Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a 4-decade longitudinal cohort study

PubMed Central

Moffitt, Terrie E.; Houts, Renate; Asherson, Philip; Belsky, Daniel W; Corcoran, David L; Hammerle, Maggie; Harrington, Honalee; Hogan, Sean; Meier, Madeline; Polanczyk, Guilherme V.; Poulton, Richie; Ramrakha, Sandhya; Sugden, Karen; Williams, Benjamin; Rohde, Luis Augusto; Caspi, Avshalom

2015-01-01

Objective Despite a prevailing assumption that adult ADHD is a childhood-onset neurodevelopmental disorder, no prospective-longitudinal study has described the childhoods of the adult-ADHD population. We report follow-back analyses of ADHD cases diagnosed in adulthood, alongside follow-forward analyses of ADHD cases diagnosed in childhood, in one cohort. Method Participants belonged to a representative birth cohort of 1,037 individuals born in Dunedin, New Zealand in 1972-73 and followed to age 38, with 95% retention. Symptoms of ADHD, associated clinical features, comorbid disorders, neuropsychological deficits, GWAS-derived polygenic risk, and life impairment indicators were assessed. Data sources were participants, parents, teachers, informants, neuropsychological testing, and administrative records. Adult ADHD diagnoses used DSM5 criteria, apart from onset-age and cross-setting corroboration, which were study outcomes. Results As expected, the childhood-ADHD group showed 6% prevalence, male excess, childhood comorbid disorders, neurocognitive deficits, polygenic risk, and, despite having outgrown their ADHD diagnosis, residual adult life impairment. As expected, the adult-ADHD group showed 3% prevalence, gender balance, adult substance dependence, adult life impairment, and treatment contact. Unexpectedly, the childhood-ADHD and adult-ADHD groups comprised virtually non-overlapping sets; 90% of adult-ADHD cases lacked a history of childhood ADHD. Also unexpectedly, the adult-ADHD group did not show tested neuropsychological deficits in childhood or adulthood, nor did they show polygenic risk for childhood ADHD. Conclusion Findings raise the possibility that adults presenting with the ADHD symptom picture may not have a childhood-onset neurodevelopmental disorder. If this finding is replicated, then the disorder's place in the classification system must be reconsidered, and research must investigate the etiology of adult ADHD. PMID:25998281

Association of atopic diseases and attention-deficit/hyperactivity disorder: A systematic review and meta-analyses.

PubMed

Schans, Jurjen van der; Çiçek, Rukiye; de Vries, Tjalling W; Hak, Eelko; Hoekstra, Pieter J

2017-03-01

Over the last decades, the hypothesis has been raised that an atopic response could lead to the development of attention-deficit/hyperactivity disorder (ADHD). This study systematically reviews the observational cross-sectional and longitudinal studies that assessed the association between atopic disorders including asthma, atopic eczema, allergic rhinitis, and ADHD in children and adolescents. For longitudinal studies, a weighted Mantel-Haenszel odds ratio of these associations was estimated. The majority of cross-sectional and longitudinal studies reported a statistically significant positive association. The meta-analysis of longitudinal studies revealed an overall weighted odds ratio for asthma of 1.34 (95% confidence interval [CI] 1.24-1.44), 1.32 (95% CI 1.20-1.45) for atopic eczema, and 1.52 (95% CI 1.43-1.63) for allergic rhinitis. Heterogeneity of study data was low (I 2 : 0%, p=0.46 and p=0.64, respectively) for both studies examining asthma and eczema but substantial for rhinitis studies (I 2 : 82%, p=0.004). This current systematic review provides strong evidence that ADHD is associated with atopic diseases and that individuals have a 30% to 50% greater chance of developing ADHD compared to controls. Copyright © 2017 Elsevier Ltd. All rights reserved.

Persistent Nonmedical Use of Prescription Stimulants among College Students: Possible Association with ADHD Symptoms

ERIC Educational Resources Information Center

Arria, Amelia M.; Garnier-Dykstra, Laura M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; O'Grady, Kevin E.; Wish, Eric D.

2011-01-01

Objective: To investigate the possible association between untreated ADHD symptoms (as measured by the Adult ADHD Self-Report Scale) and persistent nonmedical use of prescription stimulants. Method: Multinomial regression modeling was used to compare ADHD symptoms among three groups of college students enrolled in a longitudinal study over 4…

Parental Warmth and Risks of Substance Use in Children with Attention-Deficit/Hyperactivity Disorder: Findings from a 10–12 Year Longitudinal Investigation

PubMed Central

Tandon, Mini; Tillman, Rebecca; Spitznagel, Edward; Luby, Joan

2013-01-01

Objective The study examined factors in the risk trajectory for Substance Use Disorder (SUD) over a 10–12 year period in children with ADHD. Method N=145 children between the ages of 7 and 16 with ADHD and healthy controls were assessed every 2 years for 10–12 years as part of a larger, longitudinal investigation. Onset of substance use disorder was examined using Cox proportional hazards modeling, and included child and parent psychopathology, and parental warmth as well as other key factors. Results Low paternal warmth and maternal SUD were predictors of SUD in n=59 ADHD participants after adjusting for gender, child ODD, paternal SUD, maternal/paternal ADHD, maternal/paternal major depressive disorder (MDD), maternal/paternal anxiety, and low maternal warmth in the Cox model. Conclusions Longitudinal study findings suggest that in addition to the established risk of ADHD and maternal SUD in development of child SUD, low paternal warmth is also associated with onset of SUD. This was evident after controlling for pertinent parent and child psychopathology. These findings suggest that paternal warmth warrants further investigation as a key target for novel interventions to prevent SUD in children with ADHD. More focused investigations examining paternal parenting factors in addition to parent and child psychopathology in the risk trajectory from ADHD to SUD are now warranted. PMID:24955084

Parental Warmth and Risks of Substance Use in Children with Attention-Deficit/Hyperactivity Disorder: Findings from a 10-12 Year Longitudinal Investigation.

PubMed

Tandon, Mini; Tillman, Rebecca; Spitznagel, Edward; Luby, Joan

2014-06-01

The study examined factors in the risk trajectory for Substance Use Disorder (SUD) over a 10-12 year period in children with ADHD. N=145 children between the ages of 7 and 16 with ADHD and healthy controls were assessed every 2 years for 10-12 years as part of a larger, longitudinal investigation. Onset of substance use disorder was examined using Cox proportional hazards modeling, and included child and parent psychopathology, and parental warmth as well as other key factors. Low paternal warmth and maternal SUD were predictors of SUD in n=59 ADHD participants after adjusting for gender, child ODD, paternal SUD, maternal/paternal ADHD, maternal/paternal major depressive disorder (MDD), maternal/paternal anxiety, and low maternal warmth in the Cox model. Longitudinal study findings suggest that in addition to the established risk of ADHD and maternal SUD in development of child SUD, low paternal warmth is also associated with onset of SUD. This was evident after controlling for pertinent parent and child psychopathology. These findings suggest that paternal warmth warrants further investigation as a key target for novel interventions to prevent SUD in children with ADHD. More focused investigations examining paternal parenting factors in addition to parent and child psychopathology in the risk trajectory from ADHD to SUD are now warranted.

Neural correlates of inhibitory control in adult ADHD: Evidence from the Milwaukee longitudinal sample

PubMed Central

Mulligan, Richard C.; Knopik, Valerie S.; Sweet, Lawrence H.; Fischer, Mariellen; Seidenberg, Michael; Rao, Stephen M.

2011-01-01

Only a few studies have investigated the neural substrate of response inhibition in adult ADHD using Stop-Signal and Go/No-Go tasks. Inconsistencies and methodological limitations in the existing literature have resulted in limited conclusions regarding underlying pathophysiology. We examined the neural basis of response inhibition in a group of adults diagnosed with ADHD in childhood and who continue to meet criteria for ADHD while addressing limitations present in earlier studies. Adults with ADHD (n=12) and controls (n=12) were recruited from an ongoing longitudinal study and were matched for age, IQ, and education. Individuals with comorbid conditions were excluded. Functional MRI was used to identify and compare the brain activation patterns during correct trials of a response inhibition task (Go/No-Go). Our results showed that the control group recruited a more extensive network of brain regions than the ADHD group during correct inhibition trials. Adults with ADHD showed reduced brain activation in the right frontal eye field, pre-supplementary motor area, left precentral gyrus, and the inferior parietal lobe bilaterally. During successful inhibition of an inappropriate response, adults with ADHD display reduced activation in fronto-parietal networks previously implicated in working memory, goal-oriented attention, and response selection. This profile of brain activation may be specifically associated with ADHD in adulthood. PMID:21937201

School Maladjustment and External Locus of Control Predict the Daytime Sleepiness of College Students With ADHD.

PubMed

Langberg, Joshua M; Dvorsky, Melissa R; Becker, Stephen P; Molitor, Stephen J

2016-09-01

The primary aim of this study was to evaluate whether school maladjustment longitudinally predicts the daytime sleepiness of college students with ADHD above and beyond symptoms of ADHD and to determine whether internalizing dimensions mediate the relationship between maladjustment and sleepiness. A prospective longitudinal study of 59 college students comprehensively diagnosed with ADHD who completed ratings at the beginning, middle, and end of the school year. School maladjustment at the beginning of the year significantly predicted daytime sleepiness at the end of the year above and beyond symptoms of ADHD. Locus of control mediated the relationship between maladjustment and daytime sleepiness. The significant school maladjustment difficulties that students with ADHD experience following the transition to college may lead to the development of problems with daytime sleepiness, particularly for those students with high external locus of control. This pattern is likely reciprocal, whereby sleep problems in turn result in greater school impairment, reinforcing the idea that life events are outside of one's control. © The Author(s) 2014.

Relation between Outcomes on a Continuous Performance Test and ADHD Symptoms over Time

ERIC Educational Resources Information Center

Vaughn, Aaron J.; Epstein, Jeffery N.; Rausch, Joseph; Altaye, Mekibib; Langberg, Joshua; Newcorn, Jeffrey H.; Hinshaw, Stephen P.; Hechtman, Lily; Arnold, L. Eugene; Swanson, James M.; Wigal, Timothy

2011-01-01

This study examined the relationship between the developmental trajectories of neuropsychological functioning and ADHD symptomatology in a longitudinal sample of children ages 9 to 14. Participants and measures were derived from the Multimodal Treatment Study for ADHD including 534MTA participants and 254 normal controls. Despite improvement over…

Writing abilities longitudinally predict academic outcomes of adolescents with ADHD.

PubMed

Molitor, Stephen J; Langberg, Joshua M; Bourchtein, Elizaveta; Eddy, Laura D; Dvorsky, Melissa R; Evans, Steven W

2016-09-01

Students with attention-deficit/hyperactivity disorder (ADHD) often experience a host of negative academic outcomes, and deficits in reading and mathematics abilities contribute to these academic impairments. Students with ADHD may also have difficulties with written expression, but there has been minimal research in this area and it is not clear whether written expression abilities uniquely contribute to the academic functioning of students with ADHD. The current study included a sample of 104 middle school students diagnosed with ADHD (Grades 6-8). Participants were followed longitudinally to evaluate whether written expression abilities at baseline predicted student grade point average (GPA) and parent ratings of academic impairment 18 months later, after controlling for reading ability and additional relevant covariates. Written expression abilities longitudinally predicted both academic outcomes above and beyond ADHD and oppositional defiant disorder symptoms, medication use, reading ability, and baseline values of GPA and parent-rated academic impairment. Follow-up analyses revealed that no single aspect of written expression was demonstrably more impactful on academic outcomes than the others, suggesting that writing as an entire process should be the focus of intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The Association of ADHD Symptoms and Reading Acquisition during Elementary School Years

ERIC Educational Resources Information Center

Ehm, Jan-Henning; Kerner auch Koerner, Julia; Gawrilow, Caterina; Hasselhorn, Marcus; Schmiedek, Florian

2016-01-01

The present longitudinal study aimed to investigate the influence of ADHD symptoms on reading development in elementary schoolchildren. To this end, repeated assessments of ADHD symptoms (teacher ratings of inattention, hyperactivity, and impulsivity) and reading achievement (standardized tests of decoding speed and text comprehension) were…

Attention Deficit Disorder, Stimulant Use, and Childhood Body Mass Index Trajectory

PubMed Central

Bailey-Davis, Lisa; Bandeen-Roche, Karen; Pollak, Jonathan; Hirsch, Annemarie G.; Nau, Claudia; Liu, Ann Y.; Glass, Thomas A.

2014-01-01

BACKGROUND: Childhood attention-deficit/hyperactivity disorder (ADHD) has been associated with childhood and adult obesity, and stimulant use with delayed childhood growth, but the independent influences are unclear. No longitudinal studies have examined associations of ADHD diagnosis and stimulant use on BMI trajectories throughout childhood and adolescence. METHODS: We used longitudinal electronic health record data from the Geisinger Health System on 163 820 children ages 3 to 18 years in Pennsylvania. Random effects linear regression models were used to model BMI trajectories with increasing age in relation to ADHD diagnosis, age at first stimulant use, and stimulant use duration, while controlling for confounding variables. RESULTS: Mean (SD) age at first BMI was 8.9 (5.0) years, and children provided a mean (SD) of 3.2 (2.4) annual BMI measurements. On average, BMI trajectories showed a curvilinear relation with age. There were consistent associations of unmedicated ADHD with higher BMIs during childhood compared with those without ADHD or stimulants. Younger age at first stimulant use and longer duration of stimulant use were each associated with slower BMI growth earlier in childhood but a more rapid rebound to higher BMIs in late adolescence. CONCLUSIONS: The study provides the first longitudinal evidence that ADHD during childhood not treated with stimulants was associated with higher childhood BMIs. In contrast, ADHD treated with stimulants was associated with slower early BMI growth but a rebound later in adolescence to levels above children without a history of ADHD or stimulant use. The findings have important clinical and neurobiological implications. PMID:24639278

A Longitudinal Study of Childhood ADHD and Substance Dependence Disorders in Early Adulthood

PubMed Central

Breyer, Jessie L.; Lee, Susanne; Winters, Ken; August, Gerald; Realmuto, George

2014-01-01

Attention-deficit/hyperactivity disorder (ADHD) is a childhood disorder that is associated with many behavioral and social problems. These problems may continue when an individual continues to meet criteria for ADHD as an adult. In this study, we describe the outcome patterns for three different groups: individuals who had ADHD as children, but no longer meet criteria as adults (Childhood-Limited ADHD, n = 71); individuals who met ADHD criteria as children and continue to meet criteria as young adults (Persistent ADHD n = 79); and a control group of individuals who did not meet ADHD diagnostic criteria in childhood or adulthood (n = 69). Groups were compared to examine differences in change in rates of alcohol, marijuana, and nicotine dependence over three time points in young adulthood (mean ages 18, 20 and 22 years). The method used is notable as this longitudinal study followed participants from childhood into young adulthood instead of relying on retrospective self-reports from adult participants. Results indicated that there were no significant group differences in change in rates of substance dependence over time. However, individuals whose ADHD persisted into adulthood were significantly more likely to meet DSM-IV criteria for alcohol, marijuana, and nicotine dependence across the three time points after controlling for age, sex, childhood stimulant medication use, and childhood conduct problems. Implications of these findings, as well as recommendations for future research, are discussed. PMID:24731117

ADHD symptoms and body composition changes in childhood: a longitudinal study evaluating directionality of associations.

PubMed

Bowling, A B; Tiemeier, H W; Jaddoe, V W V; Barker, E D; Jansen, P W

2018-06-04

Attention-deficit/hyperactivity disorder (ADHD) is linked to increased risk of overweight/obesity among children and adults. Studies have also implicated obesity as a risk factor for ADHD. However, no studies have evaluated bidirectional, longitudinal associations between childhood fat mass and ADHD symptom severity. We investigate bidirectional associations between ADHD symptoms and measures of body composition between ages 1.5 and 9. We further examine effects of specific eating patterns linked to ADHD on associations between symptom severity and body composition. The study utilized data from children (N = 3903) participating in the Generation R cohort (Netherlands). Children were enrolled at birth and retained regardless of ADHD symptoms over time. Cross-lagged and change models examined bidirectional associations between body composition (body mass index/dual-energy X-ray absorptiometry) and ADHD symptoms at four time points in childhood. A child with a clinically concerning ADHD symptom z-score two standard deviations above the mean at age 6 would be expected to experience about 0.22 kg greater fat mass gain measured via dual-energy x-ray absorptiometry between ages 6 and 9, even if they displayed healthy eating patterns (95% CI: 0.11 - 0.28, p < 0.001). Conversely, fat mass at any age did not predict worse ADHD symptoms later. Beginning in early childhood, more ADHD symptoms predict higher fat mass at later ages. We did not find evidence of a reverse association. Based on these and prior findings, lifestyle counselling during treatment for children with a diagnosis of ADHD should be considered, even if they are diagnosed in early childhood and do not yet have a body mass index of clinical concern. © 2018 World Obesity Federation.

The Influence of Sex on the Course and Psychiatric Correlates of ADHD from Childhood to Adolescence: A Longitudinal Study

ERIC Educational Resources Information Center

Monuteaux, Michael C.; Mick, Eric; Faraone, Stephen V.; Biederman, Joseph

2010-01-01

Background: Little is known about the influence of sex on the course of attention-deficit/hyperactivity disorder (ADHD) and its comorbid psychiatric conditions. The purpose of this study was to examine the effect of sex on the course and psychiatric correlates of ADHD from childhood into adolescence. Methods: Two identically designed,…

Annual Research Review: Infant Development, Autism, and ADHD--Early Pathways to Emerging Disorders

ERIC Educational Resources Information Center

Johnson, Mark H.; Gliga, Teodora; Jones, Emily; Charman, Tony

2015-01-01

Background: Autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) are two of the most common neurodevelopmental disorders, with a high degree of co-occurrence. Methods: Prospective longitudinal studies of infants who later meet criteria for ASD or ADHD offer the opportunity to determine whether the two disorders share…

The Importance of ADHD Subtype Classification for Educational Applications of "DSM-V"

ERIC Educational Resources Information Center

Barnard, Lucy; Stevens, Tara; To, Yen M.; Lan, William Y.; Mulsow, Miriam

2010-01-01

Objective: An examination of the academic achievement of children with ADHD by stimulant treatment status must consider this heterogeneity of the disorder. With the dissemination of the final wave of data, the Special Education Elementary Longitudinal Study presents an opportunity to examine the academic achievement of students with ADHD using a…

Parental monitoring in late adolescence: relations to ADHD symptoms and longitudinal predictors.

PubMed

Salari, Raziye; Thorell, Lisa B

2015-04-01

In this study, we aimed to replicate Stattin and Kerr's (2000) study on parental monitoring and adolescents' deviant behavior, to extend their findings to ADHD symptoms, and to examine the longitudinal predictors (8-18 years) of parental knowledge and child disclosure. Results showed that conduct problems were primarily associated with parental knowledge and child disclosure, but not with parental solicitation and control. A similar pattern was observed for ADHD symptoms. However, while the relations for conduct problems were generally independent of ADHD symptoms, the relations for ADHD symptoms were primarily non-significant after controlling for conduct problems. Moreover, early behavior problems, but not insecure/disorganized attachment, were associated with parental knowledge and child disclosure in adolescence. In conclusion, child disclosure is primarily associated with deviant behavior rather than ADHD, and early child problem behavior is a more important predictor of child disclosure (implicating reciprocal relations between these two constructs) than is insecure/disorganized attachment. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Sleep and Self-Regulation from Birth to 7 Years: A Retrospective Study of Children with and Without Attention-Deficit Hyperactivity Disorder at 8 to 9 Years.

PubMed

Williams, Kate E; Sciberras, Emma

2016-06-01

To examine mean level differences and longitudinal and reciprocal relations among behavioral sleep problems, emotional dysregulation, and attentional regulation across early childhood for children with and without attention-deficit hyperactivity disorder (ADHD) at 8 to 9 years. This study used data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC)-Infant Cohort (n = 4,109 analyzed). Children with and without ADHD were identified at age 8 to 9 years via parent report of ADHD diagnosis and the 5-item Inattention-Hyperactivity subscale from the Strengths and Difficulties Questionnaire. Maternal report of child sleep problems and self-regulation was collected at 0 to 1, 2 to 3, 4 to 5, and 6 to 7 years of age. Analysis of variance was used to compare mean level differences in sleep problems and emotional and attentional regulation by ADHD group. Longitudinal structural equation modeling examined the relations among sleep and self-regulation across time in children with and without ADHD. Children with ADHD had persistently elevated levels of sleep problems (from infancy) and emotional and attentional dysregulation compared to controls (from 2 to 3 years of age). Sleep problems, emotional dysregulation, and attentional regulation were stable over time for both groups. Sleep problems were associated with greater emotional dysregulation 2 years later from 2 to 3 years of age for both groups, which in turn was associated with poorer attentional regulation. There was no direct relationship between sleep problems and later attentional regulation. Sleep problems in children with and without ADHD are associated with emotional dysregulation, which in turn contributes to poorer attentional functioning. This study highlights the importance of assessing and managing sleep problems in young children.

ADHD symptoms, academic achievement, self-perception of academic competence and future orientation: a longitudinal study.

PubMed

Scholtens, Sara; Rydell, Ann-Margret; Yang-Wallentin, Fan

2013-06-01

In the investigation of the effect of attention deficit hyperactivity disorder (ADHD) symptoms on school careers there is a need to study the role of adolescent and childhood ADHD symptoms and academic achievement, and to incorporate measures that include the individual's perspective. Our aim was to gain an overview of the long-term development of school careers in relation to ADHD symptoms. We studied associations between ADHD symptoms and academic achievement at different time-points and future orientation at the end of high school, and assessed the role of self-perceptions of academic competence in these associations. Participants were 192 children (47% girls) with a range of ADHD symptoms taken from a community sample. Collecting data at three time points, in 6th, 11th and 12th grade we tested a structural equation model. Results showed that ADHD symptoms in 6th grade negatively affected academic achievement concurrently and longitudinally. ADHD symptoms in 11th grade negatively affected concurrent academic achievement and academic self-perception and future orientation in 12th grade. Academic achievement had a positive influence on academic self-perception and future orientation. Given the other factors, self-perception of academic competence did not contribute to outcomes. We concluded that early ADHD symptoms may cast long shadows on young people's academic progress. This happens mainly by way of stability in symptoms and relations to early low academic achievement. © 2013 The Authors. Scandinavian Journal of Psychology © 2013 The Scandinavian Psychological Associations.

A multicohort, longitudinal study of cerebellar development in attention deficit hyperactivity disorder.

PubMed

Shaw, Philip; Ishii-Takahashi, Ayaka; Park, Min Tae; Devenyi, Gabriel A; Zibman, Chava; Kasparek, Steven; Sudre, Gustavo; Mangalmurti, Aman; Hoogman, Martine; Tiemeier, Henning; von Polier, Georg; Shook, Devon; Muetzel, Ryan; Chakravarty, M Mallar; Konrad, Kerstin; Durston, Sarah; White, Tonya

2018-04-25

The cerebellum supports many cognitive functions disrupted in attention deficit hyperactivity disorder (ADHD). Prior neuroanatomic studies have been often limited by small sample sizes, inconsistent findings, and a reliance on cross-sectional data, limiting inferences about cerebellar development. Here, we conduct a multicohort study using longitudinal data, to characterize cerebellar development. Growth trajectories of the cerebellar vermis, hemispheres and white matter were estimated using piecewise linear regression from 1,656 youth; of whom 63% had longitudinal data, totaling 2,914 scans. Four cohorts participated, all contained childhood data (age 4-12 years); two had adolescent data (12-25 years). Growth parameters were combined using random-effects meta-analysis. Diagnostic differences in growth were confined to the corpus medullare (cerebellar white matter). Here, the ADHD group showed slower growth in early childhood compared to the typically developing group (left corpus medullare z = 2.49, p = .01; right z = 2.03, p = .04). This reversed in late childhood, with faster growth in ADHD in the left corpus medullare (z = 2.06, p = .04). Findings held when gender, intelligence, comorbidity, and psychostimulant medication were considered. Across four independent cohorts, containing predominately longitudinal data, we found diagnostic differences in the growth of cerebellar white matter. In ADHD, slower white matter growth in early childhood was followed by faster growth in late childhood. The findings are consistent with the concept of ADHD as a disorder of the brain's structural connections, formed partly by developing cortico-cerebellar white matter tracts. © 2018 Association for Child and Adolescent Mental Health.

Relation between internalizing behaviors, externalizing behaviors, and peer victimization among children with and without ADHD.

PubMed

Fogleman, Nicholas D; Leaberry, Kirsten D; Rosen, Paul J; Walerius, Danielle M; Slaughter, Kelly E

2018-01-12

The current study explored the concurrent and longitudinal association between internalizing behaviors, externalizing behaviors, and peer victimization among children with and without ADHD. Eighty children (42 ADHD, 38 non-ADHD) ages 8-12 participated in the present study conducted over a 6-month period. During the baseline session, parents completed a structured diagnostic interview and the Vanderbilt ADHD Parent Rating Scale to determine whether their child met criteria for ADHD, and the Child Behavior Checklist (CBCL) to assess their child's internalizing and externalizing behaviors; children completed the Perception of Peer Support Scale (PPSS) to assess experiences of peer victimization. At the 6-month follow-up session, parents completed the CBCL and children completed the PPSS. Concurrently, internalizing behaviors were associated with peer victimization among children with and without ADHD; ADHD moderated this relation, such that internalizing behaviors were more strongly related to peer victimization among children with ADHD. Longitudinally, internalizing behaviors at baseline predicted peer victimization at 6-month follow-up; however, further analyses demonstrated there was a covarying change in internalizing behaviors and peer victimization. These findings suggest internalizing behaviors are related to peer victimization concurrently, and over time, and are associated with increased risk for peer victimization in the presence of ADHD. Additionally, internalizing behaviors and peer victimization appear to share a dynamic relationship; that is, decreases in internalizing behaviors predict similar decreases in peer victimization. No significant relations were observed between externalizing behaviors and peer victimization. Implications and limitations are discussed.

The Impact of Childhood ADHD on Dropping out of High School in Urban Adolescents/Young Adults

ERIC Educational Resources Information Center

Trampush, Joey W.; Miller, Carlin J.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.

2009-01-01

Objective: To examine cognitive and psychosocial factors associated with high school dropout in urban adolescents with and without childhood ADHD. Method: In a longitudinal study, 49 adolescents/young adults with childhood ADHD and 44 controls who either dropped out or graduated from high school are included. Risk factors examined as potential…

Characteristics of Adolescents and Young Adults with ADHD Who Divert or Misuse Their Prescribed Medications

ERIC Educational Resources Information Center

Wilens, Timothy E.; Gignac, Martin; Swezey, Allison; Monuteaux, Michael C.; Biederman, Joseph

2006-01-01

Objective: Little is known about the risks and characteristics of attention-deficit/hyperactivity disorder (ADHD) patients who misuse or divert their stimulant medications. As part of a 10-year longitudinal study of youths with ADHD, the authors evaluated medication diversion or misuse at the last follow-up period. Method: Structured psychiatric…

Attention Deficit Hyperactivity Disorder Symptoms and Low Educational Achievement: Evidence Supporting A Causal Hypothesis.

PubMed

de Zeeuw, Eveline L; van Beijsterveldt, Catharina E M; Ehli, Erik A; de Geus, Eco J C; Boomsma, Dorret I

2017-05-01

Attention Deficit Hyperactivity Disorder (ADHD) and educational achievement are negatively associated in children. Here we test the hypothesis that there is a direct causal effect of ADHD on educational achievement. The causal effect is tested in a genetically sensitive design to exclude the possibility of confounding by a third factor (e.g. genetic pleiotropy) and by comparing educational achievement and secondary school career in children with ADHD who take or do not take methylphenidate. Data on ADHD symptoms, educational achievement and methylphenidate usage were available in a primary school sample of ~10,000 12-year-old twins from the Netherlands Twin Register. A substantial group also had longitudinal data at ages 7-12 years. ADHD symptoms were cross-sectionally and longitudinally, associated with lower educational achievement at age 12. More ADHD symptoms predicted a lower-level future secondary school career at age 14-16. In both the cross-sectional and longitudinal analyses, testing the direct causal effect of ADHD on educational achievement, while controlling for genetic and environmental factors, revealed an association between ADHD symptoms and educational achievement independent of genetic and environmental pleiotropy. These findings were confirmed in MZ twin intra-pair differences models, twins with more ADHD symptoms scored lower on educational achievement than their co-twins. Furthermore, children with ADHD medication, scored significantly higher on the educational achievement test than children with ADHD who did not use medication. Taken together, the results are consistent with a direct causal effect of ADHD on educational achievement.

Child Executive Control as a Moderator of the Longitudinal Association Between Sleep Problems and Subsequent Attention-Deficit/Hyperactivity Disorder Symptoms.

PubMed

Kidwell, Katherine M; Hankey, Maren; Nelson, Jennifer Mize; Espy, Kimberly Andrews; Nelson, Timothy D

2017-11-01

To examine the longitudinal associations among sleep, executive control (EC), and attention-deficit/hyperactivity disorder (ADHD) symptoms in childhood. In this longitudinal study (N = 271), parents answered questions about sleep problems when children were 3 years old, children completed a comprehensive EC task battery at 4.5 years, and teachers completed standardized measures of child ADHD symptoms in 4th grade. Latent moderated structural equation models demonstrated that sleep problems at 3 years and EC deficits at 4.5 years were associated with ADHD symptoms in 4th grade. EC moderated the relationship between sleep problems and hyperactivity/impulsivity, such that children with both sleep problems and poor EC were particularly at risk for hyperactivity/impulsivity. Sleep problems and EC deficits early in development were associated with increased risk for ADHD symptoms in elementary school. Early assessment and intervention to promote healthy sleep and EC development may be helpful in ADHD prevention. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Predictors and Moderators of Quality of Life Among College Students With ADHD.

PubMed

Pinho, Trevor D; Manz, Patricia H; DuPaul, George J; Anastopoulos, Arthur D; Weyandt, Lisa L

2017-10-01

The current study examines (a) whether ADHD among college students is associated with differences in perceptions of quality of life (QoL); (b) the moderating roles of comorbidity, drug use, psychopharmacological treatment, and psychosocial treatment; and (c) the total impact of these variables on QoL. Participants were college students with and without ADHD ( N = 372) in a longitudinal study. College students with ADHD were more likely to assert negative global QoL evaluations relative to non-ADHD peers. The relationship between ADHD and QoL was not altered as a function of medication treatment, comorbid psychopathology, psychosocial treatment, or drug use. College students with ADHD behave similarly to other adults with ADHD in that they make lower subjective global evaluations of their QoL relative to their non-ADHD agemates. Other factors associated with ADHD and QoL do not appear to moderate this relationship.

Is Attention Deficit Hyperactivity Disorder a Valid Diagnosis in the Presence of High IQ? Results from the MGH Longitudinal Family Studies of ADHD

ERIC Educational Resources Information Center

Antshel, Kevin M.; Faraone, Stephen V.; Stallone, Kimberly; Nave, Andrea; Kaufmann, Felice A.; Doyle, Alysa; Fried, Ronna; Seidman, Larry; Biederman, Joseph

2007-01-01

Background: The aim of this study was to assess the validity of diagnosing attention deficit/hyperactivity disorder (ADHD) in high IQ children and to further characterize the clinical features associated with their ADHD. Methods: We operationalized giftedness/high IQ as having a full scale IQ greater than or equal to 120. We identified 92 children…

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

PubMed Central

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

2013-01-01

Background Families of children with attention deficit hyperactivity disorder (ADHD) report more negative family relationships than families of children without ADHD. Questions remain as to the role of genetic factors underlying associations between family relationships and children’s ADHD symptoms, and the role of children’s ADHD symptoms as an evocative influence on the quality of relationships experienced within such families. Utilizing the attributes of two genetically sensitive research designs, the present study examined associations between biologically related and non-biologically related maternal ADHD symptoms, parenting practices, child impulsivity/activation, and child ADHD symptoms. The combined attributes of the study designs permit assessment of associations while controlling for passive genotype-environment correlation and directly examining evocative genotype-environment correlation (rGE); two relatively under examined confounds of past research in this area. Methods A cross-sectional adoption-at-conception design (Cardiff IVF Study; C-IVF) and a longitudinal adoption-at-birth design (Early Growth and Development Study; EGDS) were used. The C-IVF sample included 160 mothers and children (age 5–8 years). The EGDS sample included 320 linked sets of adopted children (age 6 years), adoptive-, and biologically-related mothers. Questionnaires were used to assess maternal ADHD symptoms, parenting practices, child impulsivity/activation, and child ADHD symptoms. A cross-rater approach was used across measures of maternal behavior (mother reports) and child ADHD symptoms (father reports). Results Significant associations were revealed between rearing mother ADHD symptoms, hostile parenting behavior, and child ADHD symptoms in both samples. Because both samples consisted of genetically-unrelated mothers and children, passive rGE was removed as a possible explanatory factor underlying these associations. Further, path analysis revealed evidence for evocative rGE processes in the longitudinal adoption-at-birth study (EGDS) from biologically-related maternal ADHD symptoms to biologically-unrelated maternal hostile parenting through early disrupted child behavior (impulsivity/activation), with maternal hostile parenting and disrupted child behavior associated with later child ADHD symptoms, controlling for concurrent adoptive mother ADHD symptoms. Conclusions Results highlight the importance of genetically-influenced child ADHD-related temperamental attributes on genetically-unrelated maternal hostility that in turn links to later child ADHD symptoms. Implications for intervention programs focusing on early family processes and the precursors of child ADHD symptoms are discussed. PMID:24007415

Biological and rearing mother influences on child ADHD symptoms: revisiting the developmental interface between nature and nurture.

PubMed

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

2013-10-01

Families of children with attention deficit hyperactivity disorder (ADHD) report more negative family relationships than families of children without ADHD. Questions remain as to the role of genetic factors underlying associations between family relationships and children's ADHD symptoms, and the role of children's ADHD symptoms as an evocative influence on the quality of relationships experienced within such families. Utilizing the attributes of two genetically sensitive research designs, the present study examined associations between biologically related and nonbiologically related maternal ADHD symptoms, parenting practices, child impulsivity/activation, and child ADHD symptoms. The combined attributes of the study designs permit assessment of associations while controlling for passive genotype-environment correlation and directly examining evocative genotype-environment correlation (rGE); two relatively under examined confounds of past research in this area. A cross-sectional adoption-at-conception design (Cardiff IVF Study; C-IVF) and a longitudinal adoption-at-birth design (Early Growth and Development Study; EGDS) were used. The C-IVF sample included 160 mothers and children (age 5-8 years). The EGDS sample included 320 linked sets of adopted children (age 6 years), adoptive-, and biologically related mothers. Questionnaires were used to assess maternal ADHD symptoms, parenting practices, child impulsivity/activation, and child ADHD symptoms. A cross-rater approach was used across measures of maternal behavior (mother reports) and child ADHD symptoms (father reports). Significant associations were revealed between rearing mother ADHD symptoms, hostile parenting behavior, and child ADHD symptoms in both samples. Because both samples consisted of genetically unrelated mothers and children, passive rGE was removed as a possible explanatory factor underlying these associations. Further, path analysis revealed evidence for evocative rGE processes in the longitudinal adoption-at-birth study (EGDS) from biologically related maternal ADHD symptoms to biologically unrelated maternal hostile parenting through early disrupted child behavior (impulsivity/activation), with maternal hostile parenting and disrupted child behavior associated with later child ADHD symptoms, controlling for concurrent adoptive mother ADHD symptoms. Results highlight the importance of genetically influenced child ADHD-related temperamental attributes on genetically unrelated maternal hostility that in turn links to later child ADHD symptoms. Implications for intervention programs focusing on early family processes and the precursors of child ADHD symptoms are discussed. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

A Longitudinal Twin Study on the Association between Inattentive and Hyperactive-Impulsive ADHD Symptoms

ERIC Educational Resources Information Center

Greven, Corina U.; Asherson, Philip; Rijsdijk, Fruhling V.; Plomin, Robert

2011-01-01

DSM-IV distinguishes two symptom domains of attention deficit hyperactivity disorder (ADHD): inattentiveness and hyperactivity-impulsivity. The present study examines the aetiologies and developmental relations underlying the associations between inattentiveness and hyperactivity-impulsivity over time, based on a representative population sample…

A longitudinal twin study of the direction of effects between ADHD symptoms and IQ.

PubMed

Rommel, Anna Sophie; Rijsdijk, Frühling; Greven, Corina U; Asherson, Philip; Kuntsi, Jonna

2015-01-01

While the negative association between ADHD symptoms and IQ is well documented, our knowledge about the direction and aetiology of this association is limited. Here, we examine the association of ADHD symptoms with verbal and performance IQ longitudinally in a population-based sample of twins. In a population-based sample of 4,771 twin pairs, DSM-IV ADHD symptoms were obtained from the Conners' Parent Rating Scale-Revised. Verbal (vocabulary) and performance (Raven's Progressive Matrices) IQ were assessed online. ADHD symptom ratings and IQ scores were obtained at ages 12, 14 and 16 years. Making use of the genetic sensitivity and time-ordered nature of our data, we use a cross-lagged model to examine the direction of effects, while modelling the aetiologies of the association between ADHD symptoms with vocabulary and Raven's scores over time. Although time-specific aetiological influences emerged for each trait at ages 14 and 16 years, the aetiological factors involved in the association between ADHD symptoms and IQ were stable over time. ADHD symptoms and IQ scores significantly predicted each other over time. ADHD symptoms at age 12 years were a significantly stronger predictor of vocabulary and Raven's scores at age 14 years than vice versa, whereas no differential predictive effects emerged from age 14 to 16 years. The results suggest that ADHD symptoms may put adolescents at risk for decreased IQ scores. Persistent genetic influences seem to underlie the association of ADHD symptoms and IQ over time. Early intervention is likely to be key to reducing ADHD symptoms and the associated risk for lower IQ.

Developmental Trajectories of Aggression, Prosocial Behavior, and Social-Cognitive Problem Solving in Emerging Adolescents with Clinically Elevated ADHD Symptoms

PubMed Central

Kofler, Michael J.; Larsen, Ross; Sarver, Dustin E.; Tolan, Patrick H.

2015-01-01

Middle school is a critical yet understudied period of social behavioral risks and opportunities that may be particularly difficult for emerging adolescents with ADHD given their childhood social difficulties. Although childhood ADHD has been associated with increased aggression and peer relational difficulties, relatively few ADHD studies have examined social behavior beyond the elementary years, or examined aspects of positive (prosocial) behavior. In addition, social-cognitive problem solving has been implicated in ADHD; however, its longitudinal impact on prosocial and aggressive behavior is unclear. The current study examined how middle school students with clinically elevated ADHD symptoms differ from their non-ADHD peers on baseline (sixth grade) and age-related changes in prosocial and aggressive behavior, and the extent to which social-cognitive problem solving strategies mediate these relations. Emerging adolescents with (n = 178) and without (n = 3,806) clinically elevated, teacher-reported ADHD inattentive and hyperactive/impulsive symptoms were compared longitudinally across sixth through eighth grades using parallel process latent growth curve modeling, accounting for student demographic characteristics, ODD symptoms, deviant peer association, school climate, and parental monitoring. Sixth graders with elevated ADHD symptoms engaged in somewhat fewer prosocial behaviors (d= −0.44) and more aggressive behavior (d= 0.20) relative to their peers. These small social behavioral deficits decreased but were not normalized across the middle school years. Contrary to hypotheses, social-cognitive problem solving was not impaired in the ADHD group, and did not mediate the association between ADHD and social behavior during the middle school years. ADHD and social-cognitive problem solving contributed independently to social behavior, both in sixth grade and across the middle school years; the influence of social-cognitive problem solving on social behavior was highly similar for the ADHD and non-ADHD groups. PMID:26595479

No lower cognitive functioning in older adults with attention-deficit/hyperactivity disorder.

PubMed

Semeijn, E J; Korten, N C M; Comijs, H C; Michielsen, M; Deeg, D J H; Beekman, A T F; Kooij, J J S

2015-09-01

Research illustrates cognitive deficits in children and younger adults with attention-deficit/hyperactivity disorder (ADHD). Few studies have focused on the cognitive functioning in older adults. This study investigates the association between ADHD and cognitive functioning in older adults. Data were collected in a cross-sectional side study of the Longitudinal Aging Study Amsterdam (LASA). A diagnostic interview to diagnose ADHD was administered among a subsample (N = 231, age 60-94). ADHD symptoms and diagnosis were assessed with the Diagnostic Interview for ADHD in Adults (DIVA) 2.0. Cognitive functioning was assessed with tests in the domains of executive functioning, information processing speed, memory, and attention/working memory. Regression analyses indicate that ADHD diagnosis and ADHD severity were only negatively associated with cognitive functioning in the attention/working memory domain. When adjusting for depression, these associations were no longer significant. The study shows that ADHD in older adults is associated with lower cognitive functioning in the attention/working memory domain. However, this was partly explained by depressive symptoms.

Infant Brain Structures, Executive Function, and Attention Deficit/Hyperactivity Problems at Preschool Age. A Prospective Study

ERIC Educational Resources Information Center

Ghassabian, Akhgar; Herba, Catherine M.; Roza, Sabine J.; Govaert, Paul; Schenk, Jacqueline J.; Jaddoe, Vincent W.; Hofman, Albert; White, Tonya; Verhulst, Frank C.; Tiemeier, Henning

2013-01-01

Background: Neuroimaging findings have provided evidence for a relation between variations in brain structures and Attention Deficit/Hyperactivity Disorder (ADHD). However, longitudinal neuroimaging studies are typically confined to children who have already been diagnosed with ADHD. In a population-based study, we aimed to characterize the…

Mediators and Moderators of the Relation Between Parental ADHD Symptomatology and the Early Development of Child ADHD and ODD Symptoms

PubMed Central

Breaux, Rosanna P.; Brown, Hallie R.; Harvey, Elizabeth A.

2016-01-01

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. PMID:27752934

Mobile Phone Use, Blood Lead Levels, and Attention Deficit Hyperactivity Symptoms in Children: A Longitudinal Study

PubMed Central

Byun, Yoon-Hwan; Ha, Mina; Kwon, Ho-Jang; Hong, Yun-Chul; Leem, Jong-Han; Sakong, Joon; Kim, Su Young; Lee, Chul Gab; Kang, Dongmug; Choi, Hyung-Do; Kim, Nam

2013-01-01

Background Concerns have developed for the possible negative health effects of radiofrequency electromagnetic field (RF-EMF) exposure to children’s brains. The purpose of this longitudinal study was to investigate the association between mobile phone use and symptoms of Attention Deficit Hyperactivity Disorder (ADHD) considering the modifying effect of lead exposure. Methods A total of 2,422 children at 27 elementary schools in 10 Korean cities were examined and followed up 2 years later. Parents or guardians were administered a questionnaire including the Korean version of the ADHD rating scale and questions about mobile phone use, as well as socio-demographic factors. The ADHD symptom risk for mobile phone use was estimated at two time points using logistic regression and combined over 2 years using the generalized estimating equation model with repeatedly measured variables of mobile phone use, blood lead, and ADHD symptoms, adjusted for covariates. Results The ADHD symptom risk associated with mobile phone use for voice calls but the association was limited to children exposed to relatively high lead. Conclusions The results suggest that simultaneous exposure to lead and RF from mobile phone use was associated with increased ADHD symptom risk, although possible reverse causality could not be ruled out. PMID:23555766

Epidemiology of Treated Attention-Deficit/Hyperactivity Disorder (ADHD) across the Lifespan in Taiwan: A Nationwide Population-Based Longitudinal Study

PubMed Central

Huang, Charles Lung-Cheng; Chu, Chin-Chen; Cheng, Tain-Junn; Weng, Shih-Feng

2014-01-01

Objectives We used insurance claims of a nationally representative population-based cohort to assess the longitudinal treated prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents and adults. Methods Participants were identified from among National Health Insurance enrollees in Taiwan from 1999 to 2005. We identified study subjects who had at least one service claim during these years with a principal diagnosis of ADHD. A total of 6,173 patients were recorded in the treated ADHD cohort during the 6-year study. Results There was a significant increase in the treated prevalence rate of ADHD during the study period, from 64.65 per 100,000 in 2000 to 145.40 per 100,000 in 2005 (p = .001). An increase in the treated incidence rate of ADHD, from 44.67 per 100,000 in 2000 to 81.20 per 100,000 in 2005, was also observed (p = .013). However, the treated prevalence of ADHD was still lower than that of the community data in Taiwan. The peak treated prevalence of ADHD was at age 7–12 years for both males and females, and the peak treated incidence of ADHD was at age 0–6 for females and age 7–12 for males. Overall, the treated incidence and prevalence rates dropped abruptly after age 13–18 (both p<.001) for males and females (p<.001 for both). Male vs. female ratios of treated prevalence and incidence were both above 1 before age 25–30 years, but below 1 thereafter. Conclusion Although an increasing number of people with ADHD sought treatment during 1999–2005 in Taiwan, the treated prevalence of ADHD was still lower than that of the community data. The treated incidence and prevalence of ADHD fell dramatically after age 13–18. However, more women than men sought treatment in adulthood. There may be under-diagnosis and under-treatment of ADHD, especially among females and adults. PMID:24736469

Longitudinal Associations of Parental Emotion Socialization and Children's Emotion Regulation: The Moderating Role of ADHD Symptomatology.

PubMed

Breaux, Rosanna P; McQuade, Julia D; Harvey, Elizabeth A; Zakarian, Rebecca J

2018-05-01

Theory and research suggest that parents' reactions to children's emotions play a critical role in teaching children effective emotion regulation (ER) skills, but no studies have directly examined the role that parent emotion socialization plays in the development of ER in children with ADHD. Gaining insight into the causes of impaired ER, particularly in youth with ADHD who are known to have poor ER, has important theoretical and translational significance. The present study is the first to longitudinally examine whether emotion socialization predicts later physiological and adult-reported measures of ER in children with and without ADHD. It also sought to determine if these relations are moderated by ADHD symptoms. Participants were 61 children (31 girls, 30 boys; M = 10.67 years, SD = 1.28) with and without clinically significant ADHD symptoms. At Time 1, parent reports of emotion socialization and parent- and teacher-report of child ADHD symptoms were collected. At Time 2, child ER measures were collected based on parent- and teacher-report and physiological reactivity during an impossible puzzle and a social rejection task. Physiological measures included respiratory sinus arrhythmia and skin conductance level (SCL). Supportive parenting practices were associated with better parent-rated emotion regulation skills for all children and greater SCL reactivity for children with high ADHD symptoms. Non-supportive parenting reactions were associated with greater adult-rated emotional lability for children with high ADHD symptoms. Results highlight the importance of considering multiple aspects of ER, including physiological manifestations. Findings suggest that parents' use of adaptive emotion socialization practices may serve as a protective factor for children's ER development and may be particularly critical for youth with ADHD. Our findings support the use of interventions addressing parent emotion socialization to help foster better ER in children.

Is attention deficit/hyperactivity disorder among men associated with initiation or escalation of substance use at 15-month follow-up? A longitudinal study involving young Swiss men.

PubMed

Vogel, Tanja; Dom, Geert; van de Glind, Geurt; Studer, Joseph; Gmel, Gerhard; Strik, Werner; Moggi, Franz

2016-10-01

Young adults with attention deficit/hyperactivity disorder (ADHD) show higher substance use disorder (SUD) prevalence relative to non-ADHD controls; few longitudinal studies have examined the course of substance use with reference to conduct disorder (CD). We compared initiation and escalation of substance use at 15-month follow-up in men screened positive or negative for ADHD (ADHD(+) versus ADHD(-) ), controlling for CD presence in early adolescence. Participants were recruited during August 2010 and November 2011 from the census of all young men who have to pass mandatory army conscription from three of six Swiss Army recruitment centres. A two-wave data collection was performed via questionnaires at baseline and 15-month follow-up as a part of the longitudinal Cohort Study on Substance Use Risk Factors. Recruitment centres in Lausanne, Windisch and Mels, responsible for 21 cantons in German- and French-speaking areas of Switzerland. Consecutive sample of 5103 male Swiss Army conscripts who provided informed consent and responded to questionnaires at baseline and 15-month follow-up. Their mean age was 20.0 (standard deviation = 1.21) years at baseline. ADHD and CD were assessed using the adult ADHD Self-Report Scale and the MINI International Neuropsychiatric Interview Plus, respectively, at baseline, and substance use was measured via self-administered substance use questionnaires at baseline and follow-up. Compared with the ADHD(-) group, the ADHD(+) group (n = 215, 4.2%) showed heavier baseline substance use and increased likelihood of alcohol (χ(2)  = 53.96; P < 0.001), tobacco (χ(2)  = 21.73; P < 0.001) and cannabis use disorders (χ(2)  = 48.43; P < 0.001). The extent of alcohol, tobacco and cannabis use in the two groups remained stable from baseline to follow-up (no escalation). The ADHD(+) group was more likely to initiate substance use compared with the ADHD(-) group (higher initiation rates), particularly with amphetamines [odds ratio (OR) = 3.81; 95% confidence interval (CI) = 2.20-6.60; P < 0.001] and non-medical use of ADHD medication (OR = 4.45; 95% CI = 2.06-9.60; P < 0.001). CD was associated with initiation of substance use but did not mediate the associations between ADHD and substance use, revealing that the impact of ADHD on substance use was independent of CD. For men in their early 20s, attention deficit/hyperactivity disorder is a risk factor for continued heavier but not escalating use of alcohol, tobacco and cannabis when already consuming these substances, compared with young men with no ADHD. It is also a risk factor for initiating the use of cannabis, stimulants, hallucinogens and sedatives, independent of conduct disorder in early adolescence. © 2016 Society for the Study of Addiction.

Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls

PubMed Central

Stepp, Stephanie D.; Burke, Jeffrey D.; Hipwell, Alison E.; Loeber, Rolf

2011-01-01

Little empirical evidence exists regarding the developmental links between childhood psychopathology and borderline personality disorder (BPD) in adolescence. The current study addresses this gap by examining symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) as potential precursors. ADHD and BPD share clinical features of impulsivity, poor self-regulation, and executive dysfunction, while ODD and BPD share features of anger and interpersonal turmoil. The study is based on annual, longitudinal data from the two oldest cohorts in the Pittsburgh Girls Study (N = 1233). We used piecewise latent growth curve models of ADHD and ODD scores from age 8–10 and 10–13 years to examine the prospective associations between dual trajectories of ADHD and ODD symptom severity and later BPD symptoms at age 14 in girls. To examine the specificity of these associations, we also included conduct disorder (CD) and depression symptom severity at age 14 as additional outcomes. We found that higher levels of ADHD and ODD scores at age 8 uniquely predicted BPD symptoms at age 14. Additionally, the rate of growth in ADHD scores from age 10–13 and the rate of growth in ODD scores from 8–10 uniquely predicted higher BPD symptoms at age 14. This study adds to the literature on the early development of BPD by providing the first longitudinal study to examine ADHD and ODD symptom trajectories as specific childhood precursors of BPD symptoms in adolescent girls. PMID:21671009

Comorbidity in ADHD: implications for research, practice, and DSM-V.

PubMed

Jensen, P S; Martin, D; Cantwell, D P

1997-08-01

Since the introduction of DSM-III/III-R, clinicians and investigators have shown increasing interest in the study of conditions comorbid with attention-deficit hyperactivity disorder (ADHD). Better understanding ADHD comorbidity patterns is needed to guide treatment, research and future classification approaches. The ADHD literature from the past 15 years was reviewed to (1) explore the most prevalent patterns of ADHD comorbidity; (2) examine the correlates and longitudinal predictors of comorbidity; and (3) determine the extent to which comorbid patterns convey unique information concerning ADHD etiology, treatment and outcomes. To identify potential new syndromes, the authors examined comorbid patterns based on eight validational criteria. The largest available body of literature concerned the comorbidity with ADHD and conduct disorder/aggression, with a substantially smaller amount of data concerning other comorbid conditions. In many areas the literature was sparse, and pertinent questions concerning comorbidity patterns remain unexplored. Nonetheless available data warrant the delineation of two new subclassifications of ADHD: (1) ADHD aggressive subtype, and (2) ADHD, anxious subtype. Additional studies of the frequency of comorbidity and associated factors are greatly needed to include studies of differential effects of treatment of children with various comorbid ADHD disorders, as well as of ADHD children who differ on etiological factors.

Interrelations between executive function and symptoms of hyperactivity/impulsivity and inattention in preschoolers: a two year longitudinal study.

PubMed

Brocki, Karin C; Eninger, Lilianne; Thorell, Lisa B; Bohlin, Gunilla

2010-02-01

The present study, including children at risk for developing Attention Deficit Hyperactivity Disorder (ADHD), examined the idea that complex executive functions (EFs) build upon more simple ones. This notion was applied in the study of longitudinal interrelations between core EF components - simple and complex inhibition, selective attention, and working memory (WM) - at age 5 and 6 as well as their predictive relations to ADHD symptoms at age 7. The results showed that simple inhibition and selective attention at age 5 independently predicted complex inhibition and WM at age 6. In addition, EFs primarily predicted symptoms of inattention rather than hyperactivity/impulsivity even at this young age. Finally, age 6 complex inhibition was shown to act as a mediator in the relations between simple inhibition and selective attention at age 5 and symptoms of inattention at age 7. These findings provide novel longitudinal support for the theory that fundamental EF components show a progression with age toward more complex executive control (see Garon et al. Psychological Bulletin 134(1):31-60 2008). Further, complex inhibition, implicating both inhibition and WM, seems to be a particularly strong correlate of ADHD symptoms in young children and should as such be the focus of future studies examining the relation between cognitive function and ADHD symptoms from a developmental perspective.

Life Span Studies of ADHD-Conceptual Challenges and Predictors of Persistence and Outcome.

PubMed

Caye, Arthur; Swanson, James; Thapar, Anita; Sibley, Margaret; Arseneault, Louise; Hechtman, Lily; Arnold, L Eugene; Niclasen, Janni; Moffitt, Terrie; Rohde, Luis Augusto

2016-12-01

There is a renewed interest in better conceptualizing trajectories of attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood, driven by an increased recognition of long-term impairment and potential persistence beyond childhood and adolescence. This review addresses the following major issues relevant to the course of ADHD in light of current evidence from longitudinal studies: (1) conceptual and methodological issues related to measurement of persistence of ADHD, (2) estimates of persistence rate from childhood to adulthood and its predictors, (3) long-term negative outcomes of childhood ADHD and their early predictors, and (4) the recently proposed new adult-onset ADHD. Estimates of persistence vary widely in the literature, and diagnostic criteria, sample characteristics, and information source are the most important factors explaining variability among studies. Evidence indicates that ADHD severity, comorbid conduct disorder and major depressive disorder, and treatment for ADHD are the main predictors of ADHD persistence from childhood to adulthood. Comorbid conduct disorder and ADHD severity in childhood are the most important predictors of adverse outcomes in adulthood among children with ADHD. Three recent population studies suggested the existence of a significant proportion of individuals who report onset of ADHD symptoms and impairments after childhood. Finally, we highlight areas for improvement to increase our understanding of ADHD across the life span.

Heterogeneity in development of aspects of working memory predicts longitudinal attention deficit hyperactivity disorder symptom change.

PubMed

Karalunas, Sarah L; Gustafsson, Hanna C; Dieckmann, Nathan F; Tipsord, Jessica; Mitchell, Suzanne H; Nigg, Joel T

2017-08-01

The role of cognitive mechanisms in the clinical course of neurodevelopmental disorders is poorly understood. Attention Deficit Hyperactivity Disorder (ADHD) is emblematic in that numerous alterations in cognitive development are apparent, yet how they relate to changes in symptom expression with age is unclear. To resolve the role of cognitive mechanisms in ADHD, a developmental perspective that takes into account expected within-group heterogeneity is needed. The current study uses an accelerated longitudinal design and latent trajectory growth mixture models in a sample of children ages 7-13 years carefully characterized as with (n = 437) and without (n = 297) ADHD to (a) identify heterogeneous developmental trajectories for response inhibition, visual spatial working memory maintenance, and delayed reward discounting and (b) to assess the relationships between these cognitive trajectories and ADHD symptom change. Best-fitting models indicated multiple trajectory classes in both the ADHD and typically developing samples, as well as distinct relationships between each cognitive process and ADHD symptom change. Developmental change in response inhibition and delayed reward discounting were unrelated to ADHD symptom change, while individual differences in the rate of visual spatial working memory maintenance improvement predicted symptom remission in ADHD. Characterizing heterogeneity in cognitive development will be crucial for clarifying mechanisms of symptom persistence and recovery. Results here suggest working memory maintenance may be uniquely related to ADHD symptom improvement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Poverty and the Growth of Emotional and Conduct Problems in Children with Autism With and Without Comorbid ADHD.

PubMed

Flouri, Eirini; Midouhas, Emily; Charman, Tony; Sarmadi, Zahra

2015-09-01

We investigated the longitudinal relationship between socio-economic disadvantage (SED) and trajectories of emotional and conduct problems among children with autism spectrum disorder (ASD) who had comorbid attention deficit/hyperactivity disorder (ADHD; ASD + ADHD) or not (ASD - ADHD). The sample was 209 children with ASD who took part in the UK's Millennium Cohort Study. Trajectories of problems across ages 3, 5 and 7 years were analyzed using growth curve models. The ASD - ADHD group decreased in conduct problems over time but the ASD + ADHD group continued on a high trajectory. Although SED was not a risk factor for ASD + ADHD, it was associated with elevated emotional problems among children with ASD + ADHD. This effect of SED on emotional problems was not attenuated by parenting or peer problems.

Is Maternal Smoking During Pregnancy a Risk Factor for Cigarette Smoking in Offspring? A Longitudinal Controlled Study of ADHD Children Grown Up.

PubMed

Biederman, Joseph; Martelon, MaryKate; Woodworth, K Yvonne; Spencer, Thomas J; Faraone, Stephen V

2017-10-01

This study examined whether exposure to maternal smoking during pregnancy in children with and without ADHD is associated with smoking in offspring and whether this association is selective to ADHD children. Ninety-six exposed and 400 unexposed participants were derived from two longitudinal studies of boys and girls with and without ADHD. Maternal smoking during pregnancy was defined by interviews with participants' mothers. A significant association was observed between exposure to maternal smoking in pregnancy and cigarette smoking in offspring ( p = .02). Exposed offspring were also more likely to have higher rates of major depression ( p = .04), bipolar disorder ( p = .04), and conduct disorder ( p = .04), and lower IQ ( p = .01), lower Global Assessment of Functioning (GAF) score ( p = .02), and more impaired Social Adjustment Inventory for Children and Adolescents (SAICA) scores versus unexposed offspring, adjusting for social class. Maternal smoking during pregnancy was found to increase the risk for smoking and a wide range of adverse psychiatric, cognitive, and functional outcomes in youth.

Adult attention-deficit hyperactivity disorder and obesity: epidemiological study

PubMed Central

Cortese, Samuele; Faraone, Stephen V.; Bernardi, Silvia; Wang, Shuai; Blanco, Carlos

2013-01-01

Background A significant association between attention-deficit hyperactivity disorder (ADHD) and obesity has been reported. This study addresses unexplored aspects of this relationship. Aims To evaluate the association between adult obesity and: (a) persistent, remitted or lifetime ADHD; (b) number of childhood ADHD symptoms, controlling for socioeconomic status and mood, anxiety and substance use disorders. Method Face-to-face psychiatric interviews in 34 653 US adults from the National Epidemiologic Study on Alcohol and Related Conditions. Obesity was defined as a body mass index ⩾30. Results Persistent, lifetime or remitted ADHD were not associated with obesity after controlling for confounders. The number of childhood ADHD symptoms was significantly associated with adult obesity, even after adjustment, in women. Conclusions Childhood ADHD symptoms are associated with obesity in women even after comorbid psychiatric disorders are accounted for. This provides a rationale for longitudinal studies assessing the impact of the treatment of childhood ADHD symptoms on obesity in women. PMID:23661765

Life Span Studies of ADHD—Conceptual Challenges and Predictors of Persistence and Outcome

PubMed Central

Caye, Arthur; Swanson, James; Thapar, Anita; Sibley, Margaret; Arseneault, Louise; Hechtman, Lily; Arnold, L. Eugene; Niclasen, Janni; Moffitt, Terrie

2018-01-01

There is a renewed interest in better conceptualizing trajectories of attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood, driven by an increased recognition of long-term impairment and potential persistence beyond childhood and adolescence. This review addresses the following major issues relevant to the course of ADHD in light of current evidence from longitudinal studies: (1) conceptual and methodological issues related to measurement of persistence of ADHD, (2) estimates of persistence rate from childhood to adulthood and its predictors, (3) long-term negative outcomes of childhood ADHD and their early predictors, and (4) the recently proposed new adult-onset ADHD. Estimates of persistence vary widely in the literature, and diagnostic criteria, sample characteristics, and information source are the most important factors explaining variability among studies. Evidence indicates that ADHD severity, comorbid conduct disorder and major depressive disorder, and treatment for ADHD are the main predictors of ADHD persistence from childhood to adulthood. Comorbid conduct disorder and ADHD severity in childhood are the most important predictors of adverse outcomes in adulthood among children with ADHD. Three recent population studies suggested the existence of a significant proportion of individuals who report onset of ADHD symptoms and impairments after childhood. Finally, we highlight areas for improvement to increase our understanding of ADHD across the life span. PMID:27783340

Inconsistent self-report of delinquency by adolescents and young adults with ADHD.

PubMed

Sibley, Margaret H; Pelham, William E; Molina, Brooke S G; Waschbusch, Daniel A; Gnagy, Elizabeth M; Babinski, Dara E; Biswas, Aparajita

2010-07-01

The purpose of the current study was to test the ability of adolescents and young adults with childhood ADHD to reliably self-report delinquency history. Data were examined from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of children diagnosed with ADHD between 1987 and 1996. Self-report of lifetime delinquency history was compared to concurrent parent-report and to self-report 1 year later. Participants included 313 male probands and 209 demographically similar comparison individuals without ADHD. Results indicated that adolescents and young adults with childhood ADHD were more likely than comparison participants to fail to report delinquent acts reported by a parent and to recant acts they endorsed 1 year earlier. This trend was most apparent for acts of mild to moderate severity. After controlling for several covariates, current ADHD symptom severity and parent-report of the participant's tendency to lie predicted reporting fewer delinquent acts than one's parent. Current ADHD symptom severity also predicted more recanting of previously endorsed acts. Based on these findings, several recommendations are made for the assessment of delinquency history in adolescents and young adults with childhood ADHD.

Long-Term Outcomes of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder: A Systematic Review and Meta-Analysis.

PubMed

Erskine, Holly E; Norman, Rosana E; Ferrari, Alize J; Chan, Gary C K; Copeland, William E; Whiteford, Harvey A; Scott, James G

2016-10-01

Attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) are common externalizing disorders. Despite previous research demonstrating that both are longitudinally associated with adverse outcomes, there have been no systematic reviews examining all of the available evidence linking ADHD and CD with a range of health and psychosocial outcomes. Electronic databases (EMBASE, Medline, and PsycINFO) were searched for studies published from 1980 up to March 2015. Published cohort and case-control studies were included if they reported a longitudinal association between ADHD or CD and adverse outcomes with a minimum follow-up of 2 years. Outcomes with sufficient data were pooled in a random effects meta-analysis to give overall odds ratios (ORs) with corresponding 95% CIs. Of the 278 studies assessed, 114 met inclusion criteria and 98 were used in subsequent meta-analyses. ADHD was associated with adverse outcomes including academic achievement (e.g. failure to complete high school; odds ratio [OR] = 3.7, 95% CIs 2.0-7.0), other mental and substance use disorders (e.g. depression; OR = 2.3, 1.5-3.7), criminality (e.g. arrest; OR = 2.4, 1.5-3.8), and employment (e.g., unemployment; OR = 2.0, 1.0-3.9). CD was associated with outcomes relating to academic achievement (e.g. failure to complete high school; OR = 2.7, 1.5-4.7), other mental and substance use disorders (e.g., illicit drug use; OR = 2.1, 1.7-2.6), and criminality (e.g. violence; OR = 3.5, 2.3-5.3). This study demonstrated that ADHD and CD are associated with disability beyond immediate health loss. Although the analyses could not determine the mechanisms behind these longitudinal associations, they demonstrate the importance of addressing ADHD and CD early in life so as to potentially avert a wide range of future adverse outcomes. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Effects of Lisdexamfetamine Dimesylate Treatment for ADHD on Growth

ERIC Educational Resources Information Center

Faraone, Stephen V.; Spencer, Thomas J.; Kollins, Scott H.; Glatt, Stephen J.

2010-01-01

Objective: To complete an exploratory uncontrolled study of the effects of lisdexamfetamine dimesylate (LDX) on growth of children treated for attention-deficit/hyperactivity disorder (ADHD). Method: Height, weight, and body mass index (BMI) from 281 children ages 6 to 13 years from longitudinal assessments up to 15 months were compared to norms…

Efficacy and Safety of Atomoxetine in the Treatment of Children and Adolescents with Attention Deficit Hyperactivity Disorder

PubMed Central

Kohn, Michael R.; Tsang, Tracey W.; Clarke, Simon D.

2012-01-01

Several non-stimulant medications have been used in the treatment of attention deficit hyperactivity disorder (ADHD). Atomoxetine, was introduced in 2002. The safety and efficacy of atomoxetine in the treatment of ADHD for children, adolescents, and adults has been evaluated in over 4000 patients in randomized controlled studies and double blinded studies as well as in recent large longitudinal studies. This paper provides an updated summary of the literature on atomoxetine, particularly in relation to findings on the short- and long-term safety of atomoxetine in children and adolescents arising from recent large longitudinal cohort studies. Information is presented about the efficacy, safety, and tolerability of this medication. PMID:23641171

Socioeconomic Associations with ADHD: Findings from a Mediation Analysis.

PubMed

Russell, Abigail Emma; Ford, Tamsin; Russell, Ginny

2015-01-01

Children from disadvantaged socioeconomic backgrounds are at greater risk of a range of negative outcomes throughout their life course than their peers; however the specific mechanisms by which socioeconomic status relates to different health outcomes in childhood are as yet unclear. The current study investigates the relationship between socioeconomic disadvantage in childhood and attention deficit/hyperactivity disorder (ADHD), and investigates putative mediators of this association in a longitudinal population-based birth cohort in the UK. Data from the Avon Longitudinal Study of Parents and Children was used (n = 8,132) to explore the relationship between different measures of socioeconomic status at birth-3 years and their association with a diagnosis of ADHD at age 7. A multiple mediation model was utilised to examine factors occurring between these ages that may mediate the association. Financial difficulties, housing tenure, maternal age at birth of child and marital status were significantly associated with an outcome of ADHD, such that families either living in financial difficulty, living in council housing, with younger or single mothers' were more likely to have a child with a research diagnosis of ADHD at age 7. Financial difficulties was the strongest predictor of ADHD (OR 2.23 95% CI 1.57-3.16). In the multiple mediation model, involvement in parenting at age 6 and presence of adversity at age 2-4 mediated 27.8% of the association. Socioeconomic disadvantage, conceptualised as reported difficulty in affording basic necessities (e.g. heating, food) has both direct and indirect impacts on a child's risk of ADHD. Lower levels of parent involvement mediates this association, as does presence of adversity; with children exposed to adversity and those with less involved parents being at an increased risk of having ADHD. This study highlights the importance of home and environmental factors as small but important contributors toward the aetiology of ADHD.

The academic experience of male high school students with ADHD.

PubMed

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

2011-04-01

This study compared the high school academic experience of adolescents with and without childhood ADHD using data from the Pittsburgh ADHD Longitudinal Study (PALS). Participants were 326 males with childhood ADHD and 213 demographically similar males without ADHD who were recruited at the start of the follow-up study. Data were collected yearly from parents, teachers and schools. The current study used assessment points at which the participants were currently in or had recently completed grades 9, 10, 11, and 12. Results indicated that adolescents with ADHD experienced significant academic impairment in high school relative to comparison adolescents, including lower overall and main academic subject grade point averages (GPA), lower levels of class placement (e.g. remedial vs. honors), and higher rates of course failure. In addition, teacher reports indicated that adolescents with ADHD completed and turned in a significantly lower percentage of assignments and were significantly less likely to be working up to their potential. Adolescents with ADHD were also significantly more likely to be absent or tardy during the academic year, and they were over eight times more likely than adolescents without ADHD to drop out of high school. These findings demonstrate that children with ADHD continue to experience severe academic impairment into high school.

The Delinquency Outcomes of Boys with ADHD with and without Comorbidity

PubMed Central

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.

2010-01-01

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

Heavy Alcohol Use in Early Adulthood as a Function of Childhood ADHD: Developmentally-Specific Mediation by Social Impairment and Delinquency

PubMed Central

Molina, Brooke S.G.; Walther, Christine A. P.; Cheong, JeeWon; Pedersen, Sarah; Gnagy, Elizabeth M.; Pelham, William E.

2014-01-01

Frequent heavy drinking in early adulthood, particularly prior to age 21, is associated with multiple health and legal consequences including continued problems with drinking later into adulthood. Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at risk of alcohol use disorder in adulthood, but little is known about their frequency of underage drinking as young adults or about mediational pathways that might contribute to this risky outcome. The current study used data from the Pittsburgh ADHD Longitudinal Study (PALS) to test social impairment and delinquency pathways from childhood ADHD to heavy drinking in early adulthood for individuals with (n=148) and without (n=117) childhood ADHD. Although ADHD did not predict heavy drinking, indirect mediating effects in opposing directions were found. A delinquency pathway from childhood ADHD to increased heavy drinking included adolescent and subsequently adult delinquent behavior. A social impairment pathway from childhood ADHD to decreased heavy drinking included adolescent, but not adult, social impairment. These findings help to explain the heterogeneity of results for alcohol use among individuals with ADHD and suggest that common ADHD-related impairments may operate differently from each other and distinctly across developmental periods. PMID:24611838

Psychosis proneness and ADHD in young relatives of schizophrenia patients.

PubMed

Keshavan, Matcheri S; Sujata, Mandayam; Mehra, Akhil; Montrose, Debra M; Sweeney, John A

2003-01-01

Symptoms resembling the attentional deficit hyperactivity disorder (ADHD) are frequently observed in young relatives at risk for schizophrenia (HR). We examined the frequency of the ADHD syndrome and its relationship to psychosis related psychopathology and neurobehavioral abnormalities in young HR subjects (n=29) and healthy comparison subjects (HC; n=30). Thirty-one percent of HR subjects (n=9) had ADHD as a lifetime Axis-I diagnosis (HR-A). Compared to healthy comparison subjects, the HR-A group had impaired neurological function. The HR-A group but not the HR subjects without ADHD had higher scores on the Chapman's magical ideation and perceptual aberration scales. Thus, ADHD-like features are more prevalent in the HR population than the one described in the general population and are associated with more frequent psychosis-like clinical features. Longitudinal studies can clarify whether an "ADHD subgroup" within HR subjects predict an increased risk for future emergence of schizophrenia.

Predictors of and barriers to service use for children at risk of ADHD: longitudinal study.

PubMed

Sayal, Kapil; Mills, Jonathan; White, Kate; Merrell, Christine; Tymms, Peter

2015-05-01

Many children with, or at risk of, ADHD do not receive healthcare services for their difficulties. This longitudinal study investigates barriers to and predictors of specialist health service use. This is a 5-year follow-up study of children who participated in a cluster randomised controlled trial, which investigated school-level interventions (provision of books with evidence-based information and/or feedback of names of children) for children at risk of ADHD. 162 children who had high levels of ADHD symptoms at age 5 (baseline) were followed up at age 10 years. Using baseline data and follow-up information collected from parents and teachers, children who had and had not used specialist health services over the follow-up period were compared and predictors (symptom severity, comorbid problems, parental perception of burden, parental mental health, and socio-demographic factors) of specialist service use investigated. The most common parent-reported barrier reflected lack of information about who could help. Amongst children using specialist health services who met criteria for ADHD at follow-up, 36% had been prescribed stimulant medication. Specialist health service use was associated with each one-point increase in teacher-rated symptoms at baseline [inattention symptoms (adjusted OR = 1.40; 95% CI 1.12-1.76) and hyperactivity/impulsivity symptoms (adjusted OR = 1.23; 95% CI 1.05-1.44)]. Parental mental health problems were also independently associated with service use (for each one-point increase in symptoms, adjusted OR = 1.41; 95% CI 1.04-1.91). Severity of teacher-rated ADHD symptoms in early school years is a determinant of subsequent service use. Clinicians and teachers should be aware that parental mental health problems are independently associated with service use for children at risk of ADHD.

A Longitudinal Study on Attention Development in Primary School Children with and without Teacher-Reported Symptoms of ADHD.

PubMed

Suades-González, Elisabet; Forns, Joan; García-Esteban, Raquel; López-Vicente, Mónica; Esnaola, Mikel; Álvarez-Pedrerol, Mar; Julvez, Jordi; Cáceres, Alejandro; Basagaña, Xavier; López-Sala, Anna; Sunyer, Jordi

2017-01-01

Background: Prospective longitudinal studies are essential in characterizing cognitive trajectories, yet few of them have been reported on the development of attention processes in children. We aimed to explore attention development in normal children and children with attention deficit and hyperactivity disorder (ADHD) symptoms in a repeated measures design using the attention network test (ANT). Methods: The population sample included 2,835 children (49.6% girls) aged 7-11 years from 39 schools in Barcelona (Catalonia, Spain) who performed the ANT four times from January 2012 to March 2013. According to teacher ratings, 10.5% of the children presented ADHD symptoms. We performed multilevel mixed-effects linear regression models, adjusting for school and individual, to test the effects of age-related growth on the ANT networks: alerting, orienting and executive attention, and three measurements related to attentiveness: median of hit reaction time (HRT), hit reaction time standard error (HRT-SE) and variability. Results: We observed age-related growth in all the outcomes, except orienting. The curves were steeper at the younger groups, although for alertness the improvement was further at the oldest ages. Gender and ADHD symptoms interacted with age in executive attention, HRT and variability. Girls performed better in executive attention at young ages although boys reached females at around 10 years of age. For HRT, males showed faster HRT. However, girls had a more pronounced improvement and reached the levels of boys at age 11. Children with ADHD symptoms had significant differences in executive attention, HRT and variability compared to children without ADHD symptoms. Conclusions: We detected an ongoing development of some aspects of attention in primary school children, differentiating patterns by gender and ADHD symptoms. Our findings support the ANT for assessing attention processes in children in large epidemiological studies.

Financial Dependence of Young Adults with Childhood ADHD.

PubMed

Altszuler, Amy R; Page, Timothy F; Gnagy, Elizabeth M; Coxe, Stefany; Arrieta, Alejandro; Molina, Brooke S G; Pelham, William E

2016-08-01

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.

Financial Dependence of Young Adults with Childhood ADHD

PubMed Central

Altszuler, Amy R.; Page, Timothy F.; Gnagy, Elizabeth M.; Coxe, Stefany; Arrieta, Alejandro; Molina, Brooke S. G.; Pelham, William E.

2016-01-01

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

Longitudinal Evaluation of the Role of Academic and Social Impairment and Parent-Adolescent Conflict in the Development of Depression in Adolescents with ADHD.

PubMed

Eadeh, Hana-May; Bourchtein, Elizaveta; Langberg, Joshua M; Eddy, Laura D; Oddo, Lauren; Molitor, Stephen J; Evans, Steven W

2017-09-01

Older adolescents with attention-deficit/hyperactivity disorder (ADHD) have a significantly increased likelihood of developing comorbid depression. It is important to evaluate factors during the early adolescent period that may contribute to this risk. A predominant theory is that impairment and failure experiences lead to the development of low-self efficacy and depression, and that parent and family factors also play a role. In a sample of 326 young adolescents with ADHD ( Mage = 12), the present study evaluated whether parent-adolescent conflict mediated the association between social and academic impairment and the development of depression. This study builds upon prior work by evaluating these associations longitudinally and by using a multi-rater approach, including the parent, adolescent, and teacher perspectives. Social and academic impairment directly predicted depression controlling for baseline levels of depression and change in ADHD symptoms. The association between social impairment and depression was partially mediated by parent-adolescent conflict. Mediation through conflict was not found for academic impairment, and the association between academic impairment and depression was no longer significant when accounting for conflict. These findings highlight the importance of social impairment in the development of depression in adolescents with ADHD. Caregivers may play an important role in determining whether adolescents with ADHD internalize social impairment and failure experiences and develop depressive symptoms. Implications of these findings in terms of the importance of interventions focused on parent-adolescent conflict are discussed.

The association of ADHD symptoms and reading acquisition during elementary school years.

PubMed

Ehm, Jan-Henning; Kerner Auch Koerner, Julia; Gawrilow, Caterina; Hasselhorn, Marcus; Schmiedek, Florian

2016-09-01

The present longitudinal study aimed to investigate the influence of ADHD symptoms on reading development in elementary schoolchildren. To this end, repeated assessments of ADHD symptoms (teacher ratings of inattention, hyperactivity, and impulsivity) and reading achievement (standardized tests of decoding speed and text comprehension) were examined in a sample comprising 2,014 elementary schoolchildren at the end of Grades 1, 2, 3, respectively, and in the middle of Grade 4. Latent change score models revealed that the level of ADHD symptoms was associated with lower levels and less growth in decoding speed and text comprehension. Furthermore, individual differences in changes in ADHD symptoms and reading performance were negatively associated. Together, these results indicate commonalities in the development of ADHD symptomatology and reading achievement throughout elementary school. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Antisocial Alcoholism in Parents of Adolescents and Young Adults with Childhood ADHD

PubMed Central

Molina, Brooke S.G.; Gnagy, Elizabeth M.; Joseph, Heather M.; Pelham, William E.

2017-01-01

Objective Test the hypothesis that alcoholism, including antisocial alcoholism, is more prevalent among mothers and fathers of children with versus without ADHD. Method Mothers (312 ADHD group, 235 non-ADHD group) and fathers (291 ADHD group, 227 non-ADHD group) in the Pittsburgh ADHD Longitudinal Study were interviewed along with their adolescent and young adult offspring. Results Maternal and paternal alcoholism, with and without comorbid antisociality, was more prevalent in the ADHD group. Paternal alcoholism without antisociality was only marginally higher for probands after controlling for paternal ADHD. Offspring conduct disorder comorbidity was associated with parental antisociality but not parental antisocial alcoholism. Conclusions Our findings that 44% of proband fathers and 25% of proband mothers experienced alcohol problems with or without antisociality, are further evidence of increased alcoholism prevalence in families affected by ADHD. Maternal alcoholism and antisociality are prominent contributors to this family-level vulnerability. These findings indicate the need to assess long-term offspring outcomes as a function of parental alcohol and externalizing comorbidities, and perhaps other indicators of parental alcoholism phenotype, as familial vulnerability unfolds across development. PMID:27895188

Attention-deficit/hyperactivity disorder severity, diagnosis, & later academic achievement in a national sample

PubMed Central

Owens, Jayanti; Jackson, Heide

2017-01-01

Although 11% (6.4 million) American children are diagnosed with attention deficit/hyperactivity disorder (ADHD), the role of ADHD severity in shaping the association between ADHD diagnosis and academic achievement is not understood. Using a nationally-representative sample of 7830 U.S. kindergartners from the Early Childhood Longitudinal Study-Kindergarten Cohort, we use regression and propensity score matching to compare diagnosed (N = 350) and undiagnosed children who are cognitively, behaviorally, and demographically similar. Diagnosed children with less severe ADHD-related behaviors on average scored lower in reading (–0.30 SD) and math (–0.22 SD) than their undiagnosed peers – a difference two times larger than that between diagnosed and undiagnosed children with more severe ADHD-related behaviors. Pharmacological treatment did not attenuate most of this “diagnostic labeling effect” among children with less severe ADHD-related behaviors. Negative factors associated with an ADHD diagnosis may outweigh potential benefits for achievement among children with less severe ADHD-related behaviors, even those receiving treatment. PMID:27886732

Peer influence as a potential magnifier of ADHD diagnosis.

PubMed

Aronson, Brian

2016-11-01

The prevalence of Attention Deficit and Hyperactivity Disorder (ADHD) is growing in America, but its cause is unclear. Scholars have identified many environmental factors that can cause or confound ADHD diagnosis, but epidemiological studies that try to control for confounding factors still find evidence that rates of ADHD diagnosis are increasing. As a preliminary explanation to ADHD's increasing prevalence, this article examines whether core ADHD diagnostic traits are subject to peer influence. If ADHD diagnosis can be confounded by peer influence, there are several mechanisms that could have caused increased rates of diagnosis. With data drawn from two schools across three waves in the National Longitudinal Survey of Adolescent Health (n = 2193), the author uses a stochastic actor oriented model to estimate the effect of peer influence on inattention, controlling for alternative network and behavioral causes. Results indicate that respondents have a strong likelihood to modify their self-reports of inattention, a core ADHD trait, to resemble that of their friends. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is attention deficit/hyperactivity disorder among men associated with initiation or escalation of substance use at 15‐month follow‐up? A longitudinal study involving young Swiss men

PubMed Central

Vogel, Tanja; Dom, Geert; van de Glind, Geurt; Studer, Joseph; Gmel, Gerhard; Strik, Werner

2016-01-01

Abstract Background and Aims Young adults with attention deficit/hyperactivity disorder (ADHD) show higher substance use disorder (SUD) prevalence relative to non‐ADHD controls; few longitudinal studies have examined the course of substance use with reference to conduct disorder (CD). We compared initiation and escalation of substance use at 15‐month follow‐up in men screened positive or negative for ADHD (ADHD+ versus ADHD–), controlling for CD presence in early adolescence. Design Participants were recruited during August 2010 and November 2011 from the census of all young men who have to pass mandatory army conscription from three of six Swiss Army recruitment centres. A two‐wave data collection was performed via questionnaires at baseline and 15‐month follow‐up as a part of the longitudinal Cohort Study on Substance Use Risk Factors. Setting Recruitment centres in Lausanne, Windisch and Mels, responsible for 21 cantons in German‐ and French‐speaking areas of Switzerland. Participants Consecutive sample of 5103 male Swiss Army conscripts who provided informed consent and responded to questionnaires at baseline and 15‐month follow‐up. Their mean age was 20.0 (standard deviation = 1.21) years at baseline. Measurements ADHD and CD were assessed using the adult ADHD Self‐Report Scale and the MINI International Neuropsychiatric Interview Plus, respectively, at baseline, and substance use was measured via self‐administered substance use questionnaires at baseline and follow‐up. Findings Compared with the ADHD– group, the ADHD+ group (n = 215, 4.2%) showed heavier baseline substance use and increased likelihood of alcohol (χ2 = 53.96; P < 0.001), tobacco (χ2 = 21.73; P < 0.001) and cannabis use disorders (χ2 = 48.43; P < 0.001). The extent of alcohol, tobacco and cannabis use in the two groups remained stable from baseline to follow‐up (no escalation). The ADHD+ group was more likely to initiate substance use compared with the ADHD– group (higher initiation rates), particularly with amphetamines [odds ratio (OR) = 3.81; 95% confidence interval (CI) = 2.20–6.60; P < 0.001] and non‐medical use of ADHD medication (OR = 4.45; 95% CI = 2.06–9.60; P < 0.001). CD was associated with initiation of substance use but did not mediate the associations between ADHD and substance use, revealing that the impact of ADHD on substance use was independent of CD. Conclusions For men in their early 20s, attention deficit/hyperactivity disorder is a risk factor for continued heavier but not escalating use of alcohol, tobacco and cannabis when already consuming these substances, compared with young men with no ADHD. It is also a risk factor for initiating the use of cannabis, stimulants, hallucinogens and sedatives, independent of conduct disorder in early adolescence. PMID:27061514

ADHD and marijuana use expectancies in young adulthood

PubMed Central

Harty, Seth C.; Pedersen, Sarah L.; Gnagy, Elizabeth M.; Pelham, William E.; Molina, Brooke S. G.

2015-01-01

Objective This study examined mean level differences in marijuana expectancies and the differential associations between expectancies and marijuana use for individuals with and without a history of Attention-Deficit/Hyperactivity Disorder (ADHD) Background Substance use expectancies are a widely studied risk factor for alcohol and other drug use. The relations between marijuana use expectancies and self-reported marijuana use have not been examined in young adults with ADHD, a population shown to be at risk for marijuana use. Method Participants were 306 (190 ADHD and 116 nonADHD) young adults (M age = 20.06, SD = 2.03) from the Pittsburgh ADHD Longitudinal Study (PALS) who provided data about marijuana use and marijuana use expectancies. Results Individuals in the ADHD group reported lower levels of social enhancement, tension reduction, and cognitive and behavioral impairment expectancies compared to individuals in the nonADHD group. Positive and negative marijuana use expectancies were associated with marijuana use frequency in the whole sample and statistically significant ADHD group by expectancy interactions were found. Sexual enhancement expectancies were more strongly associated with marijuana use frequency among individuals with ADHD histories while cognitive behavioral impairment expectancies were more strongly associated with marijuana use frequency among individuals without ADHD. Conclusions Marijuana use expectancies may be acquired, and operate differently, for individuals with and without ADHD histories. Although future research is needed to test this speculation, these differences may be associated with ADHD-related difficulties in higher order cognitive processes that affect the encoding and utilization of expectations regarding marijuana’s effects. PMID:26548364

The risk of injury in adults with attention-deficit hyperactivity disorder: A nationwide, matched-cohort, population-based study in Taiwan.

PubMed

Chien, Wu-Chien; Chung, Chi-Hsiang; Lin, Fu-Huang; Yeh, Chin-Bin; Huang, San-Yuan; Lu, Ru-Band; Chang, Hsin-An; Kao, Yu-Chen; Chiang, Wei-Shan; Chou, Yu-Ching; Tsao, Chang-Huei; Wu, Yung-Fu; Tzeng, Nian-Sheng

2017-06-01

Few studies have investigated the risk of injuries associated with adults with attention-deficit hyperactivity disorder (ADHD), even though several studies have suggested a higher risk of injury in children and adolescents with ADHD. To investigate the risk of injury in adults with ADHD. We included 665 adults with ADHD from January 1, to December 31, 2000, and 1995 sex-, age- and index day-matched controls without ADHD from the Longitudinal Health Insurance Database (LHID) subset of the National Health Insurance Research Database in Taiwan. The Cox proportional hazard models were used to analyze the associations between the relevant demographics, and the psychiatric comorbidities and the risk of injury. The patients with ADHD had a 143% increased risk of overall injuries than the controls after considering all the confounding factors. In addition, the use of methylphenidate was associated with a 22.6% decrease in the risk of injuries in the patients with ADHD. Our findings strongly support that adults with ADHD are at an increased risk of injury, and imply that methylphenidate therapy may attenuate this risk. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predictors of Boys' ADHD Symptoms from Early to Middle Childhood: The Role of Father-Child and Mother-Child Interactions

ERIC Educational Resources Information Center

Keown, Louise J.

2012-01-01

This prospective 3-year longitudinal study investigated preschool paternal and maternal parenting predictors of Attention-Deficit/Hyperactivity Disorder(ADHD) in a community sample of 93 school-age boys. Participants were recruited on the basis of inattention-hyperactivity at age 4 and fathers and mothers were observed interacting with their sons.…

Young adult educational and vocational outcomes of children diagnosed with ADHD.

PubMed

Kuriyan, Aparajita B; Pelham, William E; Molina, Brooke S G; Waschbusch, Daniel A; Gnagy, Elizabeth M; Sibley, Margaret H; Babinski, Dara E; Walther, Christine; Cheong, Jeewon; Yu, Jihnhee; Kent, Kristine M

2013-01-01

Decreased success at work and educational attainment by adulthood are of concern for children with ADHD given their widely documented academic difficulties; however there are few studies that have examined this empirically and even fewer that have studied predictors and individual variability of these outcomes. The current study compares young adults with and without a childhood diagnosis of ADHD on educational and occupational outcomes and the predictors of these outcomes. Participants were from the Pittsburgh ADHD Longitudinal Study (PALS), a prospective study with yearly data collection. Significant group differences were found for nearly all variables such that educational and occupational attainment was lower for adults with compared to adults without histories of childhood ADHD. Despite the mean difference, educational functioning was wide-ranging. High school academic achievement significantly predicted enrollment in post-high school education and academic and disciplinary problems mediated the relationship between childhood ADHD and post-high school education. Interestingly, ADHD diagnosis and disciplinary problems negatively predicted occupational status while enrollment in post-high school education was a positive predictor. Job loss was positively predicted by a higher rate of academic problems and diagnosis of ADHD. This study supports the need for interventions that target the child and adolescent predictors of later educational and occupational outcomes in addition to continuing treatment of ADHD in young adulthood targeting developmentally appropriate milestones, such as completing post-high school education and gaining and maintaining stable employment.

Association Between Parenting Style and Social Outcomes in Children with and Without Attention-Deficit/Hyperactivity Disorder: An 18-Month Longitudinal Study.

PubMed

Bhide, Sampada; Sciberras, Emma; Anderson, Vicki; Hazell, Philip; Nicholson, Jan M

In a community-based sample of children with attention-deficit/hyperactivity disorder (ADHD) (n = 179) and non-ADHD controls (n = 212), this longitudinal study explored changes in parenting style over time; and whether parenting style prospectively predicts child functional outcomes. Attention-deficit/hyperactivity disorder diagnosis was assessed using the Conners ADHD index and Diagnostic Interview Schedule for Children IV. Children (70.3% boys) were assessed at baseline (mean age: 7.3 yr) and after 18 months (mean age: 8.9 yr) using a range of parent- and teacher-reported measures of child socioemotional and academic functioning. Parenting style was assessed through parent-reported measures of warmth, consistency, and anger. At 18-month follow-up, there was a small significant decline in parenting warmth and parenting anger, and an increase in parenting consistency across groups. In the ADHD group, parenting warmth at baseline was positively related to 18-month prosocial behavior and responsibility by parent report, whereas parenting consistency predicted these child outcomes by teacher report. Parenting anger was positively associated with peer problems and negatively associated with prosocial behavior, self-control, and responsibility by parent report. Associations were similar for non-ADHD controls and all associations held after adjusting for a range of family, child, and parent factors. After additional adjustment of baseline levels of child functioning, parenting warmth and consistency continued to be associated with 18-month child outcomes. Parenting style was unrelated to emotional problems and academic competence over time. Parenting style is independently related to aspects of future social outcomes of children with ADHD. Results hold implications for parenting interventions aimed at managing ADHD-related social impairments over time.

Re-examining the risk for switch from unipolar to bipolar major depressive disorder in youth with ADHD: a long term prospective longitudinal controlled study.

PubMed

Biederman, Joseph; Wozniak, Janet; Tarko, Laura; Serra, Giulia; Hernandez, Mariely; McDermott, Katie; Woodsworth, K Yvonne; Uchida, Mai; Faraone, Stephen V

2014-01-01

Recent studies have identified subthreshold forms of bipolar (BP)-I disorder and deficits in emotional regulation as risk factors for bipolar disorder in youth. The primary aim of this study was to investigate whether emotional dysregulation and subthreshold forms of BP-I disorder increase the risk for BP switches in ADHD youth with non-bipolar MDD. We used data from two large controlled longitudinal family studies of boys and girls with and without ADHD. Subjects (N=522) were followed prospectively and blindly over an average follow up period of 11.4 years. Comparisons were made between ADHD youth with unipolar major depression (MDD) who did (N=24) and did not (N=79) switch to BP-I disorder at follow-up. The rate of conversion to BP-I disorder at follow up was higher in MDD subjects with subthreshold BP-I disorder at baseline compared to those without (57% vs. 21%; OR=9.57, 95% CI=1.62-56.56, p=0.013) and in MDD subjects with deficient emotional self-regulation (OR=3.54, 95% CI=1.08-11.60, p=0.037). The sample was largely Caucasian, so these results may not generalize to minority groups. The sample of youth with SED was small, which limited the statistical power for some analyses. Switches from unipolar MDD to BP-I disorder in children with ADHD and MDD were predicted by baseline subthreshold BP-I disorder symptoms and baseline deficits in emotional regulation. More work is needed to assess whether these risk factors are operant outside the context of ADHD. © 2013 Published by Elsevier B.V.

Interrelations between Executive Function and Symptoms of Hyperactivity/Impulsivity and Inattention in Preschoolers: A Two Year Longitudinal Study

ERIC Educational Resources Information Center

Brocki, Karin C.; Eninger, Lilianne; Thorell, Lisa B.; Bohlin, Gunilla

2010-01-01

The present study, including children at risk for developing Attention Deficit Hyperactivity Disorder (ADHD), examined the idea that complex executive functions (EFs) build upon more simple ones. This notion was applied in the study of longitudinal interrelations between core EF components--simple and complex inhibition, selective attention, and…

Predictors of Parent-Reported Attention-Deficit/Hyperactivity Disorder in Children Aged 6-7 Years: A National Longitudinal Study

ERIC Educational Resources Information Center

Sciberras, Emma; Ukoumunne, Obioha C.; Efron, Daryl

2011-01-01

This study examined the prenatal, postnatal and demographic predictors of parent-reported attention-deficit/hyperactivity disorder (ADHD) in an Australian population-based sample. Participants were families participating in the Longitudinal Study of Australian Children. There were approximately even numbers of males (51%) and females (49%) in the…

ADHD symptoms, breast-feeding and obesity in children and adolescents.

PubMed

Türkoğlu, Serhat; Bilgiç, Ayhan; Akça, Ömer Faruk

2015-08-01

Attention-deficit-hyperactivity disorder (ADHD) has been found to be related to overweight/obesity in children and adolescents, but it is a heterogeneous disorder, and the relationships between the dimensions of ADHD and overweight/obesity are not clear. The aim of this study was to explore which dimensions of the disorder are specifically associated with overweight/obesity. The study sample consisted of 300 treatment-naive children with ADHD and 75 healthy controls aged 7-17 years. The ADHD module of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version was used to diagnose ADHD. The severity of ADHD symptoms was assessed via Conners' Parent Rating Scale (CPRS). The weight, height, and breast-feeding duration of the study samples and controls were recorded. Body mass index (BMI) was categorized according to the national age/sex-specific reference values. The rate of overweight/obese children was higher in the ADHD group. The association between ADHD symptoms and BMI percentile scores was evaluated using structural equation modeling. In that model, it was observed that the Cognitive Problems/Inattentive and Oppositional subscores of the CPRS had a positive predictive effect on the BMI percentile scores, but breast-feeding duration had a negative predictive effect on the BMI percentile scores. Inattention, oppositionality and breast-feeding duration were associated with overweight/obesity in children and adolescents with ADHD. Longitudinal studies are needed to more fully understand this relationship and the mechanisms underlying the association between ADHD and overweight/obesity. © 2015 Japan Pediatric Society.

Writing Abilities Longitudinally Predict Academic Outcomes of Adolescents with ADHD

ERIC Educational Resources Information Center

Molitor, Stephen J.; Langberg, Joshua M.; Bourchtein, Elizaveta; Eddy, Laura D.; Dvorsky, Melissa R.; Evans, Steven W.

2016-01-01

Students with attention-deficit/hyperactivity disorder (ADHD) often experience a host of negative academic outcomes, and deficits in reading and mathematics abilities contribute to these academic impairments. Students with ADHD may also have difficulties with written expression, but there has been minimal research in this area and it is not clear…

A systematic review of global publication trends regarding long-term outcomes of ADHD.

PubMed

Hodgkins, Paul; Arnold, L Eugene; Shaw, Monica; Caci, Hervé; Kahle, Jennifer; Woods, Alisa G; Young, Susan

2011-01-01

There is increased global recognition of attention deficit hyperactivity disorder (ADHD) as a serious medical condition with long-term consequences. Although originally conceived of as a childhood disorder, ADHD is being increasingly recognized in adults. Individual geographic regions may have specific interests and objectives for the study of ADHD. A systematic review of long-term outcomes (LTOs) in ADHD was conducted to evaluate research on ADHD LTOs on a global scale. Studies that were at least 2 years in duration were examined. A total of 351 studies were identified in the final analysis. We identified nine outcomes of interest and classified studies by specific geographical regions, age groups studied and study design by region and over time. Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades, with a peak number of 42 publications in 2008. This rise in publications on ADHD LTOs may reflect a rise in global interest and recognition of consequences and impairment associated with ADHD. Although many world regions have published on ADHD LTOs, the majority of studies have emerged from the US and Canada, followed by Europe. While investigators in the US and Canada were predominantly interested in drug addiction as a LTO, European researchers were more interested in antisocial behavior, and Eastern Asian investigators focused on both of these LTOs as well as self-esteem. Geographical differences in the focus of ADHD LTO studies may reflect regional variations in cultural values. Proportionally fewer prospective longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades. Finally, more studies focusing on ADHD in adolescents and adults have been conducted in recent years, and particularly adolescents in Eastern Asia. These changes in basic study design may reflect an increase in the recognition that ADHD is a lifetime chronic disorder. This systematic review analysis of publication trends in ADHD LTOs reflects geographically based interests that change over time.

A Systematic Review of Global Publication Trends Regarding Long-Term Outcomes of ADHD

PubMed Central

Hodgkins, Paul; Arnold, L. Eugene; Shaw, Monica; Caci, Hervé; Kahle, Jennifer; Woods, Alisa G; Young, Susan

2012-01-01

There is increased global recognition of attention deficit hyperactivity disorder (ADHD) as a serious medical condition with long-term consequences. Although originally conceived of as a childhood disorder, ADHD is being increasingly recognized in adults. Individual geographic regions may have specific interests and objectives for the study of ADHD. A systematic review of long-term outcomes (LTOs) in ADHD was conducted to evaluate research on ADHD LTOs on a global scale. Studies that were at least 2 years in duration were examined. A total of 351 studies were identified in the final analysis. We identified nine outcomes of interest and classified studies by specific geographical regions, age groups studied and study design by region and over time. Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades, with a peak number of 42 publications in 2008. This rise in publications on ADHD LTOs may reflect a rise in global interest and recognition of consequences and impairment associated with ADHD. Although many world regions have published on ADHD LTOs, the majority of studies have emerged from the US and Canada, followed by Europe. While investigators in the US and Canada were predominantly interested in drug addiction as a LTO, European researchers were more interested in antisocial behavior, and Eastern Asian investigators focused on both of these LTOs as well as self-esteem. Geographical differences in the focus of ADHD LTO studies may reflect regional variations in cultural values. Proportionally fewer prospective longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades. Finally, more studies focusing on ADHD in adolescents and adults have been conducted in recent years, and particularly adolescents in Eastern Asia. These changes in basic study design may reflect an increase in the recognition that ADHD is a lifetime chronic disorder. This systematic review analysis of publication trends in ADHD LTOs reflects geographically based interests that change over time. PMID:22279437

A longitudinal study of neuropsychological functioning and academic achievement in children with and without signs of attention-deficit/hyperactivity disorder.

PubMed

Rennie, Brandon; Beebe-Frankenberger, Margaret; Swanson, H Lee

2014-01-01

Attention-deficit/hyperactivity disorder (ADHD) in childhood is associated with poor academic functioning. Deficits in academic functioning have proven to be less responsive to intervention than behavioral deficits in this population, yet the causes of this academic underperformance are not well understood. The purpose of this study is to examine the relationship between ADHD and academic performance in elementary-aged children in a developmental context. To do this, we study important cognitive variables and academic achievement over a three-year timeframe. Based on teacher ratings of ADHD, children were divided into a high symptom group (n = 17) and a low symptom group (n = 34). A thorough battery of cognitive and academic tests was administered at Time 1 and again 2 years later. Cognitive measures focused specifically on working memory and response inhibition. RESULTS indicate that children who have high levels of ADHD signs differ from their low-sign peers in academic achievement and in several cognitive domains. Differences in cognitive functioning show a developmental trend consistent with earlier developmental delays in response inhibition and later delays in working memory. Working memory appears to be particularly important in several academic domains. Importantly, in a longitudinal model, working memory was more predictive of math achievement for students demonstrating signs of ADHD than for those who did not. The relationship between these cognitive variables and academic functioning are explicated in the domains of reading, math, and problem solving.

Meta-analysis of social cognition in attention-deficit/hyperactivity disorder (ADHD): comparison with healthy controls and autistic spectrum disorder.

PubMed

Bora, E; Pantelis, C

2016-03-01

Impairment in social cognition is an established finding in autism spectrum disorders (ASD). Emerging evidence suggests that attention-deficit/hyperactivity disorder (ADHD) might be also associated with deficits in theory of mind (ToM) and emotion recognition. However, there are inconsistent findings, and it has been debatable whether such deficits persist beyond childhood and how similar social cognitive deficits are in ADHD v. ASD. We conducted a meta-analysis of social cognition, including emotion recognition and ToM, studies in ADHD compared with healthy controls and ASD. The current meta-analysis involved 44 studies comparing ADHD (n = 1999) with healthy controls (n = 1725) and 17 studies comparing ADHD (n = 772) with ASD (n = 710). Facial and vocal emotion recognition (d = 0.40-0.44) and ToM (d = 0.43) abilities were significantly impaired in ADHD. The most robust facial emotion recognition deficits were evident in anger and fear. Social cognitive deficits were either very subtle (emotion recognition) or non-significant (ToM) in adults with ADHD. Deficits in social cognition, especially ToM, were significantly more pronounced in ASD compared with ADHD. General cognitive impairment has contributed to social cognitive deficits in ADHD. Performance of individuals with ADHD on social cognition lies intermediate between ASD and healthy controls. However, developmental trajectories of social cognition probably differ between ADHD and ASD as social cognitive deficits in ADHD might be improving with age in most individuals. There is a need for studies investigating a potential subtype of ADHD with persistent social cognitive deficits and exploring longitudinal changes in social cognition during development.

Parent and Teacher SNAP-IV Ratings of Attention Deficit Hyperactivity Disorder Symptoms: Psychometric Properties and Normative Ratings from a School District Sample

ERIC Educational Resources Information Center

Bussing, Regina; Fernandez, Melanie; Harwood, Michelle; Hou, Wei; Garvan, Cynthia Wilson; Eyberg, Sheila M.; Swanson, James M.

2008-01-01

To examine Swanson, Nolan, and Pelham-IV (SNAP-IV) psychometric properties, parent (N = 1,613) and teacher (N = 1,205) data were collected from a random elementary school student sample in a longitudinal attention deficit hyperactivity disorder (ADHD) detection study. SNAP-IV reliability was acceptable. Factor structure indicated two ADHD factors…

Perceptions of academic skills of children diagnosed with ADHD.

PubMed

Eisenberg, Daniel; Schneider, Helen

2007-05-01

This study investigates how the academic skills of children diagnosed with ADHD are perceived by teachers, parents, and the children themselves. The authors analyze data collected for third graders in spring 2002 in the nationally representative Early Childhood Longitudinal Survey. They use linear regressions to estimate independent associations between perceptions of academic abilities and parent-reported ADHD diagnoses, controlling for scores on standardized reading and math tests, assessments of externalizing behaviors, and other factors. Results show that for ADHD-diagnosed girls compared to other girls, both parents' and teachers' perceptions are substantially more negative. For ADHD-diagnosed boys, the differentials are also negative but less pronounced. Self-perceptions are not significantly different by ADHD status, except for boys' more negative self-perceptions related to math. Given the potentially damaging effects of these negative perceptions and expectations on self-esteem, motivation, and performance, efforts may be needed to bring perceptions of ADHD children more in line with the abilities they demonstrate on objective assessments. (J. of Att. Dis. 2007; 10(4) 390-397).

The association between attention deficit/hyperactivity disorder and internet addiction: a systematic review and meta-analysis.

PubMed

Wang, Bing-Qian; Yao, Nan-Qi; Zhou, Xiang; Liu, Jian; Lv, Zheng-Tao

2017-07-19

This study aimed to analyze the association between Attention Deficit/Hyperactivity Disorder (ADHD) and Internet addiction (IA). A systematic literature search was performed in four online databases in total including CENTRAL, EMBASE, PubMed and PsychINFO. Observational studies (case-control, cross-sectional and cohort studies) measuring the correlation between IA and ADHD were screened for eligibility. Two independent reviewers screened each article according to the predetermined inclusion criteria. A total of 15 studies (2 cohort studies and 13 cross-sectional studies) met our inclusion criteria and were included in the quantitative synthesis. Meta-analysis was conducted using RevMan 5.3 software. A moderate association between IA and ADHD was found. Individuals with IA were associated with more severe symptoms of ADHD, including the combined total symptom score, inattention score and hyperactivity/impulsivity score. Males were associated with IA, whereas there was no significant correlation between age and IA. IA was positively associated with ADHD among adolescents and young adults. Clinicians and parents should pay more attention to the symptoms of ADHD in individuals with IA, and the monitoring of Internet use of patients suffering from ADHD is also necessary. Longitudinal studies controlling for baseline mental health are needed.

Perceptual and Motor Inhibition in Adolescents/Young Adults with Childhood-Diagnosed ADHD

PubMed Central

Bedard, Anne-Claude V.; Trampush, Joey W.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.

2010-01-01

Objective This study examined perceptual and motor inhibition in a longitudinal sample of adolescents/young adults who were diagnosed with ADHD in childhood, and as a function of the relative persistence of ADHD. Method Ninety-eight participants diagnosed with ADHD in childhood were re-evaluated approximately 10 years later. Eighty-five never-ADHD controls similar in age, IQ, sociodemographic background, and gender distribution served as a comparison group. Participants were administered a psychiatric interview and the Stimulus and Response Conflict Tasks (Nassauer & Halperin, 2003). Results Participants with childhood ADHD demonstrated slower and less accurate responses to both control and conflict conditions relative to the comparison group, as well as more variable responses in both conditions of the motor inhibition task; there was no specific effect of childhood ADHD on perceptual or motor inhibition. ADHD persisters and partial remitters did not differ in overall accuracy, speed or variability in responding, but relative to partial remitters, persisters demonstrated greater slowing in response to perceptual conflict. Conclusions These findings are consistent with theories positing state regulation, but not inhibitory control deficits in the etiology of ADHD, and suggest that improved perceptual inhibition may be associated with better outcome for ADHD. PMID:20604617

Parenting style influences bullying: A longitudinal study comparing children with and without behavioural problems

PubMed Central

Rajendran, Khushmand; Kruszewski, Edyta; Halperin, Jeffrey M.

2015-01-01

Background More optimal parenting has been linked with lower rates of bullying. However, it is not clear whether parenting can alter the trajectories of bullying among children diagnosed with ADHD or ODD as well as those who are not so diagnosed. This study examined whether parenting at age 4 to 5 years was associated with changes in bullying over the next 4 years among children with Attention-deficit/Hyperactivity Disorder (ADHD) with and without comorbid Oppositional Defiant Disorder (ODD) relative to children without these disorders. Method Children from the New York metropolitan area (n = 162) were prospectively studied over 6 annual assessment points between preschool and 9 years of age. Parenting was assessed by laboratory observations of the parent and child; teachers rated child bullying, and parents reported on children's diagnostic status (Neither ADHD nor ODD, ADHD but not ODD, both ADHD and ODD). Results Children with comorbid ADHD and ODD were more likely to bully than the other two groups. Hierarchical linear modeling revealed a fall in bullying over five-years. Diagnostic status was significantly associated with initial levels of bullying. Irrespective of diagnostic group, children receiving more parent support for child autonomy at age 4 to 5 years showed a significantly greater decline in bullying than those provided with little support for autonomy. There was no longitudinal link between parent negative affect, emotionally supportive parenting and quality of parent-child interactions with bullying. Conclusions Greater parent support for child autonomy at age 4 to 5 years is related to reduced bullying. Interventions that encourage parent support for child autonomy at the time of entry into school may reduce bullying during early school years. PMID:26053670

Parenting style influences bullying: a longitudinal study comparing children with and without behavioral problems.

PubMed

Rajendran, Khushmand; Kruszewski, Edyta; Halperin, Jeffrey M

2016-02-01

More optimal parenting has been linked with lower rates of bullying. However, it is not clear whether parenting can alter the trajectories of bullying among children diagnosed with ADHD or ODD as well as those who are not so diagnosed. This study examined whether parenting at age 4-5 years was associated with changes in bullying over the next 4 years among children with Attention-deficit/Hyperactivity Disorder (ADHD) with and without comorbid Oppositional Defiant Disorder (ODD) relative to children without these disorders. Children from the New York metropolitan area (n = 162) were prospectively studied over six annual assessment points between preschool and 9 years of age. Parenting was assessed by laboratory observations of the parent and child; teachers rated child bullying, and parents reported on children's diagnostic status (Neither ADHD nor ODD, ADHD but not ODD, both ADHD and ODD). Children with comorbid ADHD and ODD were more likely to bully than the other two groups. Hierarchical linear modeling revealed a fall in bullying over five years. Diagnostic status was significantly associated with initial levels of bullying. Irrespective of diagnostic group, children receiving more parent support for child autonomy at age 4 to 5 years showed a significantly greater decline in bullying than those provided with little support for autonomy. There was no longitudinal link between parent negative affect, emotionally supportive parenting and quality of parent-child interactions with bullying. Greater parent support for child autonomy at age 4-5 years is related to reduced bullying. Interventions that encourage parent support for child autonomy at the time of entry into school may reduce bullying during early school years. © 2015 Association for Child and Adolescent Mental Health.

Longitudinal association between early atopic dermatitis and subsequent attention-deficit or autistic disorder: A population-based case-control study.

PubMed

Lee, Chih-Ying; Chen, Mu-Hong; Jeng, Mei-Jy; Hsu, Ju-Wei; Tsai, Shih-Jen; Bai, Ya-Mei; Hung, Giun-Yi; Yen, Hsiu-Ju; Chen, Tzeng-Ji; Su, Tung-Ping

2016-09-01

Atopic dermatitis (AD) is one of the common allergic diseases in children. The presence of allergic diseases was found to have association with the risk of developing attention-deficit hyperactivity disorder (ADHD) or autistic spectrum disorder (ASD) in children, but it is still inconclusive. This study was to investigate the longitudinal relationship between AD developed during toddlerhood and subsequent development of ADHD or ASD in later childhood. Toddlers born between 1998 and 2008 and diagnosed with AD at the age younger than 3 years and older than 1 month were retrieved from Taiwan's National Health Insurance Research Database. Age- and gender-matched toddlers with no lifetime AD were enrolled as the control group. All enrolled toddlers were followed until 2011 to identify the development of ADHD or ASD. Multivariate Cox regression analysis was performed to analyze the hazard ratios (HRs). The risks associated with allergic comorbidities were analyzed. A total of 18,473 toddlers were enrolled into the AD group. The presence of AD significantly increased the risk of developing ADHD (HR = 2.92, 95% confidence interval [CI] = 2.48-3.45) or ASD (HR = 8.90, 95% CI = 4.98-15.92) when aged 3 years or older. Children from the AD group with 3 comorbidities together, namely, allergic rhinitis, allergic conjunctivitis, and asthma, had the greatest risk of developing ADHD and ASD (ADHD: HR = 4.67, 95% CI = 3.81-5.43; ASD: HR = 16.65, 95% CI = 8.63-30.60). In conclusion, toddlers who suffer from AD at the age younger than 3 years are at a higher risk of developing ADHD and ASD during later childhood. Pediatricians taking care of toddlers with AD should have knowledge of this increased risk of developing ADHD and ASD later in life, especially when children have certain comorbidities such as allergic rhinitis, allergic conjunctivitis, and asthma.

Handling Students with ADHD Syndrome in Regular Elementary Schools

ERIC Educational Resources Information Center

Opic, Siniša; Kudek Miroševic, Jasna

2011-01-01

The aim of this longitudinal research is to explore the way teachers treat students with diagnosed ADHD syndrome within the process of education. The research has been conducted on a sample of 45 students, medically diagnosed with ADHD and attending five elementary schools in the area of the city of Zagreb, school year 2008./2009, and 45 control…

Prospective Association of Childhood Attention-deficit/hyperactivity Disorder (ADHD) and Substance Use and Abuse/Dependence: A Meta-Analytic Review

PubMed Central

Lee, Steve S.; Humphreys, Kathryn L.; Flory, Kate; Liu, Rebecca; Glass, Kerrie

2011-01-01

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

Symptoms of Attention-Deficit Hyperactivity Disorder (ADHD) and Home Learning Environment (HLE): Findings from a Longitudinal Study

ERIC Educational Resources Information Center

Schmiedeler, Sandra; Niklas, Frank; Schneider, Wolfgang

2014-01-01

The concept of "Home Learning Environment" (HLE) covers activities in a family providing intellectual stimulation for a child, such as reading to him or her or visiting libraries. Numerous studies have shown an association between HLE and children's cognitive development. In this longitudinal study, we focus on HLE as a predictor for…

Towards Precision Addiction Treatment: New Findings in Co-morbid Substance Use and Attention-Deficit Hyperactivity Disorders.

PubMed

Luo, Sean X; Levin, Frances R

2017-03-01

Attention-deficit hyperactivity disorder (ADHD) and substance use disorders (SUDs) may have common etiologies. ADHD is more prevalent in patients with substance use disorders, and this pattern is consistent across different substances of abuse. Individuals with SUDs and ADHD exhibit significant variations in their clinical presentations. The developmental trajectory of ADHD to SUDs is complex: ADHD symptoms appear first in some patients but not in others. Many patients present with a heterogeneous collection of psychiatric and substance use co-morbidities, and these symptoms change over time. ADHD symptom severity is also highly variable, and more severe ADHD symptoms worsen co-morbid SUDs and complicate treatment. New longitudinal studies with innovative methods in high-risk populations and in community-based samples may clarify issues related to patient-treatment matching. When closely monitored, psychostimulant and other adjunct medications can be safely used to treat ADHD in this population, and such treatment may also improve outcome of SUDs. In particular, emerging evidence suggests individual-level tailoring ("precision medicine") approaches may represent a key pathway to improve clinical outcome.

Towards Precision Addiction Treatment: New Findings in Co-morbid Substance Use and Attention-Deficit Hyperactivity Disorders

PubMed Central

Levin, Frances R.

2017-01-01

Attention-deficit hyperactivity disorder (ADHD) and substance use disorders (SUDs) may have common etiologies. ADHD is more prevalent in patients with substance use disorders, and this pattern is consistent across different substances of abuse. Individuals with SUDs and ADHD exhibit significant variations in their clinical presentations. The developmental trajectory of ADHD to SUDs is complex: ADHD symptoms appear first in some patients but not in others. Many patients present with a heterogeneous collection of psychiatric and substance use co-morbidities, and these symptoms change over time. ADHD symptom severity is also highly variable, and more severe ADHD symptoms worsen co-morbid SUDs and complicate treatment. New longitudinal studies with innovative methods in high-risk populations and in community-based samples may clarify issues related to patient-treatment matching. When closely monitored, psychostimulant and other adjunct medications can be safely used to treat ADHD in this population, and such treatment may also improve outcome of SUDs. In particular, emerging evidence suggests individual-level tailoring (“precision medicine”) approaches may represent a key pathway to improve clinical outcome. PMID:28251590

Genetic risk for attention-deficit/hyperactivity disorder contributes to neurodevelopmental traits in the general population.

PubMed

Martin, Joanna; Hamshere, Marian L; Stergiakouli, Evangelia; O'Donovan, Michael C; Thapar, Anita

2014-10-15

Attention-deficit/hyperactivity disorder (ADHD) can be viewed as the extreme end of traits in the general population. Epidemiological and twin studies suggest that ADHD frequently co-occurs with and shares genetic susceptibility with autism spectrum disorder (ASD) and ASD-related traits. The aims of this study were to determine whether a composite of common molecular genetic variants, previously found to be associated with clinically diagnosed ADHD, predicts ADHD and ASD-related traits in the general population. Polygenic risk scores were calculated in the Avon Longitudinal Study of Parents and Children (ALSPAC) population sample (N = 8229) based on a discovery case-control genome-wide association study of childhood ADHD. Regression analyses were used to assess whether polygenic scores predicted ADHD traits and ASD-related measures (pragmatic language abilities and social cognition) in the ALSPAC sample. Polygenic scores were also compared in boys and girls endorsing any (rating ≥ 1) ADHD item (n = 3623). Polygenic risk for ADHD showed a positive association with ADHD traits (hyperactive-impulsive, p = .0039; inattentive, p = .037). Polygenic risk for ADHD was also negatively associated with pragmatic language abilities (p = .037) but not with social cognition (p = .43). In children with a rating ≥ 1 for ADHD traits, girls had a higher polygenic score than boys (p = .003). These findings provide molecular genetic evidence that risk alleles for the categorical disorder of ADHD influence hyperactive-impulsive and attentional traits in the general population. The results further suggest that common genetic variation that contributes to ADHD diagnosis may also influence ASD-related traits, which at their extreme are a characteristic feature of ASD. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Young Adult Educational and Vocational Outcomes of Children Diagnosed with ADHD

PubMed Central

Kuriyan, Aparajita B.; Pelham, William E.; Molina, Brooke S. G.; Waschbusch, Daniel A.; Gnagy, Elizabeth M.; Sibley, Margaret H.; Babinski, Dara E.; Walther, Christine; Cheong, JeeWon; Yu, Jihnhee; Kent, Kristine M.

2012-01-01

Decreased success at work and educational attainment by adulthood are of concern for children with ADHD given their widely documented academic difficulties; however there are few studies that have examined this empirically and even fewer that have studied predictors and individual variability of these outcomes. The current study compares young adults with and without a childhood diagnosis of ADHD on educational and occupational outcomes and the predictors of these outcomes. Participants were from the Pittsburgh ADHD Longitudinal Study (PALS), a prospective study with yearly data collection. Significant group differences were found for nearly all variables such that educational and occupational attainment was lower for adults with compared to adults without histories of childhood ADHD. Despite the mean difference, educational functioning was wide-ranging. High school academic achievement significantly predicted enrollment in post-high school education and academic and disciplinary problems mediated the relationship between childhood ADHD and post-high school education. Interestingly, ADHD diagnosis and disciplinary problems negatively predicted occupational status while enrollment in post-high school education was a positive predictor. Job loss was positively predicted by a higher rate of academic problems and diagnosis of ADHD. This study supports the need for interventions that target the child and adolescent predictors of later educational and occupational outcomes in addition to continuing treatment of ADHD in young adulthood targeting developmentally appropriate milestones, such as completing post-high school education and gaining and maintaining stable employment. PMID:22752720

The Qualitative Interview Study of Persistent and Nonpersistent Substance Use in the MTA: Sample Characteristics, Frequent Use, and Reasons for Use.

PubMed

Swanson, James M; Wigal, Timothy; Jensen, Peter S; Mitchell, John T; Weisner, Thomas S; Murray, Desiree; Arnold, L Eugene; Hechtman, Lily; Molina, Brooke S G; Owens, Elizabeth B; Hinshaw, Stephen P; Belendiuk, Katherine; Howard, Andrea; Wigal, Sharon B; Sorensen, Page; Stehli, Annamarie

2017-10-01

To evaluate participants' perceptions about frequent use and reasons for substance use (SU) in the qualitative interview study, an add-on to the multimodal treatment study of ADHD (MTA). Using the longitudinal MTA database, 39 ADHD cases and 19 peers with Persistent SU, and 86 ADHD cases and 39 peers without Persistent SU were identified and recruited. In adulthood, an open-ended interview was administered, and SU excerpts were indexed and classified to create subtopics (frequent use and reasons for use of alcohol, marijuana, and other drugs). For marijuana, the Persistent compared with Nonpersistent SU group had a significantly higher percentage of participants describing frequent use and giving reasons for use, and the ADHD group compared with the group of peers had a significantly higher percentage giving "stability" as a reason for use. Motivations for persistent marijuana use may differ for adults with and without a history of ADHD.

Genetic associations with childhood brain growth, defined in two longitudinal cohorts.

PubMed

Szekely, Eszter; Schwantes-An, Tae-Hwi Linus; Justice, Cristina M; Sabourin, Jeremy A; Jansen, Philip R; Muetzel, Ryan L; Sharp, Wendy; Tiemeier, Henning; Sung, Heejong; White, Tonya J; Wilson, Alexander F; Shaw, Philip

2018-06-01

Genome-wide association studies (GWASs) are unraveling the genetics of adult brain neuroanatomy as measured by cross-sectional anatomic magnetic resonance imaging (aMRI). However, the genetic mechanisms that shape childhood brain development are, as yet, largely unexplored. In this study we identify common genetic variants associated with childhood brain development as defined by longitudinal aMRI. Genome-wide single nucleotide polymorphism (SNP) data were determined in two cohorts: one enriched for attention-deficit/hyperactivity disorder (ADHD) (LONG cohort: 458 participants; 119 with ADHD) and the other from a population-based cohort (Generation R: 257 participants). The growth of the brain's major regions (cerebral cortex, white matter, basal ganglia, and cerebellum) and one region of interest (the right lateral prefrontal cortex) were defined on all individuals from two aMRIs, and a GWAS and a pathway analysis were performed. In addition, association between polygenic risk for ADHD and brain growth was determined for the LONG cohort. For white matter growth, GWAS meta-analysis identified a genome-wide significant intergenic SNP (rs12386571, P = 9.09 × 10 -9 ), near AKR1B10. This gene is part of the aldo-keto reductase superfamily and shows neural expression. No enrichment of neural pathways was detected and polygenic risk for ADHD was not associated with the brain growth phenotypes in the LONG cohort that was enriched for the diagnosis of ADHD. The study illustrates the use of a novel brain growth phenotype defined in vivo for further study. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Does Childhood Attention-Deficit/Hyperactivity Disorder (ADHD) Predict Levels of Depressive Symptoms during Emerging Adulthood?

PubMed Central

Meinzer, Michael C.; Pettit, Jeremy W.; Waxmonsky, James G.; Gnagy, Elizabeth; Molina, Brooke S.G.; Pelham, William E.

2015-01-01

Little is known about the development and course of depressive symptoms through emerging adulthood among individuals with a childhood history of attention-deficit/hyperactivity disorder (ADHD). The aim of this study was to examine if a history of ADHD in childhood significantly predicted depressive symptoms during emerging adulthood (i.e., ages 18–25 years), including the initial level of depressive symptoms, continued levels of depressive symptoms at each age year, and the rate of change in depressive symptoms over time. 394 participants (205 with ADHD and 189 without ADHD; 348 males and 46 females) drawn from the Pittsburgh ADHD Longitudinal Study (PALS) completed annual self-ratings of depressive symptoms between the ages of 18 and 25 years. Childhood history of ADHD significantly predicted a higher initial level of depressive symptoms at age 18, and higher levels of depressive symptoms at every age year during emerging adulthood. ADHD did not significantly predict the rate of change in depressive symptoms from age 18 to age 25. Childhood history of ADHD remained a significant predictor of initial level of depressive symptoms at age 18 after controlling for comorbid psychiatric diagnoses, but not after controlling for concurrent ADHD symptoms and psychosocial impairment. Participants with childhood histories of ADHD experienced significantly higher levels of depressive symptoms than non-ADHD comparison participants by age 18 and continued to experience higher, although not increasing, levels of depressive symptoms through emerging adulthood. Clinical implications and directions for future research are discussed. PMID:26272531

ADHD latent class clusters: DSM-IV subtypes and comorbidity

PubMed Central

Elia, Josephine; Arcos-Burgos, Mauricio; Bolton, Kelly L.; Ambrosini, Paul J.; Berrettini, Wade; Muenke, Maximilian

2014-01-01

ADHD (Attention Deficit Hyperactivity Disorder) has a complex, heterogeneous phenotype only partially captured by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. In this report, latent class analyses (LCA) are used to identify ADHD phenotypes using K-SADS-IVR (Schedule for Affective Disorders & Schizophrenia for School Age Children-IV-Revised) symptoms and symptom severity data from a clinical sample of 500 ADHD subjects, ages 6–18, participating in an ADHD genetic study. Results show that LCA identified six separate ADHD clusters, some corresponding to specific DSM-IV subtypes while others included several subtypes. DSM-IV comorbid anxiety and mood disorders were generally similar across all clusters, and subjects without comorbidity did not aggregate within any one cluster. Age and gender composition also varied. These results support findings from population-based LCA studies. The six clusters provide additional homogenous groups that can be used to define ADHD phenotypes in genetic association studies. The limited age ranges aggregating in the different clusters may prove to be a particular advantage in genetic studies where candidate gene expression may vary during developmental phases. DSM-IV comorbid mood and anxiety disorders also do not appear to increase cluster heterogeneity; however, longitudinal studies that cover period of risk are needed to support this finding. PMID:19900717

Neuropsychological Functioning In College Students with and without ADHD

PubMed Central

Weyandt, Lisa L.; Oster, Danielle R.; Gudmundsdottir, Bergljot Gyda; DuPaul, George J.; Anastopoulos, Arthur D.

2016-01-01

Increasing numbers of students with attention-deficit/hyperactivity disorder (ADHD) are attending college; however, little empirical information is available concerning the functional impairment experienced by these students. Although preliminary studies suggest that college students with ADHD are more likely to experience a variety of psychosocial and academic difficulties compared to their peers without the disorder, findings regarding neuropsychological functioning have been inconsistent with some studies reporting that college students with ADHD perform more poorly on various cognitive and neuropsychological tasks whereas others report no differences compared to non-ADHD peers. The purpose of the present study was to: a) examine the performance of 436 first-year college students with and without ADHD (51.6% female) on measures of executive function (EF) and intelligence; and b) investigate the association of self-reported use of stimulant medication with neuropsychological performance in students with ADHD. Participant data from their first year of involvement in the Trajectories Related to ADHD in College (TRAC) project, a longitudinal study following the 4-year outcomes of college students with and without ADHD, were analyzed. Participants with ADHD performed more poorly on task-based and self-report executive function measures relative to the comparison group. In contrast, no significant group differences in intellectual performance were found. Within the ADHD group, receipt of stimulant medication was associated with improved performance on some neuropsychological tasks, but not for intellectual functioning. Additional analyses also revealed significant group differences in EF based on clinical diagnostic status. Implications of these findings and suggestions for future research are advanced. PMID:27831696

Exploring longitudinal course and treatment-baseline severity interactions in secondary outcomes of smoking cessation treatment in individuals with attention-deficit hyperactivity disorder.

PubMed

Luo, Sean X; Wall, Melanie; Covey, Lirio; Hu, Mei-Chen; Scodes, Jennifer M; Levin, Frances R; Nunes, Edward V; Winhusen, Theresa

2018-01-25

A double blind, placebo-controlled randomized trial (NCT00253747) evaluating osmotic-release oral system methylphenidate (OROS-MPH) for smoking-cessation revealed a significant interaction effect in which participants with higher baseline ADHD severity had better abstinence outcomes with OROS-MPH while participants with lower baseline ADHD severity had worse outcomes. This current report examines secondary outcomes that might bear on the mechanism for this differential treatment effect. Longitudinal analyses were conducted to evaluate the effect of OROS-MPH on three secondary outcomes (ADHD symptom severity, nicotine craving, and withdrawal) in the total sample (N = 255, 56% Male), and in the high (N = 134) and low (N = 121) baseline ADHD severity groups. OROS-MPH significantly improved ADHD symptoms and nicotine withdrawal symptoms in the total sample, and exploratory analyses showed that in both higher and lower baseline severity groups, OROS-MPH statistically significantly improved these two outcomes. No effect on craving overall was detected, though exploratory analyses showed statistically significantly decreased craving in the high ADHD severity participants on OROS-MPH. No treatment by ADHD baseline severity interaction was detected for the outcomes. Methylphenidate improved secondary outcomes during smoking cessation independent of baseline ADHD severity, with no evident treatment-baseline severity interaction. Our results suggest divergent responses to smoking cessation treatment in the higher and lower severity groups cannot be explained by concordant divergence in craving, withdrawal and ADHD symptom severity, and alternative hypotheses may need to be identified.

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

PubMed

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

2016-09-01

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

Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: findings from the MTA longitudinal study.

PubMed

Molina, Brooke S G; Howard, Andrea L; Swanson, James M; Stehli, Annamarie; Mitchell, John T; Kennedy, Traci M; Epstein, Jeffery N; Arnold, L Eugene; Hechtman, Lily; Vitiello, Benedetto; Hoza, Betsy

2018-06-01

Inconsistent findings exist regarding long-term substance use (SU) risk for children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The observational follow-up of the Multimodal Treatment Study of Children with ADHD (MTA) provides an opportunity to assess long-term outcomes in a large, diverse sample. Five hundred forty-seven children, mean age 8.5, diagnosed with DSM-IV combined-type ADHD and 258 classmates without ADHD (local normative comparison group; LNCG) completed the Substance Use Questionnaire up to eight times from mean age 10 to mean age 25. In adulthood, weekly marijuana use (32.8% ADHD vs. 21.3% LNCG) and daily cigarette smoking (35.9% vs. 17.5%) were more prevalent in the ADHD group than the LNCG. The cumulative record also revealed more early substance users in adolescence for ADHD (57.9%) than LNCG (41.9%), including younger first use of alcohol, cigarettes, marijuana, and illicit drugs. Alcohol and nonmarijuana illicit drug use escalated slightly faster in the ADHD group in early adolescence. Early SU predicted quicker SU escalation and more SU in adulthood for both groups. Frequent SU for young adults with childhood ADHD is accompanied by greater initial exposure at a young age and slightly faster progression. Early SU prevention and screening is critical before escalation to intractable levels. © 2018 Association for Child and Adolescent Mental Health.

Poverty and the Growth of Emotional and Conduct Problems in Children with Autism with and without Comorbid ADHD

ERIC Educational Resources Information Center

Flouri, Eirini; Midouhas, Emily; Charman, Tony; Sarmadi, Zahra

2015-01-01

We investigated the longitudinal relationship between socio-economic disadvantage (SED) and trajectories of emotional and conduct problems among children with autism spectrum disorder (ASD) who had comorbid attention deficit/hyperactivity disorder (ADHD; ASD + ADHD) or not (ASD-DHD). The sample was 209 children with ASD who took part in the UK's…

Temperament at 7, 12, and 25 Months in Children at Familial Risk for ADHD

ERIC Educational Resources Information Center

Auerbach, Judith G.; Berger, Andrea; Atzaba-Poria, Naama; Arbelle, Shoshana; Cypin, Nira; Friedman, Adi; Landau, Rivka

2008-01-01

As part of a longitudinal investigation of infants at familial risk for attention-deficit hyperactivity disorder (ADHD), mothers and fathers independently completed temperament ratings on their infants. In this paper, we examine the 7-, 12-, and 25-month temperament of 58 boys, 36 of whom were considered at familial risk for ADHD and 22 of whom…

Sleep Problem Trajectories and Well-Being in Children with Attention-Deficit Hyperactivity Disorder: A Prospective Cohort Study.

PubMed

Lycett, Kate; Sciberras, Emma; Hiscock, Harriet; Mensah, Fiona K

2016-06-01

Sleep problems affect up to 70% of children with attention-deficit/hyperactivity disorder (ADHD) and are associated with poorer child and family well-being in cross-sectional studies. However, whether these associations hold longitudinally is unclear. The authors aimed to examine the longitudinal relationship between sleep problem trajectories and well-being in children with ADHD. Children with ADHD (n = 186), aged 5 to 13 years, were recruited from 21 pediatric practices across the state of Victoria, Australia. Sleep problem severity data were collected at 3 time points (baseline, 6, and 12 mo) and were used to classify sleep problem trajectories. Child and family well-being (e.g., child emotional and behavioral problems, quality of life [QoL]) were measured at baseline and 12 months by teacher and/or caregiver-report. The well-being of children with "transient" and "persistent" sleep problems was compared with those "never" experiencing sleep problems using a series of hierarchical linear regression models. After accounting for socio-demographic factors, children with transient and persistent sleep trajectories experienced more caregiver-reported behavioral and emotional problems (effect size [ES] both 0.7) and poorer child QoL (ES: -0.7 and -1.2, respectively). These associations remained after also accounting for ADHD medication and symptom severity and comorbidities, but after accounting for baseline measures many associations weakened to the point of nonsignificance. In the fully adjusted model-transient sleep problems were associated with behavioral and emotional problems (ES: 0.2). These associations were not evident by teacher-report. Children with ADHD experiencing transient or persistent sleep problems have poorer caregiver-reported well-being. Managing sleep problems in children with ADHD may improve child well-being.

Epigenetic profiling of ADHD symptoms trajectories: a prospective, methylome-wide study.

PubMed

Walton, E; Pingault, J-B; Cecil, C A M; Gaunt, T R; Relton, C L; Mill, J; Barker, E D

2017-02-01

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent developmental disorder, associated with a range of long-term impairments. Variation in DNA methylation, an epigenetic mechanism, is implicated in both neurobiological functioning and psychiatric health. However, the potential role of DNA methylation in ADHD symptoms is currently unclear. In this study, we examined data from the Avon Longitudinal Study of Parents and Children (ALSPAC)-specifically the subsample forming the Accessible Resource for Integrated Epigenomics Studies (ARIES)-that includes (1) peripheral measures of DNA methylation (Illumina 450k) at birth (n=817, 49% male) and age 7 (n=892, 50% male) and (2) trajectories of ADHD symptoms (7-15 years). We first employed a genome-wide analysis to test whether DNA methylation at birth associates with later ADHD trajectories; and then followed up at age 7 to investigate the stability of associations across early childhood. We found that DNA methylation at birth differentiated ADHD trajectories across multiple genomic locations, including probes annotated to SKI (involved in neural tube development), ZNF544 (previously implicated in ADHD), ST3GAL3 (linked to intellectual disability) and PEX2 (related to perixosomal processes). None of these probes maintained an association with ADHD trajectories at age 7. Findings lend novel insights into the epigenetic landscape of ADHD symptoms, highlighting the potential importance of DNA methylation variation in genes related to neurodevelopmental and peroxisomal processes that play a key role in the maturation and stability of cortical circuits.

Shared genetic influences between attention-deficit/hyperactivity disorder (ADHD) traits in children and clinical ADHD.

PubMed

Stergiakouli, Evie; Martin, Joanna; Hamshere, Marian L; Langley, Kate; Evans, David M; St Pourcain, Beate; Timpson, Nicholas J; Owen, Michael J; O'Donovan, Michael; Thapar, Anita; Davey Smith, George

2015-04-01

Twin studies and genome-wide complex trait analysis (GCTA) are not in agreement regarding heritability estimates for behavioral traits in children from the general population. This has sparked a debate on the possible difference in genetic architecture between behavioral traits and psychiatric disorders. In this study, we test whether polygenic risk scores associated with variation in attention-deficit/hyperactivity disorder (ADHD) trait levels in children from the general population predict ADHD diagnostic status and severity in an independent clinical sample. Single nucleotide polymorphisms (SNPs) with p < .5 from a genome-wide association study of ADHD traits in 4,546 children (mean age, 7 years 7 months) from the Avon Longitudinal Study of Parents and Children (ALSPAC; general population sample) were selected to calculate polygenic risk scores in 508 children with an ADHD diagnosis (independent clinical sample) and 5,081 control participants. Polygenic scores were tested for association with case-control status and severity of disorder in the clinical sample. Increased polygenic score for ADHD traits predicted ADHD case-control status (odds ratio = 1.17 [95% CI = 1.08-1.28], p = .0003), higher ADHD symptom severity (β = 0.29 [95% CI = 0.04-0.54], p = 0.02), and symptom domain severity in the clinical sample. This study highlights the relevance of additive genetic variance in ADHD, and provides evidence that shared genetic factors contribute to both behavioral traits in the general population and psychiatric disorders at least in the case of ADHD. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

The delinquency outcomes of boys with ADHD with and without comorbidity.

PubMed

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

2011-01-01

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.

Attention-Deficit/Hyperactivity Disorder (ADHD) and Obesity: Update 2016.

PubMed

Cortese, Samuele; Tessari, Luca

2017-01-01

While psychiatric comorbidities of attention-deficit/hyperactivity disorder (ADHD) have been extensively explored, less attention has been paid to somatic conditions possibly associated with this disorder. However, mounting evidence in the last decade pointed to a possible significant association between ADHD and certain somatic conditions, including obesity. This papers provides an update of a previous systematic review on the relationship between obesity and ADHD (Cortese and Vincenzi, Curr Top Behav Neurosci 9:199-218, 2012), focusing on pertinent peer-reviewed empirical papers published since 2012. We conducted a systematic search in PubMed, Ovid, and Web of Knowledge databases (search dates: from January 1st, 2012, to July 16th, 2016). We retained a total of 41 studies, providing information on the prevalence of obesity in individuals with ADHD, focusing on the rates of ADHD in individuals with obesity, or reporting data useful to gain insight into possible mechanisms underlying the putative association between ADHD and obesity. Overall, over the past 4 years, an increasing number of studies have assessed the prevalence of obesity in individuals with ADHD or the rates of ADHD in patients with obesity. Although findings are mixed across individual studies, meta-analytic evidence shows a significant association between ADHD and obesity, regardless of possible confounding factors such as psychiatric comorbidities. An increasing number of studies have also addressed possible mechanisms underlying the link between ADHD and obesity, highlighting the role, among others, of abnormal eating patterns, sedentary lifestyle, and possible common genetic alterations. Importantly, recent longitudinal studies support a causal role of ADHD in contributing to weight gain. The next generation of studies in the field should explore if and to which extent the treatment of comorbid ADHD in individuals with obesity may lead to long-term weight loss, ultimately improving their overall well-being and quality of life.

Change Over Time in Adolescent and Friend Alcohol Use: Differential Associations for Youth with and without Childhood ADHD

PubMed Central

Belendiuk, Katherine A.; Pedersen, Sarah L.; King, Kevin M.; Pelham, William E.; Molina, Brooke S. G.

2015-01-01

Individuals with 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 one widely investigated social-contextual risk factor, friend alcohol use, in a sample of adolescents with and without a history of ADHD. One hundred and fifty nine 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 = 0.15, SE = 0.04; CI95 = 0.08 to 0.22) than for those without ADHD (r = 0.06, SE = 0.03; CI95 = 0.00 to 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. PMID:26437359

Factors associated with attention deficit/hyperactivity disorder among US children: results from a national survey.

PubMed

Lingineni, Ravi K; Biswas, Swati; Ahmad, Naveed; Jackson, Bradford E; Bae, Sejong; Singh, Karan P

2012-05-14

The purpose of this study was to investigate the association between Attention Deficit/Hyperactivity Disorder (ADHD) and various factors using a representative sample of US children in a comprehensive manner. This includes variables that have not been previously studied such as watching TV/playing video games, computer usage, family member's smoking, and participation in sports. This was a cross-sectional study of 68,634 children, 5-17 years old, from the National Survey of Children's Health (NSCH, 2007-2008). We performed bivariate and multivariate logistic regression analyses with ADHD classification as the response variable and the following explanatory variables: sex, race, depression, anxiety, body mass index, healthcare coverage, family structure, socio-economic status, family members' smoking status, education, computer usage, watching television (TV)/playing video games, participation in sports, and participation in clubs/organizations. Approximately 10% of the sample was classified as having ADHD. We found depression, anxiety, healthcare coverage, and male sex of child to have increased odds of being diagnosed with ADHD. One of the salient features of this study was observing a significant association between ADHD and variables such as TV usage, participation in sports, two-parent family structure, and family members' smoking status. Obesity was not found to be significantly associated with ADHD, contrary to some previous studies. The current study uncovered several factors associated with ADHD at the national level, including some that have not been studied earlier in such a setting. However, we caution that due to the cross-sectional and observational nature of the data, a cause and effect relationship between ADHD and the associated factors can not be deduced from this study. Future research on ADHD should take into consideration these factors, preferably through a longitudinal study design.

Longitudinal association between early atopic dermatitis and subsequent attention-deficit or autistic disorder

PubMed Central

Lee, Chih-Ying; Chen, Mu-Hong; Jeng, Mei-Jy; Hsu, Ju-Wei; Tsai, Shih-Jen; Bai, Ya-Mei; Hung, Giun-Yi; Yen, Hsiu-Ju; Chen, Tzeng-Ji; Su, Tung-Ping

2016-01-01

Abstract Atopic dermatitis (AD) is one of the common allergic diseases in children. The presence of allergic diseases was found to have association with the risk of developing attention-deficit hyperactivity disorder (ADHD) or autistic spectrum disorder (ASD) in children, but it is still inconclusive. This study was to investigate the longitudinal relationship between AD developed during toddlerhood and subsequent development of ADHD or ASD in later childhood. Toddlers born between 1998 and 2008 and diagnosed with AD at the age younger than 3 years and older than 1 month were retrieved from Taiwan's National Health Insurance Research Database. Age- and gender-matched toddlers with no lifetime AD were enrolled as the control group. All enrolled toddlers were followed until 2011 to identify the development of ADHD or ASD. Multivariate Cox regression analysis was performed to analyze the hazard ratios (HRs). The risks associated with allergic comorbidities were analyzed. A total of 18,473 toddlers were enrolled into the AD group. The presence of AD significantly increased the risk of developing ADHD (HR = 2.92, 95% confidence interval [CI] = 2.48–3.45) or ASD (HR = 8.90, 95% CI = 4.98–15.92) when aged 3 years or older. Children from the AD group with 3 comorbidities together, namely, allergic rhinitis, allergic conjunctivitis, and asthma, had the greatest risk of developing ADHD and ASD (ADHD: HR = 4.67, 95% CI = 3.81–5.43; ASD: HR = 16.65, 95% CI = 8.63–30.60). In conclusion, toddlers who suffer from AD at the age younger than 3 years are at a higher risk of developing ADHD and ASD during later childhood. Pediatricians taking care of toddlers with AD should have knowledge of this increased risk of developing ADHD and ASD later in life, especially when children have certain comorbidities such as allergic rhinitis, allergic conjunctivitis, and asthma. PMID:27684861

The brain anatomy of attention-deficit/hyperactivity disorder in young adults - a magnetic resonance imaging study.

PubMed

Gehricke, Jean-G; Kruggel, Frithjof; Thampipop, Tanyaporn; Alejo, Sharina Dyan; Tatos, Erik; Fallon, James; Muftuler, L Tugan

2017-01-01

This is one of the first studies to examine the structural brain anatomy and connectivity associated with an ADHD diagnosis and child as well as adult ADHD symptoms in young adults. It was hypothesized that an adult ADHD diagnosis and in particular childhood symptoms, are associated with widespread changes in the brain macro- and microstructure, which can be used to develop a morphometric biomarker for ADHD. Voxel-wise linear regression models were used to examine structural and diffusion-weighted MRI data in 72 participants (31 young adults with ADHD and 41 controls without ADHD) in relation to diagnosis and the number of self-reported child and adult symptoms. Findings revealed significant associations between ADHD diagnosis and widespread changes to the maturation of white matter fiber bundles and gray matter density in the brain, such as structural shape changes (incomplete maturation) of the middle and superior temporal gyrus, and fronto-basal portions of both frontal lobes. ADHD symptoms in childhood showed the strongest association with brain macro- and microstructural abnormalities. At the brain circuitry level, the superior longitudinal fasciculus (SLF) and cortico-limbic areas are dysfunctional in individuals with ADHD. The morphometric findings predicted an ADHD diagnosis correctly up to 83% of all cases. An adult ADHD diagnosis and in particular childhood symptoms are associated with widespread micro- and macrostructural changes. The SLF and cortico-limbic findings suggest complex audio-visual, motivational, and emotional dysfunctions associated with ADHD in young adults. The sensitivity of the morphometric findings in predicting an ADHD diagnosis was sufficient, which indicates that MRI-based assessments are a promising strategy for the development of a biomarker.

The brain anatomy of attention-deficit/hyperactivity disorder in young adults – a magnetic resonance imaging study

PubMed Central

Kruggel, Frithjof; Thampipop, Tanyaporn; Alejo, Sharina Dyan; Tatos, Erik; Fallon, James; Muftuler, L. Tugan

2017-01-01

Background This is one of the first studies to examine the structural brain anatomy and connectivity associated with an ADHD diagnosis and child as well as adult ADHD symptoms in young adults. It was hypothesized that an adult ADHD diagnosis and in particular childhood symptoms, are associated with widespread changes in the brain macro- and microstructure, which can be used to develop a morphometric biomarker for ADHD. Methods Voxel-wise linear regression models were used to examine structural and diffusion-weighted MRI data in 72 participants (31 young adults with ADHD and 41 controls without ADHD) in relation to diagnosis and the number of self-reported child and adult symptoms. Results Findings revealed significant associations between ADHD diagnosis and widespread changes to the maturation of white matter fiber bundles and gray matter density in the brain, such as structural shape changes (incomplete maturation) of the middle and superior temporal gyrus, and fronto-basal portions of both frontal lobes. ADHD symptoms in childhood showed the strongest association with brain macro- and microstructural abnormalities. At the brain circuitry level, the superior longitudinal fasciculus (SLF) and cortico-limbic areas are dysfunctional in individuals with ADHD. The morphometric findings predicted an ADHD diagnosis correctly up to 83% of all cases. Conclusion An adult ADHD diagnosis and in particular childhood symptoms are associated with widespread micro- and macrostructural changes. The SLF and cortico-limbic findings suggest complex audio-visual, motivational, and emotional dysfunctions associated with ADHD in young adults. The sensitivity of the morphometric findings in predicting an ADHD diagnosis was sufficient, which indicates that MRI-based assessments are a promising strategy for the development of a biomarker. PMID:28406942

Longitudinal evaluation of the importance of homework assignment completion for the academic performance of middle school students with ADHD.

PubMed

Langberg, Joshua M; Dvorsky, Melissa R; Molitor, Stephen J; Bourchtein, Elizaveta; Eddy, Laura D; Smith, Zoe; Schultz, Brandon K; Evans, Steven W

2016-04-01

The primary goal of this study was to longitudinally evaluate the homework assignment completion patterns of middle school age adolescents with ADHD, their associations with academic performance, and malleable predictors of homework assignment completion. Analyses were conducted on a sample of 104 middle school students comprehensively diagnosed with ADHD and followed for 18 months. Multiple teachers for each student provided information about the percentage of homework assignments turned in at five separate time points and school grades were collected quarterly. Results showed that agreement between teachers with respect to students assignment completion was high, with an intraclass correlation of .879 at baseline. Students with ADHD were turning in an average of 12% fewer assignments each academic quarter in comparison to teacher-reported classroom averages. Regression analyses revealed a robust association between the percentage of assignments turned in at baseline and school grades 18 months later, even after controlling for baseline grades, achievement (reading and math), intelligence, family income, and race. Cross-lag analyses demonstrated that the association between assignment completion and grades was reciprocal, with assignment completion negatively impacting grades and low grades in turn being associated with decreased future homework completion. Parent ratings of homework materials management abilities at baseline significantly predicted the percentage of assignments turned in as reported by teachers 18 months later. These findings demonstrate that homework assignment completion problems are persistent across time and an important intervention target for adolescents with ADHD. Copyright © 2015 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Comorbidity of ADHD and subsequent bipolar disorder among adolescents and young adults with major depression: a nationwide longitudinal study.

PubMed

Chen, Mu-Hong; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Li, Cheng-Ta; Lin, Wei-Chen; Chang, Wen-Han; Chen, Tzeng-Ji; Pan, Tai-Long; Su, Tung-Ping; Bai, Ya-Mei

2015-05-01

Previous studies have found that attention-deficit hyperactivity disorder (ADHD) in childhood and adolescence is associated with an increased risk of major depression and bipolar disorder in later life. However, the effect of ADHD comorbidity on the diagnostic conversion to bipolar disorder among patients with major depression is still uncertain. Using the Taiwan National Health Insurance Research Database, 58,023 subjects < 30 years of age who had major depression with (n = 1,193) or without (n = 56,830) ADHD comorbidity between the years 2000 and 2008 were enrolled in our study. Subjects who developed bipolar disorder during the follow-up to the end of 2011 were identified. Adolescents and young adults who had major depression with ADHD comorbidity had an increased incidence of subsequent bipolar disorder (18.9% versus 11.2%, p < 0.001) compared to those without ADHD. Cox regression analysis showed that ADHD comorbidity was an independent risk factor (hazard ratio = 1.50, 95% confidence interval 1.30-1.72) predicting subsequent bipolar disorder among those with major depression, adjusting for demographic data and psychiatric comorbidities. Patients with comorbid diagnoses of major depression and ADHD had an increased risk of diagnostic conversion to bipolar disorder compared to those who had major depression alone. Further studies would be required to validate this finding and to investigate the possible underlying mechanisms. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A functional NPSR1 gene variant and environment shape personality and impulsive action: a longitudinal study.

PubMed

Laas, Kariina; Reif, Andreas; Kiive, Evelyn; Domschke, Katharina; Lesch, Klaus-Peter; Veidebaum, Toomas; Harro, Jaanus

2014-03-01

Neuropeptide S and its receptor NPSR1 are involved in the regulation of arousal, attention and anxiety. We examined whether the NPSR1 gene functional polymorphism Asn¹⁰⁷Ile (rs324981, A>T) influences personality, impulsivity, and attention-deficit/hyperactivity disorder (ADHD)-related symptoms in a population-representative sample, and whether any eventual associations depend on age, sex, family relations and stressful life events (SLE). We used self-reports or teachers' ratings for both the younger (n=593) and older (n=583) cohort of the longitudinal Estonian Children Personality, Behaviour and Health Study. Males with the TT genotype displayed more ADHD-related symptoms. Adaptive impulsivity and Extraversion increased the most from age 18 to 25. While highest increases were observed in AA men, TT women exhibited the largest decreases. For participants with the AA genotype, Warmth in family was inversely associated with Neuroticism, and positively associated with Extraversion and Adaptive impulsivity. High exposure to SLE increased impulsivity and ADHD scores in TT genotype subjects. We conclude that the NPSR1 A/T polymorphism is associated with impulsivity, ADHD symptoms and personality, mirroring the activity- and anxiety-mediating role of NPSR1. Heterozygous individuals were the least sensitive to environmental factors, whereas subjects with the AA genotype and TT genotype reacted to different types of environmental adversities.

Prospective observational study protocol to investigate long-term adverse effects of methylphenidate in children and adolescents with ADHD: the Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) study

PubMed Central

Inglis, S K; Carucci, S; Garas, P; Häge, A; Banaschewski, T; Buitelaar, J K; Dittmann, R W; Falissard, B; Hollis, C; Kovshoff, H; Liddle, E; McCarthy, S; Nagy, P; Neubert, A; Rosenthal, E; Sonuga-Barke, E; Wong, I; Zuddas, A; Coghill, D C

2016-01-01

Introduction Methylphenidate is the most frequently used medication for the treatment of attention-deficit/hyperactivity disorder (ADHD) in Europe. Following concerns about its safety, the European Commission called for research into the long-term effects of methylphenidate on children and adolescents with ADHD. The Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) research programme was designed to address this call. At the heart of this programme is a 2-year longitudinal naturalistic pharmacovigilance study being conducted in 27 European sites. Methods and analysis 3 cohorts of children and adolescents (aged 6–17) living in the UK, Germany, Italy and Hungary are being recruited: Group 1 (Medicated ADHD): 800 ADHD medication-naive children and adolescents with a clinical diagnosis of ADHD about to start methylphenidate treatment for the first time. Group 2 (Unmedicated ADHD): 400 children and adolescents with a clinical diagnosis of ADHD who have never been treated with ADHD medication and have no intention of beginning medication. Group 3 (Non-ADHD): 400 children and adolescents without ADHD who are siblings of individuals in either group 1 or 2. All participants will be assessed 5 times during their 2-year follow-up period for growth and development, psychiatric, neurological and cardiovascular health. The primary outcome measure will be the height velocity SD score. Ethics and dissemination Ethical approval for the study has been granted by the East of Scotland Research Ethics Service. Following this approval, patient information leaflets and consent forms were translated as necessary and submissions made by lead sites in each of the other 3 countries to their own ethics committees. Following ethical approval in each country, local ethical permissions at each site were sought and obtained as needed. The study's website (http://www.adhd-adduce.org/page/view/2/Home) provides information for researchers, participants and the general public. Trial registration number NCT01470261. PMID:27118284

The association of ADHD and depression: Mediation by peer problems and parent-child difficulties in two complementary samples

PubMed Central

Humphreys, Kathryn L.; Katz, Shaina J.; Lee, Steve S.; Hammen, Constance L.; Brennan, Patricia A.; Najman, Jake M.

2013-01-01

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for the development of depression, with evidence that peer and academic difficulties mediate predictions of later depression from ADHD. The present study hypothesized that parent-child relationship difficulties may be an additional potential mediator of this association. Academic, peer, and parent-child functioning were tested as mediators of the association of attention problems and depression in two distinctly different, yet complementary samples. Study 1 was a cross-sectional sample of 230 5–10 year-old children with and without ADHD. Study 2 was a prospective longitudinal sample of 472 youth followed prospectively from birth to age 20 at risk for depression. Despite differences in age, measures, and designs, both studies implicated peer and parent-child problems as unique mediators of depressive symptoms, although academic difficulties did not uniquely mediate the ADHD-depression association. Further, inattention symptoms, but not hyperactivity, predicted depressive symptoms via the disruption of interpersonal functioning. The inclusion of oppositional defiant disorder into models impacted results, and supported its independent role in parent-child problems. Implications include support for interventions that target interpersonal competence, which may effectively reduce the risk of depression among children with ADHD. PMID:24016021

Longitudinal Evaluation of the Importance of Homework Assignment Completion for the Academic Performance of Middle School Students with ADHD

PubMed Central

Langberg, Joshua M.; Dvorsky, Melissa R.; Molitor, Stephen J.; Bourchtein, Elizaveta; Eddy, Laura D.; Smith, Zoe; Schultz, Brandon K.; Evans, Steven W.

2016-01-01

The primary goal of this study was to longitudinally evaluate the homework assignment completion patterns of middle school age adolescents with ADHD, their associations with academic performance, and malleable predictors of homework assignment completion. Analyses were conducted on a sample of 104 middle school students comprehensively diagnosed with ADHD and followed for 18 months. Multiple teachers for each student provided information about the percentage of homework assignments turned in at five separate timepoints and school grades were collected quarterly. Results showed that agreement between teachers with respect to students’ assignment completion was high, with an intraclass correlation of .879 at baseline. Students with ADHD were turning in an average of 12% fewer assignments each academic quarter in comparison to teacher-reported classroom averages. Regression analyses revealed a robust association between the percentage of assignments turned in at baseline and school grades 18 months later, even after controlling for baseline grades, achievement (reading and math), intelligence, family income, and race. Cross-lag analyses demonstrated that the association between assignment completion and grades was reciprocal, with assignment completion negatively impacting grades and low grades in turn being associated with decreased future homework completion. Parent ratings of homework materials management abilities at baseline significantly predicted the percentage of assignments turned in as reported by teachers 18 months later. These findings demonstrate that homework assignment completion problems are persistent across time and an important intervention target for adolescents with ADHD. PMID:26931065

Inattentive/overactive children with histories of profound institutional deprivation compared with standard ADHD cases: a brief report.

PubMed

Sonuga-Barke, E J S; Rubia, K

2008-09-01

The Inattention/Overactivity/Impulsiveness (I/OA) behavioural cluster diagnostic of ADHD is recognized as a characteristic outcome of early institutional care. We compared the symptom and neuropsychological profiles of children with a history of I/OA and early severe deprivation (D-I/OA: n=13) with standard clinical ADHD cases (S-ADHD; N=20) and children who had experienced deprivation but were not pervasively I/OA (ERA-controls; n=22). The mean age of testing was around 13 years. D-I/OA and ERA-controls were selected from the English and Romanian Adoptees (ERA) study and had spent their early lives in the extremely depriving Romanian institutions of the Ceausescu regime and were later adopted into UK families. ADHD symptoms for male D-I/OA and S-ADHD cases showed marked similarities across symptom domains. In contrast, girls with D-I/OA were more similar to ERA controls than to ADHD cases. Longitudinal data suggested that this was due to a remission of symptoms in D-I/OA girls. Neuropsychological profiles of males and females with D-I/OA, however, were similar: both were more impaired than S-ADHD and ERA controls. Children with D-I/OA were more neuropsychologically impaired than S-ADHD despite the fact that only boys showed a persistent pattern of ADHD symptoms. These results need replication in a larger sample with groups matched for gender.

Reduced right frontal cortical thickness in children, adolescents and adults with ADHD and its correlation to clinical variables: a cross-sectional study.

PubMed

Almeida, Luis G; Ricardo-Garcell, Josefina; Prado, Hugo; Barajas, Lázaro; Fernández-Bouzas, Antonio; Avila, David; Martínez, Reyna B

2010-12-01

Some longitudinal magnetic resonance imaging (MRI) studies have shown reduced volume or cortical thickness (CT) in the frontal cortices of individuals with attention-deficit/hyperactivity disorder (ADHD). These studies indicated that the aforementioned anatomical abnormalities disappear during adolescence. In contrast, cross-sectional studies on adults with ADHD have shown anatomical abnormalities in the frontal lobe region. It is not known whether the anatomical abnormalities in ADHD are a delay or a deviation in the encephalic maturation. The aim of this study was to compare CT in the frontal lobe of children, adolescents and adults of both genders presenting ADHD with that in corresponding healthy controls and to explore its relationship with the severity of the illness. An MRI scan study was performed on never-medicated ADHD patients. Twenty-one children (6-10 year-olds), twenty adolescents (14-17 year-olds) and twenty adults (25-35 year-olds) were matched with healthy controls according to age and sex. CT measurements were performed using the Freesurfer image analysis suite. The data showed regions in the right superior frontal gyrus where CT was reduced in children, adolescents and adults with ADHD in contrast to their respective healthy controls. The CT of these regions correlated with the severity of the illness. In subjects with ADHD, there is a thinning of the cortical surface in the right frontal lobe, which is present in the children, adolescents and in adults. Copyright © 2010 Elsevier Ltd. All rights reserved.

Differential associations of early callous-unemotional, oppositional, and ADHD behaviors: multiple domains within early-starting conduct problems?

PubMed

Waller, Rebecca; Hyde, Luke W; Grabell, Adam S; Alves, Martha L; Olson, Sheryl L

2015-06-01

Early-starting child conduct problems (CP) are linked to the development of persistent antisocial behavior. Researchers have theorized multiple pathways to CP and that CP comprise separable domains, marked by callous-unemotional (CU) behavior, oppositional behavior, or ADHD symptoms. However, a lack of empirical evidence exists from studies that have examined whether there are unique correlates of these domains. We examined differential correlates of CU, oppositional, and ADHD behaviors during the preschool years to test their potentially distinct nomological networks. Multimethod data, including parent and teacher reports and observations of child behavior, were drawn from a prospective, longitudinal study of children assessed at age 3 and age 6 (N = 240; 48% female). Dimensions of CU, oppositional, and ADHD behaviors were separable within Confirmatory Factor Analyses across mother and father reports. There were differential associations between CU, oppositional, and ADHD behaviors and socioemotional, cognitive, and behavioral outcomes: CU behavior was uniquely related to lower moral regulation, guilt, and empathy. ADHD was uniquely related to lower attentional focusing and observed effortful control. Finally, CU behavior uniquely predicted increases in teacher-reported externalizing from ages 3-6 over and above covariates, and ADHD and oppositional behavior. Consistent with theory, dimensions of CU, ADHD, and oppositional behavior demonstrated separable nomological networks representing separable facets within early-starting CP. © 2014 Association for Child and Adolescent Mental Health.

Attention Deficit Hyperactivity Disorder symptoms and smoking trajectories: race and gender differences.

PubMed

Lee, Chien-Ti; Clark, Trenette T; Kollins, Scott H; McClernon, F Joseph; Fuemmeler, Bernard F

2015-03-01

This study examined the influence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms severity and directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) on trajectories of the probability of current (past month) smoking and the number of cigarettes smoked from age 13 to 32. Racial and gender differences in the relationship of ADHD symptoms and smoking trajectories were also assessed. A subsample of 9719 youth (54.5% female) was drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Cohort sequential design and zero-inflated Poisson (ZIP) latent growth modeling were used to estimate the relationship between ADHD directionality and severity on smoking development. ADHD severity's effect on the likelihood of ever smoking cigarettes at the intercept (age 13) had a greater impact on White males than other groups. ADHD severity also had a stronger influence on the initial number of cigarettes smoked at age 13 among Hispanic participants. The relationships between ADHD directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) and a higher number of cigarettes smoked at the intercept were stronger among Hispanic males than others. Gender differences manifested only among Whites. ADHD severity and directionality had unique effects on smoking trajectories. Our results also highlight that the risk of ADHD symptoms may differ by race and gender. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Which anxiety disorders may differentiate attention deficit hyperactivity disorder, combined type with dysthymic disorder from attention deficit hyperactivity disorder, combined type alone?

PubMed

Vance, Alasdair; Harris, Katrina; Boots, Marilyn; Talbot, Jessica; Karamitsios, Mary

2003-10-01

Attention deficit hyperactivity disorder, combined type (ADHD-CT), dysthymic disorder, and anxiety disorders frequently co-occur in primary school age children, although there have been no published data describing their association. We investigated the association of anxiety, defined from a parent or child perspective, with primary school-age children with ADHD-CT with and without dysthymic disorder. One hundred and forty-six medication naïve children with ADHD-CT were studied. Two groups with and without dysthymic disorder were formed to compare parent and child reports of anxiety, using categorical and continuous measures of anxiety, using logistic regression. Separation anxiety disorder and social phobia were associated with primary school-age children with ADHD-CT and dysthymic disorder, compared to children with ADHD-CT without dysthymic disorder. The recognition of dysthymic disorder and anxiety disorders and their management in primary school-age children with ADHD-CT is generally poorly understood. The identification and elucidation of composite anxiety and depressive phenomena that may be systematically investigated through longitudinal studies of epidemiologically derived samples is needed in this particular group of children.

Subtyping attention-deficit/hyperactivity disorder using temperament dimensions: toward biologically based nosologic criteria.

PubMed

Karalunas, Sarah L; Fair, Damien; Musser, Erica D; Aykes, Kamari; Iyer, Swathi P; Nigg, Joel T

2014-09-01

Psychiatric nosology is limited by behavioral and biological heterogeneity within existing disorder categories. The imprecise nature of current nosologic distinctions limits both mechanistic understanding and clinical prediction. We demonstrate an approach consistent with the National Institute of Mental Health Research Domain Criteria initiative to identify superior, neurobiologically valid subgroups with better predictive capacity than existing psychiatric categories for childhood attention-deficit/hyperactivity disorder (ADHD). To refine subtyping of childhood ADHD by using biologically based behavioral dimensions (i.e., temperament), novel classification algorithms, and multiple external validators. A total of 437 clinically well-characterized, community-recruited children, with and without ADHD, participated in an ongoing longitudinal study. Baseline data were used to classify children into subgroups based on temperament dimensions and examine external validators including physiological and magnetic resonance imaging measures. One-year longitudinal follow-up data are reported for a subgroup of the ADHD sample to address stability and clinical prediction. Parent/guardian ratings of children on a measure of temperament were used as input features in novel community detection analyses to identify subgroups within the sample. Groups were validated using 3 widely accepted external validators: peripheral physiological characteristics (cardiac measures of respiratory sinus arrhythmia and pre-ejection period), central nervous system functioning (via resting-state functional connectivity magnetic resonance imaging), and clinical outcomes (at 1-year longitudinal follow-up). The community detection algorithm suggested 3 novel types of ADHD, labeled as mild (normative emotion regulation), surgent (extreme levels of positive approach-motivation), and irritable (extreme levels of negative emotionality, anger, and poor soothability). Types were independent of existing clinical demarcations including DSM-5 presentations or symptom severity. These types showed stability over time and were distinguished by unique patterns of cardiac physiological response, resting-state functional brain connectivity, and clinical outcomes 1 year later. Results suggest that a biologically informed temperament-based typology, developed with a discovery-based community detection algorithm, provides a superior description of heterogeneity in the ADHD population than does any current clinical nosologic criteria. This demonstration sets the stage for more aggressive attempts at a tractable, biologically based nosology.

Childhood ADHD and risk for substance dependence in adulthood: a longitudinal, population-based study.

PubMed

Levy, Sharon; Katusic, Slavica K; Colligan, Robert C; Weaver, Amy L; Killian, Jill M; Voigt, Robert G; Barbaresi, William J

2014-01-01

Adolescents with attention-deficit/hyperactivity disorder (ADHD) are known to be at significantly greater risk for the development of substance use disorders (SUD) compared to peers. Impulsivity, which could lead to higher levels of drug use, is a known symptom of ADHD and likely accounts, in part, for this relationship. Other factors, such as a biologically increased susceptibility to substance dependence (addiction), may also play a role. This report further examines the relationships between childhood ADHD, adolescent- onset SUD, and substance abuse and substance dependence in adulthood. Individuals with childhood ADHD and non-ADHD controls from the same population-based birth cohort were invited to participate in a prospective outcome study. Participants completed a structured neuropsychiatric interview with modules for SUD and a psychosocial questionnaire. Information on adolescent SUD was obtained retrospectively, in a previous study, from medical and school records. Associations were summarized using odds ratios (OR) and 95% CIs estimated from logistic regression models adjusted for age and gender. A total of 232 ADHD cases and 335 non-ADHD controls participated (mean age, 27.0 and 28.6 years, respectively). ADHD cases were more likely than controls to have a SUD diagnosed in adolescence and were more likely to have alcohol (adjusted OR 14.38, 95% CI 1.49-138.88) and drug (adjusted OR 3.48, 95% CI 1.38-8.79) dependence in adulthood. The subgroup of participating ADHD cases who did not have SUD during adolescence were no more likely than controls to develop new onset alcohol dependence as adults, although they were significantly more likely to develop new onset drug dependence. Our study found preliminary evidence that adults with childhood ADHD are more susceptible than peers to developing drug dependence, a disorder associated with neurological changes in the brain. The relationship between ADHD and alcohol dependence appears to be more complex.

Childhood ADHD and Risk for Substance Dependence in Adulthood: A Longitudinal, Population-Based Study

PubMed Central

Levy, Sharon; Katusic, Slavica K.; Colligan, Robert C.; Weaver, Amy L.; Killian, Jill M.; Voigt, Robert G.; Barbaresi, William J.

2014-01-01

Background Adolescents with attention-deficit/hyperactivity disorder (ADHD) are known to be at significantly greater risk for the development of substance use disorders (SUD) compared to peers. Impulsivity, which could lead to higher levels of drug use, is a known symptom of ADHD and likely accounts, in part, for this relationship. Other factors, such as a biologically increased susceptibility to substance dependence (addiction), may also play a role. Objective This report further examines the relationships between childhood ADHD, adolescent- onset SUD, and substance abuse and substance dependence in adulthood. Method Individuals with childhood ADHD and non-ADHD controls from the same population-based birth cohort were invited to participate in a prospective outcome study. Participants completed a structured neuropsychiatric interview with modules for SUD and a psychosocial questionnaire. Information on adolescent SUD was obtained retrospectively, in a previous study, from medical and school records. Associations were summarized using odds ratios (OR) and 95% CIs estimated from logistic regression models adjusted for age and gender. Results A total of 232 ADHD cases and 335 non-ADHD controls participated (mean age, 27.0 and 28.6 years, respectively). ADHD cases were more likely than controls to have a SUD diagnosed in adolescence and were more likely to have alcohol (adjusted OR 14.38, 95% CI 1.49–138.88) and drug (adjusted OR 3.48, 95% CI 1.38–8.79) dependence in adulthood. The subgroup of participating ADHD cases who did not have SUD during adolescence were no more likely than controls to develop new onset alcohol dependence as adults, although they were significantly more likely to develop new onset drug dependence. Conclusions Our study found preliminary evidence that adults with childhood ADHD are more susceptible than peers to developing drug dependence, a disorder associated with neurological changes in the brain. The relationship between ADHD and alcohol dependence appears to be more complex. PMID:25162629

Cannabis use and adult ADHD symptoms.

PubMed

Fergusson, David M; Boden, Joseph M

2008-05-01

The present study examined the associations between cannabis use in adolescence and young adulthood and self-reported adult attention deficit/hyperactivity disorder (ADHD) symptoms in adulthood. A 25-year prospective longitudinal study of the health, development, and adjustment of a birth cohort of 1265 New Zealand children. Measures included assessments of adolescent and young adult cannabis use and ADHD symptoms at age 25, measures of childhood socioeconomic disadvantage, family adversity, childhood and early adolescent behavioural adjustment and cognitive ability, and adolescent and young adult other drug use. Cannabis use by age 25 was significantly (p<.0001) associated with increasing self-reported adult ADHD symptoms at age 25. Adjustment of the association for potentially confounding factors from childhood and early adolescence reduced the magnitude of the association, but it remained statistically significant (p<.0001). However, control for the mediating effects of other drug use in adolescence and early adulthood reduced the association between cannabis use and adult ADHD symptoms to statistical non-significance (p>.20). The current study suggested that the association between cannabis use and adult ADHD symptoms was mediated by other substance use that was associated with cannabis use. The results suggest that cannabis use leads to other drug use, which in turn leads to increased ADHD symptoms. However, it should be noted that the potential influence of such factors as genetic predispositions may still be unaccounted for.

Examining the association between attention deficit hyperactivity disorder and substance use disorders: A familial risk analysis.

PubMed

Yule, Amy M; Martelon, MaryKate; Faraone, Stephen V; Carrellas, Nicholas; Wilens, Timothy E; Biederman, Joseph

2017-02-01

The main aim of this study was to use familial risk analysis to examine the association between attention deficit hyperactivity disorder (ADHD) and substance use disorders (SUDs) attending to sex effects and the specificity of alcohol and drug use disorder risks. Subjects were derived from two longitudinal case-control family studies of probands aged 6-17 years with and without DSM-III-R ADHD of both sexes and their first degree relatives followed from childhood onto young adult years. Cox proportional hazard models were used to estimate rates of ADHD and SUDs (any SUD, alcohol dependence, and drug dependence). Logistic regression was used to test both co-segregation and assortative mating. Our sample included 404 probands (ADHD: 112 boys and 96 girls; Control: 105 boys and 91 girls) and their 1336 relatives. SUDs in probands increased the risk for SUDs in relatives irrespective of ADHD status. The risk for dependence to drug or alcohol in relatives was non-specific. There was evidence that even in the absence of a SUD in the proband, ADHD by itself increased the risk of SUDs in relatives. Proband sex did not moderate the familial relationship between ADHD and SUDs. There was evidence of co-segregation between ADHD and SUD. Findings indicate that various independent pathways are involved in the transmission of SUD in ADHD and that these risks were not moderated by proband sex. ADHD children and siblings should benefit from preventive and early intervention strategies to decrease their elevated risk for developing a SUD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Coffee consumption during pregnancy and the risk of hyperkinetic disorder and ADHD: a prospective cohort study.

PubMed

Linnet, Karen Markussen; Wisborg, Kirsten; Secher, Niels Jørgen; Thomsen, Per Hove; Obel, Carsten; Dalsgaard, Søren; Henriksen, Tine Brink

2009-01-01

Based on hypotheses from experimental studies, we studied the association between intrauterine exposure to coffee and the risk of clinically verified hyperkinetic disorder and attention-deficit hyperactivity disorder (ADHD). A cohort study with prospectively collected data from the Aarhus Birth Cohort, Denmark. We included 24 068 singletons delivered between 1990 and 1998. Linkage was performed with three Danish longitudinal registers: The Danish Psychiatric Central Register, The Integrated Database for Labour Market Research and The Danish Civil Registration System. We identified 88 children with hyperkinetic disorder and ADHD. Information about coffee consumption during pregnancy was obtained at 16 weeks of gestation from self-administrated questionnaires. Potential confounding factors were evaluated using Cox regression analyses. We found that intrauterine exposure to 10 or more cups of coffee per day was associated with a threefold increased risk of hyperkinetic disorder and ADHD. After adjustments for a number of confounding factors, the risk decreased and became statistically insignificant (RR 2.3, 95% CI 0.9-5.9). Prenatal exposure to high levels of coffee did not significantly increase the risk of clinically verified hyperkinetic disorder and ADHD in childhood.

Altered white matter tract property related to impaired focused attention, sustained attention, cognitive impulsivity and vigilance in attention-deficit/hyperactivity disorder

PubMed Central

Chiang, Huey-Ling; Chen, Yu-Jen; Lo, Yu-Chun; Tseng, Wen-Yih Isaac; Gau, Susan Shur-Fen

2015-01-01

Background The neural substrate for clinical symptoms and neuropsychological performance in individuals with attention-deficit/hyperactivity disorder (ADHD) has rarely been studied and has yielded inconsistent results. We sought to compare the microstructural property of fibre tracts associated with the prefrontal cortex and its association with ADHD symptoms and a wide range of attention performance in youth with ADHD and healthy controls. Methods We assessed youths with ADHD and age-, sex-, handedness-, coil- and intelligence-matched controls using the Conners’ Continuous Performance Test (CCPT) for attention performance and MRI. The 10 target tracts, including the bilateral frontostriatal tracts (caudate to dorsolateral prefrontal cortex, ventrolateral prefrontal cortex and orbitofrontal cortex), superior longitudinal fasciculus (SLF) and cingulum bundle were reconstructed using diffusion spectrum imaging tractography. We computed generalized fractional anisotropy (GFA) values to indicate tract-specific microstructural property. Results We included 50 youths with ADHD and 50 healthy controls in our study. Youths with ADHD had lower GFA in the left frontostriatal tracts, bilateral SLF and right cingulum bundle and performed worse in the CCPT than controls. Furthermore, alteration of the right SLF GFA was most significantly associated with the clinical symptom of inattention in youths with ADHD. Finally, youths with ADHD had differential association patterns of the 10 fibre tract GFA values with attention performance compared with controls. Limitations Ten of the youths with ADHD were treated with methylphenidate, which may have long-term effects on microstructural property. Conclusion Our study highlights the importance of the SLF, cingulum bundle and frontostriatal tracts for clinical symptoms and attention performance in youths with ADHD and demonstrates the involvement of different fibre tracts in attention performance in these individuals. PMID:25871496

Altered white matter tract property related to impaired focused attention, sustained attention, cognitive impulsivity and vigilance in attention-deficit/ hyperactivity disorder.

PubMed

Chiang, Huey-Ling; Chen, Yu-Jen; Lo, Yu-Chun; Tseng, Wen-Yih I; Gau, Susan S

2015-09-01

The neural substrate for clinical symptoms and neuropsychological performance in individuals with attention-deficit/hyperactivity disorder (ADHD) has rarely been studied and has yielded inconsistent results. We sought to compare the microstructural property of fibre tracts associated with the prefrontal cortex and its association with ADHD symptoms and a wide range of attention performance in youth with ADHD and healthy controls. We assessed youths with ADHD and age-, sex-, handedness-, coil- and intelligence-matched controls using the Conners' Continuous Performance Test (CCPT) for attention performance and MRI. The 10 target tracts, including the bilateral frontostriatal tracts (caudate to dorsolateral prefrontal cortex, ventrolateral prefrontal cortex and orbitofrontal cortex), superior longitudinal fasciculus (SLF) and cingulum bundle were reconstructed using diffusion spectrum imaging tractography. We computed generalized fractional anisotropy (GFA) values to indicate tract-specific microstructural property. We included 50 youths with ADHD and 50 healthy controls in our study. Youths with ADHD had lower GFA in the left frontostriatal tracts, bilateral SLF and right cingulum bundle and performed worse in the CCPT than controls. Furthermore, alteration of the right SLF GFA was most significantly associated with the clinical symptom of inattention in youths with ADHD. Finally, youths with ADHD had differential association patterns of the 10 fibre tract GFA values with attention performance compared with controls. Ten of the youths with ADHD were treated with methylphenidate, which may have long-term effects on microstructural property. Our study highlights the importance of the SLF, cingulum bundle and frontostriatal tracts for clinical symptoms and attention performance in youths with ADHD and demonstrates the involvement of different fibre tracts in attention performance in these individuals.

Stimulant treatment history predicts frontal-striatal structural connectivity in adolescents with attention-deficit/hyperactivity disorder.

PubMed

Schweren, L J S; Hartman, C A; Zwiers, M P; Heslenfeld, D J; Franke, B; Oosterlaan, J; Buitelaar, J K; Hoekstra, P J

2016-04-01

Diffusion tensor imaging (DTI) has revealed white matter abnormalities in individuals with attention-deficit/hyperactivity disorder (ADHD). Stimulant treatment may affect such abnormalities. The current study investigated associations between long-term stimulant treatment and white matter integrity within the frontal-striatal and mesolimbic pathways, in a large sample of children, adolescents and young adults with ADHD. Participants with ADHD (N=172; mean age 17, range 9-26) underwent diffusion-weighted MRI scanning, along with an age- and gendermatched group of 96 control participants. Five study-specific white matter tract masks (orbitofrontal-striatal, orbitofrontal-amygdalar, amygdalar-striatal, dorsolateral-prefrontal-striatal and medialprefrontal-striatal) were created. First we analyzed case-control differences in fractional anisotropy (FA) and mean diffusivity (MD) within each tract. Second, FA and MD in each tract was predicted from cumulative stimulant intake within the ADHD group. After correction for multiple testing, participants with ADHD showed reduced FA in the orbitofrontal-striatal pathway (p=0.010, effect size=0.269). Within the ADHD group, higher cumulative stimulant intake was associated with lower MD in the same pathway (p=0.011, effect size=-0.164), but not with FA. The association between stimulant treatment and orbitofrontal-striatal MD was of modest effect size. It fell short of significance after adding ADHD severity or ADHD type to the model (p=0.036 and p=0.094, respectively), while the effect size changed little. Our findings are compatible with stimulant treatment enhancing orbitofrontal-striatal white matter connectivity, and emphasize the importance of the orbitofrontal cortex and its connections in ADHD. Longitudinal studies including a drug-naïve baseline assessment are needed to distinguish between-subject variability in ADHD severity from treatment effects. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

Developmental trajectories of aggression, prosocial behavior, and social-cognitive problem solving in emerging adolescents with clinically elevated attention-deficit/hyperactivity disorder symptoms.

PubMed

Kofler, Michael J; Larsen, Ross; Sarver, Dustin E; Tolan, Patrick H

2015-11-01

Middle school is a critical yet understudied period of social behavioral risks and opportunities that may be particularly difficult for emerging adolescents with attention-deficit/hyperactivity disorder (ADHD) given their childhood social difficulties. Relatively few ADHD studies have examined social behavior and social-cognitive problem solving beyond the elementary years, or examined aspects of positive (prosocial) behavior. The current study examined how middle school students with clinically elevated ADHD symptoms differ from their non-ADHD peers on baseline (6th grade) and age-related changes in prosocial and aggressive behavior, and the extent to which social-cognitive problem solving strategies mediate these relations. Emerging adolescents with (n = 178) and without (n = 3,806) clinically elevated, teacher-reported ADHD-combined symptoms were compared longitudinally across 6th through 8th grades using parallel process latent growth curve modeling, accounting for student demographic characteristics, oppositional-defiant disorder (ODD) symptoms, deviant peer association, school climate, and parental monitoring. Sixth graders with elevated ADHD symptoms engaged in somewhat fewer prosocial behaviors (d = -0.44) and more aggressive behavior (d = 0.20) relative to their peers. These small social behavioral deficits decreased but were not normalized across the middle school years. Contrary to hypotheses, social-cognitive problem solving was not impaired in the ADHD group after accounting for co-occurring ODD symptoms and did not mediate the association between ADHD and social behavior during the middle school years. ADHD and social-cognitive problem solving contributed independently to social behavior, both in 6th grade and across the middle school years; the influence of social-cognitive problem solving on social behavior was highly similar for the ADHD and non-ADHD groups. (c) 2015 APA, all rights reserved).

Infant temperament reactivity and early maternal caregiving: independent and interactive links to later childhood attention-deficit/hyperactivity disorder symptoms.

PubMed

Miller, Natalie V; Degnan, Kathryn A; Hane, Amie A; Fox, Nathan A; Chronis-Tuscano, Andrea

2018-06-11

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with origins early in life. There is growing evidence that individual differences in temperament reactivity are predictive of ADHD symptoms, yet little is known about the relations between temperament reactivity in early infancy and later ADHD symptoms or the combined effect of reactivity with early environmental factors on ADHD symptom development. Using a 9-year prospective longitudinal design, this study tested the independent and interactive contributions of infant reactivity and maternal caregiving behaviors (MCB) on parent- and teacher-reported childhood ADHD symptoms. Participants included 291 children (132 male; 159 female) who participated in a larger study of temperament and social-emotional development. Reactivity was assessed by behavioral observation of negative affect, positive affect, and motor activity during novel stimuli presentations at 4 months of age. MCB were observed during a series of semistructured mother-infant tasks at 9 months of age. Finally, ADHD symptoms were assessed by parent- and teacher-report questionnaires at 7 and 9 years, respectively. Reactivity was predictive of ADHD symptoms, but results were sex specific. For boys, infant motor activity was positively predictive of later ADHD symptoms, but only at lower quality MCB. For girls, infant positive affect was positively predictive of later ADHD symptoms at lower quality MCB, and-unexpectedly-infant positive affect and motor activity were negatively predictive of later ADHD symptoms at higher quality MCB. These results point to early parenting as a moderating factor to mitigate temperament-related risk for later ADHD, suggesting this as a potential intervention target to mitigate risk for ADHD among reactive infants. © 2018 Association for Child and Adolescent Mental Health.

Early identification of ADHD risk via infant temperament and emotion regulation: a pilot study.

PubMed

Sullivan, Elinor L; Holton, Kathleen F; Nousen, Elizabeth K; Barling, Ashley N; Sullivan, Ceri A; Propper, Cathi B; Nigg, Joel T

2015-09-01

Attention deficit hyperactivity disorder (ADHD) is theorized to have temperamental precursors early in life. These are difficult to identify because many core features of ADHD, such as breakdowns in executive function and self-control, involve psychological and neural systems that are too immature to reliably show dysfunction in early life. ADHD also involves emotional dysregulation, and these temperamental features appear earlier as well. Here, we report a first attempt to utilize indices of emotional regulation to identify ADHD-related liability in infancy. Fifty women were recruited in the 2nd trimester of pregnancy, with overselection for high parental ADHD symptoms. Measures of maternal body mass index, nutrition, substance use, stress, and mood were examined during pregnancy as potential confounds. Offspring were evaluated at 6 months of age using LABTAB procedures designed to elicit fear, anger, and regulatory behavior. Mothers completed the Infant Behavior Questionnaire about their child's temperament. After control for associated covariates, including maternal depression and prenatal stress, family history of ADHD was associated with measures of anger/irritability, including infant negative vocalizations during the arm restraint task (p = .004), and maternal ratings of infant distress to limitations (p = .036). In the regulation domain, familial ADHD was associated with less parent-oriented attention seeking during the still face procedure (p < .001), but this was not echoed in the maternal ratings of recovery from distress. Affective response at 6 months of age may identify infants with familial history of ADHD, providing an early indicator of ADHD liability. These preliminary results provide a foundation for further studies and will be amplified by enlarging this cohort and following participants longitudinally to evaluate ADHD outcomes. © 2015 Association for Child and Adolescent Mental Health.

Co-occurrence of attention-deficit hyperactivity disorder symptoms with other psychopathology in young adults: parenting style as a moderator.

PubMed

Ni, Hsing-Chang; Gau, Susan Shur-Fen

2015-02-01

The extent to which parenting styles can influence secondary psychiatric symptoms among young adults with ADHD symptoms is unknown. This issue was investigated in a sample of 2284 incoming college students (male, 50.6%), who completed standardized questionnaires about adult ADHD symptoms, other DSM-IV symptoms, and their parents' parenting styles before their ages of 16. Among them, 2.8% and 22.8% were classified as having ADHD symptoms and sub-threshold ADHD symptoms, respectively. Logistic regression was used to compare the comorbid rates of psychiatric symptoms among the ADHD, sub-threshold ADHD and non-ADHD groups while multiple linear regressions were used to examine the moderating role of gender and parenting styles over the associations between ADHD and other psychiatric symptoms. Both ADHD groups were significantly more likely than other incoming students to have other DSM-IV symptoms. Parental care was negatively associated and parental overprotection/control positively associated with these psychiatric symptoms. Furthermore, significant interactions were found of parenting style with both threshold and sub-threshold ADHD in predicting wide-ranging comorbid symptoms. Specifically, the associations of ADHD with some externalizing symptoms were inversely related to level of paternal care, while associations of ADHD and sub-threshold ADHD with wide-ranging comorbid symptoms were positively related to level of maternal and paternal overprotection/control. These results suggest that parenting styles may modify the effects of ADHD on the risk of a wide range of temporally secondary DSM-IV symptoms among incoming college students, although other causal dynamics might be at work that need to be investigated in longitudinal studies. Copyright © 2014 Elsevier Inc. All rights reserved.

[Discipline styles and co-morbid disorders of adolescents with attention deficit hyperactivity disorder: a longitudinal study].

PubMed

Colomer-Diago, Carla; Berenguer-Forner, Carmen; Tárraga-Mínguez, Raúl; Miranda-Casas, Ana

2014-02-24

Problems in cognitive functioning, social and educational development of children with attention deficit hyperactivity disorder (ADHD) continue to be present in adolescence and adulthood. Although the literature shows a significant relationship between the use of dysfunctional discipline methods and severity in the course of ADHD, follow-up studies have been rare. To analyze parenting style and ADHD symptomatology assessed in childhood (time 1) to predict the oppositional behavior and cognitive problems in early adolescence (time 2), and to study, depending on the use of dysfunctional parenting style, the course of oppositional behavior and cognitive problems. Forty-five children with ADHD-combined presentation were assessed in two different moments: time 1 (ages: 6-13) and time 2 (ages: 8-16). Oppositionism and cognitive problems in the follow-up were predicted by dysfunctional discipline styles and ADHD severity (assessed in time 1). Oppositional behavior increased between time 1 and time 2 in children with a dysfunctional parenting, whereas a decrease on oppositional symptoms was observed in the functional parenting group (time x discipline interaction effect). Dysfunctional parenting practices in childhood predicted cognitive and behavioral problems associated in adolescence. The findings have implications for the planning of interventions.

Childhood attention-deficit/hyperactivity disorder predicts intimate partner victimization in young women

PubMed Central

Guendelman, Maya D.; Ahmad, Shaikh; Meza, Jocelyn I.; Owens, Elizabeth B.; Hinshaw, Stephen P.

2015-01-01

Attention-deficit/hyperactivity disorder (ADHD) is associated with interpersonal dysfunction during childhood and adolescence, yet little is known about the romantic relationships of young women with childhood ADHD. In the present study, we draw from a longitudinal sample of girls followed prospectively into young adulthood, comparing those with (n = 114) and without (n = 79; comparisons) childhood ADHD in terms of their risk for physical victimization by an intimate partner (physical IPV; e.g., slapping, punching) by 17–24 years of age. We examined ADHD both diagnostically and dimensionally, at the same time establishing reliable indicators of young adult physical IPV. Externalizing and internalizing problems, and academic achievement during adolescence, were tested as potential mediators. Overall, participants with a childhood diagnosis of ADHD experienced more physical IPV than did comparisons (30.7% vs. 6.3%). In parallel, IPV was associated with higher levels of childhood ADHD symptomatology (d = .73). Young women with persistent ADHD stood the highest risk of experiencing IPV (37.3%), followed by those with transient ADHD (19.0%) and those never-diagnosed (5.9%). Academic achievement measured during adolescence was a significant partial mediator of the childhood ADHD symptomatology-young adult IPV relationship, even with control of sociodemographic, psychiatric, and cognitive factors, including childhood reading and math disorders. Findings indicate that in young women, childhood ADHD is a specific and important predictor of physically violent victimization in their intimate relationships. This vulnerable population requires IPV prevention and intervention, with academic empowerment as a key target. PMID:25663589

Internet Gaming Disorder Explains Unique Variance in Psychological Distress and Disability After Controlling for Comorbid Depression, OCD, ADHD, and Anxiety.

PubMed

Pearcy, Benjamin T D; McEvoy, Peter M; Roberts, Lynne D

2017-02-01

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.

Blood lead, parental marital status and the risk of attention-deficit/hyperactivity disorder in elementary school children: A longitudinal study.

PubMed

Choi, Won-Jun; Kwon, Ho-Jang; Lim, Myung Ho; Lim, Ji-Ae; Ha, Mina

2016-02-28

The aim of this study was to investigate the blood lead level and parental marital status that might influence the development of attention-deficit/hyperactivity disorder (ADHD) symptoms in school-aged children. The participants in the survey included elementary school children, and they were followed up biennially. The participants' parents or caregivers were administered a questionnaire including ADHD rating scale. Among 2967 who were not suspected to have ADHD at baseline survey, 2195 children who took follow-up test for ADHD were evaluated. The incidence rate of suspected ADHD was 5.0% (107 cases) during the two years of the follow-up period. The geometric mean blood lead level was 1.56μg/dL. Relative risk ratio for ADHD was estimated using logistic regression analysis. After adjustment for potential confounders, ADHD developed more frequently in children with blood lead levels of >2.17μg/dL (highest quartile) (RR 1.552, 95% CI 1.002-2.403) and in children with a single parent (RR 1.805, 95% CI 1.002-3.254). The RR was 3.567 (95% CI 1.595-7.980) in children with relatively high blood lead levels (>2.17μg/dL) from single-parent families, compared with those with low blood lead and a two-parent family. The ADHD risk in association with blood lead level was modified by family status. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Attention-deficit hyperactivity disorder comorbidity and antidepressant resistance among patients with major depression: A nationwide longitudinal study.

PubMed

Chen, Mu-Hong; Pan, Tai-Long; Hsu, Ju-Wei; Huang, Kai-Lin; Su, Tung-Ping; Li, Cheng-Ta; Lin, Wei-Chen; Tsai, Shih-Jen; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

2016-11-01

The comorbidity between attention deficit hyperactivity disorder (ADHD) and major depression is common. However, the influence of ADHD comorbidity in the response or resistance to antidepressants remains unknown among patients with major depression. 1891 patients with major depression and ADHD and 1891 age-/sex-matched patients with major depression only were enrolled and followed for 1 year in our study. Use of antidepressants and ADHD medications during 1-year follow-up period were assessed. Antidepressant resistance was defined as treatment failure in two or more than two different antidepressants for adequate treatment dose and duration. Patients with major depression and ADHD had an increased risk of treatment resistance to antidepressants (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.63-3.32) compared with patients with major depression only after adjusting for demographic characteristics and other psychiatric comorbidities. Regular treatment for ADHD would reduce this risk (OR: 1.76, 95% CI: 0.72-4.27). Anxiety (OR: 3.15, 95% CI: 2.24-4.44) and substance use (OR: 2.45, 95% CI: 1.16-5.17) disorders were also associated with an elevated likelihood of resistance to antidepressants during the follow-up. Patients who had dual diagnoses of major depression and ADHD were more likely to have treatment resistance to antidepressants compared with patients with major depression only. Prompt and regular treatment for ADHD would reduce this risk. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

Influence of gender on attention-deficit/hyperactivity disorder in Europe--ADORE.

PubMed

Nøvik, Torunn Stene; Hervas, Amaia; Ralston, Stephen J; Dalsgaard, Søren; Rodrigues Pereira, Rob; Lorenzo, Maria J

2006-12-01

Attention-deficit/hyperactivity disorder (ADHD) in girls in Europe is poorly understood; it is not known whether they exhibit similar symptom patterns or co-existing problems and receive the same type of treatment as boys. To examine gender differences for referral patterns, social demographic factors, ADHD core symptomatology, co-existing health problems, psychosocial functioning and treatment. Baseline data from the ADHD Observational Research in Europe (ADORE) study, a 24-month, naturalistic, longitudinal observational study in 10 European countries of children (aged 6-18 years) with hyperactive/inattentive/impulsive symptoms but no previous diagnosis of ADHD, were analysed by gender. Data from 1,478 children were analysed: 231 girls (15.7%) and 1,222 boys (84.3%) (gender data missing for 25 patients). Gender ratios (girl:boy) varied by country, ranging from 1:3 to 1:16. Comparisons showed few gender effects in core ADHD symptomatology and clinical correlates of ADHD. Compared with boys, girls had significantly more parent-rated emotional symptoms and prosocial behaviour and were more likely to be the victim of bullying and less likely to be the bully. Girls and boys had similar levels of co-existing psychiatric and physical health problems, and received the same type of treatment. Fewer girls than boys are referred for ADHD treatment, but they have a similar pattern of impairment and receive similar treatment.

Is the ADHD brain wired differently? A review on structural and functional connectivity in attention deficit hyperactivity disorder.

PubMed

Konrad, Kerstin; Eickhoff, Simon B

2010-06-01

In recent years, a change in perspective in etiological models of attention deficit hyperactivity disorder (ADHD) has occurred in concordance with emerging concepts in other neuropsychiatric disorders such as schizophrenia and autism. These models shift the focus of the assumed pathology from regional brain abnormalities to dysfunction in distributed network organization. In the current contribution, we report findings from functional connectivity studies during resting and task states, as well as from studies on structural connectivity using diffusion tensor imaging, in subjects with ADHD. Although major methodological limitations in analyzing connectivity measures derived from noninvasive in vivo neuroimaging still exist, there is convergent evidence for white matter pathology and disrupted anatomical connectivity in ADHD. In addition, dysfunctional connectivity during rest and during cognitive tasks has been demonstrated. However, the causality between disturbed white matter architecture and cortical dysfunction remains to be evaluated. Both genetic and environmental factors might contribute to disruptions in interactions between different brain regions. Stimulant medication not only modulates regionally specific activation strength but also normalizes dysfunctional connectivity, pointing to a predominant network dysfunction in ADHD. By combining a longitudinal approach with a systems perspective in ADHD in the future, it might be possible to identify at which stage during development disruptions in neural networks emerge and to delineate possible new endophenotypes of ADHD. (c) 2010 Wiley-Liss, Inc.

Neural network topology in ADHD; evidence for maturational delay and default-mode network alterations.

PubMed

Janssen, T W P; Hillebrand, A; Gouw, A; Geladé, K; Van Mourik, R; Maras, A; Oosterlaan, J

2017-11-01

Attention-deficit/hyperactivity disorder (ADHD) has been associated with widespread brain abnormalities in white and grey matter, affecting not only local, but global functional networks as well. In this study, we explored these functional networks using source-reconstructed electroencephalography in ADHD and typically developing (TD) children. We expected evidence for maturational delay, with underlying abnormalities in the default mode network. Electroencephalograms were recorded in ADHD (n=42) and TD (n=43) during rest, and functional connectivity (phase lag index) and graph (minimum spanning tree) parameters were derived. Dependent variables were global and local network metrics in theta, alpha and beta bands. We found evidence for a more centralized functional network in ADHD compared to TD children, with decreased diameter in the alpha band (η p 2 =0.06) and increased leaf fraction (η p 2 =0.11 and 0.08) in the alpha and beta bands, with underlying abnormalities in hub regions of the brain, including default mode network. The finding of a more centralized network is in line with maturational delay models of ADHD and should be replicated in longitudinal designs. This study contributes to the literature by combining high temporal and spatial resolution to construct EEG network topology, and associates maturational-delay and default-mode interference hypotheses of ADHD. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

[Autism and attention deficit hyperactivity disorder: similarities and differences in executive functioning and theory of mind].

PubMed

Miranda-Casas, Ana; Baixauli-Fortea, Immaculada; Colomer-Diago, Carla; Roselló-Miranda, Belén

2013-09-06

Although the DSM-IV-TR diagnostic criteria do not overlap, the presence of attention deficit hyperactivity disorder (ADHD) symptoms in individuals with a clinical diagnosis of autism is quite high. At the same time, children with ADHD can have autistic traits, the most prevalent being social and communication difficulties. The analysis of the combination of executive functions and theory of mind (ToM) deficits could help to explain the overlap and differentiation between the two disorders. To review the findings of empirical studies in which children with ADHD and autism have been compared on indicators of executive functions and ToM. The literature review suggests the existence of distinct patterns in autism spectrum disorders (ASD) and ADHD when the executive functioning is segmented by components. Children with ADHD experience deficits in inhibitory control, while children with ASD have problems with cognitive flexibility and planning. Regarding the domain of the mentalist skills, there are developmental differences, as well as differences in their severity. Younger children with ASD have greater deficiencies in the ToM compared to children with ADHD, and a primary deficit in social orientation. Although important progress has been made, some issues remain to be clarified, among which we can highlight the analysis of how ToM development affects poor executive functions development, using longitudinal studies that analyze the developmental paths of children with ASD and children with ADHD.

Attention-deficit/hyperactivity disorder dimensionality: the reliable 'g' and the elusive 's' dimensions.

PubMed

Wagner, Flávia; Martel, Michelle M; Cogo-Moreira, Hugo; Maia, Carlos Renato Moreira; Pan, Pedro Mario; Rohde, Luis Augusto; Salum, Giovanni Abrahão

2016-01-01

The best structural model for attention-deficit/hyperactivity disorder (ADHD) symptoms remains a matter of debate. The objective of this study is to test the fit and factor reliability of competing models of the dimensional structure of ADHD symptoms in a sample of randomly selected and high-risk children and pre-adolescents from Brazil. Our sample comprised 2512 children aged 6-12 years from 57 schools in Brazil. The ADHD symptoms were assessed using parent report on the development and well-being assessment (DAWBA). Fit indexes from confirmatory factor analysis were used to test unidimensional, correlated, and bifactor models of ADHD, the latter including "g" ADHD and "s" symptom domain factors. Reliability of all models was measured with omega coefficients. A bifactor model with one general factor and three specific factors (inattention, hyperactivity, impulsivity) exhibited the best fit to the data, according to fit indices, as well as the most consistent factor loadings. However, based on omega reliability statistics, the specific inattention, hyperactivity, and impulsivity dimensions provided very little reliable information after accounting for the reliable general ADHD factor. Our study presents some psychometric evidence that ADHD specific ("s") factors might be unreliable after taking common ("g" factor) variance into account. These results are in accordance with the lack of longitudinal stability among subtypes, the absence of dimension-specific molecular genetic findings and non-specific effects of treatment strategies. Therefore, researchers and clinicians might most effectively rely on the "g" ADHD to characterize ADHD dimensional phenotype, based on currently available symptom items.

Childhood Attention-Deficit/Hyperactivity Disorder, Sex, and Obesity: A Longitudinal Population-Based Study.

PubMed

Aguirre Castaneda, Roxana L; Kumar, Seema; Voigt, Robert G; Leibson, Cynthia L; Barbaresi, William J; Weaver, Amy L; Killian, Jill M; Katusic, Slavica K

2016-03-01

To assess obesity rates during childhood and young adulthood in patients with attention-deficit/hyperactivity disorder (ADHD) and age- and sex-matched controls derived from a population-based birth cohort because cross-sectional studies suggest an association between ADHD and obesity. Study subjects included patients with childhood ADHD (n=336) and age- and sex-matched non-ADHD controls (n=665) from a 1976 to 1982 birth cohort (N=5718). Height, weight, and stimulant treatment measurements were abstracted retrospectively from medical records documenting care provided from January 1, 1976, through August 31, 2010. The association between ADHD and obesity in patients with ADHD relative to controls was estimated using Cox models. Patients with attention-deficit/hyperactivity disorder were 1.23 (95% CI, 1.00-1.50; P<.05) times more likely to be obese during the follow-up period than were non-ADHD controls. This association was not statistically significant in either sex (female participants: hazard ratio [HR], 1.49; 95% CI, 0.98-2.27; P=.06; male participants HR, 1.17, 95% CI, 0.92-1.48; P=.20). Patients with ADHD who were not obese as of the date ADHD research diagnostic criteria were met were 1.56 (95% CI, 1.14-2.13; P<.01) times more likely to be obese during the subsequent follow-up than were controls. This association was statistically significant in female study subjects (HR, 2.02; 95% CI, 1.13-3.60; P=.02), but not in male participants (HR, 1.41; 95% CI, 0.97-2.05; P=.07). A higher proportion of patients with ADHD were obese after the age of 20 years compared with non-ADHD controls (34.4% vs 25.1%; P=.01); this difference was observed only in female patients (41.6% vs 19.2%). There were no differences in obesity rates between stimulant-treated and nontreated patients with ADHD. Childhood ADHD is associated with obesity during childhood and young adulthood in females. Treatment with stimulant medications is not associated with the development of obesity up to young adulthood. Copyright © 2016. Published by Elsevier Inc.

Association between autism symptoms and family functioning in children with attention-deficit/hyperactivity disorder: a community-based study.

PubMed

Green, Jessica L; Rinehart, Nicole; Anderson, Vicki; Efron, Daryl; Nicholson, Jan M; Jongeling, Brad; Hazell, Philip; Sciberras, Emma

2016-12-01

Autism spectrum disorder (ASD) symptoms are elevated in populations of children with attention-deficit/hyperactivity disorder (ADHD). This study examined cross-sectional associations between ASD symptoms and family functioning in children with and without ADHD. Participants were recruited to a longitudinal cohort study, aged 6-10 years (164 ADHD; 198 controls). ADHD cases were ascertained using community-based screening and diagnostic confirmation from a diagnostic interview. ASD symptoms were measured using the Social Communication Questionnaire. Outcome variables were parent mental health, family quality of life (FQoL), couple conflict and support, and parenting behaviours. After adjustment for a range of child and family factors (including other mental health comorbidities), higher ASD symptoms were associated with poorer FQoL across all three domains; emotional impact (p = 0.008), family impact (p = 0.001) and time impact (p = 0.003). In adjusted analyses by subgroup, parents of children with ADHD+ASD had poorer parent self-efficacy (p = 0.01), poorer FQoL (p ≤ 0.05), with weak evidence of an association for less couple support (p = 0.06), compared to parents of children with ADHD only. Inspection of covariates in the adjusted analyses indicated that the association between ASD symptoms and most family functioning measures was accounted forby child internalising and externalising disorders, ADHD severity, and socioeconomic status; however, ASD symptoms appear to be independently associated with poorer FQoL in children with ADHD. The presence of ASD symptoms in children with ADHD may signal the need for enhanced family support.

Prospective observational study protocol to investigate long-term adverse effects of methylphenidate in children and adolescents with ADHD: the Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) study.

PubMed

Inglis, S K; Carucci, S; Garas, P; Häge, A; Banaschewski, T; Buitelaar, J K; Dittmann, R W; Falissard, B; Hollis, C; Kovshoff, H; Liddle, E; McCarthy, S; Nagy, P; Neubert, A; Rosenthal, E; Sonuga-Barke, E; Wong, I; Zuddas, A; Coghill, D C

2016-04-26

Methylphenidate is the most frequently used medication for the treatment of attention-deficit/hyperactivity disorder (ADHD) in Europe. Following concerns about its safety, the European Commission called for research into the long-term effects of methylphenidate on children and adolescents with ADHD. The Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) research programme was designed to address this call. At the heart of this programme is a 2-year longitudinal naturalistic pharmacovigilance study being conducted in 27 European sites. 3 cohorts of children and adolescents (aged 6-17) living in the UK, Germany, Italy and Hungary are being recruited:Group 1 (Medicated ADHD): 800 ADHD medication-naive children and adolescents with a clinical diagnosis of ADHD about to start methylphenidate treatment for the first time.Group 2 (Unmedicated ADHD): 400 children and adolescents with a clinical diagnosis of ADHD who have never been treated with ADHD medication and have no intention of beginning medication.Group 3 (Non-ADHD): 400 children and adolescents without ADHD who are siblings of individuals in either group 1 or 2.All participants will be assessed 5 times during their 2-year follow-up period for growth and development, psychiatric, neurological and cardiovascular health. The primary outcome measure will be the height velocity SD score. Ethical approval for the study has been granted by the East of Scotland Research Ethics Service. Following this approval, patient information leaflets and consent forms were translated as necessary and submissions made by lead sites in each of the other 3 countries to their own ethics committees. Following ethical approval in each country, local ethical permissions at each site were sought and obtained as needed. The study's website (http://www.adhd-adduce.org/page/view/2/Home) provides information for researchers, participants and the general public. NCT01470261. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Does exposure to parental substance use disorders increase offspring risk for a substance use disorder? A longitudinal follow-up study into young adulthood.

PubMed

Yule, Amy M; Wilens, Timothy E; Martelon, MaryKate; Rosenthal, Lindsay; Biederman, Joseph

2018-05-01

The main aim of this study was to examine the risk of exposure to parental substance use disorders (SUD; alcohol or drug abuse or dependence) on the risk for SUD in offspring with and without attention deficit hyperactivity disorder (ADHD) followed into young adult years. Subjects were derived from two longitudinal case-control studies of probands of both sexes, 6-17 years, with and without DSM-III-R ADHD and their parents. Probands were followed for ten years into young adulthood. Probands with a parental history of non-nicotine SUD were included in this analysis. Exposure to SUD was determined by active non-nicotine parental SUD while the parent was living with their child after birth. Cox proportional hazard models were used to calculate the risk of non-nicotine SUD in offspring. 171 of the 404 probands reassessed at ten-year follow up had a family history of parental SUD. 102 probands were exposed to active parental SUD. The average age of our sample was 22.2 ± 3.5 years old. Exposure to maternal but not paternal SUD increased offspring risk for an alcohol use disorder in young adulthood independently of ADHD status (OR: 2.7; 95% CI: 1.1, 6.9; p = 0.04). Exposure to maternal SUD increases the risk for an alcohol use disorder in offspring ten years later in young adult years irrespective of ADHD status. Copyright © 2018 Elsevier B.V. All rights reserved.

Perinatal Problems and Psychiatric Comorbidity Among Children with ADHD

PubMed Central

Owens, Elizabeth B.; Hinshaw, Stephen P.

2013-01-01

Objective Among two large, independent samples of girls with attention-deficit/hyperactivity disorder (ADHD), we examined associations between specific (maternal gestational smoking and drug use, early labor, low birth weight, and infant breathing problems at birth) and cumulative prenatal and perinatal risk factors and psychiatric comorbidity during childhood. Method Data from the (a) Multimodal Treatment Study of Children with ADHD, a randomized clinical trial with 579 children aged 7 to 9.9 years with combined-type ADHD, and the (b) Berkeley Girls ADHD Longitudinal Sample, a naturalistic study of 140 girls with ADHD (93 combined-type and 47 inattentive-type) who were first seen when they were 6 to 12 years old, were analyzed separately. In each sample, perinatal risk factors were assessed retrospectively by maternal report, and current childhood psychiatric comorbidity was assessed using maternal report on the Diagnostic Interview Schedule for Children. Results Consistent findings across these two studies show that infant breathing problems, early labor, and total perinatal problems predicted childhood comorbid depression but not comorbid anxiety or externalizing disorders. These associations remained significant, in both samples, with control of family SES and maternal symptoms of ADHD and depression. Results attenuated slightly with control of the number of child comorbidities plus SES and maternal symptoms. Conclusion Accumulating evidence suggests that perinatal risk factors are important precursors of childhood psychiatric comorbidity and that the association between these risk factors and detrimental psychiatric outcomes cannot be explained by maternal psychiatric symptoms or SES during childhood. PMID:23581554

Risk for switch from unipolar to bipolar disorder in youth with ADHD: a long term prospective controlled study.

PubMed

Biederman, Joseph; Petty, Carter R; Byrne, Deirdre; Wong, Patricia; Wozniak, Janet; Faraone, Stephen V

2009-12-01

To investigate whether ADHD is a risk factor for switches from unipolar to bipolar disorder over time. Data from two large controlled longitudinal family studies of boys and girls with and without ADHD and their siblings were used. Subjects (n=168) were followed prospectively and blindly over an average follow-up period of 7 years. Comparisons were made between youth with unipolar major depression who did and did not switch to full or subthreshold BP-I disorder at the follow-up assessment. Subjects were assessed at baseline and follow-up on multiple domains of functioning. Positive family history of parental psychiatric disorders was also compared between groups. ADHD was associated with a significantly higher risk for switches from unipolar to bipolar disorder (28% versus 6%; z=2.80, p=0.005). In subjects with ADHD, switches from unipolar to bipolar disorder were predicted by baseline comorbid conduct disorder, school behavior problems, and a positive family history of parental mood disorder. Psychosis was an exclusionary criterion in the original ascertainment of the studies of ADHD probands, so we were unable to test this as a predictor of switching to BPD. ADHD is a risk factor for switches from unipolar to bipolar disorder, and switches could be predicted by the presence of baseline conduct disorder, school behavior problems, and a positive family history of a mood disorder in a parent. These characteristics can aid clinicians in their treatment of youth with MDD.

Invariance of ADHD Symptoms Across Sex and Age: a Latent Analysis of ADHD and Impairment Ratings from Early Childhood into Adolescence.

PubMed

Leopold, Daniel R; Christopher, Micaela E; Olson, Richard K; Petrill, Stephen A; Willcutt, Erik G

2018-04-25

A population-based longitudinal sample of 489 twin pairs was assessed at six time points over ten years to examine the measurement invariance and stability of attention-deficit/hyperactivity disorder (ADHD) symptoms, as well as the developmental relations between inattention (IN), hyperactivity-impulsivity (HI), and multiple aspects of functional impairment. Parent ratings of ADHD symptoms and functional impairment were obtained in preschool and after the completion of kindergarten, first, second, fourth, and ninth grades. Results of the temporal and sex invariance models indicated that parent ratings of the 18 ADHD symptoms function in the same manner for females and males from early childhood into adolescence. In addition to establishing this prerequisite condition for the interpretation of longitudinal and between-sex differences in the IN and HI symptom dimensions, cross-lagged models indicated that both IN and HI were associated with increased risk for both concurrent and future overall, social, and recreational impairment, whereas only IN was uniquely associated with later academic impairment. Taken together, the current results demonstrate that IN and HI are highly stable from preschool through ninth grade, invariant between females and males, and indicative of risk for impairment in multiple areas, thereby providing strong support for the validity of the symptom dimensions among both sexes.

[Executive functions and stressful characteristics of children with attention-deficit hyperactivity disorder: influence on behavioral problems during adolescence].

PubMed

Colomer-Diago, Carla; Miranda-Casas, Ana; Herdoiza-Arroyo, Paulina; Presentación-Herrero, M Jesús

2012-02-29

The identification of possible factors that are influencing the course of attention-deficit hyperactivity disorder (ADHD) will allow the development of more effective early intervention strategies. AIMS. This research, which used a longitudinal and correlational design, set out to examine the temporal consistency of the primary symptoms and ADHD associated problems. In addition, the relationships and predictive power of working memory, inhibition and stressful characteristics of children with ADHD on the disorder symptoms and behavioral problems in adolescence was analyzed. This study included 65 families with children diagnosed with ADHD. In phase 1 children performed verbal working memory, visuo-spatial and inhibition tests, and information from parents about stressful characteristics of children was collected. In phase 1 and in the follow-up phase, which took place three years later, parents and teachers reported on the primary symptoms of ADHD and behavioral problems. Inattention symptoms as well as most behavioral problems were stable over time, while hyperactivity/impulsivity symptoms decreased. Moreover, neither working memory nor inhibition showed power to predict the central manifestations of ADHD or behavioral problems, while stressful characteristics of demandingness, low adaptability and negative mood had a moderate predictive capacity. These results confirm the role of stressful child characteristics as a risk factor in the course of ADHD.

White matter abnormalities and their impact on attentional performance in adult attention-deficit/hyperactivity disorder.

PubMed

Konrad, Andreas; Dielentheis, Thomas F; El Masri, Dschamil; Dellani, Paulo R; Stoeter, Peter; Vucurevic, Goran; Winterer, Georg

2012-06-01

Inattention is the most important behavioral feature of adult patients with attention-deficit/hyperactivity disorder (ADHD). Neuroimaging studies in ADHD have demonstrated abnormalities primarily in the frontostriatal circuitry and were mostly conducted in children. We investigated white matter (WM) integrity in adult ADHD patients and the correlation of WM microstructure and neuropsychological parameters in 37 (21 men) never-medicated adult ADHD patients and 34 age- and gender-matched healthy controls. All subjects underwent clinical interviews, rating scales, and neuropsychological tests of attentional performance. Diffusion tensor imaging (DTI) was acquired, and 12 WM regions-of-interest (ROIs) within the attentional network were chosen. Group differences of mean fractional anisotropy (FA) and mean diffusivity (MD) values were calculated for each ROI, and patients' DTI measures were then correlated with measures of attentional performance. FA values in ADHD patients were significantly reduced in the left inferior longitudinal fasciculus (ILF), while MD values were significantly increased in ADHD patients in the frontal portion of the left frontooccipital fasciculus (IFO). In ADHD patients, MD values were negatively correlated with attentional performance in the left ILF. Our findings provide further support for disturbed frontostriatal structural connectivity and also point to an involvement of the left temporal white matter with an impact on attentional performance.

Resilient Adolescent Adjustment among Girls: Buffers of Childhood Peer Rejection and Attention-Deficit/Hyperactivity Disorder

PubMed Central

Mikami, Amori Yee; Hinshaw, Stephen P.

2010-01-01

Examined a risk-resilience model of peer rejection and attention-deficit/hyperactivity disorder (ADHD) in a 5-year longitudinal study of 209 ethnically and socioeconomically diverse girls aged 6–13 at baseline and 11–18 at follow-up. Risk factors were childhood ADHD diagnosis and peer rejection; hypothesized protective factors were childhood measures of self-perceived scholastic competence, engagement in goal-directed play when alone, and popularity with adults. Adolescent criterion measures were multi-informant composites of externalizing and internalizing behavior plus indicators of academic achievement, eating pathology, and substance use. ADHD and peer rejection predicted risk for all criterion measures except for substance use, which was predicted by ADHD only. ADHD and peer rejection predicted lower adolescent academic achievement controlling for childhood achievement, but they did not predict adolescent externalizing and internalizing behavior after controlling for baseline levels of these constructs. Regarding buffers, self-perceived scholastic competence in childhood (with control of academic achievement) predicted resilient adolescent functioning. Contrary to hypothesis, goal-directed play in childhood was associated with poor adolescent outcomes. Buffers were not found to have differential effectiveness among girls with ADHD relative to comparison girls. PMID:17051436

The effect of methylphenidate on very low frequency electroencephalography oscillations in adult ADHD.

PubMed

Cooper, Ruth E; Skirrow, Caroline; Tye, Charlotte; McLoughlin, Grainne; Rijsdijk, Fruhling; Banaschweski, Tobias; Brandeis, Daniel; Kuntsi, Jonna; Asherson, Philip

2014-04-01

Altered very low-frequency electroencephalographic (VLF-EEG) activity is an endophenotype of ADHD in children and adolescents. We investigated VLF-EEG case-control differences in adult samples and the effects of methylphenidate (MPH). A longitudinal case-control study was conducted examining the effects of MPH on VLF-EEG (.02-0.2Hz) during a cued continuous performance task. 41 untreated adults with ADHD and 47 controls were assessed, and 21 cases followed up after MPH treatment, with a similar follow-up for 38 controls (mean follow-up=9.4months). Cases had enhanced frontal and parietal VLF-EEG and increased omission errors. In the whole sample, increased parietal VLF-EEG correlated with increased omission errors. After controlling for subthreshold comorbid symptoms, VLF-EEG case-control differences and treatment effects remained. Post-treatment, a time by group interaction emerged; VLF-EEG and omission errors reduced to the same level as controls, with decreased inattentive symptoms in cases. Reduced VLF-EEG following MPH treatment provides preliminary evidence that changes in VLF-EEG may relate to MPH treatment effects on ADHD symptoms; and that VLF-EEG may be an intermediate phenotype of ADHD. Further studies of the treatment effect of MPH in larger controlled studies are required to formally evaluate any causal link between MPH, VLF-EEG and ADHD symptoms. Copyright © 2014 Elsevier Inc. All rights reserved.

Associations between Acetaminophen Use during Pregnancy and ADHD Symptoms Measured at Ages 7 and 11 Years

PubMed Central

Thompson, John M. D.; Waldie, Karen E.; Wall, Clare R.; Murphy, Rinky; Mitchell, Edwin A.

2014-01-01

Objective Our aim was to replicate and extend the recently found association between acetaminophen use during pregnancy and ADHD symptoms in school-age children. Methods Participants were members of the Auckland Birthweight Collaborative Study, a longitudinal study of 871 infants of European descent sampled disproportionately for small for gestational age. Drug use during pregnancy (acetaminophen, aspirin, antacids, and antibiotics) were analysed in relation to behavioural difficulties and ADHD symptoms measured by parent report at age 7 and both parent- and child-report at 11 years of age. The analyses included multiple covariates including birthweight, socioeconomic status and antenatal maternal perceived stress. Results Acetaminophen was used by 49.8% of the study mothers during pregnancy. We found significantly higher total difficulty scores (Strengths and Difficulty Questionnaire parent report at age 7 and child report at age 11) if acetaminophen was used during pregnancy, but there were no significant differences associated with any of the other drugs. Children of mothers who used acetaminophen during pregnancy were also at increased risk of ADHD at 7 and 11 years of age (Conners’ Parent Rating Scale-Revised). Conclusions These findings strengthen the contention that acetaminophen exposure in pregnancy increases the risk of ADHD-like behaviours. Our study also supports earlier claims that findings are specific to acetaminophen. PMID:25251831

Lifespan persistence of ADHD: the life transition model and its application.

PubMed

Turgay, Atilla; Goodman, David W; Asherson, Philip; Lasser, Robert A; Babcock, Thomas F; Pucci, Michael L; Barkley, Russell

2012-02-01

The understanding that attention-deficit/hyperactivity disorder (ADHD) often persists throughout life has heightened interest of patients, families, advocates, and professionals in a longitudinal approach to management. Such an approach must recognize and address known patient- and systems-based challenges of long-term mental health treatment, shifting of clinical presentations of ADHD, and commonality of psychiatric comorbidity with ADHD. The ADHD Life Transition Model is a step toward developing criteria to optimize recognition and clinical management of ADHD (eg, response, remission) across an individual's lifespan and across diverse medical subspecialties. To support therapeutic efficiency and adaptability, our proposed model highlights periods when external resources for managing ADHD are reduced, cognitive and behavioral stressors are increased, and individuals may be reevaluating how they perceive, accept, and adhere to ADHD treatment. Such a model aims to support the clinical community by placing in context new findings, which suggest that the prevention of adult psychopathology in individuals with pediatric ADHD may be possible. The ADHD Life Transition Model seeks to improve care for individuals with ADHD by (1) underscoring that ADHD persists beyond childhood in at least two-thirds of patients, (2) raising awareness of the need to approach ADHD from a chronic illness standpoint, and (3) increasing mental health professionals' diligence in symptom recognition and management of ADHD across developmental phases from childhood through adulthood. © Copyright 2012 Physicians Postgraduate Press, Inc.

Childhood Neurodevelopmental Disorders and Violent Criminality: A Sibling Control Study

ERIC Educational Resources Information Center

Lundström, Sebastian; Forsman, Mats; Larsson, Henrik; Kerekes, Nora; Serlachius, Eva; Långström, Niklas; Lichtenstein, Paul

2014-01-01

The longitudinal relationship between attention deficit hyperactivity disorder (ADHD) and violent criminality has been extensively documented, while long-term effects of autism spectrum disorders (ASDs), tic disorders (TDs), and obsessive compulsive disorder (OCD) on criminality have been scarcely studied. Using population-based registers of all…

Childhood attention-deficit/hyperactivity disorder symptoms and the development of adolescent alcohol problems: A prospective, population-based study of Swedish twins.

PubMed

Quinn, Patrick D; Pettersson, Erik; Lundström, Sebastian; Anckarsäter, Henrik; Långström, Niklas; Gumpert, Clara Hellner; Larsson, Henrik; Lichtenstein, Paul; D'Onofrio, Brian M

2016-10-01

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of problematic alcohol and other substance use in adolescence. This study used data from an ongoing, prospective, population-based twin study of Swedish children and adolescents to evaluate the extent to which the association between ADHD symptoms and alcohol problems reflects a unique source of genetic or environmental risk related to ADHD versus a broader predisposition to youth externalizing behavior. We used all available data from same-sex monozygotic (MZ) and dizygotic (DZ) twins on ADHD symptoms in childhood (age 9/12; N = 15,549) and alcohol problems in late adolescence (age 18; N = 2,564). Consistent with prior longitudinal studies, the phenotypic association between hyperactive/impulsive ADHD symptoms and alcohol problems was small in magnitude, whereas the association for inattentive symptoms was even weaker. Additive genetic influences explained 99.8% of the association between hyperactive/impulsive symptoms and alcohol problems. Furthermore, we found that the genetic risk specifically associated with hyperactive/impulsive symptoms was attenuated when estimated in the context of externalizing behavior liability during childhood, of which ADHD symptoms were specific expressions. In sensitivity analyses exploring hyperactivity in mid-adolescence, we found a similar pattern of genetic associations. These results are consistent with previous findings of genetically driven overlap in the etiology of ADHD and problematic alcohol use. At least some of this co-occurrence may result from a general predisposition to externalizing behaviors in youth. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

The nature of the association between childhood ADHD and the development of bipolar disorder: a review of prospective high-risk studies.

PubMed

Duffy, Anne

2012-12-01

The author reviewed prospective longitudinal studies of the offspring of parents with bipolar disorder to inform our understanding of the nature of the association between childhood ADHD and the risk of developing bipolar disorder in adolescence and young adulthood. A literature review of published prospective cohort studies of the offspring of bipolar parents since 1985 was undertaken using a comprehensive search strategy in several electronic databases. The author provides a qualitative synthesis of results focusing on ADHD and the association with bipolar disorder in prospectively assessed high-risk offspring. These results are discussed in light of findings from other prospective epidemiological and clinical cohort studies. From the reviewed high-risk studies, evidence suggests that the clinical diagnosis of childhood ADHD is not a reliable predictor of the development of bipolar disorder. However, the author found evidence that symptoms of inattention may be part of a mixed clinical presentation during the early stages of evolving bipolar disorder in high-risk offspring, appearing alongside anxiety and depressive symptoms. The author also found preliminary evidence that childhood ADHD may form part of a neurodevelopmental phenotype in offspring at risk for developing a subtype of bipolar disorder unresponsive to lithium stabilization. While childhood ADHD does not appear to be part of the typical developmental illness trajectory of bipolar disorder, subjective problems with attention can form part of the early course, while neurodevelopmental abnormalities may be antecedents in a subgroup of high-risk children.

Subtyping attention-deficit/hyperactivity disorder using temperament dimensions: toward biologically based nosologic criteria

PubMed Central

Karalunas, Sarah L.; Fair, Damien; Musser, Erica D.; Aykes, Kamari; Iyer, Swathi P.; Nigg, Joel T.

2014-01-01

Importance Psychiatric nosology is limited by behavioral and biological heterogeneity within existing disorder categories. The imprecise nature of current nosological distinctions limits both mechanistic understanding and clinical prediction. Here, we demonstrate an approach consistent with the NIMH Research Domain Criteria (RDoC) initiative to identifying superior, neurobiologically-valid subgroups with better predictive capacity than existing psychiatric categories for childhood Attention-Deficit Hyperactivity Disorder (ADHD). Objective Refine subtyping of childhood ADHD by using biologically-based behavioral dimensions (i.e. temperament), novel classification algorithms, and multiple external validators. In doing so, we demonstrate how refined nosology is capable of improving on current predictive capacity of long-term outcomes relative to current DSM-based nosology. Design, Setting, Participants 437 clinically well-characterized, community-recruited children with and without ADHD participated in an on-going longitudinal study. Baseline data were used to classify children into subgroups based on temperament dimensions and to examine external validators including physiological and MRI measures. One-year longitudinal follow-up data are reported for a subgroup of the ADHD sample to address stability and clinical prediction. Main Outcome Measures Parent/guardian ratings of children on a measure of temperament were used as input features in novel community detection analyses to identify subgroups within the sample. Groups were validated using three widely-accepted external validators: peripheral physiology (cardiac measures of respiratory sinus arrhythmia and pre-ejection period), central nervous system functioning (via resting-state functional connectivity MRI), and clinical outcomes (at one-year longitudinal follow-up). Results The community detection algorithm suggested three novel types of ADHD, labeled as “Mild” (normative emotion regulation); “Surgent” (extreme levels of positive approach-motivation); and “Irritable” (extreme levels of negative emotionality, anger, and poor soothability). Types were independent of existing clinical demarcations, including DSM-5 presentations or symptom severity. These types showed stability over time and were distinguished by unique patterns of cardiac physiological response, resting-state functional brain connectivity, and clinical outcome one year later. Conclusions and Relevance Results suggest that a biologically-informed temperament-based typology, developed with a discovery-based community detection algorithm, provided a superior description of heterogeneity in the ADHD population than any current clinical nosology. This demonstration sets the stage for more aggressive attempts at a tractable, biologically-based nosology. PMID:25006969

Energy Drink and Coffee Consumption and Psychopathology Symptoms Among Early Adolescents: Cross-Sectional and Longitudinal Associations

PubMed Central

2016-01-01

Background: Little is known about possible links between energy drink use and psychopathology among youth. This study examined cross-sectional and longitudinal associations between energy drink consumption and psychopathology among early adolescents. In addition, associations between psychopathology and coffee consumption were examined to assess whether findings were specific to energy drinks or also applied to another commonly used caffeinated beverage. Methods: One hundred forty-four youth who participated in the Camden Youth Development Study (72 males; mean age 11.9 at wave 1; 65% Hispanic, 30% African American) were assessed using self-report measures of frequency of energy drink and coffee consumption and depression, anxiety, conduct disorder (CD) symptoms, and teacher reports of attention-deficit hyperactivity disorder (ADHD). Youth (92%) were reassessed 16 months later. Results: Concurrently, energy drink and coffee consumption were associated with similar psychopathology symptoms; when the other beverage was adjusted for, energy drinks remained associated with CD and coffee remained associated with panic anxiety. Initial energy drink consumption predicted increasing ADHD and CD over time, though the association with CD dropped to a trend level of significance when coffee was adjusted for. Initial levels of hyperactive ADHD predicted increasing coffee consumption over time; this association remained when energy drinks were controlled. Social anxiety was associated with less increase in energy drink consumption over time, controlling for coffee. Conclusion: Energy drink and coffee consumption among early adolescents are concurrently associated with similar psychopathology symptoms. Longitudinally, the associations between these beverages and psychopathology differ, indicating that these substances have differing implications for development over time. PMID:27274416

Energy Drink and Coffee Consumption and Psychopathology Symptoms Among Early Adolescents: Cross-Sectional and Longitudinal Associations.

PubMed

Marmorstein, Naomi R

2016-06-01

Background: Little is known about possible links between energy drink use and psychopathology among youth. This study examined cross-sectional and longitudinal associations between energy drink consumption and psychopathology among early adolescents. In addition, associations between psychopathology and coffee consumption were examined to assess whether findings were specific to energy drinks or also applied to another commonly used caffeinated beverage. Methods: One hundred forty-four youth who participated in the Camden Youth Development Study (72 males; mean age 11.9 at wave 1; 65% Hispanic, 30% African American) were assessed using self-report measures of frequency of energy drink and coffee consumption and depression, anxiety, conduct disorder (CD) symptoms, and teacher reports of attention-deficit hyperactivity disorder (ADHD). Youth (92%) were reassessed 16 months later. Results: Concurrently, energy drink and coffee consumption were associated with similar psychopathology symptoms; when the other beverage was adjusted for, energy drinks remained associated with CD and coffee remained associated with panic anxiety. Initial energy drink consumption predicted increasing ADHD and CD over time, though the association with CD dropped to a trend level of significance when coffee was adjusted for. Initial levels of hyperactive ADHD predicted increasing coffee consumption over time; this association remained when energy drinks were controlled. Social anxiety was associated with less increase in energy drink consumption over time, controlling for coffee. Conclusion: Energy drink and coffee consumption among early adolescents are concurrently associated with similar psychopathology symptoms. Longitudinally, the associations between these beverages and psychopathology differ, indicating that these substances have differing implications for development over time.

The Contribution of Maternal ADHD Symptomatology, Maternal DAT1, and Home Atmosphere to Child ADHD Symptomatology at 7 Years of Age.

PubMed

Auerbach, Judith G; Zilberman-Hayun, Yael; Atzaba-Poria, Naama; Berger, Andrea

2017-04-01

Children of mothers with attention-deficit/hyperactivity disorder (ADHD) have an increased genetic and environmental risk for ADHD. The unique and interactive contributions of a maternal dopamine receptor gene (DAT1), maternal ADHD symptoms (hyperactive- impulsive, inattentive), and home atmosphere to the prediction of ADHD symptoms (hyperactive- impulsive, inattentive) in 7- year-old boys (N = 96) were examined using data from a longitudinal study of familial risk for ADHD. During the first 6 months of the study, mothers and their spouses completed a questionnaire about the mother's ADHD symptoms. Home atmosphere questionnaire data were collected 4 years later. At the 7-year assessment, mothers reported on their child's ADHD symptoms. Negative home atmosphere was significantly associated with child hyperactive-impulsive and inattentive symptoms. Maternal inattentive symptoms were significantly correlated with both child symptom dimensions. Regression models, with child genotype and maternal education controlled, showed main effects for maternal inattentive symptoms, maternal DAT1 10/10 genotype, and home atmosphere in the prediction of child inattentive symptoms. Only home atmosphere predicted child hyperactive-impulsive symptoms. There was a significant home atmosphere x maternal hyperactive-impulsive symptoms interaction in the prediction of child hyperactive-impulsive symptoms. Boys with higher levels of symptoms came from homes characterized by higher levels of negative atmosphere and had mothers with higher levels of hyperactive-impulsive symptoms. There was also a trend (p = 0.075) for a maternal DAT1 x home atmosphere interaction. Boys with higher levels of inattentive symptoms came from homes with higher levels of negative atmosphere and had mothers with the homozygous 10/10 genotype. The maternal heterozygous 9/10 genotype did not predict child symptoms.

Validity of DSM-IV attention–deficit/hyperactivity disorder symptom dimensions and subtypes

PubMed Central

Willcutt, Erik G.; Nigg, Joel T.; Pennington, Bruce F.; Solanto, Mary V.; Rohde, Luis A.; Tannock, Rosemary; Loo, Sandra K.; Carlson, Caryn L.; McBurnett, Keith; Lahey, Benjamin B.

2013-01-01

DSM-IV criteria for ADHD specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-I), and combined type (ADHD-C). To aid decision-making for DSM-5 and other future diagnostic systems, a comprehensive literature review and meta-analysis of 546 studies was completed to evaluate the validity of the DSM-IV model of ADHD. Results indicated that DSM-IV criteria identify individuals with significant and persistent impairment in social, academic, occupational, and adaptive functioning when intelligence, demographic factors, and concurrent psychopathology are controlled. Available data overwhelmingly support the concurrent, predictive, and discriminant validity of the distinction between inattention and hyperactivity-impulsivity symptoms, and indicate that nearly all differences among the nominal subtypes are consistent with the relative levels of inattention and hyperactivity-impulsivity symptoms that define the subtypes. In contrast, the validity of the DSM-IV subtype model is compromised by weak evidence for the validity of ADHD-H after first grade, minimal support for the distinction between ADHD-I and ADHD-C in studies of etiological influences, academic and cognitive functioning, and treatment response, and the marked longitudinal instability of all three subtypes. Overall, it is concluded that the DSM-IV ADHD subtypes provide a convenient clinical shorthand to describe the functional and behavioral correlates of current levels of inattention and hyperactivity-impulsivity symptoms, but do not identify discrete subgroups with sufficient long-term stability to justify the classification of distinct forms of the disorder. Empirical support is stronger for an alternative model that would replace the subtypes with dimensional modifiers that reflect the number of inattention and hyperactivity-impulsivity symptoms at the time of assessment. PMID:22612200

Risk of Type 2 Diabetes in Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder: A Nationwide Longitudinal Study.

PubMed

Chen, Mu-Hong; Pan, Tai-Long; Hsu, Ju-Wei; Huang, Kai-Lin; Su, Tung-Ping; Li, Cheng-Ta; Lin, Wei-Chen; Tsai, Shih-Jen; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

2018-05-01

Studies have suggested there is an association between attention-deficit/hyperactivity disorder (ADHD) and type 2 diabetes mellitus (DM)-related risk factors, such as obesity, hypertension, and dyslipidemia. However, the association between ADHD and type 2 DM remains unknown. Using the Taiwan National Health Insurance Research Database, we enrolled 35,949 adolescents and young adults with ADHD (ICD-9-CM code: 314) and 71,898 (1:2) age- and sex-matched controls from 2002 through 2009 and followed up with them until the end of 2011. Participants who developed type 2 DM during the follow-up period were identified. Adolescents (hazard ratio [HR] = 2.83; 95% CI, 1.96-4.09) and young adults (HR = 3.28; 95% CI, 1.41-7.63) with ADHD had a higher risk of developing type 2 DM than did the controls after adjustment for demographic characteristics, use of ADHD medications and atypical antipsychotics, and medical comorbidities. Individuals with ADHD had a shorter mean ± SD duration between enrollment and onset of type 2 DM (3.17 ± 2.33 vs 4.08 ± 2.11 years, P = .004) during the follow-up compared with the controls. Sensitivity analyses after excluding first-year (HR = 2.36; 95% CI, 1.65-3.38) and first-3-year (HR = 1.92; 95% CI, 1.19-3.09) observation periods were consistent. Long-term use of atypical antipsychotics was associated with a higher likelihood of subsequent type 2 DM (HR = 2.82, 95% CI, 1.74-4.58). Adolescents and young adults with ADHD were more likely than non-ADHD controls to develop type 2 DM in later life. In addition, those with ADHD taking atypical antipsychotics exhibited a higher risk. Although correlation does not equal causation, our findings merit further study about the relationship between ADHD and type 2 DM. © Copyright 2018 Physicians Postgraduate Press, Inc.

Estimated prevalence and incidence of diagnosed ADHD and health care utilization in adults in Sweden - a longitudinal population-based register study.

PubMed

Polyzoi, Maria; Ahnemark, Ewa; Medin, Emma; Ginsberg, Ylva

2018-01-01

Although the worldwide prevalence of attention-deficit/hyperactivity disorder (ADHD) in adults is estimated to be between 2% and 5%, it is considered to be underdiagnosed. This register study explored the prevalence of diagnosed ADHD and incidence of newly diagnosed ADHD in Swedish adults over time, and assessed comorbidities and pharmacologic treatment. National Patient Register data were used to estimate the overall prevalence of adults (≥18 years) with a registered ADHD diagnosis from 2006 to 2011, and the incidence of newly registered diagnoses from 2007 to 2011. Data from the Prescribed Drug Register were used to estimate the mean dose of the most frequently prescribed ADHD medication. The estimated annual prevalence (N=44,364) of diagnosed ADHD increased from 0.58 per 1,000 persons in 2006 to 3.54 per 1,000 persons in 2011. The estimated annual incidence of newly diagnosed ADHD (N=24,921) increased from 0.39 per 1,000 persons to 0.90 per 1,000 persons between 2007 and 2011. At least one comorbidity was diagnosed in 52.6% of adults with ADHD (54.0% of newly diagnosed adults), with anxiety, substance use disorders, and depression being the most common. Among all adults with ADHD, 78.9% (65.7% of newly diagnosed adults) were prescribed ADHD medication and one-third were prescribed more than one add-on medication. Osmotic release oral system methylphenidate was the most commonly used medication. The mean daily dose was 51.5 mg, and was significantly higher in males, patients with substance use disorders, patients with drug holidays, and patients with at least one add-on medication. The most frequent concomitant medications were anxiolytics and hypnotics. In Sweden, the number of adults diagnosed with ADHD increased between 2006 and 2011, and the majority of patients were prescribed ADHD-specific medication. Over one-half of patients had psychiatric comorbidities; one-third were prescribed more than one add-on medication. Consumption of pharmacologic ADHD medication was high in specific patient subpopulations.

Estimated prevalence and incidence of diagnosed ADHD and health care utilization in adults in Sweden – a longitudinal population-based register study

PubMed Central

Polyzoi, Maria; Ahnemark, Ewa; Medin, Emma; Ginsberg, Ylva

2018-01-01

Background Although the worldwide prevalence of attention-deficit/hyperactivity disorder (ADHD) in adults is estimated to be between 2% and 5%, it is considered to be underdiagnosed. This register study explored the prevalence of diagnosed ADHD and incidence of newly diagnosed ADHD in Swedish adults over time, and assessed comorbidities and pharmacologic treatment. Methods National Patient Register data were used to estimate the overall prevalence of adults (≥18 years) with a registered ADHD diagnosis from 2006 to 2011, and the incidence of newly registered diagnoses from 2007 to 2011. Data from the Prescribed Drug Register were used to estimate the mean dose of the most frequently prescribed ADHD medication. Results The estimated annual prevalence (N=44,364) of diagnosed ADHD increased from 0.58 per 1,000 persons in 2006 to 3.54 per 1,000 persons in 2011. The estimated annual incidence of newly diagnosed ADHD (N=24,921) increased from 0.39 per 1,000 persons to 0.90 per 1,000 persons between 2007 and 2011. At least one comorbidity was diagnosed in 52.6% of adults with ADHD (54.0% of newly diagnosed adults), with anxiety, substance use disorders, and depression being the most common. Among all adults with ADHD, 78.9% (65.7% of newly diagnosed adults) were prescribed ADHD medication and one-third were prescribed more than one add-on medication. Osmotic release oral system methylphenidate was the most commonly used medication. The mean daily dose was 51.5 mg, and was significantly higher in males, patients with substance use disorders, patients with drug holidays, and patients with at least one add-on medication. The most frequent concomitant medications were anxiolytics and hypnotics. Conclusion In Sweden, the number of adults diagnosed with ADHD increased between 2006 and 2011, and the majority of patients were prescribed ADHD-specific medication. Over one-half of patients had psychiatric comorbidities; one-third were prescribed more than one add-on medication. Consumption of pharmacologic ADHD medication was high in specific patient subpopulations. PMID:29765219

The impact of ADHD persistence, recent cannabis use, and age of regular cannabis use onset on subcortical volume and cortical thickness in young adults.

PubMed

Lisdahl, Krista M; Tamm, Leanne; Epstein, Jeffery N; Jernigan, Terry; Molina, Brooke S G; Hinshaw, Stephen P; Swanson, James M; Newman, Erik; Kelly, Clare; Bjork, James M

2016-04-01

Both Attention Deficit Hyperactivity Disorder (ADHD) and chronic cannabis (CAN) use have been associated with brain structural abnormalities, although little is known about the effects of both in young adults. Participants included: those with a childhood diagnosis of ADHD who were CAN users (ADHD_CAN; n=37) and non-users (NU) (ADHD_NU; n=44) and a local normative comparison group (LNCG) who did (LNCG_CAN; n=18) and did not (LNCG_NU; n=21) use CAN regularly. Multiple regressions and MANCOVAs were used to examine the independent and interactive effects of a childhood ADHD diagnosis and CAN group status and age of onset (CUO) on subcortical volumes and cortical thickness. After controlling for age, gender, total brain volume, nicotine use, and past-year binge drinking, childhood ADHD diagnosis did not predict brain structure; however, persistence of ADHD was associated with smaller left precentral/postcentral cortical thickness. Compared to all non-users, CAN users had decreased cortical thickness in right hemisphere superior frontal sulcus, anterior cingulate, and isthmus of cingulate gyrus regions and left hemisphere superior frontal sulcus and precentral gyrus regions. Early cannabis use age of onset (CUO) in those with ADHD predicted greater right hemisphere superior frontal and postcentral cortical thickness. Young adults with persistent ADHD demonstrated brain structure abnormalities in regions underlying motor control, working memory and inhibitory control. Further, CAN use was linked with abnormal brain structure in regions with high concentrations of cannabinoid receptors. Additional large-scale longitudinal studies are needed to clarify how substance use impacts neurodevelopment in youth with and without ADHD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Impact of ADHD Persistence, Recent Cannabis Use, and Age of Regular Cannabis Use Onset on Subcortical Volume and Cortical Thickness in Young Adults

PubMed Central

Lisdahl, Krista M.; Tamm, Leanne; Epstein, Jeffery N.; Jernigan, Terry; Molina, Brooke S.G.; Hinshaw, Stephen P.; Swanson, James M.; Newman, Erik; Kelly, Clare; Bjork, James M.

2017-01-01

Background Both Attention Deficit Hyperactivity Disorder (ADHD) and chronic cannabis (CAN) use have been associated with brain structural abnormalities, although little is known about the effects of both in young adults. Methods Participants included: those with a childhood diagnosis of ADHD who were CAN users (ADHD_CAN; n=37) and non-users (NU) (ADHD_NU; n=44) and a local normative comparison group (LNCG) who did (LNCG_CAN; n=18) and did not (LNCG_NU; n=21) use CAN regularly. Multiple regressions and MANCOVAs were used to examine the independent and interactive effects of a childhood ADHD diagnosis and CAN group status and age of onset (CUO) on subcortical volumes and cortical thickness. Results After controlling for age, gender, total brain volume, nicotine use, and past-year binge drinking, childhood ADHD diagnosis did not predict brain structure; however, persistence of ADHD was associated with smaller left precentral/postcentral cortical thickness. Compared to all non-users, CAN users had decreased cortical thickness in right hemisphere superior frontal sulcus, anterior cingulate, and isthmus of cingulate gyrus regions and left hemisphere superior frontal sulcus and precentral gyrus regions. Early cannabis use age of onset (CUO) in those with ADHD predicted greater right hemisphere superior frontal and postcentral cortical thickness. Discussion Young adults with persistent ADHD demonstrated brain structure abnormalities in regions underlying motor control, working memory and inhibitory control. Further, CAN use was linked with abnormal brain structure in regions with high concentrations of cannabinoid receptors. Additional large-scale longitudinal studies are needed to clarify how substance use impacts neurodevelopment in youth with and without ADHD. PMID:26897585

Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity.

PubMed

Sibley, Margaret H; Swanson, James M; Arnold, L Eugene; Hechtman, Lily T; Owens, Elizabeth B; Stehli, Annamarie; Abikoff, Howard; Hinshaw, Stephen P; Molina, Brooke S G; Mitchell, John T; Jensen, Peter S; Howard, Andrea L; Lakes, Kimberley D; Pelham, William E

2017-06-01

Longitudinal studies of children diagnosed with ADHD report widely ranging ADHD persistence rates in adulthood (5-75%). This study documents how information source (parent vs. self-report), method (rating scale vs. interview), and symptom threshold (DSM vs. norm-based) influence reported ADHD persistence rates in adulthood. Five hundred seventy-nine children were diagnosed with DSM-IV ADHD-Combined Type at baseline (ages 7.0-9.9 years) 289 classmates served as a local normative comparison group (LNCG), 476 and 241 of whom respectively were evaluated in adulthood (Mean Age = 24.7). Parent and self-reports of symptoms and impairment on rating scales and structured interviews were used to investigate ADHD persistence in adulthood. Persistence rates were higher when using parent rather than self-reports, structured interviews rather than rating scales (for self-report but not parent report), and a norm-based (NB) threshold of 4 symptoms rather than DSM criteria. Receiver-Operating Characteristics (ROC) analyses revealed that sensitivity and specificity were optimized by combining parent and self-reports on a rating scale and applying a NB threshold. The interview format optimizes young adult self-reporting when parent reports are not available. However, the combination of parent and self-reports from rating scales, using an 'or' rule and a NB threshold optimized the balance between sensitivity and specificity. With this definition, 60% of the ADHD group demonstrated symptom persistence and 41% met both symptom and impairment criteria in adulthood. © 2016 Association for Child and Adolescent Mental Health.

Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Pediatric Narcolepsy: A Cross-Sectional Study.

PubMed

Lecendreux, Michel; Lavault, Sophie; Lopez, Régis; Inocente, Clara Odilia; Konofal, Eric; Cortese, Samuele; Franco, Patricia; Arnulf, Isabelle; Dauvilliers, Yves

2015-08-01

To evaluate the frequency, severity, and associations of symptoms of attention-deficit/hyperactivity disorder (ADHD) in children with narcolepsy with and without cataplexy. Cross-sectional survey. Four French national reference centers for narcolepsy. 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. 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. 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. Pediatric patients with narcolepsy have high levels of treatment-resistant attention-deficit/hyperactivity disorder (ADHD) symptoms. The optimal treatment for ADHD symptoms in these patients warrants further evaluation in longitudinal intervention studies. © 2015 Associated Professional Sleep Societies, LLC.

Comorbid anxiety and depression in school-aged children with attention deficit hyperactivity disorder (ADHD) and selfreported symptoms of ADHD, anxiety, and depression among parents of school-aged children with and without ADHD

PubMed Central

XIA, Weiping; SHEN, Lixiao; ZHANG, Jinsong

2015-01-01

Background Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in children that can extend into adulthood and that is often associated with a variety of comorbid psychiatric disorders. Aim Assess the comorbidity of ADHD with anxiety disorders and depressive disorders in school-aged children, and the relationship of the severity of ADHD, anxiety, and depressive symptoms in children who have ADHD with the severity of the corresponding symptoms in their parents. Methods A two-stage screening process identified children 7-10 years of age with and without ADHD treated at the Xin Hua Hospital in Shanghai. ADHD and other DSM-IV diagnoses were determined by a senior clinician using the Schedule for Affective Disorder and Schizophrenia for School-Aged Children (K-SADS-PL). One parent for each enrolled child completed three self-report scales: the ADHD Adult Self Report Scale (ASRS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). In total 135 children with ADHD and 65 control group children without ADHD were enrolled; parents for 94 of the children with ADHD and 63 of the children without ADHD completed the parental assessment scales. Results Among the 135 children with ADHD, 27% had a comorbid anxiety disorder, 18% had a comorbid depressive disorder, and another 15% had both comorbid anxiety and depressive disorders. Parents of children with ADHD self-reported more severe ADHD inattention symptoms than parents of children without ADHD and were more likely to meet criteria for adult ADHD. Mothers (but not fathers) of children with ADHD had significantly more severe trait anxiety and depressive symptoms than mothers of children without ADHD. Among children with ADHD, the severity of ADHD symptoms was not significantly correlated with the severity of ADHD symptoms in parents, but depressive symptoms and anxiety symptoms in the children were significantly correlated with the corresponding symptoms in the parents. Conclusion School-aged children with ADHD commonly suffer from comorbid anxiety and depressive disorders, and the severity of these symptoms parallels the level of anxiety and depressive symptoms in their parents. Self-reported symptoms of ADHD are significantly more common in parents of children with ADHD than in parents of children without ADHD. Longitudinal studies are needed to disentangle the genetic, biological, and social factors responsible for these complex inter-relationships. PMID:27199527

RISK FOR SWITCH FROM UNIPOLAR TO BIPOLAR DISORDER IN YOUTH WITH ADHD: A LONG TERM PROSPECTIVE CONTROLLED STUDY

PubMed Central

Biederman, Joseph; Petty, Carter R.; Byrne, Deirdre; Wong, Patricia; Wozniak, Janet; Faraone, Stephen V.

2009-01-01

Background To investigate whether ADHD is a risk factor for switches from unipolar to bipolar disorder over time. Methods Data from two large controlled longitudinal family studies of boys and girls with and without ADHD and their siblings were used. Subjects (n=168) were followed prospectively and blindly over an average follow up period of 7 years. Comparisons were made between youth with unipolar major depression who did and did not switch to full or subthreshold BP-I disorder at the follow-up assessment. Subjects were assessed at baseline and follow-up on multiple domains of functioning. Positive family history of parental psychiatric disorders was also compared between groups. Results ADHD was associated with a significantly higher risk for switches from unipolar to bipolar disorder (28% vs 6%; z=2.80, p=0.005). In subjects with ADHD, switches from unipolar to bipolar disorder were predicted by baseline comorbid conduct disorder, school behavior problems, and a positive family history of parental mood disorder. Limitations Psychosis was an exclusionary criterion in the original ascertainment of the studies of ADHD probands, so we were unable to test this as a predictor of switching to BPD. Conclusions ADHD is a risk factor for switches from unipolar to bipolar disorder, and switches could be predicted by the presence of baseline conduct disorder, school behavior problems, and a positive family history of a mood disorder in a parent. These characteristics can aid clinicians in their treatment of youth with MDD. PMID:19324422

ADHD and autistic traits, family function, parenting style, and social adjustment for Internet addiction among children and adolescents in Taiwan: a longitudinal study.

PubMed

Chen, Yi-Lung; Chen, Sue-Huei; Gau, Susan Shur-Fen

2015-04-01

This longitudinal study investigated the prevalence, predictors, and related factors for Internet addiction among elementary and junior high school students in Taiwan. A convenient sample of grades 3, 5, and 8 students (n = 1153) was recruited from six elementary and one junior high schools. They were assessed during the beginning and the end of the spring semester of 2013. Internet addiction was examined by the Chen Internet Addiction Scale (CIAS). Other factors were screened using the Chinese version of the Autism Spectrum Quotient (AQ) for autistic trait, the Parental Bonding Instrument (PBI) for parenting, the Family APGAR for family support, the Social Adjustment Inventory for Children and Adolescents for social function, and the Swanson, Nolan, and Pelham, version IV scale (SNAP-IV) for ADHD symptoms. The prevalence of Internet addiction decreased from 11.4% to 10.6%. Male, low family support, poor social adjustment, and high ADHD-related symptoms were related to Internet addiction. However, there was an inverse relationship between autistic traits and Internet addiction. Further, its predictivity could be accounted by poor academic performance, male, and protective parenting style. Internet addiction is not uncommon among youths in Taiwan. The predictors identified in this study could be the specific measures for the development of a prevention program for Internet addiction in the youth population. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sleep habits in children with attention-deficit/hyperactivity disorder predominantly inattentive type and associations with comorbid psychopathology symptoms.

PubMed

Becker, Stephen P; Pfiffner, Linda J; Stein, Mark A; Burns, G Leonard; McBurnett, Keith

2016-05-01

Much of what is currently known about the sleep functioning of children with attention-deficit/hyperactivity disorder (ADHD) is based on samples of children with ADHD combined type, and no study to date has examined the association between sluggish cognitive tempo (SCT) and sleep functioning in children diagnosed with ADHD. Accordingly, the objectives of this study were to (1) describe the sleep habits of children diagnosed with ADHD predominantly inattentive type (ADHD-I) and (2) examine whether comorbid internalizing, oppositional, and/or SCT symptoms are associated with poorer sleep functioning in children with ADHD-I. This study extends the current literature by using a large, clinical sample of children with ADHD-I to examine the association between SCT and other psychopathology symptoms with children's sleep functioning. Participants included 147 children (age: 6-11, 59% male, 55% White) diagnosed with ADHD-I using a semi-structured diagnostic interview. Parents completed measures assessing their child's sleep habits as well as comorbid anxiety, depression, oppositionality, and SCT symptoms. Fourteen percent of children with ADHD-I obtain less sleep than recommended and 31% have a sleep onset latency of greater than 20 minutes. The few children taking medication for ADHD had a longer sleep onset latency than those without medication. Twenty-seven percent of parents indicated that it is "difficult" to get their child out of bed on school days and 41% of parents indicated that their child needs to catch-up on sleep on the weekend "at least a little". Regression analyses found anxiety and SCT sleepy/tired symptoms to be the most consistent dimensions of psychopathology associated with sleep functioning, with little support for depression or oppositionality being associated with sleep. A sizeable minority of children with ADHD-I experience impaired sleep. In addition to SCT sleepy/tired symptoms, comorbid anxiety was most consistently associated with poorer sleep functioning in children with ADHD-I. SCT daydreaming and working memory symptoms were unassociated with sleep functioning, and the size of the effects between SCT sleepy/tired and sleep functioning indicates that these are not overlapping constructs. Longitudinal studies are needed to evaluate the interrelations of sleep problems and comorbid psychopathology symptoms and their impact on the daytime functioning of children with ADHD-I. Copyright © 2015 Elsevier B.V. All rights reserved.

Compulsive buying: Earlier illicit drug use, impulse buying, depression, and adult ADHD symptoms.

PubMed

Brook, Judith S; Zhang, Chenshu; Brook, David W; Leukefeld, Carl G

2015-08-30

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant's earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Compulsive Buying: Earlier Illicit Drug Use, Impulse Buying, Depression, and Adult ADHD Symptoms

PubMed Central

Brook, Judith S.; Zhang, Chenshu; Brook, David W.; Leukefeld, Carl G.

2015-01-01

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant’s earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. PMID:26165963

Commentary: Persistent Time Estimation Deficits in ADHD? From Developmental Trajectories to Individual Targets for Intervention--Reflections on Doehnert et al. (2013)

ERIC Educational Resources Information Center

Holtmann, Martin

2013-01-01

In this commentary, Martin Holtmann, discusses Doehnert and colleagues' article in this issue (Doehnert et al., 2013). Holtmann comments that the article illustrates the value of longitudinal electrophysiological and experimental approaches to disentangle different pathways underlying the phenotype of ADHD, and points out that their…

Motives underlying smoking in college students with ADHD.

PubMed

Murphy, Kerrie Glass; Flory, Kate

2017-05-01

The positive association between attention deficit hyperactivity disorder (ADHD) symptoms and smoking in youth has been well documented. Less research has examined why individuals with ADHD, particularly college students, are at increased risk for smoking. This longitudinal study examined whether smoking motives [cognitive enhancement, tolerance, negative reinforcement (smoking to reduce negative affect or stress), craving, social influences, and weight control] helped to explain the relation between ADHD symptoms (inattention and hyperactivity/impulsivity) and cigarette smoking among college students. Participants were 889 undergraduates (21% men) and their parents who completed online surveys at the beginning and end of the Fall semester regarding their smoking behaviors, ADHD symptoms, and smoking motives. Structural equation modeling was used to analyze data and answer research questions. Nineteen percent of students reported smoking, while 20% reported one or more inattentive symptoms, 35% reported one or more hyperactive/impulsive symptoms, and 3.3% met criteria for ADHD. All smoking motives significantly moderated the relation between inattentive symptoms and smoking, while most smoking motives (negative reinforcement, tolerance, craving, cognitive enhancement, and weight control) moderated the link between hyperactive/impulsive symptoms and smoking. Results remained significant after controlling for stimulant medication use and conduct disorder symptoms. Conclusions/Importance. Addressing negative reinforcement, craving, social influences, and tolerance in prevention and intervention efforts on college campuses may reduce smoking. Results also highlight the importance of assessing a range of ADHD symptoms in college students as ADHD symptoms, even at subthreshold levels, were associated with increased smoking rates among college students.

Childhood Conduct Problems and Young Adult Outcomes Among Women with Childhood ADHD

PubMed Central

Owens, Elizabeth B.; Hinshaw, Stephen P.

2015-01-01

We tested whether conduct problems predicted young adult functioning and psychiatric symptoms among women diagnosed with ADHD during childhood, in the context of three potential adolescent mediators: internalizing problems, peer rejection, and school failure and disciplinary problems. We controlled for childhood ADHD severity, IQ, and demographic factors, and in the mediational tests, for adolescent conduct problems. Data emanated from 140 participants in the Berkeley Girls with ADHD Longitudinal Study. We used bootstrapping methods to assess indirect effects (mediators). Both childhood (F1,118 change = 9.00, p = .003, R2 change = .069) and adolescent (F1,109 change = 10.41, p = .002, R2 change = .083) conduct problems were associated with worse overall functioning during young adulthood, controlling for initial ADHD severity, child IQ, and demographics. Results were similar when predicting psychiatric symptoms. Adolescent school failure and disciplinary problems mediated the relations between childhood conduct problems and both young-adult functioning and externalizing problems; adolescent internalizing problems and peer conflict mediated the relation between childhood conduct problems and young-adult internalizing problems. As is true for boys, childhood and adolescent conduct problems are associated with poor adult outcomes among girls with ADHD, with school failure and disciplinary problems, internalizing problems, and peer conflict functioning as mediators of these relations. PMID:26854507

Development of cortical asymmetry in typically developing children and its disruption in attention-deficit/hyperactivity disorder.

PubMed

Shaw, Philip; Lalonde, Francois; Lepage, Claude; Rabin, Cara; Eckstrand, Kristen; Sharp, Wendy; Greenstein, Deanna; Evans, Alan; Giedd, J N; Rapoport, Judith

2009-08-01

Just as typical development of anatomical asymmetries in the human brain has been linked with normal lateralization of motor and cognitive functions, disruption of asymmetry has been implicated in the pathogenesis of neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD). No study has examined the development of cortical asymmetry using longitudinal neuroanatomical data. To delineate the development of cortical asymmetry in children with and without ADHD. Longitudinal study. Government Clinical Research Institute. A total of 218 children with ADHD and 358 typically developing children, from whom 1133 neuroanatomical magnetic resonance images were acquired prospectively. Cortical thickness was estimated at 40 962 homologous points in the left and right hemispheres, and the trajectory of change in asymmetry was defined using mixed-model regression. In right-handed typically developing individuals, a mean (SE) increase in the relative thickness of the right orbitofrontal and inferior frontal cortex with age of 0.011 (0.0018) mm per year (t(337) = 6.2, P < .001) was balanced against a relative left-hemispheric increase in the occipital cortical regions of 0.013 (0.0015) mm per year (t(337) = 8.1, P < .001). Age-related change in asymmetry in non-right-handed typically developing individuals was less extensive and was localized to different cortical regions. In ADHD, the posterior component of this evolving asymmetry was intact, but the prefrontal component was lost. These findings explain the way that, in typical development, the increased dimensions of the right frontal and left occipital cortical regions emerge in adulthood from the reversed pattern of childhood cortical asymmetries. Loss of the prefrontal component of this evolving asymmetry in ADHD is compatible with disruption of prefrontal function in the disorder and demonstrates the way that disruption of typical processes of asymmetry can inform our understanding of neurodevelopmental disorders.

Associations between Birth Weight and Attention-Deficit/Hyperactivity Disorder (ADHD) Symptom Severity: Indirect Effects via Primary Neuropsychological Functions

PubMed Central

Hatch, Burt; Healey, Dione M.; Halperin, Jeffrey M.

2013-01-01

Background ADHD has a range of aetiological origins which are associated with a number of disruptions in neuropsychological functioning. This study aims to examine how low birth weight, a proxy measure for a range of environmental complications during gestation, predicts ADHD symptom severity in preschool-aged children indirectly via neuropsychological functioning. Methods 197 preschool-aged children were recruited as part of a larger longitudinal study. Two neuropsychological factors were derived from NEPSY domain scores. One, referred to as ‘Primary Neuropsychological Function,’ loaded highly with Sensorimotor and Visuospatial scores. The other, termed ‘Higher-Order Function’ loaded highly with Language and Memory domain scores. Executive functioning split evenly across the two. Analyses examined whether these neuropsychological factors allowed for an indirect association between birth weight and ADHD symptom severity. Results While both factors were associated with symptom severity, only the Primary Neuropsychological Factor was associated with birth weight. Furthermore, birth weight was indirectly associated to symptom severity via this factor. Conclusions These data indicate that birth weight is indirectly associated with ADHD severity via disruption of neuropsychological functions that are more primary in function as opposed to functions that play a higher-order role in utilising and integrating the primary functions. PMID:24795955

Effectiveness of one-year pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD): an open-label prospective study of time in treatment, dose, side-effects and comorbidity.

PubMed

Fredriksen, Mats; Dahl, Alv A; Martinsen, Egil W; Klungsøyr, Ole; Haavik, Jan; Peleikis, Dawn E

2014-12-01

How to generalize from randomized placebo controlled trials of ADHD drug treatment in adults to 'real-world' clinical practice is intriguing. This open-labeled prospective observational study examined the effectiveness of long-term stimulant and non-stimulant medication in adult ADHD including dose, side-effects and comorbidity in a clinical setting. A specialized ADHD outpatient clinic gave previously non-medicated adults (n=250) with ADHD methylphenidate as first-line drug according to current guidelines. Patients who were non-tolerant or experiencing low efficacy were switched to amphetamine or atomoxetine. Primary outcomes were changes of ADHD-symptoms evaluated with the Adult ADHD Self-Report Scale (ASRS) and overall severity by the Global Assessment of Functioning (GAF). Secondary outcomes were measures of mental distress, and response on the Clinical-Global-Impressions-Improvement Scale. Data at baseline and follow-ups were compared in longitudinal mixed model analyses for time on-medication, dosage, comorbidity, and side-effects. As results, 232 patients (93%) completed examination at the 12 month endpoint, and 163 (70%) remained on medication. Compared with the patients who discontinued medication, those still on medication had greater percentage reduction in ASRS-scores (median 39%, versus 13%, P<0.001) and greater improvement of GAF (median 20% versus 4%, P<0.001) and secondary outcomes. Continued medication and higher cumulated doses showed significant associations to sustained improvement. Conversely, psychiatric comorbidity and side-effects were related to lower effectiveness and more frequent termination of medication. Taken together, one-year treatment with stimulants or atomoxetine was associated with a clinically significant reduction in ADHD symptoms and mental distress, and improvement of measured function. No serious adverse events were observed. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

Sleep Habits in Children with Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type and Associations with Comorbid Psychopathology Symptoms

PubMed Central

Becker, Stephen P.; Pfiffner, Linda J.; Stein, Mark A.; Burns, G. Leonard; McBurnett, Keith

2015-01-01

Objectives Much of what is currently known about the sleep functioning of children with attention-deficit/hyperactivity disorder (ADHD) is based on samples of children with ADHD Combined Type, and no study to date has examined the association between sluggish cognitive tempo (SCT) and sleep functioning in children diagnosed with ADHD. Accordingly, the objectives of this study were to (1) describe the sleep habits of children diagnosed with ADHD Predominantly Inattentive Type (ADHD-I), and (2) examine whether comorbid internalizing, oppositional, and/or sluggish cognitive tempo (SCT) symptoms are associated with poorer sleep functioning in children with ADHD-I. This study extends the current literature by using a large, clinical sample of children with ADHD-I to examine the association between SCT and other psychopathology symptoms with children’s sleep functioning. Methods Participants were 147 children (ages 6–11; 59% male; 55% White) diagnosed with ADHD-I using a semi-structured diagnostic interview. Parents completed measures assessing their child’s sleep habits as well as comorbid anxiety, depression, oppositionality, and SCT symptoms. Results Fourteen percent of children obtain less sleep than recommended and 31% have a sleep onset latency of greater than 20 minutes. The few children taking medication for ADHD had a longer sleep onset latency than unmedicated children. Twenty-seven percent of parents indicated that it is “difficult” to get their child out of bed on school days and 41% of parents indicated that their child needs to catch-up on sleep on the weekend “at least a little”. Regression analyses found anxiety and SCT sleepy/tired symptoms to be the most consistent dimensions of psychopathology associated with sleep functioning, with little support for depression or oppositionality being associated with sleep. Conclusions A sizeable minority of children with ADHD-I experience impaired sleep. Comorbid anxiety, in addition to SCT sleepy/tired symptoms, were most consistently associated with poorer sleep functioning in children with ADHD-I. Importantly, SCT daydreaming and SCT working memory symptoms were unassociated with sleep functioning, and the size of the effects between SCT sleepy/tired and sleep functioning indicates that these are not overlapping constructs. Longitudinal studies are needed to evaluate the interrelations of sleep problems and comorbid psychopathology symptoms and their impact on the daytime functioning of children with ADHD-I. PMID:26922623

Attention-Deficit/Hyperactivity Disorder (ADHD) Symptoms in Pediatric Narcolepsy: A Cross-Sectional Study

PubMed Central

Lecendreux, Michel; Lavault, Sophie; Lopez, Régis; Inocente, Clara Odilia; Konofal, Eric; Cortese, Samuele; Franco, Patricia; Arnulf, Isabelle; Dauvilliers, Yves

2015-01-01

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 ADHD symptoms in these patients warrants further evaluation in longitudinal intervention studies. Citation: Lecendreux M, Lavault S, Lopez R, Inocente CO, Konofal E, Cortese S, Franco P, Arnulf I, Dauvilliers Y. Attention-deficit/hyperactivity disorder (adhd) symptoms in pediatric narcolepsy: a cross-sectional study. SLEEP 2015;38(8):1285–1295. PMID:26118560

Feasibility of School-Based ADHD Interventions: A Mixed-Methods Study of Perceptions of Adolescents and Adults

PubMed Central

Bussing, Regina; Koro-Ljungberg, Mirka; Gagnon, Joseph Calvin; Mason, Dana M.; Ellison, Anne; Noguchi, Kenji; Garvan, Cynthia W.; Albarracin, Dolores

2016-01-01

Objective Little is known about perceptions surrounding academic interventions for ADHD that determine intervention feasibility. Method As part of a longitudinal mixed-methods research project, representative school district samples of 148 adolescents (54.8%), 161 parents (59.4%), 122 teachers (50.0%), 46 health care providers (53.5%), and 92 school health professionals (65.7%) completed a cross-sectional survey. They also answered open-ended questions addressing undesirable intervention effects, which were analyzed using grounded theory methods. Results Adolescents expressed significantly lower receptivity toward academic interventions than adult respondents. Stigma emerged as a significant threat to ADHD intervention feasibility, as did perceptions that individualized interventions foster inequality. Conclusion Findings suggest that adolescents’ viewpoints must be included in intervention development to enhance feasibility and avoid interventions acceptable to adults, but resisted by adolescents. PMID:24448222

Adverse Childhood Experiences and ADHD Diagnosis at Age 9 Years in a National Urban Sample.

PubMed

Jimenez, Manuel E; Wade, Roy; Schwartz-Soicher, Ofira; Lin, Yong; Reichman, Nancy E

To examine associations between adverse childhood experiences (ACEs) and attention-deficit/hyperactivity disorder (ADHD) at age 9 years using longitudinal data and assess the extent to which ACEs during middle childhood are independently associated with ADHD at age 9 years. We conducted a secondary analysis of data from the Fragile Families urban birth cohort 5- and 9-year interviews. The sample was limited to children for whom mothers were the primary caregiver and mother-reported information on 8 ACEs and ADHD were available at age 5 and 9 years. We examined associations between ACEs and parent-reported ADHD at age 9 years using logistic regression and controlling for potential confounders. We included 1572 children; 48% were African American, 11% had parent-reported ADHD at age 9 years, 41% and 42% experienced ≥1 ACE by age 5 years and between the ages of 5 and 9 years, respectively. ACEs before age 5 years were associated with ADHD at age 9 years. One, 2, and ≥3 ACEs between age 5 and 9 years were associated with ADHD at age 9 years even after controlling for ACEs before age 5 years and ADHD at age 5 years (adjusted odds ratio [AOR], 1.9; 95% confidence interval [CI], 1.2-3; AOR, 2.1; 95% CI, 1.2-3.8; and AOR, 2.2; 95% CI, 1.1-4.3). In this study of urban children, ACEs occurring before age 5 years as well as between the ages of 5 and 9 years were associated with ADHD at age 9 years. Even after controlling for early childhood ACEs and ADHD at age 5 years, the association between ADHD and ACEs in middle childhood remained significant, highlighting the importance of screening and intervention throughout childhood. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Clinical service use as people with Attention Deficit Hyperactivity Disorder transition into adolescence and adulthood: a prospective longitudinal study.

PubMed

Eklund, Hanna; Cadman, Tim; Findon, James; Hayward, Hannah; Howley, Deirdre; Beecham, Jennifer; Xenitidis, Kiriakos; Murphy, Declan; Asherson, Philip; Glaser, Karen

2016-07-11

While Attention Deficit Hyperactivity Disorder (ADHD) often persists into adulthood, little is known about the needs and service use among adolescents and young adults with ADHD. The present study followed-up a cohort diagnosed with ADHD as children and assessed their: 1) needs, 2) correlates of contact with clinical services, and 3) experiences of transition from child to adult health services. Ninety one young people aged 14-24 were recruited from the UK subset of the International Multi-Centre ADHD Genetics (IMAGE) Project. Affected young people and parents conducted face-to-face interviews and self-completion questionnaires including a modified version of the Client Services Receipt Inventory, The Barkley's ADHD rating scale, The Clinical Interview Schedule-Revised, and the Zarit Burden Interview. Changes in key need characteristics (e.g. ADHD symptoms and impairments) over a 3-year period were examined using fixed effect models. Generalised Estimating Equations (GEE) were used to explore how key characteristics (such as ADHD symptoms) were associated with contact with clinical services across the three years. At baseline 62 % met diagnostic criteria for ADHD and presented with a range of ADHD related impairments, psychiatric comorbidities, and significant caregiver burden. While ADHD symptoms and related impairments lessened significantly over the three years, psychiatric comorbidities and caregiver burden remained stable. The strongest correlate of contact with clinical services was age (OR 0.65 95 % CI 0.49-0.84) with the odds of reported contact with clinical services decreasing by 35 % for each year increase in age at baseline and by 25 % for each year increase in age over time. Only 9 % of the sample had experienced a transfer to adult services, with the majority reporting unmet needs in healthcare transition. Despite continuing needs, few were in contact with adult health services or had received sufficient help with transition between child and adult health services. The main determinant of health service use for adolescents and young adults with ADHD is age - not needs. Service models should address the needs of ADHD individuals who are no longer children.

Trajectories of Global Self-Worth in Adolescents with ADHD: Associations with Academic, Emotional, and Social Outcomes.

PubMed

Dvorsky, Melissa R; Langberg, Joshua M; Becker, Stephen P; Evans, Steven W

2018-05-01

Resilience models suggest that there are likely to be multiple trajectories of self-worth and that despite experiencing impairment, some youth with attention deficit/hyperactivity disorder (ADHD) may maintain a positive self-worth, which could buffer them against negative outcomes. The present study used a cohort-sequential longitudinal design to evaluate developmental trajectories of global self-worth in a sample of 324 middle-school-age adolescents (71% male) diagnosed with ADHD between ages 11 and 14 in predicting outcomes at age 15. Sex, medication status, and ADHD/oppositional defiant disorder symptom severity were included as covariates in the models. Using growth mixture modeling, 3 distinct self-worth trajectory groups were identified: (a) high and increasing (44.4% of participants), (b) moderate and decreasing (48.8%), and (c) low and decreasing (6.8%). Participants with high and increasing global self-worth were less likely to exhibit co-occurring depressive symptoms and had better social functioning and higher grades at age 15 relative to those in either decreasing trajectory. Implications of these findings for monitoring and supporting positive global self-worth for adolescents with ADHD are discussed.

Disorganized Attachment and Inhibitory Capacity: Predicting Externalizing Problem Behaviors

ERIC Educational Resources Information Center

Bohlin, Gunilla; Eninger, Lilianne; Brocki, Karin Cecilia; Thorell, Lisa B.

2012-01-01

The aim of the present study was to investigate whether attachment insecurity, focusing on disorganized attachment, and the executive function (EF) component of inhibition, assessed at age 5, were longitudinally related to general externalizing problem behaviors as well as to specific symptoms of ADHD and Autism spectrum disorder (ASD), and…

Irritability in ADHD: Associations with depression liability.

PubMed

Eyre, Olga; Langley, Kate; Stringaris, Argyris; Leibenluft, Ellen; Collishaw, Stephan; Thapar, Anita

2017-06-01

Irritability and the new DSM-5 diagnostic category of Disruptive Mood Dysregulation Disorder (DMDD) have been conceptualised as related to mood disorder. Irritability is common in Attention Deficit Hyperactivity Disorder (ADHD) but little is known about its association with depression risk in this group. This study aims to establish levels of irritability and prevalence of DMDD in a clinical sample of children with ADHD, and examine their association with anxiety, depression and family history of depression. The sample consisted of 696 children (mean age 10.9 years) with a diagnosis of ADHD, recruited from UK child psychiatry and paediatric clinics. Parents completed the Child and Adolescent Psychiatric Assessment, a semi-structured diagnostic interview, about their child. This was used to establish prevalence of DMDD, anxiety disorder and depressive disorder, as well as obtain symptom scores for irritability, anxiety and depression. Questionnaires assessed current parental depression, and family history of depression. Irritability was common, with 91% endorsing at least one irritable symptom. 3-month DMDD prevalence was 31%. Children with higher levels of irritability or DMDD were more likely to have comorbid symptoms of anxiety, depression and a family history of depression. Results are based on a clinical sample, so may not be generalizable to children with ADHD in the general population. Irritability and DMDD were common, and were associated with markers of depression liability. Longitudinal studies are needed to examine the association between irritability and depression in youth with ADHD as they get older. Copyright © 2017. Published by Elsevier B.V.

Do Working Memory Deficits Underlie Reading Problems in Attention-Deficit/Hyperactivity Disorder (ADHD)?

PubMed

Kofler, Michael J; Spiegel, Jamie A; Soto, Elia F; Irwin, Lauren N; Wells, Erica L; Austin, Kristin E

2018-06-19

Reading problems are common in children with ADHD and show strong covariation with these children's underdeveloped working memory abilities. In contrast, working memory training does not appear to improve reading performance for children with ADHD or neurotypical children. The current study bridges the gap between these conflicting findings, and combines dual-task methodology with Bayesian modeling to examine the role of working memory for explaining ADHD-related reading problems. Children ages 8-13 (M = 10.50, SD = 1.59) with and without ADHD (N = 78; 29 girls; 63% Caucasian/Non-Hispanic) completed a counterbalanced series of reading tasks that systematically manipulated concurrent working memory demands. Adding working memory demands produced disproportionate decrements in reading comprehension for children with ADHD (d = -0.67) relative to Non-ADHD children (d = -0.18); comprehension was significantly reduced in both groups when working memory demands were increased. These effects were robust to controls for foundational reading skills (decoding, sight word vocabulary) and comorbid reading disability. Concurrent working memory demands did not slow reading speed for either group. The ADHD group showed lower comprehension (d = 1.02) and speed (d = 0.69) even before adding working memory demands beyond those inherently required for reading. Exploratory conditional effects analyses indicated that underdeveloped working memory overlapped with 41% (comprehension) and 85% (speed) of these between-group differences. Reading problems in ADHD appear attributable, at least in part, to their underdeveloped working memory abilities. Combined with prior cross-sectional and longitudinal findings, the current experimental evidence positions working memory as a potential causal mechanism that is necessary but not sufficient for effectively understanding written language.

ADHD Symptoms in Middle Adolescence Predict Exposure to Person-Related Life Stressors in Late Adolescence in 5-HTTLPR S-allele Homozygotes.

PubMed

Brinksma, Djûke M; Hoekstra, Pieter J; de Bildt, Annelies; Buitelaar, Jan K; van den Hoofdakker, Barbara J; Hartman, Catharina A; Dietrich, Andrea

2017-12-19

Literature suggests that life stressors predict attention-deficit/hyperactivity disorder (ADHD) symptoms and that this relationship is moderated by the serotonin transporter polymorphism (5-HTTLPR). It is less clear whether, on reverse, ADHD symptoms may influence the risk of exposure to life stressors. Furthermore, the role of life stressors may vary across development depending on the type of life stressor. We used threewave longitudinal data of 1,306 adolescents from the general population and clinicreferred cohort of the TRacking Adolescents' Individual Lives Survey. The 5-HTTLPR genotype (SS, LS, LL), parent-reported ADHD symptoms at three time points (T1: Mage = 11.2; T2: Mage = 13.5; T3: Mage = 16.2 years), and the number of personrelated ('dependent') and environment-related ('independent') life stressors occurring between measurements (T1-T2, T2-T3) were assessed. Using path analyses, we examined bidirectional relations between exposure to these life stressors and ADHD symptoms between the separate waves moderated by 5-HTTLPR status. Exposure to life stressors did not predict ADHD symptoms. Rather, we found that in 5-HTTLPR Sallele homozygotes, ADHD symptoms in middle adolescence (T2) predicted exposure to the number of person-related life stressors later in adolescence (T2-T3, p = 0.001). There was no relation with environment-related life stressors. Our study suggests that S-allele homozygotes with higher levels of ADHD symptoms in middle adolescence are more vulnerable to becoming exposed to person-related ('dependent') life stressors in late adolescence. Findings emphasize the need to be aware of social-emotional adversities that may occur in genetically vulnerable adolescents with ADHD symptoms in the transition into adulthood.

Video game use in boys with autism spectrum disorder, ADHD, or typical development.

PubMed

Mazurek, Micah O; Engelhardt, Christopher R

2013-08-01

The study objectives were to examine video game use in boys with autism spectrum disorder (ASD) compared with those with ADHD or typical development (TD) and to examine how specific symptoms and game features relate to problematic video game use across groups. Participants included parents of boys (aged 8-18) with ASD (n = 56), ADHD (n = 44), or TD (n = 41). Questionnaires assessed daily hours of video game use, in-room video game access, video game genres, problematic video game use, ASD symptoms, and ADHD symptoms. Boys with ASD spent more time than did boys with TD playing video games (2.1 vs 1.2 h/d). Both the ASD and ADHD groups had greater in-room video game access and greater problematic video game use than the TD group. Multivariate models showed that inattentive symptoms predicted problematic game use for both the ASD and ADHD groups; and preferences for role-playing games predicted problematic game use in the ASD group only. Boys with ASD spend much more time playing video games than do boys with TD, and boys with ASD and ADHD are at greater risk for problematic video game use than are boys with TD. Inattentive symptoms, in particular, were strongly associated with problematic video game use for both groups, and role-playing game preferences may be an additional risk factor for problematic video game use among children with ASD. These findings suggest a need for longitudinal research to better understand predictors and outcomes of video game use in children with ASD and ADHD.

Attention deficit hyperactivity disorder and personality characteristics in older adults in the general Dutch population.

PubMed

Michielsen, Marieke; Comijs, Hannie C; Semeijn, Evert J; Beekman, Aartjan T F; Deeg, Dorly J H; Kooij, J J Sandra

2014-12-01

The authors wanted to examine the association between attention deficit hyperactivity disorder (ADHD) and personality characteristics and the potential mediating role of these characteristics in the relationship between ADHD and depression in older adults in the general Dutch population. Data from the Longitudinal Aging Study Amsterdam in 2008/2009 were used in a cross-sectional design on 231 participants with and without ADHD aged 60-94 years. Questionnaires assessing self-esteem, self-efficacy, mastery, neuroticism, and social inadequacy were administered. ADHD was measured by means of ADHD diagnosis and level of ADHD symptoms. Linear regression analyses were performed to assess the association between ADHD (symptoms) and personality characteristics. Single and multivariate mediation analyses were performed to examine the mediating role of personality characteristics in the relationship between ADHD (symptoms) and depressive symptoms. ADHD was significantly negatively associated with sense of mastery (B = -2.44, t = -3.14, df = 228, p = 0.002), self-esteem (B = -1.16, t = -2.27, df = 228, p = 0.02), and self-efficacy (B = -2.33, t = -2.02, df = 228, p = 0.045) and positively associated with neuroticism (B = 0.99, t = 4.90, df = 228, p <0.001) and social inadequacy (B = 0.65, t = 3.32, df = 229, p = 0.001). In the single mediation analyses, all personality characteristics were mediators in the relationship between ADHD symptoms and depressive symptoms. In the multivariate analysis only mastery and self-esteem were mediators. Older adults with ADHD reported lower self-esteem and sense of mastery and higher levels of neuroticism and social inadequacy than older adults without ADHD. Mastery and self-esteem partly explained the association between ADHD and depressive symptoms in old age. The results implicate that in treatment clinicians should pay attention to the personality characteristics of older adults with ADHD. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Temperament, Executive Control, and ADHD across Early Development

PubMed Central

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

2015-01-01

Research examining factors linking early temperament and later ADHD is limited by cross-sectional approaches and having the same informant rate both temperament and psychopathology. We used multi-informant/multi-method longitudinal data to test the hypothesis that negative emotionality during preschool is positively associated with ADHD symptom severity in middle childhood, but developing executive control mediates this relation. Children (N=161) with and without ADHD were evaluated three times: Parent and teacher temperament ratings and NEPSY Visual Attention at ages 3–4 years; WISC-IV Working Memory Index and NEPSY Response Set at age 6 years; and ADHD symptoms using the Kiddie-SADS at age 7 years. Parent and teacher ratings of preschoolers’ temperament were combined to form an Anger/Frustration composite. Similarly, an Executive Functioning composite was derived from age 6 measures. Bootstrapping was used to determine whether age 6 Executive Functioning mediated the relation between early Anger/Frustration and later ADHD symptom severity, while controlling for early executive functioning. Preschoolers’ Anger/Frustration was significantly associated with later ADHD symptoms, with this relation partially mediated by age 6 Executive Functioning. Developing executive control mediates the relation between early Anger/Frustration and later ADHD symptom severity, suggesting that Anger/Frustration influences ADHD symptom severity through its impact on developing executive control. Early interventions targeting the harmful influences of negative emotionality or enhancing executive functioning may diminish later ADHD severity. PMID:26854505

Emotion Regulation Mediates the Association Between ADHD and Depressive Symptoms in a Community Sample of Youth

PubMed Central

Seymour, Karen E.; Chronis-Tuscano, Andrea; Iwamoto, Derek K.; Kurdziel, Gretchen; MacPherson, Laura

2014-01-01

The purpose of this study was to examine the longitudinal relationship between attention-deficit/ hyperactivity disorder (ADHD) symptoms, emotion regulation (ER) ability, and depressive symptoms within a diverse community sample of 277 youth, ages 9–12 (56 % male). Participants were drawn from a larger study examining adolescent risk behaviors, and completed annual assessments over 3 years. Youth ADHD symptoms were assessed at Time 1 (T1) using the parent-reported Disruptive Behavior Disorders Rating Scale, ER was assessed with the parent-reported Emotion Regulation Checklist at Time 2 (T2), and youth depressive symptoms were assessed using the self-reported Revised Child Anxiety and Depression Scales at Time 3 (T3). Analyses examined T2 ER as a mediator between T1 ADHD symptoms (including the unique contributions of inattentive [IA] versus hyperactive/impulsive [HI] symptoms) and T3 depressive symptoms. Structural equation modeling (SEM) indicated the path model specified provided an excellent fit to the data. Tests of indirect effects suggested that T2 ER appears to be a significant mechanism that underlies the relationship between T1 ADHD and T3 depression, even when accounting for T1 oppositional defiant and depressive symptoms. Furthermore, while both T1 IA and HI symptoms had significant indirect effects on T3 depression through the mechanism T2 ER, HI proved a more robust predictor of T2 ER than IA. Results of this prospective study support cross-sectional findings pointing to ER as a potential mechanism linking ADHD and depressive symptoms in youth. Clinical implications and future directions are discussed. PMID:24221724

Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes.

PubMed

Willcutt, Erik G; Nigg, Joel T; Pennington, Bruce F; Solanto, Mary V; Rohde, Luis A; Tannock, Rosemary; Loo, Sandra K; Carlson, Caryn L; McBurnett, Keith; Lahey, Benjamin B

2012-11-01

Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for attention deficit/hyperactivity disorder (ADHD) specify two dimensions of inattention and hyperactivity-impulsivity symptoms that are used to define three nominal subtypes: predominantly hyperactive-impulsive type (ADHD-H), predominantly inattentive type (ADHD-I), and combined type (ADHD-C). To aid decision making for DSM-5 and other future diagnostic systems, a comprehensive literature review and meta-analysis of 546 studies was completed to evaluate the validity of the DSM-IV model of ADHD. Results indicated that DSM-IV criteria identify individuals with significant and persistent impairment in social, academic, occupational, and adaptive functioning when intelligence, demographic factors, and concurrent psychopathology are controlled. Available data overwhelmingly support the concurrent, predictive, and discriminant validity of the distinction between inattention and hyperactivity-impulsivity symptoms, and indicate that nearly all differences among the nominal subtypes are consistent with the relative levels of inattention and hyperactivity-impulsivity symptoms that define the subtypes. In contrast, the DSM-IV subtype model is compromised by weak evidence for the validity of ADHD-H after first grade, minimal support for the distinction between ADHD-I and ADHD-C in studies of etiological influences, academic and cognitive functioning, and treatment response, and the marked longitudinal instability of all three subtypes. Overall, we conclude that the DSM-IV ADHD subtypes provide a convenient clinical shorthand to describe the functional and behavioral correlates of current levels of inattention and hyperactivity-impulsivity symptoms, but do not identify discrete subgroups with sufficient long-term stability to justify the classification of distinct forms of the disorder. Empirical support is stronger for an alternative model that would replace the subtypes with dimensional modifiers that reflect the number of inattention and hyperactivity-impulsivity symptoms at the time of assessment. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Childhood conduct problems and young adult outcomes among women with childhood attention-deficit/hyperactivity disorder (ADHD).

PubMed

Owens, Elizabeth B; Hinshaw, Stephen P

2016-02-01

We tested whether conduct problems predicted young adult functioning and psychiatric symptoms among women diagnosed with attention-deficit/hyperactivity disorder (ADHD) during childhood, in the context of 3 potential adolescent mediators: internalizing problems, peer rejection, and school failure and disciplinary problems. We controlled for childhood ADHD severity, IQ, and demographic factors, and in the mediational tests, for adolescent conduct problems. Data came from 140 participants in the Berkeley Girls With ADHD Longitudinal Study. We used bootstrapping methods to assess indirect effects (mediators). Both childhood, F(1, 118) change = 9.00, p = .003, R2 change = .069, and adolescent, F(1, 109) change = 10.41, p = .002, R2 change = .083, conduct problems were associated with worse overall functioning during young adulthood, controlling for initial ADHD severity, child IQ, and demographics. Results were similar when predicting psychiatric symptoms. Adolescent school failure and disciplinary problems mediated the relations between childhood conduct problems and both young adult functioning and externalizing problems; adolescent internalizing problems and peer conflict mediated the relation between childhood conduct problems and young adult internalizing problems. As is true for boys, childhood and adolescent conduct problems are associated with poor adult outcomes among girls with ADHD, with school failure and disciplinary problems, internalizing problems, and peer conflict functioning as mediators of these relations. (c) 2016 APA, all rights reserved).

Attention-Deficit/Hyperactivity Disorder and Sluggish Cognitive Tempo throughout Childhood: Temporal Invariance and Stability from Preschool through Ninth Grade

ERIC Educational Resources Information Center

Leopold, Daniel R.; Christopher, Micaela E.; Burns, G. Leonard; Becker, Stephen P.; Olson, Richard K.; Willcutt, Erik G.

2016-01-01

Background: Although multiple cross-sectional studies have shown symptoms of sluggish cognitive tempo (SCT) and attention-deficit/hyperactivity disorder (ADHD) to be statistically distinct, studies have yet to examine the temporal stability and measurement invariance of SCT in a longitudinal sample. To date, only six studies have assessed SCT…

[Parent-child agreement in the health related quality of life (HRQOL) of children with attention-deficit/hyperactivity disorder (ADHD): a longitudinal study].

PubMed

Rajmil, L; Estrada, M D; Herdman, M; Serra-Sutton, V; Tebé, C; Izaguirre, J; Alda, J A; Alonso, J; Riley, A W; Forrest, C B; Starfield, B

2009-06-01

To assess parent-child agreement on changes over a short-term period of time in the HRQOL of children treated for ADHD over a short period of time, and to compare child and parent ratings of children with ADHD with general population norms. Prospective study in children 6-12 years old with ADHD. Children and parents completed the Spanish versions of the Child Health and Illness Profile-Child Edition (CHIP-CE) before and after 8 weeks of treatment. CHIP-PE scores at both visits were compared using paired t tests and effect sizes (ES), intra-class correlation coefficients (ICC), and scatter plots. Child and parent ratings were compared with CHIP-CE scores for a general population sample. Thirty-one children and parents were included in the analysis. The highest change between the first and the follow-up visit was on the Risk Avoidance domain both children and parents (effect size [ES]=0.24 and 0.40, respectively). The ICC ranged from 0.44 (Satisfaction) to 0.01 (Risk avoidance). Child self-ratings were close to general population values. All domains of the parent version presented standardized means below the reference values at the baseline visit and closer to the general population norm after treatment. This study found poor parent-child agreement and suggests that both ratings should be collected in future studies on the impact of ADHD and treatment effectiveness.

Exploratory analysis of diffusion tensor imaging in children with attention deficit hyperactivity disorder: evidence of abnormal white matter structure.

PubMed

Pastura, Giuseppe; Doering, Thomas; Gasparetto, Emerson Leandro; Mattos, Paulo; Araújo, Alexandra Prüfer

2016-06-01

Abnormalities in the white matter microstructure of the attentional system have been implicated in the aetiology of attention deficit hyperactivity disorder (ADHD). Diffusion tensor imaging (DTI) is a promising magnetic resonance imaging (MRI) technology that has increasingly been used in studies of white matter microstructure in the brain. The main objective of this work was to perform an exploratory analysis of white matter tracts in a sample of children with ADHD versus typically developing children (TDC). For this purpose, 13 drug-naive children with ADHD of both genders underwent MRI using DTI acquisition methodology and tract-based spatial statistics. The results were compared to those of a sample of 14 age- and gender-matched TDC. Lower fractional anisotropy was observed in the splenium of the corpus callosum, right superior longitudinal fasciculus, bilateral retrolenticular part of the internal capsule, bilateral inferior fronto-occipital fasciculus, left external capsule and posterior thalamic radiation (including right optic radiation). We conclude that white matter tracts in attentional and motor control systems exhibited signs of abnormal microstructure in this sample of drug-naive children with ADHD.

Disorganized attachment and inhibitory capacity: predicting externalizing problem behaviors.

PubMed

Bohlin, Gunilla; Eninger, Lilianne; Brocki, Karin Cecilia; Thorell, Lisa B

2012-04-01

The aim of the present study was to investigate whether attachment insecurity, focusing on disorganized attachment, and the executive function (EF) component of inhibition, assessed at age 5, were longitudinally related to general externalizing problem behaviors as well as to specific symptoms of ADHD and Autism spectrum disorder (ASD), and callous-unemotional (CU) traits. General externalizing problem behaviors were also measured at age 5 to allow for a developmental analysis. Outcome variables were rated by parents and teachers. The sample consisted of 65 children with an oversampling of children with high levels of externalizing behaviors. Attachment was evaluated using a story stem attachment doll play procedure. Inhibition was measured using four different tasks. The results showed that both disorganized attachment and poor inhibition were longitudinally related to all outcome variables. Controlling for initial level of externalizing problem behavior, poor inhibition predicted ADHD symptoms and externalizing problem behaviors, independent of disorganized attachment, whereas for ASD symptoms no predictive relations remained. Disorganized attachment independently predicted CU traits.

Additive effect of congenital heart disease and early developmental disorders on attention-deficit/hyperactivity disorder and autism spectrum disorder: a nationwide population-based longitudinal study.

PubMed

Tsao, Pei-Chen; Lee, Yu-Sheng; Jeng, Mei-Jy; Hsu, Ju-Wei; Huang, Kai-Lin; Tsai, Shih-Jen; Chen, Mu-Hong; Soong, Wen-Jue; Kou, Yu Ru

2017-11-01

In this retrospective nationwide population-based case-control study, we investigated the impact of congenital heart disease (CHD) on the development of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), which remains unclear. Children aged <18 years that were diagnosed with CHD (n = 3552) between January 1, 1997 and December 31, 2009 were identified from the National Health Insurance Research Database in Taiwan. Non-CHD controls (n = 14,208) matched for age and sex (1:4) were selected from the same dataset. All subjects were observed until December 31, 2011 or their death. Comorbid perinatal conditions and early developmental disorders (EDD) that were diagnosed before ADHD and ASD diagnosis were also analyzed. The incidence rates of perinatal comorbidities, EDD, ADHD, and ASD were higher in the CHD group than in the control group. Multivariate Cox regression analysis revealed that the CHD group had an increased risk of developing ADHD (adjusted hazard ratio [aHR] 2.52, 95% confidence interval CI 1.96-3.25) and ASD (aHR 1.97, 95% CI 1.11-3.52) after adjusting for confounding comorbidities. EDD, but not perinatal comorbidities were also independent risk factors for ADHD and ASD after adjustment. Subgroup analysis indicated that the risk for ADHD (HR 16.59, 95% CI 12.17-22.60) and ASD (HR 80.68, 95% CI 39.96-176.12) was greatly increased in CHD subjects with EDD than in non-CHD subjects without EDD. These findings suggested that CHD at birth and EDD during early childhood were two independent risk factors for ADHD and ASD and that concurrent CHD and EDD might additively increase these risks.

Predictive Validity of a Continuous Alternative to Nominal Subtypes of Attention-Deficit Hyperactivity Disorder for DSM-V

PubMed Central

Lahey, Benjamin B.; Willcutt, Erik G.

2010-01-01

Three subtypes of attention-deficit/hyperactivity disorder (ADHD) based on numbers of symptoms of inattention (I) and hyperactivity-impulsivity (HI) were defined in DSM-IV to reduce heterogeneity of the disorder, but the subtypes proved to be highly unstable over time. A continuous alternative to nominal subtyping is evaluated in a longitudinal study of 129 4–6 year old children with ADHD and 130 comparison children. Children who met criteria for all subtypes in year 1 continued to exhibit greater functional impairment than comparison children during years 2–9. Among children with ADHD in year 1, I and HI symptoms differentially predicted teacher-rated need for treatment and reading and mathematics achievement scores over the next 8 years in controlled analyses. Consistent with other studies, these findings suggest that the use of diagnostic modifiers specifying the numbers of I and HI symptoms could reduce heterogeneity and facilitate clinical intervention, prognosis, and research. PMID:21058124

Predictive validity of a continuous alternative to nominal subtypes of attention-deficit/hyperactivity disorder for DSM-V.

PubMed

Lahey, Benjamin B; Willcutt, Erik G

2010-01-01

Three subtypes of attention-deficit/hyperactivity disorder (ADHD) based on numbers of symptoms of inattention (I) and hyperactivity-impulsivity (HI) were defined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) to reduce heterogeneity of the disorder, but the subtypes proved to be highly unstable over time. A continuous alternative to nominal subtyping is evaluated in a longitudinal study of 129 four- to six-year-old children with ADHD and 130 comparison children. Children who met criteria for all subtypes in Year 1 continued to exhibit greater functional impairment than comparison children during Years 2 to 9. Among children with ADHD in Year 1, I and HI symptoms differentially predicted teacher-rated need for treatment and reading and mathematics achievement scores over the next 8 years in controlled analyses. Consistent with other studies, these findings suggest that the use of diagnostic modifiers specifying the numbers of I and HI symptoms could reduce heterogeneity and facilitate clinical intervention, prognosis, and research.

Attention-Deficit/Hyperactivity Disorder among Children with and without Intellectual Disability: An Examination across Time

ERIC Educational Resources Information Center

Neece, C. L.; Baker, B. L.; Blacher, J.; Crnic, K. A.

2011-01-01

Background: Children with intellectual and developmental disabilities are at heightened risk for mental disorders, and disruptive behaviour disorders appear to be the most prevalent. The current study is a longitudinal examination of attention-deficit/hyperactivity disorder (ADHD) among children with and without intellectual disability (ID) across…

Academic and Social Functioning Associated with Attention-Deficit/Hyperactivity Disorder: Latent Class Analyses of Trajectories from Kindergarten to Fifth Grade.

PubMed

DuPaul, George J; Morgan, Paul L; Farkas, George; Hillemeier, Marianne M; Maczuga, Steve

2016-10-01

Children with attention-deficit/hyperactivity disorder (ADHD) are known to exhibit significantly lower academic and social functioning than other children. Yet the field currently lacks knowledge about specific impairment trajectories experienced by children with ADHD, which may constrain early screening and intervention effectiveness. Data were analyzed from a nationally representative U.S. cohort in the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K) for 590 children (72.7 % male) whose parents reported a formal diagnosis of ADHD. Children's math, reading, and interpersonal skills were assessed at 5 time points between kindergarten and fifth grade. Growth mixture model analyses indicated 4 latent trajectory classes for reading, 8 classes for math, and 4 classes for interpersonal skills. Membership in reading and math trajectory classes was strongly related; overlaps with interpersonal skills classes were weaker. Trajectory class membership was correlated with demographic characteristics and behavioral functioning. Children with ADHD display substantial heterogeneity in their reading, math, and interpersonal growth trajectories, with some groups of children especially likely to display relatively severe levels of academic and social impairment over time. Early screening and intervention to address impairment, particularly reading difficulties, among kindergarten students with ADHD is warranted.

Overlapping neurobehavioral circuits in ADHD, obesity, and binge eating: Evidence from Neuroimaging Research

PubMed Central

Seymour, Karen E.; Reinblatt, Shauna P.; Benson, Leora; Carnell, Susan

2015-01-01

Attention-deficit/hyperactivity disorder (ADHD) and conditions involving excessive eating (e.g. obesity, binge / loss of control eating) are increasingly prevalent within pediatric populations, and correlational and some longitudinal studies have suggested inter-relationships between these disorders. In addition, a number of common neural correlates are emerging across conditions, e.g. functional abnormalities within circuits subserving reward processing and executive functioning. To explore this potential cross-condition overlap in neurobehavioral underpinnings, we selectively review relevant functional neuroimaging literature, specifically focusing on studies probing i) reward processing, ii) response inhibition, and iii) emotional processing and regulation, and outline three specific shared neurobehavioral circuits. Based on our review, we also identify gaps within the literature that would benefit from further research. PMID:26098969

Adolescent ADHD and adult physical and mental health, work performance, and financial stress.

PubMed

Brook, Judith S; Brook, David W; Zhang, Chenshu; Seltzer, Nathan; Finch, Stephen J

2013-01-01

There is a scarcity of longitudinal studies of adolescents with attention-deficit/hyperactivity disorder (ADHD) followed until adulthood. We studied the relationship between ADHD in adolescence and impaired general physical health, impaired general mental health, antisocial personality disorder, impaired work performance, and high financial stress in adulthood. A prospective design incorporated 6 assessments of participants spanning mean ages from 14 to 37 years. Two baseline assessments were taken between ages 14 and 16 years, and 5 outcome assessments were taken at mean age 37 years. Participants were assessed with structured interviews and questionnaires. The participants were from a community sample of individuals initially drawn in 1975 and followed to a mean age of 37 years in 2009. The adjusted odds ratios and 95% confidence intervals (CIs) for ADHD in adolescence as related to internal stress in adulthood were 1.82 (95% CI = 1.01-3.25; P < .05) for impaired general physical health, 2.36 (95% CI = 1.23-4.51; P < .01) for impaired general mental health, and 3.28 (95% CI = 1.51-7.13; P < .01) for antisocial personality disorder. The adjusted odds ratios and 95% CIs for ADHD in adolescence as related to external stress were 2.46 (95% CI = 1.37-4.43; P < .01) for impaired work performance and 3.33 (95% CI = 1.70-6.55; P < .001) for high financial stress. Clinicians should focus on early diagnosis and treatment of adolescent ADHD because it is a major predictor of an array of physical, mental, work, and financial problems in adulthood.

Childhood ADHD and addictive behaviours in adolescence: a canadian sample.

PubMed

Ostojic, Dragana; Charach, Alice; Henderson, Joanna; McAuley, Tara; Crosbie, Jennifer

2014-05-01

To compare rates of early addictive behaviours in a clinic sample of youth with childhood attention-deficit/hyperactivity disorder (ADHD) with those in community populations. We surveyed 142 adolescents (14.1 ± 1.14 years), diagnosed with ADHD before age 12, about early substance use and problem gambling using questions from two cross-sectional population studies: the Canadian National Longitudinal Survey of Children and Youth, Ontario subsample, (N=1,317; 10-15 years) and the Ontario Student Drug Use and Health Survey (N=9,288; 12-18 years). The ADHD sample reported using cigarettes, 17.8% (95% CI 12.1-25.5), alcohol, 27.1% (20.1-35.5), cannabis, 14.2% (8.9-21.7), at a similar or lower rate than the NLSCY (cigarettes, 28.3% (25.8-30.9), alcohol, 28.6% (26.0-31.3), cannabis, 16.5% (14.0-19.4), and OSDUHS samples (cigarettes, 21.9% (20.2-23.7), alcohol, 58.6% (56.0-61.2), cannabis, 26.0% (23.9-28.2). With regards to gambling, there is a non-significant trend for ADHD youth to report gambling more frequently than the provincial average, 7.9% (3.3-17.9) vs. 4.3% (2.9-6.3). Our findings support the emerging literature that youth diagnosed with ADHD in childhood may not be at greater risk for onset of substance use in early adolescence. The study identified two areas that warrant further investigation in this population; the possible increased risk for substance use among females and a trend toward early onset of gambling behaviours.

XKR4 Gene Effects on Cerebellar Development Are Not Specific to ADHD

PubMed Central

Shook, Devon; Brouwer, Rachel; de Zeeuw, Patrick; Oranje, Bob; Durston, Sarah

2017-01-01

A single-nucleotide polymorphism (SNP) of the XKR4 gene has been linked to Attention-Deficit/Hyperactivity Disorder (ADHD). This gene is preferentially expressed in cerebellum, a brain structure implicated in this disorder. This study investigated the effects of this SNP on cerebellar development in children with and without ADHD. We collected 279 longitudinal T1-weighted structural images and DNA from 58 children with ADHD and 64 typically developing (TD) children matched for age, IQ, and gender. Groups were divided by the XKR4 rs2939678 SNP into A-allele carriers versus subjects homozygous for the G-allele. Cerebellar lobular volumes were segmented into 35 regions of interest using MAGeTBrain, an automated multi-atlas segmentation pipeline for anatomical MRI, and statistically analyzed using linear mixed models. We found decreased gray matter (GM) volumes in ADHD compared to TD children in bilateral lobules VIIIA, left VIIIB, right VIIB, and vermis VI. Furthermore, we found a linear age by gene interaction in left lobule VIIB where subjects homozygous for the G-allele showed a decrease in volume over time compared to A-allele carriers. We further found quadratic age × gene and age × diagnosis interactions in left lobule IV. Subjects homozygous for the G-allele (the genotype overtransmitted in ADHD) showed more suppressed, almost flat quadratic growth curves compared to A-allele carriers, similar to individuals with ADHD compared to controls. However, there was no interaction between genotype and diagnosis, suggesting that any effects of this SNP on cerebellar development are not specific to the disorder. PMID:29311829

XKR4 Gene Effects on Cerebellar Development Are Not Specific to ADHD.

PubMed

Shook, Devon; Brouwer, Rachel; de Zeeuw, Patrick; Oranje, Bob; Durston, Sarah

2017-01-01

A single-nucleotide polymorphism (SNP) of the XKR4 gene has been linked to Attention-Deficit/Hyperactivity Disorder (ADHD). This gene is preferentially expressed in cerebellum, a brain structure implicated in this disorder. This study investigated the effects of this SNP on cerebellar development in children with and without ADHD. We collected 279 longitudinal T1-weighted structural images and DNA from 58 children with ADHD and 64 typically developing (TD) children matched for age, IQ, and gender. Groups were divided by the XKR4 rs2939678 SNP into A-allele carriers versus subjects homozygous for the G-allele. Cerebellar lobular volumes were segmented into 35 regions of interest using MAGeTBrain, an automated multi-atlas segmentation pipeline for anatomical MRI, and statistically analyzed using linear mixed models. We found decreased gray matter (GM) volumes in ADHD compared to TD children in bilateral lobules VIIIA, left VIIIB, right VIIB, and vermis VI. Furthermore, we found a linear age by gene interaction in left lobule VIIB where subjects homozygous for the G-allele showed a decrease in volume over time compared to A-allele carriers. We further found quadratic age × gene and age × diagnosis interactions in left lobule IV. Subjects homozygous for the G-allele (the genotype overtransmitted in ADHD) showed more suppressed, almost flat quadratic growth curves compared to A-allele carriers, similar to individuals with ADHD compared to controls. However, there was no interaction between genotype and diagnosis, suggesting that any effects of this SNP on cerebellar development are not specific to the disorder.

Subcortical brain volume differences of participants with ADHD across the lifespan: an ENIGMA collaboration

PubMed Central

Hoogman, Martine; Bralten, Janita; Hibar, Derrek P.; Mennes, Maarten; Zwiers, Marcel P.; Schweren, Lizanne; van Hulzen, Kimm J.E.; Medland, Sarah E.; Shumskaya, Elena; Jahanshad, Neda; de Zeeuw, Patrick; Szekely, Eszter; Sudre, Gustavo; Wolfers, Thomas; Onnink, Alberdingk M.H.; Dammers, Janneke T.; Mostert, Jeanette C.; Vives-Gilabert, Yolanda; Kohls, Gregor; Oberwelland, Eileen; Seitz, Jochen; Schulte-Rüther, Martin; di Bruttopilo, Sara Ambrosino; Doyle, Alysa E.; Høvik, Marie F.; Dramsdahl, Margaretha; Tamm, Leanne; van Erp, Theo G.M.; Dale, Anders; Schork, Andrew; Conzelmann, Annette; Zierhut, Kathrin; Baur, Ramona; McCarthy, Hazel; Yoncheva, Yuliya N.; Cubillo, Ana; Chantiluke, Kaylita; Mehta, Mitul A.; Paloyelis, Yannis; Hohmann, Sarah; Baumeister, Sarah; Bramati, Ivanei; Mattos, Paulo; Tovar-Moll, Fernanda; Douglas, Pamela; Banaschewski, Tobias; Brandeis, Daniel; Kuntsi, Jonna; Asherson, Phil; Rubia, Katya; Kelly, Clare; Di Martino, Adriana; Milham, Michael P.; Castellanos, Francisco X.; Frodl, Thomas; Zentis, Mariam; Lesch, Klaus-Peter; Reif, Andreas; Pauli, Paul; Jernigan, Terry; Haavik, Jan; Plessen, Kerstin J.; Lundervold, Astri J.; Hugdahl, Kenneth; Seidman, Larry J.; Biederman, Joseph; Rommelse, Nanda; Heslenfeld, Dirk J.; Hartman, Catharina; Hoekstra, Pieter J.; Oosterlaan, Jaap; von Polier, Georg; Konrad, Kerstin; Vilarroya, Oscar; Ramos-Quiroga, Josep-Antoni; Soliva, Joan Carles; Durston, Sarah; Buitelaar, Jan K.; Faraone, Stephen V.; Shaw, Philip; Thompson, Paul; Franke, Barbara

2017-01-01

BACKGROUND Neuroimaging studies show structural alterations in several brain regions in children and adults with attention-deficit/hyperactivity disorder (ADHD). Through the formation of the worldwide ENIGMA ADHD Working Group, we addressed weaknesses of prior imaging studies and meta-analyses in sample size and methodological heterogeneity. METHODS Our sample comprised 1713 participants with ADHD and 1529 controls from 23 sites (age range: 4–63 years; 66% males). Individual sites analyzed magnetic resonance imaging brain scans with harmonized protocols. Case-control differences in subcortical structures and intracranial volume (ICV) were assessed through mega-and meta-analysis. FINDINGS The volumes of the accumbens (Cohen’s d=−0.15), amygdala (d=−0.19), caudate (d=−0.11), hippocampus (d=−0.11), putamen (d=−0.14), and ICV (d=−0.10) were found to be smaller in cases relative to controls. Effect sizes were highest in children, case-control differences were not present in adults. Explorative lifespan modeling suggested a delay of maturation and a delay of degeneration. Psychostimulant medication use or presence of comorbid psychiatric disorders did not influence results, nor did symptom scores correlate with brain volume. INTERPRETATION Using the largest data set to date, we extend the brain maturation delay theory for ADHD to include subcortical structures and refute medication effects on brain volume suggested by earlier meta-analyses. We add new knowledge about bilateral amygdala, accumbens, and hippocampus reductions in ADHD, and provide unprecedented precision in effect size estimates. Lifespan analyses suggest that, in the absence of well-powered longitudinal studies, the ENIGMA cross-sectional sample across six decades of life provides a means to generate hypotheses about lifespan trajectories in brain phenotypes. FUNDING National Institutes of Health PMID:28219628

Maternal breastfeeding and attention-deficit/hyperactivity disorder in children: a meta-analysis.

PubMed

Tseng, Ping-Tao; Yen, Cheng-Fang; Chen, Yen-Wen; Stubbs, Brendon; Carvalho, Andre F; Whiteley, Paul; Chu, Che-Sheng; Li, Dian-Jeng; Chen, Tien-Yu; Yang, Wei-Cheng; Tang, Chia-Hung; Liang, Hsin-Yi; Yang, Wei-Chieh; Wu, Ching-Kuan; Lin, Pao-Yen

2018-06-15

Previous studies have suggested environmental factors may contribute to the risk of attention-deficit/hyperactivity disorder (ADHD). The current meta-analysis examined (1) the difference in the duration of maternal breastfeeding between children with and without ADHD, and (2) the association between maternal breastfeeding and ADHD in children. The data of individual studies were synthesized with a random-effects model. Eleven articles were included in this meta-analysis. Children with ADHD had significantly less breastfeeding duration than controls (Hedges' g = - 0.36, 95% confidence intervals (CIs) = - 0.61 to - 0.11, p = 0.005; difference in means: - 2.44 months, 95% CIs = - 3.17 to - 1.71, p < 0.001). In addition, the rates of non-exclusive breastfeeding in children with ADHD is significantly higher in "under 3 months" (odds ratio (OR) = 1.90, 95% CIs = 1.45 to 2.48, p < 0.001) but lower in "6 to 12 months" (OR = 0.69, 95% CIs = 0.49 to 0.98, p = 0.039) and "over 12 months" (OR = 0.58, 95% CIs = 0.35 to 0.97, p = 0.038) than controls. Children with ADHD received significantly higher rate of exclusive breastfeeding duration "under 3 months" (OR = 1.51, 95% CIs = 1.20 to 1.89, p < 0.001) but lower in "over 3 months" (OR = 0.52, 95% CIs = 0.29 to 0.95, p = 0.033) than controls. Furthermore, an association was found between non-breastfeeding and ADHD children (adjusted OR = 3.71, 95% CI = 1.94 to 7.11, p < 0.001). Our results suggest maternal breastfeeding is associated with a lower risk of ADHD in children. Future longitudinal research is required to confirm/refute these findings and to explore possible mechanisms underlying this association.

Longitudinal Impact of a Randomized Clinical Trial to Improve Family Function, Reduce Maternal Stress and Improve Child Outcomes in Families of Children with ADHD.

PubMed

Churchill, Shervin S; Leo, Michael C; Brennan, Eileen M; Sellmaier, Claudia; Kendall, Judy; Houck, Gail M

2018-02-23

Objective Evaluate the efficacy of a 12 month nursing case-management intervention over a period of 18 months, 6 months after the end of intervention, for families of children attention deficit hyperactivity disorder (ADHD). Methods Mother and child dyads were enrolled to participate in a randomized controlled clinical trial. Children were 4-18 years old. Data were collected at baseline, 6, 12, and 18 months or 6 months after the termination of direct intervention. Longitudinal analyses, using generalized estimating equations, were conducted to assess change in study outcomes relating to family function, maternal stress, and child behavior over the 18 month period. Results Compared to control families, some family function outcomes were moderately improved in the intervention group. In particular, intervention families demonstrated substantial improvement in implementing family behavior controls (p value = 0.038) and improvement in family satisfaction (not statistically significant p = 0.062). Although there was improvement in the overall family function measure there was not a statistically significant difference between groups. Maternal stress and child behavior outcomes were not significantly different between control and intervention groups by the end of the intervention. Conclusions for Practice Addressing ADHD is complex and requires the assessment of comorbidities that might exacerbate negative behavior. Our findings support the latest American Academy of Pediatrics guidelines to use behavioral therapy as the first line of treatment in young children. Nursing case-management interventions that provide direct family education and improve family function, especially with respect to providing structure and behavior control, may complement and facilitate behavioral therapy for treatment of ADHD and improving child behavior.

Thalamo-cortical activation and connectivity during response preparation in adults with persistent and remitted ADHD.

PubMed

Clerkin, Suzanne M; Schulz, Kurt P; Berwid, Olga G; Fan, Jin; Newcorn, Jeffrey H; Tang, Cheuk Y; Halperin, Jeffrey M

2013-09-01

The neural correlates of stimulus-driven processes, such as response preparation, have been posited to be associated with the onset of attention deficit hyperactivity disorder (ADHD) while being distinct from the neural mechanisms associated with recovery. The authors tested this hypothesis in adults with remitted and persistent ADHD. Thirty-eight young adults who were diagnosed with combined-type ADHD in childhood (probands) and 32 carefully matched comparison subjects were followed longitudinally and scanned with functional MRI while performing an event-related cued reaction time task. Probands were characterized as individuals with persistent or remitted ADHD. Differences in thalamo-cortical activation and functional connectivity during response preparation between comparison subjects and probands and between individuals with persistent ADHD and those with remitted ADHD were assessed by contrasting neural activation and functional connectivity during cue or noncue events. Probands exhibited less cue-related activation than comparison subjects in the thalamus, anterior cingulate cortex, supplementary motor area, inferior parietal lobe, and dorsolateral prefrontal cortex despite similar overall patterns of activation. There were no differences in activation between individuals in the remitted ADHD group and those in the persistent ADHD group in any hypothesized regions. However, cue-related functional connectivity between the right thalamus and brainstem was greater in comparison subjects relative to probands, and cue-related connectivity was greater between the right thalamus and prefrontal regions in individuals with remitted ADHD relative to those with persistent ADHD. Decreased thalamo-cortical activation during response preparation was present in adults diagnosed with ADHD in childhood regardless of symptom remission in adulthood, and may be partly driven by less functional coordination between the brainstem and thalamus. Greater functional integration of the thalamo-cortical network might parallel symptom recovery.

Attention problems in very preterm children from childhood to adulthood: the Bavarian Longitudinal Study.

PubMed

Breeman, Linda D; Jaekel, Julia; Baumann, Nicole; Bartmann, Peter; Wolke, Dieter

2016-02-01

Very preterm (VP; gestational age <32 weeks) and very low birth weight (VLBW; <1500 grams) is related to attention problems in childhood and adulthood. The stability of these problems into adulthood is not known. The Bavarian Longitudinal Study is a prospective cohort study that followed 260 VP/VLBW and 229 term-born individuals from birth to adulthood. Data on attention were collected at 6, 8, and 26 years of age, using parent reports, expert behavior observations, and clinical ADHD diagnoses. At each assessment, VP/VLBW individuals had significantly more attention problems, shorter attention span, and were more frequently diagnosed with ADHD than term-born comparisons. In both VP/VLBW and term-born individuals, overall, attention span increased and attention problems decreased from childhood to adulthood. Attention problems and attention span were more stable over time for VP/VLBW than term-born individuals. Similarly, ADHD diagnoses showed moderate stability from childhood to adulthood in VP/VLBW, but not in term-born individuals. However, when those with severe disabilities were excluded, differences between VP/VLBW and term-born individuals reduced. Despite improvement in attention regulation from childhood to adulthood, children born very preterm remained at increased risk for attention problems in adulthood. In contrast, term-born children with clinical attention problems outgrew these by adulthood. As inattentive behavior of VP/VLBW children may be overlooked by teachers, it may be necessary to raise awareness for school intervention programs that reduce attention problems in VP/VLBW children. © 2015 Association for Child and Adolescent Mental Health.

The Link between Peer Relations, Prosocial Behavior, and ODD/ADHD Symptoms in 7-9-Year-Old Children.

PubMed

Paap, Muirne C S; Haraldsen, Ira R; Breivik, Kyrre; Butcher, Phillipa R; Hellem, Frøydis M; Stormark, Kjell M

2013-01-01

Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms that hinder successful positive interaction with peers. The main goal of this study was to examine if the presence of symptoms of ODD and ADHD affects the relationship between positive social behavior and peer status found in 7-9-year-old children who show symptoms typical of ADHD and/or ODD. Furthermore, the possible interaction with sex was investigated. We used data collected in the first wave of The Bergen Child Study of mental health (BCS), a prospective longitudinal total population study of children's developmental and mental health. The target population consisted of children in the second to the fourth, in all public, private, and special schools in Bergen, Norway, in the fall of 2002 (N = 9430). All 79 primary schools in Bergen participated in the study. Both teacher (8809 complete cases) and parent (6253 complete cases) report were used in the analyses. ADHD and ODD scores were estimated using the Swanson Noland and Pelham rating scale version IV (SNAP-IV), and peer problems and prosocial behavior were assessed using the Strengths and Difficulties Questionnaire (SDQ). We replicated the relationship between peer problems and prosocial behavior found previously in typically developing children. Our results showed that the relationship between peer problems and prosocial behavior became weaker as the ODD symptoms increased in number and severity. For ADHD this effect was only found in the teacher report of the children. A sex effect for ODD symptoms was found only using the parent report: boys with ODD symptoms showed less prosocial behavior than girls with similar levels of ODD symptoms. Since this effect was not found using the teacher data, it may imply a situational effect (school/home) for girls with high levels of ODD. The moderator effect of ODD/ADHD was comparable for boys and girls. Our findings suggest that even if children with ADHD/ODD symptoms have the opportunity to practice their social skills in peer relationships, this is not necessarily accompanied by an increase in prosocial behavior.

The Link between Peer Relations, Prosocial Behavior, and ODD/ADHD Symptoms in 7–9-Year-Old Children

PubMed Central

Paap, Muirne C. S.; Haraldsen, Ira R.; Breivik, Kyrre; Butcher, Phillipa R.; Hellem, Frøydis M.; Stormark, Kjell M.

2013-01-01

Oppositional defiant disorder (ODD) and attention-deficit/hyperactivity disorder (ADHD) are characterized by symptoms that hinder successful positive interaction with peers. The main goal of this study was to examine if the presence of symptoms of ODD and ADHD affects the relationship between positive social behavior and peer status found in 7–9-year-old children who show symptoms typical of ADHD and/or ODD. Furthermore, the possible interaction with sex was investigated. We used data collected in the first wave of The Bergen Child Study of mental health (BCS), a prospective longitudinal total population study of children's developmental and mental health. The target population consisted of children in the second to the fourth, in all public, private, and special schools in Bergen, Norway, in the fall of 2002 (N = 9430). All 79 primary schools in Bergen participated in the study. Both teacher (8809 complete cases) and parent (6253 complete cases) report were used in the analyses. ADHD and ODD scores were estimated using the Swanson Noland and Pelham rating scale version IV (SNAP-IV), and peer problems and prosocial behavior were assessed using the Strengths and Difficulties Questionnaire (SDQ). We replicated the relationship between peer problems and prosocial behavior found previously in typically developing children. Our results showed that the relationship between peer problems and prosocial behavior became weaker as the ODD symptoms increased in number and severity. For ADHD this effect was only found in the teacher report of the children. A sex effect for ODD symptoms was found only using the parent report: boys with ODD symptoms showed less prosocial behavior than girls with similar levels of ODD symptoms. Since this effect was not found using the teacher data, it may imply a situational effect (school/home) for girls with high levels of ODD. The moderator effect of ODD/ADHD was comparable for boys and girls. Our findings suggest that even if children with ADHD/ODD symptoms have the opportunity to practice their social skills in peer relationships, this is not necessarily accompanied by an increase in prosocial behavior. PMID:24286065

Influence of Mental Health and Substance Use Problems and Criminogenic Risk on Outcomes in Serious Juvenile Offenders

ERIC Educational Resources Information Center

Schubert, Carol A.; Mulvey, Edward P.; Glasheen, Cristie

2011-01-01

Objective: To investigate the relations among certain mental health problems (MHPs; affective, anxiety, attention-deficit/hyperactivity disorder [ADHD], and substance use disorders), criminogenic risk, and outcomes in a sample of serious adolescent offenders. Method: Using data from a longitudinal study of serious adolescent offenders (N = 949;…

75 FR 6205 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-08

... longitudinal follow-up program is to study the long-term outcomes and health status for children with ADHD... Relationships. Child Health Risk Behavior Survey 37 1 15/60 (Middle School) 11-13 years. Child Health Risk Behavior Survey 153 1 25/60 (High School) 14+ years. Child MARSH--Self Description 15 1 5/60 Questionnaire...

Attention Problems and Attention-Deficit/Hyperactivity Disorder in Discordant and Concordant Monozygotic Twins: Evidence of Environmental Mediators

ERIC Educational Resources Information Center

Lehn, Hanne; Derks, Eske M.; Hudziak, James J.; Heutink, Peter; van Beijsterveldt, Toos; Boomsma, Dorret I.

2007-01-01

Objective: To study familial and nonfamilial environmental influences on attention problems and attention-deficit/hyperactivity disorder (ADHD) in monozygotic twins discordant and concordant-high and low for these traits. Method: Ninety-five twin pairs from The Netherlands Twin Register were selected. Longitudinal survey data were collected at 1,…

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

PubMed Central

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

2014-01-01

Background Attention-Deficit/Hiperactivity Disorder (ADHD) is a prevalent disorder, but its neuroanatomical circuitry is still relatively understudied, especially in the adult population. The few morphometric magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) studies available to date have found heterogeneous results. This may be at least partly attributable to some well-known technical limitations of the conventional voxel-based methods usually employed to analyze such neuroimaging data. Moreover, there is a great paucity of imaging studies of adult ADHD to date that have excluded patients with history of use of stimulant medication. Methods A newly validated method named optimally-discriminative voxel-based analysis (ODVBA) was applied to multimodal (structural and DTI) MRI data acquired from 22 treatment-naïve ADHD adults and 19 age- and gender-matched healthy controls (HC). Results Regarding DTI data, we found higher fractional anisotropy in ADHD relative to HC encompassing the white matter (WM) of the bilateral superior frontal gyrus, right middle frontal left gyrus, left postcentral gyrus, bilateral cingulate gyrus, bilateral middle temporal gyrus and right superior temporal gyrus; reductions in trace (a measure of diffusivity) in ADHD relative to HC were also found in fronto-striatal-parieto-occipital circuits, including the right superior frontal gyrus and bilateral middle frontal gyrus, right precentral gyrus, left middle occipital gyrus and bilateral cingulate gyrus, as well as the left body and right splenium of the corpus callosum, right superior corona radiata, and right superior longitudinal and fronto-occipital fasciculi. Volumetric abnormalities in ADHD subjects were found only at a trend level of significance, including reduced gray matter (GM) in the right angular gyrus, and increased GM in the right supplementary motor area and superior frontal gyrus. Conclusions Our results suggest that adult ADHD is associated with neuroanatomical abnormalities mainly affecting the WM microstructure in fronto-parieto-temporal circuits that have been implicated in cognitive, emotional and visuomotor processes. PMID:25310815

Parenting Stress and Youth Symptoms among Girls with and without ADHD

PubMed Central

Gordon, Chanelle T.; Hinshaw, Stephen P.

2017-01-01

SYNOPSIS Objective To examine the aspects of parenting stress—parental distress [PD] and parental stress due to dysfunctional interactions [PSDI]—reported by mothers of girls with attention-deficit/hyperactivity disorder (ADHD) in both childhood and adolescence and to understand their associations with internalizing and externalizing symptoms in adolescence. Design The diverse sample comprised 120 girls with ADHD and 81 age- and ethnicity-matched comparison girls, evaluated at ages 6–12 years and followed prospectively for 5 years. Basic demographics, oppositionality, childhood behavioral outcomes and symptoms, and key parenting practice were covaried in the analyses. Results Longitudinally, PD during the participants’ childhood was positively associated with adolescent externalizing and internalizing behaviors, even when statistically controlling for parallel childhood behaviors. PSDI during adolescence was associated with contemporaneous adolescent depressive symptoms and externalizing behaviors, but PD was associated with only internalizing behaviors. With respect to moderation by diagnostic group, PSDI (in childhood) was associated with adolescent internalizing symptoms only in girls with ADHD. However, associations between PD in childhood and internalizing behaviors were stronger in the comparison than the ADHD sample. Conclusions Minimizing early dysfunctional interactions might reduce internalizing behaviors in girls with ADHD. Interventions targeting parental distress may be beneficial for girls, regardless of ADHD status. PMID:29308056

Bullying Mediates Between Attention-Deficit/Hyperactivity Disorder in Childhood and Psychotic Experiences in Early Adolescence.

PubMed

Hennig, Timo; Jaya, Edo S; Lincoln, Tania M

2017-09-01

Although a childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) is known to be linked to psychotic experiences and psychotic disorders in later life, the developmental trajectories that could explain this association are unknown. Using a sample from the prospective population-based Avon Longitudinal Study of Parents and Children (ALSPAC) (N = 8247), we hypothesized that the previously reported association of ADHD combined subtype in childhood and psychotic experiences in early adolescence is mediated by traumatic events and by involvement in bullying. Moreover, we expected this mediation to be specific to ADHD and tested this by comparison with specific phobia. Children with ADHD combined subtype at age 7 were more often involved in bullying at age 10 (OR 3.635, 95% CI 1.973-6.697) and had more psychotic experiences at age 12 (OR 3.362, 95% CI 1.781-6.348). Moreover, children who were involved in bullying had more psychotic experiences (2.005, 95% CI 1.684-2.388). Bullying was a significant mediator between ADHD and psychotic experiences accounting for 41%-50% of the effect. Traumatic events from birth to age 11 were also significantly associated with ADHD combined subtype and psychotic experiences; however, there was no evidence of mediation. Specific phobia was significantly associated with psychotic experiences, but not with bullying. To conclude, bullying is a relevant translating mechanism from ADHD in childhood to psychotic experiences in early adolescence. Interventions that eliminate bullying in children with ADHD could potentially reduce the risk of having psychotic experiences in later life by up to 50%. Clinicians should thus screen for bullying in routine assessments of children with ADHD. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Parenting Style Influences Bullying: A Longitudinal Study Comparing Children with and without Behavioral Problems

ERIC Educational Resources Information Center

Rajendran, Khushmand; Kruszewski, Edyta; Halperin, Jeffrey M.

2016-01-01

Background: More optimal parenting has been linked with lower rates of bullying. However, it is not clear whether parenting can alter the trajectories of bullying among children diagnosed with ADHD or ODD as well as those who are not so diagnosed. This study examined whether parenting at age 4-5 years was associated with changes in bullying over…

Editorial: The continuing contributions of multimodal treatment of attention over nearly two decades to initial attention-deficit hyperactivity disorder pharmacotherapy and long-term clinical course.

PubMed

Bloch, Michael H

2017-06-01

The initial results of the Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) trial had profound effects on the way that Attention-Deficit Hyperactivity Disorder (ADHD) is managed clinically. Children from the original MTA cohort as well as a control group have been followed longitudinally for well over a decade and are beginning to provide important data regarding the long-term clinical course, treatment and consequences of ADHD into adulthood. Two articles in this issue of JCPP highlight important contributions from the MTA cohort. Swanson et al. highlights the potential long-term effects of stimulants on height whereas Sibley et al. highlights the importance of using multiple informants in assessing adulthood ADHD symptoms similar to children and suggest that current DSM criteria for ADHD may be overly stringent. © 2017 Association for Child and Adolescent Mental Health.

Relationships between child-reported activity level and task orientation and parental attention-deficit/hyperactivity disorder symptom ratings.

PubMed

Bell, Lindsay; Kellison, Ida; Garvan, Cynthia W; Bussing, Regina

2010-04-01

This study examines whether elementary school-aged children can report behaviors relevant to assessing symptoms of attention-deficit/hyperactivity disorder (ADHD). Interviews were conducted with 120 children aged 6 to 12 years and their parents across 3 waves as part of a longitudinal cohort study of ADHD detection and service use. Child self-reports obtained through the Dimensions of Temperament Scale-Revised-Child (DOTS-R-C) were correlated with parent-reported ADHD symptoms, which were assessed through DSM-IV-based instrument ratings obtained concurrently and 5 years later. The Dimensions of Temperament Scale-Revised-Child subscales Activity Level and Task Orientation demonstrate adequate internal consistency after eliminating items requiring reverse scoring. Children's self-reports of Task Orientation Problems correlate with their parents' concurrent reports of inattention, r(117) = .23, p < .05, and with parents' Wave 3 reports of inattention, r(118) = .25, p < .01 as well as hyperactivity, r(118) = .25, p < .01. Children's self-reports of Activity Level correlate with their parents' concurrent reports of hyperactivity, r(117) = .21, p < .05, as well as Wave 3 reports of hyperactivity/impulsivity, r(118) = .37, p < .001 and inattention, r(118) = .23, p < .05. Findings suggest that children may be capable of producing meaningful self-reports of Activity Level and Task Orientation. We propose that the development of child-friendly self-report instruments targeting ADHD symptoms is merited to facilitate the collection of child input during ADHD assessments.

The effects of childhood ADHD on adult labor market outcomes.

PubMed

Fletcher, Jason M

2014-02-01

Although several types of mental illness, including substance abuse disorders, have been linked with poor labor market outcomes, no current research has been able to examine the effects of childhood attention deficit/hyperactivity disorder (ADHD). Because ADHD has become one of the most prevalent childhood mental conditions, it is useful to understand the full set of consequences of the illness. This article uses a longitudinal national sample, including sibling pairs, to show the important labor market outcome consequences of ADHD. The employment reduction is between 10 and 14 percentage points, the earnings reduction is approximately 33%, and the increase in social assistance is 15 points, figures that are larger than many estimates of the Black people/White people earnings gap and the gender earnings gap. A small share of the link is explained by educational attainments and co-morbid health conditions and behaviors. The results also show important differences in labor market consequences by family background and age of onset. These findings, along with similar research showing that ADHD is linked with poor education outcomes and adult crime, suggest the importance of treating childhood ADHD to foster human capital. Copyright © 2013 John Wiley & Sons, Ltd.

Smoking During Adolescence as a Risk Factor for Attention Problems.

PubMed

Treur, Jorien L; Willemsen, Gonneke; Bartels, Meike; Geels, Lot M; van Beek, Jenny H D A; Huppertz, Charlotte; van Beijsterveldt, Catharina E M; Boomsma, Dorret I; Vink, Jacqueline M

2015-11-01

Cigarette smoking and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid. One explanation is that individuals with ADHD use cigarettes as "self-medication" to alleviate their attention problems. However, animal studies reported that exposure to nicotine during adolescence influences the developing brain and negatively affects attention. This is the first human study exploring the effects of smoking during adolescence on attention problems. Longitudinal data on smoking and attention problems were available for 1987 adult and 648 adolescent monozygotic twin pairs from the Netherlands Twin Register. Twin pairs were classified as concordant/discordant for smoking and compared on attention problems. Within adult discordant pairs, the difference in attention problems between the smoking and never-smoking twins was first assessed cross-sectionally. In longitudinal analyses, the increase in attention problems from adolescence, when neither twin smoked, to adulthood was compared within discordant pairs. In subgroups with longitudinal data from childhood and adolescence, changes in smoking concordance and subsequent changes in attention problems were explored. Adult twins who ever smoked reported significantly more attention problems than their never-smoking co-twin. Longitudinal analyses showed a larger increase in attention problems from adolescence to adulthood in smoking twins than their never-smoking co-twin (p < .05). In childhood and adolescence, smoking twins had more attention problems than their never-smoking co-twin, whereas scores were similar before smoking was initiated or after both twins started smoking (not significant in all groups). Results from this genetically informative study suggest smoking during adolescence leads to higher attention problem scores, lasting into adulthood. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

A structural MRI study in monozygotic twins concordant or discordant for attention/hyperactivity problems: Evidence for genetic and environmental heterogeneity in the developing brain

PubMed Central

van ’t Ent, D.; Lehn, H.; Derks, E.M.; Hudziak, J.J.; Van Strien, N.M.; Veltman, D.J.; De Geus, E.J.C.; Todd, R.D.; Boomsma, D.I.

2007-01-01

Several structural brain abnormalities have been reported in patients with Attention Deficit Hyperactivity Disorder (ADHD). However, the aetiology of these brain changes is still unclear. To investigate genetic and environmental influences on ADHD related neurobiological changes we performed Voxel Based Morphometry on MRI scans from monozygotic (MZ) twins selected from a large longitudinal population database to be highly concordant or highly discordant for ratings on the Child Behavior Checklist Attention Problem scale (CBCL-AP). Children scoring low on the CBCL-AP are at low risk for ADHD, whereas children scoring high on this scale are at high risk for ADHD. Brain differences between concordant high risk twin pairs and concordant low risk twin pairs likely reflect the genetic risk for ADHD; brain differences between the low risk and high risk twins from discordant MZ twin pairs reflect the environmental risk for ADHD. A major difference between comparisons of high and low risk twins from concordant pairs and high/low twins from discordant pairs was found for the prefrontal lobes. The concordant high risk pairs showed volume loss in orbitofrontal subdivisions. High risk members from the discordant twin pairs exhibited volume reduction in the right inferior dorsolateral prefontal cortex. In addition, the posterior corpus callosum was compromised in concordant high risk pairs, only. Our findings indicate that inattention and hyperactivity symptoms are associated with anatomical abnormalities of a distributed action-attentional network. Different brain areas of this network appear to be affected in inattention/hyperactivity caused by genetic (i.e., high concordant MZ pairs) versus environmental (i.e., high-low discordant MZ pairs) risk factors. These results provide clues that further our understanding of brain alterations in ADHD. PMID:17346990

Stability of executive function deficits into young adult years: a prospective longitudinal follow-up study of grown up males with ADHD.

PubMed

Biederman, J; Petty, C R; Fried, R; Doyle, A E; Spencer, T; Seidman, L J; Gross, L; Poetzl, K; Faraone, S V

2007-08-01

Although individuals with attention deficit-hyperactivity disorder (ADHD) commonly exhibit deficits in executive functions that greatly increase the morbidity of the disorder, all available information on the subject is cross sectional. Males (n = 85) 9-22 years with ADHD followed over 7 years into young adulthood were assessed on measures of sustained attention/vigilance, planning and organization, response inhibition, set shifting and categorization, selective attention and visual scanning, verbal and visual learning, and memory. A binary definition of executive function deficits (EFDs) was defined based on a subject manifesting at least two abnormal tests 1.5 standard deviations from controls. The majority of subjects maintained EFDs over time (kappa: 0.41, P < 0.001; sensitivity: 55%, specificity: 85%, positive predictive value: 69%, and negative predictive value: 75%). Considering the morbidity of EFDs, these findings stress the importance of their early recognition for prevention and early intervention strategies. EFDs are stable over time.

Association between family environment and attention deficit hyperactivity disorder in children--mothers' and teachers' views.

PubMed

Pires, Thiago de Oliveira; da Silva, Cosme Marcelo Furtado Passos; de Assis, Simone Gonçalves

2013-08-27

To ascertain whether factors of the family environment and gestational period are associated with the appearance of ADHD in children, as reported by various different informants (mothers and teachers). This paper presents results from the dataset of a longitudinal study to evaluate behavioral problems among schoolchildren in São Gonçalo, Rio de Janeiro State, in 2005 and 2006. The cross-section considered for this paper comprises records of exposure factors and ADHD. In all, 370 schoolchildren of the public school system were assessed by 3-stage cluster sampling. The Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) were used to measure outcomes. The exposure factors examined were: profile of child and mother, variables relating to the family environment, and perinatal considerations. The questions were answered by mothers and teachers. A hierarchical logistic regression model was used. Precariously functioning families, lack of social support for mothers, adverse life events and discord during pregnancy were the factors associated with mother-reported ADHD. When ADHD was reported by teachers, the variables selected were: Intelligence quotient (IQ) and sex, with children with low IQ scores and boys more likely to display the disorder. Assessment of ADHD by teachers or mothers reveals specific characteristics that reflect how each of these informants understands the children. This highlights the importance of using informants from different environments in diagnosing the disorder.

The social play, social skills and parent-child relationships of children with ADHD 12 months following a RCT of a play-based intervention.

PubMed

Barnes, Gabrielle; Wilkes-Gillan, Sarah; Bundy, Anita; Cordier, Reinie

2017-12-01

There is an urgent need to investigate the long-term impact of social skill interventions for children with attention deficit hyperactivity disorder (ADHD). Interventions targeting the social skills of children with ADHD have limited short-term effectiveness and rarely investigate the long-term impact. Furthermore, these interventions are most frequently conducted in the clinic setting, without including the child's natural settings and interactants, such as their regular playmates and parents. The present study investigated the social play, social skills and parent-child relationships of children with ADHD and their playmates (n = 13/group) aged 5-13 years. A two-group before and after design with a longitudinal component was applied. Participant data compared over two time points, immediately following a randomised, controlled trial (RCT) of a play-based intervention and 12 months post-RCT. From immediately following the RCT to the 12-month follow-up, children with ADHD maintained social play skill gains in the home environment. Playmates maintained social play skill gains across the home and clinic environments. Children scored within a developmentally appropriate range, falling within 1 standard deviation of the mean for social skills and most parent-child relationship scales using norm-based assessments. Results support the long-term effectiveness of the intervention. © 2017 Occupational Therapy Australia.

The Stability of Self-Reported Anxiety in Youth with Autism versus ADHD or Typical Development

ERIC Educational Resources Information Center

Schiltz, Hillary; McIntyre, Nancy; Swain-Lerro, Lindsay; Zajic, Matthew; Mundy, Peter

2017-01-01

Children with autism spectrum disorder (ASD) are at risk for anxiety symptoms. Few anxiety measures are validated for individuals with ASD, and the nature of ASD raises questions about reliability of self-reported anxiety. This study examined longitudinal stability and change of self-reported anxiety in higher functioning youth with ASD (HFASD)…

Three-year latent class trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms in a clinical sample not selected for ADHD.

PubMed

Arnold, L Eugene; Ganocy, Stephen J; Mount, Katherine; Youngstrom, Eric A; Frazier, Thomas; Fristad, Mary; Horwitz, Sarah M; Birmaher, Boris; Findling, Robert; Kowatch, Robert A; Demeter, Christine; Axelson, David; Gill, Mary Kay; Marsh, Linda

2014-07-01

This study aims to examine trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms in the Longitudinal Assessment of Manic Symptoms (LAMS) sample. The LAMS study assessed 684 children aged 6 to 12 years with the Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and rating scales semi-annually for 3 years. Although they were selected for elevated manic symptoms, 526 children had baseline ADHD diagnoses. With growth mixture modeling (GMM), we separately analyzed inattentive and hyperactive/impulsive symptoms, covarying baseline age. Multiple standard methods determined optimal fit. The χ(2) and Kruskal-Wallis analysis of variance compared resulting latent classes/trajectories on clinical characteristics and medication. Three latent class trajectories best described inattentive symptoms, and 4 classes best described hyperactive/impulsive symptoms. Inattentive trajectories maintained their relative position over time. Hyperactive/impulsive symptoms had 2 consistent trajectories (least and most severe). A third trajectory (4.5%) started mild, then escalated; and a fourth (14%) started severe but improved dramatically. The improving trajectory was associated with the highest rate of ADHD and lowest rate of bipolar diagnoses. Three-fourths of the mildest inattention class were also in the mildest hyperactive/impulsive class; 72% of the severest inattentive class were in the severest hyperactive/impulsive class, but the severest inattention class also included 62% of the improving hyperactive-impulsive class. An ADHD rather than bipolar diagnosis prognosticates a better course of hyperactive/impulsive, but not inattentive, symptoms. High overlap of relative severity between inattention and hyperactivity/impulsivity confirms the link between these symptom clusters. Hyperactive/impulsive symptoms wane more over time. Group means are insufficient to understand individual ADHD prognosis. A small subgroup deteriorates over time in hyperactivity/impulsivity and needs better treatments than currently provided. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Pathways from Birth Weight to ADHD Symptoms through Fluid Reasoning in Youth with or without Intellectual Disability.

PubMed

Morgan, Julia E; Lee, Steve S; Loo, Sandra K; Yuhan, Joshua W; Baker, Bruce L

2018-05-01

Although individual differences in fluid reasoning reliably mediate predictions of attention-deficit/hyperactivity disorder (ADHD) symptoms from birth weight in youth with typical cognitive development (TD), it is unknown if this indirect effect operates similarly in the development of ADHD symptoms secondary to intellectual disability (ID). Thus, we evaluated mediation by fluid reasoning in a longitudinal sample of 163 youth (45% female) with (n = 52) or without (n = 111) ID who were followed prospectively from age 5 to age 13. At age 9, youth completed the Arithmetic subtest of the Wechsler Intelligence Scale for Children, a measure of fluid reasoning. At ages 9 and 13, mothers and teachers separately rated youth ADHD symptoms and mothers completed a diagnostic interview. Mediation was tested via path analysis with bootstrapped confidence intervals, and moderated mediation estimated whether indirect effects differed between ID and TD youth or based on youth IQ. Controlling for demographic factors and age 9 ADHD symptoms, age 9 Arithmetic mediated birth weight and multi-method/informant age 13 ADHD symptoms, such that birth weight positively predicted Arithmetic, which negatively predicted ADHD symptoms. Neither ID status nor IQ moderated the observed indirect effect through Arithmetic, suggesting that it was similar for ID and TD youth as well as across the range of youth IQs. These findings support previous evidence that fluid reasoning, as measured by Arithmetic, may causally mediate birth weight and ADHD symptoms, and suggest that this pathway operates similarly with respect to the development of ADHD symptoms in youth with ID.

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

PubMed

Hinshaw, Stephen P; Arnold, L Eugene

2015-01-01

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

Effect of nutritional supplements on attentional-deficit hyperactivity disorder.

PubMed

Dykman, K D; Dykman, R A

1998-01-01

This study reports the effects of two nutritional products upon the severity of symptoms in children with confirmed diagnoses of Attention-Deficit Hyperactivity Disorder (ADHD): a glyconutritional product containing saccharides known to be important in healthy functioning and a phytonutritional product containing flash-dried fruits and vegetables. Seventeen ADHD children were recruited from a local parent support group. Parents of five of the subjects did not have their children on methylphenidate. Of the remaining twelve, all on methylphenidate, six were left on prescribed doses (random assignment). The other six had their doses reduced by half after two weeks (study duration was six weeks). The subjects were assessed initially and three subsequent times over a period of six weeks (longitudinal nonrandomized design). The behavior disorder items for ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) as listed in the Diagnostic and Statistical Manual for Mental Disorders (DSM IV) (American Psychiatric Association, 1994) were rated by teachers and parents on a 3-point scale. Also included was a Side Effects Scale described by Barkley (1990). The children received the glyconutritional supplement for the entire six weeks. After three weeks, the phytonutritional supplement was added to the diet to increase the probability of positive results. The glyconutritional supplement decreased the number and severity of ADHD, associated ODD and CD symptoms, and side effects in all groups during the first two weeks of the study. There was little further reduction with the addition of the phytonutritional supplement. The three study groups did not differ statistically in degree of reduction over observations. Present results suggest that symptoms of ADHD may be reduced by the addition to the diet of saccharides used by the body in glycoconjugate synthesis.

Decreased Regional Cortical Thickness and Thinning Rate Are Associated with Inattention Symptoms in Healthy Children

PubMed Central

Ducharme, Simon; Hudziak, James J.; Botteron, Kelly N.; Albaugh, Matthew D.; Nguyen, Tuong-Vi; Karama, Sherif; Evans, Alan C.

2011-01-01

Objective Children with attention-deficit/hyperactivity disorder (ADHD) have delayed cortical maturation, evidenced by regionally specific slower cortical thinning. However, the relationship between cortical maturation and attention capacities in typically developing children is unknown. This study examines cortical thickness correlates of inattention symptoms in a large sample of healthy children. Method Data from 357 healthy subjects (6.0–18.4 years of age) were obtained from the NIH MRI Study of Normal Brain Development. In cross-sectional analysis (first visit, n = 257), Child Behavior Checklist Attention Problems (AP) scores were linearly regressed against cortical thickness, controlling for age, gender, total brain volume, and site. For longitudinal data (up to three visits, n = 357/672 scans), similar analyses were performed using mixed-effects linear regressions. Interactions of AP with age and gender were tested. Results A cross-sectional “AP by age” interaction was found in bilateral orbito-frontal cortex, right inferior frontal cortex, bilateral ventromedial prefrontal cortex, bilateral dorsolateral prefrontal cortex, and several additional attention network regions. The interaction was due to negative associations between AP and thickness in younger subjects (6–10 years of age) that gradually disappeared over time secondary to slower cortical thinning. Similar trends were present in longitudinal analyses. Conclusions Higher AP scores were associated with thinner cortex at baseline and slower cortical thinning with aging in multiple areas involved in attention processes. Similar patterns have been identified in ADHD, suggesting a dimensional component to the link between attention and cortical maturation. The identified association between cortical maturation and attention in healthy development will help to inform studies of neuroimaging biomarkers of ADHD. PMID:22176936

Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in School-Aged Children, Adolescents, and Young Adults With Autism via a Digital Smartglasses-Based Socioemotional Coaching Aid: Short-Term, Uncontrolled Pilot Study

PubMed Central

Vahabzadeh, Arshya; Keshav, Neha U; Salisbury, Joseph P

2018-01-01

Background People with autism spectrum disorder (ASD) commonly experience symptoms related to attention-deficit/hyperactivity disorder (ADHD), including hyperactivity, inattention, and impulsivity. One-third of ASD cases may be complicated by the presence of ADHD. Individuals with dual diagnoses face greater barriers to accessing treatment for ADHD and respond less positively to primary pharmacologic interventions. Nonpharmacologic technology-aided tools for hyperactivity and inattention in people with ASD are being developed, although research into their efficacy and safety remains limited. Objective The objective of this preliminary study was to describe the changes in ADHD-related symptoms in children, adolescents, and young adults with ASD immediately after use of the Empowered Brain system, a behavioral and social communication aid for ASD running on augmented reality smartglasses. Methods We recruited 8 children, adolescents, and young adults with ASD (male to female ratio of 7:1, mean age 15 years, range 11.7-20.5 years) through a Web-based research signup form. The baseline score on the hyperactivity subscale of the Aberrant Behavioral Checklist (ABC-H), a measure of hyperactivity, inattention, and impulsivity, determined their classification into a high ADHD-related symptom group (n=4, ABC-H≥13) and a low ADHD-related symptom group (n=4, ABC-H<13). All participants received an intervention with Empowered Brain, where they used smartglasses-based social communication and behavioral modules while interacting with their caregiver. We then calculated caregiver-reported ABC-H scores at 24 and 48 hours after the session. Results All 8 participants were able to complete the intervention session. Postintervention ABC-H scores were lower for most participants at 24 hours (n=6, 75%) and for all participants at 48 hours (n=8, 100%). At 24 hours after the session, average participant ABC-H scores decreased by 54.9% in the high ADHD symptom group and by 20% in the low ADHD symptom group. At 48 hours after the session, ABC-H scores compared with baseline decreased by 56.4% in the high ADHD symptom group and by 66.3% in the low ADHD symptom group. Conclusions This study provides initial evidence for the possible potential of the Empowered Brain system to reduce ADHD-related symptoms, such as hyperactivity, inattention, and impulsivity, in school-aged children, adolescents, and young adults with ASD. This digital smartglasses intervention can potentially be targeted at a broader array of mental health conditions that exhibit transdiagnostic attentional and social communication deficits, including schizophrenia and bipolar disorder. Further research is required to understand the clinical importance of these observed changes and to conduct longitudinal studies on this intervention with control groups and larger sample sizes. PMID:29610109

The effect of prenatal methamphetamine exposure on attention as assessed by continuous performance tests: results from the Infant Development, Environment, and Lifestyle study.

PubMed

Kiblawi, Zeina N; Smith, Lynne M; LaGasse, Linda L; Derauf, Chris; Newman, Elana; Shah, Rizwan; Arria, Amelia; Huestis, Marilyn; DellaGrotta, Sheri; Dansereau, Lynne M; Neal, Charles; Lester, Barry

2013-01-01

To assess for the increased risk of attention-deficit hyperactivity disorder (ADHD) in young children with prenatal methamphetamine exposure from the multicenter, longitudinal Infant Development, Environment, and Lifestyle (IDEAL) study. The IDEAL study enrolled 412 mother-infant pairs at 4 sites (Tulsa, OK; Des Moines, IA; Los Angeles, CA; and Honolulu, HI). Methamphetamine-exposed subjects (n = 204) were identified by self-report and/or gas chromatography/mass spectrometry confirmation of amphetamine and metabolites in infant meconium. Matched subjects (n = 208) denied methamphetamine use and had a negative meconium screen. This analysis included a subsample of 301 subjects who were administered the Conners' Kiddie Continuous Performance Test (K-CPT) at 5.5 years of age (153 exposed and 148 comparison). Hierarchical linear models adjusted for covariates tested exposure effects on K-CPT measures. Using the same covariates, logistic regression was used to determine the effect of exposure on the incidence of a positive ADHD confidence index score, defined as greater than 50%. There were no differences between the groups in omission or commission errors or reaction time for correct trials. However, methamphetamine exposure was associated with subtle differences in other outcomes predictive of ADHD, including increased slope of reaction time across blocks (p < .001), increased variability in reaction time with longer interstimulus intervals (p < .01), and increased likelihood of greater than 50% on the ADHD confidence index (odds ratio, 3.1; 95% confidence interval, 1.2-7.8; p = .02). Prenatal methamphetamine exposure was associated with subtle differences in K-CPT scores at 5.5 years of age. Even at this relatively young age, these children exhibit indicators of risk for ADHD and warrant monitoring.

Developmental Trajectory of Motor Deficits in Preschool Children with ADHD.

PubMed

Sweeney, Kristie L; Ryan, Matthew; Schneider, Heather; Ferenc, Lisa; Denckla, Martha Bridge; Mahone, E Mark

2018-01-01

Motor deficits persisting into childhood (>7 years) are associated with increased executive and cognitive dysfunction, likely due to parallel neural circuitry. This study assessed the longitudinal trajectory of motor deficits in preschool children with ADHD, compared to typically developing (TD) children, in order to identify individuals at risk for anomalous neurological development. Participants included 47 children (21 ADHD, 26 TD) ages 4-7 years who participated in three visits (V1, V2, V3), each one year apart (V1=48-71 months, V2=60-83 months, V3=72-95 months). Motor variables assessed included speed (finger tapping and sequencing), total overflow, and axial movements from the Revised Physical and Neurological Examination for Subtle Signs (PANESS). Effects for group, visit, and group-by-visit interaction were examined. There were significant effects for group (favoring TD) for finger tapping speed and total axial movements, visit (performance improving with age for all 4 variables), and a significant group-by-visit interaction for finger tapping speed. Motor speed (repetitive finger tapping) and quality of axial movements are sensitive markers of anomalous motor development associated with ADHD in children as young as 4 years. Conversely, motor overflow and finger sequencing speed may be less sensitive in preschool, due to ongoing wide variations in attainment of these milestones.

[The neuroanatomy of attention deficit hyperactivity disorder: neuropsychological and clinical correlates].

PubMed

Albert, J; Fernandez-Jaen, A; Martin Fernandez-Mayoralas, D; Lopez-Martin, S; Fernandez-Perrone, A L; Calleja-Perez, B; Jimenez-De la Pena, M; Recio-Rodriguez, M

2016-07-16

The development of structural magnetic resonance scanning and new methods of analysis has made it possible to explore, in a hitherto unknown way, the neuroanatomical bases of attention deficit hyperactivity disorder (ADHD). Yet, little is known about the relation between the clinical symptoms and the neuropsychological dysfunctions characterising ADHD and the neuroanatomical alterations that are observed. To explore the relation between neuroanatomy, clinical features and neuropsychology in ADHD. At group level, there are a number of marked differences between the brain of children, adolescents and adults with ADHD and the brain of subjects with a typical development. These differences are observed cross-sectionally and longitudinally in all the measurements, both in the grey matter and in the white matter. Although still scarce, there is an increasing body of evidence showing that these differences are related with the core symptoms of the disorder and with the degree of clinical dysfunction. They also appear to be associated with cognitive functioning (mainly attention and inhibitory control). The relation among the different levels of analysis in the study of ADHD bring research closer to the clinical features and allows a better understanding and management of the disorder. Although progress is undoubtedly being made in this field, there are still many questions that need exploring in greater depth. There is a need for a better understanding of the association between the neuroanatomical measurements and each dimension of the symptoms, and their relationship with other neuropsychological processes that are also involved in the disorder.

Association between family environment and attention deficit hyperactivity disorder in children – mothers’ and teachers’ views

PubMed Central

2013-01-01

Background To ascertain whether factors of the family environment and gestational period are associated with the appearance of ADHD in children, as reported by various different informants (mothers and teachers). Methods This paper presents results from the dataset of a longitudinal study to evaluate behavioral problems among schoolchildren in São Gonçalo, Rio de Janeiro State, in 2005 and 2006. The cross-section considered for this paper comprises records of exposure factors and ADHD. In all, 370 schoolchildren of the public school system were assessed by 3-stage cluster sampling. The Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) were used to measure outcomes. The exposure factors examined were: profile of child and mother, variables relating to the family environment, and perinatal considerations. The questions were answered by mothers and teachers. A hierarchical logistic regression model was used. Results Precariously functioning families, lack of social support for mothers, adverse life events and discord during pregnancy were the factors associated with mother-reported ADHD. When ADHD was reported by teachers, the variables selected were: Intelligence quotient (IQ) and sex, with children with low IQ scores and boys more likely to display the disorder. Conclusions Assessment of ADHD by teachers or mothers reveals specific characteristics that reflect how each of these informants understands the children. This highlights the importance of using informants from different environments in diagnosing the disorder. PMID:23978164

Attention-Deficit/Hyperactivity Disorder in Offspring of Mothers With Inflammatory and Immune System Diseases.

PubMed

Instanes, Johanne T; Halmøy, Anne; Engeland, Anders; Haavik, Jan; Furu, Kari; Klungsøyr, Kari

2017-03-01

Prenatal inflammatory mechanisms may play a role in the pathogenesis of psychiatric disorders and could be relevant for attention-deficit/hyperactivity disorder (ADHD). We investigated maternal chronic somatic diseases with immune components as possible risk factors for ADHD in offspring. We performed a population-based nested case-control study by linking data from longitudinal Norwegian registers. We included all individuals born during the period 1967-2008 and alive at record linkage (2012). Individuals receiving ADHD medication during the years 2004-2012 were defined as patients with ADHD (N = 47,944), and all remaining individuals (N = 2,274,713) were defined as control subjects. The associations between maternal diseases and ADHD in offspring were analyzed using logistic regression models. The following chronic diseases with immune components were related to ADHD in offspring: multiple sclerosis (adjusted odds ratio [OR] = 1.8; 95% confidence interval [CI] = 1.2-2.5), rheumatoid arthritis (adjusted OR = 1.7; 95% CI = 1.5-1.9), type 1 diabetes (adjusted OR = 1.6; 95% CI = 1.3-2.0), asthma (adjusted OR = 1.5; 95% CI = 1.4-1.6), and hypothyroidism (adjusted OR = 1.2; 95% CI = 1.1-1.4). In contrast, chronic hypertension and type 2 diabetes showed no significant associations. Estimates were almost unchanged with additional adjustment for parental ADHD, infant birth weight, and gestational age. Although point estimates for male and female offspring were different for some diseases (e.g., maternal asthma [adjusted OR = 1.7; 95% CI = 1.5-1.8 for female offspring and adjusted OR = 1.5; 95% CI = 1.4-1.6 for male offspring]), none of the associations differed significantly by offspring sex. Several maternal somatic diseases with immune components were found to increase the risk of ADHD in offspring. The associations could involve several causal pathways, including common genetic predisposition and environmental factors, and increased insight into the mechanisms behind these relationships could enhance our understanding of the etiology of ADHD. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Institutional care and iron deficiency increase ADHD symptomology and lower IQ 2.5-5 years post-adoption.

PubMed

Doom, Jenalee R; Georgieff, Michael K; Gunnar, Megan R

2015-05-01

Increased ADHD symptomology and lower IQ have been reported in internationally adopted (IA) children compared to non-adopted peers (Hostinar, Stellern, Schaefer, Carlson & Gunnar, 2012; Kreppner, O'Connor & Rutter, 2001). However, it is unclear whether these outcomes are due to institutional deprivation specifically or to co-occurring micronutrient deficiencies that disrupt brain development (Fuglestad, Rao & Georgieff, 2008b). In this study, IA children were compared to children raised in their biological families to examine differences in ADHD symptomology and IQ 2.5-5 years post-adoption and to assess the contributions of iron deficiency (ID) and duration of deprivation to these cognitive outcomes. ADHD symptoms (parent- and experimenter-reported) and IQ were evaluated in 88 IA (M = 62.1 months, SD = 2.4) and 35 non-adopted children (M = 61.4 months, SD = 1.6). IA children were assessed 29-64 months post-adoption (M = 41.9 months, SD = 10.2). ID was assessed during the initial post-adoption medical visit in 69 children, and children were classified into four groups by iron status, ranging from normal to ID anemia (most severe). IA children had greater ADHD symptomology, p < .01, and lower IQ, p = .001, than non-adopted children. Within the IA group, children with more severe ID at adoption had greater ADHD symptomology, r(69) = 0.40, p = .001, and lower IQ, r(68) = -0.28, p < .05. Duration of institutional care was positively correlated with ADHD symptoms, r(86) = .28, p < .01, but not IQ, r(85) = -.08, p = .52. Longitudinal results indicate improvement in IQ from 12 months post-adoption to age 5 for children with greater ID severity at adoption and longer duration of institutional care but no improvement in ADHD symptoms. These results signify continuing effects of early deprivation and ID on ADHD symptoms and IQ years after adoption. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=vUFDAS3DD1c. © 2014 John Wiley & Sons Ltd.

Unique Associations between Childhood Temperament Characteristics and Subsequent Psychopathology Symptom Trajectories from Childhood to Early Adolescence.

PubMed

Forbes, Miriam K; Rapee, Ronald M; Camberis, Anna-Lisa; McMahon, Catherine A

2017-08-01

Existing research suggests that temperamental traits that emerge early in childhood may have utility for early detection and intervention for common mental disorders. The present study examined the unique relationships between the temperament characteristics of reactivity, approach-sociability, and persistence in early childhood and subsequent symptom trajectories of psychopathology (depression, anxiety, conduct disorder, and attention-deficit hyperactivity disorder; ADHD) from childhood to early adolescence. Data were from the first five waves of the older cohort from the Longitudinal Study of Australian Children (n = 4983; 51.2% male), which spanned ages 4-5 to 12-13. Multivariate ordinal and logistic regressions examined whether parent-reported child temperament characteristics at age 4-5 predicted the study child's subsequent symptom trajectories for each domain of psychopathology (derived using latent class growth analyses), after controlling for other presenting symptoms. Temperament characteristics differentially predicted the symptom trajectories for depression, anxiety, conduct disorder, and ADHD: Higher levels of reactivity uniquely predicted higher symptom trajectories for all 4 domains; higher levels of approach-sociability predicted higher trajectories of conduct disorder and ADHD, but lower trajectories of anxiety; and higher levels of persistence were related to lower trajectories of conduct disorder and ADHD. These findings suggest that temperament is an early identifiable risk factor for the development of psychopathology, and that identification and timely interventions for children with highly reactive temperaments in particular could prevent later mental health problems.

The discriminative capacity of CBCL/1½-5-DSM5 scales to identify disruptive and internalizing disorders in preschool children.

PubMed

de la Osa, Nuria; Granero, Roser; Trepat, Esther; Domenech, Josep Maria; Ezpeleta, Lourdes

2016-01-01

This paper studies the discriminative capacity of CBCL/1½-5 (Manual for the ASEBA Preschool-Age Forms & Profiles, University of Vermont, Research Center for Children, Youth, & Families, Burlington, 2000) DSM5 scales attention deficit and hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety and depressive problems for detecting the presence of DSM5 (DSM5 diagnostic and statistical manual of mental disorders, APA, Arlington, 2013) disorders, ADHD, ODD, Anxiety and Mood disorders, assessed through diagnostic interview, in children aged 3-5. Additionally, we compare the clinical utility of the CBCL/1½-5-DSM5 scales with respect to analogous CBCL/1½-5 syndrome scales. A large community sample of 616 preschool children was longitudinally assessed for the stated age group. Statistical analysis was based on ROC procedures and binary logistic regressions. ADHD and ODD CBCL/1½-5-DSM5 scales achieved good discriminative ability to identify ADHD and ODD interview's diagnoses, at any age. CBCL/1½-5-DSM5 Anxiety scale discriminative capacity was fair for unspecific anxiety disorders in all age groups. CBCL/1½-5-DSM5 depressive problems' scale showed the poorest discriminative capacity for mood disorders (including depressive episode with insufficient symptoms), oscillating into the poor-to-fair range. As a whole, DSM5-oriented scales generally did not provide evidence better for discriminative capacity than syndrome scales in identifying DSM5 diagnoses. CBCL/1½-5-DSM5 scales discriminate externalizing disorders better than internalizing disorders for ages 3-5. Scores on the ADHD and ODD CBCL/1½-5-DSM5 scales can be used to screen for DSM5 ADHD and ODD disorders in general populations of preschool children.

Which Kindergarten Children are at Greatest Risk for Attention-deficit/Hyperactivity and Conduct Disorder Symptomatology as Adolescents?

PubMed Central

Morgan, Paul L.; Li, Hui; Cook, Michael; Farkas, George; Hillemeier, Marianne M.; Lin, Yu-chu

2015-01-01

Objective We sought to identify which kindergarten children are simultaneously at risk of moderate or severe symptomatology in both attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) as adolescents. These risk factor estimates have not been previously available. Method Multinomial logistic regression analyses of multi-informant ratings by the end of middle school of a population-based, longitudinal sample of children followed from kindergarten to eighth grade (N = 7,456). Results Kindergarten children from low SES households, those raised by mothers with depressive symptoms or experiencing emotional problems or substance abuse, or those who were punished by spanking were significantly more likely to later display severe levels of ADHD-CD symptomatology in eighth grade. Kindergarten children frequently engaging in ADHD-CD-type behaviors were more likely to later experience both moderate (covariate adjusted OR = 2.37) and severe (covariate adjusted OR = 3.63) ADHD-CD symptomatology. Low academic achievement uniquely increased the risk of both moderate and severe symptomatology (adjusted OR range = 1.7 to 2.24). Conclusions The results should guide early screening and school-based intervention efforts for ADHD-CD. Reducing children’s risk for adolescent ADHD-CD symptomatology may require remediating low behavioral and academic functioning by the end of kindergarten. When these two modifiable factors occur together they increase kindergarten children’s odds of experiencing severe ADHD-CD symptomatology in eighth grade by a multiplicative factor of 8.1. PMID:26192391

Profiles of service utilization and the resultant economic impact in preschoolers with attention deficit/hyperactivity disorder.

PubMed

Marks, David J; Mlodnicka, Agnieszka; Bernstein, Melissa; Chacko, Anil; Rose, Scott; Halperin, Jeffrey M

2009-07-01

To examine whether preschool children with Attention deficit/hyperactivity disorder (ADHD) utilize more speech and language therapy (ST), occupational therapy (OT), and physical therapy (PT) services and are more likely to be placed in special education (SPED) classrooms as compared to their peers. Corresponding financial consequences were also examined. The amount of ST, OT, and PT, as well as SPED placements, was examined in 3- and 4-year-old children with and without ADHD (n = 109 and n = 97, respectively) during the baseline portion of an ongoing, 5-year longitudinal study. Costs for individual services and aggregate cost were determined per child and compared across groups. Preschool children with ADHD were more likely to receive individual and multiple services. Higher rates of service utilization translated into increased costs for each individual service with the exception of PT. A comprehensive understanding of service utilization in the early years of development is important in addressing the increased service use in the preschool years and assist in guiding allocation of resources.

The role of the mother-child relationship in the route from child ADHD to adolescent symptoms of depressed mood.

PubMed

Giannotta, Fabrizia; Rydell, Ann-Margret

2017-12-01

We attempt to explain the co-variation between ADHD and symptoms of depressed mood, focusing on the family context and testing whether the mother-child relationship mediates or moderates the link between child ADHD and youth depressed mood symptoms. In a longitudinal study, we used mother and youth reports for 596 Swedish youth, 50% boys, from a community sample at 10, 15, and 18 years of age. The results did not support the mediation hypothesis. Only one moderation effect was found. Mother-child conflicts in mid-adolescence, as rated by mothers, increased symptoms of depressed mood symptoms in late adolescent only for youth with high levels of hyperactivity symptoms. However, depressed mood symptoms at age 18 were predicted by low mother-child involvement in mid-adolescence, over and above the effects of inattention symptoms. This latter finding was consistent across mother and youth ratings of the relationship. Implications of these results are discussed. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Effects of lisdexamfetamine dimesylate treatment for ADHD on growth.

PubMed

Faraone, Stephen V; Spencer, Thomas J; Kollins, Scott H; Glatt, Stephen J

2010-01-01

To complete an exploratory uncontrolled study of the effects of lisdexamfetamine dimesylate (LDX) on growth of children treated for attention-deficit/hyperactivity disorder (ADHD). Height, weight, and body mass index (BMI) from 281 children ages 6 to 13 years from longitudinal assessments up to 15 months were compared to norms from the Centers for Disease Control. At study entry, children were taller and heavier than average. Growth delays were largest for weight and BMI, and there was a 13 percentile point decrease in height. Children continued to grow in terms of height while treated with LDX; we found no increase in raw weight or BMI during the study period. LDX treatment was significantly associated with diminished gains in height, weight, and BMI compared to levels that would be expected based on age-appropriate standards from the Centers for Disease Control. Growth delays were greatest for the heaviest and tallest children, for those who had not previously received stimulant therapy, and for those with a greater cumulative exposure to LDX. More work is needed to determine effects on ultimate adult height. Consistent with prior studies of stimulants, treatment with LDX leads to statistically significant reductions in expected height, weight, and BMI. Growth of patients with ADHD treated with LDX should be closely monitored and corrective action taken should growth delays be observed.

Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in School-Aged Children, Adolescents, and Young Adults With Autism via a Digital Smartglasses-Based Socioemotional Coaching Aid: Short-Term, Uncontrolled Pilot Study.

PubMed

Vahabzadeh, Arshya; Keshav, Neha U; Salisbury, Joseph P; Sahin, Ned T

2018-03-24

People with autism spectrum disorder (ASD) commonly experience symptoms related to attention-deficit/hyperactivity disorder (ADHD), including hyperactivity, inattention, and impulsivity. One-third of ASD cases may be complicated by the presence of ADHD. Individuals with dual diagnoses face greater barriers to accessing treatment for ADHD and respond less positively to primary pharmacologic interventions. Nonpharmacologic technology-aided tools for hyperactivity and inattention in people with ASD are being developed, although research into their efficacy and safety remains limited. The objective of this preliminary study was to describe the changes in ADHD-related symptoms in children, adolescents, and young adults with ASD immediately after use of the Empowered Brain system, a behavioral and social communication aid for ASD running on augmented reality smartglasses. We recruited 8 children, adolescents, and young adults with ASD (male to female ratio of 7:1, mean age 15 years, range 11.7-20.5 years) through a Web-based research signup form. The baseline score on the hyperactivity subscale of the Aberrant Behavioral Checklist (ABC-H), a measure of hyperactivity, inattention, and impulsivity, determined their classification into a high ADHD-related symptom group (n=4, ABC-H≥13) and a low ADHD-related symptom group (n=4, ABC-H<13). All participants received an intervention with Empowered Brain, where they used smartglasses-based social communication and behavioral modules while interacting with their caregiver. We then calculated caregiver-reported ABC-H scores at 24 and 48 hours after the session. All 8 participants were able to complete the intervention session. Postintervention ABC-H scores were lower for most participants at 24 hours (n=6, 75%) and for all participants at 48 hours (n=8, 100%). At 24 hours after the session, average participant ABC-H scores decreased by 54.9% in the high ADHD symptom group and by 20% in the low ADHD symptom group. At 48 hours after the session, ABC-H scores compared with baseline decreased by 56.4% in the high ADHD symptom group and by 66.3% in the low ADHD symptom group. This study provides initial evidence for the possible potential of the Empowered Brain system to reduce ADHD-related symptoms, such as hyperactivity, inattention, and impulsivity, in school-aged children, adolescents, and young adults with ASD. This digital smartglasses intervention can potentially be targeted at a broader array of mental health conditions that exhibit transdiagnostic attentional and social communication deficits, including schizophrenia and bipolar disorder. Further research is required to understand the clinical importance of these observed changes and to conduct longitudinal studies on this intervention with control groups and larger sample sizes. ©Arshya Vahabzadeh, Neha U Keshav, Joseph P Salisbury, Ned T Sahin. Originally published in JMIR Mental Health (http://mental.jmir.org), 24.03.2018.

Electroencephalography as a clinical tool for diagnosing and monitoring attention deficit hyperactivity disorder: a cross-sectional study

PubMed Central

Helgadóttir, Halla; Gudmundsson, Ólafur Ó; Baldursson, Gísli; Magnússon, Páll; Blin, Nicolas; Brynjólfsdóttir, Berglind; Emilsdóttir, Ásdís; Gudmundsdóttir, Gudrún B; Lorange, Málfrídur; Newman, Paula K; Jóhannesson, Gísli H; Johnsen, Kristinn

2015-01-01

Objectives The aim of this study was to develop and test, for the first time, a multivariate diagnostic classifier of attention deficit hyperactivity disorder (ADHD) based on EEG coherence measures and chronological age. Setting The participants were recruited in two specialised centres and three schools in Reykjavik. Participants The data are from a large cross-sectional cohort of 310 patients with ADHD and 351 controls, covering an age range from 5.8 to 14 years. ADHD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) criteria using the K-SADS-PL semistructured interview. Participants in the control group were reported to be free of any mental or developmental disorders by their parents and had a score of less than 1.5 SDs above the age-appropriate norm on the ADHD Rating Scale-IV. Other than moderate or severe intellectual disability, no additional exclusion criteria were applied in order that the cohort reflected the typical cross section of patients with ADHD. Results Diagnostic classifiers were developed using statistical pattern recognition for the entire age range and for specific age ranges and were tested using cross-validation and by application to a separate cohort of recordings not used in the development process. The age-specific classification approach was more accurate (76% accuracy in the independent test cohort; 81% cross-validation accuracy) than the age-independent version (76%; 73%). Chronological age was found to be an important classification feature. Conclusions The novel application of EEG-based classification methods presented here can offer significant benefit to the clinician by improving both the accuracy of initial diagnosis and ongoing monitoring of children and adolescents with ADHD. The most accurate possible diagnosis at a single point in time can be obtained by the age-specific classifiers, but the age-independent classifiers are also useful as they enable longitudinal monitoring of brain function. PMID:25596195

Pragmatic Language Outcomes of Children With Attention Deficit Hyperactivity Disorder After Therapist- and Parent-Delivered Play-Based Interventions: Two One-Group Pretest-Posttest Studies With a Longitudinal Component.

PubMed

Wilkes-Gillan, Sarah; Munro, Natalie; Cordier, Reinie; Cantrill, Alycia; Pearce, Wendy

The pragmatic language outcomes of children with attention deficit hyperactivity disorder (ADHD) were explored across two feasibility studies. Five children with ADHD (ages 6-11 yr), their parents, and 5 typically developing peers completed an assessment 18 mo after a therapist-delivered intervention (Study 1). Participants then completed a parent-delivered intervention (Study 2). Blinded ratings of peer-to-peer play interactions documented changes in children's pragmatic language 18 mo after the Study 1 intervention and before, immediately after, and 1 mo after the Study 2 intervention. Nonparametric statistics and Cohen's d were used to measure change. Children's pragmatic language outcomes were maintained 18 mo after the therapist-delivered intervention and significantly improved from before to 1 mo after the parent-delivered intervention. Interventions involving occupational therapist and speech-language pathologist collaboration, play, and parent and peer involvement may facilitate children's pragmatic language skills. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Are fetal growth impairment and preterm birth causally related to child attention problems and ADHD? Evidence from a comparison between high-income and middle-income cohorts

PubMed Central

Murray, Elizabeth; Pearson, Rebecca; Fernandes, Michelle; Santos, Iná S; Barros, Fernando C; Victora, Cesar G; Stein, Alan; Matijasevich, Alicia

2016-01-01

Background Cross-cohort comparison is an established method for improving causal inference. This study compared 2 cohorts, 1 from a high-income country and another from a middle-income country, to (1) establish whether birth exposures may play a causal role in the development of childhood attention problems; and (2) identify whether confounding structures play a different role in parent-reported attention difficulties compared with attention deficit hyperactivity disorder (ADHD) diagnoses. Methods Birth exposures included low birth weight (LBW), small-for-gestational age (SGA), small head circumference (HC) and preterm birth (PTB)). Outcomes of interest were attention difficulties (Strengths and Difficulties Questionnaire, SDQ) and ADHD (Development and Well-Being Assessment, DAWBA). Associations between exposures and outcomes were compared between 7-year-old children from the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK (N=6849) and the 2004 Pelotas cohort in Brazil (N=3509). Results For attention difficulties (SDQ), the pattern of association with birth exposures was similar between cohorts: following adjustment, attention difficulties were associated with SGA (OR=1.59, 95% CI 1.20 to 2.19) and small HC (OR=1.64, 95% CI 1.11 to 2.41) in ALSPAC and SGA (OR=1.35, 95% CI 1.04 to 1.75) in Pelotas. For ADHD, however, the pattern of association following adjustment differed markedly between cohorts. In ALSPAC, ADHD was associated with LBW (OR=2.29, 95% CI 1.09 to 4.80) and PTB (OR=2.33, 95% CI 1.23 to 4.42). In the Pelotas cohort, however, ADHD was associated with SGA (OR=1.69, 95% CI 1.02 to 2.82). Conclusions The findings suggest that fetal growth impairment may play a causal role in the development of attention difficulties in childhood, as similar associations were identified across both cohorts. Confounding structures, however, appear to play a greater role in determining whether a child meets the full diagnostic criteria for ADHD. PMID:26767410

Attention-deficit hyperactivity disorder, multimodal treatment, and longitudinal outcome: evidence, paradox, and challenge.

PubMed

Hinshaw, Stephen P; Arnold, L Eugene

2015-01-01

Given major increases in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and in rates of medication for this condition, we carefully examine evidence for effects of single versus multimodal (i.e., combined medication and psychosocial/behavioral) interventions for ADHD. Our primary data source is the Multimodal Treatment Study of Children with ADHD (MTA), a 14-month, randomized clinical trial in which intensive behavioral, medication, and multimodal treatment arms were contrasted with one another and with community intervention (treatment-as-usual), regarding outcome domains of ADHD symptoms, comorbidities, and core functional impairments. Although initial reports emphasized the superiority of well-monitored medication for symptomatic improvement, reanalyses and reappraisals have highlighted (1) the superiority of combination treatment for composite outcomes and for domains of functional impairment (e.g., academic achievement, social skills, parenting practices); (2) the importance of considering moderator and mediator processes underlying differential patterns of outcome, including comorbid subgroups and improvements in family discipline style during the intervention period; (3) the emergence of side effects (e.g., mild growth suppression) in youth treated with long-term medication; and (4) the diminution of medication's initial superiority once the randomly assigned treatment phase turned into naturalistic follow-up. The key paradox is that while ADHD clearly responds to medication and behavioral treatment in the short term, evidence for long-term effectiveness remains elusive. We close with discussion of future directions and a call for greater understanding of relevant developmental processes in the attempt to promote optimal, generalized, and lasting treatments for this important and impairing neurodevelopmental disorder. © 2014 John Wiley & Sons, Ltd.

Cortical morphology as a shared neurobiological substrate of attention-deficit/hyperactivity symptoms and executive functioning: a population-based pediatric neuroimaging study

PubMed Central

Mous, Sabine E.; White, Tonya; Muetzel, Ryan L.; El Marroun, Hanan; Rijlaarsdam, Jolien; Polderman, Tinca J.C.; Jaddoe, Vincent W.; Verhulst, Frank C.; Posthuma, Danielle; Tiemeier, Henning

2017-01-01

Background Attention-deficit/hyperactivity symptoms have repeatedly been associated with poor cognitive functioning. Genetic studies have demonstrated a shared etiology of attention-deficit/hyperactivity disorder (ADHD) and cognitive ability, suggesting a common underlying neurobiology of ADHD and cognition. Further, neuroimaging studies suggest that altered cortical development is related to ADHD. In a large population-based sample we investigated whether cortical morphology, as a potential neurobiological substrate, underlies the association between attention-deficit/hyperactivity symptoms and cognitive problems. Methods The sample consisted of school-aged children with data on attention-deficit/hyperactivity symptoms, cognitive functioning and structural imaging. First, we investigated the association between attention-deficit/hyperactivity symptoms and different domains of cognition. Next, we identified cortical correlates of attention-deficit/hyperactivity symptoms and related cognitive domains. Finally, we studied the role of cortical thickness and gyrification in the behaviour–cognition associations. Results We included 776 children in our analyses. We found that attention-deficit/hyperactivity symptoms were associated specifically with problems in attention and executive functioning (EF; b = −0.041, 95% confidence interval [CI] −0.07 to −0.01, p = 0.004). Cortical thickness and gyrification were associated with both attention-deficit/hyperactivity symptoms and EF in brain regions that have been previously implicated in ADHD. This partly explained the association between attention-deficit/hyperactivity symptoms and EF (bindirect = −0.008, bias-corrected 95% CI −0.018 to −0.001). Limitations The nature of our study did not allow us to draw inferences regarding temporal associations; longitudinal studies are needed for clarification. Conclusion In a large, population-based sample of children, we identified a shared cortical morphology underlying attention-deficit/hyperactivity symptoms and EF. PMID:27673503

Cortical morphology as a shared neurobiological substrate of attention-deficit/hyperactivity symptoms and executive functioning: a population-based pediatric neuroimaging study.

PubMed

Mous, Sabine E; White, Tonya; Muetzel, Ryan L; El Marroun, Hanan; Rijlaarsdam, Jolien; Polderman, Tinca J C; Jaddoe, Vincent W; Verhulst, Frank C; Posthuma, Danielle; Tiemeier, Henning

2017-03-01

Attention-deficit/hyperactivity symptoms have repeatedly been associated with poor cognitive functioning. Genetic studies have demonstrated a shared etiology of attention-deficit/hyperactivity disorder (ADHD) and cognitive ability, suggesting a common underlying neurobiology of ADHD and cognition. Further, neuroimaging studies suggest that altered cortical development is related to ADHD. In a large population-based sample we investigated whether cortical morphology, as a potential neurobiological substrate, underlies the association between attention-deficit/hyperactivity symptoms and cognitive problems. The sample consisted of school-aged children with data on attention-deficit/hyperactivity symptoms, cognitive functioning and structural imaging. First, we investigated the association between attention-deficit/ hyperactivity symptoms and different domains of cognition. Next, we identified cortical correlates of attention-deficit/hyperactivity symptoms and related cognitive domains. Finally, we studied the role of cortical thickness and gyrification in the behaviour-cognition associations. We included 776 children in our analyses. We found that attention-deficit/hyperactivity symptoms were associated specifically with problems in attention and executive functioning (EF; b = -0.041, 95% confidence interval [CI] -0.07 to -0.01, p = 0.004). Cortical thickness and gyrification were associated with both attention-deficit/hyperactivity symptoms and EF in brain regions that have been previously implicated in ADHD. This partly explained the association between attention-deficit/hyperactivity symptoms and EF (b indirect = -0.008, bias-corrected 95% CI -0.018 to -0.001). The nature of our study did not allow us to draw inferences regarding temporal associations; longitudinal studies are needed for clarification. In a large, population-based sample of children, we identified a shared cortical morphology underlying attention-deficit/hyperactivity symptoms and EF.

Developmental Trajectory of Motor Deficits in Preschool Children with ADHD

PubMed Central

Sweeney, Kristie L; Ryan, Matthew; Schneider, Heather; Ferenc, Lisa; Denckla, Martha Bridge; Mahone, E. Mark

2018-01-01

Motor deficits persisting into childhood (>7 years) are associated with increased executive and cognitive dysfunction, likely due to parallel neural circuitry. This study assessed the longitudinal trajectory of motor deficits in preschool children with ADHD, compared to typically developing (TD) children, in order to identify individuals at risk for anomalous neurological development. Participants included 47 children (21 ADHD, 26 TD) ages 4–7 years who participated in three visits (V1, V2, V3), each one year apart (V1=48–71 months, V2=60–83 months, V3=72–95 months). Motor variables assessed included speed (finger tapping and sequencing), total overflow, and axial movements from the Revised Physical and Neurological Examination for Subtle Signs (PANESS). Effects for group, visit, and group-by-visit interaction were examined. There were significant effects for group (favoring TD) for finger tapping speed and total axial movements, visit (performance improving with age for all 4 variables), and a significant group-by-visit interaction for finger tapping speed. Motor speed (repetitive finger tapping) and quality of axial movements are sensitive markers of anomalous motor development associated with ADHD in children as young as 4 years. Conversely, motor overflow and finger sequencing speed may be less sensitive in preschool, due to ongoing wide variations in attainment of these milestones. PMID:29757012

Cognitive distortions and ADHD in pathological gambling: A national longitudinal case-control cohort study.

PubMed

Romo, Lucia; Legauffre, Cindy; Guilleux, Alice; Valleur, Marc; Magalon, David; Fatséas, Mélina; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Vénisse, Jean-Luc; Grall-Bronnec, Marie; Challet-Bouju, Gaëlle

2016-12-01

Introduction The primary outcome of our study was to assess the links between the level of cognitive distortions and the severity of gambling disorder. We also aimed at assessing the links between patient gambling trajectories and attention deficit and hyperactivity disorder (ADHD). Materials and methods The study population (n = 628) was comprised of problem and non-problem gamblers of both sexes between 18 and 65 years of age, who reported gambling on at least one occasion during the previous year. Data encompassed socio-demographic characteristics, gambling habits, the South Oaks Gambling Screen, the Gambling Attitudes and Beliefs Survey - 23, the Wender Utah Rating Scale - Child, and the Adult ADHD Self-report Scale. Results The cognitive distortions with the greatest correlation to the severity of gambling disorder were the "Chasing" and "Emotions." These two dimensions were able to distinguish between problem gamblers seeking treatment or not. While age of onset of gambling and length of gambling practice were not associated with the level of distorted cognitions, a period of abstinence of at least 1 month was associated with a lower level of distorted cognitions. The presence of ADHD resulted in a higher level of distorted cognitions. Conclusion Cognitive work is essential to the prevention, and the treatment, of pathological gambling, especially with respect to emotional biases and chasing behavior. The instauration of an abstinence period of at least 1 month under medical supervision could be a promising therapeutic lead for reducing gambling-related erroneous thoughts and for improving care strategies of pathological gamblers.

Cognitive distortions and ADHD in pathological gambling: A national longitudinal case-control cohort study

PubMed Central

Romo, Lucia; Legauffre, Cindy; Guilleux, Alice; Valleur, Marc; Magalon, David; Fatséas, Mélina; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Vénisse, Jean-Luc; Grall-Bronnec, Marie; Challet-Bouju, Gaëlle

2016-01-01

Introduction The primary outcome of our study was to assess the links between the level of cognitive distortions and the severity of gambling disorder. We also aimed at assessing the links between patient gambling trajectories and attention deficit and hyperactivity disorder (ADHD). Materials and methods The study population (n = 628) was comprised of problem and non-problem gamblers of both sexes between 18 and 65 years of age, who reported gambling on at least one occasion during the previous year. Data encompassed socio-demographic characteristics, gambling habits, the South Oaks Gambling Screen, the Gambling Attitudes and Beliefs Survey – 23, the Wender Utah Rating Scale – Child, and the Adult ADHD Self-report Scale. Results The cognitive distortions with the greatest correlation to the severity of gambling disorder were the “Chasing” and “Emotions.” These two dimensions were able to distinguish between problem gamblers seeking treatment or not. While age of onset of gambling and length of gambling practice were not associated with the level of distorted cognitions, a period of abstinence of at least 1 month was associated with a lower level of distorted cognitions. The presence of ADHD resulted in a higher level of distorted cognitions. Conclusion Cognitive work is essential to the prevention, and the treatment, of pathological gambling, especially with respect to emotional biases and chasing behavior. The instauration of an abstinence period of at least 1 month under medical supervision could be a promising therapeutic lead for reducing gambling-related erroneous thoughts and for improving care strategies of pathological gamblers. PMID:27774813

Genetic and Environmental Influences on the Developmental Course of Attention-Deficit/Hyperactivity Disorder Symptoms From Childhood to Adolescence.

PubMed

Pingault, Jean-Baptiste; Viding, Essi; Galéra, Cédric; Greven, Corina U; Zheng, Yao; Plomin, Robert; Rijsdijk, Frühling

2015-07-01

Attention-deficit/hyperactivity disorder (ADHD) is conceptualized as a neurodevelopmental disorder that is strongly heritable. However, to our knowledge, no study to date has examined the genetic and environmental influences explaining interindividual differences in the developmental course of ADHD symptoms from childhood to adolescence (ie, systematic decreases or increases with age). The reason ADHD symptoms persist in some children but decline in others is an important concern, with implications for prognosis and interventions. To assess the proportional impact of genes and the environment on interindividual differences in the developmental course of ADHD symptom domains of hyperactivity/impulsivity and inattention between ages 8 and 16 years. A prospective sample of 8395 twin pairs from the Twins Early Development Study, recruited from population records of births in England and Wales between January 1, 1994, and December 31, 1996. Data collection at age 8 years took place between November 2002 and November 2004; data collection at age 16 years took place between February 2011 and January 2013. Both DSM-IV ADHD symptom subscales were rated 4 times by participants' mothers. Estimates from latent growth curve models indicated that the developmental course of hyperactivity/impulsivity symptoms followed a sharp linear decrease (mean score of 6.0 at age 8 years to 2.9 at age 16 years). Interindividual differences in the linear change in hyperactivity/impulsivity were under strong additive genetic influences (81%; 95% CI, 73%-88%). More than half of the genetic variation was specific to the developmental course and not shared with the baseline level of hyperactivity/impulsivity. The linear decrease in inattention symptoms was less pronounced (mean score of 5.8 at age 8 years to 4.9 at age 16 years). Nonadditive genetic influences accounted for a substantial amount of variation in the developmental course of inattention symptoms (54%; 95% CI, 8%-76%), with more than half being specific to the developmental course. The large genetic influences on the developmental course of ADHD symptoms are mostly specific and independent of those that account for variation in the baseline level of symptoms. Different sets of genes may be associated with the developmental course vs the baseline level of ADHD symptoms and explain why some children remit from ADHD, whereas others persist. Recent longitudinal imaging data indicate that the maintenance or increase in symptoms is underpinned by atypical trajectories of cortical development. This may reflect a specific genetic liability, distinct from that which contributes to baseline ADHD symptoms, and warrants closer follow-up.

Comparing the DSM-5 construct of Disruptive Mood Dysregulation Disorder and ICD-10 Mixed Disorder of Emotion and Conduct in the UK Longitudinal Assessment of Manic Symptoms (UK-LAMS) Study.

PubMed

Sagar-Ouriaghli, I; Milavic, G; Barton, R; Heaney, N; Fiori, F; Lievesley, K; Singh, J; Santosh, Paramala

2018-05-05

It is important to understand new diagnostic entities in classifications of psychopathology such as the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) (code F34.8) construct of Disruptive Mood Dysregulation Disorder (DMDD) and to compare it with possible equivalent disorders in other classificatory systems such as the International Classification of Diseases-10 (ICD-10), which has a category that superficially appears similar, that is, Mixed Disorder of Emotion and Conduct (MDEC) (code F92). In this study, the United Kingdom (UK) arm (UK-LAMS) of the US National Institute of Mental Health (NIMH) supported Longitudinal Assessment of Manic Symptoms (LAMS) multi-site study was used to evaluate and retrospectively construct DMDD and MDEC diagnoses in order to compare them and understand the conditions they co-occur with, in order to improve the clinical understanding. In particular, the phenomenology of UK-LAMS participants (n = 117) was used to determine whether DMDD is a unique entity within the DSM-5. The findings showed that 24 of 68 participants with either DMDD or MDEC (35.3%) fulfilled both diagnostic criteria for DMDD and MDEC, suggesting that these entities do contain overlapping features, particularly symptoms relating to Oppositional Defiant Disorder (ODD)/Conduct Disorder (CD), Attention Deficit Hyperactivity Disorder (ADHD)/Hyperkinetic Disorder (HKD) and/or an anxiety disorder. The data also showed that most of the participants who met DMDD criteria also fulfilled the diagnostic criteria for ODD/CD, ADHD, followed by an anxiety disorder. In this context, this raises the issue whether DMDD is a unique construct or whether the symptomology for DMDD can be better explained as a specifier for ODD/CD and ADHD. Unlike DMDD, MDEC clearly specifies that the label should only be used if emotional and conduct disorders co-exist.

Use and Characteristics of Antipsychotic/Methylphenidate Combination Therapy in Children and Adolescents with a Diagnosis of Attention-Deficit/Hyperactivity Disorder.

PubMed

Scholle, Oliver; Banaschewski, Tobias; Enders, Dirk; Garbe, Edeltraut; Riedel, Oliver

2018-05-16

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) frequently have comorbidities that are potential indications for antipsychotics (APs). Some studies have suggested that the combined use of methylphenidate (MPH) and APs is increasing in this population group. Longitudinal analyses and in-depth investigations on the substance level are lacking. This study aimed to estimate the cumulative proportion of concomitant AP/MPH use in children and adolescents with ADHD over a follow-up of up to 9 years and to describe patient characteristics stratified by specific AP drug. Based on claims data, concomitant AP/MPH use was identified among 67,595 children and adolescents with ADHD starting MPH treatment between 2005 and 2013. Characteristics and diagnoses-including those indicating appropriateness of AP use according to approved indications and/or guidelines-were examined at the time of first AP/MPH combination therapy. In addition, subsequent use of AP/MPH combination therapy was evaluated. The cumulative proportion of individuals with any AP/MPH combination therapy rose to over 6% within 9 years after initiating MPH. The most frequent APs first used in combination with MPH were risperidone (72%), pipamperone (15%), and tiapride (8%). Percentages of psychiatric hospitalization in the year preceding the first combination therapy with MPH were 33%, 43%, and 19%, respectively. The proportion of individuals with potentially appropriate use was high (>72%) in risperidone/MPH and tiapride/MPH and low (15%) in pipamperone/MPH combination users. Conduct disorders and tic disorders were frequent in users who were prescribed MPH with risperidone and tiapride, respectively. One-quarter of patients with AP/MPH combination therapy were one-time-only combination users. Our study suggests that a considerable proportion of children and adolescents with ADHD receive MPH in combination with APs and that this is a factor not only during the first years of MPH treatment. ADHD guidelines should specify algorithms concerning the use of AP medication.

Changes in Self-Perceptions in Children With ADHD: A Longitudinal Study of Depressive Symptoms and Attributional Style

PubMed Central

McQuade, Julia D.; Hoza, Betsy; Waschbusch, Daniel A.; Murray-Close, Dianna; Owens, Julie S.

2012-01-01

This study examined positive self-perceptions in relation to depressive symptoms and attributional style in a sample of 88 boys with attention-deficit/hyperactivity disorder (ADHD) assessed at baseline and at a 2- to 3-year follow-up. Change in boys’ self-perceptions of competency in the scholastic, social, and behavioral domains was examined as a predictor of changes in depressive symptoms and depressive attributional style. Additionally, teacher-rated perceptions of competency at baseline and follow-up were considered as unique predictors. Results indicated that across all three domains, a reduction in children’s self-perceptions of competency over time predicted greater depressive symptoms at follow-up, even when controlling for teacher-rated competency. Analyses also suggested that a reduction in self-perceptions in the social domain was the strongest relative predictor of later depressive symptoms and also predicted greater depressive attributional style at follow-up. In contrast, teacher-rated competency was not a significant predictor of depressive symptoms or attributional style at follow-up. Results support a protective function of positive self-perceptions in regards to depressive cognitions over a 2- to 3-year period for children with ADHD. However, literature suggesting risks for other negative outcomes also is discussed. PMID:21496504

Genetic Overlap Between Schizophrenia and Developmental Psychopathology: Longitudinal and Multivariate Polygenic Risk Prediction of Common Psychiatric Traits During Development.

PubMed

Nivard, Michel G; Gage, Suzanne H; Hottenga, Jouke J; van Beijsterveldt, Catharina E M; Abdellaoui, Abdel; Bartels, Meike; Baselmans, Bart M L; Ligthart, Lannie; Pourcain, Beate St; Boomsma, Dorret I; Munafò, Marcus R; Middeldorp, Christel M

2017-10-21

Several nonpsychotic psychiatric disorders in childhood and adolescence can precede the onset of schizophrenia, but the etiology of this relationship remains unclear. We investigated to what extent the association between schizophrenia and psychiatric disorders in childhood is explained by correlated genetic risk factors. Polygenic risk scores (PRS), reflecting an individual's genetic risk for schizophrenia, were constructed for 2588 children from the Netherlands Twin Register (NTR) and 6127 from the Avon Longitudinal Study of Parents And Children (ALSPAC). The associations between schizophrenia PRS and measures of anxiety, depression, attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder/conduct disorder (ODD/CD) were estimated at age 7, 10, 12/13, and 15 years in the 2 cohorts. Results were then meta-analyzed, and a meta-regression analysis was performed to test differences in effects sizes over, age and disorders. Schizophrenia PRS were associated with childhood and adolescent psychopathology. Meta-regression analysis showed differences in the associations over disorders, with the strongest association with childhood and adolescent depression and a weaker association for ODD/CD at age 7. The associations increased with age and this increase was steepest for ADHD and ODD/CD. Genetic correlations varied between 0.10 and 0.25. By optimally using longitudinal data across diagnoses in a multivariate meta-analysis this study sheds light on the development of childhood disorders into severe adult psychiatric disorders. The results are consistent with a common genetic etiology of schizophrenia and developmental psychopathology as well as with a stronger shared genetic etiology between schizophrenia and adolescent onset psychopathology. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com

Association Between Changes in Caregiver Depressive Symptoms and Child Attention-Deficit/Hyperactivity Disorder Symptoms.

PubMed

Walls, Morgan; Cabral, Howard; Feinberg, Emily; Silverstein, Michael

2018-06-01

Depression is highly prevalent among caregivers of children with attention-deficit/hyperactivity disorder (ADHD). We examined the association between caregiver depressive symptom trajectories and changes in child ADHD symptoms. We analyzed data from a randomized trial of 2 ADHD care management systems for children aged 6 to 12 years and their caregivers (n = 156 dyads). Child ADHD symptoms were measured using the Swanson, Nolan, and Pelham rating scale (SNAP-IV). Caregiver depressive symptoms were measured using the Quick Inventory of Depressive Symptomatology (QIDS). Measures were assessed at baseline, 6 months, and 12 months. We used multivariable models to examine associations between changes in caregiver depressive symptoms and changes in child ADHD symptoms. From baseline to 12 months, children of caregivers with improved depressive symptoms had significantly greater reductions in SNAP-IV scores (change score: -1.43) compared with those whose depressive symptoms did not change (change score: -0.97) or worsened (change score: -0.23, p = 0.003). In adjusted models, improved caregiver depressive symptoms were associated with greater reductions in SNAP-IV scores over the 12-month period. Compared with those with worsening caregiver depressive symptoms, children whose caregivers showed no significant changes in depressive symptoms had a -0.78 point (95% confidence interval [CI]: -1.40 to -0.17) greater reduction in the SNAP-IV score, and those children whose caregiver depressive symptoms improved had a -1.31 point greater reduction in the SNAP-IV score (95% CI: -1.97 to -0.66). Given the longitudinal association between caregiver depressive symptom and child ADHD symptom trajectories, interventions that address the behavioral health needs of the family unit may offer promise for urban children with ADHD.

Associations of child insomnia, sleep movement, and their persistence with mental health symptoms in childhood and adolescence.

PubMed

Armstrong, Jeffrey M; Ruttle, Paula L; Klein, Marjorie H; Essex, Marilyn J; Benca, Ruth M

2014-05-01

To examine the patterns of insomnia and sleep-related movement from ages 4.5 to 9 years, their concurrent associations with mental health symptoms in childhood, and the longitudinal associations of sleep-problem persistence with mental health symptoms at ages 9 and 18 years. A 14-year prospective follow-up study. Assessments included maternal report on the Children's Sleep Habits Questionnaire at ages 4.5 and 9, and child mental health symptoms via maternal report at age 4.5, multi-informant (child, teacher, mother) report at age 9, and adolescent report at age 18. Community. A total of 396 children (51% female). N/A. Sleep problems were more common at age 4.5 than 9; symptoms of insomnia and abnormal sleep movement both had persistence rates of 9-10%. At age 4.5, insomnia was associated with hostile-aggressive and hyperactive-distractible behavior, but there were no significant associations for sleep movement. At age 9, both insomnia and sleep movement were associated with symptoms of depression, externalizing, and attention deficit hyperactivity disorder (ADHD). Insomnia persistence was associated with symptoms of depression, externalizing, and ADHD at age 9 and anxiety and externalizing at age 18; sleep- movement persistence was associated with externalizing and ADHD at age 9, and ADHD at age 18. The age 18 persistence effects for insomnia and anxiety and for sleep movement and ADHD were significant when controlling for earlier mental health. Childhood insomnia and sleep movement are common and associated with mental health symptoms. Their persistence from middle to late childhood predicts associations with specific types of mental health symptoms at age 18.

An Examination of the Behavioral and Neuropsychological Correlates of Three ADHD Candidate Gene Polymorphisms (DRD4 7+, DBH TaqI A2, and DAT1 40bp VNTR) in Hyperactive and Normal Children Followed to Adulthood

PubMed Central

Barkley, Russell A.; Smith, Karen M.; Fischer, Mariellen; Navia, Bradford

2008-01-01

Several candidate gene polymorphisms have been implicated in attention deficit hyperactivity disorder (ADHD), including DAT1 40bp VNTR, DRD4 7+, and DBH TaqI A2 alleles. We used the Milwaukee longitudinal study of hyperactive (N=122) and normal (N=67) children to compare participants with and without these respective polymorphisms on ADHD-related behavioral ratings at childhood, 8 years later in adolescence, and 13+ years later into young adulthood. Neuropsychological tests were given at the adolescent and young adulthood follow-up. No differences were found between the DRD4-7+ and 7- repeat polymorphism. The DBH TaqI A2 allele, when homozygous, was associated with being more hyperactive in childhood, having more pervasive behavior problems at adolescence, and earning less money on a Card Playing Task in adulthood. At adolescence, poorer test scores were also found only in the hyperactive group with homozygous for this allele. The DAT1 40bp VNTR heterozygous 9/10 repeat, however, differed from the 10/10 repeat pair in many respects, having greater ADHD and externalizing symptoms at all three follow-ups, more cross-situational behavioral problems at both childhood and adolescence, poorer mother-teen relations at adolescence, and lower class rankings in high school. Participants with the 9/10 pair in the control group also had lower work performance, a lower grade point average in high school, greater teacher rated externalizing symptoms at adolescence, and greater omission errors on a continuous performance test in adulthood. The DAT1 40bp VNTR 9/10 polymorphism pairing appears to be reliably associated with greater symptoms of ADHD and externalizing behavior from childhood to adulthood, and with family, educational, and occupational impairments. We also present a contrary view on the appropriate endophenotypes for use in behavioral genetic research on ADHD. PMID:16741944

Prospective Effects of Adolescent Indicators of Behavioral Disinhibition on DSM-IV Alcohol, Tobacco, and Illicit Drug Dependence in Young Adulthood

PubMed Central

Palmer, Rohan H. C.; Knopik, Valerie S.; Rhee, Soo Hyun; Hopfer, Christian J.; Corley, Robin C.; Young, Susan E.; Stallings, Michael C.; Hewitt, John K.

2013-01-01

Objective To identify robust predictors of drug dependence. Methods This longitudinal study included 2361 male and female twins from an ongoing longitudinal study at the Center for Antisocial Drug Dependence (CADD) at the University of Colorado Boulder and Denver campuses. Twins were recruited for the CADD project while they were between the ages of 12 and 18. Participants in the current study were on average approximately 15 years of age during the first wave of assessment and approximately 20 years of age at the second wave of assessment. The average time between assessments was five years. A structured interview was administered at each assessment to determine patterns of substance use and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; Fourth Edition) attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), and drug dependence symptoms. Cloninger’s Tridimensional Personality Questionnaire was also used to assess novelty seeking tendencies (NS). At the second wave of assessment, DSM-IV dependence symptoms were reassessed using the same interview. Path analyses were used to examine direct and indirect mechanisms linking psychopathology and drug outcomes. Results Adolescent substance use, CD, and NS predicted young adult substance dependence, whereas the predictive effects of ADHD were few and inconsistent. Furthermore, CD and NS effects were partially mediated by adolescent substance use. Conclusions Adolescent conduct problems, novelty seeking, and drug use are important indices of future drug problems. The strongest predictor was novelty seeking. PMID:23685327

Latent transition models with latent class predictors: attention deficit hyperactivity disorder subtypes and high school marijuana use

PubMed Central

Reboussin, Beth A.; Ialongo, Nicholas S.

2011-01-01

Summary Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which is most often diagnosed in childhood with symptoms often persisting into adulthood. Elevated rates of substance use disorders have been evidenced among those with ADHD, but recent research focusing on the relationship between subtypes of ADHD and specific drugs is inconsistent. We propose a latent transition model (LTM) to guide our understanding of how drug use progresses, in particular marijuana use, while accounting for the measurement error that is often found in self-reported substance use data. We extend the LTM to include a latent class predictor to represent empirically derived ADHD subtypes that do not rely on meeting specific diagnostic criteria. We begin by fitting two separate latent class analysis (LCA) models by using second-order estimating equations: a longitudinal LCA model to define stages of marijuana use, and a cross-sectional LCA model to define ADHD subtypes. The LTM model parameters describing the probability of transitioning between the LCA-defined stages of marijuana use and the influence of the LCA-defined ADHD subtypes on these transition rates are then estimated by using a set of first-order estimating equations given the LCA parameter estimates. A robust estimate of the LTM parameter variance that accounts for the variation due to the estimation of the two sets of LCA parameters is proposed. Solving three sets of estimating equations enables us to determine the underlying latent class structures independently of the model for the transition rates and simplifying assumptions about the correlation structure at each stage reduces the computational complexity. PMID:21461139

Associations of Child Insomnia, Sleep Movement, and Their Persistence With Mental Health Symptoms in Childhood and Adolescence

PubMed Central

Armstrong, Jeffrey M.; Ruttle, Paula L.; Klein, Marjorie H.; Essex, Marilyn J.; Benca, Ruth M.

2014-01-01

Study Objectives: To examine the patterns of insomnia and sleep-related movement from ages 4.5 to 9 years, their concurrent associations with mental health symptoms in childhood, and the longitudinal associations of sleep-problem persistence with mental health symptoms at ages 9 and 18 years. Design: A 14-year prospective follow-up study. Assessments included maternal report on the Children's Sleep Habits Questionnaire at ages 4.5 and 9, and child mental health symptoms via maternal report at age 4.5, multi-informant (child, teacher, mother) report at age 9, and adolescent report at age 18. Setting: Community. Participants: A total of 396 children (51% female). Interventions: N/A. Measurements and Results: Sleep problems were more common at age 4.5 than 9; symptoms of insomnia and abnormal sleep movement both had persistence rates of 9–10%. At age 4.5, insomnia was associated with hostile-aggressive and hyperactive-distractible behavior, but there were no significant associations for sleep movement. At age 9, both insomnia and sleep movement were associated with symptoms of depression, externalizing, and attention deficit hyperactivity disorder (ADHD). Insomnia persistence was associated with symptoms of depression, externalizing, and ADHD at age 9 and anxiety and externalizing at age 18; sleep- movement persistence was associated with externalizing and ADHD at age 9, and ADHD at age 18. The age 18 persistence effects for insomnia and anxiety and for sleep movement and ADHD were significant when controlling for earlier mental health. Conclusions: Childhood insomnia and sleep movement are common and associated with mental health symptoms. Their persistence from middle to late childhood predicts associations with specific types of mental health symptoms at age 18. Citation: Armstrong JM, Ruttle PL, Klein MH, Essex MJ, Benca RM. Associations of child insomnia, sleep movement, and their persistence with mental health symptoms in childhood and adolescence. SLEEP 2014;37(5):901-909. PMID:24790268

Childhood Social Functioning and Young Adult Intimate Partner Violence in Girls With and Without ADHD: Response Inhibition as a Moderator.

PubMed

Youn, Cherry; Meza, Jocelyn I; Hinshaw, Stephen P

2018-06-01

Examine the moderating effects of response inhibition on the longitudinal association between social preference/relational aggression measured in childhood, and intimate partner violence (IPV) measured in young adulthood, among women with ( n = 140) and without ( n = 88) histories of childhood ADHD. During childhood, social preference was measured through confidential peer sociometric nominations, yielding negative and positive peer regard; relational aggression was assessed via staff behavioral observations; and response inhibition was assessed using commission errors from the continuous performance task. During young adulthood, IPV was ascertained via a clinician-administered, semistructured interview. Social preference and relational aggression independently predicted IPV; this prospective link was moderated by response inhibition. In combination with low social preference or high relational aggression in childhood, poor response inhibition predicted the highest levels of young-adult IPV. Given the developmental significance of peer relationships, additional research on the causes of and treatments for poor social functioning in ADHD is warranted.

Improving homework performance among children with ADHD: A randomized clinical trial.

PubMed

Merrill, Brittany M; Morrow, Anne S; Altszuler, Amy R; Macphee, Fiona L; Gnagy, Elizabeth M; Greiner, Andrew R; Coles, Erika K; Raiker, Joseph S; Coxe, Stefany; Pelham, William E

2017-02-01

Evidence indicates that children with Attention Deficit Hyperactivity Disorder (ADHD) experience acute and prolonged academic impairment and underachievement including marked difficulty with completing homework. This study is the first to examine the effects of behavioral, psychostimulant, and combined treatments on homework problems, which have been shown to predict academic performance longitudinally. Children with ADHD (ages 5-12, N = 75, 71% male, 83% Hispanic/Latino) and their families were randomly assigned to either behavioral treatment (homework-focused parent training and a daily report card; BPT + DRC) or a waitlist control group. Children also participated in a concurrent psychostimulant crossover trial conducted in a summer treatment program. Children's objective homework completion and accuracy were measured as well as parent-reported child homework behaviors and parenting skills. BPT + DRC had large effects on objective measures of homework completion and accuracy (Cohen's ds from 1.40 to 2.21, ps < .001). Other findings, including unimodal medication and incremental combined treatment benefits, were not significant. Behavioral treatment focused on homework problems results in clear benefits for children's homework completion and accuracy (the difference between passing and failing, on average), whereas long-acting stimulant medication resulted in limited and largely nonsignificant acute effects on homework performance. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Improving Homework Performance Among Children with ADHD: A Randomized Clinical Trial

PubMed Central

Merrill, Brittany M.; Morrow, Anne S.; Altszuler, Amy R.; Macphee, Fiona L.; Gnagy, Elizabeth M.; Greiner, Andrew R.; Coles, Erika K.; Raiker, Joseph S.; Coxe, Stefany; Pelham, William E.

2016-01-01

Objective Evidence indicates that children with Attention Deficit Hyperactivity Disorder (ADHD) experience acute and prolonged academic impairment and underachievement including marked difficulty with completing homework. This study is the first to examine the effects of behavioral, psychostimulant, and combined treatments on homework problems, which have been shown to predict academic performance longitudinally. Method Children with ADHD (ages 5-12, N = 75, 71% male, 83% Hispanic/Latino) and their families were randomly assigned to either behavioral treatment (homework-focused parent training and a daily report card; BPT+DRC) or a waitlist control group. Children also participated in a concurrent psychostimulant crossover trial conducted in a summer treatment program. Children's objective homework completion and accuracy were measured as well as parent-reported child homework behaviors and parenting skills. Results BPT+DRC had large effects on objective measures of homework completion and accuracy (Cohen's ds from 1.40, to 2.21, ps < .001). Other findings, including unimodal medication and incremental combined treatment benefits, were not significant. Conclusions Behavioral treatment focused on homework problems results in clear benefits for children's homework completion and accuracy (the difference between passing failing, on average) whereas long-acting stimulant medication resulted in limited and largely non-significant acute effects on homework performance. PMID:27618639

Does Emotion Dysregulation Mediate the Association Between Sluggish Cognitive Tempo and College Students' Social Impairment?

PubMed

Flannery, Andrew J; Becker, Stephen P; Luebbe, Aaron M

2016-09-01

Studies demonstrate an association between sluggish cognitive tempo (SCT) and social impairment, although no studies have tested possible mechanisms of this association. This study aimed to (a) examine SCT in relation to college students' social functioning; (b) test if SCT is significantly associated with emotion dysregulation beyond depressive, anxious, and ADHD symptoms; and (c) test if emotion dysregulation mediates the association between SCT symptoms and social impairment. College students (N = 158) completed measures of psychopathology symptoms, emotion dysregulation, and social functioning. Participants with elevated SCT (12%) had higher ADHD, depressive, and anxious symptoms in addition to poorer emotion regulation and social adjustment than participants without elevated SCT. Above and beyond other psychopathologies, SCT was significantly associated with social impairment but not general interpersonal functioning. SCT was also associated with emotion dysregulation, even after accounting for the expectedly strong association between depression and emotion dysregulation. Further analyses supported emotion dysregulation as a mediator of the association between SCT and social impairment. These findings are important for theoretical models of SCT and underscore the need for additional, longitudinal research. © The Author(s) 2014.

Size and synchronization of auditory cortex promotes musical, literacy, and attentional skills in children.

PubMed

Seither-Preisler, Annemarie; Parncutt, Richard; Schneider, Peter

2014-08-13

Playing a musical instrument is associated with numerous neural processes that continuously modify the human brain and may facilitate characteristic auditory skills. In a longitudinal study, we investigated the auditory and neural plasticity of musical learning in 111 young children (aged 7-9 y) as a function of the intensity of instrumental practice and musical aptitude. Because of the frequent co-occurrence of central auditory processing disorders and attentional deficits, we also tested 21 children with attention deficit (hyperactivity) disorder [AD(H)D]. Magnetic resonance imaging and magnetoencephalography revealed enlarged Heschl's gyri and enhanced right-left hemispheric synchronization of the primary evoked response (P1) to harmonic complex sounds in children who spent more time practicing a musical instrument. The anatomical characteristics were positively correlated with frequency discrimination, reading, and spelling skills. Conversely, AD(H)D children showed reduced volumes of Heschl's gyri and enhanced volumes of the plana temporalia that were associated with a distinct bilateral P1 asynchrony. This may indicate a risk for central auditory processing disorders that are often associated with attentional and literacy problems. The longitudinal comparisons revealed a very high stability of auditory cortex morphology and gray matter volumes, suggesting that the combined anatomical and functional parameters are neural markers of musicality and attention deficits. Educational and clinical implications are considered. Copyright © 2014 the authors 0270-6474/14/3410937-13$15.00/0.

Neuroanatomical phenotypes in mental illness: identifying convergent and divergent cortical phenotypes across autism, ADHD and schizophrenia.

PubMed

Park, Min Tae M; Raznahan, Armin; Shaw, Philip; Gogtay, Nitin; Lerch, Jason P; Chakravarty, M Mallar

2018-05-01

There is evidence suggesting neuropsychiatric disorders share genomic, cognitive and clinical features. Here, we ask if autism-spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) and schizophrenia share neuroanatomical variations. First, we used measures of cortical anatomy to estimate spatial overlap of neuroanatomical variation using univariate methods. Next, we developed a novel methodology to determine whether cortical deficits specifically target or are "enriched" within functional resting-state networks. We found cortical anomalies were preferentially enriched across functional networks rather than clustering spatially. Specifically, cortical thickness showed significant enrichment between patients with ASD and those with ADHD in the default mode network, between patients with ASD and those with schizophrenia in the frontoparietal and limbic networks, and between patients with ADHD and those with schizophrenia in the ventral attention network. Networks enriched in cortical thickness anomalies were also strongly represented in functional MRI results (Neurosynth; r = 0.64, p = 0.032). We did not account for variable symptom dimensions and severity in patient populations, and our cross-sectional design prevented longitudinal analyses of developmental trajectories. These findings suggest that common deficits across neuropsychiatric disorders cannot simply be characterized as arising out of local changes in cortical grey matter, but rather as entities of both local and systemic alterations targeting brain networks.

Neuroanatomical phenotypes in mental illness: identifying convergent and divergent cortical phenotypes across autism, ADHD and schizophrenia.

PubMed

Park, Min Tae M; Raznahan, Armin; Shaw, Philip; Gogtay, Nitin; Lerch, Jason P; Chakravarty, M Mallar

2018-02-05

There is evidence suggesting neuropsychiatric disorders share genomic, cognitive and clinical features. Here, we ask if autism-spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) and schizophrenia share neuroanatomical variations. First, we used measures of cortical anatomy to estimate spatial overlap of neuroanatomical variation using univariate methods. Next, we developed a novel methodology to determine whether cortical deficits specifically target or are "enriched" within functional resting-state networks. We found cortical anomalies were preferentially enriched across functional networks rather than clustering spatially. Specifically, cortical thickness showed significant enrichment between patients with ASD and those with ADHD in the default mode network, between patients with ASD and those with schizophrenia in the frontoparietal and limbic networks, and between patients with ADHD and those with schizophrenia in the ventral attention network. Networks enriched in cortical thickness anomalies were also strongly represented in functional MRI results (Neurosynth; r = 0.64, p = 0.032). We did not account for variable symptom dimensions and severity in patient populations, and our cross-sectional design prevented longitudinal analyses of developmental trajectories. These findings suggest that common deficits across neuropsychiatric disorders cannot simply be characterized as arising out of local changes in cortical grey matter, but rather as entities of both local and systemic alterations targeting brain networks.

Cross-Lagged Analysis of Interplay Between Differential Traits in Sibling Pairs: Validation and Application to Parenting Behavior and ADHD Symptomatology.

PubMed

Moscati, Arden; Verhulst, Brad; McKee, Kevin; Silberg, Judy; Eaves, Lindon

2018-01-01

Understanding the factors that contribute to behavioral traits is a complex task, and partitioning variance into latent genetic and environmental components is a useful beginning, but it should not also be the end. Many constructs are influenced by their contextual milieu, and accounting for background effects (such as gene-environment correlation) is necessary to avoid bias. This study introduces a method for examining the interplay between traits, in a longitudinal design using differential items in sibling pairs. The model is validated via simulation and power analysis, and we conclude with an application to paternal praise and ADHD symptoms in a twin sample. The model can help identify what type of genetic and environmental interplay may contribute to the dynamic relationship between traits using a cross-lagged panel framework. Overall, it presents a way to estimate and explicate the developmental interplay between a set of traits, free from many common sources of bias.

The impact of ADHD and conduct disorder in childhood on adult delinquency: a 30 years follow-up study using official crime records.

PubMed

Mordre, Marianne; Groholt, Berit; Kjelsberg, Ellen; Sandstad, Berit; Myhre, Anne Margrethe

2011-04-11

Few longitudinal studies have explored lifetime criminality in adults with a childhood history of severe mental disorders. In the present study, we wanted to explore the association between adult delinquency and several different childhood diagnoses in an in-patient population. Of special interest was the impact of disturbance of activity and attention (ADHD) and mixed disorder of conduct and emotions on later delinquency, as these disorders have been variously associated with delinquent development. Former Norwegian child psychiatric in-patients (n = 541) were followed up 19-41 years after hospitalization by record linkage to the National Register of Criminality. On the basis of the hospital records, the patients were re-diagnosed according to ICD-10. The association between diagnoses and other baseline factors and later delinquency were investigated using univariate and multivariate Cox regression analyses. At follow-up, 24% of the participants had been convicted of criminal activity. In the multivariate Cox regression analysis, conduct disorder (RR = 2.0, 95%CI = 1.2-3.4) and hyperkinetic conduct disorder (RR = 2.7, 95% CI = 1.6-4.4) significantly increased the risk of future criminal behaviour. Pervasive developmental disorder (RR = 0.4, 95%CI = 0.2-0.9) and mental retardation (RR = 0.4, 95%CI = 0.3-0.8) reduced the risk for a criminal act. Male gender (RR = 3.6, 95%CI = 2.1-6.1) and chronic family difficulties (RR = 1.3, 95% CI = 1.1-1.5) both predicted future criminality. Conduct disorder in childhood was highly associated with later delinquency both alone or in combination with hyperactivity, but less associated when combined with an emotional disorder. ADHD in childhood was no more associated with later delinquency than the rest of the disorders in the study population. Our finding strengthens the assumption that there is no direct association between ADHD and criminality.

The impact of ADHD and conduct disorder in childhood on adult delinquency: A 30 years follow-up study using official crime records

PubMed Central

2011-01-01

Background Few longitudinal studies have explored lifetime criminality in adults with a childhood history of severe mental disorders. In the present study, we wanted to explore the association between adult delinquency and several different childhood diagnoses in an in-patient population. Of special interest was the impact of disturbance of activity and attention (ADHD) and mixed disorder of conduct and emotions on later delinquency, as these disorders have been variously associated with delinquent development. Methods Former Norwegian child psychiatric in-patients (n = 541) were followed up 19-41 years after hospitalization by record linkage to the National Register of Criminality. On the basis of the hospital records, the patients were re-diagnosed according to ICD-10. The association between diagnoses and other baseline factors and later delinquency were investigated using univariate and multivariate Cox regression analyses. Results At follow-up, 24% of the participants had been convicted of criminal activity. In the multivariate Cox regression analysis, conduct disorder (RR = 2.0, 95%CI = 1.2-3.4) and hyperkinetic conduct disorder (RR = 2.7, 95% CI = 1.6-4.4) significantly increased the risk of future criminal behaviour. Pervasive developmental disorder (RR = 0.4, 95%CI = 0.2-0.9) and mental retardation (RR = 0.4, 95%CI = 0.3-0.8) reduced the risk for a criminal act. Male gender (RR = 3.6, 95%CI = 2.1-6.1) and chronic family difficulties (RR = 1.3, 95% CI = 1.1-1.5) both predicted future criminality. Conclusions Conduct disorder in childhood was highly associated with later delinquency both alone or in combination with hyperactivity, but less associated when combined with an emotional disorder. ADHD in childhood was no more associated with later delinquency than the rest of the disorders in the study population. Our finding strengthens the assumption that there is no direct association between ADHD and criminality. PMID:21481227

Association Between ADHD and Obesity: A Systematic Review and Meta-Analysis.

PubMed

Cortese, Samuele; Moreira-Maia, Carlos Renato; St Fleur, Diane; Morcillo-Peñalver, Carmen; Rohde, Luis Augusto; Faraone, Stephen V

2016-01-01

Impulsivity and inattention related to attention deficit hyperactivity disorder (ADHD) may increase food intake and, consequently, weight gain. However, findings on the association between obesity/overweight and ADHD are mixed. The authors conducted a meta-analysis to estimate this association. A broad range of databases was searched through Aug. 31, 2014. Unpublished studies were also obtained. Study quality was rated with the Newcastle-Ottawa Scale. Random-effects models were used. Forty-two studies that included a total of 728,136 individuals (48,161 ADHD subjects; 679,975 comparison subjects) were retained. A significant association between obesity and ADHD was found for both children (odds ratio=1.20, 95% CI=1.05-1.37) and adults (odds ratio=1.55, 95% CI=1.32-1.81). The pooled prevalence of obesity was increased by about 70% in adults with ADHD (28.2%, 95% CI=22.8-34.4) compared with those without ADHD (16.4%, 95% CI=13.4-19.9), and by about 40% in children with ADHD (10.3%, 95% CI=7.9-13.3) compared with those without ADHD (7.4%, 95% CI=5.4-10.1). The significant association between ADHD and obesity remained when limited to studies 1) reporting odds ratios adjusted for possible confounding factors; 2) diagnosing ADHD by direct interview; and 3) using directly measured height and weight. Gender, study setting, study country, and study quality did not moderate the association between obesity and ADHD. ADHD was also significantly associated with overweight. Individuals medicated for ADHD were not at higher risk of obesity. This study provides meta-analytic evidence for a significant association between ADHD and obesity/overweight. Further research should address possible underlying mechanisms and the long-term effects of ADHD treatments on weight in individuals with both ADHD and obesity.

Differences in predictors of traditional and cyber-bullying: a 2-year longitudinal study in Korean school children.

PubMed

Yang, Su-Jin; Stewart, Robert; Kim, Jae-Min; Kim, Sung-Wan; Shin, Il-Seon; Dewey, Michael E; Maskey, Sean; Yoon, Jin-Sang

2013-05-01

Traditional bullying has received considerable research but the emerging phenomenon of cyber-bullying much less so. Our study aims to investigate environmental and psychological factors associated with traditional and cyber-bullying. In a school-based 2-year prospective survey, information was collected on 1,344 children aged 10 including bullying behavior/experience, depression, anxiety, coping strategies, self-esteem, and psychopathology. Parents reported demographic data, general health, and attention-deficit hyperactivity disorder (ADHD) symptoms. These were investigated in relation to traditional and cyber-bullying perpetration and victimization at age 12. Male gender and depressive symptoms were associated with all types of bullying behavior and experience. Living with a single parent was associated with perpetration of traditional bullying while higher ADHD symptoms were associated with victimization from this. Lower academic achievement and lower self esteem were associated with cyber-bullying perpetration and victimization, and anxiety symptoms with cyber-bullying perpetration. After adjustment, previous bullying perpetration was associated with victimization from cyber-bullying but not other outcomes. Cyber-bullying has differences in predictors from traditional bullying and intervention programmes need to take these into consideration.

Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis.

PubMed

Hoogman, Martine; Bralten, Janita; Hibar, Derrek P; Mennes, Maarten; Zwiers, Marcel P; Schweren, Lizanne S J; van Hulzen, Kimm J E; Medland, Sarah E; Shumskaya, Elena; Jahanshad, Neda; Zeeuw, Patrick de; Szekely, Eszter; Sudre, Gustavo; Wolfers, Thomas; Onnink, Alberdingk M H; Dammers, Janneke T; Mostert, Jeanette C; Vives-Gilabert, Yolanda; Kohls, Gregor; Oberwelland, Eileen; Seitz, Jochen; Schulte-Rüther, Martin; Ambrosino, Sara; Doyle, Alysa E; Høvik, Marie F; Dramsdahl, Margaretha; Tamm, Leanne; van Erp, Theo G M; Dale, Anders; Schork, Andrew; Conzelmann, Annette; Zierhut, Kathrin; Baur, Ramona; McCarthy, Hazel; Yoncheva, Yuliya N; Cubillo, Ana; Chantiluke, Kaylita; Mehta, Mitul A; Paloyelis, Yannis; Hohmann, Sarah; Baumeister, Sarah; Bramati, Ivanei; Mattos, Paulo; Tovar-Moll, Fernanda; Douglas, Pamela; Banaschewski, Tobias; Brandeis, Daniel; Kuntsi, Jonna; Asherson, Philip; Rubia, Katya; Kelly, Clare; Martino, Adriana Di; Milham, Michael P; Castellanos, Francisco X; Frodl, Thomas; Zentis, Mariam; Lesch, Klaus-Peter; Reif, Andreas; Pauli, Paul; Jernigan, Terry L; Haavik, Jan; Plessen, Kerstin J; Lundervold, Astri J; Hugdahl, Kenneth; Seidman, Larry J; Biederman, Joseph; Rommelse, Nanda; Heslenfeld, Dirk J; Hartman, Catharina A; Hoekstra, Pieter J; Oosterlaan, Jaap; Polier, Georg von; Konrad, Kerstin; Vilarroya, Oscar; Ramos-Quiroga, Josep Antoni; Soliva, Joan Carles; Durston, Sarah; Buitelaar, Jan K; Faraone, Stephen V; Shaw, Philip; Thompson, Paul M; Franke, Barbara

2017-04-01

Neuroimaging studies have shown structural alterations in several brain regions in children and adults with attention deficit hyperactivity disorder (ADHD). Through the formation of the international ENIGMA ADHD Working Group, we aimed to address weaknesses of previous imaging studies and meta-analyses, namely inadequate sample size and methodological heterogeneity. We aimed to investigate whether there are structural differences in children and adults with ADHD compared with those without this diagnosis. In this cross-sectional mega-analysis, we used the data from the international ENIGMA Working Group collaboration, which in the present analysis was frozen at Feb 8, 2015. Individual sites analysed structural T1-weighted MRI brain scans with harmonised protocols of individuals with ADHD compared with those who do not have this diagnosis. Our primary outcome was to assess case-control differences in subcortical structures and intracranial volume through pooling of all individual data from all cohorts in this collaboration. For this analysis, p values were significant at the false discovery rate corrected threshold of p=0·0156. Our sample comprised 1713 participants with ADHD and 1529 controls from 23 sites with a median age of 14 years (range 4-63 years). The volumes of the accumbens (Cohen's d=-0·15), amygdala (d=-0·19), caudate (d=-0·11), hippocampus (d=-0·11), putamen (d=-0·14), and intracranial volume (d=-0·10) were smaller in individuals with ADHD compared with controls in the mega-analysis. There was no difference in volume size in the pallidum (p=0·95) and thalamus (p=0·39) between people with ADHD and controls. Exploratory lifespan modelling suggested a delay of maturation and a delay of degeneration, as effect sizes were highest in most subgroups of children (<15 years) versus adults (>21 years): in the accumbens (Cohen's d=-0·19 vs -0·10), amygdala (d=-0·18 vs -0·14), caudate (d=-0·13 vs -0·07), hippocampus (d=-0·12 vs -0·06), putamen (d=-0·18 vs -0·08), and intracranial volume (d=-0·14 vs 0·01). There was no difference between children and adults for the pallidum (p=0·79) or thalamus (p=0·89). Case-control differences in adults were non-significant (all p>0·03). Psychostimulant medication use (all p>0·15) or symptom scores (all p>0·02) did not influence results, nor did the presence of comorbid psychiatric disorders (all p>0·5). With the largest dataset to date, we add new knowledge about bilateral amygdala, accumbens, and hippocampus reductions in ADHD. We extend the brain maturation delay theory for ADHD to include subcortical structures and refute medication effects on brain volume suggested by earlier meta-analyses. Lifespan analyses suggest that, in the absence of well powered longitudinal studies, the ENIGMA cross-sectional sample across six decades of ages provides a means to generate hypotheses about lifespan trajectories in brain phenotypes. National Institutes of Health. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Longitudinal Assessment of the Associations among Response Access, Attention Problems, and Aggression during Childhood

ERIC Educational Resources Information Center

Van Eck, Kathryn; Flory, Kate; Malone, Patrick S.

2013-01-01

Children with ADHD symptoms often display social competence deficits, yet mechanisms for their social difficulties remain unclear. Using data from the normative sample of non-intervention respondents (N = 387; 50% male; 49% non-European-American; age at initial assessment: M = 6.5 years, SD = 0.48) in the Fast Track project (Lochman and CPPRG…

Pathways to Self-Harmful Behaviors in Young Women with and without ADHD: A Longitudinal Examination of Mediating Factors

ERIC Educational Resources Information Center

Swanson, Erika N.; Owens, Elizabeth B.; Hinshaw, Stephen P.

2014-01-01

Background: Rates of suicide attempts and nonsuicidal self-injury [(NSSI); e.g., cutting, burning] peak in adolescence and early adulthood; females and individuals with psychiatric symptoms and diagnoses appear to be at particular risk. Hinshaw et al. ["Journal of Consulting and Clinical Psychology," ([Hinshaw, S.P., 2012]), 80, 1041]…

Long-Term Effects of Methylphenidate Transdermal Delivery System Treatment of ADHD on Growth

ERIC Educational Resources Information Center

Faraone, Stephen V.; Giefer, Eldred E.

2007-01-01

Objective: To examine the long-term effects of the methylphenidate transdermal system (MTS) on the growth of children being treated for attention-deficit/hyperactivity disorder. Method: Height, weight, and body mass index (BMI) were measured in 127 children ages 6 to 12 at longitudinal assessments for up to 36 months of treatment with MTS. These…

Childhood Trajectories of Inattention, Hyperactivity and Oppositional Behaviors and Prediction of Substance Abuse/Dependence: A 15-Year Longitudinal Population-Based Study

PubMed Central

Pingault, Jean-Baptiste; Côté, Sylvana M.; Galéra, Cédric; Genolini, Christophe; Falissard, Bruno; Vitaro, Frank; Tremblay, Richard E.

2014-01-01

Numerous prospective studies have shown that children diagnosed with ADHD are at higher risk of long-term substance abuse/dependence. However, there are two important limits to these studies: a) most did not differentiate the role of hyperactivity and inattention; b) most did not control for associated behavioral problems; c) most did not consider females. Our aim was to clarify the unique and interactive contributions of childhood inattention and hyperactivity symptoms to early adulthood substance abuse/dependence. Behavioral problems of 1804 participants (814 males) in a population-based longitudinal study were assessed yearly between 6 and 12 years by mothers and teachers. The prevalence of substance abuse/dependence at age 21 years was 30.7% for nicotine, 13.4% for alcohol, 9.1 % for cannabis and 2.0% for cocaine. The significant predictors of nicotine dependence were inattention (OR: 2.25; 95% CI: 1.63–3.11) and opposition (OR: 1.65; 95%: 1.20–2.28). Only opposition contributed to the prediction of cannabis dependence (OR: 2.33; 95% CI: 1.40–3.87) and cocaine dependence (OR: 2.97; 95% CI: 1.06–8.57). The best behavioral predictor of alcohol abuse/dependence (opposition) was only marginally significant (OR: 1.38; 95% CI: 0.98–1.95). Frequent oppositional behaviors during elementary school were clearly the most pervasive predictors of substance abuse/dependence in early adulthood. The association of childhood ADHD with substance abuse/dependence is largely attributable to its association with opposition problems during childhood. However, inattention remained a key predictor of nicotine dependence, in line with genetic and molecular commonalities between the two phenotypes suggested in the literature. PMID:22733124

Childhood trajectories of inattention, hyperactivity and oppositional behaviors and prediction of substance abuse/dependence: a 15-year longitudinal population-based study.

PubMed

Pingault, J-B; Côté, S M; Galéra, C; Genolini, C; Falissard, B; Vitaro, F; Tremblay, R E

2013-07-01

Numerous prospective studies have shown that children diagnosed with attention deficit/hyperactivity disorder (ADHD) are at higher risk of long-term substance abuse/dependence. However, there are three important limits to these studies: (a) most did not differentiate the role of hyperactivity and inattention; (b) most did not control for associated behavioral problems; and (c) most did not consider females. Our aim was to clarify the unique and interactive contributions of childhood inattention and hyperactivity symptoms to early adulthood substance abuse/dependence. Behavioral problems of 1803 participants (814 males) in a population-based longitudinal study were assessed yearly between 6 and 12 years by mothers and teachers. The prevalence of substance abuse/dependence at age 21 years was 30.7% for nicotine, 13.4% for alcohol, 9.1% for cannabis and 2.0% for cocaine. The significant predictors of nicotine dependence were inattention (odds ratio (OR): 2.25; 95% confidence interval (CI): 1.63-3.11) and opposition (OR: 1.65; 95%: 1.20-2.28). Only opposition contributed to the prediction of cannabis dependence (OR: 2.33; 95% CI: 1.40-3.87) and cocaine dependence (OR: 2.97; 95% CI: 1.06-8.57). The best behavioral predictor of alcohol abuse/dependence (opposition) was only marginally significant (OR: 1.38; 95% CI: 0.98-1.95). Frequent oppositional behaviors during elementary school were clearly the most pervasive predictors of substance abuse/dependence in early adulthood. The association of childhood ADHD with substance abuse/dependence is largely attributable to its association with opposition problems during childhood. However, inattention remained an important predictor of nicotine dependence, in line with genetic and molecular commonalities between the two phenotypes suggested in the literature.

The Association of Poor Academic Performance with Tic Disorders: A Longitudinal, Mainstream School-Based Population Study.

PubMed

Cubo, Esther; Gonzalez, Cristina; Ausin, Vanesa; Delgado, Vanesa; Saez, Sara; Calvo, Sara; Garcia Soto, Xose; Cordero, José; Kompoliti, Katie; Louis, Elan D; de la Fuente Anuncibay, Raquel

2017-01-01

Little is known about the academic performance of students with tic disorders (TD). Our aim was to investigate the association of TD and poor academic performance over time. Longitudinal, observational study of mainstream schoolchildren comparing grade retention (GR) and learning disorders (LD) in students with vs. without TD between 2010 and 2014. Students with vs. without TD based on DSM-IV-TR criteria, or with vs. without GR and LD were compared in terms of comorbidities, school, and environmental characteristics. The association of TD with GR was analyzed using hazard ratios (HRs) with 95% CIs, and with LD using logistic regression analysis [Odds ratio (OR)]. Two hundred fifty-eight students were included (mean age 14.0 ± 1.71 years, 143 [55.4%] males). The incident rate for TD and GR was 2.6 and 3.3 per 100 persons-year, respectively. LD found in 21 (9.9%) students was associated with TD (OR 11.62, 95% CI 2.21-60.90, p = 0.004), and attention deficit hyperactivity disorder (ADHD; OR 6.63, 95% CI 1.55-28.37, p = 0.01). Low psychological support (HRs 12.79, 95% CI 3.39-48.17) and low sport participation (HRs 6.41, 95% CI 1.54-26.78) were risk factors for GR. TD was associated with academic difficulties, namely, LD in conjunction with ADHD but not GR. The diagnosis of TD and comorbidities, and the initiation of proper treatment could have a favorable impact on school performance, and consequently on social development. © 2017 S. Karger AG, Basel.

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

PubMed

Fredriksen, Mats; Peleikis, Dawn E

2016-01-01

This MiniReview reports and discusses the main findings of the author's thesis including a literature study of long-term pharmacological treatment of adults with attention deficit hyperactivity disorder (ADHD), and a clinical study of 1-year medication. Electronic databases were systematically reviewed for original studies on pharmacotherapy of the defined duration, 24 weeks or more. Although few trials were found with limitations such as excluding comorbidities, treatment with stimulants and atomoxetine was reported tolerated and effective compared to non-treatment. The clinical study of the thesis was conducted on 250 medication-naïve patients with ADHD referred to a specialized outpatient clinic. Comorbid psychiatric disorders were diagnosed among 75% of the patients. About 56% had not completed secondary school, and 51% had been unable to work the preceding year. Persisting inattentive symptoms and comorbid mental disorders in adulthood were related to long-term work disability. In the prospective observational study of the thesis, patients were treated with methylphenidate as first-line drug and atomoxetine or dexamphetamine as second-line drugs, according to current treatment guidelines. At 12-month follow-up, 232 patients completed evaluation and 70% persisted on medication. About 80% of these used methylphenidate. Sustained improvement of symptoms and functioning was related to continued medication. Comorbid mental disorders and side effects were related to lower effectiveness and adherence, and 12% stopped medication due to side effects. Summing up the MiniReview, treatment with stimulants and atomoxetine of adults with ADHD has long-term beneficial effects and is tolerated but more longitudinal studies should be performed. With stated limitations, the findings of the thesis should contribute to a relevant guidance for clinical practice. © 2015 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

[Quality of life of patients with attention-deficit/hyperactivity disorder: systematic review of the past 5 years].

PubMed

Velő, Szabina; Keresztény, Ágnes; Szentiványi, Dóra; Balázs, Judit

2013-06-01

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent childhood disorders which continues into adulthood in 30-60%. Many studies are interested in the examination of the impact of ADHD on QoL. The aim of the current study is to provide a systematic review of QoL studies in both children and adults with ADHD published in the past five years focusing on three domains: 1. The impact of ADHD on QoL 2. The impact of ADHD on QoL regarding age 3. The impact of ADHD on QoL regarding gender. A systematic literature search was conducted using the following databases: sciencedirect.com and MEDLINE from 2008 to 2012. The following keywords were searched: quality of life, QoL, attention deficit/hyperactivity disorder, ADHD, gender differences, gender-related, age differences, age-related. We included studies into our review which investigated both adults and children. Papers in English, German and Hungarian were included. Fourteen relevant articles were identified, among them 13 articles were in English, one in German and there were no articles in Hungarian. All of the 14 articles confirmed the negative effects of ADHD on QoL. Four studies dealt with the effects of ADHD on QoL regarding age: one paper claimed that older people with ADHD have more impairments, but have better lefi-expectations than younger people with ADHD, one study claimed that increasing age raises the odds of poor QoL, while two studies did not find any changes on QoL of patients with ADHD regarding age. Three studies dealt with the effect of ADHD on QoL regarding the gender: two studies did not find difference on QoL of patients with ADHD, while one study found that women with ADHD have lower QoL. Based on the studies published in the last 5 years, patients with ADHD have lower QoL than healthy people; moreover, they have lower QoL in many areas than patients with several somatic or other mental illnesses. More studies are needed regarding the effects of ADHD on QoL by age and gender.

Childhood behavior problems and academic outcomes in adolescence: longitudinal population-based study.

PubMed

Sayal, Kapil; Washbrook, Elizabeth; Propper, Carol

2015-05-01

To investigate the impact of increasing levels of inattention, hyperactivity/impulsivity, and oppositional/defiant behaviors at age 7 years on academic achievement at age 16 years. In a population-based sample of 7-year-old children in England, information was obtained about inattention, hyperactivity/impulsivity, and oppositional/defiant behaviors (using parent and teacher ratings) and the presence of attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders (DBDs). After adjusting for confounder variables, their associations with academic achievement in national General Certificate of Secondary Education (GCSE) examinations (using scores and minimum expected school-leaving qualification level [5 "good" GCSEs]) at age 16 years were investigated (N = 11,640). In adjusted analyses, there was a linear association between each 1-point increase in inattention symptoms and worse outcomes (2- to 3-point reduction in GCSE scores and 6% to 7% (10%-12% with teacher ratings) increased likelihood of not achieving 5 good GCSEs). ADHD was associated with a 27- to 32-point reduction in GCSE scores and, in boys, a more than 2-fold increased likelihood of not achieving 5 good GCSEs. In boys, oppositional/defiant behaviors were also independently associated with worse outcomes, and DBDs were associated with a 19-point reduction in GCSE scores and a 1.83-increased likelihood of not achieving 5 good GCSEs. Across the full range of scores at a population level, each 1-point increase in inattention at age 7 years is associated with worse academic outcomes at age 16. The findings highlight long-term academic risk associated with ADHD, particularly inattentive symptoms. After adjusting for inattention and ADHD respectively, oppositional/defiant behaviors and DBDs are also independently associated with worse academic outcomes. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Reasons Why Children and Adolescents With Attention-Deficit/Hyperactivity Disorder Stop and Restart Taking Medicine.

PubMed

Brinkman, William B; Simon, John O; Epstein, Jeffery N

2018-04-01

To describe the prevalence of reasons why children and adolescents stop and restart attention-deficit/hyperactivity disorder (ADHD) medicine and whether functional impairment is present after stopping medicine. We used the prospective longitudinal cohort from the Multimodal Treatment of Study of Children With ADHD. At the 12-year follow-up, when participants were a mean of 21.1 years old, 372 participants (76% male, 64% white) reported ever taking ADHD medicine. Participants reported the age when they last stopped and/or restarted ADHD medicine and also endorsed reasons for stopping and restarting. Seventy-seven percent (286 of 372) reported stopping medicine for a month or longer at some time during childhood or adolescence. Participants were a mean of 13.3 years old when they last stopped medicine. The most commonly endorsed reasons for stopping medication related to 1) medicine not needed/helping, 2) adverse effects, 3) logistical barriers of getting or taking medication, and 4) social concerns or stigma. Seventeen percent (64 of 372) reported restarting medicine after stopping for a month or longer. Commonly endorsed reasons for restarting related to medicine being needed or medicine helping; and resolution of logistical barriers to getting or taking medicine. For both stopping and restarting, the proportion endorsing some reasons differed by age range, with the overall pattern suggesting that parental involvement in decisions decreased with age. Nearly all participants had impairment at the assessment after stopping, regardless of whether medication was resumed. Different reasons for stopping and/or restarting medicine are relevant at different times for different teens. Tailored strategies may help engage adolescents as full partners in their treatment plan. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The Latent Structure of Attention Deficit/Hyperactivity Disorder in an Adult Sample

PubMed Central

Marcus, David K.; Norris, Alyssa L.; Coccaro, Emil F.

2012-01-01

The vast majority of studies that have examined the latent structure of attention deficit/hyperactivity disorder (ADHD) in children and adolescents have concluded that ADHD has a dimensional latent structure. In other words, ADHD symptomatology exists along a continuum and there is no natural boundary or qualitative distinction (i.e., taxon) separating youth with ADHD from those with subclinical inattention or hyperactivity/impulsivity problems. Although adult ADHD appears to be less prevalent than ADHD in youth (which could suggest a more severe adult ADHD taxon), researchers have yet to examine the latent structure of ADHD in adults. The present study used a sample (N = 600) of adults who completed a self-report measure of ADHD symptoms. The taxometric analyses revealed a dimensional latent structure for inattention, hyperactivity/impulsivity, and ADHD. These findings are consistent with previous taxometric studies that examined ADHD in children and adolescents, and with contemporary polygenic and multifactorial models of ADHD. PMID:22480749

The latent structure of attention deficit/hyperactivity disorder in an adult sample.

PubMed

Marcus, David K; Norris, Alyssa L; Coccaro, Emil F

2012-06-01

The vast majority of studies that have examined the latent structure of attention deficit/hyperactivity disorder (ADHD) in children and adolescents have concluded that ADHD has a dimensional latent structure. In other words, ADHD symptomatology exists along a continuum and there is no natural boundary or qualitative distinction (i.e., taxon) separating youth with ADHD from those with subclinical inattention or hyperactivity/impulsivity problems. Although adult ADHD appears to be less prevalent than ADHD in youth (which could suggest a more severe adult ADHD taxon), researchers have yet to examine the latent structure of ADHD in adults. The present study used a sample (N = 600) of adults who completed a self-report measure of ADHD symptoms. The taxometric analyses revealed a dimensional latent structure for inattention, hyperactivity/impulsivity, and ADHD. These findings are consistent with previous taxometric studies that examined ADHD in children and adolescents, and with contemporary polygenic and multifactorial models of ADHD. Copyright © 2012 Elsevier Ltd. All rights reserved.

Differential brain activations in adult attention-deficit/ hyperactivity disorder subtypes: a counting Stroop functional MRI study.

PubMed

Shang, Chi-Yung; Sheng, Chia; Yang, Li-Kuang; Chou, Tai-Li; Gau, Susan Shur-Fen

2018-06-01

Although previous functional neuroimaging studies have found abnormal brain activations in individuals with attention deficit hyperactivity disorder (ADHD), little was known about distinct brain dysfunctions across different ADHD subtypes. The objective of the present study was to investigate the abnormal brain activations associated with two ADHD subtypes, predominantly inattentive (ADHD-PI) and combined (ADHD-C) subtypes. Twenty-five adults with ADHD-PI, 25 with ADHD-C, and 30 healthy controls (HC) participated in this study. The brain function of the participants were assessed by using the counting Stroop task inside the scanner and the Conners' Continuous Performance Test (CCPT) outside the scanner. The HC group showed greater activations in the caudate nucleus and inferior frontal gyrus (IFG) than the ADHD-PI and ADHD-C groups. The ADHD-PI group showed greater activations in the superior parietal lobule (SPL) than the ADHD-C group. In all participants with ADHD, we found negative correlations of activation in the left caudate and the left IFG with the standard deviation of the reaction time of the CCPT, and negative correlations of activation in the left SPL with the reaction time changes across different inter-stimulus intervals. Our results demonstrated altered brain activity in the frontostriatal networks of adults with ADHD-PI and the fronto-striato-parietal networks of adults with ADHD-C. Abnormalities in the parietal areas may represent the main difference between the ADHD-PI and ADHD-C subtypes.

Early fathering as a predictor of later psychosocial functioning among preschool children with behavior problems.

PubMed

Herbert, Sharonne D; Harvey, Elizabeth A; Lugo-Candelas, Claudia I; Breaux, Rosanna P

2013-07-01

The present study examined the role of early fathering in subsequent trajectories of social emotional and academic functioning of preschool children with behavior problems. Participants were 128 preschool-aged children (73 boys, 55 girls) with behavior problems whose biological fathers took part in a longitudinal study. Children were 3 years of age at the beginning of the study and were assessed annually for 3 years. Early paternal depressive symptoms predicted many aspects of children's outcome 3 years later, including externalizing and internalizing problems, social skills deficits, and lower cognitive and academic functioning, and predicted changes in children's externalizing, internalizing, and social problems across the preschool years. Paternal socioeconomic status (SES) also consistently predicted children's later functioning across these domains. Furthermore, self-reported paternal attention-deficit hyperactivity disorder (ADHD) symptoms and laxness, as well as observed frequent commands were associated with later externalizing problems in children. Paternal depressive symptoms and laxness mediated the relation between paternal ADHD symptoms and child functioning. Results suggest that aspects of early father functioning play an important role in the psychosocial, cognitive, and academic development of preschool-aged children with behavior problems.

Amygdalar, hippocampal, and thalamic volumes in youth at high risk for development of bipolar disorder

PubMed Central

Karchemskiy, Asya; Garrett, Amy; Howe, Meghan; Adleman, Nancy; Simeonova, Diana I.; Alegria, Dylan; Reiss, Allan; Chang, Kiki

2011-01-01

Children of parents with bipolar disorder (BD), especially those with attention deficit hyperactivity disorder (ADHD) and symptoms of depression or mania, are significantly at high-risk for developing BD. As we have previously shown amygdalar reductions in pediatric BD, the current study examined amygdalar volumes in offspring of parents with (BD offspring) who have not yet developed a full manic episode. Youth participating in the study included 22 BD offspring and 22 healthy controls of comparable age, gender, handedness, and IQ. Subjects had no history of a manic episode, but met criteria for ADHD and moderate mood symptoms. MRI was performed on a 3T GE scanner, using a 3D volumetric spoiled gradient echo series. Amygdalae were manually traced using BrainImage Java software on positionally normalized brain stacks. Bipolar offspring had similar amygdalar volumes compared to the control group. Exploratory analyses yielded no differences in hippocampal or thalamic volumes. Bipolar offspring do not show decreased amygdala volume, possibly because these abnormalities occur after more prolonged illness rather than as a preexisting risk factor. Longitudinal studies are needed to determine whether amygdalar volumes change during and after the development of BD. PMID:22041532

Amygdalar, hippocampal, and thalamic volumes in youth at high risk for development of bipolar disorder.

PubMed

Karchemskiy, Asya; Garrett, Amy; Howe, Meghan; Adleman, Nancy; Simeonova, Diana I; Alegria, Dylan; Reiss, Allan; Chang, Kiki

2011-12-30

Children of parents with bipolar disorder (BD), especially those with attention deficit hyperactivity disorder (ADHD) and symptoms of depression or mania, are at significantly high risk for developing BD. As we have previously shown amygdalar reductions in pediatric BD, the current study examined amygdalar volumes in offspring of parents (BD offspring) who have not yet developed a full manic episode. Youth participating in the study included 22 BD offspring and 22 healthy controls of comparable age, gender, handedness, and IQ. Subjects had no history of a manic episode, but met criteria for ADHD and moderate mood symptoms. MRI was performed on a 3T GE scanner, using a 3D volumetric spoiled gradient echo series. Amygdalae were manually traced using BrainImage Java software on positionally normalized brain stacks. Bipolar offspring had similar amygdalar volumes compared to the control group. Exploratory analyses yielded no differences in hippocampal or thalamic volumes. Bipolar offspring do not show decreased amygdalar volume, possibly because these abnormalities occur after more prolonged illness rather than as a preexisting risk factor. Longitudinal studies are needed to determine whether amygdalar volumes change during and after the development of BD. 2011 Elsevier Ireland Ltd. All rights reserved.

Early Fathering as a Predictor of Later Psychosocial Functioning Among Preschool Children with Behavior Problems

PubMed Central

Herbert, Sharonne D.; Harvey, Elizabeth A.; Lugo-Candelas, Claudia I.; Breaux, Rosanna P.

2015-01-01

Objective The present study examined the role of early fathering in subsequent trajectories of social emotional and academic functioning of preschool children with behavior problems. Method Participants were 128 preschool-aged children (73 boys, 55 girls) with behavior problems whose biological fathers took part in a longitudinal study. Children were 3 years of age at the beginning of the study and were assessed annually for 3 years. Results Early paternal depressive symptoms predicted many aspects of children’s outcome 3 years later, including externalizing and internalizing problems, social skills deficits, and lower cognitive and academic functioning, and predicted changes in children’s externalizing, internalizing, and social problems across the preschool years. Paternal socioeconomic status (SES) also consistently predicted children’s later functioning across these domains. Furthermore, self-reported paternal attention deficit hyperactivity disorder (ADHD) symptoms and laxness, as well as observed frequent commands were associated with later externalizing problems in children. Paternal depressive symptoms and laxness mediated the relation between paternal ADHD symptoms and child functioning. Conclusions Results suggest that aspects of early father functioning play an important role in the psychosocial, cognitive, and academic development of preschool-aged children with behavior problems. PMID:23269560

Sleep problems in pediatric epilepsy and ADHD: The impact of comorbidity.

PubMed

Ekinci, Ozalp; Okuyaz, Çetin; Gunes, Serkan; Ekinci, Nuran; Kalınlı, Merve; Tan, Muhammet Emin; Teke, Halenur; Direk, Meltem Çobanoğulları; Erdoğan, Semra

2017-06-01

Attention-deficit hyperactivity disorder (ADHD) is a frequent comorbidity in pediatric epilepsy. Although sleep problems are commonly reported in both children with primary ADHD and epilepsy, those with epilepsy-ADHD comorbidity have not been well studied. This study aimed to compare sleep problems among three groups of children: 1) children with epilepsy, 2) children with epilepsy and ADHD (epilepsy-ADHD), and 3) children with primary ADHD. 53 children with epilepsy, 35 children with epilepsy-ADHD, and 52 children with primary ADHD completed the Children's Sleep Habits Questionnaire (CSHQ). Neurology clinic charts were reviewed for the epilepsy-related variables. ADHD subtypes were diagnosed according to the DSM-IV. Children with epilepsy-ADHD had the highest CSHQ total scores, while children with primary ADHD had higher scores than those with epilepsy. Besides the total score, epilepsy-ADHD group differed from the primary ADHD and epilepsy groups with higher CSHQ subscores on sleep onset delay and sleep anxiety. The frequency of moderate-severe sleep problems (CSHQ>56) was 62.9% in children with epilepsy-ADHD, while it was 40.4% and 26.4% in children with primary ADHD and epilepsy, respectively. CSHQ total scores were not different between ADHD subtypes in both children with epilepsy-ADHD and those with primary ADHD. None of the epilepsy-related variables were found to be associated with CSHQ scores. Epilepsy-ADHD is associated with a significantly poor sleep quality which is beyond that of primary ADHD and epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

Testing for Neuropsychological Endophenotypes in Siblings Discordant for ADHD

PubMed Central

Bidwell, L. Cinnamon; Willcutt, Erik G.; DeFries, John C.; Pennington, Bruce F.

2007-01-01

Objective Neurocognitive deficits associated with attention deficit-hyperactivity disorder (ADHD) may be useful intermediate endophenotypes for determining specific genetic pathways that contribute to ADHD. Methods This study administered 17 measures from prominent neuropsychological theories of ADHD (executive function, processing speed, arousal regulation and motivation/delay aversion) in dizygotic (DZ) twin pairs discordant for ADHD and control twin pairs (ages 8–18) in order to compare performance between twins affected with ADHD (n = 266), their unaffected co-twins (n = 228), and control children from twin pairs without ADHD or learning difficulties (n = 332). Results ADHD subjects show significant impairment on executive function, processing speed, and response variability measures compared to control subjects. Unaffected cotwins of ADHD subjects are significantly impaired on nearly all the same measures as their ADHD siblings, even when subclinical symptoms of ADHD are controlled. Conclusion Executive function, processing speed, and response variability deficits may be useful endophenotypes for genetic studies of ADHD. PMID:17585884

The Impact of Pharmacotherapy on Substance Use in Adolescents With Attention-Deficit/Hyperactivity Disorder: Variations Across Subtypes.

PubMed

Upadhyay, Navneet; Chen, Hua; Mgbere, Osaro; Bhatara, Vinod S; Aparasu, Rajender R

2017-08-24

The primary purpose of this study was to investigate the impact of attention-deficit/hyperactivity disorder (ADHD) pharmacotherapy on the risk of substance use within each ADHD subtype. The study used data from the National Comorbidity Survey-Adolescent supplement, a nationally representative sample of US adolescents (ages 13-18) collected from 6,483 adolescent-parent interviews conducted between 2001 and 2004. ADHD was categorized into three subtypes: ADHD-predominantly hyperactive-impulsive type (ADHD-H); ADHD-predominantly inattentive type (ADHD-I); and ADHD-combined type (ADHD-C) using Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Substance use information was obtained from the adolescents' interview. The impact of ADHD-pharmacotherapy on substance use was examined using multivariable logistic regression analysis. Among the adolescents with ADHD, ADHD pharmacotherapy significantly associated with reduced risk of substance use (OR = 0.53, 95%CI [0.31-0.90]); with regards to ADHD subtypes, ADHD pharmacotherapy is negatively associated with substance use in adolescents with ADHD-C (OR = 0.53, 95%CI [0.24-0.97]) and those with ADHD-H (OR = 0.23, 95% CI [0.07-0.78]), but it did not have statistically significant effect on risk of substance use in those with ADHD-I subtype (OR = 0.49, 95%CI [0.17-1.39]). Among the group who never received ADHD-pharmacotherapy before the interview, individuals with ADHD-H and ADHD-C had a similar risk of substance use compared to adolescents with ADHD-I (ADHD-C: OR = 1.5, 95%CI [0.77-2.95] and ADHD-H: OR = 2.10, 95%CI [0.87-4.95]). Adolescents with ADHD were equally susceptible to future substance use disregard their ADHD subtypes. Receipt of pharmacotherapy could decrease risk of substance use in adolescents with ADHD-H and ADHD-C, but it may not affect risk of substance use among individuals with ADHD-I.

Factor-Analytic and Individualized Approaches to Constructing Brief Measures of ADHD Behaviors

ERIC Educational Resources Information Center

Volpe, Robert J.; Gadow, Kenneth D.; Blom-Hoffman, Jessica; Feinberg, Adam B.

2009-01-01

Two studies were performed to examine a factor-analytic and an individualized approach to creating short progress-monitoring measures from the longer "ADHD-Symptom Checklist-4" (ADHD-SC4). In Study 1, teacher ratings on items of the ADHD:Inattentive (IA) and ADHD:Hyperactive-Impulsive (HI) scales of the ADHD-SC4 were factor analyzed in a normative…

The genetics of attention deficit/hyperactivity disorder in adults, a review

PubMed Central

Franke, B; Faraone, S V; Asherson, P; Buitelaar, J; Bau, C H D; Ramos-Quiroga, J A; Mick, E; Grevet, E H; Johansson, S; Haavik, J; Lesch, K-P; Cormand, B; Reif, A

2012-01-01

The adult form of attention deficit/hyperactivity disorder (aADHD) has a prevalence of up to 5% and is the most severe long-term outcome of this common neurodevelopmental disorder. Family studies in clinical samples suggest an increased familial liability for aADHD compared with childhood ADHD (cADHD), whereas twin studies based on self-rated symptoms in adult population samples show moderate heritability estimates of 30–40%. However, using multiple sources of information, the heritability of clinically diagnosed aADHD and cADHD is very similar. Results of candidate gene as well as genome-wide molecular genetic studies in aADHD samples implicate some of the same genes involved in ADHD in children, although in some cases different alleles and different genes may be responsible for adult versus childhood ADHD. Linkage studies have been successful in identifying loci for aADHD and led to the identification of LPHN3 and CDH13 as novel genes associated with ADHD across the lifespan. In addition, studies of rare genetic variants have identified probable causative mutations for aADHD. Use of endophenotypes based on neuropsychology and neuroimaging, as well as next-generation genome analysis and improved statistical and bioinformatic analysis methods hold the promise of identifying additional genetic variants involved in disease etiology. Large, international collaborations have paved the way for well-powered studies. Progress in identifying aADHD risk genes may provide us with tools for the prediction of disease progression in the clinic and better treatment, and ultimately may help to prevent persistence of ADHD into adulthood. PMID:22105624

Is ADHD a Risk Factor for High School Dropout? A Controlled Study.

PubMed

Fried, Ronna; Petty, Carter; Faraone, Stephen V; Hyder, Laran L; Day, Helen; Biederman, Joseph

2016-05-01

This study examined whether ADHD was an independent contributor to grade retention when adjusting for IQ, learning disorders, and social class. Outcome data was from participants in studies at Massachusetts General Hospital (n= 404 ADHD,n= 349 controls) who underwent psychiatric interviews, socioeconomic status measures, and IQ testing. 28% of individuals with ADHD repeated a grade compared with 7% of controls (p< .001). Among participants with ADHD, social class, and IQ were significant predictors of high school dropout or repeated grade. An interaction effect of ADHD and gender was also found with females with ADHD having a higher risk ratio for repeated grade/dropout compared with males with ADHD. Participants with ADHD were significantly more likely to repeat a grade, adjusting for all other variables indicating the critical importance of early identification of ADHD to help mitigate adverse educational outcomes. © The Author(s) 2013.

Handwriting assessment to distinguish comorbid learning difficulties from attention deficit hyperactivity disorder in Chinese adolescents: A case-control study.

PubMed

Li-Tsang, Cecilia W P; Li, Tim M H; Lau, Mandy S W; Ho, Choco H Y; Leung, Howard W H

2018-05-15

Attention deficit hyperactivity disorder (ADHD) and learning difficulties (LDs) are proposed as 2 overlapping disorders. The objective of this study was to investigate the handwriting performance in ADHD and comorbid ADHD-LD adolescents. The study examined the Chinese and English handwriting performance and sensorimotor skills of 32 ADHD, 12 ADHD-LD, and their matched controls. Participants with ADHD had comparable writing time and speed, but the readability was lower than their controls. Participants with ADHD-LD had lower writing speeds in both Chinese and English handwriting than their controls. The ADHD and ADHD-LD groups also showed larger variations in either speed or pen pressure than their controls. Chinese handwriting assessment effectively classified ADHD and ADHD-LD with good sensitivity and positive predictive value. Clinicians should be aware of the fundamental difference between the 2 disorders and make good use of handwriting assessment as a reference to deliver effective therapies and trainings. Copyright © 2018 John Wiley & Sons, Ltd.

Sleep Disturbances in Adolescents with ADHD: A Systematic Review and Framework for Future Research

PubMed Central

Lunsford-Avery, Jessica R.; Krystal, Andrew D.; Kollins, Scott H.

2016-01-01

Background Biological mechanisms underlying symptom and prognostic heterogeneity in Attention-Deficit/Hyperactivity Disorder (ADHD) are unclear. Sleep impacts neurocognition and daytime functioning and is disrupted in ADHD, yet little is known about sleep in ADHD during adolescence, a period characterized by alterations in sleep, brain structure, and environmental demands as well as diverging ADHD trajectories. Methods A systematic review identified studies published prior to August 2016 assessing sleep in adolescents (aged 10–19 years) with ADHD or participating in population-based studies measuring ADHD symptoms. Results Twenty-five studies were identified (19 subjective report, 6 using actigraphy/polysomnography). Findings are mixed but overall suggest associations between sleep disturbances and 1) ADHD symptoms in the population and 2) poorer clinical, neurocognitive, and functional outcomes among adolescents with ADHD. Common limitations of studies included small or non-representative samples, non-standardized sleep measures, and cross-sectional methodology. Conclusions Current data on sleep in adolescent ADHD are sparse and limited by methodological concerns. Future studies are critical for clarifying a potential role of sleep in contributing to heterogeneity of ADHD presentation and prognosis. Potential mechanisms by which sleep disturbances during adolescence may contribute to worsened symptom severity and persistence of ADHD into adulthood and an agenda to guide future research are discussed. PMID:27969004

Infant brain structures, executive function, and attention deficit/hyperactivity problems at preschool age. A prospective study.

PubMed

Ghassabian, Akhgar; Herba, Catherine M; Roza, Sabine J; Govaert, Paul; Schenk, Jacqueline J; Jaddoe, Vincent W; Hofman, Albert; White, Tonya; Verhulst, Frank C; Tiemeier, Henning

2013-01-01

Neuroimaging findings have provided evidence for a relation between variations in brain structures and attention deficit/hyperactivity disorder (ADHD). However, longitudinal neuroimaging studies are typically confined to children who have already been diagnosed with ADHD. In a population-based study, we aimed to characterize the prospective association between brain structures measured during infancy and executive function and attention deficit/hyperactivity problems assessed at preschool age. In the Generation R Study, the corpus callosum length, the gangliothalamic ovoid diameter (encompassing the basal ganglia and thalamus), and the ventricular volume were measured in 784 6-week-old children using cranial postnatal ultrasounds. Parents rated executive functioning at 4 years using the behavior rating inventory of executive function-preschool version in five dimensions: inhibition, shifting, emotional control, working memory, and planning/organizing. Attention deficit/hyperactivity problems were assessed at ages 3 and 5 years using the child behavior checklist. A smaller corpus callosum length during infancy was associated with greater deficits in executive functioning at 4 years. This was accounted for by higher problem scores on inhibition and emotional control. The corpus callosum length during infancy did not predict attention deficit/hyperactivity problem at 3 and 5 years, when controlling for the confounders. We did not find any relation between gangliothalamic ovoid diameter and executive function or Attention deficit/hyperactivity problem. Variations in brain structures detectible in infants predicted subtle impairments in inhibition and emotional control. However, in this population-based study, we could not demonstrate that early structural brain variations precede symptoms of ADHD. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

Searching for a neurobiological basis for self-medication theory in ADHD comorbid with substance use disorders: an in vivo study of dopamine transporters using (99m)Tc-TRODAT-1 SPECT.

PubMed

Silva, Neivo; Szobot, Claudia M; Shih, Ming C; Hoexter, Marcelo Q; Anselmi, Carlos Eduardo; Pechansky, Flavio; Bressan, Rodrigo A; Rohde, Luis Augusto

2014-02-01

Attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUD) frequently co-occur. Although several studies have shown changes in striatal dopamine transporter (DAT) density in these disorders, little is known about the neurobiological basis of the comorbidity. The aim of this study was to evaluate striatal DAT density in treatment-naive ADHD adolescents with SUD (ADHD + SUD) and without SUD (ADHD), compared to SUD adolescents without ADHD (SUD) and healthy control subjects (HC). Sixty-two male age-matched subjects diagnosed with DSM-IV criteria were included: ADHD + SUD (n = 18), SUD (n = 14), HC (n = 19), and ADHD (n = 11). Urine tests confirmed participants' drug use. All subjects performed SPECT scans with Tc-TRODAT-1 to evaluate DAT density in the striatum. The mean right striatum specific binding were 1.68 (ADHD), 1.38 (ADHD + SUD), 1.19 (HC), 1.17 (SUD), and in left striatum 1.65 (ADHD), 1.39 (ADHD + SUD), 1.19 (HC), and 1.17 (SUD). The ADHD group presented significantly higher striatal DAT density compared with ADHD + SUD, SUD, and HC groups. Adolescents with ADHD + SUD had significantly lower DAT density than those with ADHD, but significantly higher DAT density than those with SUD only and no significant difference from the healthy control group. The ADHD + SUD group had lower striatal DAT density in comparison with ADHD without SUD. It is possible to speculate that the use of cannabis and cocaine is responsible for the lower striatal DAT density in this group which would help in understanding the neurobiological basis for the self-medication theory in ADHD adolescents.

The influence of maternal dietary exposure to dioxins and PCBs during pregnancy on ADHD symptoms and cognitive functions in Norwegian preschool children.

PubMed

Caspersen, Ida Henriette; Aase, Heidi; Biele, Guido; Brantsæter, Anne Lise; Haugen, Margaretha; Kvalem, Helen Engelstad; Skogan, Annette Holth; Zeiner, Pål; Alexander, Jan; Meltzer, Helle Margrete; Knutsen, Helle K

2016-09-01

Polychlorinated dibenzo-p-dioxins/dibenzofurans (dioxins) and polychlorinated biphenyls (PCBs) are persistent organic pollutants (POPs) with potentially adverse impact on child neurodevelopment. Whether the potential detrimental effects of dioxins and PCBs on neurodevelopment are of specific or unspecific character is not clear. The purpose of the current study was to examine the influence of maternal dietary exposure to dioxins and PCBs on ADHD symptoms and cognitive functioning in preschoolers. We aimed to investigate a range of functions, in particular IQ, expressive language, and executive functions. This study includes n=1024 children enrolled in a longitudinal prospective study of ADHD (the ADHD Study), with participants recruited from The Norwegian Mother and Child Cohort Study (MoBa). Boys and girls aged 3.5years participated in extensive clinical assessments using well-validated tools; The Preschool Age Psychiatric Assessment interview (PAPA), Stanford-Binet 5th revision (SB-5), Child Development Inventory (CDI), and Behavior Rating Inventory of Executive Function, Preschool version (BRIEF-P). Maternal dietary exposure to dioxins and PCBs was estimated based on a validated food frequency questionnaire (FFQ) answered mid-pregnancy and a database of dioxin and PCB concentrations in Norwegian foods. Exposure to dioxins and dioxin-like PCBs (dl-compounds) was expressed in total toxic equivalents (TEQ), and PCB-153 was used as marker for non-dioxin-like PCBs (ndl-PCBs). Generalized linear and additive models adjusted for confounders were used to examine exposure-outcome associations. Exposure to PCB-153 or dl-compound was not significantly associated with any of the outcome measures when analyses were performed for boys and girls together. After stratifying by sex, adjusted analyses indicated a small inverse association with language in girls. An increase in the exposure variables of 1 SD was associated with a reduction in language score of -0.2 [CI -0.4, -0.1] for PCB-153 and -0.2 [CI -0.5, -0.1] for dl-compounds in girls. For boys, exposure to PCB-153 or dl-compounds was not associated with language skills. The difference between sex-specific associations was not statistically significant (p-value=0.13). No sex-specific effects were observed for ADHD-symptoms, IQ scores, or executive functions. We found no indications that variation in current low-level exposure to PCB-153 or dl-compounds in Norway is associated with variation ADHD-symptoms, verbal/non-verbal IQ, or executive functions including working memory in preschoolers. However, our findings indicated that maternal dietary exposure to PCB-153 or dl-compounds during pregnancy was significantly associated with poorer expressive language skills in preschool girls, although the sex-specific associations were not significantly different. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reading outcomes of children and adolescents with attention-deficit/hyperactivity disorder and dyslexia following atomoxetine treatment.

PubMed

Shaywitz, Bennett A; Williams, David W; Fox, Bethany K; Wietecha, Linda A

2014-10-01

Abstract Objective: This study assessed the efficacy of atomoxetine on attention-deficit/hyperactivity disorder (ADHD) symptoms in children and adolescents having ADHD with comorbid dyslexia (ADHD+D) and the effects of the treatment on reading measures. The analyses in this report used data from a study designed to examine the effects of a nonstimulant pharmacological agent, atomoxetine, on reading in children with ADHD+D. Patients ages 10-16 years with ADHD or ADHD+D received open-label atomoxetine for 16 weeks. The ADHD Rating Scale (ADHD-RS) and reading subtests of the Kaufman Test of Educational Achievement (K-TEA) were assessed. Changes in ADHD symptoms and reading scores were also analyzed by ADHD subtype. Treatment effect sizes and correlations between changes in ADHDRS and K-TEA scores were calculated. After atomoxetine treatment, both ADHD and ADHD+D patient groups showed significant reduction in ADHD symptom and improvements in K-TEA reading scores. The range of treatment effect sizes on K-TEA scores was 0.35-0.53 for the ADHD group and 0.50-0.62 for the ADHD+D group. Pearson's correlation coefficients revealed only a few weak correlations between changes in ADHD symptoms and reading scores, regardless of diagnostic group. ADHD symptoms and K-TEA reading scores improved for both the ADHD and ADHD+D groups following atomoxetine treatment. Correlation analyses indicate that improvements in reading outcomes cannot be explained by a reduction of ADHD symptoms alone. These findings support further exploration of the potential effects of atomoxetine on reading in children with ADHD and dyslexia or dyslexia alone.

What "Dr. Mom" ordered: a community-based exploratory study of parental self-care responses to children's ADHD symptoms.

PubMed

Bussing, Regina; E Koro-Ljungberg, Mirka; Williamson, Pamela; Gary, Faye A; Wilson Garvan, Cynthia

2006-08-01

Little is known about family initiated self-care interventions in response to symptoms of attention deficit/hyperactivity disorder (ADHD), and how self-care may co-exist with professional treatments. This paper explores parental self-care strategies for children with hyperactivity or attention problems, and examines factors and domains that influence their use from the mixed method perspective. As part of a longitudinal cohort study of ADHD detection and service use, caregivers of a representative US community sample of 266 children at high risk for ADHD completed a questionnaire that assessed five self-care strategies (behavior modification, coping, diet, over-the-counter medication use and religious practices), and made open-ended inquiry about discipline changes in response to behavioral concerns. Questionnaire responses were analyzed using logistic regression approaches. Open-ended answers were open coded; secondary analysis followed Spradley's model of domain analysis. Quantitative findings showed that behavior modification was the most commonly tried self-care strategy, followed by coping, diet, and religious practices. Over-the-counter trial was least common. The parents of professionally treated children were more likely to have employed behavior modification, coping strategies and over-the-counter medications than the parents of untreated children. Two-thirds of parents had changed their disciplinary action within three domains that were identified through qualitative analysis, including changes related to (a) the prevention of disciplinary problems (e.g., sustain eye contact, activation, consistency, clear instructions), (b) the solution of disciplinary problems (e.g., time-outs; privilege removal), and (c) parental coping associated with disciplinary problems (e.g., control own emotions, become less judgmental and more tolerant, and develop more appropriate expectations). These findings suggest that self-care strategies are commonly employed and appear to co-exist with professional treatment. Therefore, healthcare providers should actively explore parents' use of such strategies as some of them may interfere with prescribed treatments (e.g., over-the-counter) or absorb parental resources without likely benefit (e.g., diet).

Cross-sectional study of self-reported ADHD symptoms and psychological comorbidity among college students in Chandigarh, India.

PubMed

Jhambh, Ishani; Arun, Priti; Garg, Jasmin

2014-01-01

Existence of attention deficit hyperactivity disorder (ADHD) in adults is scantily researched in India. There is dearth of information on prevalence of ADHD in college students worldwide. Further, fewer studies in the past have evaluated the impact of ADHD on the psychological well-being of college students. To study the prevalence of ADHD among college students and psychological problems related to ADHD. Cross-sectional study. A total of 237 students were recruited from various medical, engineering, and commerce and arts colleges of Chandigarh, India. They were administered the Adult ADHD Self Report Scale v1.1(ASRS) and the Wender Utah Rating Scale (WURS) to diagnose adult ADHD. To assess comorbidities; General Health Questionnaire-12 (GHQ); Zung Depression Rating Scale (ZDRS); Rosenberg's Self-Esteem Scale (RSES);and questions on emotional stability, social problems, and substance use (alcohol, tobacco, and cannabis) were administered on all participants. A total of 13 students (5.48%) fulfilled the criteria for adult ADHD. These students experienced significantly higher emotional instability and low self-esteem than those without ADHD (N = 224). The occurrence of psychological problems, depression, social problems, and substance abuse was comparable in students with and without ADHD. ADHD is prevalent among the college students studying in the most competitive institutes as well. Students with ADHD experience higher emotional instability and poor self-esteem than others. It has little effect on their psychological well-being and social adjustment. Prompt detection and management of ADHD in college students may help them deal with these problems effectively.

Cognition and impulsivity in adults with attention deficit hyperactivity disorder with and without cocaine and/or crack dependence.

PubMed

Miguel, Carmen S; Martins, Paula A; Moleda, Nathalya; Klein, Margarete; Chaim-Avancini, Tiffany; Gobbo, Maria A; Alves, Tania M; Silva, Maria A; Louzã, Mario R

2016-03-01

Substance use disorder (SUD) is a common comorbidity in adults with attention deficit-hyperactivity disorder (ADHD). However,there have been few studies on cognitive profiles of these patients. Impulsivity is also commonly increased in both disorders. The central aim of this study was to compare cognition and impulsivity in subjects who had ADHD and cocaine dependence (ADHD+COC group) to those with ADHD only (ADHD-noSUD group). We hypothesized that the ADHD+COC group would show more marked cognitive dysfunction and greater impulsivity than their counterparts with ADHD only. A total of 70 adult patients diagnosed with ADHD according to (DSM-IV-TR) criteria were enrolled; 36 with ADHD+COC and 34 with ADHD-noSUD. All study participants were evaluated with a sociodemographic questionnaire; the Mini International Neuropsychiatric Interview; the Adult ADHD Self-Report Scale; the Addiction Severity Index; the Alcohol, Smoking and Substance Involvement Screening Test; the Barratt Impulsiveness Scale; and a comprehensive neurocognitive battery. Compared to individuals with ADHD-noSUD, ADHD+COC individuals had significantly lower mean IQ and higher motor impulsivity. On average, the ADHD+COC group also performed more poorly on tasks assessing verbal skills, vigilance, implicit learning during decision making, and ADHD-noSUD performed more poorly on selective attention, information processing, and visual search. Our results support the integrative theory of ADHD based on the cognitive and affective neuroscience model, and suggests that ADHD-noSUD patients have impairments in cognitive regulation, while ADHD+COC patients have impairments in both cognitive and affective regulation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Amygdala-prefrontal cortical functional connectivity during implicit emotion processing differentiates youth with bipolar spectrum from youth with externalizing disorders.

PubMed

Hafeman, Danella; Bebko, Genna; Bertocci, Michele A; Fournier, Jay C; Chase, Henry W; Bonar, Lisa; Perlman, Susan B; Travis, Michael; Gill, Mary Kay; Diwadkar, Vaibhav A; Sunshine, Jeffrey L; Holland, Scott K; Kowatch, Robert A; Birmaher, Boris; Axelson, David; Horwitz, Sarah M; Arnold, L Eugene; Fristad, Mary A; Frazier, Thomas W; Youngstrom, Eric A; Findling, Robert L; Phillips, Mary L

2017-01-15

Both bipolar spectrum disorders (BPSD) and attention deficit hyperactivity disorder (ADHD) present with emotion-regulation deficits, but require different clinical management. We examined how the neurobiological underpinnings of emotion regulation might differentiate youth with BPSD versus ADHD (and healthy controls, HCs), specifically assessing functional connectivity (FxC) of amygdala-prefrontal circuitry during an implicit emotion processing task. We scanned a subset of the Longitudinal Assessment of Manic Symptoms (LAMS) sample, a clinically recruited cohort with elevated behavioral and emotional dysregulation, and age/sex-ratio matched HCs. Our sample consisted of 22 youth with BPSD, 30 youth with ADHD/no BPSD, and 26 HCs. We used generalized psychophysiological interaction (gPPI) to calculate group differences to emerging emotional faces vs. morphing shapes in FxC between bilateral amygdala and ventral prefrontal cortex/anterior cingulate cortex. FxC between amygdala and left ventrolateral prefrontal cortex (VLPFC) in response to emotions vs. shapes differed by group (p=.05): while BPSD showed positive FxC (emotions>shapes), HC and ADHD showed inverse FxC (emotions

Predictors of Medication Continuity in Children With ADHD.

PubMed

Brinkman, William B; Sucharew, Heidi; Majcher, Jessica Hartl; Epstein, Jeffery N

2018-06-01

To identify predictors of attention-deficit/hyperactivity disorder (ADHD) medication continuity, hypothesizing greater continuity among children with (1) greater child acceptance of treatment, (2) parent belief in longer time course for ADHD, (3) positive differential between parent-perceived need for and concerns about medication, and (4) greater parent-perceived alliance with their child's doctor. We conducted a prospective longitudinal cohort of 89 children aged 6 to 10 years old newly treated for ADHD by 1 of 44 pediatricians in 11 practices. Parents completed validated surveys on their beliefs about ADHD and medicine. We audited charts and obtained pharmacy dispensing records. In our analyses, we examined the relationship between predictor variables (eg, sociodemographic and clinical characteristics, quality of care, and belief measures) and short-term (first 90 days after starting medication) and long-term (91-450 days) medication continuity as defined by the number of days covered with medication. Children had a median of 81% of days covered over 0 to 90 days and 54% of days covered over 91 to 450 days after starting medicine. In the first 90 days, medication coverage related to child age, satisfaction with information about medicine, medication titration, symptom reduction, parent beliefs about control over symptoms, uncertainty about treating with medicine, and working alliance. Long-term medication continuity related to child acceptance of treatment and differential between parent-perceived need for and concerns about medication at 3 months, not baseline factors. Adherence is a process that can change over time in response to experiences with treatment. Interventions are needed to promote productive interactions between pediatricians and families in support of continuity. Copyright © 2018 by the American Academy of Pediatrics.

A longitudinal analysis of shooter games and their relationship with conduct disorder and cself-reported delinquency.

PubMed

Smith, Sven; Ferguson, Chris; Beaver, Kevin

Despite several decades of research, little scholarly consensus has emerged regarding the role of violent video games in the development of youth psychopathology or crime. The current study employed the Avon Longitudinal Study of Parents and Children longitudinal dataset to examine the impact of the shooter game genre ownership in childhood on later adolescent conduct disorder and criminal behavior. Multivariate Poisson regressions with the robust estimator correlation matrix were performed comparing effects of independent and confounding variables. Results revealed that early childhood mental health symptoms at age seven related to ADHD, depression and early conduct disorder predicted criminal behavior at age fifteen. Male gender also predicted criminal behavior at age fifteen. However, exposure to shooter games did not predict adolescent conduct disorder or criminal behavior. We have found support that suggests that the role of violent video games in the development of youth psychopathology or crime is very little if any. Lack of a relationship between exposure to shooter games and later conduct and criminal behavior problems may be understood within the context of the Catalyst Model. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Substance use disorders and ADHD: an overview of recent Dutch research].

PubMed

van Emmerik-van Oortmerssen, K; Crunelle, C L; Carpentier, P J

2013-01-01

ADHD is an important risk factor for the development of substance use disorders (SUD). To provide an overview of recent Dutch research into the prevalence of ADHD in SUD populations and the neurobiological substrate of the reduced effect of pharmacological treatment of this patient group. We describe three studies: a meta-analysis and meta-regression analysis of the prevalence of ADHD in 6689 SUD patients; a cross-sectional study of the prevalence of ADHD and several other psychiatric disorders in 193 methadon maintenance patients, and finally a study in which the availability and occupation of dopamine transporters before and after methylphenidate treatment were measured using SPECT scans in 24 ADHD patients with and without cocaine addiction. The prevalence of ADHD in SUD patients is estimated to be 23.1% (95% confidence interval 19.4-27.2). This prevalence is influenced by the diagnostic instrument for ADHD and by the substance of abuse: cocaine is associated with a lower ADHD prevalence than other substances. The prevalence found among methadone maintenance patients was similar, namely 24.9%; additional comorbid psychiatric disorders were also frequently present. In the imaging study, lower availability of dopamine transporters and lower occupation by methylphenidate were found in cocaine-dependent ADHD patients than in ADHD patients without SUD. These studies confirm the high prevalence of ADHD in SUD patients, and provide a possible explanation for the reduced efficacy of methylphenidate in this patient population.

The relationships among ADHD, self-esteem, and test anxiety in young adults.

PubMed

Dan, Orrie; Raz, Sivan

2015-03-01

The comorbidity of adult ADHD with test anxiety (TA) has not been previously reported. This comorbidity can potentially affect clinical and academic interventions among individuals with ADHD. The present study investigated the relationships among ADHD, self-esteem, and three subscales of TA among young adults: Cognitive Obstruction, Social Derogation, and Tenseness. A total of 25 female participants diagnosed with ADHD and 30 female controls without ADHD of comparable age and education completed an Online Continuous Performance Test, an ADHD questionnaire, a self-esteem inventory, and a TA questionnaire. Participants with ADHD exhibited significantly higher levels of TA on all three subscales and lower levels of self-esteem compared with controls. Self-esteem served as a partial mediator between ADHD and cognitive obstruction TA and as a full mediator between ADHD and social derogation TA, but had no mediation effect in the relationships between ADHD and tenseness TA. The findings of this study suggest that TA, well known to affect success on tests, is correlated with ADHD. Therefore, interventions for ADHD should include components aimed at reducing TA. © 2012 SAGE Publications.

Visual search for feature conjunctions: an fMRI study comparing alcohol-related neurodevelopmental disorder (ARND) to ADHD.

PubMed

O'Conaill, Carrie R; Malisza, Krisztina L; Buss, Joan L; Bolster, R Bruce; Clancy, Christine; de Gervai, Patricia Dreessen; Chudley, Albert E; Longstaffe, Sally

2015-01-01

Alcohol-related neurodevelopmental disorder (ARND) falls under the umbrella of fetal alcohol spectrum disorder (FASD). Diagnosis of ARND is difficult because individuals do not demonstrate the characteristic facial features associated with fetal alcohol syndrome (FAS). While attentional problems in ARND are similar to those found in attention-deficit/hyperactivity disorder (ADHD), the underlying impairment in attention pathways may be different. Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) was conducted at 3 T. Sixty-three children aged 10 to 14 years diagnosed with ARND, ADHD, and typically developing (TD) controls performed a single-feature and a feature-conjunction visual search task. Dorsal and ventral attention pathways were activated during both attention tasks in all groups. Significantly greater activation was observed in ARND subjects during a single-feature search as compared to TD and ADHD groups, suggesting ARND subjects require greater neural recruitment to perform this simple task. ARND subjects appear unable to effectively use the very efficient automatic perceptual 'pop-out' mechanism employed by TD and ADHD groups during presentation of the disjunction array. By comparison, activation was lower in ARND compared to TD and ADHD subjects during the more difficult conjunction search task as compared to the single-feature search. Analysis of DTI data using tract-based spatial statistics (TBSS) showed areas of significantly lower fractional anisotropy (FA) and higher mean diffusivity (MD) in the right inferior longitudinal fasciculus (ILF) in ARND compared to TD subjects. Damage to the white matter of the ILF may compromise the ventral attention pathway and may require subjects to use the dorsal attention pathway, which is associated with effortful top-down processing, for tasks that should be automatic. Decreased functional activity in the right temporoparietal junction (TPJ) of ARND subjects may be due to a reduction in the white matter tract's ability to efficiently convey information critical to performance of the attention tasks. Limited activation patterns in ARND suggest problems in information processing along the ventral frontoparietal attention pathway. Poor integrity of the ILF, which connects the functional components of the ventral attention network, in ARND subjects may contribute to the attention deficits characteristic of the disorder.

Attention problems among children with a positive family history of alcohol abuse or dependence and controls. Prevalence and course for the period from preteen to early teen years.

PubMed

Barnow, Sven; Schuckit, Marc; Smith, Tom; Spitzer, Carsten; Freyberger, Harald-J

2007-01-01

This longitudinal study investigated the scope and course of attention problems over a period of time from preteen (ages 7-12 years) to early teen years (ages 13-17 years). We compared symptoms in subjects with and without a family history (FH) of alcohol abuse or dependence from among families without evidence of antisocial personality disorder. Evaluations of attention problems for the offspring were based on the Child Behavior Checklist and a validated semistructured interview carried out with the mother. The findings indicate no higher risk for attention problems and attention-deficit hyperactivity disorder (ADHD)-like symptoms in the children of families with an alcohol use disorder. Regarding the course of problems, the ADHD symptom count tended to decrease over time, especially for children without a FH of alcohol abuse or dependence. Further research will be needed to determine whether results can be replicated with families from different social strata and including subjects with the antisocial personality disorder.

Neurochemical correlates of internet game play in adolescents with attention deficit hyperactivity disorder: A proton magnetic resonance spectroscopy (MRS) study.

PubMed

Bae, Sujin; Han, Doug Hyun; Kim, Sun Mi; Shi, Xianfeng; Renshaw, Perry F

2016-08-30

Previous studies have examined the relationship of brain metabolic changes in patients with attention deficit hyperactivity disorder (ADHD) and internet gaming disorder (IGD). However, these studies have been limited by a small number of subjects, a large variance in subject age, and different brain regions of interest. The present study assessed the effects of chronic internet game play in ADHD children. Twenty eight ADHD adolescents with IGD (IGD+ADHD), 27 ADHD adolescents without problematic internet game playing (ADHD only) and 42 healthy comparison adolescents (HC) were included in the study. Magnetic resonance spectroscopy (MRS) was performed on a 3T MRI scanner. Our results indicate that the levels of NAA in both ADHD groups were lower than those observed in the HC group. The levels of Glu+Gln in the ADHD only group were increased, compared to those observed in the control group. However, Glu+Gln was not increased in the IGD+ADHD group. In addition, the levels of Glu+Gln in the IGD+ADHD group were positively correlated with K-ARS total and inattention scores. ADHD and IGD subjects were both characterized by decreased NAA levels within the frontal lobe, consistent with hypofrontality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Gray Matter Increase in Motor Cortex in Pediatric ADHD: A Voxel-Based Morphometry Study.

PubMed

Sutcubasi Kaya, Bernis; Metin, Baris; Tas, Zeynep Cubukcuoglu; Buyukaslan, Ayse; Soysal, Aysegul; Hatiloglu, Deniz; Tarhan, Nevzat

2018-05-01

Several studies report that ADHD is associated with reduced gray matter (GM), whereas others report no differences in GM volume between ADHD patients and controls, and some even report more GM volume in individuals with ADHD. These conflicting findings suggest that reduced GM is not a universal finding in ADHD, and that more research is needed to delineate with greater accuracy the range of GM alterations. The present study aimed to identify GM alterations in ADHD using pediatric templates. 19 drug-naïve ADHD patients and 18 controls, all aged 7 to 14 years, were scanned using magnetic resonance imaging. Relative to the controls, the ADHD patients had more GM, predominantly in the precentral and supplementary motor areas. Moreover, there were positive correlations between GM volume in these areas and ADHD scale scores. The clinical and pathophysiological significance of increased GM in the motor areas remains to be elucidated by additional research.

Does Sluggish Cognitive Tempo Fit within a Bi-factor Model of Attention-Deficit/Hyperactivity Disorder?

PubMed Central

Garner, Annie A.; Peugh, James; Becker, Stephen P.; Kingery, Kathleen M.; Tamm, Leanne; Vaughn, Aaron J.; Ciesielski, Heather; Simon, John O.; Loren, Richard E. A.; Epstein, Jeffery N.

2014-01-01

Objective Studies demonstrate sluggish cognitive tempo (SCT) symptoms to be distinct from inattentive and hyperactive-impulsive dimensions of Attention-Deficit/Hyperactivity Disorder (ADHD). No study has examined SCT within a bi-factor model of ADHD whereby SCT may form a specific factor distinct from inattention and hyperactivity/impulsivity while still fitting within a general ADHD factor, which was the purpose of the current study. Method 168 children were recruited from an ADHD clinic. Most (92%) met diagnostic criteria for ADHD. Parents and teachers completed measures of ADHD and SCT. Results Although SCT symptoms were strongly associated with inattention they loaded onto a factor independent of ADHD ‘g’. Results were consistent across parent and teacher ratings. Conclusions SCT is structurally distinct from inattention as well as from the general ADHD latent symptom structure. Findings support a growing body of research suggesting SCT to be distinct and separate from ADHD. PMID:25005039

Rejection Sensitivity and Social Outcomes of Young Adult Men with ADHD

ERIC Educational Resources Information Center

Canu, Will H.; Carlson, Caryn L.

2007-01-01

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) has been consistently linked to social maladjustment. This study investigated whether elevated rejection sensitivity (RS) could contribute to the relational problems that adults with ADHD encounter. Method: Undergraduate men in ADHD-Combined Type (ADHD-C; n = 31), ADHD-Primarily…

Coaching for ADHD

ERIC Educational Resources Information Center

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

2010-01-01

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

Thirty-day self-reported risky driving behaviors of ADHD and non-ADHD drivers.

PubMed

Rosenbloom, Tova; Wultz, Boaz

2011-01-01

The present study aims to compare differences in reported risky driving behaviors of drivers - males and females - having and not having Attention Deficit Hyperactivity Disorder (ADHD), by using a checklist of driving behaviors based on the Driving Behavior Questionnaire (DBQ). Unlike the studies which employ the DBQ by asking the subjects to fill the questionnaire once, in this present study, the participants were asked to report their behaviors on a daily basis for 30 consequent days. The checklist included two factors of risky driving behavior: Violation and Faults. Thirty-eight drivers - 10 males and 9 females with ADHD, and 9 males and 10 females without ADHD (N-ADHD) as control groups - participated in the study. The results showed that the mean of the unsafe behaviors of ADHD was higher, i.e., less safe driving, compared to that of N-ADHD. However, a statistically significant effect was found only between male ADHD and male N-ADHD for the Faults. In order to check the effect of the length of the study, the 30 days duration of the research was divided into three consecutive periods. The reported driving habits of the female ADHD showed safer behaviors than those of the males. Unlike the findings of N-ADHD of both genders, which showed a tendency towards safer driving reports in the three periods, both genders of the ADHD showed higher rates of Faults, i.e., a decrease in safety driving reports, in the three periods. The findings suggest that ADHD drivers differ from the N-ADHD drivers in making driving mistakes, i.e., Faults, due to their lack of sustained attention, but not in making Violations. However, some of the results in the present study were not very strong. Possible explanations for this as well as methodological considerations are discussed, and further research is suggested. Copyright © 2010 Elsevier Ltd. All rights reserved.

Child behavior checklist dysregulation profile in children with disruptive behavior disorders: A longitudinal study.

PubMed

Masi, Gabriele; Pisano, Simone; Milone, Annarita; Muratori, Pietro

2015-11-01

A Child Behavior Checklist (CBCL) profile defined as Dysregulation Profile (DP) (scores 2 standard deviations or more in anxiety/depression, aggression, attention subscales) has been correlated to poor emotional and behavioral self-regulation. The clinical meaning and the prognostic implications of CBCL-DP are still debated, although it seems associated with severe psychopathology and poor adjustment. In the present study, we used the CBCL-DP score to examine the adolescent outcomes (psychiatric diagnosis, substance use, psychiatric hospitalization) in 80 referred children with disruptive behavior disorders -DBD- (Oppositional Defiant Disorder or conduct disorder), aged 8-9 years, 72 males (90%) and 8 females (10%), followed-up until the age of 14-15 years. Children with higher score on the CBCL-DP profile were at increased risk for presenting ADHD and mood disorders in adolescence. While ADHD in adolescence was predicted also by an ADHD diagnosis during childhood, CBCL-DP score was the only significant predictor of a mood disorder at 14-15 years. On the contrary, CBCL-DP score was not associated with a higher risk of conduct disorder, substance use and hospitalizations in adolescence. A cost-effective and reliable diagnostic measure such as the CBCL may be a part of the diagnostic procedure aimed to capture these at-risk children, to monitor their natural history up to adolescence, and to prevent the risk of a full-blown mood disorder. The small sample size and a selection bias of severe patients with DBD limit the generalization of the findings. Copyright © 2015 Elsevier B.V. All rights reserved.

Iron Deficiency Parameters in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

PubMed

Percinel, Ipek; Yazici, Kemal Utku; Ustundag, Bilal

2016-04-01

The aim of this study is to compare iron deficiency parameters in patients with stimulant-naive attention-deficit/hyperactivity disorder (ADHD) and healthy controls, to investigate whether there are differences among the ADHD presentations, and to evaluate the relationship between ADHD symptom severity and serum ferritin levels. In addition, ADHD-Predominantly Inattentive (ADHD-PI) patients with restrictive hyperactivity/impulsivity symptoms were evaluated as a separate group with "restrictive inattention presentation" (ADHD-Rest) and were compared with other groups. Patients with ADHD-Rest are typically defined as having six or more symptoms of inattention and fewer than three symptoms of hyperactivity/impulsivity. A total of 200 ADHD cases consisting of 100 ADHD-Combine (ADHD-C) and 100 ADHD-PI and a total of 100 healthy control cases were included in the study. The Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version was performed in a semi-structured interview during the diagnosis. The Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale, the Conners' Rating Scale-Revised: Long Form (Parent-Teacher) (CPRSR:L, CTRS-R:L) were used for clinical evaluation. Hemogram, serum iron, iron binding capacity and serum ferritin levels were assessed. There were no significant differences between the ADHD patients and the healthy control cases in terms of iron deficiency parameters. Further, there were no significant differences among the ADHD presentations in terms of the same parameters, nor were there any significant differences when the groups were examined after the identification of the ADHD-Rest. The CPRS-R:L Hyperactivity and the CTRS-R:L Hyperactivity scores were negatively correlated with serum ferritin level in the ADHD group. To our knowledge, our current study is the first to compare serum ferritin levels in ADHD-Rest with other presentations of ADHD, and included the largest number of patients that were classified by ADHD presentations. Elucidation of these findings is important for both the etiology and treatment of ADHD.

Predicting Response of ADHD Symptoms to Methylphenidate Treatment Based on Comorbid Anxiety

ERIC Educational Resources Information Center

Blouin, Brittany; Maddeaux, Cindy; Stanley Firestone, Jill; van Stralen, Judy

2010-01-01

Objective: In this small pilot study, the association of comorbid anxiety with the treatment of ADHD is studied. Methods: Eighteen volunteers from a pediatric clinic are tested for ADHD and anxiety and assessed for behavioral and cognitive ADHD symptomology. Response to methylphenidate as treatment for ADHD symptoms is measured 2 to 3 weeks, and…

Reexamining the Familial Association between Asthma and ADHD in Girls

ERIC Educational Resources Information Center

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

2005-01-01

The objective of this study is to further evaluate the association between asthma and ADHD, addressing issues of familiality in female probands. A case control study of referred ADHD proband girls, controls, and relatives are used. Participants include 140 ADHD proband girls and 122 non-ADHD comparisons, with 417 and 369 first-degree biological…

Exploring Behavioral Sleep Problems in Children With ADHD and Comorbid Autism Spectrum Disorder.

PubMed

Thomas, Simone; Lycett, Kate; Papadopoulos, Nicole; Sciberras, Emma; Rinehart, Nicole

2015-12-04

This study (a) compared behavioral sleep problems in children with comorbid ADHD and autism spectrum disorder (ASD) with those with ADHD and (b) examined child/family factors associated with sleep problems. Cross-sectional study comparison of 392 children with a confirmed ADHD diagnosis (ADHD+ASD, n=93, ADHD, n=299) recruited from 21 peadiatric practises in Victoria, Australia. Data were collected from parents. Key measures included the Child Sleep Habits Questionnaire (CSHQ). Children with ADHD + ASD experienced similar levels and types of behavioral sleep problems compared with those with ADHD. In both groups, the presence of co-occurring internalizing and externalizing comorbidities was associated with sleep problems. Sleep problems were also associated with parent age in the ADHD + ASD group and poorer parent mental health in the ADHD group. Findings suggest comorbid ASD is not associated with increased behavioral sleep problems in children with ADHD and that co-occurring internalizing and externalizing comorbidities may flag children in these groups with sleep problems. © The Author(s) 2015.

[Mathematical abilities and executive function in children with attention deficit hyperactivity disorder and learning disabilities in mathematics].

PubMed

Miranda Casas, Ana; Meliá de Alba, Amanda; Marco Taverner, Rafaela

2009-02-01

Mathematical abilities and executive function in children with attention deficit hyperactivity disorder and learning disabilities in mathematics. Even though 26% of children with attention deficit hyperactivity disorder (ADHD) show a specific mathematic learning difficulty (MLD), the studies have been scarce. The present study had the following goals: 1) to study the profile related to cognitive and metacognitive skills implied in calculation and problem-solving in children with ADHD+MLD, and to compare them in children with ADHD, children with MLD, and children without problems; 2) to study the severity of the deficit in executive function (EF) in children with ADHD+MLD. Comparing the groups MLD, ADHD, ADHD+MLD, and children without problems, the results highlighted that children with ADHD+MLD showed a cognitive and metacognitive deficit in mathematic achievement. Furthermore, results showed a more severe deficit in the EF in children with ADHD+MLD.

Affect Recognition in Adults with ADHD

ERIC Educational Resources Information Center

Miller, Meghan; Hanford, Russell B.; Fassbender, Catherine; Duke, Marshall; Schweitzer, Julie B.

2011-01-01

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…

Subthreshold attention-deficit/hyperactivity disorder is associated with functional impairments across domains: a comprehensive analysis in a large-scale community study.

PubMed

Hong, Soon-Beom; Dwyer, Dominic; Kim, Jae-Won; Park, Eun-Jin; Shin, Min-Sup; Kim, Boong-Nyun; Yoo, Hee-Jeong; Cho, In-Hee; Bhang, Soo-Young; Hong, Yun-Chul; Pantelis, Christos; Cho, Soo-Churl

2014-08-01

This study compared children who experience attention-deficit/hyperactivity disorder (ADHD) symptoms but do not meet criteria (i.e., subthreshold ADHD) with those with the full syndrome and healthy controls. Presence of ADHD symptoms was determined in a nationwide community sample of 921 children, aged 8-11 years. The main outcome measures comprised attentional symptoms, comorbidity profiles, academic performance, and neurocognitive ability (i.e., ADHD Rating Scale, Child Behavior Checklist, Learning Disability Evaluation Scale, and Stroop Color-Word Test, respectively). Subthreshold ADHD was equally prevalent in boys and girls, and more prevalent in low-income families. Throughout all the outcome measurements, subthreshold ADHD was both a significantly milder condition than full syndrome ADHD and a significantly more severe condition than non-ADHD status. The findings were consistent across the total as well as the subtest scores, and after correction for multiple comparisons (p < 0.0017). Children with subthreshold ADHD were found to experience significant symptoms and functional impairments. The results of this study support the clinical relevance of subthreshold ADHD in a childhood population. Subthreshold diagnostic criteria for ADHD may be more sensitive in detecting ADHD symptoms in girls than the full syndrome criteria, and subthreshold clinical, cognitive, and behavioral symptoms of ADHD may occur in a subset of children who are possibly more sensitive to their environment. Further consideration about the diagnostic threshold for ADHD may particularly benefit girls and children in low-income families.

Childhood and persistent ADHD symptoms associated with educational failure and long-term occupational disability in adult ADHD.

PubMed

Fredriksen, Mats; Dahl, Alv A; Martinsen, Egil W; Klungsoyr, Ole; Faraone, Stephen V; Peleikis, Dawn E

2014-06-01

Few studies have examined the impact of childhood attention deficit hyperactivity disorder (ADHD) symptoms on adult ADHD functional outcomes. To address this issue dimensionally, ADHD symptoms in childhood and adulthood and their relation to educational deficits and work disability are studied in a clinical sample of adult patients with previously untreated ADHD. About 250 adults diagnosed systematically with ADHD according to DSM-IV were prospectively recruited. Primary outcomes were high school dropout and being out of the work last year. Childhood ADHD symptoms, sex differences, comorbidities of other mental disorders, and adult ADHD symptoms were examined by historical data, clinician interviews, and questionnaires. High levels of ADHD symptom severity in childhood were related to dropping out of high school [odds ratio (OR) = 3.0], as were higher numbers of hyperactive-impulsive symptoms in childhood. Significantly, more women than men were long-term work disabled (OR = 2.0). After adjusting for age and gender, persisting high levels of ADHD inattention symptoms in adulthood (OR = 2.5), number of comorbid disorders, and particularly anxiety disorders were significantly related to long-term work disability. Childhood hyperactive-impulsive symptoms and overall severity of childhood ADHD symptoms were associated with high school dropout rates; however, persisting ADHD inattention symptoms and comorbid mental disorders in adulthood were more correlated to occupational impairment. These findings underline proposals for studies on early recognition and interventions for ADHD and psychiatric comorbidity. They further suggest that inattentive symptoms be a focus of adult ADHD treatment and that workplace interventions be considered to prevent long-term work disability.

Improving working memory in children with attention-deficit/hyperactivity disorder: the separate and combined effects of incentives and stimulant medication.

PubMed

Strand, Michael T; Hawk, Larry W; Bubnik, Michelle; Shiels, Keri; Pelham, William E; Waxmonsky, James G

2012-10-01

Working memory (WM) is considered a core deficit in Attention-Deficit/ Hyperactivity Disorder (ADHD), with numerous studies demonstrating impaired WM among children with ADHD. We tested the degree to which WM in children with ADHD was improved by performance-based incentives, an analog of behavioral intervention. In two studies, WM performance was assessed using a visuo-spatial n-back task. Study 1 compared children (ages 9-12 years) with ADHD-Combined type (n = 24) to a group of typically developing (TD) children (n = 32). Study 1 replicated WM deficits among children with ADHD. Incentives improved WM, particularly among children with ADHD. The provision of incentives reduced the ADHD-control group difference by approximately half but did not normalize WM. Study 2 examined the separate and combined effects of incentives and stimulant medication among 17 children with ADHD-Combined type. Both incentives and a moderate dose of long-acting methylphenidate (MPH; ~0.3 mg/kg t.i.d. equivalent) robustly improved WM relative to the no-incentive, placebo condition. The combination of incentives and medication improved WM significantly more than either incentives or MPH alone. These studies indicate that contingencies markedly improve WM among children with ADHD-Combined type, with effect sizes comparable to a moderate dose of stimulant medication. More broadly, this work calls attention to the role of motivation in studying cognitive deficits in ADHD and in testing multifactorial models of ADHD.

Role of neurotrophic factors in attention deficit hyperactivity disorder.

PubMed

Tsai, Shih-Jen

2017-04-01

Neurotrophins (NTs), a family of proteins including nerve growth factor, brain-derived neurotrophic factor (BDNF), neurotrophin-3, and neurotrophin-4, are essential for neural growth, survival, and differentiation, and are therefore crucial for brain development. Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by problems of inattention and/or hyperactivity-impulsivity. ADHD is one of the most common childhood onset psychiatric disorders. Studies have suggested that both genetic and environmental factors influence the development of the disorder, although the precise causes of ADHD have not yet been identified. In this review, we assess the role of NTs in the pathophysiology of ADHD. Preclinical evidence indicates that BDNF knockout mice are hyperactive, and an ADHD rodent model exhibited decreased cerebral BDNF levels. Several lines of evidence from clinical studies, including blood level and genetic studies, have suggested that NTs are involved in the pathogenesis of ADHD and in the mechanism of biological treatments for ADHD. Future directions for research are proposed, such as using blood NTs as ADHD biomarkers, optimizing NT genetic studies in ADHD, considering NTs as a link between ADHD and other comorbid mental disorders, and investigating methods for optimally modulating NT signaling to discover novel therapeutics for treating ADHD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Among a sample of Iranian students, adult attention deficit hyperactivity disorder is related to childhood ADHD, but not to age, gender, socioeconomic status, or birth order--an exploratory study.

PubMed

Jahangard, Leila; Haghighi, Mohammad; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Brand, Serge

2013-10-01

The aim of the present study was to explore the prevalence of adult attention deficit hyperactivity disorder (ADHD) in young adult Iranian students and to examine gender, birth order, socioeconomic status (SES), and history of ADHD as potential predictors of adult ADHD. A total of 387 young adult students (mean age: 19.6 years; 66.3% females) completed the Adult ADHD Self-Report Scale-V1.1 symptom checklist to assess current symptoms of ADHD and the Wender Utah Rating Scale to assess symptoms of ADHD in childhood and adolescence. Experts' ratings were based on Wender-Reimherr Interview. Self-rated and expert-rated prevalence rates were 16.5% and 13.4%, respectively. Past symptoms of ADHD were correlated with current symptoms. Childhood ADHD, current hyperactivity, and disorganization predicted current ADHD. Among a sample of Iranian students, the prevalence rates of ADHD were higher than estimated rates worldwide. Data also show child ADHD to be associated with adult ADHD; gender, age, birth order, and SES did not seem to influence current symptomatology.

The Path from Childhood Behavioural Disorders to Felony Offending: Investigating the Role of Adolescent Drinking, Peer Marginalization, and School Failure

PubMed Central

Savolainen, Jukka; Mason, W. Alex; Bolen, Jonathan D.; Chmelka, Mary B.; Hurtig, Tuula; Ebeling, Hanna; Nordström, Tanja; Taanila, Anja

2016-01-01

Background Although a pathway from childhood behavioural disorders to criminal offending is well-established, the aetiological processes remain poorly understood. Also, it is not clear if attention deficit hyperactivity disorder (ADHD) is predictive of crime in the absence of comorbid disruptive behaviour disorder (DBD). Hypothesis We examined two research questions: (1) Does ADHD have a unique effect on the risk of criminal offending, independently of DBD? (2) Is the effect of childhood behavioural disorders on criminal offending direct or mediated by adolescent processes related to school experience, substance misuse, and peers? Method Structural equation modelling, with latent variables, was applied to longitudinally collected data on 4,644 males from the 1986 Northern Finland Birth Cohort Study. Results Both ADHD and DBD separately predicted felony conviction risk. Most of these effects were mediated by adolescent alcohol use and low academic performance. The effect of DBD was stronger and included a direct pathway to criminal offending. Conclusion Findings were more consistent with the life course mediation hypothesis of pathways into crime, in that the effects of each disorder category were mediated by heavy drinking and educational failure. Preventing these adolescent risk outcomes may be an effective approach to closing pathways to criminal behaviour among behaviourally disordered children. However, as there was some evidence of a direct pathway from DBD, effective treatments targeting this disorder are also expected to reduce criminal offending. PMID:25250918

The path from childhood behavioural disorders to felony offending: Investigating the role of adolescent drinking, peer marginalisation and school failure.

PubMed

Savolainen, Jukka; Mason, W Alex; Bolen, Jonathan D; Chmelka, Mary B; Hurtig, Tuula; Ebeling, Hanna; Nordström, Tanja; Taanila, Anja

2015-12-01

Although a pathway from childhood behavioural disorders to criminal offending is well established, the aetiological processes remain poorly understood. Also, it is not clear if attention deficit hyperactivity disorder (ADHD) is predictive of crime in the absence of comorbid disruptive behaviour disorder (DBD). We examined two research questions: (1) Does ADHD have a unique effect on the risk of criminal offending, independently of DBD? (2) Is the effect of childhood behavioural disorders on criminal offending direct or mediated by adolescent processes related to school experience, substance misuse and peers? Structural equation modelling, with latent variables, was applied to longitudinally collected data on 4644 men from the 1986 Northern Finland Birth Cohort Study. Both ADHD and DBD separately predicted felony conviction risk. Most of these effects were mediated by adolescent alcohol use and low academic performance. The effect of DBD was stronger and included a direct pathway to criminal offending. Findings were more consistent with the life course mediation hypothesis of pathways into crime than the behavioural continuity path, in that the effects of each disorder category were mediated by heavy drinking and educational failure. Preventing these adolescent risk outcomes may be an effective approach to closing pathways to criminal behaviour amongst behaviourally disordered children. However, as there was some evidence of a direct pathway from DBD, effective treatments targeting this disorder are also expected to reduce criminal offending. Copyright © 2014 John Wiley & Sons, Ltd.

ADHD symptomatology in eating disorders: a secondary psychopathological measure of severity?

PubMed Central

2013-01-01

Background Attention-deficit/hyperactivity disorder (ADHD) has commonly been described in psychiatric disorders. Although several studies have found positive associations between abnormal eating patterns during childhood and ADHD, there is a lack of studies on ADHD and Eating Disorders (ED). The aims of this exploratory study were 1) to assess the ADHD symptoms level in ED and to ascertain whether there are differences among ED subtypes; 2) to analyze whether the presence of ADHD symptoms is associated with more severe eating disorder symptoms and greater general psychopathology; and 3) to assess whether the ADHD symptoms level is associated with specific temperament and character traits. Methods 191 female ED patients were included. Assessment was carried out with the EDI-2, ASRS-v1.1, the SCL-90-R and the TCI-R. Results The ADHD symptoms level was similar in bulimia, eating disorder not otherwise specified and binge eating subtypes, and lower in anorexic patients. Obsessiveness and Hostility were significantly positively associated with ADHD symptoms. A path model showed that ADHD was associated with high Novelty Seeking and low Self-Directedness, whereas ED severity was influenced by ADHD severity and low Self-Directedness. Conclusions Bingeing/purging ED subtypes have a high ADHD symptoms level, also related with more severe eating, general and personality psychopathology. PMID:23758944

Interactions between MAOA and SYP polymorphisms were associated with symptoms of attention-deficit/hyperactivity disorder in Chinese Han subjects.

PubMed

Gao, Qian; Liu, Lu; Li, Hai-Mei; Tang, Yi-Lang; Wu, Zhao-Min; Chen, Yun; Wang, Yu-Feng; Qian, Qiu-Jin

2015-01-01

As candidate genes of attention--deficit/hyperactivity disorder (ADHD), monoamine oxidase A (MAOA), and synaptophysin (SYP) are both on the X chromosome, and have been suggested to be associated with the predominantly inattentive subtype (ADHD-I). The present study is to investigate the potential gene-gene interaction (G × G) between rs5905859 of MAOA and rs5906754 of SYP for ADHD in Chinese Han subjects. For family-based association study, 177 female trios were included. For case-control study, 1,462 probands and 807 normal controls were recruited. The ADHD Rating Scale-IV (ADHD-RS-IV) was used to evaluate ADHD symptoms. Pedigree-based generalized multifactor dimensionality reduction (PGMDR) for female ADHD trios indicated significant gene interaction effect of rs5905859 and rs5906754. Generalized multifactor dimensionality reduction (GMDR) indicated potential gene-gene interplay on ADHD RS-IV scores in female ADHD-I. No associations were observed in male subjects in case-control analysis. In conclusion, our findings suggested that the interaction of MAOA and SYP may be involved in the genetic mechanism of ADHD-I subtype and predict ADHD symptoms. © 2014 Wiley Periodicals, Inc.

A prospective, longitudinal study of sleep disturbance and comorbidity in opiate dependence (the ANRS Methaville study).

PubMed

Nordmann, Sandra; Lions, Caroline; Vilotitch, Antoine; Michel, Laurent; Mora, Marion; Spire, Bruno; Maradan, Gwenaelle; Morel, Alain; Roux, Perrine; Carrieri, M Patrizia

2016-04-01

Sleep disturbance is frequent in opioid-dependent patients. To date, no data are available about the impact of methadone maintenance treatment on sleep disturbance. Using 1-year follow-up data from the Methaville trial, we investigated the impact of methadone initiation and other correlates on sleep disturbance in opioid-dependent patients. Sleep disturbance severity was evaluated using two items from different scales (Center for Epidemiological Studies Depression Scale for depression and Opiate Treatment Index). We assessed the effect of methadone and other correlates on sleep disturbance severity during follow-up (months 0, 6, and 12) using a mixed multinomial logistic regression model. We included 173 patients who had 1-year follow-up data on sleep disturbance, corresponding to 445 visits. At enrolment, 60.5 % reported medium to severe sleep disturbance. This proportion remained stable during methadone treatment: 54.0 % at month 6 and 55.4 % at month 12. The final multivariate model indicated that younger patients (odds ratio (OR) [95 % CI] 0.95 [0.90-1.00]), patients with pain (OR [95 % CI] 2.45 [1.13-5.32]), patients with high or very high nicotine dependence (OR [95 % CI] 5.89 [2.41-14.39]), and patients at suicidal risk (2.50 [1.13-5.52]) had a higher risk of severe sleep disturbance. Because of collinearity between suicidal risk and attention deficit hyperactivity disorder (ADHD) symptoms, ADHD was not associated with sleep disturbance in the final model. Receiving methadone treatment had no significant effect on sleep disturbance. Sleep disturbance is frequent among opioid-dependent patients. It can be regarded as an important signal of more complex psychiatric comorbidities such as suicidal risk and ADHD. However, sleep disturbance should not be considered an obstacle to methadone maintenance treatment (MMT) initiation or continuation.

Predictors of ADHD Persistence in Girls at 5-Year Follow-Up

ERIC Educational Resources Information Center

Mick, Eric; Byrne, Deirdre; Fried, Ronna; Monuteaux, Michael; Faraone, Stephen V.; Biederman, Joseph

2011-01-01

Objective: The main aim of this study was to examine the age-dependent remission from ADHD in girls transitioning through childhood into adolescence and early adulthood. Method: We conducted a 5-year prospective follow-up study of 123 girls with ADHD and 106 non-ADHD control girls aged between 6 and 17 years at ascertainment. ADHD was considered…

Modelling ADHD: A review of ADHD theories through their predictions for computational models of decision-making and reinforcement learning.

PubMed

Ziegler, Sigurd; Pedersen, Mads L; Mowinckel, Athanasia M; Biele, Guido

2016-12-01

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. Copyright © 2016 Elsevier Ltd. All rights reserved.

Association of symptoms of attention-deficit/hyperactivity disorder with symptoms of excessive exercising in an adult general population sample.

PubMed

Berger, Nikolas A A; Müller, Astrid; Brähler, Elmar; Philipsen, Alexandra; de Zwaan, Martina

2014-09-12

An increasing number of studies suggest that physical activity can alleviate symptoms of ADHD in children. In adults there are currently insufficient data available on this subject. Interestingly, ADHD and forms of excessive exercising have both been shown to occur more frequently in adult athletes. The aim of the present study was to empirically investigate the association of ADHD and excessive exercising in the adult general population. For diagnosis of adult and childhood ADHD a large representative sample of the German general population (n = 1,615) completed a retrospective assessment of childhood ADHD and a self-report assessment of adult ADHD. Excessive exercising as well as putative mediating variables such as eating related psychopathology, depression, and anxiety were assessed using standardized self-rating instruments. Individuals with childhood only ADHD had a significantly higher frequency of excessive exercising (9.0%) than individuals without ADHD (2.7%). Excessive exercising was significantly associated with childhood only ADHD compared to no ADHD with an odds ratio of 3.239 even after controlling for socio-demographic variables, BMI, eating related and general psychopathology. Our data show that excessive exercising is significantly overrepresented in individuals in which ADHD symptoms in childhood have not persisted into adulthood. We thus hypothesize that a subgroup of individuals might suppress ADHD symptoms by excessive sporting activities. Although in healthy adults physical activity has been associated with immediate and long term improvements in cognitive functioning, studies empirically investigating associations between the effects of physical activity and adult ADHD are rare. Further studies are warranted to explore the potential role of physical activity in the treatment of ADHD in adults.

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

ERIC Educational Resources Information Center

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

2009-01-01

Objective: Identification of differences among children with ADHD only, autism spectrum disorder (ASD)+ADHD, and chronic multiple tic disorder (CMTD)+ADHD may lead to better understanding of clinical phenotypes. Method: Children were evaluated using the parent- and teacher-completed questionnaires. Results: All three groups were highly similar in…

The impact of daytime sleepiness on the school performance of college students with attention deficit hyperactivity disorder (ADHD): a prospective longitudinal study.

PubMed

Langberg, Joshua M; Dvorsky, Melissa R; Becker, Stephen P; Molitor, Stephen J

2014-06-01

This prospective longitudinal study evaluated the impact of daytime sleepiness on the school performance of 62 college students diagnosed comprehensively with attention deficit hyperactivity disorder. The primary goal of the study was to determine if self-reported daytime sleepiness rated at the beginning of the academic year could predict academic and overall functioning at the end of the academic year while also considering potentially important covariates, including symptoms of inattention, hyperactivity and impulsivity, medication status and whether or not students lived at home or on-campus. Self-reported daytime sleepiness predicted longitudinally school maladjustment, overall functional impairment and the number of D and F grades (i.e. poor and failing) students received in courses above and beyond both self- and parent-report of symptoms, but did not predict overall grade point average. Living at home served as a protective factor and was associated with less school maladjustment and overall impairment. Gender was the only significant predictor in the overall grade point average model, with female gender associated with higher overall grades. The implications of these findings for monitoring and treatment of sleep disturbances in college students with attention deficit hyperactivity disorder are discussed. © 2013 European Sleep Research Society.

Associations of sleep disturbance with ADHD: implications for treatment.

PubMed

Hvolby, Allan

2015-03-01

Attention-deficit/hyperactivity disorder (ADHD) is commonly associated with disordered or disturbed sleep. The relationships of ADHD with sleep problems, psychiatric comorbidities and medications are complex and multidirectional. Evidence from published studies comparing sleep in individuals with ADHD with typically developing controls is most concordant for associations of ADHD with: hypopnea/apnea and peripheral limb movements in sleep or nocturnal motricity in polysomnographic studies; increased sleep onset latency and shorter sleep time in actigraphic studies; and bedtime resistance, difficulty with morning awakenings, sleep onset difficulties, sleep-disordered breathing, night awakenings and daytime sleepiness in subjective studies. ADHD is also frequently coincident with sleep disorders (obstructive sleep apnea, peripheral limb movement disorder, restless legs syndrome and circadian-rhythm sleep disorders). Psychostimulant medications are associated with disrupted or disturbed sleep, but also 'paradoxically' calm some patients with ADHD for sleep by alleviating their symptoms. Long-acting formulations may have insufficient duration of action, leading to symptom rebound at bedtime. Current guidelines recommend assessment of sleep disturbance during evaluation of ADHD, and before initiation of pharmacotherapy, with healthy sleep practices the first-line option for addressing sleep problems. This review aims to provide a comprehensive overview of the relationships between ADHD and sleep, and presents a conceptual model of the modes of interaction: ADHD may cause sleep problems as an intrinsic feature of the disorder; sleep problems may cause or mimic ADHD; ADHD and sleep problems may interact, with reciprocal causation and possible involvement of comorbidity; and ADHD and sleep problems may share a common underlying neurological etiology.

Results from 2 proof-of-concept, placebo-controlled studies of atomoxetine in children with attention-deficit/hyperactivity disorder.

PubMed

Spencer, Thomas; Heiligenstein, John H; Biederman, Joseph; Faries, Douglas E; Kratochvil, Christopher J; Conners, C Keith; Potter, William Z

2002-12-01

Atomoxetine is a nonstimulant drug being studied for the treatment of attention-deficit/hyperactivity disorder (ADHD). Atomoxetine is a highly specific inhibitor of the presynaptic norepinephrine transporter with minimal affinity for other noradrenergic receptors or other neurotransmitter transporters or receptors. Results of 2 proof-of-concept studies are reported that tested the hypothesis that a selective inhibitor of presynaptic norepinephrine uptake would be effective for the treatment of ADHD in school-aged children. Two identical 12-week, stratified, randomized, double-blind, placebo-controlled trials were conducted in children who met DSM-IV criteria for ADHD. The primary efficacy outcome measure was the mean change from baseline to endpoint in the Attention-Deficit/Hyperactivity Disorder Rating Scale (ADHD RS) total score. Secondary efficacy measures included the Clinical Global Impressions-ADHD-Severity (CGI-ADHD-S) and the Conners' Parent Rating Scale-Revised: Short Form (CPRS-R:S). A total of 291 patients were randomized in the 2 trials combined (Study 1, N = 147; Study 2, N = 144). Stimulant-naive patients were randomized to atomoxetine, placebo, or methylphenidate. Patients with prior stimulant exposure were randomized to atomoxetine or placebo. Atomoxetine significantly reduced ADHD RS total scores compared with placebo in each study (p <.001). Changes in the CGI-ADHD-S (Study 1: p =.003; Study 2: p =.001) and CPRS-ADHD Index (Study 1: p =.023; Study 2: p <.001) also showed atomoxetine to be statistically significantly superior to placebo in reducing ADHD symptoms. Atomoxetine was found to be well tolerated in this population of pediatric patients. Two studies of atomoxetine early in its development confirmed that atomoxetine, a specific and selective inhibitor of noradrenergic uptake, was effective for the treatment of children with ADHD. In addition, atomoxetine was found to be well tolerated.

Intelligence profiles of Chinese school-aged boys with high-functioning ASD and ADHD

PubMed Central

Li, Gaizhi; Jiang, Wenqing; Du, Yasong; Rossbach, Kathryn

2017-01-01

Purpose This study aimed to explore the intelligence profiles of Chinese school-aged boys with high-functioning autism spectrum disorder (HFASD) and attention-deficit/hyperactivity disorder (ADHD). Additionally, differences in intelligence quotient (IQ) between the HFASD group and the ADHD group were examined. Patients and methods Thirty-two boys with HFASD, 58 boys with ADHD, and 39 typically developing (TD) boys aged 6–16 years participated in this study. The ADHD group was divided into subgroups: ADHD-I (predominantly inattentive) and ADHD-C (combined type). (The ADHD-H [hyperactive] group was excluded because of small sample size). The Wechsler Intelligence Scale for Children-IV Chinese version was administered to every participant, and the FSIQ (Full-Scale IQ) score was used as the measure of IQ. Results Both boys with HFASD and ADHD (ADHD-I and ADHD-C) showed impairments in Processing Speed Index and FSIQ, as compared to the TD group. Lower Verbal Comprehension Index scores were found in the ASD and ADHD-I groups. Interestingly, Working Memory Index was only impaired in children with ADHD. Additionally, equivalent Perceptual Reasoning Index (PRI) scores were found among the HFASD, ADHD, and TD groups. Conclusion Results indicated that both children with ADHD and HFASD have difficulty in processing speed, which may be explained by these children having neurodevelopmental disorders. These results also indicated that working memory appears to only be impacted by having ADHD. Children with ASD are known to have language difficulties while children with ADHD typically display working memory deficits; thus, these findings were expected. PMID:28670123

Sibling Relationships among Children with ADHD

ERIC Educational Resources Information Center

Mikami, Amori Yee; Pfiffner, Linda J.

2008-01-01

Objective: This study investigated the quality of sibling relationships among children with ADHD relative to those without ADHD. Additional analyses examined whether externalizing and internalizing problems comorbid with ADHD affected sibling relationships. Method: Participants were 77 children with ADHD and 14 nonproblem control children. Sibling…

ADHD and comorbid conduct problems among adolescents: associations with self-esteem and substance use.

PubMed

Glass, Kerrie; Flory, Kate; Martin, Amber; Hankin, Benjamin L

2011-03-01

Attention-deficit/hyperactivity disorder (ADHD) is a common child and adolescent disorder that is associated with negative outcomes (e.g., emotional and behavioral problems, substance use) and is often comorbid with Conduct Problems (CP). Research findings are mixed as to whether youth with ADHD alone or comorbid ADHD/CP suffer from low self-esteem. Research has also shown links between low self-esteem and ADHD (alone and with CP) with substance use; yet, no research has examined the links between self-esteem and substance use in adolescents with ADHD and CP. The current study examined the relation between ADHD with and without comorbid CP and self-esteem, and whether self-esteem moderated the relation between ADHD and ADHD/CP with substance use among adolescents. We hypothesized that adolescents with comorbid ADHD/CP would experience lower self-esteem than adolescents with ADHD alone or with neither disorder and that self-esteem would moderate the association between ADHD, CP, and substance use. Participants were 62 adolescents who completed the laboratory-based study with a parent. Results suggested that adolescents with comorbid ADHD and CP had significantly lower self-esteem than adolescents with ADHD alone or neither disorder. Self-esteem was not significantly different for adolescents with ADHD alone versus those in the control group. There was one marginally significant interaction between ADHD and self-esteem predicting substance use, such that individuals with comorbid ADHD/CP who also had low self-esteem tended to use more substances. Results have implications for treatments that target adolescents with ADHD and comorbid CP, as these adolescents are at risk for many deleterious outcomes.

Might the temperament be a bias in clinical study on attention-deficit hyperactivity disorder (ADHD)?: Novelty Seeking dimension as a core feature of ADHD.

PubMed

Donfrancesco, Renato; Di Trani, Michela; Porfirio, Maria Cristina; Giana, Grazia; Miano, Silvia; Andriola, Elda

2015-06-30

Some clinical studies on attention deficit hyperactivity disorder (ADHD) have been found to overlap those of studies on personality, particularly those on the Novelty Seeking trait (NS) as measured by the Junior Temperament and Character Inventory (JTCI). The aim of this study was to evaluate the potential role of NS in clinical research on ADHD. We enroled 146 ADHD children (125 boys; mean age=9.61, S.D.=2.50) and 223 age- and gender-matched control children (178 boys; mean age=9.41, S.D.=2.30). All the parents filled in the JTCI for the evaluation of personality according to Cloninger׳s model. An exploratory factor analysis differentiated the NS items that concern "Impulsivity" (NS1) from those that concern other features (NS2). Multivariate Analysis of Variance (MANOVAs) revealed significant differences between ADHD children and non-ADHD children in temperamental dimensions: the scores of ADHD children were higher than those of non-ADHD children in Total NS, NS1-Impulsivity and NS2. Our results show that the NS dimension of the JTCI in ADHD children is higher than in non-ADHD children, even when a correction is made for impulsivity items. This finding suggests that the NS trait plays a central role in ADHD diagnosis even when items referred to impulsivity are removed from the NS scale. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Maternal ADHD symptoms, personality, and parenting stress: Differences between mothers of children with ADHD and mothers of comparison children

PubMed Central

Algorta, Guillermo Perez; Kragh, Carolyn A.; Arnold, L. Eugene; Molina, Brooke S. G.; Hinshaw, Stephen P.; Swanson, James M.; Hetchman, Lily; Copley, LaRae M.; Lowe, Matthew; Jensen, Peter S.

2017-01-01

Mothers raising a child with ADHD can experience high parenting stress. Mothers’ personality traits and own ADHD symptoms could also affect parenting stress. 430 biological mothers from the Multimodal Treatment Study of Children with ADHD (MTA mothers) and 237 of a local normative comparison group (LNCG mothers) were evaluated at baseline. Interactions were tested between mothers’ group and maternal personality/ADHD symptoms related to parenting stress. Compared to LNCG, MTA mothers had higher parenting stress, self-reported ADHD, neuroticism, and lower conscientiousness and agreeableness. When personality and ADHD were evaluated together, ADHD symptoms interacted with mothers’ group: high maternal ADHD was positively associated with parenting stress for LNCG but not MTA mothers. Personality traits or ADHD characteristics do not appear operative for the high parenting stress of mothers of a child with ADHD. However, high maternal ADHD or low conscientiousness are associated with stress levels similar to raising a child with ADHD. PMID:25525155

Interference control, working memory, concept shifting, and verbal fluency in adults with attention-deficit/hyperactivity disorder (ADHD).

PubMed

Marchetta, Natalie D J; Hurks, Petra P M; Krabbendam, Lydia; Jolles, Jelle

2008-01-01

In this study, the authors aimed to examine 4 domains of executive functioning in adults with attention-deficit/hyperactivity disorder (ADHD)--namely interference control, concept shifting, verbal fluency, and verbal working memory. Four groups of participants were included: (a) adults diagnosed with ADHD (ADHD-super(-); n = 20), (b) adults diagnosed with both ADHD and 1 or more comorbid disorder(s) (ADHD-super(+); n = 22), (c) adults referred for ADHD because of ADHD symptomatology but not diagnosed as such (non-ADHD; n = 34), and (d) healthy controls (n = 136). ADHD-related deficits (independent of comorbidity) were revealed for concept shifting and verbal working memory. In addition, the ADHD-super(+) and non-ADHD groups displayed deficits in terms of general processing speed. Given that these deficits were not found in the ADHD-super(-) group, the authors contend that these deficits are likely attributable to comorbidity rather than ADHD itself. Contrary to the authors' expectations, these findings do not correspond with the cognitive subtype hypothesis.

False Memory in Adults With ADHD: A Comparison Between Subtypes and Normal Controls.

PubMed

Soliman, Abdrabo Moghazy; Elfar, Rania Mohamed

2017-10-01

To examine the performance on the Deese-Roediger-McDermott task of adults divided into ADHD subtypes and compares their performance to that of healthy controls to examine whether adults with ADHD are more susceptible to the production of false memories under experimental conditions. A total of 128 adults with ADHD (50% females), classified into three Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV-TR) subtypes, were compared with 48 controls. The results indicated that the ADHD participants recalled and recognized fewer studied words than the controls, the ADHD groups produced more false memories than the control group, no differences in either the false positives or the false negatives. The ADHD-combined (ADHD-CT) group recognized significantly more critical words than the control, ADHD-predominantly inattentive (ADHD-IA), and ADHD-predominantly hyperactive-impulsive (ADHD-HI) groups. The ADHD groups recalled and recognized more false positives, were more confident in their false responses, and displayed more knowledge corruption than the controls. The ADHD-CT group recalled and recognized more false positives than the other ADHD groups. The adults with ADHD have more false memories than the controls and that false memory formation varied with the ADHD subtypes.

Susceptibility of functional impairment scales to noncredible responses in the clinical evaluation of adult ADHD.

PubMed

Fuermaier, Anselm B M; Tucha, Oliver; Koerts, Janneke; Butzbach, Marah; Weisbrod, Matthias; Aschenbrenner, Steffen; Tucha, Lara

2018-05-01

A growing body of research questions the reliance of symptom self-reports in the clinical evaluation of attention-deficit/hyperactivity disorder (ADHD) in adulthood. A recent study suggested that also impairment reports are vulnerable to noncredible responses, as derived from a simulation design using a global functional impairment scale. The present study aims to add evidence to this issue, by using an ADHD specific impairment scale in a simulation design on large samples. Impairment ratings on the Weiss Functional Impairment Rating Scale (WFIRS) of 62 patients with ADHD were compared to 142 healthy individuals who were instructed to show normal behavior. Furthermore, impairment ratings of patients with ADHD were compared to ratings of 330 healthy individuals who were randomly assigned to one of four simulation conditions that were instructed to complete the scale as if they had ADHD. Patients with ADHD reported higher levels of impairment than the healthy control group in all domains of life. Furthermore, individuals instructed to feign ADHD indicated higher levels of impairments in most domains of life compared to control participants and genuine patients with ADHD. The group differences between individuals feigning ADHD and individuals with genuine ADHD, however, were only small to moderate. Further analyses revealed that the WFRIS was not useful to successfully differentiate genuine from feigned ADHD. The present study confirms the conclusion that self-reported impairments are susceptible to noncredible responses and should be used with caution in the clinical evaluation of adult ADHD.

Atypical Activations of Fronto-Cerebellar Regions During Forethought in Parents of Children With ADHD.

PubMed

Rapin, Lucile; Poissant, Hélène; Mendrek, Adrianna

2017-10-01

Although several studies suggest heritability of ADHD, only a few investigations of possible associations between people at risk and neural abnormalities in ADHD exist. In this study, we tested whether parents of children with ADHD would show atypical patterns of cerebral activations during forethought, a feature of working memory. Using Functional Magnetic Resonance Imaging (fMRI), we compared 12 parents of children with ADHD and 9 parents of control children during a forethought task. Parents of children with ADHD exhibited significantly increased neural activations in the posterior lobes of the cerebellum and in the left inferior frontal gyrus, relative to parents of control children. These findings are consistent with previous reports in children and suggest the fronto-cerebellar circuit's abnormalities during forethought in parents of children with ADHD. Future studies of people at risk of ADHD are needed to fully understand the extent of the fronto-cerebellar heritability.

Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis.

PubMed

Ruiz-Goikoetxea, Maite; Cortese, Samuele; Aznarez-Sanado, Maite; Magallón, Sara; Alvarez Zallo, Noelia; Luis, Elkin O; de Castro-Manglano, Pilar; Soutullo, Cesar; Arrondo, Gonzalo

2018-01-01

A systematic review with meta-analyses was performed to: 1) quantify the association between ADHD and risk of unintentional physical injuries in children/adolescents ("risk analysis"); 2) assess the effect of ADHD medications on this risk ("medication analysis"). We searched 114 databases through June 2017. For the risk analysis, studies reporting sex-controlled odds ratios (ORs) or hazard ratios (HRs) estimating the association between ADHD and injuries were combined. Pooled ORs (28 studies, 4,055,620 individuals without and 350,938 with ADHD) and HRs (4 studies, 901,891 individuals without and 20,363 with ADHD) were 1.53 (95% CI=1.40,1.67) and 1.39 (95% CI=1.06,1.83), respectively. For the medication analysis, we meta-analysed studies that avoided the confounding-by-indication bias [four studies with a self-controlled methodology and another comparing risk over time and groups (a "difference in differences" methodology)]. The pooled effect size was 0.879 (95% CI=0.838,0.922) (13,254 individuals with ADHD). ADHD is significantly associated with an increased risk of unintentional injuries and ADHD medications have a protective effect, at least in the short term, as indicated by self-controlled studies. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Inhibition, Reinforcement Sensitivity and Temporal Information Processing in ADHD and ADHD+ODD: Evidence of a Separate Entity?

ERIC Educational Resources Information Center

Luman, Marjolein; van Noesel, Steffen J. P.; Papanikolau, Alky; Van Oostenbruggen-Scheffer, Janneke; Veugelers, Diane; Sergeant, Joseph A.; Oosterlaan, Jaap

2009-01-01

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…

Association of Anxiety and ODD/CD in Children with and without ADHD

ERIC Educational Resources Information Center

Humphreys, Kathryn L.; Aguirre, Vincent P.; Lee, Steve S.

2012-01-01

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…

Role of school teachers in identifying attention deficit hyperactivity disorder among primary school children in Mansoura, Egypt.

PubMed

Awadalla, N J; Ali, O F; Elshaer, S; Eissa, M

2016-11-02

There is a knowledge gap in primary school teachers that affects their ability to detect attention deficit hyperactivity disorder (ADHD). This study measured primary school teachers' knowledge about ADHD, and implemented a training programme to improve early detection of ADHD. The prevalence and risk factors of ADHD were also studied. The training programme was implemented through a 2-day workshop for 39 primary school teachers who completed a validated Arabic version of the ADHD Rating Scale for 873 primary school children. The children's parents completed the questionnaire to explore ADHD risk factors. The teachers' pre-training knowledge scores of ADHD ranged from 17.9 to 46.2%. Post-training, their scores improved significantly to 69.2-94.9%. Prevalence rate of ADHD was 12.60%. On logistic regression, independent predictors of ADHD were female gender, unemployed fathers and rural residence. In conclusion, ADHD is a significant health problem among primary school children in Mansoura, Egypt. Efforts should be made to improve teachers' knowledge about ADHD and control modifiable risk factors.

Dopamine transporter gene polymorphism in children with ADHD: A pilot study in Indonesian samples.

PubMed

Wiguna, Tjhin; Ismail, Raden Irawati; Winarsih, Noorhana Setyawati; Kaligis, Fransiska; Hapsari, Anggia; Budiyanti, Lina; Sekartini, Rini; Rahayu, Susan; Guerrero, Anthony P S

2017-10-01

Several studies showed that DAT1 polymorphism closed related with ADHD although the results were not consistently found. Studies in China, South Korea, Japan revealed that 10-repeat allele gave a risk for ADHD. Based on that understanding, this study tried to identify whether the similar polymorphism of DAT1 was also apparent in Indonesian children with ADHD. This was a case - control study. Case was 50 Indonesian origin children with ADHD and without any other mental disorders and metal retardation. Control is Indonesian origin children without ADHD, other mental disorders and mental retardation. ADHD diagnosis was taken after doing the psychiatric interview and observation based on the DSM-IV TR diagnostic criteria for ADHD at the Child and Adolescent Psychiatry Out-patient Clinic, Dr. Cipto Mangunkusumo National Referral Hospital - Faculty of Medicine Universitas Indonesia. DNA isolation, DNA purity and concentration were measured. PCR was done by using a primer based on Homo sapiens solute carrier family 6 (neurotransmitter transporter), member 3 (SLC6A3), RefSeq Gene on chromosome 5 with accession number NG_015885.1. To identify the serial of repeated allele, we used the sequencing technique. There were 47 children with ADHD and 48 children without ADHD that involved in the final analysis. The mean of age amongst ADHD group was 9.18 (2.42) and 8.10 (2.46) years old in non-ADHD group. The 10-repeated allele of DAT1 was the highest proportion in both. This finding was apparently similar with other studies on DAT1 polymorphism across Asian. Copyright © 2017 Elsevier B.V. All rights reserved.

Paternal ADHD symptoms and child conduct problems: is father involvement always beneficial?

PubMed

Romirowsky, A M; Chronis-Tuscano, A

2014-09-01

Maternal psychopathology robustly predicts poor developmental and treatment outcomes for children with attention-deficit/hyperactivity disorder (ADHD). Despite the high heritability of ADHD, few studies have examined associations between paternal ADHD symptoms and child adjustment, and none have also considered degree of paternal involvement in childrearing. Identification of modifiable risk factors for child conduct problems is particularly important in this population given the serious adverse outcomes resulting from this comorbidity. This cross-sectional study examined the extent to which paternal involvement in childrearing moderated the association between paternal ADHD symptoms and child conduct problems among 37 children with ADHD and their biological fathers. Neither paternal ADHD symptoms nor involvement was independently associated with child conduct problems. However, the interaction between paternal ADHD symptoms and involvement was significant, such that paternal ADHD symptoms were positively associated with child conduct problems only when fathers were highly involved in childrearing. The presence of adult ADHD symptoms may determine whether father involvement in childrearing has a positive or detrimental influence on comorbid child conduct problems.

Late-Onset ADHD: Understanding the Evidence and Building Theoretical Frameworks.

PubMed

Caye, Arthur; Sibley, Margaret H; Swanson, James M; Rohde, Luis Augusto

2017-11-13

The traditional definition of Attention-Deficit/Hyperactivity Disorder (ADHD), assuming onset in childhood, has been challenged by evidence from four recent birth-cohort studies that reported most adults with ADHD lacked a childhood categorical ADHD diagnosis. Late onset of symptoms was evaluated in the long-term follow-up of the Multimodal Treatment study of ADHD (MTA). In most cases, other factors were present that discounted the late onset of ADHD symptoms and excluded the diagnosis of ADHD. We offer two theoretical frameworks for understanding the ADHD trajectory throughout the life cycle: (1) the complex phenotype model, and (2) the restricted phenotype model. We conclude that (a) late onset (after age 12) is a valid trajectory for ADHD symptoms, (b) the percentage of these cases with onset after adolescence is yet uncertain, and (c) the percentage meeting exclusion criteria for diagnosis of ADHD is influenced by the rigor of the methodology used to obtain evidence and whether or not DSM exclusionary criteria are applied.

Rate and predictors of divorce among parents of youth with ADHD

PubMed Central

Wymbs, Brian T.; Pelham, William E.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Wilson, Tracey K.; Greenhouse, Joel B.

2008-01-01

Despite numerous studies asserting the prevalence of marital conflict among families of children with attention-deficit hyperactivity disorder (ADHD), evidence is surprisingly less convincing regarding whether parents of youth with ADHD are more at-risk for divorce than parents of children without ADHD. Using survival analyses, this study compared the rate of marital dissolution between parents of adolescents and young adults with and without ADHD. Results indicated that parents of youth diagnosed with ADHD in childhood (n=282) were more likely to divorce and had a shorter latency to divorce than parents of children without ADHD (n=206). Among a subset of those families of youth with ADHD, prospective analyses indicated that maternal and paternal education level, paternal antisocial behavior, and child age, race/ethnicity, and oppositional-defiant/conduct problems each uniquely predicted the timing of divorce between parents of youth with ADHD. These data underscore how parent and child variables likely interact to exacerbate marital discord and, ultimately, dissolution among families of children diagnosed with ADHD in childhood. PMID:18837591

Natural Product-Derived Treatments for Attention-Deficit/Hyperactivity Disorder: Safety, Efficacy, and Therapeutic Potential of Combination Therapy

PubMed Central

Ahn, James; Ahn, Hyung Seok; Cheong, Jae Hoon; dela Peña, Ike

2016-01-01

Typical treatment plans for attention-deficit/hyperactivity disorder (ADHD) utilize nonpharmacological (behavioral/psychosocial) and/or pharmacological interventions. Limited accessibility to behavioral therapies and concerns over adverse effects of pharmacological treatments prompted research for alternative ADHD therapies such as natural product-derived treatments and nutritional supplements. In this study, we reviewed the herbal preparations and nutritional supplements evaluated in clinical studies as potential ADHD treatments and discussed their performance with regard to safety and efficacy in clinical trials. We also discussed some evidence suggesting that adjunct treatment of these agents (with another botanical agent or pharmacological ADHD treatments) may be a promising approach to treat ADHD. The analysis indicated mixed findings with regard to efficacy of natural product-derived ADHD interventions. Nevertheless, these treatments were considered as a “safer” approach than conventional ADHD medications. More comprehensive and appropriately controlled clinical studies are required to fully ascertain efficacy and safety of natural product-derived ADHD treatments. Studies that replicate encouraging findings on the efficacy of combining botanical agents and nutritional supplements with other natural product-derived therapies and widely used ADHD medications are also warranted. In conclusion, the risk-benefit balance of natural product-derived ADHD treatments should be carefully monitored when used as standalone treatment or when combined with other conventional ADHD treatments. PMID:26966583

Reduced emotional empathy in adults with subclinical ADHD: evidence from the empathy and systemizing quotient.

PubMed

Groen, Y; den Heijer, A E; Fuermaier, A B M; Althaus, M; Tucha, O

2018-06-01

Studies in children with ADHD suggest impairments in social cognitive functions, whereas studies in adults with ADHD are scarce and inconclusive. The aim of this study was to investigate the relationship between ADHD traits and self-reported social cognitive style in a sample of adults from the general population. For this purpose, a community sample of 685 adults filled out online self-report questionnaires about ADHD symptoms (ADHD Rating Scale, ARS), social cognitive functioning and friendships. The Empathy Quotient (EQ) with the subscales Cognitive Empathy (CE), Emotional Empathy (EE) and Social Skills (SS), and the Systemizing Quotient (SQ) were included for measuring social cognitive style and the Friendship Questionnaire (FQ) for the quality of friendships. Participants who met the DSM-5 criteria on the ARS ('subclinical ADHD'; n = 56) were compared regarding their social cognitive functioning scores with a control group (n = 56) that was matched for age, sex and student status. With small effect sizes, the subclinical ADHD group showed reduced EE scores on the EQ and a more male social cognitive profile. This result was not influenced by sex or ADHD subtype. This study points to a relationship between traits of ADHD and the emotional aspect of empathy, whereas more complex aspects of empathy were unrelated. These findings should be corroborated in clinical patients with ADHD, employing neuropsychological tests rather than self-report questionnaires.

Criterion validity and clinical usefulness of Attention Deficit Hyperactivity Disorder Rating Scale IV in attention deficit hyperactivity disorder (ADHD) as a function of method and age.

PubMed

López-Villalobos, José A; Andrés-De Llano, Jesús; López-Sánchez, María V; Rodríguez-Molinero, Luis; Garrido-Redondo, Mercedes; Sacristán-Martín, Ana M; Martínez-Rivera, María T; Alberola-López, Susana

2017-02-01

The aim of this research is to analyze Attention Deficit Hyperactivity Disorder Rating Scales IV (ADHD RS-IV) criteria validity and its clinical usefulness for the assessment of Attention Deficit Hyperactivity Disorder (ADHD) as a function of assessment method and age. A sample was obtained from an epidemiological study (n = 1095, 6-16 years). Clinical cases of ADHD  (ADHD-CL) were selected by dimensional ADHD RS-IV and later by clinical interview (DSM-IV). ADHD-CL cases were compared with four categorical results of ADHD RS-IV provided by parents (CATPA), teachers (CATPR), either parents or teachers (CATPAOPR) and both parents and teachers (CATPA&PR). Criterion validity and clinical usefulness of the answer modalities to ADHD RS-IV were studied. ADHD-CL rate was 6.9% in childhood, 6.2% in preadolescence and 6.9% in adolescence. Alternative methods to the clinical interview led to increased numbers of ADHD cases in all age groups analyzed, in the following sequence: CATPAOPR> CATPRO> CATPA> CATPA&PR> ADHD-CL. CATPA&PR was the procedure with the greatest validity, specificity and clinical usefulness in all three age groups, particularly in the childhood. Isolated use of ADHD RS-IV leads to an increase in ADHD cases compared to clinical interview, and varies depending on the procedure used.

[Feasibility and effectiveness of mindfulness training in adults with ADHD: a pilot study].

PubMed

Hepark, S; Kan, C C; Speckens, A

2014-01-01

Attention deficit hyperactivity disorder (ADHD) is a developmental disorder that often continues into adulthood. Stimulant medication is the common treatment for ADHD. However, there is a need for psychosocial interventions in addition to medication. To conduct a pilot study which examines the feasibility and effectiveness of mindfulness training for adults with ADHD. Eleven adults with ADHD participated in a mindfulness training scheme lasting 10 weeks. ADHD symptoms, anxiety and depressive symptoms, quality of life, mindfulness skills and attentional tasks were measured before and after the period of mindfulness training. Nine participants completed the mindfulness training and were satisfied with the training. Eight of these reported improvement in their ADHD symptoms. For all participants, their quality of life, awareness of their actions and executive control had also improved. Mindfulness is a feasible treatment strategy for adults with ADHD and seems to have a positive effect on ADHD symptoms and executive control.

Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis.

PubMed

Groenman, Annabeth P; Janssen, Tieme W P; Oosterlaan, Jaap

2017-07-01

To assess the prospective risk of developing substance-related disorders after childhood mental health disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], oppositional defiant disorder [ODD] or conduct disorder [CD], anxiety disorder, and depression) using meta-analysis. PubMed, Embase, and PsycInfo were searched for relevant longitudinal studies that described childhood (<18 years old) ADHD, ODD or CD, anxiety, or depression in relation to later alcohol-, nicotine-, or drug-related disorders or substance use disorders (SUDs) published in peer-reviewed journals in the English language from 1986 to May 2016. Two researchers conducted all review stages. Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. Thirty-seven studies including more than 762,187 participants were identified for quantitative analyses. These studies included 22,029 participants with ADHD, 434 participants with ODD or CD, 1,433 participants with anxiety disorder, and 2,451 participants with depression. Ninety-seven effects sizes were extracted for analyses. Meta-analysis showed a significantly increased risk for addiction in ADHD (n = 23, odds ratio [OR] 2.27, 95% CI 1.98-3.67; OR alcohol 2.15, 95% CI 1.56-2.97; OR drugs 1.52, 95% CI 1.52-5.27; OR nicotine 2.52, 95% CI 2.01-3.15; OR SUDs 2.61, 95% CI 1.77-3.84), ODD or CD (n = 8, OR 3.18, 95% CI 1.97-5.80; OR alcohol 1.73, 95% CI 1.51-2.00; OR drugs 4.24, 95% CI 1.3.21.5.59; OR nicotine 4.22, 95% CI 3.21-5.55; OR SUDs 4.86, 95% CI 3.09-7.56), and depression (n = 13, OR 2.03, 95% CI 1.47-2.81; OR alcohol 1.10, 95% CI 1.02-1.19; OR nicotine 2.56, 95% CI 1.89-3.48; OR SUDs 2.20, 95% CI 1.41-3.43), but not for anxiety disorders (n = 15, OR 1.34, 95% CI 0.90-1.55, not significant). Childhood ADHD, ODD, CD, and depression increase the risk of developing substance-related disorders. Anxiety disorders do not seem to increase the risk for future substance-related disorders, although the findings are highly heterogeneous. These findings emphasize the need for early detection and intervention to prevent debilitating substance-related disorders in later life. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Investigation of attention deficit hyperactivity disorder (ADHD) sub-types in children via EEG frequency domain analysis.

PubMed

Aldemir, Ramazan; Demirci, Esra; Per, Huseyin; Canpolat, Mehmet; Özmen, Sevgi; Tokmakçı, Mahmut

2018-04-01

To investigate the frequency domain effects and changes in electroencephalography (EEG) signals in children diagnosed with attention deficit hyperactivity disorder (ADHD). The study contains 40 children. All children were between the ages of 7 and 12 years. Participants were classified into four groups which were ADHD (n=20), ADHD-I (ADHD-Inattentive type) (n=10), ADHD-C (ADHD-Combined type) (n=10), and control (n=20) groups. In this study, the frequency domain of EEG signals for ADHD, subtypes and control groups were analyzed and compared using Matlab software. The mean age of the ADHD children's group was 8.7 years and the control group 9.1 years. Spectral analysis of mean power (μV 2 ) and relative-mean power (%) was carried out for four different frequency bands: delta (0--4 Hz), theta (4--8 Hz), alpha (8--13 Hz) and beta (13--32 Hz). The ADHD and subtypes of ADHD-I, and ADHD-C groups had higher average power value of delta and theta band than that of control group. However, this is not the case for alpha and beta bands. Increases in delta/beta ratio and statistical significance were found only between ADHD-I and control group, and in delta/beta, theta/delta ratio statistical significance values were found to exist between ADHD-C and control group. EEG analyzes can be used as an alternative method when ADHD subgroups are identified.

[Health-related quality of life in cases of attention deficit hyperactivity disorder with and without pharmacological treatment].

PubMed

López-Villalobos, José Antonio; Sacristán-Martín, Ana María; Garrido-Redondo, Mercedes; Martínez-Rivera, María Teresa; López-Sánchez, María Victoria; Rodríguez-Molinero, Luis; Camina-Gutiérrez, Ana Belén; Andrés-de Llano, Jesús

2018-06-02

The health-related quality of life (HRQoL) questionnaire is important in order to assess the effects of therapeutic intervention. The aim of this study is to analyse HRQoL, comparing cases of attention deficit hyperactivity disorder (ADHD) treated with methylphenidate (ADHD-T), untreated cases (ADHD-N), and controls. The study included a sample of 228 participants between 8 and 14 years old (114 controls, 57 ADHD-T, and 57 ADHD-N). Consecutive sampling was used in ADHD according to DSM-IV criteria (ADHD Rating Scales IV), and random sampling of controls matched by gender and age. The evaluation of HRQoL was made by using KIDSCREEN-52 parent version. The intensity of ADHD symptoms is significantly lower in ADHD-T than in ADHD-N. There is a moderate significant correlation between greater intensity of ADHD symptoms and worse HRQoL. ADHD cases have significantly worse HRQoL than controls on psychic well-being, mood, relationship with parents and friends, school environment, and social acceptance. The cases of ADHD-T have significantly better HRQoL than ADHD-N in the school dimension, but do not differ significantly in other dimensions of KIDSCREEN-52. It would be advisable that the treatment of ADHD integrates multi-dimensional therapeutic models that improve the basic symptoms of the disorder, as well as the HRQoL. Copyright © 2018. Publicado por Elsevier España, S.L.U.

Attention Deficit Hyperactivity Disorder comorbid oppositional defiant disorder and its predominately inattentive type: evidence for an association with COMT but not MAOA in a Chinese sample.

PubMed

Qian, Qiu-Jin; Liu, Jin; Wang, Yu-Feng; Yang, Li; Guan, Li-Li; Faraone, Stephen V

2009-02-19

There are three childhood disruptive behavior disorders (DBDs), attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). The most common comorbid disorder in ADHD is ODD. DSM-IV describes three ADHD subtypes: predominantly inattentive type (ADHD-IA), predominantly hyperactive-impulsive type (ADHD-HI), and combined type (ADHD-C). Prior work suggests that specific candidate genes are associated with specific subtypes of ADHD in China. Our previous association studies between ADHD and functional polymorphisms of COMT and MAOA, consistently showed the low transcriptional activity alleles were preferentially transmitted to ADHD-IA boys. Thus, the goal of the present study is to test the hypothesis that COMT Val158Met and MAOA-uVNTR jointly contribute to the ODD phenotype among Chinese ADHD boys. 171 Chinese boys between 6 and 17.5 years old (mean = 10.3, SD = 2.6) with complete COMT val158met and MAOA-uVNTR genotyping information were studied. We used logistic regression with genotypes as independent variables and the binary phenotype as the dependent variable. We used p < 0.05 as the level of nominal statistical significance. Bonferroni correction procedures were used to adjust for multiple comparisons. Our results highlight the potential etiologic role of COMT in the ADHD with comorbid ODD and its predominately inattentive type in male Chinese subjects. ADHD with comorbid ODD was associated with homozygosity of the high-activity Val allele, while the predominantly inattentive ADHD subtype was associated with the low-activity Met allele. We found no evidence of association between the MAOA-uVNTR variant and ADHD with comorbid ODD or the ADHD-IA subtype. Our study of attention deficit hyperactivity disorder comorbid oppositional defiant disorder and its predominately inattentive type highlights the potential etiologic role of COMT for ADHD children in China. But we failed to observe an interaction between COMT and MAOA, which suggests that epistasis between COMT and MAOA genes does not influence the phenotype of ADHD-IA with comorbid ODD in a clinical sample of Chinese male subjects. To confirm our findings further studies with a larger number of subjects and healthy controls are needed.

Genetics of attention deficit hyperactivity disorder.

PubMed

Faraone, Stephen V; Larsson, Henrik

2018-06-11

Decades of research show that genes play an vital role in the etiology of attention deficit hyperactivity disorder (ADHD) and its comorbidity with other disorders. Family, twin, and adoption studies show that ADHD runs in families. ADHD's high heritability of 74% motivated the search for ADHD susceptibility genes. Genetic linkage studies show that the effects of DNA risk variants on ADHD must, individually, be very small. Genome-wide association studies (GWAS) have implicated several genetic loci at the genome-wide level of statistical significance. These studies also show that about a third of ADHD's heritability is due to a polygenic component comprising many common variants each having small effects. From studies of copy number variants we have also learned that the rare insertions or deletions account for part of ADHD's heritability. These findings have implicated new biological pathways that may eventually have implications for treatment development.

Impact of Study Skills and Parent Education on First-Year GPA Among College Students With and Without ADHD: A Moderated Mediation Model.

PubMed

Gormley, Matthew J; Pinho, Trevor; Pollack, Brittany; Puzino, Kristina; Franklin, Melanie K; Busch, Chelsea; DuPaul, George J; Weyandt, Lisa L; Anastopoulos, Arthur D

2018-02-01

To test if the relationship between ADHD and academic achievement is mediated by service utilization and/or study skills, and if these mediation effects are moderated by parental education level. A bootstrapping method within structural equation modeling was used with data from 355 first year college students meeting strict criteria for ADHD or clearly without ADHD to test the mediation and moderation effects. Study skills, but not service utilization, significantly mediated the relationship between ADHD status and GPA; however, this relationship was not significant among students with at least one parent holding a master's degree or higher. Among first year college students study skills may be a more salient predictor of educational outcomes relative to ADHD status. Additional research into support services for college students with ADHD is needed, however, results suggest interventions targeting study skills may hold particular promise for these students.

Self-esteem evaluation in children and adolescents suffering from ADHD.

PubMed

Mazzone, Luigi; Postorino, Valentina; Reale, Laura; Guarnera, Manuela; Mannino, Valeria; Armando, Marco; Fatta, Laura; De Peppo, Lavinia; Vicari, Stefano

2013-01-01

Several recent studies investigated the relationship between self-esteem and ADHD, however, the results are still controversial. In the present study we analyze the characteristics of self-esteem in a sample of children and adolescents suffering from ADHD, with a particular focus on the relationship between ADHD symptoms severity and treatment strategies. A total of 85 patients with ADHD (44 drug-free and 41 drug-treated, 23 of which atomoxetine-treated and 18 Methylphenidate-treated) and 26 healthy controls were enrolled in the study in order to evaluate self-esteem using the Self-esteem Multidimensional Test (TMA). ADHD subjects revealed lower scores on all self-esteem domains compared to controls. Both ADHD drug-free (47.1%) and ADHD drug-treated (44.1%) groups showed significantly higher rates of subjects in the pathological range as compared to normal control group (8.8%) (p <.001) with a higher percentage of subjects in the pathological range. Among ADHD drug-treated subjects, the methylphenidate group showed higher self-esteem scores as compared to the atomoxetine group. A lower self-esteem profile is more common in subjects suffering from ADHD than in healthy controls, suggesting the importance of an early detection of psychological well-being in these children in order to reduce the ADHD symptoms long-term impacts.

Self-Esteem Evaluation in Children and Adolescents Suffering from ADHD

PubMed Central

Mazzone, Luigi; Postorino, Valentina; Reale, Laura; Guarnera, Manuela; Mannino, Valeria; Armando, Marco; Fatta, Laura; De Peppo, Lavinia; Vicari, Stefano

2013-01-01

Background: Several recent studies investigated the relationship between self-esteem and ADHD, however, the results are still controversial. In the present study we analyze the characteristics of self-esteem in a sample of children and adolescents suffering from ADHD, with a particular focus on the relationship between ADHD symptoms severity and treatment strategies. Methods: A total of 85 patients with ADHD (44 drug-free and 41 drug-treated, 23 of which atomoxetine-treated and 18 Methylphenidate-treated) and 26 healthy controls were enrolled in the study in order to evaluate self-esteem using the Self-esteem Multidimensional Test (TMA). Results: ADHD subjects revealed lower scores on all self-esteem domains compared to controls. Both ADHD drug-free (47.1%) and ADHD drug-treated (44.1%) groups showed significantly higher rates of subjects in the pathological range as compared to normal control group (8.8%) (p <.001) with a higher percentage of subjects in the pathological range. Among ADHD drug-treated subjects, the methylphenidate group showed higher self-esteem scores as compared to the atomoxetine group. Conclusion: A lower self-esteem profile is more common in subjects suffering from ADHD than in healthy controls, suggesting the importance of an early detection of psychological well-being in these children in order to reduce the ADHD symptoms long-term impacts. PMID:23878614

Retinal Nerve Fiber Layer Thickness in Children With ADHD.

PubMed

Hergüner, Arzu; Alpfidan, İsmail; Yar, Ahmet; Erdoğan, Erkan; Metin, Özge; Sakarya, Yaşar; Hergüner, Sabri

2018-05-01

The current study aims to compare retinal nerve fiber layer (RNFL) thickness, macular thickness, and macular volume between children with ADHD and a control group. The study group included children with ADHD and the control group consisted of age- and gender-matched participants without any psychiatric disorder. In all participants, RNFL thickness, macular thickness, and macular volume were measured by using spectral domain-optical coherence tomography (SD-OCT). ADHD symptom severity was evaluated by using parent-report measures, including Conners' Parent Rating Scale-Revised: Short Form (CPRS-R: S) and the Strengths and Difficulties Questionnaire: Parent Form (SDQ: P). We compared 90 eyes of 45 children with ADHD and 90 eyes of 45 controls. ADHD group had significantly lower RNFL thickness only in nasal quadrant than the controls. The remaining RNFL quadrants, macular thickness, and volume were not significantly different between groups. There was a reverse correlation between RNFL thickness and ADHD symptom severity. This is the first study examining the RNFL thickness in ADHD. Our findings showed that nasal RNFL thickness was lower, indicating reduced unmyelinated axons in the retina of children with ADHD. The results of this study support the evidence that ADHD involves a lag in cortical maturation and this is measurable in the retina.

Attention deficit-hyperactivity disorder symptoms in women with polycystic ovary syndrome.

PubMed

Hergüner, Sabri; Harmancı, Hatice; Toy, Harun

2015-01-01

Several studies suggest that androgens are involved in the etiology of attention deficit-hyperactivity disorder (ADHD). In this study, we investigated the ADHD symptoms in women with polycystic ovary syndrome (PCOS), a complex endocrine, hormonal, and metabolic condition associated with hyperandrogenism. Forty women between the ages of 18 and 35 years with PCOS were recruited for the study group. For comparison, 40 healthy women who had regular menses were included. Current and childhood ADHD symptoms were assessed by using the Adult ADHD Self-Report Scale and Wender-Utah Rating Scale, respectively. Women with PCOS had higher total Adult ADHD Self-Report Scale and total Wender-Utah Rating Scale scores than controls. According to the Wender-Utah Rating Scale, the frequency of childhood ADHD was significantly higher in PCOS group than the control. Adult ADHD Self-Report Scale: Hyperactivity-Impulsivity and Wender-Utah Rating Scale: Behavioral Problems/Impulsivity scores were significantly higher in women with PCOS. However, there were no significant differences between groups in both current and childhood inattention scores. We found no correlations between ADHD symptoms and serum hormone levels including testosterone in women with PCOS. These results suggest that women with PCOS have higher ADHD symptoms. Further studies are needed to investigate the association between PCOS and ADHD. © The Author(s) 2015.

Burden of illness and health care resource utilization in adult psychiatric outpatients with attention-deficit/hyperactivity disorder in Europe.

PubMed

Karlsdotter, Kristina; Bushe, Chris; Hakkaart, L; Sobanski, Esther; Kan, C C; Lebrec, Jeremie; Kraemer, Susanne; Dieteren, Nicole A H M; Deberdt, Walter

2016-09-01

To assess the burden of illness and health care resource utilization of adult nonpsychotic psychiatric outpatients with attention-deficit/hyperactivity disorder (ADHD) in Europe. This was a multicountry, cross-sectional, observational study where unselected routine patients from clinical psychiatric outpatient settings were screened and assessed for ADHD. Patients were evaluated using the Clinical Global Impressions of Severity (CGI-S) scale, the Sheehan Disability Scale (SDS), and the EuroQol-5 Dimensions questionnaire. Data on comorbidities, functional impairment, and health care resource utilization were captured. The study enrolled 2284 patients, of whom 1986 completed the study. The prevalence of ADHD was 17.4%, of whom 46.0% had a previous ADHD diagnosis. Patients with ADHD had a high clinical burden with psychiatric comorbidities, especially depression (43.0%) and anxiety disorders (36.4%). Substance abuse (9.2% vs. 3.4%) and alcohol abuse (10.3% vs. 5.2%) were more common in the ADHD cohort vs. the non-ADHD cohort. Only 11.5% of the patients with ADHD had no other psychiatric disorder. Various measures indicated a significantly poorer level of functioning for patients with ADHD than without ADHD, as indicated by higher scores for CGI-S (3.8 vs. 3.3) and SDS (18.9 vs. 11.6) and higher percentages of debt (35.5% vs. 24.3%) and criminality (13.8% vs. 6.1%). Lastly, the health care resource utilization was considerable and similar between adult psychiatric outpatients diagnosed and not diagnosed with ADHD. Although care was taken when choosing the sites for this study, to make it representative of the general outpatient adult psychiatric population, caution should be advised in generalizing the findings of our study to the general ADHD or psychiatric outpatient population. This was an observational study, thus no inference on causality can be drawn. Having ADHD imposes a considerable health and social burden on patient and health care resource utilization comparable to other chronic psychiatric disorders.

Moderator Role of Monitoring in the Inhibitory Control of Adolescents With ADHD.

PubMed

Ramos-Galarza, Carlos; Pérez-Salas, Claudia

2018-05-01

The aim of this research was to analyze the role of monitoring in the causal relationship between inhibitory control and symptoms of combined ADHD. It has been conducted a quantitative investigation of two phases. In the first study, a moderation model was analyzed ( N = 144 adolescents with combined ADHD), where monitoring was considered as a moderating variable in the causal relationship between the inhibitory control and the symptomatology of ADHD F(3, 140) = 28.03, p < .001; R 2 = .37. In the second study, the model through an experimental study was tested ( N = 52 adolescents with and without ADHD) where it was found that adolescents with ADHD improve in their inhibitory control when they receive external support to the monitoring F(1, 50) = 21.38, p < .001, η 2 = .30. Results suggest that monitoring compensates the poor performance of inhibitory control in adolescents with ADHD, which is a contribution to the theoretical construction of ADHD and to the treatments proposed for this condition because it goes beyond the classic conception of a causality chain among the deficit of inhibitory control and ADHD symptomatology to propose a new explanation about this disorder, where neuropsychology intervention of monitoring would diminish ADHD's symptomatology impact on adolescents.

[Pre- and perinatal risk factors in autism spectrum disorder and attention deficit/hyperactivity disorder].

PubMed

Schmitz, Johanna C; Cholemkery, Hannah; Medda, Juliane; Freitag, Christine M

2017-01-01

Epidemiological studies indicate the relevance of pre- and perinatal risk factors for the genesis of attention deficit/hyperactivity disorder and autism spectrum disorder. This study compares potential risk factors in a clinical sample of children with ADHD, ASD, the combination of both diseases, ADHD and oppositional defiant or conduct disorder (ADHD & ODD/CD) and examined whether the existence of additional risk factors promotes the occurrence of combined diseases. We compared the pre- and perinatal risk factors of 341 patients (299 boys, 42 girls) from a clinical population, differentiating between children with ADHD (n=80), ASD (n=122), ADHD & ASD (n=55), or ADHD & ODD/CD (n=84). We observed a higher rate of maternal smoking, a higher rate of migration, and lower parental education among the children with ADHD & ODD/CD compared to those with ASD or ADHD. The rate of migration background was higher among the children with ASD compared to children with ADHD. Miscarriage was a specific risk factor for ADHD & ASD. Numerous risk factors described in epidemiological studies occurred only rarely in our clinical sample. The distribution of most risk factors was comparable between the examined diseases.

How Substance Users With ADHD Perceive the Relationship Between Substance Use and Emotional Functioning.

PubMed

Mitchell, John T; Weisner, Thomas S; Jensen, Peter S; Murray, Desiree W; Molina, Brooke S G; Arnold, Eugene L; Hechtman, Lily; Swanson, James M; Hinshaw, Stephen P; Victor, Elizabeth C; Kollins, Scott H; Wells, Karen C; Belendiuk, Katherine A; Blonde, Andrew; Nguyen, Celeste; Ambriz, Lizeth; Nguyen, Jenny L

2017-02-01

Although substance use (SU) is elevated in ADHD and both are associated with disrupted emotional functioning, little is known about how emotions and SU interact in ADHD. We used a mixed qualitative-quantitative approach to explore this relationship. Narrative comments were coded for 67 persistent (50 ADHD, 17 local normative comparison group [LNCG]) and 25 desistent (20 ADHD, 5 LNCG) substance users from the Multimodal Treatment Study of Children with ADHD (MTA) adult follow-up (21.7-26.7 years-old). SU persisters perceived SU positively affects emotional states and positive emotional effects outweigh negative effects. No ADHD group effects emerged. Qualitative analysis identified perceptions that cannabis enhanced positive mood for ADHD and LNCG SU persisters, and improved negative mood and ADHD for ADHD SU persisters. Perceptions about SU broadly and mood do not differentiate ADHD and non-ADHD SU persisters. However, perceptions that cannabis is therapeutic may inform ADHD-related risk for cannabis use.

Risky decision making in adults with ADHD.

PubMed

Matthies, S; Philipsen, A; Svaldi, J

2012-09-01

Risky decision making and disadvantageous choices constitute core characteristics of patients with attention-deficit/hyperactivity disorder (ADHD). Consequences include negative psychosocial and health-related outcomes. However, risky decision making and its interrelations with emotional states in ADHD are poorly understood. Therefore, the authors investigated risky decision making without and after boredom induction in adults with and without ADHD. In study 1, ADHD patients (n = 15) and age/education matched controls (CG; n = 16) were compared on the Game of Dice Task (GDT), an established task measuring decision making in unambiguous situations. In study 2, ADHD patients (n = 14) and CG (n = 13) underwent boredom induction prior to the GDT. In study 1, ADHD patients selected the disadvantageous alternatives significantly more often than CG. In study 2, no significant group differences were found due to an increase in risky decision making in CG following the boredom induction. Even if severity of depression did not affect our results, it may be necessary to compare GDT responses in ADHD patients with and without current depression. Risk as a motor of disadvantageous decision making needs to be taken into account in therapeutic contexts as a maintenance factor of dysfunctional behaviour. The findings of study 2 are in line with postulated alterations of emotional state adjustment in ADHD. The link between decisions making and emotional regulation in ADHD needs further attention in research. Copyright © 2012 Elsevier Ltd. All rights reserved.

ADHD Coaching with College Students: Exploring the Processes Involved in Motivation and Goal Completion

ERIC Educational Resources Information Center

Prevatt, Frances; Smith, Shannon M.; Diers, Sarah; Marshall, Diana; Coleman, Jennifer; Valler, Emilee; Miller, Nathan

2017-01-01

College students with attention-deficit/hyperactivity disorder (ADHD) often experience increased academic difficulties, which can negatively impact graduation rates, employment, self-esteem, and mental health. ADHD coaching assists students with ADHD to reduce such difficulties. The present study evaluated the processes involved in ADHD coaching…

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

ERIC Educational Resources Information Center

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

2007-01-01

Objective: Background: Children with velocardiofacial syndrome (VCFS), a contiguous deletion syndrome, have an increased prevalence of attention deficit/hyperactivity disorder (ADHD). Method: The authors compared youth with VCFS+ADHD (from the SUNY Upstate VCFS Research Program) to those with ADHD but not VCFS (from the Massachusetts General…

Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011.

PubMed

Wang, L-J; Lee, S-Y; Yuan, S-S; Yang, C-J; Yang, K-C; Huang, T-S; Chou, W-J; Chou, M-C; Lee, M-J; Lee, T-L; Shyu, Y-C

2017-12-01

Public controversy regarding the potential overdiagnosis and overmedication of children with attention-deficit/hyperactivity disorder (ADHD) has continued for decades. This study used the National Health Insurance Research Database of Taiwan (NHIRD-TW) to explore trends in ADHD diagnosis in youths and the proportion of those receiving medication, with the aim of determining whether ADHD is overdiagnosed and overmedicated in Taiwan. Youths (age ≤18 years) who had at least two NHIRD-TW claims records with ADHD diagnosis between January 2000 and December 2011 were selected as the subject cohort. In total, the study sample comprised 145 018 patients with ADHD (mean age at a diagnosis of ADHD: 7.7 ± 3.1 years; 21.4% females). The number of cases of ADHD were calculated annually for each year (from 2000 to 2011), and the number of cases per year who received medication was determined as those with at least one record of pharmacotherapy (immediate-release methylphenidate, osmotic controlled-release formulation of methylphenidate, and atomoxetine) in each year. The prevalence rates of a diagnosis of ADHD in the youths ranged from 0.11% in 2000 to 1.24% in 2011. Compared with children under 6 years of age, the ADHD diagnosis rates in children aged between 7 and 12 years (ratio of prevalence rates = 4.36) and in those aged between 13 and 18 years (ratio of prevalence rates = 1.42) were significantly higher during the study period. The prevalence in males was higher than that in females (ratio of prevalence rates = 4.09). Among the youths with ADHD, 50.2% received medications in 2000 compared with 61.0% in 2011. The probability of receiving ADHD medication increased with age. More male ADHD patients received medications that females patients (ratio of prevalence rates = 1.16). The rate of ADHD diagnosis was far lower than the prevalence rate (7.5%) identified in a previous community study using face-to-face interviews. Approximately 40-50% of the youths with ADHD did not receive any medications. These findings are not consistent with a systematic public opinion about overdiagnosis or overmedication of ADHD in Taiwan.

Attention-Deficit/Hyperactivity Disorder Symptoms, Depression Risk, and Quality of Life in Black Pregnant Women.

PubMed

Jones, Heather A; Eddy, Laura D; Bourchtein, Elizaveta; Parks, Amanda M; Green, Tiffany L; Karjane, Nicole W; Svikis, Dace S

2018-05-21

Experiencing mental health difficulties during pregnancy predicts a variety of quality-of-life (QoL) outcomes for Black women. However, one area of prenatal mental health remains underresearched: attention-deficit/hyperactivity disorder (ADHD). Given the impairments reported by adults with significant symptoms of ADHD and the linkages between depression and ADHD in nonpregnant samples, the current study aimed to examine the relationships among ADHD symptoms, depression, and QoL in Black pregnant women. Participants for this study were 116 pregnant Black women aged 18-43 years (mean age = 27.14, standard deviation = 5.67) presenting to an urban women's health clinic. We investigated associations among maternal ADHD symptoms, risk of maternal depression, and different aspects of QoL, including relationships, life outlook, and life productivity. Linear hierarchical regressions were performed to investigate the ability of maternal depression risk to mediate the relationship between maternal ADHD symptoms and QoL. Moderate to large negative correlations were found between maternal ADHD symptoms, depression risk, and quality of life (p's ≤ 0.001). Furthermore, maternal depression risk either partially or fully explained the relationship between ADHD symptoms and the different QoL variables. This study illustrates that symptoms of both ADHD and depression are important clinical considerations for Black women during pregnancy. As significant ADHD symptoms can lead to the development of depression, future research should investigate the temporal relationship between depression and QoL in pregnant women diagnosed with ADHD, as well as study whether ADHD treatment results in improvements in depressive symptoms.

Structural Brain Abnormalities of Attention-Deficit/Hyperactivity Disorder With Oppositional Defiant Disorder.

PubMed

Noordermeer, Siri D S; Luman, Marjolein; Greven, Corina U; Veroude, Kim; Faraone, Stephen V; Hartman, Catharina A; Hoekstra, Pieter J; Franke, Barbara; Buitelaar, Jan K; Heslenfeld, Dirk J; Oosterlaan, Jaap

2017-11-01

Attention-deficit/hyperactivity disorder (ADHD) is associated with structural abnormalities in total gray matter, basal ganglia, and cerebellum. Findings of structural abnormalities in frontal and temporal lobes, amygdala, and insula are less consistent. Remarkably, the impact of comorbid oppositional defiant disorder (ODD) (comorbidity rates up to 60%) on these neuroanatomical differences is scarcely studied, while ODD (in combination with conduct disorder) has been associated with structural abnormalities of the frontal lobe, amygdala, and insula. The aim of this study was to investigate the effect of comorbid ODD on cerebral volume and cortical thickness in ADHD. Three groups, 16 ± 3.5 years of age (mean ± SD; range 7-29 years), were studied on volumetric and cortical thickness characteristics using structural magnetic resonance imaging (surface-based morphometry): ADHD+ODD (n = 67), ADHD-only (n = 243), and control subjects (n = 233). Analyses included the moderators age, gender, IQ, and scan site. ADHD+ODD and ADHD-only showed volumetric reductions in total gray matter and (mainly) frontal brain areas. Stepwise volumetric reductions (ADHD+ODD < ADHD-only < control subjects) were found for mainly frontal regions, and ADHD+ODD was uniquely associated with reductions in several structures (e.g., the precuneus). In general, findings remained significant after accounting for ADHD symptom severity. There were no group differences in cortical thickness. Exploratory voxelwise analyses showed no group differences. ADHD+ODD and ADHD-only were associated with volumetric reductions in brain areas crucial for attention, (working) memory, and decision-making. Volumetric reductions of frontal lobes were largest in the ADHD+ODD group, possibly underlying observed larger impairments in neurocognitive functions. Previously reported striatal abnormalities in ADHD may be caused by comorbid conduct disorder rather than ODD. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Increase in Teachers' Knowledge about ADHD after a Week-Long Training Program: A Pilot Study

ERIC Educational Resources Information Center

Syed, Ehsan Ullah; Hussein, Sajida Abdul

2010-01-01

Objectives: ADHD affects 3% to 5% of school-age children. Clinical and community based epidemiological studies in Pakistan have shown a high prevalence of ADHD among school going children. A thorough review of literature shows that no studies of teachers' training programs regarding ADHD have been published in Pakistani research literature. The…

Differential Effects of Methylphenidate on Problem Solving in Adults with ADHD

ERIC Educational Resources Information Center

Tucha, Lara; Tucha, Oliver; Sontag, Thomas A.; Stasik, Dorota; Laufkotter, Rainer; Lange, Klaus W.

2011-01-01

Objective: Two studies were performed to assess both divergent and convergent thinking in adults with ADHD. Method: The first study compared the problem-solving abilities of healthy participants (N = 144) and unmedicated adults with ADHD (N = 144). In the second study, problem-solving abilities of adults with diagnosed ADHD (N = 22) were examined…

Attention Deficit Hyperactivity Disorder Prevalence and Correlates Pre- and Post-Bariatric Surgery: A Comparative Cross-Sectional Study.

PubMed

Nielsen, Friedrich; Georgiadou, Ekaterini; Bartsch, Merle; Langenberg, Svenja; Müller, Astrid; de Zwaan, Martina

2017-01-01

Previous research shows an association between obesity and attention deficit hyperactivity disorder (ADHD). The present study compares pre- and post-bariatric surgery patients using the internationally used Conners' Adult ADHD Rating Scale (CAARS™) to screen for ADHD. Matched samples pre- (N = 120) and post-bariatric surgery (N = 128) were compared using self-rating instruments to assess ADHD-relevant symptomatology, depression, eating-related psychopathology, and BMI. Prevalence of probable ADHD did not differ between groups using the CAARS Index Scale T-scores; however, CAARS subscales Inattention/Memory and Self-Concept showed significantly lower scores in post-surgery patients. All CAARS subscales correlated significantly with each other, with depression and eating-related psychopathology. There was no correlation between ADHD and excess BMI loss in post-surgery patients. The findings suggest that a considerable number of patients before and after bariatric surgery screened positive for ADHD. It can be hypothesized that some core ADHD symptoms improve after surgery. Future studies are warranted to investigate the influence of ADHD on long-term surgery outcomes. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Clinical Presentation, Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder (ADHD) in Older Adults: A Review of the Evidence and its Implications for Clinical Care.

PubMed

Goodman, David W; Mitchell, Sara; Rhodewalt, Lauren; Surman, Craig B H

2016-01-01

Although previously considered a disorder of childhood, studies in the last decade have demonstrated that attention-deficit hyperactivity disorder (ADHD) continues to impair function into adulthood and responds to pharmacotherapy. Due to age-specific changes in roles and challenges, it is possible that presentation and response to intervention may differ between older and younger adults. A literature search for papers that identified older adults with ADHD, including papers describing its epidemiology, manifestation, and treatment, was the basis for this paper. There is a paucity of data on ADHD in older adults; however, small observational studies have characterized the presence, impact, and treatment of ADHD in adults over the age of 50 years, and larger epidemiologic studies have demonstrated that ADHD symptoms exist in older adulthood. Optimal criteria for diagnosis of ADHD and methods of treating ADHD in older individuals have not been systematically explored. In light of the limited data, this review discusses considerations for differential diagnosis and safe pharmacotherapy of ADHD in older adults.

Motorsports Involvement among Adolescents and Young Adults with Childhood ADHD

ERIC Educational Resources Information Center

Wymbs, Brian T.; Molina, Brooke S. G.; Belendiuk, Katherine A.; Pedersen, Sarah L.; Walther, Christine A. P.; Cheong, Jee Won; McGinley, James S.; Marshal, Michael P.; Gnagy, Elizabeth M.; Pelham, William E.

2013-01-01

Although children with attention-deficit/hyperactivity disorder (ADHD) are at risk for impulsive, health-endangering behavior, few studies have examined nonsubstance, use-related risk-taking behaviors. This study examined whether adolescents and young adults with ADHD histories were more likely than those without ADHD histories to report frequent…

Increase in teachers' knowledge about ADHD after a week-long training program: a pilot study.

PubMed

Syed, Ehsan Ullah; Hussein, Sajida Abdul

2010-01-01

ADHD affects 3% to 5% of school-age children. Clinical and community based epidemiological studies in Pakistan have shown a high prevalence of ADHD among school going children. A thorough review of literature shows that no studies of teachers' training programs regarding ADHD have been published in Pakistani research literature. The aim of the present study is the development and evaluation of an ADHD training program for teachers. A teachers' training program for ADHD was designed and a pilot run in 3 schools of Karachi, Pakistan. Teachers knowledge regarding signs and symptoms of ADHD was tested before and after the workshop and then again after 6 months using an ADHD knowledge questionnaire. Forty-nine teachers, all of them women, completed the questionnaires before and after the training program, and 35 of them filled it out at the 6-month interval. Mean scores of these tests were compared using a paired t test. The authors found the difference of mean score of 1.48 +/- 2.95, and this was statistically significant (p < .005). The authors conclude that the workshop improved the knowledge of the school teachers regarding ADHD symptomatology, and it remained significant even after 6 months of training.

Environmental risk factors for attention-deficit hyperactivity disorder.

PubMed

Banerjee, Tania Das; Middleton, Frank; Faraone, Stephen V

2007-09-01

Attention-deficit hyperactivity disorder (ADHD) is the most common cognitive and behavioural disorder diagnosed among school children. It is characterized by deficient attention and problem solving, along with hyperactivity and difficulty withholding incorrect responses. This highly prevalent disorder is estimated to affect 5-10% of children and in many cases, persists into adulthood, leading to 4% prevalence among adults. Converging evidence from epidemiologic, neuropsychology, neuroimaging, genetic and treatment studies shows that ADHD is a valid medical disorder. The majority of studies performed to assess genetic risk factors in ADHD have supported a strong familial nature of this disorder. Family studies have identified a 2- to 8-fold increase in the risk for ADHD in parents and siblings of children with ADHD. Various twin and adoption studies have also highlighted the highly genetic nature of ADHD. In fact the mean heritability of ADHD was shown to be 0.77, which is comparable to other neuropsychiatric disorders such as schizophrenia or bipolar disorder. However, several biological and environmental factors have also been proposed as risk factors for ADHD, including food additives/diet, lead contamination, cigarette and alcohol exposure, maternal smoking during pregnancy, and low birth weight. Many recent studies have specifically examined the relationships between ADHD and these extraneous factors. This review describes some of these possible risk factors. Although a substantial fraction of the aetiology of ADHD is due to genes, the studies reviewed in this article show that many environmental risk factors and potential gene-environment interactions also increase the risk for the disorder.

Processing Speed Predicts Behavioral Treatment Outcomes in Children with Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type.

PubMed

Adalio, Christopher J; Owens, Elizabeth B; McBurnett, Keith; Hinshaw, Stephen P; Pfiffner, Linda J

2018-05-01

Neuropsychological functioning underlies behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD). Children with all forms of ADHD are vulnerable to working memory deficits and children presenting with the inattentive form of ADHD (ADHD-I) appear particularly vulnerable to processing speed deficits. As ADHD-I is the most common form of ADHD presented by children in community settings, it is important to consider how treatment interventions for children with ADHD-I may be affected by deficits in processing speed and working memory. We utilize data collected from 199 children with ADHD-I, aged 7 to 11 years, who participated in a randomized clinical trial of a psychosocial-behavioral intervention. Our aims are first to determine whether processing speed or working memory predict treatment outcomes in ADHD-I symptom severity, and second whether they moderate treatment effects on ADHD-I symptom severity. Results of linear regression analyses reveal that baseline processing speed significantly predicts posttreatment ADHD-I symptom severity when controlling for baseline ADHD-I symptom severity, such that better processing speed is associated with greater symptom improvement. However, predictive effects of working memory and moderation effects of both working memory and processing speed are not supported in the present study. We discuss study limitations and implications of the relation between processing speed and treatment benefits from psychosocial treatments for children with ADHD-I.

Semantic language as a mechanism explaining the association between ADHD symptoms and reading and mathematics underachievement.

PubMed

Gremillion, Monica L; Martel, Michelle M

2012-11-01

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.

Understanding deficient emotional self-regulation in adults with attention deficit hyperactivity disorder: a controlled study

PubMed Central

Biederman, Joseph; Spencer, Thomas; Miller, Carolyn A.; McDermott, Katie M.; Faraone, Stephen V.

2014-01-01

While symptoms of deficient emotional self-regulation (DESR) such as low frustration tolerance, temper outbursts, emotional impulsivity, and mood lability are commonly associated with attention deficit hyperactivity disorder (ADHD), little is known about their nature. The main aim of this post hoc study was to examine the correlates of DESR in a large sample of adults with and without ADHD. Subjects were 206 adults with ADHD and 123 adults without ADHD from a family study of ADHD. Emotional impulsivity was operationalized using items from the Barkley Current Behavior Scale. Subjects were comprehensively assessed for psychiatric comorbidity using structured diagnostic interview methodology. We used the Quality of Life, Enjoyment, and Satisfaction Questionnaire-Short Form (QLES-Q-SF) and Social Adjustment Scale-Self-report (SAS-SR) to assess quality of life and psychosocial functioning. DESR was more common among ADHD compared with non-ADHD adults, and 55 % of adults with ADHD reported extreme DESR of greater severity than 95 % of control subjects. The association of ADHD and DESR was not entirely accounted for by either current or lifetime comorbid disorders. DESR was also associated with significant functional impairment as evaluated by the QLES-Q-SF and SAS-SR, and with reduced marital status, as well as higher risk for traffic accidents and arrests. DESR adversely impacts quality of life in adults with ADHD. More work is needed to further evaluate DESR in clinical and investigational studies of subjects with ADHD. PMID:23413201

Neuropsychological Performance Patterns of Adult ADHD Subtypes.

PubMed

LeRoy, Amy; Jacova, Claudia; Young, Caedy

2018-05-01

Neuropsychological performance patterns associated with adult ADHD subtypes are unknown. The aim of the current systematic review was to identify and synthesize available literature regarding neuropsychological performance associated with adult ADHD subtypes. Searches were completed using the databases PsycINFO and PubMed for studies published before March 2017 addressing adult ADHD subtypes and neuropsychological performance. Data characterizing the neuropsychological tests utilized in each study were obtained and sorted into eight domains. To summarize the results of all comparisons (ADHD subtype compared with control, or to each other), we counted the proportion of tests within each domain with significant group differences. We deemed four domains informative in differentiating ADHD subtypes from controls. Of these, memory was the only domain that held promise in distinguishing ADHD-Inattentive and ADHD-Combined. Limitations of the available literature are highlighted and recommendations for future research are provided.

Prevalence and contributing factors to attention deficit hyperactivity disorder: A study of five- to fifteen-year-old children in Zhabei District, Shanghai

PubMed Central

Jin, Wenlan; Du, Yasong; Zhong, Xiangyang; David, Coghill

2014-01-01

Introduction This work aims to understand the features among 5- to 15-year-old children with attention deficit hyperactivity disorder (ADHD) in Zhabei District in Shanghai. Methods Children with ADHD were studied using general background questionnaire, ADHD symptom rating questionnaire, and cluster-stratified sampling. A total of 9,900 valid questionnaires were utilized in this study. We conducted diagnostic interviews with suspected ADHD children and their parents using the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th Edition) for ADHD. Results The prevalence rate of ADHD among the children was 4.6%, of which 2.4%, 0.4%, and 1.8% had ADHD-I ADHD-HI, and ADHD-C types, respectively. The prevalence rates in boys and girls were 6.6% and 2.7% (ratio, 2.41 : 1), respectively. Significant differences in prevalence rate were found among children with different age groups and ADHD types. Children aged 7–10 years had the highest prevalence rate (6.3%). Externally, residence children had higher prevalence than local residents. Significant differences in prevalence rate were also found among children with parents having different educational and socioeconomic level. Discussion The prevalence of ADHD-HI was higher than the other two types. The highest prevalence was observed in 7- to 10-year-old children. The influential factors of ADHD prevalence were age, gender, and educational level. PMID:24302704

Treatment of children with attention-deficit/hyperactivity disorder (ADHD) and irritability: results from the multimodal treatment study of children with ADHD (MTA).

PubMed

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

2015-01-01

Clinically impairing irritability affects 25% to 45% of children with attention-deficit/hyperactivity disorder (ADHD); yet, we know little about what interventions are effective in treating children with ADHD and co-occurring irritability. We used data from the Multimodal Treatment Study of Children With ADHD (MTA) to address 3 aims: to establish whether irritability in children with ADHD can be distinguished from other symptoms of oppositional defiant disorder (ODD); to examine whether ADHD treatment is effective in treating irritability; and to examine how irritability influences ADHD treatment outcomes. Secondary analyses of data from the MTA included multivariate analyses, and intent-to-treat random-effects regression models were used. Irritability was separable from other ODD symptoms. For treating irritability, systematic stimulant treatment was superior to behavioral management but not to routine community care; a combination of stimulants and behavioral treatment was superior to community care and to behavioral treatment alone, but not to medication alone. Irritability did not moderate the impact of treatment on parent- and teacher-reported ADHD symptoms in any of the 4 treatment groups. Treatments targeting ADHD symptoms are helpful for improving irritability in children with ADHD. Moreover, irritability does not appear to influence the response to treatment of ADHD. Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); http://www.clinicaltrials.gov; NCT00000388. Copyright © 2015 American Academy of Child & Adolescent Psychaitry. Published by Elsevier Inc. All rights reserved.

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

PubMed Central

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

2015-01-01

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

Differential perinatal risk factors in children with attention-deficit/hyperactivity disorder by subtype.

PubMed

Park, Subin; Cho, Soo-Churl; Kim, Jae-Won; Shin, Min-Sup; Yoo, Hee-Jeong; Oh, Seung Min; Han, Doug Hyun; Cheong, Jae Hoon; Kim, Bung-Nyun

2014-11-30

We compared the attention-deficit/hyperactivity disorder(ADHD) combined subtype (ADHD-C) to the ADHD inattentive subtype (ADHD-I) in terms of genetic, perinatal, and developmental risk factors as well as clinical and neuropsychological characteristics. A total of 147 children diagnosed with ADHD between the ages of 6 and 15 years participated in this study. The parents of the children completed the structured diagnostic interview, the ADHD Rating Scale-IV, the Children's Behavior Checklist, and structured questionnaires on perinatal risk factors, and the children underwent a neuropsychological test and were genotyped. A total of 502 children without ADHD were recruited from the community as a healthy control group. The ADHD-C children showed more severe externalizing symptoms, showed more deficits in a continuous performance test, and were more likely to have comorbid disorders. Maternal stress during pregnancy, postpartum depression, and changes in the primary caretaker during first 3 years were significantly associated with both ADHD-I and ADHD-C. The ADHD-I group was less likely to have received regular prenatal check-ups and more likely to have had postnatal medical illness than the ADHD-C group. There were no significant differences in the genotype frequencies of the dopamine transporter (DAT1) and the serotonin transporter -linked polymorphic region (5-HTTLPR) polymorphisms between ADHD-I and ADHD-C groups. This study shows that the inattentive subtype of ADHD is different from the combined subtype in many parameters including severity of symptoms, comorbidity, neuropsychological characteristics, and environmental risk factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Set shifting and working memory in adults with attention-deficit/hyperactivity disorder.

PubMed

Rohlf, Helena; Jucksch, Viola; Gawrilow, Caterina; Huss, Michael; Hein, Jakob; Lehmkuhl, Ulrike; Salbach-Andrae, Harriet

2012-01-01

Compared to the high number of studies that investigated executive functions (EF) in children with attention-deficit/hyperactivity disorder (ADHD), a little is known about the EF performance of adults with ADHD. This study compared 37 adults with ADHD (ADHD(total)) and 32 control participants who were equivalent in age, intelligence quotient (IQ), sex, and years of education, in two domains of EF--set shifting and working memory. Additionally, the ADHD(total) group was subdivided into two subgroups: ADHD patients without comorbidity (ADHD(-), n = 19) and patients with at least one comorbid disorder (ADHD(+), n = 18). Participants fulfilled two measures for set shifting (i.e., the trail making test, TMT and a computerized card sorting test, CKV) and one measure for working memory (i.e., digit span test, DS). Compared to the control group the ADHD(total) group displayed deficits in set shifting and working memory. The differences between the groups were of medium-to-large effect size (TMT: d = 0.48; DS: d = 0.51; CKV: d = 0.74). The subgroup comparison of the ADHD(+) group and the ADHD(-) group revealed a poorer performance in general information processing speed for the ADHD(+) group. With regard to set shifting and working memory, no significant differences could be found between the two subgroups. These results suggest that the deficits of the ADHD(total) group are attributable to ADHD rather than to comorbidity. An influence of comorbidity, however, could not be completely ruled out as there was a trend of a poorer performance in the ADHD(+) group on some of the outcome measures.

ADHD in acute care psychiatric inpatients.

PubMed

Lines, Katherine L; Sadek, Joseph

2018-06-01

Attention-deficit hyperactivity disorder (ADHD) is a neurocognitive disorder characterized by symptoms of inattention, impulsivity and motor hyperactivity. The worldwide prevalence of ADHD, in the general adult population, has been estimated to be 2.8%. Patients with ADHD have a high incidence of comorbidity with other psychiatric disorders. Those with a psychiatric disorder as well as ADHD have more psychosocial difficulties than those without ADHD. Despite knowing that ADHD is often comorbid with other psychiatric diagnoses, there are currently no studies elucidating the prevalence of ADHD in the inpatient psychiatric population, nor is there significant information about its impact. The lack of research into this topic suggests more needs to be done in the field of adult ADHD, especially in the inpatient psychiatric population and with respect to impairment in patient function. Knowing the prevalence of ADHD and its impact on quality of life in adult inpatients will help lay the groundwork for effective screening and management. The purpose of this study was to understand the prevalence rates of ADHD among psychiatric acute care inpatients. Other objectives included comparing the quality of life and functioning between patients with a primary psychiatric diagnosis and ADHD (treated or untreated) versus those with a primary psychiatric diagnosis and no ADHD. Thirty-three (N = 31) psychiatric inpatients were screened using the Adult ADHD Self-Report Scale. Those that screened positive for ADHD received a full diagnostic assessment for ADHD. All patients completed the Weiss Functional Impairment Rating Scale (WFIRS) to assess level of functioning and a Clinical Global Impression of Severity/Improvement Scale (on admission and discharge). Demographic information was also obtained. Of the 31 patients analyzed, 12 had a diagnosis of ADHD (36.4%). The participants diagnosed with ADHD scored significantly higher on the WFIRS, suggesting decreased functioning compared to patients without comorbid ADHD. Patients with ADHD also scored significantly higher in the individual domains of this rating scale, suggesting impairment in family, work and social functioning as well as decreased life-skills, poor self-concept and increased risk-taking behavior. In this sample, the prevalence of ADHD is significantly higher among acute care psychiatric inpatients than in the general population. Patients with concomitant ADHD suffer more functional impairment than those without. These findings merit further investigation into the value of routine screening and patient-specific treatment of ADHD in this patient population.

Piloting a mobile health intervention to increase physical activity for adolescents with ADHD.

PubMed

Schoenfelder, Erin; Moreno, Megan; Wilner, Molly; Whitlock, Kathryn B; Mendoza, Jason A

2017-06-01

Physical activity (PA) reduces symptoms of Attention Deficit Hyperactivity Disorder (ADHD); interventions to increase PA may improve functioning and health for adolescents with ADHD. Mobile health (mHealth) technology and social media constitute promising interactive modalities for engaging adolescents-who are at highest risk for ADHD treatment drop-out-in interventions to increase PA. The current pilot study evaluated feasibility and acceptability of an innovative intervention incorporating an mHealth-linked wearable activity tracker (Fitbit Flex) and a Facebook group to increase PA among adolescents with ADHD. 11 adolescents diagnosed with ADHD (age 14-18, m = 15.5; 54% female) participated in a 4-week trial utilizing the Fitbit Flex in conjunction with (1) weekly personalized step count goals (2) social support through a Facebook group and (3) daily text messages about PA. The study took place in the greater Seattle, Washington area in the fall of 2015. Adolescents completed online surveys twice per week to rate their ADHD symptoms and positive and negative mood states, and parents rated adolescent ADHD symptoms weekly. Participants were adherent to the study protocol and acceptability of the intervention was high. Linear mixed models indicated that participants significantly increased their average weekly steps over the course of the study and demonstrated improvements in both adolescent and parent-reported ADHD Inattentive symptoms. Results indicate that this mHealth intervention is engaging and promising for increasing PA among adolescents with ADHD, and warrant further study. Implications for improving ADHD symptoms and overall functioning for this undertreated population are discussed.

Effectiveness of Neurofeedback Versus Medication in Treatment of ADHD.

PubMed

Sudnawa, Khemika Khemakanok; Chirdkiatgumchai, Vilawan; Ruangdaraganon, Nichara; Khongkhatithum, Chaiyos; Udomsubpayakul, Umaporn; Jirayucharoensak, Suwicha; Israsena, Pasin

2018-06-22

Neurofeedback (NF) is an operant conditioning procedure that trains participants for self-regulation of brain activity. Previous studies have shown that NF is a promising treatment of ADHD. However, there have been only a few RCT studies comparing effectiveness of NF with medication with various NF protocol and results. The aim of this study was to evaluate theeffectiveness of unipolar electrodeneurofeedback (NF) using theta/beta protocol compared with methylphenidate (MPH) in the treatment of ADHD. Children with newly diagnosed ADHD were randomly organised into NF and MPH groups. Each of children in NF group received 30 sessions of NF. Children in MPH group were prescribed methylphenidate for 12 weeks. Vanderbilt ADHD rating scales were completed by parents and teachers to evaluate ADHD symptoms pre- and post-treatment. Student's t-tests and Cohen's dwere used to compare symptoms between groups and evaluate effect size (ES) of each treatment respectively. Forty children participated in the study. No differences in ADHD baseline symptoms between groups were found. Post-treatment, teachers reported significantly lower ADHD symptoms in the MPH group (p = 0.01), but parents reported no differences betweenthe groups (p = 0.55). MPH demonstrated large ES (Cohen's d 1.30 - 1.69), while NF showed moderate ES (Cohen's d 0.49 - 0.68) for treatment of ADHD symptoms. This study supports NF as a promising alternative treatment for ADHD in children who do not respond or experience significant adverse effects to ADHD medications. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

[Language and executive functioning skills of students with attention deficit/hyperactivity disorder (ADHD), and in reading comprehension difficulties (RCD)].

PubMed

Miranda Casas, Ana; Fernández Andrés, María Inmaculada; García Castellar, Rosa; Roselló Miranda, Belén; Colomer Diago, Carla

2011-11-01

The aim of this work was to study the specificity of deficits in linguistic and executive functioning of students with ADHD and with RCD and to determine the profile of deficits in the comorbid group (ADHD+RCD). Participants in the study were 84 students, ages 12-16 years divided into four groups with an equal number of subjects (N= 21): ADHD, RCD, ADHD+RCD and comparison group (without ADHD and without RCD). We measured vocabulary, oral comprehension, lexical access, verbal and visual working memory, inhibition and attention. The results show that the ADHD+RCD group presents the most important linguistic deficits, followed by the RCD group. On the other hand, the three clinical groups (ADHD, RCD and ADHD+RCD) display greater performance problems in working memory than the comparison group, whereas the two groups with ADHD had more problems in attention and inhibition. These results suggest the dissociation of linguistic and executive deficits that affect the RCD group and ADHD group to a greater extent, respectively. Lastly, the comorbid group showed deficits both in language and in executive skills. We discuss the implications of these findings for designing interventions.

The opposite end of the attention deficit hyperactivity disorder continuum: genetic and environmental aetiologies of extremely low ADHD traits.

PubMed

Greven, Corina U; Merwood, Andrew; van der Meer, Jolanda M J; Haworth, Claire M A; Rommelse, Nanda; Buitelaar, Jan K

2016-04-01

Although attention deficit hyperactivity disorder (ADHD) is thought to reflect a continuously distributed quantitative trait, it is assessed through binary diagnosis or skewed measures biased towards its high, symptomatic extreme. A growing trend is to study the positive tail of normally distributed traits, a promising avenue, for example, to study high intelligence to increase power for gene-hunting for intelligence. However, the emergence of such a 'positive genetics' model has been tempered for ADHD due to poor phenotypic resolution at the low extreme. Overcoming this methodological limitation, we conduct the first study to assess the aetiologies of low extreme ADHD traits. In a population-representative sample of 2,143 twins, the Strength and Weaknesses of ADHD Symptoms and Normal behaviour (SWAN) questionnaire was used to assess ADHD traits on a continuum from low to high. Aetiological influences on extreme ADHD traits were estimated using DeFries-Fulker extremes analysis. ADHD traits were related to behavioural, cognitive and home environmental outcomes using regression. Low extreme ADHD traits were significantly influenced by shared environmental factors (23-35%) but were not significantly heritable. In contrast, high-extreme ADHD traits showed significant heritability (39-51%) but no shared environmental influences. Compared to individuals with high extreme or with average levels of ADHD traits, individuals with low extreme ADHD traits showed fewer internalizing and externalizing behaviour problems, better cognitive performance and more positive behaviours and positive home environmental outcomes. Shared environmental influences on low extreme ADHD traits may reflect passive gene-environment correlation, which arises because parents provide environments as well as passing on genes. Studying the low extreme opens new avenues to study mechanisms underlying previously neglected positive behaviours. This is different from the current deficit-based model of intervention, but congruent with a population-level approach to improving youth wellbeing. © 2015 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

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

PubMed

Fenollar-Cortés, Javier; Fuentes, Luis J

2016-01-01

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. 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. 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]). 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 health professionals in dealing with ADHD.

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

PubMed Central

Fenollar-Cortés, Javier; Fuentes, Luis J.

2016-01-01

Introduction: Although the critical feature of attention-deficit/hyperactivity disorder (ADHD) is a persistent pattern of inattention and/or hyperactivity/impulsivity behavior, the disorder is clinically heterogeneous, and concomitant difficulties are common. Children with ADHD are at increased risk for experiencing lifelong impairments in multiple domains of daily functioning. In the present study we aimed to build a brief ADHD impairment-related tool -ADHD concomitant difficulties scale (ADHD-CDS)- to assess the presence of some of the most important comorbidities that usually appear associated with ADHD such as emotional/motivational management, fine motor coordination, problem-solving/management of time, disruptive behavior, sleep habits, academic achievement and quality of life. The two main objectives of the study were (i) to discriminate those profiles with several and important ADHD functional difficulties and (ii) to create a brief clinical tool that fosters a comprehensive evaluation process and can be easily used by clinicians. Methods: The total sample included 399 parents of children with ADHD aged 6–18 years (M = 11.65; SD = 3.1; 280 males) and 297 parents of children without a diagnosis of ADHD (M = 10.91; SD = 3.2; 149 male). The scale construction followed an item improved sequential process. Results: Factor analysis showed a 13-item single factor model with good fit indices. Higher scores on inattention predicted higher scores on ADHD-CDS for both the clinical sample (β = 0.50; p < 0.001) and the whole sample (β = 0.85; p < 0.001). The ROC curve for the ADHD-CDS (against the ADHD diagnostic status) gave an area under the curve (AUC) of.979 (95%, CI = [0.969, 0.990]). Discussion: The ADHD-CDS has shown preliminary adequate psychometric properties, with high convergent validity and good sensitivity for different ADHD profiles, which makes it a potentially appropriate and brief instrument that may be easily used by clinicians, researchers, and health professionals in dealing with ADHD. PMID:27378972

Comorbidity and Phenomenology of Bipolar Disorder in Children with ADHD

ERIC Educational Resources Information Center

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

2013-01-01

Objective: To assess the comorbidity of bipolar disorder (BPD) in children with ADHD and to study the psychopathological profile of ADHD children with and without mania. Method: A total of 100 children with ADHD were assessed with a semistructured diagnostic interview and questionnaires of mania, ADHD, and general psychopathology. Results: 8% of…

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

ERIC Educational Resources Information Center

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

2015-01-01

A large number of youngsters with autism spectrum disorders (ASD) display comorbid attention deficit/hyperactivity disorder (ADHD) symptoms. However, previous studies are not conclusive whether psychophysiological correlates, like cardiac reactivity, are different for ASD with comorbid ADHD (ASD+) compared to ADHD. Therefore, the current study…

An Investigation into the Psychosocial Functioning of Creative Children: The Impact of ADHD Symptomatology

ERIC Educational Resources Information Center

Healey, Dione; Rucklidge, Julia J.

2006-01-01

This study examined the relationship among creativity, ADHD symptomatology, temperament, and psychosocial functioning by comparing four groups of children aged 10-12 years: (1) 29 ADHD children without creativity, (2) 16 highly creative children displaying ADHD symptomatology, (3) 18 highly creative children without ADHD symptomatology, and (4) 30…

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

ERIC Educational Resources Information Center

Vereb, Rebecca L.; DiPerna, James C.

2004-01-01

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

Health Behaviors, Physical Health, and Health Care Utilization in Children With ADHD.

PubMed

Park, Se Jin; Jang, Hyesue; Lee, Yeeun; Kim, Chul Eung; Park, Subin

2018-05-01

To compare health behaviors, physical health outcomes, and health care utilization between children with and without ADHD. In this cross-sectional study, we obtained data for children with and without ADHD from the Korean National Health and Nutrition Examination Survey. To investigate the association between ADHD and health outcomes, we estimated the adjusted prevalence ratios (APRs) in these groups. Among 10,838 children aged 7 to 18 years with and without ADHD, those with ADHD had significantly higher APRs for overall health problems, physical illness, and injuries than those without ADHD. Despite having health care needs, children with ADHD were less likely than those without ADHD to use health care services. However, there were no significant associations between most health behaviors and ADHD. Increased efforts are needed to provide quality health care services to address the medical conditions of children with ADHD and to enhance their health care utilization when needed.

ADHD and nicotine use in schizophrenia or Asperger syndrome: a controlled study.

PubMed

Hallerbäck, Maria Unenge; Lugnegård, Tove; Gillberg, Christopher

2014-07-01

To examine ADHD prevalence, rating scales, and relationship to nicotine use in adults with schizophrenia or Asperger syndrome. Ninety-five individuals, 41 with schizophrenia and 54 with Asperger syndrome, were included. Self-rating of adult ADHD symptoms with the Wender-Reimherr Adult Attention Deficit Diagnostic Rating Scale (WRAADDS), parent rating of proband's ADHD childhood and adult life symptoms using the Swanson, Nolan, and Pelham Questionnaire (SNAP), and report of clinical ADHD diagnosis were included as ADHD measures. Nicotine use data were compared with data from a population sample. In all, 10% of the schizophrenia group and 30% of the Asperger syndrome group had a clinical ADHD diagnosis. Nicotine dependency in the whole sample was closely linked to ADHD. The prevalence of comorbid ADHD was high in schizophrenia and Asperger syndrome. The WRAADDS self-rating scale for ADHD can be one useful tool for assessing comorbid ADHD in these patient groups. © 2012 SAGE Publications.

Paternal ADHD Symptoms and Child Conduct Problems: Is Father Involvement Always Beneficial?

PubMed Central

Romirowsky, Abigail Mintz; Chronis-Tuscano, Andrea

2013-01-01

Background Maternal psychopathology robustly predicts poor developmental and treatment outcomes for children with attention-deficit/hyperactivity disorder (ADHD). Despite the high heritability of ADHD, few studies have examined associations between paternal ADHD symptoms and child adjustment, and none have also considered degree of paternal involvement in childrearing. Identification of modifiable risk factors for child conduct problems is particularly important in this population given the serious adverse outcomes resulting from this comorbidity. Methods This cross-sectional study examined the extent to which paternal involvement in childrearing moderated the association between paternal ADHD symptoms and child conduct problems among 37 children with ADHD and their biological fathers. Results Neither paternal ADHD symptoms nor involvement was independently associated with child conduct problems. However, the interaction between paternal ADHD symptoms and involvement was significant, such that paternal ADHD symptoms were positively associated with child conduct problems only when fathers were highly involved in childrearing. Conclusions The presence of adult ADHD symptoms may determine whether father involvement in childrearing has a positive or detrimental influence on comorbid child conduct problems. PMID:25250402

Cadherin-13 gene is associated with hyperactive/impulsive symptoms in attention/deficit hyperactivity disorder.

PubMed

Salatino-Oliveira, Angélica; Genro, Julia Pasqualini; Polanczyk, Guilherme; Zeni, Cristian; Schmitz, Marcelo; Kieling, Christian; Anselmi, Luciana; Menezes, Ana Maria Baptista; Barros, Fernando Cde; Polina, Evelise Regina; Mota, Nina R; Grevet, Eugênio Horácio; Bau, Claiton Henrique Dotto; Rohde, Luis Augusto; Hutz, Mara Helena

2015-04-01

Several efforts have been made to find new genetic risk variants which explain the high heritability of ADHD. At the genome level, genes involved in neurodevelopmental pathways were pointed as candidates. CDH13 and CTNNA2 genes are within GWAS top hits in ADHD and there are emerging notions about their contribution to ADHD pathophysiology. The main goal of this study is to test the association between SNPs in CDH13 and CTNNA2 genes and ADHD across the life cycle in subjects with ADHD. This study included 1,136 unrelated ADHD cases and 946 individuals without ADHD. No significant association between CDH13 and CTNNA2 was observed between cases and controls across different samples (P ≥ 0.096 for all comparisons). No allele was significantly more transmitted than expected from parents to ADHD probands. The CDH13 rs11150556 CC genotype was associated with more hyperactive/impulsive symptoms in youths with ADHD (children/adolescents clinical sample: F = 7.666, P = 0.006, FDR P-value = 0.032; Pelotas Birth Cohort sample: F = 6.711, P = 0.011, FDR P-value = 0.032). Although there are many open questions regarding the role of neurodevelopmental genes in ADHD symptoms, the present study suggests that CDH13 is associated with hyperactive/impulsive symptoms in youths with ADHD. © 2015 Wiley Periodicals, Inc.

ADHD in Tunisian Adolescents: Prevalence and Associated Factors.

PubMed

Mhalla, Ahmed; Guedria, Asma; Brahem, Takoua; Amamou, Badii; Sboui, Wiem; Gaddour, Naoufel; Gaha, Lotfi

2018-01-01

The aims of the study were to determine the prevalence of ADHD in a population of high school students and to explore the factors associated with this disorder. This was a cross-sectional study that had included 447 high school students. The diagnosis of ADHD was made by the Adult ADHD Self-Report Scale translated in Arabic language. The sociodemographic and clinical characteristics were evaluated by a preestablished questionnaire. The self-esteem was assessed by the Rosenberg Self-Esteem Scale. The prevalence of ADHD was 18.1%. The logistic regression analysis showed an association between the diagnosis of ADHD and the bad relationships with parents (odds ratio [OR] = 16.43; p < 10-3), the presence of personal psychiatric antecedents (OR = 12.16; p < 10-3), internet misuse (OR = 2.39; p = .014), and maltreatment antecedents (OR = 3.16; p = .009). The prevalence of ADHD in this study was one of the highest prevalence reported. The factors associated with ADHD may have diagnostic and therapeutic implications.

Sustained attention in adult ADHD: time-on-task effects of various measures of attention.

PubMed

Tucha, Lara; Fuermaier, Anselm B M; Koerts, Janneke; Buggenthin, Rieka; Aschenbrenner, Steffen; Weisbrod, Matthias; Thome, Johannes; Lange, Klaus W; Tucha, Oliver

2017-02-01

Neuropsychological research on adults with ADHD showed deficits in various aspects of attention. However, the majority of studies failed to explore the change of performance over time, so-called time-on-task effects. As a consequence, little is known about sustained attention performance of adults with ADHD. The aim of the present study was therefore to test the hypothesis of sustained attention deficits of adults with ADHD. Twenty-nine adults with ADHD and 30 healthy individuals were assessed on four 20-min tests of sustained attention, measuring alertness, selective attention, divided attention and flexibility. The deterioration of performance over time (time-on-task effects) was compared between patients with ADHD and healthy individuals to conclude on sustained attention performance. Compared to healthy individuals, patients with ADHD showed significant deficits of medium size in selective attention and divided attention. Furthermore, medium sustained attention deficits was observed in measures of alertness, selective attention and divided attention. This study supports the notion of sustained attention deficits of adults with ADHD.

Irritability and Parenting Styles in Adolescents With Attention-Deficit/Hyperactivity Disorder: A Controlled Study.

PubMed

Uçar, Halit Necmi; Vural, Ayşe Pınar

2018-04-17

Attention-deficit/hyperactivity disorder (ADHD) affects functioning of the family, decreasing interactions and loyalty and increasing conflict between adolescents with ADHD and their families. Irritable mood and difficulties with emotional dysregulation are common in children with ADHD. The objective of the current study was to assess levels of irritability in adolescents with ADHD using self- and parent-report scales, and investigate the relationship between irritability levels and parental attitudes. A total of 47 adolescents with ADHD and 39 adolescents with typical development participated in the current study. Findings demonstrated that higher levels of parent-reported irritability were associated with decreased egalitarian attitudes in the ADHD group. Although other parental attitudes were not associated with self- and parent-reported irritability, evaluation of the relationship between parental attitudes and irritability in adolescents with ADHD, which can guide diagnosis and treatment of ADHD, is of critical importance. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.]. Copyright 2018, SLACK Incorporated.

Do Stimulants Reduce the Risk for Alcohol and Substance Use in Youth With ADHD? A Secondary Analysis of a Prospective, 24-Month Open-Label Study of Osmotic-Release Methylphenidate.

PubMed

Hammerness, Paul; Petty, Carter; Faraone, Stephen V; Biederman, Joseph

2017-01-01

The purpose of this study was to examine the impact of stimulant treatment on risk for alcohol and illicit drug use in adolescents with ADHD. Analysis of data derived from a prospective open-label treatment study of adolescent ADHD ( n = 115, 76% male), and a historical, naturalistic sample of ADHD ( n = 44, 68% male) and non-ADHD youth ( n = 52, 73% male) of similar age and sex. Treatment consisted of extended-release methylphenidate in the clinical trial or naturalistic stimulant treatment. Self-report of alcohol and drug use was derived from a modified version of the Drug Use Screening Inventory. Rates of alcohol and drug use in the past year were significantly lower in the clinical trial compared with untreated and treated naturalistic ADHD comparators, and similar to rates in non-ADHD comparators. Well-monitored stimulant treatment may reduce the risk for alcohol and substance use in adolescent ADHD.

Gambling transitions among adult gamblers: A multi-state model using a Markovian approach applied to the JEU cohort.

PubMed

Bruneau, Mélanie; Grall-Bronnec, Marie; Vénisse, Jean-Luc; Romo, Lucia; Valleur, Marc; Magalon, David; Fatséas, Mélina; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Challet-Bouju, Gaëlle; Hardouin, Jean-Benoit

2016-06-01

The aim of this paper is to study transitions between two states of gambling in adulthood (problem gambling and non-problem gambling) and to identify factors that might influence these transitions. Data for this 2-year long longitudinal study were collected in a French Outpatient Addiction Treatment Center, in gambling establishments and through the press. Both problem gamblers and non-problem gamblers were evaluated using a structured interview and self-report questionnaires. The statistical analysis was carried out using a Markovian approach. The analyzed cohort consisted of 304 gamblers with 519 observed transitions. Participants with no past-year gambling problems (based on the DSM-IV) had a probability of about 90% of also having no past-year gambling problems at the following assessment, whereas the observed percentage of problem gamblers transitioning to non-problem gambling was of 48%. We reported (i) vulnerability factors of transitioning to problem gambling (such as an anxiety disorder or an Attention Deficit Hyperactivity Disorder (ADHD) during the childhood), (ii) protective factors for non-problem gamblers, (iii) recovery factors (such as ongoing treatment and younger age) and (iv) persistence factors of a gambling problem (such as a persistent ADHD). The status of problem gambler is unstable over time, whereas we found stability among non-problem gamblers. Our findings suggest the existence of vulnerability and protective factors in gambling. These results lead to think about preventive actions and adaptive care, such as cognitive-behavioral therapy or researching gambling problems in people with an anxiety disorder or ADHD. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment

PubMed Central

2012-01-01

Background In childhood, attention deficit/hyperactivity disorder (ADHD) is characterized by age-inappropriate levels of inattentiveness/disorganization, hyperactivity/impulsiveness, or a combination thereof. Although the criteria for ADHD are well defined, the long-term consequences in adults and children need to be more comprehensively understood and quantified. We conducted a systematic review evaluating the long-term outcomes (defined as 2 years or more) of ADHD with the goal of identifying long-term outcomes and the impact that any treatment (pharmacological, non-pharmacological, or multimodal) has on ADHD long-term outcomes. Methods Studies were identified using predefined search criteria and 12 databases. Studies included were peer-reviewed, primary studies of ADHD long-term outcomes published between January 1980 to December 2010. Inclusion was agreed on by two independent researchers on review of abstracts or full text. Published statistical comparison of outcome results were summarized as poorer than, similar to, or improved versus comparators, and quantified as percentage comparisons of these categories. Results Outcomes from 351 studies were grouped into 9 major categories: academic, antisocial behavior, driving, non-medicinal drug use/addictive behavior, obesity, occupation, services use, self-esteem, and social function outcomes. The following broad trends emerged: (1) without treatment, people with ADHD had poorer long-term outcomes in all categories compared with people without ADHD, and (2) treatment for ADHD improved long-term outcomes compared with untreated ADHD, although not usually to normal levels. Only English-language papers were searched and databases may have omitted relevant studies. Conclusions This systematic review provides a synthesis of studies of ADHD long-term outcomes. Current treatments may reduce the negative impact that untreated ADHD has on life functioning, but does not usually 'normalize' the recipients. PMID:22947230

Effects of Physical Activity Intervention on Motor Proficiency and Physical Fitness in Children With ADHD: An Exploratory Study.

PubMed

Pan, Chien-Yu; Chang, Yu-Kai; Tsai, Chia-Liang; Chu, Chia-Hua; Cheng, Yun-Wen; Sung, Ming-Chih

2017-07-01

This study explored how a 12-week simulated developmental horse-riding program (SDHRP) combined with fitness training influenced the motor proficiency and physical fitness of children with ADHD. Twelve children with ADHD received the intervention, whereas 12 children with ADHD and 24 typically developing (TD) children did not. The fitness levels and motor skills of the participants were assessed using standardized tests before and after the 12-week training program. Significant improvements were observed in the motor proficiency, cardiovascular fitness, and flexibility of the ADHD training group following the intervention. Children with ADHD exhibit low levels of motor proficiency and cardiovascular fitness; thus, using the combined 12-week SDHRP and fitness training positively affected children with ADHD.

A Pilot Trial of Mindfulness Meditation Training for ADHD in Adulthood: Impact on Core Symptoms, Executive Functioning, and Emotion Dysregulation.

PubMed

Mitchell, John T; McIntyre, Elizabeth M; English, Joseph S; Dennis, Michelle F; Beckham, Jean C; Kollins, Scott H

2017-11-01

Mindfulness meditation training is garnering increasing empirical interest as an intervention for ADHD in adulthood, although no studies of mindfulness as a standalone treatment have included a sample composed entirely of adults with ADHD or a comparison group. The aim of this study was to assess the feasibility, acceptability, and preliminary efficacy of mindfulness meditation for ADHD, executive functioning (EF), and emotion dysregulation symptoms in an adult ADHD sample. Adults with ADHD were stratified by ADHD medication status and otherwise randomized into an 8-week group-based mindfulness treatment ( n = 11) or waitlist group ( n = 9). Treatment feasibility and acceptability were positive. In addition, self-reported ADHD and EF symptoms (assessed in the laboratory and ecological momentary assessment), clinician ratings of ADHD and EF symptoms, and self-reported emotion dysregulation improved for the treatment group relative to the waitlist group over time with large effect sizes. Improvement was not observed for EF tasks. Findings support preliminary treatment efficacy, though require larger trials.

The Association Between ADHD and Antisocial Personality Disorder (ASPD): A Review.

PubMed

Storebø, Ole Jakob; Simonsen, Erik

2016-10-01

Children with ADHD have an increased risk of later developing personality disorders and criminal behavior. The object of the present review is to analyze the associations between ADHD and antisocial personality disorder (ASPD). A review of literature was done using EMBASE, PsycINFO, and Medline databases. Eighteen prospective studies (n = 5,501) showed that ADHD with and without comorbid conduct disorder (CD) is a strong predictor for the risk of later development of antisocial personality disorder (ASPD). Some of the 13 cross-sectional/retrospective studies (n = 2,451) suggested that ADHD and CD might be a separate subtype of ADHD, that especially impulsivity in ADHD is a predictor for later development of ASPD, or that callous-unemotional traits in the ADHD children are called for a risk factor for later ASPD. There is an increased risk for children with ADHD with or without comorbid CD to develop later onset of antisocial personality disorder. © The Author(s) 2013.

Reading Performance of Young Adults With ADHD Diagnosed in Childhood.

PubMed

Miranda, Ana; Mercader, Jessica; Fernández, M Inmaculada; Colomer, Carla

2017-02-01

To study reading performance of young adults with ADHD and its relation with executive functioning. Thirty young adults with a childhood diagnosis of ADHD and 30 with normal development (ND) were compared on reading accuracy, fluency, and comprehension. Furthermore, ADHD with reading disabilities (ADHD+RD) and ADHD without reading disabilities (ADHD-RD) subgroups were compared using self-report and informant-report versions of the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A). Adults with ADHD obtained significantly worse results than the ND adults on reading speed, responses to literal questions, and a cloze test. Although the comparison of the ADHD+RD and ADHD-RD groups did not show significant differences on the BRIEF-A subscales, the ADHD+RD group surpassed the critical percentile (85) on more subscales, with working memory and metacognition especially affected. The findings point out that reading should be assessed in individuals with ADHD as part of their evaluation to design effective early interventions.

Differences in the association between childhood trauma history and borderline personality disorder or attention deficit/hyperactivity disorder diagnoses in adulthood.

PubMed

Ferrer, Marc; Andión, Óscar; Calvo, Natalia; Ramos-Quiroga, Josep A; Prat, Mònica; Corrales, Montserrat; Casas, Miguel

2017-09-01

Common environmental etiological factors between borderline personality disorder (BPD) and attention deficit/hyperactivity disorder (ADHD) have not been fully studied. The main aim of this study was to investigate the relationship between childhood trauma histories, assessed by the Childhood Trauma Questionnaire-Short Form (CTQ-SF), with adult BPD, ADHD or BPD-ADHD diagnoses. Comorbid BPD-ADHD patients exhibited significantly higher clinical severity and higher scores in the Total Neglect Scale, compared to BPD and ADHD patients, and only a marginal difference was observed for Sexual Abuse when BPD and ADHD patients were compared. Physical Trauma Scales were associated with ADHD diagnosis, whereas Emotional Abuse and Sexual Abuse Scales were associated with BPD or BPD-ADHD diagnoses. The study findings support the association between experiencing traumatic events in childhood and a higher clinical severity of BPD in adulthood. Furthermore, physical trauma history in childhood could be associated with the persistence of ADHD in adulthood and emotional or sexual abuse with later development of BPD or comorbid BPD-ADHD. Whereas experiencing childhood traumas is associated with later development of more general psychopathology, our study supports that a specific type of traumatic event could increase the risk for the consolidation of a concrete psychiatric disorder in the trajectory from childhood to adulthood of vulnerable subjects.

Study Urges Treatment of Parents of ADHD Children

ERIC Educational Resources Information Center

Black Issues in Higher Education, 2004

2004-01-01

Treatment for many young children with Attention Deficit/Hyperactivity Disorder (ADHD) should also include treatment for their parents, according to new research from the University of Maryland's ADHD Program. In conducting one of the first systematic studies of pre-school children with ADHD, the research team found that parents of children with…

Impulsivity in College Students with and without ADHD

ERIC Educational Resources Information Center

Miller, Jessica A.

2010-01-01

Impulsivity is the cardinal symptom of ADHD. It is estimated that ADHD is present in eighteen percent of children and in four percent of adults. The present study repeats and extends a previous study (Gray, Breier, Foorman, & Fletcher, 2002) that measured impulsivity in adolescents with and without ADHD, which found higher false alarm rates…

Emotional Intelligence and ADHD: A Comparative Analysis in Students of Lima Metropolitan Area

ERIC Educational Resources Information Center

Barahona, Luciana M.; Alegre, Alberto A.

2016-01-01

The following study aims to identify statistically significant differences between adolescent students with and without Attention Deficit Disorder and Hyperactivity (ADHD) in emotional intelligence skills. The study sample was composed of 44 students with ADHD diagnosis and 192 students without ADHD; both groups were obtained by an intentional…

Children with ADHD and Depression: A Multisource, Multimethod Assessment of Clinical, Social, and Academic Functioning

ERIC Educational Resources Information Center

Blackman, Gabrielle L.; Ostrander, Rick; Herman, Keith C.

2005-01-01

Although ADHD and depression are common comorbidities in youth, few studies have examined this particular clinical presentation. To address method bias limitations of previous research, this study uses multiple informants to compare the academic, social, and clinical functioning of children with ADHD, children with ADHD and depression, and…

Growth Dysregulation and ADHD: An Epidemiologic Study of Children in France

ERIC Educational Resources Information Center

Faraone, Stephen V.; Lecendreux, Michel; Konofal, Eric

2012-01-01

Objective: A small literature suggests that ADHD may be associated with dysregulated growth, but this prior work primarily used clinically referred samples, so it faces difficulties of interpretation. The objective of this study is to sample the general French population for ADHD and evaluate if ADHD is associated with dysregulated growth.…

Autism and ADHD: Overlapping and Discriminating Symptoms

ERIC Educational Resources Information Center

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

2012-01-01

Children with ADHD and autism have some similar features, complicating a differential diagnosis. The purpose of our study was to determine the degree to which core ADHD and autistic symptoms overlap in and discriminate between children 2-16 years of age with autism and ADHD. Our study demonstrated that 847 children with autism were easily…

Hyperactive-Impulsive Symptoms Associated with Self-Reported Sleep Quality in Nonmedicated Adults with ADHD

ERIC Educational Resources Information Center

Mahajan, Neha; Hong, Nuong; Wigal, Timothy L.; Gehricke, Jean-G.

2010-01-01

Objective: Individuals with ADHD often report sleep problems. Though most studies on ADHD and sleep examined children or nonclinically diagnosed adults, the present study specifically examines nonmedicated adults with ADHD to determine whether inattentive and hyperactive-impulsive symptoms are associated with sleep problems. Method: A total of 22…

Associated factors with attention deficit hyperactivity disorder (ADHD): a case-control study.

PubMed

Malek, Ayyoub; Amiri, Shahrokh; Sadegfard, Majid; Abdi, Salman; Amini, Saeedeh

2012-09-01

The current study attempted to investigate factors associated with attention deficit hyperactivity disorder (ADHD) in children without co-morbidities. In this case-control study, 164 ADHD children who attended the Child and Adolescent Psychiatric Clinics of Tabriz University of Medical Sciences, Iran were compared with 166 normal children selected in a random-cluster method from primary and secondary schools. Clinical interviews based on DSM-IV-TR using K-SADS were used to diagnose ADHD cases and to select the control group. Participants were matched for age. We used chi-square and binary logistic regression for data analysis. Among the associated factors with ADHD were gender and maternal employment. Boys (OR 0.54; 95% confidence interval: 0.34 - 0.86) and those children with working mothers (OR 0.16: 95% confidence interval: 0.06 - 0.86) suffered more from ADHD. The birth season, family size, birth order, and parental kinship were not among risk factors for ADHD. The results of the study show that maternal employment and male gender are among the associated risk factors for ADHD.

Systematic Review of Patients' and Parents' Preferences for ADHD Treatment Options and Processes of Care.

PubMed

Schatz, Nicole K; Fabiano, Gregory A; Cunningham, Charles E; dosReis, Susan; Waschbusch, Daniel A; Jerome, Stephanie; Lupas, Kellina; Morris, Karen L

2015-12-01

Patient preferences are an important topic of study with respect to attention-deficit hyperactivity disorder (ADHD) interventions, as there are multiple treatment choices available, multiple developmental levels to consider, and multiple potential individuals involved in treatment (children, parents, and adults with ADHD). Stated preference methods such as discrete choice experiment (DCE), best-worst scaling (BWS), and other utility value methods such as standard gamble interview (SGI) and time trade-off (TTO) are becoming more common in research addressing preferences for ADHD treatments. A synthesis of this research may facilitate improved patient-centered and family-centered treatment for ADHD. The purpose of this review was to synthesize reports across existing DCE, BWS, TTO, and SGI studies to assess which aspects of ADHD treatment are most studied as well as most preferred and influential in treatment decisions. MEDLINE, PsycINFO. A total of 41 studies referring to preferences for ADHD treatment were identified through the initial search and contact with researchers. Of these, 13 reported ADHD treatment preference data from a study using DCE, BWS, or SGI methods. No TTO studies were identified that met inclusion criteria. Methods and designs varied considerably across studies. Relatively few studies focused on preferences among children, adolescents, and adults compared with those that focused on the preferences of parents of children with ADHD. The majority of studies focused primarily on medication treatments, with many fewer focused on psychosocial treatments. Some studies indicated that parents of children with ADHD prefer to avoid stimulant medications in favor of behavioral or psychosocial interventions. Others report that parents see medication as a preferred treatment. Treatment outcome is a particularly salient attribute for treatment decisions for many informants. Potential outcomes of various treatments play a proximal role in patients' and families' decisions for ADHD treatment. Because the majority of studies focus on medication treatments for children with ADHD, more research is necessary to understand preferences related to behavioral and other psychosocial treatments both as stand-alone interventions and used in combination with medication. Additional research is also needed to assess the treatment preferences of adults with ADHD. In general, DCE, BWS, and SGI methods allow measurement of patient preferences in a manner that approximates the uncertainty and trade-offs inherent in real-world treatment decision making and provides valuable information to inform patient-centered and family-centered treatment.

Reliability and validity of DS-ADHD: A decision support system on attention deficit hyperactivity disorders.

PubMed

Chu, Kuo-Chung; Huang, Yu-Shu; Tseng, Chien-Fu; Huang, Hsin-Jou; Wang, Chih-Huan; Tai, Hsin-Yi

2017-03-01

The purpose of this study is to examine the reliability of the clinical use of the self-built decision support system, diagnosis-supported attention deficit hyperactivity disorder (DS-ADHD), in an effort to develop the DS-ADHD system, by probing into the development of indicating patterns of past screening support systems for ADHD. The study collected data based on 107 subjects, who were divided into two groups, non-ADHD and ADHD, based on the doctor's determination, using the DSM-IV diagnostic standards. The two groups then underwent Test of Variables of Attention (TOVA) and DS-ADHD testing. The survey and testing results underwent one-way ANOVA and split-half method statistical analysis, in order to further understand whether there were any differences between the DS-ADHD and the identification tools used in today's clinical trials. The results of the study are as follows: 1) The ROC area between the TOVA and the clinical identification rate is 0.787 (95% confidence interval: 0.701-0.872); 2) The ROC area between the DS-ADHD and the clinical identification rate is 0.867 (95% confidence interval: 0.801-0.933). The study results show that DS-ADHD has the characteristics of screening for ADHD, based on its reliability and validity. It does not display any statistical differences when compared with TOVA systems that are currently on the market. However, the system is more effective and the accuracy rate is better than TOVA. It is a good tool to screen ADHD not only in Chinese children, but also in western country. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Perceived Family Climate and Self-Esteem in Adolescents With ADHD: A Study With a Control Group.

PubMed

Uçar, Halit Necmi; Eray, Şafak; Vural, Ayşe Pınar; Kocael, Ömer

2017-04-01

In this study, our objective is to assess the perception of family environments by adolescents with ADHD based on perceived expressed emotion (EE) and the self-esteem of the adolescents. Uludag University Medical Faculty Hospital completed this study with 41 adolescents with ADHD and 35 control group participants who were matched based on age and gender. The total scores of perceived EE, described as a lack of emotional support, irritability, and intrusiveness, were significantly higher in ADHD group than in the control group. The group with ADHD also showed significantly lower self-esteem. There was a negative correlation between self-esteem scores and total perceived EE scores in the ADHD group and the control group. This study showed that the adolescents with ADHD perceive less emotional support and higher levels of intrusiveness, with patients also describing their families as more irritating. Other results in this study show that adolescents with less emotional support possess lower self-esteem, as do adolescents with more irritable parents.

Attention Deficit Hyperactivity Disorder in Children With Sickle Cell Disease Referred for an Evaluation.

PubMed

Acquazzino, Melissa A; Miller, Meghan; Myrvik, Matthew; Newby, Robert; Scott, John Paul

2017-07-01

Neuropsychological deficits, including difficulties with attention, are well described in children with sickle cell disease (SCD). Very little is known about attention deficit hyperactivity disorder (ADHD) in children with SCD. The objective of this study was to determine the proportion of ADHD in children with SCD referred for neuropsychological evaluation. This prospective, cross-sectional study included patients (age, 4 to 18 y) with SCD and completion of a neuropsychological evaluation between December 2013 and March 2016. Patients were referred for neuropsychological evaluation because of concern regarding school performance, development, and/or behavior. The diagnosis of ADHD was made by a neuropsychologist on the basis of the diagnostic criteria in the Diagnostic Statistical Manual-Fourth or Fifth Editions. ADHD medication usage rate was obtained by medical record review. Of the 89 patients with SCD referred for neuropsychological evaluation, 25% (95% confidence interval, 16%-35%) met diagnostic criteria for ADHD. Only 21% of the patients with SCD and ADHD were prescribed an ADHD medication. Our study supports routine ADHD screening in children with SCD who have poor school performance or behavioral concerns. Despite the benefits of pharmacologic treatment, the majority of patients with SCD and ADHD did not receive a medication for management of their ADHD.

The effects of attention deficit hyperactivity disorder on clothing selection and habits among Turkish University students.

PubMed

Ercan, Emine; İpci, Melis; İnci, Sevim Berrin; Ercan, Elif; Ercan, Eyüp Sabri

2015-09-01

The purpose of this study was to identify the factors that influence the shopping attitudes of college students with and without ADHD. This study also examined the effects of ADHD on the academic and social lives of college students. The sample consisted of 219 university students. These students were interviewed by a psychiatrist with regard to ADHD symptoms according to the DSM-IV. The Adult ADHD Self Report Scale (ASRS), the Teen Interpersonal Influence Scale, and a demographic information form were used as measurement devices. The ADHD and control groups were classified in three different ways: (1) met the ADHD criteria for both Clinical Diagnosis and the ASRS; (2) met only the criteria for Clinical Diagnosis; or (3) met only the criteria of the ASRS. Our research shows that individuals with ADHD experience more problems with money management and are more affected by the media, friends, and brands compared with individuals without ADHD. Smoking and alcohol use disorders, accidents, being held back, and disciplinary actions often accompany ADHD in college students. To the best of our knowledge, the shopping attitudes of young adults with ADHD and the influence of the media, peers, family, and brands have not been studied until now.

The relation between maternal ADHD symptoms & improvement in child behavior following brief behavioral parent training is mediated by change in negative parenting.

PubMed

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

2011-10-01

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

Demographic Characteristics and Psychiatric Comorbidity of Children and Adolescents Diagnosed with ADHD in Specialized Healthcare.

PubMed

Joelsson, Petteri; Chudal, Roshan; Gyllenberg, David; Kesti, Anna-Kaisa; Hinkka-Yli-Salomäki, Susanna; Virtanen, Juha-Pekka; Huttunen, Jukka; Ristkari, Terja; Parkkola, Kai; Gissler, Mika; Sourander, Andre

2016-08-01

Recent studies have shown an increasing incidence of attention-deficit/hyperactivity disorder (ADHD) among children diagnosed in specialized services. This study aims to describe children with ADHD in Finnish specialized healthcare by reporting the demographic characteristics, time trends in diagnosis, psychiatric comorbidity, and the validity of register-based diagnoses. All the singletons born in Finland between 1991 and 2005 and diagnosed with ADHD by 2011 were identified and their psychiatric comorbidity data was obtained from the Finnish Hospital Discharge Register (FHDR). Parents of 69 patients were interviewed via telephone for a diagnostic validation. A total of 10,409 children were identified with ADHD, with a male: female ratio of 5.3:1 and a psychiatric comorbidity rate of 76.7 %. Of the validation sample 88 % met the diagnostic criteria of ADHD for DSM-IV. There is an increasing trend of ADHD diagnosis among both males and females. Psychiatric comorbidity is common and includes a wide range of disorders among children with ADHD. There was an increase of ADHD diagnoses especially among boys. More attention is needed to detect ADHD among girls in health services. Diagnoses in the FHDR show diagnostic validity and their sociodemographic patterns are in line with previous studies.

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

PubMed Central

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

2012-01-01

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

Attention profiles in autism spectrum disorder and subtypes of attention-deficit/hyperactivity disorder.

PubMed

Boxhoorn, Sara; Lopez, Eva; Schmidt, Catharina; Schulze, Diana; Hänig, Susann; Freitag, Christine M

2018-03-06

Attention problems are observed in attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Most neuropsychological studies that compared both disorders focused on complex executive functions (EF), but missed to contrast basic attention functions, as well as ASD- and ADHD subtypes. The present study compared EF as well as basic attention functioning of children with the combined subtype (ADHD-C), the predominantly inattentive subtype (ADHD-I), and autism spectrum disorder without ADHD (ASD-) with typically developing controls (TD). Basic attention functions and EF profiles were analysed by testing the comprehensive attention function model of van Zomeren and Brouwer using profile analysis. Additionally, neurocognitive impairments in ASD- and ADHD were regressed on dimensional measures of attention- and hyperactive-impulsive symptoms across and within groups. ADHD-C revealed a strong impairment across measures of EF compared to ASD- and TD. The ADHD-C profile furthermore showed disorder specific impairments in interference control, whereas the ASD- profile showed a disorder specific impairment in basic attention component divided attention. Attention- and hyperactive-impulsive symptom severity did not predict neurocognitive impairments across- or within groups. Study findings thus support disorder and subtype specific attention/EF profiles, which refute the idea of a continuum of ADHD-I, ADHD-C, and ASD with increasing neurocognitive impairments.

Evaluation of the Relationship between Brain-Derived Neurotropic Factor Levels and the Stroop Interference Effect in Children with Attention-Deficit Hyperactivity Disorder.

PubMed

Şimşek, Şeref; Gençoğlan, Salih; Yüksel, Tuğba; Kaplan, İbrahim; Aktaş, Hüseyin; Alaca, Rümeysa

2016-12-01

Brain-derived neurotropic factor (BDNF) has been suggested to play a role in the pathogenesis of attention-deficit hyperactivity disorder (ADHD). In addition, impairment in executive functions has been reported in children with ADHD. This study investigated the presence of a relationship between Stroop test scores and BDNF levels in children with ADHD. The study was conducted in the Department of Child Psychiatry at Dicle University. The study included 49 children between 6 and 15 years of age (M/F: 42/7), who were diagnosed with ADHD according to DSM-IV, and who did not receive previous therapy. Similar in terms of age and gender to the ADHD group, 40 children were selected in the control group. The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version was administered to all participants. Parents and teachers were administered Turgay DSM-IV-based Child and Adolescent Behavior Disorders Screening and Rating Scale to measure symptom severity in children with ADHD. Children with ADHD underwent the Stroop test. BDNF levels were evaluated in serum by ELISA. The ADHD and control groups did not differ in terms of BDNF levels. BDNF levels did not differ between ADHD subtypes. There was also no relationship between the Stroop test interference scores and BDNF levels. The findings of the present study are in line with those in studies that demonstrated no significant role of BDNF in the pathogenesis of ADHD.

Response Inhibition, Peer Preference and Victimization, and Self-Harm: Longitudinal Associations in Young Adult Women with and without ADHD.

PubMed

Meza, Jocelyn I; Owens, Elizabeth B; Hinshaw, Stephen P

2016-02-01

Self-harm (suicidal ideation and attempts; non-suicidal self-injuries behavior) peaks in adolescence and early-adulthood, with rates higher for women than men. Young women with childhood psychiatric diagnoses appear to be at particular risk, yet more remains to be learned about the key predictors or mediators of self-harm outcomes. Our aims were to examine, with respect to self-harm-related outcomes in early adulthood, the predictive validity of childhood response inhibition, a cardinal trait of attention-deficit hyperactivity disorder (ADHD), as well as the potential mediating effects of social preference and peer victimization, ascertained in early adolescence. Participants were an ethnically and socioeconomically diverse sample of 228 girls with and without ADHD, an enriched sample for deficits in response inhibition. Childhood response inhibition (RI) predicted young-adult suicide ideation (SI), suicide attempts (SA), and non-suicidal self-injury (NSSI), over and above full-scale IQ, mother's education, household income, and age. Importantly, teacher-rated social preference in adolescence was a partial mediator of the RI-SI/SA linkages; self-reported peer victimization in adolescence emerged as a significant partial mediator of the RI-NSSI linkage. We discuss implications for conceptual models of self-harm and for needed clinical services designed to detect and reduce self-harm.

Development of the Subtle ADHD Malingering Screener.

PubMed

Ramachandran, Sujith; Holmes, Erin R; Rosenthal, Meagen; Banahan, Benjamin F; Young, John; Bentley, John P

2018-05-01

The objective of this study was to develop a subtle self-report scale-the Subtle ADHD Malingering Screener (SAMS)-to screen for malingering among individuals reporting symptoms of attention deficit/hyperactivity disorder (ADHD). This study employed a cross-sectional experimental design with an ADHD group, a control group-comprising individuals without ADHD-and a malingering group-comprising individuals without ADHD who were instructed to feign ADHD in their responses. Factor analysis and psychometric testing were conducted to develop a final scale that could distinguish the malingering from the other groups. A 10-item, two-factor solution was obtained for the SAMS, with a sensitivity of 90.3% and specificity of 80.1%. The SAMS presents an innovative approach to help reduce overdiagnosis of ADHD and misuse of prescription stimulants. The efficient, straightforward form of the measure particularly enhances its potential application in both medical and psychosocial clinical settings.

Hyperactive Around the World? The History of ADHD in Global Perspective

PubMed Central

Smith, Matthew

2017-01-01

Summary A recent study has claimed that the global rate of Attention Deficit Hyperactivity Disorder (ADHD) is 5.29%. Any variation in such rates in specific studies, argue the authors, was due to methodological problems, rather than differences in the actual distribution of ADHD. Such reports strengthen the flawed notion that ADHD is a universal and essential disorder, found in all human populations across time and place. While it is true that the concept of ADHD has spread from the USA, where it emerged during the late 1950s, to most corners of the globe, such superficial pronouncements mask profound differences in how ADHD has been interpreted in different countries and regions. In this paper, I compare ADHD's emergence in Canada, the UK, Scandinavia, China and India, arguing that, while ADHD can be considered a global phenomenon, behavioural and educational imperfections remain very much a product of local historical, cultural and political factors. PMID:29670320

Attention-deficit/hyperactivity disorder symptoms and stress-related biomarkers.

PubMed

Vogel, S W N; Bijlenga, D; Verduijn, J; Bron, T I; Beekman, A T F; Kooij, J J S; Penninx, B W J H

2017-05-01

The current study examined whether (a) Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms were associated with dysregulation of stress-related mechanisms, and (b) whether ADHD symptoms interact with affective disorders in their association with dysregulated stress-related mechanisms. Data were obtained from 2307 subjects participating in the Netherlands Study of Depression and Anxiety. Stress-related mechanisms were reflected by the following biomarkers: (1) hypothalamic-pituitary-adrenal axis indicators (salivary cortisol awakening curve, evening cortisol, cortisol suppression after a 0.5mg dexamethasone suppression test (DST)); (2) autonomic nervous system measures (heart rate, pre-ejection period, respiratory sinus arrhythmia); (3) inflammatory markers (C-reactive protein, interleukin-6, tumor necrosis factor-alpha); (4) brain-derived neurotrophic factor. ADHD symptoms were measured using Conners' Adult ADHD Rating Scale and used both dichotomous (High ADHD symptoms (yes/no)) and continuous (Inattentive symptoms, Hyperactive/Impulsive symptoms, and the ADHD index). Regression analyses showed associations between High ADHD symptoms, Inattentive symptoms, the ADHD index and a higher cortisol awakening curve, between Hyperactive/Impulsive symptoms and less cortisol suppression after DST, and between Inattentive symptoms and a longer pre-ejection period. However, the associations with the cortisol awakening curve disappeared after adjustment for depressive and anxiety disorders. No associations were observed between ADHD symptoms and inflammatory markers or BDNF. ADHD symptoms did not interact with affective disorders in dysregulation of stress-related mechanisms. Some associations were observed between ADHD symptoms, the HPA-axis, and the pre-ejection period, but these were mostly driven by depressive and anxiety disorders. This study found no evidence that ADHD symptomatology was associated with dysregulations in inflammatory markers and BDNF. Consequently, ADHD symptoms did not confer an added risk to the disturbances of stress-related mechanisms in an - already at-risk - population with affective disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Problematic Peer Functioning in Girls with ADHD: A Systematic Literature Review.

PubMed

Kok, Francien M; Groen, Yvonne; Fuermaier, Anselm B M; Tucha, Oliver

2016-01-01

Children with attention deficit hyperactivity disorder (ADHD) experience many peer interaction problems and are at risk of peer rejection and victimisation. Although many studies have investigated problematic peer functioning in children with ADHD, this research has predominantly focused on boys and studies investigating girls are scant. Those studies that did examine girls, often used a male comparison sample, disregarding the inherent gender differences between girls and boys. Previous studies have highlighted this limitation and recommended the need for comparisons between ADHD females and typical females, in order to elucidate the picture of female ADHD with regards to problematic peer functioning. The aim of this literature review was to gain insight into peer functioning difficulties in school-aged girls with ADHD. PsychINFO, PubMed, and Web of Knowledge were searched for relevant literature comparing school-aged girls with ADHD to typically developing girls (TDs) in relation to peer functioning. The peer relationship domains were grouped into 'friendship', 'peer status', 'social skills/competence', and 'peer victimisation and bullying'. In total, thirteen studies were included in the review. All of the thirteen studies included reported that girls with ADHD, compared to TD girls, demonstrated increased difficulties in the domains of friendship, peer interaction, social skills and functioning, peer victimization and externalising behaviour. Studies consistently showed small to medium effects for lower rates of friendship participation and stability in girls with ADHD relative to TD girls. Higher levels of peer rejection with small to large effect sizes were reported in all studies, which were predicted by girls' conduct problems. Peer rejection in turn predicted poor social adjustment and a host of problem behaviours. Very high levels of peer victimisation were present in girls with ADHD with large effect sizes. Further, very high levels of social impairment and social skills deficits, with large effect sizes, were found across all studies. Levels of pro-social behaviour varied across studies, but were mostly lower in girls with ADHD, with small to large effect sizes. Overall, social disability was significantly higher among girls with ADHD than among TD girls. Congruous evidence was found for peer functioning difficulties in the peer relationship domains of friendship, peer status, social skills/competence, and peer victimisation and bullying in girls with ADHD.

Problematic Peer Functioning in Girls with ADHD: A Systematic Literature Review

PubMed Central

Groen, Yvonne; Fuermaier, Anselm B. M.; Tucha, Oliver

2016-01-01

Objective Children with attention deficit hyperactivity disorder (ADHD) experience many peer interaction problems and are at risk of peer rejection and victimisation. Although many studies have investigated problematic peer functioning in children with ADHD, this research has predominantly focused on boys and studies investigating girls are scant. Those studies that did examine girls, often used a male comparison sample, disregarding the inherent gender differences between girls and boys. Previous studies have highlighted this limitation and recommended the need for comparisons between ADHD females and typical females, in order to elucidate the picture of female ADHD with regards to problematic peer functioning. The aim of this literature review was to gain insight into peer functioning difficulties in school-aged girls with ADHD. Methods PsychINFO, PubMed, and Web of Knowledge were searched for relevant literature comparing school-aged girls with ADHD to typically developing girls (TDs) in relation to peer functioning. The peer relationship domains were grouped into ‘friendship’, ‘peer status’, ‘social skills/competence’, and ‘peer victimisation and bullying’. In total, thirteen studies were included in the review. Results All of the thirteen studies included reported that girls with ADHD, compared to TD girls, demonstrated increased difficulties in the domains of friendship, peer interaction, social skills and functioning, peer victimization and externalising behaviour. Studies consistently showed small to medium effects for lower rates of friendship participation and stability in girls with ADHD relative to TD girls. Higher levels of peer rejection with small to large effect sizes were reported in all studies, which were predicted by girls’ conduct problems. Peer rejection in turn predicted poor social adjustment and a host of problem behaviours. Very high levels of peer victimisation were present in girls with ADHD with large effect sizes. Further, very high levels of social impairment and social skills deficits, with large effect sizes, were found across all studies. Levels of pro-social behaviour varied across studies, but were mostly lower in girls with ADHD, with small to large effect sizes. Overall, social disability was significantly higher among girls with ADHD than among TD girls. Conclusion Congruous evidence was found for peer functioning difficulties in the peer relationship domains of friendship, peer status, social skills/competence, and peer victimisation and bullying in girls with ADHD. PMID:27870862

Alerting, Orienting, and Executive Attention in Children with ADHD

ERIC Educational Resources Information Center

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

2011-01-01

Objective: This study evaluated the alerting, orienting, and executive attention abilities of children with ADHD and their typically developing (TD) peers using a modified version of the adult attention network test (ANT-I). Method: A total of 25 children with ADHD, Combined Type (ADHD-C, mean age = 9.20 years), 20 children with ADHD,…

Parental efficacy and child behavior in a community sample of children with and without attention-deficit hyperactivity disorder (ADHD).

PubMed

Primack, Brian A; Hendricks, Kristy M; Longacre, Meghan R; Adachi-Mejia, Anna M; Weiss, Julia E; Titus, Linda J; Beach, Michael L; Dalton, Madeline A

2012-12-01

Most studies of attention-deficit hyperactivity disorder (ADHD) youth have obtained data from the perspective of either children or parents, but not both simultaneously. The purpose of this study was to examine child and parent perspectives on parenting in a large community-based sample of children with and without ADHD. We identified children in grades 4-6 and their parents through surveys administered to a random sample of public schools. We used multivariable logistic regression to determine independent associations between child and parent characteristics and the presence of ADHD while controlling for covariates and clustering by school. Sufficient data were achieved for 2,509 child/parent dyads. Ten percent of youths (n = 240) had been diagnosed with ADHD. Compared with those without ADHD, those with ADHD were more commonly male (67.9 vs. 48.0 %, p < .001) and age 12 or over (16.3 vs. 10.3 %). After adjusting for covariates and clustering, compared to children without ADHD, children with ADHD were significantly more likely to report lower self-regulation (OR = 0.68, 95 % CI = 0.53, 0.88) and higher levels of rebelliousness (OR = 2.00, 95 % CI = 1.52, 2.69). Compared with parents whose children did not have ADHD, parents of children with ADHD rated their overall parental efficacy substantially lower (OR = 0.23, 95 % CI = 0.15, 0.33). However, child assessment of parenting style was similar by ADHD. Despite the internal challenges community-based youth with ADHD face, many parents of ADHD youth exhibit valuable parental skills from the perspective of their children. Feedback of this information to parents may improve parental self-efficacy, which is known to be positively associated with improved ADHD outcomes.

Attention-deficit hyperactivity disorder in elementary school students in Shantou, China: prevalence, subtypes, and influencing factors.

PubMed

Huang, Yanhong; Zheng, Shaoxiong; Xu, Chongtao; Lin, Kun; Wu, Kusheng; Zheng, Maochun; Zhang, Jie; Xu, Haiyun

2017-01-01

Attention-deficit hyperactivity disorder (ADHD) is a frequent childhood-onset psychiatric condition and categorized into three subtypes of predominantly inattentive (ADHD-I), hyperactive impulsive (ADHD-H), and combined (ADHD-C). The prevalence and subtypes of ADHD vary considerably. The primary aim of this study was to provide a prevalence estimate of ADHD in elementary school students living in Shantou, a district of China, and in addition to examine the influence of informants, age, and gender on the prevalence. A total of 3,497 students aged 7-12 years were enrolled by random and stratified sampling. In stage I, teachers and parents of all participating students in randomly selected schools were asked to complete Chinese versions of the Conners' 10-item scale. In stage II, students with high scores (>15) were interviewed by a psychiatrist for a diagnosis with or without ADHD. Parents rated many more students with high scores than teachers did in stage I. The prevalence of ADHD determined by Diagnostic and Statistical Manual of Mental Disorders , fifth edition (DSM-5) was 5.91% (5.27%-6.55%), which is comparable to the rates reported in previous studies with Chinese children. This hits the low border of the ADHD prevalence range from 5.9 to 7.1% worldwide, and is lower than that of Chinese children living in Hong Kong, suggesting an important influence of Chinese culture on the diagnosis of ADHD. The constituent ratios of ADHD-I, ADHD-C, and ADHD-H subtypes were 67.43, 24.57, and 8.00%, respectively. The rate of ADHD-H decreased with age, whereas that of ADHD-I remained at the highest levels in all age groups, suggesting that symptoms in the inattention domain are the most persistent and refractory.

Working memory deficits in adults with ADHD: is there evidence for subtype differences?

PubMed Central

Schweitzer, Julie B; Hanford, Russell B; Medoff, Deborah R

2006-01-01

Background Working memory performance is important for maintaining functioning in cognitive, academic and social activities. Previous research suggests there are prevalent working memory deficits in children with attention deficit hyperactivity disorder (ADHD). There is now a growing body of literature characterizing working memory functioning according to ADHD subtypes in children. The expression of working memory deficits in adults with ADHD and how they vary according to subtype, however, remains to be more fully documented. Methods This study assessed differences in working memory functioning between Normal Control (NC) adults (N = 18); patients with ADHD, Combined (ADHD-CT) Type ADHD (N = 17); and ADHD, Inattentive (ADHD-IA) Type (N = 16) using subtests from the Wechsler Adult Intelligence Scale-III and Wechsler Memory Scale-III and the Paced Auditory Serial Addition Task (PASAT). Results The ADHD groups displayed significant weaknesses in contrast to the NC group on working memory tests requiring rapid processing and active stimulus manipulation. This included the Letter-Number-Sequencing test of the Wechsler scales, PASAT omission errors and the longest sequence of consecutive correct answers on the PASAT. No overall ADHD group subtype differences emerged; however differences between the ADHD groups and the NC group varied depending on the measure and the gender of the participants. Gender differences in performance were evident on some measures of working memory, regardless of group, with males performing better than females. Conclusion In general, the data support a dimensional interpretation of working memory deficits experienced by the ADHD-CT and ADHD-IA subtypes, rather than an absolute difference between subtypes. Future studies should test the effects of processing speed and load on subtype performance and how those variables interact with gender in adults with ADHD. PMID:17173676

Parental Efficacy and Child Behavior in a Community Sample of Children with and without Attention-Deficit Hyperactivity Disorder (ADHD)

PubMed Central

Primack, Brian A.; Hendricks, Kristy M.; Longacre, Meghan R.; Adachi-Mejia, Anna M.; Weiss, Julia E.; Titus, Linda J.; Beach, Michael L.; Dalton, Madeline A.

2013-01-01

Purpose Most studies of ADHD youth have obtained data from the perspective of either children or parents, but not both simultaneously. The purpose of this study was to examine child and parent perspectives on parenting in a large community-based sample of children with and without ADHD. Methods We identified children in grades 4-6 and their parents through surveys administered to a random sample of public schools. We used multivariable logistic regression to determine independent associations between child and parent characteristics and presence of ADHD while controlling for covariates and clustering by school. Results Sufficient data were achieved for 2509 child/parent dyads. Ten percent of youths (n=240) had been diagnosed with ADHD. Compared with those without ADHD, those with ADHD were more commonly male (67.9% vs. 48.0%, P<.001) and age 12 or over (16.3% vs. 10.3%). After adjusting for covariates and clustering, compared to children without ADHD, children with ADHD were significantly more likely to report lower self-regulation (OR= 0.68, 95% CI=0.53, 0.88) and higher levels of rebelliousness (OR= 2.00, 95% CI=1.52, 2.69). Compared with parents whose children did not have ADHD, parents of children with ADHD rated their overall parental efficacy substantially lower (OR=0.23, 95% CI=0.15, 0.33). However, child assessment of parenting style was similar by ADHD. Conclusions Despite the internal challenges community-based youth with ADHD face, many parents of ADHD youth exhibit valuable parental skills from the perspective of their children. Feedback of this information to parents may improve parental self-efficacy, which is known to be positively associated with improved ADHD outcomes. PMID:22886756

Maternal anxiety, depression and sleep disorders before and during pregnancy, and preschool ADHD symptoms in the NINFEA birth cohort study.

PubMed

Vizzini, L; Popovic, M; Zugna, D; Vitiello, B; Trevisan, M; Pizzi, C; Rusconi, F; Gagliardi, L; Merletti, F; Richiardi, L

2018-04-18

Maternal mental disorders have been associated with the risk of attention-deficit/hyperactivity disorder (ADHD) in children. Within the context of a mother-child cohort, we examined whether maternal anxiety, depression and sleep disorders are associated with pre-school ADHD symptoms. The study included 3634 singletons from the Italian NINFEA (Nascita e INFanzia: gli Effetti dell'Ambiente') cohort. Maternal doctor-diagnosed anxiety, depression and sleep disorders before and during pregnancy were assessed from the questionnaires completed during pregnancy and 6 months after delivery. Mothers rated child ADHD symptoms at 4 years of age, according to the Diagnostic and Statistical Manual of Mental Disorders. Hyperactive-impulsive (ADHD-H), inattentive (ADHD-I) and total ADHD scores were analysed in the models adjusted for child's gender, first-born status, maternal age, education, alcohol consumption and smoking during pregnancy. The total ADHD score at age 4 was associated with maternal lifetime anxiety (17.1% percentage difference in score compared with never; 95% CI 7.3-27.9%), sleep disorders (35.7%; 95% CI 10.7-66.5%) and depression (17.5%; 95% CI 3.2-33.8%). Similar positive associations were observed also for ADHD-H and ADHD-I traits, with slightly attenuated associations between maternal sleep disorders and child ADHD-I score, and maternal depression and both ADHD scores. All the estimates were enhanced when the disorders were active during pregnancy and attenuated for disorders active only during the pre-pregnancy period. Maternal anxiety, depression and sleep disorders are associated with a relative increase in the number of ADHD-H, ADHD-I and total ADHD symptoms in preschoolers.

Intellectual Disability in Children with Attention Deficit Hyperactivity Disorder

PubMed Central

Ahuja, Alka; Martin, Joanna; Langley, Kate; Thapar, Anita

2013-01-01

Objective To determine whether children with attention deficit hyperactivity disorder (ADHD) and mild intellectual disability (ID) are a clinically distinct ADHD subgroup. Study design This was a cross-sectional study comparing clinical characteristics (ADHD subtypes, total number of symptoms, and rates of common comorbidities) between children with ADHD and mild ID and those with ADHD and IQ test scores >70, and also between children with ADHD and ID and a general population sample of children with ID alone. The sample comprised a clinical sample of children with ADHD with ID (n = 97) and without ID (n = 874) and a general population sample of children with ID and without ADHD (n = 58). Results After correcting for multiple statistical tests, no differences were found between the 2 ADHD groups on any measure except the presence of conduct disorder (CD) symptoms and diagnoses. Children with ADHD and ID had higher rates of both (OR, 2.38; 95% CI, 1.71-3.32 and OR, 2.69; 95% CI, 1.69-4.28, respectively). Furthermore, children with ADHD and ID had significantly higher rates of oppositional defiant disorder (OR, 5.54; 95% CI, 2.86-10.75) and CD (OR, 13.66; 95% CI, 3.25-57.42) symptoms and a higher incidence of oppositional defiant disorder diagnoses (OR, 30.99; 95% CI, 6.38-150.39) compared with children with ID without ADHD. Conclusion Children with ADHD and mild ID appear to be clinically typical of children with ADHD except for more conduct problems. This finding has implications for clinicians treating these children in terms of acknowledging the presence and impact of ADHD symptoms above and beyond ID and dealing with a comorbid CD. PMID:23608559

A National Profile of Attention-Deficit Hyperactivity Disorder Diagnosis and Treatment Among US Children Aged 2 to 5 Years.

PubMed

Danielson, Melissa L; Visser, Susanna N; Gleason, Mary Margaret; Peacock, Georgina; Claussen, Angelika H; Blumberg, Stephen J

2017-09-01

Clinical guidelines provide recommendations for diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD), with specific guidance on caring for children younger than 6 years. This exploratory study describes ADHD diagnosis and treatment patterns among young children in the United States using 2 nationally representative parent surveys. The National Survey of Children's Health (2007-2008, 2011-2012) was used to produce weighted prevalence estimates of current ADHD and ADHD medication treatment among US children aged 2 to 5 years. The National Survey of Children with Special Health Care Needs (2009-2010) provided additional estimates on types of medication treatment and receipt of behavioral treatment among young children with special health care needs (CSHCN) with ADHD. In 2011 to 2012, 1.5% of young children (approximately 237,000) had current ADHD compared to 1.0% in 2007 to 2008. In 2011 to 2012, 43.7% of young children with current ADHD were taking medication for ADHD (approximately 104,000). In young CSHCN with ADHD, central nervous system stimulants were the most common medication type used to treat ADHD, and 52.8% of young CSHCN with current ADHD had received behavioral treatment for ADHD in the past year. Nearly a quarter million In young CSHCN have current ADHD, with a prevalence that has increased by 57% from 2007 to 2008 to 2011 to 2012. The demographic patterns of diagnosis and treatment described in this study can serve as a benchmark to monitor service use patterns of young children diagnosed with ADHD over time.

Evaluation of sleep organization in patients with attention deficit hyperactivity disorder (ADHD) and ADHD as a comorbidity of epilepsy.

PubMed

Kalil Neto, Felipe; Nunes, Magda L

2017-05-01

Epilepsy or attention deficit hyperactivity disorder (ADHD) can influence sleep organization in different ways. The aim of this study was to evaluate sleep organization in children and adolescents with ADHD and epilepsy, and to analyze the influence of methylphenidate. This was an observational, cross-sectional study of children and adolescents with epilepsy, who were seizure free for at least three months, and were also diagnosed with ADHD. They were selected from the epilepsy and child neurology outpatient clinic of a university hospital in Brazil. After sample size calculation, patients were consecutively included into four different groups, with 21 patients each: epilepsy + ADHD using methylphenidate, epilepsy + ADHD not using methylphenidate, only ADHD, and a healthy control group. All participants were evaluated with the Sleep Disturbance Scale for Children (SDSC) and monitored with actigraphy for five nights/days. Actigraphic analysis showed a higher number of night awakenings in the epilepsy + ADHD groups; they were most prominent in the group without methylphenidate (p = 0.001). Parental reports demonstrated a higher risk for sleep disturbances in the epilepsy + ADHD without methylphenidate and the ADHD groups (p < 0.001). Primary ADHD as a comorbidity of epilepsy impairs sleep organization in children, and the use of short-acting methylphenidate seems to improve it. Both objective (actigraphic) and subjective (SDSC) measures showed significant sleep alterations between primary ADHD and ADHD as a comorbidity of epilepsy; this was most prominent in the group without methylphenidate. Copyright © 2016 Elsevier B.V. All rights reserved.

Characteristics of undiagnosed children with parent-reported ADHD behaviour.

PubMed

Madsen, Kathrine Bang; Ravn, Mette Holmelin; Arnfred, Jon; Olsen, Jørn; Rask, Charlotte Ulrikka; Obel, Carsten

2018-02-01

There is an ongoing public debate on the diagnosis of attention deficit hyperactivity disorder (ADHD) in which critics have claimed that the disorder is over-diagnosed, while the potential under-diagnosis of children with ADHD has received little attention. In this study we estimate the number of children with parent-reported ADHD behaviour at age 7 and absence of recorded ADHD diagnosis through adolescence, and investigate whether socio-demographic characteristics of this group differed from the children diagnosed with ADHD during follow-up. Our study was based on data from the Danish National Birth Cohort, where parents of 51,527 children completed questionnaires, including the Strength and Difficulties Questionnaire (SDQ). ADHD diagnosis was identified through Danish registers and parent-reported ADHD behaviour by the specific SDQ subscale. Socio-demographic predictors of positive parent-reported SDQ ADHD behaviour and absence of recorded ADHD diagnosis in their children were examined using logistic regression analyses. Children with parent-reported ADHD behaviour and no diagnosis (1.3%) were more likely to be girls (OR 1.83; 95% CI 1.45; 2.29), more likely to have mothers with a low socioeconomic status (OR high vs. low 1.49; 95% CI 1.10; 2.02), and to live in certain regions of the country (OR: Capital vs. Southern: 2.04; 95% CI 1.51; 2.73) than children with an ADHD diagnosis. The children showed markedly impairments on all the SDQ subscales. The results demonstrate a considerable number of children with ADHD symptoms who potentially go undetected and underline the influence of socio-demographic factors in the pathway to a diagnosis of ADHD.