Journal of Attention Disorders最新文献

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.

Objective: Mind-wandering is a common cognitive experience that may be particularly salient in adolescents with attention-deficit/hyperactivity disorder (ADHD). This study aimed to investigate the characteristics and clinical relevance of mind-wandering in this population.

Method: We retrospectively analyzed data from 440 psychiatric outpatients aged 10-19 years (ADHD: n = 137; non-ADHD: n = 303) who visited a university hospital between 2023 and 2025. Mind-wandering was assessed using the Mind-Wandering Questionnaire (MWQ). Group differences in MWQ scores were examined using analysis of covariance, controlling for age, sex, Autism-Spectrum Quotient, and Quick Inventory of Depressive Symptomatology. Additional analyses compared ADHD-only with ADHD plus autism spectrum disorder (ASD) comorbidity, and hierarchical regression was conducted to determine the independent contribution of ADHD to mind-wandering.

Results: Adolescents with ADHD reported significantly higher MWQ scores than those without ADHD (p < .001, Cohen's d = 0.92), and this difference remained significant after covariate adjustment (η² = 0.098). No significant difference was observed between the ADHD-only and ADHD + ASD groups (p = .737). Hierarchical regression confirmed that ADHD independently predicted mind-wandering scores (β = 0.320, p < .001).

Conclusion: Adolescents with ADHD exhibit elevated mind-wandering, which may represent a core attentional characteristic independent of comorbidities or demographic factors. Further research is needed to clarify the mechanisms underlying mind-wandering in ADHD and to evaluate potential interventions aimed at reducing its impact.

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.