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Gonda X, Balint S, Rethelyi JM, Dome P. Settling a distracted globe: An overview of psychosocial and psychotherapeutic treatment of attention-deficit/hyperactivity disorder. Eur Neuropsychopharmacol 2024; 83:1-8. [PMID: 38490015 DOI: 10.1016/j.euroneuro.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
While the currently prevailing theory of ADHD postulates a neurobiological background and core deficits of behavioural inhibition and executive functioning as the basis of ADHD symptoms, our current conceptualisation also acknowledges the essential contributory role of psychosocial, ecological, and cognitive factors. Considering the multifactorial background of ADHD, its treatment equally needs to be multifactorial involving, besides pharmacotherapy, skill development and psychotherapy as well, especially if we postulate the increasing contribution of social factors in the background of the increasing burden of ADHD. Pharmacotherapies, including stimulants and non-stimulant ADHD medications applied as first-line treatments have a positive effect on core behavioural symptoms, however, they often do not sufficiently remediate several other symptoms and comorbid disorders, which are consequences of ADHD, especially considering that ADHD persists into adulthood and is present over the whole life span. Furthermore, pharmacological treatment is not sufficient to substitute for the skills needed to manage symptoms and adapt well to the environment. As part of a multimodal treatment approach, psychological therapies for ADHD target, besides core ADHD symptoms, other associated features including emotional dysregulation, personality development, neurocognitive dysfunction, depression, anxiety, and sleep problems. Insufficiently treated ADHD may contribute to psychological and personality developmental problems in children, as well as increased health costs and decreased productivity warranting multimodal treatment to address the areas not sufficiently targeted by ADHD-specific pharmacotherapy.
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Affiliation(s)
- Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary.
| | - Sara Balint
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| | - Janos Miklos Rethelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| | - Peter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary; National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.
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2
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Jong A, Odoi CM, Lau J, J.Hollocks M. Loneliness in Young People with ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 2024; 28:1063-1081. [PMID: 38400533 PMCID: PMC11016212 DOI: 10.1177/10870547241229096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Many studies focus on problematic peer functioning in attention deficit/hyperactivity disorder (ADHD) but loneliness has been studied less. This paper examined (1) The loneliness level differences between young people (below 25 years old) with ADHD and those without ADHD, and (2) The association between loneliness and mental health difficulties in young people with ADHD. Six electronic databases were searched and 20 studies were included. A random effects meta-analysis was carried out in RStudio using the metafor package for the first question, while a narrative synthesis summarized the findings for the second question. The meta-analysis (n = 15) found that young people with ADHD reported significantly higher loneliness than those without ADHD, with a small-to-medium weighted pool effect (Hedges' g = 0.41) and high heterogeneity (I2 = 75.1%). For the second question (n = 8), associations between loneliness and mental health difficulties in ADHD was found (r = 0.05-0.68). Targeted research and interventions on loneliness in young people with ADHD is needed.
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Affiliation(s)
- Angelina Jong
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Clarissa Mary Odoi
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
| | - Jennifer Lau
- Queen Mary University of London Wolfson Institute of Population Health, London, UK
| | - Matthew J.Hollocks
- King’s College London Institute of Psychiatry Psychology & Neuroscience, London, UK
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3
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Camilleri C, Wilson A, Beribisky N, Desrocher M, Williams T, Dlamini N, Westmacott R. Social skill and social withdrawal outcomes in children following pediatric stroke. Child Neuropsychol 2024:1-17. [PMID: 38557290 DOI: 10.1080/09297049.2024.2335107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024]
Abstract
Pediatric stroke can result in long-term impairments across attention, functional communication and motor domains. The current paper utilized parent reports of the Behavioral Assessment System for Children 2nd Edition and the Pediatric Stroke Outcome Measure to examine children's social skills and withdrawal behavior within a pediatric stroke population. Using the Canadian Pediatric Stroke Registry at The Hospital for Sick Children, data were analyzed for 312 children with ischemic stroke. Children with ischemic stroke demonstrated elevated parent-reported social skills problems (observed = 20.51%, expected = 14.00%) and clinically elevated social withdrawal (observed = 11.21%, expected = 2.00%). Attentional problems significantly contributed to reduced social skills, F (3,164) = 30.68, p < 0.01, while attentional problems and neurological impairments accounted for increased withdrawal behavior, F (2, 164) = 7.47, p < 0.01. The presence of a motor impairment was associated with higher social withdrawal compared to individuals with no motor impairment diagnosis, t(307.73) = 2.25, p < .025, d = 0.25, 95% CI [0.42, 6.21]. The current study demonstrates that children with stroke who experience motor impairments, attentional problems, reduced functional communication skills, and neurological impairments can experience deficits in their social skills and withdrawal behavior.
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Affiliation(s)
| | - Alyssia Wilson
- Department of Psychology, York University, Toronto, Canada
| | | | - Mary Desrocher
- Department of Psychology, York University, Toronto, Canada
| | - Tricia Williams
- Department of Psychology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Nomazulu Dlamini
- Department of Psychology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Robyn Westmacott
- Department of Psychology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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4
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Thompson BAD, Gilmore R, Barfoot J, Sakzewski L. A systematic review of the efficacy of group social skills interventions on social functioning and social participation in children with acquired brain injury or cerebral palsy. Child Care Health Dev 2024; 50:e13242. [PMID: 38528324 DOI: 10.1111/cch.13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/15/2023] [Accepted: 02/08/2024] [Indexed: 03/27/2024]
Abstract
AIM The aim of this study was to evaluate the efficacy of Group social skills interventions (GSSIs) versus any comparator on social functioning in children aged 5-12 years with acquired brain injury or cerebral palsy. BACKGROUND GSSIs are an evidence-based approach to foster social skills development in children with autism spectrum disorder. Currently, limited literature exploring GSSIs in children with acquired brain injury and cerebral palsy is available. RESULTS MEDLINE, SCOPUS, Embase, CINAHL, Cochrane Library, PsycINFO, clinicaltrials.gov, ICTRP and ProQuest Dissertations and Theses were systematically searched. Study screening, risk-of-bias, Grading of Recommendations Assessment, Development and Evaluation and data extraction were performed in duplicate. Six studies were included in the narrative synthesis (one randomised controlled trial and five nonrandomised studies). Results indicate that GSSIs may increase children's social skills as measured on the Social Skills Rating System and Social Skills Questionnaire. Very low certainty evidence was found for improvements in social functioning and competence. CONCLUSIONS There is low certainty evidence that participation in GSSI may lead to gains in social functioning for children with acquired brain injury or cerebral palsy. Given the certainty of the evidence, these results must be interpreted with caution. Only one randomised controlled trial of GSSIs for children with acquired brain injury was identified, underscoring the need for additional high-quality studies.
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Affiliation(s)
- Bianca A D Thompson
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Rose Gilmore
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
- Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Jacqui Barfoot
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Child Health Research Centre, Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
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5
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Kotov R, Carpenter WT, Cicero DC, Correll CU, Martin EA, Young JW, Zald DH, Jonas KG. Psychosis superspectrum II: neurobiology, treatment, and implications. Mol Psychiatry 2024:10.1038/s41380-024-02410-1. [PMID: 38351173 DOI: 10.1038/s41380-024-02410-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 02/16/2024]
Abstract
Alternatives to traditional categorical diagnoses have been proposed to improve the validity and utility of psychiatric nosology. This paper continues the companion review of an alternative model, the psychosis superspectrum of the Hierarchical Taxonomy of Psychopathology (HiTOP). The superspectrum model aims to describe psychosis-related psychopathology according to data on distributions and associations among signs and symptoms. The superspectrum includes psychoticism and detachment spectra as well as narrow subdimensions within them. Auxiliary domains of cognitive deficit and functional impairment complete the psychopathology profile. The current paper reviews evidence on this model from neurobiology, treatment response, clinical utility, and measure development. Neurobiology research suggests that psychopathology included in the superspectrum shows similar patterns of neural alterations. Treatment response often mirrors the hierarchy of the superspectrum with some treatments being efficacious for psychoticism, others for detachment, and others for a specific subdimension. Compared to traditional diagnostic systems, the quantitative nosology shows an approximately 2-fold increase in reliability, explanatory power, and prognostic accuracy. Clinicians consistently report that the quantitative nosology has more utility than traditional diagnoses, but studies of patients with frank psychosis are currently lacking. Validated measures are available to implement the superspectrum model in practice. The dimensional conceptualization of psychosis-related psychopathology has implications for research, clinical practice, and public health programs. For example, it encourages use of the cohort study design (rather than case-control), transdiagnostic treatment strategies, and selective prevention based on subclinical symptoms. These approaches are already used in the field, and the superspectrum provides further impetus and guidance for their implementation. Existing knowledge on this model is substantial, but significant gaps remain. We identify outstanding questions and propose testable hypotheses to guide further research. Overall, we predict that the more informative, reliable, and valid characterization of psychopathology offered by the superspectrum model will facilitate progress in research and clinical care.
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Affiliation(s)
- Roman Kotov
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA.
| | | | - David C Cicero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Elizabeth A Martin
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - David H Zald
- Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
| | - Katherine G Jonas
- Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA
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6
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Salam RA, Khan MH, Meerza SSA, Das JK, Lewis-Watts L, Bhutta ZA. An evidence gap map of interventions for noncommunicable diseases and risk factors among children and adolescents. Nat Med 2024; 30:290-301. [PMID: 38195753 DOI: 10.1038/s41591-023-02737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024]
Abstract
Substance misuse, obesity, mental health conditions, type 1 diabetes, cancers, and cardiovascular and chronic respiratory diseases together account for 41% of disability-adjusted life years linked to noncommunicable diseases (NCDs) among children and adolescents worldwide. However, the evidence on risk factors and interventions for this age group is scarce. Here we searched four databases to generate an evidence gap map of existing interventions and research gaps for these risk factors and NCDs. We mapped 159 reviews with 2,611 primary studies; most (96.2%) were conducted in high-income countries, and only 100 studies (3.8%) were from low- and middle-income countries (LMICs). The efficacy of therapeutic interventions on biomarkers and adverse events for NCDs appears to be well evidenced. Interventions for mental health conditions appear to be moderately evidenced, while interventions for obesity and substance misuse appear to be moderate to very low evidenced. Priority areas for future research include evaluating digital health platforms to support primary NCD prevention and management, and evaluating the impact of policy changes on the prevalence of obesity and substance misuse. Our findings highlight the wide disparity of evidence between high-income countries and LMICs. There is an urgent need for increased, targeted financing to address the research gaps in LMICs.
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Affiliation(s)
- Rehana A Salam
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Maryam Hameed Khan
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Saqlain Ali Meerza
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Institute for Global Health and Development, Aga Khan University Hospital, Karachi, Pakistan
| | - Laura Lewis-Watts
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.
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Cordier R, Parsons L, Wilkes-Gillan S, Cook M, McCloskey-Martinez M, Graham P, Littlefair D, Kent C, Speyer R. Friendship interventions for children with neurodevelopmental needs: A systematic review and meta-analysis. PLoS One 2023; 18:e0295917. [PMID: 38096327 PMCID: PMC10721178 DOI: 10.1371/journal.pone.0295917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
RATIONALE Children with neurodevelopmental disorders such as attention-deficit hyperactivity disorder (ADHD), autism, developmental language disorder (DLD), intellectual disability (ID), and social (pragmatic) communication disorder (SPCD) experience difficulties with social functioning due to differences in their social, emotional and cognitive skills. Previous systematic reviews have focussed on specific aspects of social functioning rather than broader peer functioning and friendships. OBJECTIVE To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that measured friendship outcomes for children with ADHD, autism, DLD, ID, and SPCD. METHOD Following PRISMA guidelines, we searched five electronic databases: CINAHL, Embase, Eric, PsycINFO, and PubMed. Two independent researchers screened all abstracts and disagreements were discussed with a third researcher to reach consensus. The methodological quality of studies was assessed using the Cochrane Risk of Bias Tool for Randomised Trials. RESULTS Twelve studies involving 15 interventions were included. Studies included 683 children with a neurodevelopmental disorder and 190 typically-developing children and diagnosed with either autism or ADHD. Within-group meta-analysis showed that the pooled intervention effects for friendship across all interventions were small to moderate (z = 2.761, p = 0.006, g = 0.485). The pooled intervention effect between intervention and comparison groups was not significant (z = 1.206, p = 0.400, g = 0.215). CONCLUSION Findings provide evidence that some individual interventions are effective in improving social functioning and fostering more meaningful friendships between children with neurodevelopmental disorders and their peers. Effective interventions involved educators, targeted child characteristics known to moderate peer functioning, actively involved peers, and incorporated techniques to facilitate positive peer perceptions and strategies to support peers. Future research should evaluate the effectiveness of friendship interventions for children with DLD, ID and SPCD, more comprehensively assess peer functioning, include child self-report measures of friendship, and longitudinally evaluate downstream effects on friendship.
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Affiliation(s)
- Reinie Cordier
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Australia
- Faculty of Health Sciences, Department of Health & Rehabilitation Sciences, University of Cape Town, University of Cape Town, Cape Town, South Africa
| | - Lauren Parsons
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Sarah Wilkes-Gillan
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Matthew Cook
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Matthew McCloskey-Martinez
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Pamela Graham
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - David Littlefair
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Cally Kent
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Renée Speyer
- Faculty of Health Sciences, Curtin School of Allied Health, Curtin University, Perth, Australia
- Department Special Needs Education, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
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8
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Levy T, Dupuis A, Andrade BF, Crosbie J, Kelley E, Nicolson R, Schachar RJ. Facial emotion recognition in children and youth with attention-deficit/hyperactivity disorder and irritability. Eur Child Adolesc Psychiatry 2023; 32:2271-2280. [PMID: 36050559 DOI: 10.1007/s00787-022-02033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
The ability to recognize emotions evident in people's faces contributes to social functioning and might be affected by ADHD and irritability. Given their high co-occurrence, we examined the relative contribution of ADHD and irritability to facial emotion recognition (FER). We hypothesized that irritability but not ADHD traits would predict increased likelihood of misrecognizing emotions as negative, and that FER performance would explain the association of ADHD and irritability traits with social skills. FER was measured using the Reading the Mind in the Eyes Test (RMET) in children (6-14 years old) referred for ADHD assessment (n = 304) and healthy controls (n = 128). ADHD, irritability and social skills were measured using parent ratings. We used repeated measure logistics regression, comparing the effects across emotion valence of images (i.e., neutral/positive/negative). High irritability but not ADHD diagnosis predicted lower RMET accuracy. ADHD traits predicted lower RMET accuracy in younger but not older participants, whereas irritability predicted poorer accuracy at all ages. ADHD traits predicted lower RMET accuracy across all emotion valences, whereas irritability predicted increased probability of misrecognizing neutral and positive but not negative emotions. Irritability did not increase the probability for erroneously recognizing emotions as negative. ADHD and irritability traits fully explained the association between RMET and social skills. ADHD and irritability traits might impact the ability to identify emotions portrayed in faces. However, irritability traits appear to selectively impair recognition of neutral and positive but not negative emotions. ADHD and irritability are important when examining the link between FER and social difficulties.
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Affiliation(s)
- Tomer Levy
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Annie Dupuis
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Brendan F Andrade
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology and Center for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Rob Nicolson
- Department of Psychiatry, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada
| | - Russell James Schachar
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Sadr-Salek S, Costa AP, Steffgen G. Psychological Treatments for Hyperactivity and Impulsivity in Children with ADHD: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1613. [PMID: 37892276 PMCID: PMC10605405 DOI: 10.3390/children10101613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
Treatment of the ADHD types (hyperactive-impulsive, inattentive, and combined) in children has rarely been studied separately, although their prognostic courses differ widely. In addition, data show that improvements in hyperactivity/impulsivity are hard to achieve. Thus, we focused on treatments tailored to hyperactivity/impulsivity. We examined meta-analyses and systematic reviews within the inter- and intra-individual treatments and found that psychoeducation and training for parents, school-based interventions, reinforcement strategies, and neurofeedback consistently showed small to moderate effect sizes in reducing hyperactivity/impulsivity in children. Conversely, emotional self-regulation, social skills, and cognitive trainings showed unsatisfactory results. In summary, we found that the quality of usual care can be surpassed when the designated interventions are purposefully combined into a multimodal treatment program.
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Affiliation(s)
- Shayan Sadr-Salek
- Service Psychologique, Solidarité Jeunes asbl—Haus 13, 48, rue Victor Hugo, L-4140 Esch-sur-Alzette, Luxembourg;
| | - Andreia P. Costa
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Campus Belval, MSH, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg;
| | - Georges Steffgen
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Campus Belval, MSH, 11 Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg;
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10
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Hudson JL, Minihan S, Chen W, Carl T, Fu M, Tully L, Kangas M, Rosewell L, McDermott EA, Wang Y, Stubbs T, Martiniuk A. Interventions for Young Children's Mental Health: A Review of Reviews. Clin Child Fam Psychol Rev 2023; 26:593-641. [PMID: 37488453 PMCID: PMC10465658 DOI: 10.1007/s10567-023-00443-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/26/2023]
Abstract
To determine the efficacy of intervention programs for young children (4-9 years) with emerging mental health needs, we conducted a review of meta-analytic and systematic reviews of the intervention literature. Of 41,061 abstracts identified and 15,076 screened, 152 review articles met the inclusion criteria. We reviewed interventions across multiple disciplines targeting: (1) general mental health concerns; (2) internalizing symptoms; (3) externalizing symptoms; (4) anxiety; (5) depression; (6) trauma; (7) symptoms of attention-deficit/hyperactivity disorder; and (8) mental health concerns associated with autism spectrum disorder. Substantial evidence was found for the efficacy of behavioral and cognitive behavioral interventions for general mental health concerns, externalizing symptoms (generally, as well as ADHD, conduct, and other behavioral symptoms) and internalizing symptoms (generally, as well as anxiety) aged 4-9 years. Emerging evidence was identified for interventions targeting trauma symptoms, depression symptoms, and social, emotional and behavioral symptoms in autism spectrum disorder in children aged 4-9 years. Currently there is only limited emerging evidence regarding non-behavioral or non-cognitive behavioral interventions for programs targeting children ages 4-9 years where the aim is to deliver an evidence-based program to improve child social, emotional and/or behavioral functioning. Given the recent rises in mental health needs reported in children, targeted behavioral-and/or cognitive behavior therapy-based interventions should be made widely available to children (and their families) who experience elevated symptoms.
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Affiliation(s)
- Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Sydney, Australia.
| | - Savannah Minihan
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Wenting Chen
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Talia Carl
- Black Dog Institute, University of New South Wales, Sydney, Australia
- School of Psychology, University of Sydney, Sydney, Australia
| | - Michele Fu
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Lucy Tully
- School of Psychology, University of Sydney, Sydney, Australia
| | - Maria Kangas
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Linda Rosewell
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emma A McDermott
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Yiwen Wang
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Thomas Stubbs
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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11
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Sökmen Z, Karaca S. The effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder. Arch Psychiatr Nurs 2023; 44:122-128. [PMID: 37197856 DOI: 10.1016/j.apnu.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/18/2023] [Accepted: 04/17/2023] [Indexed: 05/19/2023]
Abstract
AIM This study aimed to determine the effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder (ADHD) and receiving medication. METHOD The sample of this study with control group and pre-test, post-test and follow-up randomized experimental design consisted of children followed in the child and adolescent mental health outpatient clinic of a state hospital. The data were evaluated by parametric and non-parametric analyses. RESULTS A statistically significant increase was determined in the internal functional emotion regulation mean scores of children, who participated in the Self-Regulation Based Cognitive Psychoeducation Program, measured before, immediately after, and 6 months after the intervention (p < 0.05). A statistically significant increase was also found in their external functional emotion regulation mean scores measured before and 6 months after the intervention (p < 0.05). In addition, a statistically significant difference was found between their internal dysfunctional and external dysfunctional emotion regulation mean scores measured before and 6 months after the intervention; however the mean scores of those in the control group 6 months after the intervention were higher than those in the intervention group (p < 0.05). Furthermore, there was a statistically significant increase in their self-efficacy mean scores measured before and 6 months after the intervention (p < 0.05). CONCLUSION The Self-Regulation Based Cognitive Psychoeducation Program was found be effective in increasing the levels of emotion regulation and self-efficacy in children with ADHD.
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Affiliation(s)
- Zeynep Sökmen
- Marmara University, Institute of Health Science, Department of Psychiatric Nursing, Istanbul, Turkey.
| | - Semra Karaca
- Marmara University, Institute of Health Science, Department of Psychiatric Nursing, Istanbul, Turkey
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12
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Lv YB, Cheng W, Wang MH, Wang XM, Hu YL, Lv LQ. Effect of non-pharmacological treatment on the full recovery of social functioning in patients with attention deficit hyperactivity disorder. World J Clin Cases 2023; 11:3238-3247. [PMID: 37274030 PMCID: PMC10237121 DOI: 10.12998/wjcc.v11.i14.3238] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/25/2023] [Accepted: 04/07/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder (ADHD) is associated with adverse events, such as nausea and vomiting, dizziness, and sleep disturbances, and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients' social functioning.
AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.
METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group (methylphenidate hydrochloride and tomoxetine hydrochloride) or the non-pharmacological group (parental training, behavior modification, sensory integration therapy, and sand tray therapy), with 45 cases in each group. Outcome measures included treatment compliance, Swanson, Nolan, and Pelham, Version IV (SNAP-IV) scores, Conners Parent Symptom Questionnaire (PSQ) scores, and Weiss Functional Impairment Rating Scale (WFIRS) scores.
RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients (95.56%) compared with medication (71.11%) (P < 0.05). However, no significant differences in SNAP-IV and PSQ scores, in addition to the learning/school, social activities, and adventure activities of the WFIRS scores were observed between the two groups (P > 0.05). Patients with non-pharmacological interventions showed higher WFIRS scores for family, daily life skills, and self-concept than those in the pharmacological group (P < 0.05).
CONCLUSION Non-pharmacological interventions, in contrast to the potential risks of adverse events after long-term medication, improve patient treatment compliance, alleviate patients' behavioral symptoms of attention, impulsivity, and hyperactivity, and improve their cognitive ability, thereby improving family relationships and patient self-evaluation.
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Affiliation(s)
- Ying-Bo Lv
- Pediatric Health Care Section, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
| | - Wei Cheng
- Pediatric Health Care Section, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
| | - Meng-Hui Wang
- Pediatric Health Care Section, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
| | - Xiao-Min Wang
- Pediatric Health Care Section, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
| | - Yan-Li Hu
- Pediatric Health Care Section, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
| | - Lan-Qiu Lv
- Pediatric Health Care Section, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
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Gillies D, Leach MJ, Perez Algorta G. Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database Syst Rev 2023; 4:CD007986. [PMID: 37058600 PMCID: PMC10103546 DOI: 10.1002/14651858.cd007986.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a major problem in children and adolescents, characterised by age-inappropriate levels of inattention, hyperactivity, and impulsivity, and is associated with long-term social, academic, and mental health problems. The stimulant medications methylphenidate and amphetamine are the most frequently used treatments for ADHD, but these are not always effective and can be associated with side effects. Clinical and biochemical evidence suggests that deficiencies of polyunsaturated fatty acids (PUFA) could be related to ADHD. Research has shown that children and adolescents with ADHD have significantly lower plasma and blood concentrations of PUFA and, in particular, lower levels of omega-3 PUFA. These findings suggest that PUFA supplementation may reduce the attention and behaviour problems associated with ADHD. This review is an update of a previously published Cochrane Review. Overall, there was little evidence that PUFA supplementation improved symptoms of ADHD in children and adolescents. OBJECTIVES To compare the efficacy of PUFA to other forms of treatment or placebo in treating the symptoms of ADHD in children and adolescents. SEARCH METHODS We searched 13 databases and two trials registers up to October 2021. We also checked the reference lists of relevant studies and reviews for additional references. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials that compared PUFA with placebo or PUFA plus alternative therapy (medication, behavioural therapy, or psychotherapy) with the same alternative therapy alone in children and adolescents (aged 18 years and under) diagnosed with ADHD. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcome was severity or improvement of ADHD symptoms. Our secondary outcomes were severity or incidence of behavioural problems; quality of life; severity or incidence of depressive symptoms; severity or incidence of anxiety symptoms; side effects; loss to follow-up; and cost. We used GRADE to assess the certainty of evidence for each outcome. MAIN RESULTS We included 37 trials with more than 2374 participants, of which 24 trials were new to this update. Five trials (seven reports) used a cross-over design, while the remaining 32 trials (52 reports) used a parallel design. Seven trials were conducted in Iran, four each in the USA and Israel, and two each in Australia, Canada, New Zealand, Sweden, and the UK. Single studies were conducted in Brazil, France, Germany, India, Italy, Japan, Mexico, the Netherlands, Singapore, Spain, Sri Lanka, and Taiwan. Of the 36 trials that compared a PUFA to placebo, 19 used an omega-3 PUFA, six used a combined omega-3/omega-6 supplement, and two used an omega-6 PUFA. The nine remaining trials were included in the comparison of PUFA to placebo, but also had the same co-intervention in the PUFA and placebo groups. Of these, four trials compared a combination of omega-3 PUFA plus methylphenidate to methylphenidate. One trial each compared omega-3 PUFA plus atomoxetine to atomoxetine; omega-3 PUFA plus physical training to physical training; and an omega-3 or omega-6 supplement plus methylphenidate to methylphenidate; and two trials compared omega-3 PUFA plus dietary supplement to dietary supplement. Supplements were given for a period of between two weeks and six months. Although we found low-certainty evidence that PUFA compared to placebo may improve ADHD symptoms in the medium term (risk ratio (RR) 1.95, 95% confidence interval (CI) 1.47 to 2.60; 3 studies, 191 participants), there was high-certainty evidence that PUFA had no effect on parent-rated total ADHD symptoms compared to placebo in the medium term (standardised mean difference (SMD) -0.08, 95% CI -0.24 to 0.07; 16 studies, 1166 participants). There was also high-certainty evidence that parent-rated inattention (medium-term: SMD -0.01, 95% CI -0.20 to 0.17; 12 studies, 960 participants) and hyperactivity/impulsivity (medium-term: SMD 0.09, 95% CI -0.04 to 0.23; 10 studies, 869 participants) scores were no different compared to placebo. There was moderate-certainty evidence that overall side effects likely did not differ between PUFA and placebo groups (RR 1.02, 95% CI 0.69 to 1.52; 8 studies, 591 participants). There was also moderate-certainty evidence that medium-term loss to follow-up was likely similar between groups (RR 1.03, 95% CI 0.77 to 1.37; 13 studies, 1121 participants). AUTHORS' CONCLUSIONS Although we found low-certainty evidence that children and adolescents receiving PUFA may be more likely to improve compared to those receiving placebo, there was high-certainty evidence that PUFA had no effect on total parent-rated ADHD symptoms. There was also high-certainty evidence that inattention and hyperactivity/impulsivity did not differ between PUFA and placebo groups. We found moderate-certainty evidence that overall side effects likely did not differ between PUFA and placebo groups. There was also moderate-certainty evidence that follow-up was similar between groups. It is important that future research addresses the current weaknesses in this area, which include small sample sizes, variability of selection criteria, variability of the type and dosage of supplementation, and short follow-up times.
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Affiliation(s)
- Donna Gillies
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Matthew J Leach
- School of Nursing & Midwifery, University of South Australia, Adelaide, Australia
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McKay E, Kirk H, Martin R, Cornish K. Social difficulties in adolescent attention deficit hyperactivity disorder: Social motivation, social anxiety and symptom severity as contributing factors. J Clin Psychol 2023; 79:1113-1129. [PMID: 36413514 DOI: 10.1002/jclp.23462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/12/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Many interventions have been developed to address the social difficulties commonly experienced by adolescents with attention-deficit/hyperactivity disorder (ADHD), yet they are largely ineffective. OBJECTIVE This study examined social impairment among adolescents with and without ADHD, determining whether gender, social anxiety, age, and ADHD symptom type (inattention and hyperactivity/impulsivity) and severity are associated with social impairment. METHOD Parents and primary caregivers of adolescents (aged 13-17) with (n = 76) and without ADHD (n = 36) completed the Strengths and Weaknesses of ADHD and Normal Behavior, Social Responsiveness Scale 2nd Edition, and Spence Children's Anxiety Scale. RESULTS Adolescents with ADHD scored significantly higher than TD adolescents across social impairment domains. ADHD symptoms were associated with severity of impairment in all domains excluding Social Motivation. Hyperactivity/impulsivity and social anxiety predicted social impairment, whereas gender did not. CONCLUSION Adolescents with ADHD are more likely to experience social impairment than TD adolescents, and interventions targeting symptom reduction and social anxiety may improve these social impairments.
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Affiliation(s)
- Erin McKay
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Hannah Kirk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Rachael Martin
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Kim Cornish
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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15
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Taylor A, Kong C, Zhang Z, Herold F, Ludyga S, Healy S, Gerber M, Cheval B, Pontifex M, Kramer AF, Chen S, Zhang Y, Müller NG, Tremblay MS, Zou L. Associations of meeting 24-h movement behavior guidelines with cognitive difficulty and social relationships in children and adolescents with attention deficit/hyperactive disorder. Child Adolesc Psychiatry Ment Health 2023; 17:42. [PMID: 36973804 PMCID: PMC10042421 DOI: 10.1186/s13034-023-00588-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/08/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Evidence-based 24-h movement behavior (24-HMB) guidelines have been developed to integrate recommendations for the time spent on physical activity, sedentary behavior, and sleep. For children and adolescents, these 24-HMB guidelines recommend a maximum of two hours of recreational screen time (as part of sedentary behavior), a minimum of 60 min per day of moderate to vigorous physical activity (MVPA), and an age-appropriate sleep duration (9-11 h for 5 to 13-year-olds; 8-10 h for 14 to 17-year-olds). Although adherence to the guidelines has been associated with positive health outcomes, the effects of adhering to the 24-HMB recommendations have not been fully examined in children and adolescents with attention eficit/hyperactive disorder (ADHD). Therefore, this study examined potential associations between meeting the 24-HMB guidelines and indicators of cognitive and social difficulties in children and adolescents with ADHD. METHODS Cross-sectional data on 3470 children and adolescents with ADHD aged between 6 and 17 years was extracted from the National Survey for Children's Health (NSCH 2020). Adherence to 24-HMB guidelines comprised screen time, physical activity, and sleep. ADHD-related outcomes included four indicators; one relating to cognitive difficulties (i.e., serious difficulties in concentrating, remembering, or making decisions) and three indicators of social difficulties (i.e., difficulties in making or keeping friends, bullying others, being bullied). Logistic regression was performed to determine the associations between adherence to 24-HMB guidelines and the cognitive and social outcomes described above, while adjusting for confounders. RESULTS In total, 44.8% of participants met at least one movement behavior guideline, while only 5.7% met all three. Adjusted logistic regressions further showed that meeting all three guidelines was associated with lower odds of cognitive difficulties in relation to none of the guidelines, but the strongest model included only screen time and physical activity as predictors (OR = 0.26, 95% CI 0.12-0.53, p < .001). For social relationships, meeting all three guidelines was associated with lower odds of difficulty keeping friends (OR = 0.46, 95% CI 0.21-0.97, p = .04) in relation to none of the guidelines. Meeting the guideline for screen time was associated with lower odds of being bullied (OR = 0.61, 95% CI 0.39-0.97, p = .04) in relation to none of the guidelines. While screen time only, sleep only and the combination of both were associated with lower odds of bullying others, sleep alone was the strongest predictor (OR = 0.44, 95% CI 0.26-0.76, p = .003) in relation to none of the guidelines. CONCLUSION Meeting 24-HMB guidelines was associated with reduced likelihood of cognitive and social difficulties in children and adolescents with ADHD. These findings highlight the importance of adhering to healthy lifestyle behaviors as outlined in the 24-HMB recommendations with regard to cognitive and social difficulties in children and adolescents with ADHD. These results need to be confirmed by longitudinal and interventional studies with a large sample size.
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Affiliation(s)
- Alyx Taylor
- School of Rehabilitation, Sport and Psychology, AECC University College, Bournemouth, BH5 2DF, UK
- Body-Brain-Mind Laboratory; The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health School of Psychology, Shenzhen University, Shenzhen, 518061, China
| | - Chuidan Kong
- Body-Brain-Mind Laboratory; The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health School of Psychology, Shenzhen University, Shenzhen, 518061, China
| | - Zhihao Zhang
- Body-Brain-Mind Laboratory; The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health School of Psychology, Shenzhen University, Shenzhen, 518061, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476, Potsdam, Germany
| | - Sebastian Ludyga
- Department of Sport, Exercise, and Health, University of Basel, 4052, Basel, Switzerland
| | - Sean Healy
- Community Health Academic Group, School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, 9, Ireland
| | - Markus Gerber
- Department of Sport, Exercise, and Health, University of Basel, 4052, Basel, Switzerland
| | - Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Matthew Pontifex
- Departments of Kinesiology, Michigan State University, East Lansing, USA
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, 02115, USA
- Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, 8001, Australia
| | - Yanjie Zhang
- Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, 518172, China
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476, Potsdam, Germany
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, K1H 8L1, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Liye Zou
- Body-Brain-Mind Laboratory; The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health School of Psychology, Shenzhen University, Shenzhen, 518061, China.
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476, Potsdam, Germany.
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Jaisle EM, Groves NB, Black KE, Kofler MJ. Linking ADHD and ASD Symptomatology with Social Impairment: The Role of Emotion Dysregulation. Res Child Adolesc Psychopathol 2023; 51:3-16. [PMID: 36326970 PMCID: PMC9913618 DOI: 10.1007/s10802-022-00982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often experience social impairments. These children also frequently struggle with emotion regulation, and extant literature suggests that emotion dysregulation predicts social impairment in both clinical and neurotypical populations. However, the evidence base linking ADHD/ASD with social impairment comes primarily from samples meeting full diagnostic criteria for ADHD and/or ASD despite evidence that both syndromes reflect extreme ends of natural continuums that are normally distributed across the general population. To our knowledge, the present study is the first to concurrently examine unique and overlapping relations among ADHD/ASD symptoms, emotion regulation, and social difficulties using multi-informant measures (parent, teacher) with a clinically-evaluated sample of 108 children ages 8-13 (40 girls; 66% White/Non-Hispanic) with and without clinically-elevated ASD and ADHD symptoms and other common clinical disorders. Bias-corrected, bootstrapped conditional effects modeling revealed that ADHD-inattentive (β=-0.23) and ASD-social communication (β=-0.20) symptoms predicted social impairment directly, whereas ADHD-hyperactive/impulsive (β=-0.06) and ASD-restricted/repetitive behavior/interests (β=-0.06) symptoms predicted social impairment only via their shared associations with emotion dysregulation. Sensitivity analyses revealed that most relations were robust to control for item overlap across measures. In contrast, only the ADHD-inattention/social impairment link was robust to control for mono-informant bias, highlighting the importance of multi-informant methods and the potential for different determinants of social functioning across settings. Overall, this study implicates emotion regulation skills and all four ADHD/ASD symptom clusters as potential influences on children's social functioning, albeit with a more nuanced and potentially setting-specific pattern than suggested by prior work.
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Vanwoerden S, Franssens R, Sharp C, De Clercq B. The Development of Criterion A Personality Pathology: The Relevance of Childhood Social Functioning for Young Adult Daily Self-Functioning. Child Psychiatry Hum Dev 2022; 53:1148-1160. [PMID: 34076800 PMCID: PMC8859861 DOI: 10.1007/s10578-021-01187-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 11/24/2022]
Abstract
The DSM-5 alternative model for the diagnosis of personality disorders (AMPD) states that self- and interpersonal (Criterion A) dysfunction is necessary to diagnose a personality disorder, qualified by maladaptive personality trait profiles (Criterion B). This study tested whether childhood maladaptive personality traits predict interpersonal dysfunction during adolescence, which further predicts lower self-functioning in young adulthood. A mixed clinical-community sample of 157 10-year-olds participated for ten years. Social problems and personality traits were rated by parents at age 10 and 12. At age 20, young adults completed 14 daily ratings of self-functioning. Traits of emotional instability and disagreeableness predicted social problems and self-problems. Social problems predicted worse self-functioning in adulthood. An indirect effect of childhood narcissistic traits on higher levels of self-functioning via lower levels of social problems was found. Results are discussed in terms of their contribution to our understanding of the AMPD from a developmental perspective.
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Affiliation(s)
- Salome Vanwoerden
- Department of Psychology, Ghent University, Ghent, Belgium.
- Department of Psychiatry, University of Pittsburgh, 402 Sterling Plaza, 201 N. Craig St., Pittsburgh, PA, 1523, USA.
| | | | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, USA
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18
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A pairwise randomised controlled trial of a peer-mediated play-based intervention to improve the social play skills of children with ADHD: Outcomes of the typically-developing playmates. PLoS One 2022; 17:e0276444. [PMID: 36282854 PMCID: PMC9595544 DOI: 10.1371/journal.pone.0276444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
To examine the effectiveness of a play-based intervention for improving social play skills of typically-developing playmates of children with ADHD. Children (5–11 years) were randomised to an intervention (n = 15) or waitlisted control group (n = 14). The Test of Playfulness was scored by a blinded rater. Between-group statistics compared the change of the intervention (10-week intervention) and waitlisted control (10-week wait) groups. Change in the intervention group following intervention was significantly greater than the change in the waitlisted control group. When combining data from the groups, playmates’ (n = 29) mean ToP scores improved significantly following intervention, with a large effect pre- to post-intervention and pre-intervention to follow-up. Typically-developing playmates of children with ADHD benefited from participation in a peer-mediated intervention.
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19
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Crianças com TDAH e professoras. PSICO 2022. [DOI: 10.15448/1980-8623.2022.1.39098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
O Transtorno de Déficit de Atenção e Hiperatividade (TDAH) constitui risco no desenvolvimento infantil, impactando nas relações interpessoais e desempenho acadêmico. O presente estudo objetivou caracterizar recursos e dificuldades, relatados por professoras e crianças com TDAH, no contexto escolar. Participaram 43 estudantes (M=9,6 anos) e 36 professoras (M=43 anos) do ensino público de uma cidade do interior paulista. Os instrumentos utilizados foram entrevistas (crianças) e questionários (professoras). Foi realizada análise temática com auxílio do software Iramuteq. Os resultados apontaram dificuldades: nas crianças quanto ao autoconceito negativo, aos prejuízos acadêmicos e à exclusão por pares e, nas professoras, quanto à falta de conhecimento sobre o TDAH e à ausência de estratégias pedagógicas diferenciadas. Em relação aos recursos, o auxílio familiar em questões acadêmicas foi destacado pelas crianças e professoras. Os achados contribuem para a discussão de políticas educacionais, como formação continuada de professores e intervenções multidisciplinares.
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20
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Thompson KN, Odgers CL, Bryan BT, Danese A, Milne BJ, Strange L, Matthews T, Arseneault L. Trajectories of childhood social isolation in a nationally representative cohort: Associations with antecedents and early adulthood outcomes. JCPP ADVANCES 2022; 2:e12073. [PMID: 37431453 PMCID: PMC10242821 DOI: 10.1002/jcv2.12073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/09/2022] Open
Abstract
Background This study examined early life antecedents of childhood social isolation, whether these factors accounted for poor outcomes of isolated children, and how these associations varied according to patterns of stability and change in childhood isolation. Methods Participants included 2232 children from the Environmental Risk (E-Risk) Longitudinal Twin Study. We conducted growth mixture modelling (GMM) on combined parent and teacher reports of children's social isolation when children were 5, 7, 10 and 12 years, and we assessed associations with age-5 antecedents and age-18 outcomes using regression analyses. Results We identified three linear developmental trajectories of increasing (4.75%), decreasing (5.25%) and low stable (90.00%) social isolation. Age-5 attention deficit hyperactivity disorder (ADHD) symptoms, emotional problems, prosocial behaviours, maternal personality (openness) and size of school were associated with the decreasing trajectory of social isolation. When controlling for these antecedents, increasingly isolated children were still more likely to experience ADHD symptoms, loneliness, lower job optimism and lower physical activity at age 18. Conclusions Isolated children follow distinct patterns of change over childhood and isolation seems most detrimental to health at the time it is experienced. Social isolation can be a valuable indicator of co-occurring problems and provide targets for mental health intervention in young people.
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Affiliation(s)
- Katherine N. Thompson
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Candice L. Odgers
- Social Science Research InstituteDuke UniversityDurhamNorth CarolinaUSA
- Department of Psychological ScienceUniversity of California IrvineIrvineCaliforniaUSA
| | - Bridget T. Bryan
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
- Department of Child & Adolescent PsychiatryInstitute of PsychiatryPsychology & NeuroscienceKing's College LondonLondonUK
- National and Specialist CAMHS Trauma, Anxiety, and Depression ClinicSouth London and Maudsley NHS Foundation TrustLondonUK
| | - Barry J. Milne
- Faculty of ArtsCentre of Methods and Policy Application in the Social SciencesUniversity of AucklandAucklandNew Zealand
- Faculty of ScienceDepartment of StatisticsUniversity of AucklandAucklandNew Zealand
| | - Lily Strange
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Timothy Matthews
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Louise Arseneault
- Social, Genetic and Developmental Psychiatry CentreInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
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Orm S, Orm C, Mebostad MI, Dechsling A, Nordahl-Hansen A. Confirming the Validity of the School-Refusal Assessment Scale-Revised in a Sample of Children With Attention-Deficit/Hyperactivity Disorder. Front Psychol 2022; 13:849303. [PMID: 35345632 PMCID: PMC8957079 DOI: 10.3389/fpsyg.2022.849303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022] Open
Abstract
Children with developmental disorders, such as attention-deficit/hyperactivity disorder (ADHD), are at high risk of school-refusal behavior (SRB) compared with their peers. One of the most used scales to assess SRB is the school refusal behavior scale – revised (SRAS-R). The SRAS-R has demonstrated good psychometric properties when used with the general population of children, but, recently, its validity has been questioned when used with children with developmental disorders. We tested the psychometric properties of the SRAS-R parental reports in 96 children with ADHD (Mage = 12.4; SD = 1.7, 61.5% boys). Results showed good model fit and internal consistency for the original four-factor structure. Three of the factors were strongly correlated, suggesting that SRB among children with ADHD is caused by several factors.
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Affiliation(s)
- Stian Orm
- Division of Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
| | - Cathrine Orm
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
| | - Mette I Mebostad
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
| | - Anders Dechsling
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
| | - Anders Nordahl-Hansen
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
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Seiffer B, Hautzinger M, Ulrich R, Wolf S. The Efficacy of Physical Activity for Children with Attention Deficit Hyperactivity Disorder: A Meta-Analysis of Randomized Controlled Trials. J Atten Disord 2022; 26:656-673. [PMID: 34041952 PMCID: PMC8785285 DOI: 10.1177/10870547211017982] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND This systematic review and meta-analysis assesses the efficacy of regular, moderate to vigorous physical activity (MVPA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents in randomized controlled trials (RCTs). METHODS RCTs including children and adolescents with clinically diagnosed ADHD, implementing regular MVPA, and assessing ADHD core-symptoms on a valid rating scale post-intervention (primary outcome) were included. Outcomes were pooled through random-effects meta-analysis. Prospero registration: CRD42019142166. RESULTS MVPA had a small effect on total ADHD core symptoms (n = 11; g = -0.33; 95% CI [-0.63; -0.02]; p = .037). CONCLUSIONS MVPA could serve as an alternative treatment for ADHD. New RCTs are necessary to increase the understanding of the effect regarding frequency, intensity, type of MVPA interventions, and differential effects on age groups.
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Affiliation(s)
- Britta Seiffer
- University of Tuebingen, Department of Clinical Psychology and Psychotherapy, Tuebingen, Germany
- University of Tuebingen, Department of Education & Health Research, Tuebingen, Germany
| | - Martin Hautzinger
- University of Tuebingen, Department of Clinical Psychology and Psychotherapy, Tuebingen, Germany
| | - Rolf Ulrich
- University of Tuebingen, Department of Cognition and Perception, Tuebingen, Germany
| | - Sebastian Wolf
- University of Tuebingen, Department of Clinical Psychology and Psychotherapy, Tuebingen, Germany
- University of Tuebingen, Department of Education & Health Research, Tuebingen, Germany
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23
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Rasmussen PD, Jørring NT. "The Tale of ADHD Treatment - Each Was Partly in The Right and All Were in The Wrong". Scand J Child Adolesc Psychiatr Psychol 2022; 10:9-11. [PMID: 35719700 PMCID: PMC9154356 DOI: 10.21307/sjcapp-2022-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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24
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Guo C, Assumpcao L, Hu Z. Efficacy of Non-pharmacological Treatments on Emotional Symptoms of Children and Adults with Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis. J Atten Disord 2022; 26:508-524. [PMID: 33759605 DOI: 10.1177/10870547211001953] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The present meta-analysis aimed to evaluate the efficacy of various non-pharmacological interventions on comorbid emotional symptoms such as depression, anxiety, and emotional dysregulation (ED) in children and adults with ADHD. METHOD Forty-four randomized controlled trials (23 studies with ADHD children and 21 studies with ADHD adults) were included. Risk of bias, heterogeneity assessment, and subgroup analyses were conducted. RESULTS We found that therapies targeting the relationship between children and others (i.e., parent-training [on ED and depression] and social skills training [on ED]) were efficacious in the treatment of emotional symptoms in children with ADHD at post-intervention. As for adults with ADHD, cognitive behavioral therapy was found to be effective for the improvement of emotional symptoms at both post-intervention and follow-up. CONCLUSION Our findings demonstrate that the efficacy of non-pharmacological interventions varies substantially across children and adults with ADHD. These results provide important implications for the selection of non-pharmacological interventions for children with ADHD.
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Affiliation(s)
- Chao Guo
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
| | - Leonardo Assumpcao
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
| | - Zhiguo Hu
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, P.R. China.,Institute of Psychological Science, Hangzhou Normal University, P.R. China.,Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou, P.R. China
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25
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Hai T, Climie EA. Positive Child Personality Factors in Children with ADHD. J Atten Disord 2022; 26:476-486. [PMID: 33666141 DOI: 10.1177/1087054721997562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder. While previous studies have shown substantial impact of ADHD across multiple domains, relatively little attention has been devoted to studying positive personality factors in individuals with ADHD. To address this, the current study examined strength-based factors in children with ADHD in relation to their social skills. METHOD Sixty-four children (aged 8-12 years) with ADHD completed questionnaires related to their social skills and strength-based factors (e.g., optimism, resilience, self-concept, and coping skills). RESULTS Findings indicated significant differences between different levels of social skills in children with ADHD, with children with higher social skills reporting higher levels of resiliency, greater behavioral competence, and greater prosocial attitudes than those with lower social skills. CONCLUSIONS The results highlight the importance of fostering strong social skills in children with ADHD, leading them to perceive themselves as competent and resilient.
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Affiliation(s)
- Tasmia Hai
- University of Alberta, Edmonton, AB, Canada
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26
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Park S, Chang H. Developmental Trajectory of Inattention and Its Association With Depressive Symptoms in Adolescence: Peer Relationships as a Mediator. Front Psychol 2022; 12:736840. [PMID: 35178006 PMCID: PMC8845459 DOI: 10.3389/fpsyg.2021.736840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 12/16/2021] [Indexed: 11/21/2022] Open
Abstract
This study investigated the developmental trajectory of inattention symptoms as a predictor of later depressive symptoms in adolescence, and examined potential mediating role of peer relationships in this process. Participants were adolescents who were part of the large longitudinal panel study on Korean Youths, Korean Children & Youth Panel Survey 2010 (KCYPS 2010) of the National Youth Policy Institute (NYPI). Specifically, data were drawn from two cohorts of KCYPS that differed in participant age (Panel 1: 2003 birth cohort, n = 2,342, 48.2% girls; Panel 2: 2000 birth cohorts, n = 2,378, 40.0% girls). We analyzed data collected from 2010 to 2016 when children in panel 1 were 6-7 to 12-13 years old, and children in panel 2 were 9-10 to 15-16 years old. Results of latent growth modeling (LGM) were as follows. In Panel 1, the inattention symptoms increased from 9-10 to 12-13 years. Otherwise, the inattention symptoms decreased from 11-12 to 15-16 years in panel 2. Additionally, in both panels, initial status and slope of inattention significantly predicted later levels of depressive symptoms, and peer relationships partly mediated the association between inattention trajectory and depressive symptoms. The findings are discussed with respect to considering the growth of inattention and the quality of peer relationships as promising targets for early identification and intervention of depression in adolescents.
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Affiliation(s)
| | - Hyein Chang
- Department of Psychology, Sungkyunkwan University, Seoul, South Korea
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27
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Leifler E, Coco C, Fridell A, Borg A, Bölte S. Social Skills Group Training for Students with Neurodevelopmental Disabilities in Senior High School-A Qualitative Multi-Perspective Study of Social Validity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031487. [PMID: 35162512 PMCID: PMC8835167 DOI: 10.3390/ijerph19031487] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023]
Abstract
Including students with neurodevelopmental disabilities (NDDs) in regular classrooms has become a law-enforced common practice in many high- and middle-income countries. Still, without appropriate actions supporting the implementation of inclusive pedagogical practice, students with NDDs remain at increased risk for absenteeism, bullying and underachievement. There is limited knowledge on the feasibility of social skills group training (SSGT) in naturalistic settings. Using a qualitative approach, the objective of this study was to explore the lived experiences of (i) students diagnosed with autism or attention-deficit hyperactivity disorder and those showing subclinical social difficulties receiving either SSGT or active social control activities in a regular senior high school setting, (ii) teachers providing SSGT or the active control activity and (iii) school leaders facilitating the implementation of these actions. Due to the impact of the COVID-19 pandemic, comparison between real life versus digital administration of SSGT was also examined. Within a randomized controlled pilot trial of the school-tailored SSGT SKOLKONTAKT®, the primary perspectives of 20 students, teachers and school leaders on SSGT or the social control activities were explored. All groups perceived SSGT to enhance school attendance and academic achievement of students, as well as teacher inclusion skills and the social school climate. Findings indicate that SSGT is largely feasible and socially valid, and broader implementation of SSGT in school settings appears meaningful.
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Affiliation(s)
- Emma Leifler
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, 113 30 Stockholm, Sweden; (C.C.); (A.F.); (A.B.)
- Stockholm Health Care Services, Region Stockholm, 171 77 Stockholm, Sweden
- Department of Pedagogical, Curricular and Professional Studies, University of Gothenburg, 405 30 Gothenburg, Sweden
- Correspondence: (E.L.); (S.B.)
| | - Christina Coco
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, 113 30 Stockholm, Sweden; (C.C.); (A.F.); (A.B.)
- Stockholm Health Care Services, Region Stockholm, 171 77 Stockholm, Sweden
| | - Anna Fridell
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, 113 30 Stockholm, Sweden; (C.C.); (A.F.); (A.B.)
- Stockholm Health Care Services, Region Stockholm, 171 77 Stockholm, Sweden
| | - Anna Borg
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, 113 30 Stockholm, Sweden; (C.C.); (A.F.); (A.B.)
- Stockholm Health Care Services, Region Stockholm, 171 77 Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, 113 30 Stockholm, Sweden; (C.C.); (A.F.); (A.B.)
- Stockholm Health Care Services, Region Stockholm, 171 77 Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Services, Region Stockholm, 171 77 Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia
- Correspondence: (E.L.); (S.B.)
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28
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Crouzet L, Gramond A, Suehs C, Fabbro-Peray P, Abbar M, Lopez-Castroman J. Third-generation cognitive behavioral therapy versus treatment-as-usual for attention deficit and hyperactivity disorder: a multicenter randomized controlled trial. Trials 2022; 23:83. [PMID: 35090544 PMCID: PMC8796622 DOI: 10.1186/s13063-021-05983-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background This study aims to compare improvements in attention deficit and hyperactivity disorder (ADHD) symptom severity between a group of ADHD children and parents undergoing a new therapeutic program based on third-generation cognitive behavioral therapy (Hyper-mCBT) and a similar group undergoing treatment-as-usual with the Barkley program. Methods Two hundred forty-eight children diagnosed with ADHD will be randomly assigned to either a Hyper-mCBT program or a Barkley program. This is a multicenter randomized (1:1), 2 parallel-group, superiority trial with evaluator blinding and stratification according to center and methylphenidate treatment. The Hyper-mCBT program consists in a series of 16 simultaneous-but-separate therapy sessions for parents and for children. Discussion More effective psychotherapeutic approaches are needed for ADHD children. Pharmacotherapy seems to be more effective in reducing ADHD symptoms but it is not always helpful, it carries side effects, and it is rejected by many parents/professionals. Results for psychotherapy programs for ADHD are inconsistent although several studies have shown clinical improvements. This trial will substantiate encouraging preliminary results of an innovative psychotherapy program for both parents and children. Trial registration ClinicalTrials.gov NCT03437772. Registered on February 19, 2018. Sponsor number: PHRC-N/2016/JLC-01. RCB identification: 2017-A01349-44 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05983-2.
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Affiliation(s)
- Laetitia Crouzet
- Department of Psychiatry, Nimes University Hospital, Nimes, France
| | - Anne Gramond
- Department of Psychiatry, Nimes University Hospital, Nimes, France
| | - Carey Suehs
- Departments of Medical Information and Respiratory Diseases, Univ Montpellier, CHU Montpellier, Montpellier, France
| | - Pascale Fabbro-Peray
- Department of Biostatistics, Epidemiology, Public Health and Medical Information, Nimes University Hospital, Nimes, France
| | - Mocrane Abbar
- Department of Psychiatry, Nimes University Hospital, Nimes, France
| | - Jorge Lopez-Castroman
- Department of Psychiatry, Nimes University Hospital, Nimes, France. .,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France. .,CIBERSAM, Madrid, Spain.
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29
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Facial emotion recognition impairment predicts social and emotional problems in children with (subthreshold) ADHD. Eur Child Adolesc Psychiatry 2022; 31:715-727. [PMID: 33415471 PMCID: PMC9142461 DOI: 10.1007/s00787-020-01709-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/19/2020] [Indexed: 12/28/2022]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) symptoms often experience social and emotional problems. Impaired facial emotion recognition has been suggested as a possible underlying mechanism, although impairments may depend on the type and intensity of emotions. We investigated facial emotion recognition in children with (subthreshold) ADHD and controls using a novel task with children's faces of emotional expressions varying in type and intensity. We further investigated associations between emotion recognition accuracy and social and emotional problems in the ADHD group. 83 children displaying ADHD symptoms and 30 controls (6-12 years) completed the Morphed Facial Emotion Recognition Task (MFERT). The MFERT assesses emotion recognition accuracy on four emotions using five expression intensity levels. Teachers and parents rated social and emotional problems on the Strengths and Difficulties Questionnaire. Repeated measures analysis of variance revealed that the ADHD group showed poorer emotion recognition accuracy compared to controls across emotions (small effect). The significant group by expression intensity interaction (small effect) showed that the increase in accuracy with increasing expression intensity was smaller in the ADHD group compared to controls. Multiple regression analyses within the ADHD group showed that emotion recognition accuracy was inversely related to social and emotional problems, but not prosocial behavior. Not only children with an ADHD diagnosis, but also children with subthreshold ADHD experience impairments in facial emotion recognition. This impairment is predictive for social and emotional problems, which may suggest that emotion recognition may contribute to the development of social and emotional problems in these children.
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30
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Darling SJ, Goods M, Ryan NP, Chisholm AK, Haebich K, Payne JM. Behavioral Intervention for Social Challenges in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2021; 175:e213982. [PMID: 34661613 PMCID: PMC8524357 DOI: 10.1001/jamapediatrics.2021.3982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/20/2021] [Indexed: 11/14/2022]
Abstract
Importance Social deficits are a common and disabling feature of many pediatric disorders; however, whether behavioral interventions are associated with benefits for children and adolescents with social deficits is poorly understood. Objective To assess whether behavioral interventions in children and adolescents with neurodevelopmental or mental health disorders are associated with improvements in social function and social cognition, and whether patient, intervention, and methodological characteristics moderate the association. Data Sources For this systematic review and meta-analysis, the PsycINFO, MEDLINE, and PubMed electronic databases were searched in December 2020 for randomized clinical trials published from database inception to December 1, 2020, including terms related to neurodevelopmental or mental health disorders, social behavior, randomized clinical trials, and children and adolescents. Data were analyzed in January 2021. Study Selection Randomized clinical trials that enrolled participants aged 4 to 17 years with social deficits and examined the efficacy of a clinician-administered behavioral intervention targeting social functioning or social cognition were included. A total of 9314 records were identified, 78 full texts were assessed for eligibility, and 33 articles were included in the study; 31 of these reported social function outcomes and 12 reported social cognition outcomes. Data Extraction and Synthesis Articles were reviewed using the Cochrane Risk of Bias Assessment for randomized clinical trials. Data were independently extracted and pooled using a weighted random-effects model. Main Outcomes and Measures The main outcome was the association of behavioral intervention with social function and social cognition. Hedges g was used to measure the standardized mean difference between intervention and control groups. Standardized effect sizes were calculated for the intervention group vs the comparison group for each trial. Results A total of 31 trials including 2131 participants (1711 [80%] male; 420 [20%] female; mean [SD] age, 10.8 [2.2] years) with neurodevelopmental or mental health disorders (autism spectrum disorder [ASD] [n = 23], attention-deficit/hyperactivity disorder [n = 4], other conditions associated with social deficits [n = 4]) were analyzed to examine differences in social function between the intervention and control groups. Significantly greater gains in social function were found among participants who received an intervention than among the control groups (Hedges g, 0.61; 95% CI, 0.40-0.83; P < .001). The type of control condition (wait list vs active control vs treatment as usual) was a significant moderator of effect size (Q2, 7.11; P = .03). Twelve studies including 487 individuals with ASD (48 [10%] female; 439 [90%] male; mean [SD] age, 10.4 [1.7] years) were analyzed to examine differences in social cognition between intervention and control groups. The overall mean weighted effect was significant (Hedges g, 0.67; 95% CI, 0.39-0.96; P < .001), indicating the treatment groups had better performance on social cognitive tasks. Conclusions and Relevance In this systematic review and meta-analysis, significantly greater gains in social function and social cognition were reported among children and adolescents who received behavioral interventions for social deficits compared with participants receiving the control conditions. These findings suggest that children and adolescents with social deficits might benefit from social skills training regardless of their specific neurodevelopmental or mental health diagnosis.
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Affiliation(s)
- Simone J. Darling
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Marquelle Goods
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Nicholas P. Ryan
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Anita K. Chisholm
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Kristina Haebich
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Jonathan M. Payne
- Clinical Sciences, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
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31
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Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J, Bellgrove MA, Newcorn JH, Gignac M, Al Saud NM, Manor I, Rohde LA, Yang L, Cortese S, Almagor D, Stein MA, Albatti TH, Aljoudi HF, Alqahtani MMJ, Asherson P, Atwoli L, Bölte S, Buitelaar JK, Crunelle CL, Daley D, Dalsgaard S, Döpfner M, Espinet S, Fitzgerald M, Franke B, Gerlach M, Haavik J, Hartman CA, Hartung CM, Hinshaw SP, Hoekstra PJ, Hollis C, Kollins SH, Sandra Kooij JJ, Kuntsi J, Larsson H, Li T, Liu J, Merzon E, Mattingly G, Mattos P, McCarthy S, Mikami AY, Molina BSG, Nigg JT, Purper-Ouakil D, Omigbodun OO, Polanczyk GV, Pollak Y, Poulton AS, Rajkumar RP, Reding A, Reif A, Rubia K, Rucklidge J, Romanos M, Ramos-Quiroga JA, Schellekens A, Scheres A, Schoeman R, Schweitzer JB, Shah H, Solanto MV, Sonuga-Barke E, Soutullo C, Steinhausen HC, Swanson JM, Thapar A, Tripp G, van de Glind G, van den Brink W, Van der Oord S, Venter A, Vitiello B, Walitza S, Wang Y. The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neurosci Biobehav Rev 2021; 128:789-818. [PMID: 33549739 PMCID: PMC8328933 DOI: 10.1016/j.neubiorev.2021.01.022] [Citation(s) in RCA: 419] [Impact Index Per Article: 139.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. METHODS We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. RESULTS We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. CONCLUSIONS Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.
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Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and Neuroscience and Physiology, Psychiatry Research Division, SUNY Upstate Medical University, Syracuse, NY, USA; World Federation of ADHD, Switzerland; American Professional Society of ADHD and Related Disorders (APSARD), USA.
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Child and Adolescent Psychiatrist's Representative, Zentrales-ADHS-Netz, Germany; The German Association of Child and Adolescent Psychiatry and Psychotherapy, Germany
| | - David Coghill
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Yi Zheng
- Beijing Anding Hospital, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders, Beijing, China; Beijing Key Laboratory of Mental Disorders, Beijing, China; Beijing Institute for Brain Disorders, Beijing, China; Asian Federation of ADHD, China; Chinese Society of Child and Adolescent Psychiatry, China
| | - Joseph Biederman
- Clinical & Research Programs in Pediatric Psychopharmacology & Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia; Australian ADHD Professionals Association (AADPA), Australia
| | - Jeffrey H Newcorn
- American Professional Society of ADHD and Related Disorders (APSARD), USA; Departments of Psychiatry and Pediatrics, Division of ADHD and Learning Disorders, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martin Gignac
- Department of Child and Adolescent Psychiatry, Montreal Children's Hospital, MUHC, Montreal, Canada; Child and Adolescent Psychiatry Division, McGill University, Montreal, Canada; Canadian ADHD Research Alliance (CADDRA), Canada
| | | | - Iris Manor
- Chair, Israeli Society of ADHD (ISA), Israel; Co-chair of the neurodevelopmental section in EPA (the European Psychiatric Association), France
| | - Luis Augusto Rohde
- Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil
| | - Li Yang
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Samuele Cortese
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton,UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; University of Nottingham, Nottingham, UK
| | - Doron Almagor
- University of Toronto, SickKids Centre for Community Mental Health, Toronto, Canada; Canadian ADHD Research Alliance (CADDRA), Canada
| | - Mark A Stein
- University of Washington, Seattle, WA, USA; Seattle Children's Hospital, Seattle, WA, USA
| | - Turki H Albatti
- Saudi ADHD Society Medical and Psychological Committee, Saudi Arabia
| | - Haya F Aljoudi
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia; Saudi ADHD Society Medical and Psychological Committee, Saudi Arabia
| | - Mohammed M J Alqahtani
- Clinical Psychology, King Khalid University, Abha, Saudi Arabia; Saudi ADHD Society, Saudi Arabia
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK
| | - Lukoye Atwoli
- Department of Mental Health and Behavioural Science, Moi University School of Medicine, Eldoret, Kenya; Brain and Mind Institute, and Department of Internal Medicine, Medical College East Africa, the Aga Khan University, Kenya; African College of Psychopharmacology, Kenya; African Association of Psychiatrists, Kenya
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Healthcare Services, Region Stockholm, Sweden; Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Cleo L Crunelle
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Dept. of Psychiatry, Brussel, Belgium; International Collaboration on ADHD and Substance Abuse (ICASA), Nijmegen, the Netherlands
| | - David Daley
- Division of Psychiatry and Applied Psychology, School of Medicine University of Nottingham, Nottingham, UK; NIHR MindTech Mental Health MedTech Cooperative & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan (CANDAL), Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Søren Dalsgaard
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University Cologne, Cologne, Germany; Zentrales-ADHS-Netz, Germany
| | | | | | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Professional Board, ADHD Europe, Belgium
| | - Manfred Gerlach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany.
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Catharina A Hartman
- University of Groningen, Groningen, the Netherlands; University Medical Center Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, the Netherlands; ADHD Across the Lifespan Network from European College of Neuropsychopharmacology(ECNP), the Netherlands
| | | | - Stephen P Hinshaw
- University of California, Berkeley, CA, USA; University of California, San Francisco, CA, USA
| | - Pieter J Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands
| | - Chris Hollis
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK; NIHR MindTech MedTech Co-operative, Nottingham, UK; NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Scott H Kollins
- Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA
| | - J J Sandra Kooij
- Amsterdam University Medical Center (VUMc), Amsterdam, the Netherlands; PsyQ, The Hague, the Netherlands; European Network Adult ADHD, the Netherlands; DIVA Foundation, the Netherlands; Neurodevelopmental Disorders Across Lifespan Section of European Psychiatric Association, France
| | - Jonna Kuntsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Tingyu Li
- Growth, Development and Mental Health Center for Children and Adolescents, Children's Hospital of Chongqing Medical University, Chongqing, China; National Research Center for Clinical Medicine of Child Health and Disease, Chongqing, China; The Subspecialty Group of Developmental and Behavioral Pediatrics, the Society of Pediatrics, Chinese Medical Association, China
| | - Jing Liu
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; The Chinese Society of Child and Adolescent Psychiatry, China; The Asian Society for Child and Adolescent Psychiatry and Allied Professions, China
| | - Eugene Merzon
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Leumit Health Services, Tel Aviv, Israel; Israeli Society of ADHD, Israel; Israeli National Diabetes Council, Israel
| | - Gregory Mattingly
- Washington University, St. Louis, MO, USA; Midwest Research Group, St Charles, MO, USA
| | - Paulo Mattos
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Brazilian Attention Deficit Association (ABDA), Brazil
| | | | | | - Brooke S G Molina
- Departments of Psychiatry, Psychology, Pediatrics, Clinical & Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joel T Nigg
- Center for ADHD Research, Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Diane Purper-Ouakil
- University of Montpellier, CHU Montpellier Saint Eloi, MPEA, Medical and Psychological Unit for Children and Adolescents (MPEA), Montpellier, France; INSERM U 1018 CESP-Developmental Psychiatry, France
| | - Olayinka O Omigbodun
- Centre for Child & Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria; Department of Child & Adolescent Psychiatry, University College Hospital, Ibadan, Nigeria
| | | | - Yehuda Pollak
- Seymour Fox School of Education, The Hebrew University of Jerusalem, Israel; The Israeli Society of ADHD (ISA), Israel
| | - Alison S Poulton
- Brain Mind Centre Nepean, University of Sydney, Sydney, Australia; Australian ADHD Professionals Association (AADPA), Australia
| | - Ravi Philip Rajkumar
- Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | | | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany; German Psychiatric Association, Germany
| | - Katya Rubia
- World Federation of ADHD, Switzerland; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK; European Network for Hyperkinetic Disorders (EUNETHYDIS), Germany
| | - Julia Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany; The German Association of Child and Adolescent Psychiatry and Psychotherapy, Germany; Zentrales-ADHS-Netz, Germany
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Neurodevelopmental Disorders Across Lifespan Section of European Psychiatric Association, France; International Collaboration on ADHD and Substance Abuse (ICASA), the Netherlands; DIVA Foundation, the Netherlands
| | - Arnt Schellekens
- Radboud University Medical Centre, Donders Institute for Brain, Cognition, and Behavior, Department of Psychiatry, Nijmegen, the Netherlands; International Collaboration on ADHD and Substance Abuse (ICASA), Nijmegen, the Netherlands
| | - Anouk Scheres
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Renata Schoeman
- University of Stellenbosch Business School, Cape Town, South Africa; South African Special Interest Group for Adult ADHD, South Africa; The South African Society of Psychiatrists/Psychiatry Management Group Management Guidelines for ADHD, South Africa; World Federation of Biological Psychiatry, Germany; American Psychiatric Association, USA; Association for NeuroPsychoEconomics, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences and the MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Henal Shah
- Topiwala National Medical College & BYL Nair Ch. Hospital, Mumbai, India
| | - Mary V Solanto
- The Zucker School of Medicine at Hofstra-Northwell, Northwell Health, Hemstead, NY, USA; Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), USA; American Professional Society of ADHD and Related Disorders (APSARD), USA; National Center for Children with Learning Disabilities (NCLD), USA
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
| | - César Soutullo
- American Professional Society of ADHD and Related Disorders (APSARD), USA; European Network for Hyperkinetic Disorders (EUNETHYDIS), Germany; Louis A. Faillace MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hans-Christoph Steinhausen
- University of Zurich, CH, Switzerland; University of Basel, CH, Switzerland; University of Southern Denmark, Odense, Denmark; Centre of Child and Adolescent Mental Health, Copenhagen, Denmark
| | - James M Swanson
- Department of Pediatrics, University of California Irvine, Irvine, CA, USA
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Wales, UK
| | - Gail Tripp
- Human Developmental Neurobiology Unit, Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
| | - Geurt van de Glind
- Hogeschool van Utrecht/University of Applied Sciences, Utrecht, the Netherlands
| | - Wim van den Brink
- Amsterdam University Medical Centers, Academic Medical Center, Amsterdam, the Netherlands
| | - Saskia Van der Oord
- Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; European ADHD Guidelines Group, Germany
| | - Andre Venter
- University of the Free State, Bloemfontein, South Africa
| | - Benedetto Vitiello
- University of Torino, Torino, Italy; Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Yufeng Wang
- Asian Federation of ADHD, China; Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China
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Sampedro Baena L, la Fuente GACD, Martos-Cabrera MB, Gómez-Urquiza JL, Albendín-García L, Romero-Bejar JL, Suleiman-Martos N. Effects of Neurofeedback in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review. J Clin Med 2021; 10:jcm10173797. [PMID: 34501246 PMCID: PMC8432262 DOI: 10.3390/jcm10173797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is one of the most frequent neurodevelopmental disorders in childhood and adolescence. Choosing the right treatment is critical to controlling and improving symptoms. An innovative ADHD treatment is neurofeedback (NF) that trains participants to self-regulate brain activity. The aim of the study was to analyze the effects of NF interventions in children with ADHD. A systematic review was carried out in the CINAHL, Medline (PubMed), Proquest, and Scopus databases, following the PRISMA recommendations. Nine articles were found. The NF improved behavior, allowed greater control of impulsivity, and increased sustained attention. In addition, it improved motor control, bimanual coordination and was associated with a reduction in theta waves. NF combined with other interventions such as medication, physical activity, behavioral therapy training, or attention training with brain-computer interaction, reduced primary ADHD symptoms. Furthermore, more randomized controlled trials would be necessary to determine the significant effects.
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Affiliation(s)
- Lucía Sampedro Baena
- San Cecilio Clinical University Hospital, Andalusian Health Service, Avenida del Conocimiento, s/n, 18016 Granada, Spain; (L.S.B.); (M.B.M.-C.)
| | | | - María Begoña Martos-Cabrera
- San Cecilio Clinical University Hospital, Andalusian Health Service, Avenida del Conocimiento, s/n, 18016 Granada, Spain; (L.S.B.); (M.B.M.-C.)
| | - José L. Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Calle Cortadura del Valle S.N., 51001 Ceuta, Spain; (J.L.G.-U.); (N.S.-M.)
| | - Luis Albendín-García
- Casería de Montijo Health Center, Granada Metropolitan District, Andalusian Health Service, Calle Virgen de la Consolación, 12, 18015 Granada, Spain;
| | - José Luis Romero-Bejar
- Department of Statistics and Operational Research, University of Granada. Av. Fuentenueva, 18071 Granada, Spain
- Correspondence:
| | - Nora Suleiman-Martos
- Faculty of Health Sciences, University of Granada, Calle Cortadura del Valle S.N., 51001 Ceuta, Spain; (J.L.G.-U.); (N.S.-M.)
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Correll CU, Cortese S, Croatto G, Monaco F, Krinitski D, Arrondo G, Ostinelli EG, Zangani C, Fornaro M, Estradé A, Fusar-Poli P, Carvalho AF, Solmi M. Efficacy and acceptability of pharmacological, psychosocial, and brain stimulation interventions in children and adolescents with mental disorders: an umbrella review. World Psychiatry 2021; 20:244-275. [PMID: 34002501 PMCID: PMC8129843 DOI: 10.1002/wps.20881] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Top-tier evidence on the safety/tolerability of 80 medications in children/adolescents with mental disorders has recently been reviewed in this jour-nal. To guide clinical practice, such data must be combined with evidence on efficacy and acceptability. Besides medications, psychosocial inter-ventions and brain stimulation techniques are treatment options for children/adolescents with mental disorders. For this umbrella review, we systematically searched network meta-analyses (NMAs) and meta-analyses (MAs) of randomized controlled trials (RCTs) evaluating 48 medications, 20 psychosocial interventions, and four brain stimulation techniques in children/adolescents with 52 different mental disorders or groups of mental disorders, reporting on 20 different efficacy/acceptability outcomes. Co-primary outcomes were disease-specific symptom reduction and all-cause discontinuation ("acceptability"). We included 14 NMAs and 90 MAs, reporting on 15 mental disorders or groups of mental disorders. Overall, 21 medications outperformed placebo regarding the co-primary outcomes, and three psychosocial interventions did so (while seven outperformed waiting list/no treatment). Based on the meta-analytic evidence, the most convincing efficacy profile emerged for amphetamines, methylphenidate and, to a smaller extent, behavioral therapy in attention-deficit/hyperactivity disorder; aripiprazole, risperidone and several psychosocial interventions in autism; risperidone and behavioral interventions in disruptive behavior disorders; several antipsychotics in schizophrenia spectrum disorders; fluoxetine, the combination of fluoxetine and cognitive behavioral therapy (CBT), and interpersonal therapy in depression; aripiprazole in mania; fluoxetine and group CBT in anxiety disorders; fluoxetine/selective serotonin reuptake inhibitors, CBT, and behavioral therapy with exposure and response prevention in obsessive-compulsive disorder; CBT in post-traumatic stress disorder; imipramine and alarm behavioral intervention in enuresis; behavioral therapy in encopresis; and family therapy in anorexia nervosa. Results from this umbrella review of interventions for mental disorders in children/adolescents provide evidence-based information for clinical decision making.
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Affiliation(s)
- Christoph U Correll
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Samuele Cortese
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | | | | | | | - Gonzalo Arrondo
- Center for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Mind-Brain Group, Institute for Culture and Society, University of Navarra, Pamplona, Spain
| | | | - Caroline Zangani
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Michele Fornaro
- Department of Psychiatry, Federico II University, Naples, Italy
| | - Andrés Estradé
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Clinical and Health Psychology, Catholic University, Montevideo, Uruguay
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Marco Solmi
- Neurosciences Department, University of Padua, Padua, Italy
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Bonete S, Osuna Á, Molinero C, García-Font I. MAGNITIVE: Effectiveness and Feasibility of a Cognitive Training Program Through Magic Tricks for Children With Attention Deficit and Hyperactivity Disorder. A Second Clinical Trial in Community Settings. Front Psychol 2021; 12:649527. [PMID: 33868126 PMCID: PMC8049719 DOI: 10.3389/fpsyg.2021.649527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/05/2021] [Indexed: 11/28/2022] Open
Abstract
Previous studies have explored the impact of magic tricks on different basic cognitive processes yet there is a need of examining effectiveness of a cognitive training program through magic tricks for children with attention deficit hyperactivity disorder (ADHD). The present study examines the effectiveness and feasibility of the MAGNITIVE program, a manualized intervention for cognitive training through the learning of magic tricks. A total of 11 children with ADHD (from 8 to 12 years) participated in separated groups of two different community settings (hospital center and school), and were assessed at pre-treatment, post-treatment, and a 3-month later follow-up in different tasks involving processing speed, sustained attention, selective attention, and mental flexibility. Using non parametric statistical analyses and Reliable Change Index, the results showed that these children receiving MAGNITIVE particularly improved their performance in sustained attention, shifting attention, and mental flexibility, changes were also observed in processing speed performance yet further research is needed in terms of selective attention and inhibition, given the great individual differences within this sample. Changes were maintained when the program was finished. In terms of viability, the study proved a good treatment integrity in different contexts (hospital and school setting), adherence to the curriculum (attendance and some practice at home), and high levels of engagement satisfaction. In this second clinical trial, MAGNITIVE program appears to be a feasible training program for children with ADHD, as an alternative for medication when possible.
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Affiliation(s)
- Saray Bonete
- Department of Psychology, Universidad Francisco de Vitoria, Madrid, Spain
| | - Ángela Osuna
- Department of Psychology, Universidad Francisco de Vitoria, Madrid, Spain
| | - Clara Molinero
- Department of Psychology, Universidad Francisco de Vitoria, Madrid, Spain
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Burke K, Dittman CK, Forbes EJ, Eggins E. PROTOCOL: A systematic review and meta-analysis of randomised controlled trials evaluating the impact of parenting programmes for parents of adolescents (10-18 years) on adolescent mental health outcomes, positive development and the parent-adolescent relationship. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1146. [PMID: 37050970 PMCID: PMC8356282 DOI: 10.1002/cl2.1146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Affiliation(s)
- Kylie Burke
- Parenting and Family Support Centre, School of PsychologyThe University of QueenslandBrisbaneQueenslandAustralia
| | - Cassandra K. Dittman
- School of Health, Medical and Applied SciencesCentral Queensland UniversityBundabergQueenslandAustralia
| | - Elana J. Forbes
- Parenting and Family Support Centre, School of PsychologyThe University of QueenslandBrisbaneQueenslandAustralia
| | - Elizabeth Eggins
- School of Social Science, The University of QueenslandBrisbaneQueenslandAustralia
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Orm S, Øie MG, Fossum IN, Andersen PN, Skogli EW. Declining Trajectories of Co-occurring Psychopathology Symptoms in Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder: A 10-Year Longitudinal Study. Front Psychiatry 2021; 12:724759. [PMID: 34721102 PMCID: PMC8553244 DOI: 10.3389/fpsyt.2021.724759] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/16/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: Our objective was to examine developmental trajectories of co-occurring psychopathology symptoms from childhood to young adulthood in individuals with Attention-Deficit/Hyperactivity Disorder (ADHD), individuals with Autism Spectrum Disorder (ASD), and typically developing (TD) individuals. Method: We assessed co-occurring psychopathology symptoms in 61 individuals with ADHD, 26 with ASD, and 40 TD individuals at baseline (T1; Mage = 11.72, 64% boys), 2-year follow up (T2; Mage = 13.77), and 10-year follow up (T3; Mage = 21.35). We analyzed trajectories of internalizing behaviors, externalizing behaviors, and total problems with linear mixed models. Results: From T1 to T3, the ADHD group displayed a small decline in internalizing behaviors (d = -0.49) and large declines in externalizing behaviors (d = -0.78) and total problems (d = -0.71). The ASD group displayed large declines in internalizing behaviors (d = -0.79), externalizing behaviors (d = -0.80), and total problems (d = -0.89). From T1 to T2, the decline in externalizing behaviors and total problems were significantly smaller in the ADHD group compared with the ASD group. The ADHD and the ASD group displayed more co-occurring symptoms compared with the TD group at T3. Conclusion: Individuals with ADHD and ASD, respectively, displayed declines in co-occurring symptoms from childhood to young adulthood. Individuals with ASD displayed an earlier decline compared with individuals with ADHD. Compared with TD individuals, individuals with ADHD and ASD, respectively, continued to display elevated levels of co-occurring symptoms in young adulthood.
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Affiliation(s)
- Stian Orm
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway.,Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Ingrid Nesdal Fossum
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
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