Journal of Attention Disorders最新文献

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.

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: 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.

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.

Objective: This study investigates the effectiveness of Cognitive Behavioral Therapy (CBT) for adolescents with ADHD, while focusing on gender differences and comorbid internalizing symptoms.

Method: A quantitative secondary data analysis was performed on 200 adolescents aged 12 to 18 years who participated in randomized control trials in either the Netherlands or Norway.

Results: Overall, CBT significantly reduced ADHD symptoms from pretest to posttest on parent measures; however, treatment response varied based on gender, internalizing symptoms, and treatment formats. Girls with elevated depression showed significantly smaller reductions in ADHD symptoms compared to boys with similar depressive profiles (p = .02), even after controlling for baseline ADHD severity. Effect size analyses revealed that girls benefited from both CBT delivery formats, but symptom improvement was nearly twice as large in individual CBT (d = 0.90, large effect) compared to group CBT (d = 0.49, moderate effect).

Conclusion: These findings suggest that depression may impact treatment response among girls, and that individual CBT may offer enhanced benefits for adolescent girls with ADHD.

Objective: While individual nutrients have shown effects on inflammatory mechanisms, the effects of multinutrients (vitamins + minerals, antioxidants, and amino acids) on inflammation are unknown. We investigated whether 8 weeks of multinutrient supplementation, in a randomized controlled trial of 83 children with ADHD, would alter immune factors compared to placebo.

Methods: Multiplex technology was used to measure 25 immune factors in blood samples collected at baseline and week 8. Immune factors were compared between multinutrient and placebo groups using the Mann-Whitney test. Linear mixed effects models evaluated immune factor change over time. To understand the functional relevance of the immune factors affected by multinutrient supplementation, pathway analysis was performed using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) v6.7 Bioinformatics Resources.

Results: Interleukin (IL)-5 and IL-13 levels differed following multinutrient supplementation versus placebo (p = .005 and .03, respectively). IL-5 decreased by 1.3% in the multinutrient group (95% CI [-8.6%, 6.7%]) and increased by 17.5% in the placebo group (95% CI [6.9%, 29.2%]). IL-13 decreased by 11.4% in the multinutrient group (95% CI [-18.2%, -4.0%]), compared to a 2.4% increase in the placebo group (95% CI [-7.2%, 13.1%]). When comparing immune factors between treatment responders versus non-responders in the multinutrient group, there was a 4.3% increase in IL-15 in multinutrient responders (95% CI [-6.8%, 16.8%]) and a 14.3% decrease in non-responders (p = .03, 95% CI [-24.9%, -2.4%]). Pathway analysis identified T helper type 2 (Th2) signaling pathways affected by multinutrient supplementation, including IL-17 and cytokine-cytokine receptor interaction pathways.

Conclusion: Th2 immune factors may be influenced by multinutrient supplementation and associated with behavioral improvements in ADHD.

Objective: The American Academy of Pediatrics (AAP) recommends behavioral therapy as first-line evidence-based treatment for young children with ADHD, and in combination with medications for children ages 6 years and older. However, a significant percentage of young children are receiving medication treatment for ADHD rather than behavioral treatment. There is limited research capturing parent experiences of barriers to implementing behavioral health services for young children with ADHD diagnoses. This paper seeks to fill this gap by exploring these perceived barriers among parents of children diagnosed with ADHD.

Method: Parents of children with ADHD diagnoses (N = 29) were invited to participate in four focus groups to discuss their experiences with accessing treatment for their child. Focus group participants were recruited from one Southeast city through an ADHD parental support group and nationally from parents attending a conference on ADHD.

Results: Three themes emerged as perceived barriers that impact ADHD treatment. Parents reported barriers that can be conceptualized as (1) misconceptions and stigma; (2) availability of financial and time-related resources; and (3) treatment messaging and provider coordination. These barriers may be more pronounced for parents of young children with ADHD living in the Southeast.

Conclusion: Parent responses about perceived barriers in this study suggest a need for better coordinated care of ADHD across places of service, providers, and families. These findings may inform future efforts to improve access to and utilization of evidence-based treatments for ADHD in the Southeast and nationwide.