, and work accommodations. PMID:25092688

  13. Neural activation during response inhibition in adult Attention-Deficit/Hyperactivity Disorder: Preliminary findings on the effects of medication and symptom severity

    PubMed Central

    Congdon, Eliza; Altshuler, Lori L.; Mumford, Jeanette A.; Karlsgodt, Katherine H.; Sabb, Fred W.; Ventura, Joseph; McGough, James J.; London, Edythe D.; Cannon, Tyrone D.; Bilder, Robert M.; Poldrack, Russell A.

    2014-01-01

    Studies of adults with attention-deficit/hyperactivity disorder (ADHD) have suggested that they have deficient response inhibition, but findings concerning the neural correlates of inhibition in this patient population are inconsistent. We used the Stop-Signal task and functional magnetic resonance imaging (fMRI) to compare neural activation associated with response inhibition between adults with ADHD (N = 35) and healthy comparison subjects (N = 62), and in follow-up tests to examine the effect of current medication use and symptom severity. There were no differences in Stop-Signal task performance or neural activation between ADHD and control participants. Among the ADHD participants, however, significant differences were associated with current medication, with individuals taking psychostimulants (N = 25) showing less stopping-related activation than those not currently receiving psychostimulant medication (N = 10). Follow-up analyses suggested that this difference in activation was independent of symptom severity. These results provide evidence that deficits in inhibition-related neural activation persist in a subset of adult ADHD individuals, namely those individuals currently taking psychostimulants. These findings help to explain some of the disparities in the literature, and advance our understanding of why deficits in response inhibition are more variable in adult, as compared with child and adolescent, ADHD patients. PMID:24581734

  14. Early-adult correlates of maltreatment in girls with attention-deficit/hyperactivity disorder: Increased risk for internalizing symptoms and suicidality.

    PubMed

    Guendelman, Maya D; Owens, Elizabeth B; Galán, Chardee; Gard, Arianna; Hinshaw, Stephen P

    2016-02-01

    We examined whether maltreatment experienced in childhood and/or adolescence prospectively predicts young adult functioning in a diverse and well-characterized sample of females with childhood-diagnosed attention-deficit/hyperactivity disorder (N = 140). Participants were part of a longitudinal study and carefully evaluated in childhood, adolescence, and young adulthood (M age = 9.6, 14.3, and 19.7 years, respectively), with high retention rates across time. A thorough review of multisource data reliably established maltreatment status for each participant (M κ = 0.78). Thirty-two (22.9%) participants experienced at least one maltreatment type (physical abuse, sexual abuse, or neglect). Criterion variables included a broad array of young adult measures of functioning gleaned from multiple-source, multiple-informant instruments. With stringent statistical control of demographic, prenatal, and family status characteristics as well as baseline levels of the criterion variable in question, maltreated participants were significantly more impaired than nonmaltreated participants with respect to self-harm (suicide attempts), internalizing symptomatology (anxiety and depression), eating disorder symptomatology, and well-being (lower overall self-worth). Effect sizes were medium. Comprising the first longitudinal evidence linking maltreatment with key young adult life impairments among a carefully diagnosed and followed sample of females with attention-deficit/hyperactivity disorder, these findings underscore the clinical importance of trauma experiences within this population. PMID:25723055

  15. Early-adult correlates of maltreatment in girls with attention-deficit/hyperactivity disorder: Increased risk for internalizing symptoms and suicidality

    PubMed Central

    GUENDELMAN, MAYA D.; OWENS, ELIZABETH B.; GALÁN, CHARDEE; GARD, ARIANNA; HINSHAW, STEPHEN P.

    2016-01-01

    We examined whether maltreatment experienced in childhood and/or adolescence prospectively predicts young adult functioning in a diverse and well-characterized sample of females with childhood-diagnosed attention-deficit/hyperactivity disorder (N = 140). Participants were part of a longitudinal study and carefully evaluated in childhood, adolescence, and young adulthood (Mage = 9.6, 14.3, and 19.7 years, respectively), with high retention rates across time. A thorough review of multisource data reliably established maltreatment status for each participant (Mκ = 0.78). Thirty-two (22.9%) participants experienced at least one maltreatment type (physical abuse, sexual abuse, or neglect). Criterion variables included a broad array of young adult measures of functioning gleaned from multiple-source, multiple-informant instruments. With stringent statistical control of demographic, prenatal, and family status characteristics as well as baseline levels of the criterion variable in question, maltreated participants were significantly more impaired than nonmaltreated participants with respect to self-harm (suicide attempts), internalizing symptomatology (anxiety and depression), eating disorder symptomatology, and well-being (lower overall self-worth). Effect sizes were medium. Comprising the first longitudinal evidence linking maltreatment with key young adult life impairments among a carefully diagnosed and followed sample of females with attention-deficit/hyperactivity disorder, these findings underscore the clinical importance of trauma experiences within this population. PMID:25723055

  16. Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder. American Academy of Child and Adolescent Psychiatry.

    PubMed

    Dulcan, M

    1997-10-01

    These practice parameters review the literature on children, adolescents, and adults with attention-deficit/hyperactivity disorder (ADHD). There are three types of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Together, they occur in as many as 10% of boys and 5% of girls of elementary school age. Prevalence declines with age, although up to 65% of hyperactive children are still symptomatic as adults. Frequency in adults is estimated to be 2% to 7%. Assessment includes clinical interviews and standardized rating scales from parents and teachers. Testing of intelligence and academic achievement usually are required. Comorbidity is common. The cornerstones of treatment are support and education of parents, appropriate school placement, and pharmacology. The primary medications are psychostimulants, but antidepressants and alpha-adrenergic agonists are used in special circumstances. Other treatments such as behavior modification, school consultation, family therapy, and group therapy address remaining symptoms. PMID:9334567

  17. The association of Internet addiction symptoms with impulsiveness, loneliness, novelty seeking and behavioral inhibition system among adults with attention-deficit/hyperactivity disorder (ADHD).

    PubMed

    Li, Wendi; Zhang, Wei; Xiao, Lin; Nie, Jia

    2016-09-30

    The aims of this study were to test the associations of the Internet addiction symptoms with impulsiveness, loneliness, novelty seeking and behavioral inhibition systems among adults with attention-deficit/hyperactivity disorder (ADHD) and adults with non-ADHD. A total of 146 adults aged between 19 and 33 years involved in this study. Participants were assessed with the Chinese version of the adult ADHD Self-report scale (ASRS), the Revised Chen Internet Addiction Scale (CIAS-R), the Barratt Impulsiveness Scale 11 (BIS-11), the Tridimensional Personality Questionnaire (TPQ), the UCLA loneliness scale, and the Behavioral Inhibition System and Behavioral Activation System Scale (BIS/BAS Scale). The results of hierarchical regression analysis indicated that impulsiveness, loneliness, and behavioral inhibition system were significant predictors of Internet addition among adults with ADHD. Higher loneliness was significantly associated with more severe Internet addition symptoms among the non-ADHD group. Adults with high impulsiveness, loneliness, and BIS should be treated with caution for preventing Internet addiction. In addition, adults with and without ADHD should be provided with different preventative strategies. PMID:27449004

  18. Attention deficit disorder: current perspectives.

    PubMed

    Shaywitz, S E; Shaywitz, B A

    1987-01-01

    This review focuses on selected issues in the rapidly proliferating scientific literature on attention deficit disorder (ADD). It encompasses a brief overview of ADD, including a review of the historical trends, causation, and a description of the clinical characteristics. Critical issues fundamental to understanding of ADD are addressed next. Evidence is presented to suggest that there are several groups of children with ADD who are currently under-identified and therefore, underserved (girls with ADD; ADD without hyperactivity). The concept is introduced of uncomplicated ADD and ADD-Plus (ADD-P), a term used to designate ADD associated with other complicating features such as conduct disorder. Specific methodologic issues and their relationship to the under-identification of these groups of children follows. This discussion encompasses the reasons for diagnostic imprecision and inconsistency, emphasizing the problem of selective referral patterns and how it results in an inaccurate portrait of ADD. We then present new approaches to the definition and diagnosis of ADD based on empiric studies designed to circumvent some of these problems. We conclude with a summary of the implications of these findings, and recommendations for public policy in ADD, particularly the need to recognize that ADD may occur even in the most intellectually gifted individuals and even in students in select colleges. Often these children with the highest potential are penalized most, not because of conceptual limitations or because they do not understand, but because educators often fail to recognize the symptom complex. Many of these children are succeeding through intelligence and great effort, but many more could succeed with proper identification. PMID:3334012

  19. Atomoxetine Treatment Strengthens an Anti-Correlated Relationship between Functional Brain Networks in Medication-Naïve Adults with Attention-Deficit Hyperactivity Disorder: A Randomized Double-Blind Placebo-Controlled Clinical Trial

    PubMed Central

    Lin, Hsiang-Yuan

    2016-01-01

    Background: Although atomoxetine demonstrates efficacy in individuals with attention-deficit hyperactivity disorder, its treatment effects on brain resting-state functional connectivity remain unknown. Therefore, we aimed to investigate major brain functional networks in medication-naïve adults with attention-deficit hyperactivity disorder and the efficacy of atomoxetine treatment on resting-state functional connectivity. Methods: After collecting baseline resting-state functional MRI scans from 24 adults with attention-deficit hyperactivity disorder (aged 18–52 years) and 24 healthy controls (matched in demographic characteristics), the participants with attention-deficit hyperactivity disorder were randomly assigned to atomoxetine (n=12) and placebo (n=12) arms in an 8-week, double-blind, placebo-controlled trial. The primary outcome was functional connectivity assessed by a resting-state functional MRI. Seed-based functional connectivity was calculated and compared for the affective, attention, default, and cognitive control networks. Results: At baseline, we found atypical cross talk between the default, cognitive control, and dorsal attention networks and hypoconnectivity within the dorsal attention and default networks in adults with attention-deficit hyperactivity disorder. Our first-ever placebo-controlled clinical trial incorporating resting-state functional MRI showed that treatment with atomoxetine strengthened an anticorrelated relationship between the default and task-positive networks and modulated all major brain networks. The strengthened anticorrelations were associated with improving clinical symptoms in the atomoxetine-treated adults. Conclusions: Our results support the idea that atypical default mode network task-positive network interaction plays an important role in the pathophysiology of adult attention-deficit hyperactivity disorder. Strengthening this atypical relationship following atomoxetine treatment suggests an important pathway to

  20. Mindfulness and Attention Deficit Hyperactivity Disorder

    PubMed Central

    Smalley, Susan L.; Loo, Sandra K.; Hale, T. Sigi; Shrestha, Anshu; McGough, James; Flook, Lisa; Reise, Steven

    2010-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) is a disorder characterized by attentional difficulties. Mindfulness is a receptive attention to present experience. Both ADHD and mindfulness are associated with attention and personality. This study tests whether individuals with ADHD have lower mindfulness scores than controls and, if true, whether personality contributes to these differences. 105 adults (half with ADHD) were assessed for mindfulness, using the Kentucky Inventory of Mindfulness Skills, and personality, using the Tridimensional Character Inventory. Individuals with ADHD report themselves as less mindful than non-ADHD controls and more novelty-seeking, less self-directed, and more self-transcendent. Mindfulness is negatively associated with ADHD and positively associated with self-directedness and self-transcendence. Analyses of subscales of mindfulness suggest that ADHD is associated most with the ‘Acting in Awareness’ dimension perhaps due to shared items reflecting attentional variability. The current findings support that a large portion of variability in trait mindfulness can be explained by ADHD status and personality traits of self-directedness and self-transcendence. It further suggests that interventions that increase mindfulness might improve symptoms of ADHD and increase self-directedness and/or self-transcendence. PMID:19681107

  1. Adult attention deficit hyperactivity disorder symptoms and five-factor model traits in a clinical sample: a structural equation modeling approach.

    PubMed

    Knouse, Laura E; Traeger, Lara; O'Cleirigh, Conall; Safren, Steven A

    2013-10-01

    Relationships among attention deficit hyperactivity disorder (ADHD) symptoms and adult personality traits have not been examined in larger clinically diagnosed samples. We collected multisource ADHD symptom and self-report NEO Five-Factor Inventory (Costa and McCrae [Odessa, FL: Psychological Assessment Resources, Inc, 1992) data from 117 adults with ADHD and tested symptom-trait associations using structural equation modeling. The final model fit the data. Inattention was positively associated with neuroticism and negatively associated with conscientiousness. On the basis of ADHD expression in adulthood, hyperactivity and impulsivity were estimated as separate constructs and showed differential relationships to extraversion and agreeableness. A significant positive relationship between hyperactivity and conscientiousness arose in the context of other pathways. ADHD symptoms are reliably associated with personality traits, suggesting a complex interplay across development that warrants prospective study into adulthood. PMID:24080671

  2. Challenges in Identifying and Managing Attention-Deficit/Hyperactivity Disorder in Adults in the Primary Care Setting: A Review of the Literature

    PubMed Central

    Mattingly, Gregory

    2010-01-01

    Objective: To examine how to screen for and establish a correct diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults and to identify the outcomes associated with untreated ADHD. Data Sources: PubMed was searched using the key words ADHD, adult, diagnosis, and primary care from the years 1999 to 2009. Study Selection: This search produced 50 publications. Data Extraction: Publications were screened for data specific to the diagnosis or management of adult patients with ADHD in the primary care setting. Data Synthesis: The estimated prevalence of ADHD in adults throughout the United States is 4.4% or approximately 10 million adults. Adults with ADHD by definition must experience impairment from the symptoms of ADHD in at least 2 areas of their life. Despite significant impairment, only 1 in 10 adults with ADHD have received ADHD treatment within the past year. Given the high rates of undertreatment, primary care physicians, who provide much of the general adult mental health care in the United States, are increasingly charged with making the diagnosis of ADHD in adults. ADHD symptoms are often masked by comorbid psychiatric conditions or patient adaptations such as choice of occupation. One of the ADHD assessment tools, a short 6-item screener, can simplify identification and management of ADHD in adults and help identify which patients may require further evaluation. Conclusions: Primary care physicians should consult with other members of the health care community such as psychiatrists and psychologists when necessary, but should also develop a level of comfort with diagnosing and treating ADHD. PMID:21494335

  3. Altered intrinsic organisation of brain networks implicated in attentional processes in adult attention-deficit/hyperactivity disorder: a resting-state study of attention, default mode and salience network connectivity.

    PubMed

    Sidlauskaite, Justina; Sonuga-Barke, Edmund; Roeyers, Herbert; Wiersema, Jan R

    2016-06-01

    Deficits in task-related attentional engagement in attention-deficit/hyperactivity disorder (ADHD) have been hypothesised to be due to altered interrelationships between attention, default mode and salience networks. We examined the intrinsic connectivity during rest within and between these networks. Six-minute resting-state scans were obtained. Using a network-based approach, connectivity within and between the dorsal and ventral attention, the default mode and the salience networks was compared between the ADHD and control group. The ADHD group displayed hyperconnectivity between the two attention networks and within the default mode and ventral attention network. The salience network was hypoconnected to the dorsal attention network. There were trends towards hyperconnectivity within the dorsal attention network and between the salience and ventral attention network in ADHD. Connectivity within and between other networks was unrelated to ADHD. Our findings highlight the altered connectivity within and between attention networks, and between them and the salience network in ADHD. One hypothesis to be tested in future studies is that individuals with ADHD are affected by an imbalance between ventral and dorsal attention systems with the former playing a dominant role during task engagement, making individuals with ADHD highly susceptible to distraction by salient task-irrelevant stimuli. PMID:26260900

  4. Lower white matter microstructure in the superior longitudinal fasciculus is associated with increased response time variability in adults with attention-deficit/hyperactivity disorder

    PubMed Central

    Wolfers, Thomas; Onnink, A. Marten H.; Zwiers, Marcel P.; Arias-Vasquez, Alejandro; Hoogman, Martine; Mostert, Jeanette C.; Kan, Cornelis C.; Slaats-Willemse, Dorine; Buitelaar, Jan K.; Franke, Barbara

    2015-01-01

    Background Response time variability (RTV) is consistently increased in patients with attention-deficit/hyperactivity disorder (ADHD). A right-hemispheric frontoparietal attention network model has been implicated in these patients. The 3 main connecting fibre tracts in this network, the superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF) and the cingulum bundle (CB), show microstructural abnormalities in patients with ADHD. We hypothesized that the microstructural integrity of the 3 white matter tracts of this network are associated with ADHD and RTV. Methods We examined RTV in adults with ADHD by modelling the reaction time distribution as an exponentially modified Gaussian (ex-Gaussian) function with the parameters μ, σ and τ, the latter of which has been attributed to lapses of attention. We assessed adults with ADHD and healthy controls using a sustained attention task. Diffusion tensor imaging–derived fractional anisotropy (FA) values were determined to quantify bilateral microstructural integrity of the tracts of interest. Results We included 100 adults with ADHD and 96 controls in our study. Increased τ was associated with ADHD diagnosis and was linked to symptoms of inattention. An inverse correlation of τ with mean FA was seen in the right SLF of patients with ADHD, but no direct association between the mean FA of the 6 regions of interest with ADHD could be observed. Limitations Regions of interest were defined a priori based on the attentional network model for ADHD and thus we might have missed effects in other networks. Conclusion This study suggests that reduced microstructural integrity of the right SLF is associated with elevated τ in patients with ADHD. PMID:26079698

  5. Management of attention-deficit hyperactivity disorder

    PubMed Central

    Verma, Rohit; Balhara, Yatan Pal Singh; Mathur, Shachi

    2011-01-01

    Attention-deficit hyperactivity disorder (ADHD/ADD) is a neurobehavioral disorder of childhood onset characterized by severe, developmentally inappropriate motor hyperactivity, inattention, and impulsiveness that result in impairment in more than one setting. It affects the home, school, and community life of 39% of school-going children worldwide. There is increasing recognition that ADHD symptoms and clinically defined disorder can persist into adult life and are associated with later drug and alcohol misuse and social and work difficulties. Added to that is the extreme variability of the disorder over time, within the same individual, between individuals, and across different circumstances. Treatment with stimulants and nonstimulants has proven effective in different subgroups, with the effectiveness of specific agents most likely related to the primary neurotransmitter involved. However, stimulants with a short duration of action have been problematic for some patients. Parent training and cognitive behavioral therapies represent the most widely adjunct psychosocial interventions to pharmacotherapy. PMID:21977081

  6. Validation of the adult attention-deficit/hyperactivity disorder quality-of-life scale in European patients: comparison with patients from the USA.

    PubMed

    Brod, Meryl; Adler, Lenard A; Lipsius, Sarah; Tanaka, Yoko; Heinloth, Alexandra N; Upadhyaya, Himanshu

    2015-06-01

    The adult attention-deficit/hyperactivity disorder (ADHD) quality-of-life (AAQoL) scale was previously validated in adult patients in the USA; here, the AAQoL is validated in adult European patients. Data from a 12-week open-label acute treatment period with atomoxetine (80-100 mg/day) in adults with ADHD were used. Patients (≥ 18 to ≤ 50 years old) had a score ≥ 2 on ≥ 6 items on the inattentive or hyperactive core subscales of Conners' Adult ADHD Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV); a CAARS-Inv:SV 18-item total ADHD symptom score ≥ 20; and Conners' Adult ADHD Rating Scale-Observer: Screening Version 6-item inattentive or hyperactive core subscale scores ≥ 2. Data were stratified based on patients' geographic region (Europe vs USA). Scale validation psychometric properties results were very similar between European (n = 1,217; 57.7 % male; mean age 33.0 years) and US (n = 602; 62.1 % male; mean age 33.5 years) patients, including factor loading, internal consistency, convergent and discriminant validity, and responsiveness. Exploratory factor analysis confirmed four AAQoL subscales. Internal consistency was acceptable (Cronbach's alpha > 0.70 for all subscales). The AAQoL total score showed moderate convergent validity with CAARS-Inv:SV 18-item total ADHD symptom and clinical global impression-ADHD-severity (CGI-ADHD-S) scores; and strong convergent validity with Behavior Rating Inventory of Executive Function-Adult Version: Self-Report Global-Executive-Composite Index scores. Mean AAQoL total scores were significantly different among patients grouped by CGI-ADHD-S scores, suggesting good discriminant validity. The AAQoL total and subscale scores presented good responsiveness from baseline to 12 weeks. The AAQoL scale shows comparable validity in European and US adults with ADHD. PMID:25563210

  7. Attention Deficit Disorder. NICHCY Briefing Paper.

    ERIC Educational Resources Information Center

    Fowler, Mary

    This briefing paper uses a question-and-answer format to provide basic information about children with attention deficit disorder (ADD). Questions address the following concerns: nature and incidence of ADD; causes of ADD; signs of ADD (impulsivity, hyperactivity, disorganization, social skill deficits); the diagnostic ADD assessment; how to get…

  8. Neuroanatomical Abnormalities and Cognitive Impairments Are Shared by Adults with Attention-Deficit/Hyperactivity Disorder and Their Unaffected First-Degree Relatives

    PubMed Central

    Pironti, Valentino Antonio; Lai, Meng-Chuan; Müller, Ulrich; Dodds, Chris Martin; Suckling, John; Bullmore, Edward Thomas; Sahakian, Barbara Jacquelyn

    2014-01-01

    Background Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable neurodevelopmental disorder, yet the search for genes with a definitive role in its etiology has been elusive. Deconstructing the disorder in its endophenotypic traits, where the variance is thought to be associated with a fewer number of genes, should boost the statistical power of molecular genetic studies and clarify the pathophysiology of ADHD. In this study, we tested for neuroanatomical and cognitive endophenotypes in a group of adults with ADHD, their unaffected first-degree relatives, and typically developing control subjects. Methods Sixty participants, comprising 20 adults with ADHD, 20 unaffected first-degree relatives, and 20 typically developing control subjects matched for age and gender undertook structural magnetic resonance imaging scans. Voxel-based morphometry with DARTEL was performed to obtain regional gray and white matter volumes. General linear analyses of the volumes of brain regions, adjusting for age and total intracranial volume, were used to compare groups. Sustained attention and response inhibition were also investigated as cognitive endophenotypes. Results Neuroanatomical abnormalities in gray matter volume in the right inferior frontal gyrus and white matter volume in the caudal portion of the right inferior fronto-occipital fasciculus were shared between ADHD probands and their unaffected first-degree relatives. In addition, impairments in sustained attention were also found to be shared between ADHD patients and their relatives. Conclusions Cognitive impairments in sustained attention and neuroanatomical abnormalities in the right inferior frontal gyrus and the posterior part of right inferior fronto-occipital fasciculus are putative neurocognitive endophenotypes in adult ADHD. PMID:24199662

  9. Attention-Deficit Hyperactivity Disorder (ADHD): Treatment

    MedlinePlus

    MENU Return to Web version Attention-Deficit Hyperactivity Disorder (ADHD) | Treatment What medicines are used to treat ADHD? Some of the medicines for ADHD are called psychostimulants. Some of these ...

  10. Helping Children and Youth with Attention-Deficit/Hyperactivity Disorder: Systems of Care

    MedlinePlus

    ... Health and Human Services. Children and Adults With Attention-Deficit/ Hyperactivity Disorder www.chadd.org Tel: 301.306.7070 Federation ... information, contact: 4 Helping Children and Youth With Attention-Deficit/Hyperactivity Disorder: Systems of Care Attention -Deficit /Hyperactivity Disorder Helping ...

  11. NOS1 and SNAP25 polymorphisms are associated with Attention-Deficit/Hyperactivity Disorder symptoms in adults but not in children.

    PubMed

    Salatino-Oliveira, Angélica; Akutagava-Martins, Glaucia C; Bruxel, Estela M; Genro, Julia P; Polanczyk, Guilherme V; Zeni, Cristian; Kieling, Christian; Karam, Rafael G; Rovaris, Diego L; Contini, Verônica; Cupertino, Renata B; Mota, Nina R; Grevet, Eugenio H; Bau, Claiton H; Rohde, Luis A; Hutz, Mara H

    2016-04-01

    Several investigations documented that Attention-Deficit/Hyperactivity Disorder (ADHD) is better conceptualized as a dimensional disorder. At the same time, the disorder seems to have different neurobiological underpinnings and phenotypic presentation in children compared to adults. Neurodevelopmental genes could explain, at least partly these differences. The aim of the present study was to examine possible associations between polymorphisms in SNAP25, MAP1B and NOS1 genes and ADHD symptoms in Brazilian samples of children/adolescents and adults with ADHD. The youth sample consisted of 301 patients whereas the adult sample comprises 485 individuals with ADHD. Diagnoses of ADHD and comorbidities were based on the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria. The Swanson, Nolan and Pelham Scale-Version IV (SNAP-IV) was applied by psychiatrists blinded to genotype. The total SNAP-IV scores were compared between genotypes. Impulsivity SNAP-IV scores were also compared according to NOS1 genotypes. Adult patients homozygous for the C allele at SNAP25 rs8636 showed significantly higher total SNAP-IV scores (F = 11.215; adjusted P-value = 0.004). Impulsivity SNAP-IV scores were also significantly different according to NOS1 rs478597 polymorphisms in adults with ADHD (F = 6.282; adjusted P-value = 0.026). These associations were not observed in children and adolescents with ADHD. These results suggest that SNAP25 and NOS1 genotypes influence ADHD symptoms only in adults with ADHD. Our study corroborates previous evidences for differences in the genetic contribution to adult ADHD compared with childhood ADHD. PMID:26821215

  12. Do Problems with Information Processing Affect the Process of Psychotherapy for Adults with Learning Disabilities or Attention Deficit/Hyperactivity Disorder?

    ERIC Educational Resources Information Center

    Cosden, Merith; Patz, Sarah; Smith, Steven

    2009-01-01

    Problems in processing information can affect psychosocial functioning. Psychotherapy can be used to address psychosocial problems; however, the same information-processing problems that contribute to disabilities, such as learning disabilities (LD) or attention deficit/hyperactivity disorder (ADHD), particularly deficits in auditory processing…

  13. Transition to adult mental health services for young people with Attention Deficit/Hyperactivity Disorder (ADHD): a qualitative analysis of their experiences

    PubMed Central

    2013-01-01

    Background There is little research on the process of transition between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS). More recently, there is growing recognition that Attention Deficit/Hyperactivity Disorder (ADHD) may persist into adulthood requiring services beyond age 18. However, despite National Institute for Health and Clinical Excellence (NICE) Guidance which recommends specialist services for adults with ADHD, there is currently a lack of such services in the UK. The aim of the current study is to explore the experiences of young people with ADHD during transition from CAMHS to AMHS. Method Semi-structured qualitative interviews with ADHD patients accessing CAMHS clinics in Nottinghamshire were analysed using thematic analysis. Results Ten semi-structured interviews were transcribed and analysed. We found that patients’ relationships with their clinician were a key factor in both their reported experience of CAMHS and the transition process. Perceived responsibility of care was also pivotal in how the transition process was viewed. Nature and severity of problems and patients expectations of adult services were also contributing factors in the transition process. The need for continued parental support was openly accepted and thought to be required by the majority of young people with ADHD during transition. Conclusions Timely preparation, joint working, good clinician relationships and parental support serve to facilitate the process of transition for young people with ADHD. Nature and severity of problems are perceived to impede or facilitate transition, with predominantly more ‘complex presentations’ with associated mental health problems more familiar to AMHS (e.g. self-harm, depression) making for smoother transitions to adult services. Transitions to AMHS were more difficult when ADHD was viewed as the main or sole clinical problem. Further exploration of young people’s experiences of transition

  14. Sustained Attention and Response Inhibition in Young Children at Risk for Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Berwid, Olga G.; Curko Kera, Elizabeth A.; Marks, David J.; Santra, Amita; Bender, Heidi A.; Halperin, Jeffrey M.

    2005-01-01

    Background: Studies of school-aged children, adolescents, and adults with Attention Deficit/Hyperactivity Disorder (ADHD) have variably shown ADHD-related impairment in both inhibitory control and sustained attention. However, few studies have examined ADHD-associated patterns of performance on these tasks among younger children (below age 7…

  15. Reliability and validity of a semi-structured DSM-based diagnostic interview module for the assessment of Attention Deficit Hyperactivity Disorder in adult psychiatric outpatients.

    PubMed

    Gorlin, Eugenia I; Dalrymple, Kristy; Chelminski, Iwona; Zimmerman, Mark

    2016-08-30

    Despite growing recognition that the symptoms and functional impairments of Attention Deficit/Hyperactivity Disorder (ADHD) persist into adulthood, only a few psychometrically sound diagnostic measures have been developed for the assessment of ADHD in adults, and none have been validated for use in a broad treatment-seeking psychiatric sample. The current study presents the reliability and validity of a semi-structured DSM-based diagnostic interview module for ADHD, which was administered to 1194 adults presenting to an outpatient psychiatric practice. The module showed excellent internal consistency and interrater reliability, good convergent and discriminant validity (as indexed by relatively high correlations with self-report measures of ADHD and ADHD-related constructs and little or no correlation with other, non-ADHD symptom domains), and good construct validity (as indexed by significantly higher rates of psychosocial impairment and self-reported family history of ADHD in individuals who meet criteria for an ADHD diagnosis). This instrument is thus a reliable and valid diagnostic tool for the detection of ADHD in adults presenting for psychiatric evaluation and treatment. PMID:27259136

  16. Current pharmacotherapy of attention deficit hyperactivity disorder.

    PubMed

    Reddy, D S

    2013-10-01

    Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral developmental disorder in children and adults characterized by a persistent pattern of impulsiveness, inattention and hyperactivity. It affects about 3-10% of children and 2-5% of adolescents and adults and occurs about four times more commonly in boys than girls. The cause of ADHD is unknown, but it has strong genetic and environment components. The first-line treatment options for ADHD include behavioral therapy, pharmacotherapy with stimulants or both. Methylphenidate and amphetamine salts are the stimulant drugs of choice for ADHD treatment. Amphetamines act by increasing presynaptic release of dopamine and other biogenic amines in the brain. Methylphenidate inhibits the reuptake of dopamine and norepinephrine and therefore its pharmacology is identical to that of amphetamines. Lisdex-amfetamine is a prodrug of dextroamphetamine with low feasibility for abuse. Atomoxetine, a selective norepinephrine reuptake inhibitor, is an alternative, non-stimulant drug for ADHD but it is less efficacious than stimulants. Stimulants are generally safe but are associated with adverse effects including headache, insomnia, anorexia and weight loss. There is increased awareness about serious cardiovascular and psychiatric adverse events with ADHD drugs including concern for growth suppression in children. Stimulants have a high potential for abuse and dependence, and should be handled safely to prevent misuse and abuse. PMID:24191257

  17. The Increased Risk of Road Crashes in Attention Deficit Hyperactivity Disorder (ADHD) Adult Drivers: Driven by Distraction? Results from a Responsibility Case-Control Study

    PubMed Central

    El Farouki, Kamal; Lagarde, Emmanuel; Orriols, Ludivine; Bouvard, Manuel-Pierre; Contrand, Benjamin; Galéra, Cédric

    2014-01-01

    Background and Objective Both distractions (external and internal) and attention-deficit/hyperactivity disorder (ADHD) are serious risk factors for traffic crashes and injuries. However, it is still unknown if ADHD (a chronic condition) modifies the effect of distractions (irregular hazards) on traffic crashes. The objective of this study was to assess the effects of distractions and ADHD on traffic crash responsibility. Methods A responsibility case-control study was conducted in the adult emergency department of Bordeaux University Hospital, France. Subjects were recruited among drivers injured in a motor vehicle crash between April 2010 and August 2011. Responsibility levels were estimated using a standardized method. Frequencies of exposures were compared between drivers responsible and drivers not responsible for the crash. Independent risk factors were identified using a multivariate logistic regression including test interactions between distractions and ADHD. Results A total of 777 subjects were included in the analysis. Factors associated with responsibility were distraction induced by an external event (adjusted OR (aOR)  = 1.47; 95% confidence interval (CI) [1.06–2.05]), distraction induced by an internal thought (aOR = 2.38; CI: [1.50–3.77]) and ADHD (aOR = 2.18 CI: [1.22–3.88]). The combined effect of ADHD and external distractions was strongly associated with responsibility for the crash (aOR = 5.79 CI: [2.06–16.32]). Interaction assessment showed that the attributable proportion due to the interaction among participants with both exposures was 68%. Discussion Adults with ADHD are a population at higher risk of being responsible for a road traffic crash when exposed to external distractions. This result reinforces the need to diagnose adult ADHD and to include road safety awareness messages delivered by the physician. Developing advanced driver assistance systems devoted to the management of attention lapses is also

  18. Could I Have Attention-Deficit/Hyperactivity Disorder (ADHD)? Finding an Answer to ADHD as an Adult

    MedlinePlus

    ... education, social and family situations and relationships, employment, self-esteem, and emotional health. It is never too late ... tasks. It can also address feelings of low self-esteem and help adults with ADHD gain confidence, as ...

  19. The Source for ADD/ADHD: Attention Deficit Disorder and Attention Deficit/Hyperactivity Disorder.

    ERIC Educational Resources Information Center

    Richard, Gail J.; Russell, Joy L.

    This book is intended for professionals who are responsible for designing and implementing educational programs for children with attention deficit disorders and attention deficit/hyperactivity disorder (ADD/ADHD). Chapters address: (1) myths and realities about ADD/ADHD; (2) definitions, disorders associated with ADD/ADHD, and federal educational…

  20. Differentiating Attention Deficits in Children with Fetal Alcohol Spectrum Disorder or Attention-Deficit-Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Kooistra, Libbe; Crawford, Susan; Gibbard, Ben; Ramage, Barbara; Kaplan, Bonnie J

    2010-01-01

    Aim: The attention and inhibition problems found in children with attention-deficit-hyperactivity disorder (ADHD) are also common in children with fetal alcohol spectrum disorders (FASDs). Attempts to distinguish ADHD from FASDs in terms of these deficits are rare and were pursued in this study. Method: A total of 116 children (47 with ADHD, 31…

  1. A network meta-analysis of atomoxetine and osmotic release oral system methylphenidate in the treatment of attention-deficit/hyperactivity disorder in adult patients.

    PubMed

    Bushe, Chris; Day, Kathleen; Reed, Victoria; Karlsdotter, Kristina; Berggren, Lovisa; Pitcher, Ashley; Televantou, Foula; Haynes, Virginia

    2016-05-01

    The lack of head-to-head clinical studies powered to compare atomoxetine and osmotic release oral system (OROS) methylphenidate necessitates treatment comparison by methods that include indirect evidence such as network meta-analysis (NMA). A NMA assessing the relative treatment effects of atomoxetine and OROS methylphenidate in adults with attention-deficit/hyperactivity disorder (ADHD) was conducted. Studies were identified by systematic literature review. Analyses summarised improvements in efficacy, measured by ADHD-specific scales, using Cohen'sdto calculate the standardised mean difference (SMD), and all cause discontinuations. Results showed effect sizes (SMD, 95% credible interval (CrI)) relative to placebo that did not differ significantly between atomoxetine (0.46, 0.36-0.56) and OROS methylphenidate (0.51, 0.40-0.63) in clinical studies of up to 12 weeks' duration (SMD, 95% CrI for atomoxetine versus OROS methylphenidate: -0.05, -0.18-0.08). Patients treated with these medications responded better than those given placebo across all analyses. There was also no significant difference in discontinuation rates between atomoxetine and OROS methylphenidate (odds ratio, 95% CrI: 0.85, 0.53-1.35). Between-study heterogeneity was low overall. Results of this NMA suggest that the efficacy of atomoxetine and OROS methylphenidate in adults does not differ significantly. Clinical guidelines may require amendment to reflect these recent data. PMID:27005307

  2. Prefrontal activation during inhibitory control measured by near-infrared spectroscopy for differentiating between autism spectrum disorders and attention deficit hyperactivity disorder in adults.

    PubMed

    Ishii-Takahashi, Ayaka; Takizawa, Ryu; Nishimura, Yukika; Kawakubo, Yuki; Kuwabara, Hitoshi; Matsubayashi, Junko; Hamada, Kasumi; Okuhata, Shiho; Yahata, Noriaki; Igarashi, Takashi; Kawasaki, Shingo; Yamasue, Hidenori; Kato, Nobumasa; Kasai, Kiyoto; Kano, Yukiko

    2014-01-01

    The differential diagnosis of autism spectrum disorders (ASDs) and attention deficit hyperactivity disorder (ADHD) based solely on symptomatic and behavioral assessments can be difficult, even for experts. Thus, the development of a neuroimaging marker that differentiates ASDs from ADHD would be an important contribution to this field. We assessed the differences in prefrontal activation between adults with ASDs and ADHD using an entirely non-invasive and portable neuroimaging tool, near-infrared spectroscopy. This study included 21 drug-naïve adults with ASDs, 19 drug-naïve adults with ADHD, and 21 healthy subjects matched for age, sex, and IQ. Oxygenated hemoglobin concentration changes in the prefrontal cortex were assessed during a stop signal task and a verbal fluency task. During the stop signal task, compared to the control group, the ASDs group exhibited lower activation in a broad prefrontal area, whereas the ADHD group showed underactivation of the right premotor area, right presupplementary motor area, and bilateral dorsolateral prefrontal cortices. Significant differences were observed in the left ventrolateral prefrontal cortex between the ASDs and ADHD groups during the stop signal task. The leave-one-out cross-validation method using mean oxygenated hemoglobin changes yielded a classification accuracy of 81.4% during inhibitory control. These results were task specific, as the brain activation pattern observed during the verbal fluency task did not differentiate the ASDs and ADHD groups significantly. This study therefore provides evidence of a difference in left ventrolateral prefrontal activation during inhibitory control between adults with ASDs and ADHD. Thus, near-infrared spectroscopy may be useful as an auxiliary tool for the differential diagnosis of such developmental disorders. PMID:24298446

  3. A transmission disequilibrium test of the Ser9/Gly dopamine D3 receptor gene polymorphism in adult attention-deficit hyperactivity disorder.

    PubMed

    Muglia, Pierandrea; Jain, Umesh; Kennedy, James L

    2002-03-10

    Convincing data support the hypothesis that genetic factors are involved in the etiology of attention-deficit hyperactivity disorder (ADHD). Various lines of evidence have shown that the dopamine system plays a crucial role in the pathophysiology of ADHD. The dopamine D3 receptor gene (DRD3) represents a promising candidate to examine in ADHD. Animal studies have shown that DRD3 mRNA is highly expressed in the ventral striatum suggesting an involvement of this receptor in the control of motor behaviour. Manipulation of DRD3 in rodents has led to a mouse model with nonfunctional D3 receptors that displays hyperactive behaviour in various environmental conditions. Furthermore, administration of 7-OH-DPAT, a dopaminergic agonist that binds preferentially to D3 receptors exerts an inhibitory effect on locomotor activity while D3 antagonists induce hyperactivity. Among various polymorphisms described for DRD3, the BalI polymorphism is most interesting because it codes for an aminoacid substitution in the N-terminus of the receptor. The receptor products of the two alleles (Ser/Gly) exhibit differential affinity for dopamine. To determine if DRD3 Ser9/Gly is involved in the susceptibility to ADHD we genotyped 39 adults with ADHD and their respective parents (trios). Adult ADHD represents a promising phenotype for studying the genetic component of the disorder. In fact, a recent family study has shown that relatives of adult ADHD patients have a higher rate of ADHD compared to relatives of children with ADHD suggesting a stronger genetic component for the adult version. The results of genotyping in the 39 trios analyzed with the transmission disequilibrium test showed no excess of transmission for DRD3 MscI/BalI alleles (chi(2) = 0.360; df = 1; P = 0.54). This result, although from a relatively small sample, indicates that it is unlikely that DRD3 is playing a major role in the etiology of ADHD in our sample. PMID:11864723

  4. Efficacy of atomoxetine in adults with attention deficit hyperactivity disorder: An integrated analysis of the complete database of multicenter placebo-controlled trials

    PubMed Central

    Asherson, Philip; Bushe, Chris; Saylor, Keith; Tanaka, Yoko; Deberdt, Walter; Upadhyaya, Himanshu

    2014-01-01

    Persistence of attention deficit hyperactivity disorder (ADHD) into adulthood can be disabling or lead to substantial impairment. Several clinical trials of atomoxetine (ATX) in adults with ADHD have been reported following the National Institute for Health and Clinical Excellence (NICE) guidelines issued in 2008. We performed an integrated analysis of all Eli Lilly-sponsored, randomized, double-blind, placebo-controlled studies of ATX in adults with ADHD completed as of May 2012. Individual patient data were pooled from six short-term (10–16 week) studies (1961 patients) and three longer-term (six-month) studies (1413 patients). In the short-term analysis, ATX patients achieved a significantly greater mean reduction in ADHD symptoms than placebo patients (−12.2 vs −8.1; Conners’ Adult ADHD Rating Scale–Investigator-Rated: Screening Version (CAARS-Inv: SV); p<0.001). In the longer-term analysis, respective improvements after six months were −13.2 vs −9.7 (p<0.001). Response rates at study endpoints for ATX vs placebo, based on CAARS-Inv: SV improvement ≥30% and Clinical Global Impressions of ADHD-Severity (CGI-ADHD-S) ≤3 were 34.8% vs 22.3% in the short-term and 43.4% vs 28.0% after six months, and CAARS-Inv: SV improvements ≥40% were 41.3% vs 25.3% in the short-term and 44.0% vs 31.4% after six months (all p<0.001). Overall, ATX had a clinically significant effect in adults with ADHD, with reductions in core symptoms and clinically meaningful responder rates. PMID:25035246

  5. Attention-Deficit/Hyperactivity Disorder in Adults With Bipolar Disorder or Major Depressive Disorder: Results From the International Mood Disorders Collaborative Project

    PubMed Central

    Kennedy, Sidney H.; Soczynska, Joanna K.; Nguyen, Ha T. T.; Bilkey, Timothy S.; Woldeyohannes, Hanna O.; Nathanson, Jay A.; Joshi, Shikha; Cheng, Jenny S. H.; Benson, Kathleen M.; Muzina, David J.

    2010-01-01

    Objective: Relatively few studies have evaluated the clinical implications of lifetime attention-deficit/hyperactivity disorder (ADHD) in adults with bipolar disorder or major depressive disorder (MDD). Herein, we sought to determine the prevalence as well as the demographic and clinical correlates of lifetime ADHD in persons with a mood disorder. Method: The first 399 patients enrolled in the International Mood Disorders Collaborative Project (IMDCP) were evaluated for lifetime ADHD using the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus) as the primary instrument to derive current and lifetime DSM-IV diagnoses. All analyses of variables of interest were conducted utilizing the MINI-Plus, the Adult ADHD Self-Report Scale-v1.1, and the Wender Utah Rating Scale-Short Form. The effect of ADHD on clinical presentation, course of illness variables, comorbidity, anamnesis, treatment, and outcome are reported. The IMDCP is a joint initiative of the Mood Disorders Psychopharmacology Unit at the University Health Network, University of Toronto, Toronto, Ontario, Canada, and the Cleveland Clinic Center for Mood Disorders Treatment and Research at Lutheran Hospital, Cleveland, Ohio. All data for this study were procured between January 2008 and January 2009. Results: The percentages of subjects with MDD or bipolar disorder meeting the DSM-IV criteria for lifetime adult ADHD were 5.4% and 17.6% (P < .001), respectively. Lifetime comorbid ADHD in both mood disorder populations was associated with earlier age at illness onset (MDD, P = .049; bipolar disorder, P = .005), a higher number of psychiatric comorbidities (eg, MDD and current panic disorder with agoraphobia [P = .002]; bipolar disorder and social phobia [P = .012]), and decreased quality of life (MDD, P = .018). Conclusions: The overarching findings herein are that the adult ADHD phenotype is commonly reported by individuals with MDD or bipolar disorder and is associated with a greater illness burden

  6. Selective Attention Deficits Associated with Mild Cognitive Impairment and Early Stage Alzheimer's Disease in Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Krinsky-McHale, Sharon J.; Devenny, Darlynne A.; Kittler, Phyllis; Silverman, Wayne

    2008-01-01

    Adults with Down syndrome and early stage Alzheimer's disease showed decline in their ability to selectively attend to stimuli in a multitrial cancellation task. They also showed variability in their performance over the test trials, whereas healthy participants showed stability. These changes in performance were observed approximately 2 years…

  7. Cortisol awakening response in adults with attention deficit hyperactivity disorder: Subtype differences and association with the emotional lability.

    PubMed

    Ramos-Quiroga, J A; Corominas-Roso, M; Palomar, G; Ferrer, R; Valero, S; Corrales, M; Richarte, V; Casas, M

    2016-07-01

    Cortisol awakening response (CAR) has been studied in children with ADHD, and some authors have reported morning cortisol differences among ADHD subtypes. Despite, only half of the children with ADHD continue to exhibit the disorder into adulthood, CAR has not been studied in adults so far. One hundred and nine adults with ADHD according to the DSM-IV criteria (46 inattentive and 63 combined) ranging in age from 18 to 55 years, and 27 healthy controls were included. Psychiatric and organic comorbidities were excluded. Salivary cortisol samples were obtained at 0, 30, 45 and 60 minutes after awakening. CAR was present in 84% of the healthy controls but in only 64% of the adults with ADHD (68% of the inattentive and 61% of the combined were CAR-positive). There were no significant differences in any of the morning cortisol measures between patients and controls or between the combined and inattentive subtypes of ADHD. Among the inattentive subtype but not in the combined patients, significant positive correlations were observed between the CAR and emotional lability (p=0.05), or self-concept (p=0.014) CAARS subscales, as well as with the cognitive impulsivity subscale of the Barratt impulsiveness scale (p=0.028). These results suggest that adults with ADHD exhibit normal cortisol responses upon awakening and thus cannot be defined in terms of hypo-arousal. Neurobiological differences between the combined and inattentive subtypes involving cortisol, are discussed. PMID:27084305

  8. Developmental psychopathology: Attention Deficit Hyperactivity Disorder (ADHD)

    PubMed Central

    Schmidt, Sören; Petermann, Franz

    2009-01-01

    Background Attention Deficit/Hyperactivity Disorder (ADHD), formerly regarded as a typical childhood disorder, is now known as a developmental disorder persisting over the lifespan. Starting in preschool-age, symptoms vary depending on the age group affected. Method According to the variability of ADHD-symptoms and the heterogeneity of comorbid psychiatric disorders, a broad review of recent studies was performed. These findings were summarized in a developmental psychopathological model, documenting relevant facts on a timeline. Results Based on a genetic disposition and a neuropsychological deregulation, there is evidence for factors which persist across the lifespan, change age-dependently, or show validity in a specific developmental phase. Qualitative changes can be found for children in preschool-age and adults. Conclusion These differences have implications for clinical practice as they can be used for prevention, diagnostic proceedings, and therapeutic intervention as well as for planning future studies. The present article is a translated and modified version of the German article "Entwicklungspsychopathologie der ADHS", published in Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 56, 2008, S. 265-274. PMID:19761584

  9. Attention Deficit Hyperactivity Disorder and Athletes

    PubMed Central

    White, Russell D.; Harris, George D.; Gibson, Margaret E.

    2014-01-01

    Context: Attention deficit hyperactivity disorder (ADHD) is common in the general population, and many individuals with this condition participate in sports activity at all competition levels. Evidence Acquisition: Related studies were selected through literature searches of PubMed, MEDLINE, and Cochrane databases for the years 1991 to 2011. Key search terms were ADD, ADHD, sports, athletes, athletics, guidelines, NCAA, WADA, IOC, college, concussion, diagnosis, management, treatment, evaluation, return-to-play, pharmacotherapy, adult, adolescent, student, screening, injury, risk, neuropsychiatry, TBI, traumatic brain injury, and epidemiology. Study Design: Literature review. Level of Evidence: Level 4. Results: ADHD usually has an early onset, with delayed diagnosis in some patients due to heterogeneous presentations. Suspected cases can be evaluated with available diagnostic tools and confirmed clinically. Athletes with ADHD may participate at all competition levels. Conclusion: Athletes with ADHD are able to participate at all competition levels by following published guidelines and requirements. Exercise benefits many athletes with ADHD. The relationship between ADHD and concussion syndromes is currently under investigation. PMID:24587866

  10. Severity of childhood attention-deficit hyperactivity disorder--a risk factor for personality disorders in adult life?

    PubMed

    Matthies, Swantje; van Elst, Ludger Tebartz; Feige, Bernd; Fischer, Daniel; Scheel, Corinna; Krogmann, Eva; Perlov, Evgeniy; Ebert, Dieter; Philipsen, Alexandra

    2011-02-01

    Some evidence points to an increased rate of cluster B and C personality disorders (PDs) in adult ADHD patients. In order to assess axis II disorders comprehensively we used the diagnostic instrument of the WHO. In sixty adult out-patients with ADHD according to DSM-IV criteria PDs were assessed with the International PD Examination (IPDE) and severity of childhood ADHD with the Wender-Utah-Rating Scale (WURS). We found at least one PD in 25% of cases. Cluster C PDs were most common (36.6%) followed by Cluster B (23.3%) and A (8.3%). Avoidant (21.7%) and borderline (18.3%) were the most frequent single PD entities. ADHD patients with PD suffered from significantly more severe childhood ADHD compared to those without co-occurring PD. Applying the IPDE we confirmed a high number of PDs among adult ADHD patients. Our findings point to a higher vulnerability for the development of PDs in patients with severe childhood ADHD. PMID:21309626

  11. Prevalence of Attention Deficit Disorders in Arkansas.

    ERIC Educational Resources Information Center

    Griffin, Harold; Daley, Christine E.; Onwuegbuzie, Anthony J.

    This study examined the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among school children in Arkansas for the purpose of helping school districts plan appropriate educational interventions. The ADHD Survey was mailed to all 311 school superintendents; 128 surveys were returned. Findings revealed that, overall, 3 percent of…

  12. Attention Deficit Disorder and Hyperactivity. Second Edition.

    ERIC Educational Resources Information Center

    Friedman, Ronald J.; Doyal, Guy T.

    This book is designed for parents and teachers of children with Attention Deficit Disorder (ADD) and hyperactivity. Chapter 1 describes the symptoms, diagnosis, and causes of ADD, its effect on parents and families, inborn temperament characteristics of children with ADD, and tests and rating scales used to diagnose and treat the disorder. The…

  13. Attention Deficit Hyperactivity Disorder: The Differential Diagnosis.

    ERIC Educational Resources Information Center

    Weinberg, Warren A.; Emslie, Graham J.

    This paper presents information on the diagnostic criteria and management of disorders that may be wrongly identified as Attention Deficit Hyperactivity Disorder (ADHD) or may coexist with ADHD thus complicating identification and treatment. The disorders discussed are: depression, mania, primary disorder of vigilance, narcolepsy, developmental…

  14. Nature, Nurture, and Attention Deficit Hyperactivity Disorder.

    ERIC Educational Resources Information Center

    Faraone, Stephen V.; Biederman, Joseph

    2000-01-01

    Comments on Joseph's review of the genetics of attention deficit disorder, demonstrating errors of scientific logic and oversight of relevant research in Joseph's argument. Argues for the validity of twin studies in supporting a genetic link for ADHD and for the complementary role of nature and nurture in the etiology of the disorder. (JPB)

  15. Educators' Knowledge of Attention Deficit Disorder.

    ERIC Educational Resources Information Center

    Riley, Nancy Kincaid

    This thesis surveyed 160 teachers, 61 counselors, and 82 principals from Kansas public schools to determine their knowledge of attention deficit disorder in school-aged children. The independent variables investigated were position, extent of inservice education, gender, size of the participant's school, years of experience in education, and…

  16. Fragments: Coping with Attention Deficit Disorder.

    ERIC Educational Resources Information Center

    Stein, Amy E.

    Written by a woman who, at age 25, was diagnosed as "a textbook case for attention deficit hyperactivity disorder," (ADHD) this book, examines: the pitfalls of traditional psychotherapy and medications for those diagnosed with ADD/ADHD; how an interactive, hands-on learning environment can markedly improve the educational experience of children…

  17. Behavioral Subtypes of Attention Deficit Disorder.

    ERIC Educational Resources Information Center

    Dykman, Roscoe A.; Ackerman, Peggy T.

    1993-01-01

    This article reviews research on three behavioral subtypes of attention deficit disorder (ADD): (1) without hyperactivity (ADD/WO), (2) with hyperactivity, and (3) with hyperactivity and aggression (ADDHA). Children with ADDHA appear to be at increased risk of having oppositional and conduct disorders, whereas children with ADD/WO show symptoms…

  18. Students with Attention Deficit Disorders: An Overview.

    ERIC Educational Resources Information Center

    Salend, Spencer J.; Rohena, Elba

    2003-01-01

    This article provides the American Psychiatric Association's definition of attention deficit disorder (ADD) and then gives an overview of ADD by considering the three types of ADD, the developmental impact of ADD, factors contributing to ADD, identification and assessment of students with ADD (emphasizing multimethod and consideration of…

  19. Attention Deficit Disorder: What Parents Should Know.

    ERIC Educational Resources Information Center

    Chesapeake Inst., Washington, DC.

    This paper outlines practical information on children with attention deficit disorder (ADD). Guidelines for identifying ADD are presented, followed by a summary of what parents and students can expect from special education and related services in public schools. Pros and cons of medication are noted, and recommendations for managing the child's…

  20. Attention Deficit Disorder: Two Mothers' Perceptions.

    ERIC Educational Resources Information Center

    Fernandez, Roy C.; O'Connor, Carol

    This report discusses the outcomes of a study that investigated the decision-making process of two mothers' selection of treatment for their sons' attention deficit disorder (ADD). One mother opted for a medical treatment, and the other mother opted for a non-medical treatment. The boy who is medically treated is 14, and the non-medically treated…

  1. Medication Treatment for Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Ryan, Joseph B.; Katsiyannis, Antonis; Hughes, Elizabeth M.

    2011-01-01

    Attention deficit hyperactivity disorder (ADHD) has become the most commonly diagnosed psychiatric disorder among school-age children. For more than half a century, physicians have prescribed medications to help manage behaviors such as hyperactivity, impulsivity, and inattention. Today, there is a growing consensus that ADHD is a biologically…

  2. Associations of pineal volume, chronotype and symptom severity in adults with attention deficit hyperactivity disorder and healthy controls.

    PubMed

    Bumb, Jan Malte; Mier, Daniela; Noelte, Ingo; Schredl, Michael; Kirsch, Peter; Hennig, Oliver; Liebrich, Luisa; Fenske, Sabrina; Alm, Barbara; Sauer, Carina; Leweke, Franz Markus; Sobanski, Esther

    2016-07-01

    The pineal gland, as part of the human epithalamus, is the main production site of peripheral melatonin, which promotes the modulation of sleep patterns, circadian rhythms and circadian preferences (morningness vs. eveningness). The present study analyses the pineal gland volume (PGV) and its association with circadian preferences and symptom severity in adult ADHD patients compared to healthy controls. PGV was determined manually using high-resolution 3T MRI (T1-magnetization prepared rapid gradient echo) in medication free adult ADHD patients (N=74) compared to healthy controls (N=86). Moreover, the Morningness-Eveningness Questionnaire (MEQ), the ADHD Diagnostic Checklist and the Wender-Utah Rating Scale were conducted. PGV differed between both groups (patients: 59.9±33.8mm(3); healthy controls: 71.4±27.2mm(3), P=0.04). In ADHD patients, more eveningness types were revealed (patients: 29%; healthy controls: 17%; P=0.05) and sum scores of the MEQ were lower (patients: 45.8±11.5; healthy controls 67.2±10.1; P<0.001). Multiple regression analyses indicated a positive correlation of PGV and MEQ scores in ADHD (β=0.856, P=0.003) but not in healthy controls (β=0.054, P=0.688). Patients' MEQ scores (β=-0.473, P=0.003) were negatively correlated to ADHD symptoms. The present results suggest a linkage between the PGV and circadian preference in adults with ADHD and an association of the circadian preference to symptom severity. This may facilitate the development of new chronobiological treatment approaches for the add-on treatment in ADHD. PMID:27150337

  3. Executive function in adults with attention-deficit/hyperactivity disorder during treatment with atomoxetine in a randomized, placebo-controlled, withdrawal study.

    PubMed

    Adler, Lenard; Tanaka, Yoko; Williams, David; Trzepacz, Paula T; Goto, Taro; Allen, Albert J; Escobar, Rodrigo; Upadhyaya, Himanshu P

    2014-08-01

    We assessed the executive function in adults with attention-deficit/hyperactivity disorder (ADHD) during atomoxetine treatment in a randomized withdrawal trial. Responders (Conners' ADHD Rating Scale-Investigator Rated: Screening Version [adult prompts] ≥30% reduction from baseline and Clinical Global Impression Scale-ADHD Severity score ≤3) to open-label atomoxetine (40-100 mg/d, 12 weeks) entered a 37-week double-blind maintenance period. Patients who maintained response (double-blind atomoxetine for 12 weeks) were randomized 1:1 to atomoxetine (80-100 mg/d, n = 266) or placebo (n = 258) for 25 weeks (total duration, 1 year). Patients and investigators were blinded to response criteria and randomization timing. Change in executive function was assessed with the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) Self-Report and Informant T scores from the randomization to the last-observation-carried-forward postrandomization week 25 (after week 17). Of the enrolled patients (n = 2017; mean age, 33.2 years; male, 58.7%), 524 responders were randomized. During open-label atomoxetine, subscales and individual items on both BRIEF-A questionnaires showed significant improvement (P < 0.001). After randomization, the following T scores improved significantly (P ≤ 0.05) with patients in the atomoxetine group versus those in the placebo group: global executive composite, behavioral regulation, and metacognition indices; plan/organize, working memory, inhibit, task monitor and shift (both BRIEF-A questionnaires), emotional control and organization of materials (BRIEF-A Informant), and initiate (BRIEF-A Self-Report). Atomoxetine significantly improved the executive function compared with placebo, which was maintained for 25 weeks or more; the executive function of patients in the placebo group worsened but did not return to baseline levels after randomization. PMID:24977716

  4. Long-Term Treatment Outcome in Adult Male Prisoners With Attention-Deficit/Hyperactivity Disorder: Three-Year Naturalistic Follow-Up of a 52-Week Methylphenidate Trial.

    PubMed

    Ginsberg, Ylva; Långström, Niklas; Larsson, Henrik; Lindefors, Nils

    2015-10-01

    Despite high rates of attention-deficit/hyperactivity disorder (ADHD) among adult lawbreakers, particularly the long-term effects of ADHD pharmacotherapy remain unclear, not the least because of ethical challenges with preventing control subjects in randomized controlled trials from receiving medication over prolonged time. We followed up adult male prisoners with ADHD who completed a 5-week randomized, double-blind, placebo-controlled trial followed by a 47-week open-label extension of osmotic-release oral system methylphenidate in a Swedish high-security prison from 2007 to 2010 (ClinicalTrials.gov: NCT00482313). Twenty-five trial completers were prospectively followed up clinically 1 year (24/25, 96% participated fully or in part) and 3 years (20/25, 80% participation) after trial regarding ADHD symptoms (observer and self-reports), psychosocial functioning, substance misuse, and criminal reoffending. Methylphenidate-related improvements in ADHD symptoms and psychosocial functioning obtained during the 52-week trial were maintained at 1- and 3-year follow-ups. Specifically, after 3 years, 75% (15/20) of the respondents had been released from prison, and 67% of these (10/15) had employment, usually full time. In contrast, nonmedicated respondents at the 3-year follow-up (5/20) reported more ADHD symptoms, functional impairment, and substance misuse compared with currently medicated respondents (15/20). Further, 40% of the respondents self-reported reoffending, indicating a substantially lower relapse rate than expected (70%-80%).In summary, although these observations need validation from new and larger samples, positive effects were maintained after 4 years of methylphenidate treatment. Most study completers were employed and had no relapse in substance misuse or criminality. These results suggest that motivational support and continued medication are important for improved outcome in adult criminal offenders with ADHD. PMID:26284932

  5. Effects of Stimulant Drugs on Attention and Cognitive Deficits.

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.

    1981-01-01

    Research on the effects of stimulant drugs on attention and cognitive deficits in children with hyperactivity is reviewed. Topics covered include: attention and impulsivity, paired associate learning, school achievement, and drug induced attention and cognitive deficits. (CL)

  6. The history of attention deficit hyperactivity disorder

    PubMed Central

    Reichl, Susanne; Lange, Katharina M.; Tucha, Lara; Tucha, Oliver

    2010-01-01

    The contemporary concept of attention deficit hyperactivity disorder (ADHD) as defined in the DSM-IV-TR (American Psychiatric Association 2000) is relatively new. Excessive hyperactive, inattentive, and impulsive children have been described in the literature since the nineteenth century. Some of the early depictions and etiological theories of hyperactivity were similar to current descriptions of ADHD. Detailed studies of the behavior of hyperactive children and increasing knowledge of brain function have changed the concepts of the fundamental behavioral and neuropathological deficits underlying the disorder. This article presents an overview of the conceptual history of modern-day ADHD. PMID:21258430

  7. Methylphenidate-Elicited Dopamine Increases in Ventral Striatum Are Associated with Long-Term Symptom Improvement in Adults with Attention Deficit Hyperactivity Disorder

    SciTech Connect

    Volkow N. D.; Wang G.; Volkow, N.D.; Wang, G.-J.; Tomasi, D.; Kollins, S.H.; Wigal, T.L.; Newcorn, J.H.; Telang, F.W.; Fowler, J.S.; Logan, J.; Wong, C.T.; Swanson, J.M.

    2012-01-18

    Stimulant medications, such as methylphenidate, which are effective treatments for attention deficit hyperactivity disorder (ADHD), enhance brain dopamine signaling. However, the relationship between regional brain dopamine enhancement and treatment response has not been evaluated. Here, we assessed whether the dopamine increases elicited by methylphenidate are associated with long-term clinical response. We used a prospective design to study 20 treatment-naive adults with ADHD who were evaluated before treatment initiation and after 12 months of clinical treatment with a titrated regimen of oral methylphenidate. Methylphenidate-induced dopamine changes were evaluated with positron emission tomography and [{sup 11}C]raclopride (D{sub 2}/D{sub 3} receptor radioligand sensitive to competition with endogenous dopamine). Clinical responses were assessed using the Conners Adult ADHD Rating Scale and revealed a significant reduction in symptoms of inattention and hyperactivity with long-term methylphenidate treatment. A challenge dose of 0.5 mg/kg intravenous methylphenidate significantly increased dopamine in striatum (assessed as decreases in D{sub 2}/D{sub 3} receptor availability). In the ventral striatum, these dopamine increases were associated with the reductions in ratings of symptoms of inattention with clinical treatment. Statistical parametric mapping additionally showed dopamine increases in prefrontal and temporal cortices with intravenous methylphenidate that were also associated with decreases in symptoms of inattention. Our findings indicate that dopamine enhancement in ventral striatum (the brain region involved with reward and motivation) was associated with therapeutic response to methylphenidate, further corroborating the relevance of the dopamine reward/motivation circuitry in ADHD. It also provides preliminary evidence that methylphenidate-elicited dopamine increases in prefrontal and temporal cortices may also contribute to the clinical response.

  8. Experiences and Perceptions of Mental Health Professionals Considered Effective in the Diagnosis and Treatment of Adults with Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Erb, Bonita H.

    2013-01-01

    Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that has been documented in medical and mental health literature for over 100 years (Still, 1902). ADHD is a neurobiological based disorder characterized by three major symptoms identified at clinical levels and validated by diagnostic criteria established for the diagnosis of children…

  9. Predictors and impact of non-adherence in adults with attention-deficit/hyperactivity disorder receiving OROS methylphenidate: results from a randomized, placebo-controlled trial

    PubMed Central

    2013-01-01

    Background Medication non-adherence has an important impact on treatment efficacy and healthcare burden across a range of conditions and therapeutic areas. The aim of this analysis was to determine predictors of non-adherence and impact of non-adherence on treatment response in adults with attention-deficit/hyperactivity disorder (ADHD). Methods Post-hoc analysis of a 13-week randomized, double-blind placebo-controlled study of OROS methylphenidate (MPH) 54 and 72 mg/day. Primary efficacy variable was the Conners’ Adult ADHD Rating Scale – Screening Version (CAARS:O-SV). Daily adherence was calculated as average daily adherence (100 × capsules taken/2), with overall adherence calculated as the average daily adherence. Predictors of adherence were assessed using mixed-effects logistic regression. Descriptive statistics were generated for change in CAARS:O-SV score for adherent (> 95% adherence) and non-adherent subjects. Predictors of change were analyzed using a mixed model. Results Subjects were allocated to OROS MPH (54 mg, n = 87; 72 mg, n = 92) or placebo (n = 97). Mean adherence was 92.6% and 93.3% (OROS MPH 54 and 72 mg/day, respectively), versus 97.5% (placebo). Adherence was higher and less variable in completers. Factors significantly associated with non-adherence included female sex, shorter time since ADHD diagnosis, higher education level (completion of university) and score on the Drug Use Screening Inventory psychiatric disorders subscale. Improvements from baseline in CAARS:O-SV score were numerically greater in subjects defined as adherent than in those who were non-adherent. Significant predictors of CAARS:O-SV change in patients who completed the study included percentage adherence up to the point of assessment (p < 0.0001), baseline score (p < 0.0001) and family history of ADHD (p = 0.0003). Conclusion The results of this analysis suggest that newly diagnosed patients, those with a high score on the DUSI-R psychiatric disorder scale, women

  10. Dasotraline for the Treatment of Attention-Deficit/Hyperactivity Disorder: A Randomized, Double-Blind, Placebo-Controlled, Proof-of-Concept Trial in Adults

    PubMed Central

    Koblan, Kenneth S; Hopkins, Seth C; Sarma, Kaushik; Jin, Fengbin; Goldman, Robert; Kollins, Scott H; Loebel, Antony

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity associated with clinically significant impairment in functioning. ADHD has an early onset, but frequently persists, with a prevalence estimate of 4% in adults. Dasotraline is a novel compound that is a potent inhibitor of dopamine and norepinephrine transporters that achieves stable plasma concentrations with once-daily dosing. In this study, adult outpatients meeting DSM-IV-TR criteria for ADHD were randomized to 4 weeks of double-blind, once-daily treatment with dasotraline 4 and 8 mg/day or placebo. The primary efficacy end point was change from baseline at week 4 in the ADHD Rating Scale, Version IV (ADHD RS-IV) total score. Secondary efficacy end points included the Clinical Global Impression, Severity (CGI-S) scale, modified for ADHD symptoms. Least squares (LS) mean improvements at week 4 in ADHD RS-IV total score were significantly greater for dasotraline 8 mg/day vs placebo (−13.9 vs −9.7; P=0.019), and nonsignificantly greater for 4 mg/day (−12.4; P=0.076). The LS mean improvements in modified CGI-S were significantly greater at week 4 for dasotraline 8 mg/day vs placebo (−1.1 vs −0.7; P=0.013), and for 4 mg/day vs placebo (−1.1 vs −0.7; P=0.021). The most frequent adverse events reported were insomnia, decreased appetite, nausea, and dry mouth. Discontinuations due to treatment-emergent adverse events were 10.3% and 27.8% of patients in 4 and 8 mg/day treatment groups, respectively. This study provides preliminary evidence that once-daily dosing with dasotraline, a long-acting, dual monoamine reuptake inhibitor, may be a safe and efficacious treatment for adult ADHD. PMID:25948101

  11. Executive and attentional contributions to Theory of Mind deficit in attention deficit/hyperactivity disorder (ADHD).

    PubMed

    Mary, Alison; Slama, Hichem; Mousty, Philippe; Massat, Isabelle; Capiau, Tatiana; Drabs, Virginie; Peigneux, Philippe

    2016-01-01

    Attention deficit/hyperactivity disorder (ADHD) in children has been associated with attentional and executive problems, but also with socioemotional difficulties possibly associated with deficits in Theory of Mind (ToM). Socioemotional problems in ADHD are associated with more negative prognoses, notably interpersonal, educational problems, and an increased risk of developing other psychiatric disorders that emphasize the need to clarify the nature of their ToM deficits. In this study, we hypothesized that ToM dysfunction in children with ADHD is largely attributable to their attentional and/or executive deficits. Thirty-one children with ADHD (8-12 years, IQ > 85) and 31 typically developing (TD) children were assessed using executive functions (inhibition, planning, and flexibility) and attentional tasks, as well as two advanced ToM tasks (Reading the Mind in the Eyes and Faux Pas) involving different levels of executive control. Children with ADHD performed more poorly than TD children in attentional, executive function, and ToM tasks. Linear regression analyses conducted in the ADHD group indicated that inhibition scores predicted performance on the "Faux Pas" task the best, while attention scores were the best for predicting performance on the Reading the Mind in the Eyes task. When controlled for inhibition and attentional variables, ToM performance in children with ADHD was actually similar to TD children. Contrarily, controlling for ToM scores did not normalize performance for inhibition and attentional tasks in children with ADHD. This unidirectional relationship suggests that deficits in the EF and attentional domains are responsible for ToM deficits in ADHD, which therefore may contribute to their socioemotional difficulties. PMID:25763856

  12. Vigilance and Sustained Attention in Children and Adults with ADHD

    ERIC Educational Resources Information Center

    Tucha, Lara; Tucha, Oliver; Walitza, Susanne; Sontag, Thomas A.; Laufkotter, Rainer; Linder, Martin; Lange, Klaus W.

    2009-01-01

    Objective: The present article tests the hypothesis of a sustained attention deficit in children and adults suffering from ADHD. Method: Vigilance and sustained attention of 52 children with ADHD and 38 adults with ADHD were assessed using a computerized vigilance task. Furthermore, the attentional performance of healthy children (N = 52) and…

  13. Attention deficit hyperactivity disorder and eating disorders.

    PubMed

    Ptáček, R; Kuželová, H; Papežová, H; Stěpánková, T

    2010-01-01

    Attention deficit hyperactivity disorder (ADHD) is a common child diagnosis with frequent comorbidities (Quinn, 2008). According to present studies eating disorders may represent one of them (Mikami et al., 2008). Several studies reported ADHD relation to the higher predisposition to obesity (Altafas, 2002), higher values of signs of overnutrition, as body mass index (Waring and Lapane, 2008) or higher value of fat (Ptacek et al., 2009a, c). These characteristics are considered to be directly related to the disorder. They can be caused by impulsivity and probable specific feeding customs of ADHD patients. The presence of eating disorders in ADHD patients could partially explain previously described growth and weight changes. PMID:20946717

  14. Attention deficit disorder during adolescence: a review.

    PubMed

    Faigel, H C; Sznajderman, S; Tishby, O; Turel, M; Pinus, U

    1995-03-01

    Attention deficit disorder (ADD) in adolescents has received scant attention when compared with that given to children. With or without hyperactivity, ADD does not disappear at puberty and is an important factor in scholastic and social failure in adolescents. As a condition associated with decreased metabolism in the premotor and prefrontal superior cerebral cortex, ADD in adolescents responds well to treatment with stimulants, tricyclic antidepressants and monoamine oxidase inhibitors. Nonpharmacologic modalities such as behavior modification, individual and family therapy, and cognitive therapy are useful adjuncts to psychopharmacologic management. Without effective treatment, ADD often results in increased risk of trauma, substance abuse and conduct and affective disorders during adolescence, and marital disharmony, family dysfunction, divorce, and incarceration in adulthood. Properly treated with medication and counseling, adolescents with ADD succeed as well as their peers. PMID:7779826

  15. Attention-Deficit/Hyperactivity Disorder and Attention Networks

    PubMed Central

    Bush, George

    2010-01-01

    Research attempting to elucidate the neuropathophysiology of attention-deficit/hyperactivity disorder (ADHD) has not only shed light on the disorder itself, it has simultaneously provided new insights into the mechanisms of normal cognition and attention. This review will highlight and integrate this bidirectional flow of information. Following a brief overview of ADHD clinical phenomenology, ADHD studies will be placed into a wider historical perspective by providing illustrative examples of how major models of attention have influenced the development of neurocircuitry models of ADHD. The review will then identify major components of neural systems potentially relevant to ADHD, including attention networks, reward/feedback-based processing systems, as well as a ‘default mode' resting state network. Further, it will suggest ways in which these systems may interact and be influenced by neuromodulatory factors. Recent ADHD imaging data will be selectively provided to both illustrate the field's current level of knowledge and to show how such data can inform our understanding of normal brain functions. The review will conclude by suggesting possible avenues for future research. PMID:19759528

  16. Functional deficits of the attentional networks in autism

    PubMed Central

    Fan, Jin; Bernardi, Silvia; Dam, Nicholas T; Anagnostou, Evdokia; Gu, Xiaosi; Martin, Laura; Park, Yunsoo; Liu, Xun; Kolevzon, Alexander; Soorya, Latha; Grodberg, David; Hollander, Eric; Hof, Patrick R

    2012-01-01

    Attentional dysfunction is among the most consistent observations of autism spectrum disorders (ASD). However, the neural nature of this deficit in ASD is still unclear. In this study, we aimed to identify the neurobehavioral correlates of attentional dysfunction in ASD. We used the Attention Network Test-Revised and functional magnetic resonance imaging to examine alerting, orienting, and executive control functions, as well as the neural substrates underlying these attentional functions in unmedicated, high-functioning adults with ASD (n = 12) and matched healthy controls (HC, n = 12). Compared with HC, individuals with ASD showed increased error rates in alerting and executive control, accompanied by lower activity in the mid-frontal gyrus and the caudate nucleus for alerting, and by the absence of significant functional activation in the anterior cingulate cortex (ACC) for executive control. In addition, greater behavioral deficiency in executive control in ASD was correlated with less functional activation of the ACC. These findings of behavioral and neural abnormalities in alerting and executive control of attention in ASD may suggest core attentional deficits, which require further investigation. PMID:23139910

  17. Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults: recommendations from the British Association for Psychopharmacology.

    PubMed

    Nutt, D J; Fone, K; Asherson, P; Bramble, D; Hill, P; Matthews, K; Morris, K A; Santosh, P; Sonuga-Barke, E; Taylor, E; Weiss, M; Young, S

    2007-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is an established diagnosis in children, associated with a large body of evidence on the benefits of treatment. Adolescents with ADHD are now leaving children's services often with no readily identifiable adult service to support them, which presents problems as local pharmacy regulations often preclude the prescription of stimulant drugs by general practitioners (GPs). In addition, adults with ADHD symptoms are now starting to present to primary care and psychiatry services requesting assessment and treatment. For these reasons, the British Association for Psychopharmacology (BAP) thought it timely to hold a consensus conference to review the body of evidence on childhood ADHD and the growing literature on ADHD in older age groups. Much of this initial guidance on managing ADHD in adolescents in transition and in adults is based on expert opinion derived from childhood evidence. We hope that, by the time these guidelines are updated, much evidence will be available to address the many directions for future research that are detailed here. PMID:17092962

  18. Assessment and Characteristics of Children with Attention Deficit Disorder. Education of Children with Attention Deficit Disorder.

    ERIC Educational Resources Information Center

    Dykman, Roscoe A.; And Others

    This report summarizes activities and findings of a federally funded center at the Arkansas Children's Hospital which reviewed and disseminated literature on the identification and assessment of children with attention deficit disorders (ADD). Meetings throughout Arkansas led to the identification of interest areas, and findings are summarized for…

  19. Detection of feigned attention deficit hyperactivity disorder.

    PubMed

    Tucha, Lara; Fuermaier, Anselm B M; Koerts, Janneke; Groen, Yvonne; Thome, Johannes

    2015-08-01

    In recent years, there is an increasing awareness that individuals may purposely feign or exaggerate symptoms of attention deficit hyperactivity disorder (ADHD) to gain external incentives, including access to stimulant drugs or special academic accommodations. There are vast consequences of undetected feigned ADHD such as substantial costs covered by society for unnecessary assessments and treatments, unjustified occupation of limited medical resources and undermining society's trust in the existence of the disorder or the effectiveness of treatment. In times of economic crisis and cost savings in the medical sector, the detection of feigned ADHD is of importance. This review briefly describes the research on this topic with an emphasis on the approaches available for detection of feigned ADHD (i.e., self-report questionnaires, personality inventories, cognitive tests used in routine neuropsychological assessment and tests specifically designed for detecting feigned cognitive dysfunction). Promising approaches and measures are available for identifying feigned ADHD but there is an immediate need for further research. PMID:25096370

  20. [GEITDAH consensus on attention deficit hyperactivity disorder].

    PubMed

    Montañés-Rada, F; Gastaminza-Pérez, X; Catalá, M A; Ruiz-Sanz, F; Ruiz-Lázaro, P M; Herreros-Rodríguez, O; García-Giral, M; Ortiz-Guerra, J; Alda-Díez, J A; Mojarro-Práxedes, D; Cantó-Díez, T; Mardomingo-Sanz, M J; Sasot-Llevadot, J; Pàmias, M; Rey-Sánchez, F

    2010-11-16

    In this article, the GEITDAH -the Spanish abbreviation of the Special Interest Group on Attention Deficit Hyper-activity Disorder (ADHD)- presents a consensus reached by experts in the management of ADHD from all over Spain. The consensus concerns fundamental aspects that should be the starting point for future local or regional consensus guides. Another aim of this consensus is also to reduce the amount of variability that occurs in the health care offered to patients with ADHD in our country, as well as to act as a stimulus in educational matters. That fact that it is not very long will make it more popular among greater numbers of people and this will allow these goals to be reached more effectively. The conclusions in the consensus guide have been constructed around an introduction dealing with basic aspects and recommendations for diagnosis, treatment (both pharmacological and psychotherapeutic), patient flow and organisational aspects. PMID:21069642

  1. Collicular dysfunction in attention deficit hyperactivity disorder.

    PubMed

    Overton, Paul G

    2008-01-01

    Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterised by (inter alia) an increase in distractibility. The current front-line pharmacotherapies for the treatment of ADHD, namely the psychostimulants methylphenidate and amphetamines, have clear abuse potential, hence there is a strong need to develop new drug treatments for this disorder. Central to this process is the identification of the pathophysiological changes which underlie ADHD. Given the heterogeneity of the disorder, multiple loci are probably involved, providing multiple potential therapeutic targets. Here, we hypothesise (Hypothesis 1) that one such locus is the superior colliculus (SC), a sensory structure intimately linked with distractibility and the production of eye and head movements. It is proposed that in ADHD, the colliculus is hyper-responsive, leading to the core symptom of increased distractibility. Hypothesis 1 is supported by: 1. ADHD patients show increased distractibility in tasks which are sensitive to collicular function; 2. ADHD patients have a general problem inhibiting saccades, the generation of which involves the SC; 3. Saccadic deficits in ADHD include defects in the production of saccadic types (anti-saccades and express saccades) which are particularly associated with the colliculus; 4. Covert shifts in attention (which also have been argued to involve the SC) are also impaired in ADHD; 5. Reading disorders are frequently co-morbid with ADHD; dyslexia (which is associated with eye movement problems) is linked to a specific visual perceptual deficit in the M pathway, a major recipient of which is the colliculus. Whether or not the SC is indeed hyper-responsive in ADHD as Hypothesis 1 suggests, the SC may well represent an important therapeutic target for drugs. In fact current psychostimulant therapies, which reduce distractibility, may already work at that level (Hypothesis 2), a contention which is supported by: 1. The

  2. Raising attention to attention deficit hyperactivity disorder in schizophrenia

    PubMed Central

    Pallanti, Stefano; Salerno, Luana

    2015-01-01

    Schizophrenia and attention deficit hyperactivity disorder (ADHD) are two psychiatric disorders with a negative impact on quality of life of individuals affected. Although they are classified into distinct disorders categories, attentional dysfunction is considered as a core feature in both conditions, either at the clinical then pathophysiological level. Beyond the obvious clinical overlap between these disorders, the Research Domain Criteria approach might offer an interesting perspective for disentangling common circuits underpinning both disorders. Hence, we review evidences regarding the overlap between schizophrenia and ADHD, at the clinical level, and at the level of underlying brain mechanisms. The evidence regarding the influence of environmental risk factors in the emergence of both disorders, and their developmental trajectories is also reviewed. Among these, we will try to elucidate the complex relationship between stimulants use and psychotic symptoms, discussing the potential role of ADHD medication in inducing psychosis or in exacerbating it. We aim that, taken together, these findings may promote further investigation with important implications both for clinicians and research. In fact, considering the amounting evidence on the overlap between schizophrenia and ADHD, the delineation of their boundaries might help in the decision for diagnosis and treatment. Moreover, it may help to promote interventions focused on the prevention of both schizophrenia and ADHD, by the reduction of recognized environmental risk factors. PMID:25815254

  3. Raising attention to attention deficit hyperactivity disorder in schizophrenia.

    PubMed

    Pallanti, Stefano; Salerno, Luana

    2015-03-22

    Schizophrenia and attention deficit hyperactivity disorder (ADHD) are two psychiatric disorders with a negative impact on quality of life of individuals affected. Although they are classified into distinct disorders categories, attentional dysfunction is considered as a core feature in both conditions, either at the clinical then pathophysiological level. Beyond the obvious clinical overlap between these disorders, the Research Domain Criteria approach might offer an interesting perspective for disentangling common circuits underpinning both disorders. Hence, we review evidences regarding the overlap between schizophrenia and ADHD, at the clinical level, and at the level of underlying brain mechanisms. The evidence regarding the influence of environmental risk factors in the emergence of both disorders, and their developmental trajectories is also reviewed. Among these, we will try to elucidate the complex relationship between stimulants use and psychotic symptoms, discussing the potential role of ADHD medication in inducing psychosis or in exacerbating it. We aim that, taken together, these findings may promote further investigation with important implications both for clinicians and research. In fact, considering the amounting evidence on the overlap between schizophrenia and ADHD, the delineation of their boundaries might help in the decision for diagnosis and treatment. Moreover, it may help to promote interventions focused on the prevention of both schizophrenia and ADHD, by the reduction of recognized environmental risk factors. PMID:25815254

  4. Story Comprehension and Academic Deficits in Children with Attention Deficit Hyperactivity Disorder: What Is the Connection?

    ERIC Educational Resources Information Center

    Berthiaume, Kristen S.

    2006-01-01

    Based on the reliable findings that children with attention deficit hyperactivity disorder (ADHD) have both attentional and academic difficulties, it is assumed that the attentional deficit contributes to the academic problems. In this article, existing support for a link between the attentional and academic difficulties experienced by children…

  5. Disorganization as related to discoordination and attention deficit.

    PubMed

    Lifshitz, Nirit; Josman, Naomi; Tirosh, Emanuel

    2014-01-01

    Our objective was to examine the association of attention deficit and disorganization in boys with and without specific developmental disorder of motor function. Four groups of boys between the age of 7 and 12 years-(1) Disorganization + coordination disorder (n = 30); (2) Coordination disorder (n = 33); (3) Disorganization (n = 28); and (4) Control (n = 29)-were included. Teachers completed the Questionnaire for Assessing the Students' Organizational Abilities for the Teacher and the Conners' Teachers Rating Scale-Revised. The Movement Assessment Battery for Children and 2 subscales of an intelligence test (vocabulary and similarities) were administered. A significantly increased rate of attention deficit in children with organizational deficit was identified. Attention deficit in children with specific motor disorder was exclusively associated with an organizational deficit. Organizational deficit in childhood is highly associated with attention deficit, and this association is particularly relevant in children with specific coordination disorder. PMID:23271761

  6. Cognitive Deficits in Adults with ADHD Go beyond Comorbidity Effects

    ERIC Educational Resources Information Center

    Silva, Katiane L.; Guimaraes-da-Silva, Paula O.; Grevet, Eugenio H.; Victor, Marcelo M.; Salgado, Carlos A. I.; Vitola, Eduardo S.; Mota, Nina R.; Fischer, Aline G.; Contini, Veronica; Picon, Felipe A.; Karam, Rafael G.; Belmonte-de-Abreu, Paulo; Rohde, Luis A.; Bau, Claiton H. D.

    2013-01-01

    Objective: This study addresses if deficits in cognitive, attention, and inhibitory control performance in adults with ADHD are better explained by the disorder itself or by comorbid conditions. Method Adult patients with ADHD ("n" = 352) and controls ("n" = 94) were evaluated in the ADHD program of a tertiary hospital. The…

  7. Right Hemisphere Deficit Syndrome: Similarities with Subtypes of Children with Attention Deficit Disorder (ADD).

    ERIC Educational Resources Information Center

    Matazow, Gail S.; Hynd, George W.

    Children with Attention Deficit Disorder (ADD) often exhibit problems in visual spatial perception, math achievement, and social skills, and it has been postulated that this constellation of behaviors may constitute Right Hemisphere Deficit Syndrome (RHDS). This study examined 21 children with attention deficit disorder with hyperactivity (ADD/H),…

  8. [Prevention in attention deficit hyperactivity disorder].

    PubMed

    Quintero, J; Martin, M; Alcindor, P; Perez-Templado, J

    2016-02-21

    Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins at an early age and can be present until adulthood. Subjects with ADHD not only have symptoms such as inattention, impulsivity or hyperactivity but also have their social and emotional areas affected. In addition, they have an associated increased risk for presenting comorbilities with other psychiatric disorders, overshadowing the development. Considering ADHD as a evolutionary risk factor, prevention should be considered as a primary goal. Most preventive actions on ADHD have been focused on tertiary prevention. The present review aims to study the factors involved in the development of ADHD in order to form a prevention model beyond tertiary prevention. This research focuses on models of primary prevention (early detection of disease) and secondary prevention (to prevent or delay the disease), trying to incorporate them into daily practice. This study reviews risk factors that affect ADHD. Through actions aimed to pursue an early detection, development of the disorder could be improved, and by identifying population at risk, efforts could be concentrated on developing a true primary prevention (perinatal period and early childhood) that eventually could contribute to reduce the incidence of ADHD. PMID:26922966

  9. Comorbidity in attention deficit-hyperactivity disorder.

    PubMed

    Ishii, Takashi; Takahashi, Osamu; Kawamura, Yuuichi; Ohta, Tatsuro

    2003-10-01

    Attention deficit-hyperactivity disorder (ADHD) has been noted for its high rate of comorbidity. The present study is the first report in Japan evaluating the proportion of comorbidity in ADHD cases presenting in the clinical setting, aiming at clarifying the picture of ADHD in Japan. The subjects consisted of 68 child and adolescent cases meeting criteria for ADHD (Diagnostic and Statistical Manual of Mental Disorders, 4th edn) under treatment at a child psychiatry clinic (IQ > 50, mental age >or= 4 years old). Disorders evaluated as comorbid disorders were mood disorders, anxiety disorders, elimination disorders, sleep disorders, tic disorders, oppositional defiant disorder (ODD), conduct disorder (CD), school refusal, and epilepsy. Comorbidity with mood disorders, anxiety disorders, ODD, and CD, were found to be lower than the high rates conventionally reported in North America. The lower age of the present subjects, primarily in infancy and elementary school age with few adolescent cases, and a bias towards milder cases from an outpatient clinic without inpatient facilities are believed to be factors accounting for this disparity. Furthermore, it was a notable fact that mentally delayed cases (IQ: 51-84) amounted to 34% of the cases, indicating the necessity to consider intelligence level when formulating a treatment strategy for ADHD. PMID:12950698

  10. Anchoring the Deficit of the Anchor Deficit: Dyslexia or Attention?

    ERIC Educational Resources Information Center

    Willburger, Edith; Landerl, Karin

    2010-01-01

    In the anchoring deficit hypothesis of dyslexia ("Trends Cogn. Sci.", 2007; 11: 458-465), it is proposed that perceptual problems arise from the lack of forming a perceptual anchor for repeatedly presented stimuli. A study designed to explicitly test the specificity of the anchoring deficit for dyslexia is presented. Four groups, representing all…

  11. Assessment of Attention Deficit Disorder Using a Thematic Apperception Technique.

    ERIC Educational Resources Information Center

    Costantino, Giuseppe; And Others

    Attention deficits and attention deficit-hyperactivity disorder (AD-HD) are regarded as relatively common disorders among school-age children, but the literature reveals several confounding factors with the standard assessment techniques for the disorder. Using a structured thematic apperception technique (the TEMAS Apperception Test of G.…

  12. Is Attention Deficit Disorder Becoming a Desired Diagnosis?

    ERIC Educational Resources Information Center

    Smelter, Richard W.; And Others

    1996-01-01

    The rush to label schoolchildren as suffering from attention deficit disorder (ADD) or attention deficit-hyperactivity disorder (ADHD) has reached nearly epidemic proportions. The diagnosis often meets parents' needs to assign behavior control to Ritalin; it should be an explanation leading to genuine help, not a license for unacceptable student…

  13. [Drugs for attention deficit hyperactivity disorder].

    PubMed

    Montañés-Rada, F; Gangoso-Fermoso, A B; Martíínez-Granero, M A

    Quantitative studies have highlighted differences in several drugs approved for use in Spain in the treatment of attention deficit hyperactivity disorder. No clear differences are observed, however, in the case of qualitative studies. The number of patients needed to be treated in order for one to reach complete remission (NNT) of methylphenidate (MTF) is from 2.2 to 5, and the effect size (ES) is 0.9. Atomoxetine has an NNT of 4 and an ES of 0.7. The advantages of immediate-release MTF (IR-MTF) over the extended-release version (ER-MTF) lie in its low cost, its flexibility and the better results obtained in quantitative studies. In contrast, ER-MTF offers a lower risk of abuse, needs to be taken fewer times with less need for third parties to control administration, and there is a lower risk of stigmatisation. Combination or changes of IR-MTF and ER-MTF and the combination of MTF with atomoxetine are sometimes necessary to adjust the weekday or weekend doses. Starting treatment with IR-MTF and then maintaining or changing to ER-MTF offers certain advantages as regards safety, dose adjustments and dosage. Atomoxetine is the best alternative if there is a background of adverse events with low or moderate doses of stimulants, or lack of response to high doses of stimulants. In cases of notable comorbid anxiety, both MTF and atomoxetine have the same level of indication. If there is a risk of substance abuse, both atomoxetine and ER-MTF are the preferred treatment. For the other indications, MTF is the preferred treatment. PMID:19396764

  14. [Emotional dysfunctions in attention deficit hyperactivity disorder].

    PubMed

    Purper-Ouakil, D; Franc, N

    2011-06-01

    Inattention, motor instability, and impulsivity, associated in varying degrees of severity depending on the clinical subtype, constitute the key symptoms of attention deficit/hyperactivity disorder (ADHD). However, emotional symptoms are frequent in patients with ADHD and may, in some cases, be responsible for a major part of the negative impact on functioning and outcome. Emotional problems have been described in ADHD even in the absence of characterized comorbid conditions such as depressive or anxiety disorders. They can manifest acutely in the form of severe tantrums and aggressive behaviour, generally in reaction to an environmental trigger, or show a more chronic course of irritable or labile mood. Symptoms of emotional undercontrol seem to occur more frequently when ADHD is associated with oppositional defiant behaviour, but they are not specific and may contribute to difficulties in making a differential diagnosis, especially with bipolar disorder and prodromal symptoms of personality disorders. The frequency and negative impact of emotional symptoms and the need to differentiate them from bipolar disorder has led some authors to the description of a novel clinical entity called "severe mood dysregulation" or "temper dysregulation with dysphoria." This article aims to review the recent literature on emotional symptoms associated with ADHD and to discuss relevant clinical and biological issues. Current research highlights the links between emotional self-regulation and executive functions and possible involvement of motivational systems. The role of environmental factors in the development of emotional regulation and self-control is another important issue, especially because environmental modification is the major focus of current preventive and therapeutic interventions. PMID:21497072

  15. Career Development Needs among College and University Students with Learning Disabilities and Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Hennessey, Mary L.; Rumrill, Phillip D., Jr.; Roessler, Richard T.; Cook, Bryan G.

    2006-01-01

    The purpose of this study was to (a) examine the employment and career development concerns of postsecondary students with learning disabilities and Attention Deficit Disorder (ADD) or Attention Deficit/Hyperactivity Disorder (AD/HD) and (b) develop strategies for improving their post-graduation employment outcomes. Employing an established…

  16. Antidepressants in the treatment of attention-deficit/hyperactivity disorder.

    PubMed

    Popper, C W

    1997-01-01

    Antidepressants differ in their effectiveness for treating attention-deficit/hyperactivity disorder (ADHD) in adults and children. None are as effective as psychostimulants for treating the attentional and cognitive symptoms, but they can help reduce impulsive and hyperactive behavior. Tricyclic antidepressants have well-demonstrated efficacy in treating behavioral symptoms, but desipramine should be avoided, at least in youths and adolescents (and perhaps adults), because safer tricyclics are available. Bupropion was effective in its few controlled trials, but tics and (especially in youth) skin rash limit its value. Venlafaxine appears effective, but controlled studies are needed. Serotonin selective reuptake inhibitors have not been tested in controlled trials, but they cause inconsistent changes, often aggravate ADHD symptoms, and can cause frontal apathy and disinhibition. Clonidine has not been adequately examined but seems to have small or uncertain effects. Psychostimulants remain the treatment of choice because of their unique effect on attention. Multimodal treatments (medications plus psychosocial) might not be more effective than medications alone. PMID:9418743

  17. Distributed attentional deficits in chronic methamphetamine abusers: Evidence from the Attentional Network Task (ANT)

    PubMed Central

    Salo, Ruth; Gabay, Shai; Fassbender, Catherine; Henik, Avishai

    2016-01-01

    Objective The goal of the present study was to examine distributed attentional functions in long-term but currently abstinent methamphetamine (MA) abusers using a task that measures attentional alertness, orienting, and conflict resolution. Methods Thirty currently abstinent MA abusers (1 month–5 years) and 22 healthy non-substance using adults were administered a multimodal version of the Attentional Network Task (ANT-I). In this task subjects identified the direction of a centrally presented arrow using a key press. Analyses examined the interaction between alerting tones, location cueing and congruency between the target arrows and flanking distractor stimuli. Results All participants were faster when an auditory tone preceded the trial onset (p < 0.001), on trials in which a valid cue preceded the location of the target arrow (p < 0.001), and on congruent trials (i.e., when all display arrows faced in the same direction) (p < 0.001). Of primary interest was the finding that MA abusers were more influenced by the conflict between the peripheral arrows and the central target arrow (p = 0.009). There were also correlations between length of drug sobriety and executive function as well as between drug-induced psychiatric symptoms and alertness. Conclusions These results suggest that chronic MA abusers display cognitive deficits that may reflect a specific vulnerability to distraction on a task of executive function. These findings are consistent with other studies that have reported deficits in anterior attentional systems and top-down cognitive control. PMID:21906864

  18. [ASRS v.1.1., a tool for attention-deficit/hyperactivity disorder screening in adults treated for addictive behaviors: psychometric properties and estimated prevalence].

    PubMed

    Pedrero Pérez, Eduardo J; Puerta García, Carmen

    2007-01-01

    ASRS v.1.1. is a self-applied brief instrument for the screening of individuals presenting symptoms of attention-deficit/hyperactivity disorder (ADHD), and proposed by the WHO. The purpose of the present work was to test the instrument and examine the results of its application to a sample of 280 individuals in treatment for substance-related disorders (cross-sectional descriptive study). We administered simultaneously in the initial phases of treatment the ASRS v.1.1. (short form) and the MCMI-II to the full sample and the Wender Utah Rating Scale (WURS), ADHD-Rating Scale-IV and ASRS v.1.1. (complete form) to various sub-samples. Diagnostic interviews were also carried out and the psychometric properties and factorial structure of ASRS v.1.1. were explored. Good convergent validity, sensitivity, specificity and diagnostic capability were obtained for the six-item version of ASRS v.1.1., even though 4 out of 6 items did not discriminate between Axis I and II disorders assessed through the MCMI-II and diagnostic interviews. According to DSM-IV-TR criteria the estimated prevalence of ADHD in the sample of addicts was 8.2%. ASRS v.1.1. is criticized as a specific instrument for ADHD detection, since most of its items appear to measure a non-specific dimension of compulsiveness/impulsiveness, common to Axis-I and Axis-II disorders. Other criticisms made in the discussion concern the lack of specificity of DSM criteria and the confusion they generate among the concepts of symptom, sign and trait (including the impact on study results), the general use of the A criterion but the omission of the B, C, D and E criteria of the DSM category, differences in samples (with regard to both severity and selection criteria), and the artifactual increases in prevalence found in many studies. PMID:18173102

  19. Children with Attention-Deficit/Hyperactivity Disorder: A Review of the Literature on Social Skills Deficits.

    ERIC Educational Resources Information Center

    Frederick, Brian P.; Olmi, D. Joe

    1994-01-01

    Social interactions between children with Attention-Deficit/Hyperactivity Disorder (ADHD) and their teachers, peers, and parents are discussed. Problematic interactions may depend on social skills deficits. Changing the focus to ADHD children who are not experiencing social skills deficits may prove beneficial. A review of the previous literature…

  20. Motor Extinction: A Deficit of Attention or Intention?

    PubMed Central

    Punt, T. David; Riddoch, M. Jane; Humphreys, Glyn W.

    2013-01-01

    Motor extinction refers to a deficit of motor production on the side opposite a brain lesion that either only becomes apparent or disproportionately worsens during bilateral motor activity. It may arise due either to a contralesional deficit in setting the motor activation level (an intentional deficit) or a deficit in contralesional awareness of the sensory consequences of movement (an attentional deficit). In this study, we investigate the nature of motor extinction in a patient (LR) with a right fronto-temporal lesion through the kinematic analysis of unimanual and bimanual circle-drawing movements. While the ipsi- and contralesional limbs performed comparably for unimanual movements, the contralesional limb demonstrated marked bradykinesia and hypometria during bimanual movements. Furthermore, these deficits were not overcome when visual feedback of the contralesional limb was provided (Experiment 1). However, when performing bimanual movements in the presence of a visual template (Experiment 2), LR was able to overcome the contralesional hypometria but not the bradykinesia which proved intractable across both experiments. Both the bradykinesia and hypometria could result from an intentional deficit of motor production. However, in Experiment 2, LR also demonstrated an abnormal level of positional drift in the contralesional limb for bimanual movements indicative of an additional attentional deficit. We conclude that LR’s presentation of motor extinction is the result of a primary intentional deficit and a secondary attentional deficit. PMID:24137119

  1. Deficient Attention Is Hard to Find: Applying the Perceptual Load Model of Selective Attention to Attention Deficit Hyperactivity Disorder Subtypes

    ERIC Educational Resources Information Center

    Huang-Pollock, Cynthia L.; Nigg, Joel T.; Carr, Thomas H.

    2005-01-01

    Background: Whether selective attention is a primary deficit in childhood Attention Deficit Hyperactivity Disorder (ADHD) remains in active debate. Methods: We used the "perceptual load" paradigm to examine both early and late selective attention in children with the Primarily Inattentive (ADHD-I) and Combined subtypes (ADHD-C) of ADHD. Results:…

  2. Attention deficit hyperactivity disorder and the behavior of "Che" Guevara.

    PubMed

    Teive, Hélio A G; Zavala, Jorge A; Munhoz, Renato P; Lara, Diogo R; Lima, Pedro; Palmini, André

    2009-09-01

    Attention deficit hyperactivity disorder (ADHD) is a childhood onset neuropsychiatric disorder characterized by inattention, hyperactivity and impulsivity. ADHD is related to several co-morbidities, such as opposition defiant disorder, conduct disorder, mood and anxiety disturbances, as well as tics and Tourette's syndrome. The objective of this report is to shed an alternative light on the personality of Ernesto "Che" Guevara, discussing whether he might have had ADHD. Several published biographies of Che Guevara were reviewed. Established ADHD criteria (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), were used as a framework to evaluate Che's behaviour. In addition, we compared the main features of Che's reported behaviour to the set of abnormalities leading to the diagnosis of ADHD in adults proposed by Wender and colleagues and known as the UTAH ADHD criteria. Analysis of the most renowned biographies of Ernesto "Che" Guevara suggests that he may have had ADHD. PMID:19497749

  3. The Neurological Basis of Attention Deficit Hyperactivity Disorder.

    ERIC Educational Resources Information Center

    Ballard, Shirley; Bolan, Morna; Burton, Michael; Snyder, Sherry; Pasterczyk-Seabolt, Claire; Martin, Don

    1997-01-01

    Reviews research on attention deficit hyperactivity disorder (ADHD) and examines the role of neurochemical stimulation and signs of neurological deficits. Describes the chemical action of drugs used to treat ADHD, along with cognitive, affective, and behavioral effects, and side effects. Elaborates on drug treatment and basic behavior modification…

  4. Attention Deficit Hyperactivity Disorder: Strategies for the Classroom.

    ERIC Educational Resources Information Center

    Purvis, Johnny R.; And Others

    1992-01-01

    This article discusses classroom strategies used with students with attention deficit hyperactivity disorder (ADHD), methods for controlling the ADHD child's behavior, and the need for consistency and collaboration between the school and home. (Author/JDD)

  5. Cognitive Deficits in Nonretarded Adults with Fetal Alcohol Syndrome.

    ERIC Educational Resources Information Center

    Kerns, Kimberley A.; Don, Audrey; Mateer, Catherine A.; Streissguth, Ann P.

    1997-01-01

    Sixteen nonretarded young adults with fetal alcohol syndrome were divided into two groups, one with average to above average IQ and one with borderline to low average IQ. Subjects in both groups manifested clear deficits on neuropsychological measures sensitive to complex attention, verbal learning, and executive function at a frequency and…

  6. Dexmethylphenidate extended release: in attention-deficit hyperactivity disorder.

    PubMed

    Robinson, Dean M; Keating, Gillian M

    2006-01-01

    Dexmethylphenidate extended release (XR) is an orally administered, bimodal release, capsule formulation of the active d-enantiomer of methylphenidate (MPH), which inhibits dopamine and norepinephrine (noradrenaline) reuptake to increase their concentration in the extraneuronal space. A single dose of dexmethylphenidate XR mimics the pharmacokinetic profile of two doses of dexmethylphenidate immediate-release formulation administered 4 hours apart, albeit with less fluctuation in plasma concentration. Once-daily dexmethylphenidate XR was more effective than placebo in reducing attention-deficit hyperactivity disorder (ADHD) symptom scores in children, adolescents and adults with ADHD in four randomised, double-blind, placebo-controlled trials of up to 7 weeks' duration. In crossover trials in children (aged 6-12 years), dexmethylphenidate XR 20 mg/day reduced mean ADHD symptom scores 1 hour after administration (by 43% in one trial) and was significantly better than placebo for up to 12 hours. Dexmethylphenidate XR 5-30 mg/day reduced mean ADHD symptom scores by 49%, while scores declined by 16% with placebo in a 7-week trial in children and adolescents (aged 6-17 years). Dexmethylphenidate XR 20, 30 or 40 mg/day reduced ADHD symptom scores by 36-46% versus a 21% reduction with placebo in a 5-week trial in adults (aged 18-60 years). Dexmethylphenidate XR was generally well tolerated in children, adolescents and adults with ADHD, with an adverse-event profile typical of MPH. PMID:16620143

  7. Overview of Attention Deficit Hyperactivity Disorder in Young Children

    PubMed Central

    Singh, Ajay; Yeh, Chia Jung; Verma, Nidhi; Das, Ajay Kumar

    2015-01-01

    Attention deficit hyperactivity disorder (ADHD) is a complex disorder, which can be seen as a disorder of life time, developing in preschool years and manifesting symptoms (full and/or partial) throughout the adulthood; therefore, it is not surprising that there are no simple solutions. The aim of this paper is to provide a short and concise review which can be used to inform affected children and adults; family members of affected children and adults, and other medical, paramedical, non-medical, and educational professionals about the disorder. This paper has also tried to look into the process of how ADHD develops; what are the associated problems; and how many other children and adults are affected by such problems all over the world basically to understand ADHD more precisely in order to develop a better medical and or non-medical multimodal intervention plan. If preschool teachers and clinicians are aware of what the research tells us about ADHD, the varying theories of its cause, and which areas need further research, the knowledge will assist them in supporting the families of children with ADHD. By including information in this review about the connection between biological behavior, it is hoped that preschool teachers and clinicians at all levels will feel more confident about explaining to parents of ADHD children, and older ADHD children themselves about the probable causes of ADHD. PMID:26973960

  8. Overview of Attention Deficit Hyperactivity Disorder in Young Children.

    PubMed

    Singh, Ajay; Yeh, Chia Jung; Verma, Nidhi; Das, Ajay Kumar

    2015-09-30

    Attention deficit hyperactivity disorder (ADHD) is a complex disorder, which can be seen as a disorder of life time, developing in preschool years and manifesting symptoms (full and/or partial) throughout the adulthood; therefore, it is not surprising that there are no simple solutions. The aim of this paper is to provide a short and concise review which can be used to inform affected children and adults; family members of affected children and adults, and other medical, paramedical, non-medical, and educational professionals about the disorder. This paper has also tried to look into the process of how ADHD develops; what are the associated problems; and how many other children and adults are affected by such problems all over the world basically to understand ADHD more precisely in order to develop a better medical and or non-medical multimodal intervention plan. If preschool teachers and clinicians are aware of what the research tells us about ADHD, the varying theories of its cause, and which areas need further research, the knowledge will assist them in supporting the families of children with ADHD. By including information in this review about the connection between biological behavior, it is hoped that preschool teachers and clinicians at all levels will feel more confident about explaining to parents of ADHD children, and older ADHD children themselves about the probable causes of ADHD. PMID:26973960

  9. Attentional Engagement Deficits in Dyslexic Children

    ERIC Educational Resources Information Center

    Ruffino, Milena; Trussardi, Anna Noemi; Gori, Simone; Finzi, Alessandra; Giovagnoli, Sara; Menghini, Deny; Benassi, Mariagrazia; Molteni, Massimo; Bolzani, Roberto; Vicari, Stefano; Facoetti, Andrea

    2010-01-01

    Reading acquisition requires, in addition to appropriate phonological abilities, accurate and rapid selection of sublexical orthographic units by attentional letter string parsing. Spatio-temporal distribution of attentional engagement onto 3-pseudoletter strings was studied in 28 dyslexic and 55 normally reading children by measuring attentional…

  10. Attention and executive deficits in Alzheimer's disease. A critical review.

    PubMed

    Perry, R J; Hodges, J R

    1999-03-01

    In this review we summarize the progress that has been made in the research on attentional and executive deficits in Alzheimer's disease. Like memory, attention is now recognized as consisting of subtypes that differ in their function and anatomical basis. We base our review upon a classification of three subtypes of attention: selective, sustained and divided. This model derives from lesion studies, animal electrophysiological recordings and functional imaging. We examine how these subcomponents of attention can be reconciled with neuropsychological models of attentional control, particularly the Supervisory Attentional System and the Central Executive System of Shallice and Baddeley, respectively. We also discuss the relationship of attention to the concept of executive function. Current evidence suggests that after an initial amnesic stage in Alzheimer's disease, attention is the first non-memory domain to be affected, before deficits in language and visuospatial functions. This is consistent with the possibility that difficulties with activities of daily living, which occur in even mildly demented patients, may be related to attentional deficits. It appears that divided attention and aspects of selective attention, such as set-shifting and response selection, are particularly vulnerable while sustained attention is relatively preserved in the early stages. The phenomenon of cognitive slowing in Alzheimer's disease and normal ageing emphasizes the need to discriminate quantitative changes in attention dysfunction from qualitative changes which may be specifically related to the disease process. The neuropathological basis of these attentional deficits remains unsettled, with two competing hypotheses: spread of pathology from the medial temporal to basal forebrain structures versus corticocortical tract disconnection. Finally we discuss the difficulties of comparing evidence across studies and look at the implications for the design of future studies and future