Science.gov

Sample records for adhd combined type

  1. Global and local grey matter reductions in boys with ADHD combined type and ADHD inattentive type.

    PubMed

    Vilgis, Veronika; Sun, Li; Chen, Jian; Silk, Timothy J; Vance, Alasdair

    2016-08-30

    Attention-deficit/hyperactivity disorder (ADHD) has reliably been associated with global grey matter reductions but local alterations are largely inconsistent with perhaps the exception of the caudate nucleus. The aim of this study was to examine local and global brain volume differences between typically developing children (TD) and children with a diagnosis of ADHD. We also addressed whether these parameters would differ between children with the ADHD-combined type (ADHD-C) and those with the ADHD-inattentive type (ADHD-I). Using an ROI approach caudate volume differences were also examined. 79 boys between the ages of 8 and 17 participated in the study. Of those 33 met diagnostic criteria for the ADHD-C and 15 for the ADHD-I subtype. 31 boys were included in the TD group. Structural magnetic resonance imaging data were analysed using voxel-based morphometry. The ADHD group had significantly lower global and local grey matter volumes within clusters in the bilateral frontal, right parietal and right temporal regions compared to TD. A significant group by age interaction was found for right caudate nucleus volume. No differences between the ADHD-C and ADHD-I groups were found. Right caudate nucleus volume and age are more strongly related in ADHD than in TD consistent with previous research. PMID:27399309

  2. Differences in Motor Imagery between Children with Developmental Coordination Disorder with and without the Combined Type of ADHD

    ERIC Educational Resources Information Center

    Lewis, Matthew; Vance, Alasdair; Maruff, Paul; Wilson, Peter; Cairney, Sheree

    2008-01-01

    It has been proposed, and questioned, whether motor impairments in attention-deficit-hyperactivity disorder, combined type (ADHD-C) alone, developmental coordination disorder (DCD) alone, and ADHD-C and comorbid DCD (ADHD-C/DCD) may arise from disruption to a common set of cognitive functions and their related neural substrate. This study examined…

  3. Differences in hypothalamic-pituitary-adrenal axis functioning among children with ADHD predominantly inattentive and combined types.

    PubMed

    van West, Dirk; Claes, Stephan; Deboutte, Dirk

    2009-09-01

    Some evidence suggests that the HPA axis may be dysfunctional in children with attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to investigate whether a different pattern of HPA axis activity is found between the inattentive (I) and combined (C) subtypes of ADHD, in comparison with healthy control children. A total of 100 prepubertal subjects [52 children with ADHD combined type (ADHD-C), 23 children with ADHD predominantly inattentive type (ADHD-I), and 25 healthy control subjects] were studied. The effects of stress were studied by comparing cortisol responses to a psychosocial stressor, consisting of a public speaking task. Children with ADHD-I showed an elevated cortisol response to the psychosocial stressor, in contrast to children with ADHD-C who showed a blunted cortisol response to the psychosocial stressor. When a distinction was made between responders and non-responders (a subject was classified as a responder when there was an increase in cortisol reactivity), hyperactivity symptoms were clearly related to a lower cortisol reactivity to stress. The results indicate that a low-cortisol responsivity to stress may be a neurobiological marker for children with ADHD-C, but not for those with ADHD-I. Directions for future research and clinical implications are discussed. PMID:19294447

  4. Magnetic Resonance Imaging Volumetric Analysis of the Putamen in Children with ADHD: Combined Type versus Control

    ERIC Educational Resources Information Center

    Wellington, Tasha McMahon; Semrud-Clikeman, Margaret; Gregory, Amanda Louise; Murphy, Jennifer Mary; Lancaster, Jack Lynn

    2006-01-01

    Objective: Volumetric differences in the putamen of boys with ADHD combined subtype with psychopathic traits and controls are investigated. Method: The putamen in 24 archival magnetic resonance imaging scans of 12 boys in residential treatment with symptoms of ADHD and psychopathic traits and 12 community control boys are analyzed using Display…

  5. Executive Functioning in Children with Asperger Syndrome, ADHD-Combined Type, ADHD-Predominately Inattentive Type, and Controls

    ERIC Educational Resources Information Center

    Semrud-Clikeman, Margaret; Walkowiak, Jenifer; Wilkinson, Alison; Butcher, Brianne

    2010-01-01

    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,…

  6. Aetiology for the covariation between combined type ADHD and reading difficulties in a family study: the role of IQ

    PubMed Central

    Cheung, Celeste H.M.; Wood, Alexis C.; Paloyelis, Yannis; Arias-Vasquez, Alejandro; Buitelaar, Jan K.; Franke, Barbara; Miranda, Ana; Mulas, Fernando; Rommelse, Nanda; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Faraone, Stephen V.; Asherson, Philip; Kuntsi, Jonna

    2012-01-01

    Background Twin studies using both clinical and population-based samples suggest that the frequent co-occurrence of attention deficit hyperactivity disorder (ADHD) and reading ability/disability (RD) is largely driven by shared genetic influences. While both disorders are associated with lower IQ, recent twin data suggest that the shared genetic variability between reading difficulties and ADHD inattention symptoms is largely independent from genetic influences contributing to general cognitive ability. The current study aimed to extend the previous findings that were based on rating scale measures in a population sample by examining the generalizability of the findings to a clinical population, and by measuring reading difficulties both with a rating scale and with an objective task. We therefore investigated the familial relationships between ADHD, reading difficulties and IQ in a sample of individuals diagnosed with ADHD combined type, their siblings and control sibling pairs. Methods We ran multivariate familial models on data from 1789 individuals at ages 6 to 19. Reading difficulties were measured with both rating scale and an objective task. IQ was obtained using the Wechsler Intelligence Scales (WISC-III / WAIS-III). Results Significant phenotypic (0.2–0.4) and familial (0.3–0.5) correlations were observed among ADHD, reading difficulties and IQ. Yet 53% to 72% of the overlapping familial influences between ADHD and reading difficulties were not shared with IQ. Conclusions Our finding that familial influences shared with general cognitive ability, though present, do not account for the majority of the overlapping familial influences on ADHD and reading difficulties extends previous findings from a population-based study to a clinically-ascertained sample with combined type ADHD. PMID:22324316

  7. Combination pharmacotherapy for adult ADHD.

    PubMed

    Adler, Lenard A; Reingold, Lisa S; Morrill, Melinda S; Wilens, Timothy E

    2006-10-01

    Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders of adulthood. Although clinical guidelines recommend monotherapy with stimulants or atomoxetine, combination pharmacotherapy is a common practice among clinicians. There are four main situations in which combination medications may be necessary: partial response, dose-limiting side effects, associated disorders, and comorbid diagnoses. We present data from two chart reviews that support existing research on combination pharmacotherapy. Adjunct treatment of d-methylphenidate to stimulant medications extended the duration of therapeutic effect. Adjunct treatment of mirtazapine to stimulant medications reduced associated insomnia. These data support previous research that validates the use of combination pharmacotherapy for adults with ADHD. PMID:16968624

  8. Aetiology for the Covariation between Combined Type ADHD and Reading Difficulties in a Family Study: The Role of IQ

    ERIC Educational Resources Information Center

    Cheung, Celeste H. M.; Wood, Alexis C.; Paloyelis, Yannis; Arias-Vasquez, Alejandro; Buitelaar, Jan K.; Franke, Barbara; Miranda, Ana; Mulas, Fernando; Rommelse, Nanda; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Faraone, Stephen V.; Asherson, Philip; Kuntsi, Jonna

    2012-01-01

    Background: Twin studies using both clinical and population-based samples suggest that the frequent co-occurrence of attention deficit hyperactivity disorder (ADHD) and reading ability/disability (RD) is largely driven by shared genetic influences. While both disorders are associated with lower IQ, recent twin data suggest that the shared genetic…

  9. Cerebellar Gray Matter Density in Females with ADHD Combined Type: A Cross-Sectional Voxel-Based Morphometry Study

    ERIC Educational Resources Information Center

    Almeida Montes, Luis Guillermo; Ricardo-Garcell, Josefina; De la Torre, Lazaro Barajas; Prado Alcantara, Hugo; Martinez Garcia, Reyna Beatriz; Avila Acosta, David; Fernandez Bouzas, Antonio

    2011-01-01

    Background: MRI studies have shown a decreased cerebellum volume in individuals with ADHD. However, most of these studies were conducted with male children, many of whom were medicated with stimulants. As such, unmedicated, non-White girls are underrepresented in such MRI studies. Objective: The aim of the present study was to compare the density…

  10. Central Processing Energetic Factors Mediate Impaired Motor Control in ADHD Combined Subtype but Not in ADHD Inattentive Subtype

    ERIC Educational Resources Information Center

    Egeland, Jens; Ueland, Torill; Johansen, Susanne

    2012-01-01

    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)…

  11. ADHD

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? ADHD KidsHealth > For Teens > ADHD Print A A A ... doesn't involve hyperactivity. Symptoms and Signs of ADHD Because ADHD covers lots of different things — attention, ...

  12. Is the Inattentive Subtype of ADHD Different from the Combined/Hyperactive Subtype?

    ERIC Educational Resources Information Center

    Grizenko, Natalie; Paci, Michael; Joober, Ridha

    2010-01-01

    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…

  13. ADHD

    MedlinePlus

    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 ...

  14. The MTA at 8 Years: Prospective Follow-Up of Children Treated for Combined-Type ADHD in a Multisite Study

    ERIC Educational Resources Information Center

    Molina, Brooke S. G.; Hinshaw, Stephen P.; Swanson, James W.; Arnold, L. Eugene; Vitiello, Benedetto; Jensen, Peter S.; Epstein, Jeffery N.; Hoza, Betsy; Hechtman, Lily; Abikoff, Howard B.; Elliott, Glen R.; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Wells, Karen C.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan; Houck, Patricia R.

    2009-01-01

    Participants of the Multimodal Treatment Study of Children with Attention Deficit and Hyperactivity Disorder (ADHD) eight years earlier do not differ significantly in repeated measures or newly analyzed variables that include school grades and psychiatric hospitalization. The treatment of childhood ADHD does not predict functioning six to eight…

  15. Combining Parent and Child Training for Young Children with ADHD

    ERIC Educational Resources Information Center

    Webster-Stratton, Carolyn H.; Reid, M. Jamila; Beauchaine, Ted

    2011-01-01

    The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder (ADHD). We conducted a randomized control trial evaluating the combined parent and child program…

  16. Dystonia with MPH/Risperidone Combined Therapy for ADHD.

    PubMed

    Millichap, J Gordon; Yee, Michelle M

    2016-01-01

    Investigators from Child Neurology and Pediatrics, University of Texas Health Science Center, Houston, report extrapyramidal symptoms in a 13-year-old boy with a psychiatric history of schizophrenia, bipolar disorder, ADHD, and autism, responsive to combination risperidone, oxcarbazepine, and MPH. PMID:27004141

  17. Social and academic impairment in youth with ADHD, predominately inattentive type and sluggish cognitive tempo.

    PubMed

    Marshall, Stephen A; Evans, Steven W; Eiraldi, Ricardo B; Becker, Stephen P; Power, Thomas J

    2014-01-01

    Sluggish cognitive tempo (SCT) was originally identified as a construct that characterized the inattention problems of some children with attention deficit disorder (ADD). Research has indicated that using SCT symptoms to identify a subset of youth with attention-deficit/hyperactivity disorder, predominately inattentive type (ADHD-IT) may elucidate distinct patterns of impairment and thereby improve the external validity of ADHD subtypes. The objective of the current study was to investigate whether youth with clinically-assessed ADHD-IT and high levels of SCT exhibit unique social and academic impairments. In a clinic-referred sample of youth (N = 209; 23 % female) aged 6 to 17 years, participants who met criteria for three different groups were identified: ADHD, Combined Type (ADHD-CT; n = 80), ADHD-IT with low SCT symptoms (n = 74), and ADHD-IT with high SCT symptoms (n = 55). These groups were compared on indicators of social and academic functioning while considering the effects of co-occurring internalizing and disruptive behavior disorders. Youth with ADHD-IT high in SCT exhibited uniquely elevated withdrawal, as well as low leadership and low peer-directed relational and overt aggression, which were not accounted for by co-occurring disorders. This high-SCT group was also the only group to have more homework problems than the ADHD-CT group, but only when other disruptive behavior disorders were absent. The distinctiveness of the high-SCT group, which was primarily evident in social as opposed to academic functioning, provides partial support for the external validity and clinical utility of SCT. PMID:23709343

  18. Combining parent and child training for young children with ADHD.

    PubMed

    Webster-Stratton, Carolyn H; Reid, M Jamila; Beauchaine, Ted

    2011-01-01

    The efficacy of the Incredible Years parent and child training programs is established in children diagnosed with oppositional defiant disorder but not among young children whose primary diagnosis is attention-deficit/hyperactivity disorder (ADHD). We conducted a randomized control trial evaluating the combined parent and child program interventions among 99 children diagnosed with ADHD (ages 4-6). Mother reported significant treatment effects for appropriate and harsh discipline, use of physical punishment, and monitoring, whereas fathers reported no significant parenting changes. Independent observations revealed treatment effects for mothers' praise and coaching, mothers' critical statements, and child total deviant behaviors. Both mothers and fathers reported treatment effects for children's externalizing, hyperactivity, inattentive and oppositional behaviors, and emotion regulation and social competence. There were also significant treatment effects for children's emotion vocabulary and problem-solving ability. At school teachers reported treatment effects for externalizing behaviors and peer observations indicated improvements in treated children's social competence. PMID:21391017

  19. Motivational Differences among Students with ADHD Reading Disabilities, Combined Groups, and Typical Comparisons

    ERIC Educational Resources Information Center

    Lee, Jiyeon

    2010-01-01

    The purpose of this study was to assess reading motivational differences of students with reading disabilities/difficulties (RD), attention deficit hyperactive disorders/at-risk for ADHD, combined groups (RD+ADHD), and non-disabled comparisons (ND). Most motivational research has made academic motivational comparisons with typical students without…

  20. Rejection Sensitivity and Social Outcomes of Young Adult Men with ADHD

    ERIC Educational Resources Information Center

    Canu, Will H.; Carlson, Caryn L.

    2007-01-01

    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…

  1. Motor Profile of Children with Attention Deficit Hyperactivity Disorder, Combined Type

    ERIC Educational Resources Information Center

    Goulardins, Juliana B.; Marques, Juliana C. Bilhar; Casella, Erasmo B.; Nascimento, Roseane O.; Oliveira, Jorge A.

    2013-01-01

    Objectives: The aim of this study was to assess the motor profile of children with attention deficit hyperactivity disorder (ADHD), combined type. Method: The case group consisted of 34 treatment-naive, male patients, aged 7-11 years, who had been diagnosed with ADHD, combined type, without comorbidities (except oppositional defiant disorder). The…

  2. Alerting, Orienting, and Executive Attention in Children with ADHD

    ERIC Educational Resources Information Center

    Mullane, Jennifer C.; Corkum, Penny V.; Klein, Raymond M.; McLaughlin, Elizabeth N.; Lawrence, Michael A.

    2011-01-01

    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,…

  3. Individual and combined effects of LD and ADHD on computerized neurocognitive concussion test performance: evidence for separate norms.

    PubMed

    Elbin, R J; Kontos, Anthony P; Kegel, Nate; Johnson, Eric; Burkhart, Scott; Schatz, Philip

    2013-08-01

    Decreased neurocognitive performance in individuals with self-reported attention deficit hyperactivity disorder (ADHD) and learning disability (LD) is well documented in the neuropsychological research literature. Previous studies employing paper-and-pencil neurocognitive assessments report lower performance in individuals with ADHD and LD. The purpose of the current study was to examine the influence of a self-reported diagnosis of LD, ADHD, and combined LD/ADHD on baseline computerized neurocognitive testing (CNT) used for the concussion assessment. Results revealed athletes with a self-reported diagnosis of LD, ADHD, and/or combined LD/ADHD demonstrated lower performance on baseline CNT and reported larger numbers of symptoms than did control athletes without these diagnoses. These findings provide evidence for the development of separate normative data for athletes with LD, ADHD, and LD/ADHD diagnoses on CNT batteries commonly used for concussion management. PMID:23608188

  4. Processing Patterns of ADHD, ADHD-I, and ADHD/LD Children on the LET-II.

    ERIC Educational Resources Information Center

    Webster, Raymond E.

    This paper discusses the findings from a study that investigated the information processing characteristics of 93 children (ages 8-16) who have been diagnosed as having either attention deficit hyperactivity disorder (ADHD) only, ADHD-Predominately Inattentive Type, and combined ADHD and learning disabilities (LD). Thirty-nine average students,…

  5. A Randomized, Controlled Trial of Integrated Home-School Behavioral Treatment for ADHD, Predominantly Inattentive Type

    ERIC Educational Resources Information Center

    Pfiffner, Linda J.; Mikami, Amori Yee; Huang-Pollock, Cynthia; Easterlin, Barbara; Zalecki, Christine; McBurnett, Keith

    2007-01-01

    Objective: To evaluate the efficacy of a behavioral psychosocial treatment integrated across home and school (Child Life and Attention Skills Program) with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I). Method: Sixty-nine children ages 7 to 11 years were randomized to the Child Life and Attention Skills…

  6. The Relationship between Sensory Processing Difficulties and Leisure Activity Preference of Children with Different Types of ADHD

    ERIC Educational Resources Information Center

    Engel-Yeger, Batya; Ziv-On, Daniella

    2011-01-01

    Sensory processing difficulties (SPD) are prevalent among children with ADHD. Yet, the question whether different SPD characterize children with different types of ADHD has not received enough attention in the literature. The current study characterized sensory processing difficulties (SPD) of children with different types of ADHD and explored the…

  7. Are family variables associated with ADHD, inattentive type? A case-control study in schools.

    PubMed

    Pheula, Gabriel Ferreira; Rohde, Luis Augusto; Schmitz, Marcelo

    2011-03-01

    Attention-deficit/hyperactivity disorder (ADHD) seems to be associated with significant psychosocial adversity. However, few studies assessed the role of environmental, social and interpersonal factors specifically in ADHD, inattentive type (ADHD-I). Thus, this study aims to investigate whether family environment risk factors are associated with ADHD-I. In a case-control study, we assessed a non-referred sample of 100 children and adolescents with ADHD-I and 100 non-ADHD controls (6-18 years old). They were systematically evaluated through structured diagnostic interviews. The following family adversity measures were used: Rutter's family adversity index (marital discord, low social class, large family size, paternal criminality, maternal mental disorder), Family Environment Scale (FES) (subscores of cohesion, expressiveness and conflict) and Family Relationship Index (FRI) (based on the subscores above). After adjusting for confounding factors (social phobia and maternal history of ADHD), the odds ratio (OR) for ADHD-I increased as the number of Rutter's indicators increased. Families of children with lower FES cohesion subscores presented higher OR for ADHD-I (OR 1.24; 95% confidence interval 1.05-1.45). Lower levels of FRI, a general index of family relationship, were also related to higher risk of ADHD-I (OR 1.11; 95% confidence interval 1.03-1.21). Our findings suggest that family adversity (in general), low family cohesion and low FRI (in particular) are associated with an increase in the risk for ADHD-I. However, the cross-sectional nature of the study limits our ability to infer causality. PMID:21290154

  8. Comparative Cost Analysis of Sequential, Adaptive, Behavioral, Pharmacological, and Combined Treatments for Childhood ADHD.

    PubMed

    Page, Timothy F; Pelham, William E; Fabiano, Gregory A; Greiner, Andrew R; Gnagy, Elizabeth M; Hart, Katie C; Coxe, Stefany; Waxmonsky, James G; Foster, E Michael; Pelham, William E

    2016-01-01

    We conducted a cost analysis of the behavioral, pharmacological, and combined interventions employed in a sequential, multiple assignment, randomized, and adaptive trial investigating the sequencing and enhancement of treatment for children with attention deficit hyperactivity disorder (ADHD; Pelham et al., 201X; N = 146, 76% male, 80% Caucasian). The quantity of resources expended on each child's treatment was determined from records that listed the type, date, location, persons present, and duration of all services provided. The inputs considered were the amount of physician time, clinician time, paraprofessional time, teacher time, parent time, medication, and gasoline. Quantities of these inputs were converted into costs in 2013 USD using national wage estimates from the Bureau of Labor Statistics, the prices of 30-day supplies of prescription drugs from the national Express Scripts service, and mean fuel prices from the Energy Information Administration. Beginning treatment with a low-dose/intensity regimen of behavior modification (large-group parent training) was less costly for a school year of treatment ($961) than beginning treatment with a low dose of stimulant medication ($1,669), regardless of whether the initial treatment was intensified with a higher "dose" or if the other modality was added. Outcome data from the parent study (Pelham et al., 201X) found equivalent or superior outcomes for treatments beginning with low-intensity behavior modification compared to intervention beginning with medication. Combined with the present analyses, these findings suggest that initiating treatment with behavior modification rather than medication is the more cost-effective option for children with ADHD. PMID:26808137

  9. Project DyAdd: Fatty acids in adult dyslexia, ADHD, and their comorbid combination.

    PubMed

    Laasonen, Marja; Hokkanen, Laura; Leppämäki, Sami; Tani, Pekka; Erkkilä, Arja T

    2009-07-01

    In project DyAdd, we compared the fatty acid (FA) profiles of serum phospholipids in adults with attention deficit hyperactivity disorder (ADHD) (n=26), dyslexia (n=36), their comorbid combination (n=9), and healthy controls (n=36). FA proportions were analyzed in a 2x2 design with Bonferroni corrected post hoc comparisons. A questionnaire was used to assess dietary fat quality and use of supplements. Results showed that ADHD and dyslexia were not associated with total saturated FAs, monounsaturated FAs, or n-3 polyunsaturated FAs (PUFAs). However, those with ADHD had elevated proportions of total n-6 PUFAs (including gamma-linolenic and adrenic acids) as compared to those without ADHD. Dyslexia was related to a higher proportion of monounsaturated nervonic acid and a higher ratio of n-6/n-3 PUFAs. Among females none of the associations were significant. However in males, all the original associations observed in all subjects remained and ADHD was associated with elevated nervonic acid and n-6/n-3 PUFA ratio like dyslexia. Controlling for poorly diagnosed reading difficulties, education, dietary fat quality, or use of FA supplements did not generally remove the originally observed associations. PMID:19523794

  10. Social Functioning in Predominantly Inattentive and Combined Subtypes of Children with ADHD

    PubMed Central

    Solanto, Mary V.; Pope-Boyd, Sabrina A.; Tryon, Warren W.; Stepak, Brenda

    2014-01-01

    Objective The objective of this study was to compare the social functioning of children with the Combined (CB) and Predominantly Inattentive (PI) subtypes of AD/HD, controlling for comorbidity and medication status, which may have confounded the results of previous research. Method Rigorously diagnosed unmedicated children with PI or CB were compared on parent and teacher ratings on the multi-dimensional Social Skills Rating Scale. Results Total social impairment was substantial and equivalent in both ADHD groups whether rated by parent or teacher. In addition, when rated by teacher, the nature of the deficits varied by subtype: Children with PI were impaired in assertiveness, whereas children with CB were deficient in self-control. These findings indicate that AD/HD subtypes differ in the nature of their social dysfunction independent of comorbidity and highlight the need for interventions to target their divergent needs. PMID:19372497

  11. Neurocognitive Functioning in AD/HD, Predominantly Inattentive and Combined Subtypes

    ERIC Educational Resources Information Center

    Solanto, Mary V.; Gilbert, Sharone N.; Raj, Anu; Zhu, John; Pope-Boyd, Sa'brina; Stepak, Brenda; Vail, Lucia; Newcorn, Jeffrey H.

    2007-01-01

    The Predominantly Inattentive (PI) and Combined (CB) subtypes of AD/HD differ in cognitive tempo, age of onset, gender ratio, and comorbidity, yet a differentiating endophenotype has not been identified. The aim of this study was to test rigorously diagnosed PI, CB, and typical children on measures selected for their potential to reveal…

  12. Social Functioning in Predominantly Inattentive and Combined Subtypes of Children with ADHD

    ERIC Educational Resources Information Center

    Solanto, Mary V.; Pope-Boyd, Sabrina A.; Tryon, Warren W.; Stepak, Brenda

    2009-01-01

    Objective: The objective of this study was to compare the social functioning of children with the Combined (CB) and Predominantly Inattentive (PI) subtypes of Attention Deficit/Hyperactivity Disorder (ADHD), controlling for comorbidity and medication-status, which may have confounded the results of previous research. Method: Parents and teachers…

  13. A Combined Treatment Approach for Adults with ADHD--Results of an Open Study of 43 Patients

    ERIC Educational Resources Information Center

    Rostain, Anthony L.; Ramsay, J. Russell

    2006-01-01

    Objective: Increasing numbers of adults are seeking treatment for ADHD. Pharmacotherapy is well established as the first line treatment for adult ADHD, although medications alone may be insufficient treatment for the myriad problems experienced by these patients. Few studies have examined the clinical outcomes of a combination of pharmacotherapy…

  14. ADHD in Finland and Types of Scandinavian Cooperation.

    ERIC Educational Resources Information Center

    Tapper, Marie-Louise; Michelsson, Katarina

    This paper reviews the history and current status of services to children with attention deficit hyperactivity disorder in Finland. It notes the availability of free or almost free health services in Finland and the resulting very low infant mortality rate. The history of attention deficit hyperactivity disorders (ADHD), termed "minimal brain…

  15. Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches

    PubMed Central

    Chacko, Anil; Kofler, Michael; Jarrett, Matthew

    2014-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and chronic mental health condition that often results in substantial impairments throughout life. Although evidence-based pharmacological and psychosocial treatments exist for ADHD, effects of these treatments are acute, do not typically generalize into non-treated settings, rarely sustain over time, and insufficiently affect key areas of functional impairment (i.e., family, social, and academic functioning) and executive functioning. The limitations of current evidence-based treatments may be due to the inability of these treatments to address underlying neurocognitive deficits that are related to the symptoms of ADHD and associated areas of functional impairment. Although efforts have been made to directly target the underlying neurocognitive deficits of ADHD, extant neurocognitive interventions have shown limited efficacy, possibly due to misspecification of training targets and inadequate potency. We argue herein that despite these limitations, next-generation neurocognitive training programs that more precisely and potently target neurocognitive deficits may lead to optimal outcomes when used in combination with specific skill-based psychosocial treatments for ADHD. We discuss the rationale for such a combined treatment approach, prominent examples of this combined treatment approach for other mental health disorders, and potential combined treatment approaches for pediatric ADHD. Finally, we conclude with directions for future research necessary to develop a combined neurocognitive + skill-based treatment for youth with ADHD. PMID:25120200

  16. Dispositional Trait Types of ADHD in Young Children

    PubMed Central

    Martel, Michelle M.

    2015-01-01

    Objective This study evaluated a novel person-centered approach to parsing ADHD heterogeneity using dispositional traits. Method Participants were one hundred nine 3- to 6-year-olds, and their primary caregivers and day care providers/teachers who completed a multi-informant diagnostic procedure with longitudinal follow-up. Results Based on latent profile analysis, young children with ADHD could be divided into low control, high surgency, and high negative affect subgroups. The low control and high surgency groups exhibited increased parent- and teacher-rated hyperactive-impulsive and oppositional-defiant disorder (ODD) symptoms. Although the low control group exhibited the worst response inhibition, the high surgency group exhibited the worst working memory. Furthermore, the high surgency group exhibited high aggression and increasing levels of hyperactivity-impulsivity and ODD symptoms over time. Conclusion A subgroup of young children with ADHD with high surgency may be at particular risk for comorbid psychopathology and longitudinal worsening of symptoms. PMID:23239785

  17. Family Psychiatric History Evidence on the Nosological Relations of DSM-IV ADHD Combined and Inattentive Subtypes: New Data and Meta-Analysis

    ERIC Educational Resources Information Center

    Stawicki, Julie Ann; Nigg, Joel T.; Von Eye, Alexander

    2006-01-01

    Background: A key issue in the nosology of attention deficit hyperactivity disorder (ADHD) has concerned whether the DSM-IV combined (ADHD-C) and primarily inattentive (ADHD-PI) subtypes are in fact distinct disorders, or instead are fairly closely related, perhaps differing only in severity. Pertinent to this question, but in short supply, are…

  18. Saccade adaptation in young people diagnosed with Attention Deficit Hyperactivity Disorder Combined Type.

    PubMed

    Connolly, Amanda J; Rinehart, Nicole J; Fielding, Joanne

    2016-10-01

    Growing evidence suggests Attention Deficit Hyperactivity Disorder (ADHD) often co-occurs with Autism Spectrum Disorder (ASD), and a better understanding of the nature of their overlap, including at a neurobiological level, is needed. Research has implicated cerebellar-networks as part of the neural-circuitry disrupted in ASD, but little research has been carried out to investigate this in ADHD. We investigated cerebellar integrity using a double-step saccade adaptation paradigm in a group of male children age 8-15 (n=12) diagnosed with ADHD-Combined Type (-CT). Their performance was compared to a group of age and IQ-matched typically developing (TD) controls (n=12). Parent reported symptoms of ADHD-CT and ASD were measured, along with motor proficiency (Movement ABC-2). We found, on average, the adaptation of saccade gain was reduced for the ADHD-CT group compared to the TD group. Greater saccadic gain change (adaptation) was also positively correlated with higher Movement ABC-2 total and balance scores among the ADHD-CT participants. These differences suggest cerebellar networks underlying saccade adaptation may be disrupted in young people with ADHD-CT. Though our findings require further replication with larger samples, they suggest further research into cerebellar dysfunction in ADHD-CT, and as a point of neurobiological overlap with ASD, may be warranted. PMID:27393248

  19. Transdermal methylphenidate, behavioral, and combined treatment for children with ADHD.

    PubMed

    Pelham, William E; Burrows-Maclean, Lisa; Gnagy, Elizabeth M; Fabiano, Gregory A; Coles, Erika K; Tresco, Katy E; Chacko, Anil; Wymbs, Brian T; Wienke, Amber L; Walker, Kathryn S; Hoffman, Martin T

    2005-05-01

    Stimulant medication and behavioral treatments are evidence-based for children with attention-deficit/hyperactivity disorder, but the combination of the 2 treatments has been understudied. In this investigation, methylphenidate (MPH) was crossed with 2 levels of behavior modification (BMOD) in a summer treatment program. Twenty-seven children with attention-deficit/hyperactivity disorder, aged 6-12, participated. Children received placebo and 3 doses of transdermal MPH (12.5 cm(2), 25.0 cm(2), and 37.5 cm(2)). BMOD was implemented on alternating weeks. Both treatments produced large and significant effects. Combined treatment was superior to either treatment alone. The effects of transdermal MPH were comparable to those found in this setting in previous studies with multiple stimulant medications and formulations. Consistent with other research, low doses of MPH--even lower than in previous studies--yielded enhanced effects in combination with behavior modification. PMID:15943544

  20. Sex differences between the combined and inattentive types of attention-deficit/hyperactivity disorder: an EEG perspective.

    PubMed

    Dupuy, Franca E; Barry, Robert J; Clarke, Adam R; McCarthy, Rory; Selikowitz, Mark

    2013-09-01

    This study investigated sex differences between the EEGs of Combined and Inattentive types of attention-deficit/hyperactivity disorder (AD/HD) within boys and girls aged 8-12 years. Subject groups included 80 AD/HD Combined type (40 boys and 40 girls), 80 AD/HD Inattentive type (40 boys and 40 girls) and 80 controls (40 boys and 40 girls). An eyes-closed resting EEG was recorded and Fourier transformed to provide estimates for absolute and relative power in the delta, theta, alpha and beta frequency bands, as well as total power and the theta/beta ratio. The boy AD/HD groups, compared with boy controls, had greater absolute and relative theta, greater theta/beta ratio, reduced absolute and relative alpha, and reduced absolute and relative beta. The girl AD/HD groups, compared with girl controls, had greater absolute delta, greater absolute and relative theta, greater theta/beta ratio, greater total power, and reduced relative delta and relative beta. Between AD/HD types, Combined type boys had globally greater absolute and relative theta, greater theta/beta ratio, and less relative alpha than Inattentive type boys. While topographical differences emerged, there were no significant global differences between AD/HD types in girls. That is, EEG differences between AD/HD types are dissimilar in boys and girls. Different EEG maturational patterns between boys and girls also obscure AD/HD-related EEG abnormalities. These results have important implications for our understanding of AD/HD in girls. Ignoring such sex differences may have compromised the value of previous AD/HD investigations, and these sex differences should be recognised in future research. PMID:23603052

  1. ADHD Subtypes and Comorbid Anxiety, Depression, and Oppositional-Defiant Disorder: Differences in Sleep Problems

    PubMed Central

    Calhoun, Susan L.; Bixler, Edward O.; Vgontzas, Alexandros N.; Mahr, Fauzia; Hillwig-Garcia, Jolene; Elamir, Belal; Edhere-Ekezie, Linda; Parvin, Matthew

    2009-01-01

    Objective Sleep problems were analyzed in children with ADHD (Attention-deficit hyperactivity disorder). Methods Scales were completed by parents of 135 control children and 681 children with ADHD combined type (ADHD-C) or inattentive type (ADHD-I) with or without comorbid oppositional defiant disorder (ODD), anxiety, or depression. Results Children with ADHD-I alone had the fewest sleep problems and did not differ from controls. Children with ADHD-C had more sleep problems than controls and children with ADHD-I. Comorbid anxiety/depression increased sleep problems, whereas ODD did not. Daytime sleepiness was greatest in ADHD-I and was associated with sleeping more (not less) than normal. Medicated children had greater difficulty falling asleep than unmedicated children. Conclusions Differences in sleep problems were found as a function of ADHD subtype, comorbidity, and medication. PMID:18676503

  2. Efficacy and Safety of Omega-3/6 Fatty Acids, Methylphenidate, and a Combined Treatment in Children With ADHD.

    PubMed

    Barragán, Eduardo; Breuer, Dieter; Döpfner, Manfred

    2014-01-24

    Objective: To compare efficacy of Omega-3/6 fatty acids (Equazen eye q™) with methylphenidate (MPH) and combined MPH + Omega-3/6 in children with ADHD. Method: Participants (N = 90) were randomized to Omega-3/6, long-acting MPH, or combination for 12 months. ADHD symptoms were assessed using the ADHD Rating Scale and Clinical Global Impressions-Severity (CGI-S) scale. Results: ADHD symptoms decreased in all treatment arms. Although significant differences favoring Omega + MPH over Omega-3/6 alone were found for ADHD Total and Hyperactivity-Impulsivity subscales, results on the Inattention subscale were similar. CGI-S scores decreased slowly and consistently with Omega-3/6, compared with a rapid decrease and subsequent slight increase in the MPH-containing arms. Adverse events were numerically less frequent with Omega-3/6 or MPH + Omega-3/6 than MPH alone. Conclusion: The tested combination of Omega-3/6 fatty acids had similar effects to MPH, whereas the MPH + Omega combination appeared to have some tolerability benefits over MPH. PMID:24464327

  3. Event-Related Potentials in Adolescents with Combined ADHD and CD Disorder: A Single Stimulus Paradigm

    ERIC Educational Resources Information Center

    Du, Jing; Li, Jianming; Wang, Ying; Jiang, Qianjin; Livesley, W. John; Jang, Kerry L.; Wang, Kai; Wang, Wei

    2006-01-01

    Some studies of the event-related potentials demonstrated a reduction of the voluntary component P3 (P300 or P3b) in youngsters with the attention deficit/hyperactivity disorder (ADHD) or in conduct disorders (CD), and a reduction of the automatic processing component, mismatch negativity, in patients with both ADHD and CD (ADHD+CD). Recently, a…

  4. Predictive Validity of Attentional Functions in Differentiating Children with and without ADHD: A Componential Analysis

    ERIC Educational Resources Information Center

    Kaufmann, Liane; Zieren, Nikola; Zotter, Sibylle; Karall, Daniela; Scholl-Burgi, Sabine; Haberlandt, Edda; Fimm, Bruno

    2010-01-01

    Aim: The objective of this study was to investigate which attentional components are of predictive utility in differentiating children with attention-deficit-hyperactivity disorder, combined type (ADHD-C) from their peers without ADHD. Methods: Thirty-four children participated in the study: 17 males with ADHD-C (mean age 10y 4mo, SD 1y 9mo) and…

  5. Parenting Mediates Symptoms and Impairment in Children with ADHD-Inattentive Type

    PubMed Central

    Haack, Lauren; Villodas, Miguel T.; McBurnett, Keith; Hinshaw, Stephen; Pfiffner, Linda

    2015-01-01

    The current study investigates potential pathways between inattentive symptom severity, positive and negative parenting practices, and functional impairment (i.e., academic, social, and home impairment) in a sample of children diagnosed with ADHD, Predominantly Inattentive Type (ADHD-I). Participants included 199 children and their parents and teachers enrolled in a randomized clinical trial investigating the efficacy of an integrated psychosocial intervention for children with ADHD-I. Boys constituted just over half the sample; children averaged 8.6 years of age (range 7–11) and were from varied ethnic/racial backgrounds. As part of the initial screening and assessment procedures, parents and teachers completed questionnaires assessing child behavior and parent/family functioning. Results supported both main effects of symptoms and parenting on impairment, as well as a mediational path between symptoms and impairment via parenting, as observed by parents in the home setting. Specifically, higher severity of inattention was associated with higher rates of homework, social, and home impairment. Negative parenting contributed to homework and home impairment, and positive and negative parenting contributed to social impairment, incrementally above and beyond the impact of inattention symptom severity alone. Negative parenting partially mediated the relationship between inattentive symptom severity and impairment, such that higher rates of inattention were associated with higher rates of negative parenting, which in turn was associated with higher rates of homework, social, and home impairment. Results provide support for underlying mechanisms for associations between symptoms and impairment in children with ADHD-I, and also identify potential intervention targets to improve impairment experienced by these children. PMID:25411896

  6. ADHD Medications

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? ADHD Medicines KidsHealth > For Teens > ADHD Medicines Print A ... Medicación para el tratamiento del TDAH (ADHD) Managing ADHD With Medicine Just about everyone has trouble concentrating ...

  7. [Immunological and endocrinological pattern in ADHD etiopathogenesis].

    PubMed

    Budziszewska, Bogusława; Basta-Kaim, Agnieszka; Kubera, Marta; Lasoń, Władysław

    2010-01-01

    Attention-Deficit Hyperactivity Disorder (ADHD) is the most prevalent neurodevelopmental disorder among children. There are 3 subtypes of ADHD: (1) with prevalent inattentive symptoms (2) with prevalent hyperactive-impulsive symptoms and (3) the combined subtype. It typically manifests itself before age 7 years and occurs more frequently in boys than in girls. It is diagnosed when the hyperactivity, impulsiveness and inattention last long, appear at least in two environments and their intensity impairs the functioning of the child. The etiology of ADHD is not well-known but recent studies have shown that genetic factors are of big importance. Also several environmental influences that raise the risk for ADHD development have been identified. Recently, it has been postulated that the reduced activity of the dopaminergic and noradrenergic systems play a crucial role in ADHD pathogenesis. It is evidenced by the fact that drugs intensifying the noradrenergic and dopaminergic transmission are the most successful for ADHD treatment. At present, it has been also postulated that the disturbances in endocrine and immune systems are involved in the ADHD pathogenesis. Interconnections between functions of these systems and function of neurotransmitters are better recognized now and show that disturbances in their cooperation can be involved in some psychiatric disorders. In the case of ADHD, most data are related to disturbances in the activity of the hypothalamus-pituitary-adrenal (HPA) axis activity. In particular, the lower level of cortisol in children with ADHD, especially in the hyperactive-impulsive type ADHD, the disturbance in the circadian rhythm of this steroid and the lack of its inhibition by the dexamethasone have been documented. Many clinical data indicate that in children with ADHD, the psychological stress evokes a weaker activation of the HPA axis than in the control group. Epidemiological and preclinical investigations have shown that the disturbance in

  8. Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type.

    PubMed

    Haack, Lauren M; Villodas, Miguel T; McBurnett, Keith; Hinshaw, Stephen; Pfiffner, Linda J

    2016-01-01

    The current study investigates potential pathways between inattentive symptom severity, positive and negative parenting practices, and functional impairment (i.e., academic, social, and home impairment) in a sample of children diagnosed with attention-deficit/hyperactivity disorder, Predominantly Inattentive Type (ADHD-I). Participants included 199 children and their parents and teachers enrolled in a randomized clinical trial investigating the efficacy of an integrated psychosocial intervention for children with ADHD-I. Boys constituted slightly more than half the sample; children averaged 8.6 years of age (range = 7-11) and were from varied ethnic/racial backgrounds. As part of the initial screening and assessment procedures, parents and teachers completed questionnaires assessing child behavior and parent/family functioning. Results supported both main effects of symptoms and parenting on impairment, as well as a mediational path between symptoms and impairment via parenting, as observed by parents in the home setting. Specifically, higher severity of inattention was associated with higher rates of homework, social, and home impairment. Negative parenting contributed to homework and home impairment, and positive and negative parenting contributed to social impairment, incrementally above and beyond the impact of inattention symptom severity alone. Negative parenting partially mediated the relationship between inattentive symptom severity and impairment, such that higher rates of inattention were associated with higher rates of negative parenting, which in turn was associated with higher rates of homework, social, and home impairment. Results provide support for underlying mechanisms for associations between symptoms and impairment in children with ADHD-I and identify potential intervention targets to improve impairment experienced by these children. PMID:25411896

  9. A Two-site Randomized Clinical Trial of Integrated Psychosocial Treatment for ADHD-Inattentive Type

    PubMed Central

    Pfiffner, Linda J.; Hinshaw, Stephen P.; Owens, Elizabeth; Zalecki, Christine; Kaiser, Nina M.; Villodas, Miguel; McBurnett, Keith

    2014-01-01

    Objective This study evaluated the efficacy of the Child Life and Attention Skills (CLAS) program, a behavioral psychosocial treatment integrated across home and school, for youth with Attention Deficit Hyperactivity Disorder-Inattentive Type (ADHD-I). Method In a two-site randomized controlled trial, 199 children (ages 7-11) were randomized to CLAS (N=74), parent-focused treatment (PFT, N=74), or treatment as usual (TAU, N=51). We compared groups on parent and teacher ratings of inattention symptoms, organizational skills, social skills, and global improvement at post-treatment, and also at follow-up during the subsequent school year. Results CLAS resulted in greater improvements in teacher-reported inattention, organizational skills, social skills, and global functioning relative to both PFT and TAU at post-treatment. Parents of children in CLAS reported greater improvement in organizational skills than PFT and greater improvements on all outcomes relative to TAU at post-treatment. Differences between CLAS and TAU were maintained at follow-up for most parent-reported measures but were not significant for teacher-reported outcomes. Conclusions These findings extend support for CLAS across two study sites, revealing that integrating parent, teacher, and child treatment components, specifically adapted for ADHD-I, is superior to parent training alone and to usual care. Direct involvement of teachers and children in CLAS appears to amplify effects at school and home and underscores the importance of coordinating parent, teacher, and child treatment components for cross-setting effects on symptoms and impairment associated with ADHD-I. PMID:24865871

  10. Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: A randomized controlled trial.

    PubMed

    Steeger, Christine M; Gondoli, Dawn M; Gibson, Bradley S; Morrissey, Rebecca A

    2016-01-01

    This study examined the individual and combined effects of two nonpharmacological treatments for attention deficit/hyperactivity disorder (ADHD): Cogmed working memory training (CWMT) for adolescents and behavioral parent training (BPT) for mothers. Ninety-one adolescents (ages 11-15) and their mothers were randomized to one of four CWMT and BPT treatment and active control (placebo) group combinations of 5-week interventions. At pre- and posttest, mothers and teachers completed rating forms, and adolescents completed neuropsychological measures of working memory (WM). Individual intervention effects showed that treatment CWMT significantly improved WM spans, whereas there were no significant differences for treatment or control BPT on reports of parent-related outcomes. Combined treatment effects indicated an overall pattern of greatest improvements for the control CWMT/treatment BPT group, as compared to the other three groups, on adolescent WM deficit, behavioral regulation problems, and global executive deficit. Most significant effects for outcomes were main effects of improvements over time. A combination of CWMT and BPT did not result in increased treatment gains. However, potential effects of combined treatment may have been masked by greater perceived benefits arising from lack of struggle in the nonadaptive, CWMT active control condition. Future combined intervention research should focus on specific, theoretically driven WM deficits among individuals with ADHD, should include possible adaptations to the standard CWMT program, should examine effectiveness of cognitive treatments combined with contextual interventions and should utilize appropriate control groups to fully understand the unique and combined effects of interventions. PMID:25731907

  11. Prevalence of Restless Legs Syndrome in Adult ADHD and Its Subtypes.

    PubMed

    Snitselaar, Mark A; Smits, Marcel G; Spijker, Jan

    2016-01-01

    In this observational cross-sectional study, 49 subjects were assessed for sleep disorders and for ADHD symptoms. Thirty-six received an ADHD diagnosis (29: combined type (ADHD-C); 7: inattentive type). An RLS and RLS symptoms prevalence of 34.5% was found, with a higher prevalence rate in the ADHD-C subgroup, although not significantly (p = 0.066). RLS symptoms were correlated with particularly hyperactivity-impulsivity (ρ = 0.742; p: 0.000). ADHD patients with positive RLS scores reported higher scores on the ADHD-Rating scale compared with patients with negative RLS scores (Z: -2.968, p = 0.003), mainly due to higher hyperactivity-impulsivity scores (Z: -3.145; p = 0.002). Our findings show that clinicians need to be aware of RLS among adult ADHD patients, particularly those with severe hyperactivity-impulsivity symptoms. PMID:26418664

  12. ADHD Symptom Severity following Participation in a Pilot, 10-Week, Manualized, Family-Based Behavioral Intervention

    ERIC Educational Resources Information Center

    Curtis, David F.

    2010-01-01

    This investigation examined the effectiveness of a pilot, manualized 10-week intervention of family skills training for ADHD-related symptoms. The intervention combined behavioral parent training and child focused behavioral activation therapy. Participants were families with children ages 7-10 diagnosed with ADHD-Combined Type. This pilot…

  13. Working memory in school-aged children with attention-deficit/hyperactivity disorder combined type: are deficits modality specific and are they independent of impaired inhibitory control?

    PubMed

    Brocki, Karin C; Randall, Kate D; Bohlin, Gunilla; Kerns, Kimberly A

    2008-10-01

    This study examines differences between children with attention-deficit/ hyperactivity disorder combined type (ADHD-C) and normal controls on verbal and visuospatial working-memory (WM) tasks. The extent to which WM deficits in children with ADHD-C are independent of impaired inhibitory control was also examined. Two groups of 7- to 12-year-old boys participated in this study. The first group included 31 boys diagnosed with ADHD-C, and the second group included 34 boys without ADHD. Various verbal and visuospatial WM tasks and two inhibitory control tasks--prepotent response inhibition and interference control--were used. Overall, our results suggest impaired verbal and visuospatial WM processes in children with ADHD-C, as well as a lower level of performance on prepotent response inhibition. WM deficits in ADHD have previously been suggested to be particularly salient in the spatial domain; our results instead showed the largest effect for a verbal WM task thought to put heavy load on the executive or attentional control component of the WM system. An interpretation of this finding is that it is variation in terms of difficulty level or load on the executive WM processes, rather than variation in modality (verbal versus visuospatial), that is important in demonstrating WM deficits in ADHD-C. Finally, findings from logistic regression analyses showed that deficits in WM and inhibitory control seem to be semi-independent in children with ADHD-C, at least with regard to the elementary school age. PMID:18608645

  14. Cognition, Emotion and Behavior in Children with Tourette’s Syndrome and Children with ADHD-Combined Subtype—A Two-Year Follow-Up Study

    PubMed Central

    Hovik, Kjell Tore; Plessen, Kerstin J.; Cavanna, Andrea E.; Skogli, Erik Winther; Andersen, Per Normann; Øie, Merete

    2015-01-01

    Objective This two-year follow-up study investigates the course of and association among measures of cognitive control, focused attention, decision-making and symptom severity (anxiety, depression and behavior) in children and adolescents with Tourette’s Syndrome (TS) or Attention-Deficit/Hyperactivity Disorder-Combined subtype (ADHD-C). Method 19 children with TS, 33 with ADHD-C, and 50 typically developing children (TDC) were examined with a battery of psychometric measures and rating forms at baseline and two-years later. Results All three groups improved likewise in measures of cognitive control over time, whereas only the TDC improved in focused attention. The group of children with TS with comorbidities performed more similar to the children with ADHD-C in cognitive control at T1 and T2, whereas the children with TS without comorbidities performed more similar to the TDC in cognitive control at T1 and T2. In the decision-making task, the children with TS (with or without comorbidities) preferred a safer strategy in selecting advantageous choices than the children with ADHD-C and the TDC at T2. Children with TS and children with ADHD-C showed higher symptoms of anxiety and depression and more problems with emotional control compared with TDC at both time points. Finally, children with ADHD-C self-reported more depression symptoms than those with TS at both assessments. For the TS group, safer decision-making was related to better emotional control, and this relationship was stronger for the TS subgroup without comorbidities. Conclusion This study emphasizes the importance of addressing symptoms of anxiety and depression in children with TS or ADHD-C, identifying the effect of comorbidities in children with TS, and that children with TS or ADHD-C likely differ in their sensitivity to reinforcement contingencies. PMID:26673612

  15. Medicines for ADHD

    MedlinePlus

    ... 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 ...

  16. The Effect of Video Feedback on the Social Behavior of an Adolescent with ADHD

    ERIC Educational Resources Information Center

    Sibley, Margaret H.; Pelham, William E., Jr.; Mazur, Amy; Gnagy, Elizabeth M.; Ross, J. Megan; Kuriyan, Aparajita B.

    2012-01-01

    Objective: The social functioning of adolescents with ADHD is characteristically impaired, yet almost no interventions effectively address the peer relationships of these youth. This study evaluates the preliminary effects of a video-feedback intervention on the social behavior of a 16-year-old male with ADHD-combined type in the context of a…

  17. Working Memory Deficits in ADHD: The Contribution of Age, Learning/Language Difficulties, and Task Parameters

    ERIC Educational Resources Information Center

    Sowerby, Paula; Seal, Simon; Tripp, Gail

    2011-01-01

    Objective: To further define the nature of working memory (WM) impairments in children with combined-type ADHD. Method: A total of 40 Children with ADHD and an age and gender-matched control group (n = 40) completed two measures of visuo-spatial WM and two measures of verbal WM. The effects of age and learning/language difficulties on performance…

  18. Treating ADHD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Understanding ADHD Treating ADHD Past Issues / Spring 2014 Table of Contents Currently available treatments aim at reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types ...

  19. ADHD & Down Syndrome

    MedlinePlus

    ... at an accredited sleep center. What Types of Communication Difficulties Can Look Like ADHD? People with Down ... Down syndrome have a wide range of learning styles. A child's educational team may need to try ...

  20. Classroom changes in ADHD symptoms following clinic-based behavior therapy.

    PubMed

    Curtis, David F; Chapman, Stephanie; Dempsey, Jack; Mire, Sarah

    2013-03-01

    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. PMID:22678107

  1. One-Year Follow-Up of Combined Parent and Child Intervention for Young Children with ADHD

    ERIC Educational Resources Information Center

    Webster-Stratton, Carolyn; Reid, M. Jamila; Beauchaine, Theodore P.

    2013-01-01

    Efficacies of the Incredible Years (IY) interventions are well-established in children with oppositional defiant disorder (ODD) but not among those with a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD). We sought to evaluate 1-year follow-up outcomes among young children with ADHD who were treated with the IY interventions.…

  2. Gait abnormalities, ADHD, and environmental exposure to nitrous oxide.

    PubMed

    Fluegge, Keith

    2016-08-30

    Papadopoulos et al. (2014) investigated gait profiles of children with attention-deficit hyperactivity disorder-combined type (ADHD-CT) compared to typical developing (TD) controls. The authors reported differences in the gait profile of ADHD-CT in the self-selected fast speed category. Additionally, others have proposed a maturational delay hypothesis in gait, demonstrating that gait variability decreases with age in ADHD children. It has been previously suggested that the cognitive impairment seen in conditions like ADHD may result from chronic, environmental exposure to the air pollutant, nitrous oxide (N2O). Exposure to N2O is thought to exert its antinociceptive properties by stimulating release of dynorphin peptides in the central nervous system which act upon kappa opioid receptors (KOR). Opioid-mediated gait abnormalities in ADHD are supported with evidence that prodynorphin mutations in mice lead to cytotoxic levels of dynorphin A (DYN A) and contribute to abnormal gait profiles and gradual loss of motor coordination. Interestingly, constitutive activity of the KOR receptor in rat brain has been recently shown to undergo maturational alterations, suggesting that while altered gait profiles in ADHD may be a function of the enhanced opioidergic activity attributable to chronic exposure to the environmental air pollutant, N2O, age-attenuated constitutive activity of KOR in brain may explain the normalization of these altered gait profiles in older ADHD subjects. PMID:27285951

  3. The clinical profile of children with ADHD that require OROS-methylphenidate combined with shorter-acting formulations.

    PubMed

    Zelnik, Nathanel; Terkel-Dawer, Ruth

    2015-12-01

    Long-acting methylphenidate (MPH) formulations, including OROS-MPH, were found to be effective in alleviating ADHD symptoms throughout the day. However, sustained stimulant activity may lead to prolonged suppression of appetite and insomnia. In this study, we characterized the clinical profile of children and adolescents for whom a once-daily lower dose of OROS-MPH combined with a shorter-acting agent was more tolerable than single higher OROS-MPH dose. In our cohort of 128 children treated with OROS-MPH, 47 (36.7 %) better tolerated a lower dose of OROS-MPH combined with short-acting MPH formulations (Group I). Nevertheless, for the majority (81 patients-63.3 %), a standard single moderate dose of OROS-MPH was sufficient (Group II). The mean daily doses of MPH were: 0.83 ± 0.21 mg/kg for Group I and 1.06 ± 0.29 mg/kg for Group II. There were no significant differences in the prevalence of learning disorders, tic disorders, epilepsy and conduct disorders between these two groups. However, anxiety and marginally depression were more prevalent in Group I (46.8 and 9.7 %) than in Group II (27.2 and 1.2 %). Patients in Group I were also more tending to receive psychotherapy than patients in Group II. PMID:25838111

  4. Do Hyperactive Symptoms Matter in ADHD-I Restricted Phenotype?

    ERIC Educational Resources Information Center

    Schmitz, Marcelo; Ludwig, Henrique; Rohde, Luis A.

    2010-01-01

    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).…

  5. EEG theta and beta power spectra in adolescents with ADHD versus adolescents with ASD + ADHD.

    PubMed

    Bink, M; van Boxtel, G J M; Popma, A; Bongers, I L; Denissen, A J M; van Nieuwenhuizen, Ch

    2015-08-01

    Attention problems are common in youngsters with attention deficit hyperactivity disorder (ADHD) as well as in adolescents with combined autism spectrum disorder (ASD) and ADHD. However, it is unknown whether there is psychophysiological overlap and/or a difference in electroencephalogram (EEG) power spectra between ADHD and comorbid ASD and ADHD (ASD + ADHD), on and off stimulant medication. To explore potential differences and overlap, measures of theta and beta power in adolescents diagnosed with ADHD (n = 33) versus adolescents with combined ASD + ADHD (n = 20), categorized by stimulant medication use (57 % of the total sample), were compared. EEG measures were acquired in three conditions: (1) resting state, eyes closed (2) resting state, eyes open and (3) during an oddball task. In addition, performance on the d2 attention test was analyzed. Adolescents with ADHD displayed more absolute theta activity than adolescents with ASD + ADHD during the eyes open and task conditions, independent of stimulant medication use. In addition, only the adolescents with ADHD showed an association between diminished attention test performance and increased theta in the eyes open condition. Results of the current study suggest that although there is behavioral overlap between ADHD characteristics in adolescents with ADHD and adolescents with combined ASD + ADHD, the underlying psychophysiological mechanisms may be different. Adolescents with ASD + ADHD exhibited fewer of the EEG physiological signs usually associated with ADHD, although there was an overlap in attentional problems between the groups. This may indicate that treatments developed for ADHD work differently in some adolescents with ASD + ADHD and adolescents with ADHD only. PMID:25374034

  6. Kernel Principal Component Analysis for dimensionality reduction in fMRI-based diagnosis of ADHD.

    PubMed

    Sidhu, Gagan S; Asgarian, Nasimeh; Greiner, Russell; Brown, Matthew R G

    2012-01-01

    This study explored various feature extraction methods for use in automated diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD) from functional Magnetic Resonance Image (fMRI) data. Each participant's data consisted of a resting state fMRI scan as well as phenotypic data (age, gender, handedness, IQ, and site of scanning) from the ADHD-200 dataset. We used machine learning techniques to produce support vector machine (SVM) classifiers that attempted to differentiate between (1) all ADHD patients vs. healthy controls and (2) ADHD combined (ADHD-c) type vs. ADHD inattentive (ADHD-i) type vs. controls. In different tests, we used only the phenotypic data, only the imaging data, or else both the phenotypic and imaging data. For feature extraction on fMRI data, we tested the Fast Fourier Transform (FFT), different variants of Principal Component Analysis (PCA), and combinations of FFT and PCA. PCA variants included PCA over time (PCA-t), PCA over space and time (PCA-st), and kernelized PCA (kPCA-st). Baseline chance accuracy was 64.2% produced by guessing healthy control (the majority class) for all participants. Using only phenotypic data produced 72.9% accuracy on two class diagnosis and 66.8% on three class diagnosis. Diagnosis using only imaging data did not perform as well as phenotypic-only approaches. Using both phenotypic and imaging data with combined FFT and kPCA-st feature extraction yielded accuracies of 76.0% on two class diagnosis and 68.6% on three class diagnosis-better than phenotypic-only approaches. Our results demonstrate the potential of using FFT and kPCA-st with resting-state fMRI data as well as phenotypic data for automated diagnosis of ADHD. These results are encouraging given known challenges of learning ADHD diagnostic classifiers using the ADHD-200 dataset (see Brown et al., 2012). PMID:23162439

  7. An Asymmetric Stroop/Reverse-Stroop Interference Phenomenon in ADHD

    ERIC Educational Resources Information Center

    Song, Yongning; Hakoda, Yuji

    2011-01-01

    Objective: To examine whether participants with ADHD showed a deficit in Stroop/reverse-Stroop interference by comparing them to non-ADHD participants. Method: A group with ADHD, primarily inattentive type (n = 15), and a paired non-ADHD group (n = 15) completed the group version of the Stroop/reverse-Stroop test. Results: Asymmetric interference…

  8. ADHD-200 Global Competition: diagnosing ADHD using personal characteristic data can outperform resting state fMRI measurements.

    PubMed

    Brown, Matthew R G; Sidhu, Gagan S; Greiner, Russell; Asgarian, Nasimeh; Bastani, Meysam; Silverstone, Peter H; Greenshaw, Andrew J; Dursun, Serdar M

    2012-01-01

    Neuroimaging-based diagnostics could potentially assist clinicians to make more accurate diagnoses resulting in faster, more effective treatment. We participated in the 2011 ADHD-200 Global Competition which involved analyzing a large dataset of 973 participants including Attention deficit hyperactivity disorder (ADHD) patients and healthy controls. Each participant's data included a resting state functional magnetic resonance imaging (fMRI) scan as well as personal characteristic and diagnostic data. The goal was to learn a machine learning classifier that used a participant's resting state fMRI scan to diagnose (classify) that individual into one of three categories: healthy control, ADHD combined (ADHD-C) type, or ADHD inattentive (ADHD-I) type. We used participants' personal characteristic data (site of data collection, age, gender, handedness, performance IQ, verbal IQ, and full scale IQ), without any fMRI data, as input to a logistic classifier to generate diagnostic predictions. Surprisingly, this approach achieved the highest diagnostic accuracy (62.52%) as well as the highest score (124 of 195) of any of the 21 teams participating in the competition. These results demonstrate the importance of accounting for differences in age, gender, and other personal characteristics in imaging diagnostics research. We discuss further implications of these results for fMRI-based diagnosis as well as fMRI-based clinical research. We also document our tests with a variety of imaging-based diagnostic methods, none of which performed as well as the logistic classifier using only personal characteristic data. PMID:23060754

  9. Impairment in flexible regulation of speed and accuracy in children with ADHD.

    PubMed

    Vallesi, Antonino; D'Agati, Elisa; Pasini, Augusto; Pitzianti, Mariabernarda; Curatolo, Paolo

    2013-10-01

    Attention deficit hyperactivity disorder (ADHD) is characterized by poor adaptation of behavior to environmental demands, including difficulties in flexibly regulating behavior. To understand whether ADHD is associated with a reduction of strategic flexibility in modulating speed and accuracy, we used a perceptual decision-making task that required participants to randomly stress either fast or accurate responding. Thirty-one drug-free boys with ADHD combined-type (mean age: 10.2 years) and 33 healthy control boys (mean age: 10.7 years), matched for age and IQ, participated. Both reaction time and accuracy data were analyzed. Our findings demonstrated significantly lower accuracy in ADHD children than in controls when switching from speed to accuracy instructions. This deficit was directly associated with hyperactivity symptoms but not with inattention. Our results showed that ADHD is associated with a deficit in dynamically switching response strategy according to task demands on a trial-to-trial basis. PMID:24007981

  10. Associations of Age, Gender, and Subtypes With ADHD Symptoms and Related Comorbidity in a Danish Sample of Clinically Referred Adults.

    PubMed

    Soendergaard, Helle Moeller; Thomsen, Per Hove; Pedersen, Erik; Pedersen, Pernille; Poulsen, Agnethe Elkjaer; Winther, Lars; Nielsen, Jette Moeskjaer; Henriksen, Anne; Rungoe, Berit; Soegaard, Hans Joergen

    2014-01-10

    Objective: The aim was to examine associations of age and gender with ADHD subtypes and subsequently to examine associations of age, gender, and subtypes with comorbid psychiatric disorders. Method: Odds ratios were calculated and logistic regression performed using information from a clinical sample of 155 ADHD adults referred to a Danish specialized ADHD unit from 2010 to 2011. Results: A majority of men (65%) was found in the sample. Most patients were subtyped ADHD combined (78%), followed by ADHD inattentive (18%), and ADHD hyperactive-impulsive (4%). No significant differences were found in gender and age across subtypes. Current comorbid disorders were found in 57% of the ADHD patients. Significantly more comorbidity was found in the ADHD combined type and in patients ≥25 years. Significantly more men had substance use disorders and significantly more women had personality disorders. Conclusion: When assessing adult ADHD patients' age, gender, subtype, and related comorbid symptom profiles should be taken into account. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24412968

  11. Brief Report: Children with ADHD without Co-Morbid Autism Do Not Have Impaired Motor Proficiency on the Movement Assessment Battery for Children

    ERIC Educational Resources Information Center

    Papadopoulos, Nicole; Rinehart, Nicole; Bradshaw, John L.; McGinley, Jennifer L.

    2013-01-01

    Motor proficiency was investigated in a sample of children with Attention Deficit Hyperactivity Disorder-Combined type (ADHD-CT) without autism. Accounting for the influence of co-morbid autistic symptoms in ADHD motor studies is vital given that motor impairment has been linked to social-communication symptoms in children who have co-morbid ADHD…

  12. Coaching for ADHD

    ERIC Educational Resources Information Center

    Murphy, Kevin; Ratey, Nancy; Maynard, Sandy; Sussman, Susan; Wright, Sarah D.

    2010-01-01

    Despite limited scientific study on ADHD coaching as an intervention for adults with ADHD, the field of ADHD coaching has grown significantly and gained popularity in recent years. ADHD coaching is becoming a bona fide profession where one must advance through a rigorous training process, in order to be certified as a professional ADHD coach.…

  13. For ADHD, Start with Behavior Therapy, Not Drugs: CDC

    MedlinePlus

    ... type of psychological services, which might have included parent training. The number of children with ADHD receiving psychological services has not changed over time, the agency said. "Parents aren't the cause of their child's ADHD, ...

  14. Developing ADHD

    ERIC Educational Resources Information Center

    Taylor, Eric

    2009-01-01

    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…

  15. ADHD severity is associated with white matter microstructure in the subgenual cingulum

    PubMed Central

    Cooper, Miriam; Thapar, Anita; Jones, Derek K.

    2015-01-01

    Aims This analysis examined hypothesised associations between microstructural attributes in specific white matter (WM) tracts selected a priori and measures of clinical variability in adolescents with a diagnosis of attention deficit hyperactivity disorder (ADHD). Firstly, associations were explored between WM microstructure and ADHD severity in the subgenual cingulum. Secondly, to ensure that tract-specific approaches afforded enhanced rather than differential sensitivity, associations were measured between WM microstructure and autistic traits in the right corticospinal tract based on results of a previously-published voxelwise analysis. Methods 40 right-handed males aged 14–18 years (19 with DSM-IV combined type ADHD and 21 healthy controls) underwent a 60 direction diffusion MRI scan. Clinical ADHD and autism variation were assessed by validated questionnaires. Deterministic tractography based on spherical deconvolution methods was used to map the subgenual cingulum and corticospinal tract. Results Fractional anisotropy was positively correlated and radial diffusivity was negatively correlated with a) ADHD severity in the left subgenual cingulum and b) autistic traits in the inferior segment of the right corticospinal tract. No case–control differences were found. Conclusions Results shed light on possible anatomical correlates of ADHD severity and autistic symptoms in pathways which may be involved in the ADHD phenotype. They provide further evidence that tract-specific approaches may a) reveal associations between microstructural metrics and indices of phenotypic variability which would not be detected using voxelwise approaches, and b) provide improved rather than differential sensitivity compared to voxelwise approaches. PMID:25844319

  16. ADHD Medicines (for Kids)

    MedlinePlus

    ... Homework? Here's Help White House Lunch Recipes ADHD Medicines KidsHealth > For Kids > ADHD Medicines Print A A ... doctor can decide if ADHD medicine is needed. Medicine and the Mind There are a lot of ...

  17. College Students with ADHD

    MedlinePlus

    ... Families Guide Skip breadcrumb navigation College Students with ADHD Quick Links Facts For Families Guide Facts For ... No. 111; Updated December 2013 Many students with Attention Deficit Hyperactivity Disorder (ADHD) attend college. College students with ADHD face ...

  18. ADHD Perspectives: Medicalization and ADHD Connectivity

    ERIC Educational Resources Information Center

    Wright, Gloria Sunnie

    2012-01-01

    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…

  19. ADHD and Problem-Solving in Play

    ERIC Educational Resources Information Center

    Borg, Suzanne

    2009-01-01

    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…

  20. Intervention Strategies for Students with ADHD

    ERIC Educational Resources Information Center

    DuPaul, George J.; White, George P.

    2005-01-01

    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.

  1. Body Movements of Boys with Attention Deficit Hyperactivity Disorder (ADHD) during Computer Video Game Play.

    ERIC Educational Resources Information Center

    Farrace-DiZinno, Anna Marie; Douglas, Graham; Houghton, Stephen; Lawrence, Vivienne; West, John; Whiting, Ken

    2001-01-01

    Describes a study that recorded the type and severity of body movements of 79 boys with ADHD (attention deficit hyperactivity disorder) and 67 non-ADHD boys while playing a computer video game. Results of multivariate analysis of variance showed no statistically significant differences in body movements between ADHD and non-ADHD boys. (Author/LRW)

  2. Processing of Continuously Provided Punishment and Reward in Children with ADHD and the Modulating Effects of Stimulant Medication: An ERP Study

    PubMed Central

    Groen, Yvonne; Tucha, Oliver; Wijers, Albertus A.; Althaus, Monika

    2013-01-01

    Objectives Current models of ADHD suggest abnormal reward and punishment sensitivity, but the exact mechanisms are unclear. This study aims to investigate effects of continuous reward and punishment on the processing of performance feedback in children with ADHD and the modulating effects of stimulant medication. Methods 15 Methylphenidate (Mph)-treated and 15 Mph-free children of the ADHD-combined type and 17 control children performed a selective attention task with three feedback conditions: no-feedback, gain and loss. Event Related Potentials (ERPs) time-locked to feedback and errors were computed. Results All groups performed more accurately with gain and loss than without feedback. Feedback-related ERPs demonstrated no group differences in the feedback P2, but an enhanced late positive potential (LPP) to feedback stimuli (both gains and losses) for Mph-free children with ADHD compared to controls. Feedback-related ERPs in Mph-treated children with ADHD were similar to controls. Correlational analyses in the ADHD groups revealed that the severity of inattention problems correlated negatively with the feedback P2 amplitude and positively with the LPP to losses and omitted gains. Conclusions The early selective attention for rewarding and punishing feedback was relatively intact in children with ADHD, but the late feedback processing was deviant (increased feedback LPP). This may explain the often observed positive effects of continuous reinforcement on performance and behaviour in children with ADHD. However, these group findings cannot be generalised to all individuals with the ADHD, because the feedback-related ERPs were associated with the severity of the inattention problems. Children with ADHD-combined type with more inattention problems showed both deviant early attentional selection of feedback stimuli, and deviant late processing of non-reward and punishment. PMID:23555639

  3. A lack of default network suppression is linked to increased distractibility in ADHD

    PubMed Central

    Fassbender, Catherine; Zhang, Hao; Buzy, Wendy M.; Cortes, Carlos R.; Mizuiri, Danielle; Beckett, Laurel; Schweitzer, Julie B.

    2015-01-01

    Heightened distractibility in participants with ADHD as indexed by increased reaction time (RT) variability has been hypothesized to be due to a failure to sufficiently suppress activation in the default attention network during cognitively demanding situations. The present study utilized fMRI to examine the relationship between intra-individual variability (IIV) in task RT and suppression of BOLD response in regions of the default network, using a working memory paradigm and two levels of control tasks. IIV was calculated separately for thirteen healthy control and twelve children with ADHD, Combined Type. Children with ADHD displayed significantly more RT variability than controls. Neural measures showed that although both groups displayed a pattern of increasing deactivation of the medial prefrontal cortex (PFC) with increasing task difficulty, the ADHD group was significantly less deactive than controls. Correlations between IIV and brain activation suggested that greater variability was associated with a failure to deactivate ventromedial PFC with increasing task difficulty. T-tests on brain activation between participants with ADHD with low versus high IIV implicated a similar region so that high variability was associated with greater activity in this region. These data provide support for the theory that increased distractibility in at least some participants with ADHD may be due to an inability to sufficiently suppress activity in the default attention network in response to increasing task difficulty. PMID:19281801

  4. Topological organization of the “small-world” visual attention network in children with attention deficit/hyperactivity disorder (ADHD)

    PubMed Central

    Xia, Shugao; Foxe, John J.; Sroubek, Ariane E.; Branch, Craig; Li, Xiaobo

    2013-01-01

    Background: Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed childhood psychiatric disorder. Disrupted sustained attention is one of the most significant behavioral impairments in this disorder. We mapped systems-level topological properties of the neural network responsible for sustained attention during a visual sustained task, on the premise that strong associations between anomalies in network features and clinical measures of ADHD would emerge. Methods: Graph theoretic techniques (GTT) and bivariate network-based statistics (NBS) were applied to fMRI data from 22 children with ADHD combined-type and 22 age-matched neurotypicals, to evaluate the topological and nodal-pairing features in the functional brain networks. Correlation testing for relationships between network properties and clinical measures were then performed. Results: The visual attention network showed significantly reduced local-efficiency and nodal-efficiency in frontal and occipital regions in ADHD. Measures of degree and between-centrality pointed to hyper-functioning in anterior cingulate cortex and hypo-functioning in orbito-frontal, middle-occipital, superior-temporal, supra-central, and supra-marginal gyri in ADHD. NBS demonstrated significantly reduced pair-wise connectivity in an inner-network, encompassing right parietal and temporal lobes and left occipital lobe, in the ADHD group. Conclusions: These data suggest that atypical topological features of the visual attention network contribute to classic ADHD symptomatology, and may underlie the inattentiveness and hyperactivity/impulsivity that are characteristics of this syndrome. PMID:24688465

  5. Atomoxetine response in the inattentive and combined subtypes of attention deficit hyperactivity disorder: a retrospective chart review.

    PubMed

    Ercan, Eyup Sabri; Akyol Ardic, Ulku; Kabukcu Basay, Burge; Ercan, Elif; Basay, Omer

    2013-12-01

    The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 1994, American Psychiatric Association) describes attention deficit hyperactivity disorder (ADHD) as a heterogeneous disorder; providing diagnostic criteria for three subtypes: hyperactive/impulsive (ADHD/HI), inattentive (ADHD/I), and combined type (ADHD/C). Differences among the subtypes are well defined, but there may be also differences in terms of treatment responses. The aim of this study is to assess the responses of ADHD/I and ADHD/C to atomoxetine treatment. The medical records of the January-June 2012 term, first time referrals to outpatient clinic, were reviewed, and 37 ADHD diagnosed primary school age children (18 ADHD/I, 19 ADHD/C) that were treated with atomoxetine were determined. Thirty-five of them who completed 8 weeks of treatment duration were recruited for the study. The children with an ADHD medication use history in 2 months time prior to onset of treatment and/or the children receiving additional psychopharmacologic treatment to atomoxetine were excluded. Baseline and eighth week assessment, records were evaluated. Efficacy assessments included Turgay DSM-IV ADHD Screening and Rating Scale parent and teacher forms (T-DSM-IV) and Clinical Global Impression Scale-Severity and Improvement subscales. Safety assessments included laboratory and body weight assessments, ECG, heart rate, and blood pressure evaluations (baseline and eighth week) along a scale filled by the parents at the eighth week to review side effects. Atomoxetine was found to be effective in both ADHD/I and ADHD/C groups. Atomoxetine also decreased the opposition defiance subscale scores of T-DSM-IV (both parent and teacher forms), whereas it was not found to make statistically significant difference in the conduct disorder subscale scores. Mean difference in 8-week time in T-DSM-IV hyperactivity subscale and total scores of parent and teacher forms; inattention subscale scores of only parent forms and the

  6. Exercise: Applications to Childhood ADHD

    ERIC Educational Resources Information Center

    Wigal, Sharon B.; Emmerson, Natasha; Gehricke, Jean-G.; Galassetti, Pietro

    2013-01-01

    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…

  7. Evaluation and treatment of ADHD.

    PubMed

    Smucker, W D; Hedayat, M

    2001-09-01

    Symptoms of attention-deficit/hyperactivity disorder (ADHD) are present in as many as 9 percent of school-age children. ADHD-specific questionnaires can help determine whether children meet diagnostic criteria for the disorder. The recommended evaluation also includes documenting the type and severity of ADHD symptoms, verifying the presence of normal vision and hearing, screening for comorbid psychologic conditions, reviewing the child's developmental history and school performance, and applying objective measures of cognitive function. The stimulants methylphenidate and dextroamphetamine remain the pharmacologic agents of first choice for the management of ADHD. These agents are equally effective in improving the core symptoms of the disorder, but individual children may respond better to one stimulant medication than to another. Achievement of maximal benefit may require titration of the initial dosage and dosing before breakfast, before lunch and in the afternoon. The family physician should tailor the treatment plan to meet the unique needs of the child and family. Psychosocial, behavioral and educational strategies that enhance specific behaviors may improve educational and social functioning in the child with ADHD. PMID:11563573

  8. Occurrence of ADHD in parents of ADHD children in a clinical sample

    PubMed Central

    Starck, Martina; Grünwald, Julia; Schlarb, Angelika A

    2016-01-01

    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

  9. Combined ω3 and ω6 supplementation in children with attention-deficit hyperactivity disorder (ADHD) refractory to methylphenidate treatment: a double-blind, placebo-controlled study.

    PubMed

    Perera, Hemamali; Jeewandara, Kamal Chandima; Seneviratne, Sudarshi; Guruge, Chandima

    2012-06-01

    Children (6-12 years) with attention-deficit hyperactivity disorder (ADHD) being treated with methylphenidate and standard behavior therapy for more than 6 months, whose parents reported no improvement in behavior and academic learning, were randomly assigned to receive supplementation with a combined ω3 and ω6 preparation or a placebo. Outcome was measured at 3 and 6 months after treatment using a self-assessment checklist completed by the parents. Statistically significant improvement was found in the treatment group compared with the placebo group (P < .01) in the following measures: restlessness, aggressiveness, completing work, and academic performance. Statistically significant improvement was not found at 3 months of treatment between groups but was evident at 6 months of treatment (P < .05) with inattention, impulsiveness, and cooperation with parents and teachers. Distractibility failed to show improvement. Effect sizes ranged from 0.3 to 1.1 at 3 months and 0.2 to 1.4 at 6 months for individual symptom variables. PMID:22596014

  10. What Is ADHD?

    MedlinePlus

    ... school failures and social problems, and have low self-esteem . About 15% to 20% of kids with ADHD ... art, or music — can boost social skills and self-esteem. previous continue Alternative Treatments The only ADHD therapies ...

  11. ADHD: Tips to Try

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? ADHD: Tips to Try KidsHealth > For Teens > ADHD: Tips to Try Print A A A Text Size en español TDAH: Consejos que puedes probar ADHD , or attention deficit hyperactivity disorder, is a medical ...

  12. ADHD in College Students

    ERIC Educational Resources Information Center

    Weyandt, Lisa L.; DuPaul, George

    2006-01-01

    Objective: According to the American Psychiatric Association, 3% to 7% of the school-age population has ADHD and many children continue to display significant symptoms throughout adolescences and adulthood. Relative to the childhood literature, less is known about ADHD in adults, especially college students with ADHD. The principle purpose of this…

  13. Global consensus on ADHD/HKD.

    PubMed

    Remschmidt, Helmut

    2005-05-01

    A Global ADHD Working Group of experienced clinicians and researchers was gathered to review the latest evidence, discuss current best practice in the treatment of attention-deficit/hyperactivity disorder (ADHD), and make a statement based on consensus. The statement aims to re-affirm ADHD as a valid disorder that exists across different cultures, has a significant global impact, and should be diagnosed and effectively treated wherever it occurs. ADHD is one of the most common neurobehavioural disorders of childhood and impacts on many aspects of development, including social, emotional and cognitive functioning, in the home and school environment. Although these findings are from developed countries, the impact in developing countries is likely to be similar. There is strong supportive evidence for the validity of ADHD as a syndrome with neurobiological aspects, and complex genetic factors are primarily implicated in the aetiology. Accurate diagnosis and measurement of impairment is important to enable appropriate and successful management of symptoms. ADHD is a persistent condition that needs to be treated and monitored over time. The evidence supporting medication-based interventions (such as methylphenidate) is strong and consensus treatment algorithms to guide the multimodal treatment of ADHD, alone and in combination with common comorbidities, are suggested. PMID:15959658

  14. Effects of combined exercise on physical fitness and neurotransmitters in children with ADHD: a pilot randomized controlled study.

    PubMed

    Lee, Sun-Kyoung; Lee, Chung-Moo; Park, Jong-Hwan

    2015-09-01

    [Purpose] The purpose of the present study was to determine the effect of a jump rope and ball combined exercise program on the physical fitness the neurotransmitter (epinephrine, serotonin) levels of children with attention-deficit hyperactivity disorder. [Subjects and Methods] The subjects were 12 boys attending elementary school, whose grade levels ranged from 1-4. The block randomization method was used to distribute the participants between the combined exercise group (n = 6) and control group (n = 6). The program consisted of a 60-min exercise (10-min warm-up, 40-min main exercise, and 10-min cool down) performed three times a week, for a total of 12 weeks. [Results] The exercise group showed a significant improvement in cardiorespiratory endurance, muscle strength, muscle endurance and flexibility after 12 weeks. A significant increase in the epinephrine level was observed in the exercise group. [Conclusion] The 12-week combined exercise program in the current study (jump rope and ball exercises) had a positive effect on overall fitness level, and neurotransmission in children with attention-deficit hyperactivity disorder. PMID:26504324

  15. Effects of combined exercise on physical fitness and neurotransmitters in children with ADHD: a pilot randomized controlled study

    PubMed Central

    Lee, Sun-Kyoung; Lee, Chung-Moo; Park, Jong-Hwan

    2015-01-01

    [Purpose] The purpose of the present study was to determine the effect of a jump rope and ball combined exercise program on the physical fitness the neurotransmitter (epinephrine, serotonin) levels of children with attention-deficit hyperactivity disorder. [Subjects and Methods] The subjects were 12 boys attending elementary school, whose grade levels ranged from 1–4. The block randomization method was used to distribute the participants between the combined exercise group (n = 6) and control group (n = 6). The program consisted of a 60-min exercise (10-min warm-up, 40-min main exercise, and 10-min cool down) performed three times a week, for a total of 12 weeks. [Results] The exercise group showed a significant improvement in cardiorespiratory endurance, muscle strength, muscle endurance and flexibility after 12 weeks. A significant increase in the epinephrine level was observed in the exercise group. [Conclusion] The 12-week combined exercise program in the current study (jump rope and ball exercises) had a positive effect on overall fitness level, and neurotransmission in children with attention-deficit hyperactivity disorder. PMID:26504324

  16. Brief report: children with ADHD without co-morbid autism do not have impaired motor proficiency on the movement assessment battery for children.

    PubMed

    Papadopoulos, Nicole; Rinehart, Nicole; Bradshaw, John L; McGinley, Jennifer L

    2013-06-01

    Motor proficiency was investigated in a sample of children with Attention Deficit Hyperactivity Disorder-Combined type (ADHD-CT) without autism. Accounting for the influence of co-morbid autistic symptoms in ADHD motor studies is vital given that motor impairment has been linked to social-communication symptoms in children who have co-morbid ADHD and autistic-like symptoms. Two groups of children aged between 7-14 years were recruited; children with ADHD-CT (n = 16; mean age 10 years, 7 months [SD = 1 year, 10 months]) and a typically developing (n = 16; mean age 10 years, 6 months [SD = 2 years, 6 months]) group. Motor proficiency was measured using the Movement Assessment Battery for Children-2nd Edition, ADHD symptoms were measured using the Conner's Parent Rating Scale. Children with ADHD-CT who had been screened for co-morbid autism did not display motor difficulties on the MABC-2. Higher levels of inattention, but not hyperactivity or impulsivity were associated with poorer motor performance. These findings provide indirect evidence that the motor problems that children with ADHD experience may be related to co-occurring social responsiveness impairments. PMID:23100051

  17. Increased Delay Discounting on a Novel Real-Time Task among Girls, but not Boys, with ADHD

    PubMed Central

    Rosch, Keri S.; Mostofsky, Stewart H.

    2016-01-01

    The aim of this study was to examine delay discounting in girls and boys with ADHD-Combined type (ADHD-C) relative to typically developing (TD) children on two tasks that differ in the extent to which the rewards and delays were experienced by participants. Children ages 8–12 years with ADHD-C (n = 65; 19 girls) and TD controls (n = 55; 15 girls) completed two delay discounting tasks involving a series of choices between smaller, immediate and larger, delayed rewards. The classic delay discounting task involved choices about money at delays of 1–90 days and only some of the outcomes were actually experienced by the participants. The novel real-time discounting task involved choices about an immediately consumable reward (playing a preferred game) at delays of 25–100 s, all of which were actually experienced by participants. Participants also provided subjective ratings of how much they liked playing the game and waiting to play. Girls with ADHD-C displayed greater delay discounting compared to boys with ADHD-C and TD girls and boys on the real-time discounting task. Diagnostic group differences were not evident on the classic discounting task. In addition, children with ADHD-C reported wanting to play the game more and liking waiting to play the game less than TD children. This novel demonstration of greater delay discounting among girls with ADHD-C on a discounting task in which the rewards are immediately consumable and the delays are experienced in real-time informs our understanding of sex differences and motivational processes in children with ADHD. PMID:26549118

  18. Patterns and Predictors of Adolescent Academic Achievement and Performance in a Sample of Children with Attention-Deficit/Hyperactivity Disorder (ADHD)

    PubMed Central

    Langberg, Joshua M.; Molina, Brooke S.G.; Arnold, L. Eugene; Epstein, Jeffery N.; Altaye, Mekibib; Hinshaw, Stephen P.; Swanson, James M.; Wigal, Timothy; Hechtman, Lily

    2011-01-01

    Examined predictors of academic achievement, measured by standardized test scores, and performance, measured by school grades, in adolescents (Mage=16.8 yr) who met diagnostic criteria for ADHD-Combined type in early childhood (Mage = 8.5; N = 579). Several mediation models were also tested to determine whether ADHD medication use, receipt of special education, classroom performance, homework completion, or homework management mediated the relationship between symptoms of ADHD and academic outcomes. Childhood predictors of adolescent achievement differed from those for performance. Classroom performance and homework management mediated the relationship between symptoms of inattention and academic outcomes. Implications for understanding the relationship between symptoms of ADHD and academic functioning are discussed. PMID:21722025

  19. Inhibitory Functioning across ADHD Subtypes: Recent Findings, Clinical Implications, and Future Directions

    ERIC Educational Resources Information Center

    Adams, Zachary W.; Derefinko, Karen J.; Milich, Richard; Fillmore, Mark T.

    2008-01-01

    Although growing consensus supports the role of deficient behavioral inhibition as a central feature of the combined subtype of ADHD (ADHD/C; Barkley 1997 "Psychol Bull" 121:65-94; Nigg 2001 "Psychol Bull" 127:571-598), little research has focused on how this finding generalizes to the primarily inattentive subtype (ADHD/I). This question holds…

  20. Not Always Hyperactive? Elevated Apathy Scores in Adolescents and Adults with ADHD

    ERIC Educational Resources Information Center

    Torrente, Fernando; Lischinsky, Alicia; Torralva, Teresa; Lopez, Pablo; Roca, Maria; Manes, Facundo

    2011-01-01

    Objectives: To investigate the presence of apathy symptoms in adolescents and adults with ADHD as a behavioral manifestation of underlying motivational deficits and to determine whether apathy symptoms were associated with a specific neuropsychological profile. Method: A total of 38 ADHD participants (28 of the combined subtype [ADHD/C] and 10 of…

  1. Pharmacotherapy for adult ADHD.

    PubMed

    Adler, Lenard A

    2009-05-01

    The U.S. Food and Drug Administration has approved 3 medications, atomoxetine and the extended-release formulations of amphetamine salts and dexmethylphenidate, for the treatment of adult attention-deficit hyperactivity disorder (ADHD). Different formulations of the same drugs, as well as other agents and cognitive-behavioral therapy, have been tested to determine efficacy in ADHD alone and in ADHD with comorbid substance use disorders, mood disorders, and anxiety disorders. A deficit in research exists in regard to these comorbidities in adults with ADHD. PMID:19552859

  2. ADHD and Adolescent Athletes

    PubMed Central

    Nazeer, Ahsan; Mansour, Miriam; Gross, Kathleen A.

    2014-01-01

    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

  3. Visual Search by Children with and without ADHD

    ERIC Educational Resources Information Center

    Mullane, Jennifer C.; Klein, Raymond M.

    2008-01-01

    Objective: To summarize the literature that has employed visual search tasks to assess automatic and effortful selective visual attention in children with and without ADHD. Method: Seven studies with a combined sample of 180 children with ADHD (M age = 10.9) and 193 normally developing children (M age = 10.8) are located. Results: Using a…

  4. ADHD and delinquency--a developmental perspective.

    PubMed

    von Polier, G G; Vloet, T D; Herpertz-Dahlmann, B

    2012-01-01

    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. PMID:22371085

  5. Use and Management of Medications for Children Diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).

    ERIC Educational Resources Information Center

    Kollins, Scott H.; Barkley, Russell A.; DuPaul, George J.

    2001-01-01

    This article provides information and guidelines for the effective use of medication in treating attention deficit hyperactivity disorder (ADHD). Basic principles of psychopharmacology, different types of medications that have been used successfully to treat ADHD, and best practices for assessing the effects of medication in children with ADHD are…

  6. Increase Academic Success for Children with ADHD Using Sticky Notes and Highlighters

    ERIC Educational Resources Information Center

    Stormont, Melissa A.

    2008-01-01

    Children with attention-deficit/hyperactivity disorder (ADHD) represent about 3% to 5% of the school-age population and are most often educated in the general education classroom. Unfortunately, general educators may not be prepared to provide supports for children with ADHD or other types of diverse learning needs. Children with ADHD have many…

  7. Multiclass Classification for the Differential Diagnosis on the ADHD Subtypes Using Recursive Feature Elimination and Hierarchical Extreme Learning Machine: Structural MRI Study

    PubMed Central

    Qureshi, Muhammad Naveed Iqbal; Min, Beomjun; Jo, Hang Joon; Lee, Boreom

    2016-01-01

    The classification of neuroimaging data for the diagnosis of certain brain diseases is one of the main research goals of the neuroscience and clinical communities. In this study, we performed multiclass classification using a hierarchical extreme learning machine (H-ELM) classifier. We compared the performance of this classifier with that of a support vector machine (SVM) and basic extreme learning machine (ELM) for cortical MRI data from attention deficit/hyperactivity disorder (ADHD) patients. We used 159 structural MRI images of children from the publicly available ADHD-200 MRI dataset. The data consisted of three types, namely, typically developing (TDC), ADHD-inattentive (ADHD-I), and ADHD-combined (ADHD-C). We carried out feature selection by using standard SVM-based recursive feature elimination (RFE-SVM) that enabled us to achieve good classification accuracy (60.78%). In this study, we found the RFE-SVM feature selection approach in combination with H-ELM to effectively enable the acquisition of high multiclass classification accuracy rates for structural neuroimaging data. In addition, we found that the most important features for classification were the surface area of the superior frontal lobe, and the cortical thickness, volume, and mean surface area of the whole cortex. PMID:27500640

  8. Multiclass Classification for the Differential Diagnosis on the ADHD Subtypes Using Recursive Feature Elimination and Hierarchical Extreme Learning Machine: Structural MRI Study.

    PubMed

    Qureshi, Muhammad Naveed Iqbal; Min, Beomjun; Jo, Hang Joon; Lee, Boreom

    2016-01-01

    The classification of neuroimaging data for the diagnosis of certain brain diseases is one of the main research goals of the neuroscience and clinical communities. In this study, we performed multiclass classification using a hierarchical extreme learning machine (H-ELM) classifier. We compared the performance of this classifier with that of a support vector machine (SVM) and basic extreme learning machine (ELM) for cortical MRI data from attention deficit/hyperactivity disorder (ADHD) patients. We used 159 structural MRI images of children from the publicly available ADHD-200 MRI dataset. The data consisted of three types, namely, typically developing (TDC), ADHD-inattentive (ADHD-I), and ADHD-combined (ADHD-C). We carried out feature selection by using standard SVM-based recursive feature elimination (RFE-SVM) that enabled us to achieve good classification accuracy (60.78%). In this study, we found the RFE-SVM feature selection approach in combination with H-ELM to effectively enable the acquisition of high multiclass classification accuracy rates for structural neuroimaging data. In addition, we found that the most important features for classification were the surface area of the superior frontal lobe, and the cortical thickness, volume, and mean surface area of the whole cortex. PMID:27500640

  9. Temperament, Executive Control, and ADHD across Early Development

    PubMed Central

    Rabinovitz, Beth B.; O’Neill, Sarah; Rajendran, Khushmand; Halperin, Jeffrey M.

    2015-01-01

    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

  10. ADHD: A Teachers' Guide.

    ERIC Educational Resources Information Center

    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…

  11. Diagnosing ADHD in Adolescence

    ERIC Educational Resources Information Center

    Sibley, Margaret H.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Garefino, Allison C.; Kuriyan, Aparajita B.; Babinski, Dara E.; Karch, Kathryn M.

    2012-01-01

    Objective: This study examines adolescent-specific practical problems associated with current practice parameters for diagnosing attention-deficit/hyperactivity disorder (ADHD) to inform recommendations for the diagnosis of ADHD in adolescents. Specifically, issues surrounding the use of self- versus informant ratings, diagnostic threshold, and…

  12. Personality Disorders and Clinical Syndromes in ADHD Prisoners

    ERIC Educational Resources Information Center

    Gudjonsson, Gisli H.; Wells, June; Young, Susan

    2012-01-01

    Objective: The main objective of this article is to investigate the type of personality disorders and clinical syndromes (CSs) that were best related to ADHD symptoms among prisoners. Method: The authors screened for childhood and adult ADHD symptoms and administered the Millon Clinical Multiaxial Inventory-III (MCMI-III) to 196 serving prisoners.…

  13. Life Impairments in Adults with Medication-Treated ADHD

    ERIC Educational Resources Information Center

    Safren, Steven A.; Sprich, Susan E.; Cooper-Vince, Christine; Knouse, Laura E.; Lerner, Jonathan A.

    2010-01-01

    Objective: In developing psychosocial approaches to augment outcomes for medication-treated adults with ADHD, it is important to understand what types of life-impairments are most affected by continued ADHD symptoms that occur despite medication treatment. This may assist in delineating targets for interventions, as well as assessments of…

  14. Animal models of ADHD.

    PubMed

    Bari, A; Robbins, T W

    2011-01-01

    Studies employing animal models of attention-deficit/hyperactivity disorder (ADHD) present clear inherent advantages over human studies. Animal models are invaluable tools for the study of underlying neurochemical, neuropathological and genetic alterations that cause ADHD, because they allow relatively fast, rigorous hypothesis testing and invasive manipulations as well as selective breeding. Moreover, especially for ADHD, animal models with good predictive validity would allow the assessment of potential new therapeutics. In this chapter, we describe and comment on the most frequently used animal models of ADHD that have been created by genetic, neurochemical and physical alterations in rodents. We then discuss that an emerging and promising direction of the field is the analysis of individual behavioural differences among a normal population of animals. Subjects presenting extreme characteristics related to ADHD can be studied, thereby avoiding some of the problems that are found in other models, such as functional recovery and unnecessary assumptions about aetiology. This approach is justified by the theoretical need to consider human ADHD as the extreme part of a spectrum of characteristics that are distributed normally in the general population, as opposed to the predominant view of ADHD as a separate pathological category. PMID:21287324

  15. The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view.

    PubMed

    Rowland, Andrew S; Lesesne, Catherine A; Abramowitz, Ann J

    2002-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood. However, basic information about how the prevalence of ADHD varies by race/ethnicity, sex, age, and socio-economic status remains poorly described. One reason is that difficulties in the diagnosis of ADHD have translated into difficulties developing an adequate case definition for epidemiologic studies. Diagnosis depends heavily on parent and teacher reports; no laboratory tests reliably predict ADHD. Prevalence estimates of ADHD are sensitive to who is asked what, and how information is combined. Consequently, recent systematic reviews report ADHD prevalence estimates as wide as 2%-18%. The diagnosis of ADHD is complicated by the frequent occurrence of comorbid conditions such as learning disability, conduct disorder, and anxiety disorder. Symptoms of these conditions may also mimic ADHD. Nevertheless, we suggest that developing an adequate epidemiologic case definition based on current diagnostic criteria is possible and is a prerequisite for further developing the epidemiology of ADHD. The etiology of ADHD is not known but recent studies suggest both a strong genetic link as well as environmental factors such as history of preterm delivery and perhaps, maternal smoking during pregnancy. Children and teenagers with ADHD use health and mental health services more often than their peers and engage in more health threatening behaviors such as smoking, and alcohol and substance abuse. Better methods are needed for monitoring the prevalence and understanding the public health implications of ADHD. Stimulant medication is the treatment of choice for treating ADHD but psychosocial interventions may also be warranted if comordid disorders are present. The treatment of ADHD is controversial because of the high prevalence of medication treatment. Epidemiologic studies could clarify whether the patterns of ADHD diagnosis and treatment in community settings is

  16. Smaller splenium in children with nonverbal learning disability compared to controls, high-functioning autism and ADHD.

    PubMed

    Fine, Jodene Goldenring; Musielak, Kayla A; Semrud-Clikeman, Margaret

    2014-01-01

    The current study investigated morphological differences in the corpus callosum in children ages 8 to 18 years old with nonverbal learning disability (NLD; n = 19), high-functioning autism (HFA; n = 23), predominantly inattentive ADHD (ADHD:PI; n = 23), and combined type ADHD (ADHD:C; n = 25), as well as those demonstrating typical development (n = 57). Midsagittal area of the corpus callosum and five midsagittal anterior-to-posterior corpus callosum segments were examined using magnetic resonance imaging. Controlling for midsagittal brain area and age, no group differences were found for total corpus callosum area. This finding indicates that higher functioning children on the autistic spectrum do not have smaller corpus callosi as has been found in previous research with heterogeneous samples. Following segmentation of the corpus callosum, the NLD group was observed to have significantly smaller splenia compared to all other groups. Smaller splenia in the NLD group was associated with lower WASI PIQ scores but not WASI VIQ scores. Children with HFA were observed to have larger midbody areas than children with NLD and neurotypically developing children. Children with HFA and NLD demonstrated behavioral symptoms of inattention and hyperactivity similar to the ADHD groups indicating that corpus callosum differences seen in the NLD and HFA groups are not related to these behaviors. PMID:24215424

  17. Perinatal Risk Factors Interacting With Catechol O-Methyltransferase and the Serotonin Transporter Gene Predict ASD symptoms in Children With ADHD

    PubMed Central

    Nijmeijer, Judith S.; Hartman, Catharina A.; Rommelse, Nanda N.J.; Altink, Marieke E.; Buschgens, Cathelijne J.M.; Fliers, Ellen A.; Franke, Barbara; Minderaa, Ruud B.; Ormel, Johan; Sergeant, Joseph A.; Verhulst, Frank C.; Buitelaar, Jan K.; Hoekstra, Pieter J.

    2010-01-01

    Background Symptoms of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) often co-occur. Given the previously found familiality of ASD symptoms in children with ADHD, addressing these symptoms may be useful for genetic association studies, especially for candidate gene findings that have not been consistently replicated for ADHD. Methods We studied the association of the catechol o-methyltransferase (COMT) Val158Met polymorphism and the serotonin transporter (SLC6A4/SERT/5-HTT) 5-HTTLPR insertion/deletion polymorphism with ASD symptoms in children with ADHD, and whether these polymorphisms would interact with pre- and perinatal risk factors, i.e., maternal smoking during pregnancy and low birth weight. Analyses were performed using linear regression in 207 Dutch participants with combined type ADHD of the International Multicenter ADHD Genetics (IMAGE) study, and repeated in an independent ADHD sample (n = 439) selected from the TRracking Adolescents' Individual Lives Survey (TRAILS). Dependent variables were the total and subscale scores of the Children's Social Behavior Questionnaire (CSBQ). Results No significant main effects of COMT Val158Met, 5-HTTLPR, maternal smoking during pregnancy and low birth weight on ASD symptoms were found. However, the COMT Val/Val genotype interacted with maternal smoking during pregnancy in increasing stereotyped behavior in the IMAGE sample (p = 0.008); this interaction reached significance in the TRAILS sample after correction for confounders (p = 0.02). In the IMAGE sample, the 5-HTTLPR S/S genotype interacted with maternal smoking during pregnancy, increasing problems in social interaction (p = 0.02), and also interacted with low birth weight, increasing rigid behavior (p = 0.03). Findings for 5-HTTLPR in the TRAILS sample were similar, albeit for related CSBQ subscales. Conclusions These findings suggest gene-environment interaction effects on ASD symptoms in children with ADHD. PMID:20868372

  18. Learning Disabilities and ADHD

    MedlinePlus

    ... several areas, including speaking, reading, writing, and doing math. Attention deficit hyperactivity disorder (ADHD) is not a ... Dyscalculia makes it hard for people to understand math. They may also have problems telling time and ...

  19. Patient education. Behaviour management strategies in ADHD.

    PubMed

    Mitchell, G; Shaw, K

    2000-12-01

    Attention deficit hyperactivity disorder or ADHD is a condition characterised by inattention, hyperactivity and impulsiveness. It is often managed by a combination of medication and behaviour modification techniques. This sheet outlines some useful strategies parents and teachers may undertake. PMID:11140223

  20. Higher Reported Levels of Depression, Stress, and Anxiety Are Associated with Increased Endorsement of ADHD Symptoms by Postsecondary Students

    ERIC Educational Resources Information Center

    Harrison, Allyson G.; Alexander, Sandra J.; Armstrong, Irene T.

    2013-01-01

    This study examined the extent to which postsecondary students endorse symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) and whether experienced level of stress, depression, or anxiety are associated with higher reporting of ADHD symptoms. Students attending a combined health and counseling service completed the Conners Adult ADHD Rating…

  1. Unique white matter microstructural patterns in ADHD presentations-a diffusion tensor imaging study.

    PubMed

    Svatkova, Alena; Nestrasil, Igor; Rudser, Kyle; Goldenring Fine, Jodene; Bledsoe, Jesse; Semrud-Clikeman, Margaret

    2016-09-01

    Attention-deficit/hyperactivity disorder predominantly inattentive (ADHD-PI) and combined (ADHD-C) presentations are likely distinct disorders that differ neuroanatomically, neurochemically, and neuropsychologically. However, to date, little is known about specific white matter (WM) regions differentiating ADHD presentations. This study examined differences in WM microstructure using diffusion tensor imaging (DTI) data from 20 ADHD-PI, 18 ADHD-C, and 27 typically developed children. Voxel-wise analysis of DTI measurements in major fiber bundles was carried out using tract-based spatial statistics (TBSS). Clusters showing diffusivity abnormalities were used as regions of interest for regression analysis between fractional anisotropy (FA) and neuropsychological outcomes. Compared to neurotypicals, ADHD-PI children showed higher FA in the anterior thalamic radiations (ATR), bilateral inferior longitudinal fasciculus (ILF), and in the left corticospinal tract (CST). In contrast, the ADHD-C group exhibited higher FA in the bilateral cingulum bundle (CB). In the ADHD-PI group, differences in FA in the left ILF and ATR were accompanied by axial diffusivity (AD) abnormalities. In addition, the ADHD-PI group exhibited atypical mean diffusivity in the forceps minor (FMi) and left ATR and AD differences in right CB compared to healthy subjects. Direct comparison between ADHD presentations demonstrated radial diffusivity differences in FMi. WM clusters with FA irregularities in ADHD were associated with neurobehavioral performance across groups. In conclusion, differences in WM microstructure in ADHD presentations strengthen the theory that ADHD-PI and ADHD-C are two distinct disorders. Regions with WM irregularity seen in both ADHD presentations might serve as predictors of executive and behavioral functioning across groups. Hum Brain Mapp 37:3323-3336, 2016. © 2016 Wiley Periodicals, Inc. PMID:27159198

  2. Understanding ADHD: Symptoms in Children

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Understanding ADHD Symptoms In Children Past Issues / Spring 2014 Table ... hyperactivity, and impulsivity are the key behaviors of ADHD. It is normal for all children to be ...

  3. Women and Girls (With ADHD)

    MedlinePlus

    ... Medication and Pregnancy ADHD and Driving Organization and Time Management Managing Money Relationships & Social Skills Marriage and Partnerships ... For more information on organization, see Organizing and Time Management . 5. Career guidance . Just as women with ADHD ...

  4. Treatment of Children With Attention-Deficit/Hyperactivity Disorder (ADHD) and Irritability: Results From the Multimodal Treatment Study of Children With ADHD (MTA)

    PubMed Central

    Fernández de la Cruz, Lorena; Simonoff, Emily; McGough, James J.; Halperin, Jeffrey M.; Arnold, L. Eugene; Stringaris, Argyris

    2015-01-01

    Objective Clinically impairing irritability affects 25% to 45% of children with attention-deficit/hyperactivity disorder (ADHD); yet, we know little about what interventions are effective in treating children with ADHD and co-occurring irritability. We used data from the Multimodal Treatment Study of Children With ADHD (MTA) to address 3 aims: to establish whether irritability in children with ADHD can be distinguished from other symptoms of oppositional defiant disorder (ODD); to examine whether ADHD treatment is effective in treating irritability; and to examine how irritability influences ADHD treatment outcomes. Method Secondary analyses of data from the MTA included multivariate analyses, and intent-to-treat random-effects regression models were used. Results Irritability was separable from other ODD symptoms. For treating irritability, systematic stimulant treatment was superior to behavioral management but not to routine community care; a combination of stimulants and behavioral treatment was superior to community care and to behavioral treatment alone, but not to medication alone. Irritability did not moderate the impact of treatment on parent- and teacher-reported ADHD symptoms in any of the 4 treatment groups. Conclusion Treatments targeting ADHD symptoms are helpful for improving irritability in children with ADHD. Moreover, irritability does not appear to influence the response to treatment of ADHD. Clinical trial registration information Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); http://www.clinicaltrials.gov; NCT00000388. PMID:25524791

  5. Language Deficits in ADHD Preschoolers

    ERIC Educational Resources Information Center

    Agapitou, Paraskevi; Andreou, Georgia

    2008-01-01

    The present study examined the impact of preschool ADHD on linguistic and metalinguistic awareness and mental ability. Eight subscales of the Athina Test were administered to ADHD preschoolers and a control group. Results showed that ADHD preschoolers performed significantly lower than the control group in all tasks. The greatest difficulty for…

  6. ADHD Medication Trends in Turkey: 2009-2013.

    PubMed

    Oner, Ozgür; Yilmaz, Esra Safak; Karada X011f, Hasan; Vural, Mert; Vural, Elif Hilal; Akbulat, Akif; Gürsöz, Hakk X0131; Türkçapar, Hakan; Kerman, Saim

    2014-02-19

    Objective: To investigate the change of ADHD medication prescriptions in Turkey between 2009 and 2013. Method: Consumption data of ADHD medications, immediate release (IR) methylphenidate (MPH; Ritalin), OROS MPH (Concerta), and atomoxetine (Strattera) were obtained from IMS Health database for the November 2008 to October 2013 period. Defined daily dose (DDD) of each drug was calculated according to WHO definitions and time-series analysis was conducted. Results: There was a significant seasonal effect for prescription of all drugs. Annual use of ADHD medications increased 2.18 times for all ADHD medications combined. DDDs per 1,000 population per day for all ADHD medications were 0.28 in 2009, 0.41 in 2010, 0.52 in 2011, and 0.59 in 2012. OROS MPH represented almost 75% of all ADHD medication utilization. Conclusion: As reported from several other countries, ADHD medication use increased in Turkey. Results suggested that over- and underdiagnosis might be seen at the same time. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24554298

  7. Fixed-dose combinations in type 2 diabetes – role of the canagliflozin metformin combination

    PubMed Central

    Fleming, Joshua W; Fleming, Laurie W; Davis, Courtney S

    2015-01-01

    Canagliflozin–metformin is one of the newest combination therapies available for the treatment of type 2 diabetes mellitus (T2DM). Canagliflozin is an inhibitor of the sodium–glucose co-transporter 2 which causes an increase in the urinary excretion of glucose. In the present article, we review the safety and efficacy of canagliflozin and metformin from data obtained from Phase III metformin add-on therapy clinical trials as there are no studies to date that specifically evaluate the combination of metformin and canagliflozin. Trials included in this review were dual-therapy trials of subjects who were already taking background metformin and were assigned to receive canagliflozin, glimepiride, or sitagliptin. The addition of canagliflozin to metformin resulted in a decrease in HbA1c of 0.73%–0.93%. Canagliflozin 100 mg was considered to be non-inferior to glimepiride and sitagliptin 100 mg with the canagliflozin 300 mg dose being statistically superior to sitagliptin and glimepiride. Other advantages of the use of canagliflozin are reduction in weight (3.3–4.0 kg) and systolic blood pressure (3.3–4.7 mmHg). The primary disadvantages are potential genital mycotic infections, hypotension, and gastrointestinal side effects from metformin. All things considered, this combination appears to be safe and effective in clinical trials and represents a promising option for the treatment of T2DM. PMID:26150733

  8. Fixed-dose combinations in type 2 diabetes - role of the canagliflozin metformin combination.

    PubMed

    Fleming, Joshua W; Fleming, Laurie W; Davis, Courtney S

    2015-01-01

    Canagliflozin-metformin is one of the newest combination therapies available for the treatment of type 2 diabetes mellitus (T2DM). Canagliflozin is an inhibitor of the sodium-glucose co-transporter 2 which causes an increase in the urinary excretion of glucose. In the present article, we review the safety and efficacy of canagliflozin and metformin from data obtained from Phase III metformin add-on therapy clinical trials as there are no studies to date that specifically evaluate the combination of metformin and canagliflozin. Trials included in this review were dual-therapy trials of subjects who were already taking background metformin and were assigned to receive canagliflozin, glimepiride, or sitagliptin. The addition of canagliflozin to metformin resulted in a decrease in HbA1c of 0.73%-0.93%. Canagliflozin 100 mg was considered to be non-inferior to glimepiride and sitagliptin 100 mg with the canagliflozin 300 mg dose being statistically superior to sitagliptin and glimepiride. Other advantages of the use of canagliflozin are reduction in weight (3.3-4.0 kg) and systolic blood pressure (3.3-4.7 mmHg). The primary disadvantages are potential genital mycotic infections, hypotension, and gastrointestinal side effects from metformin. All things considered, this combination appears to be safe and effective in clinical trials and represents a promising option for the treatment of T2DM. PMID:26150733

  9. ADHD stigma among college students.

    PubMed

    Thompson, Amanda Chi; Lefler, Elizabeth K

    2016-03-01

    The current study examined ADHD stigma within a college-enrolled young adult population, including the debate regarding the cause of stigma: label or behavior. In Phase 1, 135 college students rated stigma toward one of the four fictitious partners described as having either: the label of ADHD alone, the behaviors associated with ADHD alone, the label of ADHD and a set of behaviors associated with ADHD, or neither the label nor behaviors. In Phase 2, 48 college students rated stigma toward one of the two assigned fictitious partners described as having either: the label of ADHD and a set of behaviors associated with ADHD, or the label of Depression and a set of behaviors associated with Depression. It was hypothesized that the interaction between the label and the behaviors would cause the highest levels of ADHD stigma and that ADHD would elicit more stigma than Depression. In Phase 1, stigma was associated with the behaviors of ADHD, but not the label. In Phase 2, ADHD and Depression were found to be equally stigmatized. Implications, limitations, and future directions are discussed. PMID:26135022

  10. [Symptom variations in ADHD: importance of context, development and comorbidity].

    PubMed

    Purper-Ouakil, D; Wohl, M; Michel, G; Mouren, M C; Gorwood, P

    2004-01-01

    school setting or exclusively at home. Manuzza et al. report long-term outcome of "situational" versus "pervasive" ADHD. School-ADHD, in opposition to home-ADHD shows similarities with the full blown syndrome, as regards proportion of anti-social personality disorder, psycho-social functioning and academic/professional achievements. Moderate seasonal variations have also been identified with less ADHD symptoms in August. This result is likely to reflect a better fit between individual characteristics and environmental demands during school holidays rather than neurobiological changes, as there are no convincing arguments for seasonal fluctuations of serotoninergic tone in ADHD. Another cause for variations in ADHD symptom expression may be the co-occurrence of a mood disorder. Relationships between early-onset mania and ADHD are discussed. The appropriate definition of prepubertal mania is still in debate; its recognition is hindered by symptom overlap and high level of comorbid conditions. Chronic emotional dysregulation with irritability and frequent temper tantrums, sometimes viewed as characteristics of early-onset mania, might reflect a--possibly severe--sub-type of ADHD rather than a prodrome of bipolarity. A marked cyclicity of symptoms, with periodic accentuation of ADHD and mood symptoms, requires careful monitoring and systematic analysis of comorbid conditions. Clarification of the complex interrelations between ADHD and bipolar disorder will be obtained from long-term studies. PMID:15738855

  11. College Students' Attitudes toward Their ADHD Peers

    ERIC Educational Resources Information Center

    Chew, Brandi L.; Jensen, Scott A.; Rosen, Lee A.

    2009-01-01

    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:…

  12. A critical appraisal of atomoxetine in the management of ADHD

    PubMed Central

    Childress, Ann C

    2016-01-01

    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

  13. A critical appraisal of atomoxetine in the management of ADHD.

    PubMed

    Childress, Ann C

    2016-01-01

    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

  14. Comparison of Sensorimotor Rhythm (SMR) and Beta Training on Selective Attention and Symptoms in Children with Attention Deficit/Hyperactivity Disorder (ADHD): A Trend Report

    PubMed Central

    Mohammadi, Mohammad Reza; Malmir, Nastaran; Khaleghi, Ali; Aminiorani, Majd

    2015-01-01

    Objective: The aim of this study was to assess and compare the effect of two neurofeedback protocols (SMR/theta and beta/theta) on ADHD symptoms, selective attention and EEG (electroencephalogram) parameters in children with ADHD. Method: The sample consisted of 16 children (9-15 year old: 13 boys; 3 girls) with ADHD-combined type (ADHD-C). All of children used methylphenidate (MPH) during the study. The neurofeedback training consisted of two phases of 15 sessions, each lasting 45 minutes. In the first phase, participants were trained to enhance sensorimotor rhythm (12-15 Hz) and reduce theta activity (4-8 Hz) at C4 and in the second phase; they had to increase beta (15-18 Hz) and reduce theta activity at C3. Assessments consisted of d2 attention endurance test, ADHD rating scale (parent form) at three time periods: before, middle and the end of the training. EEG signals were recorded just before and after the training. Result: Based on parents’ reports, inattention after beta/theta training, and hyperactivity/impulsivity were improved after the end of the training. All subscales of d2 test were improved except for the difference between maximum and minimum responses. However, EEG analysis showed no significant differences. Conclusion: Neurofeedback in conjunction with Methylphenidate may cause further improvement in ADHD symptoms reported by parents and selective attention without long-term impact on EEG patterns. However, determining the exact relationship between EEG parameters, neurofeedback protocols and ADHD symptoms remain unclear. PMID:26877750

  15. Treating ADHD with Agomelatine

    ERIC Educational Resources Information Center

    Niederhofer, Helmut

    2012-01-01

    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…

  16. Colour Perception in ADHD

    ERIC Educational Resources Information Center

    Banaschewski, Tobias; Ruppert, Sinje; Tannock, Rosemary; Albrecht, Bjorn; Becker, Andreas; Uebel, Henrik; Sergeant, Joseph A.; Rothenberger, Aribert

    2006-01-01

    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…

  17. ADHD, Culture and Education

    ERIC Educational Resources Information Center

    Singh, Ilina

    2008-01-01

    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…

  18. Executive Functions in Girls with ADHD Followed Prospectively into Young Adulthood

    PubMed Central

    Miller, Meghan; Ho, Jennifer; Hinshaw, Stephen P.

    2013-01-01

    Overview We prospectively followed an ethnically and socioeconomically diverse sample of girls with ADHD (n = 140) and a matched comparison group (n = 88) into young adulthood (Mage = 19.6), 10 years after childhood initial assessments, to evaluate neuropsychological functioning. We hypothesized that neuropsychological deficits would persist through young adulthood for those with ADHD, and that those with continuing ADHD symptomatology in young adulthood would show the largest impairments. Method Neuropsychological measures at follow-up emphasized executive functions (EF) including planning, organization, inhibitory control, sustained attention, working memory, and set shifting. Results Parallel to findings from childhood and adolescence, the girls with childhood-diagnosed ADHD displayed medium to large deficits in EF relative to comparisons at follow-up, even with statistical control of baseline demographic and comorbidity variables. The addition of IQ as a covariate attenuated differences but several remained significant. Comparisons between the inattentive and combined subtypes of ADHD yielded nonsignificant results with small effect sizes. EF impairments were evident in both participants whose ADHD diagnoses persisted and in those whose ADHD symptoms had remitted to a non-diagnosable level; both subgroups had more EF deficits than those who did not meet criteria for ADHD in either childhood or young adulthood. Conclusions Those in both the persistent and remitted ADHD groups showed impairments in EF relative to comparisons and generally did not differ from each other. Overall, childhood ADHD in girls portends neuropsychological/EF deficits that persist for at least 10 years. PMID:22468822

  19. Dietary, Nutrient Patterns and Blood Essential Elements in Chinese Children with ADHD.

    PubMed

    Zhou, Fankun; Wu, Fengyun; Zou, Shipu; Chen, Ying; Feng, Chang; Fan, Guangqin

    2016-01-01

    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

  20. Sensitivity of Scales to Evaluate Change in Symptomatology with Psychostimulants in Different ADHD Subtypes

    PubMed Central

    Grizenko, Natalie; Rodrigues Pereira, Ricardo M.; Joober, Ridha

    2013-01-01

    Objective: To assess the sensitivity of scales (Conners’ Global Index Parent and Teacher form [CGI-P, CGI-T], Clinical Global Impression Scale [CGI], Continuous Performance Test [CPT], and Restricted Academic Situation Scale [RASS]) in evaluating improvement in symptomatology with methylphenidate in different Attention Deficit Hyperactivity Disorder (ADHD) subtypes. Method: Four hundred and ninety children (309 with ADHD Combined/Hyperactive [ADHD-CH] and 181 with ADHD Inattentive subtype [ADHD-I]) participated in a two week double-blind placebo-controlled crossover methylphenidate trial. Results: CGI-P showed small effect size for ADHD-I and medium effect size for the ADHD-CH subtype. CGI-T showed medium effect size for ADHD-I and large effect size for ADHD-CH subtype. CGI and RASS showed large effect size while CPT showed medium effect size for both subtypes. Conclusion: Acute behavioural assessments by clinicians (CGI, RASS) are better at detecting improvement with medication in all subtypes than parent or teacher reports (CGI-P, CGI-T). CGI-T is better than CGI-P for ADHD-I in detecting change in symptomatology as there is a greater demand for attention at school. PMID:23667362

  1. Dietary, Nutrient Patterns and Blood Essential Elements in Chinese Children with ADHD

    PubMed Central

    Zhou, Fankun; Wu, Fengyun; Zou, Shipu; Chen, Ying; Feng, Chang; Fan, Guangqin

    2016-01-01

    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

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

    MedlinePlus

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

  3. Combinations of Types of Mental Health Services Received in the Past Year Among Young Adults

    MedlinePlus

    ... 08, 2015* Combinations of types of mental health services received in the past year among young adults Combinations of types of mental health services received in the past year among young adults ...

  4. Familiality of Co-existing ADHD and Tic Disorders: Evidence from a Large Sibling Study

    PubMed Central

    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

    2016-01-01

    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

  5. Multimodal behavior program for ADHD incorporating yoga and implemented by high school volunteers: a pilot study.

    PubMed

    Mehta, Sanjiv; Mehta, Vijay; Mehta, Sagar; Shah, Devesh; Motiwala, Ashok; Vardhan, Jay; Mehta, Naina; Mehta, Devendra

    2011-01-01

    A low-cost resource approach to ADHD therapy would be a practical approach to treating children in developing countries. Research has shown that ADHD is prevalent in all areas of the world, and yet treatment for children in more impoverished countries is still lacking. The approach taken was to combine yoga and meditation combined with multimodal behavioral therapy program for children ageing 6 to 11. The program was kept low cost by using trained high school volunteers and integrating the program within the public school. After 6 weeks of the program, 90.5% of children showed improvement as measured by their performance impairment score, a measurement of academic performance. Parent and Teacher evaluations of behavior also found improvement as 25 of the 64 children (39.1%) improved into the normal range as measured by the Vanderbilt questionnaire. Moreover, children could successfully learn both yoga and meditation from high school students irrespective of their age, ADHD type, or initial performance impairment. The results demonstrate efficacy of a multimodal behavioral program incorporating yoga and meditation. The use of high school volunteers from schools in the area demonstrates an effective low-cost and universally applicable approach. PMID:22389788

  6. ADHD, temperament, and parental style as predictors of the child's attachment patterns.

    PubMed

    Finzi-Dottan, Ricky; Manor, Iris; Tyano, Sam

    2006-01-01

    This study investigates the impact of temperament and parenting styles on attachment patterns in children with ADHD. The study included 65 children aged 7-15 and their parents. Children diagnosed as Combined or Predominantly Hyperactive Impulsive Type had significantly higher scores than those diagnosed as Predominantly Inattentive Type in anxious and avoidant attachment, emotionality, and activity dimensions of temperament, and their parents reported higher levels of controlling styles. Hierarchic regressions indicated that parental promotion of autonomy with children with temperamental emotionality predicted anxious attachment, while parental restriction of autonomy with children with high levels of temperamental activity predicted avoidant attachment. PMID:16858640

  7. ADHD: does parenting style matter?

    PubMed

    Modesto-Lowe, Vania; Danforth, Jeffrey S; Brooks, Donna

    2008-11-01

    Attention deficit hyperactivity disorder (ADHD) is a condition typically arising in childhood, which untreated, can have consequences reaching into adolescence and beyond. Effective pharmacological treatment is available and has become widespread in the West. Outcomes for both the child with ADHD and the parent may be influenced by the nature of interaction between them. The authors of this article aim to review published research examining the interaction between parents and their children with ADHD. A PubMed search was conducted of studies written in English between 2000 and 2007 with the keywords ADHD and parenting. Child ADHD elicits high levels of parental stress and maladaptive parenting. The presence of parental psychopathology is common and influences the parent's response to the child's ADHD symptoms. Optimizing parent-child interaction and parental psychiatric status may improve outcomes for both parent and child. PMID:18559885

  8. Combined liver-kidney transplantation in primary hyperoxaluria type 1.

    PubMed

    Cochat, P; Gaulier, J M; Koch Nogueira, P C; Feber, J; Jamieson, N V; Rolland, M O; Divry, P; Bozon, D; Dubourg, L

    1999-12-01

    Primary hyperoxaluria type 1 (PH1) is a rare autosomal recessive disorder characterised by an increased urinary excretion of calcium oxalate, leading to recurrent urolithiasis, nephrocalcinosis and accumulation of insoluble oxalate throughout the body (oxalosis) when the glomerular filtration rate falls to below 40-20 mL/min per 1.73 m(2). The disease is due to a functional defect of the liver-specific peroxisomal enzyme alanine: glyoxylate aminotransferase (AGT), the gene of which is located on chromosome 2q37.3. The diagnosis is based on increased urinary oxalate and glycollate, increased plasma oxalate and AGT measurement in a liver biopsy. AGT mistargeting may be investigated by immuno-electron microscopy and DNA analysis. End-stage renal failure is reached by the age of 15 years in 50% of PH1 patients and the overall death rate approximates 30%. The conservative treatment includes high fluid intake, pyridoxine and crystallisation inhibitors. Since the kidney is the main target of the disease, isolated kidney transplantation (Tx) has been proposed in association with vigorous peri-operative haemodialysis in an attempt to clear plasma oxalate at the time of Tx. However, because of a 100% recurrence rate, the average 3-year graft survival is 15%-25% in Europe, with a 5-10-year patient survival rate ranging from 10% to 50%. Since the liver is the only organ responsible for the detoxification of glyoxylate by AGT, deficient host liver removal is the first rationale for enzyme replacement therapy. Subsequent orthotopic liver Tx aims to supply the missing enzyme in its normal cellular and subcellular location and thus can be regarded as a form of gene therapy. Because of the usual spectrum of the disease, isolated liver Tx is limited to selected patients prior to having reached an advanced stage of chronic renal failure. Combined liver-kidney Tx has therefore become a conventional treatment for most PH1 patients: according to the European experience, patient survival

  9. ADHD subtypes and neuropsychological performance in an adult sample.

    PubMed

    Dobson-Patterson, Roberta; O'Gorman, John G; Chan, Raymond C K; Shum, David H K

    2016-08-01

    The study investigated, with an adult sample, the hypothesis that differences between subtypes of ADHD on neuropsychological tests contribute to the poor separation of ADHD and healthy groups on tests of this kind. Groups of ADHD inattentive (n=16) and combined (n=16) subtypes were carefully identified using DSM-IV criteria, and their performance on 14 measures of attention, memory, and executive function (EF) was compared between subtypes and between the two subtypes combined and a group of healthy controls (n=30). Multivariate analyses showed statistically significant differences between the two subtypes, and between the two subtypes combined and the healthy controls. Importantly for the hypothesis, where differences for neuropsychological tests in terms of effect sizes between subtypes were largest, the differences in effect sizes between the two groups combined and controls were smallest (r=-0.64, 95% CI [-0.15, -0.87]). PMID:27043366

  10. Teacher's Guide to ADHD. What Works for Special-Needs Learners Series

    ERIC Educational Resources Information Center

    Reid, Robert; Johnson, Joseph

    2011-01-01

    Meeting a key need for teachers, this book provides practical, data-based tools for helping students with attention-deficit/hyperactivity disorder (ADHD) succeed in the classroom. The authors combine instructional expertise with extensive knowledge about the nature and treatment of ADHD. Coverage includes ways to support students and teach them…

  11. Integrating Genetic, Psychopharmacological and Neuroimaging Studies: A Converging Methods Approach to Understanding the Neurobiology of ADHD

    ERIC Educational Resources Information Center

    Durston, Sarah; Konrad, Kerstin

    2007-01-01

    This paper aims to illustrate how combining multiple approaches can inform us about the neurobiology of ADHD. Converging evidence from genetic, psychopharmacological and functional neuroimaging studies has implicated dopaminergic fronto-striatal circuitry in ADHD. However, while the observation of converging evidence from multiple vantage points…

  12. A Novel Group Therapy for Children with ADHD and Severe Mood Dysregulation

    ERIC Educational Resources Information Center

    Waxmonsky, James G.; Wymbs, Fran A.; Pariseau, Meaghan E.; Belin, Peter J.; Waschbusch, Daniel A.; Babocsai, Lysett; Fabiano, Gregory A.; Akinnusi, Opeolowa O.; Haak, Jenifer L.; Pelham, William E.

    2013-01-01

    Objective: No psychosocial treatments have been developed for children with ADHD and severe mood dysregulation (SMD) despite the significant prevalence and morbidity of this combination. Therefore, the authors developed a novel treatment program for children with ADHD and SMD. Method: The novel therapy program integrates components of…

  13. Subtypes of Attention-Deficit/Hyperactivity Disorder (ADHD): Distinct or Related Disorders across Measurement Levels?

    ERIC Educational Resources Information Center

    Baeyens, Dieter; Roeyers, Herbert; Walle, Johan Vande

    2006-01-01

    The aim of this literature review is to assess the current state of knowledge regarding differences and similarities between the inattentive (IA) and combined (C) subtypes of Attention-Deficit/Hyperactivity Disorder (ADHD) in order to detail challenges concerning further conceptualization, diagnostics, and treatment. The literature on ADHD-IA and…

  14. Time Course of Treatment Effect of OROS[R] Methylphenidate in Children with ADHD

    ERIC Educational Resources Information Center

    Armstrong, Robert B.; Damaraju, C. V.; Ascher, Steve; Schwarzman, Lesley; O'Neill, James; Starr, H. Lynn

    2012-01-01

    Objective: The authors evaluated the time course of the treatment effect of Osmotic-Release Oral System methylphenidate (OROS[R] MPH) HCl (Concerta[R], Raritan, NJ) CII in children with ADHD. Method: Data were combined from two double-blind, randomized, placebo-controlled, cross-over, analog classroom studies in children (9-12 years) with ADHD.…

  15. Symptomatic Improvement in Children with ADHD Treated with Long-Term Methylphenidate and Multimodal Psychosocial Treatment

    ERIC Educational Resources Information Center

    Abikoff, Howard; Hechtman, Lily; Klein, Rachel G.; Weiss, Gabrielle; Fleiss, Karen; Etcovitch, Joy; Cousins, Lorne; Greenfield, Brian; Martin, Diane; Pollack, Simcha

    2004-01-01

    Objective: To test the hypotheses that in children with attention-deficit/hyperactivity disorder (ADHD) (1) symptoms of ADHD, oppositional defiant disorder, and overall functioning are significantly improved by methylphenidate combined with intensive multimodal psychosocial treatment compared with methylphenidate alone and with methylphenidate…

  16. A 6-year follow-up of a large European cohort of children with attention-deficit/hyperactivity disorder-combined subtype: outcomes in late adolescence and young adulthood.

    PubMed

    van Lieshout, Marloes; Luman, Marjolein; Twisk, Jos W R; van Ewijk, Hanneke; Groenman, Annabeth P; Thissen, Andrieke J A M; Faraone, Stephen V; Heslenfeld, Dirk J; Hartman, Catharina A; Hoekstra, Pieter J; Franke, Barbara; Buitelaar, Jan K; Rommelse, Nanda N J; Oosterlaan, Jaap

    2016-09-01

    There are very few studies on the long-term outcome of children and adolescents with ADHD-combined type in Europe. The objective of the present study is to assess the 6-year outcome (including pharmacological treatment) of a large cohort of participants with ADHD-combined type (N = 347, mean age 11.4 years) in late adolescence and early adulthood. At study entry and follow-up (mean age 17.4 years), participants were comprehensively assessed on ADHD and comorbid disorders by structured psychiatric interviews and multi-informant questionnaires. Overall functioning was assessed by the Children's Global Assessment Scale. The retention rate was 75.6 %. The majority of participants (86.5 %) persisted in a DSM-5 ADHD diagnosis, 8.4 % had a subthreshold diagnosis, and 5.1 % remitted from the disorder at follow-up. Comorbidities decreased strongly; oppositional defiant disorder: 58 > 31 %, conduct disorder: 19 > 7 %. At follow-up, mood- and anxiety disorders were virtually non-existent following strict criteria (1-3 %). Percentage of children having had pharmacological treatment at any time increased from 79 to 91 %. On the Children's Global Assessment Scale, 48.5 % of participants were still functionally impaired at follow-up. Parental ADHD, higher ADHD symptom severity at baseline and higher parent-reported impairment at baseline positively predicted current ADHD symptom severity (R (2) = 20.9 %). Younger baseline age, higher ADHD symptom severity at baseline and higher parent-reported impairment at baseline were positively associated with poorer overall functioning (R (2) = 17.8 %). Pharmacological treatment had no (beneficial) impact on either ADHD symptom severity or overall functioning. Results confirm that ADHD is largely persistent into late adolescence with severity and family history for the disorder as important risk factors. PMID:26837866

  17. The role of ASTN2 variants in childhood and adult ADHD, comorbid disorders and associated personality traits.

    PubMed

    Freitag, Christine M; Lempp, Thomas; Nguyen, T Trang; Jacob, Christian P; Weissflog, Lena; Romanos, Marcel; Renner, Tobias J; Walitza, Susanne; Warnke, Andreas; Rujescu, Dan; Lesch, Klaus-Peter; Reif, Andreas

    2016-08-01

    Previous linkage and genome wide association (GWA) studies in ADHD indicated astrotactin 2 (ASTN2) as a candidate gene for attention-deficit/hyperactivity disorder (ADHD). ASTN2 plays a key role in glial-guided neuronal migration. To investigate whether common variants in ASTN2 contribute to ADHD disorder risk, we tested 63 SNPs spanning ASTN2 for association with ADHD and specific comorbid disorders in two samples: 171 families of children with ADHD and their parents (N = 592), and an adult sample comprising 604 adult ADHD cases and 974 controls. The C-allele of rs12376789 in ASTN2 nominally increased the risk for ADHD in the trio sample (p = 0.025). This was not observed in the adult case-control sample alone, but retained in the combined sample (nominal p = 0.030). Several other SNPs showed nominally significant association with comorbid disorders, especially anxiety disorder, in the childhood and adult ADHD samples. Some ASTN2 variants were nominally associated with personality traits in the adult ADHD sample and overlapped with risk alleles for comorbid disorders in childhood. None of the findings survived correction for multiple testing, thus, results do not support a major role of common variants in ASTN2 in the pathogenesis of ADHD, its comorbid disorders or ADHD associated personality traits. PMID:27138430

  18. A Review of Co-Morbid Depression in Pediatric ADHD: Etiologies, Phenomenology, and Treatment

    PubMed Central

    2008-01-01

    Abstract This paper reviews the literature and highlights the need for further research regarding the phenomenology, etiology, assessment, and treatment of co-morbid depression in patients with attention-deficit/hyperactivity disorders (ADHD). Depression occurs in youths with ADHD at a significantly higher rate than in youths without ADHD. Youths with ADHD and depression together have a more severe course of psychopathology and a higher risk of long-term impairment and suicide than youths with either disorder alone. Assessment of such co-morbid depression is complicated by overlapping symptoms with ADHD and with other disorders that commonly occur with ADHD. Depressive disorders typically emerge several years after the onset of ADHD and may arise from environmental difficulties associated with chronic ADHD that interact with genetic risks as the child gets older. Despite a scarcity of well-designed treatment studies for youths with ADHD and co-morbid depression, there is increasing preliminary evidence for the role of stimulants, selective serotonergic reuptake inhibitors, bupropion, and atomoxetine to target either or both disorders. There is also some indirect evidence for the benefit of combining pharmacological treatments with psychosocial interventions that specifically target relevant environmental factors and functional impairments. PMID:19108661

  19. Inhibitory Functioning across ADHD Subtypes: Recent Findings, Clinical Implications and Future Directions

    PubMed Central

    Adams, Zachary W.; Derefinko, Karen J.; Milich, Richard; Fillmore, Mark T.

    2014-01-01

    Although growing consensus supports the role of deficient behavioral inhibition as a central feature of the combined subtype of ADHD (ADHD/C; Barkley, 2007; Nigg, 2001), little research has focused on how this finding generalizes to the primarily inattentive subtype (ADHD/I). This question holds particular relevance in light of recent work suggesting that ADHD/I might be better characterized as a disorder separate from ADHD/C (Diamond, 2005; Milich et al., 2001). The current paper describes major findings in the area of inhibitory performance in ADHD and highlights recent research suggesting important areas of divergence between the subtypes. In particular, preliminary findings point to potential differences between the subtypes with respect to how children process important contextual information from the environment, such as preparatory cues that precede responses and rewarding or punishing feedback following behavior. These suggestive findings are discussed in the context of treatment implications, which could involve differential intervention approaches for each subtype targeted to the specific deficit profiles that characterize each group of children. Future research avenues aimed toward building a sound theoretical model of ADHD/I and a better understanding of its relation to ADHD/C are also presented. Specifically, investigators are encouraged to continue studying the complex interplay between inhibitory and attentional processes, as this area seems particularly promising in its ability to improve our understanding of the potentially distinct pathologies underlying the ADHD subtypes. PMID:19072751

  20. Adaptations for Students with ADHD

    ERIC Educational Resources Information Center

    McGrady, Mart

    2005-01-01

    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…

  1. ADHD: Implications for School Counselors

    ERIC Educational Resources Information Center

    Branscome, Jennifer; Cunningham, Teddi; Kelley, Heather; Brown, Caitlyn

    2014-01-01

    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…

  2. Understanding ADHD: Our Personal Journey

    ERIC Educational Resources Information Center

    Blahy, Tammy Lynn

    2004-01-01

    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…

  3. Attention, Task Difficulty, and ADHD

    ERIC Educational Resources Information Center

    Nigg, Joel T.

    2005-01-01

    Comments on analysis of attention tasks in Attention Deficit Hyperactivity Disorder (ADHD) provided by Wilding (2005)points out that whereas many regulatory functions, including alertness or arousal, appear to be impaired in ADHD, demonstrating basic attention deficits in selection or orienting functions in the disorder has proven difficult. Yet…

  4. ADHD: From Intervention to Implementation

    ERIC Educational Resources Information Center

    Chaban, Peter

    2010-01-01

    Attention deficit/hyperactivity disorder (ADHD), a chronic neurological disorder, is not formally recognized in the educational systems across Canada. As a result, there is little opportunity for collaboration or sharing of information between the medical/research community and the educational system. Because ADHD is not formally identified,…

  5. Contemporary Trends in ADHD Research

    ERIC Educational Resources Information Center

    Norvilitis, Jill M., Ed.

    2012-01-01

    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…

  6. Sound-Field Amplification to Increase Compliance to Directions in Students with ADHD

    ERIC Educational Resources Information Center

    Maag, John W.; Anderson, Jean M.

    2007-01-01

    This study determined the effects of sound-field amplification (SFA) on the speed with which students with attention deficit hyperactivity disorder (ADHD) followed teacher directions. A multiple baseline design was used with 3 elementary-aged students with ADHD to assess the effects of SFA across 4 types of directions: (a) task demand (e.g., get…

  7. Experiences of Community College Students with ADHD: A Qualitative Study in the Tradition of Phenomenology

    ERIC Educational Resources Information Center

    Lawrence, Charla Nicole

    2009-01-01

    Postsecondary educational institutions of all types have seen increases in the number of enrollees diagnosed with ADHD. Despite such increases less in known about ADHD among college students because the majority of research has focused on children and adolescents. This qualitative study conducted in the tradition of phenomenology, explored the…

  8. The Effects of Childhood ADHD on Adult Labor Market Outcomes. NBER Working Paper No. 18689

    ERIC Educational Resources Information Center

    Fletcher, Jason

    2013-01-01

    While several types of mental illness, including substance abuse disorders, have been linked with poor labor market outcomes, no current research has been able to examine the effects of childhood ADHD. As ADHD has become one of the most prevalent childhood mental conditions, it is useful to understand the full set of consequences of the illness.…

  9. Confronting ADHD in the Music Classroom

    ERIC Educational Resources Information Center

    Moore, Patience

    2009-01-01

    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…

  10. [Alternative agents used in ADHD].

    PubMed

    Hässler, Frank; Dück, Alexander; Reis, Olaf; Buchmann, Johannes

    2009-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is, with a prevalence of 2% to 6%, one of the most common neurobehavioral disorder affecting children and adolescents, persisting into adulthood. Comorbidity and psychosocial circumstances enter into the choice of intervention strategies. Several agents have been demonstrated effective in treating individuals with ADHD. Direct or indirect attenuation of dopamine and norepinephrine neurotransmission appears closely related to both the stimulant and nonstimulant medications efficacious in ADHD. However, important differences concerning efficacy and side effects exist both between and with the specific classes of agents like neuroleptics, antidepressants, antiepileptics, alpha-agonists, beta-blockers, buspiron, l-dopa, melatonin, pycnogenol, zinc, magnesium, polyunsaturated fatty acids, and homeopathy. Elucidating the various mechanisms of action of ADHD medications may lead to better choices in matching potential responses to the characteristics of individuals. We review the purported mechanism of action and available evidence for selected complementary and alternative medicine therapies for ADHD in childhood and adolescence. PMID:19105161

  11. NEUROPSYCHOLOGICAL DEFICITS ASSOCIATED WITH HEAVY PRENATAL ALCOHOL EXPOSURE ARE NOT EXACERBATED BY COMORBID ADHD

    PubMed Central

    Glass, Leila; Ware, Ashley L.; Crocker, Nicole; Deweese, Benjamin N.; Coles, Claire D.; Kable, Julie A.; May, Philip A.; Kalberg, Wendy O.; Sowell, Elizabeth R.; Jones, Kenneth Lyons; Riley, Edward P.; Mattson, Sarah N.

    2013-01-01

    Objective: Neuropsychological functioning of individuals with attention-deficit/hyperactivity disorder (ADHD) or heavy prenatal alcohol exposure has been well documented independently. This study examined the interaction between both factors on cognitive performance in children. Method: As part of a multisite study, 344 children (8-16y, M=12.28, SD=2.52) completed a comprehensive neuropsychological battery. Four subject groups were tested: children with histories of heavy prenatal alcohol exposure (AE) and ADHD (AE+, n=90), alcohol-exposed without ADHD, (AE−, n=38), non-exposed with ADHD (ADHD, n=80), and non-exposed without ADHD (CON, n=136). Results: Separate 2(AE) × 2(ADHD) MANCOVAs revealed significant main and interactive effects of ADHD and AE on overall WISC-IV, D-KEFS, and CANTAB performance. Individual ANOVAs revealed significant interactions on 2 WISC-IV indices [Verbal Comprehension (VCI), Perceptual Reasoning (PRI)], and four D-KEFS and CANTAB subtests [Design Fluency, Verbal Fluency, Trail Making, Spatial Working Memory]. Follow-up analyses demonstrated no difference between AE+ and AE− groups on any measures. The combined AE+/− group demonstrated more severe impairment than the ADHD group on VCI and PRI, but there were no other differences between clinical groups. Conclusions: These results support a combined AE+/− group for neuropsychological research and indicate that, in some cases, the neuropsychological effects seen in ADHD are altered by prenatal alcohol exposure. The effects of alcohol exposure on verbal comprehension and perceptual reasoning were greater than those related to having ADHD without alcohol exposure, although both conditions independently resulted in cognitive impairment compared to controls. Clinically, these findings demonstrate task-dependent patterns of impairment across clinical disorders. PMID:24040921

  12. The impact of instructional context on classroom on-task behavior: a matched comparison of children with ADHD and non-ADHD classmates.

    PubMed

    Imeraj, Lindita; Antrop, Inge; Sonuga-Barke, Edmund; Deboutte, Dirk; Deschepper, Ellen; Bal, Sarah; Roeyers, Herbert

    2013-08-01

    Classroom inattentiveness is an important reason for clinical referral of children with ADHD and a strong predictor of their educational achievement. This study investigates classroom on-task behavior of Flemish children with ADHD withdrawn from medication as a function of instructional context. Thirty-one pairs of children (one with ADHD and one age- and sex-matched control; 25 boys and 6 girls 6 to 12years of age) were observed in their classroom environment during two consecutive school days. On-task behavior (time on-task and on-task span) of ADHD and non-ADHD individuals was compared in different class contexts (i.e., different class structures and academic content types). Individualized teacher supervision was simultaneously assessed. Generalized estimation equation analyses showed that children with ADHD were significantly less on-task than controls during individual work and whole class group teaching, but not during small group work, and had significantly shorter on-task span during academic tasks (mathematics, language, and sciences) and instructional transitions between tasks, but not during music and arts. These effects persisted even after controlling for the higher levels of teacher supervision observed for ADHD pupils (7%) across all contexts (vs. 4% in controls). Findings suggest that despite receiving more overall teacher supervision, children with ADHD displayed lower levels of on-task behavior in settings that place high self-regulatory, information processing, and motivational demands on them. This finding may have initial implications for classroom interventions in this population. PMID:23870443

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

    PubMed

    Waxmonsky, James G

    2005-01-01

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

  14. The impact of study design and diagnostic approach in a large multi-centre ADHD study. Part 1: ADHD symptom patterns

    PubMed Central

    2011-01-01

    Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit/hyperactivity disorder (ADHD-CT) and 1446 'unselected' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive/impulsive symptoms. Conclusions

  15. Fledgling Psychopathy in the Classroom: ADHD Subtypes Psychopathy, and Reading Comprehension in a Community Sample of Adolescents

    PubMed Central

    DeLisi, Matt; Vaughn, Michael; Beaver, Kevin M.; Wexler, Jade; Barth, Amy E.; Fletcher, Jack M.

    2011-01-01

    The current study explores characteristics that are associated with fledgling psychopathy and educational outcomes relating to reading comprehension performance in a community sample of 432 middle school students. Latent class analysis (LCA) produced a four-class solution. Class 1 was a large (71.5% of sample) ‘‘control’’ group of youths with no attention/hyperactivity deficits and the highest reading comprehension scores. Class 2 was 11.6% of the sample and was consistent with traits associated with attention deficit hyperactivity disorder (ADHD) predominantly inattentive type. Class 3 was 7.4% of the sample and was consistent with traits associated with ADHD predominantly hyperactive–impulsive type. Class 4 was 9.5% of the sample and was consistent with traits associated with ADHD combined type. Classes 2 and 4 were characterized by elevated levels of psychopathic and callous-unemotional (CU) traits and lower educational performance. This study extends the utility of fledgling psychopathy to educational outcomes, which has broad implications for adolescent development, delinquency, and youth violence. PMID:21318082

  16. Adults with ADHD. An overview.

    PubMed

    Wender, P H; Wolf, L E; Wasserstein, J

    2001-06-01

    Attention-Deficit Hyperactivity Disorder (ADHD) is a common, genetically transmitted neurological disorder, with onset in childhood, probably mediated by decreased brain dopaminergic functioning. The first author was one of the earliest to describe the persistence of symptoms into adulthood. Prevalence and natural history data suggest that of the 3 to 10% of children diagnosed with ADHD, one- to two-thirds (somewhere between 1 and 6% of the general population) continue to manifest appreciable ADHD symptoms into adult life. This paper describes how ADHD in adults can be readily diagnosed and treated, despite resembling or coexisting with other psychiatric disorders. The Wender Utah diagnostic criteria address adult characteristics of the disorder. Informant and patient interviews and rating scales are used to determine the psychiatric status of the patient as a child, make a retroactive diagnosis of childhood ADHD, and establish the current diagnosis of the adult. Stringent diagnosis is key to determining effective treatment. Dopamine agonist stimulant medications appear to be the most effective in treating ADHD. About 60% of patients receiving stimulant medication showed moderate-to-marked improvement, as compared with 10% of those receiving placebo. The core symptoms of hyperactivity, inattention, mood lability, temper, disorganization, stress sensitivity, and impulsivity have been shown to respond to treatment with stimulant medications. Non-dopaminergic medications, such as the tricyclic antidepressants and SSRIs have generally not been useful in adults with ADHD in the absence of depression or dysthymia. Pemoline is no longer approved for use in these patients, despite early favorable reports. Appropriate management of adult patients with ADHD is multimodal. Psychoeducation, counseling, supportive problem-directed therapy, behavioral intervention, coaching, cognitive remediation, and couples and family therapy are useful adjuncts to medication management

  17. Combined type IIIB with bilateral type I thyroplasty for pitch lowering with maintenance of vocal fold tension

    PubMed Central

    Hoffman, Matthew R.; Devine, Erin E.; Remacle, Marc; Ford, Charles N.; Wadium, Elizabeth; Jiang, Jack J.

    2013-01-01

    Objective To evaluate type IIIB thyroplasty using the excised larynx bench apparatus and determine how altering vocal fold contour by performing bilateral medialization of the inferior vocal fold affects phonation. This procedure could be performed in patients for whom pitch lowering is desirable, such as female-to-male transsexuals or male patients with mutational falsetto in whom intensive voice therapy was insufficient. Methods Aerodynamic, acoustic, and high-speed videokymographic data were collected for nine larynges at three subglottal pressure inputs for each of three conditions: normal; type IIIB thyroplasty; and combined type IIIB with modified bilateral type I thyroplasty intended to create a more rectangular glottal configuration. Each larynx served as its own control. Results Phonation threshold flow (p=0.005), phonation threshold power (p=0.031), and airflow varied across conditions with highest values for type IIIB thyroplasty and lowest for the combined procedure. Fundamental frequency was significantly different (p<0.001), decreasing by approximately 100 Hz from control to type IIIB trials, and then by approximately 15 Hz from IIIB to combined procedure trials. Vibratory amplitudes and intrafold phase difference were highest for type IIIB trials. Conclusions Addition of bilateral inferior medialization to type IIIB thyroplasty provided some further decrease in frequency, but mostly served to increase tension, reduce airflow, and produce a vibratory pattern which more closely mirrored control trials. Exploration of this combined procedure in patients may be warranted if not completely satisfied with the results from type IIIB thyroplasty alone. PMID:24241252

  18. EEG correlates of visual short-term memory as neuro-cognitive endophenotypes of ADHD.

    PubMed

    Wiegand, Iris; Hennig-Fast, Kristina; Kilian, Beate; Müller, Hermann J; Töllner, Thomas; Möller, Hans-Jürgen; Engel, Rolf R; Finke, Kathrin

    2016-05-01

    Attention deficit hyperactivity disorder (ADHD) frequently persists into adulthood. A reduction in visual short-term memory (vSTM) storage capacity was recently suggested as a potential neuro-cognitive endophenotype, i.e., a testable marker of an individual's liability for developing ADHD. This study aimed at identifying markers of the brain abnormalities underlying vSTM reductions in adult ADHD. We combined behavioral parameter-based assessment with electrophysiology in groups of adult ADHD patients and healthy age-matched controls. Amplitudes of ERP markers of vSTM storage capacity, the contralateral delay activity (CDA) and the P3b, were analyzed according to (i) differences between individuals with higher vs. lower storage capacity K and (ii) differences between ADHD patients and control participants. We replicated the finding of reduced storage capacity in adult ADHD. Across groups, individuals with higher relative to lower storage capacity showed a larger CDA and P3b. We further found differences between the patient and control groups in the ERPs: The CDA amplitude was attenuated in an early time window for ADHD patients compared to control participants, and was negatively correlated with ADHD patients' symptom severity ratings. Furthermore, the P3b was larger in ADHD patients relative to control participants. These electrophysiological findings indicate altered brain mechanisms underlying visual storage capacity in ADHD, which are characterized by deficient encoding and maintenance, and increased recruitment of control processes. Accordingly, (quantifiable) ERP markers of vSTM in adult ADHD bear candidacy as neuro-cognitive endophenotypes of the disease. PMID:26972967

  19. Top-Down Dysregulation—From ADHD to Emotional Instability

    PubMed Central

    Petrovic, Predrag; Castellanos, F. Xavier

    2016-01-01

    Deficient cognitive top-down executive control has long been hypothesized to underlie inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD). However, top-down cognitive dysfunction explains a modest proportion of the ADHD phenotype whereas the salience of emotional dysregulation is being noted increasingly. Together, these two types of dysfunction have the potential to account for more of the phenotypic variance in patients diagnosed with ADHD. We develop this idea and suggest that top-down dysregulation constitutes a gradient extending from mostly non-emotional top-down control processes (i.e., “cool” executive functions) to mainly emotional regulatory processes (including “hot” executive functions). While ADHD has been classically linked primarily to the former, conditions involving emotional instability such as borderline and antisocial personality disorder are closer to the other. In this model, emotional subtypes of ADHD are located at intermediate levels of this gradient. Neuroanatomically, gradations in “cool” processing appear to be related to prefrontal dysfunction involving dorsolateral prefrontal cortex (dlPFC) and caudal anterior cingulate cortex (cACC), while “hot” processing entails orbitofrontal cortex and rostral anterior cingulate cortex (rACC). A similar distinction between systems related to non-emotional and emotional processing appears to hold for the basal ganglia (BG) and the neuromodulatory effects of the dopamine system. Overall we suggest that these two systems could be divided according to whether they process non-emotional information related to the exteroceptive environment (associated with “cool” regulatory circuits) or emotional information related to the interoceptive environment (associated with “hot” regulatory circuits). We propose that this framework can integrate ADHD, emotional traits in ADHD, borderline and antisocial personality disorder into a related cluster of mental

  20. ADHD diagnosis from multiple data sources with batch effects.

    PubMed

    Olivetti, Emanuele; Greiner, Susanne; Avesani, Paolo

    2012-01-01

    The Attention Deficit Hyperactivity Disorder (ADHD) affects the school-age population and has large social costs. The scientific community is still lacking a pathophysiological model of the disorder and there are no objective biomarkers to support the diagnosis. In 2011 the ADHD-200 Consortium provided a rich, heterogeneous neuroimaging dataset aimed at studying neural correlates of ADHD and to promote the development of systems for automated diagnosis. Concurrently a competition was set up with the goal of addressing the wide range of different types of data for the accurate prediction of the presence of ADHD. Phenotypic information, structural magnetic resonance imaging (MRI) scans and resting state fMRI recordings were provided for nearly 1000 typical and non-typical young individuals. Data were collected by eight different research centers in the consortium. This work is not concerned with the main task of the contest, i.e., achieving a high prediction accuracy on the competition dataset, but we rather address the proper handling of such a heterogeneous dataset when performing classification-based analysis. Our interest lies in the clustered structure of the data causing the so-called batch effects which have strong impact when assessing the performance of classifiers built on the ADHD-200 dataset. We propose a method to eliminate the biases introduced by such batch effects. Its application on the ADHD-200 dataset generates such a significant drop in prediction accuracy that most of the conclusions from a standard analysis had to be revised. In addition we propose to adopt the dissimilarity representation to set up effective representation spaces for the heterogeneous ADHD-200 dataset. Moreover we propose to evaluate the quality of predictions through a recently proposed test of independence in order to cope with the unbalancedness of the dataset. PMID:23060755

  1. Top-Down Dysregulation-From ADHD to Emotional Instability.

    PubMed

    Petrovic, Predrag; Castellanos, F Xavier

    2016-01-01

    Deficient cognitive top-down executive control has long been hypothesized to underlie inattention and impulsivity in attention-deficit/hyperactivity disorder (ADHD). However, top-down cognitive dysfunction explains a modest proportion of the ADHD phenotype whereas the salience of emotional dysregulation is being noted increasingly. Together, these two types of dysfunction have the potential to account for more of the phenotypic variance in patients diagnosed with ADHD. We develop this idea and suggest that top-down dysregulation constitutes a gradient extending from mostly non-emotional top-down control processes (i.e., "cool" executive functions) to mainly emotional regulatory processes (including "hot" executive functions). While ADHD has been classically linked primarily to the former, conditions involving emotional instability such as borderline and antisocial personality disorder are closer to the other. In this model, emotional subtypes of ADHD are located at intermediate levels of this gradient. Neuroanatomically, gradations in "cool" processing appear to be related to prefrontal dysfunction involving dorsolateral prefrontal cortex (dlPFC) and caudal anterior cingulate cortex (cACC), while "hot" processing entails orbitofrontal cortex and rostral anterior cingulate cortex (rACC). A similar distinction between systems related to non-emotional and emotional processing appears to hold for the basal ganglia (BG) and the neuromodulatory effects of the dopamine system. Overall we suggest that these two systems could be divided according to whether they process non-emotional information related to the exteroceptive environment (associated with "cool" regulatory circuits) or emotional information related to the interoceptive environment (associated with "hot" regulatory circuits). We propose that this framework can integrate ADHD, emotional traits in ADHD, borderline and antisocial personality disorder into a related cluster of mental conditions. PMID:27242456

  2. 38 CFR 21.7112 - Programs of education combining two or more types of courses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... combining two or more types of courses. 21.7112 Section 21.7112 Pensions, Bonuses, and Veterans' Relief... education combining two or more types of courses. (a) Concurrent enrollment. (1) When a veteran or... two educational institutions are different, the concurrent enrollment shall be measured by...

  3. 38 CFR 21.7612 - Programs of education combining two or more types of courses.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... combining two or more types of courses. 21.7612 Section 21.7612 Pensions, Bonuses, and Veterans' Relief... Members of the Selected Reserve Programs of Education § 21.7612 Programs of education combining two or more types of courses. An approved program may consist of courses offered by two...

  4. Characterizing heterogeneity in children with and without ADHD based on reward system connectivity

    PubMed Central

    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.

    2015-01-01

    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. PMID:25660033

  5. Social Functioning in Children with ADHD Treated with Long-Term Methylphenidate and Multimodal Psychosocial Treatment

    ERIC Educational Resources Information Center

    Abikoff, Howard; Hechtman, Lily; Klein, Rachel G.; Gallagher, Richard; Fleiss, Karen; Etcovitch, Joy; Cousins, Lorne; Greenfield, Brian; Martin, Diane; Pollack, Simcha

    2004-01-01

    Objective: To test that methylphenidate combined with intensive multimodal psychosocial intervention, which includes social skills training, significantly enhances social functioning in children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and methylphenidate plus nonspecific psychosocial treatment…

  6. Family conflict tendency and ADHD.

    PubMed

    Niederhofer, H; Hackenberg, B; Lanzendörfer, K

    2004-04-01

    A lack of perseverance, poor attention, and poorly modulated behaviour are important criteria of Attention Deficit Hyperactive Disorder (ADHD). Instructions often have to be repeated, sometimes even by different family members before a child with ADHD attends and complies. We hypothesised that a child with ADHD might cause less disagreement in families with almost no conflicts. Responses to the Mannheim Parents Interview and teacher's form of the Conners scale completed by families of 15 boys (ages 6 to 12 years), diagnosed with ADHD were compared with those of a matched, healthy control group of 15 boys. Parents completed a form assessing the family's cooperation and child-rearing practices. Having few family conflicts, i.e., almost no Verbal Disagreement may reduce Physical Punishment and Anger and Disregard and augment the Openness to another's needs and, for that reason, have protective effects on children's behaviour modulation. PMID:15154188

  7. ADHD, Methylphenidate, and Childhood Epilepsy.

    PubMed

    Sharma, Rahul; Plioplys, Sigita

    2016-06-01

    Investigators from the Department of Functional Neurology, Epileptology and Epilepsy Institute (IDEE), and the Lyon's University Hospital examined the clinical determinants of ADHD severity in children with epilepsy (CWE) along with the response to treatment with methylphenidate (MPH). PMID:27617408

  8. Pharmacological Management of Treatment-Induced Insomnia in ADHD

    ERIC Educational Resources Information Center

    Kratochvil, Christopher J.; Lake, Marybeth; Pliszka, Steven R.; Walkup, John T.

    2005-01-01

    A 7-year-old girl with attention-deficit/hyperactivity disorder (ADHD), combined subtype, and oppositional defiant disorder presents with a complaint of marked insomnia. Her parents describe 60 to 90 minutes of nightly initial insomnia that began with the initiation of 36 mg OROS methylphenidate (Concerta) 2 months ago. Behavioral interventions…

  9. Interventions in School Settings for Students With ADHD

    ERIC Educational Resources Information Center

    Miranda, Ana; Jarque, Sonia; Tarraga, Raul

    2006-01-01

    This article consists of a review of 16 research studies on treatments in school settings for children with attention deficit hyperactivity disorder (ADHD) carried out in the last decade. It includes both simple interventions and multicomponent interventions where different techniques are combined. Based on this revision, the conclusion is drawn…

  10. Physical Activity Experiences of Boys with and without ADHD

    ERIC Educational Resources Information Center

    Harvey, William J.; Reid, Greg; Bloom, Gordon A.; Staples, Kerri; Grizenko, Natalie; Mbekou, Valentin; Ter-Stepanian, Marina; Joober, Ridha

    2009-01-01

    Physical activity experiences of 12 age-matched boys with and without attention-deficit hyperactivity disorder (ADHD) were explored by converging information from Test of Gross Motor Development-2 assessments and semistructured interviews. The knowledge-based approach and the inhibitory model of executive functions, a combined theoretical lens,…

  11. ADHD and cannabis use in young adults examined using fMRI of a Go/NoGo task.

    PubMed

    Rasmussen, Jerod; Casey, B J; van Erp, Theo G M; Tamm, Leanne; Epstein, Jeffery N; Buss, Claudia; Bjork, James M; Molina, Brooke S G; Velanova, Katerina; Mathalon, Daniel H; Somerville, Leah; Swanson, James M; Wigal, Tim; Arnold, L Eugene; Potkin, Steven G

    2016-09-01

    Children diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for substance abuse. Response inhibition is a hallmark of ADHD, yet the combined effects of ADHD and regular substance use on neural networks associated with response inhibition are unknown. Task-based functional Magnetic Resonance Imaging (fMRI) data from young adults with childhood ADHD with (n = 25) and without (n = 25) cannabis use ≥ monthly in the past year were compared with a local normative comparison group (LNCG) with (n = 11) and without (n = 12) cannabis use. Go/NoGo behavioral and fMRI data were evaluated for main and interaction effects of ADHD diagnosis and cannabis use. ADHD participants made significantly more commission errors on NoGo trials than controls. ADHD participants also had less frontoparietal and frontostriatal activity, independent of cannabis use. No main effects of cannabis use on response inhibition or functional brain activation were observed. An interaction of ADHD diagnosis and cannabis use was found in the right hippocampus and cerebellar vermis, with increased recruitment of these regions in cannabis-using controls during correct response inhibition. ADHD participants had impaired response inhibition combined with less fronto-parietal/striatal activity, regardless of cannabis use history. Cannabis use did not impact behavioral response inhibition. Cannabis use was associated with hippocampal and cerebellar activation, areas rich in cannabinoid receptors, in LNCG but not ADHD participants. This may reflect recruitment of compensatory circuitry in cannabis using controls but not ADHD participants. Future studies targeting hippocampal and cerebellar-dependent function in these groups may provide further insight into how this circuitry is altered by ADHD and cannabis use. PMID:26489976

  12. Match or Mismatch? Influence of Parental and Offspring ASD and ADHD Symptoms on the Parent-Child Relationship

    ERIC Educational Resources Information Center

    van Steijn, Daphne J.; Oerlemans, Anoek M.; van Aken, Marcel A. G.; Buitelaar, Jan K.; Rommelse, Nanda N. J.

    2013-01-01

    Few studies have examined the influence of parental ASD and ADHD symptoms in combination with child pathology on the parent- child relationship as perceived by the child. A sample of 132 families was recruited with one child with ASD (with/without ADHD), and one unaffected sibling. Affected children (regardless of diagnosis) reported lower…

  13. Diagnosis of ADHD in Adults: What Is the Appropriate "DSM-5" Symptom Threshold for Hyperactivity-Impulsivity?

    ERIC Educational Resources Information Center

    Solanto, Mary V.; Wasserstein, Jeanette; Marks, David J.; Mitchell, Katherine J.

    2012-01-01

    Objective: To empirically identify the appropriate symptom threshold for hyperactivity-impulsivity for diagnosis of ADHD in adults. Method: Participants were 88 adults (M [SD] age = 41.69 [11.78] years, 66% female, 16% minority) meeting formal "DSM-IV" criteria for ADHD combined or predominantly inattentive subtypes based on a structured…

  14. Effective Methylphenidate Treatment of an Adult Aspergers Syndrome and a Comorbid ADHD: A Clinical Investigation with fMRI

    ERIC Educational Resources Information Center

    Roy, Mandy; Dillo, Wolfgang; Bessling, Svenja; Emrich, Hinderk M.; Ohlmeier, Martin D.

    2009-01-01

    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…

  15. Comparative Study of Children with ADHD Only, Autism Spectrum Disorder + ADHD, and Chronic Multiple Tic Disorder + ADHD

    ERIC Educational Resources Information Center

    Gadow, Kenneth D.; DeVincent, Carla J.; Schneider, Jayne

    2009-01-01

    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…

  16. Do ADHD Medicines Boost Substance Abuse Risk?

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_159904.html Do ADHD Medicines Boost Substance Abuse Risk? Chances were actually ... that their children who take stimulants to treat attention deficit hyperactivity disorder (ADHD) may be at higher risk for substance ...

  17. ADHD More Often Missed in Minority Kids

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160571.html ADHD More Often Missed in Minority Kids Study found ... percentage of black children show the symptoms of attention-deficit/hyperactivity disorder (ADHD) than white kids, they are less likely ...

  18. Faststats: Attention Deficit Hyperactivity Disorder (ADHD)

    MedlinePlus

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

  19. Symptoms of autism and ADHD: a Swedish twin study examining their overlap.

    PubMed

    Ronald, Angelica; Larsson, Henrik; Anckarsäter, Henrik; Lichtenstein, Paul

    2014-05-01

    Autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) show high comorbidity. The following questions were addressed regarding their specific symptoms: What is the factor structure of ASD and ADHD symptoms, to what degree do different symptom domains cluster together, to what extent are these domains caused by the same genetic and environmental influences, and what is the best model of their co-occurrence? A population-based twin cohort of over 17,000 9- and 12-year-olds were assessed using the Autism-Tics, AD/HD, and other Comorbidities parental interview inventory. Principal component analyses were conducted, and symptom domain clustering was assessed. Four multivariate twin models were compared. Factors split into three ASD (social impairments, communication impairments, and restricted repetitive behaviors and interests), and three ADHD (inattention, hyperactivity, and impulsivity) symptom domains. Some ASD-ADHD symptom domain combinations clustered together often, although others not at all. A two-factor common pathway model fit the data, suggesting that ASD and ADHD symptom domains tap into separate "ASD" and "ADHD" latent factors that showed high genetic overlap. All subdomains also showed significant specific genetic and environmental influences, reflecting the etiological heterogeneity both within and between ASD and ADHD. These findings support the conceptual distinction of ASD and ADHD, and demonstrate the considerable natural co-occurrence of particular ASD/ADHD symptom domains. The results imply that more children with 1 condition show features of the other condition than show complete comorbidity. Emphasis on symptom co-occurrence, rather than complete comorbidity between disorders, may help focus clinical approaches and advance molecular genetic research. PMID:24731073

  20. Biological and Rearing Mother Influences on Child ADHD Symptoms: Revisiting the Developmental Interface between Nature and Nurture

    PubMed Central

    Harold, Gordon T.; Leve, Leslie D.; Barrett, Douglas; Elam, Kit; Neiderhiser, Jenae M.; Natsuaki, Misaki N.; Shaw, Daniel S.; Reiss, David; Thapar, Anita

    2013-01-01

    Background Families of children with attention deficit hyperactivity disorder (ADHD) report more negative family relationships than families of children without ADHD. Questions remain as to the role of genetic factors underlying associations between family relationships and children’s ADHD symptoms, and the role of children’s ADHD symptoms as an evocative influence on the quality of relationships experienced within such families. Utilizing the attributes of two genetically sensitive research designs, the present study examined associations between biologically related and non-biologically related maternal ADHD symptoms, parenting practices, child impulsivity/activation, and child ADHD symptoms. The combined attributes of the study designs permit assessment of associations while controlling for passive genotype-environment correlation and directly examining evocative genotype-environment correlation (rGE); two relatively under examined confounds of past research in this area. Methods A cross-sectional adoption-at-conception design (Cardiff IVF Study; C-IVF) and a longitudinal adoption-at-birth design (Early Growth and Development Study; EGDS) were used. The C-IVF sample included 160 mothers and children (age 5–8 years). The EGDS sample included 320 linked sets of adopted children (age 6 years), adoptive-, and biologically-related mothers. Questionnaires were used to assess maternal ADHD symptoms, parenting practices, child impulsivity/activation, and child ADHD symptoms. A cross-rater approach was used across measures of maternal behavior (mother reports) and child ADHD symptoms (father reports). Results Significant associations were revealed between rearing mother ADHD symptoms, hostile parenting behavior, and child ADHD symptoms in both samples. Because both samples consisted of genetically-unrelated mothers and children, passive rGE was removed as a possible explanatory factor underlying these associations. Further, path analysis revealed evidence for

  1. ADHD (ATTENTION DEFFICIT HYPERACTIVITY DISORDER)--A TROUBLING ENTITY, SOMETIMES PERPETUATING DURING ADULT LIFE.

    PubMed

    Amihăesei, Ioana Cristina; Zamfir, Carmen Lăcrămioara

    2016-01-01

    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. PMID:27125066

  2. Combined use of RFLP and PCR-ASO typing for HLA-DR-Dw and DQw typing.

    PubMed

    Bignon, J D; Bidwell, J L

    1991-01-01

    Due to some limitations of restriction fragment length polymorphism (RFLP) analysis in HLA-DR-DQ typing, we present a combined use of RFLP and polymerase chain reaction (PCR)-allele-specific oligonucleotide (ASO) typing. This scheme consists in selectively amplifying the few RFLP ill-defined genes (DR1/DR'Br' and DR4-Dw subsets) using PCR with allele specific primers to avoid cross-hybridization. PMID:1676910

  3. Case Report: "ADHD Trainer": the mobile application that enhances cognitive skills in ADHD patients.

    PubMed

    Ruiz-Manrique, Gonzalo; Tajima-Pozo, Kazuhiro; Montañes-Rada, Francisco

    2014-01-01

    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. PMID:26962432

  4. Case Report: "ADHD Trainer": the mobile application that enhances cognitive skills in ADHD patients

    PubMed Central

    Ruiz-Manrique, Gonzalo; Tajima-Pozo, Kazuhiro; Montañes-Rada, Francisco

    2015-01-01

    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. PMID:26962432

  5. Personalized Treatment of Mothers With ADHD and Their Young At-Risk Children: A SMART Pilot.

    PubMed

    Chronis-Tuscano, Andrea; Wang, Christine H; Strickland, Jennifer; Almirall, Daniel; Stein, Mark A

    2016-01-01

    Young children of mothers with adult attention-deficit/hyperactivity disorder (ADHD) are at risk for ADHD by virtue of genetics and environmental factors. Moreover, parent ADHD is associated with maladaptive parenting and poor child behavioral treatment response. Thus, a combined approach consisting of behavioral parent training (BPT) and maternal stimulant medication (MSM) may be needed to effectively treat ADHD within families. However, providing combined BPT+MSM initially to all families may be unnecessarily burdensome because not all families likely need combined treatment. The purpose of this study is to examine how to combine, sequence, and personalize treatment for these multiplex families in order to yield benefits to both the parent and child, thereby impacting the course of child ADHD and disruptive behavior symptoms. This article presents our rationale for, design of, and preliminary experiences (based on 26 participants) with an ongoing pilot Sequential Multiple Assessment Randomized Trial (SMART) designed to answer questions regarding the feasibility and acceptability of study protocols and interventions. This article also describes how the subsequent full-scale SMART might change based on what is learned in the SMART pilot and illustrates how the full-scale SMART could be used to inform clinical decision making about how to combine, sequence, and personalize treatment for complex children and families in which a parent has ADHD. PMID:26799502

  6. Personalized Treatment of Mothers with ADHD and Their Young At-Risk Children: A SMART Pilot

    PubMed Central

    Chronis-Tuscano, Andrea; Wang, Christine H.; Strickland, Jennifer; Almirall, Daniel; Stein, Mark A.

    2015-01-01

    Rationale Young children of mothers with adult attention-deficit/hyperactivity disorder (ADHD) are at risk for ADHD by virtue of genetics and environmental factors. Moreover, parent ADHD is associated with maladaptive parenting and poor child behavioral treatment response. Thus, a combined approach consisting of behavioral parent training (BPT) and maternal stimulant medication (MSM) may be needed to effectively treat ADHD within families. However, providing combined BPT+MSM initially to all families may be unnecessarily burdensome since not all families likely need combined treatment. The purpose of this study is to examine how to combine, sequence, and personalize treatment for these multiplex families in order to yield benefits to both the parent and child, thereby impacting the course of child ADHD and disruptive behavior symptoms. Study Design and Preliminary Experiences This paper presents our rationale for, design of, and preliminary experiences (based on N = 26 participants) with an ongoing pilot Sequential Multiple Assessment Randomized Trial (SMART) designed to answer questions regarding the feasibility and acceptability of study protocols and interventions. This manuscript also describes how the subsequent full-scale SMART might change based on what is learned in the SMART pilot, and illustrates how the full-scale SMART could be used to inform clinical decision making about how to combine, sequence, and personalize treatment for complex children and families in which a parent has ADHD. PMID:26799502

  7. Investigating the efficacy of integrated cognitive behavioral therapy for adult treatment seeking substance use disorder patients with comorbid ADHD: study protocol of a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Attention deficit hyperactivity disorder (ADHD) frequently co-occurs with substance use disorders (SUD). The combination of ADHD and SUD is associated with a negative prognosis of both SUD and ADHD. Pharmacological treatments of comorbid ADHD in adult patients with SUD have not been very successful. Recent studies show positive effects of cognitive behavioral therapy (CBT) in ADHD patients without SUD, but CBT has not been studied in ADHD patients with comorbid SUD. Methods/design This paper presents the protocol of a randomized controlled trial to test the efficacy of an integrated CBT protocol aimed at reducing SUD as well as ADHD symptoms in SUD patients with a comorbid diagnosis of ADHD. The experimental group receives 15 CBT sessions directed at symptom reduction of SUD as well as ADHD. The control group receives treatment as usual, i.e. 10 CBT sessions directed at symptom reduction of SUD only. The primary outcome is the level of self-reported ADHD symptoms. Secondary outcomes include measures of substance use, depression and anxiety, quality of life, health care consumption and neuropsychological functions. Discussion This is the first randomized controlled trial to test the efficacy of an integrated CBT protocol for adult SUD patients with a comorbid diagnosis of ADHD. The rationale for the trial, the design, and the strengths and limitations of the study are discussed. Trial registration This trial is registered in http://www.clinicaltrials.gov as NCT01431235. PMID:23663651

  8. Autism and ADHD: Overlapping and Discriminating Symptoms

    ERIC Educational Resources Information Center

    Mayes, Susan Dickerson; Calhoun, Susan L.; Mayes, Rebecca D.; Molitoris, Sarah

    2012-01-01

    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…

  9. The Energetic Brain: Understanding and Managing ADHD

    ERIC Educational Resources Information Center

    Reynolds, Cecil R.; Vannest, Kimberly J.; Harrison, Judith R.

    2012-01-01

    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…

  10. The Neurobiological Profile of Girls with ADHD

    ERIC Educational Resources Information Center

    Mahone, E. Mark; Wodka, Ericka L.

    2008-01-01

    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…

  11. Interpersonal Coping among Boys with ADHD

    ERIC Educational Resources Information Center

    Hampel, Petra; Manhal, Simone; Roos, Thomas; Desman, Christiane

    2008-01-01

    Objective: The authors investigate self-reported coping with interpersonal stressors among boys with and without ADHD in two studies and provide initial evidence for effects of different subgroups of ADHD on coping in Study 2. Method: In Study 1, 20 Austrian adolescents with ADHD were compared to 20 healthy controls. In Study 2, 44 German children…

  12. Children with ADHD in Residential Care

    ERIC Educational Resources Information Center

    Casey, Kathryn J.; Hagaman, Jessica L.; Trout, Alexandra L.; Reid, Robert; Chmelka, Beth; Thompson, Ronald W.; Daly, Daniel L.

    2008-01-01

    Little is known about the characteristics or functioning of children with ADHD in residential care as compared to their non-ADHD peers. This study evaluated data on 538 children with (n = 125) and without (n = 413) ADHD in residential care to determine demographic, mental health, behavioral, and treatment (i.e., medication use) characteristics.…

  13. Gifted Children with AD/HD.

    ERIC Educational Resources Information Center

    Lovecky, Deirdre V.

    This brief paper on gifted children with attention deficit hyperactivity disorder (AD/HD) focuses on the special educational needs of this population. Emphasis is on four major conclusions: (1) gifted children with AD/HD differ from average children with AD/HD in cognitive, social, and emotional variables (e.g., the gifted child is likely to show…

  14. Discriminating among ADHD alone, ADHD with a comorbid psychological disorder, and feigned ADHD in a college sample.

    PubMed

    Williamson, Kimberly D; Combs, Hannah L; Berry, David T R; Harp, Jordan P; Mason, Lisa H; Edmundson, Maryanne

    2014-01-01

    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). PMID:25225947

  15. Fixed-dose combination of sitagliptin and metformin for the treatment of type 2 diabetes

    PubMed Central

    Reynolds, Jonathan K

    2009-01-01

    JanumetTM, a fixed dose combination of sitagliptin/metformin HCL manufactured by Merck Pharmaceuticals, has received US Food and Drug Administration approval for treatment of patients with type 2 diabetes, that are inadequately controlled, either by sitagliptin or metformin alone or together in free-dose combination form. Sitagliptin, an inhibitor of the enzyme DDP-4, assists patients with type 2 diabetes mellitus to achieve glycemic control. It has been shown to be safe and effective at 100 mg daily doses. The effect of giving sitagliptin in combination with metformin is thought to have a complimentary and possibly additive effect on glycemic control. PMID:21437126

  16. Children With Conduct Problems and Co-occurring ADHD: Behavioral Improvements Following Parent Management Training

    PubMed Central

    Bjørnebekk, Gunnar; Kjøbli, John; Ogden, Terje

    2015-01-01

    To scale up evidence-based treatment of conduct problems, parent management training, Oregon model (PMTO) has been disseminated throughout Norway. This study examined whether Attention Deficit Hyperactivity Disorder (ADHD) predicted the outcomes of PMTO. Of 253 children and families, 97 were reported to have an ADHD diagnosis. Although different at intake, the groups with and without ADHD had close to an equal change in behavioral status following treatment. Maternal depression and family income predicted the combined group's behavior following PMTO. The study indicates that reductions in conduct problems following PMTO are of the same magnitude in children with or without ADHD. However, some characteristics may differentially predict outcomes for children with combined problems. PMID:25892844

  17. Nutritional supplements for the treatment of ADHD.

    PubMed

    Bloch, Michael H; Mulqueen, Jilian

    2014-10-01

    Polyunsaturated fatty acid supplementation appears to have modest benefit for improving ADHD symptoms. Melatonin appears to be effective in treating chronic insomnia in children with ADHD but appears to have minimal effects in reducing core ADHD symptoms. Many other natural supplements are widely used in the United States despite minimal evidence of efficacy and possible side effects. This review synthesizes and evaluates the scientific evidence regarding the potential efficacy and side effects of natural supplements and herbal remedies for ADHD. We provide clinicians with recommendations regarding their potential use and role in overall ADHD treatment. PMID:25220092

  18. Alpha desynchronization and fronto-parietal connectivity during spatial working memory encoding deficits in ADHD: A simultaneous EEG-fMRI study.

    PubMed

    Lenartowicz, Agatha; Lu, Steven; Rodriguez, Cameron; Lau, Edward P; Walshaw, Patricia D; McCracken, James T; Cohen, Mark S; Loo, Sandra K

    2016-01-01

    The underlying mechanisms of alpha band (8-12 Hz) neural oscillations are of importance to the functioning of attention control systems as well as to neuropsychiatric conditions that are characterized by deficits of that system, such as attention deficit hyperactivity disorder (ADHD). The objectives of the present study were to test if visual encoding-related alpha event-related desynchronization (ERD) correlates with fronto-parieto-occipital connectivity, and whether this is disrupted in ADHD during spatial working memory (SWM) performance. We acquired EEG concurrently with fMRI in thirty boys (12-16 yrs. old, 15 with ADHD), during SWM encoding. Psychophysiological connectivity analyses indicated that alpha ERD during SWM encoding was associated with both occipital activation and fronto-parieto-occipital functional connectivity, a finding that expands on prior associations between alpha ERD and occipital activation. This finding provides novel support for the interpretation of alpha ERD (and the associated changes in occipital activation) as a phenomenon that involves, and perhaps arises as a result of, top-down network interactions. Alpha ERD was associated less strongly with occipital activity, but associated more strongly with fronto-parieto-occipital connectivity in ADHD, consistent with a compensatory attentional response. Additionally, we illustrate that degradation of EEG data quality by MRI-amplified motion artifacts is robust to existing cleaning algorithms and is significantly correlated with hyperactivity symptoms and the ADHD Combined Type diagnosis. We conclude that persistent motion-related MR artifacts in EEG data can increase variance and introduce bias in interpretation of group differences in populations characterized by hypermobility--a clear limitation of current-state EEG-fMRI methodology. PMID:26955516

  19. Alpha desynchronization and fronto­parietal connectivity during spatial working memory encoding deficits in ADHD: A simultaneous EEG­fMRI study

    PubMed Central

    Lenartowicz, Agatha; Lu, Steven; Rodriguez, Cameron; Lau, Edward P.; Walshaw, Patricia D.; McCracken, James T.; Cohen, Mark S.; Loo, Sandra K.

    2016-01-01

    The underlying mechanisms of alpha band (8–12 Hz) neural oscillations are of importance to the functioning of attention control systems as well as to neuropsychiatric conditions that are characterized by deficits of that system, such as attention deficit hyperactivity disorder (ADHD). The objectives of the present study were to test if visual encoding-related alpha event-related desynchronization (ERD) correlates with fronto-parieto-occipital connectivity, and whether this is disrupted in ADHD during spatial working memory (SWM) performance. We acquired EEG concurrently with fMRI in thirty boys (12–16 yrs. old, 15 with ADHD), during SWM encoding. Psychophysiological connectivity analyses indicated that alpha ERD during SWM encoding was associated with both occipital activation and fronto-parieto-occipital functional connectivity, a finding that expands on prior associations between alpha ERD and occipital activation. This finding provides novel support for the interpretation of alpha ERD (and the associated changes in occipital activation) as a phenomenon that involves, and perhaps arises as a result of, top-down network interactions. Alpha ERD was associated less strongly with occipital activity, but associated more strongly with fronto-parieto-occipital connectivity in ADHD, consistent with a compensatory attentional response. Additionally, we illustrate that degradation of EEG data quality by MRI-amplified motion artifacts is robust to existing cleaning algorithms and is significantly correlated with hyperactivity symptoms and the ADHD Combined Type diagnosis. We conclude that persistent motion-related MR artifacts in EEG data can increase variance and introduce bias in interpretation of group differences in populations characterized by hypermobility — a clear limitation of current-state EEG-fMRI methodology. PMID:26955516

  20. Examining autistic traits in children with ADHD: Does the Autism Spectrum Extend to ADHD?

    PubMed Central

    Grzadzinski, Rebecca; Di Martino, Adriana; Brady, Emily; Mairena, Maria Angeles; O'Neale, Matthew; Petkova, Eva; Lord, Catherine; Castellanos, F. Xavier

    2010-01-01

    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 ratings of core ASD traits (ADHD+) not accounted for by ADHD or behavioral symptoms. Further, analyses revealed greater oppositional behaviors, but not ADHD severity or anxiety, in the ADHD+ subgroup compared to those with ADHD only. These results highlight the importance of specifically examining autistic traits in children with ADHD for better characterization in studies of the underlying physiopathology and treatment. PMID:21108041

  1. ADHD and behavioral disorders: Assessment, management, and an update from DSM-5.

    PubMed

    Austerman, Joseph

    2015-11-01

    Behavioral disorders in pediatric patients--primarily attention deficit hyperactivity disorder (ADHD)--pose a clinical challenge for health care providers to accurately assess, diagnose, and treat. In 2013, updated diagnostic criteria for behavioral disorders were published, including ADHD and a new diagnostic entity: disruptive mood dysregulation disorder. Revised criteria for ADHD includes oldest age for occurrence of symptoms, need for symptoms to be present in more than one setting, and requirement for number of symptoms in those aged 17 and older. Assessment of ADHD relies primarily on the clinical interview, including the medical and social history, along with the aid of objective measures. The clinical course of ADHD is chronic with symptom onset occurring well before adolescence. Most patients have symptoms that continue into adolescence, and some into adulthood. Many patients with ADHD have comorbid disorders such as depression, disruptive behavior disorders, or substance abuse, which need to be addressed first in the treatment plan. Treatment of ADHD relies on a combination of psychopharmacologic, academic, and behavioral interventions, which produce response rates up to 80%. PMID:26555810

  2. Pharmacological and psychosocial treatments for adolescents with ADHD: an updated systematic review of the literature.

    PubMed

    Sibley, Margaret H; Kuriyan, Aparajita B; Evans, Steven W; Waxmonsky, James G; Smith, Bradley H

    2014-04-01

    Smith, Waschbusch, Willoughby, and Evans (2000) reviewed a small treatment literature on ADHD in adolescents and concluded that methylphenidate stimulant medication was a well-established treatment and behavior therapy (BT) demonstrated preliminary efficacy. This review extends and updates the findings of the prior one based on the previous 15years of research. Studies published since 1999 were identified and coded using standard criteria and effect sizes were calculated where appropriate. Highlights of the last 15years of research include an expansion of pharmacological treatment options and developmentally appropriate psychosocial treatment packages for adolescents with ADHD. Additionally, nonstimulant medications (e.g., atomoxetine) are now approved for the treatment of ADHD in adolescence. The review concludes that medication and BT produce a similar range of therapeutic effects on the symptoms of adolescents with ADHD. However, results suggest that BT may produce greater overall benefits on measures of impairment. There was no evidence that cognitive enhancement trainings, such as working memory training or neurofeedback improved the functioning of adolescents with ADHD. Whether to use medication, BT, or their combination to treat an adolescent with ADHD is complicated and we provide evidence-informed guidelines for treatment selection. The reviewed evidence does not support current American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatry professional guidelines, which state that stimulant medication is the preferred treatment for adolescents with ADHD. Recommendations for assessment, practice guidelines, and future research are discussed. PMID:24632046

  3. Risk factors of abuse of parents by their ADHD children.

    PubMed

    Ghanizadeh, Ahmad; Jafari, Peyman

    2010-01-01

    It is interesting that there is scant research of abuse of parents by their children and no study was found on the abuse of parents by their attention deficit hyperactivity disorder (ADHD) children. Seventy-four children and adolescents suffering from ADHD and their parents were interviewed. The diagnoses were made according to DSM-IV diagnostic criteria. A questionnaire was developed to assess the children's abuse toward parents. More than half of the parents are suffering from at least one of the forms of abuse by their ADHD children. Scores of parental abuse were not related to gender. Different types of abuse correlated with oppositional defiant disorder (ODD), tic, and separation anxiety disorder (SAD). Fathers' and mothers' age, the level of education, and type of occupation were not risk factors of the abuse scores. ODD and mother's major depressive disorder were predictors of the abuse. There was a very disturbing high rate of abuse by children against parents. There is an interrelation of different forms of abuse. This study contributes to increasing awareness on the abuse of parents by their ADHD children. PMID:19820986

  4. Child maltreatment and ADHD symptoms in a sample of young adults

    PubMed Central

    Sanderud, Karoline; Murphy, Siobhan; Elklit, Ask

    2016-01-01

    Objective The present study investigated the relationship between different types of childhood maltreatment (emotional, sexual, overall abuse, and no abuse) and the symptoms of attention deficit hyperactivity disorder (ADHD) in young adulthood. Method Data were collected from a Danish national study conducted by The Danish National Centre for Social Research in 2008 and 2009. A sample of 4,718 young adults (24 years of age) were randomly selected using the total birth cohort of children born in 1984. Structured interviews were conducted with a response rate of 63%, equating to a total sample size of 2,980 participants. Results Chi-square analyses revealed significant relationships between child maltreatment groups and a probable diagnosis of ADHD using the Adult ADHD Self-Report Scale (ASRS). Binary logistic regression analysis showed that the overall abuse class was more strongly associated with probable ADHD (OR=5.08), followed by emotional abuse (OR=3.09) and sexual abuse (OR=2.07). Conclusions The results showed that childhood maltreatment was associated with increased risk of ADHD symptoms in young adulthood. The findings of this study are discussed within the existing literature and suggestions for future research are outlined in order to replicate these findings in other adult populations. Highlights of the article Child maltreatment is associated with higher levels of ADHD symptoms in a nationally representative sample of young Danish adults. Co-occurring (multiple) types of maltreatment display stronger associations with ADHD symptoms with attenuated effects for sexual abuse. Males confer stronger associations with ADHD symptoms than females. Findings underscore the importance of exploring the role of childhood trauma in young adults with ADHD symptoms. PMID:27306866

  5. Impaired visuomotor adaptation in adults with ADHD.

    PubMed

    Kurdziel, Laura B F; Dempsey, Katherine; Zahara, Mackenzie; Valera, Eve; Spencer, Rebecca M C

    2015-04-01

    Attention-deficit hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in children that often continues into adulthood. It has been suggested that motor impairments in ADHD are associated with underlying cerebellar pathology. If such is the case, individuals with ADHD should be impaired on motor tasks requiring healthy cerebellar function. To test this, we compared performance of individuals with ADHD and ADHD-like symptoms with non-ADHD controls on a visuomotor adaptation task known to be impaired following cerebellar lesions. Participants adapted reaching movements to a visual representation that was rotated by 30°. Individuals with ADHD and those with ADHD-like symptoms took longer to correct the angle of movement once the rotation was applied relative to controls. However, post-adaptation residual effect did not differ for individuals with ADHD and ADHD-like symptoms compared to the control group. These results are consistent with the hypothesis that mild cerebellar deficits are evident in the motor performance of adults with ADHD. PMID:25567090

  6. Impaired visuomotor adaptation in adults with ADHD

    PubMed Central

    Kurdziel, Laura B. F.; Dempsey, Katherine; Zahara, Mackenzie; Valera, Eve; Spencer, Rebecca M. C.

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in children that often continues into adulthood. It has been suggested that motor impairments in ADHD are associated with underlying cerebellar pathology. If such is the case, individuals with ADHD should be impaired on motor tasks requiring healthy cerebellar function. To test this, we compared performance of individuals with ADHD and ADHD-like symptoms with non-ADHD controls on a visuomotor adaptation task known to be impaired following cerebellar lesions. Participants adapted reaching movements to a visual representation that was rotated by 30°. Individuals with ADHD and those with ADHD-like symptoms took longer to correct the angle of movement once the rotation was applied relative to controls. However, post-adaptation residual effect did not differ for individuals with ADHD and ADHD-like symptoms compared to the control group. These results are consistent with the hypothesis that mild cerebellar deficits are evident in the motor performance of adults with ADHD. PMID:25567090

  7. ADHD in college: A qualitative analysis.

    PubMed

    Lefler, Elizabeth K; Sacchetti, Gina M; Del Carlo, Dawn I

    2016-06-01

    Attention-deficit/hyperactivity disorder (ADHD) affects many adults and is particularly impairing for emerging adults enrolled in college. Research has shown substantial academic impairment for these individuals. However, research on ADHD impairment has largely been quantitative and focused on children. Therefore, the current study employed Interpretative Phenomenological Analysis to explore the lived experience of college students with ADHD with the following two research questions: (1) What is it like to be a college student with ADHD? and (2) What resources are utilized by college students with ADHD? Thirty-six college students with ADHD were interviewed in focus group settings. Our participants reported a complex and mixed experience living with ADHD in college and varied use of treatments and other accommodations. Specifically, three Constructs emerged in the current study: Consequences of Diagnosis, Impairment, and Treatment Management. Implications for professionals working with these students and future directions for researchers are discussed. PMID:26825556

  8. Efficacy of Neurofeedback Versus Pharmacological Support in Subjects with ADHD.

    PubMed

    González-Castro, Paloma; Cueli, Marisol; Rodríguez, Celestino; García, Trinidad; Álvarez, Luis

    2016-03-01

    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. PMID:26290167

  9. ADHD, Multimodal Treatment, and Longitudinal Outcome: Evidence, Paradox, and Challenge

    PubMed Central

    Arnold, L. Eugene

    2014-01-01

    Given major increases in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and in rates of medication for this condition, we carefully examine evidence for effects of single versus multimodal (i.e., combined medication and psychosocial/behavioral) interventions for ADHD. Our primary data source is the Multimodal Treatment Study of Children with ADHD (MTA), a 14-month, randomized clinical trial in which intensive behavioral, medication, and multimodal treatment arms were contrasted with one another and with community intervention (treatment-as-usual), regarding outcome domains of ADHD symptoms, comorbidities, and core functional impairments. Although initial reports emphasized the superiority of well-monitored medication for symptomatic improvement, reanalyses and reappraisals have highlighted (a) the superiority of combination treatment for composite outcomes and for domains of functional impairment (e.g., academic achievement, social skills, parenting practices); (b) the importance of considering moderator and mediator processes underlying differential patterns of outcome, including comorbid subgroups and improvements in family discipline style during the intervention period; (c) the emergence of side effects (e.g., mild growth suppression) in youth treated with long-term medication; and (d) the diminution of medication’s initial superiority once the randomly assigned treatment phase turned into naturalistic follow-up. The key paradox is that whereas ADHD clearly responds to medication and behavioral treatment in the short term, evidence for long-term effectiveness remains elusive. We close with discussion of future directions and a call for greater understanding of relevant developmental processes in the attempt to promote optimal, generalized, and lasting treatments for this important and impairing neurodevelopmental disorder. PMID:25558298

  10. Glutamate/glutamine and neuronal integrity in adults with ADHD: a proton MRS study.

    PubMed

    Maltezos, S; Horder, J; Coghlan, S; Skirrow, C; O'Gorman, R; Lavender, T J; Mendez, M A; Mehta, M; Daly, E; Xenitidis, K; Paliokosta, E; Spain, D; Pitts, M; Asherson, P; Lythgoe, D J; Barker, G J; Murphy, D G

    2014-01-01

    There is increasing evidence that abnormalities in glutamate signalling may contribute to the pathophysiology of attention-deficit hyperactivity disorder (ADHD). Proton magnetic resonance spectroscopy ([1H]MRS) can be used to measure glutamate, and also its metabolite glutamine, in vivo. However, few studies have investigated glutamate in the brain of adults with ADHD naive to stimulant medication. Therefore, we used [1H]MRS to measure the combined signal of glutamate and glutamine (Glu+Gln; abbreviated as Glx) along with other neurometabolites such as creatine (Cr), N-acetylaspartate (NAA) and choline. Data were acquired from three brain regions, including two implicated in ADHD-the basal ganglia (caudate/striatum) and the dorsolateral prefrontal cortex (DLPFC)-and one 'control' region-the medial parietal cortex. We compared 40 adults with ADHD, of whom 24 were naive for ADHD medication, whereas 16 were currently on stimulants, against 20 age, sex and IQ-matched healthy controls. We found that compared with controls, adult ADHD participants had a significantly lower concentration of Glx, Cr and NAA in the basal ganglia and Cr in the DLPFC, after correction for multiple comparisons. There were no differences between stimulant-treated and treatment-naive ADHD participants. In people with untreated ADHD, lower basal ganglia Glx was significantly associated with more severe symptoms of inattention. There were no significant differences in the parietal 'control' region. We suggest that subcortical glutamate and glutamine have a modulatory role in ADHD adults; and that differences in glutamate-glutamine levels are not explained by use of stimulant medication. PMID:24643164

  11. Predicting aggression in children with ADHD

    PubMed Central

    2014-01-01

    Objective The present study uses structural equation modeling of latent traits to examine the extent to which family factors, cognitive factors and perceptions of rejection in mother-child relations differentially correlate with aggression at home and at school. Methods Data were collected from 476 school-age (7–15 years old) children with a diagnosis of ADHD who had previously shown different types of aggressive behavior, as well as from their parents and teachers. Structural equation modeling was used to examine the differential relationships between maternal rejection, family, cognitive factors and aggression in home and school settings. Results Family factors influenced aggression reported at home (.68) and at school (.44); maternal rejection seems to be related to aggression at home (.21). Cognitive factors influenced aggression reported at school (.-05) and at home (-.12). Conclusions Both genetic and environmental factors contribute to the development of aggressive behavior in ADHD. Identifying key risk factors will advance the development of appropriate clinical interventions and prevention strategies and will provide information to guide the targeting of resources to those children at highest risk. PMID:24860616

  12. Distinct neural signatures detected for ADHD subtypes after controlling for micro-movements in resting state functional connectivity MRI data.

    PubMed

    Fair, Damien A; Nigg, Joel T; Iyer, Swathi; Bathula, Deepti; Mills, Kathryn L; Dosenbach, Nico U F; Schlaggar, Bradley L; Mennes, Maarten; Gutman, David; Bangaru, Saroja; Buitelaar, Jan K; Dickstein, Daniel P; Di Martino, Adriana; Kennedy, David N; Kelly, Clare; Luna, Beatriz; Schweitzer, Julie B; Velanova, Katerina; Wang, Yu-Feng; Mostofsky, Stewart; Castellanos, F Xavier; Milham, Michael P

    2012-01-01

    In recent years, there has been growing enthusiasm that functional magnetic resonance imaging (MRI) could achieve clinical utility for a broad range of neuropsychiatric disorders. However, several barriers remain. For example, the acquisition of large-scale datasets capable of clarifying the marked heterogeneity that exists in psychiatric illnesses will need to be realized. In addition, there continues to be a need for the development of image processing and analysis methods capable of separating signal from artifact. As a prototypical hyperkinetic disorder, and movement-related artifact being a significant confound in functional imaging studies, ADHD offers a unique challenge. As part of the ADHD-200 Global Competition and this special edition of Frontiers, the ADHD-200 Consortium demonstrates the utility of an aggregate dataset pooled across five institutions in addressing these challenges. The work aimed to (1) examine the impact of emerging techniques for controlling for "micro-movements," and (2) provide novel insights into the neural correlates of ADHD subtypes. Using support vector machine (SVM)-based multivariate pattern analysis (MVPA) we show that functional connectivity patterns in individuals are capable of differentiating the two most prominent ADHD subtypes. The application of graph-theory revealed that the Combined (ADHD-C) and Inattentive (ADHD-I) subtypes demonstrated some overlapping (particularly sensorimotor systems), but unique patterns of atypical connectivity. For ADHD-C, atypical connectivity was prominent in midline default network components, as well as insular cortex; in contrast, the ADHD-I group exhibited atypical patterns within the dlPFC regions and cerebellum. Systematic motion-related artifact was noted, and highlighted the need for stringent motion correction. Findings reported were robust to the specific motion correction strategy employed. These data suggest that resting-state functional connectivity MRI (rs-fcMRI) data can be

  13. Distinct neural signatures detected for ADHD subtypes after controlling for micro-movements in resting state functional connectivity MRI data

    PubMed Central

    Fair, Damien A.; Nigg, Joel T.; Iyer, Swathi; Bathula, Deepti; Mills, Kathryn L.; Dosenbach, Nico U. F.; Schlaggar, Bradley L.; Mennes, Maarten; Gutman, David; Bangaru, Saroja; Buitelaar, Jan K.; Dickstein, Daniel P.; Di Martino, Adriana; Kennedy, David N.; Kelly, Clare; Luna, Beatriz; Schweitzer, Julie B.; Velanova, Katerina; Wang, Yu-Feng; Mostofsky, Stewart; Castellanos, F. Xavier; Milham, Michael P.

    2012-01-01

    In recent years, there has been growing enthusiasm that functional magnetic resonance imaging (MRI) could achieve clinical utility for a broad range of neuropsychiatric disorders. However, several barriers remain. For example, the acquisition of large-scale datasets capable of clarifying the marked heterogeneity that exists in psychiatric illnesses will need to be realized. In addition, there continues to be a need for the development of image processing and analysis methods capable of separating signal from artifact. As a prototypical hyperkinetic disorder, and movement-related artifact being a significant confound in functional imaging studies, ADHD offers a unique challenge. As part of the ADHD-200 Global Competition and this special edition of Frontiers, the ADHD-200 Consortium demonstrates the utility of an aggregate dataset pooled across five institutions in addressing these challenges. The work aimed to (1) examine the impact of emerging techniques for controlling for “micro-movements,” and (2) provide novel insights into the neural correlates of ADHD subtypes. Using support vector machine (SVM)-based multivariate pattern analysis (MVPA) we show that functional connectivity patterns in individuals are capable of differentiating the two most prominent ADHD subtypes. The application of graph-theory revealed that the Combined (ADHD-C) and Inattentive (ADHD-I) subtypes demonstrated some overlapping (particularly sensorimotor systems), but unique patterns of atypical connectivity. For ADHD-C, atypical connectivity was prominent in midline default network components, as well as insular cortex; in contrast, the ADHD-I group exhibited atypical patterns within the dlPFC regions and cerebellum. Systematic motion-related artifact was noted, and highlighted the need for stringent motion correction. Findings reported were robust to the specific motion correction strategy employed. These data suggest that resting-state functional connectivity MRI (rs-fcMRI) data can

  14. ADHD Knowledge, Perceptions and Information Sources: Perspectives from a Community Sample of Adolescents and their Parents”

    PubMed Central

    Bussing, Regina; Zima, Bonnie T.; Mason, Dana M.; Meyer, Johanna.M.; White, Kimberly; Garvan, Cynthia W.

    2012-01-01

    PURPOSE The chronic illness model advocates for psychoeducation within a collaborative care model to enhance outcomes. To inform psychoeducational approaches for attention-deficit/hyperactivity disorder (ADHD), this study describes parent and adolescent knowledge, perceptions and information sources and explores how these vary by sociodemographic characteristics, ADHD risk, and past child mental health service use. METHODS Parents and adolescents were assessed 7.7 years after initial school district screening for ADHD risk. The study sample included 374 adolescents (56% high and 44% low ADHD risk), on average 15.4 (SD 1.8) years old, and 36% were African American. Survey questions assessed ADHD knowledge, perceptions, and cues to action, and elicited utilized and preferred information sources. Multiple logistic regression was used to determine potential independent predictors of ADHD knowledge. McNemar's tests compared information source utilization against preference. RESULTS Despite relatively high self-rated ADHD familiarity, misperceptions among parents and adolescents were common, including a sugar etiology (25% and 27%, respectively) and medication overuse (85% and 67%). African American respondents expressed lower ADHD awareness and greater belief in sugar etiology than Caucasians. Parents used a wide range of ADHD information sources while adolescents relied on social network members and teachers/school. However, parents and adolescents expressed similar strong preferences for the Internet (49% and 51%) and doctor (40% and 27%) as ADHD information sources. CONCLUSION Culturally appropriate psychoeducational strategies are needed that combine doctor-provided ADHD information with reputable Internet sources. Despite time limitations during patient visits, both parents and teens place high priority on receiving information from their doctor. PMID:23174470

  15. Is ADHD a "Real" Disorder?

    ERIC Educational Resources Information Center

    Quinn, Michael; Lynch, Andrea

    2016-01-01

    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…

  16. Are ADHD Kids More Creative?

    ERIC Educational Resources Information Center

    Fugate, C. Matthew

    2016-01-01

    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…

  17. ADHD Psychosocial Treatments: Generalization Reconsidered

    ERIC Educational Resources Information Center

    Abikoff, Howard

    2009-01-01

    Behavioral interventions have demonstrated clinical utility in improving the behavior of children with ADHD, especially in specialized therapeutic milieus (Pelham et al., 2000). Improvements in children's target behaviors often occur in the treatment settings where contingencies are in place and delivered consistently. However, generalization of…

  18. Comorbidity of Migraine with ADHD

    ERIC Educational Resources Information Center

    Fasmer, Ole Bernt; Riise, Trond; Lund, Anders; Dilsaver, Steven C.; Hundal, Oivind; Oedegaard, Ketil J.

    2012-01-01

    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:…

  19. Comorbidity of Asthma with ADHD

    ERIC Educational Resources Information Center

    Fasmer, Ole Bernt; Riise, Trond; Eagan, Tomas Mikal; Lund, Anders; Dilsaver, Steven C.; Hundal, Oivind; Oedegaard, Ketil J.

    2011-01-01

    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…

  20. Auditory Conflict Processing in ADHD

    ERIC Educational Resources Information Center

    van Mourik, Rosa; Sergeant, Joseph A.; Heslenfeld, Dirk; Konig, Claudia; Oosterlaan, Jaap

    2011-01-01

    Background: Impaired cognitive control has been implicated as an important developmental pathway to attention deficit/hyperactivity disorder (ADHD). Cognitive control is crucial to suppress interference resulting from conflicting information and can be measured by Stroop-like tasks. This study was conducted to gain insight into conflict processing…

  1. Parents, ADHD and the internet.

    PubMed

    Terbeck, Sylvia; Chesterman, L Paul

    2012-09-01

    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

  2. Causes of ADHD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Understanding ADHD Causes of ADHD Past Issues / Spring 2014 Table of Contents Scientists ... research discounts this theory than supports it. Diagnosing ADHD Children mature at different rates and have different ...

  3. Adults with ADHD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... this page please turn JavaScript on. Feature: Understanding ADHD Adults with ADHD Past Issues / Spring 2014 Table of Contents Some ... as clear cut as symptoms seen in children. ADHD Research The expansion of knowledge in genetics, brain ...

  4. Causes of ADHD | NIH MedlinePlus the Magazine

    MedlinePlus

    ... causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD ... percentage of children with ADHD have suffered a traumatic brain injury. Sugar. The idea that refined sugar ...

  5. ADHD Symptoms and Subtypes: Relationship between Childhood and Adolescent Symptoms

    ERIC Educational Resources Information Center

    Hurtig, Tuula; Ebeling, Hanna; Taanila, Anja; Miettunen, Jouko; Smalley, Susan L.; McGough, James J.; Loo, Sandra K.; Jarvelin, Marjo-Riitta; Moilanen, Irma K.

    2007-01-01

    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.

  6. Attention-deficit hyperactivity disorder (ADHD), substance use disorders, and criminality: a difficult problem with complex solutions.

    PubMed

    Knecht, Carlos; de Alvaro, Raquel; Martinez-Raga, Jose; Balanza-Martinez, Vicent

    2015-05-01

    The association between attention-deficit hyperactivity disorder (ADHD) and criminality has been increasingly recognized as an important societal concern. Studies conducted in different settings have revealed high rates of ADHD among adolescent offenders. The risk for criminal behavior among individuals with ADHD is increased when there is psychiatric comorbidity, particularly conduct disorder and substance use disorder. In the present report, it is aimed to systematically review the literature on the epidemiological, neurobiological, and other risk factors contributing to this association, as well as the key aspects of the assessment, diagnosis, and treatment of ADHD among offenders. A systematic literature search of electronic databases (PubMed, EMBASE, and PsycINFO) was conducted to identify potentially relevant studies published in English, in peer-reviewed journals. Studies conducted in various settings within the judicial system and in many different countries suggest that the rate of adolescent and adult inmates with ADHD far exceeds that reported in the general population; however, underdiagnosis is common. Similarly, follow-up studies of children with ADHD have revealed high rates of criminal behaviors, arrests, convictions, and imprisonment in adolescence and adulthood. Assessment of ADHD and comorbid condition requires an ongoing and careful process. When treating offenders or inmates with ADHD, who commonly present other comorbid psychiatric disorder complex, comprehensive and tailored interventions, combining pharmacological and psychosocial strategies are likely to be needed. PMID:25411986

  7. 38 CFR 21.7612 - Programs of education combining two or more types of courses.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Programs of education combining two or more types of courses. 21.7612 Section 21.7612 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) VOCATIONAL REHABILITATION AND EDUCATION Educational Assistance for Members of the Selected...

  8. Meta-Analysis of the Effects of Type and Combination of Feedback on Children's Discrimination Learning.

    ERIC Educational Resources Information Center

    Getsie, Rosemary L.; And Others

    1985-01-01

    To estimate the relative effects of three types and three combinations of feedback on children's discrimination learning, a meta-analysis was performed on the findings of 89 studies. In general, reward compared to punishment or to reward plus punishment is the least efficient method of feedback for teaching children discrimination materials.…

  9. Analysis of Critical Incidents and Shifting Perspectives: Transitions in Illness Careers Among Adolescents with ADHD

    PubMed Central

    Williamson, Pamela; Koro-Ljungberg, Mirka; Bussing, Regina

    2013-01-01

    Adolescence represents a developmental period for children with attention-deficit hyperactivity disorder (ADHD) during which the severity of mental health problems may change at a time when teens are consolidating their self identify and possibly questioning the label of an ADHD diagnosis, treatment, and types of interventions. This study investigates the shared critical events related to help-seeking reported by eight teenagers with ADHD, their mothers, and teachers and how the reported events and constructed shared focus on specific problems might explain teenagers’ transitions in their illness careers. Data collected through a qualitative application of the experience sampling method illuminated diverse illness career transitions including continuing treatment, transitioning from being treated to untreated, from being untreated to treated, and remaining untreated. Our findings support a model of shifting perspectives on illness and wellness among adolescents with ADHD, rather than a staged progression of adaptation to a chronic disorder. PMID:19224878

  10. Aspects of language in children with ADHD: applying functional analyses to explore language use.

    PubMed

    Mathers, Margaret E

    2006-02-01

    This article reports some outcomes from an exploratory study that compares children diagnosed with ADHD and without language impairment with typically developing children for aspects of language use. Discourse analysis based on a systemic functional linguistics approach is applied to spoken and written samples from three different text types that are supplied by 11 children diagnosed with ADHD and 11 typically developing children. Comparisons of multiple variables most often show differences in use between the groups. Closer examination of these differences shows that relative to the controls, the ADHD group uses fewer strategies of textual organization and more avoidance, tangential, and unrelated meanings and more abandoned utterances and spelling and punctuation errors. Clinical implications suggest that careful linguistic analysis of spoken and written language of children with ADHD cannot only identify the linguistic resources they use within everyday contexts but may also indicate areas where intervention may be beneficial. PMID:16481669

  11. Study of ABO blood types by combining membrane electrophoresis with surface-enhanced Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Wang, Jing; Lin, Juqiang; Huang, Zufang; Sun, Liqing; Shao, Yonghong; Lu, Peng; Shi, Wei; Lin, Jinyong; Chen, Rong

    2012-12-01

    The molecular characterization of ABO blood types, which is clinically significant in blood transfusion, has clinical and anthropological importance. Polymerase chain reaction sequence-based typing (PCR-SBT) is one of the most commonly used methods for the analysis of genetic bases of ABO blood types. However, such methods as PCR-SBT are time-consuming and are high in demand of equipments and manipulative skill. Here we showed that membrane electrophoresis based SERS method employed for studying the molecular bases of ABO blood types can provide rapidand easy-operation with high sensitivity and specificity. The plasma proteins were firstly purified by membrane electrophoresis and then mixed with silver nanoparticles to perform SERS detection. We use this method to classify different blood types, including blood type A (n=13), blood type B (n=9) and blood type O (n=10). Combination of principal component analysis (PCA) and liner discriminant analysis (LDA) was then performed on the SERS spectra of purified albumin, showing good classification results among different blood types. Our experimental outcomes represent a critical step towards the rapid, convenient and accurate identification of ABO blood types.

  12. Self-pathologizing, self-condemning, self-liberating: Youths' accounts of their ADHD-related behavior.

    PubMed

    Honkasilta, Juho; Vehmas, Simo; Vehkakoski, Tanja

    2016-02-01

    This study analyzes the discursive construction of attention deficit hyperactivity disorder (ADHD) and self in relation to a socioculturally shared understanding of moral norms. Thirteen Finnish youth aged 11 to 16 diagnosed with ADHD were interviewed during this discourse analysis study. The youth accounted for their culturally undesirable behavior, performance and traits through three different types of accounts: (1) externalizing personal responsibility due to a compelling medical condition, (2) internalizing personal responsibility through moral self-condemnation, and (3) distancing oneself from the socially imposed stereotypes and stigmas related to ADHD. This study challenges dominant understanding of young people with a diagnosis of ADHD and contributes to our understanding of how ADHD is constructed in their lives. PMID:26774711

  13. Learning disabilities and ADHD: overlapping spectrumn disorders.

    PubMed

    Mayes, S D; Calhoun, S L; Crowell, E W

    2000-01-01

    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. PMID:15495544

  14. Brief Report: Adaptive Functioning in Children with ASD, ADHD and ASD + ADHD

    ERIC Educational Resources Information Center

    Ashwood, Karen L.; Tye, Charlotte; Azadi, Bahare; Cartwright, Sally; Asherson, Philip; Bolton, Patrick

    2015-01-01

    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…

  15. Examining Autistic Traits in Children with ADHD: Does the Autism Spectrum Extend to ADHD?

    ERIC Educational Resources Information Center

    Grzadzinski, Rebecca; Di Martino, Adriana; Brady, Emily; Mairena, Maria Angeles; O'Neale, Matthew; Petkova, Eva; Lord, Catherine; Castellanos, F. Xavier

    2011-01-01

    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…

  16. Social Adjustment among Taiwanese Children with Symptoms of ADHD, ODD, and ADHD Comorbid with ODD

    ERIC Educational Resources Information Center

    Tseng, Wan-Ling; Kawabata, Yoshito; Gau, Susan Shur-Fen

    2011-01-01

    This study examined social problems at school and relationships with peers, siblings, mothers, and fathers among children with ADHD only (n = 41), ODD only (n = 14), ADHD + ODD (n = 47), and normal controls (n = 204) from a school-based sample of 2,463 first to ninth graders in Taiwan. ADHD and ODD symptoms were determined by teacher and mother…

  17. Cardiac Reactivity and Stimulant Use in Adolescents with Autism Spectrum Disorders with Comorbid ADHD Versus ADHD

    ERIC Educational Resources Information Center

    Bink, M.; Popma, A.; Bongers, I. L.; van Boxtel, G. J. M.; Denissen, A.; van Nieuwenhuizen, Ch.

    2015-01-01

    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…

  18. Comparing ADHD in Velocardiofacial Syndrome to Idiopathic ADHD: A Preliminary Study

    ERIC Educational Resources Information Center

    Antshel, Kevin M.; Faraone, Stephen V.; Fremont, Wanda; Monuteaux, Michael C.; Kates, Wendy R.; Doyle, Alysa; Mick, Eric; Biederman, Joseph

    2007-01-01

    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…

  19. Teachers' Knowledge of ADHD, Treatments for ADHD, and Treatment Acceptability: An Initial Investigation. Research Brief

    ERIC Educational Resources Information Center

    Vereb, Rebecca L.; DiPerna, James C.

    2004-01-01

    The purpose of this study was to begin to explore the relationship among teachers' knowledge of Attention Deficit Hyperactivity Disorder (ADHD), knowledge of common treatments for ADHD, and acceptability of different approaches to treatment for ADHD (medication and behavior management). Relationships also were explored between these variables and…

  20. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD

    PubMed Central

    2010-01-01

    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

  1. Willingness to use ADHD treatments: a mixed methods study of perceptions by adolescents, parents, health professionals and teachers.

    PubMed

    Bussing, Regina; Koro-Ljungberg, Mirka; Noguchi, Kenji; Mason, Dana; Mayerson, Gillian; Garvan, Cynthia W

    2012-01-01

    Little is known about factors that influence willingness to engage in treatment for attention deficit/hyperactivity disorder (ADHD). From 2007 to 2008, in the context of a longitudinal study assessing ADHD detection and service use in the United States, we simultaneously elicited ADHD treatment perceptions from four stakeholder groups: adolescents, parents, health care professionals and teachers. We assessed their willingness to use ADHD interventions and views of potential undesirable effects of two pharmacological (short- and long-acting ADHD medications) and three psychosocial (ADHD education, behavior therapy, and counseling) treatments. In multiple regression analysis, willingness was found to be significantly related to respondent type (lower for adolescents than adults), feeling knowledgeable, and considering treatments acceptable and helpful, but not significantly associated with stigma/embarrassment, respondent race, gender and socioeconomic status. Because conceptual models of undesirable effects are underdeveloped, we used grounded theory method to analyze open-ended survey responses to the question: "What other undesirable effects are you concerned about?" We identified general negative treatment perceptions (dislike, burden, perceived ineffectiveness) and specific undesirable effect expectations (physiological and psychological side effects, stigma and future dependence on drugs or therapies) for pharmacological and psychosocial treatments. In summary, findings indicate significant discrepancies between teens' and adults' willingness to use common ADHD interventions, with low teen willingness for any treatments. Results highlight the need to develop better treatment engagement practices for adolescents with ADHD. PMID:22133584

  2. How do ADHD children perceive their cognitive, affective, and behavioral aspects of anger expression in school setting?

    PubMed Central

    2010-01-01

    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

  3. Willingness to use ADHD Treatments: A Mixed Methods Study of Perceptions by Adolescents, Parents, Health Professionals and Teachers

    PubMed Central

    Bussing, Regina; Koro-Ljungberg, Mirka; Noguchi, Kenji; Mason, Dana; Mayerson, Gillian; Garvan, Cynthia W

    2011-01-01

    Little is known about factors that influence willingness to engage in treatment for attention deficit/hyperactivity disorder (ADHD). From 2007 to 2008, in the context of a longitudinal study assessing ADHD detection and service use in the United States, we simultaneously elicited ADHD treatment perceptions from four stakeholder groups: adolescents, parents, health care professionals and teachers. We assessed their willingness to use ADHD interventions and views of potential undesirable effects of two pharmacological (short- and long-acting ADHD medications) and three psychosocial (ADHD education, behavior therapy, and counseling) treatments. In multiple regression analysis, willingness was found to be significantly related to respondent type (lower for adolescents than adults), feeling knowledgeable, and considering treatments acceptable and helpful, but not significantly associated with stigma/embarrassment, respondent race, gender and socioeconomic status. Because conceptual models of undesirable effects are underdeveloped, we used grounded theory method to analyze open-ended survey responses to the question: “What other undesirable effects are you concerned about?” We identified general negative treatment perceptions (dislike, burden, perceived ineffectiveness) and specific undesirable effect expectations (physiological and psychological side-effects, stigma and future dependence on drugs or therapies) for pharmacological and psychosocial treatments. In summary, findings indicate significant discrepancies between teens’ and adults’ willingness to use common ADHD interventions, with low teen willingness for any treatments. Results highlight the need to develop better treatment engagement practices for adolescents with ADHD. PMID:22133584

  4. Combination therapies in the management of type 2 diabetes: the use of insulin degludec/liraglutide

    PubMed Central

    Minze, Molly G; Chastain, Lisa M

    2016-01-01

    The global burden of type 2 diabetes is estimated to currently affect over 350 million people worldwide and is anticipated to continue increasing over the next 20 years. Current treatment guidelines recommend the choice of pharmacotherapy based upon patient-specific parameters, with combination therapy for patients with a hemoglobin A1c level ≥9%. A new combination therapy of insulin degludec + liraglutide provides a long-acting basal insulin with a glucagon-like peptide agonist. In clinical trials, this combination product has reduced hemoglobin A1c and fasting plasma glucose more than the individual agents alone. Further advantages observed with this combination include weight loss and decrease in hypoglycemia compared to basal insulin alone. PMID:27099505

  5. Comorbidity of ADHD and incontinence in children.

    PubMed

    von Gontard, Alexander; Equit, Monika

    2015-02-01

    ADHD and incontinence are common childhood disorders which co-occur at much higher rates than expected by chance. The aim of this review was to provide an overview both of the comorbidity of nocturnal enuresis (NE), daytime urinary incontinence (DUI) and faecal incontinence (FI) in children with ADHD; and, vice versa, of the co-occurrence of ADHD in children with NE, DUI and FI. Most clinical studies have focussed on the association of ADHD and NE. Population-based studies have shown that children with DUI have an even greater risk for ADHD than those with NE. While children with FI have the highest overall comorbidity rates of psychological disorders, these are heterogeneous with a wide range of internalising and externalising disorders--not necessarily of ADHD. Genetic studies indicate that ADHD and NE, DUI and FI do not share the same genetic basis. The comorbidity is conferred by non-genetic factors. Possible aetiological and pathogenetic links between ADHD and incontinence are provided by neurophysiological, imaging and pharmacological studies. The co-occurrence has clinical implications: children with ADHD and NE, DUI and FI are more difficult to treat, show lower compliance and have less favourable treatment outcomes for incontinence. Therefore, both groups of disorders have to be assessed and treated specifically. PMID:24980793

  6. ADHD and growth: questions still unanswered.

    PubMed

    Ptacek, Radek; Kuzelova, Hana; Stefano, George B; Raboch, Jirí; Kream, Richard M; Goetz, Michal

    2014-01-01

    Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood psychiatric disorders. It is manifested in every part of an affected child's behavior, with multiple symptomatology and heterogenous etiology. Published studies report that ADHD children may show changes in growth and development. Most of the studies on ADHD have been focused on connections between medication and growth changes and describe growth delays associated with medication. However, recent research results point to the low significance of the changes accompanying pharmacological treatment. Changes in growth may not only be a secondary effect of the treatment, but may also be specific characteristics of ADHD. PMID:24625909

  7. Combined Effect of Three Types of Biophysical Stimuli for Bone Regeneration

    PubMed Central

    Kang, Kyung Shin; Hong, Jung Min; Jeong, Young Hun; Seol, Young-Joon; Yong, Woon-Jae; Rhie, Jong-Won

    2014-01-01

    Pretreatment using various types of biophysical stimuli could provide appropriate potential to cells during construction of the engineered tissue in vitro. We hypothesized that multiple combinations of these biophysical stimuli could enhance osteogenic differentiation in vitro and bone formation in vivo. Cyclic strain, an electromagnetic field, and ultrasound were selected and combined as effective stimuli for osteogenic differentiation using a developed bioreactor. Here we report the experimental evaluation of the osteogenic effects of various combinations of three different biophysical stimuli in vitro and in vivo using human adipose-derived stem cells (ASCs). Osteogenic differentiation of ASCs was accelerated by multiple-combination biophysical stimulation in vitro. However, both single stimulation and double-combination stimulation were sufficient to accelerate bone regeneration in vivo, while the osteogenic marker expression of those groups was not as high as that of triple-combination stimulation in vitro. We inferred from these data that ASCs appropriately differentiated into the osteogenic lineage by biophysical stimulation could be a better option for accelerating bone formation in vivo than relatively undifferentiated or completely differentiated ASCs. Although many questions remain about the mechanisms of combined effects of various biophysical stimuli, this approach could be a more powerful tool for bone tissue regeneration. PMID:24446961

  8. The ADHD Concomitant Difficulties Scale (ADHD-CDS), a Brief Scale to Measure Comorbidity Associated to ADHD

    PubMed Central

    Fenollar-Cortés, Javier; Fuentes, Luis J.

    2016-01-01

    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

  9. Psychiatric Comorbidity at the Time of Diagnosis in Adults With ADHD: The CAT Study.

    PubMed

    Piñeiro-Dieguez, Benjamin; Balanzá-Martínez, Vicent; García-García, Pilar; Soler-López, Begoña

    2014-01-24

    Objective: The CAT (Comorbilidad en Adultos con TDAH) study aimed to quantify and characterize the psychiatric comorbidity at the time of diagnosis of ADHD in adult outpatients. Method: Cross-sectional, multicenter, observational register of adults with ADHD diagnosed for the first time. Results: In this large sample of adult ADHD (n = 367), psychiatric comorbidities were present in 66.2% of the sample, and were more prevalent in males and in the hyperactive-impulsive and combined subtypes. The most common comorbidities were substance use disorders (39.2%), anxiety disorders (23%), and mood disorders (18.1%). In all, 88.8% patients were prescribed pharmacological treatment for ADHD (in 93.4% of cases, modified release methylphenidate capsules 50:50). Conclusion: A high proportion of psychiatric comorbidity was observed when adult outpatients received a first-time diagnosis of ADHD. The systematic registering of patients and comorbidities in clinical practice may help to better understand and manage the prognostic determinants in adult ADHD. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24464326

  10. Glutamate/glutamine and neuronal integrity in adults with ADHD: a proton MRS study

    PubMed Central

    Maltezos, S; Horder, J; Coghlan, S; Skirrow, C; O'Gorman, R; Lavender, T J; Mendez, M A; Mehta, M; Daly, E; Xenitidis, K; Paliokosta, E; Spain, D; Pitts, M; Asherson, P; Lythgoe, D J; Barker, G J; Murphy, D G

    2014-01-01

    There is increasing evidence that abnormalities in glutamate signalling may contribute to the pathophysiology of attention-deficit hyperactivity disorder (ADHD). Proton magnetic resonance spectroscopy ([1H]MRS) can be used to measure glutamate, and also its metabolite glutamine, in vivo. However, few studies have investigated glutamate in the brain of adults with ADHD naive to stimulant medication. Therefore, we used [1H]MRS to measure the combined signal of glutamate and glutamine (Glu+Gln; abbreviated as Glx) along with other neurometabolites such as creatine (Cr), N-acetylaspartate (NAA) and choline. Data were acquired from three brain regions, including two implicated in ADHD—the basal ganglia (caudate/striatum) and the dorsolateral prefrontal cortex (DLPFC)—and one ‘control' region—the medial parietal cortex. We compared 40 adults with ADHD, of whom 24 were naive for ADHD medication, whereas 16 were currently on stimulants, against 20 age, sex and IQ-matched healthy controls. We found that compared with controls, adult ADHD participants had a significantly lower concentration of Glx, Cr and NAA in the basal ganglia and Cr in the DLPFC, after correction for multiple comparisons. There were no differences between stimulant-treated and treatment-naive ADHD participants. In people with untreated ADHD, lower basal ganglia Glx was significantly associated with more severe symptoms of inattention. There were no significant differences in the parietal ‘control' region. We suggest that subcortical glutamate and glutamine have a modulatory role in ADHD adults; and that differences in glutamate–glutamine levels are not explained by use of stimulant medication. PMID:24643164

  11. Impairment of Concept Formation Ability in Children with ADHD: Comparisons between Lower Grades and Higher Grades

    PubMed Central

    Hong, Hye Jeong; Kim, Jin Sung; Seo, Wan Seok; Koo, Bon Hoon; Bai, Dai Seg; Jeong, Jin Young

    2010-01-01

    Objective We investigated executive functions (EFs), as evaluated by the Wisconsin Card Sorting Test (WCST), and other EF between lower grades (LG) and higher grades (HG) in elementary-school-age attention deficit hyperactivity disorder (ADHD) children. Methods We classified a sample of 112 ADHD children into 4 groups (composed of 28 each) based on age (LG vs. HG) and WCST performance [lower vs. higher performance on WCST, defined by the number of completed categories (CC)] Participants in each group were matched according to age, gender, ADHD subtype, and intelligence. We used the Wechsler intelligence Scale for Children 3rd edition to test intelligence and the Computerized Neurocognitive Function Test-IV, which included the WCST, to test EF. Results Comparisons of EFs scores in LG ADHD children showed statistically significant differences in performing digit spans backward, some verbal learning scores, including all memory scores, and Stroop test scores. However, comparisons of EF scores in HG ADHD children did not show any statistically significant differences. Correlation analyses of the CC and EF variables and stepwise multiple regression analysis in LG ADHD children showed a combination of the backward form of the Digit span test and Visual span test in lower-performance ADHD participants significantly predicted the number of CC (R2=0.273, p<0.001). Conclusion This study suggests that the design of any battery of neuropsychological tests for measuring EF in ADHD children should first consider age before interpreting developmental variations and neuropsychological test results. Researchers should consider the dynamics of relationships within EF, as measured by neuropsychological tests. PMID:20927306

  12. Towards an ICF core set for ADHD: a worldwide expert survey on ability and disability.

    PubMed

    de Schipper, Elles; Mahdi, Soheil; Coghill, David; de Vries, Petrus J; Gau, Susan Shur-Fen; Granlund, Mats; Holtmann, Martin; Karande, Sunil; Levy, Florence; Almodayfer, Omar; Rohde, Luis; Tannock, Rosemary; Bölte, Sven

    2015-12-01

    This is the second in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF and Children and Youth version, ICF-CY) core sets for attention deficit hyperactivity disorder (ADHD). The objective of this stage was to gather the opinions from international experts on which ability and disability concepts were considered relevant to functioning in ADHD. An email-based survey was carried out amongst international experts in ADHD. Relevant functional ability and disability concepts were extracted from their responses and linked to the ICF/-CY categories by two independent researchers using a standardised linking procedure. 174 experts from 11 different disciplines and 45 different countries completed the survey. Meaningful concepts identified in their responses were linked to 185 ICF/-CY categories. Of these, 83 categories were identified by at least 5 % of the experts and considered the most relevant to ADHD: 30 of these were related to Body functions (most identified: attention functions, 85 %), 30 to Activities and Participation (most identified: school education, 52 %), 20 to Environmental factors (most identified: support from immediate family, 61 %), and 3 to Body structures (most identified: structure of brain, 83 %). Experts also provided their views on particular abilities related to ADHD, naming characteristics such as high-energy levels, flexibility and resiliency. Gender differences in the expression of ADHD identified by experts pertained mainly to females showing more internalising (e.g. anxiety, low self-esteem) and less externalising behaviours (e.g. hyperactivity), leading to a risk of late- and under-diagnosis in females. Results indicate that the impact of ADHD extends beyond the core symptom domains, into all areas of life and across the lifespan. The current study in combination with three additional preparatory studies (comprehensive scoping review, focus groups, clinical study

  13. Enlarged striatal volume in adults with ADHD carrying the 9-6 haplotype of the dopamine transporter gene DAT1.

    PubMed

    Onnink, A Marten H; Franke, Barbara; van Hulzen, Kimm; Zwiers, Marcel P; Mostert, Jeanette C; Schene, Aart H; Heslenfeld, Dirk J; Oosterlaan, Jaap; Hoekstra, Pieter J; Hartman, Catharina A; Vasquez, Alejandro Arias; Kan, Cornelis C; Buitelaar, Jan; Hoogman, Martine

    2016-08-01

    The dopamine transporter gene, DAT1 (SLC6A3), has been studied extensively as a candidate gene for attention-deficit/hyperactivity disorder (ADHD). Different alleles of variable number of tandem repeats (VNTRs) in this gene have been associated with childhood ADHD (10/10 genotype and haplotype 10-6) and adult ADHD (haplotype 9-6). This suggests a differential association depending on age, and a role of DAT1 in modulating the ADHD phenotype over the lifespan. The DAT1 gene may mediate susceptibility to ADHD through effects on striatal volumes, where it is most highly expressed. In an attempt to clarify its mode of action, we examined the effect of three DAT1 alleles (10/10 genotype, and the haplotypes 10-6 and 9-6) on bilateral striatal volumes (nucleus accumbens, caudate nucleus, and putamen) derived from structural magnetic resonance imaging scans using automated tissue segmentation. Analyses were performed separately in three cohorts with cross-sectional MRI data, a childhood/adolescent sample (NeuroIMAGE, 301 patients with ADHD and 186 healthy participants) and two adult samples (IMpACT, 118 patients with ADHD and 111 healthy participants; BIG, 1718 healthy participants). Regression analyses revealed that in the IMpACT cohort, and not in the other cohorts, carriers of the DAT1 adult ADHD risk haplotype 9-6 had 5.9 % larger striatum volume relative to participants not carrying this haplotype. This effect varied by diagnostic status, with the risk haplotype affecting striatal volumes only in patients with ADHD. An explorative analysis in the cohorts combined (N = 2434) showed a significant gene-by-diagnosis-by-age interaction suggesting that carriership of the 9-6 haplotype predisposes to a slower age-related decay of striatal volume specific to the patient group. This study emphasizes the need of a lifespan approach in genetic studies of ADHD. PMID:26935821

  14. A Follow-Up Study of Maternal Expressed Emotion Toward Children With Attention-Deficit/Hyperactivity Disorder (ADHD): Relation With Severity and Persistence of ADHD and Comorbidity

    PubMed Central

    Richards, Jennifer S.; Vásquez, Alejandro Arias; Rommelse, Nanda N.J.; Oosterlaan, Jaap; Hoekstra, Pieter J.; Franke, Barbara; Hartman, Catharina A.; Buitelaar, Jan K.

    2014-01-01

    Objective Attention-deficit/hyperactivity disorder (ADHD) is associated with conflicted parent–child relationships. The underlying mechanisms of this association are not yet fully understood. We investigated the cross-sectional and longitudinal relationships between externalizing psychopathology in children with ADHD, and expressed emotion (EE; warmth and criticism) and psychopathology in mothers. Method In this 6-year follow-up study 385 children with an ADHD combined subtype were included at baseline (mean=11.5 years, 83.4% male), of which 285 children (74%) were available at follow-up (mean=17.5 years, 83.5% male). At both time points, measures of child psychopathology (i.e., ADHD severity, oppositional, and conduct problems), maternal EE, and maternal psychopathology (i.e., ADHD and affective problems) were obtained. Results EE was not significantly correlated over time. At baseline, we found a nominally negative association (p≤.05) between maternal warmth and child ADHD severity. At follow-up, maternal criticism was significantly associated with child oppositional problems, and nominally with child conduct problems. Maternal warmth was nominally associated with child oppositional and conduct problems. These associations were independent of maternal psychopathology. No longitudinal associations were found between EE at baseline and child psychopathology at follow-up, or child psychopathology at baseline and EE at follow-up. Conclusions The results support previous findings of cross-sectional associations between parental EE and child psychopathology. This, together with the finding that EE was not stable over six years, suggests that EE is a momentary state measure varying with contextual and developmental factors. EE does not appear to be a risk factor for later externalizing behavior in children with ADHD. PMID:24565358

  15. Combined Laparoscopic and Percutaneous Treatment of a Type II Endoleak Following Endovascular Abdominal Aortic Aneurysm Repair

    SciTech Connect

    Karkos, Christos D. Hayes, Paul D.; Lloyd, David M.; Fishwick, Guy; White, Steve A.; Quadar, Salman; Sayers, Robert D.

    2005-06-15

    We describe a novel approach in treating a persistent type II endoleak related to the inferior mesenteric artery (IMA) and the lower lumbar arteries. The endoleak failed to thrombose following percutaneous IMA coil embolization. We proceeded to one-stage laparoscopic IMA division and intra-sac thrombin injection under direct laparoscopic vision and fluroscopy. A CT scan at 1 and 7 months post-intervention showed no evidence of endoleak and the growth of the aneurysm was arrested. This combined laparoscopic and percutaneous approach may be a useful treatment option in the management of persistent complex type II endoleak. Its durability, however has yet to be defined.

  16. Optimal management of ADHD in older adults

    PubMed Central

    Torgersen, Terje; Gjervan, Bjorn; Lensing, Michael B; Rasmussen, Kirsten

    2016-01-01

    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

  17. Incidental Vocabulary Acquisition: The Effects of Task Type, Word Occurrence and Their Combination

    ERIC Educational Resources Information Center

    Laufer, Batia; Rozovski-Roitblat, Bella

    2011-01-01

    We investigated how long-term retention of new words was affected by task type, number of word occurrences in the teaching materials and the combination of the two factors. The tasks were: reading a text with occasional Focus on Form when learners used dictionaries (T+F), or reading a text with Focus on Forms, i.e. word focused exercises (T+Fs).…

  18. Effects of combination therapy with vildagliptin and valsartan in a mouse model of type 2 diabetes

    PubMed Central

    2013-01-01

    Background Dipeptidyl peptidase-4 (DPP-4) inhibitors modulate incretin hormones and exert anti-diabetic effects in type 2 diabetes mellitus. Treatment with angiotensin II type 1 receptor blockers (ARB) is a proven successful intervention for hypertension with type 2 diabetes. The present study investigated the combined effects of the DPP-4 inhibitor vildagliptin and the ARB valsartan in a mouse model of type 2 diabetes. Methods C57BL/6 J mice fed with high-fat diet (HFD) or db/db mice were treated with placebo, phloridzin (PHZ), vildagliptin alone (ViL), valsartan alone (VaL) or ViL with VaL (ViLVaL) for 8 weeks. Results Glucose metabolism was improved in response to PHZ, ViL and ViLVaL in both HFD and db/db mice. Upon glucose challenge, ViLVaL showed the greatest suppression of blood glucose excursions, with increased insulin secretion, in db/db mice. ViLVaL treatment also showed an improvement of insulin sensitivity in db/db mice. Serum inflammatory cytokines were significantly decreased, and adiponectin was highest, in the ViLVaL group. ViLVaL improved insulin signaling and attenuated stress signaling in liver with amelioration of hepatic steatosis due to activated fatty acid oxidation in db/db mice. Furthermore, immunohistochemical analysis of the pancreas revealed that the combination treatment resulted in an increased expression of insulin and PDX-1, and increased insulin content. Conclusions The combination therapy of ViL and VaL improves both pancreatic beta-cell function and insulin sensitivity, with a reduction of the inflammatory and cell stress milieu in mouse models of T2DM. Our results suggest that this combination therapy exerts additive or even synergistic benefits to treat T2DM. PMID:24188631

  19. Developmental progression to early adult binge drinking and marijuana use from worsening versus stable trajectories of adolescent ADHD and delinquency

    PubMed Central

    Howard, Andrea L.; Molina, Brooke S. G.; Swanson, James M.; Hinshaw, Stephen P.; Belendiuk, Katherine A.; Harty, Seth C.; Arnold, L. Eugene; Abikoff, Howard B.; Hechtman, Lily; Stehli, Annamarie; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Wigal, Timothy

    2015-01-01

    Aims To examine the association between developmental trajectories of inattention, hyperactivity-impulsivity, and delinquency through childhood and adolescence (ages 8-16) and subsequent binge drinking and marijuana use in early adulthood (age 21). Design Prospective naturalistic follow-up of children with attention-deficit/hyperactivity disorder (ADHD) previously enrolled in a randomized controlled trial (RCT). Treatment-phase assessments occurred at 3, 9, and 14 months after randomization; follow-up assessments occurred at 24 months, 36 months, and 6, 8, and 12 years after randomization. Setting Secondary analysis of data from the Multimodal Treatment Study of ADHD (MTA), a multi-site RCT comparing the effects of careful medication management, intensive behavior therapy, their combination, and referral to usual community care. Participants 579 children with DSM-IV ADHD combined type, aged 7.0 and 9.9 years old at baseline (M=8.5, SD=.80). Measurements Ratings of inattention, hyperactivity-impulsivity, and delinquency were collected from multiple informants at baseline and through the 8-year follow-up. Self-reports of binge drinking and marijuana use were collected at the 12-year follow-up (M age 21). Findings Trajectories of worsening inattention symptoms and delinquency (and less apparent improvement in hyperactivity-impulsivity) were associated with higher rates of early adult binge drinking and marijuana use, compared with trajectories of stable or improving symptoms and delinquency (of 24 comparisons, 22 p-values <.05), even when symptom levels in stable trajectories were high. Conclusions Worsening inattention symptoms and delinquency during adolescence are associated with increased-levels of early adult substance use; this pattern may reflect a developmental course of vulnerability to elevated substance use in early adulthood. PMID:25664657

  20. Therapeutic outcomes of canal wall up mastoidectomy in combination with Type I tympanoplasty in otitis media

    PubMed Central

    Zhang, Liansheng

    2016-01-01

    Objective: To evaluate the therapeutic effects in terms of disease clearance and hearing improvement of canal wall up mastoidectomy in combination with Type I tympanoplasty in otitis media. Methods: A total of 78 patients (81 ears) with otitis media were treated by canal wall up mastoidectomy in combination with Type I tympanoplasty. The postoperative tympanic membrane morphology, average of pure-tone hearing thresholds and average air-bone gap were used as the indices for evaluating therapeutic effects. Results: The patients were followed up for two years in average. All the tympanic membranes recovered, with the ear canals being dry. There were five cases (5 ears) of tympanic membrane retraction and one case of otitis media recurrence. Hearing was effectively recovered by 76.54% (62/81) after surgery. Conclusion: Combining canal wall up mastoidectomy with Type I tympanoplasty can treat otitis media safely and effectively due to high postoperative dry ear canal rate, satisfactory reconstruction of hearing and maintenance of ear morphology. PMID:27375690

  1. Patient considerations in type 2 diabetes – role of combination dapagliflozin–metformin XR

    PubMed Central

    Kuecker, Catherine M; Vivian, Eva M

    2016-01-01

    Purpose The purpose of this review article is to provide guidance to health care providers regarding the use of dapagliflozin–metformin XR (extended release) as a therapeutic option for the treatment of patients with type 2 diabetes mellitus (T2DM). Methods The PubMed database was searched through August 2015 to identify clinical trials and meta-analyses evaluating the use of the sodium–glucose cotransporter type 2 inhibitor dapagliflozin administered as monotherapy or in combination with metformin. Results Fourteen studies were included for this review, six of which evaluated dapagliflozin in combination with metformin, one of which evaluated dapagliflozin monotherapy, and four of which evaluated dapagliflozin as an add-on therapy to other antidiabetic agents. The combination of dapagliflozin and metformin resulted in an A1C decrease of up to 2%, weight loss of 2–3 kg, and modest systolic blood pressure decrease of 3–5 mmHg. However, long-term effects on cancer and cardiovascular health are still being investigated. Providing patients with a fixed-dose combination therapy such as dapagliflozin-metformin XR can increase medication adherence and patient satisfaction, and improve glycemic control. Dapagliflozin–metformin XR is ideal because it can be administered orally once a day, is associated with a low risk of hypoglycemia, and provides the added benefit of weight reduction and modest blood pressure lowering. Conclusion The unique combined mechanism of action and favorable efficacy and safety profile of dapagliflozin–metformin XR support consideration of this fixed-dose combination as a treatment option for patients with T2DM. PMID:26966383

  2. The Relation Between Maternal ADHD Symptoms & Improvement in Child Behavior Following Brief Behavioral Parent Training is Mediated by Change in Negative Parenting

    PubMed Central

    Chronis-Tuscano, Andrea; O’Brien, Kelly A.; Johnston, Charlotte; Jones, Heather A.; Clarke, Tana L.; Raggi, Veronica L.; Rooney, Mary E.; Diaz, Yamalis; Pian, Jessica; Seymour, Karen E.

    2012-01-01

    This study examined the extent to which maternal attention-deficit/hyperactivity disorder (ADHD) symptoms predict improvement in child behavior following brief behavioral parent training. Change in parenting was examined as a potential mediator of the negative relationship between maternal ADHD symptoms and improvement in child behavior. Seventy mothers of 6–10 year old children with ADHD underwent a comprehensive assessment of adult ADHD prior to participating in an abbreviated parent training program. Before and after treatment, parenting was assessed via maternal reports and observations and child disruptive behavior was measured via maternal report. Controlling for pre-treatment levels, maternal ADHD symptomatology predicted post-treatment child disruptive behavior problems. The relation between maternal ADHD symptomatology and improvement in child behavior was mediated by change in observed maternal negative parenting. This study replicated findings linking maternal ADHD symptoms with attenuated child improvement following parent training, and is the first to demonstrate that negative parenting at least partially explains this relationship. Innovative approaches combining evidence-based treatment for adult ADHD with parent training may therefore be necessary for families in which both the mother and child have ADHD. Larger-scale studies using a full evidence-based parent training program are needed to replicate these findings. PMID:21537894

  3. Initial combination therapy for type 2 diabetes mellitus: is it ready for prime time?

    PubMed

    Zinman, Bernard

    2011-01-01

    The increased prevalence of type 2 diabetes mellitus is primarily being driven by the increasing global rates of overweight/obesity. Given the magnitude of this epidemic, we can expect these metabolic abnormalities to play an increasing role in the development of cardiovascular disease. In a pathophysiologic sense, type 2 diabetes is a multiorgan, multifactorial condition, characterized by β-cell dysfunction, insulin resistance in peripheral tissues and the liver, defective incretin activity, and elevated levels of free fatty acids and proinflammatory mediators. Despite the considerable burden of disease associated with type 2 diabetes, most patients are not at, or are unable to achieve, recommended glycemic control guideline targets. In part, this is because of the relentlessly progressive nature of the disease, but it may also be attributable to the current diabetes treatment paradigm, which is characterized by ineffective lifestyle interventions, followed by monotherapy and frequent early treatment failure with prolonged periods of elevated glucose as a consequence of clinical inertia. Thus, it is most appropriate to rethink the current treatment paradigm for type 2 diabetes in the context of a more aggressive initial therapy; specifically with early initiation of combination therapy. Our current understanding of the complex pathophysiology of the disease and the progressive deterioration in glycemic control over time supports the philosophy of earlier intervention with a more comprehensive initial therapy. Thus, while control of hyperglycemia remains the paramount goal, focusing on the underlying pathophysiology of type 2 diabetes is increasingly becoming the therapeutic strategy, with the aim of potentially providing disease modification. Although this is a logical approach, it remains to be demonstrated that early combination therapy will result in disease modification in a clinical setting. Not surprisingly, the incretin-based therapies have gained a great

  4. What Parents Should Know about ADHD

    ERIC Educational Resources Information Center

    Mullet, Dianna R.; Rinn, Anne N.

    2016-01-01

    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),…

  5. Decision Making in Adults with ADHD

    ERIC Educational Resources Information Center

    Montyla, Timo; Still, Johanna; Gullberg, Stina; Del Missier, Fabio

    2012-01-01

    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…

  6. An ADHD Primer. 2nd Edition

    ERIC Educational Resources Information Center

    Weyandt, Lisa L.

    2007-01-01

    Filled with current, practical, and useful information for professionals and individuals, this second edition summarizes the literature concerning ADHD across the lifespan. It offers a better understanding of the disorder by addressing the potential causes of ADHD, the developmental course, and numerous treatment approaches. The author delivers…

  7. Classroom Management and the ADHD Student

    ERIC Educational Resources Information Center

    Colberg, Laura

    2010-01-01

    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…

  8. Rethinking a Right Hemisphere Deficit in ADHD

    ERIC Educational Resources Information Center

    Hale, T. Sigi; Loo, Sandra K.; Zaidel, Eran; Hanada, Grant; Macion, James; Smalley, Susan L.

    2009-01-01

    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…

  9. Agomelatine Treatment with Adolescents with ADHD

    ERIC Educational Resources Information Center

    Niederhofer, Helmut

    2012-01-01

    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…

  10. Language Characteristics of Children with ADHD.

    ERIC Educational Resources Information Center

    Kim, Okmi H.; Kaiser, Ann P.

    2000-01-01

    Language characteristics of 11 children (ages 6-8) with attention-deficit/hyperactivity disorder (ADHD) and 11 typically developing children were compared for semantic, syntactic, and pragmatic language skills. Findings indicated no differences on receptive vocabulary, but children with ADHD performed worse on tests of expressive speech and…

  11. The Neurobiological Profile of Girls with ADHD

    PubMed Central

    Mahone, E. Mark; Wodka, Ericka L.

    2012-01-01

    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 neurobiological basis of these deficits is less consistently observed. There is growing evidence that boys’ and girls’ brains develop and mature at different rates, suggesting that the trajectory of early anomalous brain development in ADHD may also be sex-specific. It remains unclear, however, whether earlier brain maturation observed in girls with ADHD is protective. In this review, we outline the current theory and research findings that seek to establish a unique neurobiological profile of girls with ADHD, highlighting sex differences in typical brain development and among children with ADHD. The review highlights findings from neurological, neurocognitive, and behavioral studies. Future research directions are suggested, including the need for longitudinal neuroimaging and neurobehavioral investigation beginning as early as the preschool years, and continuing through adolescence and adulthood, with consideration of identified sex differences in the development of ADHD. PMID:19072756

  12. Characterizing the ADHD Phenotype for Genetic Studies

    ERIC Educational Resources Information Center

    Stevenson, Jim; Asherson, Phil; Hay, David; Levy, Florence; Swanson, Jim; Thapar, Anita; Willcutt, Erik

    2005-01-01

    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…

  13. Heart Rate and Reinforcement Sensitivity in ADHD

    ERIC Educational Resources Information Center

    Luman, Marjolein; Oosterlaan, Jaap; Hyde, Christopher; van Meel, Catharina S.; Sergeant, Joseph A.

    2007-01-01

    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)…

  14. Oppositional Defiant Disorder in Adults with ADHD

    ERIC Educational Resources Information Center

    Reimherr, Frederick W.; Marchant, Barrie K.; Olsen, John L.; Wender, Paul H.; Robison, Reid J.

    2013-01-01

    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…

  15. The Relationship between ADHD and Giftedness

    ERIC Educational Resources Information Center

    Orendorff, Kimberly A.

    2009-01-01

    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…

  16. Teacher Perceptions of Classroom Interventions for Children with ADHD: A Cross-Cultural Comparison of Teachers in the United States and New Zealand

    ERIC Educational Resources Information Center

    Curtis, David F.; Pisecco, Stewart; Hamilton, Richard J.; Moore, Dennis W.

    2006-01-01

    This investigation compared United States and New Zealand teachers' perceptions of classroom interventions for attention deficit hyperactivity disorder (ADHD). Participants read one of six vignettes describing a child with symptoms representative of ADHD. The number and type of symptoms were consistent across all vignettes. Next, teachers read a…

  17. [Correction of dyslipidemia in patients with chronic hepatitis C, combined with diabetes type 2].

    PubMed

    Derbak, M; Boldizhar, P

    2014-01-01

    The article shows the results of treatment of 118 patients with chronic hepatitis C (CHC) which is associated with type 2 diabetes mellitus (DM). When planning therapeutic interventions in chronic hepatitis C in patients with diabetes, it is considered the presence of visceral obesit , dyslipidemia, and hepatic steatosis. The efficacy of different treatment regimens was studied. Found that the usage of ursodeoxycholic acid and ademetionin in HCV patients with diabetes type 2 receiving standard antiviral therapy (SAVT), significantly make a positive effect on the level of dyslipidemia. The normalization of lipid profile allows for a full course of SAVT, which reduces the frequency of relapse. It is also noted that the simultaneous use of ademetionin and ursodeoxycholic acid in treatment of chronic hepatitis C leads to a reduction of side effects of SAVT. Metabolic therapy may be recommended for patients with chronic hepatitis C in combination with type 2 diabetes in case of SAVT, and at its contraindications or intolerance. PMID:24523328

  18. Potential of infrared spectroscopy in combination with extended canonical variate analysis for identifying different paper types

    NASA Astrophysics Data System (ADS)

    Riba, Jordi-Roger; Canals, Trini; Cantero, Rosa; Iturriaga, Hortensia

    2011-02-01

    The increasing use of secondary fiber in papermaking has led to the production of paper containing a wide range of contaminants. Wastepaper mills need to develop quality control methods for evaluating the incoming wastepaper stock as well as testing the specifications of the final product. The goal of this work is to present a fast and successful methodology for identifying different paper types. In this way, undesirable paper types can be refused, thus improving the runnability of the paper machine and the quality of the paper manufactured. In this work we examine various types of paper using information obtained by an appropriate chemometric treatment of infrared spectral data. For this purpose, we studied a large number of paper sheets of three different types (namely coated, offset and cast-coated) supplied by several paper manufacturers. We recorded Fourier transform infrared (FTIR) spectra with the aid of an attenuated total reflectance (ATR) module and near-infrared (NIR) reflectance spectra by means of fiber optics. Both techniques proved expeditious and required no sample pretreatment. The primary objective of this work was to develop a methodology for the accurate identification of samples of different paper types. For this purpose, we used the chemometric discrimination technique extended canonical variate analysis (ECVA) in combination with the k nearest neighbor (kNN) method to classify samples in the prediction set. Use of the NIR and FTIR techniques under these conditions allowed paper types to be identified with 100% success in prediction samples.

  19. Combining artificial neural networks and circulation type classification: does it improve downscaling models?

    NASA Astrophysics Data System (ADS)

    Philipp, Andreas; Beck, Christoph; Kaspar, Severin; Jacobeit, Jucundus

    2014-05-01

    Circulation type classifications may be used for downscaling in so called reference class forecasting (RCF), i.e. to to assign atmospheric circulation predictors to a certain type of a circulation type classification and use the value for the target variable associated with this type in the past as a model value. Doing so often already leads to useful statistical assessment models. However a generally superior method is that of artificial neural networks (NNW). Using adequate configuration, the latter are able to outperform the RCF method in virtually all cases. However the adequate configuration of NNWs is often not easy to decide and the training of the network weights may be an extensive and slow process while RCF is relatively fast. In the context of a starting project dealing with alpine climate change studies (Virtual Alpine Observatory II, VAO2), this study evaluates if a combination of both statistical approaches (called neural networks of classification types, NNC) may lead to an improvement for statistical downscaling. Preliminary results suggest that the gain in skill and the computational speed for the network training largely depends on the configuration of both: the circulation type classification and the network configuration regarding, topology, learning rate, predictors and so on. In this context it is important to consider the evolution of the learning process, where sometimes the NNW is superior and sometimes the NNC.

  20. Combination therapy of dipeptidyl peptidase-4 inhibitors and metformin in type 2 diabetes: rationale and evidence.

    PubMed

    Liu, Y; Hong, T

    2014-02-01

    The main pathogenesis of type 2 diabetes mellitus (T2DM) includes insulin resistance and pancreatic islet dysfunction. Metformin, which attenuates insulin resistance, has been recommended as the first-line antidiabetic medication. Dipeptidyl peptidase-4 (DPP-4) inhibitors are novel oral hypoglycaemic agents that protect glucagon-like peptide-1 (GLP-1) from degradation, maintain the bioactivity of endogenous GLP-1, and thus improve islet dysfunction. Results from clinical trials have shown that the combination therapy of DPP-4 inhibitors and metformin [as an add-on, an initial combination or a fixed-dose combination (FDC)] provides excellent efficacy and safety in patients with T2DM. Moreover, recent studies have suggested that metformin enhances the biological effect of GLP-1 by increasing GLP-1 secretion, suppressing activity of DPP-4 and upregulating the expression of GLP-1 receptor in pancreatic β-cells. Conversely, DPP-4 inhibitors have a favourable effect on insulin sensitivity in patients with T2DM. Therefore, the combination of DPP-4 inhibitors and metformin provides an additive or even synergistic effect on metabolic control in patients with T2DM. This article provides an overview of clinical evidence and discusses the rationale for the combination therapy of DPP-4 inhibitors and metformin. PMID:23668534

  1. Reexamining the Familial Association between Asthma and ADHD in Girls

    ERIC Educational Resources Information Center

    Hammerness, Paul; Monuteaux, Michael C.; Faraone, Stephen V.; Gallo, Lauren; Murphy, Heather; Biederman, Joseph

    2005-01-01

    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…

  2. Giftedness and ADHD: Identification, Misdiagnosis, and Dual Diagnosis

    ERIC Educational Resources Information Center

    Mullet, Dianna R.; Rinn, Anne N.

    2015-01-01

    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…

  3. ADHD Symptomology and Impairment: Relevance to Postsecondary Education

    ERIC Educational Resources Information Center

    Jansen, Joy

    2010-01-01

    ADHD is a pervasive and persistent condition which continues into adulthood with a prevalence rate of 5%. Research demonstrates that 2% to 4% of the college learner population is affected by ADHD and, interestingly enough, ADHD symptomology prevalence rates have been shown to be higher than expected within the general college population. ADHD is a…

  4. The Academic Experience of Male High School Students with ADHD

    ERIC Educational Resources Information Center

    Kent, Kristine M.; Pelham, William E.; Molina, Brooke S. G.; Sibley, Margaret H.; Waschbusch, Daniel A.; Yu, Jihnhee; Gnagy, Elizabeth M.; Biswas, Aparajita; Babinski, Dara E.; Karch, Kathryn M.

    2011-01-01

    This study compared the high school academic experience of adolescents with and without childhood ADHD using data from the Pittsburgh ADHD Longitudinal Study (PALS). Participants were 326 males with childhood ADHD and 213 demographically similar males without ADHD who were recruited at the start of the follow-up study. Data were collected yearly…

  5. Retrospective Reports of Childhood Trauma in Adults with ADHD

    ERIC Educational Resources Information Center

    Rucklidge, Julia J.; Brown, Deborah L.; Crawford, Susan; Kaplan, Bonnie J.

    2006-01-01

    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…

  6. Sustained and Focused Attention Deficits in Adult ADHD

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  7. Comorbidity and Phenomenology of Bipolar Disorder in Children with ADHD

    ERIC Educational Resources Information Center

    Serrano, Eduardo; Ezpeleta, Lourdes; Castro-Fornieles, Josefina

    2013-01-01

    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…

  8. Iron and ADHD: Time to Move beyond Serum Ferritin Levels

    ERIC Educational Resources Information Center

    Donfrancesco, Renato; Parisi, Pasquale; Vanacore, Nicola; Martines, Francesca; Sargentini, Vittorio; Cortese, Samuele

    2013-01-01

    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…

  9. Mapping a Type 1 FHB resistance on chromosome 4AS of Triticum macha and deployment in combination with two Type 2 resistances.

    PubMed

    Burt, C; Steed, A; Gosman, N; Lemmens, M; Bird, N; Ramirez-Gonzalez, R; Holdgate, S; Nicholson, P

    2015-09-01

    Markers closely flanking a Type 1 FHB resistance have been produced and the potential of combining this with Type 2 resistances to improve control of FHB has been demonstrated. Two categories of resistance to Fusarium head blight (FHB) in wheat are generally recognised: resistance to initial infection (Type 1) and resistance to spread within the head (Type 2). While numerous sources of Type 2 resistance have been reported, relatively fewer Type 1 resistances have been characterised. Previous study identified a Type 1 FHB resistance (QFhs.jic-4AS) on chromosome 4A in Triticum macha. Little is known about the effect of combining Type 1 and Type 2 resistances on overall FHB symptoms or accumulation of the mycotoxin deoxynivalenol (DON). QFhs.jic-4AS was combined independently with two Type 2 FHB resistances (Fhb1 and one associated with the 1BL/1RS translocation). While combining Type 1 and Type 2 resistances generally reduced visual symptom development, the effect on DON accumulation was marginal. A lack of polymorphic markers and a limited number of recombinants had originally prevented accurate mapping of the QFhs.jic-4AS resistance. Using an array of recently produced markers in combination with new populations, the position of QFhs.jic-4AS has been determined to allow this resistance to be followed in breeding programmes. PMID:26040404

  10. Combined Interventional and Surgical Treatment for Acute Aortic Type A Dissection

    SciTech Connect

    Liu Jincheng; Zhang Jinzhou Yang Jian; Zuo Jian; Zhang Jinbao; Yu Shiqiang; Chen Tao; Xu Xuezeng; Wei Xufeng; Yi Dinghua

    2008-07-15

    Surgical repair and endovascular stent-graft placement are both therapies for thoracic aortic dissection. A combination of these two approaches may be effective in patients with type A dissection. In this study, we evaluated the prognosis of this combined technique. From December 2003 to December 2006, 15 patients with type A dissection were admitted to our institute; clinical data were retrospectively reviewed. Follow-up was performed at discharge and approximately 12 months after operation. Endovascular stent-graft placement by interventional radiology and surgical repair for reconstruction of aortic arch was performed in all patients. Total arch replacement for distal arch aneurysm was carried out under deep hypothermia with circulatory arrest; antegrade-selected cerebral perfusion was used for brain protection. Four patients concomitantly received a coronary artery bypass graft. Hospital mortality rate was 6.7%; the patient died of cerebral infarction. Neurological complications developed in two patients. Multi-detector-row computed tomography scans performed before discharge revealed complete thrombosis of the false lumen in six patients and partial thrombosis in eight patients. At the follow-up examination, complete thrombosis was found in another three patients, aortic rupture, endoleaks, or migration of the stent-graft was not observed and injuries of peripheral organs or anastomotic endoleaks did not occur. For patients with aortic type A dissection, combining intervention and surgical procedures is feasible, and complete or at least partial thrombosis of the false lumen in the descending aorta can be achieved. This combined approach simplified the surgical procedures and shortened the circulatory arrest time, minimizing the necessity for further aortic operation.

  11. Combined effect of temperature and zinc on Caenorhabditis elegans wild type and daf-21 mutant strains.

    PubMed

    Wang, Yunbiao; Ezemaduka, Anastasia N

    2014-04-01

    Heavy metal pollution in aquatic ecosystems is a far reaching environmental problem. The possible influences of heavy metal exposure and the potential harm to organisms when combined with other environmental stressors such as temperature have been largely unexplored. An aquatic toxicity test of Caenorhabditis elegans was performed to estimate the 24h median lethal concentration (LC50) of different zinc concentrations at different temperatures (15°C, 20°C, 25°C, and 30°C). We also examined the time course thermotolerance on wild type (N2) and daf-21 null (JT6130) adults exposed to 6.1mM zinc at 37°C. Hsp90 protein expression level in response to the combined effect of temperature and zinc toxicity was also investigated by both Western blots and ELISA. Our results show that C. elegans wild type nematodes exhibit severe lethal toxicity after a 24h exposure to zinc at higher temperatures. In addition, the expression level of Hsp90 was highly inhibited in adult worms subjected to zinc stress. This toxicity assay at different temperatures provides insight into organism response to combined effects of temperature and zinc toxicity. PMID:24679967

  12. Evaluation of underlying mechanisms in the link between childhood ADHD symptoms and risk for early initiation of substance use.

    PubMed

    Vitulano, Michael L; Fite, Paula J; Hopko, Derek R; Lochman, John; Wells, Karen; Asif, Irfan

    2014-09-01

    Although there has been support for attention-deficit/hyperactivity disorder (ADHD) as a risk for early substance use, this link is not fully established or understood. Furthermore, the potential mechanisms explaining these associations are unclear. The current study examined peer rejection, school bonding, and internalizing problems as potential mediators of the association between childhood ADHD symptoms and risk for early initiation of substance use. The sample included a control group of 126 students with problematic aggression (79% African American, 66% male) from an intervention study following children from fourth to ninth grade. Results suggested that ADHD symptoms follow a path to early initiation of tobacco use through the combined effects of peer rejection and internalizing problems as well as through internalizing problems alone. ADHD symptoms were also associated with the cubic slope of marijuana use initiation, such that increased ADHD symptoms were associated with a strong cubic trend (e.g., a more rapid acceleration of risk for initiation). ADHD symptoms were not associated with risk for early initiation of alcohol use. Identification of important vulnerability factors in children with ADHD symptoms highlight the need for primary prevention and psychological interventions that target these factors and decrease the likelihood of early tobacco and marijuana use initiation. PMID:25222174

  13. Effects of behavioral and pharmacological therapies on peer reinforcement of deviancy in children with ADHD-only, ADHD and conduct problems, and controls

    PubMed Central

    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.

    2015-01-01

    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

  14. Novel Low Fluence Combination Laser Treatment of Solar Lentigines in Type III Asian Skin

    PubMed Central

    Tian, Brian Wei Cheng Anthony

    2015-01-01

    Objective: To demonstrate a novel low fluence combination laser technique [Erbium-doped yttrium aluminum garnet (Erb:YAG) and neodymium-doped yttrium aluminum garnet (Nd:YAG)] to effectively treat solar lentigines in type III Asian skin in a single session. Design: A prospective study. Setting: A Singapore-based clinic. Participants: Five patients (all females) were enrolled into the study. The ages ranged 35-60 years; all patients had Fitzpatrick skin type III. Measurements: Photographs were taken at baseline and at 1-month follow-up. These were reviewed by two independent physicians who were blinded to the study. Changes in pigment severity were assessed by a 5-point scale (1: Aggravation of pigment, 2: No change, 3: 25-50% improvement, 4: 51-75% improvement, and 5: 76-100% improvement). Results: All patients received a single treatment session. At 1-month follow-up, a reduction in pigment was observed in all patients. Both physicians’ reports were independently agreeable. All patients scored 5, having >90% improvement in pigment severity. No hypopigmentation, postinflammatory hyperpigmentation (PIH), or recurrence was seen. Conclusion: Low fluence combination laser is effective and safe for clearance of solar lentigines in type III Asian skin. PMID:26865789

  15. Options for empagliflozin in combination therapy in type 2 diabetes mellitus

    PubMed Central

    Hershon, Kenneth S

    2016-01-01

    Objective To update clinicians with an overview of empagliflozin for the treatment of type 2 diabetes mellitus (T2DM), with focus on use in combination regimens. Methods Keyword searches were conducted in the Medline database to identify literature reporting clinical trials of at least 12 weeks’ duration using empagliflozin treatment in patients with T2DM. Results When given as monotherapy or in combination therapy (as add-on or single-pill therapy) with metformin, pioglitazone, sulfonylurea, linagliptin, and insulin, empagliflozin produced clinically meaningful reductions in glycated hemoglobin levels, plasma glucose concentrations, bodyweight, and blood pressure. These changes were sustained during long-term treatment. In a dedicated cardiovascular event trial, empagliflozin on top of standard of care demonstrated a significant reduction in the risk of cardiovascular mortality and all-cause mortality. Across the clinical trials, empagliflozin combination therapies were well tolerated, and empagliflozin used alone was not associated with increased risk of hypoglycemia versus placebo. Indeed, the combination of empagliflozin and metformin had a significantly reduced rate of hypoglycemia compared with the combination of metformin and a sulfonylurea. On the other hand, empagliflozin treatment did have increased risk of genital infections compared with placebo. In clinical trials to date, diabetic ketoacidosis was not seen more frequently with empagliflozin than with placebo, but physicians should be alert to the possibility of this rare event. Conclusion Empagliflozin has the potential to make an important contribution to the treatment of patients with T2DM. In some patients, empagliflozin may be used as monotherapy, but it is most likely to be used in combination with other therapies. Given the reduced risk of mortality seen when empagliflozin was added to standard care in patients at high cardiovascular risk, as well as the lack of alternative options for

  16. Combination of Vildagliptin and Pioglitazone in Experimental Type 2 Diabetes in Male Rats.

    PubMed

    Refaat, Rowaida; Sakr, Ahmed; Salama, Mona; El Sarha, Ashgan

    2016-09-01

    Preclinical Research The majority of studies on vildagliptin and pioglitazone have focused on their combination in glycemic control. The aim of the present study was to investigate their effects in combination on (i) hyperglycemia-induced oxidative stress and inflammation and (ii) on organs involved in the pathophysiology of diabetes, pancreas, kidney and liver. Type 2 diabetes was induced using low-dose streptozotocin in male Wistar rats. Diabetic rats were treated for 4 weeks, with vildagliptin (10 mg/kg/day), pioglitazone (10 mg/kg/day) and their combination. Diabetic rats showed elevated fasting serum glucose, fasting serum insulin, serum transaminases together with a deleterious lipid profile and elevated serum creatinine and urea concentrations. Serum levels of the inflammatory markers tumor necrosis factor-α (TNF-α) and nitrite/nitrate were also elevated compared to normal rats. Oxidative stress was manifested by lowered hepatic reduced glutathione (GSH) and increased malondialdehyde (MDA) levels. Pancreatic sections from diabetic rats showed degenerated islets with poorly maintained architecture that was prevented by drug treatment. Pioglitazone was generally more effective than vildagliptin in the studied parameters except for the lipid profile where the effect of both drugs was comparable and for the liver enzymes and renal parameters where vildagliptin was more effective. The combination of vildagliptin and pioglitazone produced superior effects than either drug alone. Drug Dev Res 77 : 251-257, 2016. © 2016 Wiley Periodicals, Inc. PMID:27520857

  17. Torque Characteristics Simulation on Small Scale Combined Type Vertical Axis Wind Turbine

    NASA Astrophysics Data System (ADS)

    Feng, Fang; Li, Shengmao; Li, Yan; Xu, Dan

    The straight-bladed vertical axis wind turbine (SB-VAWT) receives more attentions recently for its goodness of simple design, low cost and good maintenance. However, its starting performance is poor. To increase its starting torque, Savonius rotor was combined on the SB-VAWT in this study because Savonius rotor has good starting torque coefficient. Based on the wind tunnel tests data, a small scaled combined type SB-VAWT (CSB-VAWT) which has 50W rated power output was designed. The starting torque coefficient, dynamic torque and power performance were analyzed. Both the starting and dynamic torque performance of the CSB-VAWT have been greatly improved according to the simulation results.

  18. Commentary: Switching the zoom on the ADHD research lens - a reflection on Leventakou et al. (2016).

    PubMed

    Cortese, Samuele

    2016-06-01

    The study by Leventakou and colleagues is emblematic of a welcome change in focus in attention-deficit/hyperactivity disorder (ADHD) research. First, the authors focused on the overlooked association between ADHD and aberrant eating patterns, reflecting an emerging change in the conceptualization of ADHD as a condition affecting not only high-level cognitive processes but also more basic functions such as eating and sleeping, as well as the underlying complex metabolic and possibly inflammatory pathways. Second, the authors focused, for the first time, on the relationship between ADHD and eating disorders in preschoolers, which is of relevance for the design of preventive strategies. Third, they zoomed closely to several types of aberrant eating behaviours; besides confirming the association of ADHD symptoms to emotional overeating, they also found an intriguing relationship between impulsivity and food fussiness. Further changes in perspective focusing on the underlying mechanisms, as well as using a wide-angle lens to capture the longitudinal relationship between ADHD and aberrant eating behaviours will not only provide a more detailed (clinical) picture of individuals with ADHD but will also hopefully lead to more effective preventive/treatment strategies. PMID:27192953

  19. What can ADHD without comorbidity teach us about comorbidity?

    PubMed

    Takeda, Toshinobu; Ambrosini, Paul J; deBerardinis, Rachel; Elia, Josephine

    2012-01-01

    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, gender, IQ, SES and ADHD symptoms were compared among ADHD comorbid free subjects and ADHD with internalizing and externalizing disorders. Logistic regression analyses were also carried out to investigate the relationship between comorbidity and parental psychiatric status. Age range was younger in the ADHD without comorbidity and older in ADHD+internalizing disorders. No significant difference in IQ or SES was found among ADHD comorbid and comorbid-free groups. ADHD with internalizing disorder has a significantly greater association with paternal psychiatric conditions. After matching by age, gender, IQ and SES, ADHD with externalizing disorders had significantly higher total ADHD, hyperactivity/impulsivity score and single item score of difficulty awaiting turn than ADHD without comorbidity and ADHD with internalizing disorders. Older age ranges, ADHD symptom severity and parental psychopathology may be risk factors for comorbidity. PMID:22119689

  20. [WPW syndrome combined with AV block 2 in an adult with glycogenosis (Type II)].

    PubMed

    Francesconi, M; Auff, E; Ursin, C; Sluga, E

    1982-08-01

    A 31 year-old female with a five year history of muscle weakness, cardiac palpitations and elevation of activity of some serum enzymes of muscular origin, showed signs of the WPW syndrome on ECG, often in combination with grade 2 A-V block. Type II glycogenosis (Pompe's disease) was diagnosed on the basis of the results of physical examination, laboratory findings--especially subtotal deficiency of acid maltase (a-1,4 glucosidase) activity-and morphological aspects of light and electron microscopy of a quadriceps muscle biopsy specimen. To our knowledge the coincidence of such a rarely encountered arrhythmia with glycogenosis type II in an adult has never been reported so far. PMID:6959422

  1. Inflammation: good or bad for ADHD?

    PubMed

    Donev, Rossen; Thome, Johannes

    2010-12-01

    Attention deficit hyperactivity disorder (ADHD) is characterised by the typical behavioural core symptoms of inattentiveness, hyperactivity and impulsiveness. ADHD is a usually chronic health conditions, mostly diagnosed in childhood, creating a significant challenge for youth, their families and professionals who treat it. This disorder requires long-term treatments, including psychotherapeutic and pharmacological interventions, which in some cases may lead to adverse effects. Understanding the mechanism by which ADHD risk factors affect the biochemical processes in the human brain and consequentially the behaviour will help to identify novel targets for the development of therapeutics with less adverse results and better efficacy including higher responder rates. Although inflammatory responses in the brain have been recognised for years as critical in neurodegeneration and behaviour in a number of neurological and psychiatric disorders, their role for the development, treatment and prevention of ADHD has been so far largely overlooked, although historically, ADHD symptoms were initially observed in patients who survived an ONJ infection, i.e. inflammation. In this review, we discuss the interrelationship between different ADHD risk factors and inflammation with respect to the triggered molecular mechanisms and the contribution they are likely to have to this disorder. This paper provides a rationale for future studies on ADHD with an intent to inspiring the development of new agents for a more efficient management of this disorder. PMID:21432611

  2. Are There Executive Dysfunction Subtypes Within ADHD?

    PubMed

    Roberts, Bethan A; Martel, Michelle M; Nigg, Joel T

    2013-11-01

    Objective: Children with ADHD have heterogeneous behavioral and neuropsychological profiles. The aim of this study was to examine the possible utility of executive function (EF) subtypes within ADHD. Method: Participants were 357 children aged 6 through 13 with a diagnosis of ADHD. Children completed a brief laboratory battery measuring EF, including response inhibition, response variability, speed, and set-shifting. Children also completed standardized intelligence and achievement testing. Results: Two-way cluster analysis of EF profiles of children with ADHD produced a three-cluster solution, labeled poor inhibitory control, poor set-shifting/speed, and intact task performance. Clusters significantly differed in measures of intelligence, academic achievement, and other disruptive behavior and anxiety/mood symptoms. Conclusion: These findings further support the idea that children with ADHD have heterogeneous EF profiles and suggest that the theory of ADHD should consider these individual differences in EF profiles within the ADHD diagnostic category. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24214969

  3. [Differential Diagnosis of ADHD from Personality Disorders].

    PubMed

    Ushijima, Sadanobu

    2015-01-01

    The author discussed some points regarding the process of differentially diagnosing ADHD from antisocial personality disorder with antisocial behaviors, such as the use of amphetamines, theft, and violence, and borderline personality disorder with eating disorder, self-harming, overdose, and domestic violence. Firstly, the characteristics of ADHD are a lack of interest in criminal activity, cunning, cruelty, or coming from a broken home, which are frequently observed in cases of conduct disorder. The second point concerns the main anxieties and conflicts of those with ADHD and borderline personality disorder. ADHD patients usually do not have anxieties regarding sensitiveness in interpersonal relationships, which borderline patients are likely to have. The characteristic anxieties of ADHD patients usually involve self-reproach, self-deprecation, and self-hatred derived from various kinds of mistake associated with ADHD symptoms, such as a short attention span, restlessness, and impulsiveness. Finally, the author points out that we also have to be aware of the various kinds of identity problem, even in the case of patients with typical symptoms of ADHD. PMID:26721071

  4. Identifying Unique Versus Shared Pre- and Perinatal Risk Factors for ASD and ADHD Using a Simplex-Multiplex Stratification.

    PubMed

    Oerlemans, Anoek M; Burmanje, Marlot J; Franke, Barbara; Buitelaar, Jan K; Hartman, Catharina A; Rommelse, Nanda N J

    2016-07-01

    Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) frequently co-occur. Besides shared genetic factors, pre- and perinatal risk factors (PPFs) may determine if ASD, ADHD, or the combination of both disorders becomes manifest. This study aimed to test shared and unique involvement of PPFs for ASD and ADHD, using an approach that stratifies the sample into affected/unaffected offspring and single-incidence (SPX) versus multi-incidence (MPX) families. Pre- perinatal data based on retrospective parent-report were collected in 288 children (71 % males) from 31 SPX and 59 MPX ASD families, 476 children (65 % males) from 31 SPX and 171 MPX ADHD families, and 408 control children (42 % males). Except for large family size and more firstborns amongst affected offspring, no shared PFFs were identified for ASD and ADHD. PPFs predominantly related to ASD (maternal infections and suboptimal condition at birth) were more often reported in affected than unaffected siblings. PPFs associated with ADHD (low parental age, maternal diseases, smoking and stress) were shared between affected and unaffected siblings. Firstborn-ship was more frequent in SPX than MPX ASD probands. Our results suggest that the co-morbidity of ASD and ADHD is not likely explained by shared PPFs. Instead, PPFs might play a crucial role in the developmental pathways leading up to either disorder. PPFs in ADHD appear to index an increased shared risk, whereas in ASD PPFs possibly have a more determining role in the disorder. SPX-MPX stratification detected possible etiological differences in ASD families, but provided no deeper insight in the role of PPFs in ADHD. PMID:26466830

  5. Clinical Considerations for Use of Initial Combination Therapy in Type 2 Diabetes.

    PubMed

    Cahn, Avivit; Cefalu, William T

    2016-08-01

    Type 2 diabetes is a progressive disorder characterized by increasing hyperglycemia and the need to gradually intensify therapy in order to achieve and maintain glycemic control. Early initiation of combination therapy has been proposed as an approach to achieve glycemic goals earlier and delay the deterioration of glycemic control and with possible better preservation of β-cell function. We discuss in this article the pros and cons of this approach, focusing on individuals with HbA1c at diagnosis of 7.5-9.0%, where difference of opinion still exists on management. Initial combination therapy is proposed to lead to better and faster achievement of glycemic targets versus monotherapy and to impede clinical inertia and may possibly slow the deterioration of β-cell function. However, treating patients with sequential therapy is proposed to allow one to fully assess the efficacy and risk-to-benefit ratio of each drug as it is added. Furthermore, there is no evidence to support that rapid addition and titration of medications according to the glycemic profile achieved are inferior to initial combination therapy if glycemic targets are attained in a timely manner. Initial combination therapy is argued to postpone clinical inertia to the next decision point but does not eliminate it. Additionally, it may have been the agents chosen and not the timing of their initiation that led to improved β-cell function in the studies of initial combination therapy, and there are no data currently comparing use of the same drugs initiated simultaneously or sequentially. Heightened awareness of providers, individualization of therapy and setting, and reaching glycemic targets remain the mainstays of care. PMID:27440826

  6. A Type A and Type D Combined Personality Typology in Essential Hypertension and Acute Coronary Syndrome Patients: Associations with Demographic, Psychological, Clinical, and Lifestyle Indicators.

    PubMed

    Steca, Patrizia; D'Addario, Marco; Magrin, Maria Elena; Miglioretti, Massimo; Monzani, Dario; Pancani, Luca; Sarini, Marcello; Scrignaro, Marta; Vecchio, Luca; Fattirolli, Francesco; Giannattasio, Cristina; Cesana, Francesca; Riccobono, Salvatore Pio; Greco, Andrea

    2016-01-01

    Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs), but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men). Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed. PMID:27589065

  7. ADHD Symptoms, Autistic Traits, and Substance Use and Misuse in Adult Australian Twins

    PubMed Central

    De Alwis, Duneesha; Agrawal, Arpana; Reiersen, Angela M; Constantino, John N; Henders, Anjali; Martin, Nicholas G; Lynskey, Michael T

    2014-01-01

    Objective: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder frequently co-occur. Several studies show increased risk of substance use disorders in ADHD, yet there is limited information related to how ADHD symptoms, autistic traits, and their combined effects are associated with nicotine, alcohol, and cannabis use and use disorders in the general population. Method: Cross-sectional interview and self-report questionnaire data from 3,080 young adult Australian twins (mean age 31.9 years) were used to assess ADHD symptoms, autistic traits, substance use, and substance use disorders. Substance use disorders—based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria—were assessed in the full sample as well as in those who reported substance use. Logistic regression analyses were used for comparing the associations between ADHD symptoms, autistic traits, substance use, and substance misuse after conduct disorder, sex, age, and zygosity were controlled for. Results: Greater ADHD symptoms and autistic traits scores were associated with elevated levels of regular smoking; cannabis use; and nicotine, alcohol, and cannabis use disorders, even after conduct disorder was adjusted for. In contrast, for alcohol use, those with high autistic traits scores were less likely to report drinking to intoxication. However, upon initiation, and similar to the findings for nicotine and cannabis, they were at elevated risk for developing alcohol dependence. Conclusions: Increased liability to ADHD and elevated autistic traits scores were associated with substance use and misuse, with the exception of alcohol use. Given the social underpinnings of drinking, persons with autistic traits may be less likely to engage in it; however, upon engagement in drinking, their vulnerability to alcohol dependence is elevated. PMID:24650814

  8. The Impact of Gestational Thyroid Hormone Concentrations on ADHD Symptoms of the Child

    PubMed Central

    Päkkilä, Fanni; Männistö, Tuija; Pouta, Anneli; Hartikainen, Anna-Liisa; Ruokonen, Aimo; Surcel, Heljä-Marja; Bloigu, Aini; Vääräsmäki, Marja; Järvelin, Marjo-Riitta; Moilanen, Irma

    2014-01-01

    Context: Maternal hypothyroidism during pregnancy is associated with adverse neuropsychological development in the offspring. Objective: The objective of the study was to evaluate the effect of maternal thyroid dysfunction during pregnancy on a child's attention-deficit/hyperactivity disorder (ADHD) symptoms. Design, Settings, and Participants: The prospective, population-based Northern Finland Birth Cohort 1986 (9362 pregnancies; 9479 infants) included analysis of maternal TSH, free T4, and thyroid-peroxidase antibodies (TPO-Abs) from early pregnancy samples (5791 women). Teachers evaluated the children's ADHD symptoms at 8 years using the Rutter B2 scale (5131 mother-child pairs), in which a high score indicated probable psychiatric disorders and three questions focused directly on ADHD. Main outcome measures: The odds ratios (ORs) and 95% confidence intervals (95% CIs) of child having ADHD symptoms and/or a high Rutter B2 score after exposure to increases in maternal TSH levels (after logarithmic transformation), low free T4 levels, and TPO-Ab positivity was tested with logistic regression, adjusting for maternal/family covariates. Data were stratified by the child's gender due to interaction. Results: Among girls the odds of inattention (OR 1.18, 95% CI 1.02–1.37), high Rutter B2 total score (OR 1.23, 95% CI 1.03–1.48), and combined ADHD symptoms (OR 1.39, 95% CI 1.07–1.80) significantly increased with every natural log increase in maternal TSH concentrations. Such findings were not evident in boys. No associations were seen between ADHD symptoms and low maternal free T4 levels or TPO-Ab positivity. Conclusions: Increases in maternal TSH in early pregnancy showed weak but significant association with girls' ADHD symptoms. PMID:24384024

  9. Abnormal Parietal Brain Function in ADHD: Replication and Extension of Previous EEG Beta Asymmetry Findings

    PubMed Central

    Hale, T. Sigi; Kane, Andrea M.; Tung, Kelly L.; Kaminsky, Olivia; McGough, James J.; Hanada, Grant; Loo, Sandra K.

    2014-01-01

    Background: Abundant work indicates ADHD abnormal posterior brain structure and function, including abnormal structural and functional asymmetries and reduced corpus callosum size. However, this literature has attracted considerably less research interest than fronto-striatal findings. Objective: To help address this imbalance, the current study replicates and extends our previous work showing abnormal parietal brain function in ADHD adults during the Conner’s Continuous Performance Test (CPT). Method: Our previous study found that ADHD adults had increased rightward EEG beta (16–21 Hz) asymmetry in inferior parietal brain regions during the CPT (p = 0.00001), and that this metric exhibited a lack of normal correlation (i.e., observed in controls) with beta asymmetry at temporal–parietal regions. We re-tested these effects in a new ADHD sample and with both new and old samples combined. We additionally examined: (a) EEG asymmetry in multiple frequency bands, (b) unilateral effects for all asymmetry findings, and (c) the association between EEG asymmetry and a battery of cognitive tests. Results: We replicated our original findings by demonstrating abnormal rightward inferior parietal beta asymmetry in adults with ADHD during the CPT, and again this metric exhibited abnormal reduced correlation to temporal–parietal beta asymmetry. Novel analyses also demonstrated a broader pattern of rightward beta and theta asymmetry across inferior, superior, and temporal–parietal brain regions, and showed that rightward parietal asymmetry in ADHD was atypically associated with multiple cognitive tests. Conclusion: Abnormal increased rightward parietal EEG beta asymmetry is an important feature of ADHD. We speculate that this phenotype may occur with any form of impaired capacity for top-down task-directed control over sensory encoding functions, and that it may reflect associated increase of attentional shifting and compensatory sustained/selective attention. PMID

  10. Attention-Deficit/Hyperactivity Disorder (ADHD) in Adulthood: Concordance and Differences between Self- and Informant Perspectives on Symptoms and Functional Impairment

    PubMed Central

    Mörstedt, Beatrice; Corbisiero, Salvatore; Bitto, Hannes; Stieglitz, Rolf-Dieter

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a severe mental illness, associated with major impairment and a high comorbidity rate. Particularly undiagnosed ADHD in adulthood has serious consequences. Thus, a valid diagnosis is important. In adulthood, the diagnostic process for ADHD is complicated: symptoms may overlap with comorbid disorders, and the onset and progression of the disorder must be reconstructed retrospectively. Guidelines for the diagnostic process recommend the inclusion of additional informant ratings. Research into the relation between self- and informant ratings shows extremely heterogeneous results. The levels of agreement range from low to high. The focus of this study is the concordance and differences between self- and informant ratings on ADHD symptoms and impairments. In this regard, two possible influencing factors (gender and relationship type) are also examined. 114 people participated in this study, 77 with an ADHD diagnosis and 37 without a diagnosis. For all participants, either parents or partners also rated ADHD symptoms and impairments. Small to moderate concordance was found between self- and informant ratings, with females being slightly more concordant than males, particularly for ratings of problems with self-concept. Examination of the consistency within a particular perspective showed that people with ADHD seemed to be unaware of the causal relation between ADHD symptoms and their impairments. A close investigation found almost no influence of gender and relationship type on differences within perspectives. Based on these results, the implications for the diagnostic process are that additional informant information is clearly necessary and helpful. PMID:26529403

  11. Summer treatment programs for youth with ADHD.

    PubMed

    Fabiano, Gregory A; Schatz, Nicole K; Pelham, William E

    2014-10-01

    Children with attention-deficit/hyperactivity disorder (ADHD) require intensive treatments to remediate functional impairments and promote the development of adaptive skills. The summer treatment program (STP) is an exemplar of intensive treatment of ADHD. STP intervention components include a reward and response-cost point system, time-out, use of antecedent control (clear commands, establishment of rules and routines), and liberal praise and rewards for appropriate behavior. Parents also participate in parent management training programming to learn how to implement similar procedures within the home setting. There is strong evidence supporting the efficacy of the STP as an intervention for ADHD. PMID:25220085

  12. “I Use Weed for My ADHD”: A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD

    PubMed Central

    Mitchell, John T.; Sweitzer, Maggie M.; Tunno, Angela M.; Kollins, Scott H.; McClernon, F. Joseph

    2016-01-01

    Background Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for problematic cannabis use. However, clinical and anecdotal evidence suggest an increasingly popular perception that cannabis is therapeutic for ADHD, including via online resources. Given that the Internet is increasingly utilized as a source of healthcare information and may influence perceptions, we conducted a qualitative analysis of online forum discussions, also referred to as threads, on the effects of cannabis on ADHD to systematically characterize the content patients and caregivers may encounter about ADHD and cannabis. Methods A total of 268 separate forum threads were identified. Twenty percent (20%) were randomly selected, which yielded 55 separate forum threads (mean number of individual posts per forum thread = 17.53) scored by three raters (Cohen’s kappa = 0.74). A final sample of 401 posts in these forum threads received at least one endorsement on predetermined topics following qualitative coding procedures. Results Twenty-five (25%) percent of individual posts indicated that cannabis is therapeutic for ADHD, as opposed to 8% that it is harmful, 5% that it is both therapeutic and harmful, and 2% that it has no effect on ADHD. This pattern was generally consistent when the year of each post was considered. The greater endorsement of therapeutic versus harmful effects of cannabis did not generalize to mood, other (non-ADHD) psychiatric conditions, or overall domains of daily life. Additional themes emerged (e.g., cannabis being considered sanctioned by healthcare providers). Conclusions Despite that there are no clinical recommendations or systematic research supporting the beneficial effects of cannabis use for ADHD, online discussions indicate that cannabis is considered therapeutic for ADHD—this is the first study to identify such a trend. This type of online information could shape ADHD patient and caregiver perceptions, and influence cannabis use and clinical care

  13. Combined diphtheria, tetanus, pertussis, and Haemophilus influenzae type b vaccines for primary immunisation.

    PubMed Central

    Bell, F; Martin, A; Blondeau, C; Thornton, C; Chaplais, J; Finn, A

    1996-01-01

    A total of 146 infants were immunised at ages 2, 3, and 4 months with a combined diphtheria, tetanus, pertussis (DTP)--Haemophilus influenzae type b (Hib) tetanus toxoid conjugate (PRP-T) vaccine (Pasteur Merieux) to assess the antibody response and adverse events associated with immunisation. Adverse events, including fever, were recorded by parents in a diary for three days following each injection. Blood was taken before the first immunisation and four weeks after the third immunisation to assess antibody response. Data were compared with those from historical controls who had received DTP and PRP-T vaccines by separate injection. The combined vaccine was well tolerated. Rates of local and general reactions were similar to those reported for infants immunised by separate injection. All infants achieved protective antibody titres (> 0.01 IU/ml) for diphtheria and tetanus; 98% acquired Hib (PRP) antibody > 0.15 microgram/ml and 82.5% > 1.0 microgram/ml. Pertussis antibody titres (pertussis toxin, filamentous haemagglutinin, total agglutinins, and agglutinins 2 and 3) showed appreciable rise following immunisation. DTP and PRP-T vaccines provide similar antibody responses and adverse effects whether mixed in the same syringe or administered by separate injection. The vaccines could be combined for use in the United Kingdom primary immunisation schedule. PMID:8984914

  14. Use of oral combination therapy for type 2 diabetes in primary care: Meeting individualized patient goals.

    PubMed

    Lavernia, Frank; Adkins, Sarah E; Shubrook, Jay H

    2015-01-01

    The management of type 2 diabetes mellitus (T2DM) by primary care physicians (PCPs) has become increasingly complex due to limitations on consultation time, an increasing array of drug treatment options, and issues of comorbidities and polypharmacy. Diabetes is a progressive condition and treatment with a single glucose-lowering agent can only address limited pathophysiologic targets and does not provide adequate glycemic control in many cases. Consequently, most patients with T2DM will eventually require treatment with multiple glucose-lowering medications. Oral combination therapy in T2DM may be given as multiple-pills, or as single-pill, fixed-dose combinations (FDCs), the latter of which offer convenience, ease of administration, and a reduction in the medication burden. Therefore, FDCs can potentially improve patients' treatment adherence and optimize achievement and maintenance of glycemic targets. However, cost factors also need to be considered. An understanding of the issues associated with the use of combination therapy in T2DM will help PCPs to guide patient-centered decision making and promote the effective management of T2DM. PMID:26439384

  15. A comparative study of the effects of ABT-418 and methylphenidate on spatial memory in an animal model of ADHD.

    PubMed

    Guo, Tianyou; Yang, Chuang; Guo, Lanting; Liu, Kezhi

    2012-10-18

    Impaired learning performance in scholastic settings is a characteristic of attention deficit hyperactivity disorder (ADHD). Our present study compares the effect of a nicotinic acetylcholine receptor (nAChR) agonist, ABT-418, and methylphenidate (MPH) on spatial memory in spontaneously hypertensive rats (SHRs), an animal model of ADHD. Neither chronic administration of ABT-418 nor MPH affected the learning performance during training in the Morris water maze. However, both compounds significantly improved memory. SHRs treated with a combination of the compounds did not perform better than either drug alone. Furthermore, the cortical α4 and β2 nAChR subunits and the hippocampal α4 subunit expression were significantly enhanced by ABT-418 treatments. Collectively, these results suggest that ABT-418 effectively improved spatial memory in an animal model of ADHD, providing a theoretical foundation for the use of a nAChR agonist in ADHD treatment. PMID:22985505

  16. [Radiofrequency ablation of type I atrial flutter: combination of electrophysiological and anatomical techniques].

    PubMed

    Rodríguez, H; Iturralde Torres, P; Cruz Cruz, F; Muñoz, M; Colín, L; Kershenovich, S; González Hermosillo, J A

    1997-01-01

    Atrial flutter type I (FLA) is one of the most common arrhythmias found in clinical practice. Reentry into the right atrium (AD) is the mechanism of this arrhythmia. The reentry mechanism has critical sites where radiofrequency (RF) can act blocking the circuit. Both, electrophysiological and anatomical approaches using RF to FLA have demonstrated a success rate above 80%. Our group combined both techniques treating 35 patients with FLA type I (22 men and 13 women), with mean age of 40.8 +/- 15 years old (range 9-70). In 21 patients (60%) this arrhythmia was associated with cardiopathy. All patients had failed to respond to different antiarrhythmic therapy. The success rate was 82.8% (29/35). When compared failure vs success we observed that patients who failed were older (51.8 vs 38.5 years old, p < 0.05), had structural cardiopathy (83.3% vs 55.1%, p = NS), had FLA type I with P waves with shorter cycle length (195 vs 254 ms, p = 0.052), had the arrhythmia chronically (129.6 vs 68.1 month, p = NS), had great left atrium diameter (41.2 vs 36.7 mm, p = 0.052) and frequently had been associated with atrial fibrillation (33.3% vs 3.4%, p = 0.02). There were no complications. Six (20.6%) patients reverted to FLA. We followed our patients during mean time 8.37 +/- 8.8 months (1-36). Our results support the notion that FLA type I can be treated with high percentage of success and low risk of complications when both RF techniques are combined. Our predictors of failure were: gender and associated atrial fibrillation (p < 0.05). We conclude that RF is the treatment of choice in every patient with FLA type I who had failed to antiarrhythmic therapy. We recommend RF as soon as FLA has been diagnosed because the probability of success is higher in such instances. PMID:9480657

  17. DRD4 and DAT1 in ADHD: Functional neurobiology to pharmacogenetics

    PubMed Central

    Turic, Darko; Swanson, James; Sonuga-Barke, Edmund

    2010-01-01

    Attention deficit/hyperactivity disorder (ADHD) is a common and potentially very impairing neuropsychiatric disorder of childhood. Statistical genetic studies of twins have shown ADHD to be highly heritable, with the combination of genes and gene by environment interactions accounting for around 80% of phenotypic variance. The initial molecular genetic studies where candidates were selected because of the efficacy of dopaminergic compounds in the treatment of ADHD were remarkably successful and provided strong evidence for the role of DRD4 and DAT1 variants in the pathogenesis of ADHD. However, the recent application of non-candidate gene strategies (eg, genome-wide association scans) has failed to identify additional genes with substantial genetic main effects, and the effects for DRD4 and DAT1 have not been replicated. This is the usual pattern observed for most other physical and mental disorders evaluated with current state-of-the-art methods. In this paper we discuss future strategies for genetic studies in ADHD, highlighting both the pitfalls and possible solutions relating to candidate gene studies, genome-wide studies, defining the phenotype, and statistical approaches. PMID:23226043

  18. The neuronal mechanisms underlying improvement of impulsivity in ADHD by theta/beta neurofeedback.

    PubMed

    Bluschke, Annet; Broschwitz, Felicia; Kohl, Simon; Roessner, Veit; Beste, Christian

    2016-01-01

    Neurofeedback is increasingly recognized as an intervention to treat core symptoms of attention deficit hyperactivity disorder (ADHD). Despite the large number of studies having been carried out to evaluate its effectiveness, it is widely elusive what neuronal mechanisms related to the core symptoms of ADHD are modulated by neurofeedback. 19 children with ADHD undergoing 8 weeks of theta/beta neurofeedback and 17 waiting list controls performed a Go/Nogo task in a pre-post design. We used neurophysiological measures combining high-density EEG recording with source localization analyses using sLORETA. Compared to the waiting list ADHD control group, impulsive behaviour measured was reduced after neurofeedback treatment. The effects of neurofeedback were very specific for situations requiring inhibitory control over responses. The neurophysiological data shows that processes of perceptual gating, attentional selection and resource allocation processes were not affected by neurofeedback. Rather, neurofeedback effects seem to be based on the modulation of response inhibition processes in medial frontal cortices. The study shows that specific neuronal mechanisms underlying impulsivity are modulated by theta/beta neurofeedback in ADHD. The applied neurofeedback protocol could be particularly suitable to address inhibitory control. The study validates assumed functional neuroanatomical target regions of an established neurofeedback protocol on a neurophysiological level. PMID:27514985

  19. The neuronal mechanisms underlying improvement of impulsivity in ADHD by theta/beta neurofeedback

    PubMed Central

    Bluschke, Annet; Broschwitz, Felicia; Kohl, Simon; Roessner, Veit; Beste, Christian

    2016-01-01

    Neurofeedback is increasingly recognized as an intervention to treat core symptoms of attention deficit hyperactivity disorder (ADHD). Despite the large number of studies having been carried out to evaluate its effectiveness, it is widely elusive what neuronal mechanisms related to the core symptoms of ADHD are modulated by neurofeedback. 19 children with ADHD undergoing 8 weeks of theta/beta neurofeedback and 17 waiting list controls performed a Go/Nogo task in a pre-post design. We used neurophysiological measures combining high-density EEG recording with source localization analyses using sLORETA. Compared to the waiting list ADHD control group, impulsive behaviour measured was reduced after neurofeedback treatment. The effects of neurofeedback were very specific for situations requiring inhibitory control over responses. The neurophysiological data shows that processes of perceptual gating, attentional selection and resource allocation processes were not affected by neurofeedback. Rather, neurofeedback effects seem to be based on the modulation of response inhibition processes in medial frontal cortices. The study shows that specific neuronal mechanisms underlying impulsivity are modulated by theta/beta neurofeedback in ADHD. The applied neurofeedback protocol could be particularly suitable to address inhibitory control. The study validates assumed functional neuroanatomical target regions of an established neurofeedback protocol on a neurophysiological level. PMID:27514985

  20. Combining Information from Common Type 2 Diabetes Risk Polymorphisms Improves Disease Prediction

    PubMed Central

    Weedon, Michael N; McCarthy, Mark I; Hitman, Graham; Walker, Mark; Groves, Christopher J; Zeggini, Eleftheria; Rayner, N. William; Shields, Beverley; Owen, Katharine R; Hattersley, Andrew T; Frayling, Timothy M

    2006-01-01

    Background A limited number of studies have assessed the risk of common diseases when combining information from several predisposing polymorphisms. In most cases, individual polymorphisms only moderately increase risk (~20%), and they are thought to be unhelpful in assessing individuals' risk clinically. The value of analyzing multiple alleles simultaneously is not well studied. This is often because, for any given disease, very few common risk alleles have been confirmed. Methods and Findings Three common variants (Lys23 of KCNJ11, Pro12 of PPARG, and the T allele at rs7903146 of TCF7L2) have been shown to predispose to type 2 diabetes mellitus across many large studies. Risk allele frequencies ranged from 0.30 to 0.88 in controls. To assess the combined effect of multiple susceptibility alleles, we genotyped these variants in a large case-control study (3,668 controls versus 2,409 cases). Individual allele odds ratios (ORs) ranged from 1.14 (95% confidence interval [CI], 1.05 to 1.23) to 1.48 (95% CI, 1.36 to 1.60). We found no evidence of gene-gene interaction, and the risks of multiple alleles were consistent with a multiplicative model. Each additional risk allele increased the odds of type 2 diabetes by 1.28 (95% CI, 1.21 to 1.35) times. Participants with all six risk alleles had an OR of 5.71 (95% CI, 1.15 to 28.3) compared to those with no risk alleles. The 8.1% of participants that were double-homozygous for the risk alleles at TCF7L2 and Pro12Ala had an OR of 3.16 (95% CI, 2.22 to 4.50), compared to 4.3% with no TCF7L2 risk alleles and either no or one Glu23Lys or Pro12Ala risk alleles. Conclusions Combining information from several known common risk polymorphisms allows the identification of population subgroups with markedly differing risks of developing type 2 diabetes compared to those obtained using single polymorphisms. This approach may have a role in future preventative measures for common, polygenic diseases. PMID:17020404

  1. Neural Correlates of Aggression in Medication-Naive Children with ADHD: Multivariate Analysis of Morphometry and Tractography

    PubMed Central

    Cha, Jiook; Fekete, Tomer; Siciliano, Francesco; Biezonski, Dominik; Greenhill, Laurence; Pliszka, Steven R; Blader, Joseph C; Krain Roy, Amy; Leibenluft, Ellen; Posner, Jonathan

    2015-01-01

    Aggression is widely observed in children with attention deficit/hyperactivity disorder (ADHD) and has been frequently linked to frustration or the unsatisfied anticipation of reward. Although animal studies and human functional neuroimaging implicate altered reward processing in aggressive behaviors, no previous studies have documented the relationship between fronto-accumbal circuitry—a critical cortical pathway to subcortical limbic regions—and aggression in medication-naive children with ADHD. To address this, we collected behavioral measures and parental reports of aggression and impulsivity, as well as structural and diffusion MRI, from 30 children with ADHD and 31 healthy controls (HC) (mean age, 10±2.1 SD). Using grey matter morphometry and probabilistic tractography combined with multivariate statistical modeling (partial least squares regression and support vector regression), we identified anomalies within the fronto-accumbal circuit in childhood ADHD, which were associated with increased aggression. More specifically, children with ADHD showed reduced right accumbal volumes and frontal-accumbal white matter connectivity compared with HC. The magnitude of the accumbal volume reductions within the ADHD group was significantly correlated with increased aggression, an effect mediated by the relationship between the accumbal volume and impulsivity. Furthermore, aggression, but not impulsivity, was significantly explained by multivariate measures of fronto-accumbal white matter connectivity and cortical thickness within the orbitofrontal cortex. Our multi-modal imaging, combined with multivariate statistical modeling, indicates that the fronto-accumbal circuit is an important substrate of aggression in children with ADHD. These findings suggest that strategies aimed at probing the fronto-accumbal circuit may be beneficial for the treatment of aggressive behaviors in childhood ADHD. PMID:25645374

  2. Neural Correlates of Aggression in Medication-Naive Children with ADHD: Multivariate Analysis of Morphometry and Tractography.

    PubMed

    Cha, Jiook; Fekete, Tomer; Siciliano, Francesco; Biezonski, Dominik; Greenhill, Laurence; Pliszka, Steven R; Blader, Joseph C; Roy, Amy Krain; Leibenluft, Ellen; Posner, Jonathan

    2015-06-01

    Aggression is widely observed in children with attention deficit/hyperactivity disorder (ADHD) and has been frequently linked to frustration or the unsatisfied anticipation of reward. Although animal studies and human functional neuroimaging implicate altered reward processing in aggressive behaviors, no previous studies have documented the relationship between fronto-accumbal circuitry-a critical cortical pathway to subcortical limbic regions-and aggression in medication-naive children with ADHD. To address this, we collected behavioral measures and parental reports of aggression and impulsivity, as well as structural and diffusion MRI, from 30 children with ADHD and 31 healthy controls (HC) (mean age, 10±2.1 SD). Using grey matter morphometry and probabilistic tractography combined with multivariate statistical modeling (partial least squares regression and support vector regression), we identified anomalies within the fronto-accumbal circuit in childhood ADHD, which were associated with increased aggression. More specifically, children with ADHD showed reduced right accumbal volumes and frontal-accumbal white matter connectivity compared with HC. The magnitude of the accumbal volume reductions within the ADHD group was significantly correlated with increased aggression, an effect mediated by the relationship between the accumbal volume and impulsivity. Furthermore, aggression, but not impulsivity, was significantly explained by multivariate measures of fronto-accumbal white matter connectivity and cortical thickness within the orbitofrontal cortex. Our multi-modal imaging, combined with multivariate statistical modeling, indicates that the fronto-accumbal circuit is an important substrate of aggression in children with ADHD. These findings suggest that strategies aimed at probing the fronto-accumbal circuit may be beneficial for the treatment of aggressive behaviors in childhood ADHD. PMID:25645374

  3. Managing the risks of ADHD treatments.

    PubMed

    Schneider, Benjamin N; Enenbach, Michael

    2014-10-01

    Pharmacotherapy of attention deficit-hyperactivity disorder (ADHD) is a well-established and effective treatment modality. However, ADHD medications are not without side effects. Understanding the prevalence of adverse events and effective management of risks associated with stimulants and other medications used to treat ADHD is central to broad applicability and effective treatment. This review discusses the literature on the prevalence of adverse events and management strategies employed. We searched online MEDLINE/PubMed and Cochrane databases for articles using several keywords relating to adverse events associated with ADHD medication management. We discuss the relevant data on the significance and prevalence of side effects and adverse events, highlight recent updates in the field, and suggest approaches to clinical management. PMID:25135779

  4. Future Directions in ADHD Etiology Research

    PubMed Central

    Nigg, Joel T.

    2015-01-01

    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 development of ADHD. Second, neurobiological findings will have limited impact if not examined in the context of significant race and cultural variation in ADHD-related developmental processes, and in the context of rapidly changing social and technological contexts of children’s development worldwide. Third, further examination of the phenotype and characterization of its dimensional and categorical structure remains a major need. Overall, the coming decades of etiology research on ADHD will be expected to capitalize on new scientific tools. The hope in the field is that new insights into fundamental prevention can emerge. PMID:22642834

  5. Risk of Tics with Psychostimulants for ADHD.

    PubMed

    Millichap, J Gordon

    2015-12-01

    Investigators at Yale University, New Haven, CT, conducted a meta-analysis to examine the risk of new onset or worsening of tics caused by psychostimulants used in the treatment of children with ADHD. PMID:26933551

  6. Focusing on ADHD - Attention Deficit Hyperactivity Disorder

    MedlinePlus

    ... on ADHD Health Capsules Genetic Sites Tied to Schizophrenia Helping Older Adults Talk With Their Doctors Featured ... and child mental health expert at NIH. “The diagnosis is made because the level of hyperactivity or ...

  7. [CHARACTERISTICS OF COMBINED ANESTHESIA WITH EPIDURAL COMPONENTE DEPENDING ON VEGETATIVE NERVOUS SYSTEM TYPE].

    PubMed

    Hasanov, F J; Aslanov, A A; Muradov, N F; Namazova, K N

    2016-01-01

    The research objective was to study the characteristics of combined anesthesia with epidural componente (CAEC) depending on vegetative nervous system type (VNS) in patients who underwent large scale traumatic surgical operations on abdominal cavity organs. The scientific research was conducted in Anaesthesiology--Reanimation Department of the Scientific Surgical Centre named after acad. MA. Topchubashev, the Ministry of Health of the Azerbaijan Republic. The research objects were 69 patients who underwent operations in conditions of CAEC due to different serious surgical pathologies of abdominal cavity organs. VNS type was identified based on electroencephalogram, Cerdo Vegetative Index (CVI), Hildebrandt coefficient (HC) and single neurophysiological tests. The patients were divided into three groups depending on VNS type: I--normotonics--17 patients (24.7%), II--sympathatonics--25 patients (36.2%), and III--vagotonics--27 patients (39.1%). Blood adrenocorticotropic hormone (ACTH) and cortisol concentration were studied in 3 stages: I -preoperative, II--operation traumatic stage, III--the 1st postoperative days. The other indicators (heart rate, systolic blood pressure--SBP, dyastolic blood pressure--DBR average blood pressure--BP ave., pulse oximetry SpO₂, ECG, gases in blood and acid-base balance, electrolytes, blood glucose level, myocardium oxygen demand--MOD) were registered after 20 minutes and the 2nd day after operation besides the above stages. The research results indicated that it is possible to define the vegetative nervous system type superiority based on complex of single tests data, EEG, ECG, Cerdo Vegetative Index, Hildebrandt coefficient. CAEC can be considered optimun alternative of general anesthesia ensuring neurohumoral and hemodynamic stability in large scale, traumatic operations on abdominal cavity organs. Clinical course of CAEC is characterized by firmer hemodynamic and humoral stability in patients with functional balance of

  8. Effects of Methylphenidate on Quality of Life in Children with Both Developmental Coordination Disorder and ADHD

    ERIC Educational Resources Information Center

    Flapper, Boudien C. T.; Schoemaker, Marina M

    2008-01-01

    Measurement of health-related quality of life (HRQOL) in attention-deficit-hyperactivity disorder (ADHD) gives a more complete picture of day-to-day functioning and treatment effects than behavioural rating alone. The aim of this pilot study was to investigate the impact of the combined diagnoses of developmental coordination disorder (DCD) and…

  9. Developmental and Subtype Differences in Behavioral Assets and Problems in Children Diagnosed with ADHD

    ERIC Educational Resources Information Center

    Short, Elizabeth J.; Fairchild, Lynn; Findling, Robert L.; Manos, Michael J.

    2007-01-01

    Objective: Developmental and subtype differences in behavioral assets and problems were examined in 318 children newly diagnosed with ADHD. Method: Three age groups were compared: 4 to 6.9 years (n = 95), 7 to 9.9 years (n = 136), and 10 to 15 years (n = 87); with two subtypes examined: inattentive (n = 151), and hyperactive/combined (n = 167).…

  10. A Comparison of Dutch and US Teachers' Perceptions of the Incidence and Management of ADHD

    ERIC Educational Resources Information Center

    Havey, J. Michael

    2007-01-01

    Dutch and US teachers were questioned about their perceptions of the incidence and causes of ADHD, as well as their views of appropriate treatments. Dutch teachers were more likely than US teachers to think the etiology of the disorder lay in biochemistry, while US teachers were more likely to believe in a combination of environmental and…

  11. ADHD: A Crash-Free Course

    ERIC Educational Resources Information Center

    Gigout-Hues, Lisa

    2006-01-01

    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…

  12. C-type natriuretic peptide in combination with sildenafil attenuates proliferation of rhabdomyosarcoma cells.

    PubMed

    Zenitani, Masahiro; Nojiri, Takashi; Uehara, Shuichiro; Miura, Koichi; Hosoda, Hiroshi; Kimura, Toru; Nakahata, Kengo; Miyazato, Mikiya; Okuyama, Hiroomi; Kangawa, Kenji

    2016-05-01

    Rhabdomyosarcoma (RMS) is a malignant mesenchymal tumor and the most common soft tissue sarcoma in children. Because of several complications associated with intensive multimodal therapies, including growth disturbance and secondary cancer, novel therapies with less toxicity are urgently needed. C-type natriuretic peptide (CNP), an endogenous peptide secreted by endothelial cells, exerts antiproliferative effects in multiple types of mesenchymal cells. Therefore, we investigated whether CNP attenuates proliferation of RMS cells. We examined RMS patient samples and RMS cell lines. All RMS clinical samples expressed higher levels of guanylyl cyclase B (GC-B), the specific receptor for CNP, than RMS cell lines. GC-B expression in RMS cells decreased with the number of passages in vitro. Therefore, GC-B stable expression lines were established to mimic clinical samples. CNP increased cyclic guanosine monophosphate (cGMP) levels in RMS cells in a dose-dependent manner, demonstrating the biological activity of CNP. However, because cGMP is quickly degraded by phosphodiesterases (PDEs), the selective PDE5 inhibitor sildenafil was added to inhibit its degradation. In vitro, CNP, and sildenafil synergistically inhibited proliferation of RMS cells stably expressing GC-B and decreased Raf-1, Mitogen-activated protein kinase kinase (MEK), and extracellular signal-regulated kinase (ERK) phosphorylation. These results suggested that CNP in combination with sildenafil exerts antiproliferative effects on RMS cells by inhibiting the Raf/MEK/ERK pathway. This regimen exerted synergistic effects on tumor growth inhibition without severe adverse effects in vivo such as body weight loss. Thus, CNP in combination with sildenafil represents a promising new therapeutic approach against RMS. PMID:26816265

  13. [The comorbidity of learning difficulties and ADHD symptoms in primary-school-age children].

    PubMed

    Schuchardt, Kirsten; Fischbach, Anne; Balke-Melcher, Christina; Mähler, Claudia

    2015-05-01

    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. PMID:26098006

  14. Increased ongoing neural variability in ADHD.

    PubMed

    Gonen-Yaacovi, Gil; Arazi, Ayelet; Shahar, Nitzan; Karmon, Anat; Haar, Shlomi; Meiran, Nachshon; Dinstein, Ilan

    2016-08-01

    Attention Deficit Hyperactivity Disorder (ADHD) has been described as a disorder where frequent lapses of attention impair the ability of an individual to focus/attend in a sustained manner, thereby generating abnormally large intra-individual behavioral variability across trials. Indeed, increased reaction time (RT) variability is a fundamental behavioral characteristic of individuals with ADHD found across a large number of cognitive tasks. But what is the underlying neurophysiology that might generate such behavioral instability? Here, we examined trial-by-trial EEG response variability to visual and auditory stimuli while subjects' attention was diverted to an unrelated task at the fixation cross. Comparisons between adult ADHD and control participants revealed that neural response variability was significantly larger in the ADHD group as compared with the control group in both sensory modalities. Importantly, larger trial-by-trial variability in ADHD was apparent before and after stimulus presentation as well as in trials where the stimulus was omitted, suggesting that ongoing (rather than stimulus-evoked) neural activity is continuously more variable (noisier) in ADHD. While the patho-physiological mechanisms causing this increased neural variability remain unknown, they appear to act continuously rather than being tied to a specific sensory or cognitive process. PMID:27179150

  15. Cognitive enhancers for the treatment of ADHD

    PubMed Central

    Bidwell, L. Cinnamon; McClernon, F. Joseph; Kollins, Scott H.

    2012-01-01

    Attention-deficit hyperactivity disorder (ADHD) is associated with multiple cognition-related phenotypic features in both children and adults. This review aims to clarify the role of cognition in ADHD and how prevailing treatments, which are often highly effective at reducing the clinical symptoms of the disorder, fare in modulating ADHD-related cognitive processes. First, we consider how the broad construct of cognition can be conceptualized in the context of ADHD. Second, we review the available evidence for how a range of both pharmacological and non-pharmacological interventions have fared with respect to enhancing cognition in individuals affected by this pervasive disorder. Findings from the literature suggest that the effects across a broad range of pharmacological and non-pharmacological interventions on the characteristic symptoms of ADHD can be distinguished from their effects on cognitive impairments. As such the direct clinical relevance of cognition enhancing effects of different interventions is somewhat limited. Recommendations for future research are discussed, including the identification of cognition-related end ophenotypes, the refinement of the ADHD clinical phenotype, and studying the difference between acute and chronic treatment regimens. PMID:21596055

  16. Pharmacotherapy of inattention and ADHD in adolescents.

    PubMed

    McBurnett, Keith; Swetye, Michael; Muhr, Heather; Hendren, Robert L

    2013-08-01

    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. PMID:24298754

  17. The development, characterization, and performance evaluation of a new combination type personnel neutron dosimeter

    SciTech Connect

    Liu, J.C.; Sims, C.S.; Poston, J.W.; Texas A and M Univ., College Station, TX . Dept. of Nuclear Engineering)

    1989-10-01

    A new combination type personnel neutron dosimeter has been designed and developed at the Oak Ridge National Laboratory (ORNL). The combination personnel neutron dosimeter (CPND) consists of a Harshaw albedo neutron thermoluminescent dosimeter (two pairs of TLD-600/TLD- 700) and two bubble detectors (one BD-100R and one BDS-1500 from Bubble Technology Industries, Canada). The CPND was developed with the aim of having crude neutron spectrometric capability, universal applicability, better angular response, and an improved lower limit of detection (LLD). The CPND has been well characterized in the following areas: reusability, linearity, lower limit of detection (LLD), detection capability in mixed neutron-gamma fields, angular dependence, and neutron energy dependence. the characterization was accomplished with irradiations using a {sup 238}Pu-Be source, a {sup 252}Cf(D{sub 2}O) source, a {sup 252}Cf source, a {sup 252}Cf(PE) source, monoenergetic neutrons from accelerator and reactor filtered beams, {sup 137}Cs, and X-rays. Optimum signal readout procedures, signal processing techniques, routine operational usage, and neutron dose equivalent evaluation algorithms for the CPND were developed with the goals of having the best precision and accuracy as well as being convenient to use. 97 refs., 43 figs., 22 tabs.

  18. Mediating role of childhood emotional abuse on the relationship between severity of ADHD and PTSD symptoms in a sample of male inpatients with alcohol use disorder.

    PubMed

    Evren, Cuneyt; Umut, Gokhan; Bozkurt, Muge; Evren, Bilge; Agachanli, Ruken

    2016-05-30

    The aim of the present study was to evaluate relationship of PTSD symptom severity with severity of ADHD symptoms while controlling the effect of childhood trauma in a sample of male inpatients with alcohol use disorder (AUD). Participants included 190 male inpatients with AUD. Participants were evaluated with the Childhood Trauma Questionnaire (CTQ-28), the Adult ADHD Self-Report Scale (ASRS) and PTSD Checklist Civilian version (PCL-C). PTSD and ADHD scores were mildly correlated with severity of childhood trauma and types of traumas, the only exception was emotional neglect, which was not correlated with PTSD and ADHD. Severity of ADHD symptoms was associated with the severity of PTSD symptoms, together with the severity of childhood trauma in a linear regression model. In another linear regression model where dimensions of ADHD and childhood trauma were considered as independent variables, emotional abuse and both inattentive and hyperactive/impulsive dimensions of ADHD were associated with the severity of PTSD. These findings suggest that the severity of adult ADHD symptoms is related with the severity of PTSD symptoms, while severity of childhood trauma, particularly emotional abuse may have an mediating role on this relationship among male inpatients with AUD. PMID:27058158

  19. Magnetically suspended rotary blood pump with radial type combined motor-bearing.

    PubMed

    Masuzawa, T; Kita, T; Matsuda, K; Okada, Y

    2000-06-01

    A magnetically suspended centrifugal blood pump is being developed with a combined motor-bearing for long-term ventricular assist systems. The combined motor-bearing actively suspends a rotor in a radial direction to deal with radial force unbalance in the pump and rotates the rotor by using the electric magnetic field. Therefore, the pump has no mechanical parts such as bearings of the motor and has a long lifetime. The developed pump consists of a thin rotor with a semi open-type 6 vane impeller and a stator to suspend and rotate the rotor. The rotor has 4-pole permanent magnets on the circumferential surface. The outer diameter and the thickness of the rotor are 60 mm and 8 mm, respectively. Axial movement and tilt of the rotor are restricted by passive stability based on the thin rotor structure. Radial movements of the rotor, such as levitation in radial direction and rotation, are controlled actively by using electric magnets of the stator. The electric magnet coils to produce levitation and rotation forces are constructed on the periphery stator. The p +/- 2-pole algorithm and the synchronous motor mechanism are adopted to levitate and rotate the rotor. The radial gap between the rotor and the stator is 1 mm. A closed-loop circuit filled with water was connected to the developed pump to examine the basic performance of the pump and the magnetic suspension system. Maximum rotational speed, flow rate, and head were 2,800 rpm, 11 L/min, and 270 mm Hg, respectively. The rotor with the impeller could be suspended completely during the entire pumping process. We conclude the pump with the combined motor-bearing has sufficient performance for the blood pump. PMID:10886067

  20. Parent-Reported Health Consequences and Relationship to Expenditures in Children with ADHD.

    PubMed

    deJong, Neal A; Williams, Christianna S; Thomas, Kathleen C

    2016-04-01

    Objectives (1) To describe parents' report of special needs for children with ADHD on the Children with Special Health Care Needs (CSHCN) Screener; and (2) to assess the association between responses to Screener items and annual mental health and total health expenditures per child. Methods In pooled 2002-2011 Medical Expenditure Panel Survey (MEPS) data, we identify children ages 4-17 years with ADHD. We use OLS and two-part regressions to model the relationship between CSHCN Screener items and mental health and total health expenditures. Based on these models we estimate adjusted, average total health expenditures for children with ADHD-both with and without a co-morbid mental health condition-and different combinations of endorsed Screener items. This research was conducted in accordance with prevailing ethical principles. Results There were 3883 observations on 2591 children with ADHD. Without a co-morbid mental health condition, average total expenditures per year from adjusted, model-based estimates were $865 for those meeting no Screener items, $2664 for those meeting only the medication item, $3595 for those meeting the medication and counseling items, and $4203 for those meeting the medication, counseling, and use of more health services items. Children with a co-morbid mental health condition had greater total health expenditures for each combination of Screener items. The associations between Screener items and mental health expenditures were similar, but with a slightly lower marginal effect of the medication item (p < 0.001 for all comparisons). Conclusions Parents' responses on the CSHCN Screener are associated with meaningful variation in expenditures for children with ADHD. Though cross-sectional, this study suggests that the CSHCN Screener can be a useful categorization scheme for children with ADHD. It may be an efficient, standardized tool at the point of care for identifying children who need more resources and for targeting intensive

  1. Long-term far-transfer effects of working memory training in children with ADHD: a randomized controlled trial.

    PubMed

    Bigorra, Aitana; Garolera, Maite; Guijarro, Silvina; Hervás, Amaia

    2016-08-01

    ADHD affects working memory (WM) and other executive functions (EFs) and thereby negatively impacts school performance, clinical symptoms and functional impairment. The main aim of this study was to analyse the efficacy of computerized WM training (CWMT) on EF rating scales. A secondary objective was to assess its efficacy on performance-based measures of EF (PBMEF), learning, clinical symptoms and functional impairment. 66 children with combined-type ADHD between 7 and 12 years of age from the Child and Adolescent Psychiatric Unit (Spain) were included in this randomized, double-blind, placebo-controlled, parallel-group clinical trial. The participants were randomized (1:1) to an experimental group (EG) (CWMT) (n = 36) or a control group (CG) (placebo training). Assessments were conducted at baseline (T0), 1-2 weeks (T1), and 6 months post-intervention (T2) with the administration of EF rating scales, PBMEF, measures of academic achievement, and questionnaires regarding clinical symptoms and functional impairment. Participants, parents, teachers and professionals who performed the cognitive assessments were blinded. Adjusted multiple linear regression analysis showed significant improvements in EF scales-parent version, from T1 to T2, on the metacognition index [p = 0.03, d' = -0.78 (95 % CI -1.28 to -0.27)] and on WM (also significant at T2-T0) and plan/organize subscales. Significant improvements were also noted in EF scales-teacher version, from T0 to T1 and T2, on the metacognitive index [p = 0.05, d' = -0.37 (95 % CI -0.86 to 0.12) T1-T0, p = 0.02, d' = -0.81 (95 % CI -1.31 to -0.30) T2-T0] and on the initiate, WM, monitor and shift subscales. There were also significant improvements in PBMEF, ADHD symptoms, and functional impairment. CWMT had a significant impact on ADHD deficits by achieving long-term far-transfer effects. PMID:26669692

  2. Biocompatible polymeric nanocomplexes as an intracellular stimuli-sensitive prodrug for type-2 diabetes combination therapy.

    PubMed

    Wang, Feng-Zhen; Xie, Zhi-Shen; Xing, Lei; Zhang, Bing-Feng; Zhang, Jia-Liang; Cui, Peng-Fei; Qiao, Jian-Bin; Shi, Kun; Cho, Chong-Su; Cho, Myung-Haing; Xu, Xiaojun; Li, Ping; Jiang, Hu-Lin

    2015-12-01

    Combination therapy is usually considered as a promising strategy owing to its advantages such as reduced doses, minimized side effects and improved therapeutic efficiency in a variety of diseases including diabetes. Here we synthesized a new highly intracellular stimuli-sensitive chitosan-graft-metformin (CS-MET) prodrug by imine reaction between oxidative chitosan and metformin for type 2 diabetes (T2D) therapy. Hypothetically, CS-MET functions dually as an anti-diabetes prodrug as well as a gene delivery vector without superfluous materials. CS-MET formed nanocomplexes with therapeutic gene through electrostatic interactions and entered cells by Organic Cation Transporter (OCT)-independent endocytosis. The incorporation of metformin into chitosan has been found to increase endosomal escape via the proton sponge effect. When vector carrying a short-hairpin RNA (shRNA) silencing sterol regulatory element-binding protein (SREBP), a major transcription factor involved in de novo lipogenisis, it reduced the SREBP mRNA and proteins efficiently. Furthermore, by intraperitoneal injection, CS-MET/shSREBP nanocomplexes effectively knocked down SREBP in livers of western-type diet (WD)-induced obese C57BL/6J mice, markedly reversed insulin resistance and alleviated the fatty liver phenotype without obvious toxic effects. Thus we were able to show that the intracellular stimuli-sensitive CS-MET prodrug renders a potential platform to increase the anti-diabetes activity with synergistic enhancement of gene therapy. PMID:26409000

  3. Type-2 fuzzy set extension of DEMATEL method combined with perceptual computing for decision making

    NASA Astrophysics Data System (ADS)

    Hosseini, Mitra Bokaei; Tarokh, Mohammad Jafar

    2013-05-01

    Most decision making methods used to evaluate a system or demonstrate the weak and strength points are based on fuzzy sets and evaluate the criteria with words that are modeled with fuzzy sets. The ambiguity and vagueness of the words and different perceptions of a word are not considered in these methods. For this reason, the decision making methods that consider the perceptions of decision makers are desirable. Perceptual computing is a subjective judgment method that considers that words mean different things to different people. This method models words with interval type-2 fuzzy sets that consider the uncertainty of the words. Also, there are interrelations and dependency between the decision making criteria in the real world; therefore, using decision making methods that cannot consider these relations is not feasible in some situations. The Decision-Making Trail and Evaluation Laboratory (DEMATEL) method considers the interrelations between decision making criteria. The current study used the combination of DEMATEL and perceptual computing in order to improve the decision making methods. For this reason, the fuzzy DEMATEL method was extended into type-2 fuzzy sets in order to obtain the weights of dependent criteria based on the words. The application of the proposed method is presented for knowledge management evaluation criteria.

  4. Combined Resistivity and Shear Wave Velocity Soil-type Estimation Beneath a Coastal Protection Levee.

    NASA Astrophysics Data System (ADS)

    Lorenzo, J. M.; Goff, D.; Hayashi, K.

    2015-12-01

    Unconsolidated Holocene deltaic sediments comprise levee foundation soils in New Orleans, USA. Whereas geotechnical tests at point locations are indispensable for evaluating soil stability, the highly variable sedimentary facies of the Mississippi delta create difficulties to predict soil conditions between test locations. Combined electrical resistivity and seismic shear wave studies, calibrated to geotechnical data, may provide an efficient methodology to predict soil types between geotechnical sites at shallow depths (0- 10 m). The London Avenue Canal levee flank of New Orleans, which failed in the aftermath of Hurricane Katrina, 2005, presents a suitable site in which to pioneer these geophysical relationships. Preliminary cross-plots show electrically resistive, high-shear-wave velocity areas interpreted as low-permeability, resistive silt. In brackish coastal environments, low-resistivity and low-shear-wave-velocity areas may indicate both saturated, unconsolidated sands and low-rigidity clays. Via a polynomial approximation, soil sub-types of sand, silt and clay can be estimated by a cross-plot of S-wave velocity and resistivity. We confirm that existent boring log data fit reasonably well with the polynomial approximation where 2/3 of soil samples fall within their respective bounds—this approach represents a new classification system that could be used for other mid-latitude, fine-grained deltas.

  5. Microstructural Abnormalities in the Combined and Inattentive Subtypes of Attention Deficit Hyperactivity Disorder: a Diffusion Tensor Imaging Study

    PubMed Central

    Lei, Du; Ma, Jun; Du, Xiaoxia; Shen, Guohua; Jin, Xingming; Gong, Qiyong

    2014-01-01

    Previous research has demonstrated that there are specific white matter abnormalities in patients with attention deficit/hyperactivity disorder (ADHD). However, the results of these studies are not consistent, and one of the most important factors that affects the inconsistency of previous studies maybe the ADHD subtype. Different ADHD subtypes may have some overlapping microstructural damage, but they may also have unique microstructural abnormalities. The objective of this study was to investigate the microstructural abnormalities associated with two subtypes of ADHD: combined (ADHD-C) and inattentive (ADHD-I). Twenty-eight children with ADHD-C, 28 children with ADHD-I and 28 healthy children participated in this study. Fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (AD) were used to analyze diffusion tensor imaging (DTI) data to provide specific information regarding abnormal brain areas. Our results demonstrated that ADHD-I is related to abnormalities in the temporo-occipital areas, while the combined subtype (ADHD-C) is related to abnormalities in the frontal-subcortical circuit, the fronto-limbic pathway, and the temporo-occipital areas. Moreover, an abnormality in the motor circuit may represent the main difference between the ADHD-I and ADHD-C subtypes. PMID:25363043

  6. The Role of ADHD in Academic Adversity: Disentangling ADHD Effects from Other Personal and Contextual Factors

    ERIC Educational Resources Information Center

    Martin, Andrew J.

    2014-01-01

    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.…

  7. Reconstituting the ADHD Girl: Accomplishing Exclusion and Solidifying a Biomedical Identity in an ADHD Class

    ERIC Educational Resources Information Center

    Hjörne, Eva; Evaldsson, Ann-Carita

    2015-01-01

    In this study, we explore what happens to young people labelled as having attention deficit hyperactivity disorder (ADHD) after they have been excluded from mainstream class and placed in a special class. More specifically, we focus on how a specific disability identity is locally accomplished and ascribed to a girl placed in an ADHD class…

  8. The role of ADHD in academic adversity: disentangling ADHD effects from other personal and contextual factors.

    PubMed

    Martin, Andrew J

    2014-12-01

    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. Responses from 136 students with ADHD and 3,779 non-ADHD peers from 9 high schools were analyzed using logistic regression. Dependent measures included academic failure, grade repetition, school refusal, changing classes and school, school exclusion, and schoolwork noncompletion. Covariates comprised personal (e.g., sociodemographics, personality, prior achievement, specific learning disabilities, motivation) and contextual (e.g., school size, school socioeconomic status, school average achievement) factors. Findings indicated that, after accounting for personal and contextual covariates, ADHD explained significant variance in numerous adversities (schoolwork noncompletion, school suspension, school expulsion, changing schools, grade repetition). Thus, beyond the effects of numerous personal and contextual covariates, ADHD has a distinct presence in students' academic adversity. Also interesting, after accounting for other personal and contextual factors, was academic adversity with which ADHD was not associated. Findings provide direction for educational intervention targeting ADHD and associated factors found to be significant in the study. PMID:24820011

  9. Toward a better understanding of ADHD: LPHN3 gene variants and the susceptibility to develop ADHD

    PubMed Central

    Arcos-Burgos, Mauricio

    2012-01-01

    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

  10. Effects of Prenatal Alcohol Exposure and ADHD on Adaptive Functioning

    PubMed Central

    Ware, Ashley L.; Glass, Leila; Crocker, Nicole; Deweese, Benjamin N.; Coles, Claire D.; Kable, Julie A.; May, Philip A.; Kalberg, Wendy O.; Sowell, Elizabeth R.; Jones, Kenneth Lyons; Riley, Edward P.; Mattson, Sarah N.

    2014-01-01

    Background Heavy prenatal alcohol exposure and attention-deficit/hyperactivity disorder (ADHD) are associated with adaptive behavior deficits. The present study examined the interaction between these two factors on parent ratings of adaptive behavior. Methods As part of a multisite study, primary caregivers of 317 children (8–16y, M=12.38) completed the Vineland Adaptive Behavior Scales-II (VABS-II). Four groups of subjects were included: children with prenatal alcohol exposure with (AE+, n = 82) and without ADHD (AE−, n = 34), children with ADHD (ADHD, n = 71), and control children (CON, n = 130). VABS-II domain scores (Communication, Daily Living Skills, Socialization) were examined using separate 2 (Alcohol Exposure [AE]) × 2 (ADHD diagnosis) between-subjects ANCOVAs. Results There were significant main effects of AE (p < .001) and ADHD (p < .001) on all VABS-II domains; alcohol-exposed children had lower scores than children without prenatal alcohol exposure and children with ADHD had lower scores than those without ADHD. There was a significant AE × ADHD interaction effect for Communication [F (1, 308) = 7.49, p = .007, partial η2 =.024], but not Daily Living Skills or Socialization domains (ps > .27). Follow up analyses in the Communication domain indicated the effects of ADHD were stronger in comparison subjects (ADHD vs. CON) than exposed subjects (AE+ vs. AE−) and the effects of alcohol exposure were stronger in subjects without ADHD (AE− vs. CON) than in subjects with ADHD (AE+ vs. ADHD). Conclusion As found previously, both prenatal alcohol exposure and ADHD increase adaptive behavior deficits in all domains. However, these two factors interact to cause the greatest impairment in children with both prenatal alcohol exposure and ADHD for communication abilities. These results further demonstrate the deleterious effects of prenatal alcohol exposure and broadens our understanding of how ADHD exacerbates behavioral outcomes in this population

  11. Aerobic and Combined Exercise Sessions Reduce Glucose Variability in Type 2 Diabetes: Crossover Randomized Trial

    PubMed Central

    Figueira, Franciele R.; Umpierre, Daniel; Casali, Karina R.; Tetelbom, Pedro S.; Henn, Nicoli T.; Schaan, Beatriz D.

    2013-01-01

    Purpose To evaluate the effects of aerobic (AER) or aerobic plus resistance exercise (COMB) sessions on glucose levels and glucose variability in patients with type 2 diabetes. Additionally, we assessed conventional and non-conventional methods to analyze glucose variability derived from multiple measurements performed with continuous glucose monitoring system (CGMS). Methods Fourteen patients with type 2 diabetes (56±2 years) wore a CGMS during 3 days. Participants randomly performed AER and COMB sessions, both in the morning (24 h after CGMS placement), and at least 7 days apart. Glucose variability was evaluated by glucose standard deviation, glucose variance, mean amplitude of glycemic excursions (MAGE), and glucose coefficient of variation (conventional methods) as well as by spectral and symbolic analysis (non-conventional methods). Results Baseline fasting glycemia was 139±05 mg/dL and HbA1c 7.9±0.7%. Glucose levels decreased immediately after AER and COMB protocols by ∼16%, which was sustained for approximately 3 hours. Comparing the two exercise modalities, responses over a 24-h period after the sessions were similar for glucose levels, glucose variance and glucose coefficient of variation. In the symbolic analysis, increases in 0 V pattern (COMB, 67.0±7.1 vs. 76.0±6.3, P = 0.003) and decreases in 1 V pattern (COMB, 29.1±5.3 vs. 21.5±5.1, P = 0.004) were observed only after the COMB session. Conclusions Both AER and COMB exercise modalities reduce glucose levels similarly for a short period of time. The use of non-conventional analysis indicates reduction of glucose variability after a single session of combined exercises. Trial Registration Aerobic training, aerobic-resistance training and glucose profile (CGMS) in type 2 diabetes (CGMS exercise). ClinicalTrials.gov ID: NCT00887094. PMID:23536769

  12. ADHD classification using bag of words approach on network features

    NASA Astrophysics Data System (ADS)

    Solmaz, Berkan; Dey, Soumyabrata; Rao, A. Ravishankar; Shah, Mubarak

    2012-02-01

    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.

  13. Neuroanatomical and Neuropsychological Correlates of the Cerebellum in Children with Attention-Deficit/Hyperactivity Disorder-Combined Type

    ERIC Educational Resources Information Center

    Bledsoe, Jesse C.; Semrud-Clikeman, Margaret; Pliszka, Steven R.

    2011-01-01

    Objective: Studies of healthy individuals and those with cerebellar damage have implicated the cerebellum in a variety of cognitive and behavioral processes. Decreased cerebellar volume has been found in children with attention-deficit/hyperactivity disorder (ADHD) and differentially related to behavioral outcomes. The present study investigated…

  14. Identification of combined action types in experiments with two toxicants: a response surface linear model with a cross term.

    PubMed

    Panov, Vladimir G; Varaksin, Anatoly N

    2016-02-01

    Within the framework of the response surface linear model with a cross term, i.e. a model of the type Y(x1, x2) = b0 + b1x1 + b2x2 + b12x1x2 (hyperbolic paraboloid), a complete solution of identification of combined action types of two toxicants x1 and x2 is presented. It is shown that the type of combined effect in this model is determined by two factors: the direction in which the toxicants act (unidirectional or oppositely directed), and the position of the saddle point S of a hyperbolic paraboloid. For unidirectional actions of toxicants, already-known ways to identify the type of combined effect (including a shape of the isobole: concave-up or concave-down) provided identical and unambiguous answers regarding the type of combined effect (antagonism or synergism). For oppositely directed actions of toxicants, the shape of the isobole (concave-up or concave-down) did not allow us to determine the type of combined action type unambiguously. We show that in both cases (unidirectional or oppositely directed actions of toxicants) the signs of the model coefficients b1, b2 and b12, in conjunction with the coordinates of the saddle point S help unambiguously identify the type of combined action by comparing the observed effect with the zero interaction response surface. An atlas of all possibly combined action types for two toxicants for the hyperbolic paraboloid model was created. Applications of the developed formalism to experimental data are provided. PMID:26894918

  15. Understanding the Phenotypic Structure of Adult Retrospective ADHD Symptoms during Childhood in the United States

    ERIC Educational Resources Information Center

    Ranby, Krista W.; Boynton, Marcella H.; Kollins, Scott H.; McClernon, F. Joseph; Yang, Chongming; Fuemmeler, Bernard F.

    2012-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a highly heterogeneous disorder, and the phenotypic structure comprising inattentive and hyperactive-impulsive type symptoms has been the focus of a growing body of recent research. Methodological studies are needed to better characterize phenotypes to advance research as well as clinical…

  16. Increased Intraindividual Variability Is a Marker of ADHD but Also of Dyslexia: A Study on Handwriting

    ERIC Educational Resources Information Center

    Borella, Erika; Chicherio, Christian; Re, Anna Maria; Sensini, Vanessa; Cornoldi, Cesare

    2011-01-01

    It has been suggested that intraindividual variability (IIV) in neuropsychological tasks may be a specific characteristic of Attention-Deficit Hyperactivity Disorder (ADHD), but previous research has not thoroughly examined whether IIV also concerns academic performance or other types of developmental disabilities. The present study investigates…

  17. Parental Recall of Pre-School Behavior Related to ADHD and Disruptive Behavior Disorder

    ERIC Educational Resources Information Center

    Ercan, Eyup Sabri; Somer, Oya; Amado, Sonia; Thompson, Dennis

    2005-01-01

    The aim of this study was to examine the contribution of Age of Onset Criterion (AOC) to the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and disruptive behavior disorder. For this purpose, a 10-item Likert-type Parent Assessment of Pre-school Behavior Scale (PARPS), developed by the experimenters, was used to examine the presence…

  18. The Efficacy of Parent Training Programs for ADHD Children: A Fifteen-Year Review

    ERIC Educational Resources Information Center

    Kohut, Kandace S.; Andrews, Jac

    2004-01-01

    This article reviews ten studies using parent training as a treatment approach for ADHD children. Six elements of research methods are considered: (1) type of parent training program; (2) parental psychopathological assessment; (3) parental involvement; (4) setting of treatment; (5) medication usage; and, (6) follow-up analysis. The studies were…

  19. Pattern classification of response inhibition in ADHD: Toward the development of neurobiological markers for ADHD

    PubMed Central

    Hart, Heledd; Chantiluke, Kaylita; Cubillo, Ana I; Smith, Anna B; Simmons, Andrew; Brammer, Michael J; Marquand, Andre F; Rubia, Katya

    2014-01-01

    The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is based on subjective measures despite evidence for multisystemic structural and functional deficits. ADHD patients have consistent neurofunctional deficits in motor response inhibition. The aim of this study was to apply pattern classification to task-based functional magnetic resonance imaging (fMRI) of inhibition, to accurately predict the diagnostic status of ADHD. Thirty adolescent ADHD and thirty age-matched healthy boys underwent fMRI while performing a Stop task. fMRI data were analyzed with Gaussian process classifiers (GPC), a machine learning approach, to predict individual ADHD diagnosis based on task-based activation patterns. Traditional univariate case-control analyses were also performed to replicate previous findings in a relatively large dataset. The pattern of brain activation correctly classified up to 90% of patients and 63% of controls, achieving an overall classification accuracy of 77%. The regions of the discriminative network most predictive of controls included later developing lateral prefrontal, striatal, and temporo-parietal areas that mediate inhibition, while regions most predictive of ADHD were in earlier developing ventromedial fronto-limbic regions, which furthermore correlated with symptom severity. Univariate analysis showed reduced activation in ADHD in bilateral ventrolateral prefrontal, striatal, and temporo-parietal regions that overlapped with areas predictive of controls, suggesting the latter are dysfunctional areas in ADHD. We show that significant individual classification of ADHD patients of 77% can be achieved using whole brain pattern analysis of task-based fMRI inhibition data, suggesting that multivariate pattern recognition analyses of inhibition networks can provide objective diagnostic neuroimaging biomarkers of ADHD. Hum Brain Mapp 35:3083–3094, 2014. © 2013 Wiley Periodicals, Inc. PMID:24123508

  20. Pattern classification of response inhibition in ADHD: toward the development of neurobiological markers for ADHD.

    PubMed

    Hart, Heledd; Chantiluke, Kaylita; Cubillo, Ana I; Smith, Anna B; Simmons, Andrew; Brammer, Michael J; Marquand, Andre F; Rubia, Katya

    2014-07-01

    The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is based on subjective measures despite evidence for multisystemic structural and functional deficits. ADHD patients have consistent neurofunctional deficits in motor response inhibition. The aim of this study was to apply pattern classification to task-based functional magnetic resonance imaging (fMRI) of inhibition, to accurately predict the diagnostic status of ADHD. Thirty adolescent ADHD and thirty age-matched healthy boys underwent fMRI while performing a Stop task. fMRI data were analyzed with Gaussian process classifiers (GPC), a machine learning approach, to predict individual ADHD diagnosis based on task-based activation patterns. Traditional univariate case-control analyses were also performed to replicate previous findings in a relatively large dataset. The pattern of brain activation correctly classified up to 90% of patients and 63% of controls, achieving an overall classification accuracy of 77%. The regions of the discriminative network most predictive of controls included later developing lateral prefrontal, striatal, and temporo-parietal areas that mediate inhibition, while regions most predictive of ADHD were in earlier developing ventromedial fronto-limbic regions, which furthermore correlated with symptom severity. Univariate analysis showed reduced activation in ADHD in bilateral ventrolateral prefrontal, striatal, and temporo-parietal regions that overlapped with areas predictive of controls, suggesting the latter are dysfunctional areas in ADHD. We show that significant individual classification of ADHD patients of 77% can be achieved using whole brain pattern analysis of task-based fMRI inhibition data, suggesting that multivariate pattern recognition analyses of inhibition networks can provide objective diagnostic neuroimaging biomarkers of ADHD. PMID:24123508

  1. Interaction of recalled parental ADHD symptoms and rearing behavior with current attachment and emotional dysfunction in adult offspring with ADHD.

    PubMed

    Edel, Marc-Andreas; Juckel, Georg; Brüne, Martin

    2010-06-30

    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. PMID:20452044

  2. Skills training groups for men with ADHD in compulsory care due to substance use disorder: a feasibility study.

    PubMed

    Bihlar Muld, B; Jokinen, J; Bölte, S; Hirvikoski, T

    2016-09-01

    Dialectical behavior therapy (DBT)-based skills training has been developed and previously evaluated for adults with ADHD in a psychiatric outpatient context. The aim of the present study was to evaluate the feasibility of DBT-based skills training as a voluntary intervention for men with ADHD in compulsory care due to severe substance abuse. Forty sufficiently detoxified men with ADHD in compulsory care due to life-threatening substance use disorder (SUD) were included in DBT-based skills training groups. Self- and staff-rating scales were administered before and after the treatment. The refusal rate was 42.9 %. Of those who started the DBT-based skills training, 70 % completed the treatment (attendance at ≥75 % of the sessions). The treatment acceptability was good. Both ADHD and psychiatric symptoms decreased from pre- to post-intervention in self-ratings, but not in staff ratings. The patients reported improved general well-being. The correlation between self- and staff ratings was poor. Motivation for voluntary nonpharmacological treatment was low in a compulsory care context. However, the results indicate that a DBT-based skills training program for adults with ADHD may be feasible for some patients with ADHD in combination with SUD in compulsory care, provided that considerable resources are allocated with adjustments to the target group and compulsory care context. PMID:27059489

  3. [Proposals for social policies to improve the quality of life in attention deficit/hyperactivity disorder [ADHD

    PubMed

    Cid Foix, Ana

    2011-01-01

    This article describes the effects of pre and postnatal stress on the cerebral morphological findings described as attention deficit/hyperactivity disorder. [ADHD]. The consequences of ADHD cause social problems because these children have difficulties with family, school and social integration. Previous treatments are reviewed up to the present day. The drug that has been used most frequently is Metilphenidate, a psychostimulant, and recently, a new drug, Atomoxetine, a non psychostimulant was introduced. The therapy is combined with physiological training. These drugs give relief to the symptoms but their long term side-effects are unknown. Recent investigations have shown that children with ADHD who are receiving either cognitive or control training have increased cerebral activity without previous medication. With these facts in mind the European ADHD Guidelines group suggests a new focus of attention on the children and adults with this problem with the aim of modifying the treatment followed until now. The ethical motives for this review are: a) to make society more aware of the problems of ADHD with the aim of taking measures to avoid the possible causes of the illness; b) to take into account that the effects of long term psychostimulant drugs on the developing mind are unknown; c) to gather information that supports the view that diagnosis of ADHD has increased. PMID:22040136

  4. Attention-Deficit / Hyperactivity Disorder (ADHD): Data and Statistics

    MedlinePlus

    ... 2012) Detailed Information by State Top of Page Peer Relationships [ Read abstract ] Parents of children with a ... of ADHD report almost 3 times as many peer problems as those without a history of ADHD ( ...

  5. ADHD Meds Tied to Lower Bone Density in Kids

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_157591.html ADHD Meds Tied to Lower Bone Density in Kids ... 3, 2016 (HealthDay News) -- Children on medications for attention deficit hyperactivity disorder (ADHD) may have lower bone density than their ...

  6. Most Teens Who Abuse ADHD Meds Get Them from Others

    MedlinePlus

    ... news/fullstory_157662.html Most Teens Who Abuse ADHD Meds Get Them From Others Study finds 54 ... TUESDAY, March 8, 2016 (HealthDay News) -- Abuse of ADHD stimulant drugs such Ritalin or Adderall is on ...

  7. Sound Sleep Elusive for Many Kids with ADHD

    MedlinePlus

    ... fullstory_159266.html Sound Sleep Elusive for Many Kids With ADHD Those with the attention disorder sleep ... made about children with attention-deficit/hyperactivity disorder -- kids with ADHD don't sleep as well as ...

  8. Attention-Deficit / Hyperactivity Disorder (ADHD): Symptoms and Diagnosis

    MedlinePlus

    ... Recommend on Facebook Tweet Share Compartir Is it ADHD? Symptoms Checklist Fill out the symptoms checklist and ... more about other concerns and conditions . How is ADHD diagnosed? Healthcare professionals use the guidelines in the ...

  9. Acetaminophen During Pregnancy May Up Risk of ADHD in Kids

    MedlinePlus

    ... html Acetaminophen During Pregnancy May Up Risk of ADHD in Kids But only association found, and researchers ... their child will develop behavioral problems such as attention-deficit/hyperactivity disorder (ADHD), a new study suggests. Acetaminophen is generally ...

  10. ADHD Common Among College Students Who Misuse Stimulant Drugs

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160405.html ADHD Common Among College Students Who Misuse Stimulant Drugs ... misuse stimulant drugs are more likely to have attention-deficit hyperactivity disorder (ADHD) or other psychiatric problems, a new study ...

  11. ADHD Can First Appear in Young Adulthood for Some

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_158907.html ADHD Can First Appear in Young Adulthood for Some, ... British study suggests that attention-deficient hyperactivity disorder (ADHD) may often develop in the young adult years. ...

  12. ADHD among adolescents with intellectual disabilities: Pre-pathway influences

    PubMed Central

    Neece, Cameron; Baker, Bruce; Lee, Steve

    2013-01-01

    Children and adolescents with intellectual disabilities (ID) are at heightened risk for developing ADHD. However, the validity of ADHD as a diagnosis for youth with ID remains controversial. To advance research on validity, the present study examined the hypothesized precursors to ADHD in typically developing adolescents (TD) and adolescents with ID, specifically with regard to family history of ADHD, molecular genetics, and neuropsychological functioning. Results indicated that youth ADHD symptoms were related to parental ADHD symptoms regardless of the adolescent’s cognitive functioning. Additionally, findings suggested that the DRD4 genetic variant and adolescent set-shifting abilities were related to adolescent ADHD symptoms independent of cognitive functioning. This study provides an initial investigation of the biological correlates of ADHD among youth with ID. PMID:23665431

  13. Are parental autism spectrum disorder and/or attention-deficit/Hyperactivity disorder symptoms related to parenting styles in families with ASD (+ADHD) affected children?

    PubMed

    van Steijn, Daphne J; Oerlemans, Anoek M; de Ruiter, Saskia W; van Aken, Marcel A G; Buitelaar, Jan K; Rommelse, Nanda N J

    2013-11-01

    An understudied and sensitive topic nowadays is that even subthreshold symptoms of autism spectrum disorder (ASD) and attention-deficit/Hyperactivity disorder (ADHD) in parents may relate to their parenting styles. The aim of this study was to explore the influence of (the combined) effect of child diagnosis (ASD or ASD + ADHD affected/unaffected children) and parental ASD and/or ADHD on parenting styles. Ninety-six families were recruited with one child with a clinical ASD (+ADHD) diagnosis, and one unaffected sibling. Parental ASD and ADHD symptoms were assessed using self-report. The Parenting Styles Dimensions Questionnaire (PSDQ) self- and spouse-report were used to measure the authoritative, authoritarian, and permissive parenting styles. Fathers and mothers scored significantly higher than the norm data of the PSDQ on the permissive style regarding affected children, and lower on the authoritative and authoritarian parenting style for affected and unaffected children. Self- and spouse-report correlated modestly too strongly. Higher levels of paternal (not maternal) ADHD symptoms were suboptimally related to the three parenting styles. Further, two parent-child pathology interaction effects were found, indicating that fathers with high ADHD symptoms and mothers with high ASD symptoms reported to use a more permissive parenting style only towards their unaffected child. The results highlight the negative effects of paternal ADHD symptoms on parenting styles within families with ASD (+ADHD) affected offspring and the higher permissiveness towards unaffected offspring specifically when paternal ADHD and/or maternal ASD symptoms are high. Parenting training in these families may be beneficial for the well-being of all family members. PMID:23564208

  14. Lisdexamfetamine: A Review in ADHD in Adults.

    PubMed

    Frampton, James E

    2016-04-01

    Lisdexamfetamine dimesylate (lisdexamfetamine) is a long-acting amfetamine prodrug with a convenient once-daily oral regimen that offers the potential for improved adherence and reduced abuse compared with short-acting preparations of amfetamines. Lisdexamfetamine (as Elvanse Adult(®); Tyvense Adult™) has been approved for use in adults with attention-deficit hyperactivity disorder (ADHD) under the EU decentralization procedure, with the first approvals in the UK, Sweden and Denmark. This approval reflects the results of three short-term trials in adults with ADHD in which fixed- or flexible-dose lisdexamfetamine produced significantly greater improvements than placebo in ADHD symptoms, overall functioning, executive functioning (including in patients with significant pre-existing impairment) and quality of life. Of note, a post hoc analysis of one of these studies suggested that the response to lisdexamfetamine was generally similar in treatment-naïve patients and those who had already received-and not responded satisfactorily to-previous ADHD therapies, including methylphenidate (MPH). Two further studies demonstrated the longer-term effectiveness of flexible-dose lisdexamfetamine in reducing ADHD symptoms, albeit maintenance of efficacy required ongoing treatment with the drug. Lisdexamfetamine was generally well tolerated in clinical trials, with an adverse event profile typical of that reported for other long-acting stimulants. Head-to-head comparisons with other long-acting agents, notably MPH and atomoxetine, are lacking. Nonetheless, on the basis of the available data, lisdexamfetamine provides a useful alternative option for the treatment of adults with ADHD, including those who have not responded adequately to previous ADHD therapies, including MPH. PMID:27048350

  15. ADHD in girls and boys – gender differences in co-existing symptoms and executive function measures

    PubMed Central

    2013-01-01

    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

  16. Brief Report: The Effects of Typed and Spoken Modality Combinations on the Language Performance of Adults with Autism.

    ERIC Educational Resources Information Center

    Forsey, Janice; And Others

    1996-01-01

    A study of five adult males with autism investigated which combination of input/output modalities (typed or spoken) enhanced the syntactic, semantic, and/or pragmatic performance of individuals with autism when engaging in conversations with a normal language adult. Results found that typed communications facilitated the use of longer utterances.…

  17. Attention deficits revealed by passive auditory change detection for pure tones and lexical tones in ADHD children

    PubMed Central

    Yang, Ming-Tao; Hsu, Chun-Hsien; Yeh, Pei-Wen; Lee, Wang-Tso; Liang, Jao-Shwann; Fu, Wen-Mei; Lee, Chia-Ying

    2015-01-01

    Inattention (IA) has been a major problem in children with attention deficit/hyperactivity disorder (ADHD), accounting for their behavioral and cognitive dysfunctions. However, there are at least three processing steps underlying attentional control for auditory change detection, namely pre-attentive change detection, involuntary attention orienting, and attention reorienting for further evaluation. This study aimed to examine whether children with ADHD would show deficits in any of these subcomponents by using mismatch negativity (MMN), P3a, and late discriminative negativity (LDN) as event-related potential (ERP) markers, under the passive auditory oddball paradigm. Two types of stimuli—pure tones and Mandarin lexical tones—were used to examine if the deficits were general across linguistic and non-linguistic domains. Participants included 15 native Mandarin-speaking children with ADHD and 16 age-matched controls (across groups, age ranged between 6 and 15 years). Two passive auditory oddball paradigms (lexical tones and pure tones) were applied. The pure tone oddball paradigm included a standard stimulus (1000 Hz, 80%) and two deviant stimuli (1015 and 1090 Hz, 10% each). The Mandarin lexical tone oddball paradigm’s standard stimulus was /yi3/ (80%) and two deviant stimuli were /yi1/ and /yi2/ (10% each). The results showed no MMN difference, but did show attenuated P3a and enhanced LDN to the large deviants for both pure and lexical tone changes in the ADHD group. Correlation analysis showed that children with higher ADHD tendency, as indexed by parents’ and teachers’ ratings on ADHD symptoms, showed less positive P3a amplitudes when responding to large lexical tone deviants. Thus, children with ADHD showed impaired auditory change detection for both pure tones and lexical tones in both involuntary attention switching, and attention reorienting for further evaluation. These ERP markers may therefore be used for the evaluation of anti-ADHD drugs that

  18. Attention deficits revealed by passive auditory change detection for pure tones and lexical tones in ADHD children.

    PubMed

    Yang, Ming-Tao; Hsu, Chun-Hsien; Yeh, Pei-Wen; Lee, Wang-Tso; Liang, Jao-Shwann; Fu, Wen-Mei; Lee, Chia-Ying

    2015-01-01

    Inattention (IA) has been a major problem in children with attention deficit/hyperactivity disorder (ADHD), accounting for their behavioral and cognitive dysfunctions. However, there are at least three processing steps underlying attentional control for auditory change detection, namely pre-attentive change detection, involuntary attention orienting, and attention reorienting for further evaluation. This study aimed to examine whether children with ADHD would show deficits in any of these subcomponents by using mismatch negativity (MMN), P3a, and late discriminative negativity (LDN) as event-related potential (ERP) markers, under the passive auditory oddball paradigm. Two types of stimuli-pure tones and Mandarin lexical tones-were used to examine if the deficits were general across linguistic and non-linguistic domains. Participants included 15 native Mandarin-speaking children with ADHD and 16 age-matched controls (across groups, age ranged between 6 and 15 years). Two passive auditory oddball paradigms (lexical tones and pure tones) were applied. The pure tone oddball paradigm included a standard stimulus (1000 Hz, 80%) and two deviant stimuli (1015 and 1090 Hz, 10% each). The Mandarin lexical tone oddball paradigm's standard stimulus was /yi3/ (80%) and two deviant stimuli were /yi1/ and /yi2/ (10% each). The results showed no MMN difference, but did show attenuated P3a and enhanced LDN to the large deviants for both pure and lexical tone changes in the ADHD group. Correlation analysis showed that children with higher ADHD tendency, as indexed by parents' and teachers' ratings on ADHD symptoms, showed less positive P3a amplitudes when responding to large lexical tone deviants. Thus, children with ADHD showed impaired auditory change detection for both pure tones and lexical tones in both involuntary attention switching, and attention reorienting for further evaluation. These ERP markers may therefore be used for the evaluation of anti-ADHD drugs that aim to

  19. A Comparative Study of Sustained Attentional Bias on Emotional Processing in ADHD Children to Pictures with Eye-Tracking

    PubMed Central

    PISHYAREH, Ebrahim; TEHRANI-DOOST, Mehdi; MAHMOODI-GHARAIE, Javad; KHORRAMI, Anahita; RAHMDAR, Saeid Reza

    2015-01-01

    Objective ADHD children have anomalous and negative behavior especially in emotionally related fields when compared to other. Evidence indicates that attention has an impact on emotional processing. The present study evaluates the effect of emotional processing on the sustained attention of children with ADHD type C. Materials & Methods Sixty participants form two equal groups (each with 30 children) of normal and ADHD children) and each subject met the required selected criterion as either a normal or an ADHD child. Both groups were aged from 6–11-years-old. All pictures were chosen from the International Affective Picture System (IAPS) and presented paired emotional and neutral scenes in the following categories: pleasant-neutral; pleasant-unpleasant; unpleasant-neutral; and neutral–neutral. Sustained attention was evaluated based on the number and duration of total fixation and was compared between the groups with MANOVA analysis. Results The duration of sustained attention on pleasant in the pleasant-unpleasant pair was significant. Bias in duration of sustained attention on pleasant scenes in pleasant-neutral pairs is significantly different between the groups. Conclusion Such significant differences might be indicative of ADHD children deficiencies in emotional processing. It seems that the highly deep effect of emotionally unpleasant scenes to gain the focus of ADHD children’s attention is responsible for impulsiveness and abnormal processing of emotional stimuli. PMID:25767541

  20. Restless Leg Syndrome in ADHD children: levetiracetam as a reasonable therapeutic option.

    PubMed

    Gagliano, Antonella; Aricò, Irene; Calarese, Tiziana; Condurso, Rosaria; Germanò, Eva; Cedro, Clemente; Spina, Edoardo; Silvestri, Rosalia

    2011-06-01

    The comorbidity of Attention Deficit Hyperactivity Disorder (ADHD) with sleep disorders has been extensively studied. In particular, Restless Legs Syndrome (RLS) appears to be consistently more frequent in children with ADHD. Several papers also draw attention to the frequent occurrence of epileptic seizures and EEG abnormalities in ADHD children. We performed a preliminary open label study to evaluate the efficacy of Levetiracetam (LEV) to ameliorate the sleep pattern and reduce RLS symptoms in children with a complex comorbidity between Attention Deficit Hyperactivity Disorder (ADHD), RLS and focal interictal epileptic discharges (IEDs) on EEG. We recruited seven children (all males, aged between 5 and 12years) who fulfilled the following criteria: ADHD diagnosis combined subtype; presence of idiopathic RLS; and presence of focal IEDs on EEG. All children were given LEV at a starting dose of approximately 10-20mg/kg/day followed by 10mg/kg/day incrementing at 1-week intervals up to 50-60mg/kg/day given in two separate doses. At a 3 and 6month follow-up, all children showed significant improvement (p<0.05) in global International RLS Rating Scale (IRLS-RS). Parents' reports revealed improved sleep quality with fewer awakenings and restorative sleep in their children. LEV was well tolerated and no major side effects were reported. With an accessory report we observed the reduction of epileptiform EEG activity during sleep. In most patients (6 on 7) the discharges completely disappeared; in the last patient epileptiform EEG activity was significantly reduced. These children may represent a subgroup of ADHD patients in which the hyperactivity and attention difficulties might be aggravated by sleep disturbances and by IEDs. LEV could represent a therapeutic option for these comorbid conditions. PMID:20950971

  1. Objective assessment of ADHD core symptoms in children with heavy prenatal alcohol exposure.

    PubMed

    Infante, M Alejandra; Moore, Eileen M; Nguyen, Tanya T; Fourligas, Nikolaos; Mattson, Sarah N; Riley, Edward P

    2015-09-01

    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. PMID:25447751

  2. Amplitude variability over trials in hemodynamic responses in adolescents with ADHD: The role of the anterior default mode network and the non-specific role of the striatum.

    PubMed

    Sørensen, L; Eichele, T; van Wageningen, H; Plessen, K J; Stevens, M C

    2016-01-01

    It has been suggested that intra-individual variability (IIV) in performance on attention and other cognitive tasks might be a cognitive endophenotype in individuals with ADHD. Despite robust IIV findings in behavioral data, only sparse data exist on how what type of brain dysfunction underlies variable response times. In this study, we asked whether ADHD IIV in reaction time on a commonly-used test of attention might be related to variation in hemodynamic responses (HRs) observed trial-to-trial. Based on previous studies linking IIV to regions within the "default mode" network (DMN), we predicted that adolescents with ADHD would have higher HR variability in the DMN compared with controls, and this in turn would be related to behavioral IIV. We also explored the influence of social anxiety on HR variability in ADHD as means to test whether higher arousal associated with high trait anxiety would affect the neural abnormalities. We assessed single-trial variability of HRs, estimated from fMRI event-related responses elicited during an auditory oddball paradigm in adolescents with ADHD and healthy controls (11-18 years old; N = 46). Adolescents with ADHD had higher HR variability compared with controls in anterior regions of the DMN. This effect was specific to ADHD and not associated with traits of age, IQ and anxiety. However, an ADHD effect of higher HR variability also appeared in a basal ganglia network, but for these brain regions the relationships of HR variability and social anxiety levels were more complex. Performance IIV correlated significantly with variability of HRs in both networks. These results suggest that assessment of trial-to-trial HR variability in ADHD provides information beyond that detectable through analysis of behavioral data and average brain activation levels, revealing specific neural correlates of a possible ADHD IIV endophenotype. PMID:27622136

  3. The Problem with ADHD: Researchers' Constructions and Parents' Accounts

    ERIC Educational Resources Information Center

    Pajo, Bora; Cohen, David

    2013-01-01

    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…

  4. Variability of Attention Processes in ADHD: Observations from the Classroom

    ERIC Educational Resources Information Center

    Rapport, Mark D.; Kofler, Michael J.; Alderson, R. Matt; Timko, Thomas M., Jr.; DuPaul, George J.

    2009-01-01

    Objective: Classroom- and laboratory-based efforts to study the attentional problems of children with ADHD are incongruent in elucidating attentional deficits; however, none have explored within- or between-minute variability in the classroom attentional processing in children with ADHD. Method: High and low attention groups of ADHD children…

  5. Impulsivity in College Students with and without ADHD

    ERIC Educational Resources Information Center

    Miller, Jessica A.

    2010-01-01

    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…

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

    ERIC Educational Resources Information Center

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

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

  7. Gifted Children with Attention Deficit Hyperactivity Disorder (ADHD). ERIC Digest.

    ERIC Educational Resources Information Center

    Neihart, Maureen

    This digest summarizes what is known about gifted children with attention deficit hyperactivity disorder (ADHD). It identifies three subtypes of ADHD, noting both criteria for diagnosis and the subjective determination of what constitutes significant impairment. Discussion of differences in gifted and non-gifted children with ADHD reports findings…

  8. Time out of Mind: Temporal Perspective in Adults with ADHD

    ERIC Educational Resources Information Center

    Carelli, Maria G.; Wiberg, Britt

    2012-01-01

    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…

  9. Pragmatic Deficits and Social Impairment in Children with ADHD

    ERIC Educational Resources Information Center

    Staikova, Ekaterina; Gomes, Hilary; Tartter, Vivien; McCabe, Allyssa; Halperin, Jeffrey M.

    2013-01-01

    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…

  10. Screening for ADHD in an Adult Social Phobia Sample

    ERIC Educational Resources Information Center

    Mortberg, Ewa; Tilfors, Kerstin; Bejerot, Susanne

    2012-01-01

    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…

  11. Assessing the Concordance of Measures Used to Diagnose Adult ADHD

    ERIC Educational Resources Information Center

    Belendiuk, Katherine A.; Clarke, Tana L.; Chronis, Andrea M.; Raggi, Veronica L.

    2007-01-01

    Objective: Recent evidence suggests that ADHD persists into adulthood, but the best means of diagnosis and the concordance of measures used to diagnose adult ADHD are unknown. Method: The current study explores the relationships of these measures in a sample of 69 mothers of children with ADHD. Results: This study determines the concordance of (a)…

  12. Racial/Ethnic Disparities in ADHD Diagnosis by Kindergarten Entry

    ERIC Educational Resources Information Center

    Morgan, Paul L.; Hillemeier, Marianne M.; Farkas, George; Maczuga, Steve

    2014-01-01

    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…

  13. Predictors of Postural Stability in Children with ADHD

    ERIC Educational Resources Information Center

    Ghanizadeh, Ahmad

    2011-01-01

    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…

  14. Attention Deficit Hyperactivity Disorder (ADHD) in Childhood Epilepsy

    ERIC Educational Resources Information Center

    Reilly, Colin J.

    2011-01-01

    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…

  15. Memory for Object Locations in Boys with and without ADHD

    ERIC Educational Resources Information Center

    Reck, Sarah G.; Hund, Alycia M.; Landau, Steven

    2010-01-01

    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…

  16. Autistic Traits in a Population-Based ADHD Twin Sample

    ERIC Educational Resources Information Center

    Reiersen, Angela M.; Constantino, John N.; Volk, Heather E.; Todd, Richard D.

    2007-01-01

    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…

  17. ADHD in Indian Elementary Classrooms: Understanding Teacher Perspectives

    ERIC Educational Resources Information Center

    David, Neena

    2013-01-01

    ADHD in India is culturally viewed as a school specific condition. Parents perceive accessing child psychiatric services as stigmatizing and prefer educational interventions for ADHD. There is a crucial need for research that restructures information and intervention paradigms about ADHD within a school context. The objectives of the present study…

  18. Obsessive-compulsive adults with and without childhood ADHD symptoms.

    PubMed

    Tan, Oguz; Metin, Baris; Metin, Sinem

    2016-09-01

    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. PMID:27056070

  19. Medications Do Not Necessarily Normalize Cognition in ADHD Patients

    ERIC Educational Resources Information Center

    Gualtieri, C. Thomas; Johnson, Lynda G.

    2008-01-01

    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…

  20. What Can ADHD without Comorbidity Teach Us about Comorbidity?

    ERIC Educational Resources Information Center

    Takeda, Toshinobu; Ambrosini, Paul J.; deBerardinis, Rachel; Elia, Josephine

    2012-01-01

    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,…

  1. ADHD with Comorbid Anxiety: A Review of the Current Literature

    ERIC Educational Resources Information Center

    Schatz, David Beck; Rostain, Anthony L.

    2006-01-01

    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,…

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  4. Atomoxetine Treatment of ADHD in Children with Comorbid Tourette Syndrome

    ERIC Educational Resources Information Center

    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

    2008-01-01

    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…

  5. ADHD: Misconceptions and the Four Rules of Treatment

    ERIC Educational Resources Information Center

    Kutscher, Martin L.

    2008-01-01

    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…

  6. Functional Impairment and Occupational Outcome in Adults with ADHD

    ERIC Educational Resources Information Center

    Gjervan, Bjorn; Torgersen, Terje; Nordahl, Hans M.; Rasmussen, Kirsten

    2012-01-01

    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…

  7. Motorsports Involvement among Adolescents and Young Adults with Childhood ADHD

    ERIC Educational Resources Information Center

    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.

    2013-01-01

    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…

  8. Numerical simulation analysis and optimum design for combined type pressure reducing valves

    NASA Astrophysics Data System (ADS)

    Gou, D. M.; Guo, P. C.; Zheng, X. B.; Luo, X. Q.; Sun, L. G.

    2016-05-01

    Pressure reducing valve is an extremely significant equipment of energy dissipation for the water supply by gravity with pressure reducing technology in hydropower stations, and which has a pronounced effect on the normal technical water supply even safety operation for the hydropower units. A three-dimensional numerical calculation of flow field and cavitation characteristics towards a combined type pressure reducing valves was carried out based on the system of technical water supply in this paper. The numerical results show that the investigated valve could meet the requirements of technological supply water pressure and great pressure loss was caused when the water flow was accelerated by narrow overflowing section between throttling cone and valve seat. At working operation, obvious cavitation phenomenon was observed on the surface of throttling cone, and the maximum volume fraction of vapor reached 0.537%. Based on above researches, this paper introduces an optimization model for profile line design of throttling cone. The optimal results show that the cavitation performance is effectively improved with identical pressure drop compared with original results.

  9. Properties of biomass-derived biochars: Combined effects of operating conditions and biomass types.

    PubMed

    Luo, Lei; Xu, Chuang; Chen, Zien; Zhang, Shuzhen

    2015-09-01

    Combined effects of operating conditions including heating temperature (200-700 °C), time (1-8h) and rate, and atmosphere (air-flow, air-limited and N2) on the physicochemical properties of biochars with pine sawdust, maize straw and sugarcane bagasse as feedstocks were investigated. The results demonstrated that production temperature and atmosphere acted as the predominant factors that determined the properties of biochars. The X-ray diffraction data confirmed the occurrence of phase transition in the biomass structures at around 400 °C. Heating time and rate showed little effect on the functional group compositions of the biochars within 8h, particularly under N2 atmosphere. In addition, the molecular weights of the biochar-derived dissolved organic carbon tended to increase with increasing temperature. Feedstock type also affected the biochar properties by the compositional differences in mineral salts and cellulose/lignin in the three biomass materials. This work provides important information for optimizing procedures for biochar production with desired properties and high yield. PMID:26022969

  10. Investigating integument alterations in cubicle housed dairy cows: which types and locations can be combined?

    PubMed

    Brenninkmeyer, C; Dippel, S; Brinkmann, J; March, S; Winckler, C; Knierim, U

    2016-02-01

    In this study, a data set of 2922 lactating dairy cows in a sample of 64 conventional and organic dairy farms with Holstein Friesian cows in Germany and 31 conventional dairy farms with the dual purpose breed Fleckvieh in Austria was used to screen for correlations between the occurrences of different integument alterations. All cows were housed in cubicle systems. Alterations were classified as hairless areas (H), scabs or wounds (W) or swellings (S) and assessed at 15 locations of the cows' body. Highest median farm prevalences were found at the joints of the legs, which are already commonly included in studies on integumentary alterations: median farm prevalence was 83% for S and 48% for H at the carpal joints, followed by H (38%) and S (20%) at the lateral tarsal joints and H at the lateral calcanei (20%). Additional body parts with notable median prevalences for H were the hip bones (13%), pin bones (12%) and sacrum (11%). Three cluster models, with 2, 5 and 14 clusters, were built by hierarchical clustering of prevalences of the 30 most relevant alteration location combinations. Clustering revealed that location overruled type of lesion in most cases. Occasionally, clusters represented body segments significantly distant from each other, for example the carpal joints and lateral and dorsal calcanei. However, some neighbouring areas such as the medial and lateral hock area should be analysed separately from each other for causal analysis as they formed distinct clusters. PMID:26144555

  11. Laparoscopic Management or Laparoscopy Combined with Transvaginal Management of Type II Cesarean Scar Pregnancy

    PubMed Central

    Wang, Huan-Ying; Li, Yan-Na; Wei, Wei; Zhang, Da-Wei; Lu, Yu-Qiu; Zhang, Hao-Feng

    2013-01-01

    Objective: To evaluate the clinical effectiveness of laparoscopic management of cesarean scar pregnancy (CSP) by deep implantation. Background: A pregnancy implanting within the scar from a previous cesarean delivery is a rare condition of ectopic pregnancy. There are two different types of CSPs. Type I is caused by implantation of the amniotic sac on the scar with progression toward either the cervicoisthmic space or the uterine cavity. Type II (CSP-II) is caused by deep implantation into a previous CS defect with infiltrating growth into the uterine myometrium and bulging from the uterine serosal surface, which may result in uterine rupture and severe bleeding during the first trimester of pregnancy. Thus, timely management with an early and accurate diagnosis of CSP-II is important. However, laparoscopic management in CSP-II has not yet been evaluated. Methods: Eleven patients with CSP-II underwent conservative laparoscopic surgery or laparoscopy combined with transvaginal bilateral uterine artery ligation and resection of the scar with gestational tissue and wound repair to preserve the uterus from March 2008 to November 2011. Patients with CSP-II were diagnosed using color Doppler sonography, and the diagnosis was confirmed by laparoscopy. The operation time, the blood loss during surgery, the levels of β-human chorionic gonadotropin (β-hCG) before surgery, the time taken for serum β-hCG levels to return to <100 mIU/mL postoperatively, and the time for the uterine body to revert to its original state were retrospectively analyzed. Results: All 11 operations were successfully performed using laparoscopy with preservation of the uterus. One patient underwent a dilation and curettage after laparoscopic bilateral uterine artery ligation. Eight patients were treated solely by laparoscopic bilateral uterine artery ligation and resection of the scar with gestational tissue and wound repair. The remaining two patients underwent laparoscopic bilateral uterine artery

  12. Adult ADHD Medications and Their Cardiovascular Implications

    PubMed Central

    Lewis, O.

    2016-01-01

    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

  13. Story comprehension in children with ADHD.

    PubMed

    Lorch, E P; Milich, R; Sanchez, R P

    1998-09-01

    A wealth of research is available examining children's story comprehension. However, little attention has been directed toward understanding the story comprehension of children with attention deficit hyperactivity disorder (ADHD). The present paper attempts to integrate the developmental literature on children's story comprehension with the little that is known about the story comprehension processes of children with ADHD. This review is guided by a network model of story representation that emphasizes the structure of causal and enabling relations between story events. Examination of the available studies indicates that children with ADHD lag behind their peers in their understanding of causal relations, and that their attentional problems may contribute to difficulties in understanding factual information in the preschool years and causally related information in the elementary years. Some evidence also is presented suggesting that children with ADHD are less effective in taking advantage of story structure features in guiding their recall of story events. Suggestions for future research are offered that would elaborate our knowledge of the developmental progression in the processing of complex information by children with ADHD. PMID:11324305

  14. Adult ADHD Medications and Their Cardiovascular Implications.

    PubMed

    Sinha, A; Lewis, O; Kumar, R; Yeruva, S L H; Curry, B H

    2016-01-01

    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

  15. Stimulant Treatment of ADHD and Cigarette Smoking: A Meta-Analysis

    PubMed Central

    Faraone, Stephen V.; Kollins, Scott H.

    2014-01-01

    BACKGROUND AND OBJECTIVE: Individuals with attention-deficit/hyperactivity disorder (ADHD) have a significantly higher risk of cigarette smoking. The nature of the relationship between smoking and psychostimulant medications commonly used to treat ADHD is controversial. Our objective was to examine the relationship between stimulant treatment of ADHD and cigarette smoking by using meta-analysis, and to identify study and sample characteristics that moderate this relationship. METHODS: Literature searches on PubMed and PsycInfo databases identified published studies for inclusion. Included studies compared cigarette smoking outcomes for stimulant-treated and untreated ADHD individuals. Seventeen studies met inclusion criteria, and 14 (total n = 2360) contained sufficient statistical information for inclusion in the meta-analysis. Two authors extracted odds ratios or frequencies of smokers in the treatment or nontreatment groups, and coded study characteristics including sample source, percentage of male participants, follow-up length, treatment consistency, type of smoking measure, prospective study, and controlling for comorbidities. RESULTS: Meta-analysis revealed a significant association between stimulant treatment and lower smoking rates. Meta-regression indicated that effect sizes were larger for studies that used clinical samples, included more women, measured smoking in adolescence rather than adulthood, conceptualized stimulant treatment as consistent over time, and accounted for comorbid conduct disorder. CONCLUSIONS: Nearly all studies were naturalistic, precluding causal inferences. Available data were insufficient to examine additional influences of patient demographics, treatment effectiveness, or other comorbidities. Consistent stimulant treatment of ADHD may reduce smoking risk; the effect was larger in samples with more severe psychopathology. Implications for further research, treatment of ADHD, and smoking prevention are discussed. PMID:24819571

  16. Shared Genetic Influences Between Attention-Deficit/Hyperactivity Disorder (ADHD) Traits in Children and Clinical ADHD

    PubMed Central

    Stergiakouli, Evie; Martin, Joanna; Hamshere, Marian L.; Langley, Kate; Evans, David M.; St Pourcain, Beate; Timpson, Nicholas J.; Owen, Michael J.; O'Donovan, Michael; Thapar, Anita; Davey Smith, George

    2015-01-01

    Objective Twin studies and genome-wide complex trait analysis (GCTA) are not in agreement regarding heritability estimates for behavioral traits in children from the general population. This has sparked a debate on the possible difference in genetic architecture between behavioral traits and psychiatric disorders. In this study, we test whether polygenic risk scores associated with variation in attention-deficit/hyperactivity disorder (ADHD) trait levels in children from the general population predict ADHD diagnostic status and severity in an independent clinical sample. Method Single nucleotide polymorphisms (SNPs) with p < .5 from a genome-wide association study of ADHD traits in 4,546 children (mean age, 7 years 7 months) from the Avon Longitudinal Study of Parents and Children (ALSPAC; general population sample) were selected to calculate polygenic risk scores in 508 children with an ADHD diagnosis (independent clinical sample) and 5,081 control participants. Polygenic scores were tested for association with case-control status and severity of disorder in the clinical sample. Results Increased polygenic score for ADHD traits predicted ADHD case-control status (odds ratio = 1.17 [95% CI = 1.08–1.28], p = .0003), higher ADHD symptom severity (β = 0.29 [95% CI = 0.04–0.54], p = 0.02), and symptom domain severity in the clinical sample. Conclusion This study highlights the relevance of additive genetic variance in ADHD, and provides evidence that shared genetic factors contribute to both behavioral traits in the general population and psychiatric disorders at least in the case of ADHD. PMID:25791149

  17. Knowledge of Attention Deficit Hyperactivity Disorder (ADHD) and Attitudes toward Teaching Children with ADHD: The Role of Teaching Experience

    ERIC Educational Resources Information Center

    Anderson, Donnah L.; Watt, Susan E.; Noble, William; Shanley, Dianne C.

    2012-01-01

    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…

  18. Depression and Anxiety among Transitioning Adolescents and College Students with ADHD, Dyslexia, or Comorbid ADHD/Dyslexia

    ERIC Educational Resources Information Center

    Nelson, Jason M.; Gregg, Noel

    2012-01-01

    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.…

  19. Temporal Stability of ADHD in the High-IQ Population: Results from the MGH Longitudinal Family Studies of ADHD

    ERIC Educational Resources Information Center

    Antshel, Kevin M.; Faraone, Stephen V.; Maglione, Katherine; Doyle, Alysa; Fried, Ronna; Seidman, Larry; Biederman, Joseph

    2008-01-01

    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.

  20. The Development, Characterization, and Performance Evaluation of a New Combination Type Personnel Neutron Dosimeter

    NASA Astrophysics Data System (ADS)

    Liu, Chwei-Jeng

    A new combination type personnel neutron dosimeter has been designed and developed at the Oak Ridge National Laboratory (ORNL). The combination personnel neutron dosimeter (CPND) consists of a Harshaw albedo neutron thermoluminescent dosimeter (two pairs of TLD-600/TLD-700) and two bubble detectors (one BD-100R and one BDS-1500 from Bubble Technology Industries, Canada). The CPND was developed with the aim of having crude neutron spectrometric capability, universal applicability, better angular response, and an improved lower limit of detection (LLD). The CPND has been well characterized in the following areas: reusability, linearity, lower limit of detection (LLD), detection capability in mixed neutron-gamma fields, angular dependence, and neutron energy dependence. The characterization was accomplished with irradiations using a ^{238} Pu-Be source, a ^{252} Cf(D_2O) source, a ^{252}Cf source, a ^ {252}Cf(PE) source, monoenergetic neutrons from accelerator and reactor filtered beams, ^ {137}Cs, and X-rays. Optimum signal readout procedures, signal processing techniques, routine operational usage, and neutron dose equivalent evaluation algorithms for the CPND were developed with the goals of having the best precision and accuracy as well as being convenient to use. Various reference spectra were developed to evaluate the performance (mainly the spectrometric and the dose equivalent measurement capabilities) of the CPND. The performance of the CPND was evaluated by in-situ tests in radiation fields existing in the working environment at ORNL. The spectra in these areas were measured previously with a calibrated Bonner multisphere spectrometer. The CPND also was tested with laboratory radioisotopic sources in single-source and multi-source exposure situations. Finally, the CPND was tested by participating in the fourteenth Personnel Dosimetry Intercomparison Study. The results of the tests mentioned above demonstrated that the CPND meets the ambitious design purposes

  1. Motor regulation problems and pain in adults diagnosed with ADHD

    PubMed Central

    2013-01-01

    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

  2. Advances in understanding and treating ADHD

    PubMed Central

    2011-01-01

    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

  3. The screens culture: impact on ADHD.

    PubMed

    Weiss, Margaret D; Baer, Susan; Allan, Blake A; Saran, Kelly; Schibuk, Heidi

    2011-12-01

    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. PMID:21948003

  4. Occupational issues of adults with ADHD

    PubMed Central

    2013-01-01

    Background ADHD is a common neurodevelopmental disorder that persists into adulthood. Its symptoms cause impairments in a number of social domains, one of which is employment. We wish to produce a consensus statement on how ADHD affects employment. Methods This consensus development conference statement was developed as a result of a joint international meeting held in July 2010. The consensus committee was international in scope (United Kingdom, mainland Europe, United Arab Emirates) and consisted of individuals from a broad range of backgrounds (Psychiatry, Occupational Medicine, Health Economists, Disability Advisors). The objectives of the conference were to discuss some of the occupational impairments adults with ADHD may face and how to address these problems from an inclusive perspective. Furthermore the conference looked at influencing policy and decision making at a political level to address impaired occupational functioning in adults with ADHD and fears around employing people with disabilities in general. Results The consensus was that there were clear weaknesses in the current arrangements in the UK and internationally to address occupational difficulties. More so, Occupational Health was not wholly integrated and used as a means of making positive changes to the workplace, but rather as a superfluous last resort that employers tried to avoid. Furthermore the lack of cross professional collaboration on occupational functioning in adults with ADHD was a significant problem. Conclusions Future research needs to concentrate on further investigating occupational functioning in adults with ADHD and pilot exploratory initiatives and tools, leading to a better and more informed understanding of possible barriers to employment and potential schemes to put in place to address these problems. PMID:23414364

  5. ADHD symptomatology is best conceptualized as a spectrum: a dimensional versus unitary approach to diagnosis.

    PubMed

    Heidbreder, Rebeca

    2015-12-01

    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

  6. How 'core' are motor timing difficulties in ADHD? A latent class comparison of pure and comorbid ADHD classes.

    PubMed

    van der Meer, Jolanda M J; Hartman, Catharina A; Thissen, Andrieke J A M; Oerlemans, Anoek M; Luman, Marjolein; Buitelaar, Jan K; Rommelse, Nanda N J

    2016-04-01

    Children with attention-deficit/hyperactivity disorder (ADHD) have motor timing difficulties. This study examined whether affected motor timing accuracy and variability are specific for ADHD, or that comorbidity with autism spectrum disorders (ASD) contributes to these motor timing difficulties. An 80-trial motor timing task measuring accuracy (μ), variability (σ) and infrequent long response times (τ) in estimating a 1-s interval was administered to 283 children and adolescents (8-17 years) from both a clinic and population based sample. They were divided into four latent classes based on the SCQ and CPRS-R:L data. These classes were: without behavioral problems 'Normal-class' (n = 154), with only ADHD symptoms 'ADHD-class' (n = 49), and two classes with both ASD and ADHD symptoms; ADHD(+ASD)-class (n = 39) and ASD(+ADHD)-class (n = 41). The pure ADHD-class did not deviate from the Normal class on any of the motor timing measures (mean RTs 916 and 925 ms, respectively). The comorbid ADHD(+ASD) and ASD(+ADHD) classes were significantly less accurate (more time underestimations) compared to the Normal class (mean RTs 847 and 870 ms, respectively). Variability in motor timing was reduced in the younger children in the ADHD(+ASD) class, which may reflect a tendency to rush the tedious task. Only patients with more severe behavioral symptoms show motor timing deficiencies. This cannot merely be explained by high ADHD severity with ASD playing no role, as ADHD symptom severity in the pure ADHD-class and the ASD(+ADHD) class was highly similar, with the former class showing no motor timing deficits. PMID:26154019

  7. Natural Product-Derived Treatments for Attention-Deficit/Hyperactivity Disorder: Safety, Efficacy, and Therapeutic Potential of Combination Therapy

    PubMed Central

    Ahn, James; Ahn, Hyung Seok; Cheong, Jae Hoon; dela Peña, Ike

    2016-01-01

    Typical treatment plans for attention-deficit/hyperactivity disorder (ADHD) utilize nonpharmacological (behavioral/psychosocial) and/or pharmacological interventions. Limited accessibility to behavioral therapies and concerns over adverse effects of pharmacological treatments prompted research for alternative ADHD therapies such as natural product-derived treatments and nutritional supplements. In this study, we reviewed the herbal preparations and nutritional supplements evaluated in clinical studies as potential ADHD treatments and discussed their performance with regard to safety and efficacy in clinical trials. We also discussed some evidence suggesting that adjunct treatment of these agents (with another botanical agent or pharmacological ADHD treatments) may be a promising approach to treat ADHD. The analysis indicated mixed findings with regard to efficacy of natural product-derived ADHD interventions. Nevertheless, these treatments were considered as a “safer” approach than conventional ADHD medications. More comprehensive and appropriately controlled clinical studies are required to fully ascertain efficacy and safety of natural product-derived ADHD treatments. Studies that replicate encouraging findings on the efficacy of combining botanical agents and nutritional supplements with other natural product-derived therapies and widely used ADHD medications are also warranted. In conclusion, the risk-benefit balance of natural product-derived ADHD treatments should be carefully monitored when used as standalone treatment or when combined with other conventional ADHD treatments. PMID:26966583

  8. Examining Manual and Visual Response Inhibition among ADHD Subtypes

    PubMed Central

    Adams, Zachary W.; Milich, Richard; Fillmore, Mark T.

    2014-01-01

    This study compared inhibitory functioning among ADHD subtype groups on manual and visual versions of the stop task. Seventy-six children, identified as ADHD/I (n = 17), ADHD/C (n =43), and comparison (n = 20) completed both tasks. Results indicated that both ADHD groups were slower to inhibit responses than the comparison group on both tasks. Comparison children were faster to inhibit than activate responses on both tasks. Children in the ADHD groups also demonstrated this robust pattern on the manual task. However, on the visual task, the ADHD groups evidenced slowed inhibition comparable to the time required to activate responding. This implies that the visual task is more sensitive than the manual task to inhibitory deficits associated with ADHD. The ADHD/I and the ADHD/C groups did not differ on most measures, suggesting that neither stop task is effective in differentiating the subtypes. These findings extend work highlighting the role of disinhibition in ADHD, and contrast recent work suggesting divergence between ADHD subtypes. PMID:20449644

  9. ADHD matures: time for practitioners to do the same?

    PubMed

    Bolea, B; Adamou, M; Arif, M; Asherson, P; Gudjonsson, G; Müller, U; Nutt, D J; Pitts, M; Thome, J; Young, S

    2012-06-01

    Attention deficit and hyperactivity disorder (ADHD) is not restricted to children. Abundant evidence from follow-up studies accumulated since the 1970s supports the concept of ADHD in adulthood. Genetic research points to a heritability of 76%, and neuroimaging studies have reported structural and functional brain abnormalities in patients with ADHD. Contrary to popular belief, ADHD is not a culturally bound disorder and has been described worldwide. ADHD has a cost for society, as adults with this disorder suffer from increased rates of unemployment and psychiatric comorbidity, including substance use disorders. Studies undertaken in forensic populations describe high rates of ADHD in these groups, particularly amongst young offenders. One of the main issues in the diagnosis of ADHD in the adult is the fact that most clinicians have not been educated to diagnose and treat ADHD. Effective pharmacological treatments for ADHD are available and should be prescribed for these patients. The National Institute for Health and Clinical Excellence (NICE) and the British Association for Psychopharmacology (BAP) guidelines established a benchmark for service development required to treat ADHD adequately in the adult population. However, the implementation of new services has been slow. More resources are needed to effectively assess and treat ADHD in the adult. PMID:21890596

  10. Subcorneal pustulosis with combined lack of IgG/IgM and monoclonal gammopathy type IgA/Kappa.

    PubMed

    Rasch, Astrid; Schimmer, Melanie; Sander, Christian A

    2009-08-01

    Subcorneal pustulosis (Sneddon-Wilkinson disease) is a rare inflammatory neutrophilic dermatosis. While subcorneal pustulosis is often associated with an IgA gammopathy, the combined lack of IgG/IgM seen in our case is rare. An 83-year-old man with combined lack of IgG/IgM and monoclonal gammopathy type IgA/Kappa presented with subcorneal pustules. Intravenous immunoglobulin therapy led to complete regression and might be another therapeutic option. PMID:19243482

  11. Variability of kinematic graphomotor fluency in adults with ADHD.

    PubMed

    Duda, Thomas A; Casey, Joseph E; McNevin, Nancy

    2014-12-01

    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. PMID:25457429

  12. Sleep patterns and the risk for ADHD: a review

    PubMed Central

    Cassoff, Jamie; Wiebe, Sabrina T; Gruber, Reut

    2012-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is often associated with comorbid sleep disturbances. Sleep disturbances may be a risk factor for development of the disorder, a symptom of the disorder, or a comorbid condition affected by a similar psychopathology. Various studies have examined the impact of sleep deprivation on the presence/exacerbation of ADHD symptomology, as well as longitudinal and concurrent associations between different sleep disturbances and ADHD, yet the notion of sleep disturbances as a predecessor to ADHD remains unclear. As such, this review examines the evidence for sleep disturbances as a risk factor for the development of ADHD, as well as the mechanisms underlying the association between sleep patterns and ADHD. Additionally, clinical implications regarding the comorbid nature of sleep disturbances and ADHD will be considered. PMID:23620680

  13. Reinforcement Enhances Vigilance Among Children With ADHD: Comparisons to Typically Developing Children and to the Effects of Methylphenidate

    PubMed Central

    Bubnik, Michelle G.; Hawk, Larry W.; Pelham, William E.; Waxmonsky, James G.; Rosch, Keri S.

    2014-01-01

    Sustained attention and reinforcement are posited as causal mechanisms in Attention-Deficit/Hyperactivity Disorder (ADHD), but their interaction has received little empirical study. In two studies, we examined the impact of performance-based reinforcement on sustained attention over time, or vigilance, among 9- to 12-year-old children. Study 1 demonstrated the expected vigilance deficit among children with ADHD (n=25; 12% female) compared to typically developing (TD) controls (n=33; 22% female) on a standard continuous performance task (CPT). During a subsequent visit, reinforcement improved attention more among children with ADHD than controls. Study 2 examined the separate and combined effects of reinforcement and acute methylphenidate (MPH) on CPT performance in children with ADHD (n=19; 21% female). Both reinforcement and MPH enhanced overall target detection and attenuated the vigilance decrement that occurred in no-reinforcement, placebo condition. Cross-study comparisons suggested that the combination of MPH and reinforcement eliminated the vigilance deficit in children with ADHD, normalizing sustained attention. This work highlights the clinically and theoretically interesting intersection of reinforcement and sustained attention. PMID:24931776

  14. Alternating versus continuous drug regimens in combination chemotherapy of human immunodeficiency virus type 1 infection in vitro.

    PubMed Central

    Mazzulli, T; Rusconi, S; Merrill, D P; D'Aquila, R T; Moonis, M; Chou, T C; Hirsch, M S

    1994-01-01

    We compared the in vitro efficacies of two-, three-, and four-drug combinations given continuously or in alternating regimens against a clinical isolate of human immunodeficiency virus type 1. In H9 cells and peripheral blood mononuclear cells, at the drug concentrations used in this study, there was greater suppression of human immunodeficiency virus type 1 infection as the number of drugs in the regimen was increased from one to four simultaneously administered agents. Although alternating drug regimens were effective, they were not better than continuous administration of either single drugs or combinations of agents and were less effective than giving all drugs of an alternating regimen simultaneously. PMID:8031028

  15. Ability of College Students to Simulate ADHD on Objective Measures of Attention

    ERIC Educational Resources Information Center

    Booksh, Randee Lee; Pella, Russell D.; Singh, Ashvind N.; Gouvier, William Drew

    2010-01-01

    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.…

  16. Combined antisense knockdown of type 1 and type 2 iodothyronine deiodinases disrupts embryonic development in zebrafish (Danio rerio).

    PubMed

    Walpita, Chaminda N; Crawford, Alexander D; Darras, Veerle M

    2010-03-01

    Thyroid hormones (THs) are important regulators of gene expression during vertebrate development. In teleosts, early embryos rely on the maternal TH deposit in the egg yolk, consisting predominantly of T(4). Activation of T(4) to T(3) by iodothyronine deiodinases (Ds) may therefore be an important factor in determining T(3)-dependent development. In zebrafish, both Ds capable of T(3) production, D1 and D2, are first expressed very early during embryonic development. We sought to determine their relative importance for zebrafish embryonic development by inhibiting their expression via antisense oligonucleotides against D1 and D2, and by a combined knockdown of both deiodinases. The impact of these treatments on the rate of embryonic development was estimated via three morphological indices: otic vesicle length, head-trunk angle and pigmentation index. Knockdown of D1 alone seemed not to affect developmental progression. In contrast, D2 knockdown resulted in a clear developmental delay in all parameters scored, suggesting that D2 is the major contributor to TH activation in developing zebrafish embryos. Importantly, combined knockdown of D1 and D2 caused not only a more pronounced developmental delay than D2 knockdown alone but also the appearance of dysmorphologies in a substantial minority of treated embryos. This shows that although D1 may not be essential in euthyroid conditions, it may be crucial under depleted thyroid status as is the case when T(3) production by D2 is inhibited. These results indicate that zebrafish embryos are dependent on T(4) uptake and its subsequent activation to T(3), and suggest that substantial inhibition of embryonic T(4) to T(3) conversion reduces intracellular T(3) availability below the threshold level necessary for normal development. PMID:19800339

  17. Delivering Evidence-Based Treatments for Child Attention-Deficit/Hyperactivity Disorder (ADHD) in the Context of Parental ADHD

    PubMed Central

    Wang, Christine H.; Mazursky-Horowitz, Heather

    2015-01-01

    Behavioral parent training (BPT) and stimulant medications are efficacious treatments for child attention-deficit/hyperactivity disorder (ADHD); however, there is some evidence to suggest that parental ADHD may reduce the effectiveness of both treatment modalities. This review paper summarizes the literature related to the evidence-based behavioral and pharmacological treatment of child ADHD in the context of parental ADHD. We also review the literature on the effects of treating parents’ ADHD symptoms on parenting and child behavior outcomes. Although the literature is small and inconsistent, studies suggest that medicating parents’ ADHD symptoms may or may not be sufficient in demonstrating desired improvements in parenting and child behavioral outcomes. Therefore, interventions targeting both parent and child ADHD, when both are present, are likely needed to improve parent-child interactions and family functioning. Ongoing studies using a multimodal approach are discussed. PMID:25135774

  18. The use of stimulant medications for non-core aspects of ADHD and in other disorders.

    PubMed

    Sinita, Eugenia; Coghill, David

    2014-12-01

    Psychostimulants play a central role in the management of ADHD. Here we review the evidence pertaining to the use of methylphenidate, dexamphetamine and related amphetamine salts, the prodrug lisdexamfetamine and modafinil for the management of comorbid ADHD and non-ADHD indications. There is a growing consensus that stimulant medications are helpful at improving the emotional dysregulation and lability, and oppositional and conduct symptoms that are often associated with ADHD. There is some evidence that psychostimulants may improve outcomes in those with treatment resistant depression, reduce negative symptoms and improve cognitive performance in schizophrenia, and that methylphenidate may reduce binge eating in those with bulimia nervosa. In general medicine, whilst the evidence is at times contradictory, psychostimulants have been shown in some studies to be effective treatments for chronic fatigue and narcolepsy, and to improve outcomes post stroke, post head injury, in dementia and various cancers. It seems likely that these effects often result from a combination of, reduction in fatigue, improvements in concentration and cognitive functioning and a lifting of mood which may be a direct or indirect consequence of the medication. Further studies seem warranted and these should focus on efficacy, effectiveness and long term safety. This article is part of the Special Issue entitled 'CNS Stimulants'. PMID:24951855

  19. Olmesartan Combined With Amlodipine on Oxidative Stress Parameters in Type 2 Diabetics, Compared With Single Therapies

    PubMed Central

    Derosa, Giuseppe; Mugellini, Amedeo; Pesce, Rosa Maria; D’Angelo, Angela; Maffioli, Pamela

    2016-01-01

    Abstract To evaluate the effects of a fixed combination of olmesartan/amlodipine compared with olmesartan or amlodipine alone on some parameters of endothelial damage in diabetic, hypertensive patients. We enrolled 221 patients; 74 were randomized to olmesartan 20 mg, 72 to amlodipine 10 mg, and 75 to olmesartan/amlodipine fixed combination 20/5 mg for 12 months. We assessed blood pressure monthly; in addition, we also assessed at baseline, and after 6 and 12 months, the following parameters: lipoprotein (a), myeloperoxidase (MPO), isoprostanes, and paraoxonase-1 (PON-1). Blood pressure values obtained with fixed olmesartan/amlodipine combination were significantly lower than those reached with single monotherapies. There was a reduction of lipoprotein (a), and isoprostanes levels with olmesartan/amlodipine fixed combination, both compared with baseline, and with single monotherapies. On the other hand, there was an increase of PON-1 with fixed olmesartan/amlodipine combination, both compared with baseline, and with single drugs. All treatments reduced MPO compared with baseline; however, in group-to-group comparison, MPO reduction was greater with olmesartan/amlodipine fixed combination. Fixed combination of olmesartan/amlodipine was more effective than single monotherapies in reducing oxidative stress, especially in increasing PON-1, and reducing isoprostanes levels in diabetic and hypertensive patients. PMID:27043671

  20. Atypical Alpha Asymmetry in Adults with ADHD

    ERIC Educational Resources Information Center

    Hale, T. Sigi; Smalley, Susan L.; Hanada, Grant; Macion, James; McCracken, James T.; McGough, James J.; Loo, Sandra K.

    2009-01-01

    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…

  1. Multitasking performance of Chinese children with ADHD.

    PubMed

    Chan, Raymond C K; Guo, Miaoyan; Zou, Xiaobing; Li, Dan; Hu, Zhouyi; Yang, Binrang

    2006-07-01

    The aim of this study was to explore multitasking skills in a Chinese sample of 22 children with attention deficit-hyperactivity disorder (ADHD) compared with 22 healthy controls matched by gender, age, and IQ. All of the participants completed the children's version of the Six Elements Test (C-SET) and neuropsychological tests that captured specific domains of attention, memory, and executive function. Children with ADHD performed significantly worse than the healthy controls in all domains except the number of rules broken in the C-SET. The majority of the C-SET domain scores correlated significantly with measures of executive function. The ADHD group also demonstrated deficits in various neurocognitive test performances compared with the healthy group. This preliminary study suggests that the C-SET is sensitive to multitasking behavior in Chinese children with ADHD. The main impairments of multitasking behavior in this clinical group involve the inhibition of goal-directed planning, flexible strategy generation, and self-monitoring. PMID:16981611

  2. Origins of altered reinforcement effects in ADHD

    PubMed Central

    Johansen, Espen Borgå; Killeen, Peter R; Russell, Vivienne A; Tripp, Gail; Wickens, Jeff R; Tannock, Rosemary; Williams, Jonathan; Sagvolden, Terje

    2009-01-01

    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

  3. Diagnosis and management of ADHD in children.

    PubMed

    Felt, Barbara T; Biermann, Bernard; Christner, Jennifer G; Kochhar, Param; Harrison, Richard Van

    2014-10-01

    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. PMID:25369623

  4. Substance Use in College Students with ADHD

    ERIC Educational Resources Information Center

    Rooney, Mary; Chronis-Tuscano, Andrea; Yoon, Yesel

    2012-01-01

    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-…

  5. ADHD, Science and the Common Man

    ERIC Educational Resources Information Center

    Colley, Bill

    2010-01-01

    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…

  6. Pediatricians Vary Widely in Diagnosing ADHD, Depression

    MedlinePlus

    ... often U.S. pediatricians diagnose and prescribe drugs for attention-deficit/hyperactivity disorder (ADHD) and other mental health conditions, a new ... Services, or federal policy. More Health News on: Attention Deficit Hyperactivity Disorder ... Recent Health News Related MedlinePlus Health Topics ...

  7. Gender Differences in ADHD Subtype Comorbidity

    ERIC Educational Resources Information Center

    Levy, Florence; Hay, David A.; Bennett, Kellie S.; McStephen, Michael

    2005-01-01

    Objective: To examine gender differences in attention-deficit/hyperactivity disorder ("ADHD") symptom comorbidity with "oppositional defiant disorder", "conduct disorder", "separation anxiety disorder", "generalized anxiety disorder", speech therapy, and remedial reading in children. Method: From 1994 to 1995, data from a large sample (N = 4,371)…

  8. Adjustment to College in Students with ADHD

    ERIC Educational Resources Information Center

    Rabiner, David L.; Anastopoulos, Arthur D.; Costello, Jane; Hoyle, Rick H.; Swartzwelder, H. Scott

    2008-01-01

    Objective: To examine college adjustment in students reporting an ADHD diagnosis and the effect of medication treatment on students' adjustment. Method: 1,648 first-semester freshmen attending a public and a private university completed a Web-based survey to examine their adjustment to college. Results: Compared with 200 randomly selected control…

  9. Treating ADHD with Hypnosis and Neurotherapy.

    ERIC Educational Resources Information Center

    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…

  10. Emotion Understanding in Children with ADHD

    ERIC Educational Resources Information Center

    Da Fonseca, David; Seguier, Valerie; Santos, Andreia; Poinso, Francois; Deruelle, Christine

    2009-01-01

    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…

  11. ADHD: Behavioral, Educational, and Medication Interventions

    ERIC Educational Resources Information Center

    DuPaul, George J.; White, George P.

    2006-01-01

    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…

  12. Managing Your Child's ADHD This Holiday Season

    ERIC Educational Resources Information Center

    Barnett-Reyes, Saundra

    2005-01-01

    Most people spend all year looking forward to the time of holidays and the celebration and reflection it brings. Although family traditions abound with hearty food and holiday cheer, the holidays can also be stressful for parents of children who have attention-deficit/hyperactivity disorder (ADHD). In this article, the author provides several tips…

  13. Applying a Psychoeducational Perspective to ADHD

    ERIC Educational Resources Information Center

    Penny, Ann Marie; Waschbusch, Daniel A.; Carrey, Norm; Drabman, Ronald S.

    2005-01-01

    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…

  14. ADHD in the Classroom: Effective Intervention Strategies

    ERIC Educational Resources Information Center

    DuPaul, George J.; Weyandt, Lisa L.; Janusis, Grace M.

    2011-01-01

    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…

  15. Future Directions in ADHD Etiology Research

    ERIC Educational Resources Information Center

    Nigg, Joel T.

    2012-01-01

    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…

  16. ADHD Characteristics in Canadian Aboriginal Children

    ERIC Educational Resources Information Center

    Baydala, Lola; Sherman, Jody; Rasmussen, Carmen; Wikman, Erik; Janzen, Henry

    2006-01-01

    Objective: The authors examine how many Aboriginal children attending two reservation-based elementary schools in Northern Alberta, Canada, would demonstrate symptoms associated with ADHD using standardized parent and teacher questionnaires. Method: Seventy-five Aboriginal children in Grades 1 through 4 are tested. Seventeen of the 75 (22.7%)…

  17. Origins of altered reinforcement effects in ADHD.

    PubMed

    Johansen, Espen Borgå; Killeen, Peter R; Russell, Vivienne A; Tripp, Gail; Wickens, Jeff R; Tannock, Rosemary; Williams, Jonathan; Sagvolden, Terje

    2009-01-01

    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

  18. Fading Memories: Retrospective Recall Inaccuracies in ADHD

    ERIC Educational Resources Information Center

    Miller, Carlin J.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.

    2010-01-01

    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…

  19. Gifted or ADHD? The Possibilities of Misdiagnosis

    ERIC Educational Resources Information Center

    Hartnett, D. Niall; Nelson, Jason M.; Rinn, Anne N.

    2003-01-01

    This research intends to provide empirical support for the possibility of misdiagnosis of giftedness and Attention Deficit Hyperactivity Disorder (ADHD). Forty-four graduate students enrolled in a school counseling program acted as participants. Participants were given one of two forms, both of which provided a hypothetical case study of a young…

  20. Not Just a Sum? Identifying Different Types of Interplay between Constituents in Combined Interventions

    PubMed Central

    Van Deun, Katrijn; Thorrez, Lieven; van den Berg, Robert A.; Smilde, Age K.; Van Mechelen, Iven

    2015-01-01

    Motivation Experiments in which the effect of combined manipulations is compared with the effects of their pure constituents have received a great deal of attention. Examples include the study of combination therapies and the comparison of double and single knockout model organisms. Often the effect of the combined manipulation is not a mere addition of the effects of its constituents, with quite different forms of interplay between the constituents being possible. Yet, a well-formalized taxonomy of possible forms of interplay is lacking, let alone a statistical methodology to test for their presence in empirical data. Results Starting from a taxonomy of a broad range of forms of interplay between constituents of a combined manipulation, we propose a sound statistical hypothesis testing framework to test for the presence of each particular form of interplay. We illustrate the framework with analyses of public gene expression data on the combined treatment of dendritic cells with curdlan and GM-CSF and show that these lead to valuable insights into the mode of action of the constituent treatments and their combination. Availability and Implementation R code implementing the statistical testing procedure for microarray gene expression data is available as supplementary material. The data are available from the Gene Expression Omnibus with accession number GSE32986. PMID:25965065

  1. ADHD classification by a texture analysis of anatomical brain MRI data.

    PubMed

    Chang, Che-Wei; Ho, Chien-Chang; Chen, Jyh-Horng

    2012-01-01

    The ADHD-200 Global Competition provides an excellent opportunity for building diagnostic classifiers of Attention-Deficit/Hyperactivity Disorder (ADHD) based on resting-state functional MRI (rs-fMRI) and structural MRI data. Here, we introduce a simple method to classify ADHD based on morphological information without using functional data. Our test results show that the accuracy of this approach is competitive with methods based on rs-fMRI data. We used isotropic local binary patterns on three orthogonal planes (LBP-TOP) to extract features from MR brain images. Subsequently, support vector machines (SVM) were used to develop classification models based on the extracted features. In this study, a total of 436 male subjects (210 with ADHD and 226 controls) were analyzed to show the discriminative power of the method. To analyze the properties of this approach, we tested disparate LBP-TOP features from various parcellations and different image resolutions. Additionally, morphological information using a single brain tissue type (i.e., gray matter (GM), white matter (WM), and CSF) was tested. The highest accuracy we achieved was 0.6995. The LBP-TOP was found to provide better discriminative power using whole-brain data as the input. Datasets with higher resolution can train models with increased accuracy. The information from GM plays a more important role than that of other tissue types. These results and the properties of LBP-TOP suggest that most of the disparate feature distribution comes from different patterns of cortical folding. Using LBP-TOP, we provide an ADHD classification model based only on anatomical information, which is easier to obtain in the clinical environment and which is simpler to preprocess compared with rs-fMRI data. PMID:23024630

  2. Combination therapy with insulin and oral agents: optimizing glycemic control in patients with type 2 diabetes mellitus.

    PubMed

    Yki-Järvinen, Hannele

    2002-01-01

    The United Kingdom Prospective Diabetes Study (UKPDS) showed that tight glycemic control with any of several therapeutic regimens has the potential to significantly reduce the risk for long-term microvascular complications of type 2 diabetes. An important question that remains to be answered is what is the best approach to optimizing glycemic control in patients with this disease. This article reviews results of studies in which insulin was used alone or in combination with oral antidiabetic agents for treatment of patients with type 2 diabetes. Analysis of comparative studies (13 in insulin-naive and 26 in previously insulin-treated patients) showed that combination therapy involving one to two insulin injections per day plus oral therapy is usually more effective than insulin monotherapy for achieving and maintaining glycemic control. Combination treatment for type 2 diabetes can be significantly improved by newly developed preparations that lack the major limitations of older products. Once-daily administration of isophane insulin (NPH insulin) is limited by a 15-18-h duration of action and a peak effect that occurs about 6 h after injection. Insulin glargine, a new insulin analogue developed using recombinant DNA technology, has a flat pharmacodynamic profile and a 24-h duration of action. Results from a recent comparative study indicate that insulin glargine plus oral therapy may provide better post-dinner glucose control as well as less symptomatic and nocturnal hypoglycemia than oral therapy combined with NPH insulin. The studies reviewed in the present article support the conclusion that combination therapy with insulin glargine combined with one or more oral antidiabetic agents may be the treatment of choice for achieving glycemic control in patients with type 2 diabetes. PMID:12324990

  3. Neuropsychological correlates of emotional lability in children with ADHD

    PubMed Central

    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

    2012-01-01

    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

  4. Epigenetics in Developmental Disorder: ADHD and Endophenotypes

    PubMed Central

    Archer, Trevor; Oscar-Berman, Marlene; Blum, Kenneth

    2011-01-01

    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

  5. Three-year serologic immunity against canine parvovirus type 2 and canine adenovirus type 2 in dogs vaccinated with a canine combination vaccine.

    PubMed

    Larson, L J; Schultz, R D

    2007-01-01

    A group of client-owned dogs and a group of dogs at a commercial kennel were evaluated for duration of antibody responses against canine parvovirus type 2 (CPV-2) and canine adenovirus type 1 (CAV-1) after receiving a combination vaccine containing recombinant canarypox-vectored canine distemper virus (CDV) and modified-live CPV-2, CAV-2, and canine parainfluenza virus, with (C6) or without (C4) two serovars of Leptospira (Recombitek C4 or C6, Merial). Duration of antibody, which correlates with protective immunity, was found to be at least 36 months in both groups. Recombitek combination vaccines can confidently be given every 3 years with assurance of protection in immunocompetent dogs against CPV-2 and CAV-1 as well as CDV. This allows this combination vaccine, like other, similar modified- live virus combination products containing CDV, CAV-2, and CPV-2, to be administered in accordance with the recommendations of the American Animal Hospital Association Canine Vaccine Task Force. PMID:18183549

  6. Abnormal functional resting-state networks in ADHD: graph theory and pattern recognition analysis of fMRI data.

    PubMed

    dos Santos Siqueira, Anderson; Biazoli Junior, Claudinei Eduardo; Comfort, William Edgar; Rohde, Luis Augusto; Sato, João Ricardo

    2014-01-01

    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

  7. The influence of components of diet on the symptoms of ADHD in children.

    PubMed

    Konikowska, Klaudia; Regulska-Ilow, Bozena; Rózańska, Dorota

    2012-01-01

    In most children with ADHD the cause of the disease is not exactly known, and its etiology is multifactorial. The conventional treatment is based on the combination of behavioral and psychological therapy and the pharmacotherapy. The pharmacotherapy has a high effectiveness in ADHD treatment, but it is often associated with undesirable side effects, such as: loss of appetite and weight, growth inhibition, abdominal pain, headaches, sleeping problems and increased blood pressure. In the recent years, much attention was devoted to the issue of an appropriate diet in this disease, especially when the standard pharmacotherapy is not effective. The diet of pregnant and lactating woman, and child may have an impact on the development and deepening of the hyperkinetic syndrome. There is much evidence to indicate that it is linked to nutritional factors. Chronic deficiencies of certain minerals such as zinc, iron, magnesium and iodine and insufficient dietary intake of long-chain polyunsaturated fatty acids may have a significant impact on the development and deepening of the symptoms of ADHD in children. A crucial role in the diet of pregnant and lactating women, and child plays also polyunsaturated omega-3 fatty acids, mainly DHA, which are necessary for proper development and function of brain. Their chronic deficiency may contribute to increase risk of ADHD in children. The authors of several studies also demonstrated the positive impact of the elimination food products containing synthetic food additives, like artificial food dyes and preservatives on the behavior of children with ADHD. The beneficial effects brought also the elimination of food products, that are rich in salicylates. It was found that the intake of food products with a low glycemic index helps to reduce symptoms in some hyperactive children. Providing an appropriate supply of nutrients and minerals and elimination of certain food products from diet is especially important during intensive growth and

  8. A University of a New Type: University Combines Education with Labor

    ERIC Educational Resources Information Center

    Chinese Education, 1973

    1973-01-01

    The educational program of a communist labor university in South China's Kiangsi Province is described. Classes in agriculture, forestry, accounting, animal husbandry, and farm machinery are offered on a part-work, part-study basis which combines education with productive labor. (SM)

  9. A Discrete Choice Conjoint Experiment to Evaluate Parent Preferences for Treatment of Young, Medication Naive Children with ADHD

    ERIC Educational Resources Information Center

    Waschbusch, Daniel A.; Cunningham, Charles E.; Pelham, William E., Jr.; Rimas, Heather L.; Greiner, Andrew R.; Gnagy, Elizabeth M.; Waxmonsky, James; Fabiano, Gregory A.; Robb, Jessica A.; Burrows-MacLean, Lisa; Scime, Mindy; Hoffman, Martin T.

    2011-01-01

    The current study examined treatment preferences of 183 parents of young (average age = 5.8 years, SD = 0.6), medication naive children with ADHD. Preferences were evaluated using a discrete choice experiment in which parents made choices between different combinations of treatment characteristics, outcomes, and costs. Latent class analysis…

  10. Is Overactivity a Core Feature in ADHD? Familial and Receiver Operating Characteristic Curve Analysis of Mechanically Assessed Activity Level

    ERIC Educational Resources Information Center

    Wood, Alexis C.; Asherson, Philip; Rijsdijk, Fruhling; Kuntsi, Jonna

    2009-01-01

    Objective: Symptoms of overactivity form part of the "DSM-IV" criteria for the combined or hyperactive-impulsive subtypes of attention-deficit/hyperactivity disorder (ADHD); yet little data exist that would quantify the nature of the overactivity component. We aimed to quantify the ability of four different measures of motion sensor data, taken…

  11. Validation of the AQT Color-Form Additive Model for Screening and Monitoring Pharmacological Treatment of ADHD

    ERIC Educational Resources Information Center

    Nielsen, Niels Peter; Wiig, Elisabeth Hemmersam

    2013-01-01

    Objective:This retrospective study used A Quick Test of Cognitive Speed (AQT) processing-speed and efficiency measures for evaluating sensitivity and monitoring effects during pharmacological treatment of adults with ADHD. Method: Color (C), form (F), and color-form (CF) combination naming were administered to 69 adults during outpatient…

  12. Students with Learning Disabilities and AD/HD in the Foreign Language Classroom: Supporting Students and Instructors

    ERIC Educational Resources Information Center

    Leons, Eve; Herbert, Christie; Gobbo, Ken

    2009-01-01

    This article explores why students with learning disabilities and attention deficit hyperactivity disorder (AD/HD) struggle with the foreign language curriculum and how their difficulties manifest themselves in the classroom setting. Findings of a three-year, federally funded study that sought to combine expertise in the field of learning…

  13. Academic Achievement and Emotional Status of Children with ADHD Treated with Long-Term Methylphenidate and Multimodal Psychosocial Treatment

    ERIC Educational Resources Information Center

    Hechtman, Lily; Abikoff, Howard; Klein, Rachel G.; Weiss, Gabrielle; Respitz, Chara; Kouri, Joan; Blum, Carol; Greenfield, Brian; Etcovitch, Joy; Fleiss, Karen; Pollack, Simcha

    2004-01-01

    Objective: To test the hypothesis that intensive multimodal psychosocial intervention (that includes academic assistance and psychotherapy) combined with methylphenidate significantly enhances the academic performance and emotional status of children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and with…

  14. Design and Rationale of Controlled Study of Long-Term Methylphenidate and Multimodal Psychosocial Treatment in Children with ADHD

    ERIC Educational Resources Information Center

    Klein, Rachel G.; Abikoff, Howard; Hechtman, Lily; Weiss, Gabrielle

    2004-01-01

    Objective: To describe the rationale, methodology, and sample characteristics of a dual-site treatment study (New York and Montreal) of children with attention-deficit/hyperactivity disorder (ADHD) conducted between 1990 and 1995. The hypotheses were that (1) methylphenidate combined with comprehensive multimodal psychosocial treatment was…

  15. Children with ADHD Treated with Long-Term Methylphenidate and Multimodal Psychosocial Treatment: Impact on Parental Practices

    ERIC Educational Resources Information Center

    Hechtman, Lily; Abikoff, Howard; Klein, Rachel G.; Greenfield, Brian; Etcovitch, Joy; Cousins, Lorne; Fleiss, Karen; Weiss, Margaret; Pollack, Simcha

    2004-01-01

    Objective: To test the hypothesis that multimodal psychosocial intervention, which includes parent training, combined with methylphenidate significantly enhances the behavior of parents of children with attention-deficit/hyperactivity disorder (ADHD), compared with methylphenidate alone and compared with methylphenidate and nonspecific…

  16. Safety and Efficacy of Sitagliptin-Metformin in Fixed Combination for the Treatment of Type 2 Diabetes Mellitus

    PubMed Central

    Ballav, Chitrabhanu; Gough, Stephen C.L.

    2013-01-01

    The biguanide, metformin, is considered first-line treatment for type 2 diabetes. Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor acts through the incretin pathway and has a glucose dependent mode of action. The complementary hypoglycemic properties of these drugs make fixed dose combination treatment an attractive prospect. Evidence from recent clinical trials suggests a beneficial effect of the combination on efficacy, demonstrated by significant improvement of hemoglobin A1c (HbA1c), fasting and postprandial glucose levels. The fixed dose combination is likely to have greater patient tolerability compared with monotherapy with either agent because of low rates of hypoglycemia, weight neutrality, and lower rates of side effects. High acquisition cost and paucity of long-term safety data are, however, potential barriers to their wider use. An overview of the pharmacology and clinical outcomes from recent trials of the metformin-sitagliptin combination and how the combination could fit into the type 2 diabetes treatment algorithm is presented in this review. PMID:24031162

  17. Impacts of Transportation Routes on Landscape Diversity: A Comparison of Different Route Types and Their Combined Effects

    NASA Astrophysics Data System (ADS)

    Su, Shiliang; Xiao, Rui; Li, Delong; Hu, Yi'na

    2014-03-01

    A comparison of different transportation route types and their combined effects on landscape diversity was conducted within Tiaoxi watershed (China) between 1994 and 2005. Buffer analysis and Mann-Kendall's test were used to quantify the relationships between distance from transportation routes (railway, highway, national, and provincial road) and a family of landscape diversity parameters (Simpson's diversity index, Simpson's evenness index, Shannon's diversity index, and Shannon's evenness index). One-way ANOVA was further applied to compare influences from different route types and their combined effects. Five other landscape metrics (patch density, edge density, area-weighted mean shape index, connectance index, and Euclidean nearest neighbor distance) were also calculated to analyze the associations between landscape diversity and landscape pattern characteristics. Results showed that transportation routes exerted significant impacts on landscape diversity. Impact from railway was comparable to that from highway and national road but was more significant than that from provincial road. The spatial influential range of railway and national road was wider than that of highway and provincial road. Combined effects of routes were nonlinear, and impacts from different route types were more complex than those from the same type. The four landscape diversity metrics were comparably effective at the buffer zone scale. In addition, landscape diversity can be alternatively used to indicate fragmentation, connectivity, and isolation at route buffer scale. This study demonstrates an applicable approach to quantitatively characterize the impacts from transportation routes on landscape patterns and has potential to facilitate route network planning.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-01-01

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

  20. The Pharmacogenomic Era: Promise for Personalizing ADHD Therapy

    PubMed Central

    Stein, Mark A.; McGough, James J.

    2008-01-01

    Synopsis Currently, ADHD treatment is often determined empirically through trial and error until an adequate response is obtained or side effects occur. ADHD is highly heritable and there is wide individual variability in response to ADHD medications, suggesting that the mechanism of action of stimulant medications may provide clues for genetic predictors of response. The promise of ADHD pharmacogenetics is far reaching, and includes the potential to develop individualized medication regimens that improve symptom response, decrease risk for side effects, improve long-term tolerability, and thus contribute to long-term treatment compliance and improved general effectiveness. Early ADHD pharmacogenetic studies have focused predominantly on catecholamine pathway genes and response to methylphenidate. Future efforts will also examine a wider range of stimulant and non-stimulant medications on a range of outcome measures and time periods. Based upon these studies, the potential for personalizing ADHD treatment in clinical practice will be determined. PMID:18295157