Journal of Attention Disorders最新文献

Objective: Mind-wandering is a common cognitive experience that may be particularly salient in adolescents with attention-deficit/hyperactivity disorder (ADHD). This study aimed to investigate the characteristics and clinical relevance of mind-wandering in this population.

Method: We retrospectively analyzed data from 440 psychiatric outpatients aged 10-19 years (ADHD: n = 137; non-ADHD: n = 303) who visited a university hospital between 2023 and 2025. Mind-wandering was assessed using the Mind-Wandering Questionnaire (MWQ). Group differences in MWQ scores were examined using analysis of covariance, controlling for age, sex, Autism-Spectrum Quotient, and Quick Inventory of Depressive Symptomatology. Additional analyses compared ADHD-only with ADHD plus autism spectrum disorder (ASD) comorbidity, and hierarchical regression was conducted to determine the independent contribution of ADHD to mind-wandering.

Results: Adolescents with ADHD reported significantly higher MWQ scores than those without ADHD (p < .001, Cohen's d = 0.92), and this difference remained significant after covariate adjustment (η² = 0.098). No significant difference was observed between the ADHD-only and ADHD + ASD groups (p = .737). Hierarchical regression confirmed that ADHD independently predicted mind-wandering scores (β = 0.320, p < .001).

Conclusion: Adolescents with ADHD exhibit elevated mind-wandering, which may represent a core attentional characteristic independent of comorbidities or demographic factors. Further research is needed to clarify the mechanisms underlying mind-wandering in ADHD and to evaluate potential interventions aimed at reducing its impact.

ObjectiveChildren and adolescents frequently struggle with social skills performance in academic settings, which can negatively impact quality of life. As such, social skills training is frequently recommended; however, the effectiveness of school-based social skills training has not been synthesized. As such, the purpose of the current study was to evaluate the empirical evidence pertaining to both stand-alone and multimodal school-based social skills programs for students with ADHD, and to assess the effects of potential moderating variables.

Method: A systematic review and meta-analysis was conducted of studies between the years of 1975 and 2023 following the recommendations of the Cochrane Foundation and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results: Seventeen studies, single-case, within group, and between-group designs met the established inclusion criteria, with 10 included in the meta-analysis. The findings revealed small to large effects; however, the overall meta-analytic effect size was negligible (ES = 0.09). The differences in social skills approaches, intensity, parent involvement, and setting did not moderate the effects.

Conclusion: These findings underscore the necessity for ongoing exploration and refinement of social skills interventions tailored for youth with ADHD.

Objective: ADHD can impair children's functioning. Socioeconomic and sociodemographic factors present barriers to treatment access and lead to disparate outcomes in children with ADHD. The purpose of this study was to describe trajectories of functional outcomes and ADHD symptom counts across 3 years and explore the moderating effects of income and race/ethnicity on these trajectories among U.S. children with ADHD.

Method: This longitudinal study of children currently and/or previously meeting diagnostic criteria for ADHD (N = 1,587, age = 9-10 years at baseline) used data from the Adolescent Brain Cognitive Development (ABCD) Study^®. Outcomes were child-reported functional outcome measures (family conflict, prosocial behavior, and school experiences) and parent-reported inattentive and hyperactive symptom counts across 3 years. Multi-level, mixed-effects models for longitudinal data were used to characterize each outcome trajectory and examine the moderating effects of baseline household income and race/ethnicity.

Results: The sample was 68% male and 54% White, with 53% meeting diagnostic criteria for past-only ADHD, 12% current-only ADHD, and 35% both past and current ADHD. Significant changes in family conflict, school experiences, inattentive symptom counts, and hyperactive symptom counts were demonstrated across 3 years (trajectories, p < .05). Income significantly moderated prosocial behavior trajectories, while race/ethnicity significantly moderated family conflict and prosocial behavior trajectories (time interaction, p < .05).

Conclusions: The findings suggest that factors related to income and race/ethnicity influence trajectories of change in family conflict and prosocial behavior outcomes in children with a history of ADHD. Future studies should explore these disparities and identify targets for intervention, such as increased access to diagnosis and treatment for individuals at risk of poorer functional outcomes.

Objective: This study examines the impact of long-acting stimulant (LAS) pharmacotherapy for ADHD on academic outcomes among students in grades K-12 using retrospective analysis of administrative data.

Methods: ADHD diagnosis was identified based on ADHD management plans in school records, physician notes in billing records, and/or prescription records. Prescription records identified LAS-treated students (n = 15,544), excluding those treated with immediate/intermediate-acting stimulants or atomoxetine. A control group without ADHD (n = 204,681), and another with untreated ADHD (n = 27,880) were also identified. The following outcomes were examined using multivariate regression: report card scores, standardized assessment exam performance, graduation from high school, school attendance, and transition to post-secondary education.

Results: ADHD was associated with lower average report card scores and provincial assessment exam scores and increased frequency of school absence among grades K-12, and decreased likelihood of high school graduation and transition to post-secondary education. LAS treatment was associated with improved report card (score estimate -4.93 Treated, -6.19 Untreated) and provincial assessment exam scores (percentile rank estimate -9.20 Treated, -11.50 Untreated) among grades 9 to 12, reduced absences among grades K-12 (absence rate estimate -3.33 Treated, 7.96 Untreated), and increased likelihood of graduation (OR of failure to graduate 1.39 Treated, 2.22 Untreated) and transition to post-secondary education (OR of no transition 0.77 Treated, 1.42 Untreated; reference = No ADHD group).

Conclusion: LAS pharmacotherapy is associated with improved academic performance, attendance, and likelihood of graduation and transition to post-secondary education.

Objective: Inhibition is a critical executive function for stopping routine responses and facilitating planned behaviour. Although the results are mixed, individuals with ADHD are reported to have poorer inhibition performance; however, this remains a subject of ongoing debate. Findings in the literature suggest that the central executive component of working memory and resource allocation could play a role. The present study investigated whether varying maintenance demands would influence inhibition performance among children with and without ADHD.

Materials and methods: The study sample comprised 80 children aged between 7 and 11 years (60 males and 20 females; M_age = 9.01). For the first time in the literature, participants completed a Go/no-go Task with four levels of gradually increased working memory load. The data was analysed using mixed repeated measures ANOVA.

Results and conclusion: A significant main effect of group, load and interaction were obtained. There was no significant difference in inhibition performance between the two groups when there was no working memory load. However, in the presence of a load, the ADHD group consistently scored lower across all load conditions. Their inhibition performance declined as the load increased. Under the heaviest load condition, the ADHD group obtained the worst scores, whereas the control group's performance improved. In conclusion, introducing a working memory load has a large negative impact on the inhibition performance of the ADHD group but not the control group. These results suggest that children with ADHD struggle to allocate enough resources to meet the increased task demand for optimal inhibition performance.

Objective: The aim of this study was to explore neural oscillation features (resting-state + oddball-EROs) of ADHD symptoms in children in a dimensional approach and to construct a multi-metric model combining objective EEG measures and subjective parental ratings to predict children's behavioral performance.

Method: Seventy-seven children (age range: 6-12 years) participated in laboratory assessment. ADHD symptoms were first evaluated using the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), followed by EEG recordings during both resting-state and oddball task conditions. Three parent rating scales were also used to evaluate children's behavioral performance: the ADHD Rating Scale-IV (ADHD RS-IV): Home Version, the Child Behavior Checklist (CBCL), and the Conners' Parent Rating Scales (CPRS).

Results: Seventy-one children with valid IVA-CPT results were included in data analysis. The main results revealed a relationship between poorer attention performance and decreased eye-open alpha1 power in the resting state, reduced N2 delta power in the oddball condition, and elevated non-delta band power in the standard condition of the oddball task. Poorer response control performance was associated with increased eye-closed alpha1 power, as well as increased eye-open alpha2 and beta2 power. Stepwise regression analysis showed that the inattention subscale from parental assessments on the RS-IV, combined with P3 alpha power in the standard condition of the oddball task, was the strongest predictor of children's attention performance.

Conclusion: The current study identified important neural oscillation features of ADHD symptoms in both the resting state and during an oddball task and offers new insights into multi-metric prediction for ADHD assessment and diagnosis.

Objective: Previous studies have found that ADHD symptoms often co-occur with aggressive behavior in adolescents, and that reactive aggression is more closely related to ADHD symptoms than proactive aggression. However, the specific co-occurrence patterns of ADHD symptoms and different functions of aggression remain unclear, as does their relationship with parenting practices. This study used a person-centered approach to examine the co-occurrence patterns of ADHD symptoms, reactive aggression, and proactive aggression and their associations with parenting practices.

Method: A total of 1,152 mother-adolescent dyads participated in this study (adolescents: M_age = 14.29; 48.0% girls). Latent profile analysis was conducted to identify adolescent profiles of ADHD, reactive, and proactive aggression, followed by multinomial logistic regression to examine relationships between these profiles and auxiliary variables.

Results: Latent profile analysis identified three patterns of adolescent- and mother-reported ADHD symptoms, reactive aggression, and proactive aggression: low symptom (84.4%), reactive co-occurrence (10.0%), and complete co-occurrence (5.6%). Multinomial logistic regression revealed that adolescents in the complete co-occurrence group had higher rates of corporal punishment, while adolescents in the reactive co-occurrence group exhibited higher rates of verbal hostility.

Conclusion: These findings highlight the importance of distinguishing between reactive and proactive aggression in the context of ADHD and suggest that different co-occurrence patterns may be shaped by distinct parenting practices. Addressing specific parenting behaviors could help mitigate aggression in adolescents with ADHD symptoms.

Background: In response to the increasing prevalence of ADHD, efforts have focused on understanding methods to optimize psychosocial, emotional, and behavioral well-being, defined as flourishing. Mood disturbances, environmental vulnerabilities, and Adverse Childhood Experiences (ACEs) are risk factors for not flourishing. There is limited research on protective relational factors, as measured by Positive Childhood Experiences (PCEs), as facilitators of flourishing in children with ADHD and comorbid mood disturbances.

Method: Using a nationally representative sample of 4,847 children, aged 6 to 17 years-old, currently diagnosed with ADHD, hierarchical binary logistic regression examined whether the number of PCEs present for children with and without mood disturbances could significantly predict who was flourishing or not. The initial model included demographics, ADHD treatment-related variables, and the number of ACEs encountered.

Results: After controlling for covariates, the odds of flourishing measured by the Child Flourishing Index (CFI) for children with ADHD were 7.31 [4.51, 11.86] times greater for those with 6 to 7 PCEs compared to peers with 0 to 2 PCEs, and 3.37 [2.24, 5.06] times greater for those with 3 to 5 PCEs relative to peers with 0 to 2 PCEs. Furthermore, parents who reported their children had neither current anxiety nor depression were 2.92 [1.87, 4.55] times more likely to flourish than children currently reported to have both anxiety and depression. These associations were consistent regardless of the level of ACEs.

Conclusions: Our findings suggest that more PCEs and the absence of mood disturbance may attenuate the influence of ACEs on healthy adjustment for children with ADHD. Encouraging resilience in families, connecting with caregivers, and community volunteering were the most predictive positive childhood experiences of flourishing in this national sample of youth with ADHD and comorbid mood disturbance. Current results also provide guidance for future research on PCEs measurement, screening for comorbidities, and clinical intervention in neurodiverse samples.

Objective: To examine whether children with attention-deficit/hyperactivity disorder (ADHD) can produce attentional orienting in response to gaze cues, and to identify which type of attentional orienting is impaired and why.

Method: Two experiments employed a gaze cue-target paradigm using inhibition of return (IOR) as an indicator of exogenous attentional orienting. Experiment 1 used normal upright gaze faces as cues. Experiment 2 used inverted gaze faces as cues.

Results: When normal gaze faces were used as the gaze cue, no IOR effect was observed in children with ADHD (Experiment 1); whereas when inverted gaze faces were used as the gaze cue, the IOR effect was produced in children with ADHD (Experiment 2).

Conclusion: These results indicated that the ability to produce exogenous attentional orienting to the gaze cue is impaired in children with ADHD and that this impairment resulted from their reduced ability to exogenously orient to the intact face. These findings provide new evidence of social cognitive deficits and attentional orienting deficits in children with ADHD, and help provide support for children in educational settings.

Objective: ADHD is commonly comorbid with depression and this comorbidity is associated with increased symptom severity and worse outcomes than either condition alone. Depression is highly heterogeneous and may present differently in populations with ADHD. This study aimed to explore different symptom presentations of depression and associated clinical correlates in a clinical ADHD sample. Method: We analysed data from the Study of ADHD Genes and Environment (SAGE). Parents completed semi-structured interviews about their child's psychopathology at baseline (M_age = 10.9 years) and the Mood and Feelings Questionnaire to capture their child's depression symptoms approximately 5 years later (M_age = 14.6 years, N = 246). Depression symptom presentations were derived by latent profile analysis. Results: Analyses found three presentations of depression symptoms: a 'low symptoms' class (48.5% of the sample), a 'high symptoms' class (15.5%) with consistently high depression symptoms, particularly for suicidality and poor self-esteem items, and an 'irritable/poor sleep' class (36.1%) with high scores for irritability and poor sleep and intermediate levels of other depression symptoms. All three classes had elevated irritability and symptoms that overlap with ADHD. Behavioural problems (oppositional defiant disorder; conduct disorder) were associated with an increased likelihood of being in the high symptoms compared to low symptoms class, and higher autism symptoms were associated with being in the 'irritable/poor sleep' compared to low symptoms class. Conculsion: Our findings suggest that while young people with ADHD often have elevated depression symptoms, there is notable heterogeneity. Young people with ADHD and behavioural disorders may be particularly at risk of a more severe depression symptom presentations characterised by high suicidal cognitions, whilst those with ADHD and autistic traits may present with more irritability and poor sleep.