Journal of Attention Disorders最新文献

Objective: Attention Deficit/Hyperactivity Disorder (ADHD) is a chronic and impairing neurodevelopmental disorder diagnosed in approximately 2% to 4% of preschool-age children and 9% of all children. Behavioral parent training (BPT) and high-quality education are effective treatments for young children with ADHD; however, poor rates of treatment access and participation limit the reach of BPTs to rural and underserved communities. In this study, we tested the newly developed Rural Outreach and ADHD Research-Early Childhood (ROAR-EC) program, a clinician-led, 7-session education and parent training program designed for delivery over telemedicine.

Method: We conducted a pilot RCT to assess the feasibility, acceptability, engagement of mechanism, and exploratory group × time effects of the ROAR-EC program compared to a control group in a sample of 44 children diagnosed with ADHD from a predominantly rural area (ages 3-7; M_age = 4.8; 62% male; 96% White; 89% non-Hispanic/Latinx). Families were randomized into either ROAR-EC or treatment as usual through developmental pediatrics and followed for 24 weeks. Assessed were metrics of feasibility, acceptability, parenting practices, caregiver empowerment, disruptive behaviors, and ADHD symptoms.

Results: Results indicated that ROAR-EC was feasible to implement and acceptable to caregivers. Repeated measures ANOVAs found significant group × time interaction effects in favor of the treatment group compared to control for family empowerment, parenting practices, total behavior problems, impairment, and inattentive symptoms.

Conclusions: This study demonstrated the promise of brief telemedicine programs as feasible, acceptable, and likely beneficial alternatives to traditional BPTs for young children with ADHD in rural and low-resource areas.

Background: ADHD has been characterised by excessive mind wandering (MW), or thoughts unrelated to the task at hand, with recent findings indicating that ADHD is specifically associated with more unintentional, but not intentional, MW. These two types of MW are also differentially associated with affective well-being. Most existing studies in ADHD, however, mainly rely on retrospective reports of MW tendencies, which are susceptible to memory-related errors and biases. Further, most studies categorise participants based on overall levels of ADHD, instead of accounting for the spectrum and dimensional heterogeneity of ADHD, including inattention and hyperactivity symptom dimensions. Our study aimed to address the knowledge gap regarding the relationship between different types of MW and affective well-being, across different symptom dimensions of ADHD.

Methods: We used ecological momentary assessment to capture participants' momentary attention state (on-task, intentional MW, or unintentional MW) and affective valence, six times daily for 7 days. Using linear mixed-effects modelling to account for inter-individual variance, we tested whether inattention and hyperactivity symptom dimensions of ADHD differentially moderate the relationship between attention states and affective valence.

Results: We found that higher levels of inattention symptoms predicted more negative affect during intentional MW compared to on-task attention; in contrast, higher levels of hyperactivity symptoms predicted more positive affect during intentional MW compared to on-task attention.

Discussion: Together, our results indicate that intentional MW moderates opposing effects of inattention and hyperactivity ADHD symptoms on affective valence. Our findings suggest that intentional MW - and not just unintentional MW - may also play a role in affective or behavioural outcomes associated with ADHD symptomatology, and highlight the importance of considering the heterogeneity of ADHD symptomatology, as well as the distinction between intentional and unintentional MW, in future ADHD research.

Objective: Attention-deficit/hyperactivity disorder (ADHD) has been shown to increase the risk of young adults perpetrating and being victims of intimate partner violence (IPV). However, research has yet to examine the IPV experiences of both dyad members where one or both partners has ADHD, and how those experiences differ from couples including partners without ADHD.

Methods: 41 "ADHD couples" (m age = 22.7 years), where one (n = 33) or both (n = 8) dyad members had ADHD, and 28 "Non-ADHD couples" (m age = 23.4 years), where both dyad members did not have ADHD, participated. Both partners reported on the frequency they perpetrated and were victims of psychological and physical IPV.

Results: Both partners in ADHD couples reported perpetrating more psychological and physical IPV than dyad members in Non-ADHD couples. Partners in ADHD couples also reported being victims of IPV more than partners in Non-ADHD couples.

Conclusions: The risk of IPV perpetration in young adult couples with ADHD appears to be a two-way street. Research is needed to examine possible explanations for this pattern of reciprocal IPV, including mutual ADHD symptoms and related behavior (e.g., alcohol intoxication).

Objective: The rates of college students experiencing mental health challenges are increasing. Students with marginalized identities such as women, first generation college students (FGCS), or students with disabilities may be more at risk, and having multiple marginalized identities can impose added challenges. This study examined students' identities that contribute to college students with psychological disorders': (1) severity of mental health challenges, and (2) use of on-campus psychological services.

Methods: A nationwide survey was used to draw a sample of college students with psychological disorders (N = 5,120).

Results: For students with psychological disorders, being a woman was associated with heightened mental health challenges, even when other identities were accounted for (i.e., FGCS status, disability status, dual identities). Having ADHD was also associated with heightened mental health challenges when dual identities were not accounted for. Additionally, when students with ADHD's dual identity as a FGCS was accounted for, students with psychological disorders and ADHD who are also FGCS were found to experience heightened psychological challenges. Moreover, FGCS were less likely to utilize mental health services on campus, even when other identities were accounted for.

Conclusion: Findings highlight the role marginalized identities play for college students with psychological disorders and the importance of considering students' intersectionality when it comes to mental health and seeking professional support.

Background: College students often engage in heavy alcohol use and experience poor sleep. These risks are exacerbated among students with ADHD, who are especially vulnerable to both poor sleep and alcohol-related negative consequences. Although prior research has often focused on average sleep patterns, the impact of variability in sleep (i.e., bedtime, duration, and waketime) remains understudied. This variability may be particularly important for individuals with ADHD, given the self-regulation challenges that underline both sleep and alcohol use. Therefore, we examined ADHD-related differences in sleep variability and tested whether sleep variability predicts alcohol-related negative consequences.

Methods: Utilizing 2-week daily diaries in a sample engaging in heavy drinking (N = 101; ADHD = 51, without ADHD = 50), Dynamic Structural Equation Models (DSEM) were applied to examine ADHD group differences in sleep variability and sleep averages (bedtime, waketime, and duration) and alcohol-related negative consequences, and test if sleep variability predicted negative consequences.

Results: ADHD group status was significantly associated with later average waketimes, but not in average bedtimes or average sleep duration. However, students with ADHD did report significantly greater variability in their bedtimes, waketimes and sleep duration, as well as greater alcohol-related negative consequences, compared to controls. Notably, ADHD was not a significant covariate in any adjusted models; instead, greater sleep duration variability significantly predicted increased negative consequences independent of ADHD status.

Conclusion: These findings highlight the importance of considering sleep variability for those with ADHD and more generally as a risk mechanism associated with alcohol-related negative consequences in college students who report heavy drinking.

Background: Research on college students with ADHD largely has focused on impairments associated with this condition, as opposed to how resilience might buffer ADHD-related challenges. The present study examined potential differences in quality of life (QoL), resilience, and sociodemographic characteristics by students' ADHD diagnostic/symptom status and whether diagnostic/symptom group differences in QoL were more/less pronounced at different levels of resilience. Method: Using data from an online survey distributed at six US colleges/universities, participants (N = 4,897; 74% female; 60% White) reported on current ADHD symptomatology and diagnostic status; personal, social, and familial resilience; and physical, psychological, social, environmental, and global QoL. Results: Compared to students who were undiagnosed and asymptomatic or diagnosed and asymptomatic, participants who were symptomatic (diagnosed and undiagnosed) evidenced lower resilience and QoL across all domains. There were significant interactions between ADHD group and resilience for global QoL and environmental QoL. Global QoL among undiagnosed and symptomatic participants was consistently lower than the reference group (undiagnosed and asymptomatic), particularly at lower levels of resilience. For environmental QoL, the slopes for both diagnosed groups were less steep compared to the reference group, suggesting resilience was less closely associated with environmental QoL. Conclusion: Findings suggest that current ADHD symptomatology, as opposed to a formal ADHD diagnosis, is a better predictor of psychosocial impairment. Helping students with an ADHD diagnosis to continue developing resilience ultimately may benefit QoL; however, students who are currently symptomatic - particularly those who are undiagnosed - likely need additional support to experience the protective benefits of resilience.

Background: Adverse childhood experiences (ACEs) are known to have several negative effects on mental health and well-being. However, few studies have examined the role of these events in the development of ADHD and the protective factors that could guide prevention and intervention strategies in college students. The aim of current study is to examine the potential role of self-compassion and emotion regulation in the relationship between ACEs and ADHD symptoms in college students. Method: The sample of the study consisted of 442 young adults (67.4% female; 32.6% male) aged between 18 and 29 years (M = 20.43, SD = 1.74) from a public university in Türkiye. Participants completed validated measures that were combined in a single battery with a web-based tool. Results: We found that ACEs were associated with lower levels of self-compassion (Cohen's d = 0.43) and emotion regulation (Cohen's d = 0.29), along with higher levels of attention deficit (Cohen's d = 0.47) and hyperactivity-impulsivity (Cohen's d = 0.46) symptoms. Further results indicated that ACEs were a significant positive predictor of attention deficit and hyperactivity-impulsivity symptoms and a negative predictor of self-compassion and emotion regulation. Additionally, self-compassion showed an indirect effect on the relationship between ACEs and emotion regulation, as well as the association between ACEs and attention-deficit/hyperactivity-impulsivity symptoms. Finally, we found that emotion regulation had an indirect effect on the association between self-compassion and attention-deficit/hyperactivity-impulsivity symptoms. Conclusion: These findings provide further evidence supporting the importance of self-compassion-based strategies to reduce attention-deficit/hyperactivity impulsivity by promoting emotion regulation skills in college students.

Objective: The Asian American and Native Hawaiian/Pacific Islander (AA & NH/PI) population represents one of the fastest-growing racial /ethnic groups in the United States, yet members of this community are among the least likely to receive services for ADHD. Studies seeking to explain discrepancies between the need for and use of ADHD services in AA & NH/PI populations have highlighted decreased problem recognition as precluding access to services. We sought to investigate the roles of three previously proposed factors (i.e., perceived impairment, ADHD knowledge, and ADHD stigma) in explaining differences in ADHD problem recognition in AA & NH/PI versus White, Black, Hispanic/Latinx, and Multiracial/Multiethnic college students.

Method: Participants were 1,451 college students aged 18 to 29 years (M = 19.3, SD = 1.64) who met self-reported symptom and impairment criteria for ADHD. They completed questionnaires assessing ADHD problem recognition, perceived impairment, ADHD knowledge, and ADHD stigma.

Results: Compared to the White Group, the AA & NH/PI Group had significantly lower probability of endorsing the belief that they should be diagnosed with ADHD. The AA & NH/PI Group also reported lower levels of ADHD knowledge and increased levels of ADHD stigma and perceived impairment compared to the White Group. Increased ADHD knowledge was associated with greater likelihood of ADHD problem recognition. Examination of indirect effects suggested that differences in ADHD problem recognition between AA & NH/PI and White Groups were partially explained by differences in ADHD knowledge.

Conclusion: Results highlighted the importance of clarifying mechanisms underlying ADHD-related service-use patterns in AA & NH/PI populations to better understand and address mental health needs.

Prescription stimulant diversion (i.e., giving, selling, or trading one's medication) and non-medical prescription stimulant use (i.e., using in ways not prescribed) are common among undergraduates; however, few evidence-based interventions target these behaviors. This study evaluated the efficacy and feasibility of a 30-min, interactive web-based intervention providing psychoeducation around diversion and non-medical use, practice refusing medication requests, and medication adherence strategies. Students (M_age = 20.42 years; 74% female; 86% White) with current stimulant prescriptions from three US universities were randomized to the intervention (n = 128) or attention-matched placebo (n = 121) in a single-blind design, with 1- and 2-month boosters and 3- and 6-month follow-ups. Primary outcomes were diversion, non-medical use, and diversion intentions; secondary outcomes were perceived norms, perceived risk, self-efficacy to resist diversion and non-medical use, and prescriber communication. Contrary to pre-registered hypotheses, intervention participants did not report decreases in primary outcomes. There were small-to-medium effects on secondary outcomes of risk perceptions (d = 0.39 [0.12, 0.68]), perceived non-medical use norms (d = 0.51 [0.24, 0.76]), and self-efficacy to avoid non-medical use (d = 0.47 [0.10, 0.85]), but not on perceived diversion norms, self-efficacy to avoid diversion, and prescriber communication. Post-hoc analyses showed a 76% reduction in odds of any diversion (OR = 0.24 [0.08, 0.68]) and a 60% reduction of any non-medical use (OR = 0.40 [0.21, 0.77]) for intervention participants during the 6-month follow-up period. This intervention was acceptable and feasible to implement and evidenced some efficacy in modifying risk perceptions, self-efficacy, and perceived norms. Since diversion and misuse episodes were not reduced, future intervention refinements may tailor content to different levels of diversion and misuse risk. Registered in ClinicalTrials.gov on May 12, 2021: NCT04885166.

Background: Since DSM-5, ADHD has been classified as a neurodevelopmental disorder, and this placement has often reinforced dominant models that emphasize neurobiological mechanisms-treating attention as an internal trait shaped by executive dysfunction or dopaminergic imbalance. While these frameworks offer valuable insights, they often marginalize the ecological, relational, and sociomaterial contexts in which attention arises or collapses. Context is too often treated as background rather than condition.

Objective: This paper proposes a field-based reconceptualization of attention: a relational ontology in which patterns of behavior and experience gathered under the ADHD diagnosis are not solely located within the individual but emerge from dynamic tension between organism and environment.

Methods: Drawing from ecological psychology, dynamic systems theory, and phenomenological psychiatry, we develop the notion of fielded attention-a model in which attention is not a fixed trait but a modulation shaped by rhythm, affordance, and environmental curvature. We conduct a conceptual analysis in three stages: (1) critique of trait-based diagnostic frameworks that statistically neutralize context; (2) elaboration of a field ontology of attention that reframes breakdowns as ruptures in relational coherence; and (3) derivation of translational implications for research and care design.

Results: The analysis identifies an epistemic shift in which environmental and social structures are often flattened into reductionist risk factors, and heterogeneity in ADHD symptom expression is reframed as field sensitivity-a signal of developmental plasticity rather than diagnostic noise. Translational implications include the design of learning and care environments (including architectural and temporal structure) and adoption of field-sensitive research methods such as ecological momentary assessment and spatial diaries.

Conclusions: Rather than reject biological models, this framework resituates them within broader ecologies of modulation. By repositioning context as ontologically central, fielded attention advances a more ethically responsive and developmentally situated account of ADHD.