Journal of Attention Disorders最新文献

Objective: ADHD can impair children's functioning. Socioeconomic and sociodemographic factors present barriers to treatment access and lead to disparate outcomes in children with ADHD. The purpose of this study was to describe trajectories of functional outcomes and ADHD symptom counts across 3 years and explore the moderating effects of income and race/ethnicity on these trajectories among U.S. children with ADHD.

Method: This longitudinal study of children currently and/or previously meeting diagnostic criteria for ADHD (N = 1,587, age = 9-10 years at baseline) used data from the Adolescent Brain Cognitive Development (ABCD) Study^®. Outcomes were child-reported functional outcome measures (family conflict, prosocial behavior, and school experiences) and parent-reported inattentive and hyperactive symptom counts across 3 years. Multi-level, mixed-effects models for longitudinal data were used to characterize each outcome trajectory and examine the moderating effects of baseline household income and race/ethnicity.

Results: The sample was 68% male and 54% White, with 53% meeting diagnostic criteria for past-only ADHD, 12% current-only ADHD, and 35% both past and current ADHD. Significant changes in family conflict, school experiences, inattentive symptom counts, and hyperactive symptom counts were demonstrated across 3 years (trajectories, p < .05). Income significantly moderated prosocial behavior trajectories, while race/ethnicity significantly moderated family conflict and prosocial behavior trajectories (time interaction, p < .05).

Conclusions: The findings suggest that factors related to income and race/ethnicity influence trajectories of change in family conflict and prosocial behavior outcomes in children with a history of ADHD. Future studies should explore these disparities and identify targets for intervention, such as increased access to diagnosis and treatment for individuals at risk of poorer functional outcomes.

ObjectiveChildren and adolescents frequently struggle with social skills performance in academic settings, which can negatively impact quality of life. As such, social skills training is frequently recommended; however, the effectiveness of school-based social skills training has not been synthesized. As such, the purpose of the current study was to evaluate the empirical evidence pertaining to both stand-alone and multimodal school-based social skills programs for students with ADHD, and to assess the effects of potential moderating variables.

Method: A systematic review and meta-analysis was conducted of studies between the years of 1975 and 2023 following the recommendations of the Cochrane Foundation and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).

Results: Seventeen studies, single-case, within group, and between-group designs met the established inclusion criteria, with 10 included in the meta-analysis. The findings revealed small to large effects; however, the overall meta-analytic effect size was negligible (ES = 0.09). The differences in social skills approaches, intensity, parent involvement, and setting did not moderate the effects.

Conclusion: These findings underscore the necessity for ongoing exploration and refinement of social skills interventions tailored for youth with ADHD.

Objective: The objective was to determine the differential validity of a cognitive disengagement syndrome-only (CDS-only) group from ADHD-inattentive presentation-only (IN-only), ADHD-hyperactive-impulsive presentation-only (HI-only), and ADHD-combined presentation (C-only) groups within childhood (ages 5-10) and adolescence (ages 11-16).

Methods: Parents of a nationally representative sample of 5,525 Spanish youth (ages 5-16, 56.1% boys) completed measures of CDS, ADHD-inattention (IN), and ADHD-hyperactivity/impulsivity (HI) and other measures. Scores greater/less than the top 5% on CDS, IN, and HI were used to create: (1) control, (2) CDS-only, (3) ADHD-IN-only, (4) ADHD-HI-only, (5) ADHD-C-only, (6) CDS + ADHD-IN, (7) CDS + ADHD-HI, and (8) CDS + ADHD-C groups within childhood and adolescence.

Results: Within childhood, the CDS-only group had higher scores than the three ADHD presentations on anxiety, depression, somatization, daytime sleep-related impairment, nighttime sleep disturbance, social impairment, and peer withdrawal, whereas CDS-only, ADHD-IN-only, and ADHD-HI-only groups did not differ on oppositional defiant disorder (ODD) and academic impairment (ADHD-C-only higher). Within adolescence, the CDS-only group again had higher scores than the three ADHD presentations on somatization and daytime sleep-related impairment but was now lower than the three ADHD presentations on ODD as well as lower on academic impairment than the ADHD-IN-only and ADHD-C-only groups. Within adolescence, the CDS-only group and the three ADHD presentations did not differ on depression, social impairment, or peer withdrawal.

Conclusion: The CDS-only group had strong differential validity from ADHD-IN-only, ADHD-HI-only, and ADHD-C-only groups within childhood with less striking differences in adolescence. In addition to more studies with adolescents, etiological models with multi-informant longitudinal data are needed to better understand the differences in CDS and ADHD dimensions and their changes across development.

Objective: This scoping review aimed to examine the application of eye-tracking technology in children with Attention-Deficit/Hyperactivity Disorder (ADHD), focusing on the scientific fields involved, methodologies employed, research goals, and outcomes related to its effectiveness.

Method: Following PRISMA guidelines for Scoping Reviews, a total of 22 studies using eye-tracking with children diagnosed with ADHD were identified and analyzed. Data were extracted regarding study aims, methodological approaches, disciplinary origins, and key findings.

Results: The majority of studies originated from neuroscience and psychiatry, with contributions from artificial intelligence, machine learning, virtual reality, and biomedical engineering. Eye-tracking technology was used for three main purposes: (1) identification and diagnosis of ADHD, (2) investigation of cognitive and behavioral mechanisms-particularly attention and inhibitory control, and (3) as an intervention tool to improve cognitive functions. Findings indicated that eye-tracking, especially when integrated with virtual reality or machine learning, may support efficient ADHD diagnosis. Moreover, studies reported that distinct eye movement patterns are associated with attention deficits, inhibitory control issues, impaired working memory, and challenges in emotional and social processing. Interventions using eye-tracking demonstrated potential in training attention control and motor coordination.

Conclusion: Eye-tracking technology holds promise as both a diagnostic and interventional tool for children with ADHD. Future research should address methodological limitations, explore long-term effectiveness, and further investigate multimodal integration with emerging technologies.

Objective: Previous studies indicate that national traumatic events, particularly terror attacks, have a broad impact on the general population, including individuals not directly exposed. However, research on how such events affect inattention and hyperactivity/impulsivity symptoms in individuals with ADHD remains limited.

Method: This study examined the impact of the October 7 terror attack in Israel on ADHD-related symptoms. Young adults with and without ADHD (43 ADHD and 42 control) completed assessments of current and childhood ADHD symptoms, as well as anxiety, at two time-points: before and after the national traumatic event. Participants also reported their level of exposure to the October 7 attack and the subsequent war.

Results: The control group showed a substantial increase in inattention and hyperactivity/impulsivity symptoms after the attack, whereas the ADHD group exhibited no such increase and instead showed a slight reduction in symptom severity. Changes in symptoms in both groups were not influenced by direct exposure to an immediate threat. The increase in symptom severity tended to decline over time and was positively correlated with heightened anxiety symptoms.

Conclusion: These results suggest that national traumatic events can temporarily increase inattention and hyperactivity/impulsivity symptoms among young adults without an ADHD diagnosis, even if they were not directly exposed to the events. This increase tends to return to baseline over time. Conversely, individuals diagnosed with ADHD did not experience a worsening of symptoms and instead showed a slight reduction in severity, particularly in inattention, following the traumatic event. Future research should further explore the functional capabilities of individuals with ADHD under acute stress to deepen the understanding of this relationship.

Objective: Investigate whether patterns of heart rate variability (indexed via respiratory sinus arrhythmia) and visual attention at 12 to 18 months of age predict elevated ADHD symptoms, autism, or neither during the preschool period.

Method: Ninety infants 12 to 18 months of age (M = 17.27, SD = 1.93; 36 females; 82.2% non-Hispanic) participated in a split-screen eye-tracking task of dynamic social and non-social moving objects. Respiratory sinus arrhythmia was derived from heart rate data collected at baseline and during the task condition. Between 24 and 65 months of age (M = 38.22, SD = 11.14), participants were evaluated and classified into one of three outcome groups: ADHD Concerns (n = 21), Autism (n = 12), or Comparison (i.e., non-Autism/non-ADHD Concerns; n = 57).

Results: The ADHD Concerns group exhibited significantly less whole-screen looking time (t(76) = -2.98, p = .004, d = 0.82) and spent a significantly lower proportion of time attending to the social portion of the stimulus (t(76) = -2.53, p = .01, d = 0.67) than the Comparison group. Respiratory sinus arrhythmia reactivity moderated the association between proportion of time spent looking at the social portion of the stimulus in infancy and ADHD symptoms during the preschool period (b = 0.004, 95% CI [0.0001, 0.01], t(89) = 2.11, p = .04), such that greater quantity/intensity of ADHD symptoms was associated with a smaller proportion of look time to the social portion of the stimulus for infants engaging in HRV withdrawal, but not HRV augmentation. Hypotheses focused on autism were not supported.

Conclusions: Infants demonstrate distinct patterns of visual attention predictive of elevated ADHD symptoms in the preschool period. Heart rate variability may also demonstrate predictive utility in the context of early ADHD when examined in relation to social attention, but not independently.

Objective: The current study aimed to elucidate characteristics of co-occurring ADHD and anxiety in a community-based sample of children. Previous work has highlighted the prevalence and associated impairment of each condition alone, but less research has focused on the co-occurrence of these disorders.

Method: The present study first sought to examine the prevalence of this co-occurrence in a sample of 2,257 school-age children. The study also compared academic, social, and adaptive impairment among children with ADHD alone, anxiety alone, both ADHD and anxiety, or neither condition. Lastly, the study explored sex differences in the prevalence of co-occurring ADHD and anxiety and their associated impairment.

Results: Results supported previous findings surrounding prevalence of the co-occurrence, as children with ADHD were over twice as likely to exhibit elevated anxiety than children without ADHD. While ADHD was more common in boys, among all children with ADHD more girls displayed co-occurring anxiety. Both ADHD and anxiety were associated with impairment in nearly all domains of functioning, but children with both conditions broadly displayed the most functional impairment.

Conclusion: Results of the current study underscore the clinical relevance of the co-occurrence between ADHD and anxiety in children and suggest that future research is warranted to further investigate this phenomenon.

Objective: Accumulating evidence indicates high rates of major depressive disorder (MDD) in children and adolescents with ADHD. This systematic review and meta-analysis aimed to examine the rate of depression in children and adolescents with ADHD who are without intellectual disability (ID).

Method: A comprehensive search of six databases identified 20,745 studies. After screening based on inclusion and exclusion criteria, 24 studies were retained. A meta-analysis estimated the pooled depression rate in this population, and subgroup analyses examined differences based on sex, pubertal status, ADHD medication use, recruitment settings, depression assessment tools, informants, and risk of bias rating. Depression rates in children and adolescents with ADHD were compared with neurotypical peers in the retained case-control studies.

Results: Depression rates in children and adolescents with ADHD across the included studies ranged from 1.7% to 60%, with the meta-analysis estimating a pooled depression rate of 11.31% (95% CI [0.07, 0.16]). Subgroup analyses indicated significant differences by sex, with females showing higher rates than males. Differences were also noted by assessment methods, with the highest rates observed when both questionnaires and interviews were used. While other factors did not significantly affect rates, notable trends were identified and reported in the current article.

Conclusion: Depression is a common co-occurrent psychiatric condition in children and adolescents with ADHD, with rates observed in this review and meta-analysis being higher than those reported for neurotypical children and adolescents. This review underscores the importance of combining multiple assessment methods to capture a comprehensive picture of depression in this population, as well as ensuring balanced demographic representation. This review also suggests that further research should explore the depression developmental patterns in children and adolescents with ADHD and identify whether patterns are similar to the neurotypical population.

Objective: This study aims to determine the prevalence of Attention Deficit Hyperactivity Disorder (ADHD), considering both parents' and teachers' reports and clinical diagnosis, and to examine the relationship between ADHD prevalence and measurement tools, sex, age, and clinical presentations.

Method: This two-phase epidemiological study was conducted on 689 preschoolers aged 3 to 6 years in Kocaeli, Turkey. In the first phase, the Conners Rating Scale-Revised Long Form and the ADHD Rating Scale-IV Preschool Version were administered to teachers after parents. In the second phase, diagnostic evaluation was performed using DSM-5 ADHD criteria for children scoring above the 93rd percentile on any scale, according to either parent or teacher reports.

Results: The prevalence of ADHD was estimated to range from 2% to 12.6%, depending on the measurement method. The prevalence of ADHD diagnosis was 3.3%, with a male-to-female ratio of 1.9:1. The hyperactive-impulsive presentation (1.62%) was more common than the combined presentation (1.32%) and the inattentive presentation (0.44%).

Conclusion: Our findings are consistent with the literature, emphasizing the importance of ADHD screening in preschool children for early diagnosis. Measurement tools used in ADHD screening and parent-teacher responses should be evaluated carefully.

Objective: There is substantial evidence supporting the distinction between cognitive disengagement syndrome (CDS) and attention-deficit/hyperactivity disorder (ADHD), particularly from the inattentive subtype. However, despite proposed etiological and phenomenological similarities, the relationship between CDS and dissociation remains underexplored. This study investigates the relationship between CDS and dissociation and evaluates their combined impact on functional impairment while accounting for comorbid internalizing and externalizing problems in adolescents with ADHD.

Method: A total of 103 adolescents with ADHD (aged 11-17, M = 14.15, SD = 1.71) and their parents participated in this multicenter, cross-sectional study. ADHD diagnosis was established using the Best Estimate Clinical Diagnosis method. Standardized assessments included the Adolescent Dissociative Experiences Scale (A-DES) and the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) for self-report, while parents completed the modified version of Sluggish Cognitive Tempo Scale (SCT-S), Strengths and Difficulties Questionnaire-Parent Form (SDQ-P), and Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P).

Results: No significant correlations were observed between the parent-reported CDS Modified Total and the adolescent-reported A-DES Total score (r = -.024, p = .811), or any of its subdomains, after controlling for anxiety symptoms. Regression analyses revealed that CDS Modified Total (β = .0121, p = .032), and A-DES Absorption & Imaginative Involvement (β = .0085, p = .042) were independent predictors of parent-reported functional impairment along with SDQ-P Emotional Symptoms (β = .0399, p = .040), SDQ-P Conduct Problems (β = .0752, p < .001), RCADS-CV Separation Anxiety Disorder (β = .0245, p = .017). The dominance analysis indicated that the parent-reported SDQ Conduct Problems subscale had the highest average R² contribution (M = 0.1625) while the parent-reported CDS Modified Total demonstrated the lowest average R² contribution across models (M = 0.0498).

Conclusion: The findings suggest that CDS and dissociation represent distinct constructs, at least when rated by different informants, and that both may have significant and independent contributions to functional impairment in adolescents with ADHD. These results highlight the need to consider a broader range of contributing factors beyond symptom severity alone for the effective management of ADHD.