Merkt, Julia; Petermann, Franz
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders in childhood and adolescence and has many negative consequences for both the child and the family. Early identification of children with ADHD would be helpful for the prevention of long-term consequences. This review appraises questionnaires and clinical interviews that can be used for the diagnosis of ADHD in preschool-aged children (3-5 years). We compare and discuss both German and international methods. The role of questionnaires and clinical interviews in the diagnostic process of ADHD is discussed.
Steenhuis, Mark-Peter; Serra, Marike; Minderaa, Rudolf Boudewijn; Hartman, Catharina Annette
The authors recently developed an Internet version of the Diagnostic Interview Schedule for Children-Version 4 (DISC-IV), parent version (D. Shaffer, P. Fisher, C. P. Lucas, M. K. Dulcan, & M. E. Schwab-Stone, 2000), with the main purpose of using it at home without an interviewer. This offers many advantages (e.g., extended applicability,…
In this podcast we talk to Prof Eric Taylor about the changes to the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in DSM-5 and how these changes will affect clinical practice. The podcast for this interview is available at: http://www.biomedcentral.com/sites/2999/download/Taylor.mp3.
Schmidt, Sören; Banaschewski, Tobias; Garbe, Edeltraut; Petermann, Franz; Petermann, Ulrike
Attention Deficit-/Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric disorders in childhood and adolescence, often accompanied by comorbid disorders. A high standard of diagnostic assessment combined with a demand for valid diagnostic instruments is necessary. The K-SADS-PL is an established semi-structured interview, focusing on the categorical assessment of psychiatric disorders. The aim of the following study was to examine specific characteristics of ADHD symptomatology including functional and behavioral assessment. Therefore correlations between the result in a diagnostic interview (K-SADS-PL) and different ADHD-specific instruments were performed. Groups were formed (exposed vs. unexposed), based on the diagnostic finding in the K-SADS-PL. Group-specific test score differences were calculated and compared by multivariate analyses of covariance. Children with ADHD showed a significantly higher impact of conduct and emotional problems than the unexposed group. Health related quality of life was more impaired in children and families suffering from ADHD which refers to the relevance of family-oriented psychotherapy.
Rösler, M; Retz, W; Thome, J; Schneider, M; Stieglitz, R-D; Falkai, P
The diagnosis of attention-deficit hyperactivity disorder (ADHD) in adults is a complex procedure which should include retrospective assessment of childhood ADHD symptoms either by patient recall or third party information, diagnostic criteria according to DSM-IV, current adult ADHD psychopathology including symptom severity and pervasiveness, functional impairment, quality of life and comorbidity. In order to obtain a systematic database for the diagnosis and evaluation of the course ADHD rating scales can be very useful. This article reviews rating instruments that have found general acceptance. The Wender-Utah Rating Scale (WURS) and the Childhood Symptoms Scale by Barkley and Murphy try to make a retrospective assessment of childhood ADHD symptoms. The Connors Adult ADHD Rating Scales (CAARS), the Current Symptoms Scales by Barkley and Murphy (CSS), the Adult Self Report Scale (ASRS) by Adler et al. and Kessler et al. or the Attention Deficit Hyperactivity Disorder--Self Report Scale (ADHD-SR by Rösler et al.) are self report rating scales focusing mainly on the DSM-IV criteria. The CAARS and the CSS have other report forms too. The Brown ADD Rating Scale (Brown ADD-RS) and the Attention Deficit Hyperactivity Disorder--Other Report Scale (ADHD-OR by Rösler et al.) are instruments for use by clinicians or significant others. Both self rating scales and observer report scales quantify the ADHD symptoms by use of a Likert scale mostly ranging from 0 to 3. This makes the instruments useful to follow the course of the disease quantitatively. Comprehensive diagnostic interviews not only evaluate diagnostic criteria, but also assess different psychopathological syndrome scores, functional disability measures, indices of pervasiveness and information about comorbid disorders. The most comprehensive procedures are the Brown ADD Diagnostic Form and the Adult Interview (AI) by Barkley and Murphy. An instrument of particular interest is the Wender Reimherr Interview (WRI
Boekelheide, Priscilla Day
The therapeutic and diagnostic aspect of the preabortion interview are discussed with attention to specifics that will identify students with the greatest likelihood for psychological problems and/or repeat abortions. (JD)
Sibley, Margaret H; Coxe, Stefany; Molina, Brooke S G
Attention deficit/hyperactivity disorder (ADHD) is a chronic disorder that afflicts individuals into adulthood. The field continues to refine diagnostic standards for ADHD in adults, complicated by the disorder's heterogeneous presentation, subjective symptoms, and overlap with other disorders. Two key diagnostic questions are from whom to collect diagnostic information and which symptoms should be contained on an adult diagnostic checklist. Using a trifactor model, Martel et al. examine these questions in a sample of adults with and without self-identified ADHD symptoms. In this response, we highlight the importance of their finding that self and informant symptom reports differ in a sample of adults who acknowledge ADHD symptoms. We also review issues that continue to face the field related to model specification, evaluating symptom utility, and sample composition, discussing how these issues influence conclusions that may be drawn from Martel et al. and similar investigations. We conclude that the article makes an important research contribution about the nature of self and informant ADHD symptom reports but emphasize that symptom checklist refinement must occur through a broad lens that considers work from a range of sample types and clinically informative analytic strategies.
Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert
Objective: Describe the general health, comorbidities and health service use among U.S. children with ADHD. Method: The 2001 National Health Interview Survey (NHIS) contained the Strengths and Difficulties Questionnaire (SDQ; used to determine probable ADHD), data on medical problems, overall health, and health care utilization. Results: Asthma…
... Has ADHD en español El ADHD ADHD, or attention deficit hyperactivity disorder , is a medical condition that affects ... them through first. ADHD used to be called attention deficit disorder , or ADD for short. In 1994, it ...
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 ...
Gorlin, Eugenia I; Dalrymple, Kristy; Chelminski, Iwona; Zimmerman, Mark
Despite growing recognition that the symptoms and functional impairments of Attention Deficit/Hyperactivity Disorder (ADHD) persist into adulthood, only a few psychometrically sound diagnostic measures have been developed for the assessment of ADHD in adults, and none have been validated for use in a broad treatment-seeking psychiatric sample. The current study presents the reliability and validity of a semi-structured DSM-based diagnostic interview module for ADHD, which was administered to 1194 adults presenting to an outpatient psychiatric practice. The module showed excellent internal consistency and interrater reliability, good convergent and discriminant validity (as indexed by relatively high correlations with self-report measures of ADHD and ADHD-related constructs and little or no correlation with other, non-ADHD symptom domains), and good construct validity (as indexed by significantly higher rates of psychosocial impairment and self-reported family history of ADHD in individuals who meet criteria for an ADHD diagnosis). This instrument is thus a reliable and valid diagnostic tool for the detection of ADHD in adults presenting for psychiatric evaluation and treatment.
Serrano, Eduardo; Ezpeleta, Lourdes; Castro-Fornieles, Josefina
Objective: To assess the comorbidity of bipolar disorder (BPD) in children with ADHD and to study the psychopathological profile of ADHD children with and without mania. Method: A total of 100 children with ADHD were assessed with a semistructured diagnostic interview and questionnaires of mania, ADHD, and general psychopathology. Results: 8% of…
Angold, Adrian; Erkanli, Alaattin; Copeland, William; Goodman, Robert; Fisher, Prudence W.; Costello, E. Jane
Objective: To compare examples of three styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) ("respondent-based"), the Child and Adolescent Psychiatric Assessment (CAPA) ("interviewer-based"), and the Development and Well-Being Assessment (DAWBA) ("expert judgment"). Method: Roughly equal numbers of…
Rolon-Arroyo, Benjamin; Arnold, David H.; Harvey, Elizabeth A.; Marshall, Nastassja
Data are presented from two samples of preschool children to evaluate the reliability, concurrent validity, and predictive validity of the ADHD, ODD, and CD sections of the Diagnostic Interview Schedule for Children, Fourth Edition (DISC-IV). Information was obtained from a community sample of 128 children (Mage = 53.16 months; 63 girls) and from a sample of 72 externalizing children (Mage = 45.23 months; 31 girls) plus 25 control children (Mage = 44.51 months; 8 girls). In both studies, the DISC-IV was administered to parents along with parent and teacher behavior rating scales, and teacher rating scales were obtained again later to evaluate the predictive validity of the DISC-IV (after approximately 6 months in Study 1, and 3 years in Study 2). The ADHD and ODD sections exhibited acceptable internal consistency in both studies, and showed concurrent validity with parent behavior rating scales. In both studies, the ADHD section was also concurrent with teacher reports. In Study 2, the ADHD, ODD, and CD sections distinguished externalizing children from controls. In both studies, the ADHD section predicted future teacher ratings beyond initial teacher ratings, and beyond initial parent rating scales; the ODD section similarly predicted later teacher ratings in Study 1. Findings provide strong support for the utility of the ADHD section for preschool children and moderate support for the ODD and CD sections. PMID:27909389
... skills. Sometimes groups of people who have ADHD work together in group therapy. Group therapy can help people with ADHD ... Medicines Is My ADHD Medication Affecting My Sleep? Learning Disabilities How to Make Homework Less Work Contact Us Print Resources Send to a Friend ...
Ioannidis, Konstantinos; Serfontein, Jaco; Müller, Ulrich
There is increasing literature suggesting a link between attention-deficit hyperactivity disorder (ADHD) and eating disorders (EDs), especially bulimia nervosa. ADHD is under-diagnosed in girls and children of high intelligence are typically missed. We identified a case of a 23-year-old woman suffering from severe bulimia nervosa and previously unsuspected ADHD in adulthood; we diagnosed and treated her with extended-release methylphenidate. We performed a literature review on the ADHD and bulimia nervosa comorbidity. We discuss the reasons why her ADHD remained undiagnosed and the difficulties in diagnosing ADHD in patients with EDs. We suggest that identifying comorbid ADHD is crucial for these patients and argue for the use of a structured interview, collateral history and investigation of onset of symptoms to establish a diagnosis of ADHD in adults with bulimia nervosa. Comorbidities and overlap of symptomatology need to be taken into account.
Rogers, Richard; And Others
Examined clinical usefulness of the Schedule of Affective Disorders and Schizophrenia (SADS) diagnostic interview in evaluations of criminal responsibility. Findings, based on 78 evaluations from a forensic clinic, indicated that SADS successfully differentiated between sane and insane evaluatees. Differences were primarily in severity of symptoms…
Ghanizadeh, Ahmad; Jafari, Peyman
Objective: The objective was to study the cultural structure of Farsi-speaking parents' ratings with diagnostic definitions of ADHD. Method: The children with ADHD and their parents were interviewed. The parents rated their children on the Farsi-speaking parents' ADHD rating questionnaire. Results: The principal components analysis extracted the…
Renou, S; Hergueta, T; Flament, M; Mouren-Simeoni, M-C; Lecrubier, Y
Structured diagnostic interviews, which evolved along the development of classification's systems, are now widely used in adult psychiatry, in the fields of clinical trials, epidemiological studies, academic research as well as, more recently, clinical practice. These instruments improved the reliability of the data collection and interrater reliability allowing greater homogenisation of the subjects taking part in clinical research, essential factor to ensure the reproducibility of the results. The diagnostic instruments, conversely to the clinical traditional diagnostic processes allow a systematic and exhaustive exploration of disorders, diagnostic criteria but also severity levels, and duration. The format of the data collection, including the order of exploration of the symptoms, is fixed. The formulation of the questions is tested to be univocal, in order to avoid confusions. In child and adolescent, researches in pharmacology and epidemiology increased a lot in the last decade and the standardisation of diagnostic procedures is becoming a key feature. This Article aims to make an assessment, a selection, and a description of the standardized instruments helping psychiatric diagnosis currently available in the field of child and adolescent's psychiatry. Medline and PsycINFO databases were exhaustively checked and the selection of the instruments was based on the review of four main criteria: i) compatibility with international diagnostic systems (DSM IV and/or ICD-10); ii) number of disorders explored; iii) peer reviewed Journals and iv) richness of psychometric data. After the analysis of the instruments described or mentioned in the literature, 2 structured interviews [the Diagnostic Interview Schedule for Children (DISC) and the Children's Interview for Psychiatric Syndromes (ChIPS)] and 4 diagnostic semi-structured interviews [the Schedule for Affective Disorders and Schizophrenia for School-Age Children (Kiddie-SADS), the Diagnostic Interview for
Iglesias, Alex; Iglesias, Adam
This article reports on the use of hypnosis to facilitate the diagnostic process in two cases of pediatric hysterical reactions. The Hypnotic Diagnostic Interview for Hysterical Disorders (HDIHD), an interview tool, specifically designed for these cases, is reported. The first case was an adolescent male with motor Conversion Disorder manifested as paralysis of his lower limbs. The second was a preadolescent girl with sensory Conversion Disorder manifested as reduction of visual field in her right eye. Freudian conceptualization of hysterical reactions was employed as the conceptual basis in the formulation of these cases. This orientation posits hysterical phenomena a psychological defense employed by individuals exposed to traumatic experiences in order to effectuate a defense from intolerable affective material. The emotionally overwhelming material converts into physical reactivity free of the traumatic consequences by keeping the intolerable images and emotions deeply repressed within the subconscious. As the focus on these cases was diagnostic, treatment efforts were avoided. As it turned out, environmental interventions, based on the obtained information from the hypnotic interviews, extinguished the symptoms. The children were symptom free at follow-up.
The concept of ADHD has evolved gradually and still carries some traces of its origins. The idea of uncontrolled behaviour as a medical problem arose in eighteenth and nineteenth century accounts. It raised cultural issues about how far control was expected of children. This article traces the development of ideas with particular references to Hoffman's "Struwwelpeter", Frederick Still's "Disorders of Moral Control", minimal brain damage, and the hyperkinetic syndrome.
Bell, Allison S
ADHD is an impairing psychological disorder that predominantly affects children, but also adults to a lesser extent. As a result, a considerable amount of research has been completed in recent years to better understand the nature of the disorder to best treat individuals experiencing symptoms of ADHD. Especially with the publication of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (DSM-V) on the horizon, substantial empirical work has been analyzing current ADHD diagnostic criteria and what upcoming changes should be made. Among child and adult populations, adjusting or completely eradicating the age of onset criterion is well supported. With specifically adult populations, amending symptoms to be more developmentally and environmentally appropriate also appears necessary. Even though research additionally questions the state of ADHD subtypes (with both child and adult populations) and other general diagnostic issues (model for diagnosis and level of impairment), continued research is needed to better clarify what other changes should be made in the DSM-V and beyond.
Weissenberger, S; Klicperova-Baker, M; Zimbardo, P; Schonova, K; Akotia, D; Kostal, J; Goetz, M; Raboch, J; Ptacek, R
The article draws primarily from the behavioral findings (mainly psychiatric and psychological observations) and points out the important relationships between attention-deficit/hyperactivity disorder (ADHD) symptoms and time orientation. Specifically, the authors argue that there is a significant overlap between the symptoms of ADHD and Present Hedonism. Present Hedonism is defined by Zimbardo’s time perspective theory and assessed by Zimbardo Time Perspective Inventory. Developmental data on Present Hedonism of males and females in the Czech population sample (N=2201) are also presented. The hypothesis of relationship between ADHD and Present Hedonism is mainly derived from the prevalence of addictive behavior (mainly excessive Internet use, alcohol abuse, craving for sweets, fatty foods, and fast foods), deficits in social learning, and increased aggressiveness both in ADHD and in the population scoring high on Present Hedonism in the Zimbardo Time Perspective Inventory. We conclude that Zimbardo’s time perspective offers both: 1) a potential diagnostic tool – the Zimbardo Time Perspective Inventory, particularly its Present Hedonism scale, and 2) a promising preventive and/or therapeutic approach by the Time Perspective Therapy. Time Perspective Therapy has so far been used mainly to treat past negative trauma (most notably, posttraumatic stress disorder); however, it also has value as a potential therapeutic tool for possible behavioral compensation of ADHD. PMID:27895485
Weissenberger, S; Klicperova-Baker, M; Zimbardo, P; Schonova, K; Akotia, D; Kostal, J; Goetz, M; Raboch, J; Ptacek, R
The article draws primarily from the behavioral findings (mainly psychiatric and psychological observations) and points out the important relationships between attention-deficit/hyperactivity disorder (ADHD) symptoms and time orientation. Specifically, the authors argue that there is a significant overlap between the symptoms of ADHD and Present Hedonism. Present Hedonism is defined by Zimbardo's time perspective theory and assessed by Zimbardo Time Perspective Inventory. Developmental data on Present Hedonism of males and females in the Czech population sample (N=2201) are also presented. The hypothesis of relationship between ADHD and Present Hedonism is mainly derived from the prevalence of addictive behavior (mainly excessive Internet use, alcohol abuse, craving for sweets, fatty foods, and fast foods), deficits in social learning, and increased aggressiveness both in ADHD and in the population scoring high on Present Hedonism in the Zimbardo Time Perspective Inventory. We conclude that Zimbardo's time perspective offers both: 1) a potential diagnostic tool - the Zimbardo Time Perspective Inventory, particularly its Present Hedonism scale, and 2) a promising preventive and/or therapeutic approach by the Time Perspective Therapy. Time Perspective Therapy has so far been used mainly to treat past negative trauma (most notably, posttraumatic stress disorder); however, it also has value as a potential therapeutic tool for possible behavioral compensation of ADHD.
Moyer, Patricia S.; Milewicz, Elizabeth
Examines the questioning strategies used by (n=48) preservice teachers during one-on-one diagnostic mathematics interviews with children. Conducts audiotaped interviews, following analyses, and reflection on the interview. Indicates that using the diagnostic interview format allows preservice teachers to recognize and reflect upon effective…
Snow, Anne V.; Lecavalier, Luc; Houts, Carrie
Background: Multivariate statistics can assist in refining the nosology and diagnosis of pervasive developmental disorders (PDD) and also contribute important information for genetic studies. The Autism Diagnostic Interview-Revised (ADI-R) is one of the most widely used assessment instruments in the field of PDD. The current study investigated its…
Biederman, Joseph; Ball, Sarah W.; Mick, Eric; Monuteaux, Michael C.; Kaiser, Roselinde; Bristol, Elyssa; Faraone, Stephen V.
Objective: We evaluated correlates of the diagnosis of ADHD in youth by informant source. Method: Ninety-four pairs of mother reports and youth self-reports on ADHD were independently assessed, using diagnostic interviews from a large study of youth of both genders with and without ADHD. Comparisons were made on measures of interpersonal, school,…
Humphreys, Kathryn L.; Mehta, Natasha; Lee, Steve S.
Objective: To study the independent association of parental depression and ADHD on three dimensions of child psychopathology among 178 children aged 5 to 10 years. Method: Self-reported measures of parental depression and ADHD as well as rating scales and structure diagnostic interviews of child internalizing, ADHD, and externalizing problems were…
Dipeolu, Abiola; Hargrave, Stephanie; Storlie, Cassandra A.
Individuals diagnosed with mental health disorders may have work-related difficulties that impact functioning in all life domains. With limited research on the integration of career and mental health counseling, authors used a discriminant function analysis to assess the predictability of accurately identifying diagnostic categories among 258…
Psychometric properties of the Japanese version of the Adult Attention-deficit hyperactivity disorder (ADHD) Self-Report Scale (ASRS-J) and its short scale in accordance with DSM-5 diagnostic criteria.
Takeda, Toshinobu; Tsuji, Yui; Kurita, Hiroshi
We developed the Japanese version of the Adult ADHD Self-Report Scale (ASRS-J) and report its psychometric properties. The ASRS-J and other questionnaires were administered to 48 adults with ADHD, 46 adults with non-ADHD psychiatric disorders, 96 non-clinical adults, and 894 university students. ADHD diagnoses were made using the Japanese semi-structured diagnostic interview for adult ADHD, which is compatible with the DSM-5. The ASRS-J, its subscales, and the short form, all had Cronbach's α values of around 0.80. Total scores on the ASRS-J and the ASRS-J-6 were highly correlated with readministration after a two-week interval. The total and 18 individual item scores in the ASRS-J were significantly higher in the ADHD group than the other three groups. ASRS-J scores were correlated with scores on the Japanese version of Conners' Adult ADHD Rating Scales-Self Report subscales (0.59≤r≤0.77), with one exception. ASRS-J scores were also correlated (albeit more weakly; r=0.38) with Beck Depression Inventory-II total scores. Employing optimal cut-offs, sensitivity, specificity, and positive and negative predictive values of the ASRS-J and ASRS-J-6 are all above 0.69. The ASRS-J and ASRS-J-6 showed acceptable psychometric properties, although further study is necessary.
Monuteaux, Michael C.; Faraone, Stephen V.; Herzig, Kathleen; Navsaria, Neha; Biederman, Joseph
The familial relationship between dyscalculia and attention-deficit/hyperactivity disorder (ADHD) was assessed. We conducted a familial risk analysis using probands with and without ADHD of both genders and their first-degree relatives. Participants were assessed with structured diagnostic interviews and a cognitive test battery. We found elevated…
Tsuchiya, Kenji J.; Matsumoto, Kaori; Yagi, Atsuko; Inada, Naoko; Kuroda, Miho; Inokuchi, Eiko; Koyama, Tomonori; Kamio, Yoko; Tsujii, Masatsugu; Sakai, Saeko; Mohri, Ikuko; Taniike, Masako; Iwanaga, Ryoichiro; Ogasahara, Kei; Miyachi, Taishi; Nakajima, Shunji; Tani, Iori; Ohnishi, Masafumi; Inoue, Masahiko; Nomura, Kazuyo; Hagiwara, Taku; Uchiyama, Tokio; Ichikawa, Hironobu; Kobayashi, Shuji; Miyamoto, Ken; Nakamura, Kazuhiko; Suzuki, Katsuaki; Mori, Norio; Takei, Nori
To examine the inter-rater reliability of Autism Diagnostic Interview-Revised, Japanese Version (ADI-R-JV), the authors recruited 51 individuals aged 3-19 years, interviewed by two independent raters. Subsequently, to assess the discriminant and diagnostic validity of ADI-R-JV, the authors investigated 317 individuals aged 2-19 years, who were…
A review of the research and legal literature summarizes the status of attention deficit hyperactivity disorder (ADHD) under school law. Following a brief introduction, discussion of ADHD as a disability notes the impact of ADHD on overall functioning and provides a table of diagnostic criteria for subtypes of ADHD. The following section focuses…
Knight, Rose; Wright, Vince
Spatial visualisation is a subset of spatial ability and is exemplified in predicting whether or not a net will fold to form a target solid. The researchers examined video of interviews to explore the schemes of Year 5 students for determining the validity of nets for a cube and pyramid. Findings suggest the significance of imaged actions, shown…
Medical diagnostics help us evaluate a range of disorders, such as cancer and infectious diseases. In the United States and other developed countries, doctors have access to advanced equipment and laboratories that provide reliable diagnoses. As a result, when we are sick, we feel confident that we will get the treatment we need. Unfortunately,…
Skuse, David; Warrington, Richard; Bishop, Dorothy; Chowdhury, Uttom; Lau, Jennifer; Mandy, William; Place, Maurice
Objective: Autism is a diagnostic spectrum of variable severity, with significant comorbidity. No existing standardized interview measures autistic features dimensionally. The authors aimed to develop a parental autism interview that could be administered to unselected clinical and general population samples that measures both symptom intensity…
Montoya, Louise A.; Egnatovitch, Reginald; Eckhardt, Elizabeth; Goldstein, Marjorie; Goldstein, Richard A.; Steinberg, Annie G.
This article describes the translation goals, challenges, strategies, and solutions employed in the development of a computer-based, self administered, psychiatric diagnostic instrument, the Diagnostic Interview Schedule for the Deaf (D-DIS-IV) in American Sign Language (ASL) with English captions. The article analyzes the impact of the…
Biederman, Joseph; Ball, Sarah W.; Monuteaux, Michael C.; Kaiser, Roselinde; Faraone, Stephen V.
Objective: To evaluate the association between the clinical scales of the child behavior checklist (CBCL) and the comorbid diagnosis of oppositional defiant disorder (ODD) in a large sample of youth with attention deficit hyperactivity disorder (ADHD). Method: The sample consisted of 101 girls and 106 boys ages 6 to 17 with ADHD. Conditional…
Counts, Carla A.; Nigg, Joel T.; Stawicki, Julie Ann; Rappley, Marsha D.; von Eye, Alexander
Objective: This study evaluated the relationship between a family adversity index and DSM-IV attention-deficit/hyperactivity disorder (ADHD) subtypes and associated behavior problems. The relationship of family adversity to symptoms and subtypes of ADHD was examined. Method: Parents and 206 children aged 7-13 completed diagnostic interviews and…
Monuteaux, Michael C; Faraone, Stephen V; Herzig, Kathleen; Navsaria, Neha; Biederman, Joseph
The familial relationship between dyscalculia and attention-deficit/hyperactivity disorder (ADHD) was assessed. We conducted a familial risk analysis using probands with and without ADHD of both genders and their first-degree relatives. Participants were assessed with structured diagnostic interviews and a cognitive test battery. We found elevated rates of ADHD in relatives of both ADHD proband groups, regardless of dyscalculia status, and elevated rates of dyscalculia in relatives of probands with dyscalculia, irrespective of ADHD status. There was no evidence for cosegregation or assortative mating. Our findings support the hypothesis that ADHD and dyscalculia are independently transmitted in families and are etiologically distinct. These results reinforce the current nosological approach to these disorders and underscore the need for separate identification and treatment strategies for children with both conditions.
Bell, Allison S.
ADHD is an impairing psychological disorder that predominantly affects children, but also adults to a lesser extent. As a result, a considerable amount of research has been completed in recent years to better understand the nature of the disorder to best treat individuals experiencing symptoms of ADHD. Especially with the publication of the…
Bruchmuller, Katrin; Margraf, Jurgen; Schneider, Silvia
Objective: Unresolved questions exist concerning diagnosis of ADHD. First, some studies suggest a potential overdiagnosis. Second, compared with the male-female ratio in the general population (3:1), many more boys receive ADHD treatment compared with girls (6-9:1). We hypothesized that this occurs because therapists do not adhere to "Diagnostic…
Neighbors, H. W.; Trierweiler, S. J.; Munday, C.; Thompson, E. E.; Jackson, J. S.; Binion, V. J.; Gomez, J.
This study is a primary data collection that varied patient race and diagnosis and used two diagnostic interviewing conditions: one clinician-structured (phase one) and the other a semi-structured diagnostic instrument (phase two). Four basic research questions are addressed: What is the relationship between race and the hospital diagnosis? How is race related to diagnosis in both research interviewing conditions? Why does diagnostic concordance between the hospital diagnosis and the research diagnosis vary by research interviewing condition? Is diagnostic concordance between the hospital and research diagnosis influenced by patient race? A total of 291 patients completed an interview during phase one, while 665 patients completed an interview during phase two. Blacks were more likely to receive a hospital diagnosis of schizophrenia and less likely to be diagnosed with mood disorder. Patient race was similarly related to the research diagnoses produced in the clinician-structured research condition (phase one). Although less pronounced, a higher percentage of African Americans than whites received a diagnosis of schizophrenia using the semi-structured DSM-III-R Symptom Checklist (phase two). The black-white distribution for mood disorders showed that whites were more likely than blacks to be diagnosed with mood disorder. PMID:10641496
Salto-Tellez, Manuel; Raison, Claire
Interview with Professor Manuel Salto-Tellez by Claire Raison, Commissioning Editor Professor Manuel Salto-Tellez of Queen's University, Belfast, Northern Ireland is an expert histopathologist and molecular diagnostician. Professor Salto-Tellez is a lead investigator at the Northern Ireland Molecular Pathology Laboratory and also serves as a member of the Editorial Advisory Board for Expert Review of Molecular Diagnostics. In this interview, he proposes directions for the future of molecular pathology and molecular diagnostics, integrating all aspects of pathology toward a common goal.
Kim, So Hyun; Lord, Catherine
Autism Diagnostic Interview-Revised (Rutter et al. in "Autism diagnostic interview-revised." Western Psychological Services, Los Angeles, 2003) diagnostic algorithms specific to toddlers and young preschoolers were created using 829 assessments of children aged from 12 to 47 months with ASD, nonspectrum disorders, and typical development. The…
Altszuler, Amy R.; Page, Timothy F.; Gnagy, Elizabeth M.; Coxe, Stefany; Arrieta, Alejandro; Molina, Brooke S. G.; Pelham, William E.
This study used data from the Pittsburgh ADHD Longitudinal Study (PALS) to evaluate financial outcomes of young adults (YA) with ADHD relative to comparisons. Participants for this study included 309 individuals who had been diagnosed with ADHD (DSM-III-R or DSM-IV) in childhood and 208 comparison YA without childhood ADHD diagnoses (total N=517) who were followed through age 25. Participants were predominately male (88 %) and Caucasian (84 %). Diagnostic interviews were conducted in childhood. Young adults and their parents reported on financial outcomes and a number of predictor variables. Young adults with ADHD experienced greater financial dependence on family members (p<0.05) and the welfare system (p<0.01) and had lower earnings (p<0.05) than comparisons. ADHD diagnostic status, education attainment, and delinquency were significant predictors of financial outcomes. A projection of lifetime earnings indicated that ADHD group participants could expect to earn $543,000–$616,000 less over their lifetimes than comparisons. Due to the propensity of individuals with ADHD to underreport problems, the data are likely to be underestimates. These findings support the need for interventions to improve labor market outcomes as well as the development of interventions that target the management of personal finances for individuals with ADHD in young adulthood. PMID:26542688
Altszuler, Amy R; Page, Timothy F; Gnagy, Elizabeth M; Coxe, Stefany; Arrieta, Alejandro; Molina, Brooke S G; Pelham, William E
This study used data from the Pittsburgh ADHD Longitudinal Study (PALS) to evaluate financial outcomes of young adults (YA) with ADHD relative to comparisons. Participants for this study included 309 individuals who had been diagnosed with ADHD (DSM-III-R or DSM-IV) in childhood and 208 comparison YA without childhood ADHD diagnoses (total N = 517) who were followed through age 25. Participants were predominately male (88 %) and Caucasian (84 %). Diagnostic interviews were conducted in childhood. Young adults and their parents reported on financial outcomes and a number of predictor variables. Young adults with ADHD experienced greater financial dependence on family members (p < 0.05) and the welfare system (p < 0.01) and had lower earnings (p < 0.05) than comparisons. ADHD diagnostic status, education attainment, and delinquency were significant predictors of financial outcomes. A projection of lifetime earnings indicated that ADHD group participants could expect to earn $543,000-$616,000 less over their lifetimes than comparisons. Due to the propensity of individuals with ADHD to underreport problems, the data are likely to be underestimates. These findings support the need for interventions to improve labor market outcomes as well as the development of interventions that target the management of personal finances for individuals with ADHD in young adulthood.
Ghimire, Dirgha J.; Chardoul, Stephanie; Kessler, Ronald C.; Axinn, William G.; Adhikari, Bishnu P.
Background Efforts to develop and validate fully-structured diagnostic interviews of mental disorders in non-Western countries have been largely unsuccessful. However, the principled methods of translation, harmonization, and calibration that have been developed by cross-national survey methodologists have never before been used to guide such development efforts. The current report presents the results of a rigorous program of research using these methods designed to modify and validate the Composite International Diagnostic Interview (CIDI) for an epidemiological survey in Nepal. Methods A five-step process of translation, harmonization, and calibration was used to modify the instrument. A blinded clinical reappraisal design was used to validate the instrument. Results Preliminary interviews with local mental health expert led to a focus on major depressive episode, mania/hypomania, panic disorder, post-traumatic stress disorder, generalized anxiety disorder, and intermittent explosive disorder. After an iterative process of multiple translations-revisions guided by the principles developed by cross-national survey methodologists, lifetime DSM-IV diagnoses based on the final Nepali CIDI had excellent concordance with diagnoses based on blinded SCID clinical reappraisal interviews. Conclusions Valid assessment of mental disorders can be achieved with fully-structured diagnostic interviews even in low-income non-Western settings with rigorous implementation of replicable developmental strategies. PMID:23494758
Miller, Alisa; Enlow, Michelle Bosquet; Reich, Wendy; Saxe, Glenn
The goal of this study was to develop a semistructured clinical interview for assessing acute stress disorder (ASD) in youth and test its psychometric properties. Youth (N = 168) with an acute burn or injury were administered the acute stress disorder module of the Diagnostic Interview for Children and Adolescents (DICA-ASD). The DICA-ASD demonstrated strong psychometric properties, including high internal consistency (alpha = .97) and perfect diagnostic interrater agreement (kappa = 1.00). Participants diagnosed with ASD scored significantly higher than those not diagnosed on validated traumatic stress symptomatology measures but not on other symptomatology measures, providing evidence of convergent and discriminant validity. Preliminary evidence supports the reliability and validity of the first semistructured clinical interview for diagnosing ASD in youth.
Ünsel Bolat, Gül; Ercan, Eyüp Sabri; Salum, Giovanni Abrahão; Bilaç, Öznur; Massuti, Rafael; Uysal Özaslan, Taciser; Bolat, Hilmi; Rohde, Luis Augusto
The American Psychiatric Association (APA) working group on Attention-Deficit/Hyperactivity Disorder (ADHD) proposed the inclusion of four new impulsivity symptoms. However, they were not included in DSM-5 due to the lack of sufficient evidence. The aim of this study is to investigate the performance of the proposed four ADHD impulsivity symptoms with respect to: (a) ADHD factor structure; (b) performance in predicting clinical impairment; (c) specificity for ADHD diagnosis and (d) best symptomatic threshold to predict clinical impairment. The sample comprised 416 children (31 ADHD subjects according to both DSM-IV and proposed DSM-5, 20 ADHD subjects according to just one diagnostic system and 365 controls) from 12 schools. Diagnoses were derived using semi-structured interviews and ADHD rating scales. Results from confirmatory factor analysis indicate that addition of the four new impulsivity items provided a slightly better factor structure if compared to models including only 18 items. Regression analyses showed that only one of the new impulsivity symptoms (impatient) was part of the list of best predictors of impairment. None of the four new impulsivity items was specifically associated with ADHD diagnosis. The best cutoff point in the hyperactivity/impulsivity dimension for predicting impairment did not change significantly. Overall, our findings suggest that the determination on how to best capture impulsivity dimension as part of the ADHD construct needs more investigation and that there is not enough evidence to include these four assessed impulsivity symptoms as part of the ADHD criteria.
Schmiedeler, Sandra; Schneider, Wolfgang
In this study we discuss implications of the dimensional versus categorical approach in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and focus on the educational relevance of an early assessment. In a longitudinal study in a German community sample we investigated the development of ADHD symptoms from kindergarten until the end of Grade 1 as well as the association to pre-academic skills and later academic performance. At three time points in kindergarten, children (original sample N = 793; Mn age 4 years 10 months) were assessed in regard to school-relevant precursors of reading, spelling and mathematical abilities; ADHD symptoms were rated by parents and preschool teachers. In elementary school academic performance in reading, spelling, and mathematics was measured with standardized tests. Results show that stability of ADHD symptoms during preschool was high considering the dimensional approach, whereas in regard to the categorical classification many children crossing the cut-off point at one measurement point did not do so at the next assessment. Furthermore, preschool ADHD symptoms were negatively correlated with all school-relevant precursors. This was more pronounced for symptoms of inattention than for hyperactivity/impulsivity. Observing later development, preschool ADHD symptoms predicted academic achievement in mathematics and reading at the end of Grade 1 even after individual differences in nonverbal intelligence and specific precursors had been statistically controlled for.
Popp, Lukka; Neuschwander, Murielle; Mannstadt, Sandra; In-Albon, Tina; Schneider, Silvia
Objective: In clinical structured diagnostic interviews, diagnoses based on parent and child reports have low to moderate agreement. The aims of the present study are (1) to examine diagnostic agreement on anxiety disorders between parents and children on the levels of current and lifetime diagnostic category and diagnoses focusing in particular on diagnostic criteria and (2) to identify parent- and child-related predictors for diagnostic agreement. Method: The sample consisted of 166 parent-child dyads interviewed with the Structured Diagnostic Interview for Mental Disorders in Children (Kinder-DIPS, Schneider et al., 2009). The children (51.8% girls) were between the ages of 7 and 18 years (M = 10.94; SD = 2.22). Results: Overall, parent-child agreement on the diagnostic category of anxiety disorder (k = 0.21; k = 0.22) and the specific anxiety diagnoses (base rate > 10%) of social phobia, specific phobia and separation anxiety disorder (k = 0.24–0.52; k = 0.19–0.43) and corresponding diagnostic criteria (k = 0.22–0.67; k = 0.24–0.41) were low to moderate with the highest agreement on separation anxiety disorder (k > 0.43). Lower maternal depression, and higher social support reported by mother and father were associated with higher parent-child agreement. Maternal depression was indicated as the strongest predictor. Parental sense of competence, parental anxiety, the amount of parent-child interaction and the child's age and gender had no predictive value. Conclusions: Parent-child agreement can be expected to be higher on the level of anxiety criteria compared to specific anxiety diagnoses and diagnostic anxiety category. Psychological strains in the family—especially maternal depression and low social support—lower the parent-child agreement on anxiety symptoms. Child- and relation-related variables (age, gender, amount of time parent(s) and children interact) play no role in the prediction of low parent-child agreement.
NORDGAARD, JULIE; REVSBECH, RASMUS; SÆBYE, DITTE; PARNAS, JOSEF
The use of structured psychiatric interviews performed by non-clinicians is frequent for research purposes and is becoming increasingly common in clini-cal practice. The validity of such interviews has rarely been evaluated empirically. In this study of a sample of 100 diagnostically heterogeneous, first-admitted inpatients, the results of an assessment with the Structured Clinical Interview for DSM-IV (SCID), yielding a DSM-IV diagnosis and performed by a trained non-clinician, were compared with a consensus lifetime best diagnostic estimate (DSM-IV) by two experienced research clinicians, based on multiple sources of information, which included videotaped comprehensive semi-structured narrative interviews. The overall kappa agreement was 0.18. The sensitivity and specificity for the diagnosis of schizophrenia by SCID were 19% and 100%, respectively. It is concluded that structured interviews performed by non-clinicians are not recommendable for clinical work and should only be used in research with certain precautions. It is suggested that a revival of systematic theoretical and practical training in psychopathology is an obvious way forward in order to improve the validity and therapeutic utility of psychiatric diagnosis. PMID:23024678
Ward-King, Jessica; Cohen, Ira L.; Penning, Henderika; Holden, Jeanette J. A.
The Autism Diagnostic Interview-Revised is one of the "gold standard" diagnostic tools for autism spectrum disorders. It is traditionally administered face-to-face. Cost and geographical concerns constrain the employment of the ADI-R for large-scale research projects. The telephone interview is a reasonable alternative, but has not yet been…
Van De Glind, Geurt; Van Emmerik-Van Oortmerssen, Katelijne; Carpentier, Pieter Jan; Levin, Frances R.; Koeter, Maarten W.J.; Barta, Csaba; Kaye, Sharlene; Skutle, Arvid; Franck, Johan; Konstenius, Maija; Bu, Eli-Torild; Moggi, Franz; Dom, Geert; Demetrovics, Zolt; Fatséas, Mélina; Schillinger, Arild; Kapitány-Fövény, Máté; Verspreet, Sofie; Seitz, Andrea; Johnson, Brian; Faraone, Stephen V.; Ramos-Quiroga, J. Antoni; Allsop, Steve; Carruthers, Susan; Schoevers, Robert A.; Van Den Brink, Wim
Attention deficit/hyperactivity disorder (ADHD) is an increasingly recognized comorbid condition in subjects with substance use disorders (SUDs). This paper describes the methods and study population of the International ADHD in Substance Use Disorders Prevalence (IASP) study. Objectives of the IASP are to determine the prevalence of ADHD in adult treatment seeking patients with SUD in different countries and SUD populations, determine the reliability and validity of the Adult ADHD Self-report Scale V 1.1 (ASRS) as ADHD screening instrument in SUD populations, investigate the comorbidity profile of SUD patients with and without ADHD, compare risk factors and protective factors in SUD patients with and without a comorbid diagnosis of ADHD, and increase our knowledge about the relationship between ADHD and the onset and course of SUD. In this cross-sectional, multi-centre two stage study, subjects were screened for ADHD with the ASRS, diagnosed with the Conner’s Adult ADHD Diagnostic Interview for DSM-IV (CAADID), and evaluated for SUD, major depression, bipolar disorder, anti social personality disorder and borderline personality disorder. Three thousand five hundred and fifty-eight subjects from 10 countries were included. Of these 40.9% screened positive for ADHD. This is the largest international study on this population evaluating ADHD and comorbid disorders. Copyright © 2013 John Wiley & Sons, Ltd. PMID:24022983
Diamond, Allison E.; Fisher, Aaron J.
Dysregulation of the autonomic nervous system (ANS) has been well documented in individuals diagnosed with a range of psychological disorders, including generalized anxiety disorder (GAD) and major depressive disorder (MDD). Moreover, these disorders both confer an increased risk of cardiovascular disease—which may relate to increased sympathetic and decreased parasympathetic tone. Extant research has indicated a reduction in autonomic flexibility in GAD, and while reduced flexibility has also been seen in MDD, the specific physiological alterations have been more difficult to categorize due to methodological limitations, including high co-morbidity rates with anxiety disorders. Prior studies have largely assessed autonomic functioning in stress paradigms or at the trait level, yet to date, no research has investigated the ANS during a diagnostic interview, a ubiquitous task employed in both research and clinical settings. In this study we sought to identify physiological differences in both branches of the ANS across diagnostic categories in the context of a diagnostic interview. Participants (n = 82) were administered a structured clinical interview, during which heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) were recorded in participants carrying a diagnosis of GAD (n = 34), MDD (n = 22), Social Anxiety Disorder (SAD; n = 15) and healthy controls (n = 27). Person-specific linear regression models were employed to assess the level and slope for HR, RSA and PEP throughout the course of the interview. A multivariate analysis of variance (MANOVA) model was conducted to baseline differences in HR, RSA and PEP between diagnostic groups. Multiple regression models were then conducted to differences in slope of HR, RSA and PEP throughout the course of the interview amongst diagnostic groups, including both suppression and worry as moderators. Results indicated significant increases in RSA throughout the interview in MDD (p = 0
Kysow, Kate; Park, Joanne; Johnston, Charlotte
This study examined the use of compensatory strategies reported by adults with ADHD symptoms and their relation to measures of functioning. Forty-nine adults (55.1 % female) completed a structured diagnostic interview to assess ADHD, and responses were coded for compensatory strategies: Adaptation, Paying Attention, Organization, External Support, and Avoidance. The majority of adults with ADHD symptoms reported using compensatory strategies, and their reported strategy use in childhood was related to their use in adulthood. No gender differences were found in the use of strategies, although Organization and External Support were used more often for inattention than for hyperactive/impulsive symptoms. Use of the compensatory strategy, Adaptation, was significantly related to measures of functioning, and the use of strategies reduced the negative relationship between ADHD symptoms and parenting difficulties. Results encourage the development of compensatory strategies among adults with ADHD symptoms, as well as provide recommendations for treatment programs.
Mewton, Louise; Slade, Tim; Teesson, Maree; Memedovic, Sonja; Krueger, Robert F
This study aims to identify problems in the structure and wording of questions designed to operationalize four DSM-IV diagnostic criteria for alcohol use disorders (AUDs): (1) use of alcohol in hazardous situations (hazard); (2) tolerance; (3) use of alcohol in larger amounts/longer periods than intended (larger/longer); (4) unsuccessful attempts to cut down or control alcohol use (quit/cut down). Ten experts appraised the questions related to these criteria in the WMH-CIDI according to a standardized checklist. These experts identified three main problems: (1) the double-barrelled nature of some of the questions; (2) definitional issues; and (3) unclear thresholds for criterion endorsement. Cognitive interviews of 100 young adult drinkers aged 18-24 were then conducted. The double-barrelled nature of the DSM-IV criteria led to their subsequent over- or under-endorsement. Key terms in the questions under investigation were defined inconsistently. There was also a large amount of variability in the thresholds at which larger/longer and quit/cut down were endorsed. Many of these problems could be linked back to the DSM-IV text. The findings raise questions as to the validity of AUD diagnoses when established via structured diagnostic interview. Further research should focus on testing alternative structure and wording of key AUD criteria to ensure accurate operationalizations of these criteria in structured diagnostic interviews.
Hill, B.D.; Pella, Russell D.; Singh, Ashvind N.; Jones, Glenn N.; Gouvier, Wm. Drew
Objective: The Wender Utah Rating Scale (WURS) is used to retroactively assess ADHD symptoms. This study sought to determine whether the WURS actually functions as an index of dysfunctional personality traits. Method: Five hundred twenty-two adult participants completed the WURS and at least one of the following measures: Wechsler Adult…
Background Attention-Deficit/Hyperactivity Disorder (ADHD) affects approximately 5% of children worldwide and results in significant impairments in daily functioning. Few community-ascertained samples of children with ADHD have been studied prospectively to identify factors associated with differential outcomes. The Children’s Attention Project is the first such study in Australia, examining the mental health, social, academic and quality of life outcomes for children with diagnostically-confirmed ADHD compared to non-ADHD controls. The study aims to map the course of ADHD symptoms over time and to identify risk and protective factors associated with differential outcomes. Methods/design The sample for this prospective longitudinal study is being recruited across 43 socio-economically diverse primary schools across Melbourne, Australia. All children in Grade 1, the second year of formal schooling (6–8 years), are screened for ADHD symptoms using independent parent and teacher reports on the Conners’ 3 ADHD index (~N = 5260). Children screening positive for ADHD by both parent and teacher report, and a matched sample (gender, school) screening negative, are invited to participate in the longitudinal study. At baseline this involves parent completion of the NIMH Diagnostic Interview Schedule for Children IV (DISC-IV) to confirm likely ADHD diagnostic status and identify other mental health difficulties, direct child assessments (cognitive, academic, language and executive functioning; height and weight) and questionnaires for parents and teachers assessing outcomes, as well as a broad range of risk and protective factors (child, parent/family, teacher/school, and socio-economic factors). Families will be initially followed up for 3 years. Discussion This study is the first Australian longitudinal study of children with ADHD and one of the first community-based longitudinal studies of diagnostically confirmed children with ADHD. The study’s examination of
The research presented in this paper focuses on the cognitive diagnostic strategies that prospective elementary mathematics teachers (PTs) use in their reflections of one-on-one diagnostic interviews with children in grade one. Thereby, it responds to the detected lack of knowledge regarding qualitative facets of diagnostic proceeding in interview…
Klein, B; Damiani-Taraba, G; Koster, A; Campbell, J; Scholz, C
Children involved with child protection services (CPS) are diagnosed and treated for attention-deficit hyperactivity disorder (ADHD) at higher rates than the general population. Children with maltreatment histories are much more likely to have other factors contributing to behavioural and attentional regulation difficulties that may overlap with or mimic ADHD-like symptoms, including language and learning problems, post-traumatic stress disorder, attachment difficulties, mood disorders and anxiety disorders. A higher number of children in the child welfare system are diagnosed with ADHD and provided with psychotropic medications under a group care setting compared with family-based, foster care and kinship care settings. However, children's behavioural trajectories change over time while in care. A reassessment in the approach to ADHD-like symptoms in children exposed to confirmed (or suspected) maltreatment (e.g. neglect, abuse) is required. Diagnosis should be conducted within a multidisciplinary team and practice guidelines regarding ADHD diagnostic and management practices for children in CPS care are warranted both in the USA and in Canada. Increased education for caregivers, teachers and child welfare staff on the effects of maltreatment and often perplexing relationship with ADHD-like symptoms and co-morbid disorders is also necessary. Increased partnerships are needed to ensure the mental well-being of children with child protection involvement.
Mayes, Susan Dickerson; Calhoun, Susan L.; Chase, Gary A.; Mink, Danielle M.; Stagg, Ryan E.
Objective: Wechsler Intelligence Scale for Children Freedom-from-Distractibility/Working Memory Index (FDI/WMI), Processing Speed Index (PSI), and Gordon Diagnostic System (GDS) scores in ADHD children were examined as a function of subtype and coexisting anxiety, depression, and oppositional-defiant disorder. Method: Participants were 587…
Lampert, T. L.; Polanczyk, G.; Tramontina, S.; Mardini, V.; Rohde, L. A.
Objective: To evaluate the diagnostic performance of the Attention Problem Scale of the Child Behavior Checklist (CBCL-APS) for the screening of Attention-Deficit/Hyperactivity Disorder (ADHD) in a sample of Brazilian children and adolescents. Methods: The CBCL-APS was given to 763 children and adolescents. Child psychiatrists using DSM-IV…
Sibley, Margaret H.; Pelham, William E.; Molina, Brooke S.G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Biswas, Aparajita; MacLean, Michael G.; Babinski, Dara E.; Karch, Kathryn M.
This study examined the association between childhood ADHD and juvenile delinquency by examining data from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of individuals diagnosed with ADHD in childhood (ages 5–12) and recontacted in adolescence and young adulthood for yearly follow-up (age at first follow-up interview M= 17.26, SD=3.17). Participants were 288 males with childhood ADHD and 209 demographically similar males without ADHD who were recruited into the follow-up study. Delinquency information gathered yearly during the second through eighth follow-up provided a comprehensive history of juvenile delinquency for all participants. Four childhood diagnostic groups [ADHD-only (N=47), ADHD+ODD (N=135), ADHD+CD (N=106), and comparison (N=209)] were used to examine group differences on delinquency outcomes. Analyses were conducted across three dimensions of delinquency (i.e., severity, age of initiation, and variety). Individuals with childhood ADHD+CD displayed significantly worse delinquency outcomes than the other three groups, across almost all indices of offending. When compared to comparison participants, boys with ADHD-only and ADHD+ODD in childhood displayed earlier ages of delinquency initiation, a greater variety of offending, and higher prevalence of severe delinquency. These findings suggest that although childhood ADHD+CD creates the greatest risk for delinquency, boys with ADHD-only and ADHD+ODD also appear at a higher risk for later offending. The patterns of offending that emerged from the PALS are discussed in the context of the relationship between ADHD, comorbidity, and delinquency. PMID:20697799
Background The aim of this study was to investigate the associations between attention deficit hyperactivity disorder (ADHD), the most common neuropsychiatric disorder in school children, and childhood allergic disease by evaluating their respective prevalence. Methods Subjects were comprised of first and second grade students in twenty two elementary schools in a city in the Republic of Korea. The mode of measurement for ADHD was based on DSM-IV from clinical interviews conducted by child psychiatrists. Along with the diagnostic interviews, we also used the epidemiological questionnaires, Computerized Attention Deficit-Hyperactivity Disorder Diagnostic System, the abbreviated Conner’s Parent Rating Scale (CPRS), and DuPaul’s ADHD Rating Scales. Allergic conditions, such as asthma, have been separately evaluated based on the questionnaire items whose validity and reliability were proved by the International Study of Asthma and Allergies in Children (ISAAC). All questionnaires were completed by the subjects’ parents. Results The lifetime prevalence rate of asthma in ADHD patients was 36.6%, compared to a prevalence of 24.3% in control subjects. The lifetime prevalence rate of allergic rhinitis in ADHD patients was 59.0%, compared to a prevalence of 47.0% in control subjects. Statistically significant difference has been found between the two groups. In the logistic regression model of the ADHD and the control group, the relative risk of asthma was 1.60 times higher (confidence interval 1.301-1.964), the relative risk of allergic rhinitis was 1.38 times higher (confidence interval 1.124-1.681), which showed statistical significance. Conclusions The findings of this study suggest significant association between ADHD and childhood asthma and allergic rhinitis. Therefore, appropriate evaluation and treatment are needed for asthmatic children with attention-deficit symptoms, or allergic rhinitis with ADHD. Besides, further research is needed to determine the
Chojnicka, Izabela; Płoski, Rafał
Childhood autism belongs to pervasive developmental disorders and is characterised by qualitative abnormalities in reciprocal social interactions, communication, and by restricted, repetitive interests and behaviours. Until now there was no standardised tool for a diagnosis of autism in Poland. The paper presents the Polish version of the Autism Diagnostic Interview - Revised (ADI-R), which is the "gold standard" for the diagnosis of autism in Europe, United States and Australia. It describes the translation process and adaptation of the original version into Polish, as well as differences between the two versions. ADI-R is a complex, standardised, semi-structured investigator-based interview for parent or caregiver of person with autism, linked to ICD-10 and DSM-IV-TR criteria and appropriate for both adults and children, who have the minimum mental age of 24 months. Moreover ADI-R consists of, beside diagnostic algorithms, the current behaviour algorithms, which enable to assess and compare various levels of functioning during planning and implementation of treatment and therapy. ADI-R is also a very useful tool in the diagnosis for scientific purposes due to its standardisation.
Soke, Gnakub Norbert; Philofsky, Amy; Diguiseppi, Carolyn; Lezotte, Dennis; Rogers, Sally; Hepburn, Susan
We prospectively examined mean changes in Autism Diagnostic Interview-Revised (ADI-R) Total and Domains scores and stability of the ADI-R diagnostic classification in 28 children with autism initially assessed at age 2-4 years and reassessed 2 years later. Mean Total, Social Interaction, and Communication scores decreased significantly from Time 1…
Martel, Michelle M.; Gremillion, Monica L.; Roberts, Bethan A.; Zastrow, Brittany L.; Tackett, Jennifer L.
Despite the fact that Attention-Deficit/Hyperactivity Disorder (ADHD) is often conceptualized as an extreme trait, there remains controversy about the best way to understand associations between temperament traits and ADHD. The current study examines longitudinal associations between temperament traits and ADHD during early childhood in order to critically examine vulnerability and spectrum models of trait—ADHD associations. Study participants were 109 children between the ages of 3 and 6 and their primary caregivers and teachers/daycare providers, community-recruited for ADHD-related problems. Primary caregivers completed the Kiddie Disruptive Behavior Disorders Schedule semi-structured diagnostic interview at the initial appointment and one year later. At the initial appointment, primary caregivers completed the Child Behavior Questionnaire as a measure of child temperament traits. Results from the initial time point indicated that high neuroticism and high surgency were associated with inattentive and hyperactive-impulsive ADHD symptoms, and low effortful control was associated with hyperactive-impulsive ADHD symptoms. However, none of these traits predicted the one-year course of ADHD symptoms. Results are more consistent with a spectrum (vs. vulnerability) model of trait-psychopathology associations, suggesting that traits, but may not influence longitudinal course during early childhood. PMID:25598568
Martel, Michelle M; Gremillion, Monica L; Roberts, Bethan A; Zastrow, Brittany L; Tackett, Jennifer L
Despite the fact that Attention-Deficit/Hyperactivity Disorder (ADHD) is often conceptualized as an extreme trait, there remains controversy about the best way to understand associations between temperament traits and ADHD. The current study examines longitudinal associations between temperament traits and ADHD during early childhood in order to critically examine vulnerability and spectrum models of trait-ADHD associations. Study participants were 109 children between the ages of 3 and 6 and their primary caregivers and teachers/daycare providers, community-recruited for ADHD-related problems. Primary caregivers completed the Kiddie Disruptive Behavior Disorders Schedule semi-structured diagnostic interview at the initial appointment and one year later. At the initial appointment, primary caregivers completed the Child Behavior Questionnaire as a measure of child temperament traits. Results from the initial time point indicated that high neuroticism and high surgency were associated with inattentive and hyperactive-impulsive ADHD symptoms, and low effortful control was associated with hyperactive-impulsive ADHD symptoms. However, none of these traits predicted the one-year course of ADHD symptoms. Results are more consistent with a spectrum (vs. vulnerability) model of trait-psychopathology associations, suggesting that traits, but may not influence longitudinal course during early childhood.
Magana, Sandy; Smith, Leann E.
Research shows that Latinos are less likely to be diagnosed with autism than their non-Latino counterparts. One factor that may contribute to these differences is that autism diagnostic instruments have not been adapted for the Latino population. The present study compared scores from the Autism Diagnostic Interview-Revised for two groups: 48…
Kim, So Hyun; Thurm, Audrey; Shumway, Stacy; Lord, Catherine
Using two independent datasets provided by National Institute of Health funded consortia, the Collaborative Programs for Excellence in Autism and Studies to Advance Autism Research and Treatment (n = 641) and the National Institute of Mental Health (n = 167), diagnostic validity and factor structure of the new Autism Diagnostic Interview (ADI-R)…
Attention-deficit hyperactivity disorder (ADHD) is described as the most common neurobehavioral condition of childhood. We raise the concern that ADHD is not a disease per se but rather a group of symptoms representing a final common behavioral pathway for a gamut of emotional, psychological, and/or learning problems. Increasing numbers of children, especially boys, are diagnosed with ADHD and treated with stimulant medications according to a simplified approach. Methodical review of the literature, however, raised concerning issues. "Core" ADHD symptoms of inattentiveness, hyperactivity and impulsivity are not unique to ADHD. Rates of "comorbid" psychiatric and learning problems, including depression and anxiety, range from 12 to 60%, with significant symptom overlap with ADHD, difficulties in diagnosis, and evidence-based treatment methods that do not include stimulant medications. No neuropsychologic test result is pathognomic for ADHD, and structural and functional neuroimaging studies have not identified a unique etiology for ADHD. No genetic marker has been consistently identified, and heritability studies are confounded by familial environmental factors. The validity of the Conners' Rating Scale-Revised has been seriously questioned, and parent and teacher "ratings" of school children are frequently discrepant, suggesting that use of subjective informant data via scale or interview does not form an objective basis for diagnosis of ADHD. Empiric diagnostic trials of stimulant medication that produce a behavioral response have been shown not to distinguish between children with and without "ADHD." In summary, the working dogma that ADHD is a disease or neurobehavioral condition does not at this time hold up to scrutiny of evidence. Thorough evaluation of symptomatic children should be individualized, and include assessment of educational, psychologic, psychiatric, and family needs.
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…
The Added Value of the Combined Use of the Autism Diagnostic Interview-Revised and the Autism Diagnostic Observation Schedule: Diagnostic Validity in a Clinical Swedish Sample of Toddlers and Young Preschoolers
Zander, Eric; Sturm, Harald; Bölte, Sven
The diagnostic validity of the new research algorithms of the Autism Diagnostic Interview-Revised and the revised algorithms of the Autism Diagnostic Observation Schedule was examined in a clinical sample of children aged 18-47 months. Validity was determined for each instrument separately and their combination against a clinical consensus…
Ezpeleta, Lourdes; Granero, Roser
Executive functioning in 3-year-old preschoolers with attention-deficit hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), comorbid ADHD+ODD, and children without any of these conditions (control group) was examined. A community sample including 622 children was diagnosed using a diagnostic interview following DSM-IV criteria, and assessed using the Behavior Rating Inventory of Executive Function Preschool version (BRIEF-P) and the Kiddie-Conners' Continuous Performance Test. The children diagnosed with ADHD showed the poorest executive function (EF) profile in comparison with controls, and were closely followed up in this respect by the comorbid ADHD+ODD children. The ADHD and comorbid groups presented similar executive difficulties. The ODD group obtained mean scores statistically equal to those of controls in EF. These findings suggest that, in preschoolers, executive functioning deficits assessed with a performance-based measure or with behavioural descriptions are specific to children with ADHD, in comparison with those with ODD. This study contributes knowledge about EFs in two prevalent and comorbid disorders in preschool children, ADHD and ODD, knowledge that can help our understanding of specific deficits and the design of specific early intervention initiatives.
Gupta, Rashmi; Kar, Bhoomika R.
We present a critical account of existing tools used to diagnose children with Attention Deficit Hyperactivity Disorder and to make a case for the assessment of cognitive impairments as a part of diagnostic system. Surveys have shown that clinicians rely almost entirely upon subjective reports or their own clinical judgment when arriving at…
Ramsay, J Russell
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental syndrome that emerges in childhood or early adolescence and persists into adulthood for a majority of individuals. There are many other adults with ADHD who may not seek out evaluation and treatment until adulthood, having been able to “get by” before struggling with inattention, hyperactivity, and/or impulsivity in adulthood, in addition to facing the associated features of disorganization, poor time management, and procrastination among many others. A lifetime diagnosis of ADHD is associated with a wide range of life impairments, which makes a comprehensive and accurate diagnostic assessment essential in order to obtain appropriate treatment. Moreover, while there are effective medical and psychosocial treatments for ADHD, it is important to be able to track treatment response in order to evaluate whether adjustments in specific interventions are needed or referrals for adjunctive treatments and supports are indicated to facilitate optimal therapeutic outcomes. The goal of this article is to provide a clinically useful review of the various measures that practicing clinicians can use to aid in the diagnostic assessment and monitoring of psychosocial and medical treatment of ADHD in adult patients. This review includes various structured interviews, screening scales, adult ADHD symptom inventories, measures of associated features of ADHD, as well as ratings of impairment and functioning which can be adapted to clinicians’ practice needs in order to track treatment progress and optimize treatments for adults with ADHD. PMID:28184164
Kuntsi, J; Eley, T C; Taylor, A; Hughes, C; Asherson, P; Caspi, A; Moffitt, T E
Previous studies show that the symptoms of attention deficit hyperactivity disorder (ADHD) and lower intelligence quotient (IQ) covary in children. We investigated the aetiology of this association in a large population-based sample of 5-year-old twins. The twins were individually assessed on an IQ test, and data on ADHD symptoms were obtained from mother interviews and teacher ratings. Confirming previous studies, the phenotypic correlation between ADHD symptom scores and IQ was -0.3 and, in a categorical analysis, children with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) ADHD research diagnosis obtained IQ scores nine points lower, on average, than comparison children. We show here that the co-occurrence of ADHD and lower IQ has genetic origins: 86% of the association between ADHD symptom scores and IQ, and 100% of the association between ADHD diagnosis and IQ, was accounted for by genetic influences that are shared by ADHD and IQ. Some candidate genes for ADHD could also contribute to variation in IQ or vice versa.
The proposed revision of the diagnostic criteria in DSM-5 for attention-deficit/hyperactivity disorder (ADHD) will not fundamentally change the concept of ADHD. This is mainly due to the fact that, DSM-5 will retain the exact DSM-IV wording of all 18 symptoms, but will add new examples that make the criteria more appropriate for children, adolescents and adults. The age of onset will also be changed from 7 to 12 years, the subtyping of the disorder will change, and pervasive developmental disorders will no longer be an exclusion criterion. Although the main concept is unchanged, the suggested changes will most likely increase the prevalence of ADHD, especially in adults and adolescents, but maybe also in children. The added examples will also result in necessary revisions and new validations of rating scales and diagnostic interviews. This review will examine each of the proposed DSM-5 changes and the impact they may have, and in addition, the paper will make an overview of the main characteristics of some of the international and national guidelines for assessment and treatment of ADHD and how these impact the clinical practice.
Lin, Yu-Ju; Lo, Kuan-Wu; Yang, Li-Kuang; Gau, Susan Shur-Fen
The newly published Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) elevates the threshold of the ADHD age-of-onset criterion from 7 to 12 years. This study evaluated the quality of life and functional impairment of adults with ADHD who had symptoms onset by or after 7 years and examined the mediation effect of family function and anxiety/depression symptoms between ADHD diagnosis and quality of life and functional impairment. We assessed 189 adults with ADHD and 153 non-ADHD controls by psychiatric interview and self-administered reports on the Adult ADHD Quality of Life Scale, Weiss Functional Impairment Rating Scale, Family APGAR, and Adult Self Report Inventory-4. The ADHD group was divided into early-onset ADHD (onset <7 years, n=147) and late-onset ADHD (onset between 7 and 12 years, n=42). The mediation analysis was conducted to verify the mediating factors from ADHD to functional impairment and quality of life. The late-onset ADHD had more severe functional impairment at work and poorer family support than early-onset ADHD while they had comparable impairment at other domains. Less perceived family support and current anxiety/depressive symptoms partially mediated the link between ADHD diagnosis and quality of life/functional impairment both in early- and late-onset ADHD. Our data support decreased quality of life and increased functional impairment in adult ADHD, regardless of age of onset, and these adverse outcomes may be mediated by family support and anxiety/depression at adulthood. Our findings also imply that the new DSM-5 ADHD criteria do not over-include individuals without impairment.
... under a psychiatrist's or other doctor's care. ADHD medications have helped teens with ADHD in all sorts of areas, even helping reduce things like substance abuse, injuries, and automobile accidents. ADHD medicines also can ...
Galanter, Cathryn A.; Hundt, Stephanie R.; Goyal, Parag; Le, Jenna; Fisher, Prudence W.
Objective: The "DSM-IV-TR "criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and…
Fusar-Poli, P; Cappucciati, M; Rutigliano, G; Lee, T Y; Beverly, Q; Bonoldi, I; Lelli, J; Kaar, S J; Gago, E; Rocchetti, M; Patel, R; Bhavsar, V; Tognin, S; Badger, S; Calem, M; Lim, K; Kwon, J S; Perez, J; McGuire, P
Background. Several psychometric instruments are available for the diagnostic interview of subjects at ultra high risk (UHR) of psychosis. Their diagnostic comparability is unknown. Methods. All referrals to the OASIS (London) or CAMEO (Cambridgeshire) UHR services from May 13 to Dec 14 were interviewed for a UHR state using both the CAARMS 12/2006 and the SIPS 5.0. Percent overall agreement, kappa, the McNemar-Bowker χ (2) test, equipercentile methods, and residual analyses were used to investigate diagnostic outcomes and symptoms severity or frequency. A conversion algorithm (CONVERT) was validated in an independent UHR sample from the Seoul Youth Clinic (Seoul). Results. There was overall substantial CAARMS-versus-SIPS agreement in the identification of UHR subjects (n = 212, percent overall agreement = 86%; kappa = 0.781, 95% CI from 0.684 to 0.878; McNemar-Bowker test = 0.069), with the exception of the brief limited intermittent psychotic symptoms (BLIPS) subgroup. Equipercentile-linking table linked symptoms severity and frequency across the CAARMS and SIPS. The conversion algorithm was validated in 93 UHR subjects, showing excellent diagnostic accuracy (CAARMS to SIPS: ROC area 0.929; SIPS to CAARMS: ROC area 0.903). Conclusions. This study provides initial comparability data between CAARMS and SIPS and will inform ongoing multicentre studies and clinical guidelines for the UHR psychometric diagnostic interview.
Boyle, Michael H.; Cunningham, Charles E.; Georgiades, Katholiki; Cullen, John; Racine, Yvonne; Pettingill, Peter
Background: This study examines the use of the Brief Child and Family Phone Interview (BCFPI) to screen for childhood psychiatric disorder based on Diagnostic Interview Schedule for Children Version IV (DISC-IV) classifications of attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD),…
Rowland, Andrew S.; Umbach, David M.; Bohlig, E. Michael; Stallone, Lil; Sandler, Dale P.
Objective: To evaluate the impact of changing the response labels of a teacher rating scale in a population-based study of ADHD. Method: For parents, the Diagnostic Interview Schedule for Children, which asks whether each of 18 symptoms occurred "often" in the past year, was used. For teachers, most scales use a 4-point scale, with…
Martel, Michelle M; Nigg, Joel T; Schimmack, Ulrich
Although Diagnostic and Statistical Manual of Mental Disorders-Fifth edition requires that attention-deficit/hyperactivity disorder (ADHD) symptoms are apparent across settings, assessed by multiple informants, there remains no standardized approach to integration of multiple sources in adult ADHD diagnosis. The goal of the study was to evaluate informant effects on adult ADHD symptom ratings. Participants were 406 adults, ages 18 to 37, and identified second reporters, recruited from the community, and completing a comprehensive diagnostic and cognitive assessment, including a clinician-administered diagnostic interview and self- and other-report questionnaires of ADHD symptoms. Structural equation modeling indicated good fit for a trifactor model of ADHD, including general ADHD, specific inattention and hyperactivity-impulsivity, and self- and other-perspective factors. Yet there were a number of symptoms on the specific hyperactive-impulsive and self-factors that exhibited nonsignificant loadings. Significant differential item functioning across self-ratings and informant ratings was also noted. The external validation indices of laboratory executive function and diagnostic team-rated impairment was significantly correlated with the specific inattentive factor. While executive function was marginally significantly correlated with the other perspective factor, impairment was associated with the self-perspective factor. Overall, inattentive symptoms may be more sensitive measures of adult ADHD, and other and self-ratings may provide different information in relation to external criteria.
Perrin, James M; Fluet, Chris; Kuhlthau, Karen A; Anderson, Betsy; Wells, Nora; Epstein, Susan; Allen, Debby; Tobias, Carol
Parents of most children with attention-deficit hyperactivity disorder (ADHD) are employed. Employers have interest in decreasing employee absenteeism and improving workplace productivity, partly through employee benefits. The authors interviewed employers to (1) determine how they view the needs of employees with children with ADHD and (2) identify benefits that might help employees with children with ADHD. The authors carried out a systematic interview study of mainly family-friendly, large employers in four U.S. urban markets (Boston, Cleveland, Miami, Seattle). Multidisciplinary interview teams used a protocol to gather basic company information, benefit philosophy, current insurance and other employee benefits, and knowledge of ADHD and its impacts on employees. Initially, the interview team and then the larger project team reviewed all protocols for common themes. The authors interviewed staff of 41 employers (human resource managers, work/life program directors, benefits directors). Only 15 of 41 interviewees knew about ADHD, its prevalence, or its effects on parents. They had little knowledge of how differences in managed behavioral health may affect families' access to diagnostic and treatment services for ADHD, although most had experience with primary care management of depression among employees. Employers offer a variety of other benefits, including work/life and employee assistance programs, occasionally providing employees help with caring for a child with a mental health condition, on-site parent training programs, or assistance with child care. Other potentially useful employee benefits include flexible work and leave policies and information and referral services that can link parents with community programs. Although employers have limited awareness of ADHD and its potential effect on employees' work, this study identified opportunities to improve both health insurance and other benefits for employees with children with ADHD.
Hus, Vanessa; Lord, Catherine
The Autism Diagnostic Interview-Revised (ADI-R) is commonly used to inform diagnoses of autism spectrum disorders (ASD). Considering the time dedicated to using the ADI-R, it is of interest to expand the ways in which information obtained from this interview is used. The current study examines how algorithm totals reflecting past (ADI-Diagnostic)…
Mansour, Rosleen; Dovi, Allison T; Lane, David M; Loveland, Katherine A; Pearson, Deborah A
Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning.
Kishore, Jugal; Kapoor, Vinay; Reddaiah, V.P.
To study the reliability and applicability of the Composite International Diagnostic Interview (CIDI) in a rural community of India, a two steps sampling procedure was adopted, Step I: A clinical diagnosis based on the Diagnostic and Statistical Manual of Mental Disorder-Ill-Revised (DSM-IIIR) criteria was administered to 218 persons aged 18-60 years who consulted the Primary Health Centre (PHC); Step II: Of these persons, 71 were selected for detailed examination with the CIDI Hindi version in their home environment. The current diagnoses produced by the CIDI (scored two ways DSM-III-R and ICD-10) were evaluated against the DSM-III-R clinical diagnoses. The kappa values were 0.43 and 0.64. The likelihood ratios of positive CIDI-DSM-III-R and CIDI-ICD-10 were found to be 13.11 and 17.23; the specificity rates were 95.4% in each; the positive predictive values were 96.6% and 97.4% and the sensitivity rates were 59.2% and 77.5%. A significant longer time was faken for coding one CIDI. Only 8% of the 71 CIDI interviewed required more than one sitting. 96% of those interviewed were receptive for future interviews with CIDI. The study findings emphasize the good reliability and acceptability of the CIDI in a rural community of India. PMID:21430810
Ezpeleta, Lourdes; de la Osa, Núria; Granero, Roser; Domènech, Josep Maria; Reich, Wendy
There is a need for reliable and well-validated diagnostic measures for studying psychopathology in preschool and young children. The goal is to study the psychometric properties of the Diagnostic Interview for Children and Adolescents for Parents of Preschool and Young Children (DICA-PPYC) in the general population. A sample of 852 Spanish school children, aged 3 to 7 years, were randomly selected and screened for a double phase design. A total of 251 families were interviewed with the DICA-PPYC and 244 participated in a test-retest design. Different measures of psychopathology and functional impairment were also administered. Test-retest agreement with a mean interval of 8.8 days ranged from excellent to slight (kappa from 1 to 0.39) for DSM-IV-TR and from good to fair (kappa from 0.77 to 0.49) for Research Diagnostic Criteria-Preschool Age diagnoses. Attenuation between test and retest was not significant for the prevalence of diagnoses, although it was significant for the number of externalising and total symptoms in the interview. The diagnoses converged moderately with the CBCL and Dominic scores. The presence of diagnoses in the DICA-PPYC significantly differentiated preschoolers and young children who had used mental health services, were more impaired, and presented more severe psychopathology measured by dimensional scales. The DICA-PPYC is a reliable and valid semi-structured interview schedule for preschool and young children, and can serve to advance the knowledge and mental health care of this population.
Walker, William C; Cifu, David X; Hudak, Anne M; Goldberg, Gary; Kunz, Richard D; Sima, Adam P
The existing gold standard for diagnosing a suspected previous mild traumatic brain injury (mTBI) is clinical interview. But it is prone to bias, especially for parsing the physical versus psychological effects of traumatic combat events, and its inter-rater reliability is unknown. Several standardized TBI interview instruments have been developed for research use but have similar limitations. Therefore, we developed the Virginia Commonwealth University (VCU) retrospective concussion diagnostic interview, blast version (VCU rCDI-B), and undertook this cross-sectional study aiming to 1) measure agreement among clinicians' mTBI diagnosis ratings, 2) using clinician consensus develop a fully structured diagnostic algorithm, and 3) assess accuracy of this algorithm in a separate sample. Two samples (n = 66; n = 37) of individuals within 2 years of experiencing blast effects during military deployment underwent semistructured interview regarding their worst blast experience. Five highly trained TBI physicians independently reviewed and interpreted the interview content and gave blinded ratings of whether or not the experience was probably an mTBI. Paired inter-rater reliability was extremely variable, with kappa ranging from 0.194 to 0.825. In sample 1, the physician consensus prevalence of probable mTBI was 84%. Using these diagnosis ratings, an algorithm was developed and refined from the fully structured portion of the VCU rCDI-B. The final algorithm considered certain symptom patterns more specific for mTBI than others. For example, an isolated symptom of "saw stars" was deemed sufficient to indicate mTBI, whereas an isolated symptom of "dazed" was not. The accuracy of this algorithm, when applied against the actual physician consensus in sample 2, was almost perfect (correctly classified = 97%; Cohen's kappa = 0.91). In conclusion, we found that highly trained clinicians often disagree on historical blast-related mTBI determinations. A fully structured interview
Wang, Lanlan; Yuan, Chenmei; Qiu, Jianying; Gunderson, John; Zhang, Min; Jiang, Kaida; Leung, Freedom; Zhong, Jie; Xiao, Zeping
Background Borderline personality disorder (BPD) is the most studied of the Axis II disorders. One of the most widely used diagnostic instruments is the Diagnostic Interview for Borderline Patients - Revised (DIB-R). The aim of this study was to test the reliability and validity of DIB-R for use in the Chinese culture. Methods The reliability and validity of the DIB-R Chinese version were assessed in a sample of 236 outpatients with a probable BPD diagnosis. The Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) was used as a standard. Test/re-test reliability was tested at 6 months later with 20 patients and inter-rater reliability was tested on 32 patients. Results The Chinese version of the DIB-R showed good internal global consistency (Cronbach’s alpha of 0.916), good test-retest reliability (Pearson correlation of 0.704), good inter-raters reliability (ICC of 0.892 and Kappa of 0.861). When compared to the DSM-IV diagnosis as measured by the SCID-II, the DIB-R showed relatively good sensitivity (0.768) and specificity (0.891) at the cutoff of 7; moderate diagnostic convergence (Kappa of 0.631), as well as good discriminating validity. Conclusion The Chinese version of the DIB-R has good psychometric properties, which renders it a valuable method for examining the presence, the severity and component phenotypes of BPD in Chinese samples. PMID:24302703
... ADHD medications work by increasing the levels of brain chemicals called neurotransmitters . Neurotransmitters help send messages between nerve cells in the brain. There are two main kinds of ADHD medications: ...
Rosenström, Tom; Elovainio, Marko; Jokela, Markus; Pirkola, Sami; Koskinen, Seppo; Lindfors, Olavi; Keltikangas-Järvinen, Liisa
Concordance between sum scores of self-reported depressive symptoms and structured interview diagnoses has been studied extensively, but are these the best attainable self-report-based predictions for interview diagnoses? We maximized the cross-validated concordance between World Health Organization's Composite International Diagnostic Interview (CIDI) diagnosis and Beck's Depression Inventory (BDI), and General Health Questionnaire (GHQ), from the viewpoint of exploratory statistics, re-analysing Health 2000 general-population sample of adults over 30 years in mainland Finland (N = 5200-5435). BDI sum-score prediction of CIDI diagnosis could be superseded by using (1) weighted sums of items, (2) classification trees constructed from items, or (3) a single item. Best solution (2) yielded cross-validated Youden's Index 0.757 [standard error (SE) = 0.001, sensitivity = 0.907, specificity = 0.851], improving the concordance to 1.07-fold (1.18-fold for 12-month diagnosis). A single-item solution was best for the GHQ. All positive predictive values remained low (0.09-0.31). Thus, CIDI-to-questionnaire concordance can be improved by using all information in the questionnaires instead of just sum scores, but latent-trait theory for questionnaires is incompatible with interview diagnoses (single item achieved better concordance than summing all). Self-reports have low predictive value for CIDI diagnoses in the general population, but better in settings with higher major depressive disorder (MDD) base rates. Copyright © 2015 John Wiley & Sons, Ltd.
LYON, THOMAS D.; AHERN, ELIZABETH C.; SCURICH, NICHOLAS
We describe a Bayesian approach to evaluating children’s abuse disclosures and review research demonstrating that children’s disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children’s age. We discuss how some commentators understate the probative value of children’s disclosures by: confusing the probability of abuse given disclosure with the probability of disclosure given abuse, assuming that children formally questioned about sexual abuse have a low prior probability of sexual abuse, misstating the probative value of abuse disclosure, and confusing the distinction between disclosure and nondisclosure with the distinction between true and false disclosures. We review interviewing methods that increase the probative value of disclosures, including interview instructions, narrative practice, noncontingent reinforcement, and questions about perpetrator/caregiver statements and children’s reactions to the alleged abuse. PMID:22339423
Fayyad, John; Sampson, Nancy A; Hwang, Irving; Adamowski, Tomasz; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Andrade, Laura H S G; Borges, Guilherme; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hu, Chiyi; Karam, Elie G; Lee, Sing; Navarro-Mateu, Fernando; O'Neill, Siobhan; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Ten Have, Margreet; Torres, Yolanda; Xavier, Miguel; Zaslavsky, Alan M; Kessler, Ronald C
We previously reported on the cross-national epidemiology of ADHD from the first 10 countries in the WHO World Mental Health (WMH) Surveys. The current report expands those previous findings to the 20 nationally or regionally representative WMH surveys that have now collected data on adult ADHD. The Composite International Diagnostic Interview (CIDI) was administered to 26,744 respondents in these surveys in high-, upper-middle-, and low-/lower-middle-income countries (68.5% mean response rate). Current DSM-IV/CIDI adult ADHD prevalence averaged 2.8% across surveys and was higher in high (3.6%)- and upper-middle (3.0%)- than low-/lower-middle (1.4%)-income countries. Conditional prevalence of current ADHD averaged 57.0% among childhood cases and 41.1% among childhood subthreshold cases. Adult ADHD was significantly related to being male, previously married, and low education. Adult ADHD was highly comorbid with DSM-IV/CIDI anxiety, mood, behavior, and substance disorders and significantly associated with role impairments (days out of role, impaired cognition, and social interactions) when controlling for comorbidities. Treatment seeking was low in all countries and targeted largely to comorbid conditions rather than to ADHD. These results show that adult ADHD is prevalent, seriously impairing, and highly comorbid but vastly under-recognized and undertreated across countries and cultures.
Maljaars, Jarymke; Noens, Ilse; Scholte, Evert; van Berckelaer-Onnes, Ina
The Diagnostic Interview for Social and Communication Disorders (DISCO; Wing, 2006) is a standardized, semi-structured and interviewer-based schedule for diagnosis of autism spectrum disorder (ASD). The objective of this study was to evaluate the criterion and convergent validity of the DISCO-11 ICD-10 algorithm in young and low-functioning…
Lauth, Bertrand; Arnkelsson, Guðmundur B; Magnússon, Páll; Skarphéðinsson, Guðmundur Á; Ferrari, Pierre; Pétursson, Hannes
Diagnostic information on adolescents may be elicited from both youths and their parents, especially for depressive and suicidal symptomatology. The objective of this study was to examine the degree of agreement between parent and adolescent reports of major psychiatric disorders, at the diagnostic and at the symptom level, in a severely affected inpatient clinical population. 64 parent-adolescent pairs were interviewed separately with the semi-structured diagnostic interview Kiddie-SADS-PL. Symptomatology was also assessed with 11 self-report and parent-report scales, all translated, adapted and in most cases validated in Iceland. A total of 25 subscales were included to assess emotional dimensions such as depression or anxiety and cognitive dimensions such as attention deficit or self-concept. Good agreement was found for social phobia and fair agreement for generalized anxiety disorder. Although parent-youth agreement was poor in most cases at the symptoms level, significant correlations indicated consistency for most severity scores, except those related to depressive symptomatology, attention deficit, separation anxiety or conduct disorder. The low agreement between reports of suicidal ideation is in line with results from previous studies and suggests that parents might under- or over-estimate this symptomatology. The combination of data obtained with diagnostic interviews and rating-scales confirmed results from prior empirical work, giving greater weight to parents' reports of observable behavior and to adolescents' reports of subjective experiences, especially depressive symptomatology. Our findings suggest that both parent and child informants are necessary to obtain adequate assessments in adolescents. Further research should explore the correspondence between discrepant diagnoses and external criteria such as parental psychopathology or parent-child relationships and attachment. Psychoanalysis could benefit from cognitive neuroscience and use cognitive
Sleath, Betsy; Carpenter, Delesha M; Sayner, Robyn; Thomas, Kathleen; Mann, Larry; Sage, Adam; Sulzer, Sandra H; Sandler, Adrian D
The purpose of this study was to examine youth perceptions of attention deficit hyperactivity disorder (ADHD) communication with their pediatric providers, their reported adherence to their ADHD medications, and their desired location for an ADHD educational program. Youth ages 7 through 17 with an ADHD diagnosis were recruited. A research associate interviewed the youth. Parents completed demographic questionnaires. Seventy families participated. One-third of the youth wanted more discussion about ADHD with their providers during visits. The average youth had over eight questions about ADHD and its treatment. Most youth wanted to learn about ADHD at their provider's office. Non-white and older youth were significantly more likely to be less adherent to their ADHD medications. Youth want their providers to engage them more during visits. Providers should take advantage of this interest to engage youth more in discussions regarding ADHD and its treatment during pediatric ADHD visits.
Sibley, Margaret H; Pelham, William E; Molina, Brooke S G; Gnagy, Elizabeth M; Waschbusch, Daniel A; Biswas, Aparajita; MacLean, Michael G; Babinski, Dara E; Karch, Kathryn M
This study examined the association between childhood ADHD and juvenile delinquency by examining data from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of individuals diagnosed with ADHD in childhood (ages 5-12) and recontacted in adolescence and young adulthood for yearly follow-up (age at first follow-up interview M = 17.26, SD = 3.17). Participants were 288 males with childhood ADHD and 209 demographically similar males without ADHD who were recruited into the follow-up study. Delinquency information gathered yearly during the second through eighth follow-up provided a comprehensive history of juvenile delinquency for all participants. Four childhood diagnostic groups [ADHD-only (N = 47), ADHD + ODD (N = 135), ADHD + CD (N = 106), and comparison (N = 209)] were used to examine group differences on delinquency outcomes. Analyses were conducted across three dimensions of delinquency (i.e., severity, age of initiation, and variety). Individuals with childhood ADHD + CD displayed significantly worse delinquency outcomes than the other three groups, across almost all indices of offending. When compared to comparison participants, boys with ADHD-only and ADHD + ODD in childhood displayed earlier ages of delinquency initiation, a greater variety of offending, and higher prevalence of severe delinquency. These findings suggest that although childhood ADHD + CD creates the greatest risk for delinquency, boys with ADHD-only and ADHD + ODD also appear at a higher risk for later offending. The patterns of offending that emerged from the PALS are discussed in the context of the relationship between ADHD, comorbidity, and delinquency.
Hu, Valerie W.; Steinberg, Mara E.
Heterogeneity in phenotypic presentation of ASD has been cited as one explanation for the difficulty in pinpointing specific genes involved in autism. Recent studies have attempted to reduce the “noise” in genetic and other biological data by reducing the phenotypic heterogeneity of the sample population. The current study employs multiple clustering algorithms on 123 item scores from the Autism Diagnostic Interview-Revised (ADI-R) diagnostic instrument of nearly 2000 autistic individuals to identify subgroups of autistic probands with clinically relevant behavioral phenotypes in order to isolate more homogeneous groups of subjects for gene expression analyses. Our combined cluster analyses suggest optimal division of the autistic probands into 4 phenotypic clusters based on similarity of symptom severity across the 123 selected item scores. One cluster is characterized by severe language deficits, while another exhibits milder symptoms across the domains. A third group possesses a higher frequency of savant skills while the fourth group exhibited intermediate severity across all domains. Grouping autistic individuals by multivariate cluster analysis of ADI-R scores reveals meaningful phenotypes of subgroups within the autistic spectrum which we show, in a related (accompanying) study, to be associated with distinct gene expression profiles. PMID:19455643
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
Kepley, Hayden O.; Ostrander, Rick
Objective: To investigate the family environments of children in a community sample with ADHD and co-occurring anxiety. Method: Family Environment Scale, Behavioral Assessment System for Children, and Structured Clinical Interview are administered to parents of children with ADHD with and without anxiety. Results: ADHD families are uniformly less…
Reiersen, Angela M.; Constantino, John N.; Volk, Heather E.; Todd, Richard D.
Background: Most diagnostic nomenclatures do not allow for the concurrent diagnosis of autism and attention-deficit/hyperactivity disorder (ADHD). Clinic-based studies suggest autistic symptoms are common in children with ADHD, but such studies are prone to referral bias. This study assesses whether children with ADHD selected from the general…
Spencer, Thomas J.; Sallee, F. Randy; Gilbert, Donald L.; Dunn, David W.; McCracken, James T.; Coffey, Barbara J.; Budman, Cathy L.; Ricardi, Randall K.; Leonard, Henrietta L.; Allen, Albert J.; Milton, Denai R.; Feldman, Peter D.; Kelsey, Douglas K.; Geller, Daniel A.; Linder, Steven L.; Lewis, Donald W.; Winner, Paul K.; Kurlan, Roger M.; Mintz, Mark
Objective: This study examines changes in severity of tics and ADHD during atomoxetine treatment in ADHD patients with Tourette syndrome (TS). Method: Subjects (7-17 years old) with ADHD ("Diagnostic and Statistical Manual of Mental Disorders, DSM-IV") and TS were randomly assigned to double-blind treatment with placebo (n = 56) or atomoxetine…
Dao, Tam K; Poritz, Julia M P; Moody, Rachel P; Szeto, Kim
The Posttraumatic Stress Disorder Interview for Vietnamese Refugees (PTSD-IVR) was created specifically to assess for the presence of current and lifetime history of premigration, migration, encampment, and postmigration traumas in Vietnamese refugees. The purpose of the present study was to describe the development of and investigate the interrater and test-retest reliability of the PTSD-IVR and its validity in relation to the diagnoses obtained from the Longitudinal, Expert, and All Data (LEAD; Spitzer, 1983) standard. Clinicians conducted the diagnosis process with 127 Vietnamese refugees using the LEAD standard and the PTSD-IVR. Assessment of the reliability and validity of the PTSD-IVR yielded good to excellent AUC (area under the receiver operating characteristic curve; .86, .87) and κ values (.66, .74) indicating the reliability of the PTSD-IVR and the agreement between the LEAD procedure and the PTSD-IVR. The results of the present study suggest that the PTSD-IVR performs successfully as a diagnostic instrument specifically created for Vietnamese refugees in their native language.
Devena, Sarah E.; Watkins, Marley W.
The Wechsler Intelligence Scale for Children-Fourth Edition General Abilities Index and Cognitive Proficiency Index have been advanced as possible diagnostic markers of attention deficit hyperactivity disorder. This hypothesis was tested with a hospital sample with attention deficit hyperactivity disorder (n = 78), a referred but nondiagnosed…
Martin, Callie; Dunham, Mardis; Patel, Samir H.; Contreras-Bloomdahl, Susana
"The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)," requires that symptoms of ADHD must be "developmentally inappropriate" in order for an ADHD diagnosis to be considered. Because the DSM-5 does not specifically outline procedure for determining developmental inappropriateness of behaviors,…
Chamberlain, Samuel R.; Ioannidis, Konstantinos; Leppink, Eric W.; Niaz, Faiza; Redden, Sarah A.; Grant, Jon E.
Objective Attention-Deficit Hyperactivity Disorder (ADHD) has been associated with various manifestations of impulsivity in adults, including elevated rates of other impulsive disorders, substance use, questionnaire-based impulsivity scores, and inhibitory dysregulation on neurocognitive tests. The relationship between ADHD and all these other forms of impulsivity have yet to be explored within the context of a single comprehensive study. Methods 423 young adults, who gambled ≥5 times in the preceding year, were recruited using media advertisements and undertook detailed assessment including structured psychiatric interview, questionnaires, and neurocognitive tests. Participants with ADHD symptoms were identified using the Adult ADHD Self-Report Scale Screener (ASRS-V1.1) and were compared to controls using multivariate analysis of variance (MANOVA). Results ADHD symptoms were found in 20.3% of the sample, but only 7.3% of these subjects had ever received a formal diagnosis. ADHD symptoms were associated with significantly lower quality of life, lower self-esteem, higher emotional dysregulation, higher impulsivity-compulsivity questionnaire scores, more problematic internet use, greater occurrence of psychiatric disorders, and impaired stop-signal reaction times. Of these variables, stop-signal reaction times and Barratt attentional impulsiveness were the strongest predictors of group classification. Conclusions ADHD symptoms are common and under-diagnosed in young adults who gamble, and are most strongly linked with certain other types of impulsivity (questionnaire- and cognitive-based measures) and with emotional dysregulation, suggesting that these are each important considerations in understanding the pathophysiology of the disorder, but also potential treatment targets. It is necessary to question whether treatment for adult ADHD could be enhanced by considering self-esteem, emotional reactivity, and impaired inhibitory control as specific treatment targets
Lai, Kelly Y. C.; Leung, Patrick W. L.; Mo, Flora Y. M.; Lee, Marshall M. C.; Shea, Caroline K. S.; Chan, Grace F. C.; Che, Kiti K. I.; Luk, Ernest S. L.; Mak, Arthur D. P.; Warrington, Richard; Skuse, David
Autism spectrum disorder (ASD) is a disorder with high levels of co-morbidities. The Developmental, Dimensional and Diagnostic Interview (3Di) is a relatively new instrument designed to provide dimensional as well as categorical assessment of autistic behaviours among children with normal intelligence. Its sound psychometric properties and…
van den Kieboom, Leigh A.; Magiera, Marta T.; Moyer, John C.
In this study, we explored the relationship between prospective teachers' algebraic thinking and the questions they posed during one-on-one diagnostic interviews that focused on investigating the algebraic thinking of middle school students. To do so, we evaluated prospective teachers' algebraic thinking proficiency across 125…
Chuthapisith, Jariya; Taycharpipranai, Pasinee; Ruangdaraganon, Nichara; Warrington, Richard; Skuse, David
This study aimed to examine the effectiveness of a translated version of the short version of the Developmental, Dimensional and Diagnostic Interview (3Di) in discriminating children with autism spectrum disorders (ASDs) from typically developing children. Two groups, comprising 63 children with clinically ascertained ASDs and 67 typically…
Johnson, Lynda G.
Although attention deficit/hyperactivity disorder (ADHD) is one of the most common cognitive disorders, the usual diagnostic procedures pursued by psychiatrists, neurologists, pediatricians, and family practitioners are based largely, if not exclusively, on subjective assessments of perceived behavior. The recommended approaches to ADHD diagnosis are reviewed, first from the perspective of the various expert panels, and then from the research literature upon which those recommendations are based. The authors agree that ADHD is a clinical diagnosis, and that the assessment of subjective reports can be systematic. But they propose that objective data should also contribute to the clinical diagnosis of ADHD; and that new computerized assessment technology can generate objective cognitive data in an efficient and cost-effective way. Computerized tests can also improve the assessment of treatment response over time. PMID:21120096
Ohio Coalition for the Education of Children with Disabilities, Marion.
This guide is designed to assist parents of children with attention deficit hyperactivity disorder (ADHD). It begins by explaining the neurological basis for ADHD and provides the diagnostic criteria for ADHD. Conditions that may occur with ADHD are listed and the importance of nutrition is stressed. The following section focuses on special…
Mayes, S D; Calhoun, S L; Crowell, E W
Clinical and psychoeducational data were analyzed for 119 children ages 8 to 16 years who were evaluated in a child diagnostic clinic. A learning disability (LD) was present in 70% of the children with attention-deficit/hyperactivity disorder (ADHD), with a learning disability in written expression two times more common (65%) than a learning disability in reading, math, or spelling. Children with LD and ADHD had more severe learning problems than children who had LD but no ADHD, and the former also had more severe attention problems than children who had ADHD but no LD. Further, children with ADHD but no LD had some degree of learning problem, and children with LD but no ADHD had some degree of attention problem. Results suggest that learning and attention problems are on a continuum, are interrelated, and usually coexist.
Lecendreux, Michel; Lavault, Sophie; Lopez, Régis; Inocente, Clara Odilia; Konofal, Eric; Cortese, Samuele; Franco, Patricia; Arnulf, Isabelle; Dauvilliers, Yves
Study Objectives: To evaluate the frequency, severity, and associations of symptoms of attention-deficit/hyperactivity disorder (ADHD) in children with narcolepsy with and without cataplexy. Design: Cross-sectional survey. Setting: Four French national reference centers for narcolepsy. Patients: One hundred eight consecutively referred children aged younger than 18 y with narcolepsy, with (NwC, n = 86) or without cataplexy (NwoC, n = 22), and 67 healthy controls. Interventions: The participants, their families, and sleep specialists completed a structured interview and questionnaires about sleep, daytime sleepiness, fatigue, and ADHD symptoms (ADHD-rating scale based upon Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision [DSM-IV-TR] symptoms), and use of psychostimulants for the treatment of narcolepsy (administered in 68.2%). Polysomnographic measures were collected. Measurements and Results: Clinically significant levels of ADHD symptoms were found in 4.8% of controls compared with 35.3% in patients with NwoC (P < 0.001) and 19.7% in patients with NwC (P < 0.01). Total ADHD scores were 6.4 (95% confidence interval [CI]: 4.5, 9.0) in controls compared with 14.2 (95% CI: 10.6, 18.9; P < 0.001), in patients with NwoC and 12.2 (95% CI: 9.8, 15.3; P < 0.01) in patients with NwC; subscores of inattention and hyperactivity/impulsivity were also significantly higher in both narcolepsy groups compared with controls. No difference was found between the NwC and NwoC groups for any ADHD measure. ADHD symptom severity was associated with increased levels of sleepiness, fatigue, and insomnia. Compared with the 34 untreated patients, the 73 patients treated with psychostimulants (modafinil in 91%) showed a trend toward lower narcolepsy symptoms but not lower ADHD symptoms. Conclusions: Pediatric patients with narcolepsy have high levels of treatment-resistant attention-deficit/hyperactivity disorder (ADHD) symptoms. The optimal treatment for
Background The purpose of this study was to expand the understanding of the burden of illness experienced by adults with Attention Deficit-Hyperactivity Disorder (ADHD) living in different countries and treated through different health care systems. Methods Fourteen focus groups and five telephone interviews were conducted in seven countries in North America and Europe, comprised of adults who had received a diagnosis of ADHD. The countries included Canada, France, Germany, Italy, The Netherlands, United Kingdom, and United States (two focus groups in each country). There were 108 participants. The focus groups were designed to elicit narratives of the experience of ADHD in key domains of symptoms, daily life, and social relationships. Consonant with grounded theory, the transcripts were analyzed using descriptive coding and then themed into larger domains. Results Participants’ statements regarding the presentation of symptoms, childhood experience, impact of ADHD across the life course, addictive and risk-taking behavior, work and productivity, finances, relationships and psychological health impacts were similarly themed across all seven countries. These similarities were expressed through the domains of symptom presentation, childhood experience, medication treatment issues, impacts in adult life and across the life cycle, addictive and risk-taking behavior, work and productivity, finances, psychological and social impacts. Conclusions These data suggest that symptoms associated with adult ADHD affect individuals similarly in different countries and that the relevance of the diagnostic category for adults is not necessarily limited to certain countries and sociocultural milieus. PMID:22583562
Robeva, Raina; Penberthy, Jennifer Kim; Loboschefski, Tim; Cox, Daniel; Kovatchev, Boris
Manifestations of ADHD are observed at both psychological and physiological levels and assessed via various psychometric, EEG, and imaging tests. However, no test is 100% accurate in its assessment of ADHD. This study introduces a stochastic assessment combining psychometric tests with previously reported (Consistency Index) and newly developed (Alpha Blockade Index) EEG-based physiological markers of ADHD. The assessment utilizes classical Bayesian inference to refine after each step the probability of ADHD of each individual. In a pilot study involving six college females with ADHD and six matched controls, the assessment achieved correct classification for all ADHD and non-ADHD participants. In comparison, the classification of ADHD versus non-ADHD participants was < 85% for any one of the tests separately. The procedure significantly improved the score separation between ADHD versus non-ADHD groups. The final average probabilities for ADHD were 76% for the ADHD group and 8% for the control group. These probabilities correlated (r = .87) with the Brown ADD scale and (r = .84) with the ADHD-Symptom Inventory used for the screening of the participants. We conclude that, although each separate test was not completely accurate, a combination of several tests classified correctly all ADHD and all non-ADHD participants. The application of the proposed assessment is not limited to the specific tests used in this study--the assessment represents a general paradigm capable of accommodating a variety of ADHD tests into a single diagnostic assessment.
de Bildt, Annelies; Sytema, Sjoerd; Zander, Eric; Bölte, Sven; Sturm, Harald; Yirmiya, Nurit; Yaari, Maya; Charman, Tony; Salomone, Erica; LeCouteur, Ann; Green, Jonathan; Bedia, Ricardo Canal; Primo, Patricia García; van Daalen, Emma; de Jonge, Maretha V.; Guðmundsdóttir, Emilía; Jóhannsdóttir, Sigurrós; Raleva, Marija; Boskovska, Meri; Rogé, Bernadette; Baduel, Sophie; Moilanen, Irma; Yliherva, Anneli; Buitelaar, Jan; Oosterling, Iris J.
The current study aimed to investigate the Autism Diagnostic Interview-Revised (ADI-R) algorithms for toddlers and young preschoolers (Kim and Lord, "J Autism Dev Disord" 42(1):82-93, 2012) in a non-US sample from ten sites in nine countries (n = 1,104). The construct validity indicated a good fit of the algorithms. The diagnostic…
Constantino, John N.; Davis, Sandra A.; Todd, Richard D.; Schindler, Matthew K.; Gross, Maggie M.; Brophy, Susan L.; Metzger, Lisa M.; Shoushtari, Christiana S.; Splinter, Reagan; Reich, Wendy
A study compared the Social Responsiveness Scale (SRS) with the Autism Diagnostic Interview-Revised in 61 children (ages 4-16) with autism. Correlations between the test scores for DSM-IV criterion sets were on the order of 0.7. SRS scores were unrelated to I.Q. and exhibited inter-rater reliability on the order of 0.8. (Contains references.)…
Mahdi, Soheil; Viljoen, Marisa; Massuti, Rafael; Selb, Melissa; Almodayfer, Omar; Karande, Sunil; de Vries, Petrus J; Rohde, Luis; Bölte, Sven
This is the third in a series of four cross-cultural 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). To explore the perspectives of individuals diagnosed with ADHD, self-advocates, immediate family members and professional caregivers on relevant areas of impairment and functional abilities typical for ADHD across the lifespan as operationalized by the ICF(-CY). A qualitative study using focus group discussions or semi-structured interviews of 76 participants, divided into 16 stakeholder groups. Participants from five countries (Brazil, India, Saudi Arabia, South Africa and Sweden) were included. A deductive qualitative content analysis was conducted to extract meaningful functioning and disability concepts from verbatim material. Extracted concepts were then linked to ICF(-CY) categories by independent researchers using a standardized linking procedure. In total, 82 ICF(-CY) categories were identified, of which 32 were related to activities and participation, 25 to environmental factors, 23 to body functions and 2 to body structures. Participants also provided opinions on experienced positive sides to ADHD. A high level of energy and drive, creativity, hyper-focus, agreeableness, empathy, and willingness to assist others were the most consistently reported strengths associated with ADHD. Stakeholder perspectives highlighted the need to appraise ADHD in a broader context, extending beyond diagnostic criteria into many areas of ability and disability as well as environmental facilitators and barriers. This qualitative study, along with three other studies (comprehensive scoping review, expert survey and clinical study), will provide the scientific basis to define ICF(-CY) Core Sets for ADHD, from which assessment tools can be derived for use in clinical and research setting, as well as in health care
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…
Pearcy, Benjamin T D; McEvoy, Peter M; Roberts, Lynne D
This study extends knowledge about the relationship of Internet Gaming Disorder (IGD) to other established mental disorders by exploring comorbidities with anxiety, depression, Attention Deficit Hyperactivity Disorder (ADHD), and obsessive compulsive disorder (OCD), and assessing whether IGD accounts for unique variance in distress and disability. An online survey was completed by a convenience sample that engages in Internet gaming (N = 404). Participants meeting criteria for IGD based on the Personal Internet Gaming Disorder Evaluation-9 (PIE-9) reported higher comorbidity with depression, OCD, ADHD, and anxiety compared with those who did not meet the IGD criteria. IGD explained a small proportion of unique variance in distress (1%) and disability (3%). IGD accounted for a larger proportion of unique variance in disability than anxiety and ADHD, and a similar proportion to depression. Replications with clinical samples using longitudinal designs and structured diagnostic interviews are required.
... Room? What Happens in the Operating Room? ADHD Medicines KidsHealth > For Kids > ADHD Medicines A A A ... doctor can decide if ADHD medicine is needed. Medicine and the Mind There are a lot of ...
Snyder, Steven M; Quintana, Humberto; Sexson, Sandra B; Knott, Peter; Haque, A F M; Reynolds, Donald A
Previous validation studies of attention deficit/hyperactivity disorder (ADHD) assessment by rating scales or EEG have provided Class-IV evidence per standards of the American Academy of Neurology. To investigate clinical applications, we collected Class-I evidence, namely from a blinded, prospective, multi-center study of a representative clinical sample categorized with a clinical standard. Participating males (101) and females (58) aged 6 to 18 had presented to one of four psychiatric and pediatric clinics because of the suspected presence of attention and behavior problems. DSM-IV diagnosis was performed by clinicians assisted with a semi-structured clinical interview. EEG (theta/beta ratio) and ratings scales (Conners Rating Scales-Revised and ADHD Rating Scales-IV) were collected separately in a blinded protocol. ADHD prevalence in the clinical sample was 61%, whereas the remainder had other childhood/adolescent disorders or no diagnosis. Comorbidities were observed in 66% of ADHD patients and included mood, anxiety, disruptive, and learning disorders at rates similar to previous findings. EEG identified ADHD with 87% sensitivity and 94% specificity. Rating scales provided sensitivity of 38-79% and specificity of 13-61%. While parent or teacher identification of ADHD by rating scales was reduced in accuracy when applied to a diverse clinical sample, theta/beta ratio changes remained consistent with the clinician's ADHD diagnosis. Because theta/beta ratio changes do not identify comorbidities or alternative diagnoses, the results do not support the use of EEG as a stand-alone diagnostic and should be limited to the interpretation that EEG may complement a clinical evaluation for ADHD.
Mannuzza, Salvatore; Castellanos, Francisco X.; Roizen, Erica R.; Hutchison, Jesse A.; Lashua, Erin C.; Klein, Rachel G.
Objective: To investigate the relationship between ADHD symptoms and impairment among adults diagnosed as having ADHD in childhood (ages 6-12). Method: Clinicians blindly interviewed 121 White males; the mean age was 41 years across the sample. "DSM-IV" adult ADHD behaviors were systematically rated, and impairment resulting from…
Wolraich, Mark L.; Bickman, Leonard; Lambert, E. Warren; Simmons, Tonya; Doffing, Melissa A.
This study examines interventions designed to improve communication between individuals who take care of children with ADHD. A teacher rating of 6,171 elementary school children identifies 1,573 children with ADHD or with high risk for ADHD. Parent interviews and information from teachers are collected on 243 children who are randomized into…
Fenollar-Cortés, Javier; Fuentes, Luis J.
Introduction: Although the critical feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity/impulsivity behavior, the disorder is clinically heterogeneous, and concomitant difficulties are common. Children with ADHD are at increased risk for experiencing lifelong impairments in multiple domains of daily functioning. In the present study we aimed to build a brief ADHD impairment-related tool -ADHD concomitant difficulties scale (ADHD-CDS)- to assess the presence of some of the most important comorbidities that usually appear associated with ADHD such as emotional/motivational management, fine motor coordination, problem-solving/management of time, disruptive behavior, sleep habits, academic achievement and quality of life. The two main objectives of the study were (i) to discriminate those profiles with several and important ADHD functional difficulties and (ii) to create a brief clinical tool that fosters a comprehensive evaluation process and can be easily used by clinicians. Methods: The total sample included 399 parents of children with ADHD aged 6–18 years (M = 11.65; SD = 3.1; 280 males) and 297 parents of children without a diagnosis of ADHD (M = 10.91; SD = 3.2; 149 male). The scale construction followed an item improved sequential process. Results: Factor analysis showed a 13-item single factor model with good fit indices. Higher scores on inattention predicted higher scores on ADHD-CDS for both the clinical sample (β = 0.50; p < 0.001) and the whole sample (β = 0.85; p < 0.001). The ROC curve for the ADHD-CDS (against the ADHD diagnostic status) gave an area under the curve (AUC) of.979 (95%, CI = [0.969, 0.990]). Discussion: The ADHD-CDS has shown preliminary adequate psychometric properties, with high convergent validity and good sensitivity for different ADHD profiles, which makes it a potentially appropriate and brief instrument that may be easily used by clinicians, researchers, and
Wright, Gloria Sunnie
Today's "ADHDscape" is no longer confined to images of fidgety children falling off classroom chairs. Trans-generational images flood popular culture, from "ADHD creator" with entrepreneurial style, to "ADHD troublemaker". Indeed, ADHD's enigmatic characteristics seem to apply as much to crying babies as to forgetful grannies. With the recent…
Wang, Ye; Gushta, Matthew
The No Child Left Behind Act resulted in increased school-level implementation of assessment-based school interventions that aim to improve student performance. Diagnostic assessments are included among these interventions, designed to help teachers use evidence about student performance to modify and differentiate instruction and improve student…
Robaey, Philippe; Amre, Devendra; Schachar, Russell; Simard, Louise
Objective To evaluate internal and external consistency of a French adaptation of the SWAN (a 7-point rating strength-based scale, from far below to far above average) and its accuracy as a diagnostic test among children with Attention Deficit/Hyperactivity Disorder (ADHD). Method Parents of 88 children referred for ADHD were interviewed using the SWAN-F, a structured interview (DISC-4.0) and the Conners’ Rating Scale. Internal consistency and divergent and convergent validity of the SWAN-F were examined using the DISC-4.0 and Conners’ Rating Scales as reference standards for four dimensions: Inattention, Hyperactivity/Impulsivity, ADHD, Oppositional Defiant Disorder. Results The internal consistency of SWAN-F was within acceptable ranges for all dimensions (Cronbach’s alpha greater than 0.80). Scores of the SWAN-F subscales were strongly associated with the DISC-4.0 diagnostic assignments and Conners’ Rating Scales, following logical patterns of correspondence between diagnoses. Its accuracy as a diagnostic test was comparable to Conners’ Rating Scale, with a lower rate of false positives. Conclusions The information gathered with the SWAN-F is compatible with that obtained using the DISC-4.0 and Conners’ Rating Scale. Strength-based rating scales have the potential to evaluate the normal distribution of behaviors and to provide reliable cut-off defining abnormal behavior. PMID:18392156
Sibley, Margaret H.; Pelham, William E.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Biswas, Aparajita; MacLean, Michael G.; Babinski, Dara E.; Karch, Kathryn M.
This study examined the association between childhood ADHD and juvenile delinquency by examining data from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of individuals diagnosed with ADHD in childhood (ages 5-12) and recontacted in adolescence and young adulthood for yearly follow-up (age at first follow-up interview M=17.26,…
Over the past 50 years the concept of attention deficit/hyperactivity disorder (ADHD) has developed from the notion of a specific form of brain dysfunction to that of a heterogeneous set of related behaviours. The great advances in genetics, neuroimaging and neuropsychiatry have made it one of the best understood forms of complex mental disturbance--but much remains to be done to translate understanding into practice. More effective treatment may come from identifying and treating more specific components of disorder and by a focus on identifying the factors determining course in the longer term so that they, as well as the core features of disorder, can become targets for intervention.
Melara, Claudia Alexia
Students with Attention Deficit Hyperactivity Disorder (ADHD) are at greater risk for failing to complete their postsecondary educational degrees than their typical peers. The present qualitative sought to identify factors influencing the academic persistence of students with ADHD in postsecondary settings. Utilizing direct interviews with…
Ruan, W. June; Goldstein, Risë B.; Chou, S. Patricia; Smith, Sharon M.; Saha, Tulshi D.; Pickering, Roger P.; Dawson, Deborah A.; Huang, Boji; Stinson, Frederick S.; Grant, Bridget F.
This study presents test-retest reliability statistics and information on internal consistency for new diagnostic modules and risk factor of alcohol, drug, and psychiatric disorders the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV). Test-retest statistics were derived from a random sample of 1,899 adults selected from 34,653 respondents who participated in the 2004–2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Internal consistency of continuous scales was assessed using the entire Wave 2 NESARC. Both test and retest interviews were conducted face-to-face. Test-retest and internal consistency results for diagnoses and symptom scales associated with posttraumatic stress disorder, attention-deficit/hyperactivity disorder, and borderline, narcissistic, and schizotypal personality disorders were predominantly good (kappa > 0.63; ICC > 0.69; alpha > 0.75) and reliability for risk factor measures fell within the good to excellent range (intraclass correlations = 0.50–0.94; alpha = 0.64–0.90). The high degree of reliability found in this study suggests that new AUDADIS-IV diagnostic measures can be useful tools in research settings. The availability of highly reliable measures of risk factors of alcohol, drug, and psychiatric disorders will contribute to the validity of conclusions drawn from future research in the domains of substance use disorder and psychiatric epidemiology. PMID:17706375
Robeva, Raina; Penberthy, Jennifer Kim
Accurate diagnosis of attentional disorders such as attention-deficit hyperactivity disorder (ADHD) is imperative because there are multiple negative psychosocial sequelae related to undiagnosed and untreated ADHD. Early and accurate detection can lead to effective intervention and prevention of negative sequelae. Unfortunately, diagnosing ADHD presents a challenge to traditional assessment paradigms because there is no single test that definitively establishes its presence. Even though ADHD is a physiologically based disorder with a multifactorial etiology, the diagnosis has been traditionally based on a subjective history of symptoms. In this chapter we outline a stochastic method that utilizes a Bayesian interface for quantifying and assessing ADHD. It can be used to combine of a variety of psychometric tests and physiological markers into a single standardized instrument that, on each step, refines a probability for ADHD for each individual based on information provided by the individual assessments. The method is illustrated with data from a small study of six college female students with ADHD and six matched controls in which the method achieves correct classification for all participants, where none of the individual assessments was capable of achieving perfect classification. Further, we provide a framework for applying this Bayesian method for performing meta-analysis of data obtained from disparate studies and using disparate tests for ADHD based on calibration of the data into a unified probability scale. We use this method to combine data from five studies that examine the diagnostic abilities of different behavioral rating scales and EEG assessments of ADHD, enrolling a total of 56 ADHD and 55 control subjects of different age groups and gender.
Hansen, Berit Hjelde; Skirbekk, Benedicte; Oerbeck, Beate; Wentzel-Larsen, Tore; Kristensen, Hanne
This study examined associations between sleep problems and attentional and behavioral functioning in 137 children aged 7 to 13 years with anxiety disorders (n = 39), attention deficit hyperactivity disorder (ADHD; n = 38), combined anxiety disorder and ADHD (n = 25), and 35 controls. Diagnoses were made using the semistructured diagnostic interview Schedule for Affective Disorders and Schizophrenia for School-age Children-Present and Lifetime Version. Sleep problems were assessed using the Children's Sleep Habits Questionnaire, attention was measured by the Attention Network Test, and behavioral problems were measured by teacher ratings on the Achenbach System of Empirically Based Assessment, Teacher Report Form. Sleep problems were associated with reduced efficiency of the alerting attention system for all children and with increased internalizing problems in children with anxiety disorders.
Quintana, Maria Inês; Mari, Jair de Jesus; Ribeiro, Wagner Silva; Jorge, Miguel Roberto; Andreoli, Sergio Baxter
The objective was to study the accuracy of the post-traumatic stress disorder (PTSD) section of the Composite International Diagnostic Interview (CIDI 2.1) DSM-IV diagnosis, using the Structured Clinical Interview (SCID) as gold standard, and compare the ICD-10 and DSM IV classifications for PTSD. The CIDI was applied by trained lay interviewers and the SCID by a psychologist. The subjects were selected from a community and an outpatient program. A total of 67 subjects completed both assessments. Kappa coefficients for the ICD-10 and the DSM IV compared to the SCID diagnosis were 0.67 and 0.46 respectively. Validity for the DSM IV diagnosis was: sensitivity (51.5%), specificity (94.1%), positive predictive value (9.5%), negative predictive value (66.7%), misclassification rate (26.9%). The CIDI 2.1 demonstrated low validity coefficients for the diagnosis of PTSD using DSM IV criteria when compared to the SCID. The main source of discordance in this study was found to be the high probability of false-negative cases with regards to distress and impairment as well as to avoidance symptoms.
Starck, Martina; Grünwald, Julia; Schlarb, Angelika A
Background Despite the fact that there is a large amount of research on childhood attention deficit hyperactivity disorder (ADHD) treatment and an increasing amount of research on adult ADHD, little is known about the prevalence and influence of parental ADHD. Therefore, this study examined the frequency of parental ADHD in a clinical sample of German children suffering from ADHD. We also tried to find different levels of symptom severity for prognostic relevance. Furthermore, the association between subtypes of ADHD in children and their parents was investigated. Method In this study, parents of 79 ADHD children were screened for ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 10th edition. The Wender Utah Rating Scale and the ADHS-Self-Report were given to 75 mothers and 49 fathers for retrospective and current symptoms. Frequency of ADHD symptoms and severity groups was calculated and relationship between parental and children’s ADHD was tested. Results ADHD occurrence for mothers of children with ADHD was 41.3%, for fathers 51.0%. About 16.0% of the mothers had a mixed type, 9.3% had a hyperactive-impulsive subtype, and 16.0% had an inattentive subtype. Of the fathers, 18.4% had a mixed type, 10.2% had a hyperactive-impulsive subtype, and 22.4% had an inattentive subtype; 61% of the mothers and 46.9% of the fathers had low symptom severity. Medium symptom severity was reported by 37.7% mothers and 46.9% fathers, while 1.3% of the mothers and 6.2% of the fathers showed severe symptoms. No significant correlation between parental and child diagnoses was observed. Conclusion As nearly half of the parents suffered from ADHD, these results are a matter of concern in families with ADHD children. Besides parent–child interactions, parental ADHD symptoms might influence parental education style and also effects parent training as well as the child’s therapy outcome. In the
Potter, Jennifer S; Prather, Kristi; Kropp, Frankie; Byrne, Mimmie; Sullivan, C Rollynn; Mohamedi, Nadia; Copersino, Marc L; Weiss, Roger D
Treatment research with opioid-dependent populations has not traditionally distinguished between those dependent on prescription opioids versus dependent upon heroin. Evidence suggests there is a substantial subpopulation of individuals with opioid dependence resulting largely or exclusively from prescription opioid use. Because this subpopulation may respond to treatment differently from heroin users, a method for discriminating DSM-IV opioid dependence due to prescription opioid use would provide more precision when examining this population. This paper describes an innovative method using a currently available diagnostic instrument, to diagnose DSM-IV opioid dependence and distinguish between dependence resulting from prescription opioids versus dependence upon heroin.
Frigerio, Alessandra; Montali, Lorenzo; Marzocchi, Gian Marco
Teachers' perceptions of attention deficit hyperactivity disorder (ADHD) can influence the diagnostic rates of the disorder and the management of children in schools. This study investigated the knowledge and perceptions of ADHD in a sample of 589 Italian primary school teachers using a self-report questionnaire that included the ADHD perceptions…
Makris, Nikos; Liang, Lichen; Biederman, Joseph; Valera, Eve M.; Brown, Ariel B.; Petty, Carter; Spencer, Thomas J.; Faraone, Stephen V.; Seidman, Larry J.
Objective We assessed the neural correlates of adult ADHD in treatment-naïve participants, an approach necessary for identifying neural substrates unconfounded by medication effects. Method The sample consisted of 24 medication-naïve adults with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) diagnosed ADHD and 24 healthy controls, comparable on age, sex, handedness, reading achievement, IQ, and psychiatric comorbidity. All participants were assessed with structured diagnostic interviews. Magnetic resonance imaging (MRI)-based regional voxel-based morphometry (r-VBM) was used to assess volumetric differences in a priori defined brain regions of interest. Results VBM analysis revealed group differences in the hypothesized cortical and subcortical areas; however, only cerebellar volume reductions in ADHD retained significance (p < .05) after corrections for multiple comparisons. Conclusion These results support the notion that medication-naïve ADHD as expressed in adulthood, manifests subtle brain volume reductions from normal in the cerebellum, and possibly in other syndrome-congruent gray-matter structures. Larger samples are required to confirm these findings. PMID:24189200
Walg, Marco; Hapfelmeier, Gerhard; El-Wahsch, Daniel; Prior, Helmut
Alterations in temporal processing may represent a primary cause of key symptoms in ADHD. This study is aimed at investigating the nature of time-processing alterations in ADHD and assessing the possible utility of testing time estimation for clinical diagnostics. Retrospective verbal time estimation in the range of several minutes was examined in 50 boys with ADHD and 53 boys with other mental disorders. All participants (age 7-16) attended an outpatient clinic for ADHD diagnostics. The diagnostic assessment included the WISC-IV. Subjects with ADHD made longer and less accurate duration estimates than the clinical control group. The ADHD group showed a specific WISC-IV profile with processing speed deficits. In the ADHD group there was a correlation between processing speed and quality of time estimation that was not observed in the comparison group: higher processing speed indices were related to more accurate duration estimates. The findings provide support for the presence of a faster internal clock in subjects with ADHD and lend further support to the existence of a specific WISC-IV profile in subjects with ADHD. The results show that analyzing WISC-IV profiles and time estimation tasks are useful differential diagnosis tools, particularly when it comes to distinguishing between "real ADHD" and pseudo-ADHD.
... learning skills, including memory tips from LD Online. Attention deficit hyperactivity disorder (ADHD) top ADHD is a ... condition that affects a person’s ability to pay attention, sit still, and follow directions. If you have ...
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Zhou, Rui; Xia, Qun; Shen, Huaiyun; Yang, Xiaoyun; Zhang, Yongli; Xu, Jiali
As the most common mental disorder identified in children and teenagers, attention deficit hyperactivity disorder (ADHD) affects millions of children and their families, making it a critical health issue worldwide. This article reviewed the historical opinions about the diagnosis of ADHD and defined different subtypes of this disorder. It also summarized the current diagnostic criteria and available medications. After re-visiting the etiology of ADHD in the sense of both genetic and environment factors, it was further hypothesized that viral infection might be involved in ADHD pathogenesis. Human cytomegalovirus (HCMV) infection may be associated with ADHD, although both clinical observations and animal studies need to be performed for validation. PMID:26550354
Lenartowicz, Agatha; Loo, Sandra K.
Electroencephalography (EEG) has, historically, played a focal role in the assessment of neural function in children with attention deficit hyperactivity disorder (ADHD). We review here the most recent developments in the utility of EEG in the diagnosis of ADHD, with emphasis on the most commonly used and emerging EEG metrics and their reliability in diagnostic classification. Considering the clinical heterogeneity of ADHD and the complexity of information available from the EEG signals, we suggest that considerable benefits are to be gained from multivariate analyses and a focus towards understanding of the neural generators of EEG. We conclude that while EEG cannot currently be used as a diagnostic tool, vast developments in analytical and technological tools in its domain anticipate future progress in its utility in the clinical setting. PMID:25234074
The quality of life of children and adolescents with ADHD undergoing outpatient psychiatric treatment: simple disorders of activity and attention and hyperkinetic conduct disorders in comparison with each other and with other diagnostic groups.
Remschmidt, Helmut; Mattejat, Fritz
(1) How does the quality of life of patients with ADHD treated in an ambulatory care setting compare to that of other patient groups in child and adolescent psychiatry? (2) Can differences in the quality of life be demonstrated between patients with simple disorders of activity and attention and those with hyperkinetic conduct disorders? (3) How does the quality of life in these patient groups change over one year of treatment? The Inventory for the Assessment of Life Quality in Children and Adolescents (Inventar zur Untersuchung der Lebensqualität von Kindern und Jugendlichen, ILK) was applied to a sample of 726 patients derived from nine different outpatient practices for child and adolescent psychiatry. Among them were 196 patients with a simple disorder of activity and attention and 64 with a hyperkinetic conduct disorder. A comparison between these two groups was the main aim of the study. The mean age of the patients in the sample (all diagnoses) was 8.7 ± 3 years. The two groups of hyperkinetic patients made up 35% of the overall sample, and both of them showed a marked male predominance. The hyperkinetic patients tended to have lower quality-of-life scores than patients in the other diagnostic groups. Longitudinal observation revealed improvements in the quality of life across all patient groups, but the patients with hyperkinetic disorders (both groups) improved the least. The parents of the hyperkinetic patients, too, reported suffering greater stress because of their children's condition than the parents of children with other types of disorders. The ILK instrument has test-metrical qualities that render it usable and capable of holding its own among other, comparable instruments. It can be used to assess the quality of life of children with various diagnoses. Children with ADHD tend to have the least favorable quality-of-life scores, yet they do show some degree of improvement in their quality of life after a year of treatment.
Schmidt, Sören; Schüßler, Gerhard; Petermann, Franz
ADHD can be regarded as a lifespan disorder. From biopsychosocial vantage point, ADHD leads to age-specific impairments, high psychological distress and is associated with a high occurrence of comorbid disorders. For this review, we summarize actual findings from epidemiological, neuroscientific and clinical studies to present an overview of ADHD-research. We discuss the proposed revisions for DSM-V criteria by comparing them with the present DSM-IV-TR criteria, with a focus on the implications for research and practice. In the second part of this paper, we present new findings from socioeconomic, diagnostic and therapeutic perspectives. There is evidence for a high economic burden that is indirectly caused by ADHD (e.g., production loss, material costs, higher accident rates). Consequently, there is a high demand for comprehensive diagnostic and therapeutic approaches. We present a summary of the latest available diagnostic instruments and therapeutic manuals. The results of research and practice show a growing support for a lifespan perspective on ADHD psychopathology. The burdens resulting from ADHD are evident in all age groups, which has led to establishing age-specific diagnostic and therapeutic materials. Although there is a lack in ADHD-specific healthcare in adulthood, this should be realized by structural changes in healthcare services.
McBurnett, Keith; Swetye, Michael; Muhr, Heather; Hendren, Robert L
This article reviews the current use of stimulants in adolescents. The evidence base for treatment of attention-deficit/hyperactivity disorder (ADHD) in adolescents is meager compared with that of ADHD in children, and much recent research of older populations with ADHD has been directed toward adults rather than adolescents. The structure of psychosocial treatment of ADHD differs across developmental ranges. For example, in children, treatment of ADHD uses direct behavior modification via parents and teachers. Treatment approaches then change toward contracting in adolescents (acknowledging the emerging independence common at this age) and toward self-management and coaching in adults. Medication for ADHD, however, does not substantially differ across developmental epochs. In supplementation of data, specifically on adolescence, much of our understanding of treating adolescents comes from upward or downward extension of the child and adult data. Symptomatic treatment (treatment for inattention, hyperactivity, or impulsive behavior) has always been a parallel approach to diagnostic and developmentally specific selection of treatment based on an incomplete literature. In recognition, this article assumes that inference from children or adults to adolescents, in the absence of adolescent-specific data, is commonplace and often confirmed with clinical experience. Such inferences, in the face of literature gaps, in no way obviate the need for continued research focused on adolescence.
Bunte, Tessa L; Schoemaker, Kim; Hessen, David J; van der Heijden, Peter G M; Matthys, Walter
The aim of the present study was to investigate the clinical usefulness of a semi-structured diagnostic parent interview, i.e., the Kiddie-Disruptive Behavior Disorder Schedule (K-DBDS), in preschool children. For Oppositional Defiant Disorder (ODD), to define symptoms two coding methods were compared, i.e., one based on the threshold "often" and the other based on the frequency of behaviors in combination with the presence of clinical concern. For Attention-Deficit/Hyperactivity Disorder (ADHD), to define symptoms, two coding methods were compared, i.e., one with and one without consideration of pervasiveness across contexts. Participants were referred preschool children with externalizing behavioral problems (N = 193; 83% male) and typically developing (TD) children (N = 58; 71% male). The referred children were given a diagnosis of either ODD/CD (N = 39), or ADHD (N = 58) or comorbid ODD/CD+ADHD (N = 57) or no diagnosis (N = 39) based on best-estimate diagnosis. Receiver Operating Characteristic curve analyses showed that a cutoff score of four ODD symptoms using "often" as the threshold for frequency of behaviors led to a sensitivity of 87% and a specificity of 93%; the coding method which included the frequency of behaviors yielded a sensitivity of 56% and a specificity of 100%. For ADHD, a clinical cutoff score of five symptoms without the pervasiveness criterion yielded a sensitivity of 83% and a specificity of 98%; when the pervasiveness criterion was included sensitivity was 77% and specificity 98%. In the clinical assessment of ODD and ADHD in preschool children, the K-DBDS may be used with ODD symptom definition based on the threshold "often" and ADHD pervasiveness across contexts not included.
Brown, Matthew R G; Sidhu, Gagan S; Greiner, Russell; Asgarian, Nasimeh; Bastani, Meysam; Silverstone, Peter H; Greenshaw, Andrew J; Dursun, Serdar M
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.
Gremillion, Monica L; Martel, Michelle M
ADHD is associated with academic underachievement, but it remains unclear what mechanism accounts for this association. Semantic language is an underexplored mechanism that provides a developmental explanation for this association. The present study will examine whether semantic language deficits explain the association between ADHD and reading and mathematics underachievement, taking into account alternative explanations for associations, including verbal working memory (WM) impairments, as well as specificity of effects to inattentive and hyperactive-impulsive ADHD symptom domains. Participants in this cross-sectional study were 546 children (54 % male) ages six to twelve (M = 9.77, SD = 1.49). ADHD symptoms were measured via maternal and teacher report during structured interviews and on standardized rating forms. Children completed standardized semantic language, verbal WM, and academic testing. Semantic language fully mediated the ADHD-reading achievement association and partially mediated the ADHD-mathematics achievement association. Verbal WM also partially mediated the ADHD-mathematics association but did not mediate the ADHD-reading achievement association. Results generalized across inattentive and hyperactive-impulsive ADHD symptom domains. Semantic language explained the association between ADHD and reading underachievement and partially explained the association between ADHD and mathematics underachievement. Together, language impairment and WM fully explained the association between ADHD and reading underachievement, in line with developmental models suggesting that language and WM conjointly influence the development of attention and subsequent academic achievement. This work has implication for the development of tailored interventions for academic underachievement in children with ADHD.
Glockner-Rist, Angelika; Pedersen, Anya; Rist, Fred
Objective: Adult "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.; "DSM-IV") and retrospective childhood Wender-Utah ADHD criteria are implemented in self-report measures to assess adult ADHD and its required onset in childhood. Yet their dimensional structure and relationship to adult ADHD depressivity is still…
López Seco, F; Mundo-Cid, P; Aguado-Gracia, J; Gaviria-Gómez, A M; Acosta-García, S; Martí-Serrano, S; Vilella, E; Masana-Marín, A
The objective of this study was to analyze the possible association between maternal attachment style and comorbidity associated with childhood ADHD. We evaluated a total of 103 children with ADHD treated at a Child and Adolescent Mental Health Centre and their mothers. Comorbidity was evaluated using the MINI-KID interview. Maternal attachment was evaluated using the Adult Attachment Questionnaire. We considered child variables that could be associated with the clinical course of ADHD, such as symptom severity, age, gender, evolution time, academic level, and current pharmacological treatment; parental variables, such as the mother's psychiatric history, current psychopathology, marital status, academic level, income, and employment, were also considered. We found an association between maternal insecure attachment and comorbid depressive disorder in childhood ADHD. An insecure maternal attachment style must be considered in the assessment and treatment of childhood ADHD with comorbid depression.
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Nazeer, Ahsan; Mansour, Miriam; Gross, Kathleen A.
Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects the child and adolescent population. It is characterized by impairment in attention/concentration, hyperactivity, and impulsivity, all of which can impact performance of athletes. ADHD treatment within the athletic population is a unique challenge. The research in this field has been relatively limited. The National Collegiate Athletic Association and International Olympic Committee both regulate the use of psychostimulants for treatment of ADHD due to their performance-enhancing effects. In this article, authors have discussed the screening methods, pharmacological treatment, side effects, and behavioral approaches for the treatment of ADHD in adolescent athletes. PMID:24987666
Retz, Wolfgang; Rösler, Michael
ADHD is associated with social problems and aggressive behavior. As hyperactive-impulsive traits are core symptoms of ADHD, it has been hypothesized that reactive-impulsive violence is more likely related to ADHD psychopathology than proactive-instrumental violence. One hundred and twenty-seven adult violent offenders participated in the study. Diagnosis of ADHD and ratings of reactive and proactive features of the committed crimes were performed using standardized instruments. According to DSM-IV, 16.5% subjects fulfilled diagnostic criteria for ADHD, 23.6% were diagnosed as ADHD in partial remission, and 59.8% had no ADHD. Univariate analyses revealed higher reactive violence ratings in both ADHD groups when compared to subjects without ADHD, whereas the opposite was found regarding proactive violence ratings. Using multivariate analyses of variance controlled for age, gender and comorbid substance use disorders, childhood ADHD psychopathology and current ADHD significantly increased the risk of reactive violence and decreased the risk of proactive violence. Significant impact of male gender on proactive violence was found. The findings suggest that ADHD is associated with reactive but not proactive violence in aggressive offenders.
Kuijper, Sanne J M; Hartman, Catharina A; Bogaerds-Hazenberg, Suzanne T M; Hendriks, Petra
The present study focuses on the similarities and differences in language production between children with autism spectrum disorder (ASD) and children with attention-deficit/hyperactivity disorder (ADHD). In addition, we investigated whether Theory of Mind (ToM), working memory, and response inhibition are associated with language production. Narratives, produced by 106 Dutch-speaking children (36 with ASD, 34 with ADHD, and 36 typically developing) aged 6 to 12 during ADOS assessment, were examined on several linguistic measures: verbal productivity, speech fluency, syntactic complexity, lexical semantics, and discourse pragmatics. Children were tested on ToM, working memory, and response inhibition and parents filled in the Children's Communication Checklist (CCC-2). Gold-standard diagnostic measures (Autism Diagnostic Observation Schema [ADOS], Autism Diagnostic Interview Revised [ADI-R], and the Parent Interview for Child Symptoms [PICS]) were administered to all children to confirm diagnosis. Regarding similarities, both clinical groups showed impairments in narrative performance relative to typically developing children. These were confirmed by the CCC-2. These impairments were not only present on pragmatic measures, such as the inability to produce a narrative in a coherent and cohesive way, but also on syntactic complexity and their production of repetitions. As for differences, children with ADHD but not children with ASD showed problems in their choice of referring expressions and speech fluency. ToM and working memory performance but not response inhibition were associated with many narrative skills, suggesting that these cognitive mechanisms explain some of the impairments in language production. We conclude that children with ASD and children with ADHD manifest multiple and diverse language production problems, which may partly relate to their problems in ToM and working memory. (PsycINFO Database Record
Mueller, Kathryn L.; Tomblin, J. Bruce
Attention-Deficit/Hyperactivity Disorder (ADHD) is a common developmental disorder often associated with other developmental disorders including speech, language, and reading disorders. Here we review the principal features of ADHD and current diagnostic standards for the disorder. We outline the ADHD subtypes, which are based upon the dimensions of inattention and hyperactivity. These serve as the phenotype for ADHD. Current nomenclature implies a deficit in the cognitive construct of attention, and this has taken researchers on an extended inquiry into several potential endophenotypes underlying ADHD, in particular executive function and its subcomponents. We review this literature and then delve into the neurobiology of ADHD. This research has suggested to us that the corticostriatal system is a strong candidate system in the etiology of ADHD, in part because of the dopaminergic system, which is known to play a role in the disorder. We present this system as an important contributor to the comorbidty of ADHD with other developmental disorders, especially language disorder. PMID:25506117
Tourette syndrome (TS) is a common, neuropsychiatric disorder which has many similarities to attention deficit hyperactivity disorder (ADHD). TS probands have a high frequency of a variety of behavioral disorders including depression. The depression may be due to a pleiotropic effect of the Gts genes, proband ascertainment bias, or a result of coping with the chronic tics. To distinguish between these hypotheses we examined the responses to 17 Diagnostic Interview Schedule questions to evaluate the 9 DSM-III-R criteria for major depressive episode in 1,080 adults consisting of TS and ADHD probands, their relatives and controls. Using a Bonferonni corrected p there was a significant progressive increase in 16 of 17 depressive symptoms and for a life time history of a major depressive episode in groups with increased genetic loading for Gts genes. Similar trends were seen in the small number of ADHD probands and their relatives. There was also a significant increase for these variables in non-proband TS relatives versus non-TS relatives, indicating the association of depression with Gts genes was not due to ascertainment bias or the inappropriate choice of controls. Multiple linear regression analysis indicated that obsessive-compulsive behaviors, sex, ADHD, drug abuse, and age all showed a more significant effect on depressive symptoms than the number of tics. The presence or absence of TS in the relatives had a much greater effect on risk for depression than the presence or absence of an episode of major depression in the proband. These results are consistent with the hypothesis that Gts and ADHD genes play a major role in depression. 69 refs., 5 tabs.
Alizadeh, Hamid; Applequist, Kimberly F.; Coolidge, Frederick L.
Objective: This study examines the relationship between parental self-confidence, warmth, and involvement, and corporal punishment in families of children with attention deficit/hyperactivity disorder (ADHD). Method: The diagnosis of ADHD was established through clinical interviews with the parents, children, and teachers, according the criteria…
Baker, Leigh; Prevatt, Frances; Proctor, Briley
Objective: This study examines differences in reported levels of drug and alcohol use between college students with and without ADHD. Method: The Michigan Alcohol Screening Test (MAST) and several self-report and interview questions, developed by Barkley, were used to examine the drug and alcohol use of college students with and without ADHD.…
Heins, Marianne J; Bruggers, Inge; van Dijk, Liset; Korevaar, Joke C
Many children receive attention-deficit hyperactivity disorder (ADHD) medication, but factors that determine medication prescription are largely unknown. This study aimed to determine the relative impact of factors on the child, family and general practitioner (GP) practice level on ADHD medication prescription. We included 1259 Dutch children aged 6-18 years with a diagnostic code of ADHD or related behavioural problems (ICPC codes P20-P22) in NIVEL primary care database. Using multilevel analyses, we examined predictors of ADHD medication prescription. Children diagnosed as 'hyperactive' were 16 times more likely to be prescribed ADHD medication than those with 'behavioural concerns'. Children with a parent or sibling receiving ADHD medication were three to four times more likely to be prescribed ADHD medication themselves. Children from GP practices with a high percentage of children with ADHD were twice as likely to be prescribed ADHD medication. Concluding, factors on the individual, family and GP practice level determine ADHD medication prescription. Future research into the decision-making process for ADHD medication is warranted.
Brownlie, E. B.; Lazare, Kim; Beitchman, Joseph
Objective: This article evaluates the diagnostic utility of a self-report screening tool for adults based on "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.; "DSM-IV") ADHD criteria. Method: Children with speech/language (S/L) impairment and typically developing controls had ADHD symptoms rated by parents and…
Jones, Karyn Dayle
In mental health, family, and community counseling settings, master's-level counselors engage in unstructured clinical interviewing to develop diagnoses based on the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; "DSM-IV-TR"; American Psychiatric Association, 2000). Although counselors receive education about…
Harrington, Kelly M.; Waldman, Irwin D.
The objective of the current study was to evaluate how the inclusion of 3 Sluggish Cognitive Tempo (SCT) symptoms in Attention-Deficit/Hyperactivity Disorder (ADHD) diagnostic criteria influences the external validity of the ADHD subtypes. The sample comprised 228 children (166 boys, 62 girls) ranging in age from 5-18 years who were referred to…
Karama, Sherif; Amor, Leila Ben; Grizenko, Natalie; Ciampi, Antonio; Mbekou, Valentin; Ter-Stepanian, Marina; Lageix, Philippe; Baron, Chantal; Schwartz, George; Joober, Ridha
Background: To study the factor structure of the Restricted Academic Situation Scale (RASS), a psychometric tool used to assess behavior in children with ADHD, 117 boys and 21 girls meeting "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.; "DSM-IV") criteria for ADHD and aged between 6 and 12 years were recruited. Assessments were…
Rodriguez, Alina; Bohlin, Gunilla
Background: There are some indications that maternal lifestyle during pregnancy (smoking and stress) contributes to symptoms of ADHD in children. We prospectively studied whether prenatal exposure to maternal smoking and/or stress is associated with ADHD symptoms and diagnostic criteria (according to DSM-IV) in 7-year-olds. Methods: Nulliparous…
Faraone, Stephen V.; Biederman, Joseph
To provide a better estimate of the prevalence of ADHD in adulthood, the authors complete a telephone survey of 966 randomly selected adults. They compute two diagnoses from the survey data. Participants meeting "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.) criteria for both childhood and adulthood are defined as narrow ADHD.…
Lahey, Benjamin B.; Hartung, Cynthia M.; Loney, Jan; Pelham, William E.; Chronis, Andrea M.; Lee, Steve S.
We assessed the predictive validity of attention-deficit/hyperactivity disorder (ADHD) in 20 girls and 98 boys who met the Diagnostic and Statistical Manual for Mental Disorders (4th ed., American Psychiatric Association, 1994) criteria for ADHD at 4 to 6 years of age compared to 24 female and 102 male comparison children. Over the next 8 years,…
Wender, Paul H.; Reimherr, Frederick W.; Marchant, Barrie K.; Sanford, Mary Eve; Czajkowski, Laura A.; Tomb, David A.
Objective: To determine the effects of long-term methylphenidate treatment on symptom severity and social adjustment in adult ADHD. Method: Adults (n = 116) meeting operational diagnostic criteria for ADHD (the "Utah Criteria") entered a randomized double-blind crossover trial of methylphenidate and placebo. Participants who improved on…
Griggs, Marissa Swaim; Mikami, Amori Yee
The current study investigated the influence of maternal ADHD symptoms on: (a) mothers' own social functioning; (b) their child's social functioning; and (c) parent-child interactions following a lab-based playgroup involving children and their peers. Participants were 103 biological mothers of children ages 6-10. Approximately half of the children had ADHD, and the remainder were comparison youth. After statistical control of children's ADHD diagnostic status and mothers' educational attainment, mothers' own inattentive ADHD symptoms predicted poorer self-reported social skills. Children with ADHD were reported to have more social problems by parents and teachers, as well as received fewer positive sociometric nominations from playgroup peers relative to children without ADHD. After control of child ADHD status, higher maternal inattention and hyperactivity/impulsivity each predicted children having more parent-reported social problems; maternal inattention predicted children receiving more negative sociometric nominations from playgroup peers. There were interactions between maternal ADHD symptoms and children's ADHD diagnostic status in predicting some child behaviors and parent-child relationship measures. Specifically, maternal inattention was associated with decreased prosocial behavior for children without ADHD, but did not influence the prosocial behavior of children with ADHD. Maternal inattention was associated with mothers' decreased corrective feedback and, at a trend level, decreased irritability toward their children with ADHD, but there was no relationship between maternal inattention and maternal behaviors for children without ADHD. A similar pattern was observed for maternal hyperactivity/impulsivity and mothers' observed irritability towards their children. Treatment implications of findings are discussed.
... this page: //medlineplus.gov/ency/article/007592.htm Medicines for ADHD To use the sharing features on ... that the treatment plan is successful. TYPES OF MEDICINES Stimulants are the most commonly used type of ...
... They also have higher rates of cigarette and drug addiction, and more driving infractions. The good news ... Scientists are continuing to research and develop new drugs for ADHD. It is important to confer with ...
... Content Article Body The fact that many more boys than girls are diagnosed with ADHD—at a ... many parents and teachers that ADHD is a “boys’ disorder” that rarely occurs in girls. In fact, ...
... sure you're learning in a way that works for you. For example, some schools will allow extra time for students with ADHD to take tests. Some teens may benefit from smaller class sizes and tutoring help. Use ...
Harrison, Christopher; Charles, Janice; Britt, Helena
The BEACH program (Bettering the Evaluation and Care of Health) shows that management of attention deficit (hyperactivity) disorder (AD(H)D) was rare in general practice, occurring only six times per 1,000 encounters with children aged 5-17 years, between April 2000 and December 2007. This suggests that general practitioners manage AD(H)D about 46,000 times for this age group nationally each year.
Kurtz, Steven M S
The school nurse has a tremendous opportunity to be a part of the home, school, and community team in promoting state-of-the-art care for youngsters with ADHD. The multi-modal strategic approach, combining carefully titrated pharmacotherapy with these specific behavioral interventions in the child's school and other settings, currently provides the greatest likelihood of a positive treatment outcome for youth with ADHD.
Felt, Barbara T; Biermann, Bernard; Christner, Jennifer G; Kochhar, Param; Harrison, Richard Van
Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children, and the prevalence is increasing. Physicians should evaluate for ADHD in children with behavioral concerns (e.g., inattention, hyperactivity, impulsivity, oppositionality) or poor academic progress using validated assessment tools with observers from several settings (home, school, community) and self-observation, if possible. Physicians who inherit a patient with a previous ADHD diagnosis should review the diagnostic process, and current symptoms and treatment needs. Coexisting conditions (e.g., anxiety, learning, mood, or sleep disorders) should be identified and treated. Behavioral treatments are recommended for preschool-aged children and may be helpful at older ages. Effective behavioral therapies include parent training, classroom management, and peer interventions. Medications are recommended as first-line therapy for older children. Psychostimulants, such as methylphenidate and dextroamphetamine, are most effective for the treatment of core ADHD symptoms and have generally acceptable adverse effect profiles. There are fewer supporting studies for atomoxetine, guanfacine, and clonidine, and they are less effective than the psychostimulants. Height, weight, heart rate, blood pressure, symptoms, mood, and treatment adherence should be recorded at follow-up visits.
Attention-deficit/hyperactivity disorder (ADHD) is a chronic, lifelong disorder with childhood-onset, which seriously impairs the affected adults in a variety of daily living functions like educational and occupational functioning, partnership and parenting. ADHD is associated with a high percentage of comorbid psychiatric disorders in every lifespan. In adulthood between 65-89% of all patients with ADHD suffer from one or more additional psychiatric disorders, above all mood and anxiety disorders, substance use disorders and personality disorders, which complicates the clinical picture in terms of diagnostics, treatment and outcome issues. The present overview provides information of comorbid psychiatric disorders in adults with ADHD, underlying associations and clinical implications.
Lorenzen, Elizabeth A.; And Others
Directed especially at graduating college seniors, this paper contains information about employment interviews and how to prepare for them. Subjects discussed include the following: preparing for interviews (analyzing strengths and weaknesses, gathering information about the company); points to remember (dress codes, follow up thank-you letters);…
A previous study had confirmed that a substantial number of low achievers in grades 5 through 8 had high algorithmic confidence in each of the four arithmetic operations with whole numbers. The purpose of the present study was to follow up the results through interviewing low achievement-high confidence students in order to ascertain if they…
In this article, I present a study conducted with 10 Southeastern US early childhood teachers on their views concerning problem behaviour, in general, and the practice of diagnosis and pharmaceutical treatment for Attention/Deficit Hyperactivity Disorder (ADHD), in particular. Themes that emerged from the interview data included: (1) teachers'…
Harvey, William J.; Reid, Greg; Bloom, Gordon A.; Staples, Kerri; Grizenko, Natalie; Mbekou, Valentin; Ter-Stepanian, Marina; Joober, Ridha
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,…
Roessner, Veit; Banaschewski, Tobias; Becker, Andreas; Buse, Judith; Wanderer, Sina; Buitelaar, Jan K.; Sergeant, Joseph A.; Sonuga-Barke, Edmund J.; Gill, Michael; Manor, Iris; Miranda, Ana; Mulas, Fernando; Oades, Robert D.; Roeyers, Herbert; Steinhausen, Hans-Christoph; Faraone, Steven V.; Asherson, Philip; Rothenberger, Aribert
Background: The association of attention-deficit/hyperactivity disorder (ADHD) and tic disorder (TD) is frequent and clinically important. Very few and inconclusive attempts have been made to clarify if and how the combination of ADHD+TD runs in families. Aim: To determine the first time in a large-scale ADHD sample whether ADHD+TD increases the risk of ADHD+TD in siblings and, also the first time, if this is independent of their psychopathological vulnerability in general. Methods: The study is based on the International Multicenter ADHD Genetics (IMAGE) study. The present sub-sample of 2815 individuals included ADHD-index patients with co-existing TD (ADHD+TD, n = 262) and without TD (ADHD–TD, n = 947) as well as their 1606 full siblings (n = 358 of the ADHD+TD index patients and n = 1248 of the ADHD-TD index patients). We assessed psychopathological symptoms in index patients and siblings by using the Strength and Difficulties Questionnaire (SDQ) and the parent and teacher Conners' long version Rating Scales (CRS). For disorder classification the Parental Account of Childhood Symptoms (PACS-Interview) was applied in n = 271 children. Odds ratio with the GENMOD procedure (PROCGENMOD) was used to test if the risk for ADHD, TD, and ADHD+TD in siblings was associated with the related index patients' diagnoses. In order to get an estimate for specificity we compared the four groups for general psychopathological symptoms. Results: Co-existing ADHD+TD in index patients increased the risk of both comorbid ADHD+TD and TD in the siblings of these index patients. These effects did not extend to general psychopathology. Interpretation: Co-existence of ADHD+TD may segregate in families. The same holds true for TD (without ADHD). Hence, the segregation of TD (included in both groups) seems to be the determining factor, independent of further behavioral problems. This close relationship between ADHD and TD supports the clinical approach to carefully assess ADHD in any case
Stickley, Andrew; Koyanagi, Ai; Takahashi, Hidetoshi; Kamio, Yoko
Prior research has produced conflicting findings on the association between attention-deficit/hyperactivity disorder (ADHD) and pain, while studies among community-dwelling adults are lacking. This study examined the association between ADHD symptoms and pain in the general adult population, and the extent to which this association is influenced by comorbid common mental disorders (CMDs). Data came from the 2007 Adult Psychiatric Morbidity Survey which included a representative sample of the English adult household population aged ≥16 years (N=7403). The Adult ADHD Self-Report Scale (ASRS) Screener was used to obtain information on ADHD symptoms, while pain was assessed by the degree to which it interfered with work activity in the previous month. The Clinical Interview Schedule Revised (CIS-R) was used to evaluate six categories of CMDs. In a binary logistic regression analysis adjusted for socio-demographic factors and physical health conditions, an ADHD symptom score ≥14 was strongly associated with extreme pain (odds ratio [OR]: 3.15, 95% confidence interval [CI]: 2.09-4.74). The OR was attenuated greatly after further adjustment for CMDs (OR: 1.64, 95% CI: 1.05-2.58) but remained statistically significant. Adults with ADHD symptoms have higher odds for experiencing pain. CMDs are influential in this association but do not fully explain it.
Davis, Catherine C.; Claudius, Milena; Palinkas, Lawrence A.; Wong, John B.; Leslie, Laurel K.
Objective: To examine components of family-centered care in families' stories about treatment decision making for their child with ADHD. Method: Twenty-eight families participated in qualitative interviews that addressed families' perspectives on (a) the treatment decision-making process, (b) the cause and impact of their child's symptoms, and (c)…
It is known that developmental coordination problems in children with ADHD are very common. However, it is not clear whether different subtypes of coordination problems are associated with ADHD comorbidities, inattentiveness severity, and impulsivity/hyperactivity severity. A clinical sample of 122 children and adolescents with ADHD and their parents were interviewed. The parents completed the validated and reliable Farsi version of DCD-Q regarding their children. The internal reliability of the DCD-Q was high for the full scale and the subscales. The confirmatory factor analysis indicated that the fit for the hypothesized factor structure of the DCD-Q was poor. Linear regression analysis indicated that the scores of validated DCD-Q in children with ADHD, except for the fine motor/hand writing score, were not predicted by the variables of gender, handedness, age, inattentiveness score, hyperactivity/impulsivity score, and oppositional defiant behavior score. The fit for the hypothesized factor structure of the DCD-Q is poor in children with ADHD. Fine motor/hand writing was predicted by inattention severity. The other subtypes of developmental coordination problems in children with ADHD cannot be attributed to the variables of gender, inattentiveness severity, hyperactivity/impulsivity severity, comorbidity with separation anxiety symptoms and oppositional defiant behavior score, and handedness.
Lee, Soyoung I.; Schachar, Russell J.; Chen, Shirley X.; Ornstein, Tisha J.; Charach, Alice; Barr, Cathy; Ickowicz, Abel
Background: The goal of this study was to compare the predictive validity of the two main diagnostic schemata for childhood hyperactivity--attention-deficit hyperactivity disorder (ADHD; "Diagnostic and Statistical Manual"-IV) and hyperkinetic disorder (HKD; "International Classification of Diseases"-10th Edition). Methods: Diagnostic criteria for…
Sibley, Margaret H; Altszuler, Amy R; Morrow, Anne S; Merrill, Brittany M
This study possessed 2 aims: (a) to develop and validate a clinician-friendly measure of academic problem behavior that is relevant to the assessment of adolescents with attention deficit/hyperactivity disorder (ADHD) and (b) to better understand the cross-situational expression of academic problem behaviors displayed by these youth. Within a sample of 324 adolescents with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision diagnosed ADHD (age M = 13.07, SD = 1.47), parent, teacher, and adolescent self-report versions of the Adolescent Academic Problems Checklist (AAPC) were administered and compared. Item prevalence rates, factorial validity, interrater agreement, internal consistency, and concurrent validity were evaluated. Findings indicated the value of the parent and teacher AAPC as a psychometrically valid measure of academic problems in adolescents with ADHD. Parents and teachers offered unique perspectives on the academic functioning of adolescents with ADHD, indicating the complementary roles of these informants in the assessment process. According to parent and teacher reports, adolescents with ADHD displayed problematic academic behaviors in multiple daily tasks, with time management and planning deficits appearing most pervasive. Adolescents with ADHD display heterogeneous academic problems that warrant detailed assessment prior to treatment. As a result, the AAPC may be a useful tool for clinicians and school staff conducting targeted assessments with these youth.
Vaidyanathan, Sreelakshmi; Shah, Henal; Gayal, Tejas
Objectives Sleep disturbances in children with ADHD impact their functioning and overall Quality of Life. This paper’s purpose is to study the occurrence of sleep disturbances in children with ADHD, in comparison to their healthy siblings and further, within the ADHD group, to look for correlation between sleep disturbances and age, severity of symptoms, presentations of ADHD and illness parameters. Methods The parents of 120 children of age group between 5–16 years, (60 children diagnosed with ADHD as per DSM-5 criteria and 60 of their healthy siblings) consecutively enrolled from a hospital’s Child Psychiatry Outpatient services were interviewed using Child Sleep Habits Questionnaire (CSHQ) and severity of ADHD symptoms was rated using ADHD – RS. Results Sleep disturbances are more prevalent in pharmacologically treated children with ADHD than their healthy siblings, reduce with increasing age and are found more in the Predominantly Hyperactive/impulsive presentation of ADHD. Conclusion Sleep disturbances are more prevalent in pharmacologically treated ADHD, making it an important aspect of ADHD management. PMID:27924144
Martel, Michelle M; Roberts, Bethan; Gremillion, Monica; von Eye, Alexander; Nigg, Joel T
The current paper provides external validation of the bifactor model of ADHD by examining associations between ADHD latent factor/profile scores and external validation indices. 548 children (321 boys; 302 with ADHD), 6 to 18 years old, recruited from the community participated in a comprehensive diagnostic procedure. Mothers completed the Child Behavior Checklist, Early Adolescent Temperament Questionnaire, and California Q-Sort. Children completed the Stop and Trail-Making Task. Specific inattention was associated with depression/withdrawal, slower cognitive task performance, introversion, agreeableness, and high reactive control; specific hyperactivity-impulsivity was associated with rule-breaking/aggressive behavior, social problems, errors during set-shifting, extraversion, disagreeableness, and low reactive control. It is concluded that the bifactor model provides better explanation of heterogeneity within ADHD than DSM-IV ADHD symptom counts or subtypes.
Fatséas, Melina; Hurmic, Hortense; Serre, Fuschia; Debrabant, Romain; Daulouède, Jean-Pierre; Denis, Cécile; Auriacombe, Marc
Attention Deficit Hyperactivity Disorder (ADHD) is highly prevalent among adults with addictive disorders, but little is known about addiction patterns associated with ADHD diagnosis. This study examined addiction severity in patients with co-occurring addictive disorders and ADHD controlling for the potential influence of associated psychiatric comorbidity. Data were collected in French outpatient addiction treatment centers. A total of 217 patients seeking treatment for substance or gambling addiction were included. At treatment entry, participants were interviewed with the Addiction Severity Index, the Conners Adult ADHD Diagnosis Interview for the DSM-IV (CAADID), the Mini International Neuropsychiatric Interview (MINI) and the Structured Clinical Interview for DSM-IV Axis II for borderline personality disorder (SCID II). History of ADHD was associated with an earlier onset of addiction, poly-dependence (defined by presence of at least two current substance dependence diagnoses in addition to tobacco dependence if present) and borderline personality disorder. Persistence of ADHD during adulthood was associated with a higher prevalence of poly-dependence. This study highlights the need for early implementation of preventive interventions for substance use or behavioral addiction in children/adolescents with ADHD and the need to consider ADHD in the treatment of addictive disorders.
Barabasz, Arreed; Barabasz, Marianne
Presents details of Instant Alert Hypnosis procedure as an adjunct to neurotherapy in the treatment of attention deficit/hyperactivity disorder. Discusses AD/HD diagnostic issues, demographics, traditional treatments, neurological basis, EEG assessment, implications for the use of hypnosis, and the efficacy and promise of neurotherapy with and…
Gibbins, Christopher; Toplak, Maggie E.; Flora, David B.; Weiss, Margaret D.; Tannock, Rosemary
Objective: To examine factor structures of "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.) symptoms of ADHD in adults. Method: Two sets of models were tested: (a) models with inattention and hyperactivity/impulsivity as separate but correlated latent constructs and (b) hierarchical general factor models with a general factor for…
Tripp, Gail; Schaughency, Elizabeth A.; Langlands, Robyn; Mouat, Kelly
We used global ratings to compare the family (parent[s]-child) interactions of 51 clinic-referred children with ADHD and 32 non problem children. Children and parent(s) were videotaped while engaging in problem solving and game playing activities. Independent coders, blind to children's diagnostic status, rated the interactions using measures…
Conduct disorder (CD) is one of the most common psychiatric disorders in childhood and adolescence. It is characterized by a variety of chronic antisocial behaviors, a repetitive and persistent pattern of behavior that violates the basic rights of others, major age-appropriate societal norms, or both. Aggressive behavior, lying, stealing, fire-setting, and running away from home and school are the most frequent manifestations of CD and are often accompanied by hyperactivity, impulsive behavior, explosiveness, cognitive and learning problems, and poor social skills. The rate of comorbidity is high, with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) being the most common; comorbid anxiety and depressive disorders are also seen, especially in adolescents. The diagnostic process should include the use of structured interviews, and scores from reliable and valid rating scales that cover all psychiatric disorders must be considered in the differential diagnosis, because CD alone is an extreme rarity and multiple disorders are almost always the rule rather than exception. Treatment should include parenting skills training combined with training of the child to improve his or her relationships with peers, academic performance, and compliance with legitimate demands of authority figures. The appropriate use of medications and integration of patient/parent education and support, as well as individual, group, family, residential, and inpatient treatment may be beneficial for patients with CD and ADHD. The article describes a number of psychopharmacological agents that are used in patients with CD with ADHD and other comorbid disorders. Drugs that may be useful include psychostimulants; atomoxetine (Strattera); antidepressants (imipramine [Tofranil], desipramine [Norpramin]); Selective Serotonin Reuptake Inhibitors (SSRIs); atypical antipsychotics such as risperidone (Risperdal); or mood regulators including lithium (Eskalith).
... ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with ... similar to treatment for childhood ADHD, though some ADHD medications approved for children are not approved for adult use. Adult ADHD ...
Miller, Meghan; Hanford, Russell B.; Fassbender, Catherine; Duke, Marshall; Schweitzer, Julie B.
Objective: This study compared affect recognition abilities between adults with and without ADHD. Method: The sample consisted of 51 participants (34 men, 17 women) divided into 3 groups: ADHD-combined type (ADHD-C; n = 17), ADHD-predominantly inattentive type (ADHD-I; n = 16), and controls (n = 18). The mean age was 34 years. Affect recognition…
Chew, Brandi L.; Jensen, Scott A.; Rosen, Lee A.
Objective: The attitudes of college students with and without ADHD toward peers with ADHD were examined. Method: A total of 196 college students (30 diagnosed with ADHD) anonymously completed four attitude measures. General analyses of attitudes toward peers with ADHD as well as comparisons between those with and without ADHD are made. Results:…
This article is a socio-historical account of the development of the Attention Deficit/Hyperactivity Disorder (ADHD) diagnosis and methylphenidate treatment in America, attending particularly to the political and institutional contexts that have supported this development. Historical developments in early-mid-twentieth-century America frame a…
... with ADHD to take tests. Some teens may benefit from smaller class sizes and tutoring help. Use tools that help you stay organized. For example, keep track of assignments in a homework notebook, including a list of books and readings you'll need to bring home to do. ...
Banaschewski, Tobias; Ruppert, Sinje; Tannock, Rosemary; Albrecht, Bjorn; Becker, Andreas; Uebel, Henrik; Sergeant, Joseph A.; Rothenberger, Aribert
Attention-deficit/hyperactivity disorder (ADHD) is associated with unexplained impairments on speeded naming of coloured stimuli. These deficits may reflect hypofunctioning retinal dopaminergic mechanisms impairing particularly blue-yellow colour discrimination. Colour perception and rapid colour naming ability were investigated in 14 children…
Objective: Agomelatine is a relatively new antidepressant, with affinities to MT1 and MT2 (responsible for the circadian rhythm) as well as to 5-HT2C receptors. Since antidepressants have demonstrated some benefit in the treatment of ADH and because of the fact, that ADHD is often associated with sleep disorders, we assumed, that it might be a…
Wei, Christina; Suhr, Julie A
Prior research has shown that performance on cognitive tasks can be influenced by expectations (Smith & Sullivan, 2003 ; Suhr & Gunstad, 2002 , 2005 ). The current study examined whether cuing a belief about the diagnostic saliency of a cognitive task among young adults who expressed concern about having attention-deficit hyperactivity disorder (ADHD) influenced task performance. Participants were randomly assigned to either receive neutral directions or be cued to a belief that the task had diagnostic saliency prior to completing a working-memory task. Supporting our hypothesis, college students with higher prestudy report of ADHD symptoms who were cued with a belief about the diagnostic saliency of the task performed worse compared with students who received neutral instructions. As many researchers and clinicians currently rely exclusively on self-reported symptoms and neuropsychological tests to diagnose ADHD, our findings highlight the importance of comprehensive assessment for provision of appropriate clinical services to adults presenting with ADHD concerns.
Hegarty, Catherine E; Foland-Ross, Lara C; Narr, Katherine L; Sugar, Catherine A; McGough, James J; Thompson, Paul M; Altshuler, Lori L
Objectives Attention-deficit hyperactivity disorder (ADHD) is prevalent in patients with bipolar disorder (BP), but very few studies consider this when interpreting magnetic resonance imaging findings. No studies, to our knowledge, have screened for or controlled for the presence of ADHD when examining cortical thickness in patients with BP. We used a 2 × 2 design to evaluate the joint effects of BP and ADHD on cortical thickness and uncover the importance of ADHD comorbidity in BP subjects. Methods The study included 85 subjects: 31 healthy controls, 17 BP-only, 19 ADHD-only, and 18 BP/ADHD. All patients with BP were subtype I, were euthymic, and were not taking lithium. Groups did not differ significantly in age or sex distribution. We used cortical thickness measuring tools combined with cortical pattern matching methods to align sulcal/gyral anatomy across participants. Significance maps were used to check for both main effects of BP and ADHD and their interaction. Post-hoc comparisons assessed how the effects of BP on cortical thickness varied as a function of the presence or absence of ADHD. Results Interactions of BP and ADHD diagnoses were found in the left subgenual cingulate and right orbitofrontal cortex, demonstrating that the effect of BP on cortical thickness depends on ADHD status. Conclusions Some brain abnormalities attributed to BP may result from the presence of ADHD. Diagnostic interactions were found in regions previously implicated in the pathophysiology of BP, making it vital to control for an ADHD comorbid diagnosis when attempting to isolate neural or genetic abnormalities specific to BP. PMID:23167934
Polanczyk, Guilherme; Caspi, Avshalom; Houts, Renate; Kollins, Scott H.; Rohde, Luis Augusto; Moffitt, Terrie E.
Objective: To evaluate whether including children with onset of symptoms between ages 7 and 12 years in the ADHD diagnostic category would: (a) increase the prevalence of the disorder at age 12, and (b) change the clinical and cognitive features, impairment profile, and risk factors for ADHD compared with findings in the literature based on the…
Goerss, Jean; Amend, Edward R.; Webb, James T.; Webb, Nadia; Beljan, Paul
The Hartnett, Nelson, and Rinn 2004 study indicates that diagnostic confusion between ADD/ADHD and giftedness exists, and that research on medication practices is warranted. Mika disagrees, saying that there is no empirical evidence of misdiagnosis of gifted children as having ADD/ADHD. We disagree with Mika's logic, and describe evidence that…
Van Eck, Kathryn; Finney, Sara J.; Evans, Steven W.
The Disruptive Behavior Disorders (DBD) scale includes the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.) criteria for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct disorder. This study examined only the ADHD items of the DBD scale. This scale is frequently used for assessing parent-…
Mahone, E Mark; Cirino, Paul T; Cutting, Laurie E; Cerrone, Paula M; Hagelthorn, Kathleen M; Hiemenz, Jennifer R; Singer, Harvey S; Denckla, Martha B
The dynamic, multidimensional nature of executive function (EF), thought to be characteristically impaired in those with attention deficit hyperactivity disorder (ADHD), has been challenging to operationalize and assess in a clinical setting [Barkley, R. A. (1997). ADHD and the nature of self-control. New York: Guilford Press.]. Gioia, Isquith, Guy, and Kenworthy [Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000) Behavior Rating Inventory of Executive Function. Odessa, FL: Psychological Assessment Resources.] developed the Behavior Rating Inventory of Executive Function (BRIEF) to address these concerns. In order to provide concurrent validity information on the BRIEF, parents of 76 children (ADHD=18; Tourette syndrome (TS)=21; TS+ADHD=17; controls=20) completed the BRIEF, additional behavior rating scales and interviews, measures of psychoeducational (PE) competence, and performance-based measures of EF. Both ADHD and TS+ADHD groups were rated as more impaired (P<.0001) than the other groups on the five primary BRIEF indices. BRIEF index scores showed no significant correlation with performance-based EF or PE measures, with the exception of math achievement; however, the BRIEF showed a strong relationship with interviews and other parent rating measures of behaviors seen in ADHD. Future attempts to validate the BRIEF should focus on differences within subtypes of ADHD (e.g., inattentive, combined subtypes), and separating ADHD from other clinical groups in which EF is reported to be a problem.
Reich, Wendy; Huang, Hongyan; Todd, Richard D.
Objective: To determine treatment patterns for youth attention-deficit/hyperactivity disorder (ADHD) symptoms in a general population sample of 1,610 twins. Method: Twin pairs ages 7 to 17 years and parents ascertained from birth records in the state of Missouri were interviewed using the Missouri Assessment of Genetics Interview for Children…
Conrad, Peter; Bergey, Meredith R
Attention Deficit Hyperactivity Disorder (ADHD) has been medicalized in the United States since the 1960s. Primarily used in North America until the 1990s, ADHD diagnosis and treatment have increasingly been applied internationally. After documenting the expansion of ADHD in a global context, this paper presents five brief international examples examining ADHD usage and expansion: the United Kingdom, Germany, France, Italy and Brazil. We then identify and describe several vehicles that facilitate the migration of the ADHD diagnosis: the transnational pharmaceutical industry; the influence of western psychiatry; moving from ICD to DSM diagnostic criteria; the role of the Internet including the related advent of easily accessible online screening checklists; and advocacy groups. Finally, we discuss what this globalization of a diagnosis reflects about the potential global medicalization of other conditions.
... The Role of Medication Diagnosis Slideshow For Teachers Classroom Management Teacher Training on ADHD Tips for Teachers Video Series Classroom Accommodations Executive Functioning Social Skills Instructional Process Homework ...
Fried, Ronna; Chan, James; Feinberg, Leah; Pope, Amanda; Woodworth, K. Yvonne; Faraone, Stephen V.; Biederman, Joseph
Objective Both working memory (WM) (a brain system that provides temporary storage and manipulation of the information) and attention-deficit/hyperactivity disorder (ADHD) have been associated with educational deficits. Since WM deficits are prevalent in children with ADHD, the main aim of the present study was to examine whether educational deficits are driven by working memory deficits or driven by the effect of ADHD itself. Method Participants were referred youth with (N=276) and without (N=241) ADHD ascertained from pediatric and psychiatric sources. Assessment included measures of psychiatric, psychosocial, educational, and cognitive functioning. Education deficits were defined as grade retention or placement in special classes, and were assessed using interviews and written rating scales. Working memory was assessed using the WISC-R Freedom from Distractibility (FFD) factor based on digit span, arithmetic and coding. Results Significantly more youth with ADHD had WM deficits than controls (31.9% vs. 13.7%, p< 0.05). In ADHD children, WM deficits were significantly (p<0.01) associated with an increased risk for grade retention and placement in special classes as well as lower scores on reading and math achievement tests, relative to ADHD children without WM deficits. In contrast, no other differences were noted in other areas of functioning. Although WM deficits also had some adverse impact on educational and cognitive correlates in non ADHD controls, these differences failed to attain statistical significance. Conclusion WM deficits significantly and selectively increase the risk for academic deficits and cognitive dysfunction in children with ADHD beyond those conferred by ADHD. Screening for WM deficits may help identify children with ADHD at high risk for academic and cognitive dysfunction. PMID:26902180
Morsink, Sarah; Sonuga-Barke, Edmund; Mies, Gabry; Glorie, Nathalie; Lemiere, Jurgen; Van der Oord, Saskia; Danckaerts, Marina
Individuals with ADHD appear to respond differently to incentives than their peers. This could be due to a general altered sensitivity to reinforcers. However, apart from differences in the degree of motivation, individuals with ADHD might also be motivated by qualitatively different factors. This study aimed to harvest a range of motivational factors and identify ADHD-related qualitative differences in motivation, from the adolescent's point of view. Semi-structured interviews allowing participants to describe what motivates them in daily life were conducted with young adolescents (9-16 years) with and without ADHD. Thematic analysis was undertaken using NVivo software. Major themes relating to motivation were identified from the interview data. These were: (1) achieving a sense of togetherness; (2) feeling competent; (3) fulfilling a need for variation; (4) gaining pleasure from applying effort to achieve a goal; (5) valuing social reinforcement; (6) desiring to be absorbed/forget problems; (7) feeling free and independent, (8) attaining material reinforcement; and (9) an enjoyment of bodily stimulation. The theme structure was very similar for both groups. However, individuals with ADHD differed in some specifics: their focus on the passing of time, the absence of preference for predictable and familiar tasks, and their less elaborate description of the togetherness theme. A broad range of motivational themes was identified, stretching beyond the current focus of ADHD research and motivational theories. Similarities and differences in motivational values of individuals with and without ADHD should be taken into account in reward sensitivity research, and in psychological treatment.
Hermens, Daniel F; Rowe, Donald L; Gordon, Evian; Williams, Leanne M
Despite high rates of prescription, little is known about the long-term consequences of stimulant medication therapy for attention-deficit hyperactivity disorder (ADHD) sufferers. Historically, the clinical use of stimulants for ADHD has been based on trial and error before optimal therapy is reached. Concurrently, scientific research on the mechanism of action of stimulants has influenced neurobiological models of ADHD, but has not always informed their prescription. Whilst the two main stimulant types (methylphenidate and dexamphetamine) have numerous similarities, they also differ (slightly) in mechanism and possibly individual response. A further issue relates to differences in cost and availability compounded by the expectation for stimulants to be effective in ameliorating a broad spectrum of ADHD-related symptoms. Thus, there is an increasing need for treating clinicians to prescribe not only the most effective drug, but also the most appropriate dose with the associated release mechanism and schedule for each ADHD patient presented. In this regard, the field is witnessing an emergence of the personalized medicine approach to ADHD, in which treatment decisions are tailored to each individual. This shift requires a new approach to research into treatment response prediction. Given the heterogeneity of ADHD, a profile of information may be required to capture the most sensitive predictors of treatment response in individuals. These profiles will also benefit from the integration of data from clinical rating scales with more direct measures of cognition and brain function. In conclusion, there is a need to establish a more robust normative framework as the baseline for treatment, as well as diagnostic decisions, and as discussed, the growth of integrated neuroscience databases will be important in this regard.
Kirov, Roumen; Uebel, Henrik; Albrecht, Bjoern; Banaschewski, Tobias; Yordanova, Juliana; Rothenberger, Aribert
Sleep problems are a prominent feature in children with attention-deficit/hyperactivity disorder (ADHD) but their relationships to sleep structure are not consistent across studies. We aimed at further examining the sleep architecture in children with ADHD, while considering the role of the first-night effect (FNE) as a possible confounder. Twenty unmedicated children with ADHD combined type (8-15 years old; mean 11.24, SD 2.31) and 19 healthy controls, matched for age and gender, underwent polysomnography during an adaptation and a consecutive second night. ADHD and controls displayed a typical FNE without group differences. Independently of testing night, children with ADHD spent more time in sleep and had shortened rapid eye movement (REM) sleep latency and a greater amount of REM sleep relative to controls. However, the increased REM sleep amount in ADHD children was more expressed in the second night when it was also significantly related to scores of inattention and hyperactivity. Our results (1) document similar sleep adaptation processes in children with ADHD and typically developing children, (2) reveal that REM sleep changes in association with ADHD-specific psychopathology may characterize sleep in ADHD children, which is evident only when the FNE is accounted for, (3) indicate that ADHD psychopathology and adaptation night may exert opposite effects on REM sleep in children. These results may prompt the awareness of clinicians about the importance of actual sleep alterations and their precise evaluation in children with ADHD, which could significantly contribute to better diagnostic, treatment and early prevention strategies.
Theiling, J; Petermann, F; Daseking, M
This study has examined the relationship between cognitive functions and self-reported symptoms in ADHD adults. Cognitive functions were investigated with the Wechsler Adult Intelligence Scale-IV (WAIS-IV) in N=113 ADHD adults. The severity of self-reported symptoms was based on a screening questionnaire (ADHS-E). Results indicated only weak correlations between self-reported ADHD symptoms and WAIS-IV performance. The ADHS-E scale "Emotion & Affect" accounted for a small but significant variance on most WAIS-IV indices and turned out to be the most important variable to explain performance. The findings suggest that concurrent and discrepant information contribute to a differentiated examination on adult ADHD and that both objective performance diagnostics and self-reports complement each other within the diagnostic process.
Polanczyk, Guilherme V; Willcutt, Erik G; Salum, Giovanni A; Kieling, Christian; Rohde, Luis A
Background: Previous studies have identified significant variability in attention-deficit / hyperactivity disorder (ADHD) prevalence estimates worldwide, largely explained by methodological procedures. However, increasing rates of ADHD diagnosis and treatment throughout the past few decades have fuelled concerns about whether the true prevalence of the disorder has increased over time. Methods: We updated the two most comprehensive systematic reviews on ADHD prevalence available in the literature. Meta-regression analyses were conducted to test the effect of year of study in the context of both methodological variables that determined variability in ADHD prevalence (diagnostic criteria, impairment criterion and source of information), and the geographical location of studies. Results: We identified 154 original studies and included 135 in the multivariate analysis. Methodological procedures investigated were significantly associated with heterogeneity of studies. Geographical location and year of study were not associated with variability in ADHD prevalence estimates. Conclusions: Confirming previous findings, variability in ADHD prevalence estimates is mostly explained by methodological characteristics of the studies. In the past three decades, there has been no evidence to suggest an increase in the number of children in the community who meet criteria for ADHD when standardized diagnostic procedures are followed. PMID:24464188
Blahy, Tammy Lynn
No good time exists to face the realities of attention deficit and hyperactivity disorder (ADHD). Children across the United States and Canada are accompanied to clinics and schools by frightened, worried parents. In the book, In Understanding ADHD (2001), Ken and Andrea McCluskey bring to life the realities of the everyday journey of coping with…
Branscome, Jennifer; Cunningham, Teddi; Kelley, Heather; Brown, Caitlyn
The focus of this article is to provide an overview of the current state of knowledge of ADHD and to provide evidence-based training interventions for school counselors. An overview of basic information about ADHD will be provided, including diagnosis, presentation, causes, prevalence, and common misconceptions. Evidence-based training…
Sciberras, Emma; Efron, Daryl; Iser, Alina
Objective: This study aimed to investigate the agreement between parent- and child-reported quality of life (QoL) and the self-perceptions of children with ADHD. Method: A cross-sectional survey of school-aged children with ADHD and their parents was undertaken. Results: Parents reported their child's QoL as lower than the children rated…
Norvilitis, Jill M., Ed.
With many children and adults affected by Attention Deficit Hyperactivity Disorder, researchers strive to understand the underpinnings of ADHD and associated factors on both a basic and applied level. The goal of this volume is to explore some of the broad array of research in the field of ADHD. The 12 chapters cover a variety of topics as varied…
ADHD is a neurobiological-based brain disorder, most often hereditary, affecting nearly one in twenty students. The ADHD brain functions differently because the area between the frontal lobe and rear lobe is having short-circuit problems and is not transmitting necessary information. The technical part of the disorder does not engage us as…
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…
Gehrmann, J; Brandl, A
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria, attention deficit hyperactivity disorder (ADHD) affects around 5% of all children and adolescents worldwide. The causes of ADHD are multifactorial, with a large genetic influence but also involvement of exogenic and psychosocial factors. Its core symptoms consist of attention deficits, hyperactivity and disruption of impulse control. It is important that symptoms appear before the age of six and are evident in multiple different situations, such as in familial and school environments. ADHD is a dimensional disorder, which means that the diagnostic process is time consuming, comprising a physical and neurological examination, behavioral observations and differentiated psychological assessments. In the field of otolaryngology, ADHD represents one of the important differential diagnoses to an auditory processing disorder (APD), alongside reading- and writing impairments and delayed speech development. In the instance of additional behavioral problems or more severe symptoms, it is advisable to transfer the patient to a specialized pediatrician or child and adolescent psychiatrist for appropriate counseling and treatment where required.
Brock, Stephen E.; Clinton, Amanda
This article examines recent literature related to the diagnosis of Attention-deficit/Hyperactivity Disorder (AD/HD) in childhood. First, the article discusses diagnostic criteria presented in the "Diagnostic and Statistical Manual of Mental Disorders" (American Psychiatric Association, 2000). Next, it explores the diagnostic procedures for AD/HD…
Bunte, Tessa L; Laschen, Sarah; Schoemaker, Kim; Hessen, David J; van der Heijden, Peter G M; Matthys, Walter
The aim of the present study was to investigate the clinical usefulness of an observational tool--the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS)--in the diagnosis of disruptive behavior disorders (DBD) and attention deficit/hyperactivity disorder (ADHD) in preschoolers. We hypothesized that the DB-DOS may help support the presumption of a diagnosis generated by the information from parents and teachers (or other caregivers). Participants were referred preschool children with externalizing behavioral problems (N = 193; 83% male) and typically developing children (N = 58; 71% male). In view of the clinical validity study each child was given a diagnosis of either DBD (N = 40), or ADHD (N = 54) or comorbid (DBD + ADHD; N = 66) based on best-estimate diagnosis. The DB-DOS demonstrated good interrater and test-retest reliability for DBD and ADHD symptom scores. Confirmatory factor analysis demonstrated an excellent fit of the DB-DOS multidomain model of DBD symptom scores and a satisfactory fit of ADHD symptom scores. The DB-DOS demonstrated good convergent validity, moderate divergent validity, and good clinical validity on a diagnostic group level for DBD and ADHD symptom scores. The Receiver Operating Characteristic curve analyses revealed that for DBD the sensitivity and specificity are moderate and for ADHD good to excellent. The presumption of a diagnosis based on information from parents, teachers, and cognitive assessment was supported by the DB-DOS in 60% for DBD and 75% for ADHD. The DB-DOS can be used to help support a presumption of a DBD and/or ADHD diagnosis in preschool children.
Reimherr, Fred W; Marchant, Barrie K; Gift, Thomas E; Steans, Tammy A; Wender, Paul H
Much recent research describes the importance of emotional symptoms in ADHD. While there is no accepted system for including emotionality in diagnosing ADHD, the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS) provides a tool to facilitate this. It assesses a range of adult ADHD symptoms which load on two factors: inattentive and emotional dysregulation. The consistently high inattentive factor was used to define significant elevation on the more variable emotional dysregulation factor (which contains four WRAADDS domains: hyperactivity/restlessness, temper, affective lability, and emotional over-reactivity) allowing the definition of two ADHD diagnostic types. We compared these two types on a broad range of adult subject characteristics, including response to methylphenidate (MPH) treatment assessed during two clinical trials. Marked impairment in three of the four emotional domains reflected a symptom severity level equivalent to that of the inattentive factor. 59 % met this threshold, defining them as ADHD emotion dysregulation presentation, as opposed to 41 % with ADHD inattentive presentation. Cluster analysis validated these groups by generating similar clusters with 85 % agreement regarding membership. ADHD emotional dysregulation presentation subjects showed more childhood ADHD symptoms, adult symptoms of oppositional defiant disorder, and evidence of personality disorder. Both types showed similar improvement during the double-blind MPH arm of the trials and during a 6-month open-label phase. Based on the presence of symptoms of emotional dysregulation, ADHD in adults can be conceptualized as two types. Impairment and comorbidity in adults with ADHD are largely concentrated in ADHD emotional dysregulation presentation patients.
Roman-Urrestarazu, Andres; Lindholm, Päivi; Moilanen, Irma; Kiviniemi, Vesa; Miettunen, Jouko; Jääskeläinen, Erika; Mäki, Pirjo; Hurtig, Tuula; Ebeling, Hanna; Barnett, Jennifer H; Nikkinen, Juha; Suckling, John; Jones, Peter B; Veijola, Juha; Murray, Graham K
When adolescents with ADHD enter adulthood, some no longer meet disorder diagnostic criteria but it is unknown if biological and cognitive abnorma lities persist. We tested the hypothesis that people diagnosed with ADHD during adolescence present residual brain abnormalities both in brain structure and in working memory brain function. 83 young adults (aged 20-24 years) from the Northern Finland 1986 Birth Cohort were classified as diagnosed with ADHD in adolescence (adolescence ADHD, n = 49) or a control group (n = 34). Only one patient had received medication for ADHD. T1-weighted brain scans were acquired and processed in a voxel-based analysis using permutation-based statistics. A sub-sample of both groups (ADHD, n = 21; controls n = 23) also performed a Sternberg working memory task whilst acquiring fMRI data. Areas of structural difference were used as a region of interest to evaluate the implications that structural abnormalities found in the ADHD group might have on working memory function. There was lower grey matter volume bilaterally in adolescence ADHD participants in the caudate (p < 0.05 FWE corrected across the whole brain) at age 20-24. Working memory was poorer in adolescence ADHD participants, with associated failure to show normal load-dependent caudate activation. Young adults diagnosed with ADHD in adolescence have structural and functional deficits in the caudate associated with abnormal working memory function. These findings are not secondary to stimulant treatment, and emphasise the importance of taking a wider perspective on ADHD outcomes than simply whether or not a particular patient meets diagnostic criteria at any given point in time.
Morley, Christopher P
The regional study by Baumgardner and colleagues converges with existing literature to clearly show that the distribution of ADHD diagnosis falls along socioeconomic lines, according to the relative wealth of neighborhoods. This adds additional evidence that trends in the diagnosis and treatment for ADHD in children move in the exact opposite direction from those who are at highest risk for meeting criteria, for experiencing impairment, for and downstream socioeconomic sequelae. Contributing factors, such as marginal diagnoses (such as when parent and teacher symptom reports diverge), inadequate insurance coverage, limited time, and lack of familiarity and comfort with diagnostic and prescribing guidelines, may leave the door open to misdiagnosis and treatment. In some cases, this may take the form of over-diagnosis and over-treatment, in the form of false-positive diagnoses with ADHD, and treatments for it, or may alternatively take the form of false-negative diagnoses. If the social and epidemiological data are any indication, it is furthermore likely that such false-positive or false-negative outcomes may break along socioeconomic lines. Increased use of formal screening tools, increased curricular time for mental health in primary care residencies, support for physicians in the field in the form of referral options and remote consultation and support, may all serve to improve quality of care for individual patients, and may also serve to regularize treatment across socioeconomic and sociodemographic lines, hence reducing disparities. Further research is needed to study the root causes and dynamics that create such disparities, but the steps outlined above may help in the near term.
Cubero-Millán, Isabel; Molina-Carballo, Antonio; Machado-Casas, Irene; Fernández-López, Luisa; Martínez-Serrano, Sylvia; Tortosa-Pinto, Pilar; Ruiz-López, Aida; Luna-del-Castillo, Juan-de-Dios; Uberos, José; Muñoz-Hoyos, Antonio
The vast majority of Attention-deficit/hyperactivity disorder (ADHD) patients have other associated pathologies, with depressive symptoms as one of the most prevalent. Among the mediators that may participate in ADHD, melatonin is thought to regulate circadian rhythms, neurological function and stress response. To determine (1) the serum baseline daily variations and nocturnal excretion of melatonin in ADHD subtypes and (2) the effect of chronic administration of methylphenidate, as well as the effects on symptomatology, 136 children with ADHD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: DSM-IV-TR criteria) were divided into subgroups using the “Children’s Depression Inventory” (CDI). Blood samples were drawn at 20:00 and 09:00 h, and urine was collected between 21:00 and 09:00 h, at inclusion and after 4.61 ± 2.29 months of treatment. Melatonin and its urine metabolite were measured by radioimmunoassay RIA. Factorial analysis was performed using STATA 12.0. Melatonin was higher predominantly in hyperactive-impulsive/conduct disordered children (PHI/CD) of the ADHD subtype, without the influence of comorbid depressive symptoms. Methylphenidate ameliorated this comorbidity without induction of any changes in the serum melatonin profile, but treatment with it was associated with a decrease in 6-s-melatonin excretion in both ADHD subtypes. Conclusions: In untreated children, partial homeostatic restoration of disrupted neuroendocrine equilibrium most likely led to an increased serum melatonin in PHI/CD children. A differential cerebral melatonin metabolization after methylphenidate may underlie some of the clinical benefit. PMID:25257531
Ramos, Rosa; Freire, Carmen; Julvez, Jordi; Fernández, Mariana F; García-Esteban, Raquel; Torrent, Maties; Sunyer, Jordi; Olea, Nicolás
We aimed to investigate the association of attention-deficit hyperactivity disorder (ADHD) symptoms and social competence outcomes with cognitive status in preschool children. The study population was drawn from three birth cohorts belonging to the Spanish INMA (Infancia y Medio Ambiente) project: Menorca (n = 289), Ribera d'Ebre (n = 60), and Granada (n = 108). Children were assessed at the age of 4 years for cognitive functions (McCarthy Scales of Children's Abilities, MSCA) by psychologists and for inattention and hyperactivity symptoms (ADHD Criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, ADHD-DSM-IV) and social competence (California Preschool Social Competence Scale) by their teachers. Multiple regression analyses were conducted to examine potential associations between behavioral outcomes (ADHD symptoms and social competence) and MSCA cognitive outcomes, adjusting for confounders. The presence of general ADHD symptoms (inattention, hyperactivity, or both) and poorer social competence both showed negative associations with cognitive outcomes. When we compared children according to ADHD subtypes, those with inattention symptoms alone and those with both inattention and hyperactivity symptoms showed significantly lower cognitive function scores in comparison to children with no ADHD symptoms. Behavioral dysfunctions in preschoolers may be associated with impairment of cognitive functions.
Rothenberger, Lillian Geza
Immense resource allocations have led to great data output in genetic research. Concerning ADHD resources spent on genetic research are less than those spent on clinical research. But there are successful efforts made to increase support for molecular genetics research in ADHD. Concerning genetics no evidence based conclusive results have significant impact on prevention, diagnosis or treatment yet. With regard to ethical aspects like the patients' benefit and limited resources the question arises if it is indicated to think about a new balance of resource allocation between molecular genetics and non-genetics research in ADHD. An ethical reflection was performed focusing on recent genetic studies and reviews based on a selective literature search. There are plausible reasons why genetic research results in ADHD are somehow disappointing for clinical practice so far. Researchers try to overcome these gaps systematically, without knowing what the potential future benefits for the patients might be. Non-genetic diagnostic/therapeutic research may lead to clinically relevant findings within a shorter period of time. On the other hand, non-genetic research in ADHD may be nurtured by genetic approaches. But, with the latter there exist significant risks of harm like stigmatization and concerns regarding data protection. Isolated speeding up resources of genetic research in ADHD seems questionable from an ethical point of view. There is a need to find a new balance of resource allocation between genetic and non-genetic research in ADHD, probably by integrating genetics more systematically into clinical research. A transdisciplinary debate is recommended.
Background Young adolescents’ and their parents’ experiences with Attention-Deficit/Hyperactivity Disorder (ADHD) and its treatment were explored to investigate beliefs and attitudes regarding use of stimulant medication, and their influence on treatment decisions. Methods Using in-depth qualitative interviews, 12 adolescents with ADHD aged 12 – 15 years, and their parents described their experiences of ADHD and its treatment. Twenty four interviews, 12 with adolescents and 12 with their parents elicited detailed descriptions of beliefs about ADHD, attitudes about stimulant use and the circumstances surrounding treatment decisions. Verbatim transcripts were iteratively analyzed by a team of researchers following an interpretive interactionist framework. Results Young people offered three themes describing ADHD: 1) personality trait, 2) physical condition or disorder, and 3) minor issue or concern. Regarding medication use, youth described 1) benefits, 2) changes in sense of self, 3) adverse effects, and 4) desire to discontinue use. Parents’ beliefs were more homogeneous than youth beliefs, describing ADHD as a disorder requiring treatment. Most parents noted benefits from stimulant use. Themes were 1) medication as a last resort, 2) allowing the child to reach his or her potential; and 3) concerns about adverse and long-term effects. Families described how responsibility for treatment decisions is transferred from parent to adolescent over time. Conclusions Young adolescents can have different beliefs about ADHD and attitudes about medication use from their parents. These beliefs and attitudes influence treatment adherence. Incorporating input from young adolescents when making clinical decisions could potentially improve continuity of treatment for youth with ADHD. PMID:24725829
Gawrilow, Caterina; Merkt, Julia; Goossens-Merkt, Heinrich; Bodenburg, Sebastian; Wendt, Mike
Adults with ADHD have problems in everyday multitasking situations presumably because of deficits in executive functions. The present study aims to find out (a) whether adults with ADHD show deficient multitasking performance in a standardized task, (b) how they perceive the multitasking situation, and (c) which task structure might be beneficial for them as compared with adults without ADHD. Therefore, we experimentally compared task performance, mood, and motivation in a group of 45 men with ADHD (M-age = 34.47, SD = 9.95) with a comparison group of 42 men without ADHD (M-age = 31.12, SD = 10.59) in three conditions: (a) a multitasking paradigm, (b) an interleaving condition in which tasks had to be performed without planning or monitoring, and (c) a non-interleaving condition. Our results showed no impaired multitasking performance in adults with ADHD. However, they showed better mood and more motivation in the non-interleaving condition.
Bishop, Somer L.; Huerta, Marisela; Gotham, Katherine; Havdahl, Karoline Alexandra; Pickles, Andrew; Duncan, Amie; Bal, Vanessa Hus; Croen, Lisa; Lord, Catherine
Lay Abstract Recent advances in multiple areas of autism research, including genetics and epidemiology, have increased the need for large numbers of participants with autism spectrum disorders (ASD). The Autism Symptom Interview (ASI) is a brief phone interview that was designed to facilitate rapid ascertainment of children with ASD for research studies. The ASI is based on questions from the Autism Diagnostic Interview-Revised (ADI-R), a comprehensive, semi-structured parent interview, but the ASI is designed to be administered in approximately 20 minutes by interviewers with minimal training. This study reports on the initial validation of the ASI, School-Age, for children ages 5 to 12 years. Children with previous diagnoses or suspicion of ASD or another neurodevelopmental disorder participated in a comprehensive diagnostic assessment as part of the study and were classified as ASD or non-ASD following the assessment. The ASI scores of children with and without ASD were then compared. For verbal children (defined as using phrases or better on a daily basis), the ASI showed reasonable accuracy in identifying children with ASD (sensitivity=.87), but specificity was low (.62). However, when ASI scores were considered together with scores from the Autism Diagnostic Observation Schedule (ADOS), sensitivity was maintained at .82, and specificity improved to .92. These findings suggest that the ASI school age may serve as a useful tool to more quickly classify children with ASD for research purposes. Scientific Abstract This study reports on the initial validation of the Autism Symptom Interview (ASI), School-Age, a brief (15–20 minute) phone interview derived from questions from the Autism Diagnostic Interview-Revised (ADI-R). The ASI, School-Age was administered by interviewers with minimal training to parents of children ages 5 to 12 who had all been previously identified with (or referred for assessment of) ASD or another neurodevelopmental disorder. Children
Passarotti, Alessandra M.; Trivedi, Nidhi; Dominguez-Colman, Liza; Patel, Manharkumar; Langenecker, Scott A.
Background Recent research evidence suggests that executive function (EF) is impaired in both pediatric bipolar disorder (PBD) and attention deficit-hyperactivity disorder (ADHD), although the underlying cognitive mechanisms are still unclear. In this study we examined EF, including cognitive and emotional control, in three pediatric groups with overlapping symptoms. Methods Sixteen children and adolescents with PBD, 17 children and adolescents with ADHD, Type Combined, and 13 children and adolescents with PBD and comorbid ADHD (PBD+ADHD) (mean age=12.70, SD=2.21) were assessed using the Behavioral Rating Inventory of Executive Function – Parental Report (BRIEF-PR), clinical scales and neuropsychological tests of attention, working memory and executive function. Results All groups showed impairment on the Trails A and B tests. However, there were no significant group differences. On the BRIEF-PR while all three groups were impaired in General Executive Functioning and Metacognition only the two PBD groups revealed more extensive EF dysfunction, in both cognitive and emotional control domains, relative to the ADHD group. Conversely, the ADHD group exhibited selective deficits in cognitive domains such as working memory, planning/organization, monitoring, and metacognition. The two PBD groups showed greater impairment than the ADHD group in the domains of Inhibition, Shifting, Monitoring and Emotional Control. Furthermore, results from regression analyses suggest cognitive predictors of EF impairment in ADHD and mood predictors for inhibition in PBD. Conclusions The current results contribute new knowledge on domain-specific similarities and differences in executive dysfunction between PBD, ADHD, and the comorbid phenotype, which may inform the diagnostic process and cognitive intervention. PMID:27924149
Harvey, Elizabeth A; Breaux, Rosanna P; Lugo-Candelas, Claudia I
Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are among the most common childhood disorders and frequently co-occur. The present study sought to advance our understanding of how comorbidity between ADHD and ODD develops during the preschool years by testing a cross-lagged model that integrates 2 prominent models: the developmental precursor model and the correlated risk factors model. Participants were 199 children (107 boys) who took part in a longitudinal study of preschoolers with behavior problems. Parent reports of ADHD and ODD symptoms were collected annually from ages 3 to 6 and a family history interview was administered at age 3. In support of the developmental precursors model, ADHD symptoms predicted later argumentative/defiant symptoms. In support of the correlated risk factors model, family histories of ADHD and ODD/CD symptoms were correlated risk factors that uniquely predicted ADHD and anger/irritable symptoms in children. Results suggest that the correlated risk factors model may best explain the development of comorbidity between symptoms of ADHD and anger/irritability, whereas the developmental precursors model may better explain the development of comorbidity between symptoms of ADHD and argumentative/defiance.
Gadow, Kenneth D.; DeVincent, Carla J.; Schneider, Jayne
Objective: Identification of differences among children with ADHD only, autism spectrum disorder (ASD)+ADHD, and chronic multiple tic disorder (CMTD)+ADHD may lead to better understanding of clinical phenotypes. Method: Children were evaluated using the parent- and teacher-completed questionnaires. Results: All three groups were highly similar in…
... this? Submit What's this? Submit Button NCHS Home Attention Deficit Hyperactivity Disorder (ADHD)* Recommend on Facebook Tweet Share Compartir Data ... attention deficit disorder (ADD)" is used rather than "attention deficit hyperactivity disorder (ADHD)" in some data sources. More data Association ...
Martel, Michelle; Nikolas, Molly; Nigg, Joel T.
A study is conducted to determine the specificity of executive function weakness in attention-deficit/hyperactivity disorder (ADHD) during adolescence. Results suggest that executive function weakness in ADHD is specifically associated with symptoms of inattention-disorganization.
Bitter, István; Simon, Viktoria; Bálint, Sára; Mészáros, Agnes; Czobor, Pál
The goal of the study was twofold: (1) to investigate the effect of different diagnostic criteria on prevalence estimates of adult attention deficit hyperactivity disorder (ADHD), and (2) to provide prevalence estimates of adult ADHD for the first time in a Hungarian sample. Subjects between 18 and 60 years were included in the screening phase of the study (N = 3,529), conducted in 17 GP practices in Budapest. Adult self-report scale 6-item version was used for screening. Out of 279 positively screened subjects 161 subjects participated in a clinical interview and filled out a self-report questionnaire to confirm the diagnosis. Beside DSM-IV diagnostic criteria, we applied four alternative diagnostic criteria: 'No-onset' (DSM-IV criteria without the specific requirement for onset); full/Sx (DSM-IV "symptoms only" criteria); and reduced/Sx (DSM-IV "symptoms only" criteria with a reduced threshold for symptom count). Crude prevalence estimates adjusted for the specificity and sensitivity data of the screener were 1.35% in the 'DSM-IV' group, 1.64% in the 'No-onset' group, 3.65% in the 'Sx/full' group and 4.16% in the 'Sx/reduced' group. Logistic regression analysis showed that ADHD was significantly more prevalent with younger age and male gender [chi(2) = 14.46; P = 0.0007]. Prevalence estimates corrected for the 'not-interviewed' subsample and adjusted for specificity and sensitivity data of the screener was 2.3% in males, 0.91% in females; 2.02% in the < or =40 years age group and 0.70% in the >40 years age group, based on DSM-IV diagnostic criteria. Prevalence rates found in this study are somewhat lower, but still are in line with those reported in the literature.
Mörstedt, Beatrice; Corbisiero, Salvatore; Bitto, Hannes; Stieglitz, Rolf-Dieter
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
Mörstedt, Beatrice; Corbisiero, Salvatore; Bitto, Hannes; Stieglitz, Rolf-Dieter
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.
Mahone, E. Mark; Wodka, Ericka L.
Since boys are more commonly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) than girls, the majority of theories and published research studies of ADHD have been based on samples comprised primarily (or exclusively) of boys. While psychosocial impairment in girls with ADHD is well established, the neuropsychological and…
Reynolds, Cecil R.; Vannest, Kimberly J.; Harrison, Judith R.
ADHD affects millions of people-some 3 to 5% of the general population. Written by a neuroscientist who has studied ADHD, a clinician who has diagnosed and treated it for 30 years, and a special educator who sees it daily, "The Energetic Brain" provides the latest information from neuroscience on how the ADHD brain works and shows how to harness…
This policy brief discusses students with attention deficit hyperactivity disorder (ADHD) and their school performance. Reasons are presented to explain why children with ADHD fail. The three main characteristics of ADHD (inattention, impulsivity, and hyperactivity) and their interference with academic performance are discussed. The brief…
Mayes, Susan Dickerson; Calhoun, Susan L.; Mayes, Rebecca D.; Molitoris, Sarah
Children with ADHD and autism have some similar features, complicating a differential diagnosis. The purpose of our study was to determine the degree to which core ADHD and autistic symptoms overlap in and discriminate between children 2-16 years of age with autism and ADHD. Our study demonstrated that 847 children with autism were easily…
Firmin, Michael W.; Phillips, Annie
This phenomenological research study replicates R. Segal's (1998) study of 17 Canadian families. The authors interview 17 American families participating in the national support group Children and Adults with Attention Deficit Disorder, focusing on the challenges they face in rearing children diagnosed with ADHD. Three particular themes emerge.…
DeSantis, Alan; Noar, Seth M.; Webb, Elizabeth M.
Qualitative methods were used to investigate the use of nonmedical Attention Deficit Hyperactivity Disorder (ADHD) stimulants by fraternity members. The primary goal of the study was to determine students' levels of understanding and motivations for use of these Schedule II controlled substances. Seventy-nine in-depth interviews were conducted.…
Ghanizadeh, Ahmad; Mohammadi, Mohammad Reza; Moini, Rozita
Objective: To study the psychiatric comorbidity of a clinical sample of children with ADHD and the psychiatric disorders in their parents. Method: Structured psychiatric interviews assessing lifetime psychiatric disorders by "DSM-IV" criteria, using the Farsi version of the Schedule for Affective Disorders and Schizophrenia. Results: The…
Adler, Lenard A; Faraone, Stephen V; Spencer, Thomas J; Berglund, Patricia; Alperin, Samuel; Kessler, Ronald C
Although DSM-5 stipulates that symptoms of attention-deficit hyperactivity disorder (ADHD) are the same for adults as children, clinical observations suggest that adults have more diverse deficits than children in higher-level executive functioning and emotional control. Previous psychometric analyses to evaluate these observations have been limited in ways addressed in the current study, which analyzes the structure of an expanded set of adult ADHD symptoms in three pooled US samples: a national household sample, a sample of health plan members, and a sample of adults referred for evaluation at an adult ADHD clinic. Exploratory factor analysis found four factors representing executive dysfunction/inattention (including, but not limited to, all the DSM-5 inattentive symptoms, with non-DSM symptoms having factor loadings comparable to those of DSM symptoms), hyperactivity, impulsivity, and emotional dyscontrol. Empirically-derived multivariate symptom profiles were broadly consistent with the DSM-5 inattentive-only, hyperactive/impulsive-only, and combined presentations, but with inattention including executive dysfunction/inattention and hyperactivity-only limited to hyperactivity without high symptoms of impulsivity. These results show that executive dysfunction is as central as DSM-5 symptoms to adult ADHD, while emotional dyscontrol is more distinct but nonetheless part of the combined presentation of adult ADHD.
Abikoff, Howard B.; Thompson, Margaret; Laver-Bradbury, Cathy; Long, Nicholas; Forehand, Rex L.; Brotman, Laurie Miller; Klein, Rachel G.; Reiss, Philip; Huo, Lan; Sonuga-Barke, Edmund
Background The ‘New Forest Parenting Package’ (NFPP), an 8-week home-based intervention for parents of preschoolers with ADHD, fosters constructive parenting to target ADHD-related dysfunctions in attention and impulse control.Although NFPP has improved parent and laboratory measures of ADHD in community samples of children with ADHD-like problems, its efficacy in a clinical sample, and relative to an active treatment comparator, is unknown. The aims are to evaluate the short and long-term efficacy and generalization effects of NFPP compared to an established clinic-based parenting intervention for treating noncompliant behavior (‘Helping the Noncompliant Child’ [HNC]) in young children with ADHD. Methods A randomized controlled trial with three parallel arms was the design for this study. 164 3-4-year-olds, 73.8% male, meeting DSM-IV ADHD diagnostic criteria were randomized to NFPP (N = 67), HNC (N = 63), or wait-list control (WL, N = 34). All participants were assessed at post-treatment. NFPP and HNC participants were assessed at follow-up in the next school year. Primary outcomes were ADHD ratings by teachers blind to and uninvolved in treatment, and by parents. Secondary ADHD outcomes included clinician assessments, and laboratory measures of on-task behavior and delay of gratification. Other outcomes included parent and teacher ratings of oppositional behavior, and parenting measures. (Trial name: Home-Based Parent Training in ADHD Preschoolers; Registry: ClinicalTrials.gov Identifier: NCT01320098; URL: http://www/clinicaltrials.gov/ct2/show/NCT01320098). Results In both treatment groups, children's ADHD and ODD behaviors, as well as aspects of parenting, were rated improved by parents at the end of treatment compared to controls. Most of these gains in the children's behavior and in some parenting practices were sustained at follow-up. However, these parent-reported improvements were not corroborated by teacher ratings or objective observations. NFPP
Kelly, Clare; Castellanos, F Xavier; Tomaselli, Olivia; Lisdahl, Krista; Tamm, Leanne; Jernigan, Terry; Newman, Erik; Epstein, Jeffery N; Molina, Brooke S G; Greenhill, Laurence L; Potkin, Steven G; Hinshaw, Stephen; Swanson, James M
One of the most salient long-term implications of a childhood diagnosis of ADHD is an increased risk for substance use, abuse, or dependence in adolescence and adulthood. The extent to which cannabis use affects ADHD-related alterations in brain functional organization is unknown, however. To address this research gap, we recruited a sample of 75 individuals aged 21-25 years with and without a childhood diagnosis of ADHD Combined Type, who were either frequent users or non-users of cannabis. These participants have been followed longitudinally since age 7-9.9 years as part of a large multi-site longitudinal study of ADHD, the Multimodal Treatment Study of Children with ADHD (MTA). We examined task-independent intrinsic functional connectivity (iFC) within 9 functional networks using a 2 × 2 design, which compared four groups of participants: (1) individuals with a childhood diagnosis of ADHD who currently use cannabis (n = 23); (2) individuals with ADHD who do not currently use cannabis (n = 22); (3) comparisons who currently use cannabis (n = 15); and (4) comparisons who do not currently use cannabis (n = 15). The main effects of childhood ADHD were primarily weakened iFC in networks supporting executive function and somatomotor control. Contrary to expectations, effects of cannabis use were distinct from those of diagnostic group and no interactions were observed. Exploratory brain-behavior analyses suggested that ADHD-related effects were primarily linked with poorer neurocognitive performance. Deficits in the integrity of functional networks supporting executive function and somatomotor control are consistent with the phenotypic and neurocognitive features of ADHD. Our data suggest that cannabis use does not exacerbate ADHD-related alterations, but this finding awaits replication in a larger sample. Longitudinal neuroimaging studies are urgently required to delineate the neurodevelopmental cascade that culminates in positive and negative outcomes
Williamson, Kimberly D; Combs, Hannah L; Berry, David T R; Harp, Jordan P; Mason, Lisa H; Edmundson, Maryanne
Since the early 2000s concern has increased that college students might feign ADHD in pursuit of academic accommodations and stimulant medication. In response, several studies have validated tests for use in differentiating feigned from genuine ADHD. Although results have generally been positive, relatively few publications have addressed the possible impact of the presence of psychological disorders comorbid with ADHD. Because ADHD is thought to have accompanying conditions at rates of 50% and higher, it is important to determine if the additional psychological disorders might compromise the accuracy of feigning detection measures. The present study extended the findings of Jasinski et al. (2011) to examine the efficacy of various measures in the context of feigned versus genuine ADHD with comorbid psychological disorders in undergraduate students. Two clinical groups (ADHD only and ADHD + comorbid psychological disorder) were contrasted with two non-clinical groups (normal controls answering honestly and normal participants feigning ADHD). Extending previous research to individuals with ADHD and either an anxiety or learning disorder, performance validity tests such as the Test of Memory Malingering (TOMM), the Letter Memory Test (LMT), and the Nonverbal Medical Symptom Validity Test (NV-MSVT) were effective in differentiating both ADHD groups from normal participants feigning ADHD. However, the Digit Memory Test (DMT) underperformed in this study, as did embedded validity indices from the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and Woodcock Johnson Tests of Achievement-III (WJ-III).
Stein, Mark A; Snyder, Steven M; Rugino, Thomas A; Hornig, Mady
Neuropsychiatric EEG-Based ADHD Assessment Aid (NEBA) is an EEG-based device designed to aid in the diagnostic process for ADHD by identifying individuals less likely to have ADHD by virtue of a lower theta/beta ratio. In using NEBA as an example, the Arns et al. commentary misstates the purpose of NEBA, which is to widen the differential rather than to make the diagnosis. Arns et al. caution about missing an ADHD diagnosis, but fail to mention the impact of overdiagnosis. If we are to advance our knowledge of the etiology and pathophysiology of ADHD, as well as develop tailored treatments and ultimately improve outcomes for ADHD, then biomarkers and objective assessment aids such as NEBA are needed to improve and refine diagnostic accuracy beyond symptom description and clinical history.
Biederman, J; Monuteaux, M; Kendrick, E; Klein, K; Faraone, S
Aims: To examine the informativeness of the Child Behavior Checklist (CBCL) as a screening tool to identify comorbid and non-comorbid cases of attention deficit hyperactivity disorder (ADHD) in a paediatrically referred population. It was hypothesised that specific scales of the CBCL would help identify specific comorbidities within ADHD cases in the primary care setting. Methods: The sample consisted of children and adolescents 6–17 years old of both genders with ADHD (n = 121). A receiver operating curve (ROC) approach was used to determine which CBCL scales best differentiated between ADHD cases with and without its comorbidities with conduct, anxiety, and mood disorders. Results: ROC analysis showed that the CBCL Delinquent Behavior and Aggressive Behavior scales predicted the structured interview derived diagnoses of conduct and bipolar disorder, the Anxious/Depressed and Aggressive Behavior scales predicted major depression, and the Anxious/Depressed and Attention problems scales predicted anxiety disorders. Conclusions: These results extend to a paediatrically referred population with previously reported findings in psychiatric samples documenting good convergence between structured interview diagnoses and syndrome congruent CBCL scales. These findings support the utility of the CBCL as a screening tool for the identification of psychiatric comorbidity in ADHD youth in the primary care setting. PMID:16177156
Dallos, Rudi; Smart, Cordet
This article reports the preliminary findings of a study of attachment patterns and relationship themes using the TAAI (Transition to Adulthood Attachment Interview), AAI (Adult Attachment Interview) and family interviews (based on the first of 15 families). Research data is presented on a young man aged 16 with a diagnosis of ADHD and his family. Individual interviews, attachment interviews, and family interviews were conducted in order to explore the link between family dynamics, ADHD and attachment strategies. In contrast to findings from existing research indicating pre-occupied patterns for young people diagnosed with ADHD, the young man displayed a complex 'disoriented' attachment pattern which primarily featured a dismissive strategy. However, this was combined with pre-occupied patterns triggered by intrusions from unresolved traumas and memories of his parents' continuing unresolved conflicts. His sense of confusion and lack of a coherent strategy appeared to be closely related to his position of being triangulated into his parents' conflicts. Trans-generational processes were also influential, in that the parents' corrective intentions at more positive parenting were impeded by their own lack of experience of positive attachments in their own childhoods. The study emphasizes the need to consider the relationship between attachment patterns and problems within wider systemic process in the family, in particular triangulation and corrective scripts.
Ashwood, Karen L; Tye, Charlotte; Azadi, Bahare; Cartwright, Sally; Asherson, Philip; Bolton, Patrick
Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Children with ASD and ADHD demonstrate deficits in adaptive functioning, yet pure and comorbid groups have not been directly compared. Vineland Adaptive Behaviour Scales (VABS-II) data were examined in boys with ASD (n = 17), ADHD (n = 31) and ASD + ADHD (n = 38). Results demonstrated lower socialisation and composite scores and greater discrepancy between cognitive and adaptive abilities in the ASD + ADHD group compared to the ADHD-only group. Significant associations were shown between reduced adaptive functioning and autism symptoms, but not ADHD symptoms. Children with ASD + ADHD present with exacerbated impairments in adaptive functioning relative to children with ADHD, associated with ASD symptoms. Disentangling variation in adaptive skills may aid the assessment of complex cases.
Babakhanian, Mohammadreza; Sayar, Soraya; Babakhanian, Masaudeh; Mohammadi, Gholamreza
Background Attention deficit/hyperactivity disorder (ADHD) is a psychiatric disorder that can result in stress for the mother, resulting in poor health. Objectives The current study, conducted in 2012, aims to assess stress among forty-six Iranian mothers of ADHD children (Group 1) who were admitted to a psychiatric center in Tehran with forty-six Iranian mothers of normal children (Group 2) in 2012. Materials and Methods The Child Symptom Inventory-4 (CSI-4), the child behavior checklist (CBCL) and the parental stress index-short form (PSI/SF) were completed. Data was analyzed using the Levene test and the independent t-test in SPSS Version 18. Results With the exception of mood, ADHD children had more problems in attention compared with normal children. As a result, mothers of ADHD children had more stress compared with the controls. Conclusions ADHD can impair a mother’s mental health by inducing stress. Specific diagnostic and treatment programs should be designed and tailored for the mothers of ADHD children in order to decrease stress. PMID:27284276
Moreno-García, Inmaculada; Delgado-Pardo, Gracia; Roldán-Blasco, Carmen
This study assesses attention and response control through visual and auditory stimuli in a primary care pediatric sample. The sample consisted of 191 participants aged between 7 and 13 years old. It was divided into 2 groups: (a) 90 children with ADHD, according to diagnostic (DSM-IV-TR) (APA, 2002) and clinical (ADHD Rating Scale-IV) (DuPaul, Power, Anastopoulos, & Reid, 1998) criteria, and (b) 101 children without a history of ADHD. The aims were: (a) to determine and compare the performance of both groups in attention and response control, (b) to identify attention and response control deficits in the ADHD group. Assessments were carried out using the Integrated Visual and Auditory Continuous Performance Test (IVA/CPT, Sandford & Turner, 2002). Results showed that the ADHD group had visual and auditory attention deficits, F(3, 170) = 14.38; p < .01, deficits in fine motor regulation (Welch´s t-test = 44.768; p < .001) and sensory/motor activity (Welch'st-test = 95.683, p < .001; Welch's t-test = 79.537, p < .001). Both groups exhibited a similar performance in response control, F(3, 170) = .93, p = .43.Children with ADHD showed inattention, mental processing speed deficits, and loss of concentration with visual stimuli. Both groups yielded a better performance in attention with auditory stimuli.
Fisher, Amy K; Mackey, Tomiko D; Langendoen, Carol; Barnard, Marie
The purpose of this study was to examine the potential effect of child race and interviewer race on forensic interviewing outcomes. The results of the regression analysis indicated that child race and interviewer race had a significant effect on interview outcome category (no findings, inconclusive, or findings consistent with sexual abuse). Furthermore, the results indicate that the interaction of child and interviewer race had predictive value for rates of findings consistent with sexual abuse but not in the direction predicted. Cross-race dyads had significantly higher rates of interview outcomes consistent with sexual abuse. These findings suggest that more research into the effect of race on disclosure of child sexual abuse is needed.
Evidence suggests that ADHD can impair academic achievement in college students and throughout the life span. College students with ADHD are an at-risk population who might benefit from interventions. An offshoot of CBT-oriented therapy that has grown significantly and gained popularity in recent years is ADHD coaching. ADHD coaching is a psychosocial intervention that helps individuals develop skills, strategies, and behaviors to cope with the core impairments associated with ADHD. Most coaching programs are primarily based on a CBT approach and target planning, time management, goal setting, organization, and problem solving. This paper describes ADHD coaching for college students and discusses how coaching is different from standard CBT treatment. This is followed by a review of empirical studies of the effectiveness of ADHD coaching for college students. Finally, some specific considerations and procedures used in coaching are described.
Arnold, L. Eugene; Lofthouse, Nicholas; Hersch, Sarah; Pan, Xueliang; Hurt, Elizabeth; Bates, Bethany; Kassouf, Kathleen; Moone, Stacey; Grantier, Cara
Objective: Preparing for a definitive randomized clinical trial (RCT) of neurofeedback (NF) for ADHD, this pilot trial explored feasibility of a double-blind, sham-controlled design and adherence/palatability/relative effect of two versus three treatments/week. Method: Unmedicated 6- to 12-year-olds with "Diagnostic and Statistical Manual of…
Cordeiro, Mara L.; Farias, Antonio C.; Cunha, Alexandre; Benko, Cassia R.; Farias, Lucilene G.; Costa, Maria T.; Martins, Leandra F.; McCracken, James T.
Objective: The validity of a diagnosis of ADHD in children with a high intelligence quotient (IQ) remains controversial. Using a multidisciplinary approach, rigorous diagnostic criteria, and worldwide-validated psychometric instruments, we identified a group of children attending public schools in southern Brazil for co-occurrence of high IQ and…
Waite, Roberta; Ramsay, J. Russell
Background: Guidelines for assessment, diagnosis, and treatment of ADHD have been drawn from research focused primarily on Caucasian males generating, in part, the need to redress health disparities. Diagnostic criteria may therefore be limited, especially regarding gender differences and other associated cultural, familial, socio-environmental,…
Faraone, Stephen V.; Spencer, Thomas J.; Kollins, Scott H.; Glatt, Stephen J.; Goodman, David
Objective: To explore dose-response effects of lisdexamfetamine dimesylate (LDX) treatment for ADHD. Method: This was a 4-week, randomized, double-blinded, placebo-controlled, parallel-group, forced-dose titration study in adult participants, aged 18 to 55 years, meeting "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.)…
McKee, Tara E.
Objective: Current diagnostic criteria specify that ADHD involves difficulties with inattention and/or hyperactivity/impulsivity. Researchers using factor analysis have consistently found support for an inattention factor in both children and adults. Findings have been mixed regarding whether hyperactivity and impulsivity reflect one or two…
Rasmussen, Kirsten; Levander, Sten
Objective: To analyze sex differences among adult, never-treated patients referred for central stimulant treatment of ADHD. Method: Data for 600 consecutive patients from northern Norway referred for evaluation by an expert team during 7 years were analyzed. General background information, diagnostic and social history, and symptom profiles were…
Thaler, Nicholas S.; Bello, Danielle T.; Etcoff, Lewis M.
Objective: The current study investigated the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) cluster profiles of children with ADHD to examine the association between IQ profiles and diagnostic frequency, symptomatology, and outcome in this population. Method: Hierarchical cluster analysis was conducted on 189 children with a…
Kofler, Michael J; Raiker, Joseph S; Sarver, Dustin E; Wells, Erica L; Soto, Elia F
Hyperactivity, or excess gross motor activity, is considered a core and ubiquitous characteristic of ADHD. Alternate models question this premise, and propose that hyperactive behavior reflects, to a large extent, purposeful behavior to cope with environmental demands that interact with underlying neurobiological vulnerabilities. The present review critically evaluates the ubiquity and environmental modifiability of hyperactivity in ADHD through meta-analysis of 63 studies of mechanically measured activity level in children, adolescents, and adults with ADHD relative to typically developing groups. Random effects models corrected for publication bias confirmed elevated gross motor activity in ADHD (d=0.86); surprisingly, neither participant age (child vs. adult) nor the proportion of each ADHD sample diagnosed with the inattentive subtype/presentation moderated this effect. In contrast, activity level assessed during high cognitive load conditions in general (d=1.14) and high executive functioning demands in particular (d=1.39) revealed significantly higher effect sizes than activity level during low cognitive load (d=0.36) and in-class schoolwork (d=0.50) settings. Low stimulation environments, more rigorous diagnostic practices, actigraph measurement of movement frequency and intensity, and ADHD samples that included fewer females were also associated with larger effects. Overall, the results are inconsistent with DSM-5 and ADHD models that a) describe hyperactivity as ubiquitous behavior, b) predict a developmental decline in hyperactivity, or c) differentiate subtypes/presentations according to perceived differences in hyperactive behavior. Instead, results suggest that the presence and magnitude of hyperactive behavior in ADHD may be influenced to a considerable extent by environmental factors in general, and cognitive/executive functioning demands in particular.
Flory, Kate; Molina, Brooke S. G.; Pelham, William E., Jr.; Gnagy, Elizabeth; Smith, Bradley
This study compared young adults (ages 18 to 26) with and without childhood attention deficit hyperactivity disorder (ADHD) on self-reported risky sexual behaviors. Participants were 175 men with childhood ADHD and 111 demographically similar men without ADHD in the Pittsburgh ADHD Longitudinal Study (PALS). Childhood ADHD predicted earlier…
Baeyens, Dieter; Roeyers, Herbert; Walle, Johan Vande
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 ADHD-C was reviewed and contrasted across genetic, neuroanatomical, neurophysiological/ neurochemical, neuro(psycho)logical, and clinical psychiatric measurement levels. It was found that the more fundamental the measurement level, the less unambiguous evidence is found for subtype differences. Only on the clinical psychiatric diagnostic level, do more or less clear-cut differences in cognitive, social, academic, and behavioural functioning emerge. In conclusion, fundamental research that compares ADHD-IA and ADHD-C is relatively rare. At this point, only irrefutable phenomenological evidence of subtype differences seems to be available, even in attention problems which are presumed to be identical. The question as to whether both subtypes should be considered as two independent disorders was not adequately resolved.
An airport interview is an initial interview for a senior administrative position conducted at an airport hotel not too far from the campus in question. Meeting at an airport enables a search committee to interview a large number of candidates in a short period of time with a degree of confidentiality. At the conclusion of the airport interviews,…
Wong, Hui Mei; Goh, Esther C L
This article provides in-depth insights on the bidirectional dynamics between parents and their children with attention deficit hyperactivity disorder (ADHD). Five family units (8 parents, 5 children, N = 13) participated in this study. Parents and their child with ADHD were interviewed individually in their homes. Stressful moments of parent-child dynamics revolved around managing their child's behavior and doing homework. Findings highlight the child's agency and power of influence, and the possible recovery of negative dynamics. It is recommended that practitioners adopt the strengths perspective in working with these families and incorporate child's agency and bidirectional dynamics in interventions.
Fugate, C. Matthew
Unfortunately, there are many students that feel "stupid" in classrooms all around the country. They know they are gifted, but their ADHD and co-occurring conditions can make them feel isolated and alone. This is hard not only for the children, but for the parents who may feel powerless in helping their child know how special he or she…
Wigal, Sharon B.; Emmerson, Natasha; Gehricke, Jean-G.; Galassetti, Pietro
ADHD is the most common neurobehavioral disorder of childhood, presenting with pervasive and impairing symptoms of inattention, hyperactivity, impulsivity, or a combination. The leading hypothesis of the underlying physiology of this disorder of inattention and/or hyperactivity-impulsivity is based on catecholamine dysfunction. Pharmacotherapy…
Adi-Japha, Esther; Landau, Yael E; Frenkel, Lior; Teicher, Mina; Gross-Tsur, Varda; Shalev, Ruth S
Multiple complaints in the domain of writing are common among children with Attention Deficit Hyperactivity Disorder (ADHD). In this work we sought to characterize the writing disorder by studying dysgraphia in twenty 6th grade boys with ADHD and normal reading skills matched to 20 healthy boys who served as a comparison group. Dysgraphia, defined as deficits in spelling and handwriting, was assessed according to neuropsychological explanatory processes within 3 primary domains: linguistic processing, motor programming and motor kinematics. Children with ADHD made significantly more spelling errors, but showed a unique pattern introducing letter insertions, substitutions, transpositions and omissions. This error type, also known as graphemic buffer errors, can be explained by impaired attention aspects needed for motor planning. Kinematic manifestations of writing deficits were fast, inaccurate and an inefficient written product accompanied by higher levels of axial pen pressure. These results suggest that the spelling errors and writing deficits seen in children with ADHD and normal reading skills stem primarily from non-linguistic deficits, while linguistic factors play a secondary role. Recommendations for remediation include educational interventions, use of word processing and judicious use of psychostimulants.
Quinn, Michael; Lynch, Andrea
In many western countries, attention deficit hyperactivity disorder (ADHD) has achieved celebrity status, such that it probably no longer requires introduction. The disorder is a global phenomenon, spreading rapidly as result of the increasing dominance internationally of US psychiatric models, the need for new markets for major pharmaceutical…
Fasmer, Ole Bernt; Riise, Trond; Lund, Anders; Dilsaver, Steven C.; Hundal, Oivind; Oedegaard, Ketil J.
Objective: The purpose of this study was to investigate how often drugs used to treat migraine and ADHD are prescribed to the same patients to assess, indirectly, the comorbidity of these disorders. Method: We used data from the Norwegian prescription database for 2006, including the total Norwegian population (N = 4,640,219). Results:…
Fasmer, Ole Bernt; Riise, Trond; Eagan, Tomas Mikal; Lund, Anders; Dilsaver, Steven C.; Hundal, Oivind; Oedegaard, Ketil J.
Objective: To assess how frequently drugs used to treat asthma and ADHD are prescribed to the same patients. Method: The authors used data from the Norwegian Prescription Database for 2006, including the total Norwegian population (n = 4,640,219). Results: Anti-asthma drugs were prescribed to 350,894 persons (7.56 % of the population), anti-ADHD…
Lee, Steve S; Humphreys, Kathryn L; Flory, Kate; Liu, Rebecca; Glass, Kerrie
Given the clinical and public health significance of substance disorders and the need to identify their early risk factors, we examined the association of childhood attention-deficit/hyperactivity disorder (ADHD) with substance use (nicotine, alcohol, marijuana) and abuse/dependence outcomes (nicotine, alcohol, marijuana, cocaine, other). To strengthen a potential causal inference, we meta-analyzed longitudinal studies that prospectively followed children with and without ADHD into adolescence or adulthood. Children with ADHD were significantly more likely to have ever used nicotine and other substances, but not alcohol. Children with ADHD were also more likely to develop disorders of abuse/dependence for nicotine, alcohol, marijuana, cocaine, and other substances (i.e., unspecified). Sex, age, race, publication year, sample source, and version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) used to diagnose ADHD did not significantly moderate the associations with substance outcomes that yielded heterogeneous effect sizes. These findings suggest that children with ADHD are significantly more likely to develop substance use disorders than children without ADHD and that this increased risk is robust to demographic and methodological differences that varied across the studies. Finally, few studies addressed ADHD and comorbid disruptive behavior disorders (DBD), thus preventing a formal meta-analytic review. However, we qualitatively summarize the results of these studies and conclude that comorbid DBD complicates inferences about the specificity of ADHD effects on substance use outcomes.
Lee, Steve S.; Humphreys, Kathryn L.; Flory, Kate; Liu, Rebecca; Glass, Kerrie
Given the clinical and public health significance of substance disorders and the need to identify their early risk factors, we examined the association of childhood attention-deficit/hyperactivity disorder (ADHD) with substance use (e.g., nicotine, alcohol) and abuse/dependence outcomes (nicotine, alcohol, marijuana, cocaine, other). To strengthen a potential causal inference, we meta-analyzed longitudinal studies that prospectively followed children with and without ADHD into adolescence or adulthood. Children with ADHD were significantly more likely to have ever used nicotine and other substances, but not alcohol. Children with ADHD were also more likely to develop disorders of abuse/dependence for nicotine, alcohol, marijuana, cocaine, and other substances (i.e., unspecified). Sex, age, race, publication year, sample source, and version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) used to diagnose ADHD did not significantly moderate the associations with substance outcomes that yielded heterogeneous effect sizes. These findings suggest that children with ADHD are significantly more likely to develop substance use disorders than children without ADHD and that this increased risk is robust to demographic and methodological differences that varied across the studies. Finally, few studies addressed ADHD and comorbid disruptive behavior disorders (DBD), thus preventing a formal meta-analytic review. However, we qualitatively summarize the results of these studies and conclude that comorbid DBD complicates inferences about the specificity of ADHD effects on substance use outcomes. PMID:21382538
Fatseas, Melina; Alexandre, Jean-Marc; Vénisse, Jean-Luc; Romo, Lucia; Valleur, Marc; Magalon, David; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Guilleux, Alice; Groupe Jeu; Challet-Bouju, Gaëlle; Grall-Bronnec, Marie
Previous studies showed that Pathological Gambling and Attention Deficit/Hyperactivity Disorder (ADHD) often co-occur. The aim of this study was to examine whether ADHD is associated with specific severity patterns in terms of gambling behavior, psychopathology and personality traits. 599 problem and non-problem-gamblers were recruited in addiction clinics and gambling places in France. Subjects were assessed with the Wender-Utah Rating Scale-Child, the Adult ADHD Self-Report Scale, the Mini International Neuropsychiatric Interview, the Temperament and Character Inventory, the South Oaks Gambling Screen and questionnaires assessing gambling related cognitive distortions and gambling habits. 20.7% (n=124) of gamblers were screened positive for lifetime or current ADHD. Results from the multivariate analysis showed that ADHD was associated with a higher severity of gambling-related problems and with more psychiatric comorbidity. Among problem gamblers, subjects with history of ADHD were also at higher risk for unemployment, psychiatric comorbidity and specific dysfunctional personality traits. This study supports the link between gambling related problems and ADHD in a large sample of problem and non-problem gamblers, including problem-gamblers not seeking treatment. This points out the necessity to consider this disorder in the prevention and in the treatment of pathological gambling.
Egeland, Jens; Ueland, Torill; Johansen, Susanne
Participants with attention-deficit/hyperactivity disorder (ADHD) are often impaired in visuomotor tasks. However, little is known about the contribution of modal impairment in motor function relative to central processing deficits or whether different processes underlie the impairment in ADHD combined (ADHD-C) versus ADHD inattentive (ADHD-I)…
Wymbs, Brian T; Dawson, Anne E; Egan, Theresa E; Sacchetti, Gina M; Tams, Sean T; Wymbs, Frances A
Parents of children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) often have elevated ADHD and depressive symptoms, both of which increase the risk of ineffective parenting and interparental discord. However, little is known about whether child ADHD/ODD behavior and parent ADHD or depressive symptoms uniquely or synergistically predict the quality of parenting and interparental communication during triadic (mother-father-child) interactions. Ninety parent couples, including 51 who have children diagnosed with ADHD, were randomly assigned to interact with a 9-12 year-old confederate child (84 % male) exhibiting either ADHD/ODD-like behavior or typical behavior. Parents reported their own ADHD and depressive symptoms, and parents and observers rated the quality of parenting and interparental communication during the interaction. Actor-partner interdependence modeling indicated that child ADHD/ODD behavior predicted less positive and more negative parenting and communication, independent of adult ADHD and depressive symptoms. Parent couples including two parents with elevated ADHD communicated more positively while managing children exhibiting ADHD/ODD behavior than couples managing children behaving typically or couples with only one parent with elevated ADHD symptoms. Couples including one parent with, and one parent without, elevated ADHD or depressive symptoms parented less positively and more negatively, and communicated more negatively, when managing children exhibiting ADHD/ODD behavior than when managing children behaving typically. Taken together, depending on the similarity of ADHD and depressive symptom levels in parent couples, adults managing children exhibiting ADHD/ODD behavior may parent or communicate positively or negatively. Findings highlight the need to consider the psychopathology of both parents when treating children with ADHD in two-parent homes.
Terbeck, Sylvia; Chesterman, L Paul
The objective of this study is to examine the potential impact of using the internet on medical consultations by analysing the attitudes, attributions, and emotional responses of parents who have been informed by specialists that their child does not have attention-deficit hyperactivity disorder (ADHD) and to examine the nature of the feedback they obtained from members of online internet support groups. Over 40,000 messages from the five most popular international internet forums discussing children with ADHD were analysed. Messages from parents who reported that they had seen at least one specialist (e.g. paediatrician, psychiatrist or psychologist) because of their concerns that their child had ADHD were identified. The children included boys and girls with an age range from 2 to 16 years. Of these, we analysed messages where the parents additionally reported that the specialist had excluded a diagnosis of ADHD. Using these criteria, 91 messages from parents who had consulted over 200 different specialists and 398 replies to these messages were identified for content analysis. The replies to concerned parents were analysed to determine whether they were offered impartial advice. A majority of the parents reported that they did not believe the specialist and were unhappy about their child not being diagnosed with ADHD. They expressed dissatisfaction with the professional's opinions and the implication that their child's conduct was caused by their poor parenting skills. Importantly, 87.6 % of the responses that these parents received, from other members of online forums, reinforced the parent's negative attitude towards the professional's judgement. It was generally suggested that the parents should not believe the expert and should seek a further opinion. The use of the internet may encourage "doctor shopping" and mistrust in health services. Medical professionals and others may need to be aware of this, and parents may need more support than is generally
Voeller, Kytja K S
Approaches to the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) are undergoing a major change as a result of information from studies on the genetics of ADHD and the use of new neuroimaging technologies. Moreover, pharmacogenomics, although still in its infancy, will provide a basis for much more sophisticated treatment strategies for ADHD, particularly once more information is available about the genetics of ADHD. Even at this point in time, there is some pertinent information available that, although not ready for application in clinical settings, nonetheless provides a broader perspective for the clinician. In terms of etiology, ADHD is a neuropsychiatric disorder. There is a genetic basis in about 80% of the cases, involving a number of different genes, and in about 20% of the cases, ADHD is the result of an acquired insult to the brain. Some individuals likely have both genetic and acquired forms. Although medication works well in many cases of ADHD, optimal treatment of ADHD requires integrated medical and behavioral treatment. The family plays a crucial role in the management of children with ADHD. Because there is often a very high degree of comorbidity between ADHD and learning disabilities, teachers also have a great deal to contribute in the day-to-day management of these children. Early recognition and treatment prevent the development of more serious psychopathology in adolescence and adulthood.
Hurtig, Tuula; Ebeling, Hanna; Taanila, Anja; Miettunen, Jouko; Smalley, Susan L.; McGough, James J.; Loo, Sandra K.; Jarvelin, Marjo-Riitta; Moilanen, Irma K.
A study aims to examine attention-deficit/hyperactivity disorder(ADHD) symptoms and subtypes in childhood and adolescence. The results conclude the persistence of ADHD from childhood to adolescence with specific symptoms contributing to persistent ADHD.
Sideridis, Georgios D.; Prock, Lisa Albers; Sheridan, Margaret A.
OBJECTIVES: The goals of this study were (1) to provide estimates of diagnostic stability for a sample of young children diagnosed with attention-deficit/hyperactivity disorder (ADHD) after undergoing comprehensive multidisciplinary assessments and (2) to identify baseline child and family characteristics that predict diagnostic stability over time. METHODS: Children aged 3 to 6 years, 11 months consecutively diagnosed with ADHD after multidisciplinary consultations at a tertiary care clinic between 2003 and 2008 were recontacted in 2012 and 2013 (N = 120). At follow-up, the primary outcome was the proportion of children who continued to meet diagnostic criteria for ADHD. To identify predictors of diagnostic stability, logistic regression models were used. In addition, a latent class model was used to independently classify subjects into distinct clusters. RESULTS: In this cohort, 70.4% of the children contacted at follow-up continued to meet diagnostic criteria for ADHD. Predictors of diagnostic stability included externalizing and internalizing symptoms at baseline, parental history of psychopathology, and family socioeconomic status. The latent class model independently identified 3 distinct profiles: (1) children who no longer met ADHD criteria; (2) children with persistent ADHD and high parental psychopathology; and (3) children with persistent ADHD and low family socioeconomic status. CONCLUSIONS: Young children who underwent comprehensive developmental and psychological assessments before receiving an ADHD diagnosis, had higher rates of diagnostic stability than in previous studies of community samples. Child and family factors that predict diagnostic stability have the potential to guide treatment planning for children diagnosed with ADHD before 7 years of age. PMID:24639272
Waldman, Irwin D.; Lilienfeld, Scott O.
Examined diagnostic efficiency of symptoms for experimentally diagnosed oppositional defiant disorder (OD) and attention-deficit hyperactivity disorder (ADHD) in 102 elementary-age boys. Findings from teacher ratings revealed that, on average, ADHD symptoms were as useful as OD symptoms as exclusion criteria for OD, whereas OD symptoms were nearly…
Martel, Michelle M.
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
ADHD is, I argue, an impairment in sense of time and a matter of difference in rhythm; it can be understood as a certain being in the world, or more specifically, as a disruption in the experience of time and a state of desynchronization and arrhythmia. Through excerpts of interviews with adults diagnosed with ADHD and observations, I illustrate how impairment in time is manifested in an embodied experience of being out of sync. I suggest that the experience of ADHD is characterized as 1) an inner restlessness and bodily arrhythmia; 2) an intersubjective desynchronization between the individual and its surroundings; and 3) a feeling of lagging behind socially due to difficulties in social skills. In closing, I argue that an increasingly accelerating society is augmenting the experience of being out of sync rather than eliminating it.
DeSantis, Alan; Noar, Seth M; Webb, Elizabeth M
Qualitative methods were used to investigate the use of nonmedical Attention Deficit Hyperactivity Disorder (ADHD) stimulants by fraternity members. The primary goal of the study was to determine students' levels of understanding and motivations for use of these Schedule II controlled substances. Seventy-nine in-depth interviews were conducted. Key findings highlighted how: a) easy it was for subjects to obtain stimulants; b) little health information nonmedical users have about stimulants; c) academic stress created a fertile context for stimulant use; and d) a small number of prescribed users supply the vast majority of nonmedical users with their stimulants. Most nonmedical users claimed to primarily use ADHD stimulants in periods of high academic stress and believed that they not only reduced fatigue, but also increased reading comprehension, interest, cognition, and memory. These qualitative data have supplied a rich and complex understanding behind nonmedical ADHD stimulant use among fraternity members.
Patros, Connor H G; Alderson, R Matt; Kasper, Lisa J; Tarle, Stephanie J; Lea, Sarah E; Hudec, Kristen L
Impulsive behavior is a core DSM-5 diagnostic feature of attention-deficit/hyperactivity disorder (ADHD) that is associated with several pejorative outcomes. Impulsivity is multidimensional, consisting of two sub-constructs: rapid-response impulsivity and reward-delay impulsivity (i.e., choice-impulsivity). While previous research has extensively examined the presence and implications of rapid-response impulsivity in children with ADHD, reviews of choice-impulsive behavior have been both sparse and relatively circumscribed. This review used meta-analytic methods to comprehensively examine between-group differences in choice-impulsivity among children and adolescents with and without ADHD. Twenty-eight tasks (from 26 studies), consisting of 4320 total children (ADHD=2360, TD=1,960), provided sufficient information to compute an overall between-group effect size for choice-impulsivity performance. Results revealed a medium-magnitude between-group effect size (g=.47), suggesting that children and adolescents with ADHD exhibited moderately increased impulsive decision-making compared to TD children and adolescents. Further, relative to the TD group, children and adolescents with ADHD exhibited similar patterns of impulsive decision-making across delay discounting and delay of gratification tasks. However, the use of single-informant diagnostic procedures relative to multiple informants yielded larger between-group effects, and a similar pattern was observed across samples that excluded females relative to samples that included females.
To assess whether the writing styles of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) combined type differ significantly from those of children in a nonclinical control group, writing samples from 17 children with ADHD combined type and 18 children in a nonclinical control group were compared using the language analysis program Korean Linguistic Inquiry and Word Count. These writing samples, produced in response to instructions, served as dependent variables. Analysis showed that children with ADHD used fewer linguistic variables (e.g., sentences, phrases, and morphemes) than the control group. In addition, the ADHD group used fewer words reflecting cognitive processes and fewer pronouns than members of the control group. Also, the ADHD group showed a different pattern in the use of words referring to friends. This study provides preliminary descriptive data on language use among children diagnosed with a main subtype of ADHD.
Antshel, Kevin M.; Faraone, Stephen V.; Fremont, Wanda; Monuteaux, Michael C.; Kates, Wendy R.; Doyle, Alysa; Mick, Eric; Biederman, Joseph
Objective: Background: Children with velocardiofacial syndrome (VCFS), a contiguous deletion syndrome, have an increased prevalence of attention deficit/hyperactivity disorder (ADHD). Method: The authors compared youth with VCFS+ADHD (from the SUNY Upstate VCFS Research Program) to those with ADHD but not VCFS (from the Massachusetts General…
Ashwood, Karen L.; Tye, Charlotte; Azadi, Bahare; Cartwright, Sally; Asherson, Philip; Bolton, Patrick
Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Children with ASD and ADHD demonstrate deficits in adaptive functioning, yet pure and comorbid groups have not been directly compared. Vineland Adaptive Behaviour Scales (VABS-II) data were examined in boys with ASD (n = 17), ADHD (n = 31) and…
Bink, M.; Popma, A.; Bongers, I. L.; van Boxtel, G. J. M.; Denissen, A.; van Nieuwenhuizen, Ch.
A large number of youngsters with autism spectrum disorders (ASD) display comorbid attention deficit/hyperactivity disorder (ADHD) symptoms. However, previous studies are not conclusive whether psychophysiological correlates, like cardiac reactivity, are different for ASD with comorbid ADHD (ASD+) compared to ADHD. Therefore, the current study…
Grzadzinski, Rebecca; Di Martino, Adriana; Brady, Emily; Mairena, Maria Angeles; O'Neale, Matthew; Petkova, Eva; Lord, Catherine; Castellanos, F. Xavier
We examined to what extent increased parent reports of autistic traits in some children with Attention Deficit Hyperactivity Disorder (ADHD) are the result of ADHD-related symptoms or qualitatively similar to the core characteristics of autism spectrum disorders (ASD). Results confirm the presence of a subgroup of children with ADHD and elevated…
O’Neill, Sarah; Schneiderman, Robyn L.; Rajendran, Khushmand; Marks, David J.; Halperin, Jeffrey M.
Objective To assess the relative ability of parent, teacher, and clinician behavioral ratings of preschoolers to predict ADHD severity and diagnosis at 6 years of age. Method Hyperactive/inattentive preschoolers [N=104, 75% boys, Mean (SD) age = 4.37 (.47) years] were followed over two years (mean=26.44 months, SD=5.66). At baseline (BL), parents and teachers completed the ADHD-RS-IV and clinicians completed the Behavioral Rating Inventory for Children following a psychological testing session. At age 6, [Mean (SD) age = 6.62 (.35) years], parents were interviewed with the K-SADS-PL; teachers completed the ADHD-RS-IV; and laboratory measures of hyperactivity, impulsivity, and inattention were obtained from children. Hierarchical logistic and linear regression analyses examined which combination of BL ratings best predicted 6-year-old ADHD diagnosis and severity, respectively. Results At age 6, 56 (53.8%) children met DSM-IV criteria for a diagnosis of ADHD. BL ratings from parent/teacher/clinician, parent/teacher and parent/clinician combinations significantly predicted children who had an ADHD diagnosis at age 6. Parent and clinician, but not teacher, behavior ratings were significant independent predictors of ADHD diagnosis and severity at 6-years-old. However, only clinician reports of preschoolers’ behaviors predicted laboratory measures of over-activity and inattention at follow-up. Conclusion Cross-situationality is important for a diagnosis of ADHD during the preschool years. Among parents, teachers and clinicians, positive endorsements from all three informants, parent/teacher or parent/clinician appear to have prognostic value. Clinicians’ ratings of preschoolers’ inattention, impulsivity and hyperactivity are valid sources of information for predicting ADHD diagnosis and severity over time. PMID:24085388
Williams, Leanne M; Tsang, Tracey W; Clarke, Simon; Kohn, Michael
There remains a translational gap between research findings and their implementation in clinical practice that applies to attention-deficit/hyperactivity disorder (ADHD), as well as to other major disorders of brain health in childhood, adolescence and adulthood. Research studies have identified potential 'markers' to support diagnostic, functional assessment and treatment decisions, but there is little consensus about these markers. Of these potential markers, cognitive measures of thinking functions, such as sustaining attention and associated electrical brain activity, show promise in complementing the clinical management process. Emerging evidence highlights the relevance of emotional, as well as thinking, functions to ADHD. Here, we outline an integrative neuroscience framework for ADHD that offers one means to bring together cognitive measures of thinking functions with measures of emotion, and their brain and genetic correlates. Understanding these measures and the relationships between them is a first step towards the development of tools that will help to assess the heterogeneity of ADHD, and aid in tailoring treatment choices.
Segenreich, Daniel; Paez, Marina Silva; Regalla, Maria Angélica; Fortes, Dídia; Faraone, Stephen V; Sergeant, Joseph; Mattos, Paulo
A strong genetic role in the etiology of attention-deficit hyperactivity disorder (ADHD) has been demonstrated by several studies using different methodologies. Shortcomings of genetic studies often include the lack of golden standard practices for diagnosis for ADHD, the use of categorical instead of a dimensional approach, and the disregard for assortative mating phenomenon in parents. The current study aimed to overcome these shortcomings and analyze data through a novel statistical approach, using multilevel analyses with Bayesian procedures and a specific mathematical model, which takes into account data with an elevated number of zero responses (expected in samples with few or no ADHD symptoms). Correlations of parental clinical variables (ADHD, anxiety and depression) to offspring psychopathology may vary according to gender and type of symptoms. We aimed to investigate how those variables interact within each other. One hundred families, comprising a proband child or adolescent with ADHD or a typically developing child or adolescent were included and all family members (both biological parents, the proband child or adolescent and their sibling) were examined through semi-structured interviews using DSM-IV criteria. Results indicated that: (a) maternal clinical variables (ADHD, anxiety and depression) were more correlated with offspring variables than paternal ones; (b) maternal inattention (but not hyperactivity) was correlated with both inattention and hyperactivity in the offspring; (c) maternal anxiety was correlated with offspring inattention; on the other hand, maternal inattention was correlated with anxiety in the offspring. Although a family study design limits the possibility of revealing causality and cannot disentangle genetic and environmental factors, our findings suggest that ADHD, anxiety and depression are variables that correlate in families and should be addressed together. Maternal variables significantly correlated with offspring
Presents an interview of Sandra Thompson on various topics relating to the Chinese language. The interview touches on conversational data on Chinese, the lack of morphological complexity in Mandarin Chinese, and the development of Chinese functionalism. (12 references) (CK)
Landaas, Elisabeth Toverud; Aarsland, Tore Ivar Malmei; Ulvik, Arve; Halmøy, Anne; Ueland, Per Magne; Haavik, Jan
Background Micronutrients containing vitamins are reported to reduce symptom levels in persons with attention-deficit hyperactivity disorder (ADHD), but data on vitamin levels in ADHD are sparse. Aims To examine the relationship between vitamin concentrations, ADHD diagnosis and psychiatric symptoms in young adult ADHD patients and controls. Method Eight vitamins and the nicotine metabolite cotinine were analysed in serum samples from 133 ADHD patients and 131 controls aged between 18 and 40, who also reported ADHD symptoms and comorbid conditions. Results Lower concentrations of vitamins B2, B6 and B9 were associated with the ADHD diagnosis, and B2 and B6 also with symptom severity. Smokers had lower levels of vitamins B2 and B9. Conclusions ADHD patients were overrepresented in the group with low levels of some vitamins, possibly indicative of inadequate dietary intake of these micronutrients in a subgroup of patients. It is important to identify these patients in dietary intervention trials of ADHD. Declaration of interest J.H. has received lecture honoraria as part of continuing medical education programmes sponsored by Novartis, Eli Lilly and Company, and Janssen-Cilag. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27990293
Kibby, Michelle Y.; Kroese, Judith M.; Krebbs, Hillery; Hill, Crystal E.; Hynd, George W.
Limited research has been conducted on the structure of the pars triangularis (PT) in dyslexia despite functional neuroimaging research finding it may play a role in phonological processing. Furthermore, research to date has not examined PT size in ADHD even though the right inferior frontal region has been implicated in the disorder. Hence, one of the purposes of this study was to examine the structure of the PT in dyslexia and ADHD. The other purposes included examining the PT in relation to overall expressive language ability and in relation to several specific linguistic functions given language functioning often is affected in both dyslexia and ADHD. Participants included 50 children: 10 with dyslexia, 15 with comorbid dyslexia/ADHD, 15 with ADHD, and 10 controls. Using a 2 (dyslexia or not) X 2 (ADHD or not) MANCOVA, findings revealed PT length and shape were comparable between those with and without dyslexia. However, children with ADHD had smaller right PT lengths than those without ADHD, and right anterior ascending ramus length was related to attention problems in the total sample. In terms of linguistic functioning, presence of an extra sulcus in the left PT was related to poor expressive language ability. In those with adequate expressive language functioning, left PT length was related to phonological awareness, phonological short-term memory and rapid automatic naming (RAN). Right PT length was related to RAN and semantic processing. Further work on PT morphology in relation to ADHD and linguistic functioning is warranted. PMID:19356794
Edwards, Claire; Howlett, Etaoine
The role of patients' organisations in shaping (medical) knowledge about particular health conditions and illnesses sheds light on notions of informed patienthood and the dynamics of lay-expert knowledge in the context of medicalisation. This paper considers dynamics of knowledge production in relation to a specific condition area, Attention Deficit Hyperactivity Disorder (ADHD), by investigating how parents of children with ADHD are intervening in knowledge creation about the effectiveness of different treatments for the disorder. It draws on qualitative research carried out between 2009 and 2011 with organisations representing parents of children with ADHD in Ireland, to explore how parents have commissioned evaluations of alternative interventions to medication. Drawing on analysis of 12 semi-structured interviews with both parents and professionals active in the arena of ADHD, documentary evidence, and observation at parent organisations' events, the study demonstrates how parents' interventions have sought to expand the therapeutic domain of ADHD beyond the exclusive realm of biopsychiatry, and the dilemmas they face in making their experiences count in a context where the need for evidence has become paramount in the governance of health.
van Avendonk, Mariëlle J P; Hassink-Franke, Lieke J A; Stijntjes, Freek; Wiersma, Tjerk; Burgers, Jako S
The diagnosis of ADHD may be considered if a child is hyperactive, impulsive or inattentive, and if this behaviour results in evidently impaired functioning in multiple settings. Children with behavioural problems and slightly impaired functioning may benefit from patient information, education and parenting advice. From the age of 6 years, children can be offered diagnostic testing and professional support within the primary care setting, provided sufficient knowledge and expertise is available and there is collaboration with other health care providers. Management of a child with ADHD but no comorbid psychiatric disorder, consists of a step-by-step plan including education, parent and teacher guidance and, optionally, behavioural therapy for the child. In consultation with parents, child and other therapists, methylphenidate can be prescribed if behavioural interventions are not sufficiently effective. Children taking medication for ADHD should be monitored periodically, including assessment of the effectiveness and side effects.
Belendiuk, Katherine A; Pedersen, Sarah L; King, Kevin M; Pelham, William E; Molina, Brooke S G
Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for experiencing alcohol-related problems by adulthood. However, few studies have examined contextual factors that may contribute to this risk. The current study examined 1 widely investigated social-contextual risk factor, friend alcohol use, in a sample of adolescents with and without a history of ADHD. One hundred and 59 adolescents (14-17 years old) with childhood ADHD and 117 demographically similar youth without ADHD were interviewed annually in the Pittsburgh ADHD Longitudinal Study. Adolescents reported the frequency of their own alcohol use in the prior 12 months and the number of friends who used alcohol regularly or occasionally (perceived friend alcohol use). Multiple-group parallel process models indicated that increases in friend alcohol use were more strongly associated with increases in adolescent alcohol use over time for individuals with ADHD (r = .15, SE = 0.04; 95% confidence interval [CI] = [0.08, 0.22]) than for those without ADHD (r = .06, SE = 0.03; 95% CI [0.00, 0.11]). These results suggest that social factors are an important part of escalating alcohol use among adolescents with ADHD histories, and they highlight the possibility that interventions focused on the peer context could be important for these at-risk youth. Additional social network research on adolescent alcohol use within the larger context of other relationships (e.g., family and romantic relationships) is indicated.
Arias, Victor B.; Nuñez, Daniel E.; Martínez-Molina, Agustín; Ponce, Fernando P.; Arias, Benito
The Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria assume that the 18 symptoms carry the same weight in an Attention Deficit with Hyperactivity Disorder (ADHD) diagnosis and bear the same discriminatory capacity. However, it is reasonable to think that symptoms may differ in terms of severity and even in the reliability with they represent the disorder. To test this hypothesis, the aim of this study was to calibrate in a sample of Spanish children (age 4–7; n = 784) a scale for assessing the symptoms of ADHD proposed by Diagnostic and Statistical Manual of Mental Disorders, IV-TR within the framework of Item Response Theory. Samejima’s Graded Response Model was used as a method for estimating the item difficulty and discrimination parameters. The results showed that ADHD subscales (Attention Deficit and Hyperactivity / Impulsivity) had good psychometric properties and had also a good fit to the model. However, relevant differences between symptoms were observed at the level of severity, informativeness and reliability for the assessment of ADHD. This finding suggests that it would be useful to identify the symptoms that are more important than the others with regard to diagnosing ADHD. PMID:27736911
Garcia Rosales, Alexandra; Vitoratou, Silia; Banaschewski, Tobias; Asherson, Philip; Buitelaar, Jan; Oades, Robert D; Rothenberger, Aribert; Steinhausen, Hans-Christoph; Faraone, Stephen V; Chen, Wai
In view of ICD-11 revision, we evaluate whether the 18 DSM-IV diagnostic items retained by DSM-5 could be further improved (i) in predicting ADHD 'caseness' and 'impairment' and (ii) discriminating ADHD without CD (ADHD - CD) cases from ADHD with CD (ADHD + CD) cases. In a multi-centre study sample consisting of 1497 ADHD probands and 291 unaffected subjects, 18 diagnostic items were examined for redundancy; then each item was evaluated for association with caseness, impairment and CD status using Classical Test Theory, Item-Response Theory and logistic regression methods. First, all 18 DSM-IV items contributed significantly and independently to the clinical diagnosis of ADHD. Second, not all the DSM-IV items carried equal weighting. "Often loses things", "forgetfulness" and "difficulty sustaining attention" mark severity for Inattentiveness (IA) items and "often unduly noisy", "exhibits a persistent pattern of restlessness", "leaves seat in class" and "often blurts out answers" for Hyperactivity/Impulsivity (HI) items. "Easily distracted", "inattentive to careless mistakes", "often interrupts" and "often fidgets" are associated with milder presentations. In the IA domain, "distracted" yields most information in the low-severity range of the latent trait, "careless" in the mid-severity range and "loses" in the high-severity range. In the HI domains, "interrupts" yields most information in the low-severity range and "motor" in the high-severity range. Third, all 18 items predicted impairment. Fourth, specific ADHD items are associated with ADHD + CD status. The DSM-IV diagnostic items were valid and not redundant; however, some carried more weight than others. All items were associated with impairment.
Torgersen, Terje; Gjervan, Bjorn; Lensing, Michael B; Rasmussen, Kirsten
Background The manifestation of attention-deficit/hyperactivity disorder (ADHD) among older adults has become an interesting topic of interest due to an increasing number of adults aged 50 years and older (≥50 years) seeking assessment for ADHD. Unfortunately, there is a lack of research on ADHD in older adults, and until recently only a few case reports existed. Method A systematic search was conducted in the databases Medline/PubMed and PsycINFO in order to identify studies regarding ADHD in adults ≥50 years. Results ADHD persists into older ages in many patients, but the prevalence of patients fulfilling the criteria for the diagnosis at age ≥50 years is still unknown. It is reason to believe that the prevalence is falling gradually with age, and that the ADHD symptom level is significantly lower in the age group 70–80 years than the group 50–60 years. There is a lack of controlled studies of ADHD medication in adults ≥50 years, but this review suggests that many patients aged ≥50 years experience beneficial effects of pharmacological treatment. The problem with side effects and somatic complications may rise to a level that makes pharmacotherapy for ADHD difficult after the age of 65 years. Physical assessment prior to initiation of ADHD medication in adults ≥50 years should include a thorough clinical examination, and medication should be titrated with low doses initially and with a slow increase. In motivated patients, different psychological therapies alone or in addition to pharmacotherapy should be considered. Conclusion It is essential when treating older adult patients with ADHD to provide good support based on knowledge and understanding of how ADHD symptoms have affected health, quality of life, and function through the life span. Individualized therapy for each elderly patient should be recommended to balance risk–benefit ratio when pharmacotherapy is considered to be a possible treatment. PMID:26811680
Halldorsdottir, Thorhildur; Ollendick, Thomas H; Ginsburg, Golda; Sherrill, Joel; Kendall, Philip C; Walkup, John; Sakolsky, Dara J; Piacentini, John
The purpose of this study is to examine the influence of Attention-Deficit/Hyperactivity Disorder (ADHD), independent of Oppositional Defiant Disorder (ODD), on acute treatment response, remission rates and maintenance of gains at 6-month follow-up in anxious youth (ages 7-17, 76% Caucasian, 52% female) who received cognitive-behavioral therapy (CBT) alone, pharmacotherapy alone, the combination of CBT and pharmacotherapy or placebo pill in the Child/Adolescent Multimodal Study. Treatment response was defined as independent evaluator rated meaningful improvement in anxiety. Remission was operationalized as the absence of targeted anxiety disorders. ADHD and ODD were examined as moderators of outcomes at a diagnostic level. In the CBT group only, an ADHD diagnosis predicted poorer immediate treatment response and remission rates. However, these associations were not obtained for the pharmacotherapy groups. Participants with comorbid ODD were not less likely to achieve acute treatment response and remission rates than their counterparts across treatment conditions. Due to small sample size of the comorbid subgroups, our analyses must be considered preliminary. Nevertheless, our initial findings suggest further exploration of the separate roles of ADHD and ODD are worth pursuing, as they may be differentially associated with treatment outcomes in anxious youth treated with CBT but not youth treated with pharmacotherapy. If confirmed, findings may indicate that anxious youth with comorbid ADHD are less likely to benefit from CBT strategies alone and raise the possibility that these youth need adjunctive pharmacotherapy or psychosocial interventions.
Ghosh, Paramita; Sarkar, Kanyakumarika; Bhaduri, Nipa; Ray, Anirban; Sarkar, Keka; Sinha, Swagata; Mukhopadhyay, Kanchan
Contribution of genes in attention deficit hyperactivity disorder (ADHD) has been explored in various populations, and several genes were speculated to contribute small but additive effects. We have assessed variants in four genes, DDC (rs3837091 and rs3735273), DRD2 (rs1800496, rs1801028, and rs1799732), DRD4 (rs4646984 and rs4646983), and COMT (rs165599 and rs740603) in Indian ADHD subjects with comorbid attributes. Cases were recruited following the Diagnostic and Statistical Manual for Mental Disorders-IV-TR after obtaining informed written consent. DNA isolated from peripheral blood leukocytes of ADHD probands (N = 170), their parents (N = 310), and ethnically matched controls (n = 180) was used for genotyping followed by population- and family-based analyses by the UNPHASED program. DRD4 sites showed significant difference in allelic frequencies by case-control analysis, while DDC and COMT exhibited bias in familial transmission (P < 0.05). rs3837091 "AGAG," rs3735273 "A," rs1799732 "C," rs740603 "G," rs165599 "G" and single repeat alleles of rs4646984/rs4646983 showed positive correlation with co-morbid characteristics (P < 0.05). Multi dimensionality reduction analysis of case-control data revealed significant interactive effects of all four genes (P < 0.001), while family-based data showed interaction between DDC and DRD2 (P = 0.04). This first study on these gene variants in Indo-Caucasoid ADHD probands and associated co-morbid conditions indicates altered dopaminergic neurotransmission in ADHD.
Evren, Cuneyt; Umut, Gokhan; Evren, Bilge
The aim of the present study was to evaluate relationship of self-mutilative behaviour (SMB) with the severity of childhood trauma and adult attention-deficit/hyperactivity disorder (ADHD) symptoms in a sample of inpatients with alcohol use disorder (AUD). Participants included 188 inpatients with AUD. Participants were evaluated with the Self-mutilative Behaviour Questionnaire, the Childhood Trauma Questionnaire (CTQ-28) and the Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale (Adult ADHD Scale). Among inpatients with AUD those who have a history of SMB constituted the SMB group (n = 57, 30.3%), and those without a history of SMB constituted the group without SMB (n = 131, 69.7%). Risk of high ADHD risk was 2.5 times higher among those with SMB. Adult ADHD Scale and CTQ-28 scores were also higher in the group with SMB. In the first backward logistic regression model, the severity of ADHD symptoms predicted the presence of SMB, together with the severity of childhood trauma, whereas in the second model, physical neglect and inattentive (IN) dimension of ADHD predicted the presence of SMB. These findings suggest that the higher severity of physical neglect and adult IN dimension of ADHD may be related to SMB among inpatients with AUD.
Egeland, Jens; Ueland, Torill; Johansen, Susanne
Participants with attention-deficit/hyperactivity disorder (ADHD) are often impaired in visuomotor tasks. However, little is known about the contribution of modal impairment in motor function relative to central processing deficits or whether different processes underlie the impairment in ADHD combined (ADHD-C) versus ADHD inattentive (ADHD-I) subtype. The present study analyzes performance on the Visual Motor Integration Test relative to less effortful motor tests as well as on measures of energetics. Both ADHD groups showed evidence of impaired motor function on both visual-motor integration (VMI) and the less effortful motor tests. The ADHD-C group performed below the ADHD-I group on VMI, but their performance correlated highly with the measures of the energetic pools of arousal and effort. Different mechanisms may underlie impaired fine motor skills in ADHD. Central processing deficits contribute significantly to the deficit of ADHD-C but do not explain the motor impairment in ADHD-I.
Wymbs, Brian T; Wymbs, Frances A; Dawson, Anne E
Attention-deficit hyperactivity disorder (ADHD) in children and adults increases risk of parenting difficulties and interparental discord. However, little is known about whether disruptive child behavior and adult ADHD operate additively or synergistically to predict parenting and interparental relationship quality. As part of a larger study, 90 parent couples were randomly assigned to interact with a 9-12 year-old confederate child exhibiting either ADHD/ODD-like behavior or typical behavior. Before these interactions, parents reported their own ADHD symptoms. Afterwards, parents reported on their partner's parenting and interparental communication behavior. Observers coded the parenting and communication behavior of both partners during the tasks. Child ADHD/ODD-like behavior was found to predict less positive and more negative parenting and communication reported by partners and observers beyond adult ADHD symptoms and other covariates. Elevated adult ADHD symptoms only uniquely increased risk of observer-coded negative parenting. Child and adult ADHD behavior interacted synergistically to predict partner-reported negative parenting and interparental communication, such that parents reporting greater ADHD symptoms-especially inattentiveness-were rated by their partners as parenting and communicating more negatively when managing child ADHD/ODD-like behavior than parents with fewer ADHD symptoms or those managing typical child behavior. Child and adult ADHD behavior did not interact to predict observer-coded parenting or interparental communication, and patterns did not differ for mothers or fathers. Our results underscore the potential risk of parents with elevated ADHD symptoms parenting and communicating negatively, at least as perceived by their partners, during interactions with children exhibiting ADHD/ODD behavior.
Breaux, Rosanna P; Brown, Hallie R; Harvey, Elizabeth A
The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children's ADHD.
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopment disorder of childhood that persists into adulthood in the majority of cases. In adults, the clinical picture of ADHD is complex and comorbidity with other psychiatric disorders is the rule. The documentation that the disorder had a childhood onset and the various comorbid symptomatologies present both in childhood and adult life represent the most influential obstacles for the accurate clinical diagnosis of the disorder. In 75% of cases with adult ADHD there is at least one coexisting comorbid disorder, with anxiety and mood disorders as well as substance abuse and impulse control disorders being the most prevalent ones. Adult psychiatrists have limited experience in the diagnosis, treatment and overall management of the disorder. Greece is a member of the European Network Adult ADHD (ENAA), founded in 2003, aiming to increase awareness of the disorder and to improve knowledge and patient care for adults with ADHD across Europe. A clinic where diagnosis as well as treatment recommendations are given after a thorough assessment of adult ADHD patients, is hosted at the First Department of Psychiatry of the Athens National and Kapodistian University. The clinic is in close collaboration with ENAA. The diagnosis of ADHD is given after a detailed evaluation of the patient, based on history taken, self-administered questionnaires and a specific psychiatric interview. The reliable trace of the symptoms' onset back in early childhood, current symptomatology, as well as its impact on at least two major areas of functioning (school, home, work or personal relationships) are pivotal for the assessment procedure. Special attention should be paid in the distinction of symptoms often coexisting with the core symptoms of the ADHD, such as emotional liability, incessant mental activity, avoidance of situations like queuing, especially when there is also frustration, from those indicating a comorbid
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…
Orendorff, Kimberly A.
Attention Deficit Hyperactivity Disorder (ADHD) is a common disorder that is often identified when a child first enters school. About 2% of boys and girls in our population are diagnosed with the disorder (Kaufmann, 2000). Although ADHD is the most frequent reason that children are referred to a mental health professional, the diagnosis of ADHD…
ADHD covers a group of common, chronic neurodevelopmental disorders characterised by developmentally abnormal and disabling levels of restlessness and overactivity (usually combined with impulsiveness) and/or inattention. There are three subtypes of ADHD: predominantly inattentive; predominantly hyperactive-impulsive; and combined type. For a diagnosis of ADHD to be made: onset of symptoms has to occur before the age of seven, symptoms should have been present longer than 6 months and they must be causing significant impairment. The prevalence of ADHD is at least 5%. Two-thirds of children with ADHD continue to have symptoms in adolescence. At the age of 25, half will still have symptoms which continue to cause significant impairment. ADHD is associated with an increased rate of other disorders: mood disorders; anxiety; other behavioural disorders; autism spectrum disorders; tic disorders; specific learning difficulties; developmental co-ordination disorder and sleep disorders. The GP has an important role in identification of possible ADHD, and onward referral, and also in the management of ADHD post-diagnosis, particularly with respect to prescribing medication usually on a shared care basis with specialist services.
Sollman, Myriam J.; Ranseen, John D.; Berry, David T. R.
Significant motivations and incentives exist for young-adult students to seek a diagnosis of attention-deficit/hyperactivity disorder (ADHD). With ADHD information readily accessible on the Internet, today's students are likely to be symptom educated prior to evaluation. This may result in false-positive diagnoses, particularly when students are…
Mullet, Dianna R.; Rinn, Anne N.
Some gifted children suffer from Attention Deficit Hyperactivity Disorder (ADHD), a neurodevelopmental disorder that impairs a child's functioning. For a diagnosis of ADHD, children under the age of 17 must display at least six symptoms of inattention or hyperactivity/impulsivity in at least two different settings (school and home, for example),…
DuPaul, George J.; White, George P.
The authors describe three types of ADHD behavior that affect from 3 percent to 7 percent of elementary school children, mostly boys. They recommend supplementing stimulant medication with behavior modification strategies, at home and school, to improve ADHD students' social skills and school performance.
Objective: Antidepressants, in particular Atomextine, along with stimulants have demonstrated benefit in the treatment of ADHD. Agomelatine is a new antidepressant with additional affinities to the melatonergic system. As ADHD has been associated with sleep disorders, it is assumed that Agomelatiine might serve as a therapeutic alternative to…
Montyla, Timo; Still, Johanna; Gullberg, Stina; Del Missier, Fabio
Objectives: This study examined decision-making competence in ADHD by using multiple decision tasks with varying demands on analytic versus affective processes. Methods: Adults with ADHD and healthy controls completed two tasks of analytic decision making, as measured by the Adult Decision-Making Competence (A-DMC) battery, and two affective…
This paper reports a small-scale study to determine whether there is a difference in problem-solving abilities, from a play perspective, between individuals who are diagnosed as ADHD and are on medication and those not on medication. Ten children, five of whom where on medication and five not, diagnosed as ADHD predominantly inattentive type, were…
Luman, Marjolein; Oosterlaan, Jaap; Hyde, Christopher; van Meel, Catharina S.; Sergeant, Joseph A.
Background: Both theoretical and clinical accounts of attention-deficit/hyperactivity disorder (ADHD) implicate a dysfunctional reinforcement system. This study investigated heart rate parameters in response to feedback associated with reward and response cost in ADHD children and controls aged 8 to 12. Methods: Heart rate responses (HRRs)…
Antshel, Kevin M.; Nastasi, Robert
An aspect of metacognition, metamemory (knowledge and awareness of one's memory) was investigated across time in preschool children with ADHD (n = 31) and a sample of age, sex, socioeconomic and IQ-matched typically developing children (n = 31). Only children with stable ADHD diagnoses were included. Participants were assessed on a variety of…
Reimherr, Frederick W.; Marchant, Barrie K.; Olsen, John L.; Wender, Paul H.; Robison, Reid J.
Objective: Oppositional defiant disorder (ODD) is the most common comorbid condition in childhood ADHD. This trial was prospectively designed to explore ODD symptoms in ADHD adults. Method: A total of 86 patients in this placebo-controlled, double-blind trial of methylphenidate transdermal system (MTS) were categorized based on the presence of ODD…
Stevenson, Jim; Asherson, Phil; Hay, David; Levy, Florence; Swanson, Jim; Thapar, Anita; Willcutt, Erik
The genetic study of ADHD has made considerable progress. Further developments in the field will be reliant in part on identifying the most appropriate phenotypes for genetic analysis. The use of both categorical and dimensional measures of symptoms related to ADHD has been productive. The use of multiple reporters is a valuable feature of the…
Hale, T. Sigi; Loo, Sandra K.; Zaidel, Eran; Hanada, Grant; Macion, James; Smalley, Susan L.
Introduction: Early observations from lesion studies suggested right hemisphere (RH) dysfunction in ADHD. However, a strictly right-lateralized deficit has not been well supported. An alternatively view suggests increased R greater than L asymmetry of brain function and abnormal interhemispheric interaction. If true, RH pathology in ADHD should…
Does the Cultural Formulation Interview (CFI) for the Fifth Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site
Aggarwal, Neil K.; DeSilva, Ravi; Nicasio, Andel V.; Boiler, Marit; Lewis-Fernández, Roberto
Objectives Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. Design We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n=64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Results Despite racial, ethnic, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient’s perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but 2 codes fell under the implementation outcome of clinical utility, 2 fell under acceptability, and none fell under feasibility. Conclusion Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes
This article reports the findings of a research study that used a critical social research methodology to review the increase in use of the diagnosis of attention deficit hyperactivity disorder (ADHD) and conceptualized the phenomenon within a theoretical framework based upon Beck's (1992, 1999) periodization of social change, the Risk Society. The study was qualitative in nature. Data were drawn from a wide range of sources including legitimating hearings, reports and studies, texts and seminal documents, field observations in schools and classrooms, and electronic discussion/bulletin board, and in-depth interviews with parents and teachers. The analysis used a critical framework to locate specific instances of claim and counter-claim and to set the historical context for understanding the "modern biological" method of intervention with children considered by parents and teachers as having ADHD. The findings of the study are structured in the context of risks. Further research will inform whether the risks become threats. Through exposure of silences, myths, contradictions and power relationships that create risks surrounding the ADHD phenomenon, it is hoped that discourse concerning the hegemonic medical model of ADHD in research and in the wider community will be further critically examined.
Lynch, Fiona A; Moulding, Richard; McGillivray, Jane A
Individuals with ADHD and comorbid hoarding disorder are vulnerable to severe consequences from hoarding symptoms. Despite this, and the early onset of hoarding disorder, the nature of hoarding symptoms in children with comorbid ADHD is unknown. We therefore explored the phenomenology of hoarding symptoms among ten 8-12year olds with ADHD and clinically significant hoarding symptoms through parental perceptions. Parents completed in-depth semi-structured interviews. The data was analyzed using Interpretative Phenomenological Analysis. Six superordinate themes were identified: emotional distress; parental avoidance and accommodating behaviors; family impacts of hoarding; excessive acquisition and saving; executive functioning; parental insight and intervention. In contrast to previous suggestions that emotional distress was not associated with hoarding in ADHD, these findings highlight that emotional distress appeared to be core to the hoarding disorder profile of the present sample of children with ADHD. This has important implications for health practitioners who may consider conceptualizing, assessing, and treating hoarding symptoms in children with comorbid ADHD using a cognitive behavioral model of hoarding disorder.
Connolly, JJ; Glessner, JT; Elia, J; Hakonarson, H
Attention deficit hyperactivity disorder (ADHD) is the most common neurobiological disorder in children, with a prevalence of ~6–7%1,2 that has remained stable for decades2. The social and economic burden associated with patients3, families, and broader systems (healthcare/educational) is substantial, with the annual economic impact of ADHD exceed $30 billion in the US alone4. Efficacy of pharmacotherapy in treating ADHD symptoms has generally been considerable with at least ¾ of individuals benefitting from pharmacotherapy, typically in the form of stimulants5. In this review, we begin by briefly reviewing the history of pharmacotherapy in relation to ADHD, before focusing (primarily) on the state-of-the-field on themes such as biophysiology, pharmacokinetics, and pharmacogenomics. We conclude with a summary of emerging clinical and research studies, particularly the potential role for precision therapy in matching ADHD patients and drug types. PMID:26366330
Schmitz, Marcelo; Ludwig, Henrique; Rohde, Luis A.
The objective of the current study was to evaluate a proposed restrictive inattentive type of Attention Deficit Hyperactivity Disorder (ADHD) by comparing clinical correlates among youths with ADHD inattentive type (ADHD-I) as a function of the number of hyperactivity symptoms presented (none vs. 3 or less) and controls (individuals without ADHD).…
Mullet, Dianna R.; Rinn, Anne N.
Many gifted characteristics overlap the symptoms of attention deficity-hyperactivity disorder (ADHD). The potential for the misdiagnosis of giftedness as ADHD exists, but so does the potential for a dual diagnosis of giftedness and ADHD. A decade after the misdiagnosis of giftedness as ADHD was first investigated we examine lessons learned…
Rucklidge, Julia J.; Brown, Deborah L.; Crawford, Susan; Kaplan, Bonnie J.
Objective: Although studies have documented higher prevalence of abuse in children with ADHD, no studies have investigated childhood reports of abuse in individuals identified with ADHD in adulthood. Method: Forty ADHD women, 17 ADHD males, 17 female controls, and 40 male controls complete the Childhood Trauma Questionnaire and other measures of…
Marchetta, Natalie D. J.; Hurks, Petra P. M.; De Sonneville, Leo M. J.; Krabbendam, Lydia; Jolles, Jelle
Objective: To examine the specificity of deficits in focused attention and sustained attention in adults with ADHD and to evaluate the effect of comorbidity. Method: Twenty-eight adults with ADHD without comorbidity were compared with 28 ADHD outpatients with comorbidity. Two control groups were used: 68 adults referred for ADHD but with another…
Donfrancesco, Renato; Parisi, Pasquale; Vanacore, Nicola; Martines, Francesca; Sargentini, Vittorio; Cortese, Samuele
Objective: (a) To compare serum ferritin levels in a sample of stimulant-naive children with ADHD and matched controls and (b) to assess the association of serum ferritin to ADHD symptoms severity, ADHD subtypes, and IQ. Method: The ADHD and the control groups included 101 and 93 children, respectively. Serum ferritin levels were determined with…
Mullane, Jennifer C.; Corkum, Penny V.; Klein, Raymond M.; McLaughlin, Elizabeth N.; Lawrence, Michael A.
Objective: This study evaluated the alerting, orienting, and executive attention abilities of children with ADHD and their typically developing (TD) peers using a modified version of the adult attention network test (ANT-I). Method: A total of 25 children with ADHD, Combined Type (ADHD-C, mean age = 9.20 years), 20 children with ADHD,…
Hammerness, Paul; Monuteaux, Michael C.; Faraone, Stephen V.; Gallo, Lauren; Murphy, Heather; Biederman, Joseph
The objective of this study is to further evaluate the association between asthma and ADHD, addressing issues of familiality in female probands. A case control study of referred ADHD proband girls, controls, and relatives are used. Participants include 140 ADHD proband girls and 122 non-ADHD comparisons, with 417 and 369 first-degree biological…
Thorell, Lisa B; Eninger, Lilianne; Brocki, Karin C; Bohlin, Gunilla
The present study investigated whether the Childhood Executive Function Inventory (CHEXI) can discriminate between young children fulfilling the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) and normally developing children. Unlike other executive function rating instruments, the CHEXI focuses specifically on inhibitory control and working memory, without including items that overlap with the diagnostic criteria of ADHD. The CHEXI was found to discriminate very well between children fulfilling the criteria for ADHD and normally developing children, also when controlling for the effect of IQ and socioeconomic status (SES). Both sensitivity and specificity of the two CHEXI subscales were shown to be high using either parent or teacher ratings. The highest overall classification rate was found for parent ratings on the inhibition subscale, with sensitivity and specificity reaching 93.3. To summarize, the CHEXI should be considered a promising measure for identifying young children with ADHD, although it is for future research to determine whether the CHEXI can be successfully used to also discriminate between different psychopathological groups.
Snyder, Steven M; Rugino, Thomas A; Hornig, Mady; Stein, Mark A
clinician's ADHD evaluation could help improve diagnostic accuracy from 61% to 88%. Conclusions The EEG-based assessment aid may help improve accuracy of ADHD diagnosis by supporting greater criterion E certainty. PMID:25798338
Fond, Guillaume; Ducasse, Déborah
The motivational interview aims to help patients to resolve their ambivalence regarding problematic behaviors and to guide them into change. It differs from other therapeutic approaches mainly through the attitude of the therapist. In motivational interviewing, the therapist defends the statu quo. By reactance, the patient defends the change and enhance her/his motivation. This article provides a summary of the other concepts of motivational interviewing and its applications in the psychiatric daily practice.
Chen, Wei J.; And Others
Examined diagnostic accuracy of Child Behavior Checklist (CBCL) scales for attention-deficit hyperactivity disorder (ADHD). Estimated 3 logistic regression models in 121 children with and without ADHD, then tested models in cross-validation sample (n=122) and among 219 siblings of samples. In all four groups, CBCL Attention Problems scale had…
Luman, Marjolein; van Noesel, Steffen J. P.; Papanikolau, Alky; Van Oostenbruggen-Scheffer, Janneke; Veugelers, Diane; Sergeant, Joseph A.; Oosterlaan, Jaap
This study compared children with ADHD-only, ADHD+ODD and normal controls (age 8-12) on three key neurocognitive functions: response inhibition, reinforcement sensitivity, and temporal information processing. The goal was twofold: (a) to investigate neurocognitive impairments in children with ADHD-only and children with ADHD+ODD, and (b) to test…
White, Marilyn Domas
Characterizes the questioning behavior in reference interviews preceding delegated online searches of bibliographic databases and relates it to questioning behavior in other types of interviews/settings. Compares questions asked by the information specialist and those asked by the client; findings show the information specialist dominates the…
Paulk, Larry J.
Describes an exit interview procedure for employees leaving the school system designed to identify potential personnel problems, maintain good employee relations, provide statistics on reasons for turnover, and provide assessment data for inservice education programs. Reports statistical data based on interview implementation, 1981-83. (TE)
Rossmann, Allan; Wasserstein, Ron
Ron Wasserstein is Executive Director of the American Statistical Association (ASA). He previously served as Vice-President for Academic Affairs and Professor of Statistics at Washburn University. This interview took place via email on January 21- February 24, 2014. Topics covered in this interview are as follows: 1) Beginnings, 2) Teaching…
Informational interviews are valuable tools for improving writing, editing, and interviewing skills, and they are also extremely valuable in improving the soft skills that are valued by employers, such as confidence, adaptability, the ability to set and keep deadlines, the ability to manage risk, and so on. These soft skills, this article argues,…
Daresh, John C.
When interviewing for a principal position, candidates should practice with friends and acquaintances, anticipate "sure thing" questions, listen and respond carefully, know something about the school and community, show passion and enthusiasm, and ask interviewers what the new principal ought to tackle first. (MLH)
This article presents an interview with Mark Ashwill, Director of the Institute of International Education-Vietnam in Ha Noi, Vietnam, a branch of the Institute of International Education (IIE). In this interview, Ashwill talks about his work as Director of the Institute of International Education-Vietnam, the role that communications technology…
Boyer, Bianca E; Geurts, Hilde M; Prins, Pier J M; Van der Oord, Saskia
Adolescents with ADHD have planning problems, often affecting school- and social functioning. Evidence-based treatments for adolescents with ADHD are scarce and treatment drop-out rates are substantial. The effectiveness of two new, individual, short-term cognitive behavioral therapies (CBT) was investigated: One with an aim on improving planning skills and one solution-focused treatment (SFT) without such an aim. Motivational Interviewing elements were added to both treatments to enhance treatment compliance. In a multi-center randomized clinical trial, 159 adolescents (12-17 years) with ADHD were randomly assigned to one of both treatments. Pre-, post- and 3-month follow-up data were gathered on five domains: Parent-rated ADHD, planning problems and executive functioning (primary outcomes), neuropsychological measures of planning, comorbid symptoms, general functioning, and teacher measures. Attrition was low in both treatments (5%). Adolescents improved significantly between pre- and post-test with large effect sizes on all domains. Improvements remained stable or continued to improve from post-test to follow-up, also when controlling for medication use. Marginally significant differences were found in favor of the planning-focused treatment: parents and therapists evaluated this treatment more positively than SFT and the planning-focused treatment showed more reduction of parent-rated planning problems. Two new CBTs with integrated motivational components were feasible and attrition was low. ADHD symptoms and co-existing problems of the adolescents improved from pre-test to 3 months after treatment. As the planning-focused treatment was evaluated more positive and had marginal additional beneficial effects to SFT, especially planning-focused CBT seems promising to fill the gap in available treatments for adolescents with ADHD.
Harrison, Judith R.; Vannest, Kimberly J.; Reynolds, Cecil R.
Objective: The objectives of this study were to evaluate whether behaviors that differentiate children and adolescents with ADHD from those without are related to the primary diagnostic criteria (i.e., inattention and impulsivity--hyperactivity), symptoms of comorbid conditions, functional impairment, or a combination, and to determine whether…
Wilson, Beverly J.; Manangan, Christen N.; Dauterman, Hayley A.; Davis, Heather N.
The current study sought to understand the relation between diagnostic status (autism spectrum disorders [ASD] versus typically developing) and internalizing problems in children with and without co-occurring attention deficit hyperactivity disorder (ADHD) symptoms. Participants were 88 children, ages 3:0-6:11, their parents and teachers. Findings…
Graziano, Paulo A.; McNamara, Joseph P.; Geffken, Gary R.; Reid, Adam M.
Objective:This study examined whether "top-down" and "bottom-up" control processes can differentiate children with ADHD who exhibit co-occurring aggression and/or internalizing symptoms. Method: Participants included 74 children ("M" age = 10.7 years) with a "Diagnostic and Statistical…
Lyons, M F
Those who don't "interview well" are not likely to receive the job offer, despite their qualifications. A job interview is actually a fierce competitive activity that offers only two grades: an A or F. By nature, physicians are competitive; they like to win. Infrequent interviewees are prone to making easily corrected mistakes, such as showing no enthusiasm or having poor eye contact. The key for interviewing success is preparation--doing research, developing a personal statement, and role-playing practice interviews. View the interview as a sales call whose bottom-line goal is to achieve an offer, or at least to let you leave with the option to return for future discussions.
Rommel, Anna-Sophie; Kitsune, Glenn L; Michelini, Giorgia; Hosang, Georgina M; Asherson, Philip; McLoughlin, Gráinne; Brandeis, Daniel; Kuntsi, Jonna
While attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) denote distinct psychiatric conditions, diagnostic delineation is impeded by considerable symptomatic overlap. Direct comparisons across ADHD and BD on neurophysiological measures are limited. They could inform us on impairments that are specific to or shared between the disorders and, therefore, potential biomarkers that may aid in the identification of the diagnostic boundaries. Our aim was to test whether quantitative EEG (QEEG) identifies differences or similarities between women with ADHD and women with BD during resting-state and task conditions. QEEG activity was directly compared between 20 ADHD, 20 BD and 20 control women during an eyes-open resting-state condition (EO) and a cued continuous performance task (CPT-OX). Both ADHD (t38 = 2.50, p = 0.017) and BD (t38 = 2.54, p = 0.018) participants showed higher absolute theta power during EO than controls. No significant differences emerged between the two clinical groups. While control participants showed a task-related increase in absolute theta power from EO to CPT-OX (t19 = -3.77, p = 0.001), no such change in absolute theta power was observed in the ADHD (t19 = -0.605, p = 0.553) or BD (t19 = 1.82, p = 0.084) groups. Our results provide evidence for commonalities in brain dysfunction between ADHD and BD. Absolute theta power may play a role as a marker of neurobiological processes in both disorders.
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Berger, Itai; Slobodin, Ortal; Aboud, Merav; Melamed, Julia; Cassuto, Hanoch
While data from behavioral, neuropsychological, and brain studies suggested that Attention-Deficit/Hyperactivity Disorder (ADHD) is related to a developmental lag that reduces with age, other studies have proposed that ADHD represents a deviant brain function. The present study used a cross-sectional approach to examine whether ADHD children show a developmental delay in cognitive performance measured by continuous performance test (CPT). We thus, compared six age groups of ADHD children (N = 559) and their unaffected peers (N = 365), aged 6–11, in four parameters of MOXO-CPT performance: Attention, Timing, Hyperactivity and Impulsivity. Results have shown that despite improvement in CPT performance with age, ADHD children continued to demonstrate impaired performance as compared to controls. In most parameters, CPT performance of ADHD children matched that of 1–3 years younger normal controls, with a delay most prominent in older children. However, in the Hyperactivity parameter, ADHD children's performance resembled that of much younger healthy children, with almost no evidence for a developmental catch up. This study suggests that while some cognitive functions develop slower but normally, other functions (e.g., inhibitory control) show a different trajectory. PMID:24298243
Lyons, Michael J.; And Others
Students in an abnormal psychology course worked in teams to produce dramatizations of diagnostic interviews and then presented them in class. Positive and negative aspects of the activity are discussed. (RM)
Sarver, Dustin E; Rapport, Mark D; Kofler, Michael J; Raiker, Joseph S; Friedman, Lauren M
Excess gross motor activity (hyperactivity) is considered a core diagnostic feature of childhood ADHD that impedes learning. This view has been challenged, however, by recent models that conceptualize excess motor activity as a compensatory mechanism that facilitates neurocognitive functioning in children with ADHD. The current study investigated competing model predictions regarding activity level's relation with working memory (WM) performance and attention in boys aged 8-12 years (M = 9.64, SD = 1.26) with ADHD (n = 29) and typically developing children (TD; n = 23). Children's phonological WM and attentive behavior were objectively assessed during four counterbalanced WM tasks administered across four separate sessions. These data were then sequenced hierarchically based on behavioral observations of each child's gross motor activity during each task. Analysis of the relations among intra-individual changes in observed activity level, attention, and performance revealed that higher rates of activity level predicted significantly better, but not normalized WM performance for children with ADHD. Conversely, higher rates of activity level predicted somewhat lower WM performance for TD children. Variations in movement did not predict changes in attention for either group. At the individual level, children with ADHD and TD children were more likely to be classified as reliably Improved and Deteriorated, respectively, when comparing their WM performance at their highest versus lowest observed activity level. These findings appear most consistent with models ascribing a functional role to hyperactivity in ADHD, with implications for selecting behavioral treatment targets to avoid overcorrecting gross motor activity during academic tasks that rely on phonological WM.
Luman, Marjolein; van Noesel, Steffen J P; Papanikolau, Alky; Van Oostenbruggen-Scheffer, Janneke; Veugelers, Diane; Sergeant, Joseph A; Oosterlaan, Jaap
This study compared children with ADHD-only, ADHD+ODD and normal controls (age 8-12) on three key neurocognitive functions: response inhibition, reinforcement sensitivity, and temporal information processing. The goal was twofold: (a) to investigate neurocognitive impairments in children with ADHD-only and children with ADHD+ODD, and (b) to test whether ADHD+ODD is a more severe from of ADHD in terms of neurocognitive performance. In Experiment 1, inhibition abilities were measured using the Stop Task. In Experiment 2, reinforcement sensitivity and temporal information processing abilities were measured using a Timing Task with both a reward and penalty condition. Compared to controls, children with ADHD-only demonstrated impaired inhibitory control, showed more time underestimations, and showed performance deterioration in the face of reward and penalty. Children with ADHD+ODD performed in-between children with ADHD-only and controls in terms of inhibitory controls and the tendency to underestimate time, but were more impaired than controls and children with ADHD-only in terms of timing variability. In the face of reward and penalty children with ADHD+ODD improved their performance compared to a neutral condition, in contrast to children with ADHD-only. In the face of reward, the performance improvement in the ADHD+ODD group was disproportionally larger than that of controls. Taken together the findings suggest that, in terms of neurocognitive functioning, comorbid ADHD+ODD is a substantial different entity than ADHD-only.
Doernberg, Ellen; Hollander, Eric
Neurodevelopmental disorders, specifically autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) have undergone considerable diagnostic evolution in the past decade. In the United States, the current system in place is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), whereas worldwide, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) serves as a general medical system. This review will examine the differences in neurodevelopmental disorders between these two systems. First, we will review the important revisions made from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) to the DSM-5, with respect to ASD and ADHD. Next, we will cover the similarities and differences between ASD and ADHD classification in the DSM-5 and the ICD-10, and how these differences may have an effect on neurodevelopmental disorder diagnostics and classification. By examining the changes made for the DSM-5 in 2013, and critiquing the current ICD-10 system, we can help to anticipate and advise on the upcoming ICD-11, due to come online in 2017. Overall, this review serves to highlight the importance of progress towards complementary diagnostic classification systems, keeping in mind the difference in tradition and purpose of the DSM and the ICD, and that these systems are dynamic and changing as more is learned about neurodevelopmental disorders and their underlying etiology. Finally this review will discuss alternative diagnostic approaches, such as the Research Domain Criteria (RDoC) initiative, which links symptom domains to underlying biological and neurological mechanisms. The incorporation of new diagnostic directions could have a great effect on treatment development and insurance coverage for neurodevelopmental disorders worldwide.
Conner, Alex C; Kissling, Christian; Hodges, Edward; Hünnerkopf, Regina; Clement, R Marc; Dudley, Edward; Freitag, Christine M; Rösler, Michael; Retz, Wolfgang; Thome, Johannes
Adult attention deficit hyperactivity disorder (ADHD) is a widely under-reported but nevertheless common condition with a clear heritable component. Several genes have been proposed to play a role in the childhood onset of this neurodevelopmental disorder; however, association studies of persistence of ADHD into adulthood have rarely been performed. Neurotrophic factors (NTFs) are known to be involved in several aspects of neuronal development and neural plasticity in adults. They have also been linked, particularly through brain-derived neurotrophic factor (BDNF) interaction with dopamine transport, to the pathophysiology of ADHD. This study compares the genotypes of six different single nucleotide polymorphisms of genes within the neurotrophin system and their possible association with adult ADHD score in 143 high-risk male subjects referred to a forensic psychiatric unit. The genes included NTF3, NTRK2 (TrkB), NTRK3 (TrkC), BDNF, and p75(NTR). While none of the SNPs showed significant association with ADHD symptoms, one polymorphism within the exon of NTF3 (rs6332) showed a trend toward an association between the A-allele and increased scores using both the retrospective childhood analysis Wender-Utah Rating Scale (WURS-k) (P = 0.05) and the adult ADHD assessment Wender-Reimherr interview (P = 0.03). This SNP is a silent mutation which might be in linkage disequilibrium with a functional risk variant for ADHD. As the association was only suggestive, however, this finding needs replication in a larger study with higher power.
Conn, P Jeffrey
Dr Conn is the Lee E Limbird Professor of Pharmacology at Vanderbilt University and Director of the Vanderbilt Center for Neuroscience Drug Discovery (VCNDD). Dr Conn received a PhD in Pharmacology from Vanderbilt in 1986 and pursued postdoctoral studies at Yale University. He served as a professor of Pharmacology at Emory University from 1988 to 2000, before moving to Merck and Co. (PA, USA) as head of the Department of Neuroscience. Dr Conn moved to Vanderbilt University in 2003 where he is the founding director of the VCNDD, with a primary mission of facilitating translation of recent advances in basic science to novel therapeutics. The VCNDD consists of approximately 100 full-time scientists and has advanced novel molecules from four major programs as development candidates for clinical testing with industry partners. Dr Conn has served in editorial positions with multiple international journals and has served the scientific advisory boards of multiple foundations and companies. He has received numerous awards based on the impact of his basic and translational research. Dr Conn's current research is focused on development of novel treatment strategies for schizophrenia, Parkinson's disease and other serious brain disorders. Interview conducted by Hannah Coaker, Assistant Commissioning Editor.
Middle school student Molly Moore interviews NASA's Associate Administrator for Education, Leland Melvin. She asks about his career as an engineer and astronaut and what it was like to live and wor...
An interview with Joseph Featherstone, a teacher at Michigan State University, reveals his attitudes regarding good teaching. Good teaching is a victory over meaninglessness, giving children the chance to hope and to have faith in their future. (CB)
Peters, Kath; Halcomb, Elizabeth
Interviews are a common method of data collection in nursing research. They are frequently used alone in a qualitative study or combined with other data collection methods in mixed or multi-method research. Semi-structured interviews, where the researcher has some predefined questions or topics but then probes further as the participant responds, can produce powerful data that provide insights into the participants' experiences, perceptions or opinions.
Nordgaard, Julie; Sass, Louis A; Parnas, Josef
There is a glaring gap in the psychiatric literature concerning the nature of psychiatric symptoms and signs, and a corresponding lack of epistemological discussion of psycho-diagnostic interviewing. Contemporary clinical neuroscience heavily relies on the use of fully structured interviews that are historically rooted in logical positivism and behaviorism. These theoretical approaches marked decisively the so-called "operational revolution in psychiatry" leading to the creation of DSM-III. This paper attempts to examine the theoretical assumptions that underlie the use of a fully structured psychiatric interview. We address the ontological status of pathological experience, the notions of symptom, sign, prototype and Gestalt, and the necessary second-person processes which are involved in converting the patient's experience (originally lived in the first-person perspective) into an "objective" (third person), actionable format, used for classification, treatment, and research. Our central thesis is that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects. We claim that in order to perform faithful distinctions in this particular domain, we need a more adequate approach, that is, an approach that is guided by phenomenologically informed considerations. Our theoretical discussion draws upon clinical examples derived from structured and semi-structured interviews. We conclude that fully structured interview is neither theoretically adequate nor practically valid in obtaining psycho-diagnostic information. Failure to address these basic issues may have contributed to the current state of malaise in the study of psychopathology.
Brook, Uzi; Boaz, Mona
Three hundred and eight pupils in the age group 12-18 years were interviewed and examined. They had been diagnosed as having attention deficit and hyperactivity disorder (ADHD) and learning disabilities (LD), and were attending a high school devoted to special education. Their classification into subgroups was as follows: ADHD - inattentive (I) = 22.1%, ADHD - hyperactivity/impulsivity (HI) = 12.3% and combined = 42.2%. Only 25% of them were treated by methylphenidate (Ritalin). Ninety-four percent of them were diagnosed with comorbidity of 'learning disabilities'. Thirty-four percent of them reported being severely stressed when going to school and sitting in class. Their complaints were: tiredness and excessive needs to sleep, frequent quarrelling with close friends, feeling different from other classmates and having low self-esteem (SE). They complaint that their parents don't understand them. Things that irritated them the most were being lied to and coercion by others. The authors suggest to consider ADHD/LD as neurobehavioral disability. It is mandatory to prepare them for adult life with proper social skills and a suitable occupation.
Moody, Myles D
Prior research indicates that attention-deficit/hyperactivity disorder (ADHD) is underdiagnosed, or less likely to be diagnosed, among Black children relative to White children and children in other non-Black racial categories. Scholars have suggested that this may be a result of cultural biases or misconceptions that affect the ways classroom behavior is interpreted. The purpose of this pilot study was to engage a larger theoretical framework that explores the relationships between parents and teachers and to examine some of the ways in which common cultural misconceptions can lead to flawed behavioral ascriptions in the classroom, producing negative social outcomes for Black children. Findings from ethnography and interviews reveal that the most common barriers in this low-income neighborhood school setting included poor parent-teacher rapport, a general lack of basic understanding for how ADHD can affect classroom behavior, and faulty procedures in the school setting based on cultural stereotypes. These findings suggest that school officials' disinclination to recommend ADHD testing for Black children may be largely a result of the aforementioned obstacles. A larger study based on these results may produce more robust findings about the barriers that contribute to racial disparities in ADHD diagnoses.
... There's no solid evidence that food additives cause attention-deficit/hyperactivity disorder (ADHD). However, the topic of food additives and their possible effects is controversial. Some studies indicate that certain food ...
... child’s diet?Should I limit my child’s screen time (TV, computer, video games)? ResourcesAmerican Psychiatric Association, Help With ADHDNational Alliance on Mental Illness, Not Just a Childhood Disorder: How ADHD ...
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…
Halperin, Jeffrey M; Bédard, Anne-Claude V; Curchack-Lichtin, Jocelyn T
It is proposed that the time is ripe for the development of secondary preventive interventions for attention-deficit/hyperactivity disorder (ADHD). By targeting preschool children, a developmental stage during which ADHD symptoms first become evident in most children with the disorder, many of the adverse long-term consequences that typify the trajectory of ADHD may be avoided. A dynamic/interactive model of the biological and environmental factors that contribute to the emergence and persistence of ADHD throughout the lifespan is proposed. Based on this model, it is argued that environmental influences and physical exercise can be used to enhance neural growth and development, which in turn should have an enduring and long-term impact on the trajectory of ADHD. Central to this notion are 2 hypotheses: 1) environmental influences can facilitate structural and functional brain development, and 2) changes in brain structure and function are directly related to ADHD severity over the course of development and the degree to which the disorder persists or remits with time. We present experimental and correlational data supporting the first hypothesis and longitudinal data in individuals with ADHD supporting the second. The case is made for initiating such an intervention during the preschool years, when the brain is likely to be more "plastic" and perhaps susceptible to lasting modifications, and before complicating factors, such as comorbid psychiatric disorders, academic failure, and poor social and family relationships emerge, making successful treatment more difficult. Finally, we review recent studies in young children with ADHD that might fall under the umbrella of secondary prevention.
Sitzmann, Marion; Garcia, Reloy
This booklet offers practical examples and guidelines to assist job hunters and other applicants in effectively confronting the interview process. Chapters include "Preparing for an Interview," which traces the process from making an initial inquiry to the actual interview situation and analyzes the interviewer's role; "The Job Interview: Practice…
von Polier, G G; Vloet, T D; Herpertz-Dahlmann, B
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders of childhood and adolescence. Until now, it has been unclear whether ADHD by itself constitutes a risk factor for later delinquency or does so only in combination with other disruptive symptoms. This article seeks to give a comprehensive account of the literature to shed light on the developmental pathway from childhood ADHD to adult criminality. Comorbid ADHD and conduct disorder (CD) are significantly related to a range of biological and environmental risk factors such as neurocognitive impairment, high parental psychopathology, poor social functioning, and other comorbid mental disorders, particularly substance abuse, that are described in this review. In addition, the results of treatment studies are presented, with a special focus on the results of the Multimodal Treatment Study of Children with ADHD (MTA). Although treatment programs, including medication and psychosocial treatment, can be very effective in improving the functioning of children with ADHD in the social and academic domains in the short term, there is no conclusive evidence that such treatments lower the risk for developing delinquency in adulthood.
Retz, Wolfgang; Rösler, Michael
Disruptive behavior includes psychopathological and behavioral constructs like aggression, impulsivity, violence, antisociality and psychopathy and is often closely related with diagnostic categories like conduct disorder (CD), attention deficit disorder (ADHD) and antisocial personality disorder (ASP). There is now clear evidence that neurobiological and environmental factors contribute to these phenotypes. A mounting body of evidence also suggests interactive effects of genetic and environmental risks. In this selective review we give an overview over epidemiological aspects of the relation between ADHD and antisocial behavior, including violent aggression and psychopathy. Moreover, we summarize recent findings from molecular genetic studies and particularly discuss pleiotropic effects of a functional polymorphism of the serotonin transporter promoter gene (5HTTLPR) and childhood adversity on ADHD and violent behavior. The reported gene-environment interactions are not only informative for understanding the neurobiological underpinnings of disruptive behavior, but also throw some light on the relation between ADHD and violent behavior from a genetic perspective. The impact of genetic research on forensic psychiatry and future directions of neurobiological research are discussed.
de Zeeuw, Eveline L; van Beijsterveldt, Catharina E M; Lubke, Gitta H; Glasner, Tina J; Boomsma, Dorret I
One criterion for a diagnostic and statistical manual of mental disorders (DSM-IV) diagnosis of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) is that symptoms are present in at least two settings, and often teacher ratings are taken into account. The short Conners' Teacher Rating Scales-Revised (CTRS-R) is a widely used standardized instrument measuring ODD and ADHD behavior in a school setting. In the current study CTRS-R data were available for 7, 9 and 12-year-old twins from the Netherlands Twin Register. Measurement invariance (MI) across student gender and teacher gender was established for three of the four scales (Oppositional Behavior, Hyperactivity and ADHD Index) of the CTRS-R. The fourth scale (ATT) showed an unacceptable model fit even without constraints on the data and revision of this scale is recommended. Gene-environment (GxE) interaction models revealed that heritability was larger for children sharing a classroom. There were some gender differences in the heritability of ODD and ADHD behavior and there was a moderating effect of teacher's gender at some of the ages. Taken together, this indicates that there was evidence for GxE interaction for classroom sharing, gender of the student and gender of the teacher.
Del-Ponte, Bianca; Santos, Iná S; Tovo-Rodrigues, Luciana; Anselmi, Luciana; Munhoz, Tiago N; Matijasevich, Alicia
Objective Studies evaluating caffeine intake during pregnancy and long-term outcomes, such as the child's neurobehaviour, are still scarce and their results are inconsistent. The objective of the present study was to evaluate the association between maternal consumption of caffeine during pregnancy and attention deficit hyperactivity disorder (ADHD) at the age of 11 years. Methodology All children born in the city of Pelotas, Brazil, during the year 2004, were selected for a cohort study. The mothers were interviewed at birth to obtain information on coffee and yerba mate consumption during pregnancy, among other matters. At the age of 11 years, presence of ADHD was evaluated using the Development and Well-Being Assessment (DAWBA) questionnaire, applied to the mothers. The prevalence of ADHD was calculated, with 95% CIs. The association between caffeine consumption and ADHD was tested by means of logistic regression. Results 3485 children were included in the analyses. The prevalence of ADHD was 4.1% (95% CI 3.4% to 4.7%): 5.8% (95% CI 4.7% to 6.9%) among boys and 2.3% (95% CI 1.5% to 3.0%) among girls. The prevalence of caffeine consumption during the entire pregnancy and in the first, second and third trimesters was 88.7% (87.7% to 89.7%), 86.5% (85.4% to 87.5%), 83.0% (81.8% to 84.2%) and 92.3% (91.4% to 93.1%), respectively. Caffeine consumption during the entire pregnancy and the first, second and third trimesters were not associated with ADHD in the crude or adjusted analysis. Conclusions The present study did not show any association between maternal caffeine consumption during pregnancy and ADHD at the age of 11 years. PMID:27920084
During the past 15 years, an impressive amount of genetic information has become available in the research field of psychiatry, particularly as it relates to attention-deficit/hyperactivity disorder (ADHD). However, the classical clinical approach to ADHD has minimally affected and not significantly been improved by this genetic revolution. It is difficult to predict how long it will take for genetic findings to alter the way clinicians treat patients with ADHD. New medications or treatment protocols may take years to become routine clinical practice. However, when taken together, recent successes in genomics, pharmacogenomics, and genetic epidemiology have the potential (1) to prevent comorbid consequences of ADHD, (2) to individualize therapies for patients with ADHD, and (3) to define new epidemiological policies to aid with the impact of ADHD on society. Here, we present an overview of how genetic research may affect and improve the quality of life of patients with ADHD: as an example, we use the discovery of LPHN3, a new gene in which variants have recently been shown to be associated with ADHD. PMID:21432600
Hall, Cathy W.; Peterson, Andrea D.; Webster, Raymond E.; Bolen, Larry M.; Brown, Michael B.
Study examined ability of attention deficit hyperactive disorder (ADHD) children with and without learning disability to perceive nonverbal social cues. ADHD/LD children demonstrated significant difficulty in comparison to their peers in effectively perceiving paralanguage cues. This group also showed significant improvement on the Postures and…
Martin, Andrew J.
Students with attention-deficit/hyperactivity disorder (ADHD) experience significant academic difficulties that can lead to numerous negative academic consequences. With a focus on adverse academic outcomes, this study seeks to disentangle variance attributable to ADHD from variance attributable to salient personal and contextual covariates.…
Kalil, Katiane L S; Bau, Claiton H D; Grevet, Eugenio H; Sousa, Nyvia O; Garcia, Christiane R; Victor, Marcelo M; Fischer, Aline G; Salgado, Carlos A I; Belmonte-de-Abreu, Paulo
Adults with attention-deficit/hyperactivity disorder (ADHD) are predisposed to smoking, but the neuropsychological correlates of this association have not been elucidated so far. The present study evaluates possible associations between cognitive performance and smoking and other comorbidities in adults with ADHD. Two hundred and sixty-four (264) patients were evaluated in the adult ADHD outpatient clinic of the Hospital de Clínicas de Porto Alegre. The diagnoses were based on the DSM-IV criteria and interviews were performed with the Portuguese version of K-SADS-E for ADHD and oppositional-defiant disorder. Axis I psychiatric comorbidities were evaluated with the SCID-IV and the cognitive performance with the Vocabulary and Block Design subtests of the Wechsler Adult Intelligence Scale-Revised (WAIS-R). The evaluation of the influence of the WAIS-R scores on each dependent variable was performed with logistic regression analyses. Lower scores in the Block Design subtest of WAIS-R were associated with smoking and the presence of anxiety disorder. These results suggest that a subgroup of ADHD patients with lower Block Design subtest scores may be at increased risk of smoking as a cognitive enhancement. Our findings also confirmed the previously suggested association between anxiety and lower Block Design scores.
Sobanski, E; Sabljic, D; Alm, B; Skopp, G; Kettler, N; Mattern, R; Strohbeck-Kühner, P
This study assesses driving behaviour and history of driving outcomes through a semi-structured interview in 27 clinically referred German adults with ADHD and 27 age-, gender- and education-matched non-ADHD controls. In nineteen of the ADHD-subjects a test battery of driving-related cognitive measures was performed (ART 2020) and re-assessed after at least six weeks of treatment with methylphenidate (n = 9) or after a six-week medication free period (n = 10).ADHD-subjects drove significantly more kilometres per year, were more often registered by traffic authorities and fined more frequently, were involved in more accidents and described their driving style as more insecure and hectic than controls. A high-risk driving group was delineated with 3-6 accidents per ADHD-subject. All results were controlled for intercorrelations with driving experience. Methylphenidate treatment resulted in improved information processing, e.g., better visu-motor coordination under high-stress conditions, improved visual orientation and sustained visual attention compared to baseline and our untreated control group.
King, Kerry; Alexander, Daleen; Seabi, Joseph
This qualitative study explored siblings’ perceptions of the impact a sibling diagnosed with ADHD has within the family system. Specific focus was placed on the different ways these different sibling cohorts were parented. Participants constituted eight adult females with a mean age of 20 years from different cultural and socio-economic backgrounds in the province of Gauteng, South Africa. Data was collected using semi-structured interviews and was analysed thematically. The four themes that emerged from the interviews include differential parental treatment, rejection, discrepancy with discipline, and the parentified child. Specifically, the results of this study revealed feelings of differential parental treatment and discipline that took place in the home and rejection experienced by the non-ADHD sibling. There was also a common theme of a parentified child, who had to carry a burden of caring for their sibling with ADHD. The non-diagnosed siblings perceive themselves to be particularly negatively impacted. The results are discussed in light of the previous empirical studies, and recommendations are made. PMID:27649212
O'Connell, Daniel C; Kowal, Sabine; Ageneau, Carie
A psycholinguistic hypothesis regarding the use of interjections in spoken utterances, originally formulated by Ameka (1992b, 1994) for the English language, but not confirmed in the German-language research of Kowal and O'Connell (2004 a & c), was tested: The local syntactic isolation of interjections is paralleled by their articulatory isolation in spoken utterances i.e., by their occurrence between a preceding and a following pause. The corpus consisted of four TV and two radio interviews of Hillary Clinton that had coincided with the publication of her book Living History (2003) and one TV interview of Robin Williams by James Lipton. No evidence was found for articulatory isolation of English-language interjections. In the Hillary Clinton interviews and Robin Williams interviews, respectively, 71% and 73% of all interjections occurred initially, i.e., at the onset of various units of spoken discourse: at the beginning of turns; at the beginning of articulatory phrases within turns, i.e., after a preceding pause; and at the beginning of a citation within a turn (either Direct Reported Speech [DRS] or what we have designated Hypothetical Speaker Formulation [HSF]. One conventional interjection (OH) occurred most frequently. The Robin Williams interview had a much higher occurrence of interjections, especially nonconventional ones, than the Hillary Clinton interviews had. It is suggested that the onset or initializing role of interjections reflects the temporal priority of the affective and the intuitive over the analytic, grammatical, and cognitive in speech production. Both this temporal priority and the spontaneous and emotional use of interjections are consonant with Wundt's (1900) characterization of the primary interjection as psychologically primitive. The interjection is indeed the purest verbal implementation of conceptual orality.
Yang, Hui-Nien; Tai, Yueh-Ming; Yang, Li-Kuang; Gau, Susan Shur-Fen
Childhood attention-deficit/hyperactivity disorder (ADHD) symptoms may persist, co-occur with anxiety and depression (ANX/DEP), and influence quality of life (QoL) in later life. However, the information about whether these persistent ADHD and ANX/DEP mediate the influence of childhood ADHD on adverse QoL in adulthood is lacking. This study aimed to determine whether adult ADHD symptoms and/or ANX/DEP mediated the association between childhood ADHD and QoL. We assessed 1382 young men aged 19-30 years in Taiwan using self-administered questionnaires for retrospective recall of ADHD symptoms at ages 6-12, and assessment of current ADHD and ANX/DEP symptoms, and QoL. We conducted mediation analyses and compared the values of mediation ratio (PM) by adding mediators (adult ADHD and ANX/DEP), individually and simultaneously into a regression model with childhood ADHD as an independent variable and QoL as a dependent variable. Our results showed that both adult ADHD and ANX/DEP symptoms significantly mediated the association between childhood ADHD and QoL (PM=0.71 for ANX/DEP, PM=0.78 for adult ADHD symptoms, and PM=0.91 for both). The significance of negative correlations between childhood ADHD and four domains of adult QoL disappeared after adding these two mediators in the model. Our findings suggested that the strong relationship between childhood ADHD and adult life quality can be explained by the presence of persistent ADHD symptoms and co-occurring ANX/DEP. These two mediators are recommended to be included in the assessment and intervention for ADHD to offset the potential adverse life quality outcome in ADHD.
Edel, Marc-Andreas; Juckel, Georg; Brüne, Martin
Research into attachment and emotion regulation has shown that children with ADHD are at risk of developing attachment disorders and emotion regulation disturbances, which in part may be due to the rearing style of their parents. No such data exists for adults with persistent ADHD. We hypothesized that current attachment style and emotion processing of adult patients with ADHD may be influenced by the presence of parental ADHD symptoms when the now adult patients were children, assuming that ADHD symptoms of parents have an impact on their parenting style. We examined recalled parental ADHD symptoms and rearing style as well as current attachment and emotion regulation abilities in a sample of 73 adults with ADHD using several self-rating instruments. Recalled prevalence of ADHD symptoms in the mother, and less so in the father, of adult patients with ADHD was significantly associated with partly adverse parental rearing styles, current attachment problems in romantic partnerships and emotion regulation disturbances compared with adult ADHD patients without possibly affected parent. ADHD symptoms in parents of children with ADHD may present a risk factor for attachment problems and poor emotion regulation when ADHD children are grown.
Background The aims of this study were to assess the prevalence of a comorbid Attention Deficit Hyperactivity Disorder (ADHD) diagnosis in Borderline Personality Disorder (BPD), and its impact on the clinical presentation of BPD in adolescents, and to determine which type of impulsivity specifically characterizes adolescents with BPD-ADHD. Methods ADHD diagnoses were sought in a sample of 85 DSM-IV BPD adolescents drawn from the EURNET BPD. Axis-I and -II disorders were determined with the K-SADS-PL and the SIDP-IV, respectively. Impulsivity was assessed with the BIS-11. Results 11% (N = 9) of BPD participants had a current ADHD diagnosis. BPD-ADHD adolescents showed higher prevalence of Disruptive disorders (Chi2 = 9.09, p = 0.01) and a non-significant trend for a higher prevalence of other cluster B personality disorders (Chi2 = 2.70, p = 0.08). Regression analyses revealed a significant association between Attentional/Cognitive impulsivity scores and ADHD (Wald Z = 6.69; p = 0.01; Exp(B) = 2.02, CI 95% 1.19-3.45). Conclusions Comorbid ADHD influences the clinical presentation of adolescents with BPD and is associated with higher rates of disruptive disorders, with a trend towards a greater likelihood of cluster B personality disorders and with higher levels of impulsivity, especially of the attentional/cognitive type. A subgroup of BPD patients may exhibit developmentally driven impairments of the inhibitory system persisting since childhood. Specific interventions should be recommended for this subsample of BPD adolescents. PMID:21961882
Presents an interview with Dr. Nathan Hare, who proposes to address some of the problems of lower class, Black male youth by developing a formally supervised ritual to initiate the Black boy into adult male maturity and asserts that materialism prevents rather than promotes success. (KH)
This interview with Esther Dyson, who is president and owner of EDventure Holdings which focuses on emerging information technology worldwide, discusses personal responsibility for technology; government's role; content ownership and intellectual property; Internet development; education and computers; parents' role in education; teacher…
Rossman, Allan; Utts, Jessica
This article offers a transcript of author Allan Rossman's interview with Jessica Utts, Professor and Chair of Statistics at the University of California-Irvine. Utts is also a Fellow of the American Statistical Association and a recipient of a Founders Award from ASA. Additionally, she has been elected as President of ASA for the year 2016. The…
Albers, Peggy; Koshewa, Allen
Interviews Shelley Harwayne, founder of the Manhattan New School, who has been named one of 10 new regional superintendents for New York City's public school system. Explains that Shelley's work is renowned in literacy. Discusses leadership, diversity, teaching, and professional development. (PM)
Rossman, Allan; Franklin, Christine
Chris Franklin is Senior Lecturer, Undergraduate Coordinator, and Lothar Tresp Honoratus Honors Professor of Statistics at the University of Georgia. She is a Fellow of the American Statistical Association and received the USCOTS Lifetime Achievement Award in 2013. This interview took place via email on August 16, 2013-October 9, 2013. Franklin…
von Munkwitz-Smith, Jeffrey
This issue of "College and University" marks a transition in the Editor-in-Chief Position, with the interview of Louise Lonabocker, who has served in this capacity for the past ten years. She has also served as President of AACRAO, and in both positions, Lonabocker has been a role model for many AACRAO leaders. Lonabocker describes the…
This article presents an interview with Deborah Andrews about her experiences during her editorship of "Business Communication Quarterly." From June 1997 to March 2005, Debby served as editor of the journal, encouraging all readers to ask important questions about their work: How should we define business communication? On which disciplines and…
Interviewing children is a critical element of the education reporter's daily work. However, practices for gaining access and avoiding harm and embarrassment vary widely depending on the news organization and individual reporter in question. This document aims to provide journalists with broad guidelines, but it stops short of advocating for the…
Presents an interview with Patrick Shannon, a professor of Education at Penn State University. Describes how he writes widely on the politics of literacy and, in particular, the marketing of literacy. Discusses his interpretation of how literacy is marketed in schools today. (SG)
Ives, Edward D.
This guide is divided into 11 sections, each containing a number of questions and suggestions for conducting successful folklore and oral history interviews. Section 1, "Settlement and Dwellings," deals with the physical environment, local inhabitants, houses and outbuildings, and public buildings. Section 2, "Livelihood and…
Gadow, Kenneth D; DeVincent, Carla J
The goal of this study was to examine the clinical significance of co-occurring tics and attention-deficit hyperactivity disorder (ADHD) as indicators of a more complex symptomatology in children with and without pervasive developmental disorder. Parents and teachers completed a Diagnostic and Statistical Manual of Mental Disorders-IV-referenced rating scale for 3- to 5- (n = 182/135) and 6- to 12- (n = 301/191) year-old children with pervasive developmental disorder and clinic controls, respectively. The percentage of children with tic behaviors varied with age: preschoolers (25%, 44%) versus elementary schoolchildren (60%, 66%) (parent and teacher ratings, respectively). For many psychiatric symptoms, screening prevalence rates were highest for the ADHD + tics group and lowest for the group with symptoms of neither, but the pattern of group differences varied by age group and informant. In general, there were few differences between the ADHD only and tics only groups. The pattern of ADHD/tic group differences was similar for both children with and without pervasive developmental disorder. We concluded that these findings support the notion that the co-occurrence of ADHD and tics is an indicator of a more complex psychiatric symptomatology in children with pervasive developmental disorder.
Froelich, Robert E.
Course develops medical interviewing skills of students through a programed manual, role-playing exercises, programed patients and medical interviewing films, and the writing of medical histories. (IR)
Seda, Ileana; Pearson, P. David
Presents open-ended and semistructured interviews to assess reading comprehension. Highlights the potential value of interviews in aligning assessment practices with instruction and learning theory. (MG)
Ziegler, Sigurd; Pedersen, Mads L; Mowinckel, Athanasia M; Biele, Guido
Attention deficit hyperactivity disorder (ADHD) is characterized by altered decision-making (DM) and reinforcement learning (RL), for which competing theories propose alternative explanations. Computational modelling contributes to understanding DM and RL by integrating behavioural and neurobiological findings, and could elucidate pathogenic mechanisms behind ADHD. This review of neurobiological theories of ADHD describes predictions for the effect of ADHD on DM and RL as described by the drift-diffusion model of DM (DDM) and a basic RL model. Empirical studies employing these models are also reviewed. While theories often agree on how ADHD should be reflected in model parameters, each theory implies a unique combination of predictions. Empirical studies agree with the theories' assumptions of a lowered DDM drift rate in ADHD, while findings are less conclusive for boundary separation. The few studies employing RL models support a lower choice sensitivity in ADHD, but not an altered learning rate. The discussion outlines research areas for further theoretical refinement in the ADHD field.
Silva, Katiane L.; Guimaraes-da-Silva, Paula O.; Grevet, Eugenio H.; Victor, Marcelo M.; Salgado, Carlos A. I.; Vitola, Eduardo S.; Mota, Nina R.; Fischer, Aline G.; Contini, Veronica; Picon, Felipe A.; Karam, Rafael G.; Belmonte-de-Abreu, Paulo; Rohde, Luis A.; Bau, Claiton H. D.
Objective: This study addresses if deficits in cognitive, attention, and inhibitory control performance in adults with ADHD are better explained by the disorder itself or by comorbid conditions. Method Adult patients with ADHD ("n" = 352) and controls ("n" = 94) were evaluated in the ADHD program of a tertiary hospital. The…
Efron, Daryl; Sciberras, Emma; Hassell, Phillip
Attention Deficit Hyperactivity Disorder (ADHD) can have a major impact on students' functioning at school--academically and socially. This study examined parental perceptions of schools in relation to their understanding of ADHD, information provided and general support. Parents of consecutive children with ADHD seen at the Centre for Community…
Prevatt, Frances; Proctor, Briley; Baker, Leigh; Garrett, Lori; Yelland, Sherry
Objective: To evaluate the time estimation abilities of college students with ADHD on a novel, complex task that approximated academically oriented activities. Method: Totally 20 college students with ADHD were compared to a sample of 20 non-ADHD students. Both groups completed a task, and scores were obtained for time to complete the task, errors…
Objective: As children with ADHD who have more inattention problems are more frequently with fine motor problems, it is not clear whether postural balance problems are associated with different subtypes of ADHD. This study investigates the predictors of postural stability in children with ADHD considering the covariant factors of age, gender, and…
Kutscher, Martin L.
Contrary to popular opinion, attention deficit hyperactivity disorder (ADHD) is not just about hyperactive people who have short attention spans. ADHD is a disorder that involves difficult problems on a wide range of "executive dysfunction," a wide range of co-occuring conditions, and family problems. People need to recognize that ADHD is not just…
Reck, Sarah G.; Hund, Alycia M.; Landau, Steven
Objective: To determine whether 7- to 12-year-old boys with ADHD, relative to non-ADHD age-mates, exhibit greater difficulty learning and remembering object locations. The second purpose was to examine the functional utility of mnemonic strategies, specifically speech-to-self, used by boys with and without ADHD. Method: Boys with and without ADHD…
O'Laughlin, Elizabeth M.; Yaakoba-Richmond, Rakefet
Attention-deficit hyperactivity disorder (ADHD) is the most common psychiatric disorder of childhood. The extensive research on ADHD indicates that both assessment and treatment of ADHD is best accomplished through the involvement of multiple informants. By establishing a supervisory relationship with a university-based training clinic, child…
Gualtieri, C. Thomas; Johnson, Lynda G.
Objective: Although ADHD medications are effective for the behavioral components of the disorder, little information exists concerning their effects on cognition, especially in community samples. Method: A cross-sectional study of ADHD patients treated with three different ADHD drugs was conducted. Patients' performance on a computerized…
Wymbs, Brian T.; Molina, Brooke S. G.; Belendiuk, Katherine A.; Pedersen, Sarah L.; Walther, Christine A. P.; Cheong, Jee Won; McGinley, James S.; Marshal, Michael P.; Gnagy, Elizabeth M.; Pelham, William E.
Although children with attention-deficit/hyperactivity disorder (ADHD) are at risk for impulsive, health-endangering behavior, few studies have examined nonsubstance, use-related risk-taking behaviors. This study examined whether adolescents and young adults with ADHD histories were more likely than those without ADHD histories to report frequent…
Bender, William N.
This book is intended as a practical guide for parents and teachers in managing children or students with attention deficit hyperactivity disorder (ADHD). Specific strategies and techniques are presented that will facilitate learning for individuals with ADHD in both the home and school environment. Chapters include: "ADHD at Home and in the…
Miller, Jessica A.
Impulsivity is the cardinal symptom of ADHD. It is estimated that ADHD is present in eighteen percent of children and in four percent of adults. The present study repeats and extends a previous study (Gray, Breier, Foorman, & Fletcher, 2002) that measured impulsivity in adolescents with and without ADHD, which found higher false alarm rates…
Pajo, Bora; Cohen, David
An enduring controversy over the nature of ADHD complicates parents' decisions regarding children likely to be diagnosed with the condition. Using a fallibilist perspective, this review examines how researchers construe ADHD and acknowledge the controversy. From a systematic literature search of empirical reports using parents of ADHD-diagnosed…
Carelli, Maria G.; Wiberg, Britt
Objective: ADHD is often associated with difficulties in planning and time management. In this study, the authors examined the hypothesis that these functional problems in ADHD reflect systematic biases in temporal orientation. Method: To test this hypothesis, adults with ADHD (n = 30) and healthy controls (n = 60) completed the Swedish version of…
Yerys, Benjamin E.; Nissley-Tsiopinis, Jenelle; de Marchena, Ashley; Watkins, Marley W.; Antezana, Ligia; Power, Thomas J.; Schultz, Robert T.
Scientists and clinicians regularly use clinical screening tools for attention deficit/hyperactivity disorder (ADHD) to assess comorbidity without empirical evidence that these measures are valid in youth with autism spectrum disorder (ASD). We examined the prevalence of youth meeting ADHD criteria on the ADHD rating scale fourth edition…
Zambo, Debby; Zambo, Ron; Sidlik, Lawrence
Neuroscience is revealing how the brains of individuals with Attention Deficit Hyperactivity Disorder (ADHD) function, and advances in medicine are leading to treatments. This study investigated preservice teachers' knowledge and beliefs about students with ADHD. The majority of preservice teachers knew someone with ADHD, which, along with courses…
Morgan, Paul L.; Hillemeier, Marianne M.; Farkas, George; Maczuga, Steve
Background: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur by kindergarten entry is currently unknown. We investigated risk factors associated with an ADHD diagnosis by kindergarten entry generally, and specifically whether racial/ethnic disparities in ADHD diagnosis occur by…
This study examined Korean early childhood teachers' understanding of behavioural characteristics of children with Attention Deficit/Hyperactivity Disorder (ADHD), difficulties about and concerns for children with ADHD, the kinds of support for which teachers looked, experiences teachers had with the parents of children with ADHD, and…
Tan, Oguz; Metin, Baris; Metin, Sinem
Obsessive-compulsive disorder (OCD) and attention-deficit and hyperactivity disorder (ADHD) frequently coexist. To understand whether childhood ADHD can increase the risk of OCD in adulthood and whether it influences the phenomenology of OCD, we investigated the symptoms of ADHD during childhood in obsessive-compulsive adults who had never been diagnosed as ADHD. Adults with OCD (n = 83) were given the Wender Utah Rating Scale (WURS), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Barratt Impulsiveness Scale-11 (BIS-11), Hamilton Depression Rating Scale-17 (HDRS-17) and Beck Anxiety Inventory (BAI). The prevalence of childhood ADHD symptoms was 40.9 % (n = 34) and that of adult ADHD was 16.9 % (n = 14). Patients with childhood ADHD symptoms had an earlier onset of OCD, higher scores of the BAI and BIS-11. The scores of the Y-BOCS and HDRS-17 did not differ between those having and not having childhood ADHD symptoms. Childhood history of ADHD symptoms is common in adult OCD patients who have never been diagnosed as ADHD. Childhood ADHD symptoms are associated with an earlier age of OCD, more severe anxiety and higher impulsiveness. Even remitted ADHD may be a risk factor for OCD in later life.
Schatz, David Beck; Rostain, Anthony L.
Objective/Method: ADHD is often comorbid with anxiety disorders, with rates approaching 25% in many samples. This current review's goal is to examine the literature on ADHD with comorbid anxiety from 1998 to the present. Results: Recent studies indicate that anxiety in ADHD may a) partially inhibit the impulsivity and response inhibition deficits,…
Fliers, Ellen; Vermeulen, Sita; Rijsdijk, Fruhling; Altink, Marieke; Buschgens, Cathelijne; Rommelse, Nanda; Faraone, Stephen; Sergeant, Joseph; Buitelaar, Jan; Franke, Barbara
Analysis of the data from a genetics study of children with attention-deficit/hyperactivity disorder (ADHD) and their affected or unaffected siblings finds that ADHD-affected children had significantly more motor problems than their unaffected siblings. It is concluded that there is a common basis between ADHD and motor problems that may be due to…
Reilly, Colin J.
ADHD and epilepsy common are both common childhood disorders and both can have significant negative consequences on a child's behavioural, learning, and social development. Both conditions can co-occur and population studies suggest that the prevalence of ADHD in childhood epilepsy is between 12 and 17%. The prevalence of epilepsy in ADHD is lower…
Adler, Lenard A.; Spencer, Thomas; Faraone, Stephen V.; Reimherr, Fred W.; Kelsey, Douglas; Michelson, David; Biederman, Joseph
The standardization of ADHD ratings in adults is important given their differing symptom presentation. The authors investigated the agreement and reliability of rater standardization in a large-scale trial of atomoxetine in adults with ADHD. Training of 91 raters for the investigator-administered ADHD Rating Scale (ADHDRS-IV-Inv) occurred prior to…
Gjervan, Bjorn; Torgersen, Terje; Nordahl, Hans M.; Rasmussen, Kirsten
Objective: ADHD is associated with poor functional outcomes. The objectives were to investigate the prevalence of functional impairment and occupational status in a clinically referred sample of adults with ADHD and explore factors predicting occupational outcome. Method: A sample of 149 adults with a confirmed diagnosis of ADHD participated in…
Miller, Carlin J.; Miller, Scott R.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.
This study focused on the personality characteristics associated with Attention-deficit/Hyperactivity disorder (ADHD) in a longitudinal sample of youth, with a particular focus on differences between those with and without persisting ADHD symptoms. Participants with ADHD (n = 90) were initially evaluated when they were 7-11 years old, and…
Takeda, Toshinobu; Ambrosini, Paul J.; deBerardinis, Rachel; Elia, Josephine
Neuropsychiatric comorbidity in ADHD is frequent, impairing and poorly understood. In this report, characteristics of comorbid and comorbid-free ADHD subjects are investigated in an attempt to identify differences that could potentially advance our understanding of risk factors. In a clinically-referred ADHD cohort of 449 youths (ages 6-18), age,…
Mortberg, Ewa; Tilfors, Kerstin; Bejerot, Susanne
Objective: Recent studies have suggested a link between a primary anxiety disorder and ADHD. Method: A total of 39 participants with a primary diagnosis of social phobia were compared with 178 patients with ADHD and 88 patients with other psychiatric disorders on measures for childhood and adult ADHD (the Wender Utah Rating Scale and the Adult…
Staikova, Ekaterina; Gomes, Hilary; Tartter, Vivien; McCabe, Allyssa; Halperin, Jeffrey M.
Background: Impaired social functioning has been well documented in individuals with attention-deficit/hyperactivity disorder (ADHD). Existing treatments for ADHD are effective for managing core symptoms, but have limited effectiveness at improving social skills, suggesting that social deficits in ADHD may not be directly related to core symptoms…
DuPaul, George J.; Weyandt, Lisa L.; O'Dell, Sean M.; Varejao, Michael
Approximately 2 to 8% of the college population reports clinically significant levels of ADHD symptomatology and at least 25% of college students with disabilities are diagnosed with ADHD. A comprehensive review of the literature was conducted with findings consistently indicating academic deficits associated with ADHD in college students. It is…
This paper focuses a sociological lens on what two early years Australian school boys labelled as having attention deficit hyperactivity disorder (ADHD) and an early years teacher have to say about social relations within informal play environments. The boys participated in separate semi-structured interviews where they predicted the likely…
Herrera, Aubrey V.; Méndez, Enrique; Casanova, Leticia; Medina-Mora, Maria Elena
The normative process of autonomy development in adolescence involves changes in adolescents’ information management typically characterized by decreasing disclosure and increasing concealment. These changes may have an important impact on the early detection and timely treatment of mental health conditions and risky behavior. Therefore, the objective was to extend our understanding of how these developmental changes in adolescent disclosure might impact adolescent mental health interviews. Specifically, we estimated the effects of third party presence and type of third party presence (adult, child, or both) on adolescents’ reports of psychiatric symptoms, substance use, suicidal behavior, and childhood adversity. In this representative sample of 3005 adolescents from Mexico City (52.1 % female), administered the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A), adult presence influenced reporting the most; in their presence, adolescents reported more ADHD, parental mental illness and economic adversity, but less panic disorder, PTSD, drug use and disorder, and suicidal behavior. The presence of children was associated with increased odds of reporting conduct disorder, opportunity for drug use, parental criminal behavior, neglect, and the death of a parent. While adolescent information management strategies are normative and even desirable as a means of gaining emotional autonomy, they may also interfere with timely detection and treatment or intervention for mental health conditions and risky behaviors. Research and practical implications of these findings are discussed. PMID:26792265
Herrera, Aubrey V; Benjet, Corina; Méndez, Enrique; Casanova, Leticia; Medina-Mora, Maria Elena
The normative process of autonomy development in adolescence involves changes in adolescents' information management typically characterized by decreasing disclosure and increasing concealment. These changes may have an important impact on the early detection and timely treatment of mental health conditions and risky behavior. Therefore, the objective was to extend our understanding of how these developmental changes in adolescent disclosure might impact adolescent mental health interviews. Specifically, we estimated the effects of third party presence and type of third party presence (adult, child, or both) on adolescents' reports of psychiatric symptoms, substance use, suicidal behavior, and childhood adversity. In this representative sample of 3005 adolescents from Mexico City (52.1 % female), administered the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A), adult presence influenced reporting the most; in their presence, adolescents reported more ADHD, parental mental illness and economic adversity, but less panic disorder, PTSD, drug use and disorder, and suicidal behavior. The presence of children was associated with increased odds of reporting conduct disorder, opportunity for drug use, parental criminal behavior, neglect, and the death of a parent. While adolescent information management strategies are normative and even desirable as a means of gaining emotional autonomy, they may also interfere with timely detection and treatment or intervention for mental health conditions and risky behaviors. Research and practical implications of these findings are discussed.
Watson, Gretchen Lefever; Arcona, Andrea Powell; Antonuccio, David O; Healy, David
Medicating ADHD is a controversial subject that was acutely inflamed in 1995 when high rates of ADHD diagnosis and treatment were documented in southeastern Virginia. Psychologists in southeastern Virginia formed a regional school health coalition to implement and evaluate interventions to address the problem. Other professionals with strong ties to the pharmaceutical industry launched ad hominem attacks on the coalition's research and work. These attacks contributed to the work being terminated in 2005. In the ensuing years, ADHD drug treatment continued to escalate. Today, the national rate of ADHD diagnosis exceeds all reasonable estimates of the disorder's true prevalence, with 14 % of American children being diagnosed before reaching young adulthood. Notable key opinion leaders continue to claim that there is no cause for concern, but with a message shift from "the prevalence is not too high" to "high prevalence is not too concerning." This paper provides an object lesson about how innovative research can be derailed to the detriment of sound medical and mental health care of children when industry interests are threatened. Tenure may be the only option for protecting innovative research from specious attacks. The authors offer a summary of the data on ADHD drug treatments, suggest judicious use of such treatments, and add their voices to others who are once again sounding a cautionary alarm.
Killeen, Peter R; Russell, Vivienne A; Sergeant, Joseph A
Energetic insufficiency in neurons due to inadequate lactate supply is implicated in several neuropathologies, including attention-deficit/hyperactivity disorder (ADHD). By formalizing the mechanism and implications of such constraints on function, the behavioral Neuroenergetics Theory (NeT) predicts the results of many neuropsychological tasks involving individuals with ADHD and kindred dysfunctions, and entails many novel predictions. The associated diffusion model predicts that response times will follow a mixture of Wald distributions from the attentive state, and ex-Wald distributions after attentional lapses. It is inferred from the model that ADHD participants can bring only 75-85% of the neurocognitive energy to bear on tasks, and allocate only about 85% of the cognitive resources of comparison groups. Parameters derived from the model in specific tasks predict performance in other tasks, and in clinical conditions often associated with ADHD. The primary action of therapeutic stimulants is to increase norepinephrine in active regions of the brain. This activates glial adrenoceptors, increasing the release of lactate from astrocytes to fuel depleted neurons. The theory is aligned with other approaches and integrated with more general theories of ADHD. Therapeutic implications are explored.
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
Råstam, Maria; Täljemark, Jakob; Tajnia, Armin; Lundström, Sebastian; Gustafsson, Peik; Lichtenstein, Paul; Gillberg, Christopher; Anckarsäter, Henrik; Kerekes, Nóra
AIM. To establish the prevalence of restrictive eating problems, the overlap and association with attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorders (ASD) and to estimate the heritability of eating problems in a general population sample of twins aged 9 and 12. METHODS. Parents of all Swedish 9- and 12-year-old twin pairs born between 1993 and 1998 (n = 12,366) were interviewed regarding symptoms of ADHD, ASD, and eating problems (EAT-P). Intraclass correlations and structural equation modelling were used for evaluating the influence of genetic and environmental factors. Cross-twin, cross-trait correlations were used to indicate a possible overlap between conditions. RESULTS. The prevalence of eating problems was 0.6% in the study population and was significantly higher in children with ADHD and/or ASD. Among children with eating problems, 40% were screened positive for ADHD and/or ASD. Social interaction problems were strongly associated with EAT-P in girls, and impulsivity and activity problems with EAT-P in boys. The cross-twin, cross-trait correlations suggested low correlations between EAT-P and ADHD or EAT-P and ASD. Genetic effects accounted for 44% of the variation in liability for eating problems. CONCLUSIONS. In the group with eating problems, there was a clear overrepresentation of individuals with ADHD and/or ASD symptoms.
van Hulst, Branko M.; de Zeeuw, Patrick; Bos, Dienke J.; Rijks, Yvonne; Neggers, Sebastiaan F. W.; Durston, Sarah
Background: Changes in reward processing are thought to be involved in the etiology of attention-deficit/hyperactivity disorder (ADHD), as well as other developmental disorders. In addition, different forms of therapy for ADHD rely on reinforcement principles. As such, improved understanding of reward processing in ADHD could eventually lead to…
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Anderson, Donnah L.; Watt, Susan E.; Noble, William; Shanley, Dianne C.
Knowledge of attention deficit hyperactivity disorder (ADHD) and attitudes toward teaching children with ADHD are compared across stages of Australian teachers' careers. Relative to pre-service teachers with (n = 218) and without (n = 109) teaching experience, in-service teachers (n = 127) show more overall knowledge of ADHD, more knowledge of…
Nelson, Jason M.; Gregg, Noel
Objective: To investigate depressive and anxious symptomatology among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. Method: Transitioning adolescents and college students with these disorders along with a non-ADHD/dyslexia college sample completed self-report measures of depression and anxiety.…
Antshel, Kevin M.; Faraone, Stephen V.; Maglione, Katherine; Doyle, Alysa; Fried, Ronna; Seidman, Larry; Biederman, Joseph
A study was conducted to establish the relationship between Attention-Deficit/Hyperactivity (ADHD) disorder and high-IQ children and whether ADHD has a high predictive value among youths with high-IQ. Results further supported the hypothesis for the predictive validity of ADHD in high-IQ youths.
Liotti, Mario; Pliszka, Steven R.; Higgins, Kellie; Perez, Ricardo, III; Semrud-Clikeman, Margaret
Executive function and working memory deficits are not only present in ADHD, but also in reading disorder (RD). Here, high-density ERPs were recorded during the Stop Signal Task in 53 children and adolescents: An ADHD-combined type group, a group with RD, and a healthy control group. The ADHD-C group displayed unique abnormalities of the frontal…
Background Most children who are diagnosed with attention deficit-hyperactivity disorder (ADHD) have moderate-to-severe motor problems using the Motor Function Neurological Assessment battery (MFNU). The MFNU focuses on specific muscle adjustment problems associated with ADHD, especially motor inhibition problems and high muscle tone. Here we investigated whether adults with ADHD/hyperkinetic disorder (HKD) have similar motor problems. In our clinical experience, adults with ADHD often complain about back, shoulder, hip, and leg pain. We also investigate reported pain in adults with ADHD. Methods Twenty-five adult outpatients diagnosed with ADHD/HKD who were responders to methylphenidate (MPH) were compared to 23 non-ADHD controls on 16 MFNU subtests and using a ‘total score’ (‘TS’) parameter. The MFNU test leader was blinded to group identity. The two groups were also compared using the Pain Drawing and Numerical Pain Rating Scale. Results The adult ADHD group had significantly (p < .001) more motor problems (higher TS) than controls. On the muscle regulation subtests, 36–96% of the ADHD group showed ‘moderate’ to ‘severe’ problems compared to 13–52% of the control group, and 80% of the ADHD group reported widespread pain. Highly significant differences were found between the ADHD and control groups for the variables ‘pain level’ (p < .001) and ‘pain location’ (p < .001). Significant correlations were found between TS and ‘pain location’ and between TS and ‘pain level’. Conclusions These findings suggest that similar to children with ADHD, adults diagnosed with ADHD also have motor inhibition problems and heightened muscle tone. The presence of significantly higher pain levels and more widespread pain in the ADHD group compared to non-ADHD controls might indicate that pain is a long-term secondary effect of heightened muscle tone and restricted movement that can be demonstrated in children and adults by the MFNU
Attention deficit hyperactivity disorder (ADHD) is a neurocognitive behavioral developmental disorder most commonly seen in childhood and adolescence, which often extends to the adult years. Relative to a decade ago, there has been extensive research into understanding the factors underlying ADHD, leading to far more treatment options available for both adolescents and adults with this disorder. Novel stimulant formulations have made it possible to tailor treatment to the duration of efficacy required by patients, and to help mitigate the potential for abuse, misuse and diversion. Several new non-stimulant options have also emerged in the past few years. Among these, cognitive behavioral interventions have proven popular in the treatment of adult ADHD, especially within the adult population who cannot or will not use medications, along with the many medication-treated patients who continue to show residual disability. PMID:21658285
O'Mahony, Niamh; Florentino-Liano, Blanca; Carballo, Juan J; Baca-García, Enrique; Rodríguez, Antonio Artés
This work proposes the use of miniature wireless inertial sensors as an objective tool for the diagnosis of ADHD. The sensors, consisting of both accelerometers and gyroscopes to measure linear and rotational movement, respectively, are used to characterize the motion of subjects in the setting of a psychiatric consultancy. A support vector machine is used to classify a group of subjects as either ADHD or non-ADHD and a classification accuracy of greater than 95% has been achieved. Separate analyses of the motion data recorded during various activities throughout the visit to the psychiatric consultancy show that motion recorded during a continuous performance test (a forced concentration task) provides a better classification performance than that recorded during "free time".
Weiss, Margaret D; Baer, Susan; Allan, Blake A; Saran, Kelly; Schibuk, Heidi
Children's use of electronic media, including Internet and video gaming, has increased dramatically to an average in the general population of roughly 3 h per day. Some children cannot control their Internet use leading to increasing research on "internet addiction." The objective of this article is to review the research on ADHD as a risk factor for Internet addiction and gaming, its complications, and what research and methodological questions remain to be addressed. The literature search was done in PubMed and Psychinfo, as well as by hand. Previous research has demonstrated rates of Internet addiction as high as 25% in the population and that it is addiction more than time of use that is best correlated with psychopathology. Various studies confirm that psychiatric disorders, and ADHD in particular, are associated with overuse, with severity of ADHD specifically correlated with the amount of use. ADHD children may be vulnerable since these games operate in brief segments that are not attention demanding. In addition, they offer immediate rewards with a strong incentive to increase the reward by trying the next level. The time spent on these games may also exacerbate ADHD symptoms, if not directly then through the loss of time spent on more developmentally challenging tasks. While this is a major issue for many parents, there is no empirical research on effective treatment. Internet and off-line gaming overuse and addiction are serious concerns for ADHD youth. Research is limited by the lack of measures for youth or parents, studies of children at risk, and studies of impact and treatment.
Migdalska, Anna; Nawara, Magdalena; Bal, Jerzy; Mazurczak, Tadeusz
Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder of childhood, affecting approximately 5-10% of children. ADHD is considered to be a multifactorial disorder because both genetic and environmental components may contribute to its progress. The etiology of attention deficit hyperactivity disorder (ADHD) is unknown, however family, twin and adoption studies have suggested that genetic factors are very important in its etiopathogenesis. The research of genetic basis of ADHD consists of linkage analysis, candidate gene approach and association studies. These analyses and also investigations on animal models of disease suggest that mutations in genes involved in dopaminergic, serotonergic and adrenergic systems are likely to be responsible for ADHD.
Claesdotter-Hybbinette, Emma; Safdarzadeh-Haghighi, Maryam; Råstam, Maria; Lindvall, Magnus
Studies have shown that the auditory brainstem response (ABR) is often affected in neurodevelopmental disorders. The aim of this study is to investigate possible differences in ABR between young females with ADHD compared to control subjects. This study focuses on young females, age 7-17 with ADHD, comparing the ABR of 43 young females with ADHD to 21 age- and gender-matched control subjects. Young females with ADHD have a significantly different ABR in a region between cochlear nucleus and superior olivary complex as well as in the thalamic region compared to control subjects. These data indicate specific differences in ABR between girls with ADHD compared to female controls.
Moroney, Elizabeth; Tung, Irene; Brammer, Whitney A; Peris, Tara S; Lee, Steve S
Although parental attention-deficit/hyperactivity disorder (ADHD) is a risk factor for multiple negative youth outcomes, it is unknown how change in parental ADHD symptoms over time affects change in child ADHD symptoms; moreover, mediators of these predictions are largely unknown. Parents of 230 5-10 year-old children (68 % male) with (n = 120) and without ADHD (n = 110) were followed prospectively for 6-7 years across three separate waves. Parents self-reported their ADHD and depression symptoms and similarly rated offspring ADHD, oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms; youth self-reported their substance use. Temporally-ordered mediators consisted of parental expressed emotion (EE), derived from the Five Minute Speech Sample, and self-reported positive and negative parenting behavior. Controlling for key demographics and parental depression symptoms, increasing parental ADHD symptoms were a time-varying predictor of worsening youth ADHD and ODD, although it was unrelated to change in CD and alcohol/substance use. Next, although EE facets (i.e., criticism, emotional over-involvement) did not mediate these predictions, negative parenting behavior significantly mediated predictions of youth ADHD (and marginally in predictions of ODD) from parental ADHD symptoms. These quasi-experimental findings suggest that parental ADHD symptoms are a potential unique causal risk factor for offspring ADHD and ODD; also, preventing negative parenting behavior secondary to parental ADHD symptoms is critical to improve trajectories of youth ADHD and ODD. We consider parental ADHD symptoms and family factors underlying emergent externalizing problems utilizing a developmental psychopathology framework, including implications for intervention and prevention.
Toplak, Maggie E; Bucciarelli, Stefania M; Jain, Umesh; Tannock, Rosemary
Performance-based measures and ratings of executive functions were examined in a sample of adolescents with attention deficit/hyperactivity disorder (ADHD) and comparison controls. Performance-based measures of executive function included inhibition, working memory, set shifting, and planning, and ratings of these same executive functions were completed by parents and teachers. Adolescents with ADHD demonstrated lower executive function performance than controls and displayed elevated ratings on the executive function ratings by parents and teachers. Significant associations were obtained between the performance-based measures and the parent and teacher ratings, but each measure was not uniquely associated with its respective scale on the rating scales. When performance-based measures and ratings were examined as predictors of ADHD status, the parent and teacher ratings entered as significant predictors of ADHD status. Further commonality analyses indicated that performance-based measures accounted for little unique variance in predicting ADHD status and also displayed little overlap with the behavioral ratings. These findings highlight the diagnostic utility of behavioral ratings of executive function in predicting ADHD status; however, behavioral ratings should not be assumed to be a proxy for performance on measures of executive function in clinical practice.
Joseph, Nidhin; Zhang-James, Yanli; Perl, Andras; Faraone, Stephen V.
Objective To clarify the role of oxidative stress and antioxidant activity in ADHD. Method We examined the association of ADHD and oxidative stress by applying random effects meta-analysis to studies of oxidative stress and antioxidant status in medication naive patients with ADHD and controls. Results Six studies of a total of 231 ADHD patients and 207 controls met our selection criteria. The association between ADHD and antioxidant status was not significant. We found a significant association between ADHD and oxidative stress that could not be accounted for by publication bias. The significant association lost significance after correcting for intrastudy clustering. No one observation accounted for the positive result. Conclusion These results are preliminary given the small number of studies. They suggest that patients with ADHD have normal levels of antioxidant production, but that their response to oxidative stress is insufficient, leading to oxidative damage. PMID:24232168
Duda, Thomas A; Casey, Joseph E; McNevin, Nancy
Although graphomotor differences and variability of performance have been observed in children with attention deficit hyperactivity disorder (ADHD), no study has investigated whether this variability manifests in the kinematic graphomotor domain in adults with ADHD. Fourteen ADHD and 20 control participants wrote a novel grapheme and common word on a digitizing tablet 30 times each, with ADHD participants counterbalanced on and off stimulant medication. Variability of graphomotor fluency was significantly greater in ADHD versus control participants only in the novel writing task, both on, F(1,31)=5.988, p=.020, and off stimulant medication, F(1,32)=8.789, p=.006. Results suggest that motor control differences in ADHD are not limited to childhood and extend into adulthood. Given sufficient additional research, variability of kinematic graphomotor fluency may increase the sensitivity/specificity of differential diagnoses and/or represent a biomarker for ADHD.
de Jong, Christien G W; Licht, Robert; Sergeant, Joseph A; Oosterlaan, Jaap
In order to achieve further insight into the comorbidity of reading disorder (RD) and attention deficit/hyperactivity disorder (ADHD), lexical processing and rapid naming were studied in RD and ADHD. The Dual Route Cascaded model postulates that lexical processing contains two parallel processes: lexical route processing and sublexical route processing. An orthographic decision task and a phonological decision task were used to measure lexical and sublexical route processing, respectively. In addition, a rapid naming task was used to compare 27 children with RD, 18 children with ADHD, 20 children with ADHD+RD, and 29 controls. RD and ADHD shared impairments in accuracy of orthographic and phonological decision making as well as in rapid naming, which suggest that RD and ADHD may be overlapping disorders that share deficits in both lexical route and sublexical route processing. RD was dissociated from ADHD by being slower in both orthographical and phonological decision making that indicates unique deficits in RD on lexical and sublexical speed.
Mader, Lothar; Quevillon, Randal
Clinical child interviews have received little attention in the psychological literature and in the absence of empirical findings, curent interview practices are primarily based on clinical lore. In order to investigate the effects of interviewing style and interviewer mode of dress, on the quantity and quality of information obtained from 8 to 11…
Franc, N; Maury, M; Purper-Ouakil, D
Attention-deficit/hyperactivity disorder (ADHD) is defined on the basis of developmentally inappropriate inattention, motor activity and impulsivity that emerges early in development and causes impairment in social and academic functioning. ADHD is described as a multifactorial disease, with a well studied genetic vulnerability, and early environmental factors also playing an important role in the development and course of the disorder. Current aetiological models emphasize interaction between genes and environment. The concept of attachment, as proposed by John Bowlby, reflects quality of early interactions, and should therefore be considered as an early developmental factor. First, clinical findings emphasize similitude between both disorders; emotional dysregulation is an important feature in reactive attachment disorder as well as in ADHD. Emotion regulation is highly related to attachment security in young children and could play a part in the development of early attention processes. Moreover, difficult temperament is associated with higher risk for ADHD on the one hand, and can disturb the process of attachment on the other. Parental caregiving - including maternal sensitivity, positive parenting practices - is a main factor involved in the development of attachment, and has shown to be associated with better outcomes in ADHD children, especially with less oppositional/conduct disorders. Second, the aim of our review is to present clinical studies that have looked for a link between ADHD and attachment: the type of attachment could play a part in the course of the disorder: insecure and disorganised attachment types tend to be associated with a higher risk of externalised behaviors in children. For ADHD, this effect seems to be weaker than for other externalised disorders, and has been shown only in populations of at-risk children. Clinical studies also raise the question of possible links between reactive attachment disorder and ADHD. In children suffering
Scheirs, J. G. M.; Timmers, E. A.
Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) and Attention Deficit/Hyperactivity Disorder (ADHD) have partly overlapping symptoms. It can also be debated whether a third diagnostic category exists: children with a combined diagnosis. In this study an attempt was made to distinguish among the three groups on the basis of…
Ferrin, Maite; Vance, Alasdair
Background: Neurological subtle signs (NSS) are minor neurological abnormalities that have been shown to be increased in a number of neurodevelopmental conditions. For attention deficit/hyperactivity disorder (ADHD), it remains unclear whether NSS may aid the clinical diagnostic process. Methods: This study explored the association of total and…
The concept of relationship has rapidly evolved over the past few years, since the emergence of the internet network and the development of remote communication and exchanges. The emergence of cyberculture with the development of the internet has led to a new representation of the social link, in which communication never stops. In this context, computer mediated intersubjective relationships represent a main line of thinking and research. Thus, can we consider for example that relationship is only composed of an informational exchange? Would there be other dimensions possibly missing in computer mediated relationships? In this case, how could we re-introduce these aspects, "re-humanize" the remote relationships? New practices in psychology emerge with the ICT usage, both in the fields of research and for therapeutic purposes. Some fields like medicine already use remote health platforms that have proven useful in certain situations. In the field of remote clinical psychology, different media are used that contribute to the framework definition of the remote clinical interview, where the concept of relation holds a central place. Videoconference enables the introduction of an important element from the point of view of sensoriality: the body image, which engages the subjects' interaction in a different way than in a written or verbal exchange. But is the use of videoconference sufficient to establish a clinical framework comparable to the traditional one? How can the computer-mediated relationship enable and establish a potential object relation, rather than a mirrored one? Thinking through an online adaptation of the clinical interview framework led to the elaboration of a specific tool dedicated to this purpose and to research into the access to intersubjectivity in clinical video interview. This study's encouraging results have fostered the pursuit of this experience in the form of a platform dedicated to the conduction of clinical interviews through
Mexican society contains a variety of indigenous cultures as well as European influences. Most babies in rural areas are delivered by midwives. Traditional midwives, government-trained and empirical midwives, nurse-midwives, and foreign-trained midwives all practice in Mexico. Nurse-midwives in one project are demonstrating their ability to meet the needs of urban childbearing women. A midwifery organization is developing under the leadership of midwives influenced by the contemporary midwifery movement in the United States. In this article, some traditional Mexican midwifery practices are discussed and interviews with several different Mexican midwives from a variety of backgrounds are presented.
Dovis, Sebastiaan; Van der Oord, Saskia; Wiers, Reinout W; Prins, Pier J M
Both cognitive and motivational deficits are thought to give rise to the problems in the combined (ADHD-C) and inattentive subtype (ADHD-I) of attention-deficit hyperactivity disorder (ADHD). In both subtypes one of the most prominent cognitive weaknesses appears to be in visuospatial working memory (WM), which is composed of short-term memory (STM) and a central executive (CE). In children with ADHD-C, both STM and the CE seem impaired, and together with motivational impairments, give rise to their deficits in visuospatial WM. In children with ADHD-I, no studies investigated these WM components and their interplay with motivational impairments. Effects of a standard (feedback only) and a high level of reinforcement (feedback + 10 euros) on visuospatial WM-, STM-, and CE performance were examined in 27 children with ADHD-I (restrictive-subtype), 70 children with ADHD-C, and 40 typically developing controls (aged 9-12). In both ADHD-subtypes CE and WM performance was worse than in controls. STM performance of children with ADHD-I was, in contrast to that of children with ADHD-C, not different from controls. STM and WM performance was worse in ADHD-C than in ADHD-I, whereas CE-related performance did not differ. High reinforcement improved STM and WM performance in both subtypes but not in controls. This improvement was equally pronounced in both subtypes. High reinforcement did not improve CE-related performance. Both subtypes have equally pronounced motivational deficits, which have detrimental effects on their visuospatial STM and WM performance. In contrast to children with ADHD-C, children with ADHD-I seem unimpaired on visuospatial STM; only an impaired CE and motivational impairments give rise to their deficits in visuospatial WM.
Hall, Charlotte L; Valentine, Althea Z; Groom, Madeleine J; Walker, Gemma M; Sayal, Kapil; Daley, David; Hollis, Chris
Attention-deficit hyperactivity disorder (ADHD) is typically diagnosed using clinical observation and subjective informant reports. Once children commence ADHD medication, robust monitoring is required to detect partial or non-responses. The extent to which neuropsychological continuous performance tests (CPTs) and objective measures of activity can clinically aid the assessment and titration process in ADHD is not fully understood. This review describes the current evidence base for the use of CPTs and objectively measured activity to support the diagnostic procedure and medication management for children with ADHD. Four databases (PsycINFO, Medline, Allied and Complementary Medicine (AMED), and PsycARTICLES) were systematically searched to understand the current evidence base for (1) the use of CPTs to aid clinical assessment of ADHD; (2) the use of CPTs to aid medication management; and (3) the clinical utility of objective measures of activity in ADHD. Sixty relevant articles were identified. The search revealed six commercially available CPTs that had been reported on for their clinical use. There were mixed findings with regard to the use of CPTs to assess and manage medication, with contrasting evidence on their ability to support clinical decision-making. There was a strong evidence base for the use of objective measures of activity to aid ADHD/non-ADHD group differentiation, which appears sensitive to medication effects and would also benefit from further research on their clinical utility. The findings suggest that combining CPTs and an objective measure of activity may be particularly useful as a clinical tool and worthy of further pursuit.
Canu, Will H.; Carlson, Caryn L.
Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) has been consistently linked to social maladjustment. This study investigated whether elevated rejection sensitivity (RS) could contribute to the relational problems that adults with ADHD encounter. Method: Undergraduate men in ADHD-Combined Type (ADHD-C; n = 31), ADHD-Primarily…
Grizenko, Natalie; Paci, Michael; Joober, Ridha
Objective: To compare the ADHD combined/hyperactive subtype (ADHD/CH) to the ADHD inattentive subtype (ADHD/I) on the level of comorbidity, treatment response, and possible etiological factors. Method: A total of 371 clinically referred children diagnosed with ADHD aged between 6 and 12 years are recruited for a double-blind, placebo-controlled…
Booksh, Randee Lee; Pella, Russell D.; Singh, Ashvind N.; Gouvier, William Drew
Objective: The authors examined the ability of college students to simulate ADHD symptoms on objective and self-report measures and the relationship between knowledge of ADHD and ability to simulate ADHD. Method: Undergraduate students were assigned to a control or a simulated ADHD malingering condition and compared with a clinical AD/HD group.…
Schroeder, Valarie M.; Kelley, Michelle L.
We examined the relationships between executive functioning, family environment, and parenting practices in children diagnosed with ADHD as compared to children without ADHD. Participants were parents (N = 134) of 6- to 12-year-old ADHD and non-ADHD-diagnosed children. Compared to the control group, parents of children diagnosed with ADHD reported…
Humphreys, Kathryn L.; Aguirre, Vincent P.; Lee, Steve S.
The goal of this study is to examine levels of oppositional defiant disorder (ODD) and conduct disorder (CD) in four groups of children: attention-deficit/hyperactivity disorder (ADHD) only, anxiety only, ADHD and anxiety, and controls (i.e., non-ADHD youth). Although children with ADHD exhibit more ODD and CD than non-ADHD youth, it is unknown if…
Daley, D; Birchwood, J
This paper reviews the relationship between attention deficit hyperactivity disorder (ADHD) and academic performance. First, the relationship at different developmental stages is examined, focusing on pre-schoolers, children, adolescents and adults. Second, the review examines the factors underpinning the relationship between ADHD and academic underperformance: the literature suggests that it is the symptoms of ADHD and underlying cognitive deficits not co-morbid conduct problems that are at the root of academic impairment. The review concludes with an overview of the literature examining strategies that are directed towards remediating the academic impairment of individuals with ADHD.
... good" fats -- may be less likely to have attention deficit hyperactivity disorder (ADHD), a small study suggests. Research on 120 ... Health and Human Services. More Health News on: Attention Deficit Hyperactivity Disorder Diets Recent Health News Related MedlinePlus Health Topics ...
Barabasz, Arreed; Barabasz, Marianne
Traditional diagnosis procedures for Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD) may lead to over-diagnosis and are fraught with complications because the target behavioral symptoms are found in a variety of other disorders. Traditional treatments consisting of powerful side effect laden psychostimulant drugs…
Nigg, Joel T.
Reviews salient emerging themes in the scientific literature related to identifying etiology and pathophysiology of ADHD. While bypassing the need for new treatment research, the review highlights three themes. First, recognition of the epigenetic effects is expected to revitalize the search for and mapping of early environmental influences on the…
Johansen, Espen Borgå; Killeen, Peter R; Russell, Vivienne A; Tripp, Gail; Wickens, Jeff R; Tannock, Rosemary; Williams, Jonathan; Sagvolden, Terje
Attention-deficit/hyperactivity disorder (ADHD), characterized by hyperactivity, impulsiveness and deficient sustained attention, is one of the most common and persistent behavioral disorders of childhood. ADHD is associated with catecholamine dysfunction. The catecholamines are important for response selection and memory formation, and dopamine in particular is important for reinforcement of successful behavior. The convergence of dopaminergic mesolimbic and glutamatergic corticostriatal synapses upon individual neostriatal neurons provides a favorable substrate for a three-factor synaptic modification rule underlying acquisition of associations between stimuli in a particular context, responses, and reinforcers. The change in associative strength as a function of delay between key stimuli or responses, and reinforcement, is known as the delay of reinforcement gradient. The gradient is altered by vicissitudes of attention, intrusions of irrelevant events, lapses of memory, and fluctuations in dopamine function. Theoretical and experimental analyses of these moderating factors will help to determine just how reinforcement processes are altered in ADHD. Such analyses can only help to improve treatment strategies for ADHD. PMID:19226460
Educators are confronted every day with local, state, and federal mandates; large class sizes; lack of resources; high-stakes tests; and diversity of all kinds. Throw into that mix a youngster with attention-deficit hyperactive disorder (ADHD) and it's no wonder that teachers are frustrated and at a loss for what to do. Professionals define ADHD…
Penny, Ann Marie; Waschbusch, Daniel A.; Carrey, Norm; Drabman, Ronald S.
This article examines whether various cognitive abilities are associated with symptoms of ADHD. Cognitive ability is conceptualized using Cattell-Horn-Carroll (CHC) theory as measured using the Woodcock-Johnson Tests of Cognitive Ability (3rd ed.). This article also examines whether test session behavior mediates the association between cognitive…
Offers an overview of ADD and ADHD, their causes and long-term prognoses, including the complexities of the conditions, the incomplete knowledge about them, and the difficulties of diagnosis during early childhood. Summarizes assessment and treatment options and concludes that the conditions have so many secondary effects that designing an…
DuPaul, George J.; White, George P.
Attention-deficit/hyperactivity disorder (ADHD) is a disruptive behavior disorder which is characterized by levels of inattention (e.g., difficulty in concentrating on schoolwork), impulsivity (e.g., frequently interrupting conversations or activities), and/or overactivity (e.g., difficulty remaining seated when required to do so) that are well…
In this paper, a response is made to the assertion that discourses surrounding attention-deficit hyperactivity disorder (ADHD) are dominated by those who choose to frame such difficulties within a biomedical paradigm, and that valid alternative explanations are often marginalised as a result. It is suggested, however, that if such a discontinuity…
DuPaul, George J.; Weyandt, Lisa L.; Janusis, Grace M.
School-related difficulties are commonly associated with attention deficit hyperactivity disorder (ADHD). This article describes effective school-based intervention strategies including behavioral interventions, modifications to academic instruction, and home-school communication programs. One overlooked aspect of treatment of children with ADHD…
Da Fonseca, David; Seguier, Valerie; Santos, Andreia; Poinso, Francois; Deruelle, Christine
Several studies suggest that children with ADHD tend to perform worse than typically developing children on emotion recognition tasks. However, most of these studies have focused on the recognition of facial expression, while there is evidence that context plays a major role on emotion perception. This study aims at further investigating emotion…
Rooney, Mary; Chronis-Tuscano, Andrea; Yoon, Yesel
Objective: The college years represent a developmental transition during which the initiation and escalation of heavy drinking set the stage for lifelong difficulties with alcohol and other drugs. Evidence from studies of adolescents and young adults with ADHD suggests that college students with the disorder may be uniquely vulnerable to alcohol-…
Miller, Carlin J.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.
Objective: This longitudinal study examines the recall accuracy of childhood ADHD symptoms in late adolescence and early adulthood by youth and their parents, compared with reports obtained during childhood. Method: Participants (N = 94) are initially evaluated when they are aged between 7 and 11 and reassessed when they are aged between 16 and 22…
"Baxter pushed me away every moment that we worked together, He was rude, sarcastic, and often downright mean. He got up and walked away every time I asked him to do something he didn't want to, which was ... everything." That's how Lisa Medoff describes the 4th grade boy whom she tutored twice a week to help him manage his ADHD. Despite…
Hale, T. Sigi; Smalley, Susan L.; Hanada, Grant; Macion, James; McCracken, James T.; McGough, James J.; Loo, Sandra K.
Introduction: A growing body of literature suggests atypical cerebral asymmetry and interhemispheric interaction in ADHD. A common means of assessing lateralized brain function in clinical populations has been to examine the relative proportion of EEG alpha activity (8-12 Hz) in each hemisphere (i.e., alpha asymmetry). Increased rightward alpha…
Archer, Trevor; Oscar-Berman, Marlene; Blum, Kenneth
Heterogeneity in attention-deficit/hyperactivity disorder (ADHD), with complex interactive operations of genetic and environmental factors, is expressed in a variety of disorder manifestations: severity, co-morbidities of symptoms, and the effects of genes on phenotypes. Neurodevelopmental influences of genomic imprinting have set the stage for the structural-physiological variations that modulate the cognitive, affective, and pathophysiological domains of ADHD. The relative contributions of genetic and environmental factors provide rapidly proliferating insights into the developmental trajectory of the condition, both structurally and functionally. Parent-of-origin effects seem to support the notion that genetic risks for disease process debut often interact with the social environment, i.e., the parental environment in infants and young children. The notion of endophenotypes, markers of an underlying liability to the disorder, may facilitate detection of genetic risks relative to a complex clinical disorder. Simple genetic association has proven insufficient to explain the spectrum of ADHD. At a primary level of analysis, the consideration of epigenetic regulation of brain signalling mechanisms, dopamine, serotonin, and noradrenaline is examined. Neurotrophic factors that participate in the neurogenesis, survival, and functional maintenance of brain systems, are involved in neuroplasticity alterations underlying brain disorders, and are implicated in the genetic predisposition to ADHD, but not obviously, nor in a simple or straightforward fashion. In the context of intervention, genetic linkage studies of ADHD pharmacological intervention have demonstrated that associations have fitted the “drug response phenotype,” rather than the disorder diagnosis. Despite conflicting evidence for the existence, or not, of genetic associations between disorder diagnosis and genes regulating the structure and function of neurotransmitters and brain-derived neurotrophic
Interviews with stakeholders are one-to-one conversations about a specific topic or issue. The primary purpose of these interviews is to obtain project-relevant information and elicit stakeholder reactions and suggestions.