Journal of Attention Disorders最新文献

Objectives: ADHD is now recognized as a common condition in adulthood, but the evidence supporting a separate characterization of a cognitive profile for ADHD in older adults is scarce. Consequently, the goal of the current study was to conduct a systematic review that helps clarify the cognitive characteristics of ADHD in older individuals.

Method: We conducted a systematic review with narrative synthesis, considering studies on older adults with ADHD and research on cognitive domains involved in adults 50 years old and older with a confirmed diagnosis of ADHD, in three electronic databases (PubMed, Web of Science, and Embase). Ten studies (3 longitudinal and 7 cross-sectional) with clearly separated cognitive data for older adults with ADHD were included in this review.

Results: Results showed an overall worse performance in attention and episodic memory for older adults with ADHD compared to their younger counterparts and older healthy controls. Evidence concerning executive functions was mixed, with some studies showing a worse performance in working memory compared to older healthy controls, but with other studies showing a similar or even better performance than younger adults with ADHD.

Conclusions: A cognitive characterization of ADHD in older adults requires further research to clarify whether it can be considered a separate entity and how to establish a differential diagnosis with other age-related conditions. Moreover, there is a need for internationally agreed common neuropsychological assessment protocols that set boundaries between younger and older adults with ADHD.

Objective: The study aims to examine the contributions of Emilio Mira y López (1896-1964) to the early conceptualization and treatment of what is now known as Attention Deficit Hyperactivity Disorder (ADHD). It seeks to contextualize his ideas within broader historical, pedagogical, and psychiatric developments in Spain and internationally.

Method: A historical-analytical approach was employed, reviewing Mira y López's publications El niño que no aprende (The Child Who Does Not Learn, 1947), as well as related psychiatric and educational literature from the early 20th century. His work was analyzed alongside contributions from contemporaries and predecessors, with a focus on terminology, neurophysiological concepts, and early treatment strategies.

Results: Mira y López described the "unstable child" or "butterfly child" with symptoms that align closely with modern ADHD: impulsivity, distractibility, and lack of sustained attention. He proposed that these children suffer from an imbalance between excitatory and inhibitory brain functions, suggesting early therapeutic interventions including behavioral techniques and opotherapeutic (hormonal) medications. His research emphasized a medical and pedagogical approach to learning difficulties and prefigured ideas found in the emerging field of child psychopharmacology.

Conclusion: Emilio Mira y López's understanding of childhood instability reflected the influence of French and Anglo-American psychiatry and anticipated key elements of today's ADHD frameworks. His physiological model of inhibition mirrors Charles Bradley's "inhibition hypothesis," which led to the use of stimulants for hyperactivity. Mira's early proposals contributed to shaping a more comprehensive, interdisciplinary view of childhood mental health and learning difficulties in Spain and Latin America.

Background: Attention Deficit Hyperactivity Disorder (ADHD) and Specific Learning Difficulties (SLD) are both associated with attentional and cognitive difficulties. This study examined the extent to which the cognitive impairments could be consequences of elevated levels of inattention and hyperactivity/impulsivity.

Method: Secondary analysis was conducted on data from four groups selected from the Centre for Attention, Learning, and Memory, a neurodivergent cohort of children aged 5 to 18 years with a mean age of 9 years : children with ADHD only (n = 70), learning difficulties only (n = 406), ADHD with learning difficulties (n = 128), and a comparison group (n = 166). Covariance analyses examined whether any differences in basic cognitive skills and higher executive functions between the neurodivergent and comparison groups could result from variations in inattention and hyperactivity/impulsivity.

Results: Irrespective of ADHD status, children with learning difficulties had low scores in short-term memory, working memory, sustained attention, processing speed, set sequencing, and set shifting. These cognitive deficits largely persisted when inattention and hyperactivity/impulsivity were covaried. In contrast, the ADHD only group performed at age-appropriate levels on measures of verbal short-term memory, verbal and visuospatial working memory, processing speed, and sustained attention. Their difficulties with set sequencing and visuospatial short-term memory were accounted for by inattention and hyperactivity/impulsivity, whereas their challenges with set shifting were independent of these attentional behaviors.

Conclusions: The results point to distinct neurodevelopmental pathways to cognitive functioning for children with learning difficulties and those with ADHD. The independence of learning-related cognitive skills from levels of inattention and hyperactivity/impulsivity in children with learning difficulties either with or without ADHD suggests they represent the core deficits that underlie their learning difficulties. The limited cognitive challenges of children with ADHD without learning difficulties may be consequences of their elevated levels of attentional behaviors. Understanding the cognitive and learning profiles of children with ADHD and learning difficulties vital for identifying optimal intervention and support strategies that address their individual needs.

Objective: Susceptibility to visual illusions is a consequence of the adaptation of the visual system, however, their perception or lack of it reflects differences in more general, global cognitive processes. Few studies have focussed on the susceptibility of individuals with attention-deficit/hyperactivity disorder (ADHD), even though visual impairment and percept differences have been thoroughly documented.

Method: The present study evaluated 75 children (ages 6.09-12.99 years, 72% male) and 37 teenagers (ages 13-16.95 years, 62% male) with ADHD, and a sex-and-age matched sample of typically developing peers. They were tested with 103 pairs of illusory and control images spanning five illusion types.

Results: We found increased susceptibility to the Müller-Lyer and Kanizsa Subjective Contour and decreased susceptibility to the Ebbinghaus illusion among children with ADHD when compared to typically developing controls. No differences were found for susceptibility to the Simultaneous Contrast and Moving Snake illusions. As for reaction times, we did not find differences between participants with ADHD and their control peers when judging illusions; however, in general participants give answers faster in the illusory trials than in control trials with the same magnitude of difficulties which also confirm the susceptibility of the illusions.

Conclusion: Our findings point to small but important perceptual alterations, such as slightly reduced or delayed top-down or global processing ability in children with ADHD. Further research can focus on how these alterations may be useful to detect developmental alterations and understand perceptual difficulties in children with neuropathology.

The moderate brain arousal (MBA) model posits that individuals with (elevated traits of) ADHD have lower levels of neural noise and that auditory random noise can elicit stochastic resonance (SR) and increase neural noise, which improves their cognitive performance. Indeed, research shows that auditory random noise, such as white noise, improves cognitive performance in individuals with (elevated traits of) ADHD. However, the assumptions regarding neural noise in ADHD and the requirement of SR have been insufficiently examined due to a lack of studies incorporating both a second non-random auditory condition and an index of neural noise. Therefore, 69 neurotypical adults completed the ASRS to assess ADHD traits and underwent eyes-closed resting-state EEG, subdivided into three 2-min blocks: silence, continuous auditory pink noise (a random signal), and a continuous 100 Hz pure tone (a non-random signal). We then analyzed the aperiodic slope of the EEG power spectral density, a proposed direct measure of neural noise. Pink noise affected the aperiodic slope differently based on ADHD traits; specifically, it increased the slope in individuals with elevated ADHD traits, indicating a decrease in neural noise. Crucially, the same effect was observed for the pure tone. These findings challenge the MBA model by demonstrating that both random (pink noise) and non-random (pure tone) signals reduce neural noise in individuals with elevated ADHD traits, contradicting the proposed mechanism of stochastic resonance, as well as the direction of effects suggested by the MBA model. These findings warrant further investigation, also in a clinical ADHD sample.

Objective: It is often argued that executive functioning (EF) tasks and EF questionnaires measure the same construct at different levels of analysis. However, item content on EF questionnaires varies by publisher/rater, indicating a striking lack of consensus on what EF represents when measured via questionnaires. In two separate samples spanning early and middle childhood, and utilizing a multi-method multi-rater approach, we systematically compare the concurrent validity of different questionnaire-based conceptualizations of EF.

Methods: Parents and teachers of children aged 8 to 12 years (N = 226) and 5 to 7 years (N = 152) completed indices marketed as EF on the Behavioral Rating Inventory of Executive Function (BRIEF); Conners' Rating Scale; and the Behavior Assessment System for Children (BASC). Their associations with performance on tasks of working memory (WM) and inhibition were compared against established indices of inattention, impulsivity, and academic underachievement on the same forms.

Results: Across samples, parent and teacher ratings of academic difficulty were most strongly associated with performance, particularly for WM. EF indices were no better (and were sometimes worse) at predicting concurrent EF than established indices of inattention/impulsivity.

Conclusions: Developers of EF scales must either improve the divergent validity of their scales against established indices of attention/impulsivity or improve the convergent validity with tests of EF. Otherwise, the clinical utility of questionnaire-based EF remains questionable. Implications for theory development and research are discussed.

Objective: Proneness to boredom has been reported in ADHD populations; however, no study to date has examined potential mediators of ADHD-related boredom. The current study investigated whether individuals with ADHD traits exhibit higher levels of boredom propensity relative to their peers without ADHD traits and explore if attention control and working memory mediate the relationship between ADHD and proneness to boredom.

Method: Young adults (M_age = 19.1, SD = 1.3) with (n = 31) and without (n = 57) ADHD traits completed self-report measures (i.e., boredom proneness, current ADHD symptoms, and childhood indicators of ADHD) and six counterbalanced performance-based cognitive measures (i.e., three attention control and three working memory tasks).

Results: Young adults with ADHD traits exhibited large magnitude effect size differences in proneness to boredom relative to their peers without ADHD traits (d = 2.09). In addition, proneness to boredom and ADHD trait group status were related to worse performance on attention control and working memory factors. Both attention control and working memory factors partially mediated the relation between ADHD and boredom, accounting for 5.8% and 6.4% of the variance in ADHD-related boredom, respectively.

Conclusion: Executive attention processes related to difficulty controlling attention and using working memory may provide a partial explanation for why individuals with ADHD traits experience boredom.

Objective: Experiences of "auditory hyper-reactivity" and decreased sound tolerance, which can be separated into phenotypes such as hyperacusis and misophonia, are prevalent in autism and ADHD and impact quality of life and wellbeing. Furthermore, atypical patterns of attention regulations-including hyper-focus and inattention-are common in both autism and ADHD. Prior research also suggests sensory hyper-reactivity can cause anxiety, and anxiety can be associated with hyper-vigilance. It is currently unclear whether hyper-focusing on stimuli, having one's attention captured by them, or being hyper-vigilant toward them could lead to sensory hyper-reactivity. Therefore, this study investigates relationships among hyper-focus, inattention, hyper-vigilance, auditory hyper-reactivity, and anxiety.

Method: Four hundred ninety-two adults (122 ADHD-only, 130 autistic-only, 141 autistic + ADHD, and 99 comparison) completed questionnaires indexing hyper-focus, inattention, and various forms of auditory hyper-reactivity; participants also completed a psychoacoustic measure by rating the pleasantness of misophonic trigger sounds.

Result: Per questionnaires, auditory hyper-reactivity was markedly elevated in both autistic and ADHD participants relative to comparison participants (.46 ≤ Cliff's δ ≤ .84), whereas differences between autism and ADHD alone were small (.05 ≤ |Cliff's δ| ≤ .21) and not consistent in sensitivity analyses. Path analysis suggested hyper-vigilance, hyper-focus, and inattention were related to auditory hyper-reactivity, which was related to anxiety, which was related to hyper-vigilance, potentially reflecting a cyclic relationship. However, psychoacoustic misophonia was only modestly related to self-reported misophonia scores (.22 ≤ Spearman's ρ ≤ .31), and contributed little to the auditory hyper-reactivity composite included in the path analysis.

Conclusion: These findings generally support the idea that attention may be connected to many neurodivergent people's auditory hyper-reactivity, but also emphasize the need for improved measurement of sensory experiences.

Purpose: Attention is proposed to consist of three discrete neurofunctional networks, though evidence suggests that two of these - the alerting and cognitive control networks - are interdependent. The neural mechanism(s) underlying this interdependence have not been identified; however, the locus coeruleus - norepinephrine (LC-NE) system may provide a potential explanation for this interaction. Further, both alerting-cognitive control interdependence and LC-NE activity may be altered in autistic individuals, and thus may provide a unique window into the relationship between the LC-NE system and network interdependence. The objective of the current study was to utilize electrophysiological and pupillary indices of LC-NE activity to examine the associations between attentional network interdependence, LC-NE activity, and autism and ADHD traits.

Methods: A total of 77 neurotypical undergraduate students completed two tasks: (1) a resting eye-tracking task to measure pupil diameter (tonic LC activity), and (2) a cued-flanker task to measure cue-related pupil diameter response (cue PDR; phasic LC activity) and attentional network interdependence using behavioral, electrophysiological, and pupillometric indices. Autistic and ADHD traits were measured by self-reported questionnaires.

Results: Consistent with prior reports, our behavioral and electrophysiological results support network interdependence. Phasic LC activity was positively related to alerting-cognitive control interdependence. Finally, the tonic and phasic LC-NE indices were linked to distinct ADHD subscales but not to autistic traits.

Conclusion: These findings expand our understanding of neurofunctional mechanism associated with alerting-cognitive control interdependence and demonstrate that LC-NE activation may be associated with ADHD rather than with autistic traits.

Objective: The aim of this study was to explore neural oscillation features (resting-state + oddball-EROs) of ADHD symptoms in children in a dimensional approach and to construct a multi-metric model combining objective EEG measures and subjective parental ratings to predict children's behavioral performance.

Method: Seventy-seven children (age range: 6-12 years) participated in laboratory assessment. ADHD symptoms were first evaluated using the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), followed by EEG recordings during both resting-state and oddball task conditions. Three parent rating scales were also used to evaluate children's behavioral performance: the ADHD Rating Scale-IV (ADHD RS-IV): Home Version, the Child Behavior Checklist (CBCL), and the Conners' Parent Rating Scales (CPRS).

Results: Seventy-one children with valid IVA-CPT results were included in data analysis. The main results revealed a relationship between poorer attention performance and decreased eye-open alpha1 power in the resting state, reduced N2 delta power in the oddball condition, and elevated non-delta band power in the standard condition of the oddball task. Poorer response control performance was associated with increased eye-closed alpha1 power, as well as increased eye-open alpha2 and beta2 power. Stepwise regression analysis showed that the inattention subscale from parental assessments on the RS-IV, combined with P3 alpha power in the standard condition of the oddball task, was the strongest predictor of children's attention performance.

Conclusion: The current study identified important neural oscillation features of ADHD symptoms in both the resting state and during an oddball task and offers new insights into multi-metric prediction for ADHD assessment and diagnosis.