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Systematic Review and Meta-Analysis: Do White Noise or Pink Noise Help With Task Performance in Youth With Attention-Deficit/Hyperactivity Disorder or With Elevated Attention Problems? 系统回顾和元分析:白噪声和粉红噪声对注意力缺陷/多动障碍患者的注意力有帮助吗?
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2023.12.014

Objective

Public interest in the potential benefits of white, pink, and brown noise for attention-deficit/hyperactivity disorder (ADHD) has recently mushroomed. White noise contains all frequencies of noise and sounds like static; pink or brown noise has more power in the lower frequencies and may sound, respectively, like rain or a waterfall. This meta-analysis evaluated effects on laboratory tasks in individuals with ADHD or elevated ADHD symptoms.

Method

Eligible studies reported on participants with diagnosis of ADHD or elevated symptoms of ADHD who were assessed in a randomized trial using laboratory tasks intended to measure aspects of attention or academic work involving attention or executive function while exposed to white, pink, and brown noise and compared with a low/no noise condition. Two authors independently reviewed and screened studies for eligibility. A random-effects meta-analysis was conducted with preplanned moderator analyses of age, diagnostic status, and task type. Publication bias was evaluated. The GRADE tool was used to assess certainty of the evidence. Sensitivity analyses were conducted to evaluate robustness.

Results

Studies of children and college-age young adults with ADHD or ADHD symptoms (k = 13, N = 335) yielded a small but statistically significant benefit of white and pink noise on task performance (g = 0.249, 95% CI [0.135, 0.363], p < .0001). No studies of brown noise were identified. Heterogeneity was minimal, and moderators were nonsignificant; results survived sensitivity tests, and no publication bias was identified. In non-ADHD comparison groups (k = 11, N = 335), white and pink noise had a negative effect (g = −0.212, 95% CI [−0.355, −0.069], p = .0036).

Conclusion

White and pink noise provide a small benefit on laboratory attention tasks for individuals with ADHD or high ADHD symptoms, but not for non-ADHD individuals. This article addresses theoretical implications, cautions, risks, and limitations.

Plain language summary

Public interest in the potential benefits of white, pink, and brown noise exposure for enhancing task performance for individuals with attention-deficit/hyperactivity disorder (ADHD) has increased substantially. This systematic review and meta-analysis included 13 studies with 335 participants and found that white/pink noise improved cognitive performance for children and young adults with ADHD or significant ADHD symptoms. In contrast, white/pink noise impaired cognitive performance for individuals without ADHD. Positive effects of noise were small, but these results point to a possible low-cost, low-risk intervention that may benefit youth with ADHD. Additional studies are needed to confirm effects and identify safe and appropriate decibel levels. The potential detrimental effects for individuals without ADHD also requires furth

目的:最近,公众对白噪音/粉红噪音/棕色噪音治疗注意力缺陷/多动症(ADHD)的潜在益处产生了浓厚的兴趣。白噪声包含所有频率的噪声,听起来像静电;粉红和棕色噪声的低频功率更大,听起来可能分别像雨声或瀑布声。这项荟萃分析评估了这些噪音对患有多动症或多动症症状加重的人完成实验室任务的影响:符合条件的研究报告了诊断为多动症或多动症状加重的参与者的情况,这些参与者在随机试验中接受了实验室任务评估,这些任务旨在测量暴露于白色/粉色/棕色噪声中的注意力或涉及注意力或执行功能的学术工作的各个方面,并与低噪声/无噪声条件进行了比较。两位作者独立审查并筛选了符合条件的研究。进行了随机效应荟萃分析,并对年龄、诊断状况和任务类型进行了预先计划的调节分析。对发表偏倚进行了评估。使用 GRADE 工具评估证据的确定性。进行了敏感性分析以评估稳健性:对有多动症/多动症症状的儿童和大学适龄青年进行的研究(k=13,N=335)显示,白色/粉色噪音对任务表现有微小但具有统计学意义的益处(g=0.249;95% CI=0.135,0.363;p结论:白色/粉色噪音对任务表现有微小但具有统计学意义的益处(g=0.249;95% CI=0.135,0.363;p):白色/粉红色噪音对患有多动症或有严重多动症症状的人的实验室注意力任务有微小的益处,但对非多动症患者没有益处。讨论涉及理论意义、注意事项、风险和局限性。
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引用次数: 0
Scoping Review: Transdiagnostic Measurement of Impulsivity Domains in Youth Using the UPPS Impulsive Behavior Scales 范围审查:使用 UPPS 冲动行为量表对青少年冲动行为进行跨诊断测量。
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2024.03.011

Objective

Impulsivity contributes to many clinically relevant behaviors impacting youth. A scoping review was conducted to characterize existing research using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking (UPPS) Impulsive Behavior Scales in youth populations, to review the psychometric and validity data of UPPS, and to summarize findings related to sex/gender and diagnostic populations of youth.

Method

PubMed, Embase, and PsycNET databases were searched from January 1, 2001 (original UPPS publication) through October 2, 2022, according to PRISMA extension for Scoping Reviews guidelines. Articles were reviewed for inclusion/exclusion by 2 authors. Original research articles in English using any UPPS version or subscale in persons aged ≤21 years were included.

Results

Inclusion criteria were met by 45 articles, with low bias and moderate-to-high quality. Most were cross-sectional studies; studies investigated diverse community and clinical samples. The UPPS demonstrated consistent factor structure, good reliability, and good external validity with other measures of impulsive behaviors and conditions associated with impaired impulse control. Some studies observed differences in UPPS domain scores between sex/gender groups or differential patterns in relationships between UPPS domains and clinical variables. UPPS subscale scores often differed in youth with attention-deficit/hyperactivity disorder, conduct disorders, substance use, and excess weight/obesity compared with control youth. UPPS domains commonly had interactions with sex/gender, sociodemographic, and diagnosis-related variables.

Conclusion

The current literature suggests that the UPPS has utility in measuring distinct components of impulsivity in clinical and nonclinical populations of youth. Specificity in discriminating diagnostic groups and predicting risk currently remains uncertain. Further research is needed to integrate UPPS measures with experimental models and additional neurobiological methods and to assess longitudinal developmental trajectories.

Plain language summary

Impulsivity contributes to many clinically relevant behaviors and mental health disorders that impact youth. The Urgency, Premeditation, Perseverance, Sensation Seeking (UPPS) Impulsive Behavior Scale has been increasingly used in research to measure deficits in impulse control. In this scoping review the authors examined 45 studies that used versions of the UPPS to measure different domains of impulsivity in youth aged 21 years and younger. The authors found evidence in the literature for the validity and reliability of the UPPS and its variants in measuring impulsivity in youth. Certain patterns of UPPS subscale scores corresponded with clinical behaviors and diagnoses including attention-deficit/hyperactivity disorder (ADHD), conduct disorder, substance use, and

目的:冲动是影响青少年的许多临床相关行为的原因之一。我们进行了一项范围综述,以描述在青少年群体中使用紧迫感、预谋(缺乏)、毅力(缺乏)、感觉寻求(UPPS)冲动行为量表(UPPS)进行的现有研究的特点;综述其心理测量学和有效性数据;并总结与青少年的性别和诊断人群相关的研究结果:根据PRISMA-ScR指南,对PubMed、Embase和PsycNET数据库从2001年1月1日(UPPS最初出版时间)到2022年10月2日进行了检索。由两位作者对文章的纳入/排除进行审查。我们收录了使用任何 UPPS 版本或分量表的 21 岁以下人群的英文原创研究文章:45篇文章符合纳入标准,偏倚较低,质量为中上水平。大多数文章为横断面文章;研究调查了不同的社区和临床样本。UPPS与其他测量冲动行为和与冲动控制受损相关的情况的方法具有一致的因子结构、良好的可靠性和良好的外部有效性。一些研究发现,不同性别群体的UPPS领域得分存在差异,或UPPS领域与临床变量之间的关系存在不同模式。与对照组青少年相比,患有注意力缺陷/多动障碍、行为障碍、药物使用和超重/肥胖症的青少年的UPPS分量表得分往往有所不同。UPPS领域通常与性/性别、社会人口学和诊断相关变量存在相互作用:目前的文献表明,UPPS 可用于测量临床和非临床青少年群体中冲动性的不同组成部分。但在区分诊断群体和预测风险方面的特异性目前仍不确定。还需要进一步研究将UPPS测量方法与实验模型和其他神经生物学方法相结合,并对纵向发展轨迹进行评估。
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引用次数: 0
Child and Youth Artwork 儿童和青少年艺术作品
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/S0890-8567(24)00273-9
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引用次数: 0
Editorial Board Page 编辑委员会页面
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/S0890-8567(24)00270-3
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引用次数: 0
Interpersonal Mechanisms Between Child Maltreatment Timing and Young Adult Internalizing and Externalizing Symptomatology 儿童虐待时间与青少年内化和外化症状之间的人际关系机制
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2023.12.008

Objective

Children who experience maltreatment are prone to exhibit interpersonal deficits and lack secure attachment, which can lead to internalizing and externalizing symptomatology. This study investigated timing and chronicity of maltreatment and its impacts on psychopathology outcomes in young adulthood. Two interpersonal mediators were examined: problems with peers and childhood attachment security.

Method

Children with and without maltreatment exposure were recruited to take part in a 1-week research summer camp (N = 697; mean [SD] age = 11.29 [0.97] years; 71.3% Black or African American; 50.5% male). Participants were recontacted in young adulthood to complete a second wave of assessments (n = 427; mean [SD] age = 19.67 [1.16] years; 78.0% Black or African American; 48.9% male). Structural equation modeling was used to estimate indirect effects from child maltreatment timing to young adult internalizing and externalizing symptomatology via childhood attachment security and peer problems.

Results

Findings highlighted the detrimental impact of chronic maltreatment, which was associated with higher levels of peer problems (β = .24, p < .001) and less secure attachment (β = −.13, p < .01) in childhood. Also, lower attachment quality in childhood mediated the association between chronic maltreatment and self-reported internalizing (a × b = 0.02, p < .05) and externalizing symptomatology (a × b = 0.02, p < .05). Additionally, childhood peer problems mediated the association between chronic maltreatment and caregiver-reported internalizing problems (a × b = 0.04, p < .05).

Conclusion

Chronic maltreatment is particularly harmful for interpersonal outcomes of children. Mediation findings differed by who reported on psychopathology, showing the importance of considering multireporter measures of psychopathology.

Plain language summary

Child maltreatment is an interpersonal stressor that may impact developmental outcomes throughout a youth’s life. In this study of 697 children who participated in a 1-week research summer camp and were contacted in young adulthood, the authors found that chronic maltreatment significantly increased the risk of difficulties in forming secure attachments as well as having problems with peers during childhood. In turn, these challenges were linked to emotional and behavioral symptomology in young adulthood. These findings emphasize the need to support children facing chronic maltreatment to improve their long-term mental health.

目的遭受虐待的儿童容易表现出人际交往障碍和缺乏安全依恋,从而导致内化和外化症状。本研究调查了虐待的时间和长期性及其对青少年成年期精神病理学结果的影响。我们研究了两个人际中介因素:与同伴相处的问题和童年依恋安全感。方法招募曾受虐待和未受虐待的儿童参加为期一周的研究夏令营(N = 697;Mage = 11.29 [SD = .97];71.3%为黑人或非裔美国人;50.5%为男性)。我们在参与者成年后再次与他们联系,让他们完成第二轮评估(人数 = 427,平均年龄 = 19.67 [SD = 1.16];78.0% 为黑人或非裔美国人;48.9% 为男性)。我们使用结构方程模型估算了儿童受虐待时间通过童年依恋安全感和同伴问题对青年成人内化和外化症状的间接影响。结果发现,长期虐待的有害影响与童年时期同伴问题水平较高(β = .24,p < .001)和依恋安全感较低(β = -.13,p < .01)有关。我们还发现,童年时期较低的依恋质量对长期虐待与自我报告的内化症状(α*β = .02,p < .05)和外化症状(α*β = .02,p < .05)之间的关联起到了中介作用。此外,童年同伴问题对长期虐待与照顾者报告的内化问题(α*β = .04,p <.05)之间的关联起着中介作用。不同的心理病理学报告者得出的调解结果也不尽相同,这说明了考虑多报告者心理病理学测量方法的重要性。
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引用次数: 0
Reimagining Narrative Approaches Through Comics for Systems-Involved Youth 通过漫画重新想象系统参与青年的叙事方法
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2023.11.006
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引用次数: 0
The Impact of Childhood Mental Health and Substance Use on Methylation Aging Into Adulthood 童年心理健康和药物使用对成年期甲基化的影响
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2023.10.014

Objective

To test whether childhood mental health symptoms, substance use, and early adversity accelerate the rate of DNA methylation (DNAm) aging from adolescence to adulthood.

Method

DNAm was assayed from blood samples in 381 participants in both adolescence (mean [SD] age = 13.9 [1.6] years) and adulthood (mean [SD] age = 25.9 [2.7] years). Structured diagnostic interviews were completed with participants and their parents at multiple childhood observations (1,950 total) to assess symptoms of common mental health disorders (attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, anxiety, and depression) and common types of substance use (alcohol, cannabis, nicotine) and early adversities.

Results

Neither childhood mental health symptoms nor substance use variables were associated with DNAm aging cross-sectionally. In contrast, the following mental health symptoms and substance variables were associated with accelerated DNAm aging from adolescence to adulthood: depressive symptoms (b = 0.314, SE = 0.127, p = .014), internalizing symptoms (b = 0.108, SE = 0.049, p = .029), weekly cannabis use (b =1.665, SE = 0.591, p = .005), and years of weekly cannabis use (b = 0.718, SE = 0.283, p = .012). In models testing all individual variables simultaneously, the combined effect of the variables was equivalent to a potential difference of 3.17 to 3.76 years in DNAm aging. A final model tested a variable assessing cumulative exposure to mental health symptoms, substance use, and early adversities. This cumulative variable was strongly associated with accelerated aging (b = 0.126, SE = 0.044, p = .005).

Conclusion

Mental health symptoms and substance use accelerated DNAm aging into adulthood in a manner consistent with a shared risk mechanism.

Plain language summary

Using data from 381 participants in the Great Smoky Mountains Study, the authors examined whether childhood mental health symptoms, substance use, and early adversity accelerate biological aging, as measured by DNA methylation age, from adolescence to adulthood. Depressive symptoms and cannabis use were found to significantly accelerate biological aging. Models that tested the combined effect of mental health symptoms, substance use, and early adversity demonstrated that there was a shared effect across these types of childhood problems on accelerated aging.

方法 381 名参与者分别在青春期(平均年龄 13.9 岁;SD 1.6 岁)和成年期(平均年龄 25.9 岁;SD 2.7 岁)进行了血液 DNAm 检测。对参与者及其父母进行了多次儿童期观察(共 1,950 次),并完成了结构化诊断访谈,以评估常见心理健康障碍症状(多动症、注意力缺陷障碍、抑郁症、焦虑症和抑郁症)以及常见药物使用类型(酒精、大麻、尼古丁)和早期逆境。相反,以下心理健康症状和药物变量与 DNAm 从青春期到成年期的加速老化有关:抑郁症状(b [SE] = 0.314 [0.127],P = .014)、内化症状(b [SE] = 0.108 [0.049],P = .029)、每周使用大麻(b [SE] = 1.665 [0.591],P = .005)和每周使用大麻的年数(b [SE] = 0.718 [0.283],P = .012)。在同时测试所有单个变量的模型中,这些变量的综合效应相当于 DNAm 老化可能相差 3.17 至 3.76 年。最后一个模型测试了一个评估精神健康症状、药物使用和早期逆境累积暴露的变量。这一累积变量与加速衰老密切相关(b [SE] =0.126 [0.044],P = .005)。
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引用次数: 0
Editorial: Chronicity of Maltreatment and the Importance of Attachment and Peer Relationships on Youth Mental Health Trajectory 社论:虐待的长期性以及依恋和同伴关系对青少年心理健康轨迹的重要性
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2024.01.005
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引用次数: 0
Study Preregistration: Testing a Digital Suicide Risk Reduction Platform for Adolescents: A Pragmatic Randomized Controlled Trial 研究预注册:测试针对青少年的降低自杀风险数字平台:实用随机对照试验
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2024.03.012
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引用次数: 0
Lessons Learned From Magna-Tiles 从 Magna-Tiles 公司吸取的经验教训。
IF 9.2 1区 医学 Q1 PEDIATRICS Pub Date : 2024-08-01 DOI: 10.1016/j.jaac.2024.04.006
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引用次数: 0
期刊
Journal of the American Academy of Child and Adolescent Psychiatry
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