Journal of Attention Disorders最新文献

Objective: To test whether pediatrician training leads to provider utilization of stimulant diversion prevention strategies as reported by adolescent patients with ADHD.

Methods: Pediatric practices received a stimulant diversion prevention workshop (SDP) or continued treatment-as-usual (TAU) in a cluster-randomized controlled trial. Surveys were completed by 341 stimulant-treated patients at baseline and three follow-up assessments.

Results: In intent-to-treat analyses of patient reports, SDP adolescents reported more provider use of diversion prevention strategies compared to TAU. They also reported more parent-patient communication about diversion. Provider satisfaction with the training was strong.

Conclusions: Pediatricians can make use of clinical practice strategies for the prevention of stimulant diversion following a 1-hr training; findings are novel given their reliance on confidential patient report of provider behavior and increase confidence in the results. Coupled with the positive provider satisfaction ratings, results suggest that this brief workshop may be an option for concerned providers that also has the effect of increasing discussion at home about safe use of stimulants.

Background: Concussions are a prevalent health concern, affecting millions of individuals in the United States yearly. Concussion symptomology overlaps with other conditions making diagnosis and management particularly challenging, particularly among individuals with ADHD. ADHD is a neurodevelopmental disorder that affects a significant portion of the adult population.

Objective: To enhance our understanding of symptom resolution and identify factors that could influence concussion care management, the purpose of the current study was to examine the recovery trajectory of adults diagnosed with both ADHD and concussion compared to the trajectory of adults who have experienced a concussion but do not have an ADHD diagnosis.

Methods: The study included a retrospective chart review of patients treated for concussion at a concussion specialty clinic.

Results: The findings of the study revealed no significant differences in history of concussion or recovery time between patients with and without ADHD. It was observed that patients with ADHD had a higher prevalence of anxiety, depression, and other mental health conditions.

Conclusions: The findings of the current study underscore the need for additional research to guide the care of patients diagnosed with both ADHD and concussion.

Objective: Very few studies have investigated intervention approaches that may be efficacious for youth with ADHD and co-occurring cognitive disengagement syndrome (CDS) symptoms. This study examined the feasibility, acceptability, and preliminary efficacy of a mindfulness-based intervention for adolescents with ADHD and co-occurring CDS symptoms. Methods: Fourteen adolescents ages 13 to 17 years (35.71% female; 64.29% White, 7.14% Black, 28.57% Multiracial) with ADHD and elevated CDS symptoms completed the 8-week group-based Mindful Awareness Practices (MAPs) program developed for individuals with ADHD. We collected measures of CDS, ADHD, mind-wandering, mindfulness, and other difficulties and functioning at baseline, 1-month post-intervention, and 3-month post-intervention to examine preliminary efficacy. We measured participant session attendance, session engagement, at-home practice adherence, and satisfaction of adolescents and caregivers at 1-month post-intervention to examine feasibility and acceptability. We also collected qualitative feedback from adolescents and caregivers at 1-month post-intervention. Results: The intervention was overall feasible to administer, and caregivers and adolescents reported satisfaction with the intervention despite some difficulties with attendance and engagement. We observed improvements to both caregiver- and adolescent-reported CDS symptoms and ADHD-inattentive symptoms from pre-intervention to post-intervention time points, though findings across 1- and 3-month follow-up differed based on informant. We also observed improvements to some indices of adolescent-reported mind-wandering, mindfulness, brooding rumination, and academic functioning. For caregiver report, the only other noted improvement was for executive functioning. No improvements were reported by teachers. Conclusions: Findings support the initial feasibility, acceptability, and preliminary efficacy of MAPs for adolescents with ADHD and co-occurring CDS symptoms on a range of outcomes. Larger trials with a randomized design are warranted to further examine mindfulness-based interventions for adolescents with ADHD and co-occurring CDS symptoms.

Objective: Maladaptive daydreaming (MD) is characterized by vivid, excessive fantasy activity that becomes prioritized over other activities and may result in avoidant coping strategies. Little is known about the relationship between MD and internalized stigma in the neurodivergent sample. The current study aimed to examine emotional dysregulation, escapism and self-perception (self-esteem and internalized stigma) as potential determinants of MD in three groups: adults on the autism spectrum, with ADHD, and both diagnoses ("AuDHD"), including their neurodivergent symptoms (autistic traits, empathizing, ADHD symptoms).

Methods: A sample of 293 persons (139 with ADHD, 74 on the autism spectrum, and 80 with both diagnoses) completed self-report scales concerning ADHD symptoms, autism spectrum symptoms, empathizing, self-esteem, daydreaming as escapism, emotional dysregulation, maladaptive daydreaming, and internalized stigma. A correlation analysis was implemented. Additionally, a group comparison and quantile regression for the 25th, 50th, and 75th percentile of maladaptive daydreaming in the three groups were executed.

Results: The results showed that internalized stigma, emotional dysregulation, escapism, and self-esteem have significant associations with MD in the neurodiverse sample. The ADHD group achieved the lowest scores in emotional dysregulation, discrimination experience, and social withdrawal. The groups did not vary in MD rates, stereotype endorsement, stigma resistance, nonacceptance of emotional responses, and impulse control difficulties. The AuDHD group achieved higher results than the ASD group only in the ADHD symptoms. Quantile regression revealed differences in the predictors of maladaptive daydreaming in the three groups. ADHD symptoms and self-suppression escapism were significant predictors for the higher levels of MD in persons with singular autism or ADHD diagnosis.

Conclusion: The results showed no differences in MD rates, although there were significant variations in predictive features among the three samples. The role of internalized stigma and self-esteem was highlighted in the results as significant associates of MD prevalence. These outcomes expand the current knowledge in the context of maladaptive daydreaming, internalized stigma, self-esteem and emotional dysregulation in a neurodiverse sample and allow for proposing clinical applications and further research directions.

Background: The shortage of prescription stimulants is an ongoing issue that is impacting the ability of individuals with ADHD to access their medication. Amidst concerns that this shortage may have a substantial impact on individuals' ability to manage their symptoms effectively, this research seeks to understand the experiences and consequences for those affected.

Methods: In this study, we interviewed individuals with ADHD who have been directly impacted by the stimulant shortage. Thematic analysis focused on identifying common themes related to challenges with medication access and the resulting effects on daily living.

Results: The study uncovered significant difficulties in accessing ADHD medication due to current shortages, leading to disruptions in the management of ADHD symptoms and subsequent detriments to individuals' professional, educational, and personal lives. Systematic controls aimed at reducing non-medical use were found to exacerbate these access issues, inadvertently compounding the challenges faced by those using medication for legitimate medical needs. Individuals also described ways they coped with the shortage, with some seeking ADHD medication via unofficial channels.

Conclusion: Our findings highlight the urgency of addressing stimulant shortages to safeguard the wellbeing of individuals with ADHD. This study also calls for a critical review of policy measures regulating stimulant medication access, and their effectiveness at reducing non-medical use given the unintended consequences these regulations appear to have on individuals prescribed these medications for therapeutic purposes.

Objective: This study examined the unique and interactive effects of PA volume and within-person fluctuations in PA volume (i.e., intraindividual variability in PA volume; PA-var) on preschoolers' (N = 141; 47.5% girls) ADHD symptoms.

Method: Preschoolers wore accelerometers during the school day over a 2-week period. Teachers reported on children's hyperactive, impulsive, and inattentive symptoms on the ADHD Rating Scale-IV Preschool Version.

Results: In the context of regression models, higher levels of PA-var were linked with lower levels of impulsive symptoms. Higher levels of PA volume were linked with higher levels of hyperactive and inattentive symptoms, but only when PA fluctuation (i.e., PAvar) was relatively low. Post hoc analyses with teacher-reported impairment as the outcome revealed a significant interaction such that the positive association between PA volume and impairment was stronger at lower, as compared to higher, levels of PA-var.

Conclusion: Larger fluctuations in preschoolers' PA volume may indicate lower risk for displaying impulsive symptoms. Moreover, preschoolers with high levels of PA that remain relatively consistent throughout the day may be at increased risk for exhibiting hyperactive and inattentive symptoms and related impairment, suggesting they are unable to regulate their activity to meet expectations in the school environment.

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: Previous studies have demonstrated poor oral hygiene in children with attention deficit hyperactivity disorder (ADHD). However, the association between ADHD and periodontitis is still unclear.

Methods: In all, 16,211 adolescents with ADHD and 162,110 age- and sex-matched controls participated in the study between 2001 and 2011. To identify the occurrence of periodontitis, the participants were followed up till the end of 2011. Confounding factors, including smoking, diabetes, and depressive disorder, were assessed and adjusted in the Cox regression models.

Results: Adolescents with ADHD (HR: 2.29) were more likely to develop periodontitis later in life than controls. We additionally observed the beneficial effect of atomoxetine (HR: 0.42) on the periodontitis risk among adolescents with ADHD. However, this finding should be interpreted cautiously given the small sample (n = 290) of children taking atomoxetine in the present study.

Conclusions: ADHD is an independent risk factor for subsequent periodontitis development. Oral health should be closely monitored in adolescents with ADHD. Future investigation of the shared pathomechanisms between periodontitis and ADHD is warranted.

Objective: This study aims to investigate the impact of positive illusory bias (PIB) on the relationship between ADHD symptoms and functioning in college students, with a focus on gender differences.

Method: The sample consisted of 195 college students, including 148 with ADHD and 47 without ADHD. Measures of ADHD symptomatology, life satisfaction, affect, gender identity, and impairment were collected, along with cumulative grade point average.

Results: ADHD symptomatology was inversely linked to subjective well-being, with PIB acting as a significant moderator. Functional impairment was predicted by ADHD symptoms and subjective well-being, while social impairment and academic functioning were predicted by PIB and well-being. Significant gender differences were found, particularly in the interaction between PIB and ADHD symptoms for non-binary individuals.

Conclusion: This study suggests that PIB is relevant for emerging adults with ADHD enrolled in higher education. Subjective well-being and PIB act as buffers against the detrimental functional and social effects of ADHD symptoms in emerging adult college students. The study highlights the importance of considering gender-specific approaches in understanding and supporting the mental health of this population.

Objective: The purpose of this content analysis study was to characterize patterns of research on Black youth with ADHD.

Method: Relevant articles were identified through searching psychology and medical databases and cross-referencing citations in previously published review articles. The 204 empirical articles included in this study (1) were conducted in the United States, (2) had a predominantly child or adolescent sample, (3) had more than 80% Black youth/families in the study sample and/or conducted separate analyses for Black youth/families, and (4) examined ADHD symptoms or diagnoses. Articles were categorized into five primary content areas: Assessment, Treatment, Perceptions, Prevalence, and Associated Correlates. Journal characteristics, sample characteristics, and methodological characteristics are presented across these content areas.

Results: Findings show a relatively low representation of Black youth with ADHD in the literature, with most studies using race comparative approaches and secondary data analyses, and many being published in medical journals.

Conclusion: Based on these results, changes are recommended both at the individual study and broader systems levels (e.g., funding agencies). More research, funding, and publications centering Black youth with ADHD are vital to understanding and correcting long-standing health disparities for this community.