Journal of Attention Disorders最新文献

Objective: Previous studies have found that ADHD symptoms often co-occur with aggressive behavior in adolescents, and that reactive aggression is more closely related to ADHD symptoms than proactive aggression. However, the specific co-occurrence patterns of ADHD symptoms and different functions of aggression remain unclear, as does their relationship with parenting practices. This study used a person-centered approach to examine the co-occurrence patterns of ADHD symptoms, reactive aggression, and proactive aggression and their associations with parenting practices.

Method: A total of 1,152 mother-adolescent dyads participated in this study (adolescents: M_age = 14.29; 48.0% girls). Latent profile analysis was conducted to identify adolescent profiles of ADHD, reactive, and proactive aggression, followed by multinomial logistic regression to examine relationships between these profiles and auxiliary variables.

Results: Latent profile analysis identified three patterns of adolescent- and mother-reported ADHD symptoms, reactive aggression, and proactive aggression: low symptom (84.4%), reactive co-occurrence (10.0%), and complete co-occurrence (5.6%). Multinomial logistic regression revealed that adolescents in the complete co-occurrence group had higher rates of corporal punishment, while adolescents in the reactive co-occurrence group exhibited higher rates of verbal hostility.

Conclusion: These findings highlight the importance of distinguishing between reactive and proactive aggression in the context of ADHD and suggest that different co-occurrence patterns may be shaped by distinct parenting practices. Addressing specific parenting behaviors could help mitigate aggression in adolescents with ADHD symptoms.

Objective: This study aimed to assess the impact of exercise on hyperactivity/impulsivity, inhibitory control, and inhibition-related event-related potential (ERP) components in individuals with ADHD.

Method: A systematic search identified relevant studies, and methodological quality was assessed using the Revised Cochrane Risk-of-Bias tool for randomized trials (RoB 2) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I), with data analysis conducted using Stata software.

Results: A total of 36 studies (38 comparisons) were included, comprising 10 acute and 26 chronic exercise interventions. Exercise yielded a small-to-moderate improvement in inhibitory control but showed no significant effects on hyperactivity/impulsivity or inhibition-related N2 and P3 components. Subgroup analyses of inhibitory control revealed significant moderating effects of age (children/adolescents), intervention type (chronic interventions), frequency (three sessions per week), control condition (sedentary or no-intervention groups), and study quality (studies with moderate or high risk of bias).

Conclusion: Exercise enhances inhibitory control in individuals with ADHD, with the effect being especially pronounced in children and adolescents. Chronic interventions and a frequency of three sessions per week appear to be most beneficial. However, it shows no significant effect on hyperactivity/impulsivity or inhibition-related N2 and P3 components. The impact of exercising should not be overestimated.

Objective: To examine whether children with attention-deficit/hyperactivity disorder (ADHD) can produce attentional orienting in response to gaze cues, and to identify which type of attentional orienting is impaired and why.

Method: Two experiments employed a gaze cue-target paradigm using inhibition of return (IOR) as an indicator of exogenous attentional orienting. Experiment 1 used normal upright gaze faces as cues. Experiment 2 used inverted gaze faces as cues.

Results: When normal gaze faces were used as the gaze cue, no IOR effect was observed in children with ADHD (Experiment 1); whereas when inverted gaze faces were used as the gaze cue, the IOR effect was produced in children with ADHD (Experiment 2).

Conclusion: These results indicated that the ability to produce exogenous attentional orienting to the gaze cue is impaired in children with ADHD and that this impairment resulted from their reduced ability to exogenously orient to the intact face. These findings provide new evidence of social cognitive deficits and attentional orienting deficits in children with ADHD, and help provide support for children in educational settings.

Objective: Blood-brain barrier permeability (BBB) has been suggested to be involved in the etiopathogenesis of ADHD. Claudin-5, β-catenin and paxillin are important molecules with different roles in this barrier. Alterations in these molecules may disrupt the neurodevelopmental process by affecting various critical processes in the developing brain. Therefore, this study aimed to evaluate whether the peripheral levels of these molecules differ in children and adolescents with ADHD.

Method: A total of 90 patients with ADHD aged between 8 and 18 years and 60 healthy controls were included in this study. The severity of ADHD symptoms was determined with the Atilla Turgay Scale. Child Anxiety-Depression Scale-Revised was completed to evaluate additional psychiatric problems of the patients. Serum levels of biochemical parameters were measured using enzyme-linked immunosorbent assay kits.

Results: Serum claudin-5 levels were significantly lower and β-catenin levels were significantly higher in the ADHD group compared to the control group. However, there was no significant difference in paxillin serum levels between the groups.

Conclusion: This study suggests that claudin-5 and beta-catenin may play a role in the pathogenesis of ADHD. These proteins may affect the brain by causing a dysregulation in BBB permeability or through other mechanisms.

Objective: Although inattention symptoms have been previously linked to cognitive performance in younger samples, few studies have examined links between ADHD symptoms and cognitive performance for middle aged and older adults.

Methods: In this study, we drew from a nationally representative sample from the Health and Retirement Study (HRS) of ~1,400 middle to older adults (M_age = 66.9, SD = 8.4; 41.4% male; 60.7% White) who completed a set of cognitive measures and an ADHD symptomatology questionnaire in the 2016 Wave of the HRS. A multigroup path model was run by examining the association between self-reported ADHD symptom subscale scores for inattention and hyperactivity/impulsivity as well as self-reported depressive symptoms and cognitive outcomes across three groups: middle age, young-old, and middle-old.

Results: Inattention symptoms were significantly associated with Serial 7s and Immediate Recall, however the constrained model was the best fitting model, suggesting no differences in the associations between self-reported inattention symptoms and cognitive outcomes by age.

Conclusion: These results are consistent with previous work on the links between ADHD symptoms and cognitive performance in younger populations and add to the literature on ADHD in later life. This may have implications for clinicians and practitioners as well as future research on older adults with ADHD.

Background: ADHD is associated with oxidative stress (OS), possibly stemming from deficiencies in essential nutrients. Previous randomized controlled trials (RCTs), including Micronutrients for ADHD in Youth (MADDY), demonstrated improved symptoms in response to treatment with multinutrients compared to placebo. It remains unknown whether multinutrient supplementation influences antioxidant status and OS, and if these factors contributed to improvements observed in children with ADHD in the MADDY RCT.

Objectives: Utilizing samples from the MADDY RCT, (1) compare the change in antioxidant (AO) and OS biomarkers after 8 weeks of multinutrient supplementation vs placebo, and (2) evaluate these biomarkers at baseline, and their change after 8 weeks, as moderators/mediators of treatment response.

Methods: Activity of glutathione peroxidase (GPx) and glutathione reductase (GR) enzymes, plus oxidative stress index (OSI) based on ratio of reactive oxygen metabolites (ROM) to biological antioxidant potential (BAP), were measured in plasma at baseline and week 8. Differences between groups were determined using two-sample t-test or Mann-Whitney U-test. Logistic regression models assessed AO/OS biomarkers for mediation/moderation of treatment response.

Results: Plasma from 77 children (aged 9.9 ± 1.7 years; 71% male) treated with multinutrients (n = 45) or placebo (n = 32) was analyzed. After 8 weeks, ROM decreased with multinutrients and increased with placebo (-14.3 vs. +26.8 Carratelli units, p = .017); but no significant differences in OSI, BAP, GPx, and GR between groups. None of the baseline AO/OS biomarker levels were moderators of treatment response. Eight-week change in both OSI and ROM trended toward mediation of treatment response (OR = 0.00058, 95% CI [0.000, 2.30], p = .078 and OR = 0.985, 95% CI [0.968, 1.002], p = 0.086, respectively) but did not reach significance.

Conclusions: Eight weeks of multinutrient supplementation in children with ADHD reduced ROM without significant change in antioxidant status, suggesting decrease in oxidative stress. Given the preliminary signals associating a decrease in OS with symptom improvement following multinutrient supplementation, future research is warranted to understand OS in ADHD pathogenesis.

Clinical trial registry: NCT03252522.

Background: ADHD is one of the most common mental disorders in children and adolescents. While international research on health service utilization, barriers to care, and treatment satisfaction is growing, evidence from Germany remains limited. This study aimed to examine the utilization of mental health care services in a sample of German children and adolescents with an administrative ADHD diagnosis registered with their health insurance company. Treatment satisfaction, belief in treatment efficacy and factors influencing mental health care utilization were examined.

Methods: As part of the consortium project INTEGRATE-ADHD, data from 4,948 children and adolescents were analyzed. Parents of 7- to 17-year-olds participated in an online survey answering questions about their child's ADHD health care utilization, treatment satisfaction and efficacy, and factors influencing utilization using established instruments. Sociodemographic factors, geographic characteristics, ADHD symptom severity, and parental psychopathology were also assessed. Descriptive analyses and multivariate logistic regressions were conducted.

Results: Approximately 40% of the children and adolescents with an administrative ADHD diagnosis were currently receiving ADHD treatment. The majority of parents (76%) were satisfied with the treatment, and 85% considered the treatment effective. Children with more severe ADHD symptoms had a threefold higher likelihood of receiving treatment, while youths with a migration background were less likely to receive mental health care. The most common reasons for not utilizing mental health care included the treatment having already ended, a lack of available treatment options, long waiting times, a lack of motivation among children, or the inability to continue treatment due to the COVID-19 pandemic.

Conclusions: To overcome the identified barriers in ADHD treatment, we recommend improving access to evidence-based ADHD treatment and expanding its implementation to prevent undertreatment and the associated individual suffering and societal costs.

Objectives: Interest in the role of female hormones in ADHD has grown in recent years and, with an increasing number of women diagnosed with ADHD later in life, it is important hormonal changes across the lifespan are considered. This exploratory study examines the relationships between ADHD status (diagnosis and medication use) and symptoms, and menopause stage (pre/peri/post) and symptoms.

Methods: Employing a cross-sectional approach, we recruited a sample of 656 women aged 45 to 60 years, of which 245 had an existing diagnosis of ADHD. Women completed several questionnaires assessing their ADHD symptoms (Adult Self-Report Scale, ASRS) and menopausal experiences (Women's Health Questionnaire, WHQ; Menopause-Specific Quality of Life Questionnaire, MENQoL; Hot Flush Rating Scale, HFRS; Hot Flush Related Daily Interference Scale, HFDIS).

Results: ANCOVA revealed no significant effects of an ADHD diagnosis or interaction effects between diagnosis and menopause stage after applying an FDR correction. Similarly, when medication was considered (i.e., non-ADHD, ADHD with medication, and ADHD without medication) there were no main effects of group or interaction effects with menopause stage.

Conclusions: These results indicate women with ADHD do not experience greater menopausal complaints than women without at any menopausal stage. However, there were significant correlations between ADHD symptoms and menopausal complaints across all participants but at a group level, these were less prominent in those with ADHD, which could indicate different attribution of symptoms in women with ADHD. Future research should further explore menopause in women with ADHD considering longitudinal designs and qualitative studies to examine potential overlap of symptoms and symptom attribution.

Background: ADHD is the most common neurodevelopmental disorder. While much is known about the functional and academic impacts of ADHD, impacts on long-term health-related quality of life (HRQoL) are less well-documented.

Aims: To explore, in children aged 4 to 17 years, associations between clinical ADHD symptoms and (1) children's HRQoL; (2) whether internalizing or externalizing problems attenuate this association; and (3) factors contributing to this association.

Methods: Data were drawn from the Longitudinal Study of Australian Children at child ages 4 to 17 years (N = 4,194). Clinical ADHD symptoms (e.g., score >8) were measured using the hyperactivity scale from the Strengths and Difficulties Questionnaire (SDQ). Internalizing or externalizing problems were classified as children with scores ≥5 on the Emotional Problems and scores ≥4 on the Conduct Problems scale on the SDQ, respectively. Children's HRQoL was measured using the Pediatric Quality of Life Inventory (PedsQL). Linear mixed models were used, adjusting for child and family factors.

Results: Compared to those with no ADHD symptoms, children with ADHD symptoms had significantly lower HRQoL across all domains from 4 to 17 years (mean difference = 7.65, 95% CI [6.09, 9.19]). Internalizing and externalizing problems slightly attenuated the association between ADHD symptoms and children's HRQoL (mean difference = 4.91, 95% CI [3.40, 6.43]). Being a female or having autism or other medical conditions, or taking ADHD/ADD medication or caregiver having mental health problems was associated with poorer HRQoL while having two or more siblings was associated with better HRQoL.

Conclusion: ADHD clinical symptoms are associated with poorer children's HRQoL from 4 to 17 years. Given that co-occurring medical conditions and poor caregiver mental health are associated with poorer child HRQoL, ADHD treatment needs to identify and address co-occurring conditions and parental mental health.