Jordan, Brian T; Martin, Nancy; Austin, J Sue
The purpose of this research was to establish new norms for the Jordan-3 for children ages 5 to 18 years. The research also investigated the frequency of visual reversals in children previously identified as having reading disability, attention-deficit/hyperactivity disorder, and broader learning disabilities. Participants were regular education students, ages 5 through 18 years, and special education students previously diagnosed with attention-deficit/hyperactivity disorder, reading disability, or broader learning disability. Jordan-3 Accuracy and Error raw scores were compared to assess if there was a significant difference between the two groups. Mean Accuracy and Error scores were compared for males and females. Children with learning disability and attention-deficit/hyperactivity disorder had higher reversals when compared to regular education children, which lends continued support to the Jordan-3 as a valid and reliable measure of visual reversals in children and adolescents. This study illustrates the utility of the Jordan-3 when assessing children who may require remediation to reach their academic potential.
... If so, your child may have attention deficit hyperactivity disorder (ADHD). Nearly everyone shows some of these ... children. The main features of ADHD are Inattention Hyperactivity Impulsivity No one knows exactly what causes ADHD. ...
... Education Visitor Information RePORT NIH Fact Sheets Home > Attention Deficit Hyperactivity Disorder (ADHD) Small Text Medium Text Large Text Attention Deficit Hyperactivity Disorder (ADHD) Attention deficit/hyperactivity disorder (ADHD) is one ...
This brief paper summarizes information on attention deficit hyperactivity disorder (ADHD). First it identifies eight common characteristics of this disorder: (1) inattentiveness and distractibility, (2) impulsiveness, (3) hyperactivity, (4) attention-demanding behavior, (5) learning difficulties, (6) coordination difficulties, (7) unacceptable…
Matthews, Marguerite; Nigg, Joel T; Fair, Damien A
Over the last two decades, there have been numerous technical and methodological advances available to clinicians and researchers to better understand attention deficit hyperactivity disorder (ADHD) and its etiology. Despite the growing body of literature investigating the disorder's pathophysiology, ADHD remains a complex psychiatric disorder to characterize. This chapter will briefly review the literature on ADHD, with a focus on its history, the current genetic insights, neurophysiologic theories, and the use of neuroimaging to further understand the etiology. We address some of the major concerns that remain unclear about ADHD, including subtype instability, heterogeneity, and the underlying neural correlates that define the disorder. We highlight that the field of ADHD is rapidly evolving; the descriptions provided here will hopefully provide a sturdy foundation for which to build and improve our understanding of the disorder.
Thapar, Anita; Cooper, Miriam
Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder with a prevalence of 1·4-3·0%. It is more common in boys than girls. Comorbidity with childhood-onset neurodevelopmental disorders and psychiatric disorders is substantial. ADHD is highly heritable and multifactorial; multiple genes and non-inherited factors contribute to the disorder. Prenatal and perinatal factors have been implicated as risks, but definite causes remain unknown. Most guidelines recommend a stepwise approach to treatment, beginning with non-drug interventions and then moving to pharmacological treatment in those most severely affected. Randomised controlled trials show short-term benefits of stimulant medication and atomoxetine. Meta-analyses of blinded trials of non-drug treatments have not yet proven the efficacy of such interventions. Longitudinal studies of ADHD show heightened risk of multiple mental health and social difficulties as well as premature mortality in adult life.
Attention Deficit Hyperactivity Disorder (ADHD) is a common behavioral disorder in children. It is characterized by motor hyperactivity, impulsivity and inattention inappropriate for the age. Approximately 5-10 % of school age children are diagnosed to have ADHD. The affected children show significant impairment in social behavior and academic performance. The DSM-5 criteria are useful in diagnosing three subtypes of ADHD based on presence of symptoms described in 3 domains viz ., inattention, hyperactivity and impulsivity. Co-morbidities like specific learning disability, anxiety disorder, oppositional defiant disorder are commonly associated with ADHD.Education of parents and teachers, behavioral therapy and medication are main components of management. Methylphenidate and Atomoxetine are effective in controlling symptoms of ADHD in most children. Research studies estimated that 30-60 % of children continue to show symptoms of ADHD in adulthood. The general practitioner can play an important role in early diagnosis, appropriate assessment and guiding parents for management of children with ADHD.
Cunill, Ruth; Castells, Xavier
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders and can persist into the adulthood. ADHD has important social, academic and occupational consequences. ADHD diagnosis is based on the fulfillment of several clinical criteria, which can vary depending on the diagnostic system used. The clinical presentation can show great between-patient variability and it has been related to a dysfunction in the fronto-striatal and meso-limbic circuits. Recent investigations support a model in which multiple genetic and environmental factors interact to create a neurobiological susceptibility to develop the disorder. However, no clear causal association has yet been identified. Although multimodal treatment including both pharmacological and psychosocial interventions is usually recommended, no convincing evidence exists to support this recommendation. Pharmacological treatment has fundamentally shown to improve ADHD symptoms in the short term, while efficacy data for psychosocial interventions are scarce and inconsistent. Yet, drug treatment is increasingly popular and the last 2 decades have witnessed a sharp increase in the prescription of anti-ADHD medications coinciding with the marketing of new drugs to treat ADHD.
... this? Submit What's this? Submit Button NCHS Home Attention Deficit Hyperactivity Disorder (ADHD)* Recommend on Facebook Tweet Share Compartir Data ... attention deficit disorder (ADD)" is used rather than "attention deficit hyperactivity disorder (ADHD)" in some data sources. More data Association ...
Deutsch, Curtis K.; Dube, William V.; McIlvane, William J.
Attention-Deficit Hyperactivity Disorder (ADHD) and its earlier nosologic classifications have been extensively investigated since the 1960s, with PubMed listings alone exceeding 13,000 entries. Strides have been made in the diagnosis and treatment of ADHD in individuals with intellectual function in the normal range, as described in companion…
Lukov, Limor; Friedmann, Naama; Shalev, Lilach; Khentov-Kraus, Lilach; Shalev, Nir; Lorber, Rakefet; Guggenheim, Revital
We examine whether attention deficits underlie developmental dyslexia, or certain types of dyslexia, by presenting double dissociations between the two. We took into account the existence of distinct types of dyslexia and of attention deficits, and focused on dyslexias that may be thought to have an attentional basis: letter position dyslexia (LPD), in which letters migrate within words, attentional dyslexia (AD), in which letters migrate between words, neglect dyslexia, in which letters on one side of the word are omitted or substituted, and surface dyslexia, in which words are read via the sublexical route. We tested 110 children and adults with developmental dyslexia and/or attention deficits, using extensive batteries of reading and attention. For each participant, the existence of dyslexia and the dyslexia type were tested using reading tests that included stimuli sensitive to the various dyslexia types. Attention deficit and its type was established through attention tasks assessing sustained, selective, orienting, and executive attention functioning. Using this procedure, we identified 55 participants who showed a double dissociation between reading and attention: 28 had dyslexia with normal attention and 27 had attention deficits with normal reading. Importantly, each dyslexia with suspected attentional basis dissociated from attention: we found 21 individuals with LPD, 13 AD, 2 neglect dyslexia, and 12 surface dyslexia without attention deficits. Other dyslexia types (vowel dyslexia, phonological dyslexia, visual dyslexia) also dissociated from attention deficits. Examination of 55 additional individuals with both a specific dyslexia and a certain attention deficit found no attention function that was consistently linked with any dyslexia type. Specifically, LPD and AD dissociated from selective attention, neglect dyslexia dissociated from orienting, and surface dyslexia dissociated from sustained and executive attention. These results indicate that
Lukov, Limor; Friedmann, Naama; Shalev, Lilach; Khentov-Kraus, Lilach; Shalev, Nir; Lorber, Rakefet; Guggenheim, Revital
We examine whether attention deficits underlie developmental dyslexia, or certain types of dyslexia, by presenting double dissociations between the two. We took into account the existence of distinct types of dyslexia and of attention deficits, and focused on dyslexias that may be thought to have an attentional basis: letter position dyslexia (LPD), in which letters migrate within words, attentional dyslexia (AD), in which letters migrate between words, neglect dyslexia, in which letters on one side of the word are omitted or substituted, and surface dyslexia, in which words are read via the sublexical route. We tested 110 children and adults with developmental dyslexia and/or attention deficits, using extensive batteries of reading and attention. For each participant, the existence of dyslexia and the dyslexia type were tested using reading tests that included stimuli sensitive to the various dyslexia types. Attention deficit and its type was established through attention tasks assessing sustained, selective, orienting, and executive attention functioning. Using this procedure, we identified 55 participants who showed a double dissociation between reading and attention: 28 had dyslexia with normal attention and 27 had attention deficits with normal reading. Importantly, each dyslexia with suspected attentional basis dissociated from attention: we found 21 individuals with LPD, 13 AD, 2 neglect dyslexia, and 12 surface dyslexia without attention deficits. Other dyslexia types (vowel dyslexia, phonological dyslexia, visual dyslexia) also dissociated from attention deficits. Examination of 55 additional individuals with both a specific dyslexia and a certain attention deficit found no attention function that was consistently linked with any dyslexia type. Specifically, LPD and AD dissociated from selective attention, neglect dyslexia dissociated from orienting, and surface dyslexia dissociated from sustained and executive attention. These results indicate that
Biederman, Joseph; Faraone, Stephen V
Attention-deficit hyperactivity disorder (ADHD) is a disorder of inattention, impulsivity, and hyperactivity that affects 8-12% of children worldwide. Although the rate of ADHD falls with age, at least half of children with the disorder will have impairing symptoms in adulthood. Twin, adoption, and molecular genetic studies show ADHD to be highly heritable, and other findings have recorded obstetric complications and psychosocial adversity as predisposing risk factors. Converging evidence from animal and human studies implicates the dysregulation of frontal-subcortical-cerebellar catecholaminergic circuits in the pathophysiology of ADHD, and molecular imaging studies suggest that abnormalities of the dopamine transporter lead to impaired neurotransmission. Studies during the past decade have shown the safety and effectiveness of new non-stimulant drugs and long-acting formulations of methylphenidate and amfetamine. Other investigations have also clarified the appropriate role of targeted psychosocial treatments in the context of ongoing pharmacotherapy.
Van Bogaert, P
Attention deficit disorder, eventually associated with hyperactivity (ADD +/- H), is nowadays viewed as a syndrome often of unknown etiology but probably not unique, with important genetic influence and associated environmental factors. The cognitive model proposing ADHD as a result of impaired inhibitory control which makes the child less flexible to changing circumstances suffers from poor sensibility and specificity. As studies aimed to make genotype-phenotype correlations were disappointing, recent genetic researches tend to correlate the genotype to an endophenotype defined from neuro-imaging data with encouraging preliminary results. Treatment with methylphenidate has long been considered as a first choice for disabling forms of ADHD, but recent data do not show evidence for superiority of methylphenidate compared to non pharmacological approach at long-term. Evaluation and treatment of each suspected case of ADHD need to be tailored with special concern for associated conditions as psycho-affective troubles or learning difficulties.
Faraone, Stephen V; Asherson, Philip; Banaschewski, Tobias; Biederman, Joseph; Buitelaar, Jan K; Ramos-Quiroga, Josep Antoni; Rohde, Luis Augusto; Sonuga-Barke, Edmund J S; Tannock, Rosemary; Franke, Barbara
Attention-deficit/hyperactivity disorder (ADHD) is a persistent neurodevelopmental disorder that affects 5% of children and adolescents and 2.5% of adults worldwide. Throughout an individual's lifetime, ADHD can increase the risk of other psychiatric disorders, educational and occupational failure, accidents, criminality, social disability and addictions. No single risk factor is necessary or sufficient to cause ADHD. In most cases ADHD arises from several genetic and environmental risk factors that each have a small individual effect and act together to increase susceptibility. The multifactorial causation of ADHD is consistent with the heterogeneity of the disorder, which is shown by its extensive psychiatric co-morbidity, its multiple domains of neurocognitive impairment and the wide range of structural and functional brain anomalies associated with it. The diagnosis of ADHD is reliable and valid when evaluated with standard criteria for psychiatric disorders. Rating scales and clinical interviews facilitate diagnosis and aid screening. The expression of symptoms varies as a function of patient developmental stage and social and academic contexts. Although there are no curative treatments for ADHD, evidenced-based treatments can markedly reduce its symptoms and associated impairments. For example, medications are efficacious and normally well tolerated, and various non-pharmacological approaches are also valuable. Ongoing clinical and neurobiological research holds the promise of advancing diagnostic and therapeutic approaches to ADHD. For an illustrated summary of this Primer, visit: http://go.nature.com/J6jiwl.
Brown, Thomas E.
A recent study conducted by the U.S. Centers for Disease Control estimated that approximately 7.8 percent of U.S. children ages 4-17 are currently diagnosed with Attention Deficit Disorder (ADD) or Attention Deficit/Hyperactivity Disorder (ADHD). For decades, most educators, physicians, psychologists, and parents have thought of ADD/ADHD as…
Gordon, Heather A; Rucklidge, Julia J; Blampied, Neville M; Johnstone, Jeanette M
Abstract Objective: The purpose of this study was to investigate the clinical effect and safety of a broad spectrum, 36 ingredient micronutrient (vitamins and minerals) in treating children with attention-deficit/hyperactivity disorder (ADHD). Methods: This open-label, on-off-on-off (reversal design) study followed 14 participants (8–12 years of age) with ADHD, diagnosed using standardized instruments, for 6 months with no dropouts. Following baseline assessment, including hematology and biochemistry screening, participants began an 8 week treatment phase with micronutrients titrated up to maximum dose (15 capsules/day). Treatment was withdrawn for 4 weeks, reinstated for a further 8 weeks, and then withdrawn for 4 weeks. Primary outcomes included the Conners' Parent Rating Scale, the Clinical Global Impressions Scale (CGI), and the Strengths and Difficulties Questionnaire – Parent version (SDQ). Secondary outcomes were mood and global functioning. Results: Modified Brinley plots revealed a reduction in ADHD symptoms, improved mood, and improved overall functioning during intervention phases, and deterioration in ADHD symptoms, mood, and overall functioning during the withdrawal phases. Reliable change analyses, Cohen's d and percent superiority effect sizes, 95% confidence intervals and t tests confirmed clinically and statistically significant change between the intervention and withdrawal phases, with large effect sizes observed pre- to post-exposure of micronutrients (d = 1.2–2.2) on ADHD symptoms during intervention phases. Seventy-one percent of participants showed at least a 30% decrease in ADHD symptoms by the end of the second treatment phase, and 79% were identified as “much improved” or “very much improved” at the end of the second phase (5 months) based on the clinician-rated CGI when considering functioning generally. The SDQ showed that these benefits occurred across other areas of functioning including emotional symptoms, conduct
This briefing paper uses a question-and-answer format to provide basic information about children with attention deficit disorder (ADD). Questions address the following concerns: nature and incidence of ADD; causes of ADD; signs of ADD (impulsivity, hyperactivity, disorganization, social skill deficits); the diagnostic ADD assessment; how to get…
Riccio, Cynthia A.; And Others
This article reviews various models in the neurological conceptualization of attention deficit disorder (ADD), with and without hyperactivity. It discusses neuroanatomical, neurochemical, and neurophysiological perspectives on ADD. (Author/DB)
Scott, Mary E.
The term "attention deficit disorder" (ADD) is defined, criteria used by the American Psychiatric Association in diagnosing ADD are listed, and possible causes noted. Remediation needs of children with ADD include attention skills, self-esteem, and social skills. Early diagnosis is important, and teachers and parents need to identify…
Erk, Robert R.
Broadly examines diagnostic category of attention deficit disorder (ADD), which affects individuals from childhood to or through adult life, with special attention to cases in which predominant characteristic seems to be inattentiveness. To work with individuals with ADD, counselors need to understand nomenclature, etiology, unique symptoms, and…
and their applications. Clinical Psychology Review , 5, 429-445. Gascon, G., Johnson, R. & Burd, L. (1986). Central auditory processing and attention...Rancurello, M.D. (1985). Childhood hyperactivity: An overview of rating scales and their applications. Clinical Psychology Review , 5, 429-445
Kooistra, Libbe; Crawford, Susan; Gibbard, Ben; Ramage, Barbara; Kaplan, Bonnie J
Aim: The attention and inhibition problems found in children with attention-deficit-hyperactivity disorder (ADHD) are also common in children with fetal alcohol spectrum disorders (FASDs). Attempts to distinguish ADHD from FASDs in terms of these deficits are rare and were pursued in this study. Method: A total of 116 children (47 with ADHD, 31…
Richard, Gail J.; Russell, Joy L.
This book is intended for professionals who are responsible for designing and implementing educational programs for children with attention deficit disorders and attention deficit/hyperactivity disorder (ADD/ADHD). Chapters address: (1) myths and realities about ADD/ADHD; (2) definitions, disorders associated with ADD/ADHD, and federal educational…
This introduction to students with attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) covers a historical perspective of these disorders, definitions of ADHD, etiology, behaviors associated with ADD and ADHD, developmental course, identification and assessment, services, classroom interventions, medication…
Blesch, Lauri; Breese McCoy, Sarah J
Attention deficit and hyperactivity are known possible symptoms or correlates of obstructive sleep apnea (OSA). However, these associations may be missed in children, because children often fail to report excessive daytime sleepiness, and attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are common primary diagnoses in themselves. We report on a 17-year-old, slender, non-snoring male who presented to his pediatrician with a prolonged history of four complaints: inattention, fidgeting, frequent sinusitis, and somnolence. He was diagnosed with ADHD, while the somnolence, which often abated somewhat upon use of antibiotics for sinusitis, was attributed to the sinus infections. A later sleep study revealed OSA, and thorough additional testing proved that the original ADHD diagnosis was in error. All four conditions were allayed with proper use of a continuous positive airway pressure (CPAP) machine.
Barber, Anita D; Jacobson, Lisa A; Wexler, Joanna L; Nebel, Mary Beth; Caffo, Brian S; Pekar, James J; Mostofsky, Stewart H
Intra-subject variability (ISV) is the most consistent behavioral deficit in Attention Deficit Hyperactivity Disorder (ADHD). ISV may be associated with networks involved in sustaining task control (cingulo-opercular network: CON) and self-reflective lapses of attention (default mode network: DMN). The current study examined whether connectivity supporting attentional control is atypical in children with ADHD. Group differences in full-brain connection strength and brain-behavior associations with attentional control measures were examined for the late-developing CON and DMN in 50 children with ADHD and 50 typically-developing (TD) controls (ages 8-12 years). Children with ADHD had hyper-connectivity both within the CON and within the DMN. Full-brain behavioral associations were found for a number of between-network connections. Across both groups, more anti-correlation between DMN and occipital cortex supported better attentional control. However, in the TD group, this brain-behavior association was stronger and occurred for a more extensive set of DMN-occipital connections. Differential support for attentional control between the two groups occurred with a number of CON-DMN connections. For all CON-DMN connections identified, increased between-network anti-correlation was associated with better attentional control for the ADHD group, but worse attentional control in the TD group. A number of between-network connections with the medial frontal cortex, in particular, showed this relationship. Follow-up analyses revealed that these associations were specific to attentional control and were not due to individual differences in working memory, IQ, motor control, age, or scan motion. While CON-DMN anti-correlation is associated with improved attention in ADHD, other circuitry supports improved attention in TD children. Greater CON-DMN anti-correlation supported better attentional control in children with ADHD, but worse attentional control in TD children. On the other
Ryan, Joseph B.; Katsiyannis, Antonis; Hughes, Elizabeth M.
Attention deficit hyperactivity disorder (ADHD) has become the most commonly diagnosed psychiatric disorder among school-age children. For more than half a century, physicians have prescribed medications to help manage behaviors such as hyperactivity, impulsivity, and inattention. Today, there is a growing consensus that ADHD is a biologically…
Fernandez, Roy C.; O'Connor, Carol
This report discusses the outcomes of a study that investigated the decision-making process of two mothers' selection of treatment for their sons' attention deficit disorder (ADD). One mother opted for a medical treatment, and the other mother opted for a non-medical treatment. The boy who is medically treated is 14, and the non-medically treated…
Zarski, John J.; And Others
Examined validity of Wisconsin Card Sorting Test, Canter Background Interference Procedure for the Bender Visual-Motor Gestalt Test, Conners Parent Questionnaire, and three measures of the Wechsler Intelligence Scale for Children-Revised for identifying attention deficit disorders. Compared test results among clinical, special education, and…
Friedman, Ronald J.; Doyal, Guy T.
This book is designed for parents and teachers of children with Attention Deficit Disorder (ADD) and hyperactivity. Chapter 1 describes the symptoms, diagnosis, and causes of ADD, its effect on parents and families, inborn temperament characteristics of children with ADD, and tests and rating scales used to diagnose and treat the disorder. The…
Griffin, Harold; Daley, Christine E.; Onwuegbuzie, Anthony J.
This study examined the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among school children in Arkansas for the purpose of helping school districts plan appropriate educational interventions. The ADHD Survey was mailed to all 311 school superintendents; 128 surveys were returned. Findings revealed that, overall, 3 percent of…
Thompson, Anna M.
A parent and educator who has spent the past 10 years struggling to help her own ADHD (attention deficit-hyperactivity disorder) child offers suggestions for managing the challenges facing such children and enhancing the quality of their lives. Since drug regimens have limitations, parents need to read appropriate literature and receive…
Weinberg, Warren A.; Emslie, Graham J.
This paper presents information on the diagnostic criteria and management of disorders that may be wrongly identified as Attention Deficit Hyperactivity Disorder (ADHD) or may coexist with ADHD thus complicating identification and treatment. The disorders discussed are: depression, mania, primary disorder of vigilance, narcolepsy, developmental…
Stein, Amy E.
Written by a woman who, at age 25, was diagnosed as "a textbook case for attention deficit hyperactivity disorder," (ADHD) this book, examines: the pitfalls of traditional psychotherapy and medications for those diagnosed with ADD/ADHD; how an interactive, hands-on learning environment can markedly improve the educational experience of…
Faraone, Stephen V.; Biederman, Joseph
Comments on Joseph's review of the genetics of attention deficit disorder, demonstrating errors of scientific logic and oversight of relevant research in Joseph's argument. Argues for the validity of twin studies in supporting a genetic link for ADHD and for the complementary role of nature and nurture in the etiology of the disorder. (JPB)
Salend, Spencer J.; Rohena, Elba
This article provides the American Psychiatric Association's definition of attention deficit disorder (ADD) and then gives an overview of ADD by considering the three types of ADD, the developmental impact of ADD, factors contributing to ADD, identification and assessment of students with ADD (emphasizing multimethod and consideration of…
Schiller, Ellen; And Others
Attention deficit disorder (ADD) is recognized as the most common neurobehavioral disorder in American children. The paper examines how to obtain a proper diagnosis for children with ADD, how medication for ADD affects children, how children with ADD can be properly served in public schools, and where to go for help. (SM)
Cherkes-Julkowski, Miriam; Stolzenberg, Jonathan
Two discriminant function analyses were conducted to determine the cognitive/educational profile which differentiated 4 groups of 68 elementary/secondary level students: attention deficit disorder (ADD), with and without medication; learning disabilities (LD); and nonhandicapped. By treating the LD and nonmedicated ADD subjects as one group, a…
Essex, Nathan L.; Schifani, John
Until recently, children with Attention Deficit Disorder (ADD) were often placed in special education classrooms. The critical challenge for administrators is ensuring that ADD children are correctly identified and appropriately educated. To avoid lawsuits, principals must lead the development of appropriate policies, procedures, and strategies to…
Montague, Marjorie; And Others
This article recommends that, to comply with federal legislation, a multilevel, multimodal approach be used for assessment and identification of students with attention deficit disorder (ADD). It identifies several purposes of ADD assessment, explains various instruments and procedures, and offers guidelines for using assessment to determine…
Dykman, Roscoe A.; Ackerman, Peggy T.
This article reviews research on three behavioral subtypes of attention deficit disorder (ADD): (1) without hyperactivity (ADD/WO), (2) with hyperactivity, and (3) with hyperactivity and aggression (ADDHA). Children with ADDHA appear to be at increased risk of having oppositional and conduct disorders, whereas children with ADD/WO show symptoms…
Chesapeake Inst., Washington, DC.
This paper outlines practical information on children with attention deficit disorder (ADD). Guidelines for identifying ADD are presented, followed by a summary of what parents and students can expect from special education and related services in public schools. Pros and cons of medication are noted, and recommendations for managing the child's…
Lerner, Janet W.; Lerner, Sue R.
This paper examines the family of disorders referred to as attention deficit disorders (ADD). It addresses the topics of special education legislation; the history of ADD; associated conditions (learning disabilities, behavior/emotional disorders, and other health impairments); assessment; treatment (medical and educational, family counseling, and…
Gadow, Kenneth D.
Research on the effects of stimulant drugs on attention and cognitive deficits in children with hyperactivity is reviewed. Topics covered include: attention and impulsivity, paired associate learning, school achievement, and drug induced attention and cognitive deficits. (CL)
... good work. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), is a national nonprofit organization that ... 2017 by Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). All Rights Reserved. Press Privacy Attention ...
Modesto-Lowe, Vania; Farahmand, Pantea; Chaplin, Margaret; Sarro, Lauren
Attention deficit hyperactivity disorder (ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperactivity declines over time, inattention and executive function difficulties persist, leading to functional deficits. Adolescents and adults with ADHD have pervasive impairment in interpersonal and family relationships. They may develop addiction, delinquent behavior and comorbid psychiatric disorders. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. Mindfulness training, derived from Eastern meditation practices, may improve self-regulation of attention. It may also be a useful strategy to augment standard ADHD treatments and may be used as a potential tool to reduce impairments in patients with residual symptoms of ADHD. Clinically, this would manifest by an increased ability to suppress task-unrelated thoughts and distractions resulting in improved attention, completion of tasks and potential improvement in occupational and social function. PMID:26740931
Lange, Klaus W; Reichl, Susanne; Lange, Katharina M; Tucha, Lara; Tucha, Oliver
The contemporary concept of attention deficit hyperactivity disorder (ADHD) as defined in the DSM-IV-TR (American Psychiatric Association 2000) is relatively new. Excessive hyperactive, inattentive, and impulsive children have been described in the literature since the nineteenth century. Some of the early depictions and etiological theories of hyperactivity were similar to current descriptions of ADHD. Detailed studies of the behavior of hyperactive children and increasing knowledge of brain function have changed the concepts of the fundamental behavioral and neuropathological deficits underlying the disorder. This article presents an overview of the conceptual history of modern-day ADHD.
Reichl, Susanne; Lange, Katharina M.; Tucha, Lara; Tucha, Oliver
The contemporary concept of attention deficit hyperactivity disorder (ADHD) as defined in the DSM-IV-TR (American Psychiatric Association 2000) is relatively new. Excessive hyperactive, inattentive, and impulsive children have been described in the literature since the nineteenth century. Some of the early depictions and etiological theories of hyperactivity were similar to current descriptions of ADHD. Detailed studies of the behavior of hyperactive children and increasing knowledge of brain function have changed the concepts of the fundamental behavioral and neuropathological deficits underlying the disorder. This article presents an overview of the conceptual history of modern-day ADHD. PMID:21258430
Williams, C; Wright, B; Partridge, I
The topic of attention deficit hyperactivity disorder (ADHD) is fascinating and controversial. A variety of stances have been taken by different clinicians, support groups, and the media. A nature/nurture argument has developed that may have a tendency to polarize views. This review aims to present research findings that inform the debate. It deals with symptomatology, aetiology, and prevalence, with assessment for diagnosis, management, and outcome. The importance of comprehensive management taking into consideration not just attention abilities but a range of other factors that have an impact upon them is stressed. Management should be pragmatic, multifaceted, and based around the establishment of good working relationships with family and school. PMID:10621994
OBJECTIVE To review the etiology, diagnosis, and management of attention deficit disorder (ADD) in adults. SOURCES OF INFORMATION PsycINFO, PubMed, and Psychiatry 24x7.com were searched. Several books on ADD in adults were reviewed. I also drew on my own clinical experience assessing and treating adults with ADD for more than 20 years. MAIN MESSAGE The classic triad of ADD symptoms are inattention, impulsiveness, and hyperactivity or restlessness. Although ADD is a well established brain disorder, the diagnosis remains controversial. Attention deficit disorder has been called a fad, not a legitimate diagnosis, but it is a well established, well documented, medical condition that can cause much suffering if left untreated. At one time we thought children would outgrow ADD at puberty, but we now know that many will continue to have residual symptoms throughout adolescence and adulthood. If left untreated, ADD can interfere with relationships, employment, and self-esteem. Treatment with stimulants and adjunctive care is often effective. CONCLUSION Attention deficit disorder in adults represents a substantial burden of illness. It can be diagnosed and treated successfully. PMID:17273498
Mary, Alison; Slama, Hichem; Mousty, Philippe; Massat, Isabelle; Capiau, Tatiana; Drabs, Virginie; Peigneux, Philippe
Attention deficit/hyperactivity disorder (ADHD) in children has been associated with attentional and executive problems, but also with socioemotional difficulties possibly associated with deficits in Theory of Mind (ToM). Socioemotional problems in ADHD are associated with more negative prognoses, notably interpersonal, educational problems, and an increased risk of developing other psychiatric disorders that emphasize the need to clarify the nature of their ToM deficits. In this study, we hypothesized that ToM dysfunction in children with ADHD is largely attributable to their attentional and/or executive deficits. Thirty-one children with ADHD (8-12 years, IQ > 85) and 31 typically developing (TD) children were assessed using executive functions (inhibition, planning, and flexibility) and attentional tasks, as well as two advanced ToM tasks (Reading the Mind in the Eyes and Faux Pas) involving different levels of executive control. Children with ADHD performed more poorly than TD children in attentional, executive function, and ToM tasks. Linear regression analyses conducted in the ADHD group indicated that inhibition scores predicted performance on the "Faux Pas" task the best, while attention scores were the best for predicting performance on the Reading the Mind in the Eyes task. When controlled for inhibition and attentional variables, ToM performance in children with ADHD was actually similar to TD children. Contrarily, controlling for ToM scores did not normalize performance for inhibition and attentional tasks in children with ADHD. This unidirectional relationship suggests that deficits in the EF and attentional domains are responsible for ToM deficits in ADHD, which therefore may contribute to their socioemotional difficulties.
Shaw, Philip; Stringaris, Argyris; Nigg, Joel; Leibenluft, Ellen
Although it has long been recognized that many individuals with attention deficit hyperactivity disorder (ADHD) also have difficulties with emotion regulation, no consensus has been reached on how to conceptualize this clinically challenging domain. The authors examine the current literature using both quantitative and qualitative methods. Three key findings emerge. First, emotion dysregulation is prevalent in ADHD throughout the lifespan and is a major contributor to impairment. Second, emotion dysregulation in ADHD may arise from deficits in orienting toward, recognizing, and/or allocating attention to emotional stimuli; these deficits implicate dysfunction within a striato-amygdalo-medial prefrontal cortical network. Third, while current treatments for ADHD often also ameliorate emotion dysregulation, a focus on this combination of symptoms reframes clinical questions and could stimulate novel therapeutic approaches. The authors then consider three models to explain the overlap between emotion dysregulation and ADHD: emotion dysregulation and ADHD are correlated but distinct dimensions; emotion dysregulation is a core diagnostic feature of ADHD; and the combination constitutes a nosological entity distinct from both ADHD and emotion dysregulation alone. The differing predictions from each model can guide research on the much-neglected population of patients with ADHD and emotion dysregulation.
Rogeness, G A; Maas, J W; Javors, M A; Macedo, C A; Fischer, C; Harris, W R
The symptoms of hyperactivity, impulsivity, and concentration deficits associated with attention deficit disorder (ADD) may be related, in part, to alterations in dopaminergic and noradrenergic functioning. In this study we correlate the above symptoms with 24-hour urinary catecholamines and their metabolites in emotionally disturbed boys divided into two groups based on their plasma dopamine-beta-hydroxylase (DBH) activities and also divided into the following diagnostic groups: conduct disorder, undersocialized; conduct disorder, socialized; and subjects without conduct disorder. Boys in the low DBH group showed significant correlations between the ADD symptoms and the biochemical measures. The low DBH group may be more genetically homogeneous with regard to catecholamine function, making relationships between catecholamine function and behavior more visible. The group of boys with conduct disorder, socialized had higher 24-hour urinary norepinephrine and vanillylmandelic acid output. The relationship between monoamines and their metabolites appeared to differ among diagnostic groups.
Schmidt, K; Freidson, S
This report describes the course of psychiatric illness in two boys. Both presented with attention deficit hyperactivity disorder (ADHD) in midchildhood; after puberty, one boy developed a schizophrenic illness while the other boy developed a major affective illness. Although the major ADHD outcome studies have found no link between the childhood occurrence of ADHD and psychosis in adulthood, occasionally such a link may exist. The theoretical and practical implications of this finding are discussed. It should be noted, however, that such outcome is highly atypical and very rare.
Brennan, Avis R.; Arnsten, Amy F.T.
Neuropsychological and imaging studies indicate that attention deficit hyperactivity disorder (ADHD) is associated with alterations in prefrontal cortex (PFC) and its connections to striatum and cerebellum. Research in animals, in combination with observations of patients with cortical lesions, has shown that the PFC is critical for the regulation of behavior, attention, and affect using representational knowledge. The PFC is important for sustaining attention over a delay, inhibiting distraction, and dividing attention, while more posterior cortical areas are essential for perception and the allocation of attentional resources. The PFC in the right hemisphere is especially important for behavioral inhibition. Lesions to the PFC produce a profile of distractibility, forgetfulness, impulsivity, poor planning, and locomotor hyperactivity. The PFC is very sensitive to its neurochemical environment, and either too little (drowsiness) or too much (stress) catecholamine release in PFC weakens cognitive control of behavior and attention. Recent electrophysiological studies in animals suggest that norepinephrine enhances “signals” through postsynaptic α2A adrenoceptors in PFC, while dopamine decreases “noise” through modest levels of D1 receptor stimulation. α2A-Adrenoceptor stimulation strengthens the functional connectivity of PFC networks, while blockade of α2 receptors in the monkey PFC recreates the symptoms of ADHD, resulting in impaired working memory, increased impulsivity, and locomotor hyperactivity. Genetic alterations in catecholamine pathways may contribute to dysregulation of PFC circuits in this disorder. Medications may have many of their therapeutic effects by optimizing stimulation of α2A adrenoceptors and D1 receptors in the PFC, thus strengthening PFC regulation of behavior and attention. PMID:18591484
Yoo, Hee Jeong; Cho, Soo Churl; Ha, Jihyun; Yune, Sook Kyung; Kim, Seog Ju; Hwang, Jaeuk; Chung, Ain; Sung, Young Hoon; Lyoo, In Kyoon
The objective of this study was to evaluate the relationship between attention deficit-hyperactivity/impulsivity symptoms and Internet addiction. In total, 535 elementary school students (264 boys, 271 girls; mean age, 11.0 +/- 1.0 years) were recruited. The presence or severity of Internet addiction was assessed by the Young's Internet Addiction test. Parents and teachers of the children completed the DuPaul's attention deficit hyperactivity disorder (ADHD) rating scale (ARS; Korean version, K-ARS) and Child Behavior Checklists. Children with the highest and lowest quartiles in K-ARS scores were defined to be in ADHD and non-ADHD groups, respectively. Five children (0.9%) met criteria for a definite Internet addiction and 75 children (14.0%) met criteria for a probable Internet addiction. K-ARS scores had significant positive correlations with Young's Internet Addiction test scores. The Internet addiction group had higher total scores of K-ARS and ADHD-related subcategories in the Child Behavior Checklists than the non-addiction group. The ADHD group had higher Internet addiction scores compared with the non-ADHD group. Therefore, significant associations have been found between the level of ADHD symptoms and the severity of Internet addiction in children. In addition, current findings suggest that the presence of ADHD symptoms, both in inattention and hyperactivity-impulsivity domains, may be one of the important risk factors for Internet addiction.
Dykman, Roscoe A.; And Others
This report summarizes activities and findings of a federally funded center at the Arkansas Children's Hospital which reviewed and disseminated literature on the identification and assessment of children with attention deficit disorders (ADD). Meetings throughout Arkansas led to the identification of interest areas, and findings are summarized for…
Fuermaier, Anselm B M; Hüpen, Philippa; De Vries, Stefanie M; Müller, Morgana; Kok, Francien M; Koerts, Janneke; Heutink, Joost; Tucha, Lara; Gerlach, Manfred; Tucha, Oliver
A large body of research demonstrated that individuals with attention deficit hyperactivity disorder (ADHD) suffer from various neuropsychological deficits. In contrast, less is known and only divergent evidence exists on perceptual functions of individuals with ADHD. This is problematic as neuropsychological and perceptual functions are closely interrelated and are often difficult to disentangle in behavioral assessments. This study presents the conduct and results of a systematic literature review on perceptual functions in children and adults with ADHD. This review considers studies using psychophysical methods (objective measurements) and self- and informant reports (subjective measurements). Results indicate that individuals with ADHD have altered perceptual functions in various domains as compared to typically developing individuals. Increased perceptual functions in individuals with ADHD were found with regard to olfactory detection thresholds, whereas reduced perceptual functions were evident for aspects of visual and speech perception. Moreover, individuals with ADHD were found to experience discomfort to sensory stimuli at a lower level than typically developing individuals. Alterations of perceptual functions in individuals with ADHD were shown to be moderated by various factors, such as pharmacological treatment, cognitive functions, and symptom severity. We conclude by giving implications for daily life functioning and clinical practice.
Montañés-Rada, F; Gastaminza-Pérez, X; Catalá, M A; Ruiz-Sanz, F; Ruiz-Lázaro, P M; Herreros-Rodríguez, O; García-Giral, M; Ortiz-Guerra, J; Alda-Díez, J A; Mojarro-Práxedes, D; Cantó-Díez, T; Mardomingo-Sanz, M J; Sasot-Llevadot, J; Pàmias, M; Rey-Sánchez, F
In this article, the GEITDAH -the Spanish abbreviation of the Special Interest Group on Attention Deficit Hyper-activity Disorder (ADHD)- presents a consensus reached by experts in the management of ADHD from all over Spain. The consensus concerns fundamental aspects that should be the starting point for future local or regional consensus guides. Another aim of this consensus is also to reduce the amount of variability that occurs in the health care offered to patients with ADHD in our country, as well as to act as a stimulus in educational matters. That fact that it is not very long will make it more popular among greater numbers of people and this will allow these goals to be reached more effectively. The conclusions in the consensus guide have been constructed around an introduction dealing with basic aspects and recommendations for diagnosis, treatment (both pharmacological and psychotherapeutic), patient flow and organisational aspects.
Baxter, P S
Attention-deficit hyperactivity disorder has been redefined in the classifications in the International Classification of Disease, 10th revision and Diagnostic and Statistical Manual of Mental Disorders, fourth edition. The definitions are more concordant than their predecessors and reemphasize the distinction between inattentiveness and hyperactivity. The causes and mechanisms are still uncertain, but dietary sugar or aspartame and thyroid dysfunction do not seem to be major factors. Specific subgroups, such as children with comorbid psychologic disorders, tic disorders, or mental handicap, seem to have different origins, natural history, prognoses, and responses to treatment, reflecting the heterogeneous nature of the disorder. Psychostimulant therapy has unquestioned short-term effects on behavior but less certain benefits on long-term psychosocial outcome or on academic performance.
Greenhill, Laurence L; Posner, Kelly; Vaughan, Brigette S; Kratochvil, Christopher J
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a childhood onset of symptoms and impairment. Although it is most frequently identified during elementary school years, epidemiologic data suggest that the onset of ADHD frequently occurs earlier, with presentation as young as 3 years of age. Early identification, however, allows consideration of appropriate interventions. Many data are available on safe and efficacious treatment options for school-aged children who have ADHD; however, little is known about the use of these modalities in preschoolers and, ultimately, the long-term effects of early treatment. Recognition of the preschool presentation of ADHD, appropriate differential diagnosis, and identification of comorbid conditions, and a developmental perspective on the course and potential outcomes of the disorder may guide treatment planning. Newly available data on the safety and efficacy of pharmacotherapy and psychosocial intervention for preschoolers who have ADHD may help clinicians make treatment decisions for these young children and their families.
Thapar, Anita; Cooper, Miriam; Jefferies, Rachel; Stergiakouli, Evangelia
Attention deficit hyperactivity disorder (ADHD) affects around 1-3% of children. There is a high level of comorbidity with developmental and learning problems as well as with a variety of psychiatric disorders. ADHD is highly heritable, although there is no single causal risk factor and non-inherited factors also contribute to its aetiology. The genetic and environmental risk factors that have been implicated appear to be associated with a range of neurodevelopmental and neuropsychiatric outcomes, not just ADHD. The evidence to date suggests that both rare and multiple common genetic variants likely contribute to ADHD and modify its phenotype. ADHD or a similar phenotype also appears to be more common in extreme low birth weight and premature children and those exposed to exceptional early adversity. In this review, the authors consider recent developments in the understanding of risk factors that influence ADHD.
Verma, Rohit; Balhara, Yatan Pal Singh; Mathur, Shachi
Attention-deficit hyperactivity disorder (ADHD/ADD) is a neurobehavioral disorder of childhood onset characterized by severe, developmentally inappropriate motor hyperactivity, inattention, and impulsiveness that result in impairment in more than one setting. It affects the home, school, and community life of 39% of school-going children worldwide. There is increasing recognition that ADHD symptoms and clinically defined disorder can persist into adult life and are associated with later drug and alcohol misuse and social and work difficulties. Added to that is the extreme variability of the disorder over time, within the same individual, between individuals, and across different circumstances. Treatment with stimulants and nonstimulants has proven effective in different subgroups, with the effectiveness of specific agents most likely related to the primary neurotransmitter involved. However, stimulants with a short duration of action have been problematic for some patients. Parent training and cognitive behavioral therapies represent the most widely adjunct psychosocial interventions to pharmacotherapy.
Gmehlin, Dennis; Fuermaier, Anselm B M; Walther, Stephan; Tucha, Lara; Koerts, Janneke; Lange, Klaus W; Tucha, Oliver; Weisbrod, Matthias; Aschenbrenner, Steffen
Adults with attention deficit hyperactivity disorder (ADHD) show attentional dysfunction such as distractibility and mind-wandering, especially in lengthy tasks. However, fundamentals of dysfunction are ambiguous and relationships of neuropsychological test parameters with self-report measures of ADHD symptoms are marginal. We hypothesize that basic deficits in sustaining attention explain more complex attentional dysfunction in persons with ADHD and relate to ADHD symptoms. Attentional function was analyzed by computing ex-Gaussian parameters for 3 time Blocks in a 20 min test of sustained alertness. Changes in performance across these blocks were analyzed by comparing adult persons with ADHD (n = 24) with healthy matched controls (n = 24) and correlated with neuropsychological measures of selective and divided attention as well as self-report measures of ADHD symptoms. We found a significantly steeper increase in the number of slow responses (ex-Gaussian parameter τ) in persons with ADHD with time on task in basic sustained alertness. They also performed significantly worse in tasks of sustained selective and divided attention. However, after controlling for an increase in τ during the alertness task, significant differences between groups disappeared for divided and partly selective attention. Increases in τ in the sustained alertness task correlated significantly with self-report measures of ADHD symptoms. Our results provide evidence that very basic deficits in sustaining attention in adults with ADHD are related to infrequent slow responses (=attentional lapses), with changes over time being relevant for more complex attentional function and experienced ADHD symptoms in everyday life.
Overton, Paul G
Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterised by (inter alia) an increase in distractibility. The current front-line pharmacotherapies for the treatment of ADHD, namely the psychostimulants methylphenidate and amphetamines, have clear abuse potential, hence there is a strong need to develop new drug treatments for this disorder. Central to this process is the identification of the pathophysiological changes which underlie ADHD. Given the heterogeneity of the disorder, multiple loci are probably involved, providing multiple potential therapeutic targets. Here, we hypothesise (Hypothesis 1) that one such locus is the superior colliculus (SC), a sensory structure intimately linked with distractibility and the production of eye and head movements. It is proposed that in ADHD, the colliculus is hyper-responsive, leading to the core symptom of increased distractibility. Hypothesis 1 is supported by: 1. ADHD patients show increased distractibility in tasks which are sensitive to collicular function; 2. ADHD patients have a general problem inhibiting saccades, the generation of which involves the SC; 3. Saccadic deficits in ADHD include defects in the production of saccadic types (anti-saccades and express saccades) which are particularly associated with the colliculus; 4. Covert shifts in attention (which also have been argued to involve the SC) are also impaired in ADHD; 5. Reading disorders are frequently co-morbid with ADHD; dyslexia (which is associated with eye movement problems) is linked to a specific visual perceptual deficit in the M pathway, a major recipient of which is the colliculus. Whether or not the SC is indeed hyper-responsive in ADHD as Hypothesis 1 suggests, the SC may well represent an important therapeutic target for drugs. In fact current psychostimulant therapies, which reduce distractibility, may already work at that level (Hypothesis 2), a contention which is supported by: 1. The
Etchepareborda, Máximo C; Díaz Lucero, Andrés
In the last decades there have been those in favor of recognizing the attention deficit disorder (ADD) as a neurodevelopment entity with a strong neurobiological basis responding to a specific interdisciplinary treatment versus those who think, sustain and defend that the accumulated scientific evidence is not sufficient to justify the disorder as a development anomaly in need of a specific therapeutic outline. The attention model versus the autoregulation model are described. The neurological basis of the disorder is discussed analyzing the use of functional neuroimages such as PET (positron emission tomography), SPECT (single photon emission tomography) and FMR (functional magnetic resonance) neuroanatomy, neurophysiology, neurochemistry of neurotransmitters up to genetics. The importance of an adequate diagnosis is emphasized, analyzing the cognitive areas involved and trying to differentiate the ADD types, and to determine in some cases the phenotype or phenocopy of the disorder. The different treatments advocated are discussed taking into account the interdisciplinary approaches. Finally, a complete analysis of the information available is presented and conclusions are drawn to facilitate the understanding of this disorder.
Noorbala, Ahmad-Ali; Akhondzadeh, Shahin
Attention-deficit/hyperactivity disorder is a common neurobehavioral disorder of childhood and adolescence. The etiology of attention-deficit/hyperactivity disorder is not well understood. Neurochemical studies suggest, alterations in catecholaminergic, mainly dopaminergic and noradrenergic, transmitter functions markedly contribute to the symptoms of this disorder. The symptoms of attention-deficit/hyperactivity disorder are significantly ameliorated by the agents that specifically influence these neurotransmitters. Animal studies implicate areas of the brain in which these neurotransmitters are most dominant. Psychostimulant medications are generally the first choice in the treatment of attention-deficit/hyperactivity disorder. Approximately 70% of the children treated show improvement in the primary attention-deficit/hyperactivity disorder symptoms and in comorbidity such as conduct disorder, although the benefits may not hold beyond two years. Despite the well-established efficacy and safety of stimulants for attention-deficit/hyperactivity disorder, alternative medicines are still needed for several reasons. About 30% of children and adolescents with this disorder may not respond to stimulants or may be unable to tolerate potential adverse events such as decreased appetite, mood lability and sleep disturbances. Although stimulants do not increase the risk for later substance abuse in attention-deficit/hyperactivity disorder, concerns have been raised about special prescription rules and a potential for abuse by persons other than the attention-deficit/hyperactivity disorder subjects. This review focuses on etiology, assessment, and treatment of attention-deficit/hyperactivity disorder.
Matazow, Gail S.; Hynd, George W.
Children with Attention Deficit Disorder (ADD) often exhibit problems in visual spatial perception, math achievement, and social skills, and it has been postulated that this constellation of behaviors may constitute Right Hemisphere Deficit Syndrome (RHDS). This study examined 21 children with attention deficit disorder with hyperactivity (ADD/H),…
Purper-Ouakil, Diane; Lepagnol-Bestel, Aude-Marie; Grosbellet, Edith; Gorwood, Philip; Simonneau, Michel
Attention deficit/hyperactivity disorder (ADHD) is a frequent and disabling condition in school children, with cognitive and behavioral symptoms persisting into adulthood in a majority of patients. Etiology of ADHD is considered multifactorial and heterogenous, with an important contribution of genetic factors. Apart from genetic risk factors, emphasis has been put on the early environment, and prenatal exposure to nicotine, alcohol, prematurity and low birth weight have been associated with subsequent ADHD symptoms. This article reviews recent findings in neurobiology, genetics and neuroimaging of ADHD. Despite their clinical heterogeneity and frequent comorbidities, key symptoms of ADHD, such as impulsivity, hyperactivity and inattention are regularly improved by dopaminergic agonists, leading to consider dopaminergic dysfunction a possibly contributing factor in ADHD. Norepinephrine agonists also have clinical efficacy on ADHD symptoms and several other neurotransmission systems are likely involved in the etiology of ADHD. Dysfunction of neurotransmitter systems have been related to impairments of sustained attention, inhibitory control and working memory. Cognitive tasks focusing on reaction time and verbal working memory fit certain criteria for ADHD endophenotypes, offering a pathway to bridge the gap between observed traits and genetic vulnerability. Despite ADHD being a highly heritable disorder, most candidate genes with replicated findings across association studies only account for a small proportion of genetic variance. Neuroimaging studies using treatment effect or cognitive tasks show differential activation patterns in ADHD patients, with trends towards normalization under treatment. Further insight into neurobiological mechanisms involved in ADHD will arise from collaborative networks and combination of imaging, genetic and neurobiological techniques with consideration of the developmental aspects of ADHD.
Quintero, J; Martin, M; Alcindor, P; Perez-Templado, J
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins at an early age and can be present until adulthood. Subjects with ADHD not only have symptoms such as inattention, impulsivity or hyperactivity but also have their social and emotional areas affected. In addition, they have an associated increased risk for presenting comorbilities with other psychiatric disorders, overshadowing the development. Considering ADHD as a evolutionary risk factor, prevention should be considered as a primary goal. Most preventive actions on ADHD have been focused on tertiary prevention. The present review aims to study the factors involved in the development of ADHD in order to form a prevention model beyond tertiary prevention. This research focuses on models of primary prevention (early detection of disease) and secondary prevention (to prevent or delay the disease), trying to incorporate them into daily practice. This study reviews risk factors that affect ADHD. Through actions aimed to pursue an early detection, development of the disorder could be improved, and by identifying population at risk, efforts could be concentrated on developing a true primary prevention (perinatal period and early childhood) that eventually could contribute to reduce the incidence of ADHD.
Fuermaier, Anselm B M; Tucha, Lara; Evans, Ben Lewis; Koerts, Janneke; de Waard, Dick; Brookhuis, Karel; Aschenbrenner, Steffen; Thome, Johannes; Lange, Klaus W; Tucha, Oliver
Adults with attention deficit hyperactivity disorder (ADHD) suffer from various impairments of cognitive, emotional and social functioning, which can have considerable consequences for many areas of daily living. One of those areas is driving a vehicle. Driving is an important activity of everyday life and requires an efficient interplay between multiple cognitive, perceptual, and motor skills. In the present study, a selective review of the literature on driving-related difficulties associated with ADHD is performed, seeking to answer whether individuals with ADHD show increased levels of unsafe driving behaviours, which cognitive (dys)functions of individuals with ADHD are related to driving difficulty, and whether pharmacological treatment significantly improves the driving behaviour of individuals with ADHD. The available research provides convincing evidence that individuals with ADHD have different and more adverse driving outcomes than individuals without the condition. However, it appears that not all individuals with ADHD are affected uniformly. Despite various cognitive functions being related with driving difficulties, these functions do not appear helpful in detecting high risk drivers with ADHD, nor in predicting driving outcomes in individuals with ADHD, since impairments in these functions are defining criteria for the diagnoses of ADHD (e.g., inattention and impulsivity). Pharmacological treatment of ADHD, in particular stimulant drug treatment, appears to be beneficial to the driving difficulties experienced by individuals with ADHD. However, additional research is needed, in particular further studies that address the numerous methodological weaknesses of many of the previous studies.
Voeller, Kytja K S
Approaches to the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) are undergoing a major change as a result of information from studies on the genetics of ADHD and the use of new neuroimaging technologies. Moreover, pharmacogenomics, although still in its infancy, will provide a basis for much more sophisticated treatment strategies for ADHD, particularly once more information is available about the genetics of ADHD. Even at this point in time, there is some pertinent information available that, although not ready for application in clinical settings, nonetheless provides a broader perspective for the clinician. In terms of etiology, ADHD is a neuropsychiatric disorder. There is a genetic basis in about 80% of the cases, involving a number of different genes, and in about 20% of the cases, ADHD is the result of an acquired insult to the brain. Some individuals likely have both genetic and acquired forms. Although medication works well in many cases of ADHD, optimal treatment of ADHD requires integrated medical and behavioral treatment. The family plays a crucial role in the management of children with ADHD. Because there is often a very high degree of comorbidity between ADHD and learning disabilities, teachers also have a great deal to contribute in the day-to-day management of these children. Early recognition and treatment prevent the development of more serious psychopathology in adolescence and adulthood.
Quiviger, S; Caci, H
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder described in international classifications and thought to affect about 5% of school-aged children and 3% of adults in the general population. In France, most clinicians are not formally trained in assessing and treating ADHD, leading to underdiagnosis of the disorder. ADHD impacts all the aspects of these children's daily life (school performance, family and social life) and later their adult life. We invited all the private-practice pediatricians in the east of the Provence-Alpes-Côte d'Azur region (southeast France) to participate in a survey: 57 out of 81 accepted. The results show that their knowledge on ADHD could be improved, and that their a priori conception of the etiology of the disorder (neurodevelopmental syndrome versus societal syndrome) guides their clinical approach. We recommend pediatricians be trained to improve screening, diagnosis, and ADHD treatment monitoring in children. This recommendation might also apply to general practitioners for children and parents/adults.
3-9% of schoolchildren in the U.K. suffer Attention Deficit and Hyperactivity Disorder (ADHD). Since the 1950s stimulants have been used. particularly methylphenidate and dextroamphetamine, with some 75% response rate. The first non-stimulant medication--atmoxetine hydrochloride, has also been used. However, side effects have included: growth retardation; appetite loss: headache: stomachache: heart problem: insomnia: seizure; change of character: addiction or even suicidal thoughts. Alternative treatments have been used including omega-3s, yet the way they benefit in ADHD is uncertain. They may be important in remodelling dendrites and synapses, and/or sustaining: blood brain barrier, neuronal membrane. neurotransmitter channel, receptors and ion channel. Stevens in 2003 found long-chain polyunsaturated fatty acids (LCPUFAs) effective for oppositional defiant disorder, whereas Eicosapentaenoic acid (EPA) specifically was helpful with disruptive behaviour. Docosahexaenoic acid (DHA) is important during gestation and early infancy, particularly for neurodevelopment. The Durham Trial by Richardson published in 2005, tested omega-3s with omega-6s on schoolchildren with developmental coordination disorder (many of them had ADHD symptoms), improving scores in co-ordination and short term memory.
The proposed revision of the diagnostic criteria in DSM-5 for attention-deficit/hyperactivity disorder (ADHD) will not fundamentally change the concept of ADHD. This is mainly due to the fact that, DSM-5 will retain the exact DSM-IV wording of all 18 symptoms, but will add new examples that make the criteria more appropriate for children, adolescents and adults. The age of onset will also be changed from 7 to 12 years, the subtyping of the disorder will change, and pervasive developmental disorders will no longer be an exclusion criterion. Although the main concept is unchanged, the suggested changes will most likely increase the prevalence of ADHD, especially in adults and adolescents, but maybe also in children. The added examples will also result in necessary revisions and new validations of rating scales and diagnostic interviews. This review will examine each of the proposed DSM-5 changes and the impact they may have, and in addition, the paper will make an overview of the main characteristics of some of the international and national guidelines for assessment and treatment of ADHD and how these impact the clinical practice.
Goulardins, Juliana B; Marques, Juliana C B; De Oliveira, Jorge A
Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder during childhood, affecting approximately 3-6% of school-aged children; its cardinal symptoms of high activity, impulsivity, and behavioral distractibility might be assumed to have close relationships to interferences with motor skills. A separate body of literature attests to ways that motor problems can severely impact children's daily lives, as motor problems may occur in 30-50% of children with ADHD. This article critically reviews research on motor impairment in children with ADHD, notable differences in motor performance of individuals with ADHD compared with age-matched controls, and possible neural underpinnings of this impairment. We discuss the highly prevalent link between ADHD and developmental coordination disorder (DCD) and the lack of a clear research consensus about motor difficulties in ADHD. Despite increasing evidence and diagnostic classifications that define DCD by motor impairment, the role of ADHD symptoms in DCD has not been delineated. Similarly, while ADHD may predispose children to motor problems, it is unclear whether any such motor difficulties observed in this population are inherent to ADHD or are mediated by comorbid DCD. Future research should address the exact nature and long-term consequences of motor impairment in children with ADHD and elucidate effective treatment strategies for these disorders together and apart.
Brown, Ronald T.
Eighty-eight children were identified as having attention deficit disorder with hyperactivity (ADD-H) and 58 with attention deficit disorder without hyperactivity (ADD). When the two subgroups were compared, teachers rated ADD-H children more problematic. Teacher ratings could discriminate ADD from ADD-H groups. Findings corroborated distinctions…
Smelter, Richard W.; And Others
The rush to label schoolchildren as suffering from attention deficit disorder (ADD) or attention deficit-hyperactivity disorder (ADHD) has reached nearly epidemic proportions. The diagnosis often meets parents' needs to assign behavior control to Ritalin; it should be an explanation leading to genuine help, not a license for unacceptable student…
Turnquist, K; Frances, R; Rosenfeld, W; Mobarak, A
Diagnosis of attention deficit disorder in a 35-year-old man and treatment with pemoline substantially improved his response to alcoholism treatment and aftercare. The authors conclude that treatment of attention deficit disorder may aid in rehabilitation of alcoholic patients.
Stoner, Gary; Carey, Sean P.
Responds to previous article (Hakola, this issue) on legal rights of students with Attention Deficit Disorder (ADD). Presents contrasting perspective on educational services for children diagnosed with Attention Deficit Hyperactivity Disorder, linked more closely to professional research and practice than to law. Concerns discussed are grounded in…
Montañés-Rada, F; Gangoso-Fermoso, A B; Martíínez-Granero, M A
Quantitative studies have highlighted differences in several drugs approved for use in Spain in the treatment of attention deficit hyperactivity disorder. No clear differences are observed, however, in the case of qualitative studies. The number of patients needed to be treated in order for one to reach complete remission (NNT) of methylphenidate (MTF) is from 2.2 to 5, and the effect size (ES) is 0.9. Atomoxetine has an NNT of 4 and an ES of 0.7. The advantages of immediate-release MTF (IR-MTF) over the extended-release version (ER-MTF) lie in its low cost, its flexibility and the better results obtained in quantitative studies. In contrast, ER-MTF offers a lower risk of abuse, needs to be taken fewer times with less need for third parties to control administration, and there is a lower risk of stigmatisation. Combination or changes of IR-MTF and ER-MTF and the combination of MTF with atomoxetine are sometimes necessary to adjust the weekday or weekend doses. Starting treatment with IR-MTF and then maintaining or changing to ER-MTF offers certain advantages as regards safety, dose adjustments and dosage. Atomoxetine is the best alternative if there is a background of adverse events with low or moderate doses of stimulants, or lack of response to high doses of stimulants. In cases of notable comorbid anxiety, both MTF and atomoxetine have the same level of indication. If there is a risk of substance abuse, both atomoxetine and ER-MTF are the preferred treatment. For the other indications, MTF is the preferred treatment.
Hennessey, Mary L.; Rumrill, Phillip D., Jr.; Roessler, Richard T.; Cook, Bryan G.
The purpose of this study was to (a) examine the employment and career development concerns of postsecondary students with learning disabilities and Attention Deficit Disorder (ADD) or Attention Deficit/Hyperactivity Disorder (AD/HD) and (b) develop strategies for improving their post-graduation employment outcomes. Employing an established…
Lou, H.C.; Henriksen, L.; Bruhn, P.; Borner, H.; Nielsen, J.B.
We have previously reported that periventricular structures are hypoperfused in attention deficit and hyperactivity disorder (ADHD). This study has expanded the number of patients, who were divided into two groups: six patients with pure ADHD, and 13 patients with ADHD in combination with other neurologic symptoms. By using xenon 133 inhalation and emission tomography, the regional cerebral blood flow distribution was determined and compared with a control group. Striatal regions were found to be hypoperfused and, by inference, hypofunctional in both groups. This hypoperfusion was statistically significant in the right striatum in ADHD, and in both striatal regions in ADHD with other neuropsychologic and neurologic symptoms. The primary sensory and sensorimotor cortical regions were highly perfused. Methylphenidate increased flow to striatal and posterior periventricular regions, and tended to decrease flow to primary sensory regions. Low striatal activity, partially reversible with methylphenidate, appears to be a cardinal feature in ADHD.
Huang-Pollock, Cynthia L.; Nigg, Joel T.; Carr, Thomas H.
Background: Whether selective attention is a primary deficit in childhood Attention Deficit Hyperactivity Disorder (ADHD) remains in active debate. Methods: We used the "perceptual load" paradigm to examine both early and late selective attention in children with the Primarily Inattentive (ADHD-I) and Combined subtypes (ADHD-C) of ADHD. Results:…
Ballard, Shirley; Bolan, Morna; Burton, Michael; Snyder, Sherry; Pasterczyk-Seabolt, Claire; Martin, Don
Reviews research on attention deficit hyperactivity disorder (ADHD) and examines the role of neurochemical stimulation and signs of neurological deficits. Describes the chemical action of drugs used to treat ADHD, along with cognitive, affective, and behavioral effects, and side effects. Elaborates on drug treatment and basic behavior modification…
Resta, S P; Eliot, J
32 boys, between the ages of 8 and 13 years, were identified on four teachers' and parents' rating scales (including the diagnostic criteria of the DSM-III for ADD) as showing attention deficits and hyperactivity (ADD + H; n = 10), attention deficits without hyperactivity (ADD-H; n = 11), or without ADD (attention deficits controls; n = 11). All subjects were administered Bender's Visual-motor Gestalt test and the Written Language Assessment. The ADD + H children produced significantly more errors on the Bender-Gestalt test, and both groups with attention deficits had lower (poorer) scores on most of the written language subtests. Results were interpreted as providing evidence that these children possessed significant limitations in their writing, copying, and composition.
Ruffino, Milena; Trussardi, Anna Noemi; Gori, Simone; Finzi, Alessandra; Giovagnoli, Sara; Menghini, Deny; Benassi, Mariagrazia; Molteni, Massimo; Bolzani, Roberto; Vicari, Stefano; Facoetti, Andrea
Reading acquisition requires, in addition to appropriate phonological abilities, accurate and rapid selection of sublexical orthographic units by attentional letter string parsing. Spatio-temporal distribution of attentional engagement onto 3-pseudoletter strings was studied in 28 dyslexic and 55 normally reading children by measuring attentional…
Glushchenko, V V
We have studied 128 adolescents, aged 15-16 years, with attention-deficit hyperactivity disorder (ADHD) using clinico-psychopathological, psychometric and electroencephalographic methods. Taking into account the age dynamics, the following components of ADHD have been singled out: motor (impulsivity-hyperactivity), subjective-cognitive (attention deficit) and somato-autonomic. The significance of subjective-cognitive disturbances, along with neurophysiological dysfunction, in the ADHD pathogenesis has been proved. Quantitative (productivity deficit) and qualitative (concentration deficit) disorders have been assessed. Author substantiated the deficit of emotional-motivational self-regulation measured by the M. Luscher test and the Self-assessment scale. The specific for ADHD pattern of alpha-rhythm reactivity has been found in EEG.
Krupskaia, E V; Machinskaia, R I
The information concerning specific features of different attention components (alertness, sustention and selectivity) in children with attention deficit hyperactivity disorder (ADHD) is analyzed and systematized. According to the data reviewed, behavioral and attention problems described as ADHD are not homogeneous. Literature analysis of attention characteristics in children with ADHD shows that different components can be disrupted if ADHD is diagnosed as inattentive or combined subtype, but the main deficit in this case is that of selective voluntary attention. In case of hyperactivity/impulsivity subtype of ADHD, attention is impaired mainly in its brain activation components.
Attention-deficit/hyperactivity disorder (AD/HD) negatively affects the cognitive and psychomotoric spheres of the pupil's social behavior and social adaptation. The review of many studies states that pupils with AD/HD achieve worse learning results because of insufficiently functioning cognitive processes, such as attention, (work) memory,…
Marchetta, Natalie D. J.; Hurks, Petra P. M.; De Sonneville, Leo M. J.; Krabbendam, Lydia; Jolles, Jelle
Objective: To examine the specificity of deficits in focused attention and sustained attention in adults with ADHD and to evaluate the effect of comorbidity. Method: Twenty-eight adults with ADHD without comorbidity were compared with 28 ADHD outpatients with comorbidity. Two control groups were used: 68 adults referred for ADHD but with another…
Buchholz, Judy; Davies, Anne Aimola
Alerting, orienting and executive control of attention are investigated in five adult cases of dyslexia. In comparison with a control group, alerting and executive control were found to be generally intact for each case. Two spatial cueing tasks were employed. For the task requiring target detection, orienting difficulties were evident only in…
Stasik, Dorota; Tucha, Oliver; Tucha, Lara; Walitza, Susanne; Lange, Klaus W
The present article is a review of studies concerning graphomotor functions (handwriting) in children with attention deficit hyperactivity disorder (ADHD) and the stimulant-induced (methylphenidate) alterations of both qualitative and quantitative aspects of handwriting. This review indicates an interaction between attentional functions and handwriting in ADHD children treated with methylphenidate. The comparison of writing movements of children on and off methylphenidate revealed that medication resulted in improved handwriting. However, kinematic analysis showed a deterioration in handwriting fluency on methylphenidate. A number of studies have demonstrated that children with ADHD display deficits regarding attentional functions. Treatment with methylphenidate has been shown to induce improvements of various attentional functions. Children with ADHD may use their increased attentional capacities to focus on skills (e.g. handwriting) that are independent of conscious control or may even be disturbed by attention.
Loe, Irene M.; Feldman, Heidi M.; Yasui, Enami; Luna, Beatriz
The evaluation of the cognitive control in children with attention-deficit hyperactivity disorder through the use of oculomotor tests reveal that this group showed susceptibility to peripheral distractors and deficits in response inhibition. All subjects were found to have intact sensorimotor function and working memory.
Mahone, E. Mark; Mostofsky, Stewart H.; Lasker, Adrian G.; Zee, David; Denckla, Martha B.
Girls, but not boys, with attention deficit hyperactivity disorder (ADHD) have significantly longer visually guided saccades latencies. It is found that sex differences in children with ADHD extend beyond symptom presentation to the development of oculomotor control.
Fernández-Mayoralas, Daniel Martín; Fernández-Perrone, Ana L; López-Arribas, Sonia; Pelaz-Antolín, Antonio; Fernández-Jaén, Alberto
Introduccion. Se entiende por adopcion o filiacion adoptiva el acto juridico mediante el cual se crea un vinculo de parentesco entre dos personas, de tal forma que se establece entre ellas una relacion de paternidad o maternidad. Objetivos. Tratar de exponer los problemas derivados de la exposicion prenatal al alcohol y otros factores de riesgo, de la hipoestimulacion durante el 'periodo critico' en pacientes institucionalizados (especialmente aquellos adoptados de paises del este de Europa) y su relacion con el trastorno de deficit de atencion/hiperactividad (TDAH). Realizar una aproximacion al diagnostico, prevencion y tratamiento de estos problemas. Desarrollo. Estos niños presentan problemas de relacion psicosocial, problemas conductuales, retraso del desarrollo del lenguaje o de la lectura y, sobre todo, TDAH. Existe una enorme dificultad practica a la hora de separar ambos factores durante la evaluacion de niños adoptados de paises del este de Europa en las consultas de neuropediatria. La interrelacion de todos estos factores no es bien conocida. Conclusiones. Existe una intima relacion entre la exposicion prenatal al alcohol y las consecuencias de la adopcion. Se necesitan estudios aleatorizados controlados con placebo, con mayores muestras poblacionales, que comprueben el beneficio y perfil de efectos secundarios, tanto con psicoestimulantes como con la atomoxetina en este grupo de pacientes.
Takeda, Toshinobu; Ando, Mizuho; Kumagai, Keiko
Yuzero Motora (1856-1912), regarded as the first professional Japanese psychologist, tried to address students' attention difficulties through attention training methods of his own design. His reports contain the first description of ADHD-like symptoms in the history of Japan. Motora viewed "distractibility" as the irregular transition of attention. Students with low scores and attention difficulties who participated in Motora's exercises showed improvement in arithmetic, psychological testing, and certain aspects of daily life. This article describes Motora's theoretical conception of attention and attention training methodology, the history of attention deficit and attention training, and the significance of Motora's experiments.
Pope, Alan T.; Bogart, Edward H.
Describes the Extended Attention Span Training (EAST) system for modifying attention deficits, which takes the concept of biofeedback one step further by making a video game more difficult as the player's brain waves indicate that attention is waning. Notes contributions of this technology to neuropsychology and neurology, where the emphasis is on…
Poynter, William; Ingram, Paul; Minor, Scott
The purpose of this study was to determine whether an index of self-reported attention deficits predicts the pattern of visual field asymmetries observed in behavioral measures of attention. Studies of "normal" subjects do not present a consistent pattern of asymmetry in attention functions, with some studies showing better left visual field (LVF)…
Da Fonseca, D; Adida, M; Belzeaux, R; Azorin, J-M
The attention deficit disorder and the bipolar disorder maintain a complex relation. Indeed, these two syndromes share numerous symptoms that engender numerous diagnostic difficulties. According to several studies, it seems that these two disorders are really different with significant differences at the functional and anatomical level. However, there are common cognitive deficits as well as relatively frequent co-morbidity which is necessary to know in order to adjust the treatment.
Ouchi, Hirofumi; Ono, Kazuya; Murakami, Yukihisa; Matsumoto, Kinzo
Social isolation of rodents (SI) elicits a variety of stress responses such as increased aggressiveness, hyper-locomotion, and reduced susceptibility to pentobarbital. To obtain a better understanding of the relevance of SI-induced behavioral abnormalities to psychiatric disorders, we examined the effect of SI on latent learning as an index of spatial attention, and discussed the availability of SI as an epigenetic model of attention deficit hyperactivity disorder (ADHD). Except in specially stated cases, 4-week-old male mice were housed in a group or socially isolated for 3-70 days before experiments. The animals socially isolated for 1 week or more exhibited spatial attention deficit in the water-finding test. Re-socialized rearing for 5 weeks after 1-week SI failed to attenuate the spatial attention deficit. The effect of SI on spatial attention showed no gender difference or correlation with increased aggressive behavior. Moreover, SI had no effect on cognitive performance elucidated in a modified Y-maze or an object recognition test, but it significantly impaired contextual and conditional fear memory elucidated in the fear-conditioning test. Drugs used for ADHD therapy, methylphenidate (1-10 mg/kg, i.p.) and caffeine (0.5-1 mg/kg, i.p.), improved SI-induced latent learning deficit in a manner reversible with cholinergic but not dopaminergic antagonists. Considering the behavioral features of SI mice together with their susceptibility to ADHD drugs, the present findings suggest that SI provides an epigenetic animal model of ADHD and that central cholinergic systems play a role in the effect of methylphenidate on SI-induced spatial attention deficit.
Abad-Mas, Luis; Ruiz-Andrés, Rosalía; Moreno-Madrid, Francisca; Herrero, Raquel; Suay, Enrique
Introduccion. Los niños con trastorno por deficit de atencion/hiperactividad (TDAH) presentan alteraciones en los mecanismos atencionales y en los procesos de control inhibitorio (impulsividad e hiperactividad), que afectan de distinta manera a su rendimiento academico, socioemocional y conductual, por lo que es fundamental la consideracion de estrategias de intervencion en el ambito psicopedagogico que puedan incidir de forma favorable en el curso evolutivo de los afectados. Objetivo. Revisar las bases psicopedagogicas en la intervencion sobre el TDAH, considerando la relacion de la anatomia funcional con la sintomatologia clinica y los correspondientes programas de intervencion. Desarrollo. Se destacan los tres sindromes preferentes: orbitofrontal, dorsolateral y en el cingulo a nivel medial. Las fases de la intervencion psicopedagogica deben abarcar tanto al niño como a la familia y el colegio. El entrenamiento neurocognitivo se centra en el niño, basado en programas de entrenamiento de las funciones ejecutivas y en las actuaciones sobre el ambito academico, conductual y socioafectivo. Los programas de modificacion de conducta son complementarios y en muchas ocasiones mejoran el comportamiento comprometido en los niños con TDAH. Las orientaciones psicopedagogicas en la escuela deben considerarse necesarias para una intervencion eficaz en el entorno academico. Conclusiones. La intervencion psicopedagogica de los niños con TDAH debe contemplar la individualizacion del tratamiento dentro de una metodologia multidisciplinar, teniendo en cuenta todos los contextos en los que se desarrolla el niño, su rendimiento cognitivo y las intervenciones farmacologicas apropiadas en cada caso.
McGrath, Lauren M.; Pennington, Bruce F.; Shanahan, Michelle A.; Santerre-Lemmon, Laura E.; Barnard, Holly D.; Willcutt, Erik G.; DeFries, John C.; Olson, Richard K.
Background: This study tests a multiple cognitive deficit model of reading disability (RD), attention-deficit/hyperactivity disorder (ADHD), and their comorbidity. Methods: A structural equation model (SEM) of multiple cognitive risk factors and symptom outcome variables was constructed. The model included phonological awareness as a unique…
Mattfeld, Aaron T; Gabrieli, John D E; Biederman, Joseph; Spencer, Thomas; Brown, Ariel; Kotte, Amelia; Kagan, Elana; Whitfield-Gabrieli, Susan
Previous resting state studies examining the brain basis of attention deficit hyperactivity disorder have not distinguished between patients who persist versus those who remit from the diagnosis as adults. To characterize the neurobiological differences and similarities of persistence and remittance, we performed resting state functional magnetic resonance imaging in individuals who had been longitudinally and uniformly characterized as having or not having attention deficit hyperactivity disorder in childhood and again in adulthood (16 years after baseline assessment). Intrinsic functional brain organization was measured in patients who had a persistent diagnosis in childhood and adulthood (n = 13), in patients who met diagnosis in childhood but not in adulthood (n = 22), and in control participants who never had attention deficit hyperactivity disorder (n = 17). A positive functional correlation between posterior cingulate and medial prefrontal cortices, major components of the default-mode network, was reduced only in patients whose diagnosis persisted into adulthood. A negative functional correlation between medial and dorsolateral prefrontal cortices was reduced in both persistent and remitted patients. The neurobiological dissociation between the persistence and remittance of attention deficit hyperactivity disorder may provide a framework for the relation between the clinical diagnosis, which indicates the need for treatment, and additional deficits that are common, such as executive dysfunctions.
Objective To evaluate the use of a therapeutic regimen to treat attention deficit hyperactivity disorder patients. Methods A total of 140 patients initially underwent physical, neurological and laboratory evaluation. Thereafter, treatment was initiated with a compounding product consisting of a tricyclic antidepressant and an anxiolytic. Results The response was positive in 71.43% of patients in controlling hyperactivity and improving dispersion and attention deficit. Conclusion The therapeutic regimen utilized proved to be an effective therapeutic alternative, especially for patients who do not adapt to psychostimulant drugs. PMID:25295451
Migdalska, Anna; Nawara, Magdalena; Bal, Jerzy; Mazurczak, Tadeusz
Attention deficit hyperactivity disorder (ADHD) is a common neurobehavioral disorder of childhood, affecting approximately 5-10% of children. ADHD is considered to be a multifactorial disorder because both genetic and environmental components may contribute to its progress. The etiology of attention deficit hyperactivity disorder (ADHD) is unknown, however family, twin and adoption studies have suggested that genetic factors are very important in its etiopathogenesis. The research of genetic basis of ADHD consists of linkage analysis, candidate gene approach and association studies. These analyses and also investigations on animal models of disease suggest that mutations in genes involved in dopaminergic, serotonergic and adrenergic systems are likely to be responsible for ADHD.
O'Brien, L M; Gozal, D
Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychological disorders in children. Sleep disturbances are also very prevalent among the pediatric age range and can lead to substantial behavioral and cognitive consequences that may mimic ADHD. Conversely, children with ADHD may suffer from significant sleep disturbances that may originate in the biochemical disturbances that underlie their deficits in executive function and attention. This review addresses both these issues and provides a concise yet timely assessment of the potential links between sleep disorders and ADHD.
Xu, Guang-Qing; Lan, Yue; Huang, Dong-Feng; Rao, De-Zhong; Pei, Zhong; Chen, Ling; Zeng, Jin-Sheng
The disability of visuospatial attention can lead to poor volitional movement and functional recovery in patients with brain lesions. However, the accurate clinical method to assess visuospatial attention is limited. The frontoparietal network including the posterior parietal cortex and the frontal eye fields has been shown to involve in visuospatial attention. The Attention Network Test provided measures for three different components of visuospatial attention: alerting, orienting and executive control. This study was to probe the deficit and relationship of visuospatial attention using Attention Network Test paradigm in patients with frontoparietal network lesions. During this task, patients responded significantly slower on each cue condition and target type than controls, and showed deficits in the alerting and orienting networks. The efficiency of resolving conflict was decreased in patients with frontal lesions whereas this was increased in patients with parietal lesions. These findings suggest that the frontoparietal network is involved in the alerting and orienting attentional function and the executive function is possibly selectively associated with the frontal lobe. The Attention Network Test paradigm produces sensitive, valid and reliable subject estimates of visuospatial attention function in patients with brain lesions, and may be useful for clinical rehabilitation strategy selection for patients with the frontoparietal network lesions.
Nelson, Jason M.; Lindstrom, Will; Foels, Patricia A.
Test anxiety was examined in college students with and without attention deficit hyperactivity disorder (ADHD). Results indicated that, relative to college students without ADHD, college students with ADHD reported higher total test anxiety as well as specific aspects of test anxiety, including worry (i.e., cognitive aspects of test anxiety) and…
Foley, Marie; McClowry, Sandra Graham; Castellanos, Francisco X.
This study examined empirical and theoretical differences and similarities between attention deficit hyperactivity disorder (ADHD) and child temperament in 32 ADHD children aged 6-11 years, and a comparison group of 23 children with similar sociodemographic characteristics. Children were assessed for ADHD symptoms (hyperactivity, impulsivity, and…
Hill, P; Taylor, E
We present an auditable protocol for attention deficit/hyperactivity disorder (ADHD) or hyperkinetic disorder. The protocol is derived from standard recommendations and evidence, and is intended for outpatient medical clinic practice in secondary care. Suggested side effect rating scales are included. PMID:11316683
Wolfle, Jane A.; French, Michael P.
This paper examines characteristics of a typical 6-year-old and characteristics of attention deficit hyperactivity disorder (ADHD), including distractibility, impulsiveness, inattention, and hyperactivity. The occurrence of ADHD in gifted students is discussed. Possible causes of ADHD are noted. The 5 "M" program of treatment is…
Fouse, Beth; Brians, Suzanne
This pamphlet explains briefly what is known about attention deficit disorders (ADD), to help parents and educators have a more positive influence on the ADD child's life. It begins with definitions of terminology; characteristics of preschool, school-age, and adult individuals with ADD; and causes of ADD. It discusses special problems associated…
Redmond, Sean M.
Purpose: Attention-deficit/hyperactivity disorder (ADHD) is a ubiquitous designation that affects the identification, assessment, treatment, and study of pediatric language impairments (LIs). Method: Current literature is reviewed in 4 areas: (a) the capacity of psycholinguistic, neuropsychological, and socioemotional behavioral indices to…
Wiener, Judith; Daniels, Lesley
This article reports on a qualitative study of the school experiences of adolescents with attention-deficit/hyperactivity disorder (ADHD) in the context of quantitative research on teacher attitudes and practices, adolescent self-appraisals, and social and family relationships. Twelve adolescents with ADHD participated in in-depth, semistructured…
Schultz, Brandon K.; Storer, Jennifer; Watabe, Yuko; Sadler, Joanna; Evans, Steven W.
The authors review the research literature regarding school-based treatment of attention-deficit/hyperactivity disorder (ADHD). Students with ADHD often do not receive access to special services, even though the impairments associated with the disorder often compromise learning and cause concerns for classroom teachers, school administrators, and…
Margari, Francesco; Craig, Francesco; Petruzzelli, Maria Giuseppina; Lamanna, Annalinda; Matera, Emilia; Margari, Lucia
Attention Deficit Hyperactivity Disorder (ADHD) is a disorder with extremely complex etiology, not yet well defined but certainly multi-factorial. This study investigated the possible etiopathogenetic role of ADHD symptoms and psychopathology disorders in parents of children with ADHD. We present a case-control study of parents of 50 children…
Gold, Svea J.
The increase in the diagnosis of attention deficit disorder (ADD) and the characteristics and treatment of ADD using sensory motor exercises are discussed. Reasons for the disability are explored, including neurological differences and difficulties in interpreting sensory input. Problems with focusing and hearing as well as hypersensitivity to…
Schaughency, Elizabeth A.; Rothlind, Johannes
Issues concerning evaluation, assessment, and classification of Attention-Deficit Hyperactive Disorders (ADHD) are discussed. The diagnosis of ADHD should be a best-estimate diagnosis, based on a behavioral assessment strategy with multimethod assessment. The selection and use of assessment techniques are discussed. (SLD)
Musser, Erica D.; Galloway-Long, Hilary S.; Frick, Paul J.; Nigg, Joel T.
Objective: How best to capture heterogeneity in attention-deficit/hyperactivity disorder (ADHD) using biomarkers has been elusive. This study evaluated whether emotion reactivity and regulation provide a means to achieve this. Method: Participants were classified into three groups: children with ADHD plus low prosocial behavior (hypothesized to be…
Bosse, Marie-Line; Tainturier, Marie Josephe; Valdois, Sylviane
The visual attention (VA) span is defined as the amount of distinct visual elements which can be processed in parallel in a multi-element array. Both recent empirical data and theoretical accounts suggest that a VA span deficit might contribute to developmental dyslexia, independently of a phonological disorder. In this study, this hypothesis was…
Wootton, Carol Anne; Roets, H. E.
This study was undertaken to analyse and evaluate the nature and quality of emotional intelligence in learners with Attention Deficit Disorder (ADD), and to investigate whether their emotional intelligence was enhanced, and whether the symptoms and behaviour of these learners improved, after exposure to a programme on emotional intelligence.…
Knipp, Diana K.
This qualitative study describes teens' perceptions about attention deficit/hyperactivity disorder (AD/HD) and medications. The four modes of adaptation of the Roy Adaptation Model were the framework for this study. Data were collected through semistructured interviews with 15 high school teens aged 14-17 with parent-reported AD/HD. An inductive…
Leipold, Elizabeth E.; Bundy, Anita C.
Scores on the Test of Playfulness for 25 children with Attention Deficit Hyperactivity Disorder (ADHD) were significantly lower than those of 25 children without, especially on internal control, intrinsic motivation, and framing. Three items (mischief, teasing/joking, clowning) yielded unexpectedly higher scores for ADHD children. (SK)
Sterman, M. Barry
Examined contribution of EEG findings in the classification and treatment of attention deficit and related behavioral problems in children. Found that quantitative EEG methods disclosed patterns of abnormality in children with ADD, suggested improved guidelines for pharmacological treatment, and introduced neurofeedback, a behavioral treatment for…
Barkat, Esther U.; Lee, Jeanette W.
This report discusses the outcomes of a study that used qualitative data to examine the concept of attention deficit disorders from an international perspective. Surveys were conducted in two different parts of the world (West Virginia and Pakistan) among elementary school teachers. Seventy-two Pakistani school teachers and 149 American school…
Wiener, Judith; Mak, Meghan
This study explored peer victimization in 9- to 14-year-old children with and without Attention-Deficit/Hyperactivity Disorder (ADHD). The sample comprised 104 children, 52 of whom had a previous ADHD diagnosis. Children with ADHD had higher overall rates of self-reported victimization by peers and parent- and teacher-reported bullying behavior…
The efficacy of medications used to treat children with attention deficit disorders is reviewed, along with the importance of monitoring the medications' side effects. Medications reviewed include psychostimulants, tricyclic antidepressants, clonidine, and thyroid hormone. Factors to consider before recommendation of medication are listed.…
Ponde, Milena Pereira; Cruz-Freire, Antonio Carlos; Silveira, Andre Almeida
Objective: To assess the impact of attention deficit on learning problems in a sample of schoolchildren in the city of Salvador, Bahia, Brazil. Method: All students enrolled in selected elementary schools were included in this study, making a total of 774 children. Each child was assessed by his or her teacher using a standardized scale. "The…
Field, Tiffany M.; Quintino, Olga; Hernandez-Reif, Maria; Koslovsky, Gabrielle
Twenty-eight adolescents with attention-deficit hyperactivity disorder were provided either massage therapy or relaxation therapy for 10 consecutive school days. The massage therapy group, but not the relaxation therapy group, self-rated as happier, and observers rated them as fidgeting less following the sessions. Teachers reported more time on…
Attention Deficit Disorder (ADD) is a neurological disorder which effects learning and that has a confusing set of diagnostic symptoms and an even more confusing set of remedies ranging from medication to meditation to nothing at all. Current neurological research suggests, however, that there are strategies that the individual with ADD can use to…
This guide to attention deficit hyperactivity disorder (ADHD) is organized in three parts which address understanding the problem, getting help, and sustaining hope. A question-and-answer format addresses the following topics: symptoms of ADHD; other conditions which may produce similar symptoms; other disorders which may accompany ADHD; causes of…
Dillon, Ronna F.; Osborne, Susan S.
In this article we describe the nature of attention deficit disorders (ADDs) within an individual differences model of abilities. In so doing, a model-based explanation for the sources of learning and performance difficulties among individuals identified with ADDs is provided. Earlier models of ADDs are discussed, and the proposed loci of ADDs…
Parker, Harvey C.
This fact sheet summarizes basic information on Attention Deficit Disorders (ADD), including prevalence and characteristics, causes, identification, treatment, outcomes, and suggestions. Children with ADD comprise approximately 3-5 percent of the school age population, with boys significantly outnumbering girls. Of 14 characteristics of ADD, the…
Dalby, J. Thomas
The behavior ratings and psychometric profiles of children with attention deficit disorders (ADD) and children with developmental reading disorders (DRD) were compared. DRD children were more impaired in academic attainment and showed evidence of qualitative disturbances in reading and spelling. ADD children showed no qualitative reading or…
Sawyer, Walter E.
Examines the trend of using Attention Deficit Disorder (ADD), commonly known as hyperactivity, to classify students as learning disabled (LD). Notes that ADD characteristics are frequently observed in children with reading problems, and argues that misclassifying students as LD denies them appropriate reading instruction. (MM)
Shaywitz, Sally E.; And Others
This discussion of issues of definition and classification of attention deficit disorder (ADD) emphasizes the heterogeneity of the diagnosis, the overlap of ADD with reading disability, and lack of consistency across studies. A systematic classification study is proposed to develop a unitary, empirically derived classification for ADD. (Author/DB)
Erk, Robert R.
Counseling that involves the entire family has the potential to motivate children with Attention Deficit Disorder (ADD), improve the children's self-concept, and help them improve social skills or functioning. Probable causes, family patterns, effects of ADD on family interactions, counseling issues, and a multidimensional treatment approach are…
Hakola, Stewart R.
Notes that federal agencies that enforce special education laws found that children with Attention Deficit Disorder (ADD) are eligible for special education services and are protected by procedural safeguards established by law. Contends that many school districts do not have procedures to identify children with ADD and to ensure appropriate…
McKinney, James D.; And Others
This article describes instruments and methods to assess the primary characteristics that define attention deficit disorder (ADD) for the purpose of identification. Issues in ADD assessment include identifying co-occurring disabilities, defining the severity of ADD, and determining the pervasiveness and situational nature of the behavioral…
Fewell, Rebecca R.
A major aim of this study was to determine if Attention Deficit Hyperactivity Disorder (ADHD) type behaviors observed at the age of 30 months in low birth weight children are predictive of ADHD and school difficulties at 5 and 8 years of age. Three major questions were addressed: (1) Do children who exhibit ADHD characteristics at 30 months differ…
This article focuses on two facets of treatment for students with attention deficit hyperactivity disorder: educational accommodations and interventions for promoting appropriate behavior. It provides information on environmental adaptations, guidelines for effective class rules, implementing response cost, levels of time out, implementing a token…
Caballero, Miguel; Núñez, Fabiana; Ahern, Siobhán; Cuffí, Maria L; Carbonell, Lourdes; Sánchez, Silvia; Fernández-Dueñas, Víctor; Ciruela, Francisco
Nowadays the pharmacological treatment of the attention deficit hyperactivity disorder (ADHD) is based on amphetamine derivatives (i.e. methylphenidate). However, these drugs induce a large array of adverse side effects, thus less aggressive psychostimulant drugs (i.e. caffeine) are being proposed in the management of ADHD. Following this tendency, we decided to study the possible therapeutic use of caffeine in an animal model of ADHD, namely the neonatal 6-hydroxy-dopamine (6-OHDA)-lesioned rat. Therefore, at postnatal day 7 rats were lesioned at the left striatum with 6-OHDA or with saline. Thereafter, at postnatal day 25 their activity and attention were measured with the Olton maze before caffeine was administered ad libitum in the drinking water. Next, after 14 days of caffeine treatment, we repeated these measurements to assess the effect of caffeine on motor activity and attention deficit. Interestingly, while no changes in the motor activity measurements were observed before and after caffeine administration, a significant improvement in the attention deficit of the 6-OHDA lesioned rats was achieved after caffeine treatment. Thus, our results led us to hypothesize that caffeine might be useful to manage the attention deficit during the prepubertal period of ADHD.
Cardiovascular considerations of attention deficit hyperactivity disorder medications: a report of the European Network on Hyperactivity Disorders work group, European Attention Deficit Hyperactivity Disorder Guidelines Group on attention deficit hyperactivity disorder drug safety meeting.
Hamilton, Robert M; Rosenthal, Eric; Hulpke-Wette, Martin; Graham, John G I; Sergeant, Joseph
Regulatory decisions regarding attention deficit hyperactivity disorder drug licensing and labelling, along with recent statements from professional associations, raise questions of practice regarding the evaluation and treatment of patients with attention deficit hyperactivity disorder. To address these issues for the European community, the European Network for Hyperkinetic Disorders, through its European Attention Deficit Hyperactivity Disorder Guidelines Group, organised a meeting between attention deficit hyperactivity disorder specialists, paediatric cardiovascular specialists, and representatives of the major market authorisation holders for attention deficit hyperactivity disorder medications. This manuscript represents their consensus on cardiovascular aspects of attention deficit hyperactivity disorder medications. Although sudden death has been identified in multiple young individuals on attention deficit hyperactivity disorder medication causing regulatory concern, when analysed for exposure using currently available data, sudden death does not appear to exceed that of the general population. There is no current evidence to suggest an incremental benefit to electrocardiography assessment of the general attention deficit hyperactivity disorder patient. Congenital heart disease patients have an increased prevalence of attention deficit hyperactivity disorder, and can benefit from attention deficit hyperactivity disorder therapies, including medication. The attention deficit hyperactivity disorder specialist is the appropriate individual to evaluate benefit and risk and recommend therapy in all patients, although discussion with a heart specialist is reasonable for congenital heart disease patients. For attention deficit hyperactivity disorder patients with suspected heart disease or risk factor/s for sudden death, assessment by a heart specialist is recommended, as would also be the case for a non-attention deficit hyperactivity disorder patient. The
Baghdadi, G.; Jafari, S.; Sprott, J. C.; Towhidkhah, F.; Hashemi Golpayegani, M. R.
The problem of keeping an attention level is one of the common symptoms of attention deficit disorder. Dopamine deficiency is introduced as one of the causes of this disorder. Based on some physiological facts about the attention control mechanism and chaos intermittency, a behavioral model is presented in this paper. This model represents the problem of undesired alternation of attention level, and can also suggest different valuable predictions about a possible cause of attention deficit disorder. The proposed model reveals that there is a possible interaction between different neurotransmitters which help the individual to adaptively inhibit the attention switching over time. The result of this study can be used to examine and develop a new practical and more appropriate treatment for the problem of sustaining attention.
Krause, Margaret B
The aim of this review is to provide a background on the neurocognitive aspects of the reading process and review neuroscientific studies of individuals with developmental dyslexia, which provide evidence for amodal processing deficits. Hari, Renvall, and Tanskanen (2001) propose amodal sluggish attentional shifting (SAS) as a causal factor for temporal processing deficits in dyslexia. Undergirding this theory is the notion that when dyslexics are faced with rapid sequences of stimuli, their automatic attentional systems fail to disengage efficiently, which leads to difficulty when moving from one item to the next (Lallier et al., ). This results in atypical perception of rapid stimulus sequences. Until recently, the SAS theory, particularly the examination of amodal attentional deficits, was studied solely through the use of behavioural measures (Facoetti et al., ; Facoetti, Lorusso, Cattaneo, Galli, & Molteni, ). This paper examines evidence within the literature that provides a basis for further exploration of amodal SAS as an underlying deficit in developmental dyslexia.
Wasserman, Theodore; Wasserman, Lori Drucker
We propose that attention-deficit disorder represents an inefficiency of an integrated system designed to allocate working memory to designated tasks rather than the absence or dysfunction of a particular form of attention. A significant portion of this inefficiency in the allocation of working memory represents poor engagement of the reward circuit with distinct circuits of learning and performance that control instrumental conditioning (learning). Efficient attention requires the interaction of these circuits. For a significant percentage of individuals who present with attention-deficit disorder, their problems represent the engagement, or lack thereof, of the motivational and reward circuit as opposed to problems, or disorders of attention traditionally defined as problems with orienting, focusing, and sustaining. We demonstrate that there is an integrated system of working-memory allocation that responds by recruiting relevant aspects of both cortex and subcortex to the demands of the task being encountered. In this model, attention is viewed as a gating function determined by novelty, flight-or-fight response, and reward history/valence affecting motivation. We view the traditional models of attention, rather than describe specific types of attention per se, as representing the description of the behavioral output of this integrated orienting and engagement system designed to allocate working memory to task-specific stimuli.
Parker, Matthew O.; Gaviria, Jessica; Haigh, Alastair; Millington, Mollie E.; Brown, Verity J.; Combe, Fraser J.; Brennan, Caroline H.
The potential of zebrafish as a comparative model in behavioural neuroscience is currently hampered only by the lack of reliable and validated behavioural assays available to researchers. In the present experiment, we describe the performance of zebrafish in a test of attentional set formation. The fish were initially trained on a two-choice colour discrimination. Upon reaching acquisition criterion, the reinforced alternative was switched to the previously unreinforced alternative. Again, upon reaching criterion, the cues were replaced with a novel pair of colours (intra-dimensional shift) and reversed again on reaching criteria. We found that zebrafish show a steady decrease in trials-to-criteria over the four phases of the experiment, suggesting that they are forming and maintaining an attentional set, as has previously been demonstrated with mammals. Reversal learning deficits have been implicated in a variety of human psychological disorders (e.g., disorders of impulse control) and as such, we propose that performance of zebrafish in this procedure may represent a useful comparative model to complement existing rodent models. PMID:22561034
Konrad, Kerstin; Gunther, Thomas; Hanisch, Charlotte; Herpertz-Dahlmann, Beate
Objective: To examine the effects of methylphenidate on different attentional functions and behavior in children with attention-deficit-hyperactivity disorder (ADHD). Method: A total of 60 ADHD children aged between 8 and 12 years completed a randomized, double-blind, placebo-controlled, within-subject crossover trial with two doses of…
Zalsman, Gil; Pumeranz, Orat; Peretz, Gabriel; Ben-Dor, David H; Dekel, Sharon; Horesh, Neta; Fischel, Tsvi; Nahshoni, Eitan; Goldberg, Pablo H; Sever, Jonathan; Apter, Alan
The objective of this study was to differentiate the attention patterns associated with attention deficit disorder with or without hyperactivity using continuous performance test (CPT). The diagnoses were based on the DSM-III, III-R, and IV criteria and of the 39 children who participated in the study, 14 had attention deficit disorder with hyperactivity (ADDH) and 11 had attention deficit disorder without hyperactivity (ADDWO), while 14 normal children served as a control group. Attention patterns were examined according to the performance of subjects on the CPT and parental scores on the ADHD Rating Scale, the Child Attention Profile, and the Conners Rating Scale. CPT performances were assessed before and after administration of 10 mg methylphenidate. We found as hypothesized that the CPT differentiated between the ADDH and ADDWO groups. However, contrary to our expectations, the ADDH children made more omission errors than the ADDWO children; they also showed more hyperactivity and impulsivity. The performance of both groups improved to an equal degree after the administration of methylphenidate. It is concluded that different subtypes of the attention deficit disorders are characterized by different attention profiles and that methylphenidate improves scores on test of continuous performance.
Nigel Mellor recently retired from his work with the educational psychology service in North Tyneside. In this article, he proposes that attention-seeking behaviour may lead to major difficulties at home and school and indicates the ways in which recent research is beginning to clarify the area. Attention deficit disorders also cause great…
Max, Jeffrey E.; Manes, Facundo F.; Robertson, Brigitte A.M.; Mathews, Katherine; Fox, Peter T.; Lancaster, Jack
Objective: To investigate the association between focal stroke lesions of Posner's executive attention network and a specific region of interest in the frontal lobes (orbital frontal and mesial frontal) and either attention-deficit/hyperactivity disorder (ADHD) or traits of the disorder (ADHD symptomatology). Method: Twenty-nine children with…
Craig, Francesco; Margari, Francesco; Legrottaglie, Anna R; Palumbi, Roberto; de Giambattista, Concetta; Margari, Lucia
Executive dysfunction has been shown to be a promising endophenotype in neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This article reviewed 26 studies that examined executive function comparing ASD and/or ADHD children. In light of findings from this review, the ASD + ADHD group appears to share impairment in both flexibility and planning with the ASD group, while it shares the response inhibition deficit with the ADHD group. Conversely, deficit in attention, working memory, preparatory processes, fluency, and concept formation does not appear to be distinctive in discriminating from ASD, ADHD, or ASD + ADHD group. On the basis of neurocognitive endophenotype, the common co-occurrence of executive function deficits seems to reflect an additive comorbidity, rather than a separate condition with distinct impairments. PMID:27274255
Kashala, Espérance; Elgen, Irene; Sommerfelt, Kristian; Tylleskär, Thorkild; Lundervold, Astri
The aims of the study were: (1) to describe the performance of African children with symptoms of attention-deficit hyperactivity disorder on selected neuropsychologic tests and compare it with performance among peers of the same age without symptoms; (2) to explore through a factor analysis if the selected tests cover the same functions as known from studies in Europe and North America. A nested case-control approach was used to select the two groups of children. The tests were selected to measure aspects of executive functions, attention and memory functions as well as motor skills. A total of 185 schoolchildren (28 cases and 157 control subjects) aged 85 to 119 months old were included. The findings indicate only minor difference between children with symptoms of attention-deficit hyperactivity disorder and control subjects in most of the tasks. However, children with symptoms of attention-deficit hyperactivity disorder performed more poorly on tests of motor skills and had more violations of rules on the planning task. The factor analysis indicated a three-factor model, confirming that the selected tests could be used as measures of executive/motor functions, attention, and memory functions. Similar findings have been reported among children in Europe and North America.
Richardson, Jason R.; Taylor, Michele M.; Shalat, Stuart L.; Guillot, Thomas S.; Caudle, W. Michael; Hossain, Muhammad M.; Mathews, Tiffany A.; Jones, Sara R.; Cory-Slechta, Deborah A.; Miller, Gary W.
Attention-deficit hyperactivity disorder (ADHD) is estimated to affect 8–12% of school-age children worldwide. ADHD is a complex disorder with significant genetic contributions. However, no single gene has been linked to a significant percentage of cases, suggesting that environmental factors may contribute to ADHD. Here, we used behavioral, molecular, and neurochemical techniques to characterize the effects of developmental exposure to the pyrethroid pesticide deltamethrin. We also used epidemiologic methods to determine whether there is an association between pyrethroid exposure and diagnosis of ADHD. Mice exposed to the pyrethroid pesticide deltamethrin during development exhibit several features reminiscent of ADHD, including elevated dopamine transporter (DAT) levels, hyperactivity, working memory and attention deficits, and impulsive-like behavior. Increased DAT and D1 dopamine receptor levels appear to be responsible for the behavioral deficits. Epidemiologic data reveal that children aged 6–15 with detectable levels of pyrethroid metabolites in their urine were more than twice as likely to be diagnosed with ADHD. Our epidemiologic finding, combined with the recapitulation of ADHD behavior in pesticide-treated mice, provides a mechanistic basis to suggest that developmental pyrethroid exposure is a risk factor for ADHD.—Richardson, J. R., Taylor, M. M., Shalat, S. L., Guillot III, T. S., Caudle, W. M., Hossain, M. M., Mathews, T. A., Jones, S. R., Cory-Slechta, D. A., Miller, G. W. Developmental pesticide exposure reproduces features of attention deficit hyperactivity disorder. PMID:25630971
Merkt, Julia; Reinelt, Tilman; Petermann, Franz
The term compensation is widely used in the context of attention deficit hyperactivity disorder (ADHD), yet, it is neither defined nor theory driven. Adapting a model of psychological compensation (Bäckman and Dixon, 1992) to fit ADHD research is the aim of this review: we will (1) introduce the existing theoretical framework of psychological compensation, (2) discuss its applicability to ADHD and adapt the model to fit ADHD research, and (3) set up requirements for research on psychological compensation in ADHD. According to the framework psychological compensation can be inferred if a deficit (i.e., a mismatch between skill and environmental demand) is counterbalanced by the investment of more effort, the utilization of latent skills, or the acquisition of new skills. The framework has to be adapted because ADHD deficits are developmental and in individuals with ADHD compensation can appear independent of awareness of the deficit. A better understanding of psychological compensation in ADHD could foster diagnosis and interventions. Therefore, we suggest that future studies should follow a research design incorporating independent measures of deficit, compensation, and outcome as well as include individuals who compensate for their ADHD related deficits.
Merkt, Julia; Reinelt, Tilman; Petermann, Franz
The term compensation is widely used in the context of attention deficit hyperactivity disorder (ADHD), yet, it is neither defined nor theory driven. Adapting a model of psychological compensation (Bäckman and Dixon, 1992) to fit ADHD research is the aim of this review: we will (1) introduce the existing theoretical framework of psychological compensation, (2) discuss its applicability to ADHD and adapt the model to fit ADHD research, and (3) set up requirements for research on psychological compensation in ADHD. According to the framework psychological compensation can be inferred if a deficit (i.e., a mismatch between skill and environmental demand) is counterbalanced by the investment of more effort, the utilization of latent skills, or the acquisition of new skills. The framework has to be adapted because ADHD deficits are developmental and in individuals with ADHD compensation can appear independent of awareness of the deficit. A better understanding of psychological compensation in ADHD could foster diagnosis and interventions. Therefore, we suggest that future studies should follow a research design incorporating independent measures of deficit, compensation, and outcome as well as include individuals who compensate for their ADHD related deficits. PMID:26578998
Attention deficit disorder (AAD) and attention deficit/hyperactivity disorder (ADHD) are very frequent and protean developmental disorders without a definite biologic marker. This review proposes a framework to understand the enlarged spectrum of its manifestations based on current knowledge of the mechanisms underlying arousal and attention variations during sleep/wake cycle. The neuro-modulation's pivotal role in this process as well as in the fine tuning of synaptic architecture during development must be taken into account when trying to understand the marked fuzziness of the symptoms and the very high prevalence of reported co-morbidities. The series of related interactions includes a cyclic deactivation of the dorso-lateral portion of the prefrontal cortex (DLPFC) during sleep, suspending executive functions, co-occurring with rhythmic periods of decreased noradrenergic tonus. A protracted unbalance in modulation, with catecholaminergic relative deficiency, could explain less-than-optimum waking DLPFC activation and the most important manifestations of ADD. Beside the well documented dopaminergic effects of stimulant medication used in ADD and ADHD, a more important role must be assigned to noradrenaline (NA). At this light hyperactivity and impulsivity are less important dimensions. Rather, an attention deficit spectrum disorder should probably be regarded as a complication of a core defect in prefrontal cortex dependent inhibitory control, underlying inattention.
Davids, Eugen; Gastpar, Markus
To evaluate the association between attention deficit hyperactivity disorder (ADHD) and the diagnosis of borderline personality disorder (BPD) in adulthood, a systematic review of published follow-up data, mainly from observational studies was done. Electronic databases Medline, PsychInfo and PSYNDEXplus were searched from their earliest entries. All studies suggested significant relationships between ADHD and BPD. From a phenomenological point of view there seem to exist some similarities between these two disorders: deficits in affect regulation and impulse control, substance abuse, low self esteem and disturbed interpersonal relationship are common in both conditions. From a neuropsychological point of view dissociation in BPD might be regarded as a special form of behavioral inhibition and sustained attention comparable to ADHD. Possible therapeutic strategies of comorbid ADHD and BPD are discussed.
The prevalence of attention deficit hyperactivity disorder is about 5% of the child population, and it carries risks for mental health, educational and personal dysfunction, antisociality and death. The diagnosis in practice is made with remarkable differences in frequency between nations. Low rates in the UK, by comparison with research estimates, suggest that the condition may often be missed in clinical practice; the reasons are considered.
Singh, Kanwaljit; Zimmerman, Andrew W
Sleep problems are common in autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Sleep problems in these disorders may not only worsen daytime behaviors and core symptoms of ASD and ADHD but also contribute to parental stress levels. Therefore, the presence of sleep problems in ASD and ADHD requires prompt attention and management. This article is presented in 2 sections, one each for ASD and ADHD. First, a detailed literature review about the burden and prevalence of different types of sleep disorders is presented, followed by the pathophysiology and etiology of the sleep problems and evaluation and management of sleep disorders in ASD and ADHD.
Post, Robert E; Kurlansik, Stuart L
Attention-deficit/hyperactivity disorder in childhood can persist into adulthood in at least 30 percent of patients, with 3 to 4 percent of adults meeting the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., diagnostic criteria. A number of conditions, such as thyroid disease, mood disorders, and substance use disorders, have symptoms similar to those of attention-deficit/hyperactivity disorder and should be considered in the differential diagnosis. Steroids, antihistamines, anticonvulsants, caffeine, and nicotine also can have adverse effects that mimic attention-deficit/hyperactivity disorder symptoms. Proper diagnosis and treatment can improve daily functioning. Diagnosis relies on a thorough clinical history, supported by a number of rating scales that take five to 20 minutes to complete, depending on the scale. Clinical guidelines recommend stimulants and the nonstimulant atomoxetine as first-line treatments, followed by antidepressants. Cognitive behavior therapy has also been shown to be helpful as adjunctive treatment with medication. For adults with coexisting depression, the combination of an antidepressant and stimulants has been shown to be safe and effective. To monitor for misuse or diversion of stimulants, family physicians should consider using a controlled substances agreement and random urine drug screening in addition to regular follow-up visits.
Zelaznik, Howard N.; Vaughn, Aaron J.; Green, John T.; Smith, Alan L.; Hoza, Betsy; Linnea, Kate
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are thought to have fundamental deficits in the allocation of attention for information processing. Furthermore, it is believed that these children possess a fundamental difficulty in motoric timing, an assertion that has been explored recently in adults and children. In the present study we extend this recent work by fully exploring the classic Wing and Kristofferson (1973) analysis of timing with typically developing children (n = 24) and children with ADHD (n = 27). We provide clear evidence that not only do children with ADHD have an overall timing deficit, they also time less consistently when using a similar strategy to typically developing children. The use of the Wing and Kristofferson approach to timing, we argue, will result in the discovery of robust ADHD-related timing differences across a variety of situations. PMID:21852012
Prehn-Kristensen, Alexander; Molzow, Ina; Munz, Manuel; Wilhelm, Ines; Muller, Kathrin; Freytag, Damaris; Wiesner, Christian D.; Baving, Lioba
Sleep supports the consolidation of declarative and procedural memory. While prefrontal cortex (PFC) activity supports the consolidation of declarative memory during sleep, opposite effects of PFC activity are reported with respect to the consolidation of procedural memory during sleep. Patients with attention-deficit/hyperactivity disorder (ADHD)…
Schachar, Russell; Logan, Gordon D.; Robaey, Philippe; Chen, Shirley; Ickowicz, Abel; Barr, Cathy
We used variations of the stop signal task to study two components of motor response inhibition--the ability to withhold a strong response tendency (restraint) and the ability to cancel an ongoing action (cancellation)--in children with a diagnosis of attention deficit hyperactivity disorder (ADHD) and in non-ADHD controls of similar age (ages…
Van Vleet, Thomas M; DeGutis, Joseph M
Prominent deficits in spatial attention evident in patients with hemispatial neglect are often accompanied by equally prominent deficits in non-spatial attention (e.g., poor sustained and selective attention, pronounced vigilance decrement). A number of studies now show that deficits in non-spatial attention influence spatial attention. Treatment strategies focused on improving vigilance or sustained attention may effectively remediate neglect. For example, a recent study employing Tonic and Phasic Alertness Training (TAPAT), a task that requires monitoring a constant stream of hundreds of novel scenes, demonstrated group-level (n=12) improvements after training compared to a test-retest control group or active treatment control condition on measures of visual search, midpoint estimation and working memory (DeGutis and Van Vleet, 2010). To determine whether the modality of treatment or stimulus novelty are key factors to improving hemispatial neglect, we designed a similar continuous performance training task in which eight patients with chronic and moderate to severe neglect were challenged to rapidly and continuously discriminate a limited set of centrally presented auditory tones once a day for 9 days (36-min/day). All patients demonstrated significant improvement in several, untrained measures of spatial and non-spatial visual attention, and as a group failed to demonstrate a lateralized attention deficit 24-h post-training compared to a control group of chronic neglect patients who simply waited during the training period. The results indicate that TAPAT-related improvements in hemispatial neglect are likely due to improvements in the intrinsic regulation of supramodal, non-spatial attentional resources.
Arnsten, Amy F T
Neuropsychological and imaging studies have shown that attention-deficit/hyperactivity disorder (ADHD) is associated with alterations in prefrontal cortex (PFC) and its connections to striatum and cerebellum. Research in animals, in combination with observations of patients with cortical lesions, has shown that the PFC is critical for the regulation of behavior, attention, and affect using representational knowledge. The PFC is important for sustaining attention over a delay, inhibiting distraction, and dividing attention, while more posterior cortical areas are essential for perception and the allocation of attentional resources. The PFC in the right hemisphere is especially important for behavioral inhibition. Lesions to the PFC produce a profile of distractibility, forgetfulness, impulsivity, poor planning, and locomotor hyperactivity. The PFC is very sensitive to its neurochemical environment, and optimal levels of norepinephrine and dopamine are needed for proper PFC control of behavior and attention. Recent electrophysiologic studies in animals suggest that norepinephrine enhances "signals" through postsynaptic alpha2A-adrenoceptors in PFC, while dopamine decreases "noise" through modest levels of D1-receptor stimulation. Blockade of alpha2-receptors in the monkey PFC re-creates the symptoms of ADHD, resulting in impaired working memory, increased impulsivity, and locomotor hyperactivity. Genetic alterations in catecholamine pathways may contribute to dysregulation of PFC circuits in this disorder. Stimulant medications may have some of their therapeutic effects by increasing endogenous stimulation of alpha2A-adrenoceptors and dopamine D1-receptors in the PFC, optimizing PFC regulation of behavior and attention.
Cohen, Michael W.
This book, for parents of children or adolescents with attention deficit hyperactivity disorder (ADHD), presents currently available knowledge about the disorder and treatment recommendations. Individual chapters address the following topics: questions about ADHD, the core symptoms of ADHD, the full ADHD symptom profile and frequent coexisting…
Lange, K W; Tucha, L; Walitza, S; Gerlach, M; Linder, M; Tucha, O
The present article provides a review of a series of studies in children with attention deficit hyperactivity disorder (ADHD) concerning (1) the effects of methylphenidate on various attentional functions, (2) the stimulant-induced changes of both qualitative and quantitative (i.e. kinematic) aspects of handwriting, (3) the interaction between conscious control of handwriting and fluency of handwriting movements, and (4) possible therapeutic approaches to graphomotor disturbances. Children with ADHD showed impairments in various aspects of attentional functioning. Pharmacological treatment of ADHD children with methylphenidate resulted in marked improvements of various components of attentional functioning. In comparison to the performance following the withdrawal of methylphenidate, children with ADHD on methylphenidate displayed a significant improvement in task accuracy in the areas of vigilance, divided attention, selective attention (inhibition, focused attention and integration of sensory information) and flexibility. However, the comparison with healthy children revealed considerable deficits regarding vigilance, divided attention, flexibility and selective attention (focused attention and integration of sensory information) in children with ADHD on methylphenidate. The comparison of writing movements of children on and off methylphenidate revealed that medication resulted in a better handwriting, but a deterioration in handwriting fluency as assessed by kinematic analysis. Children with ADHD may use their increased attentional capacities to focus on skills (e.g. handwriting) that are independent of conscious control or may even be disturbed by attention. The findings summarized in this paper indicate, therefore, that administration of methylphenidate alone is insufficient in the treatment of children with ADHD. Children with ADHD may benefit from instructions on how to best use their improved attentional capacities.
Bernstein, Stephen B
Most analysts are now treating or can expect to treat adult patients with cognitive deficits such as attention deficit hyperactivity disorder (ADHD), based on the prevalence of this syndrome in children and its continuation into adulthood. ADHD is a cognitive disorder considered by nonanalytic and analytic writers to be a dysfunction of affect regulation and behavioral inhibition. Analysis deals with these issues, and most analytic theories address affect regulation. Manifestations of ADHD can mimic the clinical expression of intrapsychic conflict, in which the cognitive deficits are embedded. If these symptoms are interpreted primarily as transference resistances without acknowledging the cognitive contribution, the patient may experience a resurgence of feeling misunderstood and shamed, helpless and defective. Confusion in the countertransference is a hallmark of analyses in which cognitive deficits are intertwined with psychic conflict, sometimes leading the analyst to compartmentalize the cognitive and the conflictual and to miss aspects of the patient and the process. Appropriate action within the analytic frame may be needed to help the patient seek information, specialists, or coaches to deal with limitations in executive functioning. A variety of technical considerations and confusions in the countertransference are illustrated.
Richardson, Jason R; Taylor, Michele M; Shalat, Stuart L; Guillot, Thomas S; Caudle, W Michael; Hossain, Muhammad M; Mathews, Tiffany A; Jones, Sara R; Cory-Slechta, Deborah A; Miller, Gary W
Attention-deficit hyperactivity disorder (ADHD) is estimated to affect 8-12% of school-age children worldwide. ADHD is a complex disorder with significant genetic contributions. However, no single gene has been linked to a significant percentage of cases, suggesting that environmental factors may contribute to ADHD. Here, we used behavioral, molecular, and neurochemical techniques to characterize the effects of developmental exposure to the pyrethroid pesticide deltamethrin. We also used epidemiologic methods to determine whether there is an association between pyrethroid exposure and diagnosis of ADHD. Mice exposed to the pyrethroid pesticide deltamethrin during development exhibit several features reminiscent of ADHD, including elevated dopamine transporter (DAT) levels, hyperactivity, working memory and attention deficits, and impulsive-like behavior. Increased DAT and D1 dopamine receptor levels appear to be responsible for the behavioral deficits. Epidemiologic data reveal that children aged 6-15 with detectable levels of pyrethroid metabolites in their urine were more than twice as likely to be diagnosed with ADHD. Our epidemiologic finding, combined with the recapitulation of ADHD behavior in pesticide-treated mice, provides a mechanistic basis to suggest that developmental pyrethroid exposure is a risk factor for ADHD.
Tegelbeckers, Jana; Bunzeck, Nico; Duzel, Emrah; Bonath, Björn; Flechtner, Hans-Henning; Krauel, Kerstin
Attentional problems in patients with attention deficit hyperactivity disorder (ADHD) have often been linked with deficits in cognitive control. Whether these deficits are associated with increased sensitivity to external salient stimuli remains unclear. To address this issue, we acquired functional brain images (fMRI) in 38 boys with and without ADHD (age: 11–16 years). To differentiate the effects of item novelty, contextual rareness and task relevance, participants performed a visual oddball task including four stimulus categories: a frequent standard picture (62.5%), unique novel pictures (12.5%), one repeated rare picture (12.5%), and a target picture (12.5%) that required a specific motor response. As a main finding, we can show considerable overlap in novelty-related BOLD responses between both groups, but only healthy participants showed neural deactivation in temporal as well as frontal regions in response to novel pictures. Furthermore, only ADHD patients, but not healthy controls, engaged wide parts of the novelty network when processing the rare but familiar picture. Our results provide first evidence that ADHD patients show enhanced neural activity in response to novel but behaviorally irrelevant stimuli as well as reduced habituation to familiar items. These findings suggest an inefficient use of neuronal resources in children with ADHD that could be closely linked to increased distractibility. Hum Brain Mapp 36:2049–2060, 2015. © 2015 Wiley Periodicals, Inc. PMID:25648705
van der Stelt, O; van der Molen, M; Boudewijn Gunning, W; Kok, A
In order to gain insight into the functional and macroanatomical loci of visual selective processing deficits that may be basic to attention-deficit hyperactivity disorder (ADHD), the present study examined multi-channel event-related potentials (ERPs) recorded from 7- to 11-year-old boys clinically diagnosed as having ADHD (n=24) and age-matched healthy control boys (n=24) while they performed a visual (color) selective attention task. The spatio-temporal dynamics of several ERP components related to attention to color were characterized using topographic profile analysis, topographic mapping of the ERP and associated scalp current density distributions, and spatio-temporal source potential modeling. Boys with ADHD showed a lower target hit rate, a higher false-alarm rate, and a lower perceptual sensitivity than controls. Also, whereas color attention induced in the ERPs from controls a characteristic early frontally maximal selection positivity (FSP), ADHD boys displayed little or no FSP. Similarly, ADHD boys manifested P3b amplitude decrements that were partially lateralized (i.e., maximal at left temporal scalp locations) as well as affected by maturation. These results indicate that ADHD boys suffer from deficits at both relatively early (sensory) and late (semantic) levels of visual selective information processing. The data also support the hypothesis that the visual selective processing deficits observed in the ADHD boys originate from deficits in the strength of activation of a neural network comprising prefrontal and occipito-temporal brain regions. This network seems to be actively engaged during attention to color and may contain the major intracerebral generating sources of the associated scalp-recorded ERP components.
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder and one of the main diagnoses seen by general paediatricians today. Despite the impression often portrayed in the media, it is not a new condition; in fact it has been described for over 200 years. The past 50 years has seen a progressive increase in our understanding of the underlying neurocognitive deficits in ADHD, and over the past 20 years behavioural genetics and neuroimaging studies have shed light on the complex causal factors and neurobiological processes operating. The plethora of ADHD research has advanced our knowledge of the condition, but so far has had little impact on improving clinical practice. Stimulant medication has been the mainstay of symptomatic treatment for over 30 years; however, it is still unclear how developmental trajectories can be modified to achieve best outcomes. It is hoped that novel therapies and more individualised management will evolve over the coming decades.
Gilden, David L; Marusich, Laura R
Attention-deficit hyperactivity disorder (ADHD) has been associated with anomalies in dopamine systems. Recent advances in the understanding of the core cognitive deficits in ADHD suggest that dopamine dysfunction might be expressed through shortened time scales in reward-based learning. Here this perspective is extended by the conjecture that temporal span in working memory systems might generally be shortened. As a test of this conjecture the authors focus on the implicit memory system involved in rhythmic movement, assessing the minimum tempo at which rhythmic feeling can be sustained in adults with diagnosed ADHD and in a control group of normal adults. The authors found that people with ADHD do in fact have a rhythm cut-off that is faster in tempo than those without ADHD. This finding is consistent with the idea that impaired dopamine dynamics have systemic consequences for cognitive function, essentially recalibrating the clock that sets the time scale for the subjective experience of temporal events.
Jordan, Dale R.
Previously published as "Attention Deficit Disorder: ADHD and ADD Syndromes," this popular book is now in its fourth edition. It provides up-to-date research and more complete explanations of how Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) interfere with classroom learning, behavior at home, job…
Baldassarre, Antonello; Ramsey, Lenny; Rengachary, Jennifer; Zinn, Kristi; Siegel, Joshua S; Metcalf, Nicholas V; Strube, Michael J; Snyder, Abraham Z; Corbetta, Maurizio; Shulman, Gordon L
Strokes often cause multiple behavioural deficits that are correlated at the population level. Here, we show that motor and attention deficits are selectively associated with abnormal patterns of resting state functional connectivity in the dorsal attention and motor networks. We measured attention and motor deficits in 44 right hemisphere-damaged patients with a first-time stroke at 1-2 weeks post-onset. The motor battery included tests that evaluated deficits in both upper and lower extremities. The attention battery assessed both spatial and non-spatial attention deficits. Summary measures for motor and attention deficits were identified through principal component analyses on the raw behavioural scores. Functional connectivity in structurally normal cortex was estimated based on the temporal correlation of blood oxygenation level-dependent signals measured at rest with functional magnetic resonance imaging. Any correlation between motor and attention deficits and between functional connectivity in the dorsal attention network and motor networks that might spuriously affect the relationship between each deficit and functional connectivity was statistically removed. We report a double dissociation between abnormal functional connectivity patterns and attention and motor deficits, respectively. Attention deficits were significantly more correlated with abnormal interhemispheric functional connectivity within the dorsal attention network than motor networks, while motor deficits were significantly more correlated with abnormal interhemispheric functional connectivity patterns within the motor networks than dorsal attention network. These findings indicate that functional connectivity patterns in structurally normal cortex following a stroke link abnormal physiology in brain networks to the corresponding behavioural deficits.
Horst, Robert O; Hendren, Robert L
This article is a review of what is currently known about optimal treatments for patients with attention-deficit hyperactivity disorder (ADHD). It begins with a description of assessment techniques and the differential diagnosis, which includes learning disorders, anxiety disorders, and bipolar disorder. The high rate of comorbidity in patients with ADHD and the impact of comorbidity on treatment decisions are also discussed. Detailed descriptions of various pharmacologic treatments are provided, including a description of the role of combination pharmacotherapy and the integration of nonpharmacologic therapy. A decision-making model for selecting the most appropriate pharmacologic therapy versus combining pharmacotherapy with psychosocial interventions is described. The advantages and disadvantages of various pharmacologic agents--including long-acting stimulants and atomoxetine--are examined. Particular attention is paid to the recent Multimodal Treatment Study of Attention-Deficit Hyperactivity Disorder, sponsored by the National Institute of Mental Health, which includes a comparison of long-term pharmacotherapy, behavioral therapy, or a combination thereof, as well as an evaluation of the role of community-based therapy (i.e., treatment as usual). This article focuses on children and adolescents, because most of the research on ADHD has been conducted in this age group. However, a brief section on adults is also provided.
Rugino, Thomas A; Samsock, Teresa C
Previous clinical evidence suggested that modafinil may improve clinical features of children with attention-deficit hyperactivity disorder. To test this hypothesis, a randomized, double-blind, placebo-controlled study design was used. Of 24 children initially randomized into the study, 11 control subjects and 11 treatment patients completed the study, with evaluation before medication and after 5 to 6 weeks. The average Test of Variables of Attention attention-deficit hyperactivity disorder z score improved by 2.53 S.D.s for the modafinil group compared with a decline of 1.02 for control patients (P < or = 0.02). Conners Rating Scales ADHD total t scores for the modafinil group improved from 76.6 to 68.2 compared with improvement from 77.7 to 76.0 for control subjects (P = 0.04). Ten of 11 treatment patients were reported as "significantly" improved, whereas eight of 11 control subjects were reported as manifesting "no" or "slight" improvement (P < 0.001). Adverse effects were few and manageable, with no anorexia. Modafinil may be a useful treatment for children with ADHD, particularly when anorexia limits use of stimulants.
Bradshaw, Martha J; Salzer, Judith Schurr
Attention deficit hyperactivity disorder (ADHD) in college-age students presents a complex challenge of coping with academic coursework, refining life skills, and addressing self-limitations. Behaviors that characterize ADHD are particularly problematic for nursing students, especially when the student has difficulty with behaviors that exemplify executive functioning. The authors discuss symptoms and treatments associated with the diagnosis of ADHD and evaluation and interventions for college students, based on guidelines from the Americans With Disabilities Act. Nursing faculty can facilitate academic success by recognizing the problem in nursing students and implementing strategies useful for self-management of ADHD.
BEMPORAD, JULES; ZAMBENEDETTI, MAURIZIO
The multimodal treatment of adults with attention-deficit disorder (ADD) is described as consisting of a sequence of overlapping therapeutic measures. The initial objective is symptom amelioration through adequate pharmacotherapy. Once this has been accomplished, a period of psychoeducational therapy is recommended to teach the individual to live successfully with a chronic disorder. These two aspects of treatment may suffice for some ADD adults, but many others may require an additional course of psychotherapy to deal with dysfunctional personality characteristics resulting from having grown up with ADD. Among these are modes of defenses against painful affects, resistances to treatment, and inaccurate estimations and expectations of the self and others. PMID:22700291
Patra, Suravi; Sirka, Chandra Sekhar
Dermatitis artefacta, a self-inflicted intentional dermatosis is a very rare diagnosis in childhood. In a large proportion, the underlying psychiatric disorders go unidentified due to lack of collaboration between dermatologist and psychiatrist. The underlying psychological reasons for childhood dermatitis artefacta include emotional distress and interpersonal conflicts. A multitude of psychosocial factors interact to precipitate this disorder. Here, we report a child with dermatitis artefacta who was diagnosed with attention deficit hyperactivity disorder during psychiatric evaluation. Parental expectations and sibling rivalry were further increasing the stress of the index child. Appropriate diagnosis and management lead to treatment compliance and functional improvement in the child. PMID:27195043
Balazs, Judit; Kereszteny, Agnes
AIM To investigate suicidality and attention-deficit/hyperactivity disorder (ADHD), this paper aims to systematically review the literature as an extension of previous reviews. METHODS We searched five databases (Ovid MEDLINE, Psychinfo, PubMed, Scopus, Web of Science) with two categories of search terms: (1) suicide; suicidal; suicide behavior; suicide attempt; suicidal thought; and (2) ADHD. RESULTS The search resulted 26 articles. There is a positive association between ADHD and suicidality in both sexes and in all age groups. Comorbid disorders mediate between suicidality and ADHD. CONCLUSION Recognizing ADHD, comorbid conditions and suicidality is important in prevention.
Various medications such as clonidine facilitate calming, enhance frustration tolerance and reduce aggression in attention-deficit disorder (ADD) patients. The use of Ginkgo biloba was studied as an herbal alternative. Six psychiatric outpatients diagnosed with ADD were rated at baseline and while taking Ginkgo biloba to determine its efficacy as a treatment for ADD. Comparisons of Wender Utah ratings within subject were used to measure behavioral changes in the subjects. During Ginkgo biloba treatment, the patients' mean scores improved significantly overall and in hyperactivity, inattention, and immaturity factors. This preliminary study indicates that Ginkgo biloba might be a beneficial and useful treatment of ADD, with minimal side effects.
Englund, Julia A.; Decker, Scott L.; Allen, Ryan A.; Roberts, Alycia M.
Cognitive deficits in working memory (WM) are characteristic features of Attention-Deficit/Hyperactivity Disorder (ADHD) and autism. However, few studies have investigated cognitive deficits using a wide range of cognitive measures. We compared children with ADHD ("n" = 49) and autism ("n" = 33) with a demographically matched…
Fernández-Jaén, Alberto; Martín Fernández-Mayoralas, Daniel; Fernández-Perrone, Ana Laura; Calleja-Pérez, Beatriz; Muñoz-Jareño, Nuria; López-Arribas, Sonia
The cardinal symptoms of attention deficit hyperactivity disorder (ADHD)--inattention, hyperactivity and impulsiveness--are not specific and may be found in the general population and in other disorders. These symptoms are present in over 50% of patients with autism spectrum disorders (ASD). It thus seems quite clear that both problems can coexist in these patients. The usual pharmacological treatments for ADHD, methylphenidate and atomoxetine, appear to be useful in reducing the above-mentioned symptoms in patients with ADHD and ASD. Effectiveness seems to be lower in patients with ASD and tolerance is slightly poorer. This may be conditioned by a number of variables, including: the complexity of ASD, association with mental retardation, polypharmacotherapy, and so on. Given the long-term tolerance profile of methylphenidate and atomoxetine, these treatments appear to be a good alternative with which to improve the problems of attention and self-control these patients have. Nevertheless, further controlled studies are needed to confirm this proposition.
Shaywitz, B A; Shaywitz, S E
In this report, we examine the interrelationships between attention deficit disorder (ADD), learning disabilities (LD), and conduct and oppositional disorders (COD). We indicate that it is reasonable to consider ADD as a distinct entity, frequently co-occurring with LD on the one hand, and COD on the other. The first section reviews the interrelationships between ADD and LD. Here we focus on definitional issues, trace the historical antecedents of ADD and LD, examine the prevalence of ADD and LD, and review studies designed to differentiate cognitive from attentional mechanisms in children with ADD, LD, or both. In the next section, we review the evidence linking ADD with COD, a distinction blurred in earlier investigations by problems with referral bias. More recent studies suggest that the antecedents, clinical characteristics, and prognosis may differ in children with ADD alone compared to those with ADD in association with COD.
Kutcher, Jeffrey S
Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral development disorder affecting an estimated 6% to 9% of youth in the United States. The typical manifestations of ADHD, attention difficulties and hyperactivity, cause impairment in social and academic functioning, while common comorbid conditions can add significantly to the disease burden. Diagnosing ADHD requires a comprehensive clinical approach. Many medications have been shown to provide benefit for patients with ADHD, and a positive response to medication can be an important factor in clarifying the diagnosis. Medical therapy is of particular interest when treating athletes, as competitive bodies ban many treatment options. This review provides the sports medicine provider with a framework for the treatment of ADHD in the athlete.
Spencer, Thomas J; Biederman, Joseph; Mick, Eric
In this report, we provide an evidence-based overview of attention-deficit/hyperactivity disorder (ADHD), including diagnosis, prevalence, developmental expression of symptoms, persistence, the heterogeneity of functional outcome, impairment in afflicted adults, psychiatric comorbidity, pathophysiology, genetics, psychosocial and biologic risk factors, and neurobiology. Attention-deficit/hyperactivity disorder is an early-onset, highly prevalent neurobehavioral disorder, with genetic, environmental, and biologic etiologies, that persists into adolescence and adulthood in a sizable majority of afflicted children of both sexes. It is characterized by behavioral symptoms of inattention, hyperactivity, and impulsivity across the life cycle and is associated with considerable morbidity and disability. Comorbidity is a distinct clinical feature of both childhood and adult ADHD. Although its etiology remains unclear, emerging evidence documents its strong neurobiologic and genetic underpinnings. Despite the high diagnostic reliability and the robust evidence of the validity of ADHD, there are many underlying issues that remain to be resolved. These include establishing developmentally appropriate diagnostic criteria at older ages, further elaborating the impact of gender on symptom expression, and examining risk and protective factors in relationship to prevention or amelioration of ADHD as well as related functional impairments.
Attention-deficit/hyperactivity disorder (ADHD) is a multifactorial and clinically heterogeneous disorder that is associated with tremendous financial burden, stress to families, and adverse academic and vocational outcomes. Attention-deficit/hyperactivity disorder is highly prevalent in children worldwide, and the prevalence of this disorder in adults is increasingly recognized. Studies of adults with a diagnosis of childhood-onset ADHD indicate that clinical correlates--demographic, psychosocial, psychiatric, and cognitive features--mirror findings among children with ADHD. Predictors of persistence of ADHD include family history of the disorder, psychiatric comorbidity, and psychosocial adversity. Family studies of ADHD have consistently supported its strong familial nature. Psychiatric disorders comorbid with childhood ADHD include oppositional defiant and conduct disorders, whereas mood and anxiety disorders are comorbid with ADHD in both children and adults. Pregnancy and delivery complications, maternal smoking during pregnancy, and adverse family environment variables are considered important risk factors for ADHD. The etiology of ADHD has not been clearly identified, although evidence supports neurobiologic and genetic origins. Structural and functional imaging studies suggest that dysfunction in the fronto-subcortical pathways, as well as imbalances in the dopaminergic and noradrenergic systems, contribute to the pathophysiology of ADHD. Medication with dopaminergic and noradrenergic activity seems to reduce ADHD symptoms by blocking dopamine and norepinephrine reuptake. Such alterations in dopaminergic and noradrenergic function are apparently necessary for the clinical efficacy of pharmacologic treatments of ADHD.
Sagvolden, Terje; Russell, Vivienne A; Aase, Heidi; Johansen, Espen Borgå; Farshbaf, Mehdi
An ideal animal model should be similar to the disorder it models in terms of etiology, biochemistry, symptomatology, and treatment. Animal models provide several advantages over clinical research: simpler nervous systems, easily interpreted behaviors, genetic homogeneity, easily controlled environment, and a greater variety of interventions. Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder of childhood onset that is characterized by inattentiveness, hyperactivity, and impulsiveness. Its diagnosis is behaviorally based; therefore, the validation of an ADHD model must be based in behavior. An ADHD model must mimic the fundamental behavioral characteristics of ADHD (face validity), conform to a theoretical rationale for ADHD (construct validity), and predict aspects of ADHD behavior, genetics, and neurobiology previously uncharted in clinical settings (predictive validity). Spontaneously hypertensive rats (SHR) fulfill many of the validation criteria and compare well with clinical cases of ADHD. Poor performers in the five-choice serial reaction time task and Naples high-excitability rats (NHE) are useful models for attention-deficit disorder. Other animal models either focus on the less important symptom of hyperactivity and might be of limited value in ADHD research or are produced in ways that would not lead to a clinical diagnosis of ADHD in humans, even if ADHD-like behavior is displayed.
Bueno, Viviane Freire; Kozasa, Elisa H.; da Silva, Maria Aparecida; Alves, Tânia Maria; Louzã, Mario Rodrigues; Pompéia, Sabine
Objective. Adults with attention deficit hyperactivity disorder (ADHD) display affective problems and impaired attention. Mood in ADHD can be improved by mindful awareness practices (MAP), but results are mixed regarding the enhancement of attentional performance. Here we evaluated MAP-induced changes in quality of life (QoL), mood, and attention in adult ADHD patients and controls using more measures of attention than prior studies. Methods. Twenty-one ADHD patients and 8 healthy controls underwent 8 weekly MAP sessions; 22 similar patients and 9 controls did not undergo the intervention. Mood and QoL were assessed using validated questionnaires, and attention was evaluated using the Attentional Network Test (ANT) and the Conners Continuous Performance Test (CPT II), before and after intervention. Results. MAP enhanced sustained attention (ANT) and detectability (CPT II) and improved mood and QoL of patients and controls. Conclusion. MAP is a complementary intervention that improves affect and attention of adults with ADHD and controls. PMID:26137496
Koen, Clifford M; Carmichael, Amanda J; Koen, Kristin E
As millions of individuals who have been given a diagnosis of attention deficit disorder and attention-deficit/hyperactivity disorder enter the workforce, more individuals with these mental impairments are filing claims with the Equal Employment Opportunity Commission under the Americans with Disabilities Act (ADA) as amended in 2008 by the ADA Amendments Act. The ADA forbids employment discrimination based on an individual's disability and also requires employers to make reasonable accommodations for individuals with disabilities. Health care managers must be well prepared with knowledge of the employers' rights and responsibilities under the law. By exploring the legal challenges being made to employers' policies and practices and examining how the courts are resolving those disputes, managers can reduce the risk of expensive, time-consuming litigation caused by employment discrimination claims based on disability.
Roberts, Walter; Fillmore, Mark T.; Milich, Richard
Researchers in the cognitive sciences recognize a fundamental distinction between automatic and intentional mechanisms of inhibitory control. The use of eye-tracking tasks to assess selective attention has led to a better understanding of this distinction in specific populations such as children with attention-deficit/hyperactivity disorder (ADHD). This study examined automatic and intentional inhibitory control mechanisms in adults with ADHD using a saccadic interference (SI) task and a delayed ocular response (DOR) task. Thirty adults with ADHD were compared to 27 comparison adults on measures of inhibitory control. The DOR task showed that adults with ADHD were less able than comparison adults to inhibit a reflexive saccade towards the sudden appearance of a stimulus in the periphery. However, SI task performance showed that the ADHD group did not differ significantly from the comparison group on a measure of automatic inhibitory control. These findings suggest a dissociation between automatic and intentional inhibitory deficits in adults with ADHD. PMID:21058752
Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity)
Most studies of attention-deficit/hyperactivity disorder (ADHD) have focused on the combined type and emphasized a core problem in response inhibition. It is proposed here that the core problem in the truly inattentive type of ADHD (not simply the subthreshold combined type) is in working memory. It is further proposed that laboratory measures, such as complex-span and dual-task dichotic listening tasks, can detect this. Children with the truly inattentive type of ADHD, rather than being distractible, may instead be easily bored, their problem being more in motivation (under-arousal) than in inhibitory control. Much converging evidence points to a primary disturbance in the striatum (a frontal–striatal loop) in the combined type of ADHD. It is proposed here that the primary disturbance in truly inattentive-type ADHD (ADD) is in the cortex (a frontal–parietal loop). Finally, it is posited that these are not two different types of ADHD, but two different disorders with different cognitive and behavioral profiles, different patterns of comorbidities, different responses to medication, and different underlying neurobiologies. PMID:16262993
Attention-deficit disorder (attention-deficit/ hyperactivity disorder without hyperactivity): a neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity).
Most studies of attention-deficit/hyperactivity disorder (ADHD) have focused on the combined type and emphasized a core problem in response inhibition. It is proposed here that the core problem in the truly inattentive type of ADHD (not simply the subthreshold combined type) is in working memory. It is further proposed that laboratory measures, such as complex-span and dual-task dichotic listening tasks, can detect this. Children with the truly inattentive type of ADHD, rather than being distractible, may instead be easily bored, their problem being more in motivation (underarousal) than in inhibitory control. Much converging evidence points to a primary disturbance in the striatum (a frontal-striatal loop) in the combined type of ADHD. It is proposed here that the primary disturbance in truly inattentive-type ADHD (ADD) is in the cortex (a frontal-parietal loop). Finally, it is posited that these are not two different types of ADHD, but two different disorders with different cognitive and behavioral profiles, different patterns of comorbidities, different responses to medication, and different underlying neurobiologies.
Gomes, Hilary; Duff, Martin; Ramos, Miguel; Molholm, Sophie; Foxe, John J.; Halperin, Jeffrey
Objective This study sought to better characterize the contributions of deficits in attention allocation and distracter inhibition to the poor performance on attention tasks often seen in children with ADHD. Methods Electrophysiological (Nd, P3b) and behavioral measures (speed and accuracy) were examined during an auditory selective attention task in children with ADHD, children with typical development (TD), and adults. Thirty children (15 ADHD; 13 females) between the ages of 7 and 13 and 16 adults (8 females) participated. Results Nd waveforms were elicited from adults and children with TD, but not from children with ADHD. Further, those with ADHD exhibited significantly smaller auditory responses at 100ms (Ta). P3bs were elicited in all three groups by targets but not by unattended deviants. Performance was significantly poorer in children with ADHD than TD and RTs were more variable. Conclusions Children with ADHD evidenced poorer attention allocation, as measured by Nd and hits, but were not more distracted by unattended deviants, as measured by P3b and false alarms, than children with TD. Significance Findings for Nd, P3b, and Ta considered together suggest that deficits in auditory selective attention in children with ADHD may be attributable to reduced information early in the processing stream. PMID:21839675
Karatekin, Canan; White, Tonya; Bingham, Christopher
The authors used pupillary dilations to test whether divided attention deficits in youth-onset psychosis and attention deficit/hyperactivity disorder (ADHD) were because of limitations in recruitment of cognitive resources or abnormalities in attention allocation. Eight- to 19-year-olds with youth-onset psychosis or ADHD were administered a divided attention test consisting of an auditory digit span (DS) task and a simple visual response time (RT) task. In 4 conditions, participants performed neither (no task), 1 (DS or RT only), or both tasks (dual). Dependent variables were DS accuracy, RT, and pupillary dilation to digits as an estimate of recruitment of cognitive resources. The authors found no evidence for an abnormal attention strategy in either disorder. Instead, results were consistent with the hypothesis that both clinical groups have limitations in resource recruitment. These limitations were more severe in psychosis than in ADHD. Findings indicate that both clinical groups had difficulties in regulating physiological arousal on a moment-to-moment basis in accordance with task demands. Findings also demonstrate the importance of taking into account difficulties that constrain performance on simple tasks before interpreting impairments on complex tasks.
Klimkeit, Ester I; Mattingley, Jason B; Sheppard, Dianne M; Lee, Paul; Bradshaw, John L
Attention and executive functions were investigated in medicated and unmedicated children with ADHD combined type using a novel selective reaching task. This task involved responding as rapidly as possible to a target while at times having to ignore a distractor. Results indicated that unmedicated children with ADHD showed slow and inaccurate responding. Slow responding reflected problems at the stage of movement preparation but not movement execution. An attentional impairment, rather than a motor planning problem per se, appeared to underlie the slow movement preparation. Inaccurate responding reflected problems with response inhibition and selective attention, impulsivity, set-shifting, and difficulties in maintaining vigilance. Although medicated children with ADHD did not show slow movement preparation, they did show some response inaccuracy, resulting especially from impulsive responding. These findings suggest that ADHD is characterized by slow motor preparation (but not motor execution), and deficits in selective attention, vigilance, and executive functions. Preliminary results suggest that stimulant medication may resolve some of these motor, attentional and executive function deficits.
Hermens, Daniel F; Soei, Eleonore X C; Clarke, Simon D; Kohn, Michael R; Gordon, Evian; Williams, Leanne M
Quantitative electroencephalography has contributed significantly to elucidating the neurobiologic mechanisms of attention-deficit hyperactivity disorder. The most consistent and robust electroencephalographic disturbance in attention-deficit hyperactivity disorder has been abnormally increased theta band during resting conditions. Separate research using attention-demanding tests has elucidated cognitive disturbances that differentiate attention-deficit hyperactivity disorder. This study attempts to integrate electroencephalographic and neuropsychological indices to determine whether cognitive performance is specifically related to increased theta. Theta activity was recorded during a resting condition for 46 children/adolescents with attention-deficit hyperactivity disorder and their sex- and age-matched control subjects. Accuracy and reaction time during an auditory oddball and a visual continuous performance test were then recorded. Compared with control subjects, the attention-deficit hyperactivity disorder group manifested significantly increased (primarily left) frontal theta. Furthermore, the attention-deficit hyperactivity disorder group scored significantly delayed reaction time and decreased accuracy in both tasks. Correlation analysis revealed a significant relationship between frontal (primarily left) theta and oddball accuracy for the attention-deficit hyperactivity disorder group compared with a significant relationship between posterior (primarily right) theta and reaction time in the continuous performance test for the control group. These results indicate that spatial neurophysiologic deficits in attention-deficit hyperactivity disorder may be related to disturbances in signal detection. This observation has important implications for the role of trait-like biologic deficits in attention-deficit hyperactivity disorder predicting performance in information processing.
Corbett, Blythe A; Constantine, Laura J
Symptoms of attention deficit hyperactivity disorder (ADHD) have been widely reported in children with autism spectrum disorder (ASD). The current study investigated attention and response control in children with ASD, ADHD, and typical development using the Integrated Visual and Auditory Continuous Performance Test. Results indicate that many children with ASD show significant deficits in visual and auditory attention and greater deficits in impulsivity than children with ADHD or typical development. These findings suggest that many of the children with ASD demonstrate significant ADHD-like deficits. These findings are discussed in the context of symptoms, subtypes, and comorbidity.
de Zeeuw, Patrick; Mandl, René C W; Hulshoff Pol, Hilleke E; van Engeland, Herman; Durston, Sarah
Frontostriatal brain areas have been implicated in the neurobiology of attention deficit/hyperactivity disorder (ADHD), but little work has directly addressed the white matter connections between these regions. The present study investigates the microstructural organization and myelination of frontostriatal white matter in children with ADHD and controls. Diffusion tensor imaging and magnetization transfer imaging scans were acquired in 30 children with ADHD and 34 controls. A study specific volume of interest (VOI) of frontostriatal white matter was created using a tractography based statistical group map. Fractional anisotropy (FA, indexing microstructural organization) and magnetization transfer ratio (MTR, indexing macromolecular content, myelin in particular) were computed for the frontostriatal VOI and for total cerebral white matter. Exploratory analyses were conducted investigating the effect of stimulant use on these measures. Frontostriatal FA but not MTR was decreased in ADHD compared with controls. There were no differences in FA or MTR for total cerebral white matter. Frontostriatal FA correlated negatively with teacher-rated attention problems in controls but not children with ADHD. The duration of stimulant use did not affect the main results. Changes in frontostriatal connectivity in ADHD appear to be related to changes in microstructural organization rather than myelination per se. A correlation with attention problems for controls suggests that frontostriatal organization is relevant to ADHD-related behaviors.
Reinblatt, Shauna P
Attention deficit/hyperactivity disorder (ADHD) is a disorder characterized by impulsivity, hyperactivity, and inattention. Binge-eating behavior is often impulsive and is the hallmark of the two eating disorders, binge-eating disorder (BED) and bulimia nervosa (BN), both of which are associated with significant health impairment. Bingeing behavior is also seen in the binge purge subtype of anorexia nervosa. Individuals with AN of the binge purge subtypes, BN and BED, have been found to exhibit impulsive behaviors that are often not limited to binge eating alone. There is preliminary evidence linking ADHD to BN and to BED in both adults and children. The neurobiological mechanisms behind these associations are only beginning to emerge; however, they suggest that impulse control deficits may play a role in these eating disorders. Additionally, although they may not meet full criteria for one of these eating disorders, some adults and children with ADHD present with dysregulated, impulsive eating disorder behaviors and there is a growing association between ADHD, obesity, and binge-eating behavior in both children and adults. The relationship between ADHD and binge eating is novel, supported by growing evidence and worthy of further research. We will review the underlying neurobiological underpinnings, neuroimaging data, and possible psychopharmacological treatment options, which target both ADHD and binge-eating behaviors as well as future research and treatment directions.
Reinblatt, Shauna P.
Opinion statement Attention deficit/hyperactivity disorder (ADHD) is a disorder characterized by impulsivity, hyperactivity, and inattention. Binge-eating behavior is often impulsive and is the hallmark of the two eating disorders, binge-eating disorder (BED) and bulimia nervosa (BN), both of which are associated with significant health impairment. Bingeing behavior is also seen in the binge purge subtype of anorexia nervosa. Individuals with AN of the binge purge subtypes, BN and BED, have been found to exhibit impulsive behaviors that are often not limited to binge eating alone. There is preliminary evidence linking ADHD to BN and to BED in both adults and children. The neurobiological mechanisms behind these associations are only beginning to emerge; however, they suggest that impulse control deficits may play a role in these eating disorders. Additionally, although they may not meet full criteria for one of these eating disorders, some adults and children with ADHD present with dysregulated, impulsive eating disorder behaviors and there is a growing association between ADHD, obesity, and binge-eating behavior in both children and adults. The relationship between ADHD and binge eating is novel, supported by growing evidence and worthy of further research. We will review the underlying neurobiological underpinnings, neuroimaging data, and possible psychopharmacological treatment options, which target both ADHD and binge-eating behaviors as well as future research and treatment directions. PMID:26949595
Machado, Felipe Salles Neves; Caetano, Sheila Cavalcante; Hounie, Ana Gabriela; Scivoletto, Sandra; Muszkat, Mauro; Gattás, Ivete Gianfaldoni; Casella, Erasmo Barbante; de Andrade, Ênio Roberto; Polanczyk, Guilherme Vanoni; do Rosário, Maria Conceição
A Brazilian Health Technology Assessment Bulletin (BRATS) article regarding scientific evidence of the efficacy and safety of methylphenidate for treating attention deficit hyperactivity disorder (ADHD) has caused much controversy about its methods. Considering the relevance of BRATS for public health in Brazil, we critically reviewed this article by remaking the BRATS search and discussing its methods and results. Two questions were answered: did BRATS include all references available in the literature? Do the conclusions reflect the reviewed articles? The results indicate that BRATS did not include all the references from the literature on this subject and also that the proposed conclusions are different from the results of the articles chosen by the BRATS authors themselves. The articles selected by the BRATS authors showed that using methylphenidate is safe and effective. However, the BRATS final conclusion does not reflect the aforementioned and should not be used to support decisions on the use of methylphenidate. PMID:26061456
In the past decade, we have become increasingly aware of strong associations between overweight/obesity and symptoms of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults. This review addresses the prevalence of the comorbidity and discusses some of the mechanisms that could account for their relationship. It is suggested that the inattentive and impulsive behaviors that characterize ADHD could contribute to overeating in our current food environment, with its emphasis on fast food consumption and its many food temptations. It is also proposed-based on the compelling evidence that foods high in fat, sugar, and salt are as addictive as some drugs of abuse-that excessive food consumption could be a form of self-medication. This view conforms with the well-established evidence that drug use and abuse are substantially higher among those with ADHD than among the general population.
Attention-deficit/hyperactivity disorder (ADHD) is defined by extreme levels of inattention–disorganization and/or hyperactivity–impulsivity. In DSM-IV, the diagnostic criteria required impairment in social, academic, or occupational functioning. With DSM-5 publication imminent in 2013, further evaluation of impairment in ADHD is timely. This article reviews the current state of knowledge on health-related impairments of ADHD, including smoking, drug abuse, accidental injury, sleep, obesity, hypertension, diabetes, and suicidal behavior. It concludes by suggesting the need for new avenues of research on mechanisms of association and the potential for ADHD to be an early warning sign for secondary prevention of some poor health outcomes. PMID:23298633
Racine, Marie Brossard; Majnemer, Annette; Shevell, Michael; Snider, Laurie
Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral condition of childhood. Consequences are multifaceted and include activity limitations in daily-living skills, academic challenges, diminished socialization skills, and motor difficulties. Poor handwriting performance is an example of an affected life skill that has been anecdotally observed by educators and clinicians for this population and can negatively impact academic performance and self-esteem. To guide health and educational service delivery needs, the authors reviewed the evidence in the literature on handwriting difficulties in children with ADHD. Existing evidence would suggest that children with ADHD have impaired handwriting performance, characterized by illegible written material and/or inappropriate speed of execution compared to children without ADHD. Studies with larger sample sizes using standardized measures of handwriting performance are needed to evaluate the prevalence of the problem and to better understand the nature of handwriting difficulties and their impact in this population.
Daly, Brian P; Creed, Torrey; Xanthopoulos, Melissa; Brown, Ronald T
This article reviews studies examining the efficacy of behavioral interventions for the treatment of attention-deficit/hyperactivity disorder (ADHD). A specific emphasis is placed on evidence-based interventions that include parent training, classroom, academic, and peer interventions. Results indicate that school-aged children respond to behavioral interventions when they are appropriately implemented both at home and in the classroom setting. Combined treatments (behavioral management and stimulant medication) represent the gold standard in ADHD treatment and are often recommended as the first-line treatment option due to the many problems faced by children with ADHD. Diversity issues, although an important consideration in the treatment of ADHD, continue to remain an understudied area. Recommendations for future research are made pertaining to treatment sequencing with regard to behavior management as well as for subgroups of ADHD children who may respond best to specific treatments.
Blew, Helen; Kenny, Gerard
The aim of this article is to identify and highlight the issues facing children, young people and families experiencing Attention Deficit Hyperactivity Disorder (ADHD) in an United Kingdom context. In presenting these issues it is hoped that wider discussion and awareness of the challenges of this condition may have an effect on the planning and delivery of services within the UK. We seek to highlight that an overreliance on a medical perspective has the effect of neglecting the wider context of the rights of the child and the needs of the family. We advocate for an approach that recognizes the importance of the contributions of other professionals and the implementation of locally-agreed guidelines that incorporate the perspectives of families and the rights of the child.
Ghanizadeh, Ahmad; Mohammadi, Mohammad Reza; Akhondzadeh, Shahin; Sanaei-Zadeh, Hossein
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders with lifelong impact of the affected individuals. It is usually co-morbid with other psychiatric disorders. This paper aims to review current knowledge about ADHD in imprisoned individuals. The rate of ADHD in prisoners ranges from 10% to 70% and it has been suggested that ADHD, even without co-morbidity with conduct disorder, is a risk factor for imprisonment. Based on these findings, it may be wise to include the assessment of ADHD symptoms in all adult and adolescent prisoners. This is while available psychiatric resources for the adequate management of ADHD in prisoners are limited. Most of current knowledge on the topic comes from western countries. There is an urgent need for studies that will explore the effect of other cultures on the interactions between ADHD and imprisonment, especially in developing countries worldwide. At this point, ADHD seems to be an ignored research area in developing countries.
Attention Deficit Hyperactivity Disorder (ADHD) is a common neuropsychiatric disorder, which affects children as well as adults and leads to significant impairment in educational, social and occupational functioning and has associated personal and societal costs. Whilst there are effective medications (mostly stimulants) as well as some psychobehavioural treatments that help alleviate symptoms of ADHD, there is still need to improve our understanding of its neurobiology as well as explore other treatment options. Transcranial Magnetic Stimulation (TMS) and repetitive transcranial magnetic stimulation (rTMS) are safe and non-invasive investigative and therapeutic tools respectively. In this short article, I will explore their potential for improving our understanding of the neurobiology of ADHD as well consider its as a possible treatment option.
Liu, Feng; Minami, Haruka; Silva, Raul R
Attention-deficit/hyperactivity disorder (ADHD) affects a large number of children. For decades, the stimulants have been the mainstay of pharmacological treatment for ADHD. Dexmethylphenidate (d-MPH), the d-isomer of the traditional racemic mixtures of d,l-threo-(R,R)-MPH, was recently introduced as another potential option in the stimulant class of medications. This paper reviews and summarizes the available research literature on d-MPH regarding pharmacodynamic, pharmacokinetic, chemical structure, receptor binding, toxicology, and clinical perspectives. d-MPH potentially may offer some advantages in the realms of absorption and duration of action compared with its racemic counterpart. The differences in pharmacokinetics and clinical implications of the immediate-release and extended-release forms of d-MPH are also compared and contrasted. PMID:19412495
Oktem, F; Semerci, Z B
Attention deficit hyperactivity disorder (ADHD) is a common disturbance causing school failure and social problems. Early diagnosis and intervention allow ADHD children to adjust and succeed at school and in daily life. To identify these patients, we designed a practical questionnaire for parents. When tested on children with ADHD (n = 100), children with psychiatric problems (n = 35), and on age- and sex-mached control children (n = 100), this scale was found to be highly useful in distinguishing these three groups from each other, especially after the identification and elimination of items with lower specificity. The use of the Hacettepe ADHD scale is recommended for pediatricians, general practitioners and teachers to allow earlier diagnosis of this condition.
Teive, Hélio A G; Zavala, Jorge A; Munhoz, Renato P; Lara, Diogo R; Lima, Pedro; Palmini, André
Attention deficit hyperactivity disorder (ADHD) is a childhood onset neuropsychiatric disorder characterized by inattention, hyperactivity and impulsivity. ADHD is related to several co-morbidities, such as opposition defiant disorder, conduct disorder, mood and anxiety disturbances, as well as tics and Tourette's syndrome. The objective of this report is to shed an alternative light on the personality of Ernesto "Che" Guevara, discussing whether he might have had ADHD. Several published biographies of Che Guevara were reviewed. Established ADHD criteria (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), were used as a framework to evaluate Che's behaviour. In addition, we compared the main features of Che's reported behaviour to the set of abnormalities leading to the diagnosis of ADHD in adults proposed by Wender and colleagues and known as the UTAH ADHD criteria. Analysis of the most renowned biographies of Ernesto "Che" Guevara suggests that he may have had ADHD.
Palmer, Nancy B.; Vander Stoep, Ann; McCarty, Carolyn A.; Geyer, John R.; DeSalvo, Amy
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders diagnosed in children and adolescents (youth). ADHD is equally distributed geographically, but services are not. Access to expert evaluation and treatment remains limited for youth with ADHD living in rural areas, as well as for ethnic and racial minority youth. Telepsychiatry is a service delivery model with the potential to reach these youth and to develop collaborative models of care among local primary care physicians, remote telepsychiatrists, and local families. Care delivered through telepsychiatry can readily adhere to the practice parameters of the American Academy of Child and Adolescent Psychiatry. Work to date indicates that ADHD is the most common disorder treated through telepsychiatry. This article reviews the status of child and adolescent telepsychiatry, with particular focus on its potential to improve the care and outcomes of underserved populations of youth diagnosed with ADHD. PMID:20625857
Semrud-Clikeman, Margaret; Bledsoe, Jesse
The relationship of attention-deficit/hyperactivity disorder (ADHD) to learning disorders was reviewed and included reading disability, mathematics learning disability, and nonverbal learning disability. Genetic, neuroimaging, and neuropsychological functioning were examined for each disorder, along with a discussion of any existing literature when ADHD co-occurred with the disorder. All the disorders were found to frequently co-occur with ADHD. A review of the underlying neuroanatomic and neurofunctional data found specific structures that frequently co-occur in these disorders with others that are specific to the individual diagnosis. Aberrations in structure and/or function were found for the caudate, corpus callosum, and cerebellum, making these structures sensitive for the disorder but not specific. Suggestions for future research, particularly in relation to intervention, are provided.
Montiel-Nava, Cecilia; Peña, Joaquín A
According to the DSM-IV-TR, symptoms of inattention and hyperactivity are frequent in children with Autism Spectrum Disorders (ASD). This statement is supported by clinical observation and formal assessment. However, ASD diagnosis is still among the exclusion criteria for the Attention-Deficit/Hyperactivity Disorder (ADHD). Such exclusion generates controversy and questions regarding the need and benefits of maintaining or not these separations; so much so, that the proposed criteria for the DSM-V eliminate that exclusion condition. It is necessary a better understanding of the comorbidity between both entities in order to be able to have an appropriate sequence of the intervention goals. For that reason, if inattention and hyperactivity in individuals with ASD are considered as a representation of a comorbid diagnosis of ADHD, treatment plans for this group would be better adjusted and more likely to offer a real benefit in the outcome of their adaptive functioning.
Loo, Sandra K; Barkley, Russell A
Electrophysiological measures were among the first to be used to study brain processes in children with attention deficit hyperactivity disorder (ADHD; Diagnostic and Statistical Manual of Mental Disorders [4th ed.], American Psychiatric Association, 1994) and have been used as such for over 30 years (see Hastings & Barkley, 1978, for an early review). More recently, electroencephalography (EEG) has been used both in research to describe and quantify the underlying neurophysiology of ADHD, but also clinically in the assessment, diagnosis, and treatment of ADHD. This review will first provide a brief overview of EEG and then present some of the research findings of EEG correlates in ADHD. Then, the utility of EEG in making an ADHD diagnosis and predicting stimulant response will be examined. Finally, and more controversially, we will review the results of the most recent studies on EEG biofeedback (neurofeedback) as a treatment for ADHD and the issues that remain to be addressed in the research examining the efficacy this therapeutic approach.
Alone or used with psychostimulants, psychotherapy is the keystone of the treatment in children attention deficit disorder hyperactivity (ADHD). This article explains in which matter psychotherapy is essential. To be well done, it's necessary before starting the treatment to analyze precisely the disorder and how it interferes with the child's environment. It describes how this functional analysis must be done in order to be more precise in the choice of the treatment objectives. This article explains why in children ADHD treatment, the individual therapy must be associated with a family training and describes briefly the more studied and recognized psychotherapy techniques in those children ADHD and how other partners (teacher, speech or motor therapist) are also useful.
Lundholm-Brown, L; Dildy, M E
This article gives a brief history and background of Attention Deficit Hyperactivity Disorder (ADHD) in childhood. A review of the medical model, including the diagnostic criteria and recommended protocols for treatment, is presented. An educational cultural model based on a holistic approach in assessing causes of hyperactivity and inattention is described. The Educational Cultural Model (ECM) synthesizes the effects of significant extrinsic factors in the life of the child, such as family dynamics, societal influences, and the educational system, and intrinsic factors, such as individual temperament, energy levels, learning style, giftedness, and personal interests. In addition to the primary purpose of comparing the medical model of ADHD to the conceptual ECM, this article is designed to stimulate thinking about different ways to view ADHD.
Badger, Karen; Anderson, Lori; Kagan, Richard J
This study explored the characteristics of children with burns who were also diagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD). The study was intended to identify and better understand the risk factors for such injuries and to help direct future burn prevention and education efforts for children with these underlying disorders. We performed a retrospective, comparison group study of 103 pediatric burn patients ranging in age from 5 to 18 years. Forty-four children who were diagnosed with ADD or ADHD at the time of their burn injury were compared with a random sample of 59 burn-injured children without the diagnosis of ADD or ADHD. Variables analyzed included patient demographics, cause of burn, length of hospitalization, engagement in high risk behavior at the time of injury, presence of other developmental, mental health diagnoses, and/or school behavior problems. The ADD or ADHD group had a significantly greater incidence of mental health and school behavior problems than other children with burn injuries. They also had a significantly greater history of high risk behavior at the time of injury than the comparison group. Children with ADD or ADHD who also had an additional mental health diagnosis had a higher incidence of school behavior problems. Our findings suggest the need for additional studies of children with ADD or ADHD who sustain burn injuries. Children with ADD or ADHD who have school behavior problems and/or a tendency to engage in high-risk behavior may be at greatest risk for burn injuries and most likely to benefit from educational counseling or other modalities of burn prevention.
Gmeindl, Leon; Courtney, Susan M.
Objective To investigate whether spatial working memory (WM) is impaired in multiple sclerosis (MS), and, if it is, to localize impairment to specific cognitive subprocess(es). Method In Experiment 1, MS and control participants performed computerized memory-span and visuomotor tasks. WM subprocesses were taxed by manipulating (1) the requirement to remember serial order, (2) delay duration, and (3) the presence of irrelevant stimuli during target presentation. In Experiment 2, recall and recognition tests varied the difficulty of WM retrieval. In Experiment 3, an attention-cueing task tested the ability to voluntarily and rapidly reorient attention. Results Performance was worse for MS than for control participants in both spatial recall (Exp. 1 span: 95% CIMS = [5.11, 5.57], 95% CIControls = [5.58, 6.03], p = 0.003, 1-tailed; Exp. 2 span: 95% CIMS = [4.44, 5.54], 95% CIControls = [5.47, 6.57], p = 0.006, 1-tailed) and recognition (accuracy: 95% CIMS = [0.71, 0.81], 95% CIControls = [0.79, 0.88], p = 0.01, 1-tailed) tests. However, there was no evidence for deficits in spatiotemporal binding, maintenance, retrieval, distractor suppression, or visuomotor processing. In contrast, MS participants were abnormally slow to reorient attention (cueing effect (ms): 95% CIMS: [90, 169], 95% CIControls: [29, 107], p = 0.015, 1-tailed). Conclusions Results suggest that, whereas spatial WM is impaired in MS, once spatial information has been adequately encoded into WM, individuals with MS are, on average, able to maintain and retrieve this information. Impoverished encoding of spatial information, however, may be due to inefficient voluntary orienting of attention. PMID:22059650
Bellgrove, Mark A; Hawi, Ziarih; Gill, Michael; Robertson, Ian H
Here we describe the application of cognitive genetics to the study of attention deficit hyperactivity disorder (ADHD). Cognitive genetics owes much to the pioneering work of cognitive neuropsychologists such as John Marshall, whose careful observations of cognitive dissociations between brain-lesioned patients greatly advanced the theoretical understanding of normal cognitive function. These theories have in turn helped to constrain linkages between candidate genes and cognitive processes and thus help to drive the relatively new field of cognitive genetics in a hypothesis-driven fashion. We examined the relationship between sustained attention deficits in ADHD and genetic variation in a catecholamine-related gene, dopamine beta hydroxylase (DbetaH). DBH encodes the enzyme that converts dopamine to noradrenaline and is crucial to catecholamine regulation. A polymorphism with the DBH gene has been associated with ADHD. In fifty-two children with ADHD, we examined whether variation in the Taq I DBH gene polymorphism was related to sustained attention performance. Participants performed the Sustained Attention to Response Test (SART). Performance on the SART discriminates ADHD from control children, and in imaging work, is associated with right frontoparietal activation. A significant effect of DBH genotype was found on SART performance measures. Children possessing two copies of the ADHD-associated risk allele (A2) had significantly poorer sustained attention than those ADHD children who did not possess this allele or a non-genotyped control group. The DBH gene may contribute to the susceptibility for ADHD, in part because of its varying effects on the development of brain mechanisms mediating sustained attention.
Murray, Laura L.
Purpose: This study was designed to further elucidate the relationship between cognition and aphasia, with a focus on attention. It was hypothesized that individuals with aphasia would display variable deficit patterns on tests of attention and other cognitive functions and that their attention deficits, particularly those of complex attention…
di Michele, Flavia; Prichep, Leslie; John, E Roy; Chabot, Robert J
Recent reviews of the neurobiology of Attention-Deficit/Hyperactivity Disorder (AD/HD) have concluded that there is no single pathophysiological profile underlying this disorder. Certainly, dysfunctions in the frontal/subcortical pathways that control attention and motor behavior are implicated. However, no diagnostic criteria or behavioral/neuroimaging techniques allow a clear discrimination among subtypes within this disorder, especially when problems with learning are also considered. Two major Quantitative EEG (QEEG) subtypes have been found to characterize AD/HD. Here we review the major findings in the neurophysiology of AD/HD, focusing on QEEG, and briefly present our previous findings using a source localization technique called Variable Resolution Electromagnetic Tomography (VARETA). These two techniques represent a possible objective method to identify specific patterns corresponding to EEG-defined subtypes of AD/HD. We then propose a model representing the distribution of the neural generators in these two major AD/HD subtypes, localized within basal ganglia and right anterior cortical regions, and hippocampal, para-hippocampal and temporal cortical regions, respectively. A comprehensive review of neurochemical, genetic, neuroimaging, pharmacological and neuropsychological evidence in support of this model is then presented. These results indicate the value of the neurophysiological model of AD/HD and support the involvement of different neuroanatomical systems, particularly the dopaminergic pathways.
Ozel-Kizil, Erguvan Tugba; Kokurcan, Ahmet; Aksoy, Umut Mert; Kanat, Bilgen Bicer; Sakarya, Direnc; Bastug, Gulbahar; Colak, Burcin; Altunoz, Umut; Kirici, Sevinc; Demirbas, Hatice; Oncu, Bedriye
Patients with Attention Deficit Hyperactivity Disorder (ADHD) suffer not only from inability to focus but also from inability to shift attention for events that trigger their interests. This phenomenon is called "hyperfocusing". Previous literature about hyperfocusing is scarce and relies mainly on case reports. The study aimed to investigate and compare the severity of hyperfocusing in adult ADHD with and without psycho-stimulant use. ADHD (DSM-IV-TR) patients either psycho-stimulant naive (n=53) or on psycho-stimulants (n=79) from two ADHD clinics were recruited. The control group (n=65) consisted of healthy university students. A socio-demographic form, the Beck Depression Inventory, the Wender-Utah Rating Scale, the Adult ADHD Self- Report Scale and the Hyperfocusing Scale were applied to the participants. There was no difference between total Hyperfocusing Scale and Adult ADHD Self- Report Scale scores of two patient groups, but both have higher scores than controls (p<0.001). Hyperfocusing is higher in adult ADHD and there was no difference between stimulant-naive patients or patients on stimulants. Hyperfocusing can be defined as a separate dimension of adult ADHD.
Nugent, Kevin; Smart, Wallace
A PubMed review was conducted for papers reporting on attention-deficit/hyperactivity disorder (ADHD) in postsecondary students. The review was performed in order to determine the prevalence and symptomatology of ADHD in postsecondary students, to examine its effects on academic achievement, and discuss appropriate management. The prevalence of ADHD symptoms among postsecondary students ranges from 2% to 12%. Students with ADHD have lower grade point averages and are more likely to withdraw from courses, to indulge in risky behaviors, and to have other psychiatric comorbidities than their non-ADHD peers. Ensuring that students with ADHD receive appropriate support requires documented evidence of impairment to academic and day-to-day functioning. In adults with ADHD, stimulants improve concentration and attention, although improved academic productivity remains to be demonstrated. ADHD negatively impacts academic performance in students and increases the likelihood of drug and alcohol problems. Affected students may therefore benefit from disability support services, academic accommodations, and pharmacological treatment. PMID:25298735
Madras, Bertha K; Miller, Gregory M; Fischman, Alan J
The high incidence of attention-deficit/hyperactivity disorder (ADHD) and escalating use of ADHD medications present a compelling case for clarifying the pathophysiology of, and developing laboratory or radiologic tests for, ADHD. Currently, the majority of specific genes implicated in ADHD encode components of catecholamine signaling systems. Of these, the dopamine transporter (DAT) is a principal target of the most widely used antihyperactivity medications (amphetamine and methylphenidate); the DAT gene is associated with ADHD, and some studies have detected abnormal levels of the DAT in brain striatum of ADHD subjects. Medications for ADHD interfere with dopamine transport by brain-region- and drug-specific mechanisms, indirectly activating dopamine- and possibly norepinephrine-receptor subtypes that are implicated in enhancing attention and experiential salience. The most commonly used DAT-selective ADHD medications raise extracellular dopamine levels in DAT-rich brain regions. In brain regions expressing both the DAT and the norepinephrine transporter (NET), the relative contributions of dopamine and norepinephrine to ADHD pathophysiology and therapeutic response are obfuscated by the capacity of the NET to clear dopamine as well as norepinephrine. Thus, ADHD medications targeting DAT or NET might disperse dopamine widely and consign dopamine storage and release to regulation by noradrenergic, as well as dopaminergic neurons.
Morozova, E A; Belousova, M B
One-hundred and seven patients, aged 7-12 years, with attention deficit hyperactivity disorder (ADHD) were studied. All children were examined with psychoneurologist, additional methods included electroencephalography (EEG), ultrasound dopplerography of brachiocephalic vessels (USDG), rheoencephalography (REG), craniography and spondilography of the cervical spine. Perinatal adversities were recorded in 81.3% of children; pathological pregnancy (gestosis-26.6%, threat of miscarriage in 21.5%, treatment of latent urogenital infections -27.1% and others) and pathological deliveries (powerless labor-54.2%, asphyxia-21.5% etc) were also often observed; 43.9% of patients were discharged from the maternity hospital with diagnosis of hypoxic-traumatic CNS lesion. Mild mental retardation during the first year of life was reported in 41.1% of children, in 21.5% it remained for 3 years. The neurological study revealed coordination disturbances (31.8%), cervical insufficiency (67.9%), pyramidal insufficiency (33.6%). The changes correlating with perinatal pathology were shown by EEG, USDG and REG. Spondilography of the cervical spine confirmed the signs of the survived natal trauma in 45.8% of cases. All children received the complex therapy including drugs which improve the cerebral dynamics, nootropics, electrophoresis of spasmolytics in the cervical spine, psychotherapy sessions. Forty patients in addition received atomoxetine (strattera), the inhibitor of noradrenalin reuptake. The physician and parents as well reported the positive dynamics of patient's state as assessed the neurological status and performance on neuropsychological tests on attention concentration.
Dige, Niels; Maahr, Eija; Backenroth-Ohsako, Gunnel
Neuropsychological tests were used to evaluate different memory systems in the three subgroups of adult Attention Deficit Hyperactivity Disorder (ADHD) (n=105) using analysis of means, factor analysis, and GLM analysis with covariance of gender, estimated IQ, and level of anxiety and depression measured with the Hospital anxiety and depression scale. A higher IQ level was found in the neuropsychological background tests for the predominantly inattentive subtype (ADD). In the memory tests the dual-task memory/simultaneous capacity tests "Brown-Peterson" Consonant Trigram and Benton Visual Retention Test (BVRT) were the most sensitive and were severely reduced in all three subgroups, but only the BVRT revealed a difference between the three ADHD groups. In learning and delayed recall measured with Rey Auditory Verbal learning test and modified Diagnosticum für Cerebralschädigung (mDCS), the Attention Deficit Disorder subgroup had the best learning and delayed capacity of the three groups. A good agreement was found between the interviewed DSM-IV-TR criteria, Conners CAARS S:S scale, and Wender WURS 25-item scales. Despite the difference in number of ADHD criteria for the three ADHD subgroups, the results in the neuropsychological memory tests indicate a severe reduction in all three subgroups of adult ADHD in simultaneous capacity.
Desman, Christiane; Petermann, Franz; Hampel, Petra
To date, neuropsychological and psycho-physiological studies have revealed inconsistent results regarding an executive or motivational deficit explaining the response inhibition deficit in children with attention deficit/hyperactivity disorder (ADHD). Research on differentiating neuropsychological processes in ADHD subtypes is still scarce. Therefore, the motivational impact on response inhibition among boys with ADHD was examined in this study. In the first study, 19 boys with ADHD-combined type (ADHD-C) and 19 age-matched healthy control subjects performed a modified Go/No-Go task with the following experimental conditions: neutral, auditory feedback, reward, response cost, and reward/response cost. Performance and physiological data (heart rate and skin conductance responses) were recorded. In a second study with the modified Go/No-Go task, data for six children with ADHD-C, six with ADHD-inattentive subtype (ADHD-I), and six healthy control subjects were compared. Neither of the two studies revealed group by condition interactions. In study 1, boys with ADHD-C generally made more commissions and omissions compared to the control group. However, feedback significantly improved the response inhibition in all children. The heart rate of all children was increased in the two conditions of reward and reward/response cost. Study 2 revealed that children with ADHD-I responded more slowly and showed increased reaction time variability compared to both other groups. The present study supports an executive rather than a motivational deficit in the response inhibition among children with ADHD-C, though further results also indicate the role of auditory feedback on response inhibition. Additionally, the findings support the differentiation of ADHD-C and ADHD-I, suggesting that ADHD-I children are characterized by a sluggish cognitive tempo.
Bergwerff, Catharina E; Luman, Marjolein; Oosterlaan, Jaap
The main goal of this study was to gain more insight into sleep disturbances in children with attention-deficit/hyperactivity disorder, using objective measures of sleep quality and quantity. The evidence for sleep problems in children with attention-deficit/hyperactivity disorder thus far is inconsistent, which might be explained by confounding influences of comorbid internalizing and externalizing problems and low socio-economic status. We therefore investigated the mediating and moderating role of these factors in the association between attention-deficit/hyperactivity disorder and sleep problems. To control for the effects of stimulant medication use, all participants were tested free of medication. Sixty-three children with attention-deficit/hyperactivity disorder and 61 typically developing children, aged 6-13 years, participated. Sleep was monitored for one to three school nights using actigraphy. Parent and teacher questionnaires assessed symptoms of attention-deficit/hyperactivity disorder, internalizing behaviour, oppositional defiant disorder and conduct disorder. Results showed no differences between the attention-deficit/hyperactivity disorder and typically developing group in any sleep parameter. Within the attention-deficit/hyperactivity disorder group, severity of attention-deficit/hyperactivity disorder symptoms was not related to sleep quality or quantity. Moderation analyses in the attention-deficit/hyperactivity disorder group showed an interaction effect between attention-deficit/hyperactivity disorder symptoms and internalizing and externalizing behaviour on total sleep time, time in bed and average sleep bout duration. The results of our study suggest that having attention-deficit/hyperactivity disorder is not a risk factor for sleep problems. Internalizing and externalizing behaviour moderate the association between attention-deficit/hyperactivity disorder and sleep, indicating a complex interplay between psychiatric symptoms and sleep.
BAHÇİVAN SAYDAM, Reyhan; AYVAŞIK, H. Belgin; ALYANAK, Behiye
Introduction This study aims to evaluate executive functions (EF), such as inhibition, planning, working memory, and set shifting, in children with attention deficit hyperactivity disorder (ADHD) by comparing three ADHD subtype groups (ADHD-Inattentive, ADHD-Combined, and ADHD-Comorbid) and a normal control group. Methods Participants included 147 children. In total, 111 children were assigned to the ADHD groups of the study. Each child was matched according to the WISC-R Full-Scale IQ-score, sex, and age and was grouped as follows: ADHD-Inattentive group (ADHD-I; n=37), ADHD-Combined (ADHD-C; n=37), ADHD-Comorbid group (ADHD-Comorbid with oppositional defiant disorder and/or conduct disorder; n=37), and control group (n=36). The tests used to assess the children were Conners’ Parent and Teacher Rating Scales; Wechsler Intelligence Scale-Revised; Tower of London test; Wisconsin Card Sorting Test; Stroop Color-Word Test, and verbal fluency test. The data were analyzed by one-way ANOVA between subjects for all dependent variables. Results Children in the ADHD-I group had significantly better performances in verbal working memory and verbal category shifting than children in the ADHD-C group. There was no significant difference between the ADHD-I and ADHD-C groups in terms of inhibition, set shifting, verbal fluency, cognitive flexibility, and planning. The ADHD-Comorbid group displayed more severe impairments in EF measures than the ADHD-C group; however, the severity was not statistically significant. EF performances of children in the control group were similar to children in the ADHD-I group but better than children in the ADHD-C and ADHD-Comorbid groups. Conclusion The outcome of the study indicated that subjects in the ADHD-Comorbid and ADHD-C groups had more severe EF deficits than subjects in the ADHD-I and control groups.
Frank, Jennifer Sandson; Vance, David E; Jukkala, Angela; Meneses, Karen M
Breast cancer survivors (BCSs) commonly report deficits in attention and memory, cognitive functions crucial for daily optimal functioning. Perceived deficits are reported before, during, and after adjuvant therapy and affect quality of life throughout survivorship. Deficits of attention and memory are particularly disruptive for BCSs working or attending school who report that subtle impairment diminishes their confidence and their performance at all levels of occupation. Chemotherapy and endocrine therapy contribute to attention and memory deficits, but research findings have not fully established the extent or timing of that influence. Fortunately, potential interventions for attention and memory deficits in BCSs are promising. These include cognitive remediation therapies aimed at training for specific areas of deficit, cognitive behavioral therapies aimed at developing compensatory strategies for areas of deficit, complementary therapies, and pharmacologic therapies.
Moreau, Vincent; Rouleau, Nancie; Morin, Charles M
The objective of this study was to investigate potential relationships between two measures of sleep impairments (i.e., sleep duration and sleep efficiency [SE]) and attention and executive functioning in children with attention-deficit/hyperactivity disorder (ADHD). Parents of 43 children (mean age = 10 ± 1.8 years) with ADHD completed sleep and behavioral questionnaires. Children also wore a wrist actigraph for seven nights and were subsequently assessed with the Conners' continuous performance test (CPT)-2. A significant relationship was found between lower SE and increased variability in reaction time on the CPT. Shorter sleep duration was associated with a range of executive functioning problems as reported by the parents. The relationships between sleep duration and the executive functioning measures held even after controlling for age, gender, and use of medication, but not the relationships with SE. These results suggest that sleep quantity is an important correlate of executive functioning in children with ADHD.
Biederman, Joseph; Monuteaux, Michael C.; Doyle, Alysa E.; Seidman, Larry J.; Wilens, Timothy E.; Ferrero, Frances; Morgan, Christie L.; Faraone, Stephen V.
The association between executive function deficits (EFDs) and functional outcomes were examined among children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Participants were children and adolescents with (n = 259) and without (n = 222) ADHD, as ascertained from pediatric and psychiatric clinics. The authors defined EFD as…
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.
Ramos-Quiroga, Josep A; Sánchez-Mora, Cristina; Corominas, Margarida; Martínez, Iris; Barrau, Víctor; Prats, Laura; Casas, Miguel; Ribasés, Marta
The existing literature that reports findings linked with the involvement of neurotrophic factors in attention deficit hyperactivity disorder (ADHD) is reviewed. Neurotrophins, a family of neurotrophic factors, are a kind of proteins that are specific to the nervous system and play an essential role in neuron survival, differentiation and proliferation during the development of the central and peripheral nervous system. These molecules stimulate axonal growth and exert an influence on the connections with the target tissue in order to establish the synaptic connections. The study of neurotrophins in ADHD, a neurodevelopmental disorder, is of interest mainly due to the functions that these proteins perform in the central nervous system. Studies on animal, pharmacological and molecular genetic models yield evidence that relates neurotrophins with the disorder. This work reviews the results from the studies conducted to date on ADHD and neurotrophic factors, especially brain-derived neurotrophic factor (BDNF). Thus, although pharmacological studies suggest that the response to atomoxetine in adults with ADHD is not directly mediated by the effect on the BDNF, reductions in BDNF levels in the plasma of adult patients with ADHD have been reported. Further studies with broader samples and greater control of environmental factors that can regulate neurotrophin expression, such as diet, physical exercise and situations of social risk, are needed to be able to determine the role they play in the aetiology of ADHD.
Singh, Ajay; Yeh, Chia Jung; Verma, Nidhi; Das, Ajay Kumar
Attention deficit hyperactivity disorder (ADHD) is a complex disorder, which can be seen as a disorder of life time, developing in preschool years and manifesting symptoms (full and/or partial) throughout the adulthood; therefore, it is not surprising that there are no simple solutions. The aim of this paper is to provide a short and concise review which can be used to inform affected children and adults; family members of affected children and adults, and other medical, paramedical, non-medical, and educational professionals about the disorder. This paper has also tried to look into the process of how ADHD develops; what are the associated problems; and how many other children and adults are affected by such problems all over the world basically to understand ADHD more precisely in order to develop a better medical and or non-medical multimodal intervention plan. If preschool teachers and clinicians are aware of what the research tells us about ADHD, the varying theories of its cause, and which areas need further research, the knowledge will assist them in supporting the families of children with ADHD. By including information in this review about the connection between biological behavior, it is hoped that preschool teachers and clinicians at all levels will feel more confident about explaining to parents of ADHD children, and older ADHD children themselves about the probable causes of ADHD. PMID:26973960
Dennis, Tanya; Davis, Monica; Johnson, Ursula; Brooks, Hoplyn; Humbi, Annette
Attention deficit hyperactivity disorder (ADHD) is a prevalent childhood psychiatric condition. This study was a qualitative investigation with parents and professionals conducted in two north London boroughs, using focus groups as well as semi-structured and narrative interviews. The aim was to explore parents' and professionals' beliefs regarding the causes of ADHD and their perceptions of service provision. The sample was drawn purposively from GP practices and voluntary support groups. Professionals were recruited via professional networks. Analysis was thematic. It was found that the views of parents and professionals differed. Professionals were more likely to see ADHD as a medical condition, while parents were more likely to see ADHD in association with socio-environmental causes. Delayed diagnosis, inadequate access to information and a lack of co-ordinated care are stated as some of the reasons for parental dissatisfaction with services. Professionals emphasised the need for multidisciplinary input into the management of ADHD. The implications of these findings were that parents often battled with professionals to encourage them to see their viewpoint, access to treatment was influenced by the views of parents and professionals, and noncompliance occurred when parents had different views from professionals.
According to the DSM-5, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are different conditions that earlier versions of the DSM stated could not be diagnosed together in the same individual. Yet, over the last few decades the debate on the limits between the two disorders has continued, even though ADHD and ASD are undoubtedly clinically and cognitively different phenotypes, as demonstrated by the simple fact that they have been defined in clearly different ways. Thus, from a perspective anchored in a purely phenomenological view, there would be no grounds whatsoever on which to question the independence between the two disorders. Since, at the present time, the discussion on the convergence between ADHD and ASD cannot be considered to have been solved, this study aims to take the data available from genetics as the basis on which to review the nosological position of the two disorders. The main studies that have addressed this issue are reviewed. The data collected agree on a genetic overlap between ADHD and ASD, which is influenced by common molecular mechanisms that affect the two disorders at the same time. The conclusions that can be drawn from the data collected suggest a new conceptual model not only for ADHD and ASD, but also for complex mental disorders in general. This line of research will transform the way of understanding the treatment of mental disorders and will almost certainly open up new perspectives in this area.
Usher, Amelia M; Stewart, Lynn A; Wilton, Geoff
Previous research has shown that a significant percentage of offenders are affected by adult attention deficit hyperactivity disorder (ADHD) and its related symptoms, however it is unknown the extent to which this disorder affects federal inmates in Canada and the impact ADHD has on key correctional outcomes. Four hundred and ninety-seven male federal offenders were assessed at intake over a fourteen month period using the Adult ADHD Self-Report Scale (ASRS). Approximately 16.5% scored in the highest range, which is consistent with the clinical threshold for diagnosis for the disorder; a further 25.2% reported sub-threshold symptoms in the moderate range. ADHD symptoms were found to be associated with unstable job history, presence of a learning disability, lower educational attainment, substance abuse, higher criminal risk and need levels, and other mental health problems. ADHD symptoms were also found to predict institutional misconduct. Additionally, offenders with high levels of ADHD symptomatology fared more poorly on release to the community. Implications for institutional behavior management and the need for additional resources and adapted interventions are discussed.
Chau, Yvonne C Y; Lai, Kelly Y C; McGrath, Colman P J; Yiu, Cynthia K Y
This study assessed and compared oral health and oral-health behaviours among children with and without attention deficit hyperactivity disorder (ADHD). The study included 31 children, 12-18 yr of age, with ADHD and 31 age- and gender-matched children without ADHD. Clinical data were recorded by a trained and calibrated examiner for caries, traumatic dental injuries, periodontal health, tooth wear, and salivary function. A questionnaire was also given to parents or caregivers about the oral health habits and behaviours of these children. Data were compared using Mann-Whitney U-tests and chi-square tests. No significant differences were found between children, with or without ADHD, in caries extent or prevalence, dental trauma prevalence, prevalence of periodontal disease or plaque, tooth wear, or unstimulated salivary flow. Children with ADHD had a significantly higher percentage of sites with gingival bleeding, as well as a higher frequency of parent-reported dislike of dentists, bruxism, history of assisted toothbrushing, and toothbrushing duration <1 min. They also had higher attendance at government dental clinics. The findings indicate that children with ADHD have poorer oral hygiene and more adverse oral-health attitudes and behaviours than do children without ADHD.
Zaimoğlu, Sennur; Türkdoğan, Dilşad; Mazlum, Betül; Bekiroğlu, Nural; Tetik-Kabil, Aylin; Eyilikeder, Seda
The authors investigated the parameters for predicting epileptiform abnormalities in a group of children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 148 subjects aged between 6 and 13 (8.76 ± 1.26; 25.7% female) years. Subtypes of ADHD and comorbid psychiatric disorders were defined according to DSM-IV criteria. The Wechsler Intelligence Scale for Children-Revised was applied to all patients. Most of the subjects (89.2%) had wakefulness and sleep electroencephalography examinations lasting about one hour. The authors found out that the coexistence of speech sound disorder (odds ratio [OR] 3.90, 95% confidence interval [CI]: 1.61-9.48) and higher Digit Span test performance (OR 1.24, 95% CI: 1.06-1.44) predicted the presence of accompanying epileptiform abnormalities. The prevalence of epileptiform abnormalities was 26.4%, and they were frequently localized in the frontal (41%) and centrotemporal (28.2%) regions. Higher percentage of speech sound disorder co-occurrence (64%) in subjects with rolandic spikes suggests that epileptiform abnormalities associated with ADHD can be determined genetically at least in some cases. Pathophysiology of epileptiform abnormalities in ADHD might have complex genetic and maturational background.
Zavadenko, N N; Kolobova, N M; Suvorinova, N Iu
Frequency of comorbid disorders and neuropsychological state, executive functions (EF), were studied in two groups of patients aged from 5 to 14 years: 53 patients with attention-deficit hyperactivity disorder (ADHD) in the association with enuresis and 71 patients with ADHD without enuresis. The most cases of enuresis (50 out of 53 patients) were represented by primary nocturnal enuresis. The significant increase of total number of ADHD cases with comorbidity for oppositional-defiant disorder, anxiety disorder, tics or encopresis (77.7%) was found in the first group compared to the second one (60.6%). The presence of enuresis in ADHD was associated with the significant increase of frequency of anxiety disorders (54.7% versus 39.4%). Moreover, in the group of patients with ADHD and enuresis, the frequency of oppositional-defiant disorder and encopresis was higher in the age of 5-9 years while the frequency of obsessive-compulsive disorder and tics increased in the period of 10-14 years as compared to patients without enuresis. The assessment of executive functions with the Wisconsin Card Sorting Test did not reveal any differences between patients of two groups.
Although generally considered a childhood disorder, attention-deficit/hyperactivity disorder (ADHD) can persist into adulthood and impede achievement in the workplace. Core ADHD symptoms of inattention, hyperactivity, and impulsivity can be associated with poor organization, time management, and interpersonal relationships. Employment levels, earning power, and productivity are reduced among individuals with ADHD compared with those without ADHD. Furthermore, the costs of employing individuals with ADHD are higher because of work absences and lost productivity. The primary care provider plays an integral role in managing ADHD symptoms and providing the necessary resources that will help individuals with ADHD succeed in the workplace. Pharmacotherapy can reduce ADHD symptoms and improve functioning; however, it is also important to consider how positive traits associated with ADHD, such as creative thinking, can be used in the workplace. Workplace accommodations and behavioral therapies, such as coaching, can also enhance time management and organizational skills. This review describes how ADHD symptoms affect workplace behaviors, the effect of ADHD on employment and workplace performance, and the management of ADHD in working adults.
Purpose Attention-deficit/hyperactivity disorder (ADHD) is a ubiquitous designation that affects the identification, assessment, treatment, and study of pediatric language impairments (LIs). Method Current literature is reviewed in 4 areas: (a) the capacity of psycholinguistic, neuropsychological, and socioemotional behavioral indices to differentiate cases of LI from ADHD; (b) the impact of co-occurring ADHD on children's LI; (c) cross-etiology comparisons of the nonlinguistic abilities of children with ADHD and specific LI (SLI); and (d) the extent to which ADHD contributes to educational and health disparities among individuals with LI. Results Evidence is presented demonstrating the value of using adjusted parent ratings of ADHD symptoms and targeted assessments of children's tense marking, nonword repetition, and sentence recall for differential diagnosis and the identification of comorbidity. Reports suggest that the presence of ADHD does not aggravate children's LI. The potential value of cross-etiology comparisons testing the necessity and sufficiency of proposed nonlinguistic contributors to the etiology of SLI is demonstrated through key studies. Reports suggest that children with comorbid ADHD+LI receive speech-language services at a higher rate than children with SLI. Conclusion The ADHD context is multifaceted and provides the management and study of LI with both opportunities and obstacles. PMID:26502026
Akinci, Gulcin; Oztura, Ibrahim; Hiz, Semra; Akdogan, Ozlem; Karaarslan, Dilay; Ozek, Handan; Akay, Aynur
The authors evaluated basic sleep architecture and non-rapid eye movement (NREM) sleep alterations in drug-naïve attention-deficit/hyperactivity disorder (ADHD) children without psychiatric or other comorbidities. This cross-sectional case-control study included 28 drug-naïve children with ADHD and 15 healthy controls. This subjective studies revealed that children with ADHD had a worse sleep quality and increased daytime sleepiness. Polysomnography data showed that the sleep macrostructure was not significantly different in children with ADHD. Sleep microstructure was altered in ADHD children by means of reduced total cyclic alternating pattern rate and duration of cyclic alternating pattern sequences. This reduction was associated with a selective decrease of A1 index during stage 2 NREM. SpO2 in total sleep was slightly decreased; however, the incidence of sleep disordered breathing showed no significant difference. The authors suggest that cyclic alternating pattern scoring would provide a further insight to obtain a better understanding of the sleep structure in children with ADHD.
McLennan, John D.
Abstract Objective To review research findings that consider whether attention deficit hyperactivity disorder (ADHD) is a discrete entity or whether it is more consistent with an extreme end-of-trait distribution in the population and to then grapple with the potential clinical implications. Quality of evidence Peer-reviewed publications in the past 5 years, drawing from diverse fields (taxonomy, epidemiology, genetics, neurobiology, and neuropsychology), were identified through searches in MEDLINE and PsycINFO. Main message Accumulating research findings are most consistent with a predominately dimensional rather than a qualitatively distinct existence for ADHD. This does not negate the clinical needs of those who have substantial ADHD symptom clusters, nor the risks that such symptoms entail. However, the lack of discontinuity in the distribution of such traits in the population creates great uncertainty as to what thresholds should prompt explicit intervention. Conclusion The implications of this pattern of findings might include the need to de-emphasize categorical conceptualizations of ADHD, produce evidence to better inform risk-benefit ratios of interventions along a spectrum of symptom and functional severity, and more coherently triage and arrange service delivery on the basis of symptom and functional severity rather than artificial diagnostic categorizations. PMID:27965331
Yorbik, Ozgur; Mutlu, Caner; Tanju, Ilhan Asya; Celik, Dincer; Ozcan, Omer
The mean platelet volume (MPV), the accurate measure of platelet size, is considered a marker and determinant of platelet function. MPV can be a potentially useful prognostic biomarker in patients with cardiovascular disease. After reviewing literature, we hypothesized that attention deficit hyperactivity disorder (ADHD) in childhood may be a risk factor for coronary heart disease (CHD) in adulthood. The aim of this study was investigation of MPV and platelet count (PLT) in children with ADHD and healthy subjects. The MPV and the PLT were measured in 70 children with ADHD (aged 6-16 years), and compared with 41 healthy controls. The MPV was found to be significantly increased in ADHD group compared to control group (p=.006). There was no significant difference in the PLT between groups (p>.05). To our knowledge, this was the first study of investigating the levels of MPV and PLT in children with ADHD. Although significance and cause of increased MPV level in ADHD remain unclear in present study, further studies are warranted to investigate relationships among MPV, ADHD in childhood and CHD in adulthood.
Kanarek, Robin B
Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders in children. Symptoms of ADHD include hyperactivity, low frustration tolerance, impulsivity, and inattention. While the biological pathways leading to ADHD are not clearly delineated, a number of genetic and environmental risk factors for the disorder are recognized. In the early 1970s, research conducted by Dr. Benjamin Feingold found that when hyperactive children were given a diet free of artificial food additives and dyes, symptoms of hyperactivity were reduced. While some clinical studies supported these findings, more rigorous empirical studies conducted over the next 20 years were less positive. As a result, research on the role of food additives in contributing to ADHD waned. In recent years, however, interest in this area has revived. In response to more recent research and public petitions, in December 2009 the British government requested that food manufacturers remove most artificial food dyes from their products. While these strictures could have positive effects on behavior, the removal of food dyes is not a panacea for ADHD, which is a multifaceted disorder with both biological and environmental underpinnings.
Joo, Eun-Jeong; Lee, Kyu Young; Choi, Kyeong-Sook; Kim, Se Hyun; Song, Joo Youn; Bang, Yang Weon; Ahn, Yong Min; Kim, Yong Sik
A significant overlap between childhood mood disorders and many aspects of attention deficit hyperactivity disorder (ADHD) has been established. High rates of co-occurrence, familial aggregation, and more severe clinical manifestations of the illnesses when they are comorbid suggest that common genetic and environmental factors may contribute to the development of both disorders. Research on the co-occurrence of childhood ADHD and mood disorders in childhood has been conducted. We retrospectively investigated childhood ADHD features in adults with mood disorders. Childhood ADHD features were measured with the Korean version of the Wender Utah Rating Scale (WURS). The sample consisted of 1305 subjects: 108 subjects were diagnosed with bipolar disorder type I, 41 with bipolar disorder type II, 101 with major depressive disorder, and 1055 served as normal controls. We compared total WURS scores as well as scores on 3 factors (impulsivity, inattention, and mood instability and anxiety) among the 4 different diagnostic groups. The 4 groups differed significantly from one another on all scores. The group with bipolar disorder type II obtained the highest total scores on the WURS. The impulsivity and inattention associated with childhood ADHD were more significantly related to bipolar disorder type II than with bipolar disorder type I. The mood instability and anxiety associated with childhood ADHD seem to be significantly related to major depressive disorder in adulthood. In conclusion, multifactorial childhood ADHD features were associated with mood disorders of adulthood.
Schimmelmann, Benno Graf; Friedel, Susann; Christiansen, Hanna; Dempfle, Astrid; Hinney, Anke; Hebebrand, Johannes
Attention-Deficit and Hyperactivity Disorder (ADHD) is a common child and adolescent psychiatric disorder with a prevalence rate of 3-7%. Formal genetic studies provided an estimated heritability of 0.6-0.8 and an approximately five-fold elevated risk for ADHD in first-degree relatives. Currently, four genome scans have led to the identification of chromosomal regions potentially relevant in ADHD; especially the evidence for linkage to chromosome 5p13 is convincing. Meta-analyses of a large number of candidate gene studies suggest association with gene variants of the dopaminergic receptors DRD4 and DRD5, the serotonergic receptor HTR1B, and the synaptosomal receptor protein (SNAP-25). Hyperactivity has been investigated particularly in animal models, focusing on knockout- and quantitative trait loci (QTL) designs, with promising results for the dopaminergic system. It is likely that several gene polymorphisms with moderate to small effect sizes contribute to the phenotype ADHD; different combinations of such predisposing variants presumably underlie ADHD in different individuals. Therefore, large samples for molecular genetic studies are mandatory to detect these polymorphisms. Accordingly, several of today's findings have to be regarded as preliminary. The understanding of ADHD's neurobiology may be advanced by new technologies, such as SNP-based genome scans performed with gene chips comprising 10,000-1,000,000 SNPs, as well as using more sophisticated animal model designs.
Golmirzaei, Javad; Namazi, Shole; Amiri, Shahrokh; Zare, Shahram; Rastikerdar, Najme; Hesam, Ali Akbar; Rahami, Zahra; Ghasemian, Fatemeh; Namazi, Seyyed Shojaeddin; Paknahad, Abbas; Mahmudi, Forugh; Mahboobi, Hamidreza; Khorgoei, Tahereh; Niknejad, Bahareh; Dehghani, Fatemeh; Asadi, Shima
Background. Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders among children. The aim of this study was to evaluate risk factors for ADHD in children. Method. In this case-control study, 404 children between 4 and 11 years old were selected by cluster sampling method from preschool children (208 patients as cases and 196 controls). All the participants were interviewed by a child and adolescent psychiatrist to survey risk factors of ADHD. Results. Among cases, 59.3% of children were boys and 38.4% were girls, which is different to that in control group with 40.7% boys and 61.6% girls. The chi-square showed statistically significance (P value < 0.0001). The other significant factors by chi-square were fathers' somatic or psychiatric disease (P value < 0.0001), history of trauma and accident during pregnancy (P value = 0.039), abortion proceeds (P value < 0.0001), unintended pregnancy (P value < 0.0001), and history of head trauma (P value < 0.0001). Conclusions. Findings of our study suggest that maternal and paternal adverse events were associated with ADHD symptoms, but breast feeding is a protective factor. PMID:24319465
Esparham, Anna; Evans, Randall G.; Wagner, Leigh E.; Drisko, Jeanne A.
Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in children and is increasing in prevalence. There has also been a related increase in prescribing stimulant medication despite some controversy whether ADHD medication makes a lasting difference in school performance or achievement. Families who are apprehensive about side effects and with concerns for efficacy of medication pursue integrative medicine as an alternative or adjunct to pharmacologic and cognitive behavioral treatment approaches. Integrative medicine incorporates evidence-based medicine, both conventional and complementary and alternative therapies, to deliver personalized care to the patient, emphasizing diet, nutrients, gut health, and environmental influences as a means to decrease symptoms associated with chronic disorders. Pediatric integrative medicine practitioners are increasing in number throughout the United States because of improvement in patient health outcomes. However, limited funding and poor research design interfere with generalizable treatment approaches utilizing integrative medicine. The use of research designs originally intended for drugs and procedures are not suitable for many integrative medicine approaches. This article serves to highlight integrative medicine approaches in use today for children with ADHD, including dietary therapies, nutritional supplements, environmental hygiene, and neurofeedback. PMID:27417475
Mooney, Michael A.; McWeeney, Shannon K.; Faraone, Stephen V.; Hinney, Anke; Hebebrand, Johannes; Nigg, Joel T.; Wilmot, Beth
Despite a wealth of evidence for the role of genetics in attention deficit hyperactivity disorder (ADHD), specific and definitive genetic mechanisms have not been identified. Pathway analyses, a subset of gene-set analyses, extend the knowledge gained from genome-wide association studies (GWAS) by providing functional context for genetic associations. However, there are numerous methods for association testing of gene sets and no real consensus regarding the best approach. The present study applied six pathway analysis methods to identify pathways associated with ADHD in two GWAS datasets from the Psychiatric Genomics Consortium. Methods that utilize genotypes to model pathway-level effects identified more replicable pathway associations than methods using summary statistics. In addition, pathways implicated by more than one method were significantly more likely to replicate. A number of brain-relevant pathways, such as RhoA signaling, glycosaminoglycan biosynthesis, fibroblast growth factor receptor activity, and pathways containing potassium channel genes, were nominally significant by multiple methods in both datasets. These results support previous hypotheses about the role of regulation of neurotransmitter release, neurite outgrowth and axon guidance in contributing to the ADHD phenotype and suggest the value of cross-method convergence in evaluating pathway analysis results. PMID:27004716
Yousefi Chaijan, Parsa; Sharafkhah, Mojtaba; Abdolrazaghnejad, Ali; Amiri, Mohammad; Ebrahimi Monfared, Mohsen; Fatemi Tabaei, Saghi
Attention deficit hyperactivity disorder (ADHD) and Anxiety is the most common childhood psychiatric disorder. Based on studies, these disorders are more prevalent in some chronic disease. This study aimed at investigating the prevalence of ADHD and anxiety in children with malignancy and anxiety in their parents and comparing the results with those of the control group. One hundred, 3-15-year-old children with malignancy and 100 healthy children without malignancy or any chronic disease were included in this case-control study as case and control groups, respectively. Subjects were selected from children who were referred to the pediatric ward of Amir Kabir Hospital of Arak, Iran, in the form of simple probability and based on inclusion and exclusion criteria. ADHD and Anxiety were diagnosed by Conner's Parent Rating Scale-48 (CPRS-48) and Hamilton Anxiety Rating Scale (HARS) and were confirmed by psychologist consult. Data were analyzed by Student t-test in SPSS18. ADHD was observed in 23 cases (23%) with malignancy and 5 controls (5%) (P=0.001). In the case group, 57 children (57%) and 45 of their parents (45%) were suffering from anxiety while in the control group the figure was observed in 12 children (12%) and 11 of their parents (11%) (P=0.001). ADHD and anxiety are more common in children with malignancy as compared with children without malignancy and anxiety is also more common in their parents. Therefore, implementing interventions and psychiatric counseling are recommended for these children and their parents.
Pliszka, Steven R
Stimulants are a highly efficacious and safe treatment for attention-deficit/hyperactivity disorder (ADHD), with 75% to 90% of patients responding well if two different stimulants (amphetamine and methylphenidate) are used. Nonetheless, a subset of ADHD patients will either fail to respond to stimulants or have side effects that preclude their use (tics, severe loss of appetite, marked insomnia). For such patients, there are a number of non-stimulant agents that serve as second-line treatments. Tricyclic antidepressants (TCAs) are the most studied of these drugs. They are superior to placebo in the treatment of ADHD and may reduce abnormal movements in patients with ADHD/tic disorder. TCAs often produce side effects of sedation, dry mouth, and constipation. Bupropion is superior to placebo in the treatment of ADHD and has a more favorable side-effect profile than the TCAs. A new selective norepinephrine reuptake inhibitor, atomoxetine, has been shown to be efficacious in the treatment of ADHD and has recently received an approvable letter from the Food and Drug Administration. The a-agonists clonidine and guanfacine have also been used as alternative agents in ADHD, though the controlled data are more limited. A recent controlled clinical trial suggests a combination of methylphenidate and clonidine has advantages in the treatment of comorbid ADHD and tics over either medication alone. Clinical guidelines for each of these agents, as well as their use in combination with stimulants in comorbid conditions, will be discussed.
Blum, Kenneth; Chen, Amanda Lih-Chuan; Braverman, Eric R; Comings, David E; Chen, Thomas JH; Arcuri, Vanessa; Blum, Seth H; Downs, Bernard W; Waite, Roger L; Notaro, Alison; Lubar, Joel; Williams, Lonna; Prihoda, Thomas J; Palomo, Tomas; Oscar-Berman, Marlene
Molecular genetic studies have identified several genes that may mediate susceptibility to attention deficit hyperactivity disorder (ADHD). A consensus of the literature suggests that when there is a dysfunction in the “brain reward cascade,” especially in the dopamine system, causing a low or hypo-dopaminergic trait, the brain may require dopamine for individuals to avoid unpleasant feelings. This high-risk genetic trait leads to multiple drug-seeking behaviors, because the drugs activate release of dopamine, which can diminish abnormal cravings. Moreover, this genetic trait is due in part to a form of a gene (DRD2 A1 allele) that prevents the expression of the normal laying down of dopamine receptors in brain reward sites. This gene, and others involved in neurophysiological processing of specific neurotransmitters, have been associated with deficient functions and predispose individuals to have a high risk for addictive, impulsive, and compulsive behavioral propensities. It has been proposed that genetic variants of dopaminergic genes and other “reward genes” are important common determinants of reward deficiency syndrome (RDS), which we hypothesize includes ADHD as a behavioral subtype. We further hypothesize that early diagnosis through genetic polymorphic identification in combination with DNA-based customized nutraceutical administration to young children may attenuate behavioral symptoms associated with ADHD. Moreover, it is concluded that dopamine and serotonin releasers might be useful therapeutic adjuncts for the treatment of other RDS behavioral subtypes, including addictions. PMID:19183781
Alba, Guzmán; Pereda, Ernesto; Mañas, Soledad; Méndez, Leopoldo D; González, Almudena; González, Julián J
The techniques and the most important results on the use of electroencephalography (EEG) to extract different measures are reviewed in this work, which can be clinically useful to study subjects with attention-deficit/hyperactivity disorder (ADHD). First, we discuss briefly and in simple terms the EEG analysis and processing techniques most used in the context of ADHD. We review techniques that both analyze individual EEG channels (univariate measures) and study the statistical interdependence between different EEG channels (multivariate measures), the so-called functional brain connectivity. Among the former ones, we review the classical indices of absolute and relative spectral power and estimations of the complexity of the channels, such as the approximate entropy and the Lempel-Ziv complexity. Among the latter ones, we focus on the magnitude square coherence and on different measures based on the concept of generalized synchronization and its estimation in the state space. Second, from a historical point of view, we present the most important results achieved with these techniques and their clinical utility (sensitivity, specificity, and accuracy) to diagnose ADHD. Finally, we propose future research lines based on these results. PMID:26543369
Mooney, Michael A; McWeeney, Shannon K; Faraone, Stephen V; Hinney, Anke; Hebebrand, Johannes; Nigg, Joel T; Wilmot, Beth
Despite a wealth of evidence for the role of genetics in attention deficit hyperactivity disorder (ADHD), specific and definitive genetic mechanisms have not been identified. Pathway analyses, a subset of gene-set analyses, extend the knowledge gained from genome-wide association studies (GWAS) by providing functional context for genetic associations. However, there are numerous methods for association testing of gene sets and no real consensus regarding the best approach. The present study applied six pathway analysis methods to identify pathways associated with ADHD in two GWAS datasets from the Psychiatric Genomics Consortium. Methods that utilize genotypes to model pathway-level effects identified more replicable pathway associations than methods using summary statistics. In addition, pathways implicated by more than one method were significantly more likely to replicate. A number of brain-relevant pathways, such as RhoA signaling, glycosaminoglycan biosynthesis, fibroblast growth factor receptor activity, and pathways containing potassium channel genes, were nominally significant by multiple methods in both datasets. These results support previous hypotheses about the role of regulation of neurotransmitter release, neurite outgrowth and axon guidance in contributing to the ADHD phenotype and suggest the value of cross-method convergence in evaluating pathway analysis results. © 2016 Wiley Periodicals, Inc.
Karbalaei Sabagh, Ali; Khademi, Mojgan; Noorbakhsh, Simasadat; Razjooyan, Katayoon; Arabgol, Fariba
The aim of the present study was to compare the parenting styles in parents with and without adult attention deficit hyperactivity disorder (ADHD) who had children with ADHD. It was a case-control study with convenience sampling strategy. Participants were recruited from the parents of previously diagnosed children with ADHD referred to Imam Hossein Hospital, Tehran/ Iran. Ninety parents with adult ADHD and 120 normal parents were chosen by Conner's Adult ADHD Screening Scale (CAARS) and psychiatrist interview. Using Baumrind Parenting Styles Questionnaire and Arnold Parenting Scale, parenting styles were assessed in both the groups. Results from independent samples t-test indicated that Authoritarian parenting style (F = 0.576, p 0.022) and Over reacting style (F = 7.976, p 0.045) were significantly higher in cases. On the other hand, controls were using Permissive style (F = 0.131, p 0.044) more than cases. The results are consistent with prior studies; these findings can improve the content of parent training for children with ADHD, who have adult ADHD themselves.
Alba, Guzmán; Pereda, Ernesto; Mañas, Soledad; Méndez, Leopoldo D; González, Almudena; González, Julián J
The techniques and the most important results on the use of electroencephalography (EEG) to extract different measures are reviewed in this work, which can be clinically useful to study subjects with attention-deficit/hyperactivity disorder (ADHD). First, we discuss briefly and in simple terms the EEG analysis and processing techniques most used in the context of ADHD. We review techniques that both analyze individual EEG channels (univariate measures) and study the statistical interdependence between different EEG channels (multivariate measures), the so-called functional brain connectivity. Among the former ones, we review the classical indices of absolute and relative spectral power and estimations of the complexity of the channels, such as the approximate entropy and the Lempel-Ziv complexity. Among the latter ones, we focus on the magnitude square coherence and on different measures based on the concept of generalized synchronization and its estimation in the state space. Second, from a historical point of view, we present the most important results achieved with these techniques and their clinical utility (sensitivity, specificity, and accuracy) to diagnose ADHD. Finally, we propose future research lines based on these results.
The use of complementary and alternative medicine (CAM) for treatment of attention-deficit/hyperactivity disorder (ADHD) has increased both by parents and health care providers. Despite scientific evidence supporting the effectiveness of stimulants in the treatment of ADHD, the use of stimulants has received negative publicity and, for many parents, is worrisome. Concerns regarding adverse effects and the prospect of long-term use of pharmacologic treatments make many parents uncomfortable thus they seek "alternative treatments." With the information explosion produced by the Internet, marketing for alternative therapies such as herbal remedies, elimination diets, and food supplements for ADHD has increased. Many people use CAM because they are attracted to the CAM philosophies and health beliefs, dissatisfied with the process or results of conventional treatments, or concerned about adverse effects of stimulants. Although some scientific evidence exists regarding some CAM therapies, for most there are key questions regarding safety and efficacy of these treatments in children. The aim of this article is to provide a general overview and focus on the evidence-based studies of CAM modalities that are commonly used for ADHD.
Gardill, M. Cathleen; And Others
Behavioral strategies appropriate for use with students having attention deficit hyperactivity disorder are discussed and grouped into antecedent manipulations (such as physical arrangement and peer tutoring); consequent manipulations (reprimands, teacher attention, and contingency contracting); and cognitive behavioral interventions…
Chan, Won Shing Raymond; Hung, Se Fong; Liu, Suet Nga; Lee, Cheuk Kiu Kathy
The cognitive profiles of children with Developmental Reading Disorder (RD) and Attention-Deficit/Hyperactivity Disorders (ADHD) have been extensively studied in alphabetic language communities. Deficits in phonological processing and rapid naming have been implicated as core features of RD although whether the latter is a deficit specific to RD…
Sukhodolsky, Denis G.; Landeros-Weisenberger, Angeli; Scahill, Lawrence; Leckman, James F.; Schultz, Robert T.
Objective: Neuropsychological functioning in children with Tourette syndrome (TS) has been characterized by subtle deficits in response inhibition, visual-motor integration, and fine-motor coordination. The association of these deficits with the tics of the TS versus co-occurring attention-deficit/hyperactivity disorder (ADHD) has not been well…
Lee, Pei-chin; Niew, Wern-ing; Yang, Hao-jan; Chen, Vincent Chin-hung; Lin, Keh-chung
This meta-analysis examined the effect of behavioral parent training on child and parental outcomes for children with attention deficit hyperactivity disorder. Meta-analytic procedures were used to estimate the effect of behavioral parent training on children with attention deficit hyperactivity disorder. Variables moderating the intervention…
Parker, Harvey C.
This student workbook and accompanying teacher's guide are designed to help children with attention deficit disorders (ADD). The Attention Deficit Accommodation Plan for Teaching (ADAPT) teacher planbook guides the teacher in evaluating the students' areas of difficulty. This evaluation is the basis for the design and implementation of classroom…
Liu, Tian; Chen, Yanni; Li, Chenxi; Li, Youjun; Wang, Jue
This study investigated the cortical thickness and topological features of human brain anatomical networks related to attention deficit/hyperactivity disorder. Data were collected from 40 attention deficit/hyperactivity disorder children and 40 normal control children. Interregional correlation matrices were established by calculating the correlations of cortical thickness between all pairs of cortical regions (68 regions) of the whole brain. Further thresholds were applied to create binary matrices to construct a series of undirected and unweighted graphs, and global, local, and nodal efficiencies were computed as a function of the network cost. These experimental results revealed abnormal cortical thickness and correlations in attention deficit/hyperactivity disorder, and showed that the brain structural networks of attention deficit/hyperactivity disorder subjects had inefficient small-world topological features. Furthermore, their topological properties were altered abnormally. In particular, decreased global efficiency combined with increased local efficiency in attention deficit/hyperactivity disorder children led to a disorder-related shift of the network topological structure toward regular networks. In addition, nodal efficiency, cortical thickness, and correlation analyses revealed that several brain regions were altered in attention deficit/hyperactivity disorder patients. These findings are in accordance with a hypothesis of dysfunctional integration and segregation of the brain in patients with attention deficit/hyperactivity disorder and provide further evidence of brain dysfunction in attention deficit/hyperactivity disorder patients by observing cortical thickness on magnetic resonance imaging.
A 1997 study by Lomas and Garside suggests a 62% prevalence rate of ADHD [Attention-Deficit Hyperactivity Disorder] amongst homeless, which prompts a need for further elucidation of this relationship. This study sought to examine the relationship between Attention-Deficit Hyperactivity Disorder and the homeless youth population aged 18-24. The…
Matazow, Gail S.; Hynd, George W.
This study examined whether children (ages 6-16) diagnosed as having attention deficit disorder with hyperactivity (ADD/H) could be differentiated from those diagnosed as having attention deficit disorder without hyperactivity (ADD/WO), on an anterior-posterior gradient paradigm. It was predicted that ADD/H children (N=23) would have more deficits…
Messina, Lucinete de Freitas; Tiedemann, Klaus Bruno; de Andrade, Enio Roberto; Primi, Ricardo
Objective: This research investigated the cognitive abilities and the working memory in children and youngsters with three different types of attention-deficit/hyperactivity disorder (ADHD): (a) mainly with attention-deficit, (b) hyperactive and impulsive, and (c) combined. Method: A computerized test called Infant Cognitive Abilities Test, which…
de Vries, P. J.; Watson, P.
Background: Tuberous sclerosis complex (TSC) is a genetic disorder associated with a range of neurocognitive manifestations, including neuropsychological attention deficits most notably in dual tasking/divided attention. These dual-task deficits have so far been interpreted as evidence of a vulnerable "cognitive module" in TSC. Here, we suggest…
DuPaul, George J.
Attention deficit hyperactivity disorder is a relatively common childhood behavior disorder that typically is treated with psychotropic medication (e.g., methylphenidate), behavioral strategies, or their combination. This article provides an overview of the school-related difficulties associated with attention deficit hyperactivity disorder.…
Painter, Carol A.; Prevatt, Frances; Welles, Theresa
The authors evaluated dysfunctional career beliefs and subsequent low job satisfaction in adults reporting significant symptoms of attention-deficit/hyperactivity disorder (ADHD). Participants (N = 81) completed the Adult Attention Deficit Disorders Evaluation Scale (S. B. McCarney & P. D. Anderson, 1996), the Career Thoughts Inventory (J. P.…
Liu, Yunzhe; Zhang, Dandan; Zhao, Yanli; Tan, Shuping; Luo, Yuejia
Impaired attentional processing of negative facial expressions is prominent in schizophrenia and has been shown to be associated with patients’ social dysfunctions. However, little is known about when and which specific attention deficits influence social functions. Given the dynamic feature of attention, it is necessary to investigate the attention deficits in negative emotional processing unfolding in time. The current study used event-related potentials (ERPs) to investigate the temporal dynamics of attention deficits in emotion perception and their potential relationship with emotional/social impairments in neuroleptic naive schizophrenic patients. Two specific attention deficits were identified and were found to be associated with emotional/social impairments. More specifically, the deficit in orienting attention (evidenced with the reduced P1 amplitude) was correlated with expressive deficits, while the deficit in executive control of attention (evidenced with the reduced P3 amplitude) was correlated with avolition/asociality. Together, these findings may provide novel insights into the core pathophysiological processes and offer objective biomarkers for specific emotional/social impairments in schizophrenia. It is also hoped that this study helps to bridge the gap between basic cognitive deficits and relative high-level social dysfunctions in schizophrenic patients. PMID:27586404
Lubke, Gitta H.; Muthen, Bengt; Moilanen, Irma K.; McGough, James J.; Loo, Sandra K.; Swanson, James M.; Yang, May H.; Taanila, Anja; Hurtig, Tuula; Jarvelin, Marjo-Riitta; Smalley, Susan L.
A study aims to analyze whether behaviors of attention-deficit, hyperactivity among adolescents in Northern Finland reflect distinct subtypes of attention deficit hyperactivity disorder (ADHD). The results conclude that the majority of the Cohort falls into low-scoring groups of unaffecteds while a high-scoring minority group reflects an ADHD…
Saxbe, Catherine; Barkley, Russell A
Sluggish cognitive tempo (SCT) refers to an impairment of attention in hypoactive-appearing individuals that first presents in childhood. At this time, it exists only as a research entity that has yet to debut in official diagnostic taxonomies. However, it seems likely that a constellation of characteristic features of SCT may form the criteria for a newly defined childhood disorder in the foreseeable future, provided limitations in the extant findings can be addressed by future research. Most clinicians who assess and treat cases of attention- deficit/hyperactivity disorder (ADHD) have likely seen and treated someone who falls within the parameters for SCT. This article outlines the history of SCT and reviews the current understanding of the disorder, how it is distinguishable from and similar to other attention disorders, and what future directions research and treatment may take. Based on this review and their clinical experience, the authors conjecture that SCT is probably distinct from ADHD rather than being an ADHD subtype, although there is notable overlap with the ADHD predominantly inattentive and combined presentations.
Tucha, Oliver; Lange, Klaus W
Adverse effects of drug therapy on handwriting fluency attributed to increased attentional control have been observed in children with attention deficit hyperactivity disorder (ADHD). The writing performance of 8 children with ADHD was assessed using a digitizing tablet in a double-blind, placebo-controlled test. Participants wrote a phrase in cursive script both on and off stimulant medication writing normally, writing with eyes closed, and writing faster than normal. Medication reduced fluency of normal handwriting movements. When children with ADHD were instructed to write faster than normal or with eyes closed, however, more fluent and even automated movements resulted, even on medication. We also assessed 10 children with ADHD, 10 children without ADHD, 10 adults with ADHD, and 10 adults without ADHD. Participants with ADHD were assessed both on and off medication. Children with ADHD on medication were less fluent than children without ADHD. Without medication, Children with ADHD did not differ from children without ADHD; those on medication showed increased handwriting dysfluency. There was no significant difference between the adults. Both children and adults with ADHD could perform age-appropriate and automated handwriting movements. Children with ADHD on medication, however, gave more attention to the writing process, possibly hampering fluent handwriting movements.
Cobb, Stuart; Guy, Jacky; Bird, Adrian
Mutations in the X-linked MECP2 gene are the primary cause of the severe autism spectrum disorder RTT (Rett syndrome). Deletion of Mecp2 in mice recapitulates many of the overt neurological features seen in humans, and the delayed onset of symptoms is accompanied by deficits in neuronal morphology and synaptic physiology. Recent evidence suggests that reactivation of endogenous Mecp2 in young and adult mice can reverse aspects of RTT-like pathology. In the current perspective, we discuss these findings as well as other genetic, pharmacological and environmental interventions that attempt phenotypic rescue in RTT. We believe these studies provide valuable insights into the tractability of RTT and related conditions and are useful pointers for the development of future therapeutic strategies.
Plessen, Kerstin J.; Bansal, Ravi; Zhu, Hongtu; Whiteman, Ronald; Amat, Jose; Quackenbush, Georgette A.; Martin, Laura; Durkin, Kathleen; Blair, Clancy; Royal, Jason; Hugdahl, Kenneth; Peterson, Bradley S.
Context Limbic structures are implicated in the genesis of attention-deficit/hyperactivity disorder (ADHD) by the presence of mood and cognitive disturbances in affected individuals and by elevated rates of mood disorders in family members of probands with ADHD. Objective To study the morphology of the hippocampus and amygdala in children with ADHD. Design A cross-sectional case-control study of the hippocampus and amygdala using anatomical magnetic resonance imaging. Settings University research institute. Patients One hundred fourteen individuals aged 6 to 18 years, 51 with combined-type ADHD and 63 healthy controls. Main Outcome Measures Volumes and measures of surface morphology for the hippocampus and amygdala. Results The hippocampus was larger bilaterally in the ADHD group than in the control group (t=3.35; P<.002). Detailed surface analyses of the hippocampus further localized these differences to an enlarged head of the hippocampus in the ADHD group. Although conventional measures did not detect significant differences in amygdalar volumes, surface analyses indicated the presence of reduced size bilaterally over the area of the basolateral complex. Correlations with prefrontal measures suggested abnormal connectivity between the amygdala and prefrontal cortex in the ADHD group. Enlarged subregions of the hippocampus tended to accompany fewer symptoms. Conclusions The enlarged hippocampus in children and adolescents with ADHD may represent a compensatory response to the presence of disturbances in the perception of time, temporal processing (eg, delay aversion), and stimulus seeking associated with ADHD. Disrupted connections between the amygdala and orbitofrontal cortex may contribute to behavioral disinhibition. Our findings suggest involvement of the limbic system in the pathophysiology of ADHD. PMID:16818869
Shmueli, Dorit; Gross-Tsur, Varda
Methylphenidate (Ritalin) is the drug of choice for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Methylphenidate has been rigorously studied and found to be a safe and effective drug. However, there is a need for pharmacological alternatives since there are patients and therapists who are reluctant to use the drug. In some cases it is ineffective, others suffer from intolerable side effects and still others need treatment extended for the entire day. Recently, new pharmacological agents have been introduced for use in Israel. This article discusses the use of these new psychostimulants as well as other non-psychostimulant options. One of the new psychostimulants is Concerta, a very long acting methylphenidate preparation, that has been shown to be very effective. Adderall, a mixture of amphetamine salts, and Dexedrine (dexamphetamine) are also widely used. This article also presents data on an older psychostimulant, Cylert, Nitan (pemoline), prescribed until recently as a major alternative for Ritalin but, at present, it is rarely used because of its hepatotoxicity. Strattera (atomoxetine), a new non-stimulant drug, is a selective noradrenaline reuptake inhibitor that is a promising therapeutic option for children with ADHD. In summary, it is encouraging that there are multiple pharmacological options for treating children with ADHD. There is no one drug for all children and this is particularly important for children with do not respond to methylphenidate. Last, but not least, the mere fact that the new drugs are not called Ritalin, may play an important role in reducing the irrational opposition to the pharmacological treatment of ADHD.
Attention-deficit hyperactivity disorder (ADHD) is described as the most common neurobehavioral condition of childhood. We raise the concern that ADHD is not a disease per se but rather a group of symptoms representing a final common behavioral pathway for a gamut of emotional, psychological, and/or learning problems. Increasing numbers of children, especially boys, are diagnosed with ADHD and treated with stimulant medications according to a simplified approach. Methodical review of the literature, however, raised concerning issues. "Core" ADHD symptoms of inattentiveness, hyperactivity and impulsivity are not unique to ADHD. Rates of "comorbid" psychiatric and learning problems, including depression and anxiety, range from 12 to 60%, with significant symptom overlap with ADHD, difficulties in diagnosis, and evidence-based treatment methods that do not include stimulant medications. No neuropsychologic test result is pathognomic for ADHD, and structural and functional neuroimaging studies have not identified a unique etiology for ADHD. No genetic marker has been consistently identified, and heritability studies are confounded by familial environmental factors. The validity of the Conners' Rating Scale-Revised has been seriously questioned, and parent and teacher "ratings" of school children are frequently discrepant, suggesting that use of subjective informant data via scale or interview does not form an objective basis for diagnosis of ADHD. Empiric diagnostic trials of stimulant medication that produce a behavioral response have been shown not to distinguish between children with and without "ADHD." In summary, the working dogma that ADHD is a disease or neurobehavioral condition does not at this time hold up to scrutiny of evidence. Thorough evaluation of symptomatic children should be individualized, and include assessment of educational, psychologic, psychiatric, and family needs.
Wilens, Timothy E
Practitioners are increasingly called upon to diagnose and treat attention deficit hyperactivity disorder (ADHD) in adults. Although the use of pharmacotherapy in children with ADHD is well studied, the use of drugs for the treatment of adults with ADHD remains less well established.A systematic review of the literature identified 15 studies (n = 482 patients) of stimulants, and 27 studies of nonstimulant medications (n = 1179 subjects) including antidepressants, norepinephrine reuptake inhibitors, antihypertensive agents, amino acids and wake-promoting agents for the treatment of ADHD in adults. Controlled clinical trials in adults showed that stimulants, antidepressants and norepinephrine reuptake inhibitors demonstrated significant short-term improvements in ADHD symptoms compared with placebo. The two longer term trials with methylphenidate in adults confirmed the ongoing effectiveness and tolerability of stimulants. The response to amphetamine and methylphenidate appears to be dose-dependent. Methylphenidate and amphetamine had an immediate onset of action, whereas responses to pemoline, antidepressants and norepinephrine reuptake inhibitors appeared delayed. Controlled data on nicotinic/cholinergic compounds appear promising. Considerable variability was found in the diagnostic criteria for ADHD in adults, drug dosages and response rates between the various studies. Under controlled conditions, the aggregate literature comprised mainly of short-term studies, shows that stimulants, norepinephrine reuptake inhibitors and specific antidepressants had clinically and statistically significant beneficial effects in the treatment of ADHD in adults. Cholinergic agents appear promising. Further studies are necessary to evaluate the long-term effectiveness and tolerability of various agents, functional and neuropsychological outcomes, and the use of various agents in specific subgroups of adults with ADHD.
Cheung, Celeste H M; McLoughlin, Gráinne; Brandeis, Daniel; Banaschewski, Tobias; Asherson, Philip; Kuntsi, Jonna
Cognitive performance in attention-deficit/hyperactivity disorder (ADHD) is characterised, in part, by frequent fluctuations in response speed, resulting in high reaction time variability (RTV). RTV captures a large proportion of the genetic risk in ADHD but, importantly, is malleable, improving significantly in a fast-paced, rewarded task condition. Using the temporal precision offered by event-related potentials (ERPs), we aimed to examine the neurophysiological measures of attention allocation (P3 amplitudes) and preparation (contingent negative variation, CNV), and their associations with the fluctuating RT performance and its improvement in ADHD. 93 participants with ADHD and 174 controls completed the baseline and fast-incentive conditions of a four-choice reaction time task, while EEG was simultaneously recorded. Compared to controls, individuals with ADHD showed both increased RTV and reduced P3 amplitudes during performance on the RT task. In the participants with ADHD, attenuated P3 amplitudes were significantly associated with high RTV, and the increase in P3 amplitudes from a slow baseline to a fast-paced, rewarded condition was significantly associated with the RTV decrease. Yet, the individuals with ADHD did not show the same increase in CNV from baseline to fast-incentive condition as observed in controls. ADHD is associated both with a neurophysiological impairment of attention allocation (P3 amplitudes) and an inability to adjust the preparatory state (CNV) in a changed context. Our findings suggest that both neurophysiological and cognitive performance measures of attention are malleable in ADHD, which are potential targets for non-pharmacological interventions.
Weissman, Adam S.; Chu, Brian C.; Reddy, Linda A.; Mohlman, Jan
Inattention is among the most commonly referred problems for school-aged youth. Research suggests distinct mechanisms may contribute to attention problems in youth with anxiety disorders versus youth with attention deficit hyperactivity disorder (ADHD). This study compared children (8-17 years) with anxiety disorders (n = 24) and children (8-16…
Lehn, Hanne; Derks, Eske M.; Hudziak, James J.; Heutink, Peter; van Beijsterveldt, Toos; Boomsma, Dorret I.
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,…
Valdois, Sylviane; Bosse, Marie-Line; Tainturier, Marie-Josèphe
There is strong converging evidence suggesting that developmental dyslexia stems from a phonological processing deficit. However, this hypothesis has been challenged by the widely admitted heterogeneity of the dyslexic population, and by several reports of dyslexic individuals with no apparent phonological deficit. In this paper, we discuss the hypothesis that a phonological deficit may not be the only core deficit in developmental dyslexia and critically examine several alternative proposals. To establish that a given cognitive deficit is causally related to dyslexia, at least two conditions need to be fulfilled. First, the hypothesized deficit needs to be associated with developmental dyslexia independently of additional phonological deficits. Second, the hypothesized deficit must predict reading ability, on both empirical and theoretical grounds. While most current hypotheses fail to fulfil these criteria, we argue that the visual attentional deficit hypothesis does. Recent studies providing evidence for the independence of phonological and visual attentional deficits in developmental dyslexia are reviewed together with empirical data showing that phonological and visual attentional processing skills contribute independently to reading performance. A theoretical model of reading is outlined in support of a causal link between a visual attentional disorder and a failure in reading acquisition.
Rubia, Katya; Halari, Rozmin; Smith, Anna B.; Mohammad, Majeed; Scott, Stephen; Brammer, Michael J.
Background: Inhibitory and attention deficits have been suggested to be shared problems of disruptive behaviour disorders. Patients with attention deficit hyperactivity disorder (ADHD) and patients with conduct disorder (CD) show deficits in tasks of attention allocation and interference inhibition. However, functional magnetic resonance imaging…
Shuai, Lan; Daley, David; Wang, Yu-Feng; Zhang, Jin-Song; Kong, Yan-Ting; Tan, Xin; Ji, Ning
Background: Accumulating evidence indicates that attention deficit hyperactivity disorder (ADHD) is associated with core deficits in executive function (EF) which predicts poorer academic and occupational functioning. This makes early intervention targeting EF impairments important to prevent long-term negative outcomes. Cognitive training is a potential ADHD treatment target. The present study aimed to explore the efficacy, feasibility, and acceptability of a cognitive training program (targeting child's multiple EF components and involving parent support in daily life), as a nonpharmacological intervention for children with ADHD. Methods: Forty-four school -age children with ADHD and their parents participated in 12 sessions of EF training (last for 12 weeks) and 88 health controls (HC) were also recruited. Training effects were explored using both neuropsychological tests (Stroop color-word test, Rey-Osterrieth complex figure test, trail making test, tower of Hanoi, and false-belief task) and reports of daily life (ADHD rating scale-IV, Conners’ parent rating scale, and behavior rating inventory of executive function [BRIEF]) by analysis of paired sample t-test and Wilcoxon signed-rank test. The differences on EF performances between children with ADHD after training and HC were explored using multivariate analysis. Results: The results (before vs. after EF training) showed that after intervention, the children with ADHD presented better performances of EF both in neuropsychological tests (word interference of Stroop: 36.1 ± 14.6 vs. 27.1 ± 11.1, t = 4.731, P < 0.001; shift time of TMT: 194.9 ± 115.4 vs. 124.8 ± 72.4, Z = –4.639, P < 0.001; false-belief task: χ2 = 6.932, P = 0.008) and reports of daily life (global executive composite of BRIEF: 148.9 ± 17.5 vs. 127.8 ± 17.5, t = 6.433, P < 0.001). The performances on EF tasks for children with ADHD after EF training could match with the level of HC children. The ADHD symptoms (ADHD rating scale total
Zayats, T; Jacobsen, K K; Kleppe, R; Jacob, C P; Kittel-Schneider, S; Ribasés, M; Ramos-Quiroga, J A; Richarte, V; Casas, M; Mota, N R; Grevet, E H; Klein, M; Corominas, J; Bralten, J; Galesloot, T; Vasquez, A A; Herms, S; Forstner, A J; Larsson, H; Breen, G; Asherson, P; Gross-Lesch, S; Lesch, K P; Cichon, S; Gabrielsen, M B; Holmen, O L; Bau, C H D; Buitelaar, J; Kiemeney, L; Faraone, S V; Cormand, B; Franke, B; Reif, A; Haavik, J; Johansson, S
Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable childhood-onset neuropsychiatric condition, often persisting into adulthood. The genetic architecture of ADHD, particularly in adults, is largely unknown. We performed an exome-wide scan of adult ADHD using the Illumina Human Exome Bead Chip, which interrogates over 250 000 common and rare variants. Participants were recruited by the International Multicenter persistent ADHD CollaboraTion (IMpACT). Statistical analyses were divided into 3 steps: (1) gene-level analysis of rare variants (minor allele frequency (MAF)<1%); (2) single marker association tests of common variants (MAF⩾1%), with replication of the top signals; and (3) pathway analyses. In total, 9365 individuals (1846 cases and 7519 controls) were examined. Replication of the most associated common variants was attempted in 9847 individuals (2077 cases and 7770 controls) using fixed-effects inverse variance meta-analysis. With a Bonferroni-corrected significance level of 1.82E−06, our analyses of rare coding variants revealed four study-wide significant loci: 6q22.1 locus (P=4.46E−08), where NT5DC1 and COL10A1 reside; the SEC23IP locus (P=6.47E−07); the PSD locus (P=7.58E−08) and ZCCHC4 locus (P=1.79E−06). No genome-wide significant association was observed among the common variants. The strongest signal was noted at rs9325032 in PPP2R2B (odds ratio=0.81, P=1.61E−05). Taken together, our data add to the growing evidence of general signal transduction molecules (NT5DC1, PSD, SEC23IP and ZCCHC4) having an important role in the etiology of ADHD. Although the biological implications of these findings need to be further explored, they highlight the possible role of cellular communication as a potential core component in the development of both adult and childhood forms of ADHD. PMID:27754487
Zayats, T; Jacobsen, K K; Kleppe, R; Jacob, C P; Kittel-Schneider, S; Ribasés, M; Ramos-Quiroga, J A; Richarte, V; Casas, M; Mota, N R; Grevet, E H; Klein, M; Corominas, J; Bralten, J; Galesloot, T; Vasquez, A A; Herms, S; Forstner, A J; Larsson, H; Breen, G; Asherson, P; Gross-Lesch, S; Lesch, K P; Cichon, S; Gabrielsen, M B; Holmen, O L; Bau, C H D; Buitelaar, J; Kiemeney, L; Faraone, S V; Cormand, B; Franke, B; Reif, A; Haavik, J; Johansson, S
Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable childhood-onset neuropsychiatric condition, often persisting into adulthood. The genetic architecture of ADHD, particularly in adults, is largely unknown. We performed an exome-wide scan of adult ADHD using the Illumina Human Exome Bead Chip, which interrogates over 250 000 common and rare variants. Participants were recruited by the International Multicenter persistent ADHD CollaboraTion (IMpACT). Statistical analyses were divided into 3 steps: (1) gene-level analysis of rare variants (minor allele frequency (MAF)<1%); (2) single marker association tests of common variants (MAF⩾1%), with replication of the top signals; and (3) pathway analyses. In total, 9365 individuals (1846 cases and 7519 controls) were examined. Replication of the most associated common variants was attempted in 9847 individuals (2077 cases and 7770 controls) using fixed-effects inverse variance meta-analysis. With a Bonferroni-corrected significance level of 1.82E-06, our analyses of rare coding variants revealed four study-wide significant loci: 6q22.1 locus (P=4.46E-08), where NT5DC1 and COL10A1 reside; the SEC23IP locus (P=6.47E-07); the PSD locus (P=7.58E-08) and ZCCHC4 locus (P=1.79E-06). No genome-wide significant association was observed among the common variants. The strongest signal was noted at rs9325032 in PPP2R2B (odds ratio=0.81, P=1.61E-05). Taken together, our data add to the growing evidence of general signal transduction molecules (NT5DC1, PSD, SEC23IP and ZCCHC4) having an important role in the etiology of ADHD. Although the biological implications of these findings need to be further explored, they highlight the possible role of cellular communication as a potential core component in the development of both adult and childhood forms of ADHD.
Ahmetoglu, Emine; Aral, Neriman; Butun Ayhan, Aynur
This study was conducted in order to (a) compare the visual perceptions of seven-year-old children diagnosed with attention deficit hyperactivity disorder with those of normally developing children of the same age and development level and (b) determine whether the visual perceptions of children with attention deficit hyperactivity disorder vary with respect to gender, having received preschool education and parents` educational level. A total of 60 children, 30 with attention deficit hyperactivity disorder and 30 with normal development, were assigned to the study. Data about children with attention deficit hyperactivity disorder and their families was collected by using a General Information Form and the visual perception of children was examined through the Frostig Developmental Test of Visual Perception. The Mann-Whitney U-test and Kruskal-Wallis variance analysis was used to determine whether there was a difference of between the visual perceptions of children with normal development and those diagnosed with attention deficit hyperactivity disorder and to discover whether the variables of gender, preschool education and parents` educational status affected the visual perceptions of children with attention deficit hyperactivity disorder. The results showed that there was a statistically meaningful difference between the visual perceptions of the two groups and that the visual perceptions of children with attention deficit hyperactivity disorder were affected meaningfully by gender, preschool education and parents` educational status.
Masur, David; Shinnar, Shlomo; Cnaan, Avital; Shinnar, Ruth C.; Clark, Peggy; Wang, Jichuan; Weiss, Erica F.; Hirtz, Deborah G.
Objective: To determine the neurocognitive deficits associated with newly diagnosed untreated childhood absence epilepsy (CAE), develop a model describing the factorial structure of items measuring academic achievement and 3 neuropsychological constructs, and determine short-term differential neuropsychological effects on attention among ethosuximide, valproic acid, and lamotrigine. Methods: Subjects with newly diagnosed CAE entering a double-blind, randomized controlled clinical trial had neuropsychological testing including assessments of general intellectual functioning, attention, memory, executive function, and achievement. Attention was reassessed at the week 16–20 visit. Results: At study entry, 36% of the cohort exhibited attention deficits despite otherwise intact neurocognitive functioning. Structural equation modeling of baseline neuropsychological data revealed a direct sequential effect among attention, memory, executive function, and academic achievement. At the week 16–20 visit, attention deficits persisted even if seizure freedom was attained. More subjects receiving valproic acid (49%) had attention deficits than subjects receiving ethosuximide (32%) or lamotrigine (24%) (p = 0.0006). Parental assessment did not reliably detect attention deficits before or after treatment (p < 0.0001). Conclusions: Children with CAE have a high rate of pretreatment attentional deficits that persist despite seizure freedom. Rates are disproportionately higher for valproic acid treatment compared with ethosuximide or lamotrigine. Parents do not recognize these attentional deficits. These deficits present a threat to academic achievement. Vigilant cognitive and behavioral assessment of these children is warranted. Classification of evidence: This study provides Class I evidence that valproic acid is associated with more significant attentional dysfunction than ethosuximide or lamotrigine in children with newly diagnosed CAE. PMID:24089388
Alvarado, Jesús Ma; Puente, Aníbal; Jiménez, Virginia; Arrebillaga, Lorena
The reading achievement of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) has scarcely been explored in research conducted in the Spanish language and when it has, the results have been contradictory. The focus of the present research is to analyze participants' reading competency and metacognitive strategies as they carry out reading comprehension tasks. The sample was comprised of 187 Argentine schoolchildren aged 9 to 13 years old. 94 constituted the control group and the clinical group consisted of 93 schoolchildren diagnosed with ADHD. The metacognitive assessment was made up of two metacognitive tests, the Reading Awareness Scale (ESCOLA; acronym in Spanish) and a Spanish adaptation of Metacognitive Awareness of Reading Strategies Inventory (MARSI), and one test of reading comprehension, the Evaluation of Reading Processes for Secondary Education Students (PROLEC-SE; acronym in Spanish). Students with ADHD had lower achievement on tests o reading comprehension compared to the control group. Nevertheless, our results suggest their difficulties did not stem from readin comprehension problems, but rather from alterations in their Executive Functions, because when subjects' reading comprehensio was equalized, students with ADHD still exhibited a lower level of Metacognition, particularly when it came to planning.
Waldon, Jessica; Begum, Esmot; Gendron, Melissa; Rusak, Benjamin; Andreou, Pantelis; Rajda, Malgorzata; Corkum, Penny
This study sought to: (1) compare actigraphy-derived estimated sleep variables to the same variables based on the gold-standard of sleep assessment, polysomnography; (2) examine whether the correlations between the measures differ between children with attention-deficit/hyperactivity disorder and typically developing children; and (3) determine whether these correlations are altered when children with attention-deficit/hyperactivity disorder are treated with medication. Participants (24 attention-deficit/hyperactivity disorder; 24 typically developing), aged 6-12 years, completed a 1-week baseline assessment of typical sleep and daytime functioning. Following the baseline week, participants in the attention-deficit/hyperactivity disorder group completed a 4-week blinded randomized control trial of methylphenidate hydrochloride, including a 2-week placebo and 2-week methylphenidate hydrochloride treatment period. At the end of each observation (typically developing: baseline; attention-deficit/hyperactivity disorder: baseline, placebo and methylphenidate hydrochloride treatment), all participants were invited to a sleep research laboratory, where overnight polysomnography and actigraphy were recorded concurrently. Findings from intra-class correlations and Bland-Altman plots were consistent. Actigraphy was found to provide good estimates (e.g. intra-class correlations >0.61) of polysomnography results for sleep duration for all groups and conditions, as well as for sleep-onset latency and sleep efficiency for the typically developing group and attention-deficit/hyperactivity disorder group while on medication, but not for the attention-deficit/hyperactivity disorder group during baseline or placebo. Based on the Bland-Altman plots, actigraphy tended to underestimate for sleep duration (8.6-18.5 min), sleep efficiency (5.6-9.3%) and sleep-onset latency, except for attention-deficit/hyperactivity disorder during placebo in which actigraphy overestimated (-2.1 to 6
Buttery, Thomas J.
From a holistic perspective the term attention refers to a student's capacity to focus, direct and sustain their attention on a particular stimulus within their environment for a significant period of time. The development of students' attention spans develops progressively from the time they enter school. From the beginning some students have…
Chou, Wen-Jiun; Huang, Mei-Feng; Chang, Yu-Ping; Chen, Yu-Min; Hu, Huei-Fan; Yen, Cheng-Fang
Background and aims The aims of this study were to examine the association between social skills deficits and Internet addiction and activities in adolescents with attention-deficit/hyperactivity disorder (ADHD) as well as the moderators for this association. Methods A total of 300 adolescents, aged between 11 and 18 years, who had been diagnosed with ADHD participated in this study. Their Internet addiction levels, social skills deficits, ADHD, parental characteristics, and comorbidities were assessed. The various Internet activities that the participants engaged in were also examined. Results The associations between social skills deficits and Internet addiction and activities and the moderators of these associations were examined using logistic regression analyses. Social skills deficits were significantly associated with an increased risk of Internet addiction after adjustment for the effects of other factors [odds ratio (OR) = 1.049, 95% confidence interval (CI) = 1.030-1.070]. Social skills deficits were also significantly associated with Internet gaming and watching movies. The maternal occupational socioeconomic levels of the participants moderated the association between social skills deficits and Internet addiction. Conclusions Social skills deficits should be considered targets in prevention and intervention programs for treating Internet addiction among adolescents with ADHD.
Pritchard, Verena E.; Neumann, Ewald; Rucklidge, Julia J.
Selective attention has durable consequences for behavior and neural activation. Negative priming (NP) effects are assumed to reflect a critical inhibitory component of selective attention. The performance of adolescents with Attention Deficit/Hyperactivity Disorder (ADHD) was assessed across two conceptually based NP tasks within a selective…
Attention-deficit hyperactivity disorder (ADHD) is considered one of the most common neurodevelopmental disorders of childhood, characterized by inattention and/or hyperactivity-impulsivity. Even though a strict definition of this entity is constantly sought, ADHD is an often redefined and reconceptualized syndrome. Epidemiological studies show large differences in the incidence, pointing out that the effort of actual taxonomic systems to offer objective diagnostic criteria have not yielded substantial results. Bipolar Disorder (BD) with onset in childhood is distinguished from the adult form by the scarcity of affective symptoms. Very often, neither depressive mood, nor hypomanic euphoria are in the front line being covered by irritability with crises of violence. Children or adolescents have consecutive cycles, which include brief episodes of depressive, hypomanic, manic or mixed periods without free intervals. There was a delay in the recognition of this clinical picture. Τhe diagnostic criteria in the actual taxonomic systems are not separated from those of adults and according to some studies the disorder is under diagnosed mainly in European countries. The contemporary literature deals largely with the relationship ADHD - BD in young people because the two disorders share the same clinical picture with slight variations. Τhe differential diagnosis in favor of BD is mainly based on the presence of affective disorders in the family. The main questions raised are whether there is comorbidity, whether ADHD is overdiagnosed against BD or whether ADHD represents a prodromal manifestation of early onset BD. Children with comorbid ADHD and BD tend to express mostly a stimulant phenotype with a chronic course and have higher rates of antisocial conduct disorder. This particular phenotype suggests a symptomatic continuum between ADHD and early onset BD which is possibly responsible for the difficulties met in differential diagnosis and differences in the rates of
May, Diane E; Kratochvil, Christopher J
Throughout this decade, there has been significant research into pharmacotherapies for attention-deficit hyperactivity disorder (ADHD). This article considers the efficacy and safety of five of the more novel long-acting pharmacological treatments recently approved by the FDA for marketing in the US for paediatric ADHD, along with an alpha(2)-adrenoceptor agonist in preparation. Reviewed treatments include the non-stimulant atomoxetine, three novel extended-release (XR) stimulant preparations: dexmethylphenidate, lisdexamfetamine dimesylate and the methylphenidate transdermal system (TDS), and the recently approved XR alpha(2)-adrenoceptor agonist, guanfacine. Dexmethylphenidate XR is a stimulant treatment in a single isomer form, and has an efficacy and tolerability similar to two doses of immediate-release (IR) dexmethylphenidate when taken 4 hours apart, but is dosed at half of the usual d,l-methylphenidate dose. Dexmethylphenidate XR utilizes a beaded bimodal release, with 50% initially released and another 50% released 4 hours later to provide benefit lasting up to 10-12 hours. Lisdexamfetamine was the first stimulant treatment approved as a prodrug, whereby the single isomer d-amfetamine remains pharmacologically inactive until activated by cleaving the lysine. Its efficacy and tolerability are generally consistent with that of XR mixed amfetamine salts, with this activation method and more consistent absorption generally resulting in up to an 11- to 13-hour benefit. The methylphenidate TDS patch utilizes skin absorption to provide predictable and uniform delivery of methylphenidate when worn for 9 hours/day. The efficacy and tolerability of the methylphenidate TDS patch is generally consistent with that of osmotic-controlled release oral system (OROS) methylphenidate, providing benefit for about 11-12 hours. Because of their formulation, lisdexamfetamine and methylphenidate each have an onset of effect at about 2 hours after administration. An adjustable
Ter-Stepanian, Mariam; Grizenko, Natalie; Cornish, Kim; Talwar, Victoria; Mbekou, Valentin; Schmitz, Norbert; Joober, Ridha
Objective The goal of this study was to examine the relationship between comorbid disorders and executive function (EF) in children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). Methods Three hundred and fifty-five, 6–12 year old children clinically diagnosed with ADHD were included in the study. Comorbid anxiety disorders, Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) were examined. The EF domains were assessed using the Conners’ Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), Tower of London (ToL), Finger Windows (FW) and Self Ordered Pointing Test (SOPT). Results The findings indicate that children with comorbid anxiety disorders performed worse in domains measured by CPT and prior to controlling for age and sex, by FW. However, once sex was controlled for the results for FW were no longer significant. Children with CD obtained lower scores on WCST. Furthermore, a significant sex by CD interaction was observed. Conclusion These results indicate that comorbid disorders should be carefully examined as they play a significant role in EF performance and subsequently in day-to-day functioning of children with ADHD. PMID:28331500
Hwang, Shoou-Lian; Gau, Susan Shur-Fen; Hsu, Wen-Yau; Wu, Yu-Yu
Background: The underlying mechanism of time perception deficit in long time intervals in attention-deficit/hyperactivity disorder (ADHD) is still unclear. This study used the time reproduction dual task to explore the role of the attentional resource in time perception deficits among children and adolescents with ADHD. Methods: Participants…
Derlich, Malgorzata; Krecisz, Krzysztof; Kuczynski, Michal
To elucidate the mechanisms responsible for deteriorated postural control in children with hearing deficit (CwHD), we measured center-of-pressure (COP) variability, mean velocity and entropy in bipedal quiet stance (feet together) with or without the concurrent cognitive task (reaction to visual stimulus) on hard or foam surface in 29 CwHD and a…
Vaidya, Chandan J.; Stollstorff, Melanie
Cognitive neuroscience studies of Attention Deficit Hyperactivity Disorder (ADHD) suggest multiple loci of pathology with respect to both cognitive domains and neural circuitry. Cognitive deficits extend beyond executive functioning to include spatial, temporal, and lower-level "nonexecutive" functions. Atypical functional anatomy extends beyond…
Prosser, Brenton J.
A psycho-medical discourse that explains behavioural dysfunction through neurological deficit has dominated debate about attention deficit hyperactivity disorder (ADHD). However, if only medical questions are asked, only medical answers will be found, resulting in more or less drug treatment. When behavioural dysfunction results in impairment…
Paloyelis, Yannis; Mehta, Mitul A.; Faraone, Stephen V.; Asherson, Philip; Kuntsi, Jonna
Objective: Attention-deficit/hyperactivity disorder (ADHD) has been linked to deficits in the dopaminergic reward-processing circuitry; yet, existing evidence is limited, and the influence of genetic variation affecting dopamine signaling remains unknown. We investigated striatal responsivity to rewards in ADHD combined type (ADHD-CT) using…
Vloet, Timo D.; Gilsbach, Susanne; Neufang, Susanne; Fink, Gereon R.; Herpertz-Dahlmann, Beate; Konrad, Kerstin
Objective: Both executive functions and time perception are typically impaired in subjects with attention-deficit/hyperactivity disorder (ADHD). However, the exact neural mechanisms underlying these deficits remain to be investigated. Method: Fourteen subjects with ADHD and 14 age- and IQ-matched controls (aged 9 through 15 years) were assessed…
Van Meel, Catharina S.; Oosterlaan, Jaap; Heslenfeld, Dirk J.; Sergeant, Joseph A.
Objective: This study was designed to clarify whether poor performance of children with attention-deficit/hyperactivity disorder (ADHD) on motor timing tasks reflects a true deficit in the temporal organization of motor output or is due to a lack of intrinsic motivation. Method: Eighteen children with ADHD (age 8-12) were compared with 18 age- and…
Martinussen, Rhonda; Hayden, Jill; Hogg-Johnson, Sheilah; Tannock, Rosemary
Objective: To determine the empirical evidence for deficits in working memory (WM) processes in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: Exploratory meta-analytic procedures were used to investigate whether children with ADHD exhibit WM impairments. Twenty-six empirical research studies published from…
Ziegler, Johannes C.; Pech-Georgel, Catherine; Dufau, Stephane; Grainger, Jonathan
Visual-attentional theories of dyslexia predict deficits for dyslexic children not only for the perception of letter strings but also for non-alphanumeric symbol strings. This prediction was tested in a two-alternative forced-choice paradigm with letters, digits, and symbols. Children with dyslexia showed significant deficits for letter and digit…
Durston, Sarah; Fossella, John A.; Mulder, Martijn J.; Casey B. J.; Ziermans, Tim B.; Vessaz, M. Nathalie; Van Engeland, Herman
The study examines the effect of the dopamine transporter (DAT1) genotype in attention-deficit/hyperactivity disorder (ADHD). The results confirm that DAT1 translates the genetic risk of ADHD through striatal activation.
Kamali, Khosrow; Yoosefi Looyeh, Majid
This article describes a group narrative intervention for improving the behavior of 8- to 11-year-old children with attention-deficit/hyperactivity disorder at home and school. (Contains 2 tables and 1 note.)
Discursive psychology is used to study the gendering of attention deficit hyperactivity disorder in UK national newspapers in the period of 2009-2011. The analysis examines how gendering is embedded in causal attributions and identity constructions. Attention deficit hyperactivity disorder is portrayed as a predominantly male phenomenon with representations of attention deficit hyperactivity disorder being gendered through extreme stories about victims, villains or heroes that depict boys and men as marginalised, exceptional or dangerous. There is also a focus on mothers as the spokespersons and caretakers for parenting and family health while fathers are rendered more invisible. This contributes to our understanding of how attention deficit hyperactivity disorder is constructed in the media using a range of gendered representations that draw on cultural stereotypes familiar in Western societies.
Kottman, Terry; And Others
Parents (n=110) of children diagnosed with Attention Deficit-Hyperactivity Disorder (ADHD) completed a survey asking about demographics; developmental history; and parental perspectives regarding ADHD symptomology, identification, and treatment. Discusses implications of the results for school counselors. (JPS)
Rapport, Mark D.; Bolden, Jennifer; Kofler, Michael J.; Sarver, Dustin E.; Raiker, Joseph S.; Alderson, R. Matt
Hyperactivity is currently considered a core and ubiquitous feature of attention-deficit/hyperactivity disorder (ADHD); however, an alternative model challenges this premise and hypothesizes a functional relationship between working memory (WM) and activity level. The current study investigated whether children's activity level is functionally…
Aman, Christine J.; Roberts, Ralph J., Jr.; Pennington, Bruce F.
Examined front and right parietal lobe theories of attention deficit hyperactivity disorder (ADHD); subjects were 10- to 14-year-old boys with or without ADHD. Found that non-ADHD boys performed better on frontal- and parietal-domain tasks than unmedicated ADHD boys, unmedicated AHDH boys had greater impairments on frontal than parietal tasks, and…
Abstract Chronic prenatal exposure to ethanol can lead to a spectrum of teratogenic outcomes that are classified in humans as fetal alcohol spectrum disorders (FASD). One of the most prevalent and persistent neurocognitive components of FASD is attention deficits, and it is now thought that these attention deficits differ from traditional attention deficit hyperactivity disorder (ADHD) in their quality and response to medication. However, the neuronal mechanisms underlying attention deficits in FASD are not well understood. We show here that after developmental binge-pattern ethanol exposure, adult mice exhibit impaired performance on the five-choice serial reaction time test for visual attention, with lower accuracy during initial training and a higher rate of omissions under challenging conditions of high attention demand. Whole-cell electrophysiology experiments in these same mice find dysregulated pyramidal neurons in layer VI of the medial prefrontal cortex, which are critical for normal attention performance. Layer VI neurons show decreased intrinsic excitability and increased responses to stimulation of both nicotinic acetylcholine receptors and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) glutamate receptors. Moreover, although nicotinic acetylcholine responses correlate with performance on the five-choice task in control mice, these relationships are completely disrupted in mice exposed to ethanol during development. These findings demonstrate a novel outcome of developmental binge-pattern ethanol exposure and suggest that persistent alterations to the function of prefrontal layer VI neurons play an important mechanistic role in attention deficits associated with FASD. PMID:27844059
Nigg, Joel T.; Lewis, Kara; Edinger, Tracy; Falk, Michael
Objective: The role of diet and of food colors in attention-deficit/hyperactivity disorder (ADHD) or its symptoms warrants updated quantitative meta-analysis, in light of recent divergent policy in Europe and the United States. Method: Studies were identified through a literature search using the PubMed, Cochrane Library, and PsycNET databases…
Wiskow, Katie M; Klatt, Kevin P
Previous research has shown habit reversal training (HRT) to be effective in reducing tics. In some studies, tics have been reduced by implementing only a few components of HRT. The current study investigated the first step, awareness training, for treating tics in a young boy with Asperger syndrome, Tourette syndrome, and attention deficit hyperactivity disorder. The results showed a reduction in all tics.
Li, Xiaobo; Sroubek, Ariane; Kelly, Mary S.; Lesser, Iris; Sussman, Elyse; He, Yong; Branch, Craig; Foxe, John J.
Objective: The neurobiological basis of inattentiveness, a core feature of attention-deficit/hyperactivity disorder (ADHD), is not yet well understood. Structural abnormalities in thalamus, especially the pulvinar nuclei, have recently been reported in ADHD. Pulvinar nuclei maintain reciprocal connections with cortical/subcortical areas, and play…
Bart, Orit; Daniel, Liron; Dan, Orrie; Bar-Haim, Yair
Individuals with attention deficit hyperactive disorder (ADHD) often have coexisting developmental coordination disorder (DCD). The positive therapeutic effect of methylphenidate on ADHD symptoms is well documented, but its effects on motor coordination are less studied. We assessed the influence of methylphenidate on motor performance in children…
Kercood, Suneeta; Zentall, Sydney S.; Lee, David L.
The purpose of this study was to examine the effects of actively categorizing math problems on the math problem solving performance of students with and without attention deficit disorder (ADD). To this purpose, 52 fifth and sixth grade students were involved in actively categorizing or noncategorizing (control) tasks followed by two problem…
Mannuzza, S; Klein, R G
The authors have traced the developmental course of ADHD from childhood to adulthood, showing that it is a bumpy road for many. In early and middle adolescence, relative deficits are seen in academic and social functioning, ADHD symptoms remain problematic in two thirds to three quarters of these children, and antisocial behaviors, in some cases amounting to CD, are common. Many of these same difficulties persist into the late teenage years. Deficits continue to be observed in academic and social domains (compared with controls, probands exhibit lower grades, more courses failed, worse performance on standardized tests, have fewer friends, and are rated less adequate in psychosocial adjustment). About two fifths continue to experience ADHD symptoms to a clinically significant degree. One quarter to one third have a diagnosed antisocial disorder, and two thirds of these individuals are arrested. Also, drug abuse is observed in a significant minority of these youths. Importantly, the greatest risk factor for the development of antisocial behavior and substance abuse by the late teenage years is the maintenance of ADD symptoms. When evaluated in their mid-twenties, dysfunctions are apparent in these same areas. Compared with controls, probands complete less schooling, hold lower-ranking occupations, and continue to suffer from poor self-esteem and social skills deficits. In addition, significantly more probands than controls exhibit an antisocial personality and, perhaps, a substance use disorder in adulthood. Furthermore, many do not outgrow all facets of their childhood syndrome. These relative deficits, however, do not tell the whole story of the ADHD child's adult fate. Indeed, nearly all probands were gainfully employed. Furthermore, some had achieved a higher-level education (e.g., completed Master's degree, enrolled in medical school) and occupation (e.g., accountant, stock broker). In addition, a full two thirds of these children showed no evidence of any
Chuang, Tsung-Yen; Lee, I-Ching; Chen, Wen-Chih
ADHD or ADD (Attention Deficit/Hyperactivity Disorder) is one of the most frequently diagnosed mental and behavioral disorders of children. Children with ADHD are characterized by poor attention and distractibility and/or hyperactive and impulsive behaviors. Although there is no "cure" for ADHD, there are accepted treatments that…
Casas, Ana Miranda; Ferrer, Manuel Soriano; Fortea, Inmaculada Baixauli
Attention-deficit/hyperactivity disorder (ADHD) is frequently associated with learning disabilities. The present study examined the written composition of children with ADHD, which depends to a large degree on continuous self-regulation and attentional control skills for organizing information and maintaining the level of effort. Fifty children…
Ryser, Gail R.; Campbell, Hilary L.; Miller, Brian K.
The diagnostic criteria for attention deficit hyperactivity disorder have evolved over time with current versions of the "Diagnostic and Statistical Manual", (4th edition), text revision, ("DSM-IV-TR") suggesting that two constellations of symptoms may be present alone or in combination. The SCALES instrument for diagnosing attention deficit…
Pottinger, Audrey M.
Children with Attention-Deficit Hyperactivity Disorder (ADHD) are at risk for behavioral problems and so are frequently brought to the attention of counselors. The literature is limited, however, in examining specific counseling techniques for this population, and particularly in discussing counseling in a developing country where children do not…
Stewart, Garth A.; Steffler, Dorothy J.; Lemoine, Daniel E.; Leps, Jolene D.
Used quantitative electroencephalogram analysis to examine difference in brain wave activity of attention deficit disorders (ADD) with and without hyperactivity while completing a computerized task measuring a variety of constructs associated with attention and impulsivity. Found that although behavioral ratings confirmed differential…
Grauvogel-MacAleese, Alicia N.; Wallace, Michele D.
The present experiment extended and replicated the use of functional analysis and a peer-mediated intervention to decrease disruptive behavior displayed by children diagnosed with attention deficit hyperactivity disorder in an afterschool program. After determining that the participants displayed off-task behavior maintained by peer attention via…
Reid, Robert; Trout, Alexandra L.; Schartz, Michalla
Current recommendations for the treatment of attention deficit/hyperactivity disorder (ADHD) call for a multimodal approach including a combination of medication, behavior modification, school accommodations, and ancillary services. One method that has been proposed as an effective and efficient means for increasing students' attention and…
Reid, Robert; Lienemann, Torri Ortiz
Children with attention deficit/hyperactivity disorder (ADHD) are at increased risk of academic difficulties and special education placement (Barkley, 1998). One academic area, written expression, has received little research attention. This study assessed the effectiveness of a validated strategy instruction model--Self-Regulated Strategy…
ERIC Clearinghouse on Disabilities and Gifted Education, Reston, VA.
This digest defines attention deficit disorders (ADD), provides the attention span, hyperactivity, and impulsivity criteria for diagnosing ADD, and identifies successful strategies for teachers working with children with ADD. Strategies are provided for: (1) establishing the proper learning environment, including seating students with ADD near the…
Kopp, Svenny; Kelly, Kristina Berg; Gillberg, Christopher
Objective: Examine clinical correlates and distinguishing features of autism spectrum disorders (ASD), ADHD, and tic disorders in girls referred for social impairment, attention/academic deficits, and/or tics. Method: One hundred 3- to 18-year-old girls referred for social impairment and attention symptoms were assessed in detail. Sixty of these…
Kodak, Tiffany; Grow, Laura; Northup, John
We conducted a functional analysis of elopement in an outdoor setting for a child with a diagnosis of attention deficit hyperactivity disorder. A subsequent treatment consisting of noncontingent attention and time-out was demonstrated to be effective in eliminating elopement. Modifications of functional analysis procedures associated with the…
Mishler, Ada D.; Neider, Mark B.
Feature at a Glance Older adults experience difficulties with navigating their environments, and may need to rely on signs more heavily than younger adults. However, older adults also experience difficulties with focusing their visual attention, which suggests that signs need to be designed with the goal of making it as easy as possible to attend to them. This article discusses some design principles that may be especially important to compensate for declining attentional focus. These principles include distinctiveness, consistent appearance and location, standardized images, simplicity, isolation from other elements of the environment, and reassurance about the current route.
on Event Related Potentials, Stanford, CA. June. 11. Downing, C.J. & Pinker , S. (1985) in Attention and Performance XI ed. Posner, M.I. & Marin, O.S.M...Avenue La Jolla, CA 92093 Alexandria, VA 22333 - Dr. Steven Zornetzer Dr. Michael J. Zyda Office of Naval Research Naval Postgraduate School Code 1140 Code
Wu, Yi-Huan; Gau, Susan Shur-Fen; Lo, Yu-Chun; Tseng, Wen-Yih Isaac
The frontostriatal circuit has been postulated to account for the core symptoms such as inattention in attention deficit/hyperactivity disorder (ADHD). This study investigated the white matter integrity of frontostriatal fiber tracts using diffusion spectrum imaging (DSI) tractography and its correlations with measures of multi-dimensional aspects of inattention based on psychiatric interview and attention tasks in 25 children with ADHD and 25 matched typically developing (TD) children. All the subjects were assessed with comprehensive psychiatric interviews and the Conner's Continuous Performance Test (CCPT). DSI data were acquired on a 3-Tesla MRI system. The frontostriatal fiber pathways were reconstructed by deterministic tractography, and generalized fractional anisotropy values were measured along individual targeted tracts to investigate alterations in microstructure integrity. Children with ADHD performed worse than TD children in the dimensions of focused attention, sustained attention, impulsivity, and vigilance of the CCPT, and showed impaired integrity in four bilateral frontostriatal tracts, namely the dorsolateral-caudate, medial prefrontal-caudate, orbitofrontal-caudate, and ventrolateral-caudate tracts, and in global white matter as well. The integrity of the left orbitofronto-caudate tract was associated with the symptom of inattention in children with ADHD, compatible with the attention deficit and motivational dysfunction theories in ADHD. The integrity of the frontostriatal tracts was associated with the attention performance only in TD children, suggestive of possible recruitment of tracts other than the frontostriatal tracts implicated in attention deficits in children with ADHD. In conclusion, our results demonstrate the functional involvement of the frontostriatal circuit with respect to clinical symptoms and attention performance.
Orinstein, Alyssa J; Stevens, Michael C
Previous functional neuroimaging studies have found brain activity abnormalities in attention-deficit/hyperactivity disorder (ADHD) on numerous cognitive tasks. However, little is known about brain dysfunction unique to the predominantly-inattentive subtype of ADHD (ADHD-I), despite debate as to whether DSM-IV-defined ADHD subtypes differ in etiology. This study compared brain activity of 18 ADHD-I adolescents (ages 12-18) and 20 non-psychiatric age-matched control participants on a functional magnetic resonance image (fMRI) auditory oddball attention task. ADHD-I participants had significant activation deficits to infrequent target stimuli in bilateral superior temporal gyri, bilateral insula, several midline cingulate/medial frontal gyrus regions, right posterior parietal cortex, thalamus, cerebellum, and brainstem. To novel stimuli, ADHD-I participants had reduced activation in bilateral lateral temporal lobe structures. There were no brain regions where ADHD-I participants had greater hemodynamic activity to targets or novels than controls. Brain activity deficits in ADHD-I participants were found in several regions important to attentional orienting and working memory-related cognitive processes involved in target identification. These results differ from those in previously studied adolescents with combined-subtype ADHD, who had a lesser magnitude of activation abnormalities in frontoparietal regions and relatively more discrete regional deficits to novel stimuli. The divergent findings suggest different etiological factors might underlie attention deficits in different DSM-IV-defined ADHD subtypes, and they have important implications for the DSM-V reconceptualization of subtypes as varying clinical presentations of the same core disorder.
Prediger, Rui D S; Pamplona, Fabrício A; Fernandes, Daniel; Takahashi, Reinaldo N
The spontaneously hypertensive rat (SHR) is generally considered to be a suitable genetic model for the study of attention deficit hyperactivity disorder (ADHD), since it displays hyperactivity, impulsivity, poorly sustained attention, and deficits in learning and memory processes. Converging evidence suggests a primary role of disturbance in the dopaminergic neurotransmission in ADHD patients and in SHR, and in addition, some studies have also demonstrated alterations in adenosinergic neurotransmission in SHR. In the present study, adult female Wistar (WIS) and SHR rats received caffeine (1-10 mg/kg i.p.) 30 min before training, immediately after training, or 30 min before a test session in the spatial version of the Morris water maze. The effect of caffeine administration on WIS and SHR blood pressure was also measured. SHR needed significantly more trials in the training session to acquire the spatial information, but they displayed a similar profile to that of WIS rats in the test session (48 h later), demonstrating a selective deficit in spatial learning. Pre-training administration of caffeine (1-10 mg/kg i.p.) improved this spatial learning deficit in SHR, but did not alter the WIS performance. In contrast, post-training administration of caffeine (3 mg/kg i.p.) did not alter the SHR test performance, but increased memory retention in WIS rats. No dose of caffeine tested altered the mean blood pressure of WIS or SHR. These results demonstrate a selective spatial learning deficit in SHR which can be attenuated by pre-training administration of caffeine. In addition, the present findings indicate that the spatial learning deficit in SHR is not directly related to hypertension.
Duga, Balázs; Czakó, Márta; Komlósi, Katalin; Hadzsiev, Kinga; Sümegi, Katalin; Kisfali, Péter; Melegh, Márton; Melegh, Béla
One of the most common psychiatric disorders during childhood is attention deficit hyperactivity disorder, which affects 5-6% of children worldwide. Symptoms include attention deficit, hyperactivity, forgetfulness and weak impulse control. The exact mechanism behind the development of the disease is unknown. However, current data suggest that a strong genetic background is responsible, which explains the frequent occurrence within a family. Literature data show that copy number variations are very common in patients with attention deficit hyperactivity disorder. The authors present a patient with attention deficit hyperactivity disorder who proved to have two approximately 400 kb heterozygous microduplications at 6p25.2 and 15q13.3 chromosomal regions detected by comparative genomic hybridization methods. Both duplications affect genes (6p25.2: SLC22A23; 15q13.3: CHRNA7) which may play a role in the development of attention deficit hyperactivity disorder. This case serves as an example of the wide spectrum of indication of the array comparative genome hybridization method.
Pineda, David A; Aguirre, Daniel C; Garcia, Mauricio A; Lopera, Francisco J; Palacio, Luis G; Kamphaus, Randy W
This study assesses the validity of the Behavioral Assessment System for Children-parent and teacher questionnaires for attention-deficit hyperactivity disorder diagnosis in a randomized sample of 344 Colombian children (145 cases, 199 controls), males and females, ages 6 to 11, with an estimated Wechsler Full Scale Intelligence Quotient over 70. The assessment protocol for both groups included psychiatric, neurologic, and psychological interviews, parent and teacher rating forms, and an Attention-Deficit Hyperactivity Disorder Checklist. All Behavioral Assessment System for Children-parent and teacher dimensions, except withdrawal and somatization, significantly differentiated cases and controls. Parents and teachers rated attention-deficit hyperactivity disorder combined type children as significantly more aggressive. Both questionnaires had good discriminant accuracy for detecting cases and control children, but accuracy for discriminating between attention-deficit hyperactivity disorder subtypes was poor. The Behavioral Assessment System for Children-parent and teacher questionnaires for 6- to 11-year-olds may be useful tools for diagnosing the presence of attention-deficit hyperactivity disorder. Additional assessment methods will be needed to discriminate between the subtypes.
Knorr, Sine; Vlachova, Zuzana; Jensen, Rikke B.; Mathiesen, Elisabeth R.; Beck-Nielsen, Henning; Gravholt, Claus H.; Jensen, Dorte M.; Clausen, Tine D.; Mortensen, Erik L.; Damm, Peter
Objective The aim of this study was to examine the potential association between intrauterine exposure to maternal diabetes and attention deficits in the offspring. Research design and methods Adolescent offspring of a prospectively followed cohort of women with type 1 diabetes (n = 269) and a control group from the background population (n = 293) participated in a follow-up assessment in 2012–2013. We used scores from Conners Continuous Performance Test II to assess attention and based on a principal component analysis we evaluated scores on five different attention factors: focused attention, vigilance, hyperactivity/impulsivity, sustained attention and response style. Results A higher frequency of the exposed offspring had a parent/self-reported use of Attention Deficit Hyperactivity Disorder (ADHD) medication compared to the control group (2.2% vs. 0.0%, p = 0.01). Clinical significant differences between adolescents exposed to maternal diabetes and unexposed controls were not found in either single scores on Conners Continuous Performance Test or on any of the five attention factors identified. Conclusions Exposure to maternal type 1 diabetes did not seem to increase the risk of attention deficits in the adolescent offspring. However, a higher self-reported use of ADHD medication in the exposed group could suggest a difference in attention not revealed by the applied test. PMID:28072839
Albrecht, Björn; Uebel, Henrik; Kirov, Roumen; Banaschewski, Tobias; Rothenberger, Aribert; Kolev, Vasil
The maintenance of stable goal-directed behaviour is a hallmark of conscious executive control in humans. Notably, both correct and error human actions may have a subconscious activation-based determination. One possible source of subconscious interference may be the default mode network that, in contrast to attentional network, manifests intrinsic oscillations at very low (<0.1 Hz) frequencies. In the present study, we analyse the time dynamics of performance accuracy to search for multisecond periodic fluctuations of error occurrence. Attentional lapses in attention deficit/hyperactivity disorder are proposed to originate from interferences from intrinsically oscillating networks. Identifying periodic error fluctuations with a frequency <0.1 Hz in patients with attention deficit/hyperactivity disorder would provide a behavioural evidence for such interferences. Performance was monitored during a visual flanker task in 92 children (7- to 16-year olds), 47 with attention deficit/hyperactivity disorder, combined type and 45 healthy controls. Using an original approach, the time distribution of error occurrence was analysed in the frequency and time–frequency domains in order to detect rhythmic periodicity. Major results demonstrate that in both patients and controls, error behaviour was characterized by multisecond rhythmic fluctuations with a period of ∼12 s, appearing with a delay after transition to task. Only in attention deficit/hyperactivity disorder, was there an additional ‘pathological’ oscillation of error generation, which determined periodic drops of performance accuracy each 20–30 s. Thus, in patients, periodic error fluctuations were modulated by two independent oscillatory patterns. The findings demonstrate that: (i) attentive behaviour of children is determined by multisecond regularities; and (ii) a unique additional periodicity guides performance fluctuations in patients. These observations may re-conceptualize the understanding of
Yordanova, Juliana; Albrecht, Björn; Uebel, Henrik; Kirov, Roumen; Banaschewski, Tobias; Rothenberger, Aribert; Kolev, Vasil
The maintenance of stable goal-directed behaviour is a hallmark of conscious executive control in humans. Notably, both correct and error human actions may have a subconscious activation-based determination. One possible source of subconscious interference may be the default mode network that, in contrast to attentional network, manifests intrinsic oscillations at very low (<0.1 Hz) frequencies. In the present study, we analyse the time dynamics of performance accuracy to search for multisecond periodic fluctuations of error occurrence. Attentional lapses in attention deficit/hyperactivity disorder are proposed to originate from interferences from intrinsically oscillating networks. Identifying periodic error fluctuations with a frequency<0.1 Hz in patients with attention deficit/hyperactivity disorder would provide a behavioural evidence for such interferences. Performance was monitored during a visual flanker task in 92 children (7- to 16-year olds), 47 with attention deficit/hyperactivity disorder, combined type and 45 healthy controls. Using an original approach, the time distribution of error occurrence was analysed in the frequency and time-frequency domains in order to detect rhythmic periodicity. Major results demonstrate that in both patients and controls, error behaviour was characterized by multisecond rhythmic fluctuations with a period of ∼12 s, appearing with a delay after transition to task. Only in attention deficit/hyperactivity disorder, was there an additional 'pathological' oscillation of error generation, which determined periodic drops of performance accuracy each 20-30 s. Thus, in patients, periodic error fluctuations were modulated by two independent oscillatory patterns. The findings demonstrate that: (i) attentive behaviour of children is determined by multisecond regularities; and (ii) a unique additional periodicity guides performance fluctuations in patients. These observations may re-conceptualize the understanding of attentive
Fernandez-Jaen, A; Lopez-Martin, S; Albert, J; Martin Fernandez-Mayoralas, D; Fernandez-Perrone, A L; Calleja-Perez, B; Lopez-Arribas, S
Introduccion. Los trastornos del neurodesarrollo engloban a un grupo heterogeneo de trastornos como la discapacidad intelectual, el trastorno del espectro autista o los trastornos especificos del aprendizaje, entre otros. La reciente inclusion en las clasificaciones internacionales del trastorno por deficit de atencion/hiperactividad (TDAH) dentro de los trastornos del neurodesarrollo parece claramente justificada atendiendo a variables neurobiologicas y clinicas. Desarrollo. El caracter dimensional y la distribucion de diferentes sintomas en la poblacion caracterizan a la mayoria de los trastornos del neurodesarrollo. Se revisan estos aspectos, particularmente desde la sintomatologia y neuropsicologia en el TDAH. El caracter sintomatico dimensional del TDAH contrasta con los criterios diagnosticos de este trastorno de acuerdo a diferentes clasificaciones o guias clinicas. Contrasta igualmente con los datos recogidos a traves de diferentes exploraciones complementarias (escalas, tests...). Conclusiones. El entendimiento del continuo clinico dentro de cada trastorno del neurodesarrollo (incluido el TDAH), entre los diferentes trastornos del neurodesarrollo, y entre los trastornos del neurodesarrollo y la normalidad, es esencial para la investigacion, el diagnostico y el abordaje de todos ellos. El desarrollo de instrumentos que avalen este componente dimensional es igualmente trascendental.
Quintero-Gallego, E A; Gómez, C M; Morales, M; Márquez, J
Cerebellum astrocytomas are the most typical nervous system tumors in children. Several cognitive deficits have been previously described. These deficits are probably produced by cerebellar connection and gray matter damage. The present study examines attentional deficits in children operated on for cerebellum astrocytomas, using an attentional paradigm with theoretical and clinical bases: the Attentional Network Test (ANT). This test was designed considering the attentional network theory proposed by Posner, and its usefulness has been demonstrated in clinical settings. Children operated on for cerebellar astrocytoma showed a mild attentional deficit in the orientation network.
Su, Li; Wyble, Brad; Zhou, Lai-Quan; Wang, Kui; Wang, Yu-Na; Cheung, Eric F C; Bowman, Howard; Chan, Raymond C K
Patients with schizophrenia are known to have impairments in sensory processing. In order to understand the specific temporal perception deficits of schizophrenia, we investigated and determined to what extent impairments in temporal integration can be dissociated from attention deployment using Attentional Blink (AB). Our findings showed that there was no evident deficit in the deployment of attention in patients with schizophrenia. However, patients showed an increased temporal integration deficit within a hundred-millisecond timescale. The degree of such integration dysfunction was correlated with the clinical manifestations of schizophrenia. There was no difference between individuals with/without schizotypal personality disorder in temporal integration. Differently from previous studies using the AB, we did not find a significant impairment in deployment of attention in schizophrenia. Instead, we used both theoretical and empirical approaches to show that previous findings (using the suppression ratio to correct for the baseline difference) produced a systematic exaggeration of the attention deficits. Instead, we modulated the perceptual difficulty of the task to bring the baseline levels of target detection between the groups into closer alignment. We found that the integration dysfunction rather than deployment of attention is clinically relevant, and thus should be an additional focus of research in schizophrenia.
Rubia, Katya; Alegría, Analucía A; Brinson, Helen
Objetivo. Revisar los hallazgos de los estudios con resonancia magnetica en el trastorno por deficit de atencion/hiperactividad (TDAH) infantil y adulto. Desarrollo. Dichos estudios han demostrado que el TDAH se caracteriza por la presencia de multiples anomalias de caracter estructural y funcional, primordialmente en los circuitos frontoestriatales, pero tambien en los circuitos frontoparietotemporales, frontocerebelares e, incluso, frontolimbicos. Los datos aportados por los estudios longitudinales de resonancia magnetica estructural demuestran que el TDAH se caracteriza por un retraso en la maduracion estructural del cerebro. Esta conclusion se ve reforzada por los indicios indirectos ofrecidos por los estudios de cortes transversales, que indican la existencia de una inmadurez sustancial tanto en la funcion cerebral como en los patrones de conectividad estructural y funcional, indicios que, sin embargo, estan pendientes de confirmar en estudios longitudinales. La alteracion funcional de la corteza prefrontal ventrolateral parece estar mas afectada en el TDAH que en otros trastornos pediatricos, y existen algunos indicios de anomalias distintivas en los ganglios basales. Un metaanalisis sobre los efectos de los estimulantes en la funcion cerebral demuestra que el mecanismo de accion agudo mas congruente de los farmacos psicoestimulantes consiste en el aumento de la activacion de la corteza prefrontal inferior y los ganglios basales. Los primeros intentos por utilizar los datos de los estudios de neuroimagen para elaborar clasificaciones diagnosticas individuales de los niños con TDAH a partir de tecnicas de reconocimiento de patrones han cosechado resultados alentadores, pero todavia deben ser replicados por mas centros y aparatos de resonancia magnetica. Conclusiones. Durante los ultimos 20 años, las tecnicas de neuroimagen han perfilado los biomarcadores del TDAH, pero es necesario que nuevos estudios descubran la utilidad clinica de esa informacion, como el
Zanetti, Michele; Cartabia, Massimo; Didoni, Anna; Fortinguerra, Filomena; Reale, Laura; Mondini, Matteo; Bonati, Maurizio
This article describes the development and clinical impact of the Italian Regional ADHD Registry, aimed at collecting and monitoring diagnostic and therapeutic pathways of care for attention-deficit hyperactivity disorder children and adolescents, launched by the Italian Lombardy Region in June 2011. In particular, the model-based software used to run the registry and manage clinical care data acquisition and monitoring, is described. This software was developed using the PROSAFE programme, which is already used for data collection in many Italian intensive care units, as a stand-alone interface case report form. The use of the attention-deficit hyperactivity disorder regional registry led to an increase in the appropriateness of the clinical management of all patients included in the registry, proving to be an important instrument in ensuring an appropriate healthcare strategy for children and adolescents with attention-deficit/hyperactivity disorder.
Seitler, Burton Norman
Science tries to explain phenomena in ways that are demonstrable and replicable to develop logical, coherent, parsimonious, and predictive theoretical systems. Yet hyperactive children are given stimulants to "calm" them down, despite the fact that science would predict stimulants would increase hyperactivity. Bradley (1937, 1950) observed that half of the behavior-problem children to whom he administered a stimulant for one week became subdued. He called this finding paradoxical, speculating that inhibitory centers of the central nervous system were stimulated. While Bradley's assertion of a paradoxical reverse effect in children may be an empirical observation, it is not an explanation. The Attention Deficit/Hyperactive Disorder (ADHD) is inferred to exist from hyperactive behavior, which in turn, is inferred to be neurological in origin, a circular argument. An inevitable consequence of the belief in the hypothetical neurological etiology of ADHD is that children are typically given stimulants. Using the case of a seven-year old child, described as experiencing ADHD, who was treated successfully without medication as an illustration, the author provides an alternative, more parsimonious explanation of the etiology, suggesting that ADHD is related to agitated depression.
Wang, Li-Chih; Tsai, Huang-Ju; Yang, Hsien-Ming
While teachers have traditionally used the interesting objects to increase student attention in the classroom, evidence supporting the effectiveness of this method is lacking. The present study investigated the influence of different stimulus attributes for typical developing students and for students with attention deficit/hyperactivity disorder (ADHD) and dyslexia. Thirty children with ADHD, 30 children with dyslexia, and 30 typical developing students were tested using a measuring tool that was constructed by the authors to assess their sustained attention and selective attention on the geometric-figure assessment and the interesting-figure assessment. The geometric-figure assessment included a square, circle, trapezium, and triangle; and the interesting-figure assessment included a house, cat, hand, and tree. While the typical developing group showed better selective attention on the geometric-figure assessment, there was no difference between the dyslexic group and the ADHD group with respect to selective attention. Furthermore, the typical developing and dyslexic groups did not differ in the geometric-figure assessment in sustained attention and were both better in this area than the ADHD group. In the interesting-figure assessment, the typical developing and dyslexic groups performed similarly in sustained attention, but selective attention of the dyslexic group improved more than the ADHD group, similar to the typical developing group. Both selective attention of the dyslexic group and sustained attention of the ADHD group showed positive significant differences in the interesting-figure assessment, but sustained attention of the dyslexic group and selective attention of the ADHD group showed little difference in the interesting-figure assessment. Surprisingly, the typical developing group did not show any significant difference in the interesting-figure assessment, possibly because they had previously demonstrated a ceiling effect in the geometric
Little is known of the impact of asbestos on the health of the workers in the United States who have removed or abated asbestos from buildings following recognition of its adverse effects on health. The United States does not have a national occupational health surveillance network to monitor asbestos-related disease and, while the United States Occupational Health and Safety Administration has a strong and detailed asbestos standard, its enforcement resources are limited. A significant proportion of asbestos abatement workers are foreign-born, and may face numerous challenges in achieving safe workplaces, including lack of union representation, economic vulnerability, and inadequate training. Public health surveillance and increased and coordinated enforcement is needed to monitor the health and exposure experiences of asbestos-exposed workers. Alarming disease trends in asbestos removal workers in Great Britain suggest that, in the United States, increased public attention will be necessary to end the epidemic of asbestos-related disease.
Samuelsson, H; Hjelmquist, E K; Jensen, C; Ekholm, S; Blomstrand, C
Simple reaction time was examined in a consecutive series of 60 right hemisphere stroke patients at the postacute stage and at 6 to 7 months poststroke. Reaction times to auditory stimuli were measured within the ipsilesional side of space. Patients showing contralateral neglect in conventional tests of neglect showed significantly increased reaction times at the postacute stage and at the follow-up compared to those not showing neglect and to those in a group of normal controls. The results suggest that a lowered general attentional capacity may constitute a central component behind persistent neglect. An additional analysis of the CT scans of the patients showed that a large lesion including the paraventricular white matter in the temporal lobe was the most important anatomical correlate of persisting slow reactions.
Ziegler, Johannes C; Pech-Georgel, Catherine; Dufau, Stéphane; Grainger, Jonathan
Visual-attentional theories of dyslexia predict deficits for dyslexic children not only for the perception of letter strings but also for non-alphanumeric symbol strings. This prediction was tested in a two-alternative forced-choice paradigm with letters, digits, and symbols. Children with dyslexia showed significant deficits for letter and digit strings but not for symbol strings. This finding is difficult to explain for visual-attentional theories of dyslexia which postulate identical deficits for letters, digits and symbols. Moreover, dyslexics showed normal W-shaped serial position functions for letter and digit strings, which suggests that their deficit is not due to an abnormally small attentional window. Finally, the size of the deficit was identical for letters and digits, which suggests that poor letter perception is not just a consequence of the lack of reading. Together then, our results show that symbols that map onto phonological codes are impaired (i.e. letters and digits), whereas symbols that do not map onto phonological codes are not impaired. This dissociation suggests that impaired symbol-sound mapping rather than impaired visual-attentional processing is the key to understanding dyslexia.
Palomar, Gloria; Ferrer, Roser; Real, Alberto; Nogueira, Mariana; Corrales, Montserrat; Casas, Miguel; Ramos-Quiroga, Josep Antoni
Background: Differences in the cortisol response have been reported between children exhibiting the inattentive and hyperactive/impulsive subtypes of attention deficit hyperactivity disorder. However, there is no such information about adults. The aim of the present study was to determine the possible differences between the combined and inattentive subtypes in the cortisol response to stress. Methods: Ninety-six adults with attention deficit hyperactivity disorder, 38 inattentive and 58 combined, without any medical or psychiatric comorbidities and 25 healthy controls were included. The Trier Social Stress Test was used to assess physiological stress responses. Clinical data and subjective stress levels, including the Perceived Stress Scale, were also recorded. Results: No significant differences in the cortisol response to the Trier Social Stress Test were found between patients and controls. However, albeit there were no basal differences, lower cortisol levels at 15 (P=.015), 30 (P=.015), and 45 minutes (P=.045) were observed in the combined compared with the inattentive subtype after the stress induction; these differences disappeared 60 minutes after the stress. In contrast, the subjective stress responses showed significant differences between attention deficit hyperactivity disorder patients and controls (P<.001), but no differences were seen between attention deficit hyperactivity disorder subtypes. In turn, subjective stress measures, such as the Perceived Stress Scale, positively correlated with the whole cortisol stress response (P<.027). Conclusions: Both the combined and inattentive attention deficit hyperactivity disorder adults exhibited a normal cortisol response to stress when challenged. Nevertheless, the inattentive patients displayed a higher level of cortisol after stress compared with the combined patients. Despite the differences in the cortisol response, adults with attention deficit hyperactivity disorder reported high levels of subjective
Fox, Adam E; Caramia, Sierra R; Haskell, Molly M; Ramey, Aerial L; Singha, Depika
The spontaneously hypertensive (SHR/NCrl) rat from Charles River is one of the most widely used models of the combined subtype of Attention-Deficit/Hyperactivity Disorder (ADHD-C). Although often used as its control strain, the Wistar Kyoto (WKY/NCrl) from Charles River has been proposed as a model of the predominately inattentive subtype of ADHD (ADHD-PI). In Experiment 1 SHR/NCrl, WKY/NCrl, and Wistar (WI; the progenitor strain for the two models) rats were trained on a left→right lever-press sequence in the presence of light discriminative stimuli that signaled the active lever in the sequence. In subsequent conditions the discriminative light cues were removed or reversed. WKY/NCrl accuracy remained relatively stable across cue light transitions. SHR/NCrl and WI accuracy was more disrupted when light cues were removed or reversed-an indication that behavior of the WKY/NCrl rats may not have come under control of the discriminative light cues as it did for the other strains, but relied more on past behavior and spatial cues. In Experiment 2, all three strains were exposed to a response-initiated fixed-interval (RIFI) 8-s schedule of reinforcement. In RIFI schedules behavior must be timed from a past instance of the target response. Replicating previous work, timing during the FI was roughly equivalent across the three strains; however, latencies to initiate the FI were significantly longer for SHR/NCrl than WKY/NCrl and WI rats, suggesting SHR/NCrl behavior was less sensitive to the first-response:food contingency in the RIFI schedule. These findings identify differences in stimulus control between the three strains and may help determine the efficacy of SHR/NCrl and WKY/NCrl as models of ADHD subtypes in humans.
La Marca, Jeffry P.; O'Connor, Rollanda E.
Research consistently demonstrates that attention deficits have a deleterious effect on academic achievement. Impairments in attention, and not hyperactivity/impulsivity, are associated with learning difficulties and academic problems in students with attention-deficit/hyperactivity disorder (ADHD). To date, most studies have focused on symptoms…
Pandolfo, Pablo; Machado, Nuno J; Köfalvi, Attila; Takahashi, Reinaldo N; Cunha, Rodrigo A
Attention deficit hyperactivity disorder (ADHD) likely involves dopaminergic dysfunction in the frontal cortex and striatum, resulting in cognitive and motor abnormalities. Since both adenosine and dopamine modulation systems are tightly intertwined, we tested if caffeine (a non-selective adenosine receptor antagonist) attenuated the behavioral and neurochemical changes in adolescent spontaneously hypertensive rats (SHR, a validated ADHD animal model) compared to their control strain (Wistar Kyoto rats, WKY). SHR were hyperactive and had poorer performance in the attentional set-shifting and Y-maze paradigms and also displayed increased dopamine transporter (DAT) density and increased dopamine uptake in frontocortical and striatal terminals compared with WKY rats. Chronic caffeine treatment was devoid of effects in WKY rats while it improved memory and attention deficits and also normalized dopaminergic function in SHR. Additionally, we provide the first direct demonstration for the presence of adenosine A2A receptors (A2AR) in frontocortical nerve terminals, whose density was increased in SHR. These findings underscore the potential for caffeine treatment to normalize frontocortical dopaminergic function and to abrogate attention and cognitive changes characteristic of ADHD.
Welner, S A; Koty, Z C; Boksa, P
Adrenal chromaffin cells were isolated from donor adult rats and transplanted to the cerebral cortex of bilaterally nucleus basalis magnocellularis-lesioned rats. Chromaffin cell grafts to lesioned animals completely reversed the spatial memory deficit seen in lesioned alone animals on a T-maze alternation task. Although chromaffin cell grafts have been used previously to reverse motor abnormalities arising from defective nigro-striatal aminergic transmission, the present report is the first evidence that chromaffin cell transplants can reverse deficits in memory function. Grafts also enhanced cortical acetylcholinesterase staining.
Salo, Ruth; Gabay, Shai; Fassbender, Catherine; Henik, Avishai
Objective: The goal of the present study was to examine distributed attentional functions in long-term but currently abstinent methamphetamine (MA) abusers using a task that measures attentional alertness, orienting, and conflict resolution. Methods: Thirty currently abstinent MA abusers (1 month-5 years) and 22 healthy non-substance using adults…
Lynch, J C; McLaren, J W
1. Visual attention is often profoundly disturbed in humans after damage to the cortex of the posterior parietal lobe, particularly of the minor hemisphere, with some patients being totally unaware of visual stimuli in the hemifield of extrapersonal space contralateral to the cortical damage. This severe form of visual inattention is usually called contralateral neglect and has occasionally been reported following posterior parietal lesions in monkeys. However, in monkeys, only qualitative observations have been published and those reports are not in agreement concerning the severity of the deficit. The present experiments were designed to measure quantitatively the amount of disruption of selective visual attention which is produced by lesions of posterior parietal and parietooccipital cortical lesions in monkeys. 2. Five monkeys were trained to visually fixate and follow with their gaze a small visual stimulus as it suddenly moved varying distances (8, 16, or 24 degrees) from the midline into the left or right visual hemifields. Two animals then received a unilateral cortical lesion limited to the inferior parietal lobule (IPL). Three animals received unilateral lesions which included both the inferior parietal lobule and a portion of adjacent dorsal prestriate cortex (IPL-PS). 3. Visual inattention is commonly divided into two levels of severity. The more severe form, contralateral neglect, is the complete absence of behavioral response to a stimulus in the visual field contralateral to hemisphere damage. The less severe deficit, usually called visual extinction, is a tendency to ignore the contralateral of two visual stimuli when they appear simultaneously and symmetrically placed with respect to the center of the subject's surroundings. The five monkeys in this study were tested on a stimulus paradigm which simultaneously measured the severity of visual neglect and also the amount and duration of visual extinction which were produced by the cortical lesions. 4
Denis, Isabelle; Guay, Marie-Claude; Foldes-Busque, Guillaume; BenAmor, Leila
Twenty-five percent of children with ADHD also have an anxiety disorder (AD). As per Quay and in light of Barkley's model, anxiety may have a protective effect on cognitive deficits and behaviors associated with ADHD. This study aimed to evaluate the effect of treating AD on cognitive deficits and behaviors associated with ADHD in children with both disorders. Twenty-four children with ADHD and AD were divided into two groups: treatment for AD, and wait list. Participants were assessed at pre-treatment, post-treatment, and 6-month follow-up with the ADIS-C, the CBCL, and neuropsychological measures. The results revealed a significant improvement in automatic response inhibition and flexibility, and a decrease in inattention/hyperactivity behaviors following the treatment for AD. No significant differences were observed in motor response inhibition, working memory, or attention deficits. The results do not seem to support Quay's hypothesis: treating AD did not exacerbate cognitive deficits and behaviors associated with ADHD in our sample.
Galasso, Cinzia; Lo-Castro, Adriana; Di Carlo, Loredana; Pitzianti, Maria Bernarda; D'Agati, Elisa; Curatolo, Paolo; Pasini, Augusto
Neurofibromatosis type 1 is associated with executive dysfunctions and comorbidity with attention-deficit hyperactivity disorder (ADHD) in 30% to 50% of children. This study was designed to clarify the neurocognitive phenotype observed in neurofibromatosis type 1 by testing the hypothesis that children with neurofibromatosis type 1 have specific planning deficits independently from intellectual level and ADHD comorbidity. Eighteen children with neurofibromatosis type 1 were pair-matched to 18 children with ADHD and 18 healthy controls. All groups were assessed on the presence of ADHD symptoms (Conners Scales) and planning deficits (Tower of London). Compared with control group, groups with neurofibromatosis type 1 and ADHD demonstrated significant impairment of planning and problem solving. The lack of correlation between Tower of London results and Conners subscale scores in neurofibromatosis type 1 group confirmed that the planning and problem-solving deficit is not directly related to inattention level. These findings suggested that the executive impairment probably represents a peculiar trait of neurofibromatosis type 1 neurocognitive phenotype.
Campbell, Benjamin Charles; Eisenberg, Dan
The obesity epidemic has focused attention on obesity's health consequences beyond cardio-vascular disease and diabetes. To evaluate the potential consequences of obesity for Attention Deficit-Hyperactivity Disorder (ADHD), we surveyed the literature. Current findings link both obesity and ADHD to the dopamine system and implicate dopamine genes in body weight, eating, and ADHD. Detailed consideration suggests that dopaminergic changes in the prefrontal cortex among individuals with the ADHD subtype Attention Deficit Disorder (ADD) may increase their risk for obesity. Thus, individuals and populations with a high prevalence of hyperdopaminergic genes may experience higher rates of obesity in the presence of abundant food. From an evolutionary perspective, alterations in the dopamine system appear to effect a wide range of behavioral phenotypes. We suggest that recent evolutionary changes in the dopamine receptor genes selected to increase cognitive and behavioral flexibility may now be associated with attention problems and increased food consumption in an obesogenic environment.
Cherkasova, Mariya; Sulla, Erin M; Dalena, Kara L; Pondé, Milena P; Hechtman, Lily
Résumé OBJECTIF: Cette revue entend présenter les principales caractéristiques de la progression développementale du trouble de déficit de l’attention avec hyperactivité (TDAH) et examiner les influences les plus dominantes du cours développemental et des résultats du TDAH. MÉTHODES: Cette revue sélective porte principalement sur les études prospectives de suivi. Les publications pertinentes ont été choisies par une recherche dans les bases de données MEDLINE et PubMed, à l’aide des mots clés: TDAH, développement, préscolaire, adolescent, adulte, suivi, résultat, long terme, prédicteurs, et traitement. Des publications additionnelles ont ensuite été repérées dans les bibliographies des articles sélectionnés. RÉSULTATS: La présentation du TDAH et les déficiences qui y sont associées évoluent durant le développement, tout comme les prédicteurs de résultat. En début de développement, outre la génétique, certaines formes d’adversité prénatale accroissent le risque du TDAH. Dans les années préscolaires, la gravité des symptômes, la fonction cognitive, et les facteurs familiaux deviennent des prédicteurs significatifs des résultats à l’âge scolaire. Ces facteurs continuent de prédire les résultats à long terme des enfants d’âge scolaire; la comorbidité apparaît comme étant un autre prédicteur significatif des résultats à long terme à ce stade. CONCLUSIONS: La présentation du TDAH et les facteurs de risque d’adversité ultérieure évoluent au cours du développement, ce qui requiert des pratiques cliniques éclairées en matière de développement.
Fan, Guangqin; Feng, Chang; Wu, Fengyun; Ye, Weiwei; Lin, Fen; Wang, Chunhong; Yan, Ji; Zhu, Gaochun; Xiao, Yuanmei; Bi, Yongyi
The principal effects of Pb(2+) exposure in children are attention, memory and learning deficits that persist into adulthood. The application of the conventional chelators in children is somewhat prohibited by adverse health effects and is not effective in reversing learning deficits once they have occurred. In this study, we applied the nutrients, methionine and choline, to prevent Pb(2+)-induced cognitive impairment. Male weanling Sprague-Dawley rats were divided into five groups. Three groups of rats were exposed to Pb(2+) in drinking water containing 400mg/L Pb(2+) acetate, of which two groups were concurrently administered by oral gavage once a day, 6 days per week, with low or high doses of methionine and choline for 60 days. The normal control group received distilled water alone, and the reagent control received methionine choline chloride alone. Methionine choline treatment reversed long-term deficits in spatial learning and memory caused by Pb(2+) exposure in rats. Enhanced learning performance of Pb(2+)-exposed rats was associated with recovery of deficits in N-methyl-d-aspartate receptor (NMDAR) subunit 1 (NR1) mRNA and protein expression in the hippocampus. The effect of methionine choline on NR1 gene and protein expression was somewhat specific to Pb(2+)-exposed rats and did not affect the NR2A and NR2B subunits of the NMDAR measured in the same animals. Moreover, methionine choline treatment did not lower brain Pb(2+) content in Pb(2+)-exposed rats, although it reduced blood and bone Pb(2+) content. Methionine and choline reversed cognitive and NR1 deficits induced by Pb(2+) exposure, a beneficial effect that has significant clinical implications for the treatment of childhood Pb(2+) intoxication.
Tomasi, Dardo; Volkow, Nora D.
Background Attention-deficit/hyperactivity disorder (ADHD) is typically characterized by symptoms of inattention and hyperactivity/impulsivity, but there is increased recognition of a motivation deficit too. This neuropathology may reflect dysfunction of both attention and reward-motivation networks. Methods To test this hypothesis, we compared the functional connectivity density between 247 ADHD and 304 typically developing control children from a public magnetic resonance imaging database. We quantified short- and long-range functional connectivity density in the brain using an ultrafast data-driven approach. Results Children with ADHD had lower connectivity (short- and long-range) in regions of the dorsal attention (superior parietal cortex) and default-mode (precuneus) networks and in cerebellum and higher connectivity (short-range) in reward-motivation regions (ventral striatum and orbitofrontal cortex) than control subjects. In ADHD children, the orbitofrontal cortex (region involved in salience attribution) had higher connectivity with reward-motivation regions (striatum and anterior cingulate) and lower connectivity with superior parietal cortex (region involved in attention processing). Conclusions The enhanced connectivity within reward-motivation regions and their decreased connectivity with regions from the default-mode and dorsal attention networks suggest impaired interactions between control and reward pathways in ADHD that might underlie attention and motivation deficits in ADHD. PMID:22153589
Hwang-Gu, Shoou-Lian; Gau, Susan Shur-Fen
The literature has suggested timing processing as a potential endophenotype for attention deficit/hyperactivity disorder (ADHD); however, whether the subjective internal clock speed presented by verbal estimation and limited attention capacity presented by time reproduction could be endophenotypes for ADHD is still unknown. We assessed 223 youths with DSM-IV ADHD (age range: 10-17 years), 105 unaffected siblings, and 84 typically developing (TD) youths using psychiatric interviews, intelligence tests, verbal estimation and time reproduction tasks (single task and simple and difficult dual tasks) at 5-second, 12-second, and 17-second intervals. We found that youths with ADHD tended to overestimate time in verbal estimation more than their unaffected siblings and TD youths, implying that fast subjective internal clock speed might be a characteristic of ADHD, rather than an endophenotype for ADHD. Youths with ADHD and their unaffected siblings were less precise in time reproduction dual tasks than TD youths. The magnitude of estimated errors in time reproduction was greater in youths with ADHD and their unaffected siblings than in TD youths, with an increased time interval at the 17-second interval and with increased task demands on both simple and difficult dual tasks versus the single task. Increased impaired time reproduction in dual tasks with increased intervals and task demands were shown in youths with ADHD and their unaffected siblings, suggesting that time reproduction deficits explained by limited attention capacity might be a useful endophenotype of ADHD. PMID:25992899
Lobier, Muriel; Zoubrinetzky, Rachel; Valdois, Sylviane
The visual attention (VA) span deficit hypothesis of dyslexia posits that letter string deficits are a consequence of impaired visual processing. Alternatively, some have interpreted this deficit as resulting from a visual-to-phonology code mapping impairment. This study aims to disambiguate between the two interpretations by investigating performance in a non-verbal character string visual categorization task with verbal and non-verbal stimuli. Results show that VA span ability predicts performance for the non-verbal visual processing task in normal reading children. Furthermore, VA span impaired dyslexic children are also impaired for the categorization task independently of stimuli type. This supports the hypothesis that the underlying impairment responsible for the VA span deficit is visual, not verbal.
Schuch, Viviane; Utsumi, Daniel Augusto; Costa, Thaís Virgínia Moura Machado; Kulikowski, Leslie Domenici; Muszkat, Mauro
Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder characterized by a definite behavioral pattern that might lead to performance problems in the social, educational, or work environments. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the symptoms of ADHD were restricted to those associated with cognitive (attention deficit) and behavioral (hyperactivity/impulsivity) deficits, while deficient emotional self-regulation, a relevant source of morbidity, was left out. The etiology of it is complex, as its exact causes have not yet been fully elucidated. ADHD seems to arise from a combination of various genetic and environmental factors that alter the developing brain, resulting in structural and functional abnormalities. The aim of this paper was to review epigenetics and ADHD focused on how multidimensional mechanisms influence the behavioral phenotype. PMID:26441687
Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei
Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…
Griggs, Marissa Swaim; Mikami, Amori Yee
Objective: This study investigated the impact of parental attention-deficit/hyperactivity disorder (ADHD) symptoms on the peer relationships and parent-child interaction outcomes of children with ADHD among families completing a randomized controlled trial of parental friendship coaching (PFC) relative to control families. Method: Participants…
Young, Deidra J.; Levy, Florence; Martin, Neilson C.; Hay, David A.
The prevalence of attention-deficit/hyperactivity disorder (ADHD) has been estimated at 3-7% in the population. Children with this disorder are often characterized by symptoms of inattention and/or impulsivity and hyperactivity, which can significantly impact on many aspects of their behaviour and performance. This study investigated the…
Nadeem, Erum; Jensen, Peter S.
The studies included in this special issue add significantly to the nascent literature on teacher consultation models for attention deficit hyperactivity disorder (ADHD) and provide wonderful illustrations of how teachers might "unpack" and better understand their interventions. In this introductory essay, the authors offer suggestions for future…
Bitsakou, Paraskevi; Psychogiou, Lamprini; Thompson, Margaret; Sonuga-Barke, Edmund J. S.
Background: Delay-related motivational processes are impaired in children with Attention Deficit/Hyperactivity Disorder (ADHD). Here we explore the impact of ADHD on the performance of three putative indices of Delay Aversion (DAv): (i) the choice for immediate over delayed reward; (ii) slower reaction times following delay; and (iii) increased…
Moreno-Torres, Ignacio; Torres, Santiago; Santana, Rafael
This is the first study to explore lexical and grammatical development in a deaf child diagnosed with Attention Deficit Hyperactivity Disorder, Inattentive sub-type (ADHDI). The child, whose family language was Spanish, was fitted with a cochlear implant (CI) when she was 18 months old. ADHDI, for which she was prescribed medication, was diagnosed…
Sheridan, Margaret A.; Hinshaw, Stephen; D'Esposito, Mark
Objective: Previous research has demonstrated that during task conditions requiring an increase in inhibitory function or working memory, children and adults with attention-deficit/hyperactivity disorder (ADHD) exhibit greater and more varied prefrontal cortical(PFC) activation compared to age-matched control participants. This pattern may reflect…
Farmer, Richard F.; Rucklidge, Julia J.
Several hypotheses related to Newman's (e.g., Patterson & Newman, 1993) response modulation hypothesis were examined among adolescents with attention-deficit/hyperactivity disorder (ADHD; n = 18) and normal controls (n = 23). Consistent with predictions, youth with ADHD committed more passive avoidance errors (PAEs) than controls during the latter…
Climie, Emma A.; Mah, Janet W. T.; Chase, Cheryl Y.
The purpose of this article is to provide the reader with insight into the clinical reasoning involved in the assessment and intervention planning for a child with Attention-Deficit/Hyperactivity Disorder. The reader will be guided through the authors' conceptualization of this case, and suggestions for intervention in the classroom will be…
Nigg, Joel; Nikolas, Molly; Burt, S. Alexandra
Objective: To summarize and evaluate the state of knowledge regarding the role of measured gene-by-environment interactions in relation to attention-deficit/hyperactivity disorder. Method: A selective review of methodologic issues was followed by a systematic search for relevant articles on measured gene-by-environment interactions; the search…
Andersen, Per N.; Egeland, Jens; Øie, Merete
There are relatively few studies on learning and delayed memory with attention-deficit/hyperactivity disorder (ADHD). The objective of the present study was to examine acquisition, free delayed memory, and recognition skills in medication naive children and adolescents aged 8-16 years with ADHD combined subtype (36 participants) and inattentive…
Graham, Steve; Fishman, Evan J.; Reid, Robert; Hebert, Michael
Students with Attention Deficit Hyperactivity Disorders (ADHD) frequently experience significant difficulty mastering basic academic skills. This meta-analysis focuses on one specific potential area of learning difficulties for these students: namely, writing. To identify the extent and depth of the potential writing challenges faced by students…
Froelich, Jan; Breuer, Dieter; Doepfner, Manfred; Amonn, Frauke
A substantial lack of effective school based interventions especially in the natural setting exists in the treatment of Attention Deficit Hyperactivity Disorder. We performed a 18-week teacher training programme in a public elementary school with 378 pupils in 16 classes. After completing a screening assessment for symptoms related to ADHD and to…
Toplak, Maggie E.; Tannock, Rosemary
Time perception performance was systematically investigated in adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Specifically, the effects of manipulating modality (auditory and visual) and length of duration (200 and 1000 ms) were examined. Forty-six adolescents with ADHD and 44 controls were administered four duration…
Mautone, Jennifer A.; Marshall, Stephen A.; Sharman, Jaclyn; Eiraldi, Ricardo B.; Jawad, Abbas F.; Power, Thomas J.
Although numerous studies have evaluated the effectiveness of multimodal psychosocial interventions for children with attention deficit hyperactivity disorder, these programs are limited in that there has not been an explicit focus on the connection between family and school. This study was designed to develop and pilot test a family-school…
Reeves, Matthew Jonathan; Bailey, Richard P.
Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental psychiatric disorder among children. Despite the noted positive aspects of the disorder, it is often associated with a range of negative outcomes for that are detrimental to children's education and wider well-being. This comprehensive scoping review examined…
Cho, Su-Je; Blair, Kwang-Sun Cho
The current study evaluated the effects of a multicomponent function-based intervention on students with other health impairment (OHI) for attention deficit hyperactivity disorder (ADHD) in a private special education school. The focus of the intervention was to prevent problem behaviors and to increase academic engagement by modifying classroom…
Jardin, Bianca; Looby, Alison; Earleywine, Mitch
Objective: The purpose of the current investigation is to examine the characteristics of college students with attention-deficit hyperactivity disorder symptoms who misuse their prescribed psychostimulant medications. Methods and Participants: Forty-three undergraduate students with a prescription for Ritalin or Adderall completed structured…
Reid, Robert; Hagaman, Jessica L.; Graham, Steve
This review assessed the use of self-regulated strategy development (SRSD) for teaching written composition strategies to students with attention deficit hyperactivity disorders. We examined the participants and the settings in which SRSD has been used, the writing strategies tested, genres addressed, and the effects of SRSD on outcome measures.…
McGough, James J.; McCracken, James T.; Loo, Sandra K.; Manganiello, Marc; Leung, Michael C.; Tietjens, Jeremy R.; Trinh, Thao; Baweja, Shilpa; Suddath, Robert; Smalley, Susan L.; Hellemann, Gerhard; Sugar, Catherine A.
Objective: This study examines the potential role of candidate genes in moderating treatment effects of methylphenidate (MPH) in attention-deficit/hyperactivity disorder (ADHD). Method: Eighty-two subjects with ADHD aged 6 to 17 years participated in a prospective, double-blind, placebo-controlled, multiple-dose, crossover titration trial of…
Raz, Raanan; Gabis, Lidia
Aim: Essential fatty acids (EFAs), also known as omega-3 and omega-6 fatty acids, have been claimed to have beneficial effects as a treatment for attention-deficit-hyperactivity disorder (ADHD). Animal experiments have provided information about the role of EFA in the brain, and several mechanisms of EFA activity are well known. The current review…
Evans, Steven W.; Youngstrom, Eric
This column focuses on the valid, reliable, and useful measurement of treatment effects in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) treated in practice settings. The case is presented of Polly, an 11 year-old female who was evaluated and determined to have probably met diagnostic criteria for ADHD, combined…
Riga, Asimina; Papayiannis, Nikolaos
The present study investigates if there is a positive effect of the use of concept mapping software on students with Attention Deficit (AD) when learning descriptive writing in the secondary level of education. It also examines what kind of difficulties AD students may have come across during this learning procedure. Sample students were selected…
Karalunas, Sarah L.; Huang-Pollock, Cynthia L.
Although motivation and cognition are often examined separately, recent theory suggests that a delay-averse motivational style may negatively impact development of executive functions (EFs), such as working memory (WM) and response inhibition (RI) for children with Attention Deficit Hyperactivity Disorder (ADHD; Sonuga-Barke, 2002). This model…
McConaughy, Stephanie H.; Volpe, Robert J.; Antshel, Kevin M.; Gordon, Michael; Eiraldi, Ricardo B.
This study examined academic and social impairments of 6- to 11-year-old children with attention deficit hyperactivity disorder (ADHD; n = 101) versus other referred children without ADHD (n = 53) and controls (n = 24). Parent and teacher ratings showed significantly lower academic performance and lower social functioning for children with ADHD…
Sethi, Sujata; Gandhi, Raghu; Anand, Vidhu
Background: Parents who have children with attention-deficit hyperactivity disorder (ADHD) often experience high level of stress related to caring for their children. But not much research has been conducted in this area in India. This study aimed to assess the stress of parenting children with ADHD. Methods: This is a clinic based comparative…
Hammerness, Paul G.; Perrin, James M.; Shelley-Abrahamson, Rachel; Wilens, Timothy E.
Objective: This review provides an update on the cardiovascular impact of therapeutic stimulant-class medication for children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: Relevant clinical literature was ascertained using PubMed searches limited to human studies and the English language as of May 2011. Current…
Barkley, Russell A., Ed.
Widely regarded as the standard clinical reference, this volume provides the best current knowledge about attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults. The field's leading authorities address all aspects of assessment, diagnosis, and treatment, including psychological therapies and pharmacotherapy. Core…
Sánchez, Jose Juan Castro; Bermúdez, M. Olga Escandell; Sevilla, M. del Sol Fortea; Hernán-Pérez, Alejandra Sanjuán
The identification of factors that influence attention deficit/hyperactivity disorder (ADHD) will help to develop intervention strategies for the personal and social adjustment of these individuals. The goal of the study is to assess the perception of anxiety in a group of children and adolescents with ADHD and the anxiety that their parents…
Carbonell, Claudia L.
This literature review of attention deficit hyperactivity disorder (ADHD) reviews the diagnosis and treatment options for children diagnosed with ADHD. It describes the complexity of ADHD, its symptoms, treatments, and implications on a child's social and academic development as well as strategies for assisting such children. Individual sections…
Geller, Daniel; Donnelly, Craig; Lopez, Frank; Rubin, Richard; Newcorn, Jeffrey; Sutton, Virginia; Bakken, Rosalie; Paczkowski, Martin; Kelsey, Douglas; Sumner, Calvin
Objective: Research suggests 25% to 35% of children with attention-deficit/hyperactivity disorder (ADHD) have comorbid anxiety disorders. This double-blind study compared atomoxetine with placebo for treating pediatric ADHD with comorbid anxiety, as measured by the ADHD Rating Scale-IV-Parent Version: Investigator Administered and Scored…
O'Connell, Redmond G.; Bellgrove, Mark A.; Dockree, Paul M.; Lau, Adam; Hester, Robert; Garavan, Hugh; Fitzgerald, Michael; Foxe, John J.; Robertson, Ian H.
The ability to detect and correct errors is critical to adaptive control of behaviour and represents a discrete neuropsychological function. A number of studies have highlighted that attention-deficit hyperactivity disorder (ADHD) is associated with abnormalities in behavioural and neural responsiveness to performance errors. One limitation of…
Canu, Will H.; Schatz, Nicole K.
Attention-Deficit/Hyperactivity Disorder (ADHD) has been characterized as a comorbidity to pathological gambling (PG). However, contradictory evidence has emerged, and it has not been established whether nonimpulsive features of ADHD (e.g., inattention, hyperactivity) contribute to PG risk, or how robust this relationship is in college samples.…
Latham, Patricia H.; Latham, Peter S.
This publication provides an overview of attention deficit disorders (ADD) and the legal rights of college students with ADD. Possible accommodations that schools can make for students with ADD are provided and include: (1) provide structure and reduce distraction in class; (2) simplify and repeat instructions, as necessary, both orally and in…
Conners, C. Keith
A comprehensive assessment of children with Attention Deficit Disorder should include use of teacher rating scales. Rater biases, positive and negative halo effects, practice effects, and other problems are outweighed by the ease of use, low cost, and reasonable reliability and validity of teacher rating scales. (Author/DB)
Qian, Ying; Shuai, Lan; Chan, Raymond C. K.; Qian, Qiu-Jin; Wang, Yufeng
This study examined the developmental trajectories of executive function (EF) of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) in Han Chinese. Five hundred and fifteen children and adolescents with ADHD and 249 healthy controls took part in this study. All of them were administered four EF tests capturing…
Brock, Stephen E.; Christo, Catherine
This study compared the "Digit Naming Speed Test" (DNS) performance of 20 children with Attention-Deficit/Hyperactivity Disorder (ADHD) to 20 carefully matched peers without ADHD. Matching variables included age, grade, gender, and word reading ability. Sample construction included procedures that allowed for the identification and removal from…
Findling, Robert L.; Childress, Ann C.; Cutler, Andrew J.; Gasior, Maria; Hamdani, Mohamed; Ferreira-Cornwell, M. Celeste; Squires, Liza
Objective: To examine lisdexamfetamine dimesylate (LDX) efficacy and safety versus placebo in adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: Adolescents (13 through 17) with at least moderately symptomatic ADHD (ADHD Rating Scale IV: Clinician Version [ADHD-RS-IV] score greater than or equal to 28) were randomized to…
Daviss, W. Burleson; Patel, Nick C.; Robb, Adelaide S.; McDermott, Michael P.; Bukstein, Oscar G.; Pelham, William E., Jr.; Palumbo, Donna; Harris, Peter; Sallee, Floyd R.
A study to examine the safety and tolerance of clonidine, alone or with methylphenidate as a form of treatment in children with attention-deficit/hyperactivity disorders (ADHD) is conducted. Results conclude that clonidine used alone or in combination with methylphenidate were safe and well tolerated in children with ADHD.
Alizadeh, Hamid; Andries, Caroline
Examines the relationships between parenting styles and attention deficit hyperactivity disorder (ADHD), utilizing a sample of Iranian parents of children with and without ADHD. Results indicate significant relationships between ADHD and parenting styles. There is a negative relationship between having an ADHD child and applying authoritative…
Walcott, Christy Mangione; Landau, Steven
This study examined group differences of 49 boys ages 6 to 11 years with and without attention deficit hyperactivity disorder (ADHD) in emotion regulation during frustrating peer competition. Half of all boys in each group were explicitly instructed to hide their feelings if they became upset during the competition. Behavioral inhibition, both…
Harvey, William J.; Wilkinson, Shawn; Pressé, Cindy; Joober, Ridha; Grizenko, Natalie
Background: Physical educators suggested that they are not well-informed about behaviors of children with disabilities, especially attention-deficit hyperactivity disorder (ADHD). Children with ADHD represent a significant number of students in school systems worldwide who often experience difficulties in performing fundamental movement skills.…
Harvey, William J.; Reid, Greg; Grizenko, Natalie; Mbekou, Valentin; Ter-Stepanian, Marina; Joober, Ridha
The purpose of this study was to compare the fundamental movement skills of 22 children with attention-deficit hyperactivity disorder (ADHD), from 6 to 12 years of age, to gender- and age-matched peers without ADHD and assess the effects of stimulant medication on the movement skill performance of the children with ADHD. Repeated measures analyses…
Rojas, Neal L.; Chan, Eugenia
Use of complementary and alternative medicine (CAM) for treatment of attention-deficit hyperactivity disorder (ADHD) has become widespread in both referral and primary care populations. We review the purported mechanism of action and available evidence for selected CAM therapies for ADHD. Enduring controversies, such as elimination of artificial…
Ramos Olazagasti, Maria A.; Klein, Rachel G.; Mannuzza, Salvatore; Belsky, Erica Roizen; Hutchison, Jesse A.; Lashua-Shriftman, Erin C.; Castellanos, F. Xavier
Objective: To test whether children with attention-deficit/hyperactivity disorder (ADHD), free of conduct disorder (CD) in childhood (mean = 8 years), have elevated risk-taking, accidents, and medical illnesses in adulthood (mean = 41 years); whether development of CD influences risk-taking during adulthood; and whether exposure to…
Garnier-Dykstra, Laura M.; Pinchevsky, Gillian M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; Arria, Amelia M.
Objective: Report the distribution of scores from the Adult ADHD Self-Report Scale (ASRS) and estimate the prevalence of self-reported attention-deficit/hyperactivity disorder (ADHD) symptoms as compared to clinical diagnoses. Participants: Participants were 1,080 college students, divided into 3 groups: (1) no ADHD diagnosis (n = 972), (2)…
Kuehne, Cheryl; And Others
Investigated power of five measures to differentiate between normal children and children with Attention Deficit Disorder or Specific Learning Disabilities. Discriminant analysis revealed that Connors Parent Questionnaire was best predictor of group membership, followed in order by Connors Teacher Questionnaire, Porteus Mazes Test, and Matching…
Gerdes, Alyson C.; Hoza, Betsy
The goal of this study was to simultaneously examine maternal attributions, affect, and parenting in mothers of children with and without attention deficit hyperactivity disorder (ADHD) using a multimethod approach (vignettes, confederate child video clips, and video clips of mother's own child). Of the participants, 23 were 7- to 12-year-old…
Palumbo, Donna R.; Sallee, Floyd R.; Pelham, William E., Jr; Bukstein, Oscar G.; Daviss, W. Burleson; McDermott, Michael P.
A study to examine the effectiveness and tolerance of clonidine alone or in combination with methylphenidate as a mode of treatment of attention-deficit/hyperactivity disorders is conducted. Results indicate methylphenidate as the most effective in treatment as compared to clonidine, which was well tolerated.
Chronis, Andrea M.; Gamble, Stephanie A.; Roberts, John E.; Pelham, William E., Jr.
An adaptation of the Coping With Depression Course (CWDC) was evaluated in mothers of children with attention-deficit/hyperactivity disorder (ADHD), a population at risk for depression. Mothers were randomly assigned to receive the CWDC either immediately following an intensive summer treatment program targeting their child's behavior or after a…
Watemberg, Nathan; Waiserberg, Nilly; Zuk, Luba; Lerman-Sagie, Tally
Although physical therapy (PT) is effective in improving motor function in children with developmental coordination disorder (DCD), insufficient data are available on the impact of this intervention in children with combined attention-deficit-hyperactivity disorder (ADHD) and DCD. This prospective study aimed to establish the prevalence of DCD…
Huang, Jia; Yang, Bin-rang; Zou, Xiao-bing; Jing, Jin; Pen, Gang; McAlonan, Grainne M.; Chan, Raymond C. K.
The current study aimed to investigate temporal processing in Chinese children with Attention-Deficit-Hyperactivity Disorder(ADHD) using time production, time reproduction paradigm and duration discrimination tasks. A battery of tests specifically designed to measure temporal processing was administered to 94 children with ADHD and 100…
Max, Jeffrey E.; Schachar, Russell J.; Levin, Harvey S.; Ewing-Cobbs, Linda; Chapman, Sandra B.; Dennis, Maureen; Saunders, Ann; Landis, Julie
Objective: To assess the phenomenology and predictive factors of attention-deficit/hyperactivity disorder (ADHD) after traumatic brain injury (TBI), also called secondary ADHD (SADHD). Method: Children without preinjury ADHD 5-14 years old with TBI from consecutive admissions (n = 143) to five trauma centers were observed prospectively for 6…
Bagwell, Catherine L.; Molina, Brooke S.G.; Kashdan, Todd B.; Pelham, William E.; Hoza, Betsy
In this study, the authors examined the association between childhood attention-deficit/hyperactivity disorder (ADHD) and anxiety and mood disorders in adolescence. They compared a group of 142 adolescents ages 13 to 18 years with a history of ADHD in childhood to group of 100 community-recruited adolescents without ADHD. The two groups did not…
Lewis, Barbara A.; Short, Elizabeth J.; Iyengar, Sudha K.; Taylor, H. Gerry; Freebairn, Lisa; Tag, Jessica; Avrich, Allison A.; Stein, Catherine M.
Purpose: The purpose of this study was to examine the association of speech-sound disorders (SSD) with symptoms of attention-deficit/hyperactivity disorder (ADHD) by the severity of the SSD and the mode of transmission of SSD within the pedigrees of children with SSD. Participants and Methods: The participants were 412 children who were enrolled…
Loe, Irene M.; Balestrino, Maria D.; Phelps, Randall A.; Kurs-Lasky, Marcia; Chaves-Gnecco, Diego; Paradise, Jack L.; Feldman, Heidi M.
In a prospective study of developmental outcomes in relation to early-life otitis media, behavioral, cognitive, and language measures were administered to a large, diverse sample of children at 2, 3, 4, 6, and 9-11 years of age (N = 741). At 9-11 years of age, 9% of the children were categorized as having attention-deficit/hyperactivity disorder…
Briscoe-Smith, Allison M.; Hinshaw, Stephen P.
Objective: The objectives of this study were to examine whether girls with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of having histories of abuse and to assess whether the presence of an abuse history may constitute a distinct subgroup of youth with ADHD. Method: We examined rates and correlates of child abuse in an…
Lecendreux, Michel; Konofal, Eric; Faraone, Stephen V.
Background: Earlier studies point to the prevalence of attention deficit hyperactivity disorder (ADHD) to be similar around the world. There is, however, a wide variety in estimates. The prevalence of ADHD in youth has never been examined in France. Method: Starting with 18 million telephone numbers, 7,912 numbers are randomly selected. Among the…
Wernicke, Joachim F.; Holdridge, Karen Chilcott; Jin, Ling; Edison, Timothy; Zhang, Shuyu; Bangs, Mark E.; Allen, Albert J.; Ball, Susan; Dunn, David
The comorbidity of seizures, epilepsy, and attention-deficit-hyperactivity disorder (ADHD) prompted the examination of whether atomoxetine use for ADHD is associated with an increased risk of seizures. Seizures and seizure-related symptoms were reviewed from two independent Eli Lilly and Company databases: the atomoxetine clinical trials database…
Charach, Alice; Yeung, Emanuela; Climans, Troy; Lillie, Erin
Objective: In recent years cohort studies have examined childhood attention-deficit/hyperactivity disorder (ADHD) as a risk factor for substance use disorders (SUDs) in adolescence and young adulthood. The long-term risk is estimated for development of alcohol, cannabis, combined alcohol and psychoactive SUDs, combined SUDs (nonalcohol), and…
Neale, Benjamin M.; Medland, Sarah E.; Ripke, Stephan; Asherson, Philip; Franke, Barbara; Lesch, Klaus-Peter; Faraone, Stephen V.; Nguyen, Thuy Trang; Schafer, Helmut; Holmans, Peter; Daly, Mark; Steinhausen, Hans-Christoph; Freitag, Christine; Reif, Andreas; Renner, Tobias J.; Romanos, Marcel; Romanos, Jasmin; Walitza, Susanne; Warnke, Andreas; Meyer, Jobst; Palmason, Haukur; Buitelaar, Jan; Vasquez, Alejandro Arias; Lambregts-Rommelse, Nanda; Gill, Michael; Anney, Richard J. L.; Langely, Kate; O'Donovan, Michael; Williams, Nigel; Owen, Michael; Thapar, Anita; Kent, Lindsey; Sergeant, Joseph; Roeyers, Herbert; Mick, Eric; Biederman, Joseph; Doyle, Alysa; Smalley, Susan; Loo, Sandra; Hakonarson, Hakon; Elia, Josephine; Todorov, Alexandre; Miranda, Ana; Mulas, Fernando; Ebstein, Richard P.; Rothenberger, Aribert; Banaschewski, Tobias; Oades, Robert D.; Sonuga-Barke, Edmund; McGough, James; Nisenbaum, Laura; Middleton, Frank; Hu, Xiaolan; Nelson, Stan
Objective: Although twin and family studies have shown attention-deficit/hyperactivity disorder (ADHD) to be highly heritable, genetic variants influencing the trait at a genome-wide significant level have yet to be identified. As prior genome-wide association studies (GWAS) have not yielded significant results, we conducted a meta-analysis of…
Hanson, Ellen; Cerban, Bettina M.; Slater, Chelsea M.; Caccamo, Laura M.; Bacic, Janine; Chan, Eugenia
Currently, both the DSM-IV-TR and ICD-10 preclude the diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) in cases that present with an Autism Spectrum Disorder (ASD). This criterion will be removed in the upcoming DSM-V, but the relationship between ASD and ADHD, and in particular the prevalence of ADHD among the ASD population, remains…
Prevatt, Frances; Young, Joel L.
Traditionally diagnosed in children, attention-deficit/hyperactivity disorder (ADHD) is now regarded as a life span condition. The academic difficulties experienced by children and adolescents with ADHD have been observed to continue into young adulthood. Treatment outcome studies demonstrate that behavioral and pharmacotherapeutic interventions…
Redmond, Sean M.; Ash, Andrea C.; Hogan, Tiffany P.
Purpose: Co-occurring attention-deficit/hyperactivity disorder (ADHD) and communication disorders represent a frequently encountered challenge for school-based practitioners. The purpose of the present study was to examine in more detail the clinical phenomenology of co-occurring ADHD and language impairments (LIs). Method: Measures of nonword…
Mueller, Kathryn L.; Tomblin, J. Bruce
Attention-deficit/hyperactivity disorder (ADHD) is a common developmental disorder often associated with other developmental disorders including speech, language, and reading disorders. Here, we review the principal features of ADHD and current diagnostic standards for the disorder. We outline the ADHD subtypes, which are based upon the dimensions…
McGoey, Kara E.; Schreiber, James; Venesky, Lindsey; Westwood, Wendy; McGuirk, Lindsay; Schaffner, Kristen
The diagnosis of attention deficit hyperactivity disorder (ADHD) distinguishes two dimensions of symptoms, inattention and hyperactivity-impulsivity for ages 3 to adulthood. Currently, no separate classification for preschool-age children exists, whereas preliminary research suggests that the two-factor structure of ADHD may not match the…
Guerra, Fred R., Jr.; Brown, Michelle S.
This quantitative study examined the knowledge levels middle school teachers in South Texas have in relation to attention deficit hyperactivity disorder (ADHD). The study specifically compared teacher knowledge levels among three specific ADHD knowledge areas: (a) general knowledge of ADHD, (b) knowledge of symptoms/diagnosis of ADHD, and (c)…
Lee, Kelly M.; Olenchak, F. Richard
This paper reviews the current literature on twice-exceptional students who are dual diagnosed as having giftedness and attention deficit/hyperactivity disorder (ADHD). This area of research is warranted because giftedness and ADHD present similarly but have different ramifications for performance and outcomes. In addition, research inquiry and…
Shillingford-Butler, M. Ann; Theodore, Lea
The school setting can be a difficult place for children with attention deficit hyperactivity disorder (ADHD). The core symptoms of ADHD, which include inattention, hyperactivity, and impulsivity, make meeting the curriculum demands of the classroom challenging. That ADHD negatively impacts not only academic performance but also social and…
Russell, Ginny; Ford, Tamsin; Rosenberg, Rachel; Kelly, Susan
Background: Studies throughout Northern Europe, the United States and Australia have found an association between childhood attention deficit hyperactivity disorder (ADHD) and family socioeconomic disadvantage. We report further evidence for the association and review potential causal pathways that might explain the link. Methods: Secondary…
Mueller, Kathryn L.; Tomblin, J. Bruce
Language impairment (LI) and attention-deficit/hyperactivity disorder (ADHD) are 2 relatively common developmental disorders that have been shown to have high rates of co-occurrence in a number of studies, and this phenomenon is also commonplace in the experience of many clinicians. Understanding this comorbidity, therefore, is central to building…
Ward, Victoria Ann
Attention deficit hyperactivity disorder (ADHD) diagnosis rates have increased significantly in recent times. A teacher's role is crucial in determining if a child will be referred for an ADHD assessment. Teachers' opinions and observations are also required for and play a huge role in the actual assessment process. For this reason, their…
Johnson, Jacob J.
This article explores current research, diagnosis, and common problems of attention deficit hyperactivity disorder (ADHD) among Christian college and university students. For years, ADHD was believed to dissipate as children mature, but current research contradicts that belief. Proctor (2009) and others detail the continuance of ADHD into…
Cooper, Miriam; Thapar, Anita; Jones, Derek K.
Traits of autism spectrum disorder (ASD) in children with attention-deficit/hyperactivity disorder (ADHD) have previously been found to index clinical severity. This study examined the association of ASD traits with diffusion parameters in adolescent males with ADHD (n = 17), and also compared WM microstructure relative to controls (n = 17).…
Miller, Lucy Jane; Nielsen, Darci M.; Schoen, Sarah A.
Children with attention deficit hyperactivity disorder (ADHD) are impulsive, inattentive and hyperactive, while children with sensory modulation disorder (SMD), one subtype of Sensory Processing Disorder, have difficulty responding adaptively to daily sensory experiences. ADHD and SMD are often difficult to distinguish. To differentiate these…
Neece, C. L.; Baker, B. L.; Blacher, J.; Crnic, K. A.
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…
Walsh, Irene P.; Scullion, Mary; Burns, Sarah; MacEvilly, Deirdre; Brosnan, Geraldine
As the language presentation of children with attention deficit (hyperactivity) disorder (ADHD) is highly complex, this study aims to delineate the profile of a cohort of 40 children with ADHD, aged between 9 and 12 years, attending a child and adolescent mental health service (CAMHS). Speech and language therapists (SLTs) assessed the children on…
Al-Omari, Hasan; Al-Motlaq, Mohammad A.; Al-Modallal, Hanan
International studies have revealed variable levels of knowledge and attitudes among teachers regarding attention-deficit hyperactivity disorder (ADHD). This study investigated Jordanian teachers' ADHD knowledge and their attitudes towards children with this condition. A standardised self-report questionnaire was completed by a convenience sample…
Frigerio, Alessandra; Montali, Lorenzo; Marzocchi, Gian Marco
Teachers' perceptions of attention deficit hyperactivity disorder (ADHD) can influence the diagnostic rates of the disorder and the management of children in schools. This study investigated the knowledge and perceptions of ADHD in a sample of 589 Italian primary school teachers using a self-report questionnaire that included the ADHD perceptions…
Martin, Stacy D.; Zirkel, Perry A.
This study provides a systematic analysis of published court decisions concerning identification of students with attention deficit hyperactivity disorder under the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act. The 41 pertinent child find and eligibility court decisions yielded 51 relevant rulings,…
Bloch, Michael H.; Panza, Kaitlyn E.; Landeros-Weisenberger, Angeli; Leckman, James F.
Methylphenidate appears to provide the greatest and most immediate improvement of the symptoms of attention deficit hyperactivity disorder and does not appear to worsen tic symptoms based on a meta-analysis study. The meta-analysis included nine studies with 477 subjects.
Spencer, Twila Elaine
The purpose of this study is to educate administrators, teachers and parents on educational services available to students diagnosed with attention deficit hyperactivity disorder (ADHD). Schools are required by federal and state laws to provide a student with a disability a free appropriate public education (FAPE) in the least restrictive…
Tomblin, J. Bruce; Mueller, Kathyrn L.
This article provides a background for the topic of comorbidity of attention-deficit/hyperactivity disorder and spoken and written language and speech disorders that extends through this issue of "Topics in Language Disorders." Comorbidity is common within developmental disorders and may be explained by many possible reasons. Some of these can be…
Brodsky, Kimberly; Willcutt, Erik G.; Davalos, Deana B.; Ross, Randal G.
Background: Attention-deficit/hyperactivity disorder (ADHD) and childhood-onset psychosis (COP) are chronic, heterogeneous disorders with symptoms that frequently co-occur, but the etiology of their comorbidity is unknown. Studies of each disorder indicate that both ADHD and COP are associated with a range of neuropsychological weaknesses, but few…
Voelker, Sylvia L.
The study investigated the development of memory strategy knowledge and spontaneous use of strategy by 6- to 12-year-old boys with attention deficit disorder and hyperactivity (ADD-H). Although there was no difference between experimental and control groups in metamemory knowledge, the ADD-H subjects were less likely to use memory strategies.…
Pisterman, Susan; And Others
Examined group parent training program aimed at improving child compliance in families with attention deficit disorder with hyperactivity (ADDH) preschoolers. Evaluated treatment outcome by comparing groups on measures of parent-child interactions, compliance task, parent-supervised activities, and parent-completed Conners Hyperkinesis Index…
Allen, Terry W.
Results of a study involving control, learning disabled, and attention deficit disorder with hyperactivity (ADD-H) children (14 per group, aged 8-10 years) revealed that LD and ADD-H Ss habituated more rapidly, but they also encoded fewer aspects of the stimulus field than control Ss. (CL)
Werry, John S.; And Others
Children ages 5-13 diagnosed as Attention Deficit (ADDH), Anxiety (ANX), or Conduct plus ADDH (HC) Disorder and matched normal controls were compared on measures of impulsivity, arousal, motor performance, activity level, and cognition. When age, sex, and verbal intelligence quotient (IA) effects were partialed out, few differences among…
Raggio, Donald; And Others
The best procedure for the diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD) remains fragmented. The diagnosis is frequently based on anecdotal information and rating scales completed by parents and teachers. A major drawback to a more objective diagnosis has been the absence of standardized test data generated by the child client. The…
Barkley, Russell A.; And Others
Compared 48 children with attention deficit disorder with hyperactivity (ADD+H), with 42 without hyperactivity, and with learning-disabled and control children. ADD+H children had more externalizing and internalizing symptoms, were more off task during testing, and had more family substance abuse, ADD+H, and aggression. Results suggest two types…
Semrud-Clikeman, Margaret; Lorys-Vernon, Alison
The Wechsler Intelligence Scale for Children--Revised (WISC-R) Freedom from Distractibility (FFD) factor and other neurocognitive measures were examined as to their discriminative validity in diagnosing children with Attention Deficit Disorder/Hyperactivity (ADD/H), ADD/H children with concurrent Conduct Disorder, and children comprising a clinic…
Rhee, Soo Hyun; Willcutt, Erik G.; Hartman, Christie A.; Pennington, Bruce F.; DeFries, John C.
There is significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD). The conclusions of studies that examined the causes of comorbidity between ADHD and CD conflict, with some researchers finding support for the three independent disorders model and others finding support for the correlated risk…
Morgan, Bronwyn; Maybery, Murray; Durkin, Kevin
Compared preschoolers with autism spectrum disorders with a matched control group to investigate whether weak central coherence could account for deficits in two behaviors purported to tap capabilities fundamental to a theory of mind: joint attention and pretend play. Found that pretend play did not differentiate the two groups. Weak central…
McNamara, John K.; Willoughby, Teena; Chalmers, Heather
Some researchers suggest that having a learning disability (LD) may act as a risk factor, increasing the likelihood that adolescents experience more negative outcomes in many areas of their lives. However, researchers have yet to examine in one study how having LD with and without attention deficit hyperactivity disorder (ADHD) is related to a…
Kratter, Jonathan; Hogan, John D.
A total of 24 children, meeting several criteria for being diagnosed as having an attention deficit disorder with hyperactivity, were selected for study. Children were assigned to one of three conditions: a meditation-training group, a progressive-muscle-relaxation group, or a waiting-list control group. Subjects in the training groups were seen…
Wilens, Timothy E.; Bukstein, Oscar; Brams, Matthew; Cutler, Andrew J.; Childress, Ann; Rugino, Thomas; Lyne, Andrew; Grannis, Kara; Youcha, Sharon
Objective: To examine efficacy, tolerability, and safety of guanfacine extended release (GXR; less than or equal to 4 mg/d) adjunctive to a long-acting psychostimulant for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents 6 to 17 years of age with suboptimal, but partial, response to psychostimulant…
Abikoff, Howard; McGough, James; Vitiello, Benedetto; McCracken, James; Davies, Mark; Walkup, John; Riddle, Mark; Oatis, Melvin; Greenhill, Laurence; Skrobala, Anne; March, John; Gammon, Pat; Robinson, James; Lazell, Robert; McMahon, Donald J.; Ritz, Louise
Objective: Attention-deficit/hyperactivity disorder (ADHD) is often accompanied by clinically significant anxiety, but few empirical data guide treatment of children meeting full DSM-IV criteria for ADHD and anxiety disorders (ADHD/ANX). This study examined the efficacy of sequential pharmacotherapy for ADHD/ANX children. Method: Children, age 6…
Engelhardt, Paul E.; Ferreira, Fernanda; Nigg, Joel T.
Theoretical accounts of attention-deficit/hyperactivity disorder (ADHD) posit a prominent role for problems in response inhibition (Nigg 2006). A key avenue for impulsivity in children with ADHD is inappropriate language expression. In this study, we sought to determine whether poor inhibitory control affects language production in adolescents and…
Jones, Heather A.; Chronis-Tuscano, Andrea
Children with attention-deficit/hyperactivity disorder (ADHD) evidence many problems in the classroom. Teacher in-service training is routinely used to inform school professionals about a number of special topics; however, the efficacy of such in-service training for ADHD has not been established. The present study examined the efficacy of brief…
Holroyd, Clay B.; Baker, Travis E.; Kerns, Kimberly A.; Muller, Ulrich
Behavioral and neurophysiological evidence suggest that attention-deficit hyperactivity disorder (ADHD) is characterized by the impact of abnormal reward prediction error signals carried by the midbrain dopamine system on frontal brain areas that implement cognitive control. To investigate this issue, we recorded the event-related brain potential…
Sikstrom, Sverker; Soderlund, Goran
Attention-deficit/hyperactivity disorder (ADHD) is related to an attenuated and dysfunctional dopamine system. Normally, a high extracellular dopamine level yields a tonic dopaminergic input that down-regulates stimuli-evoked phasic dopamine responses through autoreceptors. Abnormally low tonic extracellular dopamine in ADHD up-regulates the…
Levy, Florence; Hay, David A.; Bennett, Kellie S.
While there have been significant advances in both the behaviour genetics and molecular genetics of Attention Deficit Hyperactivity Disorder (ADHD), researchers are now beginning to develop hypotheses about relationships between phenotypes and genetic mechanisms. Twin studies are able to model genetic, shared environmental and non-shared…
Froehlich, Tanya E.; Epstein, Jeffery N.; Nick, Todd G.; Melguizo Castro, Maria S.; Stein, Mark A.; Brinkman, William B.; Graham, Amanda J.; Langberg, Joshua M.; Kahn, Robert S.
Objective: Because of significant individual variability in attention-deficit/hyperactivity disorder (ADHD) medication response, there is increasing interest in identifying genetic predictors of treatment effects. This study examined the role of four catecholamine-related candidate genes in moderating methylphenidate (MPH) dose-response. Method:…
DuPaul, George J.; Eckert, Tanya L.
Reviews empirical studies that have reported the effects of academic interventions with students with attention-deficit hyperactivity disorder (ADHD). Reviews intervention in the general categories of peer tutoring, computer-assisted instruction, task and instructional modifications, and strategy training. Finds peer tutoring and task…
Price, Anne; Crawford, Shawn; Tottle, Johanne; Maunula, Susan
This publication focuses on teaching students with attention deficit/hyperactivity disorder (AD/HD). The first chapter identifies and explains AD/HD: its causes, characteristics, its diagnosis and assessment process, related conditions, and what it looks in the classroom. The following chapters offer information and sample strategies supporting…
Willcutt, Erik G.; Betjemann, Rebecca S.; Wadsworth, Sally J.; Samuelsson, Stefan; Corley, Robin; DeFries, John C.; Byrne, Brian; Pennington, Bruce F.; Olson, Richard K.
Numerous studies have examined the etiology of the association between reading difficulties and attention-deficit hyperactivity disorder (ADHD) in school-age children, but little is known about the relation between prereading skills and ADHD behaviors prior to the beginning of formal reading instruction. A population-based sample of 809 pairs of…
US Department of Education, 2006
This resource guide designed for families and educators provides information on how attention deficit hyperactivity disorder (ADHD) is identified and treated. The resource includes sections on legal requirements, treatment options educational and medical evaluations, how ADHD affects school performance, and helpful evidence-based hints on how to…
Graczyk, Patricia A.; Atkins, Marc S.; Jackson, Maudette M.; Letendre, Joan A.; Kim-Cohen, Julia; Baumann, Barbara L.; McCoy, Jon
This study examined urban educators' attitudes toward commonly recommended interventions for students with Attention Deficit Hyperactivity Disorder (ADHD). Participants included 358 pupil personnel services (PPS) professionals--school psychologists, social workers, and counselors--and 70 classroom teachers from urban elementary schools. On…
Koro-Ljungberg, Mirka; Bussing, Regina; Williamson, Pamela; Wilder, JeffriAnne; Mills, Terry
Cultural differences in illness perceptions and treatment access of teens with attention deficit/hyperactivity disorder (ADHD) are evident yet under studied. The purpose of this qualitative paper is to explore how African-American teenagers describe and narrate stories about their lives with ADHD. Data were gathered from four African-American…
Taylor, Abigail; Deb, Shoumitro; Unwin, Gemma
Attention deficit hyperactivity disorder (ADHD) is prevalent in the adult population. The associated co-morbidities and impairments can be relieved with treatment. Therefore, several rating scales have been developed to identify adults with ADHD who may benefit from treatment. No systematic review has yet sought to evaluate these scales in more…
Hansen, Berit Hjelde; Skirbekk, Benedicte; Oerbeck, Beate; Wentzel-Larsen, Tore; Kristensen, Hanne
This study examines the persistence of sleep problems over 18 months in 76 referred children with anxiety disorders and/or attention deficit hyperactivity disorders (ADHD) and 31 nonreferred controls, and explores predictors of sleep problems at follow-up (T2) in the referred children. Diagnoses were assessed at initial assessment (T1) using the…
Kirov, Roumen; Kinkelbur, Joerg; Banaschewski, Tobias; Rothenberger, Aribert
Background: In children, attention-deficit/hyperactivity disorder (ADHD), tic disorder (TD), and their coexistence (ADHD + TD comorbidity) are very common and clinically important. Associated sleep patterns and their clinical role are still insufficiently investigated. This study aimed at characterizing these sleep patterns in children with ADHD,…
Tsai, Fang-Ju; Chiang, Huey-Ling; Lee, Chi-Mei; Gau, Susan Shur-Fen; Lee, Wang-Tso; Fan, Pi-Chuan; Wu, Yu-Yu; Chiu, Yen-Nan
This study aimed to examine sleep problems in children with autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), and epilepsy in clinical settings. We assessed 64 children with ASD, 64 with ADHD, 64 with epilepsy, and 64 typically developing children without any neuropsychiatric disorders by using a sex-and age-matched…
Webster, Raymond E.; And Others
Assesses information processing and memory functioning in 50 children diagnosed with Attention Deficit Hyperactive Disorder (ADHD) with and without learning disabilities (LD). Both groups struggled with auditory ordered recall. The ADHD/LD group demonstrated more problems transferring information into short-term and long-term memory stores than…
The study examined Friendship Qualities among 39 children with attention deficit hyperactive disorder (ADHD) and 17 children without ADHD, studying in mainstreamed classes, and compared their self-reports with their parents' and teachers' perceptions. Although the literature has described ADHD children as having social difficulties, a higher rate…
Zima, Bonnie T.; Bussing, Regina; Tang, Lingqi; Zhang, Lily; Ettner, Susan; Belin, Thomas R.; Wells, Kenneth B.
Objective: To examine whether clinical severity is greater among children receiving attention-deficit/hyperactivity disorder (ADHD) care in primary care compared with those in specialty mental health clinics, and to examine how care processes and clinical outcomes vary by sector across three 6-month time intervals. Method: This was a longitudinal…
Johnson, Lynn; Sinnott, Jan
This study examined the effects of an acupressure intervention with two adolescents previously diagnosed with attention deficit hyperactivity disorder (ADHD). An inventory based on standard criteria for diagnosing ADHD was completed by each student, their parents, case workers, and teachers both before and after the intervention. The intervention…
Jitendra, Asha K.; DuPaul, George J.; Volpe, Robert J.; Tresco, Katy E.; Junod, Rosemary E. Vile; Lutz, J. Gary; Cleary, Kristi S.; Flammer-Rivera, Lizette M.; Manella, Mark C.
This study evaluated the effectiveness of two consultation-based models for designing academic interventions to enhance the educational functioning of children with attention deficit hyperactivity disorder. Children (N = 167) meeting "Diagnostic and Statistical Manual" (4th ed.--text revision; American Psychiatric Association, 2000) criteria for…
Kollins, Scott H.; Barkley, Russell A.; DuPaul, George J.
This article provides information and guidelines for the effective use of medication in treating attention deficit hyperactivity disorder (ADHD). Basic principles of psychopharmacology, different types of medications that have been used successfully to treat ADHD, and best practices for assessing the effects of medication in children with ADHD are…
Kaneko, Motohisa; And Others
This study with 30 children showing attention deficit hyperactivity disorder (ADHD) found a normal diurnal saliva cortisol rhythm in only 43.3 percent of the subjects and a dexamethasone suppression in 46.7 percent, with both these abnormalities more frequent in the severely than the mildly hyperactive group. Results suggest abnormalities in…
Jain, Rakesh; Segal, Scott; Kollins, Scott H.; Khayrallah, Moise
Objective: This study examined the efficacy and safety of clonidine hydrochloride extended-release tablets (CLON-XR) in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: This 8-week, placebo-controlled, fixed-dose trial, including 3 weeks of dose escalation, of patients 6 to 17 years old with ADHD evaluated the…
Redmond, Sean M.
Purpose: The empirical record regarding the expected co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and specific language impairment is confusing and contradictory. A research plan is presented that has the potential to untangle links between these 2 common neurodevelopmental disorders. Method: Data from completed and ongoing…
Wright, Melissa Sue
This study investigated the readiness for self-directed learning of adults with Attention Deficit Hyperactivity Disorder (ADHD), as well as their overall educational experiences. Using Guglielmino's Self-Directed Learning Readiness Scale for Adults (SDLRS-A), the researcher investigated whether the following factors were significantly related to…