Journal of Attention Disorders最新文献

Introduction: Individuals with ADHD continue to face stigma, which can negatively impact their access to, adherence to, and quality of mental health services, as well as their overall wellbeing. Perspectives of various stakeholders regarding priorities for stigma reduction remain underexplored. This study explores young adult, parent, teacher, and mental health care professional perspectives on unmet needs of children and young adults with ADHD in the Netherlands, in the context of stigma reduction.

Method: A total of 24 respondents participated in seven small focus group discussions (FGDs). The FGDs facilitated in-depth discussions exploring stakeholder group perspectives on unmet needs of children and young adults with ADHD in educational, professional, and social settings. Data was analyzed using thematic content analysis.

Results: Three thematic categories of unmet needs were identified: (1) a lack of awareness, knowledge, and understanding of ADHD; (2) insufficient personalized approaches in education and health care; and (3) limited accessibility of information and support services. Within theme 1, respondents primarily highlighted the importance of improving education for primary school teachers and mental health care professionals. Theme 2 underscored the need for increased capacity for personalization and attention to the sociopsychological factors of ADHD, alongside recognizing strengths. Theme 3 emphasized the need for easy access to reliable information and mental health care, including peer networks, as well as proper follow-up and continuity of care.

Discussion and conclusion: Findings highlight the need for improving our understanding of ADHD as a complex biopsychosocial condition, which requires specific adjustments in education and mental health care. Interventions to improve support and disrupt stigmatization should meet diverse needs, incorporate multi-level strategies, and involve key stakeholders.

Exposure to heavy metals has been associated with affecting children's neurodevelopment, particularly increasing the risk of developing attention-deficit hyperactivity disorder (ADHD). The current exploratory study aims to investigate potential associations between presence of 15 different heavy metals in urine and ADHD. A total of 190 urine samples of participants from clinical and non-clinical population (non-ADHD = 66; ADHD = 124) aged between 6 and 15 years from Barcelona and Tarragona (Spain) were analysed. Logistic regressions adjusted by sex, age, SES, BMI and diet quality were performed. Highest quartiles (3rd and 4th) of Pb (lead) (aOR 5.33; CI [1.89, 14.98]), Cd (cadmium) (aOR 3.69, CI [1.38, 9.83]), Cu (copper) (aOR 16.46, CI [4.66, 58.14]) and Sb (antimony) (aOR 3.04, CI [1.12, 8.23]) were significantly associated with increased odds of ADHD DSM-5 diagnosis. Additionally, Cu and Cd were associated with higher scores of inattention symptoms. Whereas, Cu and Sb were associated with hyperactivity-impulsivity severity. This exploratory study provides preliminary valuable evidence, suggesting potential associations between environmental factors, such as metal exposure, with ADHD in school-aged children. These findings highlight the importance of further research to support these associations and, if confirmed, explore strategies to mitigate the potential impacts of these toxicants on children's health.

Purpose: Avoidant automatic thoughts (AAT) are thoughts that precede or accompany a delay in the starting or ending of a task. In a prior study of college students using Ecological Momentary Assessment (EMA), AATs were frequent daily occurrences and participants with more severe ADHD symptoms at baseline reported more frequent AAT. Importantly, momentary presence of AAT was associated with greater task avoidance and inattentive symptoms. In the current study, we replicated and extended this study in a community sample of adults.

Method: We measured AAT in the daily lives of 106 adults using EMA. Data were collected at baseline and up to five times per day for 6 days.

Results: Using multilevel modeling, we found that baseline ADHD symptoms predicted more frequent AAT and more severe task avoidance and negative emotion in daily life. Recent presence of AAT was associated with inattention, task avoidance, and slightly elevated negative emotion in the moment. More severe baseline ADHD strengthened the relationship between AAT and both inattention and task avoidance. In exploratory analyses, we found that work tasks and household chores were the most avoided activities and that, instead, people were most likely to be doing other work tasks or engaging in screen time or self-care, respectively.

Conclusions: This study replicates and extends our prior findings regarding AAT in daily life and their relationship to ADHD and supports continued research on this construct, which may have clinical utility for intervening in problematic avoidance behaviors.

Objective: Stimulant medications are the primary pharmacological intervention for ADHD, yet our understanding of how sex and gender impact stimulant treatment outcomes remains limited. Clinical guidelines do not differ for female and male individuals despite possible sex and gender-related differences in effectiveness, adverse events, and pharmacokinetics. This theoretical framework identifies five key knowledge gaps relating to sex and gender effects in stimulant treatment.

Method: We investigate the stimulant treatment trajectories of girls and women with ADHD from diagnosis and prescription to daily use and outcomes. We examine the impact of reproductive life transitions and hormonal fluctuations and their interactions with gender socialization and gendered expectations on treatment effectiveness, stigma, and adherence.

Results: By synthesizing existing literature, proposing testable predictions, and suggesting future research directions, we highlight the urgent need for studies that systematically investigate these factors.

Conclusion: Addressing these gaps could significantly improve treatment outcomes for girls and women with ADHD, particularly during biological and gender role transitions.

Objective: To explore the association between telomere length (TL) and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6-12 years.

Method: Data from 1,759 children belonging to the HELIX project cohorts and the Asturias, Gipuzkoa and Valencia cohorts of INMA project were included. TL was determined by blood sample using a PCR protocol. ADHD symptoms were described by parents using the Conners' Parent Rating Scale-Revised: Short Form. Multiple negative binomial regression models adjusted for potential confounders were used to estimate associations.

Results: Overall estimates showed no associations between TL and ADHD symptoms. However, we observed that a longer TL was significantly associated with a lower risk of presenting hyperactivity symptoms in children belonging to the HELIX project (IRR = 0.93, 95% CI [0.87, 0.99]; p = .022).

Conclusion: While our study did not find a consistent association between TL and ADHD symptoms across all cohorts, the significant association found within the HELIX cohort suggests that longer TL may be linked to a lower risk of hyperactivity symptoms. Further research is needed to explore this association in more detail.

Objective: To compare the effect of motivational features on sustained attention in children born very preterm and at term.

Method: EEG was recorded while 34 8-to-11-year-old children born very preterm and 34 term-born peers completed two variants of a cued continuous performance task (CPT-AX); a standard CPT-AX with basic shape stimuli, and structurally similar motivating variant, with a storyline, familiar characters, and feedback.

Results: Higher hit rates, quicker response times and larger event-related potential (ERP) amplitudes were observed during the motivating, compared with the standard, task. Although groups did not differ in task performance, between-task differences in ERPs associated with orienting were larger in term-born than very preterm children.

Conclusion: The findings add to previous evidence of disruption to the brain networks that support salience detection and selective attention in children born preterm. Manipulations that increase intrinsic motivation can promote sustained attention in both term-born and very preterm children.

Objective: This study investigated the psychometric properties of the Arabic version of the Adult Self-Report Scale-5 (the ASRS-5-AR) within a large sample of adults residing in Saudi Arabia.

Methods: This cross-sectional study applied the ASRS-5-AR to a random sample of 4,299 Saudi and non-Saudi adults, aged 19 to 66 years (31.16 ± 9.26 years), living in the regions of Riyadh, Makkah, and the Eastern Province in Saudi Arabia. Collected data were analyzed using IBM SPSS Statistics 26, JASP 0.18.3.0 software, and MedCalc 22.030 statistical software.

Results: The ASRS-5-AR demonstrated strong internal consistency, with all six items showing significant positive correlation with the total score (.675-.735). Results of confirmatory factor analysis revealed a goodness-of-fit coefficient of 0.983 for the one-factor model and McDonald's omega, Cronbach's α, and Spearman-Brown coefficients of 0.786, 0.788, and 0.724, respectively. In addition, the findings revealed statistically significant differences in self-reported ADHD symptoms based on age (F = 18.68; p < .001), level of education (F = 2.61; p < .05), and marital status (F = 22.30; p < .001). However, there were no significant differences in self-reported ADHD symptoms between males and females (t = 0.625; p > .05) or Saudi and non-Saudi participants (t = 0.409; p > .05) or based on region of residence (t = 2.19; p > .05).

Conclusions: This study provides valuable insights into the psychometric properties of the ASRS-5-AR within a large sample of adults in Saudi Arabia. The findings demonstrate acceptable reliability of the ASRS-5-AR within this population. While these findings suggest the ASRS-5-AR may be a useful tool for initial assessment, further research is crucial. Future studies should focus on establishing accurate cutoff scores by comparing a general population sample with a clinically diagnosed sample of adults with ADHD in Saudi Arabia. This will allow for a more accurate evaluation of the scale's utility in identifying individuals who may require further clinical assessment.

Objective: This study examines the validity of the ASRS-5 as a new screening tool for ADHD and evaluates its proposed screening cut-off in a general population context.

Method: A nationally representative sample of 2,002 individuals aged 18 to 80 years was surveyed using the ASRS-5, with complete data obtained from 714 participants. Psychometric analysis evaluated fit to the Rasch model, response categories, dimensionality, differential item functioning, local dependency, and reliability. A cut-off score of 14, based on a simple additive scale, was applied.

Results: The ASRS-5 generally conformed to the expectations of the Rasch model. However, disordered response categories were observed for item 6, and gender-related differential item functioning was noted in items 3, 4, and 6. The ASRS-5 demonstrated a unidimensional construct, and a cut-off score of 14 identified 6.0% of the sample as potential ADHD cases.

Conclusion: Although the ASRS-5 aligns well with the Rasch model, certain measurement challenges exist. The recommended cut-off score effectively identifies an ADHD prevalence consistent with the 6.5% reported in the original ASRS-5 study.

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.

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.