Watson, Gretchen Lefever; Arcona, Andrea Powell; Antonuccio, David O; Healy, David
Medicating ADHD is a controversial subject that was acutely inflamed in 1995 when high rates of ADHD diagnosis and treatment were documented in southeastern Virginia. Psychologists in southeastern Virginia formed a regional school health coalition to implement and evaluate interventions to address the problem. Other professionals with strong ties to the pharmaceutical industry launched ad hominem attacks on the coalition's research and work. These attacks contributed to the work being terminated in 2005. In the ensuing years, ADHD drug treatment continued to escalate. Today, the national rate of ADHD diagnosis exceeds all reasonable estimates of the disorder's true prevalence, with 14 % of American children being diagnosed before reaching young adulthood. Notable key opinion leaders continue to claim that there is no cause for concern, but with a message shift from "the prevalence is not too high" to "high prevalence is not too concerning." This paper provides an object lesson about how innovative research can be derailed to the detriment of sound medical and mental health care of children when industry interests are threatened. Tenure may be the only option for protecting innovative research from specious attacks. The authors offer a summary of the data on ADHD drug treatments, suggest judicious use of such treatments, and add their voices to others who are once again sounding a cautionary alarm.
... Has ADHD en español El ADHD ADHD, or attention deficit hyperactivity disorder , is a medical condition that affects ... them through first. ADHD used to be called attention deficit disorder , or ADD for short. In 1994, it ...
González-Castro, Paloma; Cueli, Marisol; Rodríguez, Celestino; García, Trinidad; Álvarez, Luis
Behavioral training in neurofeedback has proven to be an essential complement to generalize the effects of pharmacological support in subjects who have attention deficit with hyperactivity disorder (ADHD). Therefore, this investigation attempts to analyze the efficacy of neurofeedback compared with pharmacological support and the combination of both. Participants were 131 students, classified into four groups: control (did not receive neurofeedback or pharmacological support), neurofeedback group, pharmacological support group, and combined group (neurofeedback + pharmacological support). Participants' executive control and cortical activation were assessed before and after treatment. Results indicate that the combined group obtained more benefits and that the neurofeedback group improved to a greater extent in executive control than the pharmacological support group. It is concluded that this kind of training may be an alternative to stimulate activation in subjects with ADHD.
ADHD FACT SHEET What is ADHD? Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders of childhood. It is sometimes referred to as Attention Deficit Disorder (ADD). It ...
... skills. Sometimes groups of people who have ADHD work together in group therapy. Group therapy can help people with ADHD ... Medicines Is My ADHD Medication Affecting My Sleep? Learning Disabilities How to Make Homework Less Work Contact Us Print Resources Send to a Friend ...
Hanc, Tomasz; Brzezinska, Anna Izabela
The aim of this investigation was to assess how different levels of intensity of ADHD symptoms influence the development of the subjective feeling of competence in school age children. The sample was comprised of 62 children age 11 to 13. For the purpose of estimation of the subjective feeling of competence, The Feeling of Competence Questionnaire…
Recent decades have seen an increasing number of life's problems conceptualised and interpreted through the prism of disease; among them are those affecting pupils at school. Witness the cases of hyperactivity and deficient attention, so often diagnosed as ADD/ADHD. Research indicates that there is at least some tendency towards overdiagnosis of…
Ruiz-Manrique, Gonzalo; Tajima-Pozo, Kazuhiro; Montañes-Rada, Francisco
We report the case of a 10 year old patient diagnosed with attention deficit hyperactivity disorder (ADHD) and comorbid video game addiction, who was treated with medication combined with a novel cognitive training method based on video games called TCT method. A great risk of developing video game or internet addiction has been reported in children, especially in children with ADHD. Despite this risk, we hypothesize that the good use of these new technologies might be useful to develop new methods of cognitive training. The cognitive areas in which a greater improvement was observed through the use of video games were visuospatial working memory and fine motor skills. TCT method is a cognitive training method that enhances cognitive skills such as attention, working memory, processing speed, calculation ability, reasoning, and visuomotor coordination. The purpose of reviewing this case is to highlight that regular cognitive computerized training in ADHD patients may improve some of their cognitive symptoms and might be helpful for treating video game addiction.
Myatchin, I; Lemiere, J; Danckaerts, M; Lagae, L
Working memory (WM) dysfunction and increased within-subject variability are known issues in attention deficit/hyperactivity disorder (ADHD) patients. Little is known about the electrophysiological characteristics of this variability. We evaluated behavioral and electrophysiological within-subject variability taking developmental aspects into account in a group of ADHD patients. Multichannel (n = 31) event-related potentials (ERP) were measured during a visuo-spatial backmatching task; 44 children (8-16 years old) were tested: 22 children with ADHD, combined (n = 17) and inattentive (n = 5) type, and 22 age- and intelligence-matched control children. One-backmatching (BM1) and two-backmatching (BM2) tasks were performed. Classical behavioral parameters and target and nontarget ERP were compared between groups. In addition, motor response variability and ERP amplitude variability were studied. Age-related changes in both motor response and ERP amplitude variability were analyzed in each group. Attention deficit/hyperactivity disorder children made more commission errors, which was more pronounced in the difficult (BM2) task. No difference between groups was found in ERP amplitude and in motor response variability. However, ADHD patients had higher ERP amplitude variability, which was again more pronounced in the difficult WM task. A delayed maturation of amplitude variability was seen in ADHD patients with a slower than in controls decrease in variability with age. This amplitude variability was correlated with the number of commissions, but in an opposite way for ADHD and control children. Our findings indicate an impaired visuo-spatial WM processing in ADHD children with greater ERP amplitude variability compared to controls. Our results also support the view of a delayed cortical development of visuo-spatial WM circuits in this disorder.
Mulligan, Aisling; Gill, Michael; Fitzgerald, Michael
Background: ADHD is a common, heritable disorder of childhood. Sex chromosome abnormalities are relatively rare conditions that are sometimes associated with behavioral disorders. Method: The authors present a male child with ADHD and a major de-novo Y chromosome abnormality consisting of deletion of the long arm and duplication of the short arm.…
Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich
There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account.
El Farouki, Kamal; Lagarde, Emmanuel; Orriols, Ludivine; Bouvard, Manuel-Pierre; Contrand, Benjamin; Galéra, Cédric
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
As the diagnosis of AD/HD becomes more frequent in our schools, and as many individuals across ages embrace an AD/HD identity, scholars need to account for the lived experience of the disorder to understand the meanings individuals give to it. This paper analyses the relationship between ethical practices of self-formation, power, and knowledge…
Beltrachini, L.; Blenkmann, A.; von Ellenrieder, N.; Petroni, A.; Urquina, H.; Manes, F.; Ibáñez, A.; Muravchik, C. H.
The major goal of evoked related potential studies arise in source localization techniques to identify the loci of neural activity that give rise to a particular voltage distribution measured on the surface of the scalp. In this paper we evaluate the effect of the head model adopted in order to estimate the N170 component source in attention deficit hyperactivity disorder (ADHD) patients and control subjects, considering faces and words stimuli. The standardized low resolution brain electromagnetic tomography algorithm (sLORETA) is used to compare between the three shell spherical head model and a fully realistic model based on the ICBM-152 atlas. We compare their variance on source estimation and analyze the impact on the N170 source localization. Results show that the often used three shell spherical model may lead to erroneous solutions, specially on ADHD patients, so its use is not recommended. Our results also suggest that N170 sources are mainly located in the right occipital fusiform gyrus for faces stimuli and in the left occipital fusiform gyrus for words stimuli, for both control subjects and ADHD patients. We also found a notable decrease on the N170 estimated source amplitude on ADHD patients, resulting in a plausible marker of the disease.
van Dyk, Leana; Springer, Priscilla; Kidd, Martin; Steyn, Nellie; Solomons, Regan; van Toorn, Ronald
We investigated familial and environmental risk factors in a cohort of South African children diagnosed with attention-deficit hyperactivity disorder (ADHD). A prospective, hospital-based case control study was conducted comprising 50 children diagnosed with ADHD and 50 matched non-ADHD controls. The adjusted effect of familial-environmental risk factors on ADHD was determined by systematic assessment. Birth complications, parental psychiatric disorder, maternal ADHD, early childhood trauma, and nonmaternal child care were significant risk factors for ADHD. Prolonged breastfeeding was found to be protective. In a multivariable logistic regression model, 5 criteria (birth complications, breastfeeding <3 months, at least 1 parent with tertiary education, presence of parental psychiatric disorder, and nonmaternal primary caregiver) differentiated ADHD from non-ADHD controls with a sensitivity and specificity of 74% and 86%, respectively. We found a correlation between certain familial and environmental risk factors and ADHD. A 5-criterion multivariable logistic regression model may offer clinical guidance in ADHD diagnosis.
Lia, C; Cavaggioni, G
In the last decades there was an increasing interest in early detection of prodromal symptoms in schizophrenia and, more specifically, in detecting subjects at high risk for psychosis. However, especially in case of childhood-onset schizophrenia (COS), sometimes it is possible to don't recognize its early symptoms and to ascribe the observed clinical picture to other diseases, with consequent delay in diagnosis and treatment of these patients. In this case report we want to underline the importance of an early detection of schizophrenia, with a focus on differential diagnosis between Attention Deficit/Hyperactivity Disorder and schizophrenia.
Sprich, Susan E.; Burbridge, Jennifer; Lerner, Jonathan A.; Safren, Steven A.
Although ADHD in adolescents is an impairing and prevalent condition, with community prevalence estimates between 2% and 6%, psychosocial treatments for adolescents compared to younger children are relatively understudied. Our group has successfully developed an evidence base for cognitive-behavioral therapy (CBT) for ADHD in medication-treated adults with ADHD with clinically significant symptoms. In the current paper, we describe an adaptation of this treatment to adolescents, and provide case reports on 3 adolescents who participated in an open pilot trial. The results suggest that the treatment approach was well tolerated by the adolescents and that they experienced clinical benefit. This early report of the approach in adolescents is promising and requires further efficacy testing. PMID:27616874
Hamshere, Marian L.; Langley, Kate; Martin, Joanna; Agha, Sharifah Shameem; Stergiakouli, Evangelia; Anney, Richard J.L.; Buitelaar, Jan; Faraone, Stephen V.; Lesch, Klaus-Peter; Neale, Benjamin M.; Franke, Barbara; Sonuga-Barke, Edmund; Asherson, Philip; Merwood, Andrew; Kuntsi, Jonna; Medland, Sarah E.; Ripke, Stephan; Steinhausen, Hans-Christoph; Freitag, Christine; Reif, Andreas; Renner, Tobias J.; Romanos, Marcel; Romanos, Jasmin; Warnke, Andreas; Meyer, Jobst; Palmason, Haukur; Vasquez, Alejandro Arias; Lambregts-Rommelse, Nanda; Roeyers, Herbert; Biederman, Joseph; Doyle, Alysa E.; Hakonarson, Hakon; Rothenberger, Aribert; Banaschewski, Tobias; Oades, Robert D.; McGough, James J.; Kent, Lindsey; Williams, Nigel; Owen, Michael J.; Holmans, Peter
Objective Although attention deficit hyperactivity disorder (ADHD) is highly heritable, genome-wide association studies (GWAS) have not yet identified any common genetic variants that contribute to risk. There is evidence that aggression or conduct disorder in children with ADHD indexes higher genetic loading and clinical severity. The authors examine whether common genetic variants considered en masse as polygenic scores for ADHD are especially enriched in children with comorbid conduct disorder. Method Polygenic scores derived from an ADHD GWAS meta-analysis were calculated in an independent ADHD sample (452 case subjects, 5,081 comparison subjects). Multivariate logistic regression analyses were employed to compare polygenic scores in the ADHD and comparison groups and test for higher scores in ADHD case subjects with comorbid conduct disorder relative to comparison subjects and relative to those without comorbid conduct disorder. Association with symptom scores was tested using linear regression. Results Polygenic risk for ADHD, derived from the meta-analysis, was higher in the independent ADHD group than in the comparison group. Polygenic score was significantly higher in ADHD case subjects with conduct disorder relative to ADHD case subjects without conduct disorder. ADHD polygenic score showed significant association with comorbid conduct disorder symptoms. This relationship was explained by the aggression items. Conclusions Common genetic variation is relevant to ADHD, especially in individuals with comorbid aggression. The findings suggest that the previously published ADHD GWAS meta-analysis contains weak but true associations with common variants, support for which falls below genome-wide significance levels. The findings also highlight the fact that aggression in ADHD indexes genetic as well as clinical severity. PMID:23599091
Wheeler, Linda; Pumfrey, Peter; Wakefield, Peter
By focusing on the findings from one case study, this article demonstrates a replicable individualised approach to identifying variability of ADHD symptoms across contexts at given times in a main phase and follow-up phase (situational variability) and across both phases (temporal variability) in a primary school setting. Currently we have found…
Hale, James B.; Hoeppner, Jo-Ann B.; DeWitt, Mary Beth; Coury, Daniel L.; Ritacco, David G.; Trommer, Barbara
A technique is presented for evaluating methylphenidate (MPH) effects on core behavioral symptoms of attention deficit hyperactivity disorder at the single-subject level of analysis. Case-study results and multivariate analyses suggests systematic evaluation of behavior and cognitive MPH dose-response relationships could lead to more accurate MPH…
Taylor, Myra; Houghton, Stephen
This study details the perspectives of Western Australian teachers, students and mothers on the case for an allocation of extra exam time to students diagnosed with Attention-Deficit/Hyperactivity Disorder (AD/HD). Eighteen teachers of students with AD/HD (14 high and four primary), 15 students with AD/HD (10 high and 5 primary), and their mothers…
... under a psychiatrist's or other doctor's care. ADHD medications have helped teens with ADHD in all sorts of areas, even helping reduce things like substance abuse, injuries, and automobile accidents. ADHD medicines also can ...
Griffin, Susan C; Weatherly, Helen L A; Richardson, Gerry A; Drummond, Mike F
This paper outlines methodological challenges encountered in producing an independent economic evaluation for the National Institute for Health and Clinical Excellence (NICE) to inform its technology appraisal process. The analysis used to highlight these challenges is a recent evaluation of pharmacological treatments for attention deficit hyperactivity disorder (ADHD). The NICE reference case for economic evaluation is compared with the methods necessary to complete an evaluation given the evidence base for ADHD. The primary analysis deviated from NICE methods guidelines most noticeably in the time horizon. Identifying appropriate utility data was challenging, and the results were sensitive to the values used. Issues found in this evaluation are common to many technology appraisals. Although challenging to undertake, economic evaluation in disease areas such as ADHD has great potential to add value, making the limitations of the data explicit, combining available evidence in a systematic and transparent framework and identifying future research needs.
Moorthy, Ganesh; Sallee, Floyd; Gabbita, Prasad; Zemlan, Frank; Sallans, Larry; Desai, Pankaj B
Betahistine, a potent histamine H3 receptor antagonist, is being developed for the treatment of attention deficit hyperactivity disorder (ADHD) that manifests with symptoms such as hyperactivity, impulsivity and inattention. This study describes the pharmacokinetics of betahistine in ADHD subjects at doses higher than 50 mg. These assessments were made during a randomized, placebo-controlled, single blind, dose escalation study to determine the safety, tolerability and pharmacokinetics of once daily doses of 50 mg, 100 mg and 200 mg of betahistine in subjects with ADHD. Plasma levels of 2-pyridylacetic acid (2-PAA), a major metabolite of betahistine were quantified using a validated LC-MS/MS method and used for pharmacokinetic analysis and dose proportionality of betahistine. A linear relationship was observed in Cmax and AUC0-4 of 2-PAA with the betahistine dose (R2 0.9989 and 0.9978, respectively) and dose proportionality coefficients (β) for the power model were 0.8684 (Cmax) and 1.007 (AUC0-4). A population pharmacokinetic model with first-order absorption of betahistine and metabolism to 2-PAA, followed by a first-order elimination of 2-PAA provides estimates of clearance that underscored the linear increase in systemic exposure with dose. There were no serious adverse events reported in the study, betahistine was safe and well tolerated at all the dose levels tested.
Finch, Holmes; Davis, Andrew; Dean, Raymond S.
The current study examined the measurement invariance of the Dean-Woodcock Sensory-Motor Battery (DWSMB) for children diagnosed with attention deficit hyperactivity disorder (ADHD) and an age- and gender-matched nonclinical sample. The DWSMB is a promising new instrument for assessing a wide range of cortical and subcortical sensory and motor…
Gibbs, Kathryn; Mercer, K. Louise; Carrington, Suzanne
This study explored the experience of schooling of six adolescent boys diagnosed with AD/HD from the perspectives of the boys, their mothers and their teachers. The study utilised social constructionism as the theoretical orientation and the Dynamic Developmental Theory (DDT) of AD/HD as the explanatory framework. Utilising a multiple,…
Maurizio, S; Liechti, M D; Brandeis, D; Jäncke, L; Drechsler, R
The objective of the present paper was to develop a differential electromyographic biofeedback (EMG-BF) training for children with attention-deficit/hyperactivity disorder (ADHD) matching multiple neurofeedback training protocols in order to serve as a valid control training. This differential EMG-BF training method feeds back activity from arm muscles involved in fine motor skills such as writing and grip force control. Tonic EMG-BF training (activation and deactivation blocks, involving bimanual motor tasks) matches the training of EEG frequency bands, while phasic EMG-BF training (short activation and deactivation trials) was developed as an equivalent to the training of slow cortical potentials. A case description of a child who learned to improve motor regulation in most task conditions and showed a clinically relevant reduction of behavioral ADHD symptoms illustrates the training course and outcome. Differential EMG-BF training is feasible and provides well-matched control conditions for neurofeedback training in ADHD research. Future studies should investigate its value as a specific intervention for children diagnosed with ADHD and comorbid sensorimotor problems.
... ADHD medications work by increasing the levels of brain chemicals called neurotransmitters . Neurotransmitters help send messages between nerve cells in the brain. There are two main kinds of ADHD medications: ...
Shipgood, L E; Baguley, D M
This retrospective single case study describes the effect of methylphenidate (Ritalin) on the auditory attention of an implanted child with attention deficit and hyperactivity disorder (ADHD). Child A received a Nucleus 22 cochlear implant at age 4 years 6 months. His behaviour before and after the implant surgery was challenging. Language development made little progress. Five years later a diagnosis of ADHD was made and methylphenidate (Ritalin) was prescribed. The apparent effect of this drug on auditory attention is discussed. In this study, methylphenidate did not appear to affect threshold levels or responses in tuning. However, audition did improve in everyday listening conditions. The drug did not appear to assist language development. Copyright (c) 2005 John Wiley & Sons, Ltd.
Cordeiro, Mara L.; Farias, Antonio C.; Cunha, Alexandre; Benko, Cassia R.; Farias, Lucilene G.; Costa, Maria T.; Martins, Leandra F.; McCracken, James T.
Objective: The validity of a diagnosis of ADHD in children with a high intelligence quotient (IQ) remains controversial. Using a multidisciplinary approach, rigorous diagnostic criteria, and worldwide-validated psychometric instruments, we identified a group of children attending public schools in southern Brazil for co-occurrence of high IQ and…
Fein, Deborah; Dixon, Pamela; Paul, Jennifer; Levin, Harriet
Despite prominent attentional symptoms in Pervasive Developmental Disorders (PDD) the relationship between PDD and Attention Deficit Hyperactivity Disorder (ADHD) has received little direct examination. In addition, outcome studies of children with PDD often focus on language, educational placement, or adaptive skills, but seldom on loss of the…
Waite, Roberta; Ramsay, J. Russell
Background: Guidelines for assessment, diagnosis, and treatment of ADHD have been drawn from research focused primarily on Caucasian males generating, in part, the need to redress health disparities. Diagnostic criteria may therefore be limited, especially regarding gender differences and other associated cultural, familial, socio-environmental,…
Yoshimasu, Kouichi; Barbaresi, William J.; Colligan, Robert C.; Voigt, Robert G.; Killian, Jill M.; Weaver, Amy L.; Katusic, Slavica K.
Background: To evaluate associations between attention-deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research-identified incident cases of ADHD and population-based controls. Methods: Subjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n = 5,718). Among them we…
Zayabaatar, Dalai; Dashdavaa, Vanchinsuren; Enkhjargal, Dagvasumberel; Onon, Tsulbaatar
This paper presents peculiarities of the genitive case marked subject in Modern Mongolian. First, we argue that subordinate clauses with the genitive case-marked subject in Modern Mongolian are CP. Second, we provide an explanation for certain conditions of the genitive subject construction in Modern Mongolian (MM). Third, we attempt to show the…
Ashwood, Karen L; Tye, Charlotte; Azadi, Bahare; Cartwright, Sally; Asherson, Philip; Bolton, Patrick
Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Children with ASD and ADHD demonstrate deficits in adaptive functioning, yet pure and comorbid groups have not been directly compared. Vineland Adaptive Behaviour Scales (VABS-II) data were examined in boys with ASD (n = 17), ADHD (n = 31) and ASD + ADHD (n = 38). Results demonstrated lower socialisation and composite scores and greater discrepancy between cognitive and adaptive abilities in the ASD + ADHD group compared to the ADHD-only group. Significant associations were shown between reduced adaptive functioning and autism symptoms, but not ADHD symptoms. Children with ASD + ADHD present with exacerbated impairments in adaptive functioning relative to children with ADHD, associated with ASD symptoms. Disentangling variation in adaptive skills may aid the assessment of complex cases.
Hammerness, Paul; Monuteaux, Michael C.; Faraone, Stephen V.; Gallo, Lauren; Murphy, Heather; Biederman, Joseph
The objective of this study is to further evaluate the association between asthma and ADHD, addressing issues of familiality in female probands. A case control study of referred ADHD proband girls, controls, and relatives are used. Participants include 140 ADHD proband girls and 122 non-ADHD comparisons, with 417 and 369 first-degree biological…
Wyciszkiewicz, Aleksandra; Pawlak, Mikolaj A; Krawiec, Krzysztof
Attention Deficit Hyperactivity Disorder (ADHD) is associated with altered cerebellar volume and cerebellum is associated with cognitive performance. However there are mixed results regarding the cerebellar volume in young patients with ADHD. To clarify the size and direction of this effect, we conducted the analysis on the large public database of brain images. The aim of this study was to confirm that cerebellar volume in ADHD is smaller than in control subjects in currently the largest publicly available cohort of ADHD subjects.We applied cross-sectional case control study design by comparing 286 ADHD patients (61 female) with age and gender matched control subjects. Volumetric measurements of cerebellum were obtained using automated segmentation with FreeSurfer 5.1. Statistical analysis was performed in R-CRAN statistical environment. Patients with ADHD had significantly smaller total cerebellar volumes (134.5±17.11cm(3) vs.138.90±15.32 cm(3)). The effect was present in both females and males (males 136.9±14.37 cm(3) vs. 141.20±14.75 cm(3); females 125.7±12.34 cm(3) vs. 131.20±15.03 cm(3)). Age was positively and significantly associated with the cerebellar volumes. These results indicate either delayed or disrupted cerebellar development possibly contributing to ADHD pathophysiology.
Frigerio, Alessandra; Montali, Lorenzo
Mutual aid groups have become a common form of help in the mental health field. Although self-help groups are associated with a range of health and social benefits, they remain poorly understood in terms of the dynamics of their interactions. Adopting an ethnographic-discursive approach, we conducted a 6-month observation of the meetings of a self-help group of parents with children diagnosed with attention deficit/hyperactivity disorder (ADHD) to analyze the discursive dynamics of the interactions that characterized the group. Using a set of discursive strategies and practices, the parents promoted a homogeneity of viewpoints and experiences within the group and constructed a shared and consensual narrative to endorse a specific understanding of ADHD. The production of both homogeneity within the group and a shared narrative served to absolve parents of guilt, helped parents to signify their experience within a blaming social context, and preserved their identities as "good parents."
Godinez, Detre A; Willcutt, Erik G; Burgess, Gregory C; Depue, Brendan E; Andrews-Hanna, Jessica R; Banich, Marie T
Individuals with ADHD, as well as their family members who do not meet clinical criteria, have shown deficits in executive function. However, it remains unclear whether underlying neural alterations are familial or ADHD-specific. To investigate this issue, neural activation underlying executive function was assessed using functional magnetic resonance imaging during performance of a Stroop task in three groups of individuals: 20 young adults who were diagnosed with ADHD in childhood, their 20 dizygotic co-twins without ADHD in childhood, and 20 unrelated controls selected from dizygotic twin pairs in which neither twin had ADHD in childhood (total n=60). Implicating the frontoparietal network as a location of effects specific to ADHD, activation in the superior frontal (Brodmann's Area - BA 6) and parietal regions (BA 40) was significantly reduced in twins with childhood ADHD compared to both their control co-twins and unrelated control twins. Consistent with familial influences, activity in the anterior cingulate and insula was significantly reduced in both the twins with ADHD and their co-twins compared to the unrelated controls. These results show that both ADHD-specific and familial influences related to an ADHD diagnosis impact neural systems underlying executive function.
Romo, Lucia; Legauffre, Cindy; Guilleux, Alice; Valleur, Marc; Magalon, David; Fatséas, Mélina; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Vénisse, Jean-Luc; Grall-Bronnec, Marie; Challet-Bouju, Gaëlle
Introduction The primary outcome of our study was to assess the links between the level of cognitive distortions and the severity of gambling disorder. We also aimed at assessing the links between patient gambling trajectories and attention deficit and hyperactivity disorder (ADHD). Materials and methods The study population (n = 628) was comprised of problem and non-problem gamblers of both sexes between 18 and 65 years of age, who reported gambling on at least one occasion during the previous year. Data encompassed socio-demographic characteristics, gambling habits, the South Oaks Gambling Screen, the Gambling Attitudes and Beliefs Survey – 23, the Wender Utah Rating Scale – Child, and the Adult ADHD Self-report Scale. Results The cognitive distortions with the greatest correlation to the severity of gambling disorder were the “Chasing” and “Emotions.” These two dimensions were able to distinguish between problem gamblers seeking treatment or not. While age of onset of gambling and length of gambling practice were not associated with the level of distorted cognitions, a period of abstinence of at least 1 month was associated with a lower level of distorted cognitions. The presence of ADHD resulted in a higher level of distorted cognitions. Conclusion Cognitive work is essential to the prevention, and the treatment, of pathological gambling, especially with respect to emotional biases and chasing behavior. The instauration of an abstinence period of at least 1 month under medical supervision could be a promising therapeutic lead for reducing gambling-related erroneous thoughts and for improving care strategies of pathological gamblers. PMID:27774813
Johnson, Lynda G.
Although attention deficit/hyperactivity disorder (ADHD) is one of the most common cognitive disorders, the usual diagnostic procedures pursued by psychiatrists, neurologists, pediatricians, and family practitioners are based largely, if not exclusively, on subjective assessments of perceived behavior. The recommended approaches to ADHD diagnosis are reviewed, first from the perspective of the various expert panels, and then from the research literature upon which those recommendations are based. The authors agree that ADHD is a clinical diagnosis, and that the assessment of subjective reports can be systematic. But they propose that objective data should also contribute to the clinical diagnosis of ADHD; and that new computerized assessment technology can generate objective cognitive data in an efficient and cost-effective way. Computerized tests can also improve the assessment of treatment response over time. PMID:21120096
Miller, Faith G.; Lee, David L.
The primary purpose of this quantitative synthesis of single-subject research was to investigate the relative effectiveness of function-based and non-function-based behavioral interventions for students diagnosed with attention-deficit/hyperactivity disorder. In addition, associations between various participant, assessment, and intervention…
Voeller, Kytja K S
Approaches to the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) are undergoing a major change as a result of information from studies on the genetics of ADHD and the use of new neuroimaging technologies. Moreover, pharmacogenomics, although still in its infancy, will provide a basis for much more sophisticated treatment strategies for ADHD, particularly once more information is available about the genetics of ADHD. Even at this point in time, there is some pertinent information available that, although not ready for application in clinical settings, nonetheless provides a broader perspective for the clinician. In terms of etiology, ADHD is a neuropsychiatric disorder. There is a genetic basis in about 80% of the cases, involving a number of different genes, and in about 20% of the cases, ADHD is the result of an acquired insult to the brain. Some individuals likely have both genetic and acquired forms. Although medication works well in many cases of ADHD, optimal treatment of ADHD requires integrated medical and behavioral treatment. The family plays a crucial role in the management of children with ADHD. Because there is often a very high degree of comorbidity between ADHD and learning disabilities, teachers also have a great deal to contribute in the day-to-day management of these children. Early recognition and treatment prevent the development of more serious psychopathology in adolescence and adulthood.
Claesdotter-Hybbinette, Emma; Safdarzadeh-Haghighi, Maryam; Råstam, Maria; Lindvall, Magnus
Studies have shown that the auditory brainstem response (ABR) is often affected in neurodevelopmental disorders. The aim of this study is to investigate possible differences in ABR between young females with ADHD compared to control subjects. This study focuses on young females, age 7-17 with ADHD, comparing the ABR of 43 young females with ADHD to 21 age- and gender-matched control subjects. Young females with ADHD have a significantly different ABR in a region between cochlear nucleus and superior olivary complex as well as in the thalamic region compared to control subjects. These data indicate specific differences in ABR between girls with ADHD compared to female controls.
Background Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that persists into adulthood in the majority of cases. The evidence on persistence poses several difficulties for adult psychiatry considering the lack of expertise for diagnostic assessment, limited treatment options and patient facilities across Europe. Methods The European Network Adult ADHD, founded in 2003, aims to increase awareness of this disorder and improve knowledge and patient care for adults with ADHD across Europe. This Consensus Statement is one of the actions taken by the European Network Adult ADHD in order to support the clinician with research evidence and clinical experience from 18 European countries in which ADHD in adults is recognised and treated. Results Besides information on the genetics and neurobiology of ADHD, three major questions are addressed in this statement: (1) What is the clinical picture of ADHD in adults? (2) How can ADHD in adults be properly diagnosed? (3) How should ADHD in adults be effectively treated? Conclusions ADHD often presents as an impairing lifelong condition in adults, yet it is currently underdiagnosed and treated in many European countries, leading to ineffective treatment and higher costs of illness. Expertise in diagnostic assessment and treatment of ADHD in adults must increase in psychiatry. Instruments for screening and diagnosis of ADHD in adults are available and appropriate treatments exist, although more research is needed in this age group. PMID:20815868
Le, Hoa H; Hodgkins, Paul; Postma, Maarten J; Kahle, Jennifer; Sikirica, Vanja; Setyawan, Juliana; Erder, M Haim; Doshi, Jalpa A
Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent psychiatric disorder in children/adolescents. This study reviews available European-based studies of ADHD-related costs and applies the findings to the Netherlands to estimate annual national costs for children/adolescents from a societal perspective. A systematic literature search was conducted for primary studies in Europe, published January 1, 1990 through April 23, 2013. Per-person cost estimates were converted to 2012 Euros and used to estimate annual national ADHD-related costs based on the Dutch 2011 census, ADHD prevalence rates, family composition, and employment rates. Seven studies met the inclusion criteria. The average total ADHD-related costs ranged from €9,860 to 14,483 per patient and annual national costs were between €1,041 and €1,529 million (M). The largest cost category was education (€648 M), representing 62 and 42 % of the low- and high-value overall national estimates, respectively. By comparison, ADHD patient healthcare costs ranged between €84 M (8 %) and €377 M (25 %), and social services costs were €4.3 M (0.3-0.4 %). While the majority of the costs were incurred by ADHD patients themselves, €161 M (11-15 %) was healthcare costs to family members that were attributable to having an ADHD child/adolescent. In addition, productivity losses of family members were €143-€339 M (14-22 %). Despite uncertainties because of the small number of studies identified and the wide range in the national cost estimates, our results suggest that ADHD imposes a significant economic burden on multiple public sectors in Europe. The limited number of European-based studies examining the economic burden of ADHD highlights the need for more research in this area.
Steinberg, Bruce; Blum, Kenneth; McLaughlin, Thomas; Lubar, Joel; Febo, Marcelo; Braverman, Eric R.; Badgaiyan, Rajendra D
Attention Deficit-Hyperactivity Disorder (ADHD) often continues into adulthood. Recent neuroimaging studies found lowered baseline dopamine tone in the brains of affected individuals that may place them at risk for Substance Use Disorder (SUD). This is an observational case study of the potential for novel management of Adult ADHD with a non-addictive glutaminergic-dopaminergic optimization complex KB200z. Low-resolution electromagnetic tomography (LORETA) was used to evaluate the effects of KB220z on a 72-year-old male with ADHD, at baseline and one hour following administration. The resultant z-scores, averaged across Eyes Closed, Eyes Open and Working Memory conditions, increased for each frequency band, in the anterior, dorsal and posterior cingulate regions, as well as the right dorsolateral prefrontal cortex during Working Memory, with KB220z. These scores are consistent with other human and animal neuroimaging studies that demonstrated increased connectivity volumes in reward circuitry and may offer a new approach to ADHD treatment. However, larger randomized trials to confirm these results are required. PMID:27610420
Over the past 50 years the concept of attention deficit/hyperactivity disorder (ADHD) has developed from the notion of a specific form of brain dysfunction to that of a heterogeneous set of related behaviours. The great advances in genetics, neuroimaging and neuropsychiatry have made it one of the best understood forms of complex mental…
Takeda, Toshinobu; Ambrosini, Paul J.; deBerardinis, Rachel; Elia, Josephine
Neuropsychiatric comorbidity in ADHD is frequent, impairing and poorly understood. In this report, characteristics of comorbid and comorbid-free ADHD subjects are investigated in an attempt to identify differences that could potentially advance our understanding of risk factors. In a clinically-referred ADHD cohort of 449 youths (ages 6-18), age,…
Spencer, Thomas J.; Sallee, F. Randy; Gilbert, Donald L.; Dunn, David W.; McCracken, James T.; Coffey, Barbara J.; Budman, Cathy L.; Ricardi, Randall K.; Leonard, Henrietta L.; Allen, Albert J.; Milton, Denai R.; Feldman, Peter D.; Kelsey, Douglas K.; Geller, Daniel A.; Linder, Steven L.; Lewis, Donald W.; Winner, Paul K.; Kurlan, Roger M.; Mintz, Mark
Objective: This study examines changes in severity of tics and ADHD during atomoxetine treatment in ADHD patients with Tourette syndrome (TS). Method: Subjects (7-17 years old) with ADHD ("Diagnostic and Statistical Manual of Mental Disorders, DSM-IV") and TS were randomly assigned to double-blind treatment with placebo (n = 56) or atomoxetine…
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Cornoldi, Cesare; Giofrè, David; Calgaro, Giovanni; Stupiggia, Chiara
Executive functions and, in particular, Attentional (active) Working Memory (WM) have been associated with fluid intelligence. The association contrasts with the hypothesis that children with ADHD exhibit problems with WM tasks requiring controlled attention and may have a good fluid intelligence. This paper examines whether children who are intelligent but present ADHD symptoms fail in attentional WM tasks. The latter result would be problematic for theories assuming the generality of a strict relationship between intelligence and WM. To study these issues, a battery of tests was administered to a group of 58 children who all displayed symptoms of ADHD. All children were between the age of 8 and 11 years, and were described by their teachers as smart. Children were compared to a control group matched for age, schooling, and gender. The battery included a test of fluid intelligence (Raven's Coloured Matrices), and a series of visuospatial WM tasks. Results showed that children with ADHD were high in intelligence but significantly lower than the controls in WM tasks requiring high attentional control, whereas there was no difference in WM tasks requiring low attentional control. Furthermore, only high attentional control WM tasks were significantly related to Raven's performance in the control group, whereas all WM tasks were similarly related in the ADHD group. It is concluded that performance in high attentional control WM tasks may be related to fluid intelligence, but also to a specific control component that is independent of intelligence and is poor in children with ADHD.
Wright, Gloria Sunnie
Today's "ADHDscape" is no longer confined to images of fidgety children falling off classroom chairs. Trans-generational images flood popular culture, from "ADHD creator" with entrepreneurial style, to "ADHD troublemaker". Indeed, ADHD's enigmatic characteristics seem to apply as much to crying babies as to forgetful grannies. With the recent…
Ehala, Martin; Vedernikova, Elena
The article presents a comparative analysis of the subjective vitalities (SVs) of the minority groups of Latvia (Russian-speakers), Lithuania (Russian-speakers and Poles) and Mari El (Maris) in the Russian Federation, with a particular focus on the Mari case. The same extended version of the SV questionnaire was used in quantitative surveys in all…
A review of the research and legal literature summarizes the status of attention deficit hyperactivity disorder (ADHD) under school law. Following a brief introduction, discussion of ADHD as a disability notes the impact of ADHD on overall functioning and provides a table of diagnostic criteria for subtypes of ADHD. The following section focuses…
Over the past 50 years the concept of attention deficit/hyperactivity disorder (ADHD) has developed from the notion of a specific form of brain dysfunction to that of a heterogeneous set of related behaviours. The great advances in genetics, neuroimaging and neuropsychiatry have made it one of the best understood forms of complex mental disturbance--but much remains to be done to translate understanding into practice. More effective treatment may come from identifying and treating more specific components of disorder and by a focus on identifying the factors determining course in the longer term so that they, as well as the core features of disorder, can become targets for intervention.
The recently published report of the Carnegie Foundation's National Study of Nursing Education points out significant problems with classroom teaching in schools of nursing. This article suggests Palmer's idea of the subject-centered classroom as a way to transform nursing school classrooms into collaborative learning communities. For Palmer, the subject is the big idea of nursing practice-the nurse-patient/client/family/community relationship-that should take the lead in stimulating inquiry and discussion. The article goes on to describe how teachers can develop and use unfolding case studies to bring the subject to the center of the classroom. By doing so, the classroom becomes a place where students learn a sense of salience, develop their clinical imagination, and begin their formation as professional nurses.
Robeva, Raina; Penberthy, Jennifer Kim
Accurate diagnosis of attentional disorders such as attention-deficit hyperactivity disorder (ADHD) is imperative because there are multiple negative psychosocial sequelae related to undiagnosed and untreated ADHD. Early and accurate detection can lead to effective intervention and prevention of negative sequelae. Unfortunately, diagnosing ADHD presents a challenge to traditional assessment paradigms because there is no single test that definitively establishes its presence. Even though ADHD is a physiologically based disorder with a multifactorial etiology, the diagnosis has been traditionally based on a subjective history of symptoms. In this chapter we outline a stochastic method that utilizes a Bayesian interface for quantifying and assessing ADHD. It can be used to combine of a variety of psychometric tests and physiological markers into a single standardized instrument that, on each step, refines a probability for ADHD for each individual based on information provided by the individual assessments. The method is illustrated with data from a small study of six college female students with ADHD and six matched controls in which the method achieves correct classification for all participants, where none of the individual assessments was capable of achieving perfect classification. Further, we provide a framework for applying this Bayesian method for performing meta-analysis of data obtained from disparate studies and using disparate tests for ADHD based on calibration of the data into a unified probability scale. We use this method to combine data from five studies that examine the diagnostic abilities of different behavioral rating scales and EEG assessments of ADHD, enrolling a total of 56 ADHD and 55 control subjects of different age groups and gender.
Torgersen, Terje; Gjervan, Bjorn; Lensing, Michael B; Rasmussen, Kirsten
Background The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed. Method A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years. Results ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered. Conclusion It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk–benefit ratio when pharmacotherapy is considered to be a possible treatment. PMID:26811680
Ghosh, Paramita; Sarkar, Kanyakumarika; Bhaduri, Nipa; Ray, Anirban; Sarkar, Keka; Sinha, Swagata; Mukhopadhyay, Kanchan
Contribution of genes in attention deficit hyperactivity disorder (ADHD) has been explored in various populations, and several genes were speculated to contribute small but additive effects. We have assessed variants in four genes, DDC (rs3837091 and rs3735273), DRD2 (rs1800496, rs1801028, and rs1799732), DRD4 (rs4646984 and rs4646983), and COMT (rs165599 and rs740603) in Indian ADHD subjects with comorbid attributes. Cases were recruited following the Diagnostic and Statistical Manual for Mental Disorders-IV-TR after obtaining informed written consent. DNA isolated from peripheral blood leukocytes of ADHD probands (N = 170), their parents (N = 310), and ethnically matched controls (n = 180) was used for genotyping followed by population- and family-based analyses by the UNPHASED program. DRD4 sites showed significant difference in allelic frequencies by case-control analysis, while DDC and COMT exhibited bias in familial transmission (P < 0.05). rs3837091 "AGAG," rs3735273 "A," rs1799732 "C," rs740603 "G," rs165599 "G" and single repeat alleles of rs4646984/rs4646983 showed positive correlation with co-morbid characteristics (P < 0.05). Multi dimensionality reduction analysis of case-control data revealed significant interactive effects of all four genes (P < 0.001), while family-based data showed interaction between DDC and DRD2 (P = 0.04). This first study on these gene variants in Indo-Caucasoid ADHD probands and associated co-morbid conditions indicates altered dopaminergic neurotransmission in ADHD.
McAuley, Tara; Crosbie, Jennifer; Charach, Alice; Schachar, Russell
Background: Response inhibition, working memory, and response variability are possible endophenotypes of ADHD based on their association with the disorder and evidence of heritability. One of the critical although rarely studied criteria for a valid endophenotype is that it persists despite waxing and waning of the overt manifestations of the…
Doyle, Robert L.; Frazier, Jean; Spencer, Thomas J.; Geller, Daniel; Biederman, Joseph; Wilens, Timothy
Background: Recent studies reported ADHD-like symptoms and cognitive deficits in pervasive developmental disorder (PDD). Because work in dementia documents improvement in executive function deficits with the acetylcholinesterase inhibitor donepezil, the authors reason that similar benefits could be obtained in PDD. Method: The authors describe…
Garcia Rosales, Alexandra; Vitoratou, Silia; Banaschewski, Tobias; Asherson, Philip; Buitelaar, Jan; Oades, Robert D; Rothenberger, Aribert; Steinhausen, Hans-Christoph; Faraone, Stephen V; Chen, Wai
In view of ICD-11 revision, we evaluate whether the 18 DSM-IV diagnostic items retained by DSM-5 could be further improved (i) in predicting ADHD 'caseness' and 'impairment' and (ii) discriminating ADHD without CD (ADHD - CD) cases from ADHD with CD (ADHD + CD) cases. In a multi-centre study sample consisting of 1497 ADHD probands and 291 unaffected subjects, 18 diagnostic items were examined for redundancy; then each item was evaluated for association with caseness, impairment and CD status using Classical Test Theory, Item-Response Theory and logistic regression methods. First, all 18 DSM-IV items contributed significantly and independently to the clinical diagnosis of ADHD. Second, not all the DSM-IV items carried equal weighting. "Often loses things", "forgetfulness" and "difficulty sustaining attention" mark severity for Inattentiveness (IA) items and "often unduly noisy", "exhibits a persistent pattern of restlessness", "leaves seat in class" and "often blurts out answers" for Hyperactivity/Impulsivity (HI) items. "Easily distracted", "inattentive to careless mistakes", "often interrupts" and "often fidgets" are associated with milder presentations. In the IA domain, "distracted" yields most information in the low-severity range of the latent trait, "careless" in the mid-severity range and "loses" in the high-severity range. In the HI domains, "interrupts" yields most information in the low-severity range and "motor" in the high-severity range. Third, all 18 items predicted impairment. Fourth, specific ADHD items are associated with ADHD + CD status. The DSM-IV diagnostic items were valid and not redundant; however, some carried more weight than others. All items were associated with impairment.
... learning skills, including memory tips from LD Online. Attention deficit hyperactivity disorder (ADHD) top ADHD is a ... condition that affects a person’s ability to pay attention, sit still, and follow directions. If you have ...
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Ünsel Bolat, Gül; Ercan, Eyüp Sabri; Salum, Giovanni Abrahão; Bilaç, Öznur; Massuti, Rafael; Uysal Özaslan, Taciser; Bolat, Hilmi; Rohde, Luis Augusto
The American Psychiatric Association (APA) working group on Attention-Deficit/Hyperactivity Disorder (ADHD) proposed the inclusion of four new impulsivity symptoms. However, they were not included in DSM-5 due to the lack of sufficient evidence. The aim of this study is to investigate the performance of the proposed four ADHD impulsivity symptoms with respect to: (a) ADHD factor structure; (b) performance in predicting clinical impairment; (c) specificity for ADHD diagnosis and (d) best symptomatic threshold to predict clinical impairment. The sample comprised 416 children (31 ADHD subjects according to both DSM-IV and proposed DSM-5, 20 ADHD subjects according to just one diagnostic system and 365 controls) from 12 schools. Diagnoses were derived using semi-structured interviews and ADHD rating scales. Results from confirmatory factor analysis indicate that addition of the four new impulsivity items provided a slightly better factor structure if compared to models including only 18 items. Regression analyses showed that only one of the new impulsivity symptoms (impatient) was part of the list of best predictors of impairment. None of the four new impulsivity items was specifically associated with ADHD diagnosis. The best cutoff point in the hyperactivity/impulsivity dimension for predicting impairment did not change significantly. Overall, our findings suggest that the determination on how to best capture impulsivity dimension as part of the ADHD construct needs more investigation and that there is not enough evidence to include these four assessed impulsivity symptoms as part of the ADHD criteria.
Rucklidge, Julia J
Micronutrients are increasingly used to treat psychiatric disorders including attention-deficit/hyperactivity disorder (ADHD), mood disorders, stress, and anxiety. However, a number of factors influence optimal response and absorption of nutrients, including the health of the gut, particularly the presence of yeast infections, such as Candida. As part of a wider investigation into the impact of micronutrients on psychiatric symptoms, many participants who experienced a yeast infection during their treatment showed a diminished response to the micronutrients. One case was followed systematically over a period of 3 y with documentation of deterioration in psychiatric symptoms (ADHD and mood) when infected with Candida and then symptom improvement following successful treatment of the infection with olive leaf extract (OLE) and probiotics. This case outlines that micronutrient treatment might be severely compromised by infections such as Candida and may highlight the importance of gut health when treating psychiatric disorders with nutrients. Given the role that inflammation can play in absorption of nutrients, it was hypothesized that the infection was impairing absorption of the micronutrients.
Trejo, Salvador; Toscano-Flores, José J; Matute, Esmeralda; Ramírez-Dueñas, María de Lourdes
The aim of this study was to obtain the genotype and gene frequency from parents of children with attention-deficit/hyperactivity disorder (ADHD) and then assess the Hardy–Weinberg equilibrium of genotype frequency of the variable number tandem repeat (VNTR) III exon of the dopamine receptor D4 (DRD4) gene. The genotypes of the III exon of 48 bp VNTR repeats of the DRD4 gene were determined by polymerase chain reaction in a sample of 30 parents of ADHD cases. In the 60 chromosomes analyzed, the following frequencies of DRD4 gene polymorphisms were observed: six chromosomes (c) with two repeat alleles (r) (10%); 1c with 3r (1.5%); 36c with 4r (60%); 1c with 5r (1.5%); and 16c with 7r (27%). The genotypic distribution of the 30 parents was two parents (p) with 2r/2r (6.67%); 1p with 2r/4r (3.33%); 1p with 2r/5r (3.33%); 1p with 3r/4r (3.33%); 15p with 4r/4r (50%); 4p with 4r/7r (13.33); and 6p with 7r/7r (20%). A Hardy–Weinberg disequilibrium (χ2=13.03, P<0.01) was found due to an over-representation of the 7r/7r genotype. These results suggest that the 7r polymorphism of the DRD4 gene is associated with the ADHD condition in a Mexican population. PMID:26082657
Trejo, Salvador; Toscano-Flores, José J; Matute, Esmeralda; Ramírez-Dueñas, María de Lourdes
The aim of this study was to obtain the genotype and gene frequency from parents of children with attention-deficit/hyperactivity disorder (ADHD) and then assess the Hardy-Weinberg equilibrium of genotype frequency of the variable number tandem repeat (VNTR) III exon of the dopamine receptor D4 (DRD4) gene. The genotypes of the III exon of 48 bp VNTR repeats of the DRD4 gene were determined by polymerase chain reaction in a sample of 30 parents of ADHD cases. In the 60 chromosomes analyzed, the following frequencies of DRD4 gene polymorphisms were observed: six chromosomes (c) with two repeat alleles (r) (10%); 1c with 3r (1.5%); 36c with 4r (60%); 1c with 5r (1.5%); and 16c with 7r (27%). The genotypic distribution of the 30 parents was two parents (p) with 2r/2r (6.67%); 1p with 2r/4r (3.33%); 1p with 2r/5r (3.33%); 1p with 3r/4r (3.33%); 15p with 4r/4r (50%); 4p with 4r/7r (13.33); and 6p with 7r/7r (20%). A Hardy-Weinberg disequilibrium (χ (2)=13.03, P<0.01) was found due to an over-representation of the 7r/7r genotype. These results suggest that the 7r polymorphism of the DRD4 gene is associated with the ADHD condition in a Mexican population.
Müller, Daniel J; Chiesa, Alberto; Mandelli, Laura; De Luca, Vincenzo; De Ronchi, Diana; Jain, Umesh; Serretti, Alessandro; Kennedy, James L
Increasing evidence suggests that symptoms of attention deficit hyperactivity disorder (ADHD) could persist into adult life in a substantial proportion of cases. The aim of the present study was to investigate the impact of (1) adverse events, (2) personality traits and (3) genetic variants chosen on the basis of previous findings and (4) their possible interactions on adult ADHD severity. One hundred and ten individuals diagnosed with adult ADHD were evaluated for occurrence of adverse events in childhood and adulthood, and personality traits by the Temperament and Character Inventory (TCI). Common polymorphisms within a set of nine important candidate genes (SLC6A3, DBH, DRD4, DRD5, HTR2A, CHRNA7, BDNF, PRKG1 and TAAR9) were genotyped for each subject. Life events, personality traits and genetic variations were analyzed in relationship to severity of current symptoms, according to the Brown Attention Deficit Disorder Scale (BADDS). Genetic variations were not significantly associated with severity of ADHD symptoms. Life stressors displayed only a minor effect as compared to personality traits. Indeed, symptoms' severity was significantly correlated with the temperamental trait of Harm avoidance and the character trait of Self directedness. The results of the present work are in line with previous evidence of a significant correlation between some personality traits and adult ADHD. However, several limitations such as the small sample size and the exclusion of patients with other severe comorbid psychiatric disorders could have influenced the significance of present findings.
Richard Restak asserts in "The New Brain" (Rodale Books, 2003) that "ADD/ADHD isn't so much a disorder as it is a cognitive style." With this in mind, and through much trial and error, the author of this article, a second-grade teacher at Hood-Case Elementary School in Alvin, Texas, provides suggestions to keep in mind when one has ADHD children…
Objective: Findings about the association of left-handedness and ADHD are inconsistent. While abnormal brain laterality is reported in children with ADHD, it is unclear if hand preference is associated with ADHD, severity symptoms, age, gender, comorbid psychiatric problems, or parental characteristics. Method: Subjects were 520 boys and girls…
Walg, Marco; Hapfelmeier, Gerhard; El-Wahsch, Daniel; Prior, Helmut
Alterations in temporal processing may represent a primary cause of key symptoms in ADHD. This study is aimed at investigating the nature of time-processing alterations in ADHD and assessing the possible utility of testing time estimation for clinical diagnostics. Retrospective verbal time estimation in the range of several minutes was examined in 50 boys with ADHD and 53 boys with other mental disorders. All participants (age 7-16) attended an outpatient clinic for ADHD diagnostics. The diagnostic assessment included the WISC-IV. Subjects with ADHD made longer and less accurate duration estimates than the clinical control group. The ADHD group showed a specific WISC-IV profile with processing speed deficits. In the ADHD group there was a correlation between processing speed and quality of time estimation that was not observed in the comparison group: higher processing speed indices were related to more accurate duration estimates. The findings provide support for the presence of a faster internal clock in subjects with ADHD and lend further support to the existence of a specific WISC-IV profile in subjects with ADHD. The results show that analyzing WISC-IV profiles and time estimation tasks are useful differential diagnosis tools, particularly when it comes to distinguishing between "real ADHD" and pseudo-ADHD.
This paper explores the historical shapings that have led to a modelling of "executive functions" as a way of knowing the subject of attention deficit hyperactivity disorder (ADHD). It argues that historical changes in figuring the problem of ADHD can be accounted for in terms of a process of continuous translation between neurological and…
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Van De Glind, Geurt; Van Emmerik-Van Oortmerssen, Katelijne; Carpentier, Pieter Jan; Levin, Frances R.; Koeter, Maarten W.J.; Barta, Csaba; Kaye, Sharlene; Skutle, Arvid; Franck, Johan; Konstenius, Maija; Bu, Eli-Torild; Moggi, Franz; Dom, Geert; Demetrovics, Zolt; Fatséas, Mélina; Schillinger, Arild; Kapitány-Fövény, Máté; Verspreet, Sofie; Seitz, Andrea; Johnson, Brian; Faraone, Stephen V.; Ramos-Quiroga, J. Antoni; Allsop, Steve; Carruthers, Susan; Schoevers, Robert A.; Van Den Brink, Wim
Attention deficit/hyperactivity disorder (ADHD) is an increasingly recognized comorbid condition in subjects with substance use disorders (SUDs). This paper describes the methods and study population of the International ADHD in Substance Use Disorders Prevalence (IASP) study. Objectives of the IASP are to determine the prevalence of ADHD in adult treatment seeking patients with SUD in different countries and SUD populations, determine the reliability and validity of the Adult ADHD Self-report Scale V 1.1 (ASRS) as ADHD screening instrument in SUD populations, investigate the comorbidity profile of SUD patients with and without ADHD, compare risk factors and protective factors in SUD patients with and without a comorbid diagnosis of ADHD, and increase our knowledge about the relationship between ADHD and the onset and course of SUD. In this cross-sectional, multi-centre two stage study, subjects were screened for ADHD with the ASRS, diagnosed with the Conner’s Adult ADHD Diagnostic Interview for DSM-IV (CAADID), and evaluated for SUD, major depression, bipolar disorder, anti social personality disorder and borderline personality disorder. Three thousand five hundred and fifty-eight subjects from 10 countries were included. Of these 40.9% screened positive for ADHD. This is the largest international study on this population evaluating ADHD and comorbid disorders. Copyright © 2013 John Wiley & Sons, Ltd. PMID:24022983
Banaschewski, Tobias; Jennen-Steinmetz, Christine; Brandeis, Daniel; Buitelaar, Jan K.; Kuntsi, Jonna; Poustka, Luise; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Frazier-Wood, Alexis C.; Albrecht, Björn; Chen, Wai; Uebel, Henrik; Schlotz, Wolff; van der Meere, Jaap J.; Gill, Michael; Manor, Iris; Miranda, Ana; Mulas, Fernando; Oades, Robert D.; Roeyers, Herbert; Rothenberger, Aribert; Steinhausen, Hans-Christoph; Faraone, Stephen V.; Asherson, Philip
Background Emotional lability (EL) is commonly seen in patients with Attention Deficit/Hyperactivity Disorder (ADHD). The reasons for this association are currently unknown. To address this question we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms are predicted by particular cognitive and/or motivational dysfunctions and whether these associations are mediated by the presence of ADHD symptoms. Methods A large multi-site sample of 424 carefully diagnosed ADHD cases and 564 unaffected siblings and controls aged 6 to 18 years performed a broad neuropsychological test battery, including a Go/No-Go Task, a warned 4-choice Reaction Time task, the Maudsley Index of Childhood Delay Aversion, and Digit span backwards. Neuropsychological variables were aggregated as indices of processing speed, response variability, executive functions, choice impulsivity and the influence of energetic and/or motivational factors. EL and ADHD symptoms were regressed on each neuropsychological variable in separate analyses controlling for age, gender and IQ, and, in subsequent regression analyses, for ADHD and EL symptoms respectively. Results Neuropsychological variables significantly predicted ADHD and EL symptoms with moderate to low regression coefficients. However, the association between neuropsychological parameters on EL disappeared entirely when the effect of ADHD symptoms was taken into account, revealing that the association between the neuropsychological performance measures and EL is completely mediated statistically by variations in ADHD symptoms. Conversely, neuropsychological effects on ADHD symptoms remained after EL symptom severity was taken into account. Conclusions The neuropsychological parameters examined here predict ADHD more strongly than EL. They cannot explain EL symptoms beyond what is already accounted for by ADHD symptom severity. The association between EL and ADHD
Nazeer, Ahsan; Mansour, Miriam; Gross, Kathleen A.
Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects the child and adolescent population. It is characterized by impairment in attention/concentration, hyperactivity, and impulsivity, all of which can impact performance of athletes. ADHD treatment within the athletic population is a unique challenge. The research in this field has been relatively limited. The National Collegiate Athletic Association and International Olympic Committee both regulate the use of psychostimulants for treatment of ADHD due to their performance-enhancing effects. In this article, authors have discussed the screening methods, pharmacological treatment, side effects, and behavioral approaches for the treatment of ADHD in adolescent athletes. PMID:24987666
Mann, N; Bitsios, P
Substance abuse is a frequent co-morbid condition of adult attention deficit hyperactivity disorder (ADHD). Treatment with conventional psychostimulants in adult ADHD with co-morbid stimulant abuse may be problematic. In this study, we report the case of a patient with adult ADHD with co-morbid amphetamine abuse who was treated successfully with the non-stimulant alertness-promoting drug modafinil. The drug resolved both the inattention/hyperactivity symptoms as well as the amphetamine abuse. Modafinil may be a suitable candidate treatment for adults with ADHD and stimulant abuse.
ElBaz Mohamed, Farida; Kamal, Tarek Mostafa; Zahra, Sally Soliman; Khfagy, Mona Abdel Hakiem; Youssef, Azza Mohamed
This study aimed to detect DRD4 receptor gene polymorphisms in attention-deficit hyperactivity disorder (ADHD) children and to correlate their phenotype-genotype. Fifty children with ADHD were diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria and were subjected to Conners Parent Rating Scale. All cases and controls were subjected to history taking, physical examination, IQ assessment, and dopamine receptor D4 (DRD4) exon 3 genotyping. The 7-repeat allele was present only in controls, whereas 2-repeat allele was present in the ADHD children (heterozygous 2-repeat allele in 16% and homozygous in 26% of cases). Eight percent of cases had homozygous 4-repeat allele vs 28% of controls, whereas 10% of cases had heterozygous 4-repeat allele vs 6% of controls, with its predominance in controls. The 2-repeat and 4-repeat alleles have been associated with more inattention, hyperactivity, and impulsivity phenotypes. In conclusion, children with ADHD had a significant presence of the 2-repeat allele and absence of the 7-repeat allele.
O'Mahony, Niamh; Florentino-Liano, Blanca; Carballo, Juan J; Baca-García, Enrique; Rodríguez, Antonio Artés
This work proposes the use of miniature wireless inertial sensors as an objective tool for the diagnosis of ADHD. The sensors, consisting of both accelerometers and gyroscopes to measure linear and rotational movement, respectively, are used to characterize the motion of subjects in the setting of a psychiatric consultancy. A support vector machine is used to classify a group of subjects as either ADHD or non-ADHD and a classification accuracy of greater than 95% has been achieved. Separate analyses of the motion data recorded during various activities throughout the visit to the psychiatric consultancy show that motion recorded during a continuous performance test (a forced concentration task) provides a better classification performance than that recorded during "free time".
Halperin, Jeffrey M; Bédard, Anne-Claude V; Curchack-Lichtin, Jocelyn T
It is proposed that the time is ripe for the development of secondary preventive interventions for attention-deficit/hyperactivity disorder (ADHD). By targeting preschool children, a developmental stage during which ADHD symptoms first become evident in most children with the disorder, many of the adverse long-term consequences that typify the trajectory of ADHD may be avoided. A dynamic/interactive model of the biological and environmental factors that contribute to the emergence and persistence of ADHD throughout the lifespan is proposed. Based on this model, it is argued that environmental influences and physical exercise can be used to enhance neural growth and development, which in turn should have an enduring and long-term impact on the trajectory of ADHD. Central to this notion are 2 hypotheses: 1) environmental influences can facilitate structural and functional brain development, and 2) changes in brain structure and function are directly related to ADHD severity over the course of development and the degree to which the disorder persists or remits with time. We present experimental and correlational data supporting the first hypothesis and longitudinal data in individuals with ADHD supporting the second. The case is made for initiating such an intervention during the preschool years, when the brain is likely to be more "plastic" and perhaps susceptible to lasting modifications, and before complicating factors, such as comorbid psychiatric disorders, academic failure, and poor social and family relationships emerge, making successful treatment more difficult. Finally, we review recent studies in young children with ADHD that might fall under the umbrella of secondary prevention.
Retz, Wolfgang; Rösler, Michael
ADHD is associated with social problems and aggressive behavior. As hyperactive-impulsive traits are core symptoms of ADHD, it has been hypothesized that reactive-impulsive violence is more likely related to ADHD psychopathology than proactive-instrumental violence. One hundred and twenty-seven adult violent offenders participated in the study. Diagnosis of ADHD and ratings of reactive and proactive features of the committed crimes were performed using standardized instruments. According to DSM-IV, 16.5% subjects fulfilled diagnostic criteria for ADHD, 23.6% were diagnosed as ADHD in partial remission, and 59.8% had no ADHD. Univariate analyses revealed higher reactive violence ratings in both ADHD groups when compared to subjects without ADHD, whereas the opposite was found regarding proactive violence ratings. Using multivariate analyses of variance controlled for age, gender and comorbid substance use disorders, childhood ADHD psychopathology and current ADHD significantly increased the risk of reactive violence and decreased the risk of proactive violence. Significant impact of male gender on proactive violence was found. The findings suggest that ADHD is associated with reactive but not proactive violence in aggressive offenders.
Templeton, Rosalyn A.
This paper provides a brief historical outline of attention deficit hyperactivity disorder (ADHD), its definition, its behavioral characteristics, and a guide to creating successful learning environments for these students. Diagnostic criteria for ADHD are listed and discussed, and incidence figures of 3 to 5 percent of all school-age children are…
Hamilton, Nancy J.; Astramovich, Randall L.
Children with ADHD often experience academic challenges and interpersonal difficulties which may impact their educational success. Using a case study approach, the authors explored the experiences of a child with attention deficit hyperactivity disorder (ADHD) in a fifth grade school setting. Findings indicated that the student had an elevated…
Tourjman, Smadar Valerie; Bilodeau, Mathieu
Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a common and disabling disorder among adults and is treated with stimulant and non stimulant medication. Objective: To report the case of a patient with ADHD showing good clinical response to duloxetine, a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). Case…
Fugate, C. Matthew; Gentry, Marcia
The manifestation of ADHD in girls who are gifted can place strains on motivation and academic performance as they enter their middle school years. The purpose of this collective case study research was to examine the lived experiences of five girls who are gifted with ADHD in order to gain an understanding of the array of coping mechanisms used…
Jowett, Adrian K.
This study sought to discover if staff in a university department believed the 1998 Subject Review to be a valid Quality Assurance process and if its findings could benefit the department. Fifteen academic staff members took part in semi-structured interviews and the content of their responses was analysed qualitatively. Respondents described how…
Awang, Noorehan; Ilias, Mohd Rijal; Che Hussain, Wan Siti Esah; Mokhtar, Siti Fairus
Mathematics has always become the most dislike subject among other subjects in school. Study showed that attitudes of students in science subjects such as mathematics were closely related to how they solve problems, accessing ideas and making a right decision. According to another study on mathematics achievement of eighth grade students in Malaysia, mathematics grades among bumiputera students was lower when compared to other races such as Chinese and Indians. The poor performance was due to their attitude and pre-conceived ideas towards the subject. Therefore, this study was designed todetermine the criteria and subcriteria that were considered important in measuring students' attitude toward mathematics among the bumiputeras. Factor analysis was carried out to identify the groups among criterion. Instrument used to measure mathematics attitude was Test of Mathematics Related Attitude (TOMRA) which measured student attitudes in four criteria: normality of mathematics, attitudes towards mathematics inquiry, adoption of mathematics attitude and enjoyment of mathematics lessons. The target population of this study was all computer science and quantitative science students who enrolled Calculus subject in UiTM Kedah. Findings shows that there are two criteria that influenced students attitude toward mathematics namely normality of mathematics with eleven subcriteria and enjoyment of mathematics with eight subcriteria. From the analysis it shows that the total percentage of variation explained is 35.071% with 0.837 Cronbach's alpha reliability test. The findings will help the lecturers, parents and society to consider what action should be taken to install interest and positive attitude of bumiputera students towards mathematics and thus improve their achievement.
Attention-deficit hyperactivity disorder (ADHD) is described as the most common neurobehavioral condition of childhood. We raise the concern that ADHD is not a disease per se but rather a group of symptoms representing a final common behavioral pathway for a gamut of emotional, psychological, and/or learning problems. Increasing numbers of children, especially boys, are diagnosed with ADHD and treated with stimulant medications according to a simplified approach. Methodical review of the literature, however, raised concerning issues. "Core" ADHD symptoms of inattentiveness, hyperactivity and impulsivity are not unique to ADHD. Rates of "comorbid" psychiatric and learning problems, including depression and anxiety, range from 12 to 60%, with significant symptom overlap with ADHD, difficulties in diagnosis, and evidence-based treatment methods that do not include stimulant medications. No neuropsychologic test result is pathognomic for ADHD, and structural and functional neuroimaging studies have not identified a unique etiology for ADHD. No genetic marker has been consistently identified, and heritability studies are confounded by familial environmental factors. The validity of the Conners' Rating Scale-Revised has been seriously questioned, and parent and teacher "ratings" of school children are frequently discrepant, suggesting that use of subjective informant data via scale or interview does not form an objective basis for diagnosis of ADHD. Empiric diagnostic trials of stimulant medication that produce a behavioral response have been shown not to distinguish between children with and without "ADHD." In summary, the working dogma that ADHD is a disease or neurobehavioral condition does not at this time hold up to scrutiny of evidence. Thorough evaluation of symptomatic children should be individualized, and include assessment of educational, psychologic, psychiatric, and family needs.
This paper discusses the characteristics of psychotherapy for pervasive developmental disorders (PDD) in the context of the curative effects of the movement of images. The 'autistic spectrum' is widened here and includes not only PDD, but also ADHD. The main common characteristic in these two sets of disorders seems to be the lack of a subject, which manifests itself as the absence of awareness of otherness and difficulties with boundaries and language. In these cases a normal psychotherapy is ineffective as it presupposes an established subject. However a psychotherapeutic approach with these patients can contribute to the emergence of a subject. In severe cases the process of union and separation which is enacted either in the therapeutic relationship or in symbolic play leads to the birth of a subject, and of language. In milder cases, such as ADHD, the moments of separation and confrontation with the therapist suffice. I will discuss a case of my own with Asperger's syndrome in which union and separation in the play therapy occurred simultaneously. This indicates that union and separation are not a consecutive process, but are simultaneous and lead to dialectical movement. However, in neurotic cases with an established subjectivity the symbolic meaning of image plays a central role. This corresponds to Jung's understanding of image in alchemy.
Wingate, Ursula; Andon, Nick; Cogo, Alessia
The benefits of embedding the teaching of writing into the curriculum have been advocated by educators and researchers. However, there is currently little evidence of embedded writing instruction in the UK's higher education context. In this article, we present a case study in which we report the design, implementation and evaluation of an…
... this page: //medlineplus.gov/ency/article/007592.htm Medicines for ADHD To use the sharing features on ... that the treatment plan is successful. TYPES OF MEDICINES Stimulants are the most commonly used type of ...
... They also have higher rates of cigarette and drug addiction, and more driving infractions. The good news ... Scientists are continuing to research and develop new drugs for ADHD. It is important to confer with ...
... Content Article Body The fact that many more boys than girls are diagnosed with ADHD—at a ... many parents and teachers that ADHD is a “boys’ disorder” that rarely occurs in girls. In fact, ...
... sure you're learning in a way that works for you. For example, some schools will allow extra time for students with ADHD to take tests. Some teens may benefit from smaller class sizes and tutoring help. Use ...
Harrison, Christopher; Charles, Janice; Britt, Helena
The BEACH program (Bettering the Evaluation and Care of Health) shows that management of attention deficit (hyperactivity) disorder (AD(H)D) was rare in general practice, occurring only six times per 1,000 encounters with children aged 5-17 years, between April 2000 and December 2007. This suggests that general practitioners manage AD(H)D about 46,000 times for this age group nationally each year.
Kurtz, Steven M S
The school nurse has a tremendous opportunity to be a part of the home, school, and community team in promoting state-of-the-art care for youngsters with ADHD. The multi-modal strategic approach, combining carefully titrated pharmacotherapy with these specific behavioral interventions in the child's school and other settings, currently provides the greatest likelihood of a positive treatment outcome for youth with ADHD.
Yousefichaijan, Parsa; Sharafkhah, Mojtaba; Salehi, Bahman; Rafiei, Mohammad
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood neurological disorders. The aim of this study was to investigate ADHD in children with primary monosymptomatic nocturnal enuresis (PMNE) and compare it with healthy children. A total of 100 five to 16-year-old children with PMNE and 100 healthy children without NE were included in this case-control study as the cases and control groups, respectively. Subjects were selected from children who were referred to the pediatric clinic of the Amir Kabir Hospital of Arak, Iran, based on inclusion and exclusion criteria. ADHD was diagnosed by Conner's Parent Rating Scale-48 and the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria and was confirmed by consultation with a psychiatrist. Data were analyzed by binomial test using SPSS18. ADHD inattentive type was observed in 16 cases (16%) with PMNE and five controls (5%) (P=0.01). Despite these significant differences in the case and control groups, 25 (25%) and 16 (16%) children were affected by ADHD hyperactive-impulsive type (P=0.08) and 15 (15%) and 16 (16%) children were affected by ADHD mixed type (P=0.84), respectively. ADHD inattentive type in children with PMNE was significantly more common than that in healthy children. The observed correlation between ADHD inattentive type and PMNE makes psychological counseling mandatory in children with PMNE.
Background The aim of this study was to investigate the associations between attention deficit hyperactivity disorder (ADHD), the most common neuropsychiatric disorder in school children, and childhood allergic disease by evaluating their respective prevalence. Methods Subjects were comprised of first and second grade students in twenty two elementary schools in a city in the Republic of Korea. The mode of measurement for ADHD was based on DSM-IV from clinical interviews conducted by child psychiatrists. Along with the diagnostic interviews, we also used the epidemiological questionnaires, Computerized Attention Deficit-Hyperactivity Disorder Diagnostic System, the abbreviated Conner’s Parent Rating Scale (CPRS), and DuPaul’s ADHD Rating Scales. Allergic conditions, such as asthma, have been separately evaluated based on the questionnaire items whose validity and reliability were proved by the International Study of Asthma and Allergies in Children (ISAAC). All questionnaires were completed by the subjects’ parents. Results The lifetime prevalence rate of asthma in ADHD patients was 36.6%, compared to a prevalence of 24.3% in control subjects. The lifetime prevalence rate of allergic rhinitis in ADHD patients was 59.0%, compared to a prevalence of 47.0% in control subjects. Statistically significant difference has been found between the two groups. In the logistic regression model of the ADHD and the control group, the relative risk of asthma was 1.60 times higher (confidence interval 1.301-1.964), the relative risk of allergic rhinitis was 1.38 times higher (confidence interval 1.124-1.681), which showed statistical significance. Conclusions The findings of this study suggest significant association between ADHD and childhood asthma and allergic rhinitis. Therefore, appropriate evaluation and treatment are needed for asthmatic children with attention-deficit symptoms, or allergic rhinitis with ADHD. Besides, further research is needed to determine the
Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological disorder exhibited by difficulty maintaining attention, as well as hyperactivity and impulsive behavior. Central nervous system (CNS) stimulants are the first line of treatment for ADHD. With the increase in number of adults on CNS stimulants, the question that arises is how well do we understand the long-term cardiovascular effects of these drugs. There has been increasing concern that adults with ADHD are at greater risk for developing adverse cardiovascular events such as sudden death, myocardial infarction, and stroke as compared to pediatric population. Cardiovascular response attributed to ADHD medication has mainly been observed in heart rate and blood pressure elevations, while less is known about the etiology of rare cardiovascular events like acute myocardial infarction (AMI), arrhythmia, and cardiomyopathy and its long-term sequelae. We present a unique case of AMI in an adult taking Adderall (mixed amphetamine salts) and briefly discuss the literature relevant to the cardiovascular safety of CNS stimulants for adult ADHD. PMID:27579185
du Prel Carroll, Xianming; Yi, Honggang; Liang, Yuezhu; Pang, Ke; Leeper-Woodford, Sandra; Riccardi, Patrizia; Liang, Xianhong
Background Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders, affecting an estimated 5 to 12% of school-aged children worldwide. From 15 to 19 million Chinese children suffer from ADHD. The aim of this study was to investigate the association between family-environmental factors and ADHD in a sample of Chinese children. Methods A pair-matched, case-control study was conducted with 161 ADHD children and 161 non-ADHD children of matching age and sex, all from 5–18 years of age. The ADHD subjects and the normal controls were all evaluated via structured diagnostic interviews. We examined the association between family-environmental factors and ADHD using the conditional multiple logistic regression with backward stepwise selection to predict the associated factors of ADHD. Results Having experienced emotional abuse and being a single child were both significant factors associated with children diagnosed with ADHD. ADHD subjects were more likely to have suffered from emotional abuse (OR = 11.09, 95% CI = 2.15–57.29, P = 0.004) and have been a single child in the family (OR = 6.32, 95% CI = 2.09–19.14, P = 0.001) when compared to normal controls. The results were not modified by other confounding factors. Conclusion Our findings provide evidence that family-environmental factors are associated with ADHD among children in China. These findings, if confirmed by future research, may help to decrease ADHD by increasing the awareness of the effects of childhood emotional abuse. PMID:23209774
Desman, Christiane; Petermann, Franz; Hampel, Petra
To date, neuropsychological and psycho-physiological studies have revealed inconsistent results regarding an executive or motivational deficit explaining the response inhibition deficit in children with attention deficit/hyperactivity disorder (ADHD). Research on differentiating neuropsychological processes in ADHD subtypes is still scarce. Therefore, the motivational impact on response inhibition among boys with ADHD was examined in this study. In the first study, 19 boys with ADHD-combined type (ADHD-C) and 19 age-matched healthy control subjects performed a modified Go/No-Go task with the following experimental conditions: neutral, auditory feedback, reward, response cost, and reward/response cost. Performance and physiological data (heart rate and skin conductance responses) were recorded. In a second study with the modified Go/No-Go task, data for six children with ADHD-C, six with ADHD-inattentive subtype (ADHD-I), and six healthy control subjects were compared. Neither of the two studies revealed group by condition interactions. In study 1, boys with ADHD-C generally made more commissions and omissions compared to the control group. However, feedback significantly improved the response inhibition in all children. The heart rate of all children was increased in the two conditions of reward and reward/response cost. Study 2 revealed that children with ADHD-I responded more slowly and showed increased reaction time variability compared to both other groups. The present study supports an executive rather than a motivational deficit in the response inhibition among children with ADHD-C, though further results also indicate the role of auditory feedback on response inhibition. Additionally, the findings support the differentiation of ADHD-C and ADHD-I, suggesting that ADHD-I children are characterized by a sluggish cognitive tempo.
Moffitt, Terrie E.; Houts, Renate; Asherson, Philip; Belsky, Daniel W; Corcoran, David L; Hammerle, Maggie; Harrington, Honalee; Hogan, Sean; Meier, Madeline; Polanczyk, Guilherme V.; Poulton, Richie; Ramrakha, Sandhya; Sugden, Karen; Williams, Benjamin; Rohde, Luis Augusto; Caspi, Avshalom
Objective Despite a prevailing assumption that adult ADHD is a childhood-onset neurodevelopmental disorder, no prospective-longitudinal study has described the childhoods of the adult-ADHD population. We report follow-back analyses of ADHD cases diagnosed in adulthood, alongside follow-forward analyses of ADHD cases diagnosed in childhood, in one cohort. Method Participants belonged to a representative birth cohort of 1,037 individuals born in Dunedin, New Zealand in 1972-73 and followed to age 38, with 95% retention. Symptoms of ADHD, associated clinical features, comorbid disorders, neuropsychological deficits, GWAS-derived polygenic risk, and life impairment indicators were assessed. Data sources were participants, parents, teachers, informants, neuropsychological testing, and administrative records. Adult ADHD diagnoses used DSM5 criteria, apart from onset-age and cross-setting corroboration, which were study outcomes. Results As expected, the childhood-ADHD group showed 6% prevalence, male excess, childhood comorbid disorders, neurocognitive deficits, polygenic risk, and, despite having outgrown their ADHD diagnosis, residual adult life impairment. As expected, the adult-ADHD group showed 3% prevalence, gender balance, adult substance dependence, adult life impairment, and treatment contact. Unexpectedly, the childhood-ADHD and adult-ADHD groups comprised virtually non-overlapping sets; 90% of adult-ADHD cases lacked a history of childhood ADHD. Also unexpectedly, the adult-ADHD group did not show tested neuropsychological deficits in childhood or adulthood, nor did they show polygenic risk for childhood ADHD. Conclusion Findings raise the possibility that adults presenting with the ADHD symptom picture may not have a childhood-onset neurodevelopmental disorder. If this finding is replicated, then the disorder's place in the classification system must be reconsidered, and research must investigate the etiology of adult ADHD. PMID:25998281
Matthies, Swantje; Philipsen, Alexandra
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.
Parker, Janise; Zaboski, Brian; Joyce-Beaulieu, Diana
This case demonstrates the efficacy of utilizing an intensive, multi-faceted behavioral intervention paradigm. A comprehensive, integrative, school-based service model was applied to address attention deficit hyperactivity disorder symptomology, oppositional behaviors, and explosive anger at the secondary level. The case reviews a multi-modal…
Mick, Eric; Faraone, Stephen V.; Spencer, Thomas; Zhang, Huabin F.; Biederman, Joseph
Objective: The authors assessed the psychometric properties of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-QSF) in adults with ADHD. Method: One hundred fifty ADHD and 134 non-ADHD adults from a case-control study and 173 adults randomized to placebo or methylphenidate were assessed with the Q-LES-QSF and the…
... outgoing Convention case. 97.3 Section 97.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES ISSUANCE OF ADOPTION CERTIFICATES AND CUSTODY DECLARATIONS IN HAGUE CONVENTION ADOPTION CASES § 97.3 Requirements subject to verification in an outgoing Convention case. (a) Preparation of...
... outgoing Convention case. 97.3 Section 97.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES ISSUANCE OF ADOPTION CERTIFICATES AND CUSTODY DECLARATIONS IN HAGUE CONVENTION ADOPTION CASES § 97.3 Requirements subject to verification in an outgoing Convention case. (a) Preparation of...
Collins, Stephanie L; Levin, Frances R; Foltin, Richard W; Kleber, Herbert D; Evans, Suzette M
Attention deficit hyperactivity disorder (ADHD) is prevalent in adult cocaine abusers. Yet, it remains to be determined how the response to cocaine differs in cocaine abusers with ADHD compared to cocaine abusers without ADHD. Further, since ADHD is commonly treated with stimulants, such as methylphenidate (MPH), it is important to examine whether MPH maintenance alters the response to cocaine in cocaine abusers with ADHD. Thus, the first phase of this study compared the response to cocaine in adult cocaine abusers with ADHD to those without ADHD. The second phase assessed the effects of oral sustained-release methylphenidate (MPH-SR) maintenance (40 and 60 mg) on the response to cocaine only in those with ADHD. Cocaine abusers with ADHD (N=7) and without ADHD (N=7) who were not seeking treatment remained inpatient initially for 1 week, when the effects of cocaine alone were tested (Phase 1). Cocaine abusers with ADHD remained inpatient for an additional 3 weeks, during which the effects of cocaine during oral MPH-SR maintenance were tested (Phase 2). During cocaine fixed dosing sessions, participants received four injections of i.v. cocaine (0, 16 or 48 mg/70 kg), spaced 14 min apart. During cocaine choice sessions, participants had a choice between receiving i.v. cocaine (16 or 48 mg/70 kg) or two tokens, each exchangeable for 2 US dollars. Subjective effects related to ADHD symptoms (e.g. ratings of "Able to Concentrate") were significantly lower in cocaine abusers with ADHD compared to those without ADHD when placebo cocaine was administered. Active cocaine produced similar increases in cardiovascular and positive subjective effects in both groups and there was no difference in cocaine choice between the two groups. These data suggest that the response to cocaine is not different between cocaine abusers with ADHD compared to those without ADHD. When the cocaine abusers with ADHD were maintained on MPH-SR, cardiovascular effects were increased, however, this did
Abouzari, Mehdi; Oberg, Scott; Gruber, Aaron; Tata, Matthew
Problem gambling is thought to be highly comorbid with attention-deficit hyperactivity disorder (ADHD). We propose that the neurobiological pathologies underlying problem gambling overlap with those in ADHD. In this study, we used a simplified computerized version of the Iowa Gambling Task (IGT) to assess differences in reinforcement-driven choice adaptation among participants with pathological gambling and/or ADHD. The task contained two choice options with different net payouts over the session; a good bet that resulted in a win of +50 points on 60% of trials (and -50 points on 40%), and a bad bet that resulted in +100 points on 40% of the trials (and -100 points on 60%). We quantified participants' preference for the good bet over the session and their sensitivity to reinforcement. Both the control subjects and medicated ADHD nongamblers significantly increased the proportion of good bets over the 400-trial session. Subjects with problem gambling performed worse than controls and ADHD nongamblers, but better than our limited sample of unmedicated ADHD gamblers. Control subjects, medicated ADHD nongamblers, and unmedicated ADHD nongamblers tended to tolerate losses following good bets, whereas unmedicated ADHD gamblers tended to tolerate losses following bad bets. These data reveal that ADHD, particularly when treated with medication, is not associated with poor choices on the IGT, but may exacerbate pathological choices in problem gamblers. It seems that stabilization of dopamine signaling that occurs when ADHD is treated is itself also a treatment for certain forms of problem gambling.
Childress, Ann C
Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral disorder beginning in childhood and often continuing into adulthood. A wealth of data shows that ADHD symptoms respond well to pharmacological treatment. Stimulant medications, including amphetamine and methylphenidate, are most commonly used to treat ADHD. However, with the approval of atomoxetine (Strattera®, [ATX]) by the US Food and Drug Administration in late 2002, an effective non-stimulant option became available. The US Food and Drug Administration approved ATX for the treatment of ADHD in children, adolescents, and adults. Although the effect size of ATX is generally lower than that of stimulants, the American Academy of Child and Adolescent Psychiatry Practice Parameter for the treatment of ADHD lists ATX as a first-line treatment option. ATX is widely prescribed and accounted for 6% of the prescriptions of ADHD visits in the US in 2010. Numerous trials have found that ATX improves quality of life and emotional lability in addition to core ADHD symptoms. Although some improvement may be seen in a patient as early as one week after the initiation of treatment, ATX generally takes longer to have a full effect. The median time to response using 25% improvement in ADHD symptoms in pooled trials was 3.7 weeks. Data from these trials indicate that the probability of symptom improvement may continue to increase up to 52 weeks after treatment is initiated. ATX has been shown to be safe and effective in combination with stimulants. It has also been studied systematically in subjects with ADHD and comorbid oppositional defiant disorder, anxiety, depression, and substance use disorders. The mechanism of action of ATX, its efficacy, and adverse events reported in trials is reviewed. PMID:26730199
This paper focuses a sociological lens on what two early years Australian school boys labelled as having attention deficit hyperactivity disorder (ADHD) and an early years teacher have to say about social relations within informal play environments. The boys participated in separate semi-structured interviews where they predicted the likely…
Gawrilow, Caterina; Kühnhausen, Jan; Schmid, Johanna; Stadler, Gertraud
The aim of the present literature review is threefold. (1) We will review theories, models, and studies on symptomatic hyperactivity and motoric activity in attention-deficit/hyperactivity disorder (ADHD). (2) Another focus will be on assessment methods that have been proven to be effective in the detection of hyperactivity and motoric activity in children, adolescents, and adults with and without ADHD and emerging areas of research in the field of ADHD. We will compare subjective methods (i.e., rating scales) and objective methods (i.e., accelerometers). (3) Finally, physical activity intervention studies aiming at a modification of activity and overactive behavior will be summarized that seem to be promising candidates for alleviating hyperactivity symptoms in children, adolescents, and adults with ADHD. PMID:25506329
... ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with ... similar to treatment for childhood ADHD, though some ADHD medications approved for children are not approved for adult use. Adult ADHD ...
Miller, Meghan; Hanford, Russell B.; Fassbender, Catherine; Duke, Marshall; Schweitzer, Julie B.
Objective: This study compared affect recognition abilities between adults with and without ADHD. Method: The sample consisted of 51 participants (34 men, 17 women) divided into 3 groups: ADHD-combined type (ADHD-C; n = 17), ADHD-predominantly inattentive type (ADHD-I; n = 16), and controls (n = 18). The mean age was 34 years. Affect recognition…
Chew, Brandi L.; Jensen, Scott A.; Rosen, Lee A.
Objective: The attitudes of college students with and without ADHD toward peers with ADHD were examined. Method: A total of 196 college students (30 diagnosed with ADHD) anonymously completed four attitude measures. General analyses of attitudes toward peers with ADHD as well as comparisons between those with and without ADHD are made. Results:…
This article is a socio-historical account of the development of the Attention Deficit/Hyperactivity Disorder (ADHD) diagnosis and methylphenidate treatment in America, attending particularly to the political and institutional contexts that have supported this development. Historical developments in early-mid-twentieth-century America frame a…
... with ADHD to take tests. Some teens may benefit from smaller class sizes and tutoring help. Use tools that help you stay organized. For example, keep track of assignments in a homework notebook, including a list of books and readings you'll need to bring home to do. ...
Banaschewski, Tobias; Ruppert, Sinje; Tannock, Rosemary; Albrecht, Bjorn; Becker, Andreas; Uebel, Henrik; Sergeant, Joseph A.; Rothenberger, Aribert
Attention-deficit/hyperactivity disorder (ADHD) is associated with unexplained impairments on speeded naming of coloured stimuli. These deficits may reflect hypofunctioning retinal dopaminergic mechanisms impairing particularly blue-yellow colour discrimination. Colour perception and rapid colour naming ability were investigated in 14 children…
Objective: Agomelatine is a relatively new antidepressant, with affinities to MT1 and MT2 (responsible for the circadian rhythm) as well as to 5-HT2C receptors. Since antidepressants have demonstrated some benefit in the treatment of ADH and because of the fact, that ADHD is often associated with sleep disorders, we assumed, that it might be a…
Doehnert, Mirko; Brandeis, Daniel; Schneider, Gudrun; Drechsler, Renate; Steinhausen, Hans-Christoph
Background: This longitudinal electrophysiological study investigated the course of multiple impaired cognitive brain functions in attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood by comparing developmental trajectories of individuals with ADHD and typically developing controls. Methods: Subjects with ADHD ("N"…
Kam, Hye Jin; Choi, Jong Pil; Park, Rae Woong
Signs of ADHD are discernible in specific situations, and usually assessed according to subjective impressions. We performed a preliminary comparative study from children's activity at a natural classroom environment with 3-axis accelerator for a feasible objective index. From a total of 157 children (7-9 yrs) and clinically diagnosed 24 children out of them, variances in 1-min epoch mean activity had shown significant differences among the subgroups: (1) ADHD=.0194, Other Diseases=.0080, Normal=.0009; (2) ADHD=.0194, non-ADHD=.0057(p<.01, respectively). There were also significant differences in high-level activity (>1.6G) features among subgroups with the same order (p<.01, respectively). ADHD patients exhibited more dispersed activities and higher high-level activity ratio than normal. Activity features can be useful to build an objective indexing system for screening ADHD patients.
Udal, Anne H; Egeland, Jens; Oygarden, Bjørg; Malt, Ulrik F; Lövdahl, Hans; Pripp, Are H; Groholt, Berit
Reported rates of comorbidity between early onset bipolar disorder (BD) and attention deficit hyperactivity disorder (ADHD) have a wide range, perhaps due to developmental issues and differences in interpretation of overlapping symptoms. We compared questionnaire-based and neuropsychological measures of inattention and impulsivity/hyperactivity, in children/adolescents with ADHD combined subtype (ADHD-C; n26), concurrent ADHD-C and BD (n15), BD (n25) with Controls (n69). Sub-analyses were performed on BD with and without inattention symptoms. The two ADHD-C groups displayed neuropsychological impairments that were not found in the BD group in spite of subjective and questionnaire-rated inattention. The findings caution against over-diagnosis of ADHD in BD.
Kousha, Maryam; Shahrivar, Zahra; Alaghband-rad, Javad
Objective: To assess the pattern of substance use disorder (SUD) in adolescents with and without history of attention-deficit/hyperactivity disorder (ADHD) using an Iranian sample in the context of a cultural background and drug availability is differing from Western countries. Method: In this case-control study, the participants were interviewed…
Re, Anna Maria; Cornoldi, Cesare
A large body of evidence shows that many of the academic difficulties Attention Deficit Hyperactivity Disorder (ADHD) children have may be related to their problems in executive control. However, the particular case of expressive writing has not been deeply explored. The present study examines the typical school exercise of writing a letter.…
Hale, T Sigi; Zaidel, Eran; McGough, James J; Phillips, Joseph M; McCracken, James T
Few studies directly examined the nature of hemispheric specialization and interaction in ADHD. The present experiment investigated left/right brain dynamics in unmedicated right handed adults with ADHD (n = 19) and in controls (n = 19), using a dichotic listening task to assess hemispheric differences in word and emotion recognition. We also assessed how focusing attention on a single ear modulated lateralized performance and affected cross-callosal interference effects. Analysis of variance indicated that ADHD subjects showed reduced left hemisphere specialization, were better at processing emotions, and worse at processing words compared to controls. These differences were eliminated during focused attention. Finally, during presumed right hemisphere processing of linguistic stimuli, subjects with ADHD showed reduced left hemisphere interference. We concluded that ADHD subjects demonstrated greater right hemisphere and reduced left hemisphere contribution during this task relative to controls. We posit that these hemispheric differences were due to management or use of available cognitive resources rather than inherent capacity.
Spencer, Thomas J.; Brown, Ariel; Seidman, Larry J.; Valera, Eve M.; Makris, Nikos; Lomedico, Alexandra; Faraone, Stephen V.; Biederman, Joseph
Objective To evaluate the impact of therapeutic oral doses of stimulants on the brains of ADHD subjects as measured by MRI-based neuroimaging studies (morphometric, functional, spectroscopy). Data Sources We searched PubMed and ScienceDirect through the end of calendar year 2011 using the keywords: 1) “psychostimulants” or “methylphenidate” or “amphetamine”, and 2) “neuroimaging” or “MRI” or “fMRI”, and 3) “ADHD” or “ADD” or “Attention-Deficit/Hyperactivity Disorder” or “Attention Deficit Hyperactivity Disorder”. Study Selection We included only English language articles with new data that were case or placebo-controlled and examined ADHD subjects on and off psychostimulants (as well as 5 relevant review papers). Data Extraction We combined details of study design and medication effects in each imaging modality. Results We found 29 published studies that met our criteria. These included 6 structural MRI, 20 functional MRI studies and 3 spectroscopy studies. Methods varied widely in terms of design, analytic technique, and regions of the brain investigated. Despite heterogeneity in methods, however, results were consistent. With only a few exceptions, the data on the effect of therapeutic oral doses of stimulant medication suggest attenuation of structural and functional alterations found in unmedicated ADHD subjects relative to findings in Controls. Conclusions Despite the inherent limitations and heterogeneity of the extant MRI literature, our review suggests that therapeutic oral doses of stimulants decrease alterations in brain structure and function in subjects with ADHD relative to unmedicated subjects and Controls. These medication-associated brain effects parallel, and may underlie, the well-established clinical benefits. PMID:24107764
Giblin, John M.; Strobel, Aaron L.
Objective: This study evaluated the potential effects of short-term treatment with lisdexamfetamine dimesylate (LDX) on both subjective and objective sleep characteristics in children aged 6 to 12 years (n = 24) with ADHD. Method: Polysomnography (PSG) and actigraph measures as well as assessments of subjective sleep parameters were examined in…
De Sanctis, Virginia A; Newcorn, Jeffrey H; Halperin, Jeffrey M
Children with attention-deficit/hyperactivity disorder (ADHD) are at heightened risk of antisocial behavior during adolescence/early adulthood. Here, we characterize the antisocial outcomes of a sample of urban, lower-socioeconomic-status, ethnically diverse ADHD youth and investigate the impact of maltreatment history on criminal and substance use disorder (SUD) outcomes. Ninety-eight participants diagnosed with ADHD in childhood were re-assessed 10 years later and compared with controls. Regression analyses investigated the effect of maltreatment on antisocial outcomes among four groups based on ADHD and maltreatment status. ADHD subjects and controls did not differ in rates of arrest, conviction, incarceration, or recidivism. ADHD youth were younger at their first arrest with higher rates of SUDs when compared to controls. Controls and ADHD subjects with maltreatment had significantly higher rates of SUDs compared to the no-ADHD/no-maltreatment group. Only ADHD youth with maltreatment had significantly higher rates of arrest than the reference group. In contrast to prior studies, ADHD youth did not differ from controls on most measures of antisocial behavior. Maltreatment increased the rate of arrest only among ADHD youth, though increased the rate of SUD for ADHD youth and controls. This suggests that ADHD youth, in the absence of maltreatment, are at no greater risk of SUDs or arrest than controls without maltreatment.
Azrin, Nathan H.; Vinas, Veronica; Ehle, Christopher T.
Contingent reward procedures have been found beneficial in improving classroom conduct of ADHD children. Based on the conceptualization of the Premack Principle, a previous single-subject study of an ADHD Autistic child suggested the novel use of physical activity availability as a reinforcer for attentive calmness of the Attention Deficit…
Hegarty, Catherine E; Foland-Ross, Lara C; Narr, Katherine L; Sugar, Catherine A; McGough, James J; Thompson, Paul M; Altshuler, Lori L
Objectives Attention-deficit hyperactivity disorder (ADHD) is prevalent in patients with bipolar disorder (BP), but very few studies consider this when interpreting magnetic resonance imaging findings. No studies, to our knowledge, have screened for or controlled for the presence of ADHD when examining cortical thickness in patients with BP. We used a 2 × 2 design to evaluate the joint effects of BP and ADHD on cortical thickness and uncover the importance of ADHD comorbidity in BP subjects. Methods The study included 85 subjects: 31 healthy controls, 17 BP-only, 19 ADHD-only, and 18 BP/ADHD. All patients with BP were subtype I, were euthymic, and were not taking lithium. Groups did not differ significantly in age or sex distribution. We used cortical thickness measuring tools combined with cortical pattern matching methods to align sulcal/gyral anatomy across participants. Significance maps were used to check for both main effects of BP and ADHD and their interaction. Post-hoc comparisons assessed how the effects of BP on cortical thickness varied as a function of the presence or absence of ADHD. Results Interactions of BP and ADHD diagnoses were found in the left subgenual cingulate and right orbitofrontal cortex, demonstrating that the effect of BP on cortical thickness depends on ADHD status. Conclusions Some brain abnormalities attributed to BP may result from the presence of ADHD. Diagnostic interactions were found in regions previously implicated in the pathophysiology of BP, making it vital to control for an ADHD comorbid diagnosis when attempting to isolate neural or genetic abnormalities specific to BP. PMID:23167934
Zhou, Fankun; Wu, Fengyun; Zou, Shipu; Chen, Ying; Feng, Chang; Fan, Guangqin
Dietary or nutrient patterns represent the combined effects of foods or nutrients, and elucidate efficaciously the impact of diet on diseases. Because the pharmacotherapy on attention deficit hyperactivity disorder (ADHD) was reported be associated with certain side effects, and the etiology of ADHD is multifactorial, this study investigated the association of dietary and nutrient patterns with the risk of ADHD. We conducted a case-control study with 592 Chinese children including ADHD (n = 296) and non-ADHD (n = 296) aged 6–14 years old, matched by age and sex. Dietary and nutrient patterns were identified using factor analysis and a food frequency questionnaire. Blood essential elements levels were measured using atomic absorption spectrometry. A fish-white meat dietary pattern rich in shellfish, deep water fish, white meat, freshwater fish, organ meat and fungi and algae was inversely associated with ADHD (p = 0.006). Further analysis found that a mineral-protein nutrient pattern rich in zinc, protein, phosphorus, selenium, calcium and riboflavin was inversely associated with ADHD (p = 0.014). Additionally, the blood zinc was also negatively related to ADHD (p = 0.003). In conclusion, the fish-white meat dietary pattern and mineral-protein nutrient pattern may have beneficial effects on ADHD in Chinese children, and blood zinc may be helpful in distinguishing ADHD in Chinese children. PMID:27338457
Zhou, Fankun; Wu, Fengyun; Zou, Shipu; Chen, Ying; Feng, Chang; Fan, Guangqin
Dietary or nutrient patterns represent the combined effects of foods or nutrients, and elucidate efficaciously the impact of diet on diseases. Because the pharmacotherapy on attention deficit hyperactivity disorder (ADHD) was reported be associated with certain side effects, and the etiology of ADHD is multifactorial, this study investigated the association of dietary and nutrient patterns with the risk of ADHD. We conducted a case-control study with 592 Chinese children including ADHD (n = 296) and non-ADHD (n = 296) aged 6-14 years old, matched by age and sex. Dietary and nutrient patterns were identified using factor analysis and a food frequency questionnaire. Blood essential elements levels were measured using atomic absorption spectrometry. A fish-white meat dietary pattern rich in shellfish, deep water fish, white meat, freshwater fish, organ meat and fungi and algae was inversely associated with ADHD (p = 0.006). Further analysis found that a mineral-protein nutrient pattern rich in zinc, protein, phosphorus, selenium, calcium and riboflavin was inversely associated with ADHD (p = 0.014). Additionally, the blood zinc was also negatively related to ADHD (p = 0.003). In conclusion, the fish-white meat dietary pattern and mineral-protein nutrient pattern may have beneficial effects on ADHD in Chinese children, and blood zinc may be helpful in distinguishing ADHD in Chinese children.
Dang, Linh C; Samanez-Larkin, Gregory R; Young, Jacob S; Cowan, Ronald L; Kessler, Robert M; Zald, David H
Case-control studies comparing ADHD with typically developing individuals suggest that anatomical asymmetry of the caudate nucleus is a marker of attention deficit hyperactivity disorder (ADHD). However, there is no consensus on whether the asymmetry favors the right or left caudate nucleus in ADHD, or whether the asymmetry is increased or decreased in ADHD. The current study aimed to clarify this relationship by applying a dimensional approach to assessing ADHD symptoms that, instead of relying on clinical classification, utilizes the natural behavioral continuum of traits related to ADHD. Structural T1-weighted MRI was collected from 71 adults between 18 and 35 years and analyzed for caudate asymmetry. ADHD-like attentional symptoms were assessed with an objective measure of attentional problems, the ADHD score from the Test of Variables of Attention (TOVA). Impulsivity, a core feature in ADHD, was measured using the Barratt Impulsiveness Scale, a self-report measure that assesses attentional, non-planning, and motor features of impulsivity. We found that larger right relative to left caudate volumes correlated with both higher attentional impulsiveness and worse ADHD scores on the TOVA. Higher attentional impulsiveness also correlated with worse ADHD scores, establishing coherence between the objective measure and the self-report measure of attentional problems. These results suggest that a differential passage of information through frontal-striatal networks may produce instability leading to attentional problems. The findings also demonstrate the utility of a dimensional approach to understanding structural correlates of ADHD symptoms.
Re, Anna Maria; Caeran, Monica; Cornoldi, Cesare
The present study examines the expressive writing abilities of children described by their teachers as having Attention Deficit Hyperactivity Disorder (ADHD) symptoms and of matched controls and the effects of two types of facilitation. A group of 35 ADHD children and matched controls are given the task of composing a letter either under standard instructions or with facilitation (a guide scheme), preceded by a brief training on how to use the facilitation. Results show that both groups drew benefit from the guide scheme. Despite the fact that differences between groups were maintained after the training for the case of spelling errors, the poorer performance of ADHD children vanished. It is concluded that ADHD children have poor expressive writing skills, but this can be improved through the help of a guide scheme preceded by brief training.
Barbaresi, W J; Olsen, R D
We assessed the effect of pediatrician-led inservice training on the knowledge and stress of elementary schoolteachers related to attention-deficit/hyperactivity disorder (ADHD). The subjects were 44 schoolteachers staffing a 750-student school. Preintervention and postintervention questionnaires assessed teachers' training and knowledge concerning ADHD, teacher stress, and teacher-rated student behavior. The intervention was an ADHD curriculum developed by the national organization, Children and Adults with Attention-Deficit Disorder (CHADD). At preintervention, 41% of the teachers thought that ADHD could be caused by poor parenting and 41%, by sugar or food additives; 64% thought that methylphenidate should be used only as a last resort. Postintervention percentages of teachers holding these beliefs were 7%, 5%, and 34%, respectively. Sixty-one percent had no contact with physicians prescribing stimulants. Teacher stress correlated with ADHD behavior in male students and decreased postintervention. Use of the CHADD curriculum and discussion with a pediatrician were associated with improved teacher knowledge and decreased teacher stress related to ADHD.
Roessner, Veit; Banaschewski, Tobias; Becker, Andreas; Buse, Judith; Wanderer, Sina; Buitelaar, Jan K.; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Gill, Michael; Manor, Iris; Miranda, Ana; Mulas, Fernando; Oades, Robert D.; Roeyers, Herbert; Steinhausen, Hans-Christoph; Faraone, Steven V.; Asherson, Philip; Rothenberger, Aribert
Background: The association of attention-deficit/hyperactivity disorder (ADHD) and tic disorder (TD) is frequent and clinically important. Very few and inconclusive attempts have been made to clarify if and how the combination of ADHD+TD runs in families. Aim: To determine the first time in a large-scale ADHD sample whether ADHD+TD increases the risk of ADHD+TD in siblings and, also the first time, if this is independent of their psychopathological vulnerability in general. Methods: The study is based on the International Multicenter ADHD Genetics (IMAGE) study. The present sub-sample of 2815 individuals included ADHD-index patients with co-existing TD (ADHD+TD, n = 262) and without TD (ADHD–TD, n = 947) as well as their 1606 full siblings (n = 358 of the ADHD+TD index patients and n = 1248 of the ADHD-TD index patients). We assessed psychopathological symptoms in index patients and siblings by using the Strength and Difficulties Questionnaire (SDQ) and the parent and teacher Conners' long version Rating Scales (CRS). For disorder classification the Parental Account of Childhood Symptoms (PACS-Interview) was applied in n = 271 children. Odds ratio with the GENMOD procedure (PROCGENMOD) was used to test if the risk for ADHD, TD, and ADHD+TD in siblings was associated with the related index patients' diagnoses. In order to get an estimate for specificity we compared the four groups for general psychopathological symptoms. Results: Co-existing ADHD+TD in index patients increased the risk of both comorbid ADHD+TD and TD in the siblings of these index patients. These effects did not extend to general psychopathology. Interpretation: Co-existence of ADHD+TD may segregate in families. The same holds true for TD (without ADHD). Hence, the segregation of TD (included in both groups) seems to be the determining factor, independent of further behavioral problems. This close relationship between ADHD and TD supports the clinical approach to carefully assess ADHD in any case
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Roberts, Walter; Milich, Richard; Fillmore, Mark T.
Rationale Prior research has found that adults with attention-deficit/hyperactivity disorder (ADHD) show increased sensitivity to the impairing effects of alcohol (Weafer et al. 2009). However, these studies have focused exclusively on the ascending limb of the blood alcohol concentration (BAC) curve, and it is unclear whether these adults continue to show increased sensitivity during the later phase of the dose as BAC is declining. Objective This study tested the hypothesis that those with ADHD would display increased response to alcohol during the ascending limb of the BAC curve and less recovery from the impairing effects during the descending limb. Methods Adult social drinkers with ADHD and control adults completed measures of motor coordination, reaction time, and subjective intoxication twice following 0.64 g/kg alcohol and placebo. The measures were administered during the ascending limb of the BAC curve and again during the descending limb. Results During the ascending limb, alcohol reduced motor coordination, slowed reaction time (RT), and increased self-reports of subjective intoxication. Those with ADHD displayed greater impairment of motor coordination compared with controls. During the descending limb, controls reported diminished subjective intoxication and showed recovery from the impairing effects of alcohol on both their motor coordination and their RT. Those with ADHD showed reduced subjective intoxication and faster RT during this time, but they did not recover motor control. Conclusions The protracted time course of motor impairment in adults with ADHD despite reductions in subjective intoxication may contribute to poor decision making and diminished behavioral control in this group. PMID:23430161
Li, Yueling; Baker-Ericzen, Mary; Ji, Ning; Chang, Weili; Guan, Lili; Qian, Qiujin; Zhang, Yujuan; Faraone, Stephen V; Wang, Yufeng
The dopamine D4 receptor (DRD4) gene has been frequently studied in relation to attention deficit hyperactivity disorder (ADHD) but little is known about the contribution of single nucleotide polymorphisms (SNPs) of the DRD4 gene to the development and persistence of ADHD. In the present study, we examined the association between two SNPs in DRD4 (rs1800955, rs916455) and adult ADHD persistence in a Chinese sample. Subjects (n=193) were diagnosed with ADHD in childhood and reassessed in young adulthood at an affiliated clinic of Peking University Sixth Hospital. Kaplan-Meier survival analyses and Cox proportional hazard models were used to test the association between ADHD remission and alleles of the two SNPs. DRD4 rs916455 C allele carriers were more likely to have persistent ADHD symptoms in adulthood. No significant association was found between rs1800955 allele and the course of ADHD. These newly detected associations between DRD4 polymorphisms and ADHD prognosis in adulthood may help to predict the persistence of childhood ADHD into adulthood.
Naruse, Hiroaki; Fujisawa, Takashi X.; Yatsuga, Chiho; Kubota, Masafumi; Matsuo, Hideaki; Takiguchi, Shinichiro; Shimada, Seiichiro; Imai, Yuto; Hiratani, Michio; Kosaka, Hirotaka; Tomoda, Akemi
Background Children with attention deficit/hyperactivity disorder (ADHD) frequently have motor problems. Previous studies have reported that the characteristic gait in children with ADHD is immature and that subjects demonstrate higher levels of variability in gait characteristics for the lower extremities than healthy controls. However, little is known about body movement during gait in children with ADHD. The purpose of this study was to identify the characteristic body movements associated with ADHD symptoms in children with ADHD. Methods Using a three-dimensional motion analysis system, we compared gait variables in boys with ADHD (n = 19; mean age, 9.58 years) and boys with typical development (TD) (n = 21; mean age, 10.71 years) to determine the specific gait characteristics related to ADHD symptoms. We assessed spatiotemporal gait variables (i.e. speed, stride length, and cadence), and kinematic gait variables (i.e. angle of pelvis, hip, knee, and ankle) to measure body movement when walking at a self-selected pace. Results In comparison with the TD group, the ADHD group demonstrated significantly higher values in cadence (t = 3.33, p = 0.002) and anterior pelvic angle (t = 3.08, p = 0.004). In multiple regression analysis, anterior pelvic angle was associated with the ADHD rating scale hyperactive/impulsive scores (β = 0.62, t = 2.58, p = 0.025), but not other psychiatric symptoms in the ADHD group. Conclusions Our results suggest that anterior pelvic angle represents a specific gait variable related to ADHD symptoms. Our kinematic findings could have potential implications for evaluating the body movement in boys with ADHD. PMID:28099484
Caprioglio, Alberto; Fastuca, Rosamaria; Zecca, Piero Antonio; Beretta, Matteo; Mangano, Carlo; Piattelli, Adriano; Macchi, Aldo; Iezzi, Giovanna
The present case report aimed to investigate immediate histologic changes in midpalatal suture in humans following rapid maxillary expansion compared to control. Three patients (mean age 8.3 ± 0.9 years) were enrolled in the case report and underwent midpalatal suture biopsy. Two patients underwent treatment before biopsy. The third patient did not show transversal maxillary deficiency and was enrolled as a control. Biopsy samples of midpalatal suture at 7 (subject 1) and 30 days (subject 2) after maxillary expansion as well as of one control (subject 3) were collected and processed for histology. In the control (subject 3) inter-digitations at the palatal suture gap were observed. At 7 days (subject 1) mature bone with small marrow spaces and trabecular bone with the peculiar storiform appearance inside the soft tissue and collagen fibers running parallel only in the central part were present. At 30 days (subject 2), a greater number of newly-formed bone trabeculae with a perpendicular orientation to the long axis of the suture could be seen. At 30 days the fibrous component of bone tissue was less represented compared to the sample at 7 days. Data from the preliminary histological results showed that bone formation was observed in the gap after rapid maxillary expansion, although the healing process was still ongoing. PMID:28287481
Lee, Young Jun; Lee, Joo Kang; Jung, Soo Chang; Lee, Hwang-woo; Yin, Chang Shik; Lee, Young Jin
Objective. The objective of this study was to investigate the effect of a holistic intraoral appliance (OA) on cervical spine alignment and subjective symptom severity. Design. An observational study on case series with holistic OA therapy. Setting. An outpatient clinic for holistic temporomandibular joint (TMJ) therapy under the supervision of the Pain Center, CHA Biomedical center, CHA University. Subjects. Ambulatory patients presenting with diverse chief complaints in the holistic TMJ clinic. Main Measures. Any immediate change in the curvature of cervical spine and the degree of atlantoaxial rotation was investigated in the images of simple X-ray and computed tomography of cervical spine with or without OA. Changes of subjective symptom severity were also analyzed for the holistic OA therapy cases. Results. A total of 59 cases were reviewed. Alignment of upper cervical spine rotation showed an immediate improvement (P < 0.001). Changes of subjective symptom severity also showed significant improvement (P < 0.05). Conclusion. These cases revealed rudimentary clinical evidence that holistic OA therapy may be related to an alleviated symptom severity and an improved cervical spinal alignment. These results show that further researches may warrant for the holistic TMJ therapy. PMID:23935655
Blahy, Tammy Lynn
No good time exists to face the realities of attention deficit and hyperactivity disorder (ADHD). Children across the United States and Canada are accompanied to clinics and schools by frightened, worried parents. In the book, In Understanding ADHD (2001), Ken and Andrea McCluskey bring to life the realities of the everyday journey of coping with…
Branscome, Jennifer; Cunningham, Teddi; Kelley, Heather; Brown, Caitlyn
The focus of this article is to provide an overview of the current state of knowledge of ADHD and to provide evidence-based training interventions for school counselors. An overview of basic information about ADHD will be provided, including diagnosis, presentation, causes, prevalence, and common misconceptions. Evidence-based training…
Sciberras, Emma; Efron, Daryl; Iser, Alina
Objective: This study aimed to investigate the agreement between parent- and child-reported quality of life (QoL) and the self-perceptions of children with ADHD. Method: A cross-sectional survey of school-aged children with ADHD and their parents was undertaken. Results: Parents reported their child's QoL as lower than the children rated…
Norvilitis, Jill M., Ed.
With many children and adults affected by Attention Deficit Hyperactivity Disorder, researchers strive to understand the underpinnings of ADHD and associated factors on both a basic and applied level. The goal of this volume is to explore some of the broad array of research in the field of ADHD. The 12 chapters cover a variety of topics as varied…
ADHD is a neurobiological-based brain disorder, most often hereditary, affecting nearly one in twenty students. The ADHD brain functions differently because the area between the frontal lobe and rear lobe is having short-circuit problems and is not transmitting necessary information. The technical part of the disorder does not engage us as…
Kohls, Gregor; Thönessen, Heike; Bartley, Gregory K; Grossheinrich, Nicola; Fink, Gereon R; Herpertz-Dahlmann, Beate; Konrad, Kerstin
Although attention deficit hyperactivity disorders (ADHD) and autism spectrum disorders (ASD) share certain neurocognitive characteristics, it has been hypothesized to differentiate the two disorders based on their brain's reward responsiveness to either social or monetary reward. Thus, the present fMRI study investigated neural activation in response to both reward types in age and IQ-matched boys with ADHD versus ASD relative to typically controls (TDC). A significant group by reward type interaction effect emerged in the ventral striatum with greater activation to monetary versus social reward only in TDC, whereas subjects with ADHD responded equally strong to both reward types, and subjects with ASD showed low striatal reactivity across both reward conditions. Moreover, disorder-specific neural abnormalities were revealed, including medial prefrontal hyperactivation in response to social reward in ADHD versus ventral striatal hypoactivation in response to monetary reward in ASD. Shared dysfunction was characterized by fronto-striato-parietal hypoactivation in both clinical groups when money was at stake. Interestingly, lower neural activation within parietal circuitry was associated with higher autistic traits across the entire study sample. In sum, the present findings concur with the assumption that both ASD and ADHD display distinct and shared neural dysfunction in response to reward.
Putnam, Steve; Copans, Stuart A.
Suggests that the increase of Attention Deficit/Hyperactivity Disorder (AD/HD) cases in America and Canada may be due in part to decreased levels of children's physical activity. Research has shown that exercise helps to lessen the symptoms of AD/HD. Claims that the use of regular exercise programs in school and at home is beneficial for AD/HD…
Kissgen, Ruediger; Franke, Sebastian
Since the beginning of clinical attachment research in the mid-1980s the number of research projects in this area has been continuously increasing. The research questions so far can be allocated to numerous medical disciplines such as psychosomatic medicine, adult psychiatry or child and adolescent psychiatry. Recently, children with ADHD and their families have also become subjects of this branch of research. Their specific behavioral characteristics from early childhood on constitute unique challenges on the parent-child interaction. If these interactions develop in a suboptimal way, children may develop an insecure or even a disorganized attachment quality. The latter represents a risk factor for a clinically significant psychopathological development.This article initially presents basic principles of attachment theory and discusses the relevance of the cardinal symptoms of ADHD for clinical attachment research. Subsequently, it outlines and discusses the main results of existing research regarding attachment and ADHD. It concludes with a perspective on research questions that need to be addressed in the future with regard to a transgenerational model that highlights the importance of parental attachment representations to the development of children's attachment quality.
Tell-tale signs of Attention Deficit Hyperactive Disorder (ADHD) ADHD and its relative ADD (Attention Deficit Disorder) include an inability to maintain attention, impulsive behaviors, and/or motor restlessness. There are three subcategories of ADHD; for the purpose of this article, the blanket term ADHD applies to all three. A crucial first step…
If the practice of therapeutic massage and bodywork (TMB) is to become evidence-informed, practitioners, educators, and presenters must better develop their research literacy and critical appraisal skills. Given that the IJTMB supports the publication of case reports as one fundamental form of knowledge development within the fields of TMB, it is imperative that researchers, educators, and practitioners know the difference between case reports and similar, but unrelated, forms of research. There are legal and ethical implications that must be carefully considered for each form of research or reporting. PMID:27648107
Sánchez-Mora, Cristina; Ramos-Quiroga, Josep A; Bosch, Rosa; Corrales, Montse; Garcia-Martínez, Iris; Nogueira, Mariana; Pagerols, Mireia; Palomar, Gloria; Richarte, Vanesa; Vidal, Raquel; Arias-Vasquez, Alejandro; Bustamante, Mariona; Forns, Joan; Gross-Lesch, Silke; Guxens, Monica; Hinney, Anke; Hoogman, Martine; Jacob, Christian; Jacobsen, Kaya K; Kan, Cornelis C; Kiemeney, Lambertus; Kittel-Schneider, Sarah; Klein, Marieke; Onnink, Marten; Rivero, Olga; Zayats, Tetyana; Buitelaar, Jan; Faraone, Stephen V; Franke, Barbara; Haavik, Jan; Johansson, Stefan; Lesch, Klaus-Peter; Reif, Andreas; Sunyer, Jordi; Bayés, Mònica; Casas, Miguel; Cormand, Bru; Ribasés, Marta
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high heritability. At least 30% of patients diagnosed in childhood continue to suffer from ADHD during adulthood and genetic risk factors may play an essential role in the persistence of the disorder throughout lifespan. To date, genome-wide association studies (GWAS) of ADHD have been completed in seven independent datasets, six of which were pediatric samples and one on persistent ADHD using a DNA-pooling strategy, but none of them reported genome-wide significant associations. In an attempt to unravel novel genes for the persistence of ADHD into adulthood, we conducted the first two-stage GWAS in adults with ADHD. The discovery sample included 607 ADHD cases and 584 controls. Top signals were subsequently tested for replication in three independent follow-up samples of 2104 ADHD patients and 1901 controls. None of the findings exceeded the genome-wide threshold for significance (PGC<5e-08), but we found evidence for the involvement of the FBXO33 (F-box only protein 33) gene in combined ADHD in the discovery sample (P=9.02e-07) and in the joint analysis of both stages (P=9.7e-03). Additional evidence for a FBXO33 role in ADHD was found through gene-wise and pathway enrichment analyses in our genomic study. Risk alleles were associated with lower FBXO33 expression in lymphoblastoid cell lines and with reduced frontal gray matter volume in a sample of 1300 adult subjects. Our findings point for the first time at the ubiquitination machinery as a new disease mechanism for adult ADHD and establish a rationale for searching for additional risk variants in ubiquitination-related genes.
Narad, Megan E; Garner, Annie A; Peugh, James L; Tamm, Leanne; Antonini, Tanya N; Kingery, Kathleen M; Simon, John O; Epstein, Jeffery N
Parent-teacher agreement on attention-deficit/hyperactivity disorder (ADHD) symptom ratings ranges from low to moderate. Most studies evaluating parent-teacher agreement have not assessed measurement invariance across raters. Hence, it is unclear whether discordance across raters is due to differing ADHD constructs across raters or other factors (e.g., subjective differences across raters). Additionally, the effect of development on parent-teacher agreement is relatively unknown. To address these limitations, the present study used parent and teacher ADHD ratings from a large (N = 6,659) developmentally diverse (ages 4-17) sample. Using exploratory structural equation modeling on half the sample, and then confirmatory factor analysis (CFA) on the other half of the sample, confirmed a 2-factor structure with significant cross-loadings for the 18 ADHD symptoms. CFA invariance analyses demonstrated that the 2-factor symptom structure was similar across raters and age groups. After confirming measurement invariance, the correlation between latent factors within and across raters was examined for each age group as well as across age groups. Parents reported greater severity of ADHD symptoms than did teachers, and both parents and teachers reported higher levels of hyperactivity/impulsivity in younger children than in older children and consistent levels of inattention across development. Finally, correlations between parent-teacher ratings of like factors were weak for inattention and moderate-strong for hyperactivity/impulsivity, and the magnitude of parent-teacher agreement did not vary across development. In conclusion, while parent and teacher ratings of ADHD behaviors are only weakly to moderately correlated, each reporter provides unique and valid clinical information as it relates to ADHD symptom presentation.
McGough, James; McCracken, James; Swanson, James; Riddle, Mark; Kollins, Scott; Greenhill, Laurence; Abikoff, Howard; Davies, Mark; Chuang, Shirley; Wigal, Tim; Wigal, Sharon; Posner, Kelly; Skrobala, Anne; Kastelic, Elizabeth; Ghuman, Jaswinder; Cunningham, Charles; Shigawa, Sharon; Moyzis, Robert; Vitiello, Benedetto
Objective: The authors explored genetic moderators of symptom reduction and side effects in methylphenidate-treated preschool-age children diagnosed with attention-deficit/hyperactivity disorder (ADHD). Method: DNA was isolated from 81 subjects in a double-blind, placebo-controlled, crossover methylphenidate titration. Parents and teachers…
Curtis, David F; Chapman, Stephanie; Dempsey, Jack; Mire, Sarah
This study examined classroom behavioral outcomes for children with Attention-Deficit/Hyperactivity Disorder (ADHD) following their participation in a manualized, 10-week intervention called Family Skills Training for ADHD-Related Symptoms (Family STARS). Family STARS combined behavioral parent training (BPT) and child-focused behavioral activation therapy (CBAT). Participants were children ages 7-10 diagnosed with ADHD-Combined Type. Pre- and post-treatment teacher ratings of ADHD symptoms were compared using a single group, within-subjects research design. Intervention effectiveness was analyzed using paired-samples t-tests. Results indicated statistically significant classroom improvements for externalizing behaviors and attention problems with medium and large main effects (respectively) for the intervention. Possible implications for combining CBAT with BPT for the treatment of ADHD are discussed as well as the relevance of these results for improving the effectiveness and portability of empirically supported interventions.
Latchoumane, Charles-Francois V; Kim, In-Hye; Sohn, Hansem; Jeong, Jaeseung
This study applied dynamical nonstationarity analysis (DNA) to the resting EEGs of patients with attention-deficit/hyperactivity disorder (AD/HD). We aimed to assess and characterize AD/HD using features based on the local and global duration of dynamical microstate. We hypothesized that AD/HD patients would have difficulties in maintaining stable cognitive states (e.g., attention deficit and impulsivity) and that they would thus exhibit EEGs with temporal dynamics distinct from normal controls, i.e., rapidly and frequently changing dynamics. To test this hypothesis, we recorded EEGs from 12 adolescent subjects with AD/HD and 11 age-matched healthy subjects in the resting state with eyes closed and eyes open. We found that AD/HD patients exhibited significantly faster changes in dynamics than controls in the right temporal region during the eyes closed condition, but slower changes in dynamics in the frontal region during the eyes open condition. AD/HD patients exhibited a disruption in the rate of change of dynamics in the frontotemporal region at rest, probably due to executive and attention processes. We suggest that the DNA using complementary local and global features based on the duration of dynamical microstates could be a useful tool for the clinical diagnosis of subjects with AD/HD.
Sibley, Margaret H; Coxe, Stefany; Molina, Brooke S G
Attention deficit/hyperactivity disorder (ADHD) is a chronic disorder that afflicts individuals into adulthood. The field continues to refine diagnostic standards for ADHD in adults, complicated by the disorder's heterogeneous presentation, subjective symptoms, and overlap with other disorders. Two key diagnostic questions are from whom to collect diagnostic information and which symptoms should be contained on an adult diagnostic checklist. Using a trifactor model, Martel et al. examine these questions in a sample of adults with and without self-identified ADHD symptoms. In this response, we highlight the importance of their finding that self and informant symptom reports differ in a sample of adults who acknowledge ADHD symptoms. We also review issues that continue to face the field related to model specification, evaluating symptom utility, and sample composition, discussing how these issues influence conclusions that may be drawn from Martel et al. and similar investigations. We conclude that the article makes an important research contribution about the nature of self and informant ADHD symptom reports but emphasize that symptom checklist refinement must occur through a broad lens that considers work from a range of sample types and clinically informative analytic strategies.
Sato, João Ricardo; Hoexter, Marcelo Queiroz; Castellanos, Xavier Francisco; Rohde, Luis A.
Studies based on functional magnetic resonance imaging (fMRI) during the resting state have shown decreased functional connectivity between the dorsal anterior cingulate cortex (dACC) and regions of the Default Mode Network (DMN) in adult patients with Attention-Deficit/Hyperactivity Disorder (ADHD) relative to subjects with typical development (TD). Most studies used Pearson correlation coefficients among the BOLD signals from different brain regions to quantify functional connectivity. Since the Pearson correlation analysis only provides a limited description of functional connectivity, we investigated functional connectivity between the dACC and the posterior cingulate cortex (PCC) in three groups (adult patients with ADHD, n = 21; TD age-matched subjects, n = 21; young TD subjects, n = 21) using a more comprehensive analytical approach – unsupervised machine learning using a one-class support vector machine (OC-SVM) that quantifies an abnormality index for each individual. The median abnormality index for patients with ADHD was greater than for TD age-matched subjects (p = 0.014); the ADHD and young TD indices did not differ significantly (p = 0.480); the median abnormality index of young TD was greater than that of TD age-matched subjects (p = 0.016). Low frequencies below 0.05 Hz and around 0.20 Hz were the most relevant for discriminating between ADHD patients and TD age-matched controls and between the older and younger TD subjects. In addition, we validated our approach using the fMRI data of children publicly released by the ADHD-200 Competition, obtaining similar results. Our findings suggest that the abnormal coherence patterns observed in patients with ADHD in this study resemble the patterns observed in young typically developing subjects, which reinforces the hypothesis that ADHD is associated with brain maturation deficits. PMID:23049834
Background Attention-deficit/hyperactivity disorder (ADHD) is a common neuro-psychiatric problem, affecting 7-9% of children. Pharmacological interventions are widely used with behavioral treatments in ADHD. Still, the origin of ADHD is unclear, limiting pharmacological effectiveness and making adverse effects common. The use of complementary and alternative medicine (CAM) has increased, especially for developmental and behavioral disorders, such as ADHD. CAM is used by 60-65% of parents of children with ADHD to relieve ADHD-associated symptoms and to avoid the side effects of conventional medication. Acupuncture has been widely used to treat patients with ADHD, but the available evidence of its effectiveness is insufficient. Our aim was to evaluate the effectiveness and safety of acupuncture in patients (both and each treatment naive and conventional therapy children) with ADHD (any subtype) compared to the waitlist control. Methods/Design This study is a waitlist controlled open trial. We used a computer generated randomization scheme. This randomised, controlled trial had two parallel arms (acupuncture, and waitlist group). Each arm consisted of 40 participants. The acupuncture group received acupuncture treatment two times per week for a total of 12 sessions over 6 weeks. Post-treatment follow-up was performed 3 weeks later to complement the 12 acupuncture sessions. Participants in the waitlist group did not receive acupuncture treatments during the first six weeks but were only required to be assessed. After 6 weeks, the same treatments given to the acupuncture group were provided to the waitlist group. The primary outcome of this trial included differences in Korean version of ADHD-Rating Scale (K-ADHD-RS) before randomization, 3 weeks and 6 weeks after randomization, and 3 weeks after completing the treatment. Discussion Subjective measurements, like K-ADHD-RS, are commonly used in ADHD. Although these measurements have adequate reliability and validity
Reimherr, Fred W; Marchant, Barrie K; Gift, Thomas E; Steans, Tammy A; Wender, Paul H
Much recent research describes the importance of emotional symptoms in ADHD. While there is no accepted system for including emotionality in diagnosing ADHD, the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) provides a tool to facilitate this. It assesses a range of adult ADHD symptoms which load on two factors: inattentive and emotional dysregulation. The consistently high inattentive factor was used to define significant elevation on the more variable emotional dysregulation factor (which contains four WRAADDS domains: hyperactivity/restlessness, temper, affective lability, and emotional over-reactivity) allowing the definition of two ADHD diagnostic types. We compared these two types on a broad range of adult subject characteristics, including response to methylphenidate (MPH) treatment assessed during two clinical trials. Marked impairment in three of the four emotional domains reflected a symptom severity level equivalent to that of the inattentive factor. 59 % met this threshold, defining them as ADHD emotion dysregulation presentation, as opposed to 41 % with ADHD inattentive presentation. Cluster analysis validated these groups by generating similar clusters with 85 % agreement regarding membership. ADHD emotional dysregulation presentation subjects showed more childhood ADHD symptoms, adult symptoms of oppositional defiant disorder, and evidence of personality disorder. Both types showed similar improvement during the double-blind MPH arm of the trials and during a 6-month open-label phase. Based on the presence of symptoms of emotional dysregulation, ADHD in adults can be conceptualized as two types. Impairment and comorbidity in adults with ADHD are largely concentrated in ADHD emotional dysregulation presentation patients.
Tamm, Leanne; Carlson, Caryn L.
Objective: To investigate single and combined effects of stimulant medication and contingencies on the performance of ADHD children with tasks involving different cognitive demands. Method: Children diagnosed with ADHD participated in a within-subjects design. At two separate sessions, children on either medication or placebo (administered in a…
Gawrilow, Caterina; Merkt, Julia; Goossens-Merkt, Heinrich; Bodenburg, Sebastian; Wendt, Mike
Adults with ADHD have problems in everyday multitasking situations presumably because of deficits in executive functions. The present study aims to find out (a) whether adults with ADHD show deficient multitasking performance in a standardized task, (b) how they perceive the multitasking situation, and (c) which task structure might be beneficial for them as compared with adults without ADHD. Therefore, we experimentally compared task performance, mood, and motivation in a group of 45 men with ADHD (M-age = 34.47, SD = 9.95) with a comparison group of 42 men without ADHD (M-age = 31.12, SD = 10.59) in three conditions: (a) a multitasking paradigm, (b) an interleaving condition in which tasks had to be performed without planning or monitoring, and (c) a non-interleaving condition. Our results showed no impaired multitasking performance in adults with ADHD. However, they showed better mood and more motivation in the non-interleaving condition.
Raz, Sivan; Leykin, Dmitry
Individuals with ADHD suffer from increased vulnerability to environmental and mental stressors and may be at increased risk for chronic stress in everyday life. The Hypothalamic-Pituitary-Adrenal (HPA) axis is a critical physiological system that mediates responses to stress. The present study seeks to examine test performance, test anxiety, self-reported psychological stress and cortisol reactivity to mental-cognitive stress in adults with ADHD when compared with healthy controls. Stress was induced by an arithmetic ability test. Psychological stress was assessed repeatedly throughout the experimental session. Salivary cortisol, an indicator of the HPA axis function, was evaluated immediately upon arrival, as well as 1 min and 20 min post-test completion. Results revealed higher levels of test anxiety and poorer performance on the test in the ADHD group. The ADHD and control groups showed no difference in base-line levels of subjective stress and in subjective stress levels 20 min after the test. In contrast, individuals with ADHD reported significantly higher levels of stress at the test anticipation phase and 1 min post-test completion. Cortisol response to stress differed according to group: in the ADHD group, 20 min post-test cortisol levels were significantly higher than base-line cortisol levels. This was not evident in the control group. These results suggest greater activation of the HPA axis in response to stress in adults with ADHD when compared with healthy controls. Adults with ADHD do not differ from controls in basal levels of subjective stress and cortisol, but do have stronger psychophysiological reactions in response to stressful challenges. The present findings are among the first to demonstrate significant alterations in cortisol reactivity to stress in adults with ADHD.
Amihăesei, Ioana Cristina; Zamfir, Carmen Lăcrămioara
Attention deficit hyperactivity disorder (ADHD) is considered a neurologic development disorder resulting in impairment of attention and inhibitory control, manifested as attention deficit, hyperactivity, impulsiveness; symptoms should develop between age six and twelve and have to persist for more than six months. Approximately 30-50% of the diagnosed cases are manifesting the disorder during adulthood and 2.5-5% of the adults are suffering of ADHD. Genetics are important factors in ADHD, being involved in 75% of the cases, as well in the persistence of ADHD during adult life. Three subtypes of ADHD are described--one in which is predominating the attention deficit, one with predominant hyperactivity and impulsiveness and a third combined subtype. Diagnosis criteria in ADHD are established by the American Psychiatric Association (DSM criteria) and by World Health Organization. Differential diagnosis is mainly considering bipolar disorder and borderline personality disorder. Management of ADHD is including behavioral therapies and medication, alone or combined. Stimulant medications such as amphetamine represent the therapy of choice, being effective in 80% of the cases. New data are underlying the need for following up of the cases during adulthood, since the risk for development of psychiatric conditions such as depression, anxiety, as well as the suicidal behavior is higher than in the general population.
de Zeeuw, Patrick; Weusten, Juliette; van Dijk, Sarai; van Belle, Janna; Durston, Sarah
Recent neurobiological models of ADHD suggest that deficits in different neurobiological pathways may independently lead to symptoms of this disorder. At least three independent pathways may be involved: a dorsal frontostriatal pathway involved in cognitive control, a ventral frontostriatal pathway involved in reward processing and a frontocerebellar pathway related to temporal processing. Importantly, we and others have suggested that disruptions in these three pathways should lead to separable deficits at the cognitive level. Furthermore, if these truly represent separate biological pathways to ADHD, these cognitive deficits should segregate between individuals with ADHD. The present study tests these hypotheses in a sample of children, adolescents and young adults with ADHD and controls. 149 Subjects participated in a short computerized battery assessing cognitive control, timing and reward sensitivity. We used Principal Component Analysis to find independent components underlying the variance in the data. The segregation of deficits between individuals was tested using Loglinear Analysis. We found four components, three of which were predicted by the model: Cognitive control, reward sensitivity and timing. Furthermore, 80% of subjects with ADHD that had a deficit were deficient on only one component. Loglinear Analysis statistically confirmed the independent segregation of deficits between individuals. We therefore conclude that cognitive control, timing and reward sensitivity were separable at a cognitive level and that deficits on these components segregated between individuals with ADHD. These results support a neurobiological framework of separate biological pathways to ADHD with separable cognitive deficits.
Costa Dias, Taciana G; Iyer, Swathi P; Carpenter, Samuel D; Cary, Robert P; Wilson, Vanessa B; Mitchell, Suzanne H; Nigg, Joel T; Fair, Damien A
One potential obstacle limiting our ability to clarify ADHD etiology is the heterogeneity within the disorder, as well as in typical samples. In this study, we utilized a community detection approach on 106 children with and without ADHD (aged 7-12 years), in order to identify potential subgroups of participants based on the connectivity of the reward system. Children with ADHD were compared to typically developing children within each identified community, aiming to find the community-specific ADHD characteristics. Furthermore, to assess how the organization in subgroups relates to behavior, we evaluated delay-discounting gradient and impulsivity-related temperament traits within each community. We found that discrete subgroups were identified that characterized distinct connectivity profiles in the reward system. Importantly, which connections were atypical in ADHD relative to the control children were specific to the community membership. Our findings showed that children with ADHD and typically developing children could be classified into distinct subgroups according to brain functional connectivity. Results also suggested that the differentiation in "functional" subgroups is related to specific behavioral characteristics, in this case impulsivity. Thus, combining neuroimaging data and community detection might be a valuable approach to elucidate heterogeneity in ADHD etiology and examine ADHD neurobiology.
Nichols, J Quyen V A; Shoulberg, Erin K; Garner, Annie A; Hoza, Betsy; Burt, Keith B; Murray-Close, Dianna; Arnold, L Eugene
Factor analytic studies of attention-deficit/hyperactivity disorder (ADHD) in children and adults have shown that second-order and bifactor models better represent ADHD symptoms than two- or three-factor models, yet there is far less evidence for a bestfitting model of ADHD in adolescence. Thus, the current study examined the factor structure of ADHD in adolescence and further evaluated the external validity of the best fitting model. Participants were 588 adolescents (22 % female; 366 with a childhood ADHD diagnosis; mean age 15.9 years) from the 8-year assessment of the Multimodal Treatment Study of Children with ADHD (MTA). ADHD symptoms were assessed via adolescent self-report, parent report, and teacher report on the SNAP-IV scale. Potential factor structures for the 18 symptoms of ADHD were tested for each informant, which included traditional one-factor, two-factor, and three-factor models of ADHD, as well as second-order factor (specific factors loading onto general factor) and bifactor (items loading onto both specific and general factors) models. Unique associations between external criteria and the identified factors of each informant's best fitting model were examined. Although several of the proposed models exhibited good fit, the second-order two-factor model best accounted for ADHD in adolescence according to self-report and parent report, and the second-order three-factor model was optimal according to teacher report. Several key measurement issues emerged for the hierarchical bifactor models, such as numerous Heywood cases and out-of-bound parameter estimates, which rendered them unfit as optimal representations of ADHD in adolescence. These findings and the implications of the best fitting model of ADHD in adolescence suggest that a possible reorganization of this disorder may eventually aid clinicians in the accurate diagnosis of ADHD in adolescents.
Baroncini, Vittorio; Baroncini, Giacomo; Topiwala, Pankaj
This paper tries to examine the results of a subjective evaluation experiment, made by means of the new Expert Viewing Protocol, recently approved by ITU-R Study Group 6 . The EVP subjective test was designed and performed to compare different HDR coding technologies during an MPEG meeting (San Diego, CA, February 2016) . Thanks to the wide and enthusiastic participation of the MPEG experts to the subjective evaluation experiment, it was possible to collect data from a total of sixteen viewers; this allowed to perform a sort of "validation" of the performance of the EVP. The ITU-R Recommendation states that tests with nine viewers is sufficient to get acceptable results from an EVP experiment. In our case, having data from 16 viewers, it was possible to compute the MOS and the Confidence Interval data as if it were a standard subjective assessment experiment (which typically requires more viewers). This allowed a sort of "validation" of the results obtained using results from 9 experts only vs. the results obtained using the data from the 16 viewers. The analysis of the raw data showed a rather good conversion of the EVP results towards the results obtained using the full viewers' data set. The results of the EVP evaluation of MPEG HDR content was described in details in a previous paper , to which we defer for details on the EVP protocol procedure and rules. This paper instead tries to answer to a demand for further clarification on the "context" and "limitations of use" of the EVP when performed in alternative to a formal subjective experiment trial.
A responder analysis is a common tool when clinical data are reported. In this paper, we extend the definition of responders to within subject comparisons and present a rigorous definition of the corresponding statistical functional. Via simulation studies, we get further insights under which conditions these analyses can even result in a higher power compared with an analysis based on the arithmetic mean. We report two case studies where these analyses contributed to a better understanding of the clinical data especially as some large observations were present that had a notable impact on the observed standard deviation.
Pinkhardt, Elmar H; Kassubek, Jan; Brummer, Dagmar; Koelch, Michael; Ludolph, Albert C; Fegert, Joerg M; Ludolph, Andrea G
Attention-deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in youth. About a third to one-half of the affected subjects continue to have symptoms in adulthood. Remarkably, the prevalence numbers published for adult females are higher than for girls. The differences in the epidemiological data between the age groups clearly point to underdiagnosed ADHD in girls. Major depression, the most frequent psychiatric condition worldwide in adulthood, is twice as common in female as in male adults. Anxiety and depression are also among the most common comorbidities in adults with ADHD. Therefore, an undiagnosed ADHD may often underlie the psychopathology in depressive women. Another possibly associated phenomenon is the increased frequency of smoking in adult females. Since nicotine indirectly enhances the intrasynaptic dopamine level which presumably is too low both in ADHD and in depression, smoking might be used as a self-medication in women with untreated ADHD and consecutive depression. Furthermore, smoking during pregnancy is a major risk factor for ADHD in the offspring, so the vicious circle is complete. Depression in mothers of children with ADHD is associated with a higher rate of comorbidity in the children. Improved screening for ADHD in girls and treatment in childhood might thus reduce the rate of depression and smoking in adult females. We hypothesize that earlier identification and interventions might not only improve the lives of millions of girls and women but might also reduce the prevalence rates in future generations or at least moderate the deviant behaviour in this highly heritable disorder in which the development and severity of symptoms and the functional impairment depend to a high degree on epigenetic factors.
Stone, Susan; Brown, Timothy T.; Hinshaw, Stephen P.
Background/Context: Children with attention-deficit/hyperactivity disorder (ADHD) provide a test case through which to investigate psychosocial school compositional effects. Characterized by developmentally atypical levels of inattention, activity, and impulsivity, the condition often manifests itself, and is identified, in school settings and is…
Thompson, W C
This article discusses two factors that may profoundly affect the value of DNA evidence for proving that two samples have a common source: uncertainty about the interpretation of test results and the possibility of laboratory error. Three case studies are presented to illustrate the importance of the analyst's subjective judgments in interpreting some RFLP-based forensic DNA tests. In each case, the likelihood ratio describing the value of DNA evidence is shown to be dramatically reduced by uncertainty about the scoring of bands and the possibility of laboratory error. The article concludes that statistical estimates of the frequency of matching genotypes can be a misleading index of the value of DNA evidence, and that more adequate indices are needed. It also argues that forensic laboratories should comply with the National Research Council's recommendation that forensic test results be scored in a blind or objective manner.
Gadow, Kenneth D.; DeVincent, Carla J.; Schneider, Jayne
Objective: Identification of differences among children with ADHD only, autism spectrum disorder (ASD)+ADHD, and chronic multiple tic disorder (CMTD)+ADHD may lead to better understanding of clinical phenotypes. Method: Children were evaluated using the parent- and teacher-completed questionnaires. Results: All three groups were highly similar in…
... of actions affecting land and water uses subject to the management program-Technique C. 923.44... a case-by-case basis of actions affecting land and water uses subject to the management program... review for consistency with the management program of all development plans, projects, or land and...
... of actions affecting land and water uses subject to the management program-Technique C. 923.44... a case-by-case basis of actions affecting land and water uses subject to the management program... review for consistency with the management program of all development plans, projects, or land and...
... 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 ...
Martel, Michelle; Nikolas, Molly; Nigg, Joel T.
A study is conducted to determine the specificity of executive function weakness in attention-deficit/hyperactivity disorder (ADHD) during adolescence. Results suggest that executive function weakness in ADHD is specifically associated with symptoms of inattention-disorganization.
Mahone, E. Mark; Wodka, Ericka L.
Since boys are more commonly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) than girls, the majority of theories and published research studies of ADHD have been based on samples comprised primarily (or exclusively) of boys. While psychosocial impairment in girls with ADHD is well established, the neuropsychological and…
Reynolds, Cecil R.; Vannest, Kimberly J.; Harrison, Judith R.
ADHD affects millions of people-some 3 to 5% of the general population. Written by a neuroscientist who has studied ADHD, a clinician who has diagnosed and treated it for 30 years, and a special educator who sees it daily, "The Energetic Brain" provides the latest information from neuroscience on how the ADHD brain works and shows how to harness…
This policy brief discusses students with attention deficit hyperactivity disorder (ADHD) and their school performance. Reasons are presented to explain why children with ADHD fail. The three main characteristics of ADHD (inattention, impulsivity, and hyperactivity) and their interference with academic performance are discussed. The brief…
Mayes, Susan Dickerson; Calhoun, Susan L.; Mayes, Rebecca D.; Molitoris, Sarah
Children with ADHD and autism have some similar features, complicating a differential diagnosis. The purpose of our study was to determine the degree to which core ADHD and autistic symptoms overlap in and discriminate between children 2-16 years of age with autism and ADHD. Our study demonstrated that 847 children with autism were easily…
Adler, Lenard A; Faraone, Stephen V; Spencer, Thomas J; Berglund, Patricia; Alperin, Samuel; Kessler, Ronald C
Although DSM-5 stipulates that symptoms of attention-deficit hyperactivity disorder (ADHD) are the same for adults as children, clinical observations suggest that adults have more diverse deficits than children in higher-level executive functioning and emotional control. Previous psychometric analyses to evaluate these observations have been limited in ways addressed in the current study, which analyzes the structure of an expanded set of adult ADHD symptoms in three pooled US samples: a national household sample, a sample of health plan members, and a sample of adults referred for evaluation at an adult ADHD clinic. Exploratory factor analysis found four factors representing executive dysfunction/inattention (including, but not limited to, all the DSM-5 inattentive symptoms, with non-DSM symptoms having factor loadings comparable to those of DSM symptoms), hyperactivity, impulsivity, and emotional dyscontrol. Empirically-derived multivariate symptom profiles were broadly consistent with the DSM-5 inattentive-only, hyperactive/impulsive-only, and combined presentations, but with inattention including executive dysfunction/inattention and hyperactivity-only limited to hyperactivity without high symptoms of impulsivity. These results show that executive dysfunction is as central as DSM-5 symptoms to adult ADHD, while emotional dyscontrol is more distinct but nonetheless part of the combined presentation of adult ADHD.
Kakuszi, Brigitta; Tombor, László; Papp, Szilvia; Bitter, István; Czobor, Pál
Aberrations in early-developing bottom-up processes, such as stimulus-driven response preparation, are thought to play a critical role in the onset of ADHD, and in its persistence over time. Electrophysiology offers a unique tool to gain insight into response preparation, since response preparation has been associated with distinctive ERP changes, including negative potential-shifts which occur predominantly over frontal brain areas. We examined response-preceding negative potential shifts (RPNS) as a probe of response-preparation in adult ADHD patients by obtaining high-density event-related potentials from 33 ADHD and 29 matched healthy subjects during a Go/Nogo task using a 128-channel BioSemi recording-system. Compared to controls, ADHD patients showed enhancement of the RPNS in fronto-central brain regions in the Go condition during correct responses. This change was associated with poor performance in the Stroop incongruency-task: the greater the enhancement, the higher the proportion of errors. Moreover, the ERP-enhancement showed association with the severity of ADHD-symptoms; and with heightened response-variability. Thus, ADHD patients demonstrate neurophysiological alterations in response-preparation and response-preceding brain activity, suggestive of excessive activation of prefrontal neural circuits. Given the correlation with neuropsychological and psychopathological measures, these changes may constitute a pathway for core symptoms of ADHD, including premature and impaired response-preparation and motor-hyperactivity.
Tarver, J; Daley, D; Sayal, K
Attention-deficit hyperactivity disorder (ADHD) is a complex disorder that can affect individuals across the lifespan. It is associated with substantial heterogeneity in terms of aetiology, clinical presentation and treatment outcome and is the subject of extensive research. Because of this, it can be difficult for clinicians to stay up to date with the most relevant findings and know how best to respond to parents' questions and concerns about the disorder and interventions. This is a narrative review that aims to summarize key findings from recent research into ADHD and its treatment that clinicians can share with families in order to increase their knowledge about ADHD and intervention options. ADHD develops as a result of complex interplay between interdependent genetic and non-genetic factors. The disorder is associated with substantial impairments in functioning and poor long-term outcomes. Pharmacological and non-pharmacological treatment options are available for symptom management and to improve function, but functioning outcomes often fail to normalize in children with ADHD. Despite extensive advances in understanding this complex disorder, it is clear that there is still a long way to go. In particular, we address the need for future non-pharmacological interventions to be more specifically targeted for ADHD symptoms and its commonly associated functioning deficits in order to ensure the best long-term outcomes for children with ADHD.
Greenbaum, Judith; Markel, Geraldine
This manual is intended to provide practical guidance to teachers of adolescents with attention deficit hyperactivity disorder (ADHD) and/or learning disabilities (LD) through specific techniques, teaching strategies, checklists, and student case histories. The 12 chapters address the following topics: (1) an overview of ADHD and LD including…
Roy, Mandy; Dillo, Wolfgang; Bessling, Svenja; Emrich, Hinderk M.; Ohlmeier, Martin D.
Objective: Aspergers Syndrome can present as comorbid with attention-deficit/hyperactivity disorder (ADHD). Very few cases of the assessment and treatment of this comorbidity in adulthood are described in the research literature. Method: A 26-year-old patient as suffering from ADHD in combination with Aspergers Syndrome is diagnosed. Treatment is…
Houghton, Stephen; Milner, Nikki; West, John; Douglas, Graham; Lawrence, Vivienne; Whiting, Ken; Tannock, Rosemary; Durkin, Kevin
The motor control of 49 unmedicated boys clinically diagnosed with ADHD, case-matched with 49 non-ADHD boys, was assessed while playing Crash Bandicoot I, a SonyTM Playstation platform computer video game. In Crash Bandicoot participants control the movements of a small-animated figure through a hazardous jungle environment. Operationally defined…
Williamson, Kimberly D; Combs, Hannah L; Berry, David T R; Harp, Jordan P; Mason, Lisa H; Edmundson, Maryanne
Since the early 2000s concern has increased that college students might feign ADHD in pursuit of academic accommodations and stimulant medication. In response, several studies have validated tests for use in differentiating feigned from genuine ADHD. Although results have generally been positive, relatively few publications have addressed the possible impact of the presence of psychological disorders comorbid with ADHD. Because ADHD is thought to have accompanying conditions at rates of 50% and higher, it is important to determine if the additional psychological disorders might compromise the accuracy of feigning detection measures. The present study extended the findings of Jasinski et al. (2011) to examine the efficacy of various measures in the context of feigned versus genuine ADHD with comorbid psychological disorders in undergraduate students. Two clinical groups (ADHD only and ADHD + comorbid psychological disorder) were contrasted with two non-clinical groups (normal controls answering honestly and normal participants feigning ADHD). Extending previous research to individuals with ADHD and either an anxiety or learning disorder, performance validity tests such as the Test of Memory Malingering (TOMM), the Letter Memory Test (LMT), and the Nonverbal Medical Symptom Validity Test (NV-MSVT) were effective in differentiating both ADHD groups from normal participants feigning ADHD. However, the Digit Memory Test (DMT) underperformed in this study, as did embedded validity indices from the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and Woodcock Johnson Tests of Achievement-III (WJ-III).
Morley, Christopher P
The regional study by Baumgardner and colleagues converges with existing literature to clearly show that the distribution of ADHD diagnosis falls along socioeconomic lines, according to the relative wealth of neighborhoods. This adds additional evidence that trends in the diagnosis and treatment for ADHD in children move in the exact opposite direction from those who are at highest risk for meeting criteria, for experiencing impairment, for and downstream socioeconomic sequelae. Contributing factors, such as marginal diagnoses (such as when parent and teacher symptom reports diverge), inadequate insurance coverage, limited time, and lack of familiarity and comfort with diagnostic and prescribing guidelines, may leave the door open to misdiagnosis and treatment. In some cases, this may take the form of over-diagnosis and over-treatment, in the form of false-positive diagnoses with ADHD, and treatments for it, or may alternatively take the form of false-negative diagnoses. If the social and epidemiological data are any indication, it is furthermore likely that such false-positive or false-negative outcomes may break along socioeconomic lines. Increased use of formal screening tools, increased curricular time for mental health in primary care residencies, support for physicians in the field in the form of referral options and remote consultation and support, may all serve to improve quality of care for individual patients, and may also serve to regularize treatment across socioeconomic and sociodemographic lines, hence reducing disparities. Further research is needed to study the root causes and dynamics that create such disparities, but the steps outlined above may help in the near term.
USAARL Report No. 96-05 Injury Risk for Research Subjects With Spina Bifida Occulta in a Repeated Impact Study: A Case Review By John P. Albano...TITLE (Include Security Classification) Injury risk for research subjects with spina bifida occulta in a repeated impact study: A case review 12...block number) FIELD GROUP SUB-GROUP repeated impact, spina bifida occulta, axial loading 19. ABSTRACT (Continue on reverse if necessary and identify by
Evidence suggests that ADHD can impair academic achievement in college students and throughout the life span. College students with ADHD are an at-risk population who might benefit from interventions. An offshoot of CBT-oriented therapy that has grown significantly and gained popularity in recent years is ADHD coaching. ADHD coaching is a psychosocial intervention that helps individuals develop skills, strategies, and behaviors to cope with the core impairments associated with ADHD. Most coaching programs are primarily based on a CBT approach and target planning, time management, goal setting, organization, and problem solving. This paper describes ADHD coaching for college students and discusses how coaching is different from standard CBT treatment. This is followed by a review of empirical studies of the effectiveness of ADHD coaching for college students. Finally, some specific considerations and procedures used in coaching are described.
Østergaard, Søren D.; Larsen, Janne T.; Wilens, Timothy E.; Mortensen, Preben B.; Agerbo, Esben; Mors, Ole; Petersen, Liselotte
Background Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder with early onset. ADHD is associated with significant morbidity and mortality, partly due to delayed diagnosis. Identification of children at high risk for developing ADHD could lead to earlier diagnosis and potentially change the negative trajectory of the illness for the better. Since early psychosocial adversity is considered to be a likely etiological risk factor for ADHD, markers of this construct may be useful for early identification of children at high risk. Therefore, we sought to investigate whether Rutter’s indicators of adversity (low social class, severe marital discord, large family size, paternal criminality, maternal mental disorder, and placement in out-of-home care) assessed in infancy could serve as early predictors for the development of ADHD. Methods and Findings Using data from the Danish nationwide population-based registers, we established a cohort consisting of all 994,407 children born in Denmark between January 1st 1993 and December 31st 2011 and extracted dichotomous values for the six Rutter’s indicators of adversity at age 0–12 months (infancy) for each cohort member. The cohort members were followed from their second birthday and the association between the sum of Rutter’s indicators of adversity (RIA-score) in infancy and subsequent development of ADHD was estimated by means of Cox regression. Also, the number needed to screen (NNS) to detect one case of ADHD based on the RIA-scores in infancy was calculated. During follow-up (9.6 million person-years), 15,857 males and 5,663 females from the cohort developed ADHD. For both males and females, there was a marked dose-response relationship between RIA-scores assessed in infancy and the risk for developing ADHD. The hazard ratios for ADHD were 11.0 (95%CI: 8.2–14.7) and 11.4 (95%CI: 7.1–18.3) respectively, for males and females with RIA-scores of 5–6, compared to males and
The objective of this paper is to outline clinical patient characteristics to individualize medication selection for children and adolescents with ADHD. The treatment guidelines and clinical parameters outlined in this paper are based on clinical research and evidence- and/or consensus-based guidelines for medication treatment of children and adolescents with ADHD and associated symptoms or comorbid disorders. Recommendations are made for medication selection in different clinical situations. The increased availability of ADHD medications over the past few years has provided a number of treatment options with longer symptom control and improved the remission or “multidimensional normalization” for ADHD patients. Selection of the most appropriate medication(s) for complicated cases may present a serious challenge in some situations. This paper outlines selected complicated cases and treatment options. PMID:20532027
Oh, Won-Oak; Kendall, Judy
The purpose of this study was to investigate patterns of parenting in Korean mothers of children with attention-deficit/hyperactivity disorder (ADHD) and identify major threads that structured various patterns of parenting. Q-methodology, a technique for extracting subjective attitudes, was used for data collection and analysis. Participants were asked to sort statements on issues associated with parenting. Factor analysis was applied to identify patterns in the ranking of statements. Participants were 45 Korean mothers of children with ADHD. As a result, three patterns of parenting emerged: Praise-Fairness, Strict-Control, and Sensitive Response-Balanced. These patterns differed on two axes: external and internal control and positive and negative reinforcement. This study provides an opportunity to enhance our understanding of the parenting patterns of mothers of children with ADHD in Korea. The findings can function as a cornerstone for developing future models of parenting children with ADHD and parent-child interactions.
Kleinman, Ronald E; Brown, Ronald T; Cutter, Gary R; Dupaul, George J; Clydesdale, Fergus M
The United Kingdom and European Union recently restricted the use of artificial food colorings (AFCs) to improve the health of children. These decisions provide an interesting case study of the role of scientific evidence in the assessment of food additives and risk to children's health and formulation of food policy. Although there continues to be uncertainty concerning the link between AFCs and attention-deficit/hyperactivity disorder (ADHD), policy decisions have been made that have far-reaching implications. In addition, publicity surrounding the policy changes may shape public perceptions concerning effective management of ADHD. We believe that the balance of existing evidence neither refutes nor supports the link between AFCs and ADHD, which highlights the need for carefully designed studies to further investigate the link between AFCs and ADHD. In this article we describe a model for such studies. In developing our model, we drew from current investigative standards in ADHD research, such as those used in the landmark Multimodal Treatment Study of Children With ADHD. These standards encompass methodologic considerations including sample selection, outcome assessment, and data analyses. It is our hope that this model research methodology may prove valuable in addressing design considerations in future studies of AFCs and ADHD with the goal of producing reliable data that will enable policy-makers to better formulate effective, evidence-based food-policy decisions.
Flory, Kate; Molina, Brooke S. G.; Pelham, William E., Jr.; Gnagy, Elizabeth; Smith, Bradley
This study compared young adults (ages 18 to 26) with and without childhood attention deficit hyperactivity disorder (ADHD) on self-reported risky sexual behaviors. Participants were 175 men with childhood ADHD and 111 demographically similar men without ADHD in the Pittsburgh ADHD Longitudinal Study (PALS). Childhood ADHD predicted earlier…
Fugate, C. Matthew
Unfortunately, there are many students that feel "stupid" in classrooms all around the country. They know they are gifted, but their ADHD and co-occurring conditions can make them feel isolated and alone. This is hard not only for the children, but for the parents who may feel powerless in helping their child know how special he or she…
Wigal, Sharon B.; Emmerson, Natasha; Gehricke, Jean-G.; Galassetti, Pietro
ADHD is the most common neurobehavioral disorder of childhood, presenting with pervasive and impairing symptoms of inattention, hyperactivity, impulsivity, or a combination. The leading hypothesis of the underlying physiology of this disorder of inattention and/or hyperactivity-impulsivity is based on catecholamine dysfunction. Pharmacotherapy…
Adi-Japha, Esther; Landau, Yael E; Frenkel, Lior; Teicher, Mina; Gross-Tsur, Varda; Shalev, Ruth S
Multiple complaints in the domain of writing are common among children with Attention Deficit Hyperactivity Disorder (ADHD). In this work we sought to characterize the writing disorder by studying dysgraphia in twenty 6th grade boys with ADHD and normal reading skills matched to 20 healthy boys who served as a comparison group. Dysgraphia, defined as deficits in spelling and handwriting, was assessed according to neuropsychological explanatory processes within 3 primary domains: linguistic processing, motor programming and motor kinematics. Children with ADHD made significantly more spelling errors, but showed a unique pattern introducing letter insertions, substitutions, transpositions and omissions. This error type, also known as graphemic buffer errors, can be explained by impaired attention aspects needed for motor planning. Kinematic manifestations of writing deficits were fast, inaccurate and an inefficient written product accompanied by higher levels of axial pen pressure. These results suggest that the spelling errors and writing deficits seen in children with ADHD and normal reading skills stem primarily from non-linguistic deficits, while linguistic factors play a secondary role. Recommendations for remediation include educational interventions, use of word processing and judicious use of psychostimulants.
Quinn, Michael; Lynch, Andrea
In many western countries, attention deficit hyperactivity disorder (ADHD) has achieved celebrity status, such that it probably no longer requires introduction. The disorder is a global phenomenon, spreading rapidly as result of the increasing dominance internationally of US psychiatric models, the need for new markets for major pharmaceutical…
Fasmer, Ole Bernt; Riise, Trond; Lund, Anders; Dilsaver, Steven C.; Hundal, Oivind; Oedegaard, Ketil J.
Objective: The purpose of this study was to investigate how often drugs used to treat migraine and ADHD are prescribed to the same patients to assess, indirectly, the comorbidity of these disorders. Method: We used data from the Norwegian prescription database for 2006, including the total Norwegian population (N = 4,640,219). Results:…
Fasmer, Ole Bernt; Riise, Trond; Eagan, Tomas Mikal; Lund, Anders; Dilsaver, Steven C.; Hundal, Oivind; Oedegaard, Ketil J.
Objective: To assess how frequently drugs used to treat asthma and ADHD are prescribed to the same patients. Method: The authors used data from the Norwegian Prescription Database for 2006, including the total Norwegian population (n = 4,640,219). Results: Anti-asthma drugs were prescribed to 350,894 persons (7.56 % of the population), anti-ADHD…
Egeland, Jens; Ueland, Torill; Johansen, Susanne
Participants with attention-deficit/hyperactivity disorder (ADHD) are often impaired in visuomotor tasks. However, little is known about the contribution of modal impairment in motor function relative to central processing deficits or whether different processes underlie the impairment in ADHD combined (ADHD-C) versus ADHD inattentive (ADHD-I)…
Wymbs, Brian T; Dawson, Anne E; Egan, Theresa E; Sacchetti, Gina M; Tams, Sean T; Wymbs, Frances A
Parents of children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) often have elevated ADHD and depressive symptoms, both of which increase the risk of ineffective parenting and interparental discord. However, little is known about whether child ADHD/ODD behavior and parent ADHD or depressive symptoms uniquely or synergistically predict the quality of parenting and interparental communication during triadic (mother-father-child) interactions. Ninety parent couples, including 51 who have children diagnosed with ADHD, were randomly assigned to interact with a 9-12 year-old confederate child (84 % male) exhibiting either ADHD/ODD-like behavior or typical behavior. Parents reported their own ADHD and depressive symptoms, and parents and observers rated the quality of parenting and interparental communication during the interaction. Actor-partner interdependence modeling indicated that child ADHD/ODD behavior predicted less positive and more negative parenting and communication, independent of adult ADHD and depressive symptoms. Parent couples including two parents with elevated ADHD communicated more positively while managing children exhibiting ADHD/ODD behavior than couples managing children behaving typically or couples with only one parent with elevated ADHD symptoms. Couples including one parent with, and one parent without, elevated ADHD or depressive symptoms parented less positively and more negatively, and communicated more negatively, when managing children exhibiting ADHD/ODD behavior than when managing children behaving typically. Taken together, depending on the similarity of ADHD and depressive symptom levels in parent couples, adults managing children exhibiting ADHD/ODD behavior may parent or communicate positively or negatively. Findings highlight the need to consider the psychopathology of both parents when treating children with ADHD in two-parent homes.
Fayyad, John; Sampson, Nancy A; Hwang, Irving; Adamowski, Tomasz; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Andrade, Laura H S G; Borges, Guilherme; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hu, Chiyi; Karam, Elie G; Lee, Sing; Navarro-Mateu, Fernando; O'Neill, Siobhan; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Ten Have, Margreet; Torres, Yolanda; Xavier, Miguel; Zaslavsky, Alan M; Kessler, Ronald C
We previously reported on the cross-national epidemiology of ADHD from the first 10 countries in the WHO World Mental Health (WMH) Surveys. The current report expands those previous findings to the 20 nationally or regionally representative WMH surveys that have now collected data on adult ADHD. The Composite International Diagnostic Interview (CIDI) was administered to 26,744 respondents in these surveys in high-, upper-middle-, and low-/lower-middle-income countries (68.5% mean response rate). Current DSM-IV/CIDI adult ADHD prevalence averaged 2.8% across surveys and was higher in high (3.6%)- and upper-middle (3.0%)- than low-/lower-middle (1.4%)-income countries. Conditional prevalence of current ADHD averaged 57.0% among childhood cases and 41.1% among childhood subthreshold cases. Adult ADHD was significantly related to being male, previously married, and low education. Adult ADHD was highly comorbid with DSM-IV/CIDI anxiety, mood, behavior, and substance disorders and significantly associated with role impairments (days out of role, impaired cognition, and social interactions) when controlling for comorbidities. Treatment seeking was low in all countries and targeted largely to comorbid conditions rather than to ADHD. These results show that adult ADHD is prevalent, seriously impairing, and highly comorbid but vastly under-recognized and undertreated across countries and cultures.
Terbeck, Sylvia; Chesterman, L Paul
The objective of this study is to examine the potential impact of using the internet on medical consultations by analysing the attitudes, attributions, and emotional responses of parents who have been informed by specialists that their child does not have attention-deficit hyperactivity disorder (ADHD) and to examine the nature of the feedback they obtained from members of online internet support groups. Over 40,000 messages from the five most popular international internet forums discussing children with ADHD were analysed. Messages from parents who reported that they had seen at least one specialist (e.g. paediatrician, psychiatrist or psychologist) because of their concerns that their child had ADHD were identified. The children included boys and girls with an age range from 2 to 16 years. Of these, we analysed messages where the parents additionally reported that the specialist had excluded a diagnosis of ADHD. Using these criteria, 91 messages from parents who had consulted over 200 different specialists and 398 replies to these messages were identified for content analysis. The replies to concerned parents were analysed to determine whether they were offered impartial advice. A majority of the parents reported that they did not believe the specialist and were unhappy about their child not being diagnosed with ADHD. They expressed dissatisfaction with the professional's opinions and the implication that their child's conduct was caused by their poor parenting skills. Importantly, 87.6 % of the responses that these parents received, from other members of online forums, reinforced the parent's negative attitude towards the professional's judgement. It was generally suggested that the parents should not believe the expert and should seek a further opinion. The use of the internet may encourage "doctor shopping" and mistrust in health services. Medical professionals and others may need to be aware of this, and parents may need more support than is generally
Background Anger is an ignored research area in children and young adolescents with Attention deficit hyperactivity disorder (ADHD) in the school setting. This study compares school anger dimensions in children and young adolescents with ADHD and a control group. Methods The subjects were a clinical sample of 67 children and young adolescents with ADHD and their parents, with a sample of 91 children from the community of similar age and gender as control group. Anger was measured by the Farsi version of the Multidimensional School Anger Inventory (MSAI). Results The scores of the two components of "Hostile Outlook" and "Positive Coping" were different between the groups. The mean scores for the Anger components did not statistically differ between the children with ADHD and ODD and ADHD without ODD, boys and girls, or different types of ADHD. Conclusion Children with ADHD do not report higher rates of experience of anger and they do not apply destructive strategies more than the control group. However, children with ADHD appear to have a more hostile outlook toward school and their coping strategy is weaker than that of the control group. PMID:20205823
Geissler, Julia M; Romanos, Marcel; Gerlach, Manfred; Berg, Daniela; Schulte, Claudia
Attention-deficit/hyperactivity disorder (ADHD) and Parkinson's disease (PD) involve pathological changes in brain structures such as the basal ganglia, which are essential for the control of motor and cognitive behavior and impulsivity. The cause of ADHD and PD remains unknown, but there is increasing evidence that both seem to result from a complicated interplay of genetic and environmental factors affecting numerous cellular processes and brain regions. To explore the possibility of common genetic pathways within the respective pathophysiologies, nine ADHD candidate single nucleotide polymorphisms (SNPs) in seven genes were tested for association with PD in 5333 cases and 12,019 healthy controls: one variant, respectively, in the genes coding for synaptosomal-associated protein 25 k (SNAP25), the dopamine (DA) transporter (SLC6A3; DAT1), DA receptor D4 (DRD4), serotonin receptor 1B (HTR1B), tryptophan hydroxylase 2 (TPH2), the norepinephrine transporter SLC6A2 and three SNPs in cadherin 13 (CDH13). Information was extracted from a recent meta-analysis of five genome-wide association studies, in which 7,689,524 SNPs in European samples were successfully imputed. No significant association was observed after correction for multiple testing. Therefore, it is reasonable to conclude that candidate variants implicated in the pathogenesis of ADHD do not play a substantial role in PD.
Hurtig, Tuula; Ebeling, Hanna; Taanila, Anja; Miettunen, Jouko; Smalley, Susan L.; McGough, James J.; Loo, Sandra K.; Jarvelin, Marjo-Riitta; Moilanen, Irma K.
A study aims to examine attention-deficit/hyperactivity disorder(ADHD) symptoms and subtypes in childhood and adolescence. The results conclude the persistence of ADHD from childhood to adolescence with specific symptoms contributing to persistent ADHD.
To assess whether the writing styles of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) combined type differ significantly from those of children in a nonclinical control group, writing samples from 17 children with ADHD combined type and 18 children in a nonclinical control group were compared using the language analysis program Korean Linguistic Inquiry and Word Count. These writing samples, produced in response to instructions, served as dependent variables. Analysis showed that children with ADHD used fewer linguistic variables (e.g., sentences, phrases, and morphemes) than the control group. In addition, the ADHD group used fewer words reflecting cognitive processes and fewer pronouns than members of the control group. Also, the ADHD group showed a different pattern in the use of words referring to friends. This study provides preliminary descriptive data on language use among children diagnosed with a main subtype of ADHD.
Mayes, S D; Calhoun, S L; Crowell, E W
Clinical and psychoeducational data were analyzed for 119 children ages 8 to 16 years who were evaluated in a child diagnostic clinic. A learning disability (LD) was present in 70% of the children with attention-deficit/hyperactivity disorder (ADHD), with a learning disability in written expression two times more common (65%) than a learning disability in reading, math, or spelling. Children with LD and ADHD had more severe learning problems than children who had LD but no ADHD, and the former also had more severe attention problems than children who had ADHD but no LD. Further, children with ADHD but no LD had some degree of learning problem, and children with LD but no ADHD had some degree of attention problem. Results suggest that learning and attention problems are on a continuum, are interrelated, and usually coexist.
Antshel, Kevin M.; Faraone, Stephen V.; Fremont, Wanda; Monuteaux, Michael C.; Kates, Wendy R.; Doyle, Alysa; Mick, Eric; Biederman, Joseph
Objective: Background: Children with velocardiofacial syndrome (VCFS), a contiguous deletion syndrome, have an increased prevalence of attention deficit/hyperactivity disorder (ADHD). Method: The authors compared youth with VCFS+ADHD (from the SUNY Upstate VCFS Research Program) to those with ADHD but not VCFS (from the Massachusetts General…
Ashwood, Karen L.; Tye, Charlotte; Azadi, Bahare; Cartwright, Sally; Asherson, Philip; Bolton, Patrick
Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Children with ASD and ADHD demonstrate deficits in adaptive functioning, yet pure and comorbid groups have not been directly compared. Vineland Adaptive Behaviour Scales (VABS-II) data were examined in boys with ASD (n = 17), ADHD (n = 31) and…
Bink, M.; Popma, A.; Bongers, I. L.; van Boxtel, G. J. M.; Denissen, A.; van Nieuwenhuizen, Ch.
A large number of youngsters with autism spectrum disorders (ASD) display comorbid attention deficit/hyperactivity disorder (ADHD) symptoms. However, previous studies are not conclusive whether psychophysiological correlates, like cardiac reactivity, are different for ASD with comorbid ADHD (ASD+) compared to ADHD. Therefore, the current study…
Grzadzinski, Rebecca; Di Martino, Adriana; Brady, Emily; Mairena, Maria Angeles; O'Neale, Matthew; Petkova, Eva; Lord, Catherine; Castellanos, F. Xavier
We examined to what extent increased parent reports of autistic traits in some children with Attention Deficit Hyperactivity Disorder (ADHD) are the result of ADHD-related symptoms or qualitatively similar to the core characteristics of autism spectrum disorders (ASD). Results confirm the presence of a subgroup of children with ADHD and elevated…
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
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.
Chamberlain, Samuel R.; Ioannidis, Konstantinos; Leppink, Eric W.; Niaz, Faiza; Redden, Sarah A.; Grant, Jon E.
Objective Attention-Deficit Hyperactivity Disorder (ADHD) has been associated with various manifestations of impulsivity in adults, including elevated rates of other impulsive disorders, substance use, questionnaire-based impulsivity scores, and inhibitory dysregulation on neurocognitive tests. The relationship between ADHD and all these other forms of impulsivity have yet to be explored within the context of a single comprehensive study. Methods 423 young adults, who gambled ≥5 times in the preceding year, were recruited using media advertisements and undertook detailed assessment including structured psychiatric interview, questionnaires, and neurocognitive tests. Participants with ADHD symptoms were identified using the Adult ADHD Self-Report Scale Screener (ASRS-V1.1) and were compared to controls using multivariate analysis of variance (MANOVA). Results ADHD symptoms were found in 20.3% of the sample, but only 7.3% of these subjects had ever received a formal diagnosis. ADHD symptoms were associated with significantly lower quality of life, lower self-esteem, higher emotional dysregulation, higher impulsivity-compulsivity questionnaire scores, more problematic internet use, greater occurrence of psychiatric disorders, and impaired stop-signal reaction times. Of these variables, stop-signal reaction times and Barratt attentional impulsiveness were the strongest predictors of group classification. Conclusions ADHD symptoms are common and under-diagnosed in young adults who gamble, and are most strongly linked with certain other types of impulsivity (questionnaire- and cognitive-based measures) and with emotional dysregulation, suggesting that these are each important considerations in understanding the pathophysiology of the disorder, but also potential treatment targets. It is necessary to question whether treatment for adult ADHD could be enhanced by considering self-esteem, emotional reactivity, and impaired inhibitory control as specific treatment targets
Solmaz, Berkan; Dey, Soumyabrata; Rao, A. Ravishankar; Shah, Mubarak
Attention Deficit Hyperactivity Disorder (ADHD) is receiving lots of attention nowadays mainly because it is one of the common brain disorders among children and not much information is known about the cause of this disorder. In this study, we propose to use a novel approach for automatic classification of ADHD conditioned subjects and control subjects using functional Magnetic Resonance Imaging (fMRI) data of resting state brains. For this purpose, we compute the correlation between every possible voxel pairs within a subject and over the time frame of the experimental protocol. A network of voxels is constructed by representing a high correlation value between any two voxels as an edge. A Bag-of-Words (BoW) approach is used to represent each subject as a histogram of network features; such as the number of degrees per voxel. The classification is done using a Support Vector Machine (SVM). We also investigate the use of raw intensity values in the time series for each voxel. Here, every subject is represented as a combined histogram of network and raw intensity features. Experimental results verified that the classification accuracy improves when the combined histogram is used. We tested our approach on a highly challenging dataset released by NITRC for ADHD-200 competition and obtained promising results. The dataset not only has a large size but also includes subjects from different demography and edge groups. To the best of our knowledge, this is the first paper to propose BoW approach in any functional brain disorder classification and we believe that this approach will be useful in analysis of many brain related conditions.
Landaas, Elisabeth Toverud; Aarsland, Tore Ivar Malmei; Ulvik, Arve; Halmøy, Anne; Ueland, Per Magne; Haavik, Jan
Background Micronutrients containing vitamins are reported to reduce symptom levels in persons with attention-deficit hyperactivity disorder (ADHD), but data on vitamin levels in ADHD are sparse. Aims To examine the relationship between vitamin concentrations, ADHD diagnosis and psychiatric symptoms in young adult ADHD patients and controls. Method Eight vitamins and the nicotine metabolite cotinine were analysed in serum samples from 133 ADHD patients and 131 controls aged between 18 and 40, who also reported ADHD symptoms and comorbid conditions. Results Lower concentrations of vitamins B2, B6 and B9 were associated with the ADHD diagnosis, and B2 and B6 also with symptom severity. Smokers had lower levels of vitamins B2 and B9. Conclusions ADHD patients were overrepresented in the group with low levels of some vitamins, possibly indicative of inadequate dietary intake of these micronutrients in a subgroup of patients. It is important to identify these patients in dietary intervention trials of ADHD. Declaration of interest J.H. has received lecture honoraria as part of continuing medical education programmes sponsored by Novartis, Eli Lilly and Company, and Janssen-Cilag. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27990293
Kibby, Michelle Y.; Kroese, Judith M.; Krebbs, Hillery; Hill, Crystal E.; Hynd, George W.
Limited research has been conducted on the structure of the pars triangularis (PT) in dyslexia despite functional neuroimaging research finding it may play a role in phonological processing. Furthermore, research to date has not examined PT size in ADHD even though the right inferior frontal region has been implicated in the disorder. Hence, one of the purposes of this study was to examine the structure of the PT in dyslexia and ADHD. The other purposes included examining the PT in relation to overall expressive language ability and in relation to several specific linguistic functions given language functioning often is affected in both dyslexia and ADHD. Participants included 50 children: 10 with dyslexia, 15 with comorbid dyslexia/ADHD, 15 with ADHD, and 10 controls. Using a 2 (dyslexia or not) X 2 (ADHD or not) MANCOVA, findings revealed PT length and shape were comparable between those with and without dyslexia. However, children with ADHD had smaller right PT lengths than those without ADHD, and right anterior ascending ramus length was related to attention problems in the total sample. In terms of linguistic functioning, presence of an extra sulcus in the left PT was related to poor expressive language ability. In those with adequate expressive language functioning, left PT length was related to phonological awareness, phonological short-term memory and rapid automatic naming (RAN). Right PT length was related to RAN and semantic processing. Further work on PT morphology in relation to ADHD and linguistic functioning is warranted. PMID:19356794
Fenollar-Cortés, Javier; Fuentes, Luis J.
Introduction: Although the critical feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity/impulsivity behavior, the disorder is clinically heterogeneous, and concomitant difficulties are common. Children with ADHD are at increased risk for experiencing lifelong impairments in multiple domains of daily functioning. In the present study we aimed to build a brief ADHD impairment-related tool -ADHD concomitant difficulties scale (ADHD-CDS)- to assess the presence of some of the most important comorbidities that usually appear associated with ADHD such as emotional/motivational management, fine motor coordination, problem-solving/management of time, disruptive behavior, sleep habits, academic achievement and quality of life. The two main objectives of the study were (i) to discriminate those profiles with several and important ADHD functional difficulties and (ii) to create a brief clinical tool that fosters a comprehensive evaluation process and can be easily used by clinicians. Methods: The total sample included 399 parents of children with ADHD aged 6–18 years (M = 11.65; SD = 3.1; 280 males) and 297 parents of children without a diagnosis of ADHD (M = 10.91; SD = 3.2; 149 male). The scale construction followed an item improved sequential process. Results: Factor analysis showed a 13-item single factor model with good fit indices. Higher scores on inattention predicted higher scores on ADHD-CDS for both the clinical sample (β = 0.50; p < 0.001) and the whole sample (β = 0.85; p < 0.001). The ROC curve for the ADHD-CDS (against the ADHD diagnostic status) gave an area under the curve (AUC) of.979 (95%, CI = [0.969, 0.990]). Discussion: The ADHD-CDS has shown preliminary adequate psychometric properties, with high convergent validity and good sensitivity for different ADHD profiles, which makes it a potentially appropriate and brief instrument that may be easily used by clinicians, researchers, and
Cohen-Zion, Mairav; Ancoli-Israel, Sonia
Attention-Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder of childhood. Multiple clinical and research reports suggest extensive sleep disturbances in children with ADHD, however, current data is contradictory. This paper reviewed 47 research studies (13 stimulant intervention and 34 naturalistic) on ADHD that were published since 1980. The main objectives of this review were to provide pediatric clinicians and researchers a clear and concise summary of published sleep data in children with ADHD, to provide a more accurate description of the current knowledge of the relationship between sleep and ADHD, and to provide current information on the effect of stimulant medication on sleep. Twenty-five of the reviewed studies used subjective reports of sleep, six were actigraphic studies, and 16 were overnight polysomnographic sleep studies (two of which also included Multiple Sleep Latency Tests). All participants were between the age of 3 and 19, and 60% were male. The results indicate high rates of parental reports of sleep disturbances in medicated and unmedicated children with ADHD, however, the majority of these findings have not been confirmed by objective sleep data. Although, agreement among objective studies is not absolute, the data suggest increased nighttime activity, reduced rapid eye movement sleep, and significant daytime somnolence in unmedicated children with ADHD when compared to controls. Data also suggest a possible increased prevalence of periodic limb movements in sleep in children with ADHD, however, little differences in sleep-disordered breathing. The limited number of studies, small and heterogeneous samples, and other methodological limitations make definite results difficult to determine. Future research will need to further clarify the relationship between sleep and ADHD and the effects of stimulants on sleep of children with ADHD.
Case study rhetoric, or the rhetoric of real experience, is concerned with the ways by which case studies appeal to their own intrinsic realness or authenticity. On the surface, case studies are often accepted fully as representing real experience. But the design, arrangement, and emphases of case studies are rhetorically constructed by the writer…
Mitchell, David; Lambert, David
This article discusses how subject knowledge development should be conceptualised in the preparation of new secondary school teachers. It is written at a moment of national curriculum revision in England and a "knowledge turn" in education, bringing questions of subject knowledge development to the fore. The authors argue that the…
This article addresses the question of how to systematically determine the degree of subjectivity expressed in a text, more specifically, the degree of subjectivity expressed in causal coherence relations. The main hypothesis is that the distribution of Dutch backward causal connectives (want, omdat, aangezien, and doordat) can be explained by the…
Purpose: To share the experiences and challenges faced by the Open University Library (OUL) in developing a content management (CM) system for its subject guides. Design/methodology/approach: A summary of multi-format subject guide production at the OUL is provided to justify the decision to develop a new system for their production using a…
Wang, Qi; Zhang, Mu; Luo, Jing
There exists mutual improvement and restriction between regional tourism industry and the development of the tourism subject. With the rapid development of the tourism industry, it has set up the tourism program in the universities of Yunnan Province. However, the regional development of the construction of tourism subject is not balanced and its…
Bolte, Sven; Knecht, Susan; Poustka, Fritz
To probe the specificity of traits that might be conceptualised as the broader phenotype of autism, parents of subjects with autism from simplex and multiplex families as well as parents of subjects with obsessive-compulsive disorders (OCD), early onset schizophrenia (EOS) and mental retardation (MR) were assessed using the Personality Style and…
Wakeham, Maurice; Roberts, Angharad; Shelley, Jane; Wells, Paul
This paper describes the process whereby a university library investigated the value of its subject guides to its users. A literature review and surveys of library staff, library users and other libraries were carried out. Existing library subject guides and those of other higher education libraries were evaluated. The project team reported…
Rodríguez, Celestino; González-Castro, Paloma; Cueli, Marisol; Areces, Debora; González-Pienda, Julio A.
Attention deficit with, or without, hyperactivity and impulsivity (ADHD) is categorized as neuro-developmental disorder. ADHD is a common disorder in childhood and one of the most frequent conditions affecting school ages. This disorder is characterized by a persistent behavioral pattern associated with inattention, over-activity (or hyperactivity), and difficulty in controlling impulses. Current research suggests the existence of certain patterns of cortical activation and executive control, which could more objectively identify ADHD. Through the use of a risk and resilience model, this research aimed to analyze the interaction between brain activation variables (nirHEG and Q-EEG) and executive variables (Continuous performance test -CPT-) in subjects with ADHD. The study involved 499 children, 175 females (35.1%) and 324 males (64.91%); aged from 6 to 16 years (M = 11.22, SD = 1.43). Two hundred and fifty six of the children had been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and 243 were without ADHD. For the analysis of this objective, a causal model was designed to include the following different measures of task-execution: CPT TOVA (omissions, commissions, response time, variability, D prime and the ADHD Index); electrical activity (using Q-EEG); and blood-flow oxygenation activity (using nirHEG). The causal model was tested by means of structural equation modeling (SEM). The model that had been constructed was based upon three general assumptions: (1) There are different causal models for children with ADHD and those without ADHD; (2) The activation measures influence students’ executive performance; and (3) There are measurable structural differences between the ADHD and control group models (executive and activation). In general, the results showed that: (a) activation measures influence executive patterns differently, (b) the relationship between activation variables (nirHEG and Q-EEG) depends on the brain zone being studied, (c
The article presents a perspective on the scientific explanation of the subjectivity of conscious experience. It proposes plausible answers for two empirically valid questions: the ‘how’ question concerning the developmental mechanisms of subjectivity, and the ‘why’ question concerning its function. Biological individuation, which is acquired in several different stages, serves as a provisional description of how subjective perspectives may have evolved. To the extent that an individuated informational space seems the most efficient way for a given organism to select biologically valuable information, subjectivity is deemed to constitute an adaptive response to informational overflow. One of the possible consequences of this view is that subjectivity might be (at least functionally) dissociated from consciousness, insofar as the former primarily facilitates selection, the latter action. PMID:27555835
Palleschi, G M; Cipollini, E M; Lotti, T
We present the case of a 50-year-old-man with pemphigus vulgaris involving the oropharyngolaryngeal mucosa and oesophagus. Oesophageal involvement of pemphigus vulgaris is relatively uncommon, especially in subjects in clinical remission, and has been rarely described in the literature. Endoscopic examination should be performed to avoid inappropriate therapy due to misdiagnosis of steroid-induced oesophagitis and peptic ulcers.
Egeland, Jens; Ueland, Torill; Johansen, Susanne
Participants with attention-deficit/hyperactivity disorder (ADHD) are often impaired in visuomotor tasks. However, little is known about the contribution of modal impairment in motor function relative to central processing deficits or whether different processes underlie the impairment in ADHD combined (ADHD-C) versus ADHD inattentive (ADHD-I) subtype. The present study analyzes performance on the Visual Motor Integration Test relative to less effortful motor tests as well as on measures of energetics. Both ADHD groups showed evidence of impaired motor function on both visual-motor integration (VMI) and the less effortful motor tests. The ADHD-C group performed below the ADHD-I group on VMI, but their performance correlated highly with the measures of the energetic pools of arousal and effort. Different mechanisms may underlie impaired fine motor skills in ADHD. Central processing deficits contribute significantly to the deficit of ADHD-C but do not explain the motor impairment in ADHD-I.
Wymbs, Brian T; Wymbs, Frances A; Dawson, Anne E
Attention-deficit hyperactivity disorder (ADHD) in children and adults increases risk of parenting difficulties and interparental discord. However, little is known about whether disruptive child behavior and adult ADHD operate additively or synergistically to predict parenting and interparental relationship quality. As part of a larger study, 90 parent couples were randomly assigned to interact with a 9-12 year-old confederate child exhibiting either ADHD/ODD-like behavior or typical behavior. Before these interactions, parents reported their own ADHD symptoms. Afterwards, parents reported on their partner's parenting and interparental communication behavior. Observers coded the parenting and communication behavior of both partners during the tasks. Child ADHD/ODD-like behavior was found to predict less positive and more negative parenting and communication reported by partners and observers beyond adult ADHD symptoms and other covariates. Elevated adult ADHD symptoms only uniquely increased risk of observer-coded negative parenting. Child and adult ADHD behavior interacted synergistically to predict partner-reported negative parenting and interparental communication, such that parents reporting greater ADHD symptoms-especially inattentiveness-were rated by their partners as parenting and communicating more negatively when managing child ADHD/ODD-like behavior than parents with fewer ADHD symptoms or those managing typical child behavior. Child and adult ADHD behavior did not interact to predict observer-coded parenting or interparental communication, and patterns did not differ for mothers or fathers. Our results underscore the potential risk of parents with elevated ADHD symptoms parenting and communicating negatively, at least as perceived by their partners, during interactions with children exhibiting ADHD/ODD behavior.
Breaux, Rosanna P; Brown, Hallie R; Harvey, Elizabeth A
The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children's ADHD.
Cohen, Elizabeth F; Morley, Christopher P
The diagnosis of attention-deficit hyperactivity disorder is a subject of controversy, for a host of reasons. This paper seeks to explore the manner in which children's interests may be subsumed to those of parents, teachers, and society as a whole in the course of diagnosis, treatment, and labeling, utilizing a framework for children's citizenship proposed by Elizabeth Cohen. Additionally, the paper explores aspects of discipline associated with the diagnosis, as well as distributional pathologies resulting from the application of the diagnosis in potentially biased ways.
Cohen, Elizabeth F.
The diagnosis of attention-deficit hyperactivity disorder is a subject of controversy, for a host of reasons. This paper seeks to explore the manner in which children's interests may be subsumed to those of parents, teachers, and society as a whole in the course of diagnosis, treatment, and labeling, utilizing a framework for children's citizenship proposed by Elizabeth Cohen. Additionally, the paper explores aspects of discipline associated with the diagnosis, as well as distributional pathologies resulting from the application of the diagnosis in potentially biased ways. PMID:19251776
Weyandt, Lisa L; Oster, Danielle R; Marraccini, Marisa E; Gudmundsdottir, Bergljot Gyda; Munro, Bailey A; Zavras, Brynheld Martinez; Kuhar, Ben
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, hyperactivity, and impulsivity that cause functional impairment. Recent research indicates that symptoms persist into adulthood in the majority of cases, with prevalence estimates of approximately 5% in the school age population and 2.5%–4% in the adult population. Although students with ADHD are at greater risk for academic underachievement and psychosocial problems, increasing numbers of students with ADHD are graduating from high school and pursuing higher education. Stimulant medications are considered the first line of pharmacotherapy for individuals with ADHD, including college students. Although preliminary evidence indicates that prescription stimulants are safe and effective for college students with ADHD when used as prescribed, very few controlled studies have been conducted concerning the efficacy of prescription stimulants with college students. In addition, misuse of prescription stimulants has become a serious problem on college campuses across the US and has been recently documented in other countries as well. The purpose of the present systematic review was to investigate the efficacy of prescription stimulants for adolescents and young adults with ADHD and the nonmedical use and misuse of prescription stimulants. Results revealed that both prostimulant and stimulant medications, including lisdexamfetamine dimesylate, methylphenidate, amphetamines, and mixed-amphetamine salts, are effective at reducing ADHD symptoms in adolescents and adults with ADHD. Findings also suggest that individuals with ADHD may have higher rates of stimulant misuse than individuals without the disorder, and characteristics such as sex, race, use of illicit drugs, and academic performance are associated with misuse of stimulant medications. Results also indicate that individuals both with and without ADHD are more likely to misuse short-acting agents
Meeting the academic needs of a student with Attention Deficit Hyperactivity Disorder (ADHD) can be taxing on teachers and students. This research highlights classroom management strategies that general education teachers might include in their teaching to support the academic growth students with ADHD, while continuing to support all students in…
Martin, Callie; Dunham, Mardis; Patel, Samir H.; Contreras-Bloomdahl, Susana
"The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)," requires that symptoms of ADHD must be "developmentally inappropriate" in order for an ADHD diagnosis to be considered. Because the DSM-5 does not specifically outline procedure for determining developmental inappropriateness of behaviors,…
Orendorff, Kimberly A.
Attention Deficit Hyperactivity Disorder (ADHD) is a common disorder that is often identified when a child first enters school. About 2% of boys and girls in our population are diagnosed with the disorder (Kaufmann, 2000). Although ADHD is the most frequent reason that children are referred to a mental health professional, the diagnosis of ADHD…
ADHD covers a group of common, chronic neurodevelopmental disorders characterised by developmentally abnormal and disabling levels of restlessness and overactivity (usually combined with impulsiveness) and/or inattention. There are three subtypes of ADHD: predominantly inattentive; predominantly hyperactive-impulsive; and combined type. For a diagnosis of ADHD to be made: onset of symptoms has to occur before the age of seven, symptoms should have been present longer than 6 months and they must be causing significant impairment. The prevalence of ADHD is at least 5%. Two-thirds of children with ADHD continue to have symptoms in adolescence. At the age of 25, half will still have symptoms which continue to cause significant impairment. ADHD is associated with an increased rate of other disorders: mood disorders; anxiety; other behavioural disorders; autism spectrum disorders; tic disorders; specific learning difficulties; developmental co-ordination disorder and sleep disorders. The GP has an important role in identification of possible ADHD, and onward referral, and also in the management of ADHD post-diagnosis, particularly with respect to prescribing medication usually on a shared care basis with specialist services.
Sollman, Myriam J.; Ranseen, John D.; Berry, David T. R.
Significant motivations and incentives exist for young-adult students to seek a diagnosis of attention-deficit/hyperactivity disorder (ADHD). With ADHD information readily accessible on the Internet, today's students are likely to be symptom educated prior to evaluation. This may result in false-positive diagnoses, particularly when students are…
Mullet, Dianna R.; Rinn, Anne N.
Some gifted children suffer from Attention Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder that impairs a child's functioning. For a diagnosis of ADHD, children under the age of 17 must display at least six symptoms of inattention or hyperactivity/impulsivity in at least two different settings (school and home, for example),…
DuPaul, George J.; White, George P.
The authors describe three types of ADHD behavior that affect from 3 percent to 7 percent of elementary school children, mostly boys. They recommend supplementing stimulant medication with behavior modification strategies, at home and school, to improve ADHD students' social skills and school performance.
Objective: Antidepressants, in particular Atomextine, along with stimulants have demonstrated benefit in the treatment of ADHD. Agomelatine is a new antidepressant with additional affinities to the melatonergic system. As ADHD has been associated with sleep disorders, it is assumed that Agomelatiine might serve as a therapeutic alternative to…
Montyla, Timo; Still, Johanna; Gullberg, Stina; Del Missier, Fabio
Objectives: This study examined decision-making competence in ADHD by using multiple decision tasks with varying demands on analytic versus affective processes. Methods: Adults with ADHD and healthy controls completed two tasks of analytic decision making, as measured by the Adult Decision-Making Competence (A-DMC) battery, and two affective…
This paper reports a small-scale study to determine whether there is a difference in problem-solving abilities, from a play perspective, between individuals who are diagnosed as ADHD and are on medication and those not on medication. Ten children, five of whom where on medication and five not, diagnosed as ADHD predominantly inattentive type, were…
Luman, Marjolein; Oosterlaan, Jaap; Hyde, Christopher; van Meel, Catharina S.; Sergeant, Joseph A.
Background: Both theoretical and clinical accounts of attention-deficit/hyperactivity disorder (ADHD) implicate a dysfunctional reinforcement system. This study investigated heart rate parameters in response to feedback associated with reward and response cost in ADHD children and controls aged 8 to 12. Methods: Heart rate responses (HRRs)…
Antshel, Kevin M.; Nastasi, Robert
An aspect of metacognition, metamemory (knowledge and awareness of one's memory) was investigated across time in preschool children with ADHD (n = 31) and a sample of age, sex, socioeconomic and IQ-matched typically developing children (n = 31). Only children with stable ADHD diagnoses were included. Participants were assessed on a variety of…
Reimherr, Frederick W.; Marchant, Barrie K.; Olsen, John L.; Wender, Paul H.; Robison, Reid J.
Objective: Oppositional defiant disorder (ODD) is the most common comorbid condition in childhood ADHD. This trial was prospectively designed to explore ODD symptoms in ADHD adults. Method: A total of 86 patients in this placebo-controlled, double-blind trial of methylphenidate transdermal system (MTS) were categorized based on the presence of ODD…
Stevenson, Jim; Asherson, Phil; Hay, David; Levy, Florence; Swanson, Jim; Thapar, Anita; Willcutt, Erik
The genetic study of ADHD has made considerable progress. Further developments in the field will be reliant in part on identifying the most appropriate phenotypes for genetic analysis. The use of both categorical and dimensional measures of symptoms related to ADHD has been productive. The use of multiple reporters is a valuable feature of the…
Hale, T. Sigi; Loo, Sandra K.; Zaidel, Eran; Hanada, Grant; Macion, James; Smalley, Susan L.
Introduction: Early observations from lesion studies suggested right hemisphere (RH) dysfunction in ADHD. However, a strictly right-lateralized deficit has not been well supported. An alternatively view suggests increased R greater than L asymmetry of brain function and abnormal interhemispheric interaction. If true, RH pathology in ADHD should…
Knouse, Laura E.; Mitchell, John T.
Clinicians who conduct cognitive-behavioral therapy (CBT) targeting attention-deficit/hyperactivity disorder (ADHD) in adulthood have noted that their patients sometimes verbalize overly positive automatic thoughts and set overly optimistic goals. These cognitions are frequently related to failure to engage in compensatory behavioral strategies emphasized in CBT. In this paper, we offer a functional analysis of this problematic pattern, positively-valenced cognitive avoidance, and suggest methods for addressing it within CBT for adult ADHD. We propose that maladaptive positive cognitions function to relieve aversive emotions in the short-term and are therefore negatively reinforced but that, in the long-term, they are associated with decreased likelihood of active coping and increased patterns of behavioral avoidance. Drawing on techniques from Behavioral Activation (BA), we offer a case example to illustrate these concepts and describe step-by-step methods for clinicians to help patients recognize avoidant patterns and engage in more active coping. PMID:25908901
Aperecida da Silva, Maria; Cordeiro, Quirino; Louza, Mario; Vallada, Homero
Objective: To investigate a possible association between a 3'UTR VNTR polymorphism of the dopamine transporter gene (SLC6A3) and ADHD in a Brazilian sample of adult patients. Method: Study Case-control with 102 ADHD adult outpatients ("DSM-IV" criteria) and 479 healthy controls. The primers' sequence used were: 3'UTR-Forward: 5' TGT GGT…
Connolly, JJ; Glessner, JT; Elia, J; Hakonarson, H
Attention deficit hyperactivity disorder (ADHD) is the most common neurobiological disorder in children, with a prevalence of ~6–7%1,2 that has remained stable for decades2. The social and economic burden associated with patients3, families, and broader systems (healthcare/educational) is substantial, with the annual economic impact of ADHD exceed $30 billion in the US alone4. Efficacy of pharmacotherapy in treating ADHD symptoms has generally been considerable with at least ¾ of individuals benefitting from pharmacotherapy, typically in the form of stimulants5. In this review, we begin by briefly reviewing the history of pharmacotherapy in relation to ADHD, before focusing (primarily) on the state-of-the-field on themes such as biophysiology, pharmacokinetics, and pharmacogenomics. We conclude with a summary of emerging clinical and research studies, particularly the potential role for precision therapy in matching ADHD patients and drug types. PMID:26366330
Cunha, Paulo Jannuzzi; Gonçalves, Priscila Dib; Ometto, Mariella; dos Santos, Bernardo; Nicastri, Sergio; Busatto, Geraldo F.; de Andrade, Arthur Guerra
Background: Cocaine-dependent individuals (CDI) present executive cognitive function (ECF) deficits, but the impact of psychiatric comorbidities such as Attention-Deficit Hyperactivity Disorder (ADHD) on neuropsychological functioning is still poorly understood. The aim of this study was to investigate if CDI with ADHD (CDI + ADHD) would have a distinct pattern of executive functioning when compared with CDI without ADHD (CDI). Methods: We evaluated 101 adults, including 69 cocaine-dependent subjects (divided in CDI and CDI + ADHD) and 32 controls. ECF domains were assessed with Digits Forward (DF), Digits Backward (DB), Stroop Color Word Test (SCWT), the Wisconsin Card Sorting Test (WCST), and the Frontal Assessment Battery (FAB). DSM-IV criteria for ADHD were used for diagnosis and previous ADHD symptoms (in the childhood) were retrospectively assessed by the Wender-Utah Rating Scale (WURS). Results: There were no significant differences between CDI + ADHD, CDI, and controls in estimated intellectual quotient (IQ), socioeconomic background, education (in years), and pre-morbid IQ (p > 0.05). SCWT and WCST scores did not differ across groups (p > 0.05). Nevertheless, CDI and CDI + ADHD performed more poorly than controls in total score of the FAB (p < 0.05). Also, CDI + ADHD did worse than CDI on DF (F = 4.756, p = 0.011), DB (F = 8.037, p = 0.001), Conceptualization/FAB (F = 4.635, p = 0.012), and Mental flexibility/FAB (F = 3.678, p = 0.029). We did not find correlations between cocaine-use variables and neuropsychological functioning, but previous ADHD symptoms assessed by WURS were negatively associated with DF (p = 0.016) and with the total score of the FAB (p = 0.017). Conclusion: CDI + ADHD presented more pronounced executive alterations than CDI and CDI exhibited poorer cognitive functioning than controls. Pre-existing ADHD symptoms may have a significant negative impact on
Schmitz, Marcelo; Ludwig, Henrique; Rohde, Luis A.
The objective of the current study was to evaluate a proposed restrictive inattentive type of Attention Deficit Hyperactivity Disorder (ADHD) by comparing clinical correlates among youths with ADHD inattentive type (ADHD-I) as a function of the number of hyperactivity symptoms presented (none vs. 3 or less) and controls (individuals without ADHD).…
Mullet, Dianna R.; Rinn, Anne N.
Many gifted characteristics overlap the symptoms of attention deficity-hyperactivity disorder (ADHD). The potential for the misdiagnosis of giftedness as ADHD exists, but so does the potential for a dual diagnosis of giftedness and ADHD. A decade after the misdiagnosis of giftedness as ADHD was first investigated we examine lessons learned…
Rucklidge, Julia J.; Brown, Deborah L.; Crawford, Susan; Kaplan, Bonnie J.
Objective: Although studies have documented higher prevalence of abuse in children with ADHD, no studies have investigated childhood reports of abuse in individuals identified with ADHD in adulthood. Method: Forty ADHD women, 17 ADHD males, 17 female controls, and 40 male controls complete the Childhood Trauma Questionnaire and other measures of…
Serrano, Eduardo; Ezpeleta, Lourdes; Castro-Fornieles, Josefina
Objective: To assess the comorbidity of bipolar disorder (BPD) in children with ADHD and to study the psychopathological profile of ADHD children with and without mania. Method: A total of 100 children with ADHD were assessed with a semistructured diagnostic interview and questionnaires of mania, ADHD, and general psychopathology. Results: 8% of…
Marchetta, Natalie D. J.; Hurks, Petra P. M.; De Sonneville, Leo M. J.; Krabbendam, Lydia; Jolles, Jelle
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…
Donfrancesco, Renato; Parisi, Pasquale; Vanacore, Nicola; Martines, Francesca; Sargentini, Vittorio; Cortese, Samuele
Objective: (a) To compare serum ferritin levels in a sample of stimulant-naive children with ADHD and matched controls and (b) to assess the association of serum ferritin to ADHD symptoms severity, ADHD subtypes, and IQ. Method: The ADHD and the control groups included 101 and 93 children, respectively. Serum ferritin levels were determined with…
Mullane, Jennifer C.; Corkum, Penny V.; Klein, Raymond M.; McLaughlin, Elizabeth N.; Lawrence, Michael A.
Objective: This study evaluated the alerting, orienting, and executive attention abilities of children with ADHD and their typically developing (TD) peers using a modified version of the adult attention network test (ANT-I). Method: A total of 25 children with ADHD, Combined Type (ADHD-C, mean age = 9.20 years), 20 children with ADHD,…
van Belle, Janna; van Raalten, Tamar; Bos, Dienke J; Zandbelt, Bram B; Oranje, Bob; Durston, Sarah
ADHD is characterized by increased intra-individual variability in response times during the performance of cognitive tasks. However, little is known about developmental changes in intra-individual variability, and how these changes relate to cognitive performance. Twenty subjects with ADHD aged 7-24 years and 20 age-matched, typically developing controls participated in an fMRI-scan while they performed a go-no-go task. We fit an ex-Gaussian distribution on the response distribution to objectively separate extremely slow responses, related to lapses of attention, from variability on fast responses. We assessed developmental changes in these intra-individual variability measures, and investigated their relation to no-go performance. Results show that the ex-Gaussian measures were better predictors of no-go performance than traditional measures of reaction time. Furthermore, we found between-group differences in the change in ex-Gaussian parameters with age, and their relation to task performance: subjects with ADHD showed age-related decreases in their variability on fast responses (sigma), but not in lapses of attention (tau), whereas control subjects showed a decrease in both measures of variability. For control subjects, but not subjects with ADHD, this age-related reduction in variability was predictive of task performance. This group difference was reflected in neural activation: for typically developing subjects, the age-related decrease in intra-individual variability on fast responses (sigma) predicted activity in the dorsal anterior cingulate gyrus (dACG), whereas for subjects with ADHD, activity in this region was related to improved no-go performance with age, but not to intra-individual variability. These data show that using more sophisticated measures of intra-individual variability allows the capturing of the dynamics of task performance and associated neural changes not permitted by more traditional measures.
Sleath, Betsy; Carpenter, Delesha M; Sayner, Robyn; Thomas, Kathleen; Mann, Larry; Sage, Adam; Sulzer, Sandra H; Sandler, Adrian D
The purpose of this study was to examine youth perceptions of attention deficit hyperactivity disorder (ADHD) communication with their pediatric providers, their reported adherence to their ADHD medications, and their desired location for an ADHD educational program. Youth ages 7 through 17 with an ADHD diagnosis were recruited. A research associate interviewed the youth. Parents completed demographic questionnaires. Seventy families participated. One-third of the youth wanted more discussion about ADHD with their providers during visits. The average youth had over eight questions about ADHD and its treatment. Most youth wanted to learn about ADHD at their provider's office. Non-white and older youth were significantly more likely to be less adherent to their ADHD medications. Youth want their providers to engage them more during visits. Providers should take advantage of this interest to engage youth more in discussions regarding ADHD and its treatment during pediatric ADHD visits.
Tay, Lee Yong; Lim, Cher Ping; Lim, Siew Khiaw
Many factors affect the use of information and communication technology (ICT) for teaching and learning in schools: policy and school leadership, physical and technological infrastructure, teachers' practices and beliefs, curriculum and assessment, and professional development. The subject area, that has not been given as much attention in…
Mixter, Jeffrey; Childress, Eric R.
Over the past ten years, various organizations, both public and private, have expressed interest in implementing the Faceted Application of Subject Terminology (FAST) in their cataloging workflows. As interest in FAST has grown, so too has interest in knowing how FAST is being used and by whom. Since 2002 eighteen institutions in six countries…
Cross-curricular work in schools across the United Kingdom generally involves the use of a cross-curricular dimension or theme that spans the work of several subject teachers. The limitations of this type of curriculum planning have been noted in the research literature both within the United Kingdom and across Europe. The research reported here…
Belenky et al. (1997) found five ways of women's knowing (silent knowing, receiving knowing, subjective knowing, procedural knowing, and constructed knowing) according to the study conducted on women who majored in the social sciences and liberal arts. This study is built on the same model found by Belenky et al.'s study to collect open-ended…
Hartsuiker, Robert J.; Barkhuysen, Pashiera N.
In order to study the role of working memory in sentence formulation, we elicited errors of subject-verb agreement in spoken sentence completion, while speakers did or did not maintain an extrinsic memory load (a word list). We compared participants with low and high speaking spans (a measure of verbal working memory for sentence production). As…
Pozzan, Lucia; Gleitman, Lila R; Trueswell, John C
When learning verb meanings, learners capitalize on universal linguistic correspondences between syntactic and semantic structure. For instance, upon hearing the transitive sentence “the boy is glorping the girl” two-year olds prefer a two-participant event (e.g., a boy making a girl spin) over two simultaneous one-participant events (a boy and a girl separately spinning). However, two- and three-year-olds do not consistently show the opposite preference when hearing conjoined-subject intransitive sentences (“the boy and the girl are glorping”). We hypothesized that such difficulties arise in part from the indeterminacy of the mapping between intransitive syntax and events in the world: a conjoined-subject intransitive sentence can be matched by the one-participant event (if “glorp” means “spin”), both events (“play”), or even the two-participant event (“fight”). A preferential looking study provided evidence for this hypothesis: sentences that plausibly block most non-target interpretations for novel verbs (“the boy and the umbrella are glorping”) eliminated the asymmetric difficulty associated with conjoined-subject intransitives. Thus, while conjoined-subject intransitives clearly pose some special challenges for syntax-guided word learning (“syntactic bootstrapping”) by novices (Gertner & Fisher, 2012), children’s difficulties with this sentence type also reflect expected performance in situations of semantic ambiguity. In discussion, we consider the interacting effects of syntactic- and message-level indeterminacy. PMID:26924950
Sonsteby, Alec; DeJonghe, Jennifer
Usability testing has become a routine way for many libraries to ensure that their Web presence is user-friendly and accessible. At the same time, popular subject guide creation systems, such as LibGuides, decentralize Web content creation and put authorship into the hands of librarians who may not be trained in user-centered design principles. At…
Biederman, J; Monuteaux, M; Kendrick, E; Klein, K; Faraone, S
Aims: To examine the informativeness of the Child Behavior Checklist (CBCL) as a screening tool to identify comorbid and non-comorbid cases of attention deficit hyperactivity disorder (ADHD) in a paediatrically referred population. It was hypothesised that specific scales of the CBCL would help identify specific comorbidities within ADHD cases in the primary care setting. Methods: The sample consisted of children and adolescents 6–17 years old of both genders with ADHD (n = 121). A receiver operating curve (ROC) approach was used to determine which CBCL scales best differentiated between ADHD cases with and without its comorbidities with conduct, anxiety, and mood disorders. Results: ROC analysis showed that the CBCL Delinquent Behavior and Aggressive Behavior scales predicted the structured interview derived diagnoses of conduct and bipolar disorder, the Anxious/Depressed and Aggressive Behavior scales predicted major depression, and the Anxious/Depressed and Attention problems scales predicted anxiety disorders. Conclusions: These results extend to a paediatrically referred population with previously reported findings in psychiatric samples documenting good convergence between structured interview diagnoses and syndrome congruent CBCL scales. These findings support the utility of the CBCL as a screening tool for the identification of psychiatric comorbidity in ADHD youth in the primary care setting. PMID:16177156
Luman, Marjolein; van Noesel, Steffen J. P.; Papanikolau, Alky; Van Oostenbruggen-Scheffer, Janneke; Veugelers, Diane; Sergeant, Joseph A.; Oosterlaan, Jaap
This study compared children with ADHD-only, ADHD+ODD and normal controls (age 8-12) on three key neurocognitive functions: response inhibition, reinforcement sensitivity, and temporal information processing. The goal was twofold: (a) to investigate neurocognitive impairments in children with ADHD-only and children with ADHD+ODD, and (b) to test…
Madaan, Vishal; Kolli, Venkata; Bestha, Durga P; Shah, Manan J
Lisdexamfetamine (LDX) has been a recent addition to the treatment armamentarium for Attention Deficit Hyperactivity Disorder (ADHD). It is unique among stimulants as it is a prodrug, and has been found to be safe and well-tolerated medication in children older than 6 years, adolescents and adults. It has a smooth onset of action, exerts its action up to 13 hours and may have less rebound symptoms. LDX has proven to be effective in the treatment of ADHD in placebo controlled trials, and improved performance in simulated academic and work environments have been noticed. Both stimulant-naïve and stimulant-exposed patients with ADHD appear to benefit from LDX. It has also shown some promise in improving emotional expression and executive function of patients with ADHD. Adverse effects such as decrease in sleep, loss of appetite and others have been reported with LDX use, just as with other stimulant formulations. Since most such studies exclude subjects with preexisting cardiac morbidity, prescribing precautions should be taken with LDX in such subjects, as with any other stimulant. Study subjects on LDX have been reported to have low scores on drug likability scales, even with intravenous use; as a result, LDX may have somewhat less potential for abuse and diversion. There is a need for future studies comparing other long acting stimulants with LDX in ADHD; in fact clinical trials comparing LDX with OROS (osmotic controlled-release oral delivery system) methylphenidate are currently underway. Furthermore, the utility of this medication in other psychiatric disorders and beyond ADHD is being investigated. PMID:23901276
Fisher, April Bryington; Watkins, Marley W.
Clinicians must often rely on self-report data to make a diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults. Unfortunately, self-report data are subject to intentional distortion. This becomes a concern when assessing for the disorder in the college population due to perceptions that there are benefits to having a documented…
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
Carvalhais, Carlos; Santos, Joana; Vieira da Silva, Manuela
Hospital facilities are normally very complex, which combined with patient requirements promote conditions for potential development of uncomfortable working conditions. Thermal discomfort is one such example. This study aimed to determine levels of thermal comfort, sensations, and preferences, from a field investigation conducted in two sterilization services (SS) of two hospitals from Porto and Aveiro, Portugal. The analytical determination and interpretation of thermal comfort was based upon assumptions of ISO 7726:1998 and ISO 7730:2005. The predicted mean vote (PMV) and predicted percentage of dissatisfaction (PPD) indices were obtained by measurement and estimation of environmental and personal variables, respectively, and calculated according to ISO 7730 equations. The subjective variables were obtained from thermal sensation (subjective PMV) and affective assessment (subjective PPD), reported by a questionnaire based upon ISO 10551:1995. Both approaches confirmed thermal discomfort in both SS (codified as SS1 and SS2). For all areas, PMV and PPD exceeded in all periods of the day the recommended range of -0.5 to +0.5 and <10%, respectively. No significant differences were found between day periods. The questionnaire results showed that SS2 workers reported a higher level of thermal discomfort. There were no significant differences between PMV and thermal sensations, as well as between PPD and affective assessment. The PMV/PPD model was found suitable to predict thermal sensations of occupants in hospital SS located in areas with a mild climate in Portugal.
Background ADHD is diagnosed and treated more often in males than in females. Research on gender differences suggests that girls may be consistently underidentified and underdiagnosed because of differences in the expression of the disorder among boys and girls. One aim of the present study was to assess in a clinical sample of medication naïve boys and girls with ADHD, whether there were significant gender x diagnosis interactions in co-existing symptom severity and executive function (EF) impairment. The second aim was to delineate specific symptom ratings and measures of EF that were most important in distinguishing ADHD from healthy controls (HC) of the same gender. Methods Thirty-seven females with ADHD, 43 males with ADHD, 18 HC females and 32 HC males between 8 and 17 years were included. Co-existing symptoms were assessed with self-report scales and parent ratings. EF was assessed with parent ratings of executive skills in everyday situations (BRIEF), and neuropsychological tests. The three measurement domains (co-existing symptoms, BRIEF, neuropsychological EF tests) were investigated using analysis of variance (ANOVA) and random forest classification. Results ANOVAs revealed only one significant diagnosis x gender interaction, with higher rates of self-reported anxiety symptoms in females with ADHD. Random forest classification indicated that co-existing symptom ratings was substantially better in distinguishing subjects with ADHD from HC in females (93% accuracy) than in males (86% accuracy). The most important distinguishing variable was self-reported anxiety in females, and parent ratings of rule breaking in males. Parent ratings of EF skills were better in distinguishing subjects with ADHD from HC in males (96% accuracy) than in females (92% accuracy). Neuropsychological EF tests had only a modest ability to categorize subjects as ADHD or HC in males (73% accuracy) and females (79% accuracy). Conclusions Our findings emphasize the combination of
Mick, Eric; Biederman, Joseph; Spencer, Thomas; Faraone, Stephen V.; Sklar, Pamela
Objective A polymorphism in the dopamine transporter gene (DAT1) has been previously associated with ADHD and methylphenidate has been hypothesized to block the dopamine transporter. The goal of this study was to examine whether a 40-bp variable number of tandem repeats (VNTR) of DAT1 moderate response and adverse effects associated with methylphenidate treatment of adults with ADHD. Methods Subjects were 106 adults with ADHD enrolled in six-week randomized placebo-controlled parallel design trials of methylphenidate (OROS and immediate release preparations). Results There was no evidence of an association between DAT1 VNTR and response to methylphenidate (F(2,100)=0.04, p=0.9). Similarly, there was no pattern of statistically significant association with DAT1 VNTR and cardiovascular or spontaneously reported adverse effects. Conclusions We failed to identify an association with DAT1 and the response or tolerability of methylphenidate in adults with ADHD. PMID:16917950
Berger, Itai; Slobodin, Ortal; Aboud, Merav; Melamed, Julia; Cassuto, Hanoch
While data from behavioral, neuropsychological, and brain studies suggested that Attention-Deficit/Hyperactivity Disorder (ADHD) is related to a developmental lag that reduces with age, other studies have proposed that ADHD represents a deviant brain function. The present study used a cross-sectional approach to examine whether ADHD children show a developmental delay in cognitive performance measured by continuous performance test (CPT). We thus, compared six age groups of ADHD children (N = 559) and their unaffected peers (N = 365), aged 6–11, in four parameters of MOXO-CPT performance: Attention, Timing, Hyperactivity and Impulsivity. Results have shown that despite improvement in CPT performance with age, ADHD children continued to demonstrate impaired performance as compared to controls. In most parameters, CPT performance of ADHD children matched that of 1–3 years younger normal controls, with a delay most prominent in older children. However, in the Hyperactivity parameter, ADHD children's performance resembled that of much younger healthy children, with almost no evidence for a developmental catch up. This study suggests that while some cognitive functions develop slower but normally, other functions (e.g., inhibitory control) show a different trajectory. PMID:24298243
Helseth, Sarah A.; Waschbusch, Daniel A.; Gnagy, Elizabeth M.; Onyango, Adia N.; Burrows-MacLean, Lisa; Fabiano, Gregory A.; Coles, Erika K.; Chacko, Anil; Wymbs, Brian T.; Walker, Kathryn S.; Wymbs, Frances A.; Garefino, Allison; Massetti, Greta M.; Mazzant, Jessica Robb; Hoffman, Martin T.; Waxmonsky, James G.; Nichols-Lopez, Kristin; Pelham, William E.
Objective This study compared the unique and combined effects of evidence-based treatments for ADHD —stimulant medication and behavior modification—on children’s rates of reinforcement for deviant peer behavior (RDPB). Method Using a within-subjects design, 222 elementary school-age children attending a summer treatment program, including 151 children with ADHD (127 male), with and without comorbid conduct problems, and 71 control children (57 male), received varying combinations of behavior modification (no, low-intensity, and high-intensity) and methylphenidate (placebo, 0.15 mg/kg, 0.30 mg/kg, and 0.60 mg/kg). RDPB was measured through direct observation and compared across all behavior modification and medication conditions. Results Children with ADHD reinforced the deviant behavior of their peers at a significantly higher rate than control children in the absence of either intervention. However, that difference largely disappeared in the presence of both behavior modification and medication. Both low and high-intensity behavior modification, as well as medium (0.30 mg/kg) and high (0.60 mg/kg) doses of methylphenidate, significantly reduced the rate of ADHD children’s RDPB to levels similar to the control group. Conclusions Results indicate that although untreated children with ADHD do engage in RDPB at a greater rate than their non-ADHD peers, existing evidence-based interventions can substantially decrease the presence of RDPB, thereby limiting potential iatrogenic effects in group-based treatment settings. Public Health Significance Statement This study found that children with behavior disorders reinforced their peers' deviant behaviors much more than typically developing children. However, behavior modification and medication treatments both reduced reinforcement rates, indicating that peer contagion can easily be managed in group-based treatments for children PMID:25495357
Hoebert, Michel; van der Heijden, Kristiaan B; van Geijlswijk, Ingeborg M; Smits, Marcel G
We conducted this study to assess long-term melatonin treatment course, effectiveness and safety in children with attention-deficit/hyperactivity disorder (ADHD) and chronic sleep onset insomnia (CSOI). This was conducted by means of a structured questionnaire for the parents. The subjects of this study consisted of participants who previously participated in a randomised clinical trial on melatonin efficacy. The response rate was 93% (94/101). The mean time to follow up was 3.7 yr. No serious adverse events or treatment related co-morbidities were reported. Sixty-five percent of the children still used melatonin daily and 12% occasionally. Temporal discontinuation of treatment resulted in a delay of sleep onset in 92% of the children. Nine percent of the children could discontinue melatonin completely because of improvement of sleep onset insomnia. Long-term melatonin treatment was judged to be effective against sleep onset problems in 88% of the cases. Improvement of behaviour and mood was reported in 71% and 61% respectively. We conclude that melatonin remains an effective therapy on the long term for the treatment of CSOI in children with ADHD and has no safety concerns regarding serious adverse events or treatment related co-morbidity. Discontinuation of melatonin treatment usually leads to a relapse of sleep onset insomnia and in resuming melatonin treatment, even after several years of treatment.
Cortese, Samuele; Faraone, Stephen V.; Konofal, Eric; Lecendreux, Michel
A meta-analysis of 16 subjective and objective sleep studies with a sample of 722 children with attention deficit hyperactivity disorder (ADHD) versus a control that numbers 638 shows that the children with ADHD are significantly more impaired in most of the subjective and some of the objective sleep measures than their counterpart.
Grisar, Koenraad; Maes, Honorine; Politis, Constantinus
We report the case of a 65-year-old man presenting with generalised seizures after developing a right frontal brain abscess. Stereotactic aspiration and subsequent matrix assisted laser desorption/ionisation time-of-flight analyzer (MALDI-TOF) spectrometry revealed Porphyromonas gingivalis as the only causative anaerobe microorganism. Secondary incision and drainage was required due to neurological deterioration with increased dimensions of the abscess, intracranial pressure and formation of a subdural occipitoparietal empyema. Oral imaging was positive for apical periodontitis of multiple elements; therefore, the remaining dentition was removed. Targeted antibiotic treatment included intravenous ceftriaxone and ornidazole. The patient was discharged to our revalidation unit 59 days after admission to make a full recovery. To the best of our knowledge, this is the sixth reported case of P. gingivalis causing an intracranial abscess and the third case of a true intracerebral parenchymal abscess caused by this bacterium. PMID:28228396
Luman, Marjolein; van Noesel, Steffen J P; Papanikolau, Alky; Van Oostenbruggen-Scheffer, Janneke; Veugelers, Diane; Sergeant, Joseph A; Oosterlaan, Jaap
This study compared children with ADHD-only, ADHD+ODD and normal controls (age 8-12) on three key neurocognitive functions: response inhibition, reinforcement sensitivity, and temporal information processing. The goal was twofold: (a) to investigate neurocognitive impairments in children with ADHD-only and children with ADHD+ODD, and (b) to test whether ADHD+ODD is a more severe from of ADHD in terms of neurocognitive performance. In Experiment 1, inhibition abilities were measured using the Stop Task. In Experiment 2, reinforcement sensitivity and temporal information processing abilities were measured using a Timing Task with both a reward and penalty condition. Compared to controls, children with ADHD-only demonstrated impaired inhibitory control, showed more time underestimations, and showed performance deterioration in the face of reward and penalty. Children with ADHD+ODD performed in-between children with ADHD-only and controls in terms of inhibitory controls and the tendency to underestimate time, but were more impaired than controls and children with ADHD-only in terms of timing variability. In the face of reward and penalty children with ADHD+ODD improved their performance compared to a neutral condition, in contrast to children with ADHD-only. In the face of reward, the performance improvement in the ADHD+ODD group was disproportionally larger than that of controls. Taken together the findings suggest that, in terms of neurocognitive functioning, comorbid ADHD+ODD is a substantial different entity than ADHD-only.
Shoham, Rachel; Sonuga-Barke, Edmund J. S.; Aloni, Hamutal; Yaniv, Ilan; Pollak, Yehuda
Attention deficit and hyperactivity disorder (ADHD) is often assumed to be associated with increased engagement in risk-taking behaviors. The current study sought to understand the mental processes underlying this association using a theory-driven behavioral economics perspective. Psychological risk-return models suggest that risk and benefit are inherently subjective, and risk taking is best understood as the interplay between cognitions and motivations regarding the benefits and risks of alternatives. A sample of 244 adults was assessed for ADHD symptoms. The likelihood of engagement in a range of risky behaviors (e.g., driving without wearing a seat belt), the magnitude of perceived benefit and risk ascribed to these behaviors, and benefit and risk attitudes of each participant were extracted from the Domain Specific Risk Taking (DOSPERT) scales. ADHD symptoms were correlated with more risky behaviors and perception of greater benefits from engaging in these behaviors, but were not correlated with risk perception. Mediation analysis revealed that the association between ADHD symptoms and engagement in risk taking was mediated by perceived benefits. These findings highlight the idea that people with high level ADHD symptoms tend to engage in risky behaviors because they find such behavior particularly appealing, rather than because they seek risk per se. PMID:27725684
Rosetti, Marcos F.; Ulloa, Rosa E.; Vargas-Vargas, Ilse L.; Reyes-Zamorano, Ernesto; Palacios-Cruz, Lino; de la Peña, Francisco; Larralde, Hernán; Hudson, Robyn
Searching, defined for the purpose of the present study as the displacement of an individual to locate resources, is a fundamental behavior of all mobile organisms. In humans this behavior underlies many aspects of everyday life, involving cognitive processes such as sustained attention, memory and inhibition. We explored the performance of 36 treatment-free children diagnosed with attention-deficit hyperactivity disorder (ADHD) and 132 children from a control school sample on the ecologically based ball-search field task (BSFT), which required them to locate and collect golf balls in a large outdoor area. Children of both groups enjoyed the task and were motivated to participate in it. However, performance showed that ADHD-diagnosed subjects were significantly less efficient in their searching. We suggest that the BSFT provides a promising basis for developing more complex ecologically-derived tests that might help to better identify particular cognitive processes and impairments associated with ADHD. PMID:26805450
DeSantis, Alan; Noar, Seth M; Webb, Elizabeth M
Qualitative methods were used to investigate the use of nonmedical Attention Deficit Hyperactivity Disorder (ADHD) stimulants by fraternity members. The primary goal of the study was to determine students' levels of understanding and motivations for use of these Schedule II controlled substances. Seventy-nine in-depth interviews were conducted. Key findings highlighted how: a) easy it was for subjects to obtain stimulants; b) little health information nonmedical users have about stimulants; c) academic stress created a fertile context for stimulant use; and d) a small number of prescribed users supply the vast majority of nonmedical users with their stimulants. Most nonmedical users claimed to primarily use ADHD stimulants in periods of high academic stress and believed that they not only reduced fatigue, but also increased reading comprehension, interest, cognition, and memory. These qualitative data have supplied a rich and complex understanding behind nonmedical ADHD stimulant use among fraternity members.
Starck, Martina; Grünwald, Julia; Schlarb, Angelika A
Background Despite the fact that there is a large amount of research on childhood attention deficit hyperactivity disorder (ADHD) treatment and an increasing amount of research on adult ADHD, little is known about the prevalence and influence of parental ADHD. Therefore, this study examined the frequency of parental ADHD in a clinical sample of German children suffering from ADHD. We also tried to find different levels of symptom severity for prognostic relevance. Furthermore, the association between subtypes of ADHD in children and their parents was investigated. Method In this study, parents of 79 ADHD children were screened for ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 10th edition. The Wender Utah Rating Scale and the ADHS-Self-Report were given to 75 mothers and 49 fathers for retrospective and current symptoms. Frequency of ADHD symptoms and severity groups was calculated and relationship between parental and children’s ADHD was tested. Results ADHD occurrence for mothers of children with ADHD was 41.3%, for fathers 51.0%. About 16.0% of the mothers had a mixed type, 9.3% had a hyperactive-impulsive subtype, and 16.0% had an inattentive subtype. Of the fathers, 18.4% had a mixed type, 10.2% had a hyperactive-impulsive subtype, and 22.4% had an inattentive subtype; 61% of the mothers and 46.9% of the fathers had low symptom severity. Medium symptom severity was reported by 37.7% mothers and 46.9% fathers, while 1.3% of the mothers and 6.2% of the fathers showed severe symptoms. No significant correlation between parental and child diagnoses was observed. Conclusion As nearly half of the parents suffered from ADHD, these results are a matter of concern in families with ADHD children. Besides parent–child interactions, parental ADHD symptoms might influence parental education style and also effects parent training as well as the child’s therapy outcome. In the
This paper reports case study research into the knowledge and understanding of chemistry for six secondary science student teachers. It combines innovative student-generated computer animations, using "ChemSense" software, with interviews to probe understanding of four common chemical processes used in the secondary school curriculum. Findings…
Heredia-Rizo, Alberto Marcos; López-Hervás, Antonia; Herrera-Monge, Patricia; Gutiérrez-Leonard, Ana; Piña-Pozo, Fernando
The aim of the study was to identify the differences in functionality of the upper limb in subjects suffering from shoulder impingement syndrome after intervention by two manual therapy protocols. Randomized, single-blind study with a sample of 22 subjects (58 ± 10.86 years old) divided into two groups. The conventional-group (n = 11) received mobilizations of the shoulder and the experimental-group (n = 11) was treated with soft tissue techniques in the cervical and upper thoracic regions. These two groups received electrotherapy and postural advices. The treatment lasted three weeks (15 daily sessions of 1 h and 30 min). Both active and passive range of motion (ROM) and self-perceived functionality of the upper limb (DASH questionnaire) were measured. The experimental group showed a significant improvement in the DASH scores and both groups improved mobility in the intra-group comparison pre-intervention versus post-intervention (p < .05), but not statistically significant differences were found in the between-group comparison (p > .05). Our results suggest that a combined treatment with electrotherapy, postural hygiene and manual therapy, regardless of the protocol, improves shoulder mobility and functionality.
Turel, Ofir; Bechara, Antoine
Background: Adults who present ADHD symptoms have an increased risk for vehicle accidents. One conceivable overlooked account for this association is the possibility that people with ADHD symptoms use rewarding technologies such as social networking sites (SNS) while driving, more than others. The objective of this study was to understand if and how ADHD symptoms can promote SNS use while driving and specifically to conceptualize and examine mechanisms which may underlie this association. To do so, ADHD is viewed in this study as an underlying syndrome that promotes SNS use while driving in a manner similar to how addictive syndromes promote compulsive seeking of drug rewards. Methods: Time-lagged survey data regarding ADHD, stress, self-esteem, SNS craving experience, SNS use while driving, and control variables were collected from a sample of 457 participants who use a popular SNS (Facebook) and drive, after face-validity examination with a panel of five users and pretest with a sample of 47. These data were subjected to structural equation modeling (SEM) analyses using the frequency of ADHD symptoms measured with ASRS v1.1 Part A as a continuous variable, as well as multivariate analysis of variance using ADHD classification based on ASRS v1.1 scoring guidelines. Results: ADHD symptoms promoted increased stress and reduced self-esteem, which in turn, together with ADHD symptoms, increased one's cravings to use the SNS. These cravings ultimately translated into increased SNS use while driving. Using the ASRS v1.1 classification, people having symptoms highly consistent with ADHD presented elevated levels of stress, cravings to use the SNS, and SNS use while driving, as well as decreased levels of self-esteem. Cravings to use the SNS among men were more potent than among women. Conclusion: SNS use while driving may be more prevalent than previously assumed and may be indirectly associated with ADHD symptoms. It is a new form of impulsive and risky behavior which
Karigane, Daiki; Takaya, Saho; Seki, Yuki; Mastumoto, Yuka; Onose, Akira; Kosakai, Arifumi; Sugaya, Norio; Mori, Takehiko
Cytomegalovirus (CMV) enteritis (or colitis) is generally diagnosed in immunocompromised patients in association with human immunodeficiency virus infection as well as in recipients of solid organ or hematopoietic stem cell transplant. CMV enteritis has been reported only sporadically in immunocompetent individuals. We encountered a 76-year-old woman who developed CMV enteritis without any previously identified immunocompromised states. An extensive literature review of 33 cases of CMV enteritis or colitis diagnosed in immunocompetent individuals, including the present case, revealed that the median age of the patients was 68, the accompanying symptoms were diarrhea (76%), abdominal pain (52%), and hematochezia or melena (27%), and that the outcome was generally favorable, including resolution without any treatment in 24% of the patients. CMV enteritis should be recognized more widely as a disease entity not only in immunocompromised patients but also in immunocompetent individuals, especially in elderly populations.
Awang, Noorehan; Hamid, Nur Nadiah Abd.
This study was designed to assess the attitude of Bumiputera students towards mathematics. The instrument used to measure the attitude was Test of Mathematics Related Attitude (TOMRA). This test measures students' attitudes in four criteria: normality of mathematics (N), attitudes towards mathematics inquiry (I), adoption of mathematics attitude (A) and enjoyment of mathematics lessons (E). The target population of this study was all computer science and quantitative science students who enrolled in a Calculus subject at UiTM Negeri Sembilan. Confirmatory Factor Analysis was carried out and the inter-relationship among the four criteria was analyzed using Structural Equation Modeling. The students scored high in E, moderately in A and relatively low in N and I.
Maggio, Lauren A; Bresnahan, Megan; Flynn, David B; Harzbecker, Joseph; Blanchard, Mary; Ginn, David
In exploring new ways of teaching students how to use Medical Subject Headings (MeSH), librarians at Boston University's Alumni Medical Library (AML) integrated social tagging into their instruction. These activities were incorporated into the two-credit graduate course, "GMS MS 640: Introduction to Biomedical Information," required for all students in the graduate medical science program. Hands-on assignments and in-class exercises enabled librarians to present MeSH and the concept of a controlled vocabulary in a familiar and relevant context for the course's Generation Y student population and provided students the opportunity to actively participate in creating their education. At the conclusion of these activities, students were surveyed regarding the clarity of the presentation of the MeSH vocabulary. Analysis of survey responses indicated that 46% found the concept of MeSH to be the clearest concept presented in the in-class intervention.
The increasing emphasis on evidence-based clinical practice has thrown into sharp focus multiple deficiencies in current systems of ethical review. This paper argues that a complete overhaul of systems for ethical oversight of studies involving human subjects is now required as developments in medical, epidemiological and genetic research have outstripped existing structures for ethical supervision. It shows that many problems are now evident and concludes that sequential and piecemeal amendments to present arrangements are inadequate to address these. At their core present systems of ethical review still rely on the integrity and judgment of individual investigators. One possible alternative is to train and license research investigators, make explicit their responsibilities and have ethics committees devote much more of their time to monitoring research activity in order to detect those infringing the rules. Key Words: Medical ethics • epidemiology • regulation • genetics PMID:11055035
Black, Donald Wayne; Shaw, Martha; McCormick, Brett; Bayless, John David; Allen, Jeff
We examined the neuropsychological performance of people with compulsive buying disorder (CBD) and control subjects, along with trait impulsivity, symptoms of attention deficit hyperactivity disorder (ADHD), and selected personality characteristics. Subjects received a comprehensive neuropsychological test battery, depression and ADHD symptom assessment, the Barratt Impulsiveness Scale, and a version of the Temperament and Character Inventory. Persons with CBD (n=26) and controls (n=32) were comparable in terms of age, sex, and years of education. Subjects with CBD had a mean age of 36.3 years (S.D.=15.7) and an age at onset of 19.7 years (S.D.=7.0). Compulsive buyers had more lifetime mood, anxiety, and impulse control disorders. People with Compulsive buying performed significantly better on the Wechsler Abbreviated Scale of Intelligence Picture Completion task, a test of visual perception; otherwise, there were no consistent differences in neuropsychological measures. They also had elevated levels of self-reported depression, ADHD symptoms, trait impulsivity, and novelty seeking. In conclusion, compulsive buyers have greater lifetime psychiatric comorbidity than controls, and higher levels of self-rated depression, ADHD symptoms, trait impulsivity, and novelty seeking. The present study does not support the notion that there is a pattern of neuropsychological deficits associated with CBD.
Black, Donald Wayne; Shaw, Martha; McCormick, Brett; Bayless, John David; Allen, Jeff
We examined the neuropsychological performance of people with compulsive buying disorder (CBD) and control subjects, along with trait impulsivity, symptoms of attention deficit hyperactivity disorder (ADHD), and selected personality characteristics. Subjects received a comprehensive neuropsychological test battery, depression and ADHD symptom assessment, the Barratt Impulsiveness Scale, and a version of the Temperament and Character Inventory. Persons with CBD (n=26) and controls (n=32) were comparable in terms of age, sex, and years of education. Subjects with CBD had a mean age of 36.3 years (S.D.=15.7) and an age at onset of 19.7 years (S.D.=7.0). Compulsive buyers had more lifetime mood, anxiety, and impulse control disorders. People with Compulsive buying performed significantly better on the Wechsler Abbreviated Scale of Intelligence Picture Completion task, a test of visual perception; otherwise, there were no consistent differences in neuropsychological measures. They also had elevated levels of self-reported depression, ADHD symptoms, trait impulsivity, and novelty seeking. In conclusion, compulsive buyers have greater lifetime psychiatric comorbidity than controls, and higher levels of self-rated depression, ADHD symptoms, trait impulsivity, and novelty seeking. The present study does not support the notion that there is a pattern of neuropsychological deficits associated with CBD. PMID:22766012
... There's no solid evidence that food additives cause attention-deficit/hyperactivity disorder (ADHD). However, the topic of food additives and their possible effects is controversial. Some studies indicate that certain food ...
... child’s diet?Should I limit my child’s screen time (TV, computer, video games)? ResourcesAmerican Psychiatric Association, Help With ADHDNational Alliance on Mental Illness, Not Just a Childhood Disorder: How ADHD ...
Arlotti, M; Zoboli, G; Moscatelli, G L; Magnani, G; Maserati, R; Borghi, V; Andreoni, M; Libanore, M; Bonazzi, L; Piscina, A; Ciammarughi, R
Rhodococcus equi causes a rare infection in immunocompromised hosts. We describe 24 cases of infection in patients with AIDS-related complex (ARC)/acquired immunodeficiency syndrome (AIDS). Pneumonia was always the first manifestation of R. equi infection, but extrapulmonary involvement was also observed. The main sources of bacteria were sputum, bronchial washings and blood. The strains isolated were mainly susceptible to erythromycin, vancomycin, teicoplanin, rifampicin, imipenem and aminoglycosides. Initial treatment should involve an intravenously administered antibiotic combination therapy including imipenem or vancomycin or teicoplanin, followed by orally administered maintenance combination therapy. Drug combinations should be investigated for serum bactericidal activity in vitro. Surgery does not increase survival time and should only be performed in cases that do not respond to antibiotic treatment. Presumptive risks of infection (contact with horses or farm dust, or cohabiting with people affected by R. equi infection) were present in more than 50% of patients. This finding, and the frequency of bacteria in the sputum, are not sufficient proof of transmission between humans, but do suggest the need for respiratory isolation of patients affected by R. equi pneumonia.
von Polier, G G; Vloet, T D; Herpertz-Dahlmann, B
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders of childhood and adolescence. Until now, it has been unclear whether ADHD by itself constitutes a risk factor for later delinquency or does so only in combination with other disruptive symptoms. This article seeks to give a comprehensive account of the literature to shed light on the developmental pathway from childhood ADHD to adult criminality. Comorbid ADHD and conduct disorder (CD) are significantly related to a range of biological and environmental risk factors such as neurocognitive impairment, high parental psychopathology, poor social functioning, and other comorbid mental disorders, particularly substance abuse, that are described in this review. In addition, the results of treatment studies are presented, with a special focus on the results of the Multimodal Treatment Study of Children with ADHD (MTA). Although treatment programs, including medication and psychosocial treatment, can be very effective in improving the functioning of children with ADHD in the social and academic domains in the short term, there is no conclusive evidence that such treatments lower the risk for developing delinquency in adulthood.
McBurnett, Keith; Swetye, Michael; Muhr, Heather; Hendren, Robert L
This article reviews the current use of stimulants in adolescents. The evidence base for treatment of attention-deficit/hyperactivity disorder (ADHD) in adolescents is meager compared with that of ADHD in children, and much recent research of older populations with ADHD has been directed toward adults rather than adolescents. The structure of psychosocial treatment of ADHD differs across developmental ranges. For example, in children, treatment of ADHD uses direct behavior modification via parents and teachers. Treatment approaches then change toward contracting in adolescents (acknowledging the emerging independence common at this age) and toward self-management and coaching in adults. Medication for ADHD, however, does not substantially differ across developmental epochs. In supplementation of data, specifically on adolescence, much of our understanding of treating adolescents comes from upward or downward extension of the child and adult data. Symptomatic treatment (treatment for inattention, hyperactivity, or impulsive behavior) has always been a parallel approach to diagnostic and developmentally specific selection of treatment based on an incomplete literature. In recognition, this article assumes that inference from children or adults to adolescents, in the absence of adolescent-specific data, is commonplace and often confirmed with clinical experience. Such inferences, in the face of literature gaps, in no way obviate the need for continued research focused on adolescence.
Schuchardt, Kirsten; Fischbach, Anne; Balke-Melcher, Christina; Mähler, Claudia
Children having difficulties in acquiring early literacy and mathematical skills often show an increased rate of inattention, hyperactivity, and impulsivity. This study provides data on the comorbidity rates of specific learning difficulties and ADHD symptoms. We analyzed the data of 273 children with learning difficulties despite an at least average IQ, 57 children with low IQ, and 270 children without learning difficulties and average IQ (comparison group). We assessed children’s IQ and school achievement using standardized achievement tests. ADHD symptoms were assessed via parents’ ratings. Our results showed that only 5 % of both the control group and the group with solely mathematical difficulties fulfilled the criteria of an ADHD subtype according to the DSM-IV based on parents’ ratings. In contrast, this was the case in even 20 % of the children with difficulties in reading/writing and of those with low IQ. Compared to girls, boys in the control group had a 150% higher risk for matching the criteria of one of the ADHD subtypes in parents’ ratings, whereas boys with learning difficulties and those with low IQ had an even 200% to 600% higher risk for it. The relationship between learning difficulties and ADHD symptoms can be found predominantly in the inattentive type. Possible reasons for the results are discussed.
Snyder, Steven M; Rugino, Thomas A; Hornig, Mady; Stein, Mark A
Background This study is the first to evaluate an assessment aid for attention-deficit/hyperactivity disorder (ADHD) according to both Class-I evidence standards of American Academy of Neurology and De Novo requirements of US Food and Drug Administration. The assessment aid involves a method to integrate an electroencephalographic (EEG) biomarker, theta/beta ratio (TBR), with a clinician's ADHD evaluation. The integration method is intended as a step to help improve certainty with criterion E (i.e., whether symptoms are better explained by another condition). Methods To evaluate the assessment aid, investigators conducted a prospective, triple-blinded, 13-site, clinical cohort study. Comprehensive clinical evaluation data were obtained from 275 children and adolescents presenting with attentional and behavioral concerns. A qualified clinician at each site performed differential diagnosis. EEG was collected by separate teams. The reference standard was consensus diagnosis by an independent, multidisciplinary team (psychiatrist, psychologist, and neurodevelopmental pediatrician), which is well-suited to evaluate criterion E in a complex clinical population. Results Of 209 patients meeting ADHD criteria per a site clinician's judgment, 93 were separately found by the multidisciplinary team to be less likely to meet criterion E, implying possible overdiagnosis by clinicians in 34% of the total clinical sample (93/275). Of those 93, 91% were also identified by EEG, showing a relatively lower TBR (85/93). Further, the integration method was in 97% agreement with the multidisciplinary team in the resolution of a clinician's uncertain cases (35/36). TBR showed statistical power specific to supporting certainty of criterion E per the multidisciplinary team (Cohen's d, 1.53). Patients with relatively lower TBR were more likely to have other conditions that could affect criterion E certainty (10 significant results; P ≤ 0.05). Integration of this information with a
Mazzaferri, Fulvia; Adami, Irene; Tocco, Pierluigi; Cazzadori, Angelo; Merighi, Mara; Forni, Alberto; Storato, Silvia; Ferrari, Sergio; Concia, Ercole
Cerebral aspergillosis is a rare and highly fatal infection that mainly affects immunocompromised patients. We report on a case of a heart transplanted Caucasian man, who arrived at our hospital because of the onset of diplopy. We performed a broad diagnostic work-up: the brain MRI showed a single ring-enhancing thalamo-mesencephalic area suggestive of abscess lesion; cerebrospinal fluid (CSF) analysis disclosed galactomannan and beta-D-glucan antigens. Thus the antifungal therapy was immediately started. We decided to discontinue the therapy 16 months later because of severe hepatic toxicity, given that the patient was persistently asymptomatic, brain imaging showed a progressive resolution of the abscess area and CSF antigen analysis was persistently negative. The follow-up at three months was unchanged.
Arroyo Mühr, Laila Sara; Hortlund, Maria; Bzhalava, Zurab; Nordqvist Kleppe, Sara; Bzhalava, Davit; Dillner, Joakim
Studies investigating presence of viruses in cancer often analyze case series of cancers, resulting in detection of many viruses that are not etiologically linked to the tumors where they are found. The incidence of virus-associated cancers is greatly increased in immunocompromised individuals. Non-melanoma skin cancer (NMSC) is also greatly increased and a variety of viruses have been detected in NMSC. As immunosuppressed patients often develop multiple independent NMSCs, we reasoned that viruses consistently present in independent tumors might be more likely to be involved in tumorigenesis. We sequenced 8 different NMSCs from 1 patient in comparison to 8 different NMSCs from 8 different patients. Among the latter, 12 different virus sequences were detected, but none in more than 1 tumor each. In contrast, the patient with multiple NMSCs had human papillomavirus type 15 and type 38 present in 6 out of 8 NMSCs. PMID:28257474
Skårberg, Kurt; Nyberg, Fred; Engström, Ingemar
Background The inappropriate use of anabolic androgenic steroids (AAS) was originally a problem among athletes but AAS are now often used in nonsport situations and by patients attending regular addiction clinics. The aim of this study was to improve understanding of the development of multiple drug use in patients seeking treatment at an addiction clinic for AAS-related problems. Methods We interviewed six patients (four men and two women) with experience of AAS use who were attending an addiction clinic for what they believed were AAS-related problems. The patients were interviewed in-depth about their life stories, with special emphasis on social background, substance use, the development of total drug use and subjective experienced psychological and physical side effects. Results There was significant variation in the development of drug use in relation to social background, onset of drug use, relationship to AAS use and experience of AAS effects. All patients had initially experienced positive effects from AAS but, over time, the negative experiences had outweighed the positive effects. All patients were dedicated to excess training and took AAS in combination with gym training, indicating that the use of these drugs is closely related to this form of training. Use of multiple drugs was common either in parallel with AAS use or serially. Conclusion The study shows the importance of understanding how AAS use can develop either with or without the concomitant use of other drugs of abuse. The use of AAS can, however, progress to the use of other drugs. The study also indicates the importance of obtaining accurate, comprehensive information about the development of AAS use in designing treatment programmes and prevention strategies in this area. PMID:19040748
Konrad, Kerstin; Eickhoff, Simon B
In recent years, a change in perspective in etiological models of attention deficit hyperactivity disorder (ADHD) has occurred in concordance with emerging concepts in other neuropsychiatric disorders such as schizophrenia and autism. These models shift the focus of the assumed pathology from regional brain abnormalities to dysfunction in distributed network organization. In the current contribution, we report findings from functional connectivity studies during resting and task states, as well as from studies on structural connectivity using diffusion tensor imaging, in subjects with ADHD. Although major methodological limitations in analyzing connectivity measures derived from noninvasive in vivo neuroimaging still exist, there is convergent evidence for white matter pathology and disrupted anatomical connectivity in ADHD. In addition, dysfunctional connectivity during rest and during cognitive tasks has been demonstrated. However, the causality between disturbed white matter architecture and cortical dysfunction remains to be evaluated. Both genetic and environmental factors might contribute to disruptions in interactions between different brain regions. Stimulant medication not only modulates regionally specific activation strength but also normalizes dysfunctional connectivity, pointing to a predominant network dysfunction in ADHD. By combining a longitudinal approach with a systems perspective in ADHD in the future, it might be possible to identify at which stage during development disruptions in neural networks emerge and to delineate possible new endophenotypes of ADHD.
During the past 15 years, an impressive amount of genetic information has become available in the research field of psychiatry, particularly as it relates to attention-deficit/hyperactivity disorder (ADHD). However, the classical clinical approach to ADHD has minimally affected and not significantly been improved by this genetic revolution. It is difficult to predict how long it will take for genetic findings to alter the way clinicians treat patients with ADHD. New medications or treatment protocols may take years to become routine clinical practice. However, when taken together, recent successes in genomics, pharmacogenomics, and genetic epidemiology have the potential (1) to prevent comorbid consequences of ADHD, (2) to individualize therapies for patients with ADHD, and (3) to define new epidemiological policies to aid with the impact of ADHD on society. Here, we present an overview of how genetic research may affect and improve the quality of life of patients with ADHD: as an example, we use the discovery of LPHN3, a new gene in which variants have recently been shown to be associated with ADHD. PMID:21432600
Hall, Cathy W.; Peterson, Andrea D.; Webster, Raymond E.; Bolen, Larry M.; Brown, Michael B.
Study examined ability of attention deficit hyperactive disorder (ADHD) children with and without learning disability to perceive nonverbal social cues. ADHD/LD children demonstrated significant difficulty in comparison to their peers in effectively perceiving paralanguage cues. This group also showed significant improvement on the Postures and…
Martin, Andrew J.
Students with attention-deficit/hyperactivity disorder (ADHD) experience significant academic difficulties that can lead to numerous negative academic consequences. With a focus on adverse academic outcomes, this study seeks to disentangle variance attributable to ADHD from variance attributable to salient personal and contextual covariates.…
Shapiro, E S; DuPaul, G J; Bradley-Klug, K L
This article reports on the application of a self-management strategy for improving the classroom behavior of students with attention-deficit/hyperactivity disorder (ADHD). Based on the work of Rhode, Morgan, and Young (1983), the intervention focuses on teaching students to systematically rate their own behavior according to the rating of their teacher. Although, historically, self-management strategies based on cognitive control have not been found to be effective for students with ADHD, strategies based on contingency management have not been widely reported in the literature. A description of the intervention and two case study illustrations are provided. Potential limitations and implications for research in using this strategy are discussed.
ADHD was long considered to be the attention deficit disorder of childhood. Observations over the long-term have, however, shown that some one-third of victims also continue to meet the criteria for ADHD in adulthood too. In many cases, such additional psychiatric conditions as depression or an addictive illness are also to be seen. Today, ADHD is believed to be a mainly heritable disorder with deviations in the dopaminergic system. Re-evaluation of the condition now focuses attention on the attention-related, rather than the hyperactivity-related aspects of the problem. Currently, the best therapeutic results are achieved through the use of stimulants coupled with intensive paediatric psychiatric care.
Brinksma, Djûke M; Hoekstra, Pieter J; van den Hoofdakker, Barbara; de Bildt, Annelies; Buitelaar, Jan K; Hartman, Catharina A; Dietrich, Andrea
Little is known about the effects of risk factors on attention-deficit/hyperactivity disorder (ADHD) symptom over time. Here, we longitudinally studied the role of candidate genes, pre- and perinatal factors, and their interactions on ADHD symptoms between ages 10 and 18 years. Subjects were part of the general population or clinic-referred cohort of the TRacking Adolescents' Individual Lives Survey (n = 1667). At mean ages of 11.1 (T1), 13.4 (T2), and 16.2 years (T3), ADHD symptoms were assessed with the Child Behavior Checklist. Linear Mixed Models were used to examine the association of candidate genes (i.e., DRD4, DRD2, 5-HTTLPR, COMT, and MAOA), pre- and perinatal factors (i.e., index measure of various pregnancy and delivery complications, maternal smoking, maternal drinking, and low birth weight), and their interactions with ADHD symptoms across adolescence. Pregnancy and delivery complications were associated with a higher level of ADHD symptoms across all time points, but with a significantly declining influence over time (p = 0.006). We found no main effects of the candidate genes on ADHD symptoms throughout adolescence. The simultaneous presence of the low activity MAOA genotype and low birth weight (p < 0.001) and of the 5-HTTLPR LL-allele and respectively pregnancy and delivery complications (p = 0.04) and maternal smoking (p = 0.04) were associated with more ADHD symptoms particularly during early adolescence, and these influences significantly decreased over time. Findings suggest an age-dependent role of gene-environment interactions on ADHD symptoms across adolescence.
Sigurdardottir, Helen L; Kranz, Georg S; Rami-Mark, Christina; James, Gregory M; Vanicek, Thomas; Gryglewski, Gregor; Kautzky, Alexander; Hienert, Marius; Traub-Weidinger, Tatjana; Mitterhauser, Markus; Wadsak, Wolfgang; Hacker, Marcus; Rujescu, Dan; Kasper, Siegfried; Lanzenberger, Rupert
Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder with a strong genetic component. The norepinephrine transporter (NET) is a key target for ADHD treatment and the NET gene has been of high interest as a possible modulator of ADHD pathophysiology. Therefore, we conducted an imaging genetics study to examine possible effects of single nucleotide polymorphisms (SNPs) within the NET gene on NET nondisplaceable binding potential (BPND ) in patients with ADHD and healthy controls (HCs). Twenty adult patients with ADHD and 20 HCs underwent (S,S)-[18F]FMeNER-D2 positron emission tomography (PET) and were genotyped on a MassARRAY MALDI-TOF platform using the Sequenom iPLEX assay. Linear mixed models analyses revealed a genotype-dependent difference in NET BPND between groups in the thalamus and cerebellum. In the thalamus, a functional promoter SNP (-3081 A/T) and a 5'-untranslated region (5'UTR) SNP (-182 T/C), showed higher binding in ADHD patients compared to HCs depending on the major allele. Furthermore, we detected an effect of genotype in HCs, with major allele carriers having lower binding. In contrast, for two 3'UTR SNPs (*269 T/C, *417 A/T), ADHD subjects had lower binding in the cerebellum compared to HCs depending on the major allele. Additionally, symptoms of hyperactivity and impulsivity correlated with NET BPND in the cerebellum depending on genotype. Symptoms correlated positively with cerebellar NET BPND for the major allele, while symptoms correlated negatively to NET BPND in minor allele carriers. Our findings support the role of genetic influence of the NE system on NET binding to be pertubated in ADHD.
Sigurdardottir, Helen L.; Kranz, Georg S.; Rami‐Mark, Christina; James, Gregory M.; Vanicek, Thomas; Gryglewski, Gregor; Kautzky, Alexander; Hienert, Marius; Traub‐Weidinger, Tatjana; Mitterhauser, Markus; Wadsak, Wolfgang; Hacker, Marcus; Rujescu, Dan; Kasper, Siegfried
Abstract Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder with a strong genetic component. The norepinephrine transporter (NET) is a key target for ADHD treatment and the NET gene has been of high interest as a possible modulator of ADHD pathophysiology. Therefore, we conducted an imaging genetics study to examine possible effects of single nucleotide polymorphisms (SNPs) within the NET gene on NET nondisplaceable binding potential (BPND) in patients with ADHD and healthy controls (HCs). Twenty adult patients with ADHD and 20 HCs underwent (S,S)‐[18F]FMeNER‐D2 positron emission tomography (PET) and were genotyped on a MassARRAY MALDI‐TOF platform using the Sequenom iPLEX assay. Linear mixed models analyses revealed a genotype‐dependent difference in NET BPND between groups in the thalamus and cerebellum. In the thalamus, a functional promoter SNP (−3081 A/T) and a 5′‐untranslated region (5′UTR) SNP (−182 T/C), showed higher binding in ADHD patients compared to HCs depending on the major allele. Furthermore, we detected an effect of genotype in HCs, with major allele carriers having lower binding. In contrast, for two 3′UTR SNPs (*269 T/C, *417 A/T), ADHD subjects had lower binding in the cerebellum compared to HCs depending on the major allele. Additionally, symptoms of hyperactivity and impulsivity correlated with NET BPND in the cerebellum depending on genotype. Symptoms correlated positively with cerebellar NET BPND for the major allele, while symptoms correlated negatively to NET BPND in minor allele carriers. Our findings support the role of genetic influence of the NE system on NET binding to be pertubated in ADHD. Hum Brain Mapp 37:884–895, 2016. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:26678348
Sobanski, E; Sabljic, D; Alm, B; Skopp, G; Kettler, N; Mattern, R; Strohbeck-Kühner, P
This study assesses driving behaviour and history of driving outcomes through a semi-structured interview in 27 clinically referred German adults with ADHD and 27 age-, gender- and education-matched non-ADHD controls. In nineteen of the ADHD-subjects a test battery of driving-related cognitive measures was performed (ART 2020) and re-assessed after at least six weeks of treatment with methylphenidate (n = 9) or after a six-week medication free period (n = 10).ADHD-subjects drove significantly more kilometres per year, were more often registered by traffic authorities and fined more frequently, were involved in more accidents and described their driving style as more insecure and hectic than controls. A high-risk driving group was delineated with 3-6 accidents per ADHD-subject. All results were controlled for intercorrelations with driving experience. Methylphenidate treatment resulted in improved information processing, e.g., better visu-motor coordination under high-stress conditions, improved visual orientation and sustained visual attention compared to baseline and our untreated control group.
Hsu, Chia-Fen; Eastwood, John D.; Toplak, Maggie E.
Objective: The avoidance of mental effort is a symptom criterion for Attention-Deficit/Hyperactivity Disorder (ADHD), but the experience of mental effort has received relatively little attention in the empirical study of individuals at-risk for ADHD. We explored a novel method to assess the experience of effort and discomfort during a working memory task in a sample of young adults at-risk and not at-risk for ADHD. Method: A sample of 235 undergraduate students (Mean age = 21.02, 86 males) were included in this study. Based on an ADHD-screener (ASRS), 136 participants met criteria for the ADHD-risk group and 99 were in the non-ADHD risk group. Results: Individuals at-risk for ADHD reported higher mental effort and discomfort than individuals not at-risk for ADHD, even when performance on the working memory task was comparable or statistically controlled. Mental effort required and discomfort were more strongly correlated for at-risk compared to not at-risk participants. Individuals at-risk for ADHD displayed a stronger correlation between mental effort required and actual accuracy, but individuals not at-risk for ADHD displayed a stronger association between perceived accuracy and actual accuracy for the hardest experimental conditions. The most intense moment of effort required predicted retrospective discomfort ratings of the task in the ADHD-risk group, but not in the non-risk group. Conclusion: The subjective experience of in the moment mental effort is an important and viable construct that should be more carefully defined and measured. In particular, the experience of effort required (or how taxing a task is) differentiated between individuals at-risk and individuals not at-risk for ADHD in the present study. Whereas previous ADHD research has explored effort exerted, the present work demonstrated that investigating the experience of being mentally taxed might provide a productive line of investigation that could be used to advance our understanding of the
Vassilopoulou, Antonia; Mavrikaki, Evangelia
Attention deficit hyperactivity disorder (AD/HD) is one of the most frequently occurring disorders in school children, and information and communication technology (ICT) in education is one of the tools that is lately considered as helpful for the education of some children with disorders. This research is a case study--using mixed-methods--of the…
Egeland, Jens; Johansen, Susanne Nordby; Ueland, Torill
As a group, participants with attention-deficit/hyperactivity disorder (ADHD) are impaired in academic performance and learning. This may be due to a mild intellectual impairment, impaired attention, or inability to allocate sufficient effort. If the latter is the case, this should be evident in the learning strategies applied. Four indices of…
Findling, Robert L.; Brams, Matthew; Childress, Ann C.; Lopez, Frank A.; Manos, Michael J.; Jensen, Peter S.
ADHD is one of the most common neurobehavioral disorders of childhood, and FDA-approved medications offer an efficacious treatment option. However, case reports and anecdotal sources suggest that children can have emotional responses, both salutary and detrimental, to these agents. We have previously conducted a comprehensive literature review and…
Halldner, Linda; Tillander, Annika; Lundholm, Cecilia; Boman, Marcus; Långström, Niklas; Larsson, Henrik; Lichtenstein, Paul
Background: We addressed if immaturity relative to peers reflected in birth month increases the likelihood of ADHD diagnosis and treatment. Methods: We linked nationwide Patient and Prescribed Drug Registers and used prospective cohort and nested case-control designs to study 6-69 year-old individuals in Sweden from July 2005 to December 2009…
Costa-Santos, Cristina; Coutinho, Ana; Cruz-Correia, Ricardo; Ferreira, Ana; Costa-Pereira, Altamiro
The main objective of the Introduction to Medicine (IM) subject of the first year of the Medical Course at the Faculty of Medicine of the University of Porto is to provide students with a first contact with the areas of Biostatistics, Medical Informatics, Bioethics and the History of Medicine in the belief that they will be better prepared to learn, research, evaluate, share and decide within their practice. This paper presents a case study that describes how the subject IM is organized and how the b-learning tool (Moodle) is used to correct and grade the students' work. From the 239 students registered to attend the Introduction to Medicine subject 12% failed. The average grade among the successful students was 16 (out of 20). In the previous academic year only 2% of the students failed. However, among the successful students, the average grade was inferior (15 out of 20). The e-learning model that was described in this paper was successful because the results show that the students that made use of the Moodle got better grades.
Infante, M Alejandra; Moore, Eileen M; Nguyen, Tanya T; Fourligas, Nikolaos; Mattson, Sarah N; Riley, Edward P
Attention deficits are often observed in children with prenatal alcohol exposure and attention-deficit/hyperactivity disorder (ADHD) is commonly diagnosed in this population. This study used an objective assessment tool to examine differences between alcohol-exposed and non-exposed children on core symptoms of ADHD: inattention, impulsivity, and hyperactivity. Two groups of individuals, aged 7-14years, participated in the study: alcohol-exposed children (AE, n=43), and non-exposed children (CON, n=54). Subjects were evaluated with the Quotient ADHD System, which provides objective data on ADHD core symptoms by combining an infrared motion tracking system and a computerized continuous performance task. Twelve separate ANCOVAs controlling for the effects of age and sex, were conducted on attention and motion variables. Results revealed that in comparison to the CON group, the AE group was significantly (p's<.05) less accurate, made an increased number of omission errors, had longer response latencies, and increased variability in response time. Moreover, the AE group spent less time staying still, and made an increased number of head movements, which traveled a larger distance, covered a greater area, and demonstrated a less complex movement pattern. No significant group differences were observed on the number of commission errors and temporal scaling. Our findings provide further support for the notion that inattention is a core deficit in children prenatally exposed to alcohol. Results from this study are also consistent with parent reports of increased hyperactivity. The Quotient ADHD System may be a useful objective measure of ADHD symptomatology in children with FASD.
Yang, Hui-Nien; Tai, Yueh-Ming; Yang, Li-Kuang; Gau, Susan Shur-Fen
Childhood attention-deficit/hyperactivity disorder (ADHD) symptoms may persist, co-occur with anxiety and depression (ANX/DEP), and influence quality of life (QoL) in later life. However, the information about whether these persistent ADHD and ANX/DEP mediate the influence of childhood ADHD on adverse QoL in adulthood is lacking. This study aimed to determine whether adult ADHD symptoms and/or ANX/DEP mediated the association between childhood ADHD and QoL. We assessed 1382 young men aged 19-30 years in Taiwan using self-administered questionnaires for retrospective recall of ADHD symptoms at ages 6-12, and assessment of current ADHD and ANX/DEP symptoms, and QoL. We conducted mediation analyses and compared the values of mediation ratio (PM) by adding mediators (adult ADHD and ANX/DEP), individually and simultaneously into a regression model with childhood ADHD as an independent variable and QoL as a dependent variable. Our results showed that both adult ADHD and ANX/DEP symptoms significantly mediated the association between childhood ADHD and QoL (PM=0.71 for ANX/DEP, PM=0.78 for adult ADHD symptoms, and PM=0.91 for both). The significance of negative correlations between childhood ADHD and four domains of adult QoL disappeared after adding these two mediators in the model. Our findings suggested that the strong relationship between childhood ADHD and adult life quality can be explained by the presence of persistent ADHD symptoms and co-occurring ANX/DEP. These two mediators are recommended to be included in the assessment and intervention for ADHD to offset the potential adverse life quality outcome in ADHD.
Edel, Marc-Andreas; Juckel, Georg; Brüne, Martin
Research into attachment and emotion regulation has shown that children with ADHD are at risk of developing attachment disorders and emotion regulation disturbances, which in part may be due to the rearing style of their parents. No such data exists for adults with persistent ADHD. We hypothesized that current attachment style and emotion processing of adult patients with ADHD may be influenced by the presence of parental ADHD symptoms when the now adult patients were children, assuming that ADHD symptoms of parents have an impact on their parenting style. We examined recalled parental ADHD symptoms and rearing style as well as current attachment and emotion regulation abilities in a sample of 73 adults with ADHD using several self-rating instruments. Recalled prevalence of ADHD symptoms in the mother, and less so in the father, of adult patients with ADHD was significantly associated with partly adverse parental rearing styles, current attachment problems in romantic partnerships and emotion regulation disturbances compared with adult ADHD patients without possibly affected parent. ADHD symptoms in parents of children with ADHD may present a risk factor for attachment problems and poor emotion regulation when ADHD children are grown.
Background The aims of this study were to assess the prevalence of a comorbid Attention Deficit Hyperactivity Disorder (ADHD) diagnosis in Borderline Personality Disorder (BPD), and its impact on the clinical presentation of BPD in adolescents, and to determine which type of impulsivity specifically characterizes adolescents with BPD-ADHD. Methods ADHD diagnoses were sought in a sample of 85 DSM-IV BPD adolescents drawn from the EURNET BPD. Axis-I and -II disorders were determined with the K-SADS-PL and the SIDP-IV, respectively. Impulsivity was assessed with the BIS-11. Results 11% (N = 9) of BPD participants had a current ADHD diagnosis. BPD-ADHD adolescents showed higher prevalence of Disruptive disorders (Chi2 = 9.09, p = 0.01) and a non-significant trend for a higher prevalence of other cluster B personality disorders (Chi2 = 2.70, p = 0.08). Regression analyses revealed a significant association between Attentional/Cognitive impulsivity scores and ADHD (Wald Z = 6.69; p = 0.01; Exp(B) = 2.02, CI 95% 1.19-3.45). Conclusions Comorbid ADHD influences the clinical presentation of adolescents with BPD and is associated with higher rates of disruptive disorders, with a trend towards a greater likelihood of cluster B personality disorders and with higher levels of impulsivity, especially of the attentional/cognitive type. A subgroup of BPD patients may exhibit developmentally driven impairments of the inhibitory system persisting since childhood. Specific interventions should be recommended for this subsample of BPD adolescents. PMID:21961882
Ziegler, Sigurd; Pedersen, Mads L; Mowinckel, Athanasia M; Biele, Guido
Attention deficit hyperactivity disorder (ADHD) is characterized by altered decision-making (DM) and reinforcement learning (RL), for which competing theories propose alternative explanations. Computational modelling contributes to understanding DM and RL by integrating behavioural and neurobiological findings, and could elucidate pathogenic mechanisms behind ADHD. This review of neurobiological theories of ADHD describes predictions for the effect of ADHD on DM and RL as described by the drift-diffusion model of DM (DDM) and a basic RL model. Empirical studies employing these models are also reviewed. While theories often agree on how ADHD should be reflected in model parameters, each theory implies a unique combination of predictions. Empirical studies agree with the theories' assumptions of a lowered DDM drift rate in ADHD, while findings are less conclusive for boundary separation. The few studies employing RL models support a lower choice sensitivity in ADHD, but not an altered learning rate. The discussion outlines research areas for further theoretical refinement in the ADHD field.
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.
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…
Efron, Daryl; Sciberras, Emma; Hassell, Phillip
Attention Deficit Hyperactivity Disorder (ADHD) can have a major impact on students' functioning at school--academically and socially. This study examined parental perceptions of schools in relation to their understanding of ADHD, information provided and general support. Parents of consecutive children with ADHD seen at the Centre for Community…
Prevatt, Frances; Proctor, Briley; Baker, Leigh; Garrett, Lori; Yelland, Sherry
Objective: To evaluate the time estimation abilities of college students with ADHD on a novel, complex task that approximated academically oriented activities. Method: Totally 20 college students with ADHD were compared to a sample of 20 non-ADHD students. Both groups completed a task, and scores were obtained for time to complete the task, errors…
Objective: As children with ADHD who have more inattention problems are more frequently with fine motor problems, it is not clear whether postural balance problems are associated with different subtypes of ADHD. This study investigates the predictors of postural stability in children with ADHD considering the covariant factors of age, gender, and…
Kutscher, Martin L.
Contrary to popular opinion, attention deficit hyperactivity disorder (ADHD) is not just about hyperactive people who have short attention spans. ADHD is a disorder that involves difficult problems on a wide range of "executive dysfunction," a wide range of co-occuring conditions, and family problems. People need to recognize that ADHD is not just…
Reck, Sarah G.; Hund, Alycia M.; Landau, Steven
Objective: To determine whether 7- to 12-year-old boys with ADHD, relative to non-ADHD age-mates, exhibit greater difficulty learning and remembering object locations. The second purpose was to examine the functional utility of mnemonic strategies, specifically speech-to-self, used by boys with and without ADHD. Method: Boys with and without ADHD…
O'Laughlin, Elizabeth M.; Yaakoba-Richmond, Rakefet
Attention-deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder of childhood. The extensive research on ADHD indicates that both assessment and treatment of ADHD is best accomplished through the involvement of multiple informants. By establishing a supervisory relationship with a university-based training clinic, child…
Gualtieri, C. Thomas; Johnson, Lynda G.
Objective: Although ADHD medications are effective for the behavioral components of the disorder, little information exists concerning their effects on cognition, especially in community samples. Method: A cross-sectional study of ADHD patients treated with three different ADHD drugs was conducted. Patients' performance on a computerized…
Wymbs, Brian T.; Molina, Brooke S. G.; Belendiuk, Katherine A.; Pedersen, Sarah L.; Walther, Christine A. P.; Cheong, Jee Won; McGinley, James S.; Marshal, Michael P.; Gnagy, Elizabeth M.; Pelham, William E.
Although children with attention-deficit/hyperactivity disorder (ADHD) are at risk for impulsive, health-endangering behavior, few studies have examined nonsubstance, use-related risk-taking behaviors. This study examined whether adolescents and young adults with ADHD histories were more likely than those without ADHD histories to report frequent…
Bender, William N.
This book is intended as a practical guide for parents and teachers in managing children or students with attention deficit hyperactivity disorder (ADHD). Specific strategies and techniques are presented that will facilitate learning for individuals with ADHD in both the home and school environment. Chapters include: "ADHD at Home and in the…
Miller, Jessica A.
Impulsivity is the cardinal symptom of ADHD. It is estimated that ADHD is present in eighteen percent of children and in four percent of adults. The present study repeats and extends a previous study (Gray, Breier, Foorman, & Fletcher, 2002) that measured impulsivity in adolescents with and without ADHD, which found higher false alarm rates…
Pajo, Bora; Cohen, David
An enduring controversy over the nature of ADHD complicates parents' decisions regarding children likely to be diagnosed with the condition. Using a fallibilist perspective, this review examines how researchers construe ADHD and acknowledge the controversy. From a systematic literature search of empirical reports using parents of ADHD-diagnosed…
Carelli, Maria G.; Wiberg, Britt
Objective: ADHD is often associated with difficulties in planning and time management. In this study, the authors examined the hypothesis that these functional problems in ADHD reflect systematic biases in temporal orientation. Method: To test this hypothesis, adults with ADHD (n = 30) and healthy controls (n = 60) completed the Swedish version of…
Yerys, Benjamin E.; Nissley-Tsiopinis, Jenelle; de Marchena, Ashley; Watkins, Marley W.; Antezana, Ligia; Power, Thomas J.; Schultz, Robert T.
Scientists and clinicians regularly use clinical screening tools for attention deficit/hyperactivity disorder (ADHD) to assess comorbidity without empirical evidence that these measures are valid in youth with autism spectrum disorder (ASD). We examined the prevalence of youth meeting ADHD criteria on the ADHD rating scale fourth edition…
Zambo, Debby; Zambo, Ron; Sidlik, Lawrence
Neuroscience is revealing how the brains of individuals with Attention Deficit Hyperactivity Disorder (ADHD) function, and advances in medicine are leading to treatments. This study investigated preservice teachers' knowledge and beliefs about students with ADHD. The majority of preservice teachers knew someone with ADHD, which, along with courses…
Morgan, Paul L.; Hillemeier, Marianne M.; Farkas, George; Maczuga, Steve
Background: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur by kindergarten entry is currently unknown. We investigated risk factors associated with an ADHD diagnosis by kindergarten entry generally, and specifically whether racial/ethnic disparities in ADHD diagnosis occur by…
This study examined Korean early childhood teachers' understanding of behavioural characteristics of children with Attention Deficit/Hyperactivity Disorder (ADHD), difficulties about and concerns for children with ADHD, the kinds of support for which teachers looked, experiences teachers had with the parents of children with ADHD, and…
Tan, Oguz; Metin, Baris; Metin, Sinem
Obsessive-compulsive disorder (OCD) and attention-deficit and hyperactivity disorder (ADHD) frequently coexist. To understand whether childhood ADHD can increase the risk of OCD in adulthood and whether it influences the phenomenology of OCD, we investigated the symptoms of ADHD during childhood in obsessive-compulsive adults who had never been diagnosed as ADHD. Adults with OCD (n = 83) were given the Wender Utah Rating Scale (WURS), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Barratt Impulsiveness Scale-11 (BIS-11), Hamilton Depression Rating Scale-17 (HDRS-17) and Beck Anxiety Inventory (BAI). The prevalence of childhood ADHD symptoms was 40.9 % (n = 34) and that of adult ADHD was 16.9 % (n = 14). Patients with childhood ADHD symptoms had an earlier onset of OCD, higher scores of the BAI and BIS-11. The scores of the Y-BOCS and HDRS-17 did not differ between those having and not having childhood ADHD symptoms. Childhood history of ADHD symptoms is common in adult OCD patients who have never been diagnosed as ADHD. Childhood ADHD symptoms are associated with an earlier age of OCD, more severe anxiety and higher impulsiveness. Even remitted ADHD may be a risk factor for OCD in later life.
Schatz, David Beck; Rostain, Anthony L.
Objective/Method: ADHD is often comorbid with anxiety disorders, with rates approaching 25% in many samples. This current review's goal is to examine the literature on ADHD with comorbid anxiety from 1998 to the present. Results: Recent studies indicate that anxiety in ADHD may a) partially inhibit the impulsivity and response inhibition deficits,…
Fliers, Ellen; Vermeulen, Sita; Rijsdijk, Fruhling; Altink, Marieke; Buschgens, Cathelijne; Rommelse, Nanda; Faraone, Stephen; Sergeant, Joseph; Buitelaar, Jan; Franke, Barbara
Analysis of the data from a genetics study of children with attention-deficit/hyperactivity disorder (ADHD) and their affected or unaffected siblings finds that ADHD-affected children had significantly more motor problems than their unaffected siblings. It is concluded that there is a common basis between ADHD and motor problems that may be due to…
Reilly, Colin J.
ADHD and epilepsy common are both common childhood disorders and both can have significant negative consequences on a child's behavioural, learning, and social development. Both conditions can co-occur and population studies suggest that the prevalence of ADHD in childhood epilepsy is between 12 and 17%. The prevalence of epilepsy in ADHD is lower…
Adler, Lenard A.; Spencer, Thomas; Faraone, Stephen V.; Reimherr, Fred W.; Kelsey, Douglas; Michelson, David; Biederman, Joseph
The standardization of ADHD ratings in adults is important given their differing symptom presentation. The authors investigated the agreement and reliability of rater standardization in a large-scale trial of atomoxetine in adults with ADHD. Training of 91 raters for the investigator-administered ADHD Rating Scale (ADHDRS-IV-Inv) occurred prior to…
Reiersen, Angela M.; Constantino, John N.; Volk, Heather E.; Todd, Richard D.
Background: Most diagnostic nomenclatures do not allow for the concurrent diagnosis of autism and attention-deficit/hyperactivity disorder (ADHD). Clinic-based studies suggest autistic symptoms are common in children with ADHD, but such studies are prone to referral bias. This study assesses whether children with ADHD selected from the general…
Gjervan, Bjorn; Torgersen, Terje; Nordahl, Hans M.; Rasmussen, Kirsten
Objective: ADHD is associated with poor functional outcomes. The objectives were to investigate the prevalence of functional impairment and occupational status in a clinically referred sample of adults with ADHD and explore factors predicting occupational outcome. Method: A sample of 149 adults with a confirmed diagnosis of ADHD participated in…
Miller, Carlin J.; Miller, Scott R.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.
This study focused on the personality characteristics associated with Attention-deficit/Hyperactivity disorder (ADHD) in a longitudinal sample of youth, with a particular focus on differences between those with and without persisting ADHD symptoms. Participants with ADHD (n = 90) were initially evaluated when they were 7-11 years old, and…
Ghanizadeh, Ahmad; Jafari, Peyman
Objective: The objective was to study the cultural structure of Farsi-speaking parents' ratings with diagnostic definitions of ADHD. Method: The children with ADHD and their parents were interviewed. The parents rated their children on the Farsi-speaking parents' ADHD rating questionnaire. Results: The principal components analysis extracted the…
Kepley, Hayden O.; Ostrander, Rick
Objective: To investigate the family environments of children in a community sample with ADHD and co-occurring anxiety. Method: Family Environment Scale, Behavioral Assessment System for Children, and Structured Clinical Interview are administered to parents of children with ADHD with and without anxiety. Results: ADHD families are uniformly less…
Mortberg, Ewa; Tilfors, Kerstin; Bejerot, Susanne
Objective: Recent studies have suggested a link between a primary anxiety disorder and ADHD. Method: A total of 39 participants with a primary diagnosis of social phobia were compared with 178 patients with ADHD and 88 patients with other psychiatric disorders on measures for childhood and adult ADHD (the Wender Utah Rating Scale and the Adult…
Staikova, Ekaterina; Gomes, Hilary; Tartter, Vivien; McCabe, Allyssa; Halperin, Jeffrey M.
Background: Impaired social functioning has been well documented in individuals with attention-deficit/hyperactivity disorder (ADHD). Existing treatments for ADHD are effective for managing core symptoms, but have limited effectiveness at improving social skills, suggesting that social deficits in ADHD may not be directly related to core symptoms…
DuPaul, George J.; Weyandt, Lisa L.; O'Dell, Sean M.; Varejao, Michael
Approximately 2 to 8% of the college population reports clinically significant levels of ADHD symptomatology and at least 25% of college students with disabilities are diagnosed with ADHD. A comprehensive review of the literature was conducted with findings consistently indicating academic deficits associated with ADHD in college students. It is…
Killeen, Peter R; Russell, Vivienne A; Sergeant, Joseph A
Energetic insufficiency in neurons due to inadequate lactate supply is implicated in several neuropathologies, including attention-deficit/hyperactivity disorder (ADHD). By formalizing the mechanism and implications of such constraints on function, the behavioral Neuroenergetics Theory (NeT) predicts the results of many neuropsychological tasks involving individuals with ADHD and kindred dysfunctions, and entails many novel predictions. The associated diffusion model predicts that response times will follow a mixture of Wald distributions from the attentive state, and ex-Wald distributions after attentional lapses. It is inferred from the model that ADHD participants can bring only 75-85% of the neurocognitive energy to bear on tasks, and allocate only about 85% of the cognitive resources of comparison groups. Parameters derived from the model in specific tasks predict performance in other tasks, and in clinical conditions often associated with ADHD. The primary action of therapeutic stimulants is to increase norepinephrine in active regions of the brain. This activates glial adrenoceptors, increasing the release of lactate from astrocytes to fuel depleted neurons. The theory is aligned with other approaches and integrated with more general theories of ADHD. Therapeutic implications are explored.
Mannuzza, Salvatore; Klein, Rachel G.; Moulton, John L.
This study investigates the relationship between childhood attention deficit hyperactivity disorder (ADHD) and later criminality. White boys (n = 207, ages 6–12) with ADHD, free of conduct disorder, were assessed at ages 18 and 25 by clinicians who were blind to childhood status. A non-ADHD group served as comparisons. Lifetime arrest records were obtained when subjects were 38 years old for subjects who resided in New York State throughout the follow-up interval (93 probands, 93 comparisons). Significantly more ADHD probands than comparisons had been arrested (47% vs. 24%), convicted (42% vs. 14%), and incarcerated (15% vs. 1%). Rates of felonies and aggressive offenses also were significantly higher among probands. Importantly, the development of an antisocial or substance use disorder in adolescence completely explained the increased risk for subsequent criminality. Results suggest that even in the absence of comorbid conduct disorder in childhood, ADHD increases the risk for developing antisocial and substance use disorders in adolescence, which, in turn, increases the risk for criminal behavior in adolescence and adulthood. PMID:18707766
Gauthier, Bruno; Parent, Véronique; Lageix, Philippe
The neuropsychology of attention deficit/hyperactivity disorder (ADHD) has been extensively studied, with a general focus on global performance measures of executive function. In this study, we compared how global (i.e., endpoint) versus process (i.e., dynamic) measures of performance may help characterize children with and without ADHD using a design fluency task as a case study. The secondary goal was to compare the sensitivity of standard versus connectionist statistical models to group differences in cognitive data. Thirty-four children diagnosed with ADHD and 37 children without ADHD aged 8-11 years old were tested on the Five-Point Test. The continuous process measure of performance, indexed as the number of produced designs at each consecutive 1 minute interval during 5 minutes, was analyzed against the discrete process measure, that is, the number of designs between first and last intervals and the standard global performance measure of total number of produced designs. Results show that the continuous process measure distinguished the two groups better than the two other measures. The detailed observation of production patterns revealed a decreasing linear trajectory in children without ADHD that contrasts with the flat, but fluctuating productivity pattern of children with ADHD. With regards to the second goal, results show that the connectionist and standard methods are equally sensitive to group differences for the three types of measures. This illustrates the utility of quantitative process measures together with the connectionist method in neuropsychological research and suggests great potential for a dynamical approach to cognition.
Conner, Alex C; Kissling, Christian; Hodges, Edward; Hünnerkopf, Regina; Clement, R Marc; Dudley, Edward; Freitag, Christine M; Rösler, Michael; Retz, Wolfgang; Thome, Johannes
Adult attention deficit hyperactivity disorder (ADHD) is a widely under-reported but nevertheless common condition with a clear heritable component. Several genes have been proposed to play a role in the childhood onset of this neurodevelopmental disorder; however, association studies of persistence of ADHD into adulthood have rarely been performed. Neurotrophic factors (NTFs) are known to be involved in several aspects of neuronal development and neural plasticity in adults. They have also been linked, particularly through brain-derived neurotrophic factor (BDNF) interaction with dopamine transport, to the pathophysiology of ADHD. This study compares the genotypes of six different single nucleotide polymorphisms of genes within the neurotrophin system and their possible association with adult ADHD score in 143 high-risk male subjects referred to a forensic psychiatric unit. The genes included NTF3, NTRK2 (TrkB), NTRK3 (TrkC), BDNF, and p75(NTR). While none of the SNPs showed significant association with ADHD symptoms, one polymorphism within the exon of NTF3 (rs6332) showed a trend toward an association between the A-allele and increased scores using both the retrospective childhood analysis Wender-Utah Rating Scale (WURS-k) (P = 0.05) and the adult ADHD assessment Wender-Reimherr interview (P = 0.03). This SNP is a silent mutation which might be in linkage disequilibrium with a functional risk variant for ADHD. As the association was only suggestive, however, this finding needs replication in a larger study with higher power.
Sadeghi-Bazargani, Homayoun; Abedi, Leili; Mahini, Minoo; Amiri, Shahrokh; Khorasani-Zavareh, Davoud
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
van Hulst, Branko M.; de Zeeuw, Patrick; Bos, Dienke J.; Rijks, Yvonne; Neggers, Sebastiaan F. W.; Durston, Sarah
Background: Changes in reward processing are thought to be involved in the etiology of attention-deficit/hyperactivity disorder (ADHD), as well as other developmental disorders. In addition, different forms of therapy for ADHD rely on reinforcement principles. As such, improved understanding of reward processing in ADHD could eventually lead to…
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Anderson, Donnah L.; Watt, Susan E.; Noble, William; Shanley, Dianne C.
Knowledge of attention deficit hyperactivity disorder (ADHD) and attitudes toward teaching children with ADHD are compared across stages of Australian teachers' careers. Relative to pre-service teachers with (n = 218) and without (n = 109) teaching experience, in-service teachers (n = 127) show more overall knowledge of ADHD, more knowledge of…
Nelson, Jason M.; Gregg, Noel
Objective: To investigate depressive and anxious symptomatology among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. Method: Transitioning adolescents and college students with these disorders along with a non-ADHD/dyslexia college sample completed self-report measures of depression and anxiety.…
Antshel, Kevin M.; Faraone, Stephen V.; Maglione, Katherine; Doyle, Alysa; Fried, Ronna; Seidman, Larry; Biederman, Joseph
A study was conducted to establish the relationship between Attention-Deficit/Hyperactivity (ADHD) disorder and high-IQ children and whether ADHD has a high predictive value among youths with high-IQ. Results further supported the hypothesis for the predictive validity of ADHD in high-IQ youths.
Liotti, Mario; Pliszka, Steven R.; Higgins, Kellie; Perez, Ricardo, III; Semrud-Clikeman, Margaret
Executive function and working memory deficits are not only present in ADHD, but also in reading disorder (RD). Here, high-density ERPs were recorded during the Stop Signal Task in 53 children and adolescents: An ADHD-combined type group, a group with RD, and a healthy control group. The ADHD-C group displayed unique abnormalities of the frontal…
Díaz-Rodríguez, Miguel; Valera, Angel; Page, Alvaro; Besa, Antonio; Mata, Vicente
Accurate knowledge of body segment inertia parameters (BSIP) improves the assessment of dynamic analysis based on biomechanical models, which is of paramount importance in fields such as sport activities or impact crash test. Early approaches for BSIP identification rely on the experiments conducted on cadavers or through imaging techniques conducted on living subjects. Recent approaches for BSIP identification rely on inverse dynamic modeling. However, most of the approaches are focused on the entire body, and verification of BSIP for dynamic analysis for distal segment or chain of segments, which has proven to be of significant importance in impact test studies, is rarely established. Previous studies have suggested that BSIP should be obtained by using subject-specific identification techniques. To this end, our paper develops a novel approach for estimating subject-specific BSIP based on static and dynamics identification models (SIM, DIM). We test the validity of SIM and DIM by comparing the results using parameters obtained from a regression model proposed by De Leva (1996, "Adjustments to Zatsiorsky-Seluyanov's Segment Inertia Parameters," J. Biomech., 29(9), pp. 1223-1230). Both SIM and DIM are developed considering robotics formalism. First, the static model allows the mass and center of gravity (COG) to be estimated. Second, the results from the static model are included in the dynamics equation allowing us to estimate the moment of inertia (MOI). As a case study, we applied the approach to evaluate the dynamics modeling of the head complex. Findings provide some insight into the validity not only of the proposed method but also of the application proposed by De Leva (1996, "Adjustments to Zatsiorsky-Seluyanov's Segment Inertia Parameters," J. Biomech., 29(9), pp. 1223-1230) for dynamic modeling of body segments.
Belcaro, G; Feragalli, B; Cornelli, U; Dugall, M
This case report (supplement registry study) evaluated subjects with painful 'stress' arthritis of the hand mainly localized at the joints. The patients received a suggestion to follow a rehabilitation plan (standard management; SM). A second group also used the same SM in association with the oral, pharma-standard supplement FlexiQule (Alchem) a new standardized, phytosomal preparation manufactured from the Boswellia plant, which can be used for self-management in inflammatory conditions (150 mg / 3 times daily). The two resulting registry groups included 12 subjects using SM+Flexiqule and and 11 controls (SM only). The groups were comparable. Serology showed no significant alterations: only ESR was slightly elevated (minimal elevation). After 2 weeks, the ESR was normal in the supplement group and mildly elevated in controls (p<0.05%). The decrease in hypertermic areas was greater/faster (p<0.05) in the supplement group. The identification of a working stress and the localization to the dominant hand was comparable in both groups. At 2 weeks, the decrease in pain was significantly faster and more important with the supplement (p<0.05). The hand became more usable in time and the score was better with the supplement (p<0.05). No supplemented patient had to use other drugs, while in the control group 3 subjects eventually used NSAIDs to control pain and stiffness and one used corticosteroids. In conclusion, the natural extract Flexiqule was effective in controlling work-related stress arthritis (without inflammaìtory signs) over a 2 weeks period, better than only Standard Management. More prolonged and larger studies are needed.
This exploratory phenomenological case study investigated the influence the full integration of the arts into core subject instruction has on classroom environment, student academic achievement, and student engagement as perceived by administrators, teachers, and students in one East Texas secondary school. Participant interviews were analyzed using Creswell's (2012) six-step method for analyzing phenomenological studies. The researcher implemented three learning activities in which ceramics learning objectives were fully integrated with chemistry learning objectives. The first activity combined clay properties and pottery wheel throwing with significant numbers. The second activity combined glaze formulation with moles. The third combined stoichiometry with the increased glaze formula for students to glaze the bowls they made. Findings suggest the full integration of art in core subject area instruction has numerous positive effects. Participants reported improved academic achievement for all students including reluctant learners. Students, teachers, and the administrator reported greater participation in the art integrated activities. Participants perceived a need for further training for teachers and administrators for greater success.
Background Most children who are diagnosed with attention deficit-hyperactivity disorder (ADHD) have moderate-to-severe motor problems using the Motor Function Neurological Assessment battery (MFNU). The MFNU focuses on specific muscle adjustment problems associated with ADHD, especially motor inhibition problems and high muscle tone. Here we investigated whether adults with ADHD/hyperkinetic disorder (HKD) have similar motor problems. In our clinical experience, adults with ADHD often complain about back, shoulder, hip, and leg pain. We also investigate reported pain in adults with ADHD. Methods Twenty-five adult outpatients diagnosed with ADHD/HKD who were responders to methylphenidate (MPH) were compared to 23 non-ADHD controls on 16 MFNU subtests and using a ‘total score’ (‘TS’) parameter. The MFNU test leader was blinded to group identity. The two groups were also compared using the Pain Drawing and Numerical Pain Rating Scale. Results The adult ADHD group had significantly (p < .001) more motor problems (higher TS) than controls. On the muscle regulation subtests, 36–96% of the ADHD group showed ‘moderate’ to ‘severe’ problems compared to 13–52% of the control group, and 80% of the ADHD group reported widespread pain. Highly significant differences were found between the ADHD and control groups for the variables ‘pain level’ (p < .001) and ‘pain location’ (p < .001). Significant correlations were found between TS and ‘pain location’ and between TS and ‘pain level’. Conclusions These findings suggest that similar to children with ADHD, adults diagnosed with ADHD also have motor inhibition problems and heightened muscle tone. The presence of significantly higher pain levels and more widespread pain in the ADHD group compared to non-ADHD controls might indicate that pain is a long-term secondary effect of heightened muscle tone and restricted movement that can be demonstrated in children and adults by the MFNU
Attention deficit hyperactivity disorder (ADHD) is a neurocognitive behavioral developmental disorder most commonly seen in childhood and adolescence, which often extends to the adult years. Relative to a decade ago, there has been extensive research into understanding the factors underlying ADHD, leading to far more treatment options available for both adolescents and adults with this disorder. Novel stimulant formulations have made it possible to tailor treatment to the duration of efficacy required by patients, and to help mitigate the potential for abuse, misuse and diversion. Several new non-stimulant options have also emerged in the past few years. Among these, cognitive behavioral interventions have proven popular in the treatment of adult ADHD, especially within the adult population who cannot or will not use medications, along with the many medication-treated patients who continue to show residual disability. PMID:21658285
Lenartowicz, Agatha; Loo, Sandra K.
Electroencephalography (EEG) has, historically, played a focal role in the assessment of neural function in children with attention deficit hyperactivity disorder (ADHD). We review here the most recent developments in the utility of EEG in the diagnosis of ADHD, with emphasis on the most commonly used and emerging EEG metrics and their reliability in diagnostic classification. Considering the clinical heterogeneity of ADHD and the complexity of information available from the EEG signals, we suggest that considerable benefits are to be gained from multivariate analyses and a focus towards understanding of the neural generators of EEG. We conclude that while EEG cannot currently be used as a diagnostic tool, vast developments in analytical and technological tools in its domain anticipate future progress in its utility in the clinical setting. PMID:25234074
Weiss, Margaret D; Baer, Susan; Allan, Blake A; Saran, Kelly; Schibuk, Heidi
Children's use of electronic media, including Internet and video gaming, has increased dramatically to an average in the general population of roughly 3 h per day. Some children cannot control their Internet use leading to increasing research on "internet addiction." The objective of this article is to review the research on ADHD as a risk factor for Internet addiction and gaming, its complications, and what research and methodological questions remain to be addressed. The literature search was done in PubMed and Psychinfo, as well as by hand. Previous research has demonstrated rates of Internet addiction as high as 25% in the population and that it is addiction more than time of use that is best correlated with psychopathology. Various studies confirm that psychiatric disorders, and ADHD in particular, are associated with overuse, with severity of ADHD specifically correlated with the amount of use. ADHD children may be vulnerable since these games operate in brief segments that are not attention demanding. In addition, they offer immediate rewards with a strong incentive to increase the reward by trying the next level. The time spent on these games may also exacerbate ADHD symptoms, if not directly then through the loss of time spent on more developmentally challenging tasks. While this is a major issue for many parents, there is no empirical research on effective treatment. Internet and off-line gaming overuse and addiction are serious concerns for ADHD youth. Research is limited by the lack of measures for youth or parents, studies of children at risk, and studies of impact and treatment.
Migdalska, Anna; Nawara, Magdalena; Bal, Jerzy; Mazurczak, Tadeusz
Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder of childhood, affecting approximately 5-10% of children. ADHD is considered to be a multifactorial disorder because both genetic and environmental components may contribute to its progress. The etiology of attention deficit hyperactivity disorder (ADHD) is unknown, however family, twin and adoption studies have suggested that genetic factors are very important in its etiopathogenesis. The research of genetic basis of ADHD consists of linkage analysis, candidate gene approach and association studies. These analyses and also investigations on animal models of disease suggest that mutations in genes involved in dopaminergic, serotonergic and adrenergic systems are likely to be responsible for ADHD.
Mastronardi, C A; Pillai, E; Pineda, D A; Martinez, A F; Lopera, F; Velez, J I; Palacio, J D; Patel, H; Easteal, S; Acosta, M T; Castellanos, F X; Muenke, M; Arcos-Burgos, M
Attention-deficit/hyperactivity disorder (ADHD) is a heritable, chronic, neurodevelopmental disorder with serious long-term repercussions. Despite being one of the most common cognitive disorders, the clinical diagnosis of ADHD is based on subjective assessments of perceived behaviors. Endophenotypes (neurobiological markers that cosegregate and are associated with an illness) are thought to provide a more powerful and objective framework for revealing the underlying neurobiology than syndromic psychiatric classification. Here, we present the results of applying genetic linkage and association analyses to neuropsychological endophenotypes using microsatellite and single nucleotide polymorphisms. We found several new genetic regions linked and/or associated with these endophenotypes, and others previously associated to ADHD, for example, loci harbored in the LPHN3, FGF1, POLR2A, CHRNA4 and ANKFY1 genes. These findings, when compared with those linked and/or associated to ADHD, suggest that these endophenotypes lie on shared pathways. The genetic information provided by this study offers a novel and complementary method of assessing the genetic causes underpinning the susceptibility to behavioral conditions and may offer new insights on the neurobiology of the disorder.
Mastronardi, C A; Pillai, E; Pineda, D A; Martinez, A F; Lopera, F; Velez, J I; Palacio, J D; Patel, H; Easteal, S; Acosta, M T; Castellanos, F X; Muenke, M; Arcos-Burgos, M
Attention-deficit/hyperactivity disorder (ADHD) is a heritable, chronic, neurodevelopmental disorder with serious long-term repercussions. Despite being one of the most common cognitive disorders, the clinical diagnosis of ADHD is based on subjective assessments of perceived behaviors. Endophenotypes (neurobiological markers that cosegregate and are associated with an illness) are thought to provide a more powerful and objective framework for revealing the underlying neurobiology than syndromic psychiatric classification. Here, we present the results of applying genetic linkage and association analyses to neuropsychological endophenotypes using microsatellite and single nucleotide polymorphisms. We found several new genetic regions linked and/or associated with these endophenotypes, and others previously associated to ADHD, for example, loci harbored in the LPHN3, FGF1, POLR2A, CHRNA4 and ANKFY1 genes. These findings, when compared with those linked and/or associated to ADHD, suggest that these endophenotypes lie on shared pathways. The genetic information provided by this study offers a novel and complementary method of assessing the genetic causes underpinning the susceptibility to behavioral conditions and may offer new insights on the neurobiology of the disorder. PMID:26598068
Choi, Inah; Kim, Pitna; Joo, So Hyun; Kim, Min Kyeong; Park, Jin Hee; Kim, Hee Jin; Ryu, Jong Hoon; Cheong, Jae Hoon; Shin, Chan Young
Ethanol exposure during gestational period is related to growth retardation, morphological abnormality, and even in neurological abnormalities including attention deficit/hyperactivity disorder (ADHD)-like behaviors on offspring. However, relatively little is known about the effects of maternal ethanol consumption prior to conception on their offspring. In this study, we investi-gated whether maternal ethanol administration during preconceptional phase produces ADHD-like behaviors in the rat offspring. Sprague-Dawley (SD) female rats were administrated ethanol via intragastric intubation with dosing regimen of 6 g/kg daily for 10 consecutive days and treated female rats then mated with non-treated male SD rats after 8 weeks. Another group subjected to the same procedure as those conducted on ethanol treated group except the saline administration instead of ethanol. Offspring was tested for their ADHD-like behaviors using open field test, Y maze test and impulsivity test that is performed in the aversive electronic foot shock paradigm. Offspring of preconceptional ethanol treated (EtOH) group showed hyperlocomotive activity, attention deficit and impulsivity. And reduction of striatal dopamine transporter (DAT) level was observed by Western blot in the EtOH group, compared to control (Con) group, while the immunohistochemical analysis exhibited increased expression of norepinephrine transporter (NET) in the frontal cortex. These results suggest that maternal ethanol consumption in the preconceptional phase induces ADHD-like behaviors in offspring that might be related to the abnormal expression of DAT and NET in rat. PMID:24116300
Marx, Ivo; Pieper, Juliane; Berger, Christoph; Hässler, Frank; Herpertz, Sabine C
In this study, we examined the influence of both reward and penalty on delay decisions in subjects with ADHD. Eighteen 6- to 13-year-old boys with ADHD (combined or hyperactive-impulsive subtype) along with age- and IQ-matched control participants performed a memory game. If the children were successful at the game, they could choose between a small immediate reward (one white chip in exchange for 5 s of waiting) or a large delayed reward (two white chips in exchange for 60 s of waiting). If they failed, they could choose between a large immediate penalty (two black chips in exchange for 5 s of waiting) or a small delayed penalty (one black chip in exchange for 60 s of waiting). Subsequent to task completion, white chips were exchanged for video time and black chips were exchanged with completion of a written task. All of the participants, regardless of ADHD diagnosis, were motivated to complete the task and chose the delayed alternative most often. We conclude that under highly motivating conditions, children with ADHD are not more delay averse than children from the control group with respect to anticipation of reward and penalty.
Ahmadlou, Mehran; Adeli, Hojjat
A multi-paradigm methodology is presented for electroencephalogram (EEG) based diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) through adroit integration of nonlinear science; wavelets, a signal processing technique; and neural networks, a pattern recognition technique. The selected nonlinear features are generalized synchronizations known as synchronization likelihoods (SL), both among all electrodes and among electrode pairs. The methodology consists of three parts: first detecting the more synchronized loci (group 1) and loci with more discriminative deficit connections (group 2). Using SLs among all electrodes, discriminative SLs in certain sub-bands are extracted. In part two, SLs are computed, not among all electrodes, but between loci of group 1 and loci of group 2 in all sub-bands and the band-limited EEG. This part leads to more accurate detection of deficit connections, and not just deficit areas, but more discriminative SLs in sub-bands with finer resolutions. In part three, a classification technique, radial basis function neural network, is used to distinguish ADHD from normal subjects. The methodology was applied to EEG data obtained from 47 ADHD and 7 control individuals with eyes closed. The Radial Basis Function (RBF) neural network classifier yielded a high accuracy of 95.6% for diagnosis of the ADHD in the feature space discovered in this research with a variance of 0.7%.
Pauli-Pott, Ursula; Becker, Katja
Normative development of neuropsychological functions that are assumed to underlie attention deficit/hyperactivity disorder (ADHD) may show transition periods, i.e., periods of heightened developmental discontinuity and reduced differential continuity. During such periods differences between ADHD cases and controls in these functions might be obscured because assessments probably not only reflect individual differences in the ADHD-related deviation but also individual differences in speed/onset of the transition. Our review focuses on executive inhibitory control (IC) and delay aversion/discounting (DA) because normative developmental processes of these characteristics are relatively well described. For complex IC performance a transition period can be assumed in preschool years, for DA around puberty. Published meta-analyses on neuropsychological IC tasks and a meta-regression analysis of 23 case-control comparisons in DA tasks comprising 1395 individuals with ADHD and 1195 controls confirmed our assumption. Effect sizes of case-control comparisons were significantly larger outside transition periods, i.e., in age-periods of relative developmental continuity. An increasingly precise identification of such time windows could contribute to the understanding of the etiological pathways of ADHD.
Moroney, Elizabeth; Tung, Irene; Brammer, Whitney A; Peris, Tara S; Lee, Steve S
Although parental attention-deficit/hyperactivity disorder (ADHD) is a risk factor for multiple negative youth outcomes, it is unknown how change in parental ADHD symptoms over time affects change in child ADHD symptoms; moreover, mediators of these predictions are largely unknown. Parents of 230 5-10 year-old children (68 % male) with (n = 120) and without ADHD (n = 110) were followed prospectively for 6-7 years across three separate waves. Parents self-reported their ADHD and depression symptoms and similarly rated offspring ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms; youth self-reported their substance use. Temporally-ordered mediators consisted of parental expressed emotion (EE), derived from the Five Minute Speech Sample, and self-reported positive and negative parenting behavior. Controlling for key demographics and parental depression symptoms, increasing parental ADHD symptoms were a time-varying predictor of worsening youth ADHD and ODD, although it was unrelated to change in CD and alcohol/substance use. Next, although EE facets (i.e., criticism, emotional over-involvement) did not mediate these predictions, negative parenting behavior significantly mediated predictions of youth ADHD (and marginally in predictions of ODD) from parental ADHD symptoms. These quasi-experimental findings suggest that parental ADHD symptoms are a potential unique causal risk factor for offspring ADHD and ODD; also, preventing negative parenting behavior secondary to parental ADHD symptoms is critical to improve trajectories of youth ADHD and ODD. We consider parental ADHD symptoms and family factors underlying emergent externalizing problems utilizing a developmental psychopathology framework, including implications for intervention and prevention.
The aim of this paper is to build a case for the utility of conceptualizing ADHD, not as a unitary disorder that contains several subtypes, but rather as a marker of impairment in attention and/or impulsivity that can be used to identify one of several disorders belonging to a spectrum. The literature will be reviewed to provide an overview of what is known about ADHD in terms of heterogeneity in symptomatology, neuropsychology, neurobiology, as well as comorbidity with other diseases and treatment options. The data from these areas of research will be critically analyzed to support the construct of a spectrum of disorders that can capture the great variability that exists between individuals with ADHD and can discriminate between separate disorders that manifest similar symptoms. The symptoms associated with ADHD can be viewed as dimensional markers that point to a spectrum of related disorders that have as part of their characteristics impairments of attention and impulsivity. The spectrum can accommodate symmetrically and asymmetrically comorbid psychiatric disorders associated with ADHD as well as the wide heterogeneity known to be a part of the ADHD disorder. Individuals presenting with impairments associated with ADHD should be treated as having a positive marker for a spectrum disorder that has as part of its characteristics impairments of attention and/or impulsivity. The identification of impairment in attention and/or impulsivity should be a starting point for further testing rather than being an endpoint of diagnosis that results in pharmacological treatment that may or may not be the optimal therapy. Rather than continuing to attribute a large amount of heterogeneity in symptom presentation as well as a high degree of symmetric and asymmetric comorbidity to a single disorder, clinical evaluation should turn to the diagnosis of the type of attentional deficit and/or impulsivity an individual has in order to colocate the individual's disorder on a
Joseph, Nidhin; Zhang-James, Yanli; Perl, Andras; Faraone, Stephen V.
Objective To clarify the role of oxidative stress and antioxidant activity in ADHD. Method We examined the association of ADHD and oxidative stress by applying random effects meta-analysis to studies of oxidative stress and antioxidant status in medication naive patients with ADHD and controls. Results Six studies of a total of 231 ADHD patients and 207 controls met our selection criteria. The association between ADHD and antioxidant status was not significant. We found a significant association between ADHD and oxidative stress that could not be accounted for by publication bias. The significant association lost significance after correcting for intrastudy clustering. No one observation accounted for the positive result. Conclusion These results are preliminary given the small number of studies. They suggest that patients with ADHD have normal levels of antioxidant production, but that their response to oxidative stress is insufficient, leading to oxidative damage. PMID:24232168
Duda, Thomas A; Casey, Joseph E; McNevin, Nancy
Although graphomotor differences and variability of performance have been observed in children with attention deficit hyperactivity disorder (ADHD), no study has investigated whether this variability manifests in the kinematic graphomotor domain in adults with ADHD. Fourteen ADHD and 20 control participants wrote a novel grapheme and common word on a digitizing tablet 30 times each, with ADHD participants counterbalanced on and off stimulant medication. Variability of graphomotor fluency was significantly greater in ADHD versus control participants only in the novel writing task, both on, F(1,31)=5.988, p=.020, and off stimulant medication, F(1,32)=8.789, p=.006. Results suggest that motor control differences in ADHD are not limited to childhood and extend into adulthood. Given sufficient additional research, variability of kinematic graphomotor fluency may increase the sensitivity/specificity of differential diagnoses and/or represent a biomarker for ADHD.
de Jong, Christien G W; Licht, Robert; Sergeant, Joseph A; Oosterlaan, Jaap
In order to achieve further insight into the comorbidity of reading disorder (RD) and attention deficit/hyperactivity disorder (ADHD), lexical processing and rapid naming were studied in RD and ADHD. The Dual Route Cascaded model postulates that lexical processing contains two parallel processes: lexical route processing and sublexical route processing. An orthographic decision task and a phonological decision task were used to measure lexical and sublexical route processing, respectively. In addition, a rapid naming task was used to compare 27 children with RD, 18 children with ADHD, 20 children with ADHD+RD, and 29 controls. RD and ADHD shared impairments in accuracy of orthographic and phonological decision making as well as in rapid naming, which suggest that RD and ADHD may be overlapping disorders that share deficits in both lexical route and sublexical route processing. RD was dissociated from ADHD by being slower in both orthographical and phonological decision making that indicates unique deficits in RD on lexical and sublexical speed.
Hirvikoski, T; Waaler, E; Lindström, T; Bölte, S; Jokinen, J
The aim of this pilot study was to investigate the feasibility and effectiveness of a new psychoeducative intervention program (PEGASUS) for adults with ADHD and their significant others in a psychiatric outpatient context. At three outpatient psychiatric clinics, adults with ADHD and their significant others took part in PEGASUS, a psychoeducational program based on theories from cognitive behavioral therapy, neuropsychology, and cross-disciplinary evidence regarding ADHD. In total, 108 adults were allocated to treatment (51 with ADHD and their 57 significant others). Feasibility was evaluated regarding suitability of the intervention at a psychiatric outpatient clinic and treatment completion. Preliminary efficacy was evaluated per protocol from baseline to post-intervention (n = 41 adults with ADHD and 40 significant others). In a feasibility analysis, the intervention was judged to be a suitable treatment option for 94.5 % of all individuals with a primary diagnosis of ADHD at an outpatient psychiatric clinic. In total, 43 out of 51 allocated individuals with ADHD (84.3 %) completed the intervention. The corresponding figures for their significant others were 42 out of 57 (73.7 %). Knowledge about ADHD increased, and both the quality of relationships and psychological well-being improved from baseline to post-intervention in all participants. The significant others reported a reduction in the subjective burden of care, such as worry and guilt. The objective burden of care (such as financial problems) did not change. The findings support the potential value of psychoeducation for adults with ADHD and their significant others. An ongoing randomized controlled trial will generate further evidence concerning the PEGASUS program.
Franc, N; Maury, M; Purper-Ouakil, D
Attention-deficit/hyperactivity disorder (ADHD) is defined on the basis of developmentally inappropriate inattention, motor activity and impulsivity that emerges early in development and causes impairment in social and academic functioning. ADHD is described as a multifactorial disease, with a well studied genetic vulnerability, and early environmental factors also playing an important role in the development and course of the disorder. Current aetiological models emphasize interaction between genes and environment. The concept of attachment, as proposed by John Bowlby, reflects quality of early interactions, and should therefore be considered as an early developmental factor. First, clinical findings emphasize similitude between both disorders; emotional dysregulation is an important feature in reactive attachment disorder as well as in ADHD. Emotion regulation is highly related to attachment security in young children and could play a part in the development of early attention processes. Moreover, difficult temperament is associated with higher risk for ADHD on the one hand, and can disturb the process of attachment on the other. Parental caregiving - including maternal sensitivity, positive parenting practices - is a main factor involved in the development of attachment, and has shown to be associated with better outcomes in ADHD children, especially with less oppositional/conduct disorders. Second, the aim of our review is to present clinical studies that have looked for a link between ADHD and attachment: the type of attachment could play a part in the course of the disorder: insecure and disorganised attachment types tend to be associated with a higher risk of externalised behaviors in children. For ADHD, this effect seems to be weaker than for other externalised disorders, and has been shown only in populations of at-risk children. Clinical studies also raise the question of possible links between reactive attachment disorder and ADHD. In children suffering
Wilens, Timothy; McBurnett, Keith; Stein, Mark; Lerner, Marc; Spencer, Thomas; Wolraich, Mark
Objective: Few studies have assessed effectiveness and tolerability of stimulants when used for prolonged periods in children with attention-deficit/hyperactivity disorder (ADHD). This article presents final results from an open-label, multisite study of a once-daily formulation of methylphenidate (MPH), OROS[R] MPH. Method: Subjects received OROS…
Filho, Alceu Gomes Correia; Bodanese, Rafael; Silva, Tatiana Laufer; Alvares, Julia Paglioza; Aman, Michael; Rohde, Luis Augusto
Objective: To evaluate the short-term efficacy and tolerability of risperidone and methylphenidate for reducing symptoms related to attention-deficit/hyperactivity disorder (ADHD) in children and adolescents with moderate mental retardation. Method: In a 4-week, single-blind, parallel-group trial, 45 subjects with moderate mental retardation and…
Greenewald, M. Jane; Walsh, Cheryl
An attention deficit hyperactivity disorder (ADHD) student's impulsivity and inattentiveness were interfering with his learning and that of his classmates. Prior to experimental intervention, a simple event recording was conducted over nine class periods to determine the frequency of this subject's impulsivity and inattentiveness. For ease of…
Spinelli, Simona; Vasa, Roma A.; Joel, Suresh; Nelson, Tess E.; Pekar, James J.; Mostofsky, Stewart H.
Background: Error processing is reflected, behaviorally, by slower reaction times (RT) on trials immediately following an error (post-error). Children with attention-deficit hyperactivity disorder (ADHD) fail to show RT slowing and demonstrate increased intra-subject variability (ISV) on post-error trials. The neural correlates of these behavioral…
Field, Sharon; Parker, David R.; Sawilowsky, Shlomo; Rolands, Laura
The effects of coaching on learning and study skills, self-regulation, and subjective well-being of students with ADHD attending 2- and 4-year colleges or universities was examined. Students were randomly assigned to participate in coaching or comparison groups. Coaching students received weekly phone-based coaching sessions and additional…
Plumer, Pamela J.; Stoner, Gary
This study investigates the effects of Classwide Peer Tutoring (CWPT) and peer coaching on the peer social behaviors of children with ADHD. A single-subject, multiple-baseline design is used with three elementary-school students in Grades 3 and 4. Following a baseline period, CWPT is implemented in each student's classroom. During the second…
Dovis, Sebastiaan; Van der Oord, Saskia; Wiers, Reinout W; Prins, Pier J M
Both cognitive and motivational deficits are thought to give rise to the problems in the combined (ADHD-C) and inattentive subtype (ADHD-I) of attention-deficit hyperactivity disorder (ADHD). In both subtypes one of the most prominent cognitive weaknesses appears to be in visuospatial working memory (WM), which is composed of short-term memory (STM) and a central executive (CE). In children with ADHD-C, both STM and the CE seem impaired, and together with motivational impairments, give rise to their deficits in visuospatial WM. In children with ADHD-I, no studies investigated these WM components and their interplay with motivational impairments. Effects of a standard (feedback only) and a high level of reinforcement (feedback + 10 euros) on visuospatial WM-, STM-, and CE performance were examined in 27 children with ADHD-I (restrictive-subtype), 70 children with ADHD-C, and 40 typically developing controls (aged 9-12). In both ADHD-subtypes CE and WM performance was worse than in controls. STM performance of children with ADHD-I was, in contrast to that of children with ADHD-C, not different from controls. STM and WM performance was worse in ADHD-C than in ADHD-I, whereas CE-related performance did not differ. High reinforcement improved STM and WM performance in both subtypes but not in controls. This improvement was equally pronounced in both subtypes. High reinforcement did not improve CE-related performance. Both subtypes have equally pronounced motivational deficits, which have detrimental effects on their visuospatial STM and WM performance. In contrast to children with ADHD-C, children with ADHD-I seem unimpaired on visuospatial STM; only an impaired CE and motivational impairments give rise to their deficits in visuospatial WM.
Snyder, Andrew M; Maruff, Paul; Pietrzak, Robert H; Cromer, Jennifer R; Snyder, Peter J
This study used a novel hidden maze learning test to examine the nature and magnitude of impairment on separable aspects of executive function in 36 children with ADHD. A within-subject analysis of children with ADHD was also conducted to assess cognitive effects of open-label stimulant treatment. Compared to 31 age-matched controls, unmedicated children with ADHD were slower and made significantly more errors that were indicative of relative impairment in prepotent response inhibition and ability to "maintain set" while using simple rules to complete the task. Open-label administration of stimulant medication led to faster and more efficient performance, with children with ADHD making fewer perseverative and rule-break errors than when off medication. This instrument might be useful in monitoring treatment response in specific aspects of executive function and in assisting with dose-titration decisions.
Rollnick, Marissa; Bennett, Judith; Rhemtula, Mariam; Dharsey, Nadine; Ndlovu, Thandi
This paper presents two South African case studies designed to explore the influence of subject matter knowledge on pedagogical content knowledge (PCK). In the first case study on teaching the mole in two township schools, the findings illustrate that the participant teachers favoured procedural approaches at the expense of conceptual…
Canu, Will H.; Carlson, Caryn L.
Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) has been consistently linked to social maladjustment. This study investigated whether elevated rejection sensitivity (RS) could contribute to the relational problems that adults with ADHD encounter. Method: Undergraduate men in ADHD-Combined Type (ADHD-C; n = 31), ADHD-Primarily…
Grizenko, Natalie; Paci, Michael; Joober, Ridha
Objective: To compare the ADHD combined/hyperactive subtype (ADHD/CH) to the ADHD inattentive subtype (ADHD/I) on the level of comorbidity, treatment response, and possible etiological factors. Method: A total of 371 clinically referred children diagnosed with ADHD aged between 6 and 12 years are recruited for a double-blind, placebo-controlled…
Booksh, Randee Lee; Pella, Russell D.; Singh, Ashvind N.; Gouvier, William Drew
Objective: The authors examined the ability of college students to simulate ADHD symptoms on objective and self-report measures and the relationship between knowledge of ADHD and ability to simulate ADHD. Method: Undergraduate students were assigned to a control or a simulated ADHD malingering condition and compared with a clinical AD/HD group.…
Schroeder, Valarie M.; Kelley, Michelle L.
We examined the relationships between executive functioning, family environment, and parenting practices in children diagnosed with ADHD as compared to children without ADHD. Participants were parents (N = 134) of 6- to 12-year-old ADHD and non-ADHD-diagnosed children. Compared to the control group, parents of children diagnosed with ADHD reported…
Humphreys, Kathryn L.; Aguirre, Vincent P.; Lee, Steve S.
The goal of this study is to examine levels of oppositional defiant disorder (ODD) and conduct disorder (CD) in four groups of children: attention-deficit/hyperactivity disorder (ADHD) only, anxiety only, ADHD and anxiety, and controls (i.e., non-ADHD youth). Although children with ADHD exhibit more ODD and CD than non-ADHD youth, it is unknown if…
Daley, D; Birchwood, J
This paper reviews the relationship between attention deficit hyperactivity disorder (ADHD) and academic performance. First, the relationship at different developmental stages is examined, focusing on pre-schoolers, children, adolescents and adults. Second, the review examines the factors underpinning the relationship between ADHD and academic underperformance: the literature suggests that it is the symptoms of ADHD and underlying cognitive deficits not co-morbid conduct problems that are at the root of academic impairment. The review concludes with an overview of the literature examining strategies that are directed towards remediating the academic impairment of individuals with ADHD.
... good" fats -- may be less likely to have attention deficit hyperactivity disorder (ADHD), a small study suggests. Research on 120 ... Health and Human Services. More Health News on: Attention Deficit Hyperactivity Disorder Diets Recent Health News Related MedlinePlus Health Topics ...
Barabasz, Arreed; Barabasz, Marianne
Traditional diagnosis procedures for Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD) may lead to over-diagnosis and are fraught with complications because the target behavioral symptoms are found in a variety of other disorders. Traditional treatments consisting of powerful side effect laden psychostimulant drugs…
Nigg, Joel T.
Reviews salient emerging themes in the scientific literature related to identifying etiology and pathophysiology of ADHD. While bypassing the need for new treatment research, the review highlights three themes. First, recognition of the epigenetic effects is expected to revitalize the search for and mapping of early environmental influences on the…
Johansen, Espen Borgå; Killeen, Peter R; Russell, Vivienne A; Tripp, Gail; Wickens, Jeff R; Tannock, Rosemary; Williams, Jonathan; Sagvolden, Terje
Attention-deficit/hyperactivity disorder (ADHD), characterized by hyperactivity, impulsiveness and deficient sustained attention, is one of the most common and persistent behavioral disorders of childhood. ADHD is associated with catecholamine dysfunction. The catecholamines are important for response selection and memory formation, and dopamine in particular is important for reinforcement of successful behavior. The convergence of dopaminergic mesolimbic and glutamatergic corticostriatal synapses upon individual neostriatal neurons provides a favorable substrate for a three-factor synaptic modification rule underlying acquisition of associations between stimuli in a particular context, responses, and reinforcers. The change in associative strength as a function of delay between key stimuli or responses, and reinforcement, is known as the delay of reinforcement gradient. The gradient is altered by vicissitudes of attention, intrusions of irrelevant events, lapses of memory, and fluctuations in dopamine function. Theoretical and experimental analyses of these moderating factors will help to determine just how reinforcement processes are altered in ADHD. Such analyses can only help to improve treatment strategies for ADHD. PMID:19226460
Felt, Barbara T; Biermann, Bernard; Christner, Jennifer G; Kochhar, Param; Harrison, Richard Van
Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children, and the prevalence is increasing. Physicians should evaluate for ADHD in children with behavioral concerns (e.g., inattention, hyperactivity, impulsivity, oppositionality) or poor academic progress using validated assessment tools with observers from several settings (home, school, community) and self-observation, if possible. Physicians who inherit a patient with a previous ADHD diagnosis should review the diagnostic process, and current symptoms and treatment needs. Coexisting conditions (e.g., anxiety, learning, mood, or sleep disorders) should be identified and treated. Behavioral treatments are recommended for preschool-aged children and may be helpful at older ages. Effective behavioral therapies include parent training, classroom management, and peer interventions. Medications are recommended as first-line therapy for older children. Psychostimulants, such as methylphenidate and dextroamphetamine, are most effective for the treatment of core ADHD symptoms and have generally acceptable adverse effect profiles. There are fewer supporting studies for atomoxetine, guanfacine, and clonidine, and they are less effective than the psychostimulants. Height, weight, heart rate, blood pressure, symptoms, mood, and treatment adherence should be recorded at follow-up visits.
Educators are confronted every day with local, state, and federal mandates; large class sizes; lack of resources; high-stakes tests; and diversity of all kinds. Throw into that mix a youngster with attention-deficit hyperactive disorder (ADHD) and it's no wonder that teachers are frustrated and at a loss for what to do. Professionals define ADHD…
Penny, Ann Marie; Waschbusch, Daniel A.; Carrey, Norm; Drabman, Ronald S.
This article examines whether various cognitive abilities are associated with symptoms of ADHD. Cognitive ability is conceptualized using Cattell-Horn-Carroll (CHC) theory as measured using the Woodcock-Johnson Tests of Cognitive Ability (3rd ed.). This article also examines whether test session behavior mediates the association between cognitive…
Offers an overview of ADD and ADHD, their causes and long-term prognoses, including the complexities of the conditions, the incomplete knowledge about them, and the difficulties of diagnosis during early childhood. Summarizes assessment and treatment options and concludes that the conditions have so many secondary effects that designing an…
DuPaul, George J.; White, George P.
Attention-deficit/hyperactivity disorder (ADHD) is a disruptive behavior disorder which is characterized by levels of inattention (e.g., difficulty in concentrating on schoolwork), impulsivity (e.g., frequently interrupting conversations or activities), and/or overactivity (e.g., difficulty remaining seated when required to do so) that are well…
In this paper, a response is made to the assertion that discourses surrounding attention-deficit hyperactivity disorder (ADHD) are dominated by those who choose to frame such difficulties within a biomedical paradigm, and that valid alternative explanations are often marginalised as a result. It is suggested, however, that if such a discontinuity…
DuPaul, George J.; Weyandt, Lisa L.; Janusis, Grace M.
School-related difficulties are commonly associated with attention deficit hyperactivity disorder (ADHD). This article describes effective school-based intervention strategies including behavioral interventions, modifications to academic instruction, and home-school communication programs. One overlooked aspect of treatment of children with ADHD…
Da Fonseca, David; Seguier, Valerie; Santos, Andreia; Poinso, Francois; Deruelle, Christine
Several studies suggest that children with ADHD tend to perform worse than typically developing children on emotion recognition tasks. However, most of these studies have focused on the recognition of facial expression, while there is evidence that context plays a major role on emotion perception. This study aims at further investigating emotion…
Rooney, Mary; Chronis-Tuscano, Andrea; Yoon, Yesel
Objective: The college years represent a developmental transition during which the initiation and escalation of heavy drinking set the stage for lifelong difficulties with alcohol and other drugs. Evidence from studies of adolescents and young adults with ADHD suggests that college students with the disorder may be uniquely vulnerable to alcohol-…
The proposed revision of the diagnostic criteria in DSM-5 for attention-deficit/hyperactivity disorder (ADHD) will not fundamentally change the concept of ADHD. This is mainly due to the fact that, DSM-5 will retain the exact DSM-IV wording of all 18 symptoms, but will add new examples that make the criteria more appropriate for children, adolescents and adults. The age of onset will also be changed from 7 to 12 years, the subtyping of the disorder will change, and pervasive developmental disorders will no longer be an exclusion criterion. Although the main concept is unchanged, the suggested changes will most likely increase the prevalence of ADHD, especially in adults and adolescents, but maybe also in children. The added examples will also result in necessary revisions and new validations of rating scales and diagnostic interviews. This review will examine each of the proposed DSM-5 changes and the impact they may have, and in addition, the paper will make an overview of the main characteristics of some of the international and national guidelines for assessment and treatment of ADHD and how these impact the clinical practice.
Miller, Carlin J.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.
Objective: This longitudinal study examines the recall accuracy of childhood ADHD symptoms in late adolescence and early adulthood by youth and their parents, compared with reports obtained during childhood. Method: Participants (N = 94) are initially evaluated when they are aged between 7 and 11 and reassessed when they are aged between 16 and 22…
"Baxter pushed me away every moment that we worked together, He was rude, sarcastic, and often downright mean. He got up and walked away every time I asked him to do something he didn't want to, which was ... everything." That's how Lisa Medoff describes the 4th grade boy whom she tutored twice a week to help him manage his ADHD. Despite…
Hale, T. Sigi; Smalley, Susan L.; Hanada, Grant; Macion, James; McCracken, James T.; McGough, James J.; Loo, Sandra K.
Introduction: A growing body of literature suggests atypical cerebral asymmetry and interhemispheric interaction in ADHD. A common means of assessing lateralized brain function in clinical populations has been to examine the relative proportion of EEG alpha activity (8-12 Hz) in each hemisphere (i.e., alpha asymmetry). Increased rightward alpha…
Robeva, Raina; Penberthy, Jennifer Kim; Loboschefski, Tim; Cox, Daniel; Kovatchev, Boris
Manifestations of ADHD are observed at both psychological and physiological levels and assessed via various psychometric, EEG, and imaging tests. However, no test is 100% accurate in its assessment of ADHD. This study introduces a stochastic assessment combining psychometric tests with previously reported (Consistency Index) and newly developed (Alpha Blockade Index) EEG-based physiological markers of ADHD. The assessment utilizes classical Bayesian inference to refine after each step the probability of ADHD of each individual. In a pilot study involving six college females with ADHD and six matched controls, the assessment achieved correct classification for all ADHD and non-ADHD participants. In comparison, the classification of ADHD versus non-ADHD participants was < 85% for any one of the tests separately. The procedure significantly improved the score separation between ADHD versus non-ADHD groups. The final average probabilities for ADHD were 76% for the ADHD group and 8% for the control group. These probabilities correlated (r = .87) with the Brown ADD scale and (r = .84) with the ADHD-Symptom Inventory used for the screening of the participants. We conclude that, although each separate test was not completely accurate, a combination of several tests classified correctly all ADHD and all non-ADHD participants. The application of the proposed assessment is not limited to the specific tests used in this study--the assessment represents a general paradigm capable of accommodating a variety of ADHD tests into a single diagnostic assessment.
dos Santos Siqueira, Anderson; Biazoli Junior, Claudinei Eduardo; Comfort, William Edgar; Rohde, Luis Augusto; Sato, João Ricardo
The framework of graph theory provides useful tools for investigating the neural substrates of neuropsychiatric disorders. Graph description measures may be useful as predictor variables in classification procedures. Here, we consider several centrality measures as predictor features in a classification algorithm to identify nodes of resting-state networks containing predictive information that can discriminate between typical developing children and patients with attention-deficit/hyperactivity disorder (ADHD). The prediction was based on a support vector machines classifier. The analyses were performed in a multisite and publicly available resting-state fMRI dataset of healthy children and ADHD patients: the ADHD-200 database. Network centrality measures contained little predictive information for the discrimination between ADHD patients and healthy subjects. However, the classification between inattentive and combined ADHD subtypes was more promising, achieving accuracies higher than 65% (balance between sensitivity and specificity) in some sites. Finally, brain regions were ranked according to the amount of discriminant information and the most relevant were mapped. As hypothesized, we found that brain regions in motor, frontoparietal, and default mode networks contained the most predictive information. We concluded that the functional connectivity estimations are strongly dependent on the sample characteristics. Thus different acquisition protocols and clinical heterogeneity decrease the predictive values of the graph descriptors.
dos Santos Siqueira, Anderson; Biazoli Junior, Claudinei Eduardo; Comfort, William Edgar; Rohde, Luis Augusto; Sato, João Ricardo
The framework of graph theory provides useful tools for investigating the neural substrates of neuropsychiatric disorders. Graph description measures may be useful as predictor variables in classification procedures. Here, we consider several centrality measures as predictor features in a classification algorithm to identify nodes of resting-state networks containing predictive information that can discriminate between typical developing children and patients with attention-deficit/hyperactivity disorder (ADHD). The prediction was based on a support vector machines classifier. The analyses were performed in a multisite and publicly available resting-state fMRI dataset of healthy children and ADHD patients: the ADHD-200 database. Network centrality measures contained little predictive information for the discrimination between ADHD patients and healthy subjects. However, the classification between inattentive and combined ADHD subtypes was more promising, achieving accuracies higher than 65% (balance between sensitivity and specificity) in some sites. Finally, brain regions were ranked according to the amount of discriminant information and the most relevant were mapped. As hypothesized, we found that brain regions in motor, frontoparietal, and default mode networks contained the most predictive information. We concluded that the functional connectivity estimations are strongly dependent on the sample characteristics. Thus different acquisition protocols and clinical heterogeneity decrease the predictive values of the graph descriptors. PMID:25309910
Yu, Ching-Jung; Du, Jung-Chieh; Chiou, Hsien-Chih; Yang, Shang-Han; Liao, Kai-Wei; Yang, Winnie; Chung, Ming-Yi; Chien, Ling-Chu; Hwang, Betau; Chen, Mei-Lien
Objective Nonylphenol (NP) belongs to the family of endocrine disruptors, and it is widely used in industrial applications and is ubiquitous in daily foods. Animal studies have suggested that NP exposure might promote motor hyperactivity, likely by causing deficits in dopaminergic neurons. However, research assessing NP exposure and epidemiology studies on human populations are limited. The aim of this study was to explore the association between child NP exposure and ADHD while considering particular covariants, such as lead levels and dopamine-related gene variations. Methods A case-control study was conducted on patients with clinically diagnosed ADHD; the Swanson, Nolan and Pelham, Fourth Revision (SNAP-IV) questionnaire was used to identify normal controls aged 4–15 years. Participants were examined for urinary NP concentrations, blood lead levels, and select single-nucleotide polymorphisms of two dopamine-related genes (D4 dopamine receptor, DRD4, and dopamine transporter, DAT1). Socio-demographic variables, maternal lifestyle factors during pregnancy and family medical history were obtained using a questionnaire. Results A total of 97 children with doctor-diagnosed ADHD and 110 normal controls were enrolled. The blood lead levels in both groups were similar (1.57±0.73 vs. 1.73±0.77 μg/dL, p = 0.15). No significant difference in urinary NP concentration was found between the children with ADHD and the control subjects (4.52±3.22 μg/g cr. vs. 4.64±2.95 μg/g cr., p = 0.43). ADHD was significantly more prevalent among males in this study (male to female ratio: 5:1 for the ADHD group and 1.3:1 for the control group, p<0.01). The analysis was repeated after excluding the females, but this had no effect on the association between NP and ADHD. The regression model, including or excluding females, indicated no increased odds of having ADHD in the context of NP exposure after adjusting for covariants. Conclusion This study indicated that NP exposure might not
Snyder, Steven M; Hall, James R; Cornwell, Sonya L; Quintana, Humberto
The purpose of this review is to assess the range of overall accuracies for Attention Deficit/Hyperactivity Disorder (ADHD) behavior rating scales evaluated in clinical validation studies. Studies were characterized according to the evidence standards of the American Academy of Neurology (AAN). Studies were excluded due to major design problems such as overfitting by discriminant analysis. The 13 included evaluations of rating scales revealed overall accuracy in the range of 59%-79% with a pooled mean of 69% (+/-7%, standard deviation) and a pooled sample size of 2228 subjects from nine studies. While some of the excluded studies demonstrated higher overall accuracies (>79%), these studies were observed to have factors in experimen tal design and statistics that are known to unduly inflate accuracy. We recommend further research following the full AAN standards, namely well-designed, blinded, pro spective studies of rating scales applied to clinically representative samples evaluated with a clinical standard.
Harding, Karen L; Judah, Richard D; Gant, Charles
Twenty children with attention deficit/hyperactivity disorder (AD/HD) were treated with either Ritalin (10 children) or dietary supplements (10 children), and outcomes were compared using the Intermediate Visual and Auditory/Continuous Performance Test (IVA/CPT) and the WINKS two-way analysis of variance with repeated measures and with Tukey multiple comparisons. Subjects in both groups showed significant gains (p less than 0.01) on the IVA/CPT's Full Scale Response Control Quotient and Full Scale Attention Control Quotient (p less than 0.001). Improvements in the four sub-quotients of the IVA/CPT were also found to be significant and essentially identical in both groups: Auditory Response Control Quotient (p less than 0.001), Visual Response Control Quotient (p less than 0.05), Auditory Attention Quotient (p less than 0.001), and Visual Attention Quotient (p less than 0.001). Numerous studies suggest that biochemical heterogeneous etiologies for AD/HD cluster around at least eight risk factors: food and additive allergies, heavy metal toxicity and other environmental toxins, low-protein/high-carbohydrate diets, mineral imbalances, essential fatty acid and phospholipid deficiencies, amino acid deficiencies, thyroid disorders, and B-vitamin deficiencies. The dietary supplements used were a mix of vitamins, minerals, phytonutrients, amino acids, essential fatty acids, phospholipids, and probiotics that attempted to address the AD/HD biochemical risk factors. These findings support the effectiveness of food supplement treatment in improving attention and self-control in children with AD/HD and suggest food supplement treatment of AD/HD may be of equal efficacy to Ritalin treatment.
Hasler, R; Salzmann, A; Bolzan, T; Zimmermann, J; Baud, P; Giannakopoulos, P; Perroud, N
Attention-deficit hyperactivity disorder (ADHD) is a highly heritable neurodevelopmental disorder often persisting in adulthood. Genetic studies of ADHD mainly focused on the Dopamine Transporter (DAT1) and the Dopamine Receptor 4 (DRD4) genes. Nevertheless, polymorphisms of these genes explain only a small fraction of the assigned risk, suggesting that intermediate dimensions and environmental factors should also be considered. We investigated in 77 adult ADHD subjects compared to 474 controls, how polymorphisms within the genes coding for DAT1 (40-bp VNTR in 3'UTR), the Dopamine Receptor 2 (DRD2) (rs1799732) and DRD4 (48-bp VNTR in exon 3), may modulate the expression of the disorder. By genotyping DAT1, we detected a new 9.5R allele showing a deletion of 40 bp and also an insertion of 19 bp compared to the 10R allele. This novel allele was found to be significantly protective for ADHD (p < 0.0001). Another significant difference was found in the distribution of DRD4 48-bp VNTR 6R allele when comparing patients and controls (p = 0.0007). In addition significant results were also found for DAT1 9.5R allele, which was associated with impulsiveness (p = 1.98 × 10(-4)) and trait anger scores (p = 7.66 × 10(-4)). Moreover, impulsiveness scores were partly modulated by an interaction between the DRD4 48-bp VNTR 6R allele and childhood maltreatment (p = 0.01), however, this result did not resist correction for multiple comparisons. Altogether, our results show the putative involvement of DAT1 and DRD4 genes in the aetiology of ADHD with a main role in modulation of key dimensions of the disorder.
Serrallach, Bettina; Groß, Christine; Bernhofs, Valdis; Engelmann, Dorte; Benner, Jan; Gündert, Nadine; Blatow, Maria; Wengenroth, Martina; Seitz, Angelika; Brunner, Monika; Seither, Stefan; Parncutt, Richard; Schneider, Peter; Seither-Preisler, Annemarie
Dyslexia, attention deficit hyperactivity disorder (ADHD), and attention deficit disorder (ADD) show distinct clinical profiles that may include auditory and language-related impairments. Currently, an objective brain-based diagnosis of these developmental disorders is still unavailable. We investigated the neuro-auditory systems of dyslexic, ADHD, ADD, and age-matched control children (N = 147) using neuroimaging, magnetencephalography and psychoacoustics. All disorder subgroups exhibited an oversized left planum temporale and an abnormal interhemispheric asynchrony (10–40 ms) of the primary auditory evoked P1-response. Considering right auditory cortex morphology, bilateral P1 source waveform shapes, and auditory performance, the three disorder subgroups could be reliably differentiated with outstanding accuracies of 89–98%. We therefore for the first time provide differential biomarkers for a brain-based diagnosis of dyslexia, ADHD, and ADD. The method allowed not only allowed for clear discrimination between two subtypes of attentional disorders (ADHD and ADD), a topic controversially discussed for decades in the scientific community, but also revealed the potential for objectively identifying comorbid cases. Noteworthy, in children playing a musical instrument, after three and a half years of training the observed interhemispheric asynchronies were reduced by about 2/3, thus suggesting a strong beneficial influence of music experience on brain development. These findings might have far-reaching implications for both research and practice and enable a profound understanding of the brain-related etiology, diagnosis, and musically based therapy of common auditory-related developmental disorders and learning disabilities. PMID:27471442
Serrallach, Bettina; Groß, Christine; Bernhofs, Valdis; Engelmann, Dorte; Benner, Jan; Gündert, Nadine; Blatow, Maria; Wengenroth, Martina; Seitz, Angelika; Brunner, Monika; Seither, Stefan; Parncutt, Richard; Schneider, Peter; Seither-Preisler, Annemarie
Dyslexia, attention deficit hyperactivity disorder (ADHD), and attention deficit disorder (ADD) show distinct clinical profiles that may include auditory and language-related impairments. Currently, an objective brain-based diagnosis of these developmental disorders is still unavailable. We investigated the neuro-auditory systems of dyslexic, ADHD, ADD, and age-matched control children (N = 147) using neuroimaging, magnetencephalography and psychoacoustics. All disorder subgroups exhibited an oversized left planum temporale and an abnormal interhemispheric asynchrony (10-40 ms) of the primary auditory evoked P1-response. Considering right auditory cortex morphology, bilateral P1 source waveform shapes, and auditory performance, the three disorder subgroups could be reliably differentiated with outstanding accuracies of 89-98%. We therefore for the first time provide differential biomarkers for a brain-based diagnosis of dyslexia, ADHD, and ADD. The method allowed not only allowed for clear discrimination between two subtypes of attentional disorders (ADHD and ADD), a topic controversially discussed for decades in the scientific community, but also revealed the potential for objectively identifying comorbid cases. Noteworthy, in children playing a musical instrument, after three and a half years of training the observed interhemispheric asynchronies were reduced by about 2/3, thus suggesting a strong beneficial influence of music experience on brain development. These findings might have far-reaching implications for both research and practice and enable a profound understanding of the brain-related etiology, diagnosis, and musically based therapy of common auditory-related developmental disorders and learning disabilities.
Archer, Trevor; Oscar-Berman, Marlene; Blum, Kenneth
Heterogeneity in attention-deficit/hyperactivity disorder (ADHD), with complex interactive operations of genetic and environmental factors, is expressed in a variety of disorder manifestations: severity, co-morbidities of symptoms, and the effects of genes on phenotypes. Neurodevelopmental influences of genomic imprinting have set the stage for the structural-physiological variations that modulate the cognitive, affective, and pathophysiological domains of ADHD. The relative contributions of genetic and environmental factors provide rapidly proliferating insights into the developmental trajectory of the condition, both structurally and functionally. Parent-of-origin effects seem to support the notion that genetic risks for disease process debut often interact with the social environment, i.e., the parental environment in infants and young children. The notion of endophenotypes, markers of an underlying liability to the disorder, may facilitate detection of genetic risks relative to a complex clinical disorder. Simple genetic association has proven insufficient to explain the spectrum of ADHD. At a primary level of analysis, the consideration of epigenetic regulation of brain signalling mechanisms, dopamine, serotonin, and noradrenaline is examined. Neurotrophic factors that participate in the neurogenesis, survival, and functional maintenance of brain systems, are involved in neuroplasticity alterations underlying brain disorders, and are implicated in the genetic predisposition to ADHD, but not obviously, nor in a simple or straightforward fashion. In the context of intervention, genetic linkage studies of ADHD pharmacological intervention have demonstrated that associations have fitted the “drug response phenotype,” rather than the disorder diagnosis. Despite conflicting evidence for the existence, or not, of genetic associations between disorder diagnosis and genes regulating the structure and function of neurotransmitters and brain-derived neurotrophic
Sequencing of sporadic Attention-Deficit Hyperactivity Disorder (ADHD) identifies novel and potentially pathogenic de novo variants and excludes overlap with genes associated with autism spectrum disorder.
Kim, Daniel Seung; Burt, Amber A; Ranchalis, Jane E; Wilmot, Beth; Smith, Joshua D; Patterson, Karynne E; Coe, Bradley P; Li, Yatong K; Bamshad, Michael J; Nikolas, Molly; Eichler, Evan E; Swanson, James M; Nigg, Joel T; Nickerson, Deborah A; Jarvik, Gail P
Attention-Deficit Hyperactivity Disorder (ADHD) has high heritability; however, studies of common variation account for <5% of ADHD variance. Using data from affected participants without a family history of ADHD, we sought to identify de novo variants that could account for sporadic ADHD. Considering a total of 128 families, two analyses were conducted in parallel: first, in 11 unaffected parent/affected proband trios (or quads with the addition of an unaffected sibling) we completed exome sequencing. Six de novo missense variants at highly conserved bases were identified and validated from four of the 11 families: the brain-expressed genes TBC1D9, DAGLA, QARS, CSMD2, TRPM2, and WDR83. Separately, in 117 unrelated probands with sporadic ADHD, we sequenced a panel of 26 genes implicated in intellectual disability (ID) and autism spectrum disorder (ASD) to evaluate whether variation in ASD/ID-associated genes were also present in participants with ADHD. Only one putative deleterious variant (Gln600STOP) in CHD1L was identified; this was found in a single proband. Notably, no other nonsense, splice, frameshift, or highly conserved missense variants in the 26 gene panel were identified and validated. These data suggest that de novo variant analysis in families with independently adjudicated sporadic ADHD diagnosis can identify novel genes implicated in ADHD pathogenesis. Moreover, that only one of the 128 cases (0.8%, 11 exome, and 117 MIP sequenced participants) had putative deleterious variants within our data in 26 genes related to ID and ASD suggests significant independence in the genetic pathogenesis of ADHD as compared to ASD and ID phenotypes. © 2017 Wiley Periodicals, Inc.
Bennett, Judith; Lubben, Fred; Hampden-Thompson, Gillian
This paper presents the findings of the qualitative component of a combined methods research study that explores a range of individual and school factors that influence the uptake of chemistry and physics in post-compulsory study in England. The first phase involves using the National Pupil Database to provide a sampling frame to identify four matched pairs of high-uptake and low-uptake schools by salient school factors. Case studies of these eight schools indicate that students employ selection strategies related to their career aspirations, their sense of identity and tactics, and their prior experience. The school factors influencing subject choice relate to school management, student support and guidance, and student empowerment. The most notable differences between students in high-uptake and low-uptake schools are that students in high-uptake schools appear to make a proactive choice in relation to career aspirations, rather than a reactive choice on the basis of past experience. Schools with a high uptake offer a diverse science curriculum in the final two years of compulsory study, set higher examination entry requirements for further study and, crucially, provide a range of opportunities for students to interact with the world of work and to gain knowledge and experience of science-related careers.
Zhu, Jinzhou; Wan, Xingyong; Wang, Yuming; Zhu, Kefu; Li, Chunxiao; Yu, Chaohui; Li, Youming
Fetuin is an endogenous inhibitor of the insulin receptor tyrosine kinase. Recent studies supported the possible role of fetuin B in metabolic diseases. This study is to evaluate the role of serum fetuin B in nonalcoholic fatty liver disease (NAFLD). A hospital-based case-control study of 184 subjects was conducted. Serum level of fetuin B was measured by enzyme-linked immunosorbent assay. The serum level of fetuin B in the control (91.0 ± 36.9 μg/ml) was lower than it in NAFLD (108.7 ± 38.5 μg/ml, P < 0.001). The percentage of NAFLD increased (42.9%, 58.7% and 60.2%; P < 0.001; linear-by-linear association: P < 0.001), as fetuin B concentration elevated in its tertiles, after adjustment of body mass index (BMI). Furthermore, compared with the 1st tertile, the 3rd tertile of fetuin B indicated an association with the presence of NAFLD (adjusted odds ratio = 2.087, 95% confidence interval [1.016 - 3.937], P = 0.023), after controlling age, sex, BMI, diabetes, hypertension and hypertriglyceridemia. Lastly, fetuin B correlated with diastolic blood pressure, serum alanine transaminase and triglycerides, among the controls. It suggested a potential association between serum fetuin B and the presence of NAFLD.
Gutierrez-Bonet, Carmen; Leco-Berrocal, Isabel; Fernández-Cáliz, Fernando; Martínez-González, José-María
Background In recent years the use of orthopantomography has been proposed as a low-cost, reliable and non-invasive diagnostic medium for detecting atheromatous plaque. The purpose of this study was to correlate the presence of carotid calcifications (atheroma) in orthopantomographs with specific risk factors for cerebrovascular accidents (previous cerebrovascular accidents, arterial hypertension, and diabetes). Material and Methods The methods used in this observational study of cases and control subjects followed STROBE (Strengthening the Reporting of Observational studies in Epidemiology) recommendations. The study analyzed a total of 1,602 panoramic radiographs taken for dental diagnostic purposes between January 2010 and February 2014. The main variables analyzed were the incidence of atheromatous plaque and other cardiovascular risk factors. Epidat 3.1 statistical software was used to determine minimum sample sizes and the results were analyzed using PASW (Predictive Analytics Software) Statistics 10.0.0. Results For all the variables analyzed, the correlation between radiographic detection of atheromatous plaque and the presence of cardiovascular disease risk factors was found to be statistically significant (RR>1.5). Conclusions The presence of cardiovascular risk factors is related to the incidence of radiopaque lesions at the carotid artery bifurcation, indicating the presence of atheromatous plaque. Key words:Orthopantomography, atheromatous plaque, cerebrovascular accident, diabetes, arterial hypertension. PMID:26595828
Rowles, Brieana M.; Findling, Robert L.
Developmental disorders such as subaverage intelligence, pervasive developmental disorders, and genetic syndromes are frequently associated with comorbid attention-deficit/hyperactivity disorder (ADHD) or ADHD-like symptoms. While there are not pharmacological cures for these developmental disorders, coinciding ADHD and ADHD-like symptoms that…
Kooij, J J Sandra; Bijlenga, Denise
Many adult outpatients with attention-deficit/hyperactivity disorder (ADHD) report an oversensitivity to light. We explored the link between ADHD and photophobia in an online survey (N = 494). Self-reported photophobia was prevalent in 69% of respondents with, and in 28% of respondents without, ADHD (symptoms). The ADHD (symptoms) group wore sunglasses longer during daytime in all seasons. Photophobia may be related to the functioning of the eyes, which mediate dopamine and melatonin production systems in the eye. In the brain, dopamine and melatonin are involved in both ADHD and circadian rhythm disturbances. Possibly, the regulation of the dopamine and melatonin systems in the eyes and in the brain are related. Despite the study's limitations, the results are encouraging for further study on the pathophysiology of ADHD, eye functioning, and circadian rhythm disturbances.
Monuteaux, Michael C; Faraone, Stephen V; Herzig, Kathleen; Navsaria, Neha; Biederman, Joseph
The familial relationship between dyscalculia and attention-deficit/hyperactivity disorder (ADHD) was assessed. We conducted a familial risk analysis using probands with and without ADHD of both genders and their first-degree relatives. Participants were assessed with structured diagnostic interviews and a cognitive test battery. We found elevated rates of ADHD in relatives of both ADHD proband groups, regardless of dyscalculia status, and elevated rates of dyscalculia in relatives of probands with dyscalculia, irrespective of ADHD status. There was no evidence for cosegregation or assortative mating. Our findings support the hypothesis that ADHD and dyscalculia are independently transmitted in families and are etiologically distinct. These results reinforce the current nosological approach to these disorders and underscore the need for separate identification and treatment strategies for children with both conditions.
Dalsgaard, Søren; Mortensen, Preben Bo; Frydenberg, Morten; Thomsen, Per Hove
The purpose of the study was to estimate the risk of substance use disorder (SUD) and alcohol abuse in adulthood among children and adolescents with attention-deficit hyperactivity disorder (ADHD) compared to the background population. Furthermore, to examine whether the age at initiation and duration of stimulant treatment in childhood predicts SUD and alcohol abuse in adulthood. 208 youths with ADHD (183 boys; 25 girls) were followed prospectively. Diagnoses of SUD and alcohol abuse were obtained from The Danish Psychiatric Central Register. The relative risk (RR) of SUD and alcohol abuse for cases with ADHD, compared to the background population was 7.7 (4.3-13.9) and 5.2 (2.9-9.4), respectively. Female gender, conduct disorder in childhood and older age at initiation of stimulant treatment increased the risk of later SUD and alcohol abuse. Our results warrant increased focus on the possibly increased risk of substance abuse in females with ADHD compared to males with ADHD.
To derive a biologically based theory of comorbidity in Attention Deficit Hyperactivity Disorder (ADHD). Theoretical concepts and empirical studies were reviewed to determine whether the behavioral inhibition concept provided an understanding of biological processes involved in comorbidity in ADHD. Empirical studies of ADHD have shown comorbidity of ADHD and anxiety, while studies of behavioral inhibition tend to suggest independent disruptive and anxiety traits. This paradox can be resolved by an understanding of the dynamics of mesolimbic dopamine (DA) systems, where reward and delay of reinforcement are determined by tonic/phasic DA relationships, resulting in impulsive 'fearless' responses when impaired. On the other hand, comorbid anxiety is related to impaired synaptic processes, which selectively gate fear (or aggressive) responses from the amygdala at the accumbens. Monosynaptic convergence between prefrontal, hippocampal, and amygdala projection neurons at the accumbens allows the operation of a synaptic gating mechanism between prefrontal cortex (PFC), hippocampus, and amygdala. Impairment of this mechanism by lowered PFC inhibition allows greater amygdala input, and anxiety-related processes more impact, over the accumbens. In conclusion, a dual theory incorporating long-term tonic/phasic mesolimbic DA relationships and secondly impairment of PFC and hippocampal inputs to synaptic gating of anxiety at the accumbens has implications for comorbidity in ADHD, as well as for possible pharmacological interventions, utilizing either stimulant or axiolytic interventions. The use of DA partial agonists may also be of interest.
Johnson, C R; Handen, B L; Lubetsky, M J; Sacco, K A
Using a combination of an alternating treatment and double-blind placebo-controlled drug design, the independent and combined effects of two behavioral interventions and two doses of methylphenidate (MPH) in 3 children with Attention Deficit Hyperactivity Disorder (ADHD) and mental retardation (MR) were assessed. In this single subject design, 2 of the 3 subjects responded positively to medication as measured by increased on-task behavior. The first behavioral intervention, a token economy for on-task behavior, was ineffective for increasing either on-task behavior or work accuracy when combined with placebo. However, improvement in work accuracy was realized with implementation of a second behavioral intervention that specifically targeted accuracy independent of drug conditions. The current findings highlight both the positive effects and limitations of the two commonly used treatment modalities for ADHD. Future studies should continue to extend this area of investigative efforts to produce more data-based knowledge as to the appropriate doses of treatment, both pharmacological and behavioral, with children with both ADHD and mental retardation.
Harty, Seth C.; Pedersen, Sarah L.; Gnagy, Elizabeth M.; Pelham, William E.; Molina, Brooke S. G.
Objective This study examined mean level differences in marijuana expectancies and the differential associations between expectancies and marijuana use for individuals with and without a history of Attention-Deficit/Hyperactivity Disorder (ADHD) Background Substance use expectancies are a widely studied risk factor for alcohol and other drug use. The relations between marijuana use expectancies and self-reported marijuana use have not been examined in young adults with ADHD, a population shown to be at risk for marijuana use. Method Participants were 306 (190 ADHD and 116 nonADHD) young adults (M age = 20.06, SD = 2.03) from the Pittsburgh ADHD Longitudinal Study (PALS) who provided data about marijuana use and marijuana use expectancies. Results Individuals in the ADHD group reported lower levels of social enhancement, tension reduction, and cognitive and behavioral impairment expectancies compared to individuals in the nonADHD group. Positive and negative marijuana use expectancies were associated with marijuana use frequency in the whole sample and statistically significant ADHD group by expectancy interactions were found. Sexual enhancement expectancies were more strongly associated with marijuana use frequency among individuals with ADHD histories while cognitive behavioral impairment expectancies were more strongly associated with marijuana use frequency among individuals without ADHD. Conclusions Marijuana use expectancies may be acquired, and operate differently, for individuals with and without ADHD histories. Although future research is needed to test this speculation, these differences may be associated with ADHD-related difficulties in higher order cognitive processes that affect the encoding and utilization of expectations regarding marijuana’s effects. PMID:26548364
Hellmer, Kahl; Nyström, Pär
Autism spectrum disorders (ASD) and ADHD are common neurodevelopmental disorders that benefit from early intervention but currently suffer from late detection and diagnosis: neurochemical dysregulations are extant already at birth but clinical phenotypes are not distinguishable until preschool age or later. The vast heterogeneity between subjects' phenotypes relates to interaction between multiple unknown factors, making research on factor causality insurmountable. To unlock this situation we pose the hypothesis that atypical pupillary light responses from rods, cones, and the recently discovered ipRGC system reflect early acetylcholine, melatonin, and dopamine dysregulation that are sufficient but not necessary factors for developing ASD and/or ADHD disorders. Current technology allows non-invasive cost-efficient assessment already from the first postnatal month. The benefits of the current proposal are: identification of clinical subgroups based on cause rather than phenotypes; facilitation of research on other causal factors; neonatal prediction of later diagnoses; and guidance for targeted therapeutical intervention.
Silva, Bianca Del Ponte da; Anselmi, Luciana; Schmidt, Vera; Santos, Iná S
This aim of this study was to conduct a systematic literature review on the association between maternal caffeine intake during pregnancy and attention deficit hyperactivity disorder (ADHD) in childhood. The systematic multiple-stage literature search in PubMed, LILACS, BIREME, and PsycINFO was limited to research in human subjects and published in Portuguese, English, and Spanish. A total of 373 references were retrieved. Of these, only five met the study's objectives and were kept in the review. Most of the studies employed a longitudinal design, were conducted in developed countries, and were published in the last five years. Only one study found a positive association. Studies on caffeine consumption during pregnancy and ADHD are scarce, with conflicting results and several methodological difficulties such as lack of standardized outcome measures.
Dissecting the attention deficit hyperactivity disorder (ADHD) phenotype: sustained attention, response variability and spatial attentional asymmetries in relation to dopamine transporter (DAT1) genotype.
Bellgrove, Mark A; Hawi, Ziarah; Kirley, Aiveen; Gill, Michael; Robertson, Ian H
ADHD is a childhood-onset behavioural disorder with a heterogeneous profile of neuropsychological impairment. Neuropsychological heterogeneity may, in part, reflect underlying genetic differences. Here we examined sustained attention, response variability and spatial attentional asymmetries in a sample of children and adolescents with ADHD (n=22) in relation to dopamine transporter genotype (DAT1) and also controls (n=20). Participants performed the sustained attention to response task (SART) (testing sustained attention and response variability) and the greyscales task (a perceptual measure of attentional bias). The latter has previously been shown to yield a robust leftward attentional asymmetry in healthy subjects. The 10-repeat allele of the DAT1 gene has been associated with ADHD in a number of studies and appears to have biological significance. The ADHD group was sub-divided into those individuals with two copies of the "high-risk" 10-repeat allele (high-risk DAT1) versus those with one or no copies of this allele (low-risk DAT1). The high-risk DAT1 ADHD group displayed greater response variability on the SART than either the low-risk DAT1 group or healthy controls, whereas the latter two groups did not differ. Further, the high-risk DAT1 group showed an attenuated spatial asymmetry, relative to the low-risk DAT1 ADHD group, who showed the typical leftward attentional asymmetry. Our results suggest that the 10-repeat DAT1 allele may mediate neuropsychological impairment in ADHD. The application of molecular genetics may help to define neuropsychological impaired subgroups of ADHD.
Hall, Charlotte L; Valentine, Althea Z; Groom, Madeleine J; Walker, Gemma M; Sayal, Kapil; Daley, David; Hollis, Chris
Attention-deficit hyperactivity disorder (ADHD) is typically diagnosed using clinical observation and subjective informant reports. Once children commence ADHD medication, robust monitoring is required to detect partial or non-responses. The extent to which neuropsychological continuous performance tests (CPTs) and objective measures of activity can clinically aid the assessment and titration process in ADHD is not fully understood. This review describes the current evidence base for the use of CPTs and objectively measured activity to support the diagnostic procedure and medication management for children with ADHD. Four databases (PsycINFO, Medline, Allied and Complementary Medicine (AMED), and PsycARTICLES) were systematically searched to understand the current evidence base for (1) the use of CPTs to aid clinical assessment of ADHD; (2) the use of CPTs to aid medication management; and (3) the clinical utility of objective measures of activity in ADHD. Sixty relevant articles were identified. The search revealed six commercially available CPTs that had been reported on for their clinical use. There were mixed findings with regard to the use of CPTs to assess and manage medication, with contrasting evidence on their ability to support clinical decision-making. There was a strong evidence base for the use of objective measures of activity to aid ADHD/non-ADHD group differentiation, which appears sensitive to medication effects and would also benefit from further research on their clinical utility. The findings suggest that combining CPTs and an objective measure of activity may be particularly useful as a clinical tool and worthy of further pursuit.
Fleming, Andrew P; McMahon, Robert J
Attention-deficit/hyperactivity disorder (ADHD) affects between 2 and 8 % of college students. ADHD is associated with impaired academic, psychological, and social functioning, and with a wide array of negative outcomes including lower GPAs, graduation rates, and self-reported quality of life. The college environment often brings decreased external structure and increased availability of immediate rewards, presenting added demands for behavioral self--regulation-an area in which students with ADHD are already vulnerable. Despite the significant impact of ADHD in college and the unique challenges presented by the college context, virtually no treatment development research has been conducted with this population. In order to provide a framework to guide intervention development, this comprehensive review integrates research from three key domains that inform treatment for college students with ADHD: (1) functional impairment associated with ADHD among college students, (2) etiology of ADHD and the developmental context for ADHD among emerging adults (age 18-24), and (3) treatment outcome research for ADHD among adolescents and adults. A detailed set of proposed treatment targets and intervention principles are identified, and key challenges associated with treatment development in this population are discussed.
Rabinovitz, Beth B.; O’Neill, Sarah; Rajendran, Khushmand; Halperin, Jeffrey M.
Research examining factors linking early temperament and later ADHD is limited by cross-sectional approaches and having the same informant rate both temperament and psychopathology. We used multi-informant/multi-method longitudinal data to test the hypothesis that negative emotionality during preschool is positively associated with ADHD symptom severity in middle childhood, but developing executive control mediates this relation. Children (N=161) with and without ADHD were evaluated three times: Parent and teacher temperament ratings and NEPSY Visual Attention at ages 3–4 years; WISC-IV Working Memory Index and NEPSY Response Set at age 6 years; and ADHD symptoms using the Kiddie-SADS at age 7 years. Parent and teacher ratings of preschoolers’ temperament were combined to form an Anger/Frustration composite. Similarly, an Executive Functioning composite was derived from age 6 measures. Bootstrapping was used to determine whether age 6 Executive Functioning mediated the relation between early Anger/Frustration and later ADHD symptom severity, while controlling for early executive functioning. Preschoolers’ Anger/Frustration was significantly associated with later ADHD symptoms, with this relation partially mediated by age 6 Executive Functioning. Developing executive control mediates the relation between early Anger/Frustration and later ADHD symptom severity, suggesting that Anger/Frustration influences ADHD symptom severity through its impact on developing executive control. Early interventions targeting the harmful influences of negative emotionality or enhancing executive functioning may diminish later ADHD severity. PMID:26854505
Merkt, Julia; Petermann, Franz
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders in childhood and adolescence and has many negative consequences for both the child and the family. Early identification of children with ADHD would be helpful for the prevention of long-term consequences. This review appraises questionnaires and clinical interviews that can be used for the diagnosis of ADHD in preschool-aged children (3-5 years). We compare and discuss both German and international methods. The role of questionnaires and clinical interviews in the diagnostic process of ADHD is discussed.
Altszuler, Amy R.; Page, Timothy F.; Gnagy, Elizabeth M.; Coxe, Stefany; Arrieta, Alejandro; Molina, Brooke S. G.; Pelham, William E.
This study used data from the Pittsburgh ADHD Longitudinal Study (PALS) to evaluate financial outcomes of young adults (YA) with ADHD relative to comparisons. Participants for this study included 309 individuals who had been diagnosed with ADHD (DSM-III-R or DSM-IV) in childhood and 208 comparison YA without childhood ADHD diagnoses (total N=517) who were followed through age 25. Participants were predominately male (88 %) and Caucasian (84 %). Diagnostic interviews were conducted in childhood. Young adults and their parents reported on financial outcomes and a number of predictor variables. Young adults with ADHD experienced greater financial dependence on family members (p<0.05) and the welfare system (p<0.01) and had lower earnings (p<0.05) than comparisons. ADHD diagnostic status, education attainment, and delinquency were significant predictors of financial outcomes. A projection of lifetime earnings indicated that ADHD group participants could expect to earn $543,000–$616,000 less over their lifetimes than comparisons. Due to the propensity of individuals with ADHD to underreport problems, the data are likely to be underestimates. These findings support the need for interventions to improve labor market outcomes as well as the development of interventions that target the management of personal finances for individuals with ADHD in young adulthood. PMID:26542688
Altszuler, Amy R; Page, Timothy F; Gnagy, Elizabeth M; Coxe, Stefany; Arrieta, Alejandro; Molina, Brooke S G; Pelham, William E
This study used data from the Pittsburgh ADHD Longitudinal Study (PALS) to evaluate financial outcomes of young adults (YA) with ADHD relative to comparisons. Participants for this study included 309 individuals who had been diagnosed with ADHD (DSM-III-R or DSM-IV) in childhood and 208 comparison YA without childhood ADHD diagnoses (total N = 517) who were followed through age 25. Participants were predominately male (88 %) and Caucasian (84 %). Diagnostic interviews were conducted in childhood. Young adults and their parents reported on financial outcomes and a number of predictor variables. Young adults with ADHD experienced greater financial dependence on family members (p < 0.05) and the welfare system (p < 0.01) and had lower earnings (p < 0.05) than comparisons. ADHD diagnostic status, education attainment, and delinquency were significant predictors of financial outcomes. A projection of lifetime earnings indicated that ADHD group participants could expect to earn $543,000-$616,000 less over their lifetimes than comparisons. Due to the propensity of individuals with ADHD to underreport problems, the data are likely to be underestimates. These findings support the need for interventions to improve labor market outcomes as well as the development of interventions that target the management of personal finances for individuals with ADHD in young adulthood.
Neely, Kristina A; Wang, Peiyuan; Chennavasin, Amanda P; Samimy, Shaadee; Tucker, Jacqueline; Merida, Andrea; Perez-Edgar, Koraly; Huang-Pollock, Cynthia
Poor inhibitory control is a well-established cognitive correlate of adults with ADHD. However, the simple reaction time (RT) task used in a majority of studies records performance errors only via the presence or absence of a single key press. This all-or-nothing response makes it impossible to capture subtle differences in underlying processes that shape performance. Subsequently, all-or-nothing tasks may underestimate the prevalence of executive function deficits in ADHD. The current study measured inhibitory control using a standard Go/No-Go RT task and a more sensitive continuous grip force task among adults with (N=51, 22 female) and without (N=51, 29 female) ADHD. Compared to adults without ADHD, adults with ADHD made more failed inhibits in the classic Go/No-Go paradigm and produced greater and more variable force during motor inhibition. The amount of force produced on failed inhibits was a stronger predictor of ADHD-related symptoms than the number of commissions in the standard RT task. Adults with ADHD did not differ from those without ADHD on the mean force and variability of force produced in Go trials. These findings suggest that the use of a precise and continuous motor task, such as the force task used here, provides additional information about the nature of inhibitory motor control in adults with ADHD.
Owino, Joseph Ogutu; Odundo, Paul Amolloh
History is one of the teaching subjects studied by Bachelor of Education Arts students at the University of Nairobi. In the last five years, there has been a tremendous increase in the number of students specializing in History as a teaching subject. This paper therefore has examined factors influencing students' selection of History as career…
Artul, Suheil; Artoul, Faozi; Habib, George; Nseir, William; Bisharat, Bishara; Nijim, Yousif
We present a case of a 10-year-old boy, who had severe relapsing pancreatitis, three times in two months within 3 weeks after starting treatment with methylphenidate (Ritalin) due to attention deficit hyperactivity disorder (ADHD). Pancreatitis due to the use of (methylphenidate) Ritalin was never published before. Attention must be made by the physicians regarding this possible complication, and this complication should be taken into consideration in every patient with abdominal pain who was newly treated with Ritalin.
Bisharat, Bishara; Nijim, Yousif
We present a case of a 10-year-old boy, who had severe relapsing pancreatitis, three times in two months within 3 weeks after starting treatment with methylphenidate (Ritalin) due to attention deficit hyperactivity disorder (ADHD). Pancreatitis due to the use of (methylphenidate) Ritalin was never published before. Attention must be made by the physicians regarding this possible complication, and this complication should be taken into consideration in every patient with abdominal pain who was newly treated with Ritalin. PMID:24711932
Mautone, Jennifer A.; DuPaul, George J.; Jitendra, Asha K.
The present study examines the effects of computer-assisted instruction (CAI) on the mathematics performance and classroom behavior of three second-through fourth-grade students with ADHD. A controlled case study is used to evaluate the effects of the computer software on participants' mathematics performance and on-task behavior. Participants'…
Peasgood, Tessa; Bhardwaj, Anupam; Biggs, Katie; Brazier, John E; Coghill, David; Cooper, Cindy L; Daley, David; De Silva, Cyril; Harpin, Val; Hodgkins, Paul; Nadkarni, Amulya; Setyawan, Juliana; Sonuga-Barke, Edmund J S
Childhood attention-deficit/hyperactivity disorder (ADHD) has been associated with reduced health and well-being of patients and their families. The authors undertook a large UK survey-based observational study of the burden associated with childhood ADHD. The impact of ADHD on both the patient (N = 476) and their siblings (N = 337) on health-related quality of life (HRQoL) and happiness was quantified using multiple standard measures [e.g. child health utility-9D (CHU-9D), EuroQol-5D-Youth]. In the analysis, careful statistical adjustments were made to ensure a like-for-like comparison of ADHD families with two different control groups. We controlled for carers' ADHD symptoms, their employment and relationship status and siblings' ADHD symptoms. ADHD was associated with a significant deficit in the patient's HRQoL (with a CHU-9D score of around 6 % lower). Children with ADHD also have less sleep and were less happy with their family and their lives overall. No consistent decrement to the HRQoL of the siblings was identified across the models, except that related to their own conduct problems. The siblings do, however, report lower happiness with life overall and with their family, even when controlling for the siblings own ADHD symptoms. We also find evidence of elevated bullying between siblings in families with a child with ADHD. Overall, the current results suggest that the reduction in quality of life caused by ADHD is experienced both by the child with ADHD and their siblings.
Iannaccone, Reto; Hauser, Tobias U; Ball, Juliane; Brandeis, Daniel; Walitza, Susanne; Brem, Silvia
Attention-deficit/hyperactivity disorder (ADHD) is a common disabling psychiatric disorder associated with consistent deficits in error processing, inhibition and regionally decreased grey matter volumes. The diagnosis is based on clinical presentation, interviews and questionnaires, which are to some degree subjective and would benefit from verification through biomarkers. Here, pattern recognition of multiple discriminative functional and structural brain patterns was applied to classify adolescents with ADHD and controls. Functional activation features in a Flanker/NoGo task probing error processing and inhibition along with structural magnetic resonance imaging data served to predict group membership using support vector machines (SVMs). The SVM pattern recognition algorithm correctly classified 77.78% of the subjects with a sensitivity and specificity of 77.78% based on error processing. Predictive regions for controls were mainly detected in core areas for error processing and attention such as the medial and dorsolateral frontal areas reflecting deficient processing in ADHD (Hart et al., in Hum Brain Mapp 35:3083-3094, 2014), and overlapped with decreased activations in patients in conventional group comparisons. Regions more predictive for ADHD patients were identified in the posterior cingulate, temporal and occipital cortex. Interestingly despite pronounced univariate group differences in inhibition-related activation and grey matter volumes the corresponding classifiers failed or only yielded a poor discrimination. The present study corroborates the potential of task-related brain activation for classification shown in previous studies. It remains to be clarified whether error processing, which performed best here, also contributes to the discrimination of useful dimensions and subtypes, different psychiatric disorders, and prediction of treatment success across studies and sites.
Bright, George M.
Objective The objective is to assess abuse of prescription and illicit stimulants among individuals being treated for attention-deficit/hyperactivity disorder (ADHD). Methods A survey was distributed to patients enrolled in an ADHD treatment center. It included questions designed to gain information about demographics; ADHD treatment history; illicit drug use; and misuse of prescribed stimulant medications, including type of stimulant medication most frequently misused or abused, and how the stimulant was prepared and administered. Results A total of 545 subjects (89.2% with ADHD) were included in the survey. Results indicated that 14.3% of respondents abused prescription stimulants. Of these, 79.8% abused short-acting agents; 17.2% abused long-acting stimulants; 2.0% abused both short- and long-acting agents; and 1.0% abused other agents. The specific medications abused most often were mixed amphetamine salts (Adderall; 40.0%), mixed amphetamine salts extended release (Adderall XR; 14.2%), and methylphenidate (Ritalin; 15.0%), and the most common manner of stimulant abuse was crushing pills and snorting (75.0%). Survey results also showed that 39.1% of respondents used nonprescription stimulants, most often cocaine (62.2%), methamphetamine (4.8%), and both cocaine and amphetamine (31.1%). Choice of illicit drug was based on rapidity of high onset (43.5%), ease of acquisition (40.7%), ease of use (10.2%), and cost (5.5%). Conclusions The risks for abuse of prescription and illicit stimulants are elevated among individuals being treated in an ADHD clinic. Prescription agents used most often are those with pharmacologic and pharmacokinetic characteristics that provide a rapid high. This suggests that long-acting stimulant preparations that have been developed for the treatment of ADHD may have lower abuse potential than short-acting formulations. PMID:18596945
Semrud-Clikeman, Margaret; Walkowiak, Jenifer; Wilkinson, Alison; Butcher, Brianne
The purpose of the study was to evaluate neuropsychological and behavioral rating measures of executive functions (EF) in children with two subtypes of ADHD, Asperger syndrome (AS), and controls. Relative to the control group, the clinical groups experienced more difficulty in EF. The AS group showed the most difficulty in emotional control, behavioral regulation, fluid reasoning, and planning compared to the ADHD groups. Number of symptoms of ADHD or AS was found to be significantly related to ratings of difficulty with behavior regulation, metacognition, and general behavioral regulation across the sample. These findings indicate that children with AS or ADHD may have a differing EF profile and thus, may respond differentially to interventions.
Usak, Muhammet; Ozden, Mustafa; Eilks, Ingo
This paper describes a case study focusing on the subject matter knowledge, pedagogical content knowledge, and beliefs about science teaching of student teachers in Turkey at the start of their university education. The topic of interest was that of teaching chemical reactions in secondary chemistry education. A written test was developed which…
Longford, Nicholas T.
A case is presented for adjusting the scores for free response items in the Advanced Placement (AP) tests. Using information about the rating process from the reliability studies, administrations of the AP test for three subject areas, psychology, computer science, and English language and composition, are analyzed. In the reliability studies, 299…
Buchhorn, Reiner; Conzelmann, Annette; Willaschek, Christian; Störk, Dagmar; Taurines, Regina; Renner, Tobias J
Although an extensive number of studies support the efficacy and tolerability of stimulants in the treatment of attention deficit/hyperactivity disorder (ADHD), in recent years, increasing concerns have been raised about their cardiovascular safety. We investigated whether a time domain analysis of heart rate variability (HRV) recordings in 24-h ECG under medication with stimulants yielded new information about therapy control in ADHD. We analysed the HRV parameter standard deviation of all normal sinus RR intervals over 24 h (SDNN), percentage of successive normal sinus RR intervals > 50 ms (pNN50) and root-mean-square of the successive normal sinus RR interval difference (rMSSD) from 23 children diagnosed by ADHD (19 boys and 4 girls), aged 10.5 ± 2.2 years, who were consecutively referred to our outpatient clinic for paediatric cardiology. Eleven children received medication with methylphenidate (MPH), while twelve children were initially examined without medication. Of these, eight probands were re-examined after therapy with MPH was established. Controls comprised 19 children (10 boys, 9 girls) from our Holter ECG data base without any cardiac or circulatory disease. Compared to healthy controls, the ADHD children with and without MPH treatment showed significantly higher mean heart rates (ADHD without MPH: 94.3 ± 2.2; ADHD with MPH: 90.5 ± 1.8, controls: 84.7 ± 1.8). pNN50 (ADHD without MPH: 6.5 ± 2.7; ADHD with MPH: 14.2 ± 6.9, controls: 21.5 ± 9.0) and rMSSD (ADHD without MPH: 26.1 ± 4.1; ADHD with MPH: 36.7 ± 8.3, controls: 44.5 ± 10.1) were lowest in ADHD children without MPH, middle in ADHD children with MPH and highest in controls. SDNN values were not significantly different. The hourly analysis shows highly significant reduced pNN50 and rMSSD values in untreated ADHD children between 5:00 pm and 6:00 am while the pattern approaches to levels of controls during MPH treatment. Data of this pilot study indicate a decreased vagal tone with
Leppma, Monica; Long, Daniel; Smith, Megan; Lassiter, Candace
The symptoms of ADHD are highly subjective, and there is ample empirical evidence that demonstrates the ease with which impairments in attention can be feigned on many commonly used subjective and objective measures of attention. We examined the combination of two assessment measures, NV-MSVT and IVA+, to screen for performance validity and ADHD symptoms in college students. Results indicated that the NV-MSVT was effective in differentiating between students with potential high impairment, such as ADHD, and possible malingerers. In addition, in vivo clinical data (N = 350) resulted in lower validity cut-off scores on the IVA+ than had been previously suggested. Clinical implications and future research are also discussed.
Czerniak, Suzanne M.; Sikoglu, Elif M.; King, Jean A.; Kennedy, David N.; Mick, Eric; Frazier, Jean; Moore, Constance M.
Objective Attention-Deficit/Hyperactivity Disorder (ADHD) is a psychiatric disorder affecting 5% of children. Methylphenidate (MPH) is a common medication for ADHD. Studies examining MPH's effect on pediatric ADHD patients' brain function using functional Magnetic Resonance Imaging (fMRI) have not been compiled. The goals of this systematic review were to determine (1) which area(s) of the brain in pediatric ADHD patients are modulated by a single dose of MPH, (2) if areas modulated by MPH differ by task type performed during fMRI data acquisition, (3) whether changes in brain activation due to MPH relate to clinical improvements in ADHD-related symptoms. Method We searched the electronic databases PubMed and PsycINFO (1967 to 2011) using the following terms: ADHD AND (methylphenidate OR MPH OR ritalin) AND (neuroimaging OR MRI OR fMRI OR BOLD OR event related) and identified 200 abstracts, 9 of which were reviewed based on predefined criteria. Results The middle and inferior frontal gyri, basal ganglia, and cerebellum were most often affected by MPH within ADHD patients. The middle and inferior frontal gyri were frequently affected by MPH during inhibitory control tasks. Correlation between brain regions and clinical improvement was not possible due to the lack of symptom improvement measures within the included studies. Conclusions Throughout nine task-based fMRI studies investigating MPH's effect on the brains of pediatric patients with ADHD, MPH resulted in increased activation within frontal lobes, basal ganglia, and cerebellum. In most cases, this increase “normalized” activation of at least some brain areas to that seen in typically developing children. PMID:23660970
Dawson, Anne E.; Wymbs, Brian T.; Marshall, Stephen A.; Mautone, Jennifer A.; Power, Thomas J.
Objective This study investigated the extent to which parental Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms impact child and parent outcomes following a multimodal family-school intervention, the Family School Success (FSS) program, when compared to an active-control condition (CARE). Method Participants were 139 children with ADHD (67% male; 91% non-Hispanic; 77% Caucasian; grades 2–6) and their primary caretaker (91% female; aged 26–59) who participated in a randomized clinical trial evaluating the efficacy of FSS. Associations were examined between parent-reported ADHD symptoms at baseline and intervention outcomes reported by parents and teachers after treatment and at a 3-month follow-up, including child homework and classroom impairments, child ADHD and oppositional defiant disorder symptoms, parenting behaviors, and parent-teacher relationship quality. Results Across both treatment conditions, parental ADHD was not associated with parent or child outcomes at post-assessment. However, differences emerged between the two treatment groups at follow-up for parents with ADHD, particularly when an empirically-supported symptom cutoff was used to identify parents at-risk for having ADHD. In FSS, but not in CARE, parental ADHD was associated with declines in treatment gains in the quality of the parent-teacher relationship and the child’s homework performance. Conclusions Parents at-risk for ADHD had difficulty maintaining treatment effects for themselves and their child in the FSS intervention, but not in CARE. The supportive and educational components central to the CARE intervention may be helpful in promoting the sustainability of psychosocial interventions for children with ADHD who have parents with elevated ADHD symptoms. PMID:25496523
Demirci, Esra; Erdogan, Ayten
The objectives of this study were to evaluate both face and emotion recognition, to detect differences among attention deficit and hyperactivity disorder (ADHD) subgroups, to identify effects of the gender and to assess the effects of methylphenidate and atomoxetine treatment on both face and emotion recognition in patients with ADHD. The study sample consisted of 41 male, 29 female patients, 8-15 years of age, who were diagnosed as having combined type ADHD (N = 26), hyperactive/impulsive type ADHD (N = 21) or inattentive type ADHD (N = 23) but had not previously used any medication for ADHD and 35 male, 25 female healthy individuals. Long-acting methylphenidate (OROS-MPH) was prescribed to 38 patients, whereas atomoxetine was prescribed to 32 patients. The reading the mind in the eyes test (RMET) and Benton face recognition test (BFRT) were applied to all participants before and after treatment. The patients with ADHD had a significantly lower number of correct answers in child and adolescent RMET and in BFRT than the healthy controls. Among the ADHD subtypes, the hyperactive/impulsive subtype had a lower number of correct answers in the RMET than the inattentive subtypes, and the hyperactive/impulsive subtype had a lower number of correct answers in short and long form of BFRT than the combined and inattentive subtypes. Male and female patients with ADHD did not differ significantly with respect to the number of correct answers on the RMET and BFRT. The patients showed significant improvement in RMET and BFRT after treatment with OROS-MPH or atomoxetine. Patients with ADHD have difficulties in face recognition as well as emotion recognition. Both OROS-MPH and atomoxetine affect emotion recognition. However, further studies on the face and emotion recognition are needed in ADHD.
Weiss, Margaret; Safren, Steven A.; Solanto, Mary V.; Hechtman, Lily; Rostain, Anthony L.; Ramsay, J. Russell; Murray, Candice
Background: A literature search found five empirical studies of psychological treatment for adults with ADHD, out of 1,419 articles on ADHD in adults. Practice guidelines to date all recommend multimodal intervention, given that a significant number of patients cannot tolerate, do not respond to, or fail to reach optimal outcomes with medication…
Fleming, Andrew P.; McMahon, Robert J.
Attention-deficit/hyperactivity disorder (ADHD) affects between 2 and 8 % of college students. ADHD is associated with impaired academic, psychological, and social functioning, and with a wide array of negative outcomes including lower GPAs, graduation rates, and self-reported quality of life. The college environment often brings decreased…
Safren, Steven A.; Duran, Petra; Yovel, Iftah; Perlman, Carol A.; Sprich, Susan
Objective: One of the potential causes of residual symptoms of ADHD in adults can be difficulties with consistent adherence to medications. Method: This formative study examined self-reported medication adherence in adults with ADHD with clinically significant symptoms despite medication treatment. Results: Mean adherence for the two-week period…
Pindiprolu, Sekhar S.
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed disorders among children today. Stimulants are commonly prescribed to children with ADHD to improve attention span and decrease distractibility, hyperactivity, and impulsivity. Given the increased use of stimulant medication, school personnel need to be aware of…
This article describes effective classroom intervention strategies for students experiencing symptoms of attention-deficit/hyperactivity disorder (ADHD), regardless of the severity and whether the student has a diagnosis of ADHD. These suggestions incorporate the universal design for learning (UDL) framework. This framework does not limit…
Brown, Thomas E.; Reichel, Philipp C.; Quinlan, Donald M.
Objectives: To demonstrate that high IQ adults diagnosed with ADHD suffer from executive function (EF) impairments that: a) can be identified with a combination of standardized measures and self-report data; and b) occur more commonly in this group than in the general population. Method: 157 ADHD adults with IQ greater than or equal to 120 were…
Martinussen, Rhonda; Major, Ashley
Students with attention deficit hyperactivity disorder (ADHD) are at risk for academic underachievement. Children and youth with ADHD have been found to exhibit impairments on neuropsychological measures of executive functions, including working memory. Working memory is important to attentional control and learning. This article defines working…
Bell, Lindsay; Long, Susanne; Garvan, Cynthia; Bussing, Regina
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed psychiatric disorders in childhood and adolescence. It is associated with high levels of stigma, which may lead to treatment barriers, self-fulfilling prophecies, and social rejection. This study established the reliability of the ADHD Stigma Questionnaire…
Young, Susan; Gudjonsson, Gisli H.
Objective: The objective is to ascertain whether people in partial remission (IPR) or in full remission (IR) of their ADHD symptoms continue to have neuropsychological deficits and clinical and psychosocial problems. Method: IPR and IR groups are compared with fully symptomatic ADHD patients and normal controls. Results: The results show a decline…
McKinney, Ashley A.; Canu, Will H.; Schneider, H. G.
Objective: ADHD has been linked to various constructs, yet there is a lack of focus on how its symptom clusters differentially associate with personality, which this study addresses. Method: The current study examines the relationship between impulsive and inattentive ADHD traits and personality, indexed by the Revised NEO Personality Inventory…
Banaschewski, Tobias; Jennen-Steinmetz, Christine; Brandeis, Daniel; Buitelaar, Jan K.; Kuntsi, Jonna; Poustka, Luise; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Frazier-Wood, Alexis C.; Albrecht, Bjorn; Chen, Wai; Uebel, Henrik; Schlotz, Wolff; van der Meere, Jaap J.; Gill, Michael; Manor, Iris; Miranda, Ana; Mulas, Fernando; Oades, Robert D.; Roeyers, Herbert; Rothenberger, Aribert; Steinhausen, Hans-Christoph; Faraone, Stephen V.; Asherson, Philip
Background: Emotional lability (EL) is commonly seen in patients with attention-deficit/hyperactivity disorder (ADHD). The reasons for this association remain currently unknown. To address this question, we examined the relationship between ADHD and EL symptoms, and performance on a range of neuropsychological tasks to clarify whether EL symptoms…
Gray, Sarah A.; Fettes, Peter; Woltering, Steven; Mawjee, Karizma; Tannock, Rosemary
To better understand the nature of impairment resulting from attention-deficit/hyperactivity disorder (ADHD) for students in a post-secondary education (PSE) setting, the authors analyzed the symptoms and associated impairment of 135 students with a diagnosis of ADHD who were recruited via Student Disability Services in Canadian post-secondary…
Semrud-Clikeman, Margaret; Harder, Lana
Objective: To examine written expression and the executive function skills (working memory, verbal fluency, and planning and organization) involved in written expression in college-aged students with ADHD. Method: Two groups of undergraduate students, aged 19 to 28 years, (ADHD, n = 31; control, n = 27) are evaluated on selected measures of…
Re, Anna Maria; Caeran, Monica; Cornoldi, Cesare
The present study examines the expressive writing abilities of children described by their teachers as having Attention Deficit Hyperactivity Disorder (ADHD) symptoms and of matched controls and the effects of two types of facilitation. A group of 35 ADHD children and matched controls are given the task of composing a letter either under standard…
Re, Anna Maria; Pedron, Martina; Cornoldi, Cesare
Three groups of children of different ages who were considered by their teachers as showing symptoms of attention-deficit/hyperactivity disorder (ADHD) and matched controls were tested in a series of expressive writing tasks, derived from a standardized writing test. In the first study, 24 sixth- and seventh-grade children with ADHD symptoms wrote…
Riccio, Cynthia A.; Jemison, Sandra J.
Reviews theoretical frameworks for understanding the relationship between attention-deficit hyperactivity disorder (ADHD) and learning disabilities, particularly reading disability (RD). Discusses the co-occurrence of ADHD and RD. Suggests a comprehensive assessment must include linguistic factors, particularly phonological processing. Discusses…
Caci, Herve; Bouchez, Jacques; Bayle, Franck J.
Objective: Morningness is a stable characteristic of individuals, related to impulsivity and novelty seeking. The evening orientation is a risk factor for psychiatric conditions such as depression and personality disorders. The authors hypothesized that adults suspected of having ADHD are more evening oriented than adults without ADHD. Method:…
Tymms, Peter; Merrell, Christine
Pupils diagnosed with ADHD and pupils with ADHD symptoms tend to do less well at school than their symptom-free peers. This has been found to be particularly true for predominantly inattentive pupils. This paper aimed to establish the relative importance of inattention, hyperactivity and impulsivity to the academic progress of young children. A…
Honkasilta, J.; Sandberg, E.; Närhi, V.; Jahnukainen, M.
Students with Attention Deficit/Hyperactivity Disorder (ADHD) are a growing group served under special education services in many western societies. This article describes the history and current state of the services, as well as the assessment procedure. Our conclusion is that the status of students with ADHD in Finnish basic education (Grades 1…
In this 10-part series, which will run every other month through 2008 and 2009, "EP" will explore Attention Deficit Hyperactivity Disorder (ADHD). ADHD is technically defined as a neurodevelopmental, biological condition characterized by three hallmark symptoms: inattention, hyperactivity, impulsivity. Each of these symptoms has a special meaning…
Marcus, Steven C.; Wan, George J.; Zhang, Huabin F.; Olfson, Mark
Objective: To assess risk factors for injury among children and adolescents treated with stimulants for ADHD. Method: An analysis was performed of pharmacy and service claims data from 2000-2003 California Medicaid (Medi-Cal) focusing on children and adolescents ages 6 to 17 years who initiated stimulant therapy for ADHD. Bivariate and…