Journal of Attention Disorders最新文献

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a complex neurodevelopmental disorder with numerous hypothesized risk factors that have not yet been thoroughly investigated in many non-Western populations, including Mongolian schoolchildren. Exploring these risk factors could yield insight on which children are more likely to be impacted and on how risk differs across locations and cultures.

Objective: The aim of the study was to assess whether elevated scores reported by parents and teachers on the Conners-3 Assessment, a detailed survey tool used to assess ADHD symptoms, correspond with indicators of lower socioeconomic status.

Methods: We conducted a cross-sectional analysis involving 201 schoolchildren aged 8 to 13 attending a public school in Ulaanbaatar, Mongolia. We investigated associations between factors including student age, parental education level, family income, exposure to cigarette smoke, calcium intake and vitamin D status with Conners-3 scores for inattention, hyperactivity, and defiance/aggression. Cohen's d effect sizes and adjusted mean differences (aMD) for Conners-3 scores between groups were calculated using multivariable analysis.

Results: Our findings revealed large effect sizes between different types of accommodation, a key indicator of socioeconomic status in modern Mongolia, and moderate effect sizes between different levels of parental education. Other findings included that engaging in over 2 hr of outdoor activity was independently associated with an increased inattention score (aMD 0.53, 95% CI [0.03, 1.03]) and increased hyperactivity score (aMD 0.63, 95% CI [0.10, 1.16]). A lower household income was independently associated with an increased inattention score (aMD 0.0005, 95% CI [0.000011, 0.001042]) and increased defiance/aggression score (aMD 0.0009, 95% CI [0.0004, 0.0015]). Factors such as calcium intake, Vitamin D level, exposure to cigarette smoke, and parental employment status did not yield significant associations.

Conclusion: We found that Conners-3 scores indicating higher symptoms of ADHD among Mongolian schoolchildren were associated with lower household income and high outdoor activity, and should be further investigated in relation to type of accommodation.

Objective: ADHD symptoms are highly prevalent among university students. These symptoms, particularly the inattentive cluster, predispose students to poorer academic performance and worse academic adjustment. Moreover, ADHD symptoms are often comorbid with other common mental disorders; this comorbidity also leads to poor outcomes. South African students often have fewer resources to successfully transition to university. Hence, our longitudinal study used data from a sample of South African first-year undergraduate students to investigate (a) associations between ADHD symptoms and academic performance/adjustment, (b) separate influences of the inattentive and hyperactivity-impulsivity clusters on academic performance/adjustment, and (c) the influence of the combination of ADHD and psychiatric comorbidities on academic performance/adjustment.

Method: We collected data three times through the first semester of 2023. Predictors within our regression models included sociodemographic variables, psychological variables (self-reported symptoms of ADHD, depression, anxiety, and risky alcohol use), and high school academic performance. Outcomes were first-semester GPA and self-reported academic adjustment (magnitude of change across the semester and overall adjustment at the end of the semester).

Results: Analyses showed that, unlike academic performance (N = 506), magnitude of change in academic adjustment (N = 180) was significantly predicted by ADHD symptoms and the combination of ADHD (p = .02), depression (p < .001), and anxiety symptoms (p = .01). Inattentive ADHD symptoms predicted both academic performance and magnitude of change in academic adjustment.

Conclusions: Our findings suggest that the presence of ADHD symptoms (both with and without other common mental disorders) is associated with a smaller magnitude of academic adjustment, and that the presence of inattentive symptoms of ADHD is associated with both poorer academic performance and smaller magnitude of academic adjustment. These findings are significant in informing future interventions targeting the academic outcomes of first-year university students.

Objective: Many treatment engagement challenges are documented for adolescents with ADHD. Across contexts, helping professionals (i.e., therapists, prescribers, educators, coaches) might benefit from an engagement strategy toolbox to facilitate work with adolescents with ADHD and their families.

Method: The current study describes the development and psychometric testing of the ADHD Engagement Process Code (AEPC), a measure that operationalizes engagement strategies in the context of a blended behavioral/motivational interviewing treatment for adolescent ADHD (Supporting Teens' Autonomy Daily; STAND). The AEPC also operationalizes in-session parent and adolescent engagement-related behaviors. Behavior counts and global codes were coded for 840 audio-recorded STAND sessions delivered by 21 therapists to 121 adolescents. Subsets of tapes were double coded using the AEPC's parent, adolescent, and therapist coding systems to assess kappa for line-by-line verbalizations and intraclass correlations for session-level behavior counts and global scores. Construct validity was assessed. We explored low frequency and low variability codes and examined correlations between codes.

Results: AEPC codes possessed good to excellent inter-rater reliability and strong discriminant validity. Three low frequency codes and one low variability global were identified indicating opportunities for AEPC refinement.

Conclusions: The AEPC is publicly available (https://osf.io/kshfy/) and offers a library of adolescent-specific codes for those interested in measuring provider, parent, or adolescent engagement behaviors in relevant populations or contexts.

Objective: To examine the experiences of Australian parents raising primary school-aged children with ADHD and gather feedback on a proposed ADHD parenting program.

Methods: Reflexive thematic analysis of semi-structured interviews undertaken with 11 Australian parents of 7- to 11-year-old children with ADHD. Interviews were conducted over Webex, audio recorded, transcribed verbatim, and analyzed in NVivo Ltd. software.

Results: We identified four themes: (1) "I love my child but their ADHD traits are challenging," (2) "Compliance, control, and completion," (3) "It's hard, burdensome, and exhausting and I can feel like I'm alone," and (4) "What a welcome relief."

Conclusion: Parents report that although raising neurotypical children is difficult, the presence of childhood ADHD increases the emotional and support burden placed on them. Parents were also very interested in and supportive of the proposed ADHD parenting program. The program aims to enhance parents' understanding of the neurocognitive implications of ADHD and to foster secure parent-child attachment, attuned parental responsiveness, and age-appropriate development of traits that promote well-being, adaption and recovery in people with ADHD.).

Introduction: Our study aimed to compare the sociodemographic, diagnostic, clinical, and self-report scale data of adults diagnosed with ADHD in childhood/adolescence versus adulthood and to identify risk factors associated with delayed/missed diagnosis for ADHD.

Method: Sociodemographic, clinical, and diagnostic data of 214 adults with ADHD, followed at the Adult Neurodevelopmental Disorders Clinic, Selçuk University, between January 2022 and January 2024, were analyzed. The diagnostic evaluations were made using the Structured Clinical Interview for DSM-5 Clinician Version. Clinical data included age, gender, years of education, alcohol/substance use, diagnosis age, and current medication use for ADHD. Data collected from self-report scales included both ADHD-related measurements and comorbidity-related measurements.

Results: The findings revealed that only 34.4% (n = 74) of sample received a formal ADHD diagnosis during childhood/adolescence. Adults diagnosed with ADHD in adulthood were older and had higher education levels, more severe ADHD symptoms, and increased maladaptive daydreaming (MD) scores, compared to those diagnosed in childhood or adolescence. Logistic regression analysis indicated that the severity of MD was associated with being in the group diagnosed with ADHD in adulthood while controlling for other significant parameters from bivariate analyses, such as age, years of education, and current medication use for ADHD. Finally, analyses conducted separately in both groups showed that: (1) increased MD severity was a predictor of higher ADHD symptoms in those diagnosed in adulthood, but not in those diagnosed in childhood/adolescence, and (2) MD severity had a stronger correlation with ADHD symptoms, the number of comorbid psychiatric disorders, and symptoms of excessive mind wandering, depression, and anxiety in those diagnosed in adulthood compared to those diagnosed in childhood/adolescence.

Conclusion: MD may delay ADHD diagnosis until adulthood by masking and compensating ADHD symptoms and delay in referral to mental health professionals, and it might also be a predictive symptom for recognizing ADHD in adults who have never been diagnosed; however, longitudinal studies are needed to confirm this.

Objective: ADHD is one of the most common neurodevelopmental disorders, seen in children and adolescents, and is often treated with various pharmacological agents, especially methylphenidate. There are differing opinions in the literature regarding the cardiovascular safety of long-term methylphenidate use. Studies suggest that the drug may increase the risk of hypertension, myocardial infarction, ventricular arrhythmia, sudden cardiac death, cardiomyopathy, heart failure (HF), pulmonary hypertension, and stroke. This study aimed to compare the clinical and echocardiographic characteristics of patients diagnosed with ADHD who have been using long-acting methylphenidate for an extended period with age-gender matched healthy volunteers.

Materials and methods: A total of 70 patients diagnosed with ADHD, who had been using long-acting methylphenidate for 2 years or more, and 51 healthy volunteers, who were referred to our clinic, were included in our study. Patients were evaluated with basic and advanced techniques such as Motion Mode (M-mode), two-dimensional (2D), Doppler, and 2D-Speckle Tracking (STE) using transthoracic echocardiography. All other data were evaluated instantly after the processing with the strain images analysis program.

Results: Statistically significant differences were observed between the case and control groups in terms of body mass index (BMI) and systolic blood pressure (SBP), with BMI negatively correlated and SBP positively correlated with methylphenidate use duration. There was no significant difference between the groups in apical four-chamber, three-chamber, two-chamber, and global longitudinal strain (GLS) values obtained by 2D-STE technique indicating early deterioration. The Left Ventricular (LV) lateral E' value, which indicates diastolic dysfunction, was lower in the drug group, but still within normal limits. The lateral LV E', Right Ventricular (RV) E', and RV A' values showed a significant negative correlation with the duration of drug use and remained within normal limits. Other parameters evaluating systolic/diastolic function such as E/E', left ventricular ejection fraction (LVEF), myocardial performance index (MPI), and tricuspid/mitral annular plane systolic excursion (TAPSE/MAPSE) did not differ significantly between the groups and were within normal limits. Valve structures and regurgitations were also not significantly different between the two groups.

Conclusion: Considering all parameters, we conclude that long-term use of long-acting methylphenidate does not cause cardiovascular dysfunction in late adolescent and early adult individuals. The observed differences in the E' lateral value between the case and control groups, as well as the slight correlation of lateral LV E', RV E', and RV A' values with the duration of use, do not directly indicate cardiac dysfunction.

Objectives: To determine ADHD research priorities from the perspective of ADHD professionals internationally.

Method: A two-stage modified Delphi design was used. In Stage 1 (qualitative), participants listed research questions relating to ADHD that they perceived to be most important (N = 132). In Stage 2 (quantitative), participants were then asked to rate each research question that was deemed appropriate (able to be researched and not already addressed by research) in terms of perceived importance (N = 180).

Results: Stage 1 generated 382 research questions with 10 broad areas identified for example, co-occurring conditions and treatment, etc. The top 20 most important questions related to ADHD in women/girls, long-term medication use, non-pharmacological interventions, ADHD measurement/rating scales, and efficacy of emotional regulation interventions.

Conclusion: These results can inform an ADHD research agenda which represents the views of the individuals from major ADHD professional groups internationally. Parallel work is needed focusing on research priorities from the perspective of ADHD consumers.

Objectives: Non-adherence to medication is common in the adult ADHD clinical group. The goal of this pre-registered study was to examine whether the DSM-5 Alternative Model of Personality Disorder (AMPD), generality personality dysfunction (LPFS-BF 2.0) or maladaptive personality traits (PID-5), can predict time to premature discontinuation of pharmacological treatment beyond other known factors.

Methods: A sample of 284 adult patients with ADHD (60.6% female; M_age = 32.31 years) were investigated for medication adherence from 2018 to 2023, using time-to-event analytic methods.

Results: Of the sample, 54 were found to have discontinued treatment prematurely without consulting their physician. Interestingly this group was prescribed considerably lower doses before discontinuation than adhering patients. General personality dysfunction and maladaptive antagonistic personality traits are implicated in varying degrees, with the specific maladaptive personality facets Intimacy Avoidance and Deceitfulness (PID-5) significantly predicting time to premature discontinuation of ADHD medication beyond other known reasons for non-adherence.

Conclusions: The broader implication is that the emerging personality pathology models hold promise to predict non-adherence in the adult ADHD population.

Background: Attention deficit hyperactive disorder (ADHD) is a leading mental disorder among adolescents globally and is associated with premature mortality. Knowing the trends and key determinants of ADHD in youth are critical for earlier diagnosis and interventions.

Methods: We retrospectively examined all hospitalizations in patients aged 11 to 18 years with ADHD in Spain, using data from the Spanish National Registry of Hospital Discharges spanning 2000 to 2021. We compared our data with available literature.

Results: Over the 22-year study period, there were 2,015,589 hospitalizations among adolescents in Spain, with 118,609 (5.9%) cases involving mental disorders. There were 10,292 admissions with ADHD, representing 8.7% of all hospitalizations among youth with mental disorders. Median age was of 14 years. Boys represented 72.6%. Admissions with ADHD experienced a 17-fold increase during the last decade (p < .001). The in-hospital mortality rate for adolescents with ADHD was 0.1%, lower than for other mental disorders. During the first year of the COVID-19 pandemic, admissions decreased but resumed its rising trend thereafter.

Conclusion: Hospital admissions for ADHD among adolescents have significantly increased in Spain during the last two decades. This increase outpaced the mild upward trend in ADHD diagnoses over the same period, which is not due to actual increases in the incidence of ADHD, which has remained stable at 5% worldwide. Factors beyond increased awareness, improved identification, and changes in diagnostic criteria must be considered. Boys represented 72.6% of these admissions. In-hospital mortality in adolescents with ADHD was lower than for admissions with other mental disorders.

Objective: This study aimed to investigate the relationship between Cognitive Disengagement Syndrome (CDS) symptoms in children/adolescents and their parents within the Turkish population, examining the association with co-occurring ADHD symptoms, peer/social relationships, and total difficulties.

Method: The study included 229 parents aged 18 to 50 with children aged 6 to 18 from the staff of Karabuk Training and Research Hospital. Data collection occurred from April to September 2022. Participants completed various scales, including the Adult Concentration Inventory (ACI), Adult ADHD Self-Report Scale (ASRS), Depression Anxiety Stress Scale-21 (DASS-21), Conners' Parent Rating Scale-Revised Short Form (CPRS-R), Strengths and Difficulties Questionnaire (SDQ), and Child and Adolescent Behavior Inventory Sluggish Cognitive Tempo Scale (CABI-SCT).

Results: A positive correlation was found between CDS symptoms in children/adolescents and their parents. CDS symptoms in children were also associated with significant comorbidities, such as ADHD, oppositional defiance, peer problems, and internalization problems. In parents, CDS was observed to be associated with levels of depression, anxiety, and stress.

Conclusion: The study highlights the strong relationship between CDS symptoms in children and their parents, suggesting potential genetic and environmental factors. CDS is associated with significant mental health comorbidities across all age groups. The findings underscore the need for interventions to support the mental health of both children and parents with CDS. Further research is needed to elucidate the impact and etiology of CDS on family dynamics and mental health.