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Dellenmark-Blom M, Järvholm K, Sjögren L, Levinsson A, Dahlgren J. Family screening for neurodevelopmental problems and its associations with child cognitive function enable tailored treatment for childhood obesity. Acta Paediatr 2024. [PMID: 38710886 DOI: 10.1111/apa.17263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/08/2024]
Abstract
AIM To identify neurodevelopmental disorders in children with obesity, and investigate associations to cognitive functions as well as parents' self-reported neurodevelopmental problems. METHODS Eighty children were included at two outpatient obesity clinics in Sweden 2018-2019. Of these, 50 children without previously diagnosed neurodevelopmental disorders were screened, and so were their parents. Children who screened positive for neurodevelopmental problems were referred to a specialised psychiatry unit for further diagnosis. Test results of cognitive functioning were compared with the norm and between study groups by neurodevelopmental diagnoses. RESULTS Of the screened families, 17/50 children were diagnosed by the psychiatric unit with attention deficit-hyperactivity disorder (ADHD) and 15/82 parents screened positive for neurodevelopmental problems. Having a mother who screened positive for neurodevelopmental problems was associated with child ADHD (p < 0.05). The children's full-scale intelligence quotient (92.86 ± 12.01, p < 0.001) and working memory index (90.62 ± 12.17, p < 0.001) were lower than the norm. Working memory index was lower in children with ADHD compared to without ADHD: 84.76 ± 9.58 versus 94.09 ± 12.29 (p ≤ 0.01). Executive constraints were associated with verbal deviances. CONCLUSION Increased awareness is needed about the overlap between neurodevelopmental problems and obesity in obesity clinics.
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Affiliation(s)
- Maria Dellenmark-Blom
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kajsa Järvholm
- Department of Psychology, Lund University, Lund, Sweden
- Childhood Obesity Unit, Skåne University Hospital, Malmö, Sweden
- Region Västra Götaland, Regional Obesity Center, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lovisa Sjögren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Regional Obesity Center, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Pediatrics, Halland Hospital Halmstad, Halmstad, Sweden
| | - Anna Levinsson
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research Centre of the University of Montreal University Hospital, Montreal, Canada
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Regional Obesity Center, Sahlgrenska University Hospital, Gothenburg, Sweden
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Kleppesto TH, Eilertsen EM, van Bergen E, Sunde HF, Zietsch B, Nordmo M, Eftedal NH, Havdahl A, Ystrom E, Torvik FA. Intergenerational transmission of ADHD behaviors: genetic and environmental pathways. Psychol Med 2024; 54:1309-1317. [PMID: 37920986 DOI: 10.1017/s003329172300315x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND We investigate if covariation between parental and child attention-deficit hyperactivity disorder (ADHD) behaviors can be explained by environmental and/or genetic transmission. METHODS We employed a large children-of-twins-and-siblings sample (N = 22 276 parents and 11 566 8-year-old children) of the Norwegian Mother, Father and Child Cohort Study. This enabled us to disentangle intergenerational influences via parental genes and parental behaviors (i.e. genetic and environmental transmission, respectively). Fathers reported on their own symptoms and mothers on their own and their child's symptoms. RESULTS Child ADHD behaviors correlated with their mother's (0.24) and father's (0.10) ADHD behaviors. These correlations were largely due to additive genetic transmission. Variation in children's ADHD behaviors was explained by genetic factors active in both generations (11%) and genetic factors specific to the children (46%), giving a total heritability of 57%. There were small effects of parental ADHD behaviors (2% environmental transmission) and gene-environment correlation (3%). The remaining variability in ADHD behaviors was due to individual-specific environmental factors. CONCLUSIONS The intergenerational resemblance of ADHD behaviors is primarily due to genetic transmission, with little evidence for parental ADHD behaviors causing children's ADHD behaviors. This contradicts theories proposing environmental explanations of intergenerational transmission of ADHD, such as parenting theories or psychological life-history theory.
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Affiliation(s)
- Thomas H Kleppesto
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Espen Moen Eilertsen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Elsje van Bergen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Research Institute LEARN!, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Hans Fredrik Sunde
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Brendan Zietsch
- Centre for Psychology and Evolution, School of Psychology, University of Queensland, Brisbane, Australia
| | - Magnus Nordmo
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Educational Science, University of South-Eastern Norway, Notodden, Norway
| | - Nikolai Haahjem Eftedal
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Alexandra Havdahl
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Spångbergveien 25, 0853 Oslo, Norway
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Eivind Ystrom
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Fartein Ask Torvik
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Lynch JD, Xu Y, Yolton K, Khoury JC, Chen A, Lanphear BP, Cecil KM, Braun JM, Epstein JN. [Formula: see text] Environmental predictors of children's executive functioning development. Child Neuropsychol 2024; 30:615-635. [PMID: 37621102 PMCID: PMC10891297 DOI: 10.1080/09297049.2023.2247603] [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] [Received: 04/13/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
Executive functioning (EF) abilities develop through childhood, but this development can be impacted by various psychosocial environmental influences. Using longitudinal data from the Health Outcome and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort study, we examined if psychosocial environmental factors were significant predictors of EF development. Study participants comprised 271 children and their primary caregivers (98.5% mothers) followed from birth to age 12. We identified four distinct EF developmental trajectory groups comprising a consistently impaired group (13.3%), a descending impairment group (27.7%), an ascending impairment group (9.95%), and a consistently not impaired group (49.1%). Higher levels of maternal ADHD and relational frustration appear to be risk factors for increased EF difficulty over time, while higher family income may serve as a protective factor delaying predisposed EF impairment. Important intervention targets might include teaching positive and effective parenting strategies to mothers whose children are at risk for EF dysfunction.
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Affiliation(s)
- James D. Lynch
- Department of Psychology, University of Cincinnati, 45 W. Corry Blvd, Cincinnati, OH, United States
- Center for ADHD, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 10006, Cincinnati, OH, United States
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 7035, Cincinnati, OH, United States
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, United States
| | - Jane C. Khoury
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, United States
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, 423 Guardian Drive, Philadelphia, PA, United States
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, Canada
| | - Kim M. Cecil
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, United States
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH, United States
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, 121 South Main St, Providence, RI, United States
| | - Jeffery N. Epstein
- Center for ADHD, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 10006, Cincinnati, OH, United States
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, United States
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Claussen AH, Holbrook JR, Hutchins HJ, Robinson LR, Bloomfield J, Meng L, Bitsko RH, O'Masta B, Cerles A, Maher B, Rush M, Kaminski JW. All in the Family? A Systematic Review and Meta-analysis of Parenting and Family Environment as Risk Factors for Attention-Deficit/Hyperactivity Disorder (ADHD) in Children. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:249-271. [PMID: 35438451 PMCID: PMC9017071 DOI: 10.1007/s11121-022-01358-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2022] [Indexed: 12/15/2022]
Abstract
Parenting and family environment have significant impact on child development, including development of executive function, attention, and self-regulation, and may affect the risk of developmental disorders including attention-deficit/hyperactivity disorder (ADHD). This paper examines the relationship of parenting and family environment factors with ADHD. A systematic review of the literature was conducted in 2014 and identified 52 longitudinal studies. A follow-up search in 2021 identified 7 additional articles, for a total of 59 studies that examined the association of parenting factors with ADHD outcomes: ADHD overall (diagnosis or symptoms), ADHD diagnosis specifically, or presence of the specific ADHD symptoms of inattention and hyperactivity/impulsivity. For parenting factors that were present in three or more studies, pooled effect sizes were calculated separately for dichotomous or continuous ADHD outcomes, accounting for each study's conditional variance. Factors with sufficient information for analysis were parenting interaction quality (sensitivity/warmth, intrusiveness/reactivity, and negativity/harsh discipline), maltreatment (general maltreatment and physical abuse), parental relationship status (divorce, single parenting), parental incarceration, and child media exposure. All factors showed a significant direct association with ADHD outcomes, except sensitivity/warmth which had an inverse association. Parenting factors predicted diagnosis and overall symptoms as well as inattentive and hyperactive symptoms when measured, but multiple factors showed significant heterogeneity across studies. These findings support the possibility that parenting and family environment influences ADHD symptoms and may affect a child's likelihood of being diagnosed with ADHD. Prevention strategies that support parents, such as decreasing parenting challenges and increasing access to parent training in behavior management, may improve children's long-term developmental health.
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Affiliation(s)
- Angelika H Claussen
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Helena J Hutchins
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs, Atlanta, GA, USA
| | - Lara R Robinson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeanette Bloomfield
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lu Meng
- Covid-19 Response Health System and Worker Safety Task Force, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Rebecca H Bitsko
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Brion Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Jennifer W Kaminski
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Neuperdt L, Beyer AK, Junker S, Mauz E, Hölling H, Schlack R. [Parental strain, inattention/hyperactivity symptoms and parent-reported ADHD in children and adolescents: results of the KiGGS study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:429-438. [PMID: 38536438 PMCID: PMC10995013 DOI: 10.1007/s00103-024-03859-9] [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] [Received: 08/22/2023] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND A child's attention deficit hyperactivity disorder (ADHD) is associated with strain for the parents. In turn, psychosocial parental strain is associated with higher probabilities for the occurrence of inattention/hyperactivity symptoms (IHS) in their children. The aim of this paper is to assess the association between parental strain, IHS, and a parent-reported ADHD diagnosis of the children. METHODOLOGY Based on data from n = 4596 participants of the KiGGS cohort (wave 2: 2014-2017), the type and extent of parental strain was set in relation to IHS and an ADHD diagnosis of the child in cross-sectional analysis. Frequencies, means, beta coefficients, and odds ratios adjusted for sex, age, socioeconomic status, and migration background are reported. RESULTS In individual consideration, a greater number of parental strains were associated with IHS than with an ADHD diagnosis. In a multivariate analysis, financial worries and parenting problems/conflicts with the children were significant predictors of IHS and an ADHD diagnosis, respectively. In addition, four or more types of parental strain were associated with a higher likelihood of both IHS and an ADHD diagnosis. DISCUSSION Financial and child-rearing strain are relevant to parents of children with IHS and an ADHD diagnosis. Interrelationships between parental stress and a child's IHS or an ADHD diagnosis can be assumed. To relieve their burden, prevention can either aim at improving the situation of ADHD-affected families or at improving the family's handling of the child's ADHD.
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Affiliation(s)
- Laura Neuperdt
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Ann-Kristin Beyer
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Stephan Junker
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Elvira Mauz
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Heike Hölling
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland
| | - Robert Schlack
- Abteilung Epidemiologie und Gesundheitsmonitoring, Fachgebiet Psychische Gesundheit, Robert Koch-Institut, General-Pape-Str. 62-66, 12101, Berlin, Deutschland.
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Lindström T, Buddgård S, Westholm L, Forster M, Bölte S, Hirvikoski T. Parent Training Tailored to Parents With ADHD: Development of the Improving Parenting Skills Adult ADHD (IPSA) Program. J Atten Disord 2024; 28:531-541. [PMID: 38152999 PMCID: PMC10838472 DOI: 10.1177/10870547231217090] [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: 12/29/2023]
Abstract
OBJECTIVE To describe the development of the Improving Parenting Skills Adult ADHD (IPSA) parent training (PT) program, designed for parents with ADHD. METHOD IPSA was developed using an iterative co-creation approach, involving parents with ADHD from the initial knowledge mobilization phase onwards. The program prototype was evaluated by 16 parents with ADHD, in an open trial of program feasibility. RESULTS IPSA was deemed feasible in terms of acceptability and levels of active participation, with no evidence of unintended harm. All but one participant completed the program, attending on average 84% of sessions. Pre-to-post within-group comparisons of targeted skills and outcomes revealed changes in the expected direction regarding, for example, use of introduced parenting skills (Cohen's d = 1.3). CONCLUSION The program prototype was found acceptable, accessible, and safe. Findings support the potential value of adapting PT protocols for parents with ADHD and warrant further evaluation of IPSA in a randomized controlled trial.
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Affiliation(s)
- Therese Lindström
- Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Sweden
| | | | - Lena Westholm
- Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Sweden
| | | | - Sven Bölte
- Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Sweden
- Curtin University, Perth, Western Australia
| | - Tatja Hirvikoski
- Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Sweden
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Li D, Hou D, Zhang Y, Zhao Y, Cui X, Niu Y, Xiang J, Wang B. Aberrant Functional Connectivity in Core-Periphery Structure Based on WSBM in ADHD. J Atten Disord 2024; 28:415-430. [PMID: 38102929 DOI: 10.1177/10870547231214985] [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: 12/17/2023]
Abstract
OBJECTIVE Brain network studies have revealed that the community structure of ADHD is altered. However, these studies have only focused on modular community structure, ignoring the core-periphery community structure. METHOD This paper employed the weighted stochastic block model to divide the functional connectivity (FC) into 10 communities. And we adopted core score to define the core-periphery structure of FC. Finally, connectivity strength (CS) and disruption index (DI) were used to evaluate the changes of core-periphery structure in ADHD. RESULTS The core community of visual network showed reduced CS and a positive value of DI, while the CS of periphery community was enhanced. In addition, the interaction between core communities (involving the sensorimotor and visual network) and periphery community of attention network showed increased CS and a negative valve of DI. CONCLUSION Anomalies in core-periphery community structure provide a new perspective for understanding the community structure of ADHD.
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Affiliation(s)
- Dandan Li
- Taiyuan University of Technology, Shanxi, China
| | - Dianni Hou
- Taiyuan University of Technology, Shanxi, China
| | | | - Yao Zhao
- Taiyuan University of Technology, Shanxi, China
| | | | - Yan Niu
- Taiyuan University of Technology, Shanxi, China
| | - Jie Xiang
- Taiyuan University of Technology, Shanxi, China
| | - Bin Wang
- Taiyuan University of Technology, Shanxi, China
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Lindström T, Bergman TH, Annerstedt M, Forster M, Bölte S, Hirvikoski T. Psychometric Properties of the Parental Stress Scale in Swedish Parents of Children with and without Neurodevelopmental Conditions. Scand J Child Adolesc Psychiatr Psychol 2024; 12:10-22. [PMID: 38645569 PMCID: PMC11027036 DOI: 10.2478/sjcapp-2024-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024] Open
Abstract
Background Parents of children with neurodevelopmental conditions (NDC) are at risk of experiencing elevated levels of parental stress. Access to robust instruments to assess parental stress is important in both clinical and research contexts. Objective: We aimed to evaluate the psychometric properties of a Swedish version of the Parental Stress Scale (PSS), completed by parents of 3- to 17-year-old children, with and without NDCs. Method Main analyses were conducted on data from three independent samples: a community sample (n=1018), a treatment-seeking sample of parents of children with various disabilities (n=653), and a sample of parents of children with Attention-Deficit/Hyperactivity Disorder (ADHD) who themselves reported varying ADHD symptom severities (n=562). Additional analyses were enabled by the use of data from a complementary test-retest sample (n=337). Results The internal consistency of the PSS was good (Cronbach's alpha, α=.87) and its test-retest reliability moderate (ICC=.66). The scale correlated in the expected direction with related constructs (r=.50-.56 in the community sample). An exploratory factor analysis found its internal structure to reflect two aspects of parental stress: Lack of Parental Rewards and Role Satisfaction (factor 1, α=.90) and Parental Stressors and Distress (factor 2, α=.85). The treatment-seeking parents of children with disabilities reported higher parental stress than community reference parents (p<.001; Cohen's d=1.17). Moreover, we found that parents with high ADHD symptom severity reported higher parental stress than parents with low ADHD symptom severity (p<.001; d=0.39). Conclusion In summary, we found evidence in support of the reliability and validity of the PSS, which overall was judged to be useful as a measure of parental stress in a Swedish context. In addition, our results underline the importance of considering parental stress and related needs in assessments and intervention planning involving families of children with NDCs.
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Affiliation(s)
- Therese Lindström
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Tiina Holmberg Bergman
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Mathilde Annerstedt
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Martin Forster
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Tatja Hirvikoski
- Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Center for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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Wingren M, Hayat Roshanai A, Fredriksson U, Janeslätt G, Lidström-Holmqvist K. A more active parenting after attending Let's Get Organized - Experiences of parents with ADHD. Scand J Occup Ther 2023; 30:1267-1279. [PMID: 37471235 DOI: 10.1080/11038128.2023.2225748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 05/12/2023] [Accepted: 06/12/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Parenting demands a high degree of attention, planning, and problem-solving, including time management, demands that can be challenging for parents with ADHD. Let's Get Organized (LGO) is an occupational therapy group intervention aiming at developing skills in time management, organisation and planning. There is a need to investigate if LGO may have an impact also on parenting. AIM To describe how parents with ADHD experienced the intervention, their time management strategies, parenting and family life after the occupational therapy group intervention LGO. METHOD Interviews were performed with 15 parents with ADHD, after completing LGO. Data were analysed using qualitative content analysis. RESULTS The findings are described in one overarching main category, Active parenting and better relations within and outside the family through daily time management with three underlying generic categories: Let's Get Organized facilitates empowerment in daily life; The individual and family - both facilitators of and obstacles to implementation of time management strategies; and A changed parenting and family life. CONCLUSIONS AND SIGNIFICANCE Participants experienced a positive impact on time management skills after LGO, which generated more active parenting and better predictability in the whole family. LGO can be a valuable intervention for parents with ADHD.
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Affiliation(s)
- Maria Wingren
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | | | - Gunnel Janeslätt
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Center for Clinical Research Dalarna, Sweden
| | - Kajsa Lidström-Holmqvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Ragadran J, Kamal Nor N, Ismail J, Ong JJ, Sundaraj C. Estimating the Risk of Attention Deficit Hyperactivity Disorder (ADHD) in Parents of Children with ADHD and the Association with Their Children's Disease Severity and Adherence to Medication. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1440. [PMID: 37761401 PMCID: PMC10529668 DOI: 10.3390/children10091440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is characterised by inattentiveness, hyperactivity, and impulsivity. Up to half of the affected children have a parent with ADHD. In this study, the risk of ADHD among parents of ADHD children was estimated. The associations between parental ADHD and child ADHD severity and medication adherence were determined. METHODOLOGY Parents of children and adolescents diagnosed with ADHD attending the University Kebangsaan Malaysia Medical Centre (UKMMC) were recruited between June to August 2022 and the administered Conners' Adult ADHD Rating Scale (CAARS) self-report short form, Vanderbilt ADHD Parent Rating Scale (performance section), and Medication Adherence Report Scale (MARS). RESULTS Forty-five children with ADHD were recruited and 15 out of 45 (33%) parents were detected to have ADHD. ADHD severity was worse in children with ADHD parents for total severity (mean of 34.67 vs. 29.13, p = 0.047) and difficult behaviours at home (mean of 7.87 vs. 6.27, p = 0.036). The children's academic performance and behavioural challenges at home and school were positively correlated with the parental ADHD scores for 'inattention' and 'problems with self-care' subscales. CONCLUSIONS A total of 33% of ADHD children had parents with ADHD. ADHD children with ADHD parents were more likely to have behavioural problems at home and more severe ADHD. However, no statistical significance was noted with medication adherence.
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Affiliation(s)
- Jananheendaran Ragadran
- Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Faculty, Kuala Lumpur 56000, Malaysia
| | - Norazlin Kamal Nor
- Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Faculty, Kuala Lumpur 56000, Malaysia
| | - Juriza Ismail
- Department of Paediatrics, Universiti Kebangsaan Malaysia Medical Faculty, Kuala Lumpur 56000, Malaysia
| | - Jun Jean Ong
- Department of Paediatrics, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Charlotte Sundaraj
- Department of Paediatrics, Hospital Putrajaya, Putrajaya 62502, Malaysia
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Lean RE, Gerstein ED, Smyser TA, Smyser CD, Rogers CE. Socioeconomic disadvantage and parental mood/affective problems links negative parenting and executive dysfunction in children born very preterm. Dev Psychopathol 2023; 35:1092-1107. [PMID: 34725016 PMCID: PMC9058043 DOI: 10.1017/s0954579421000961] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Poverty increases the risk of poorer executive function (EF) in children born full-term (FT). Stressors associated with poverty, including variability in parenting behavior, may explain links between poverty and poorer EF, but this remains unclear for children born very preterm (VPT). We examine socioeconomic and parental psychosocial adversity on parenting behavior, and whether these factors independently or jointly influence EF in children born VPT. At age five years, 154 children (VPT = 88, FT = 66) completed parent-child interaction and EF tasks. Parental sensitivity, intrusiveness, cognitive stimulation, and positive and negative regard were coded with the Parent-Child Interaction Rating Scale. Socioeconomic adversity spanned maternal demographic stressors, Income-to-Needs ratio, and Area Deprivation Index. Parents completed measures of depression, anxiety, inattention/hyperactivity, parenting stress, and social-communication interaction (SCI) problems. Parental SCI problems were associated with parenting behavior in parents of children born VPT, whereas socioeconomic adversity was significant in parents of FT children. Negative parenting behaviors, but not positive parenting behaviors, were related to child EF. This association was explained by parental depression/anxiety symptoms and socioeconomic adversity. Results persisted after adjustment for parent and child IQ. Findings may inform research on dyadic interventions that embed treatment for parental mood/affective symptoms and SCI problems to improve childhood EF.
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Affiliation(s)
- Rachel E Lean
- Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Emily D Gerstein
- Psychological Sciences, University Missouri-St. Louis, St. Louis, USA
| | - Tara A Smyser
- Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Christopher D Smyser
- Neurology, Washington University School of Medicine, St. Louis, USA
- Radiology, Washington University School of Medicine, St. Louis, USA
- Pediatrics, Washington University School of Medicine, St. Louis, USA
| | - Cynthia E Rogers
- Psychiatry, Washington University School of Medicine, St. Louis, USA
- Pediatrics, Washington University School of Medicine, St. Louis, USA
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12
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Lui JHL, Danko CM, Triece T, Bennett IM, Marschall D, Lorenzo NE, Stein MA, Chronis-Tuscano A. Screening for parent and child ADHD in urban pediatric primary care: pilot implementation and stakeholder perspectives. BMC Pediatr 2023; 23:354. [PMID: 37442955 PMCID: PMC10339482 DOI: 10.1186/s12887-023-04082-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 05/18/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND ADHD commonly co-occurs in children and parents. When ADHD is untreated in parents, it contributes to negative child developmental and treatment outcomes. Screening for parent and child ADHD co-occurrence in pediatric primary care may be an effective strategy for early identification and treatment. There is no data on whether this screening model can be implemented successfully and there exists limited guidance on how to effectively approach parents about their own ADHD in pediatric settings. Even greater sensitivity may be required when engaging with families living in urban, low SES communities due to systemic inequities, mistrust, and stigma. METHODS The current pilot study described the first 6 months of implementation of a parent and child ADHD screening protocol in urban pediatric primary care clinics serving a large population of families insured through Medicaid. Parents and children were screened for ADHD symptoms at annual well-child visits in pediatric primary care clinics as part of standard behavioral health screening. Independent stakeholder group meetings were held to gather feedback on factors influencing the implementation of the screening and treatment strategies. Mixed methods were used to examine initial screening completion rates and stakeholder perspectives (i.e., parents, primary care office staff, pediatricians, and behavioral health providers) on challenges of implementing the screening protocol within urban pediatric primary care. RESULTS Screening completion rates were low (19.28%) during the initial 6-month implementation period. Thematic analysis of stakeholder meetings provided elaboration on the low screening completion rates. Identified themes included: 1) divergence between provider enthusiasm and parent hesitation; 2) parent preference versus logistic reality of providers; 3) centering the experiences of people with marginalized identities; and 4) sensitivity when discussing parent mental health and medication. CONCLUSIONS Findings highlight the importance of developing flexible approaches to screening parent and child ADHD in urban pediatric health settings and emphasize the importance of cultural sensitivity when working with marginalized and under-resourced families. TRIAL REGISTRATION NCT04240756 (27/01/2020).
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Affiliation(s)
- Joyce H L Lui
- Department of Psychology, University of Maryland, College Park, MD, USA.
- Department of Psychology, Concordia University, 7141 Sherbrooke West, PY-146, Montreal, QC, Canada.
| | - Christina M Danko
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Tricia Triece
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Ian M Bennett
- Family Medicine and Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Donna Marschall
- Whole Bear Care, Children's National Hospital, Washington, DC, USA
| | - Nicole E Lorenzo
- Department of Psychology, American University, Washington, DC, USA
| | - Mark A Stein
- Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, WA, USA
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13
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Gómez-Álzate AM, Hidalgo-López C, García-Valencia J, Martínez-Zamora M, Aguirre-Acevedo DC, Cuartas-Arias M, Arcos-Burgos M, Valencia-Evhecerry J, Lopez-Jaramillo C, Palacio-Ortiz JD. Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:193-200. [PMID: 37923415 DOI: 10.1016/j.rcpeng.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/23/2021] [Indexed: 11/07/2023]
Abstract
OBJECTIVE We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). METHODS We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. RESULTS We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. CONCLUSIONS Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.
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Affiliation(s)
- Alejandra María Gómez-Álzate
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Catalina Hidalgo-López
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Jenny García-Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Instituto de Investigaciones Médicas, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Marta Martínez-Zamora
- Departamento de Psicología, Universidad CES, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Daniel Camilo Aguirre-Acevedo
- Instituto de Investigaciones Médicas, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Mauricio Cuartas-Arias
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Mauricio Arcos-Burgos
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Johanna Valencia-Evhecerry
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Carlos Lopez-Jaramillo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Departamento de Psicología, Escuela de Humanidades de la Universidad EAFIT, Medellín, Colombia.
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de la Paz L, Mooney MA, Ryabinin P, Neighbor C, Antovich D, Nigg JT, Nikolas MA. Youth Polygenic Scores, Youth ADHD Symptoms, and Parenting Dimensions: An Evocative Gene-Environment Correlation Study. Res Child Adolesc Psychopathol 2023; 51:665-677. [PMID: 36645612 PMCID: PMC10560546 DOI: 10.1007/s10802-023-01024-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/17/2023]
Abstract
Parenting practices and parental symptoms of attention-deficit/hyperactivity disorder (ADHD) have been linked to severity and course of youth ADHD. However, genetically influenced behaviors related to ADHD in youth may also influence parenting behaviors. Polygenic scores (PGS) have been widely used to quantify genetic vulnerability for ADHD but has rarely been used to examine gene-environment correlation effects. The current study examined the direct effects of youth ADHD PGS and its evocative effects on parenting behaviors via youth ADHD symptoms. 803 youth aged 6-18 years (58.5% male) completed a multistage, multi-informant assessment that included measures of parenting practices and youth and parental ADHD symptoms. A mediation model was used to evaluate direct and evocative effects. Furthermore, we examined if these evocative effects remain after controlling for parental ADHD symptoms. Sensitivity analyses across age, sex, and socioeconomic status (SES) as well as restricting ancestry groups to European only ancestry were also conducted. Results indicated that youth ADHD PGS reliably predicted youth ADHD symptoms across all models (βs ranging from 0.18 to 0.26), including across age, sex, and SES and held even with ancestry restricted to the largest group (northern European). Evocative effects emerged such that higher youth PGS significantly predicted more youth ADHD symptoms, which in turn, significantly predicted lower levels of parental involvement and higher levels of poor supervision/monitoring and inconsistent discipline. These effects remained after controlling for parent ADHD symptoms.
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Affiliation(s)
- Leiana de la Paz
- Department of Psychological and Brain Sciences, G60 Psychological and Brain Sciences Bldg., 340 Iowa Ave, Iowa City, IA, 52242, USA.
| | - Michael A Mooney
- Division of Bioinformatics and Computational Biology, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Peter Ryabinin
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | | | - Dylan Antovich
- Division of Psychology, Department of Psychiatry, Portland, OR, USA
| | - Joel T Nigg
- Division of Psychology, Department of Psychiatry, Portland, OR, USA
| | - Molly A Nikolas
- Department of Psychological and Brain Sciences, G60 Psychological and Brain Sciences Bldg., 340 Iowa Ave, Iowa City, IA, 52242, USA
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Examining Relations Between Parent and Child Psychopathology in Children with ADHD: Do Parent Cognitions Matter? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023. [DOI: 10.1007/s10862-023-10023-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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16
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Mundal I, Laake P, Bjørkly SK, Lara-Cabrera ML. Factor structure and internal consistency of the parent patient activation measure (P-PAM) in parents of children with ADHD in norwegian paediatric mental health. BMC Psychiatry 2023; 23:60. [PMID: 36691007 PMCID: PMC9869581 DOI: 10.1186/s12888-023-04550-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND This study aimed to explore the internal consistency and factor validity of the 13-item self-report questionnaire Parent-Patient Activation Measure (P-PAM) in a sample of parents of children with Attention-deficit/hyperactivity disorder. METHODS In a cross-sectional study, 239 parents were recruited from four outpatient clinics of the Child and Adolescent Mental Health Services and completed the P-PAM along with demographic variables. The factor structure of the P-PAM was examined through exploratory factor analysis, and internal consistency was estimated with the use of both Cronbach's alpha and McDonald's omega. A confirmatory factor analysis was used to estimate and test individual parameters. RESULTS The fit indices suggest an acceptable two-factor model of P-PAM and show high internal consistency and reliability for both factors, indicating that the scale measures two concepts. CONCLUSIONS Our findings provide evidence for an acceptable factor structure and a high reliability of P-PAM as a measure of parent activation, suggesting that the theoretical factors reflect the construct of parent activation as intuitively compiled into an inner cognitive factor and an outer behavioral factor, which are related.
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Affiliation(s)
- Ingunn Mundal
- Faculty of Health Siences and Social care, Molde University College, Molde, Norway
- Division of Psychiatry, Kristiansund Community Mental Health Centre, Møre Og Romsdal Hospital Trust, Kristiansund, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Petter Laake
- Faculty of Health Siences and Social care, Molde University College, Molde, Norway
- Department of Biostatistics, Oslo Centre for Statistics and Epidemiology, University of Oslo, Oslo, Norway
| | - Stål K. Bjørkly
- Faculty of Health Siences and Social care, Molde University College, Molde, Norway
- Oslo University Hospital, Centre for Forensic Research, Oslo, Norway
| | - Mariela L. Lara-Cabrera
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Division of Psychiatry, Nidelv Community Mental Health Centre, St. Olav’s University Hospital, Trondheim, Norway
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Gómez-Cano S, Zapata-Ospina JP, Arcos-Burgos M, Palacio-Ortiz JD. The role of psychosocial adversity in the aetiology and course of attention deficit hyperactivity disorder. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:65-72. [PMID: 37085236 DOI: 10.1016/j.rcpeng.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/05/2021] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Attention deficit/hyperactivity disorder (ADHD) has genetic and environmental aetiological factors. There are few publications on the environmental factors. The objective of this review is to present the role of psychosocial adversity in the aetiology and course of ADHD. METHODS A search was carried out in the following databases: PubMed, ScienceDirect, SciELO, ClinicalKey, EMBASE, Lilacs, OVID, APA and PsycNET. English and Spanish were selected without being limited by type of study or year of publication. Finally, a qualitative synthesis was conducted. RESULTS ADHD development could be related to exposure to adverse factors in the family, school or social environment. It has been proposed as an explanatory mechanism that adversity interacts with genetic variants and leads to neurobiological changes. There may also be a gene-environment correlation whereby individual hereditary characteristics increase the risk of exposure to adversity, and indirectly increase the probability of developing ADHD. Research on psychosocial adversity represents a big challenge, not only due to the complexity of its construct, but also to the effect of subjective perception of a given event. CONCLUSIONS ADHD aetiology is complex and involves the interaction of both genetic and environmental factors, in which these factors correlate and cause the disorder. The study of the role of psychosocial adversity in ADHD is fundamental, but it remains a task that entails great difficulties.
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Affiliation(s)
- Sujey Gómez-Cano
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan Pablo Zapata-Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mauricio Arcos-Burgos
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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18
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Jendreizik LT, von Wirth E, Döpfner M. Familial Factors Associated With Symptom Severity in Children and Adolescents With ADHD: A Meta-Analysis and Supplemental Review. J Atten Disord 2023; 27:124-144. [PMID: 36326291 DOI: 10.1177/10870547221132793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Both genetic and environmental factors contribute to the development of ADHD, but associations between risk factors and ADHD symptom severity in affected children remain unclear. This systematic review and meta-analysis synthesizes evidence on the association between familial factors and symptom severity in children with ADHD (PROSPERO CRD42020076440). METHOD PubMed and PsycINFO were searched for eligible studies. RESULTS Forty-three studies (N = 11,123 participants) were meta-analyzed. Five additional studies (N = 2,643 participants) were considered in the supplemental review. Parenting stress (r = .25), negative parenting practices (r = .19), broken parental partnership (r = .19), critical life events (r = .17), parental psychopathologies (r = .14-.16), socioeconomic status (r = -.10), and single-parent family (r = .10) were significantly associated with ADHD symptom severity. CONCLUSION These results suggest that psychosocial familial factors show small but significant associations with symptom severity in children with ADHD. Implications are discussed.
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He W, Liu W, Mao M, Cui X, Yan T, Xiang J, Wang B, Li D. Reduced Modular Segregation of White Matter Brain Networks in Attention Deficit Hyperactivity Disorder. J Atten Disord 2022; 26:1591-1604. [PMID: 35373644 DOI: 10.1177/10870547221085505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Despite studies reporting alterations in the brain networks of patients with ADHD, alterations in the modularity of white matter (WM) networks are still unclear. METHOD Based on the results of module division by generalized Louvain algorithm, the modularity of ADHD was evaluated. The correlation between the modular changes of ADHD and its clinical characteristics was analyzed. RESULTS The participation coefficient and the connectivity between modules of ADHD increased, and the modularity coefficient decreased. Provincial hubs of ADHD did not change, and the number of connector hubs increased. All results showed that the modular segregation of WM networks of ADHD decreased. Modules with reduced modular segregation are mainly responsible for language and motor functions. Moreover, modularity showed evident correlation with the symptoms of ADHD. CONCLUSION The modularity changes in WM network provided a novel insight into the understanding of brain cognitive alterations in ADHD.
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Affiliation(s)
- Wenbo He
- Taiyuan University of Technology, Shanxi, China
| | - Weichen Liu
- Taiyuan University of Technology, Shanxi, China
| | - Min Mao
- Taiyuan University of Technology, Shanxi, China
| | | | - Ting Yan
- Shanxi Medical University, Taiyuan, China
| | - Jie Xiang
- Taiyuan University of Technology, Shanxi, China
| | - Bin Wang
- Taiyuan University of Technology, Shanxi, China
| | - Dandan Li
- Taiyuan University of Technology, Shanxi, China
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20
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Lindström T, Kierkegaard Suttner A, Forster M, Bölte S, Hirvikoski T. Is Parents' ADHD Symptomatology Associated With the Clinical Feasibility or Effectiveness of a Psychoeducational Program Targeting Their Children's ADHD? J Atten Disord 2022; 26:1653-1667. [PMID: 35491992 PMCID: PMC9373197 DOI: 10.1177/10870547221092120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine if the clinical feasibility and effectiveness of a psychoeducational program targeting children's ADHD differ between parents with varying ADHD symptom severities. METHOD An open trial analyzed data from 549 parents of children with ADHD aged 3 to 17 years, who participated in psychoeducation at an outpatient habilitation/disability clinic. In all analyses, parents were stratified into three symptom severity groups (low/middle/high) based on scores on an ADHD screening scale. RESULTS Parental ADHD symptom severity was not associated with results on any outcome, although the odds of having incomplete data were higher in parents reporting higher symptom severity. Across the entire sample, we observed high program completion rates, positive acceptability ratings and large increases in parental knowledge. CONCLUSIONS Psychoeducation may be beneficial regardless of the participating parent's ADHD symptomatology. Further research is needed to examine whether these results are generalizable to parents diagnosed with ADHD, an underrepresented group in our study.
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Affiliation(s)
- Therese Lindström
- Karolinska Institutet and Stockholm
Health Care Services, Region Stockholm, Stockholm, Sweden,Stockholm Health Care Services, Region
Stockholm, Sweden,Therese Lindström, Child and Adolescent
Psychiatry Research Center, Center of Neurodevelopmental Disorders at Karolinska
Institutet (KIND), Gävlegatan 22B, Stockholm 113 30, Sweden.
| | - Axel Kierkegaard Suttner
- Karolinska Institutet and Stockholm
Health Care Services, Region Stockholm, Stockholm, Sweden,Stockholm Health Care Services, Region
Stockholm, Sweden
| | | | - Sven Bölte
- Karolinska Institutet and Stockholm
Health Care Services, Region Stockholm, Stockholm, Sweden,Stockholm Health Care Services, Region
Stockholm, Sweden,Curtin University, Perth, WA,
Australia
| | - Tatja Hirvikoski
- Karolinska Institutet and Stockholm
Health Care Services, Region Stockholm, Stockholm, Sweden,Stockholm Health Care Services, Region
Stockholm, Sweden
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21
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Profiles of adverse childhood experiences and family processes during early childhood. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1016/j.appdev.2022.101441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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22
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Şahinoğlu Keşkek N, Akkoyun İ, Temiz A, Kütük Ö. Hedgehog Signal Defect Leading to Familial Exudative Vitreoretinopathy-Like Disease and Gastrointestinal Malformation. Turk J Ophthalmol 2022; 52:174-178. [PMID: 35770050 PMCID: PMC9249105 DOI: 10.4274/tjo.galenos.2021.72929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objectives: The aim of the study was to present a new genetic association presenting with gastrointestinal tract malformations (GTMs) and familial exudative vitreoretinopathy (FEVR)-like disease and review the genetics of Hedgehog signaling. Materials and Methods: Three neonates were diagnosed with FEVR-like retinal vascular disease upon routine ophthalmological examination during hospitalization in the neonatal surgical intensive care unit for GTMs. Genetic analysis of the neonates was performed. Results: Gestational age of the neonates was 39, 38, and 39 weeks and birth weights were 3,500, 3,600, and 3,300 grams, respectively. All six eyes of the three infants were treated by laser photocoagulation. Recurrence was not seen in any of the eyes. Genetical analysis of all the neonates diagnosed with FEVR-like disease revealed defects in the Hedgehog pathway. Conclusion: FEVR is a genetically well-defined retinal vascular disease. The current study is the first to show an association between FEVR-like retinal vascular disease and GTMs. This study demonstrates the importance of the Hedgehog pathway in retinal vascular and gut development.
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Children and adolescents' emotional problems during the COVID-19 pandemic in Brazil. Eur Child Adolesc Psychiatry 2022; 32:1083-1095. [PMID: 35618973 PMCID: PMC9135594 DOI: 10.1007/s00787-022-02006-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 05/04/2022] [Indexed: 11/21/2022]
Abstract
Brazil has been severely affected by the COVID-19 pandemic with one of the largest numbers of youth impacted by school closure globally. This longitudinal online survey assessed emotional problems in children and adolescents aged 5-17 years living in Brazil during the COVID-19 pandemic. Recruitment occurred between June to November 2020 and participants were invited for follow-up assessments every 15 days until June 2021. Participants were 5795 children and adolescents living across the country with mean age of 10.7 (SD 3.63) years at recruitment; 50.5% were boys and 69% of white ethnicity. Weighted prevalence rates of anxiety, depressive and total emotional symptoms at baseline were 29.7%, 36.1% and 36%, respectively. Longitudinal analysis included 3221 (55.6%) participants and revealed fluctuations in anxiety and depressive symptoms during one year follow-up, associated with periods of social mobility and mortality. Emotional problems significantly increased in July and September 2020 and decreased from December 2020 to February 2021 and then significantly increased in May 2021 relative to June 2020. Older age, feeling lonely, previous diagnosis of mental or neurodevelopmental disorder, previous exposure to traumatic events or psychological aggression, parental psychopathology, and sleeping less than 8/h a day were associated with increased rates of anxiety and depressive symptoms at baseline and over time. Food insecurity and less social contact with family and peers were associated with baseline anxiety and depressive symptoms, and lowest socio-economic strata, chronic disease requiring treatment and family members physically ill due to COVID-19 were associated with increasing rates over time. The pandemic severely affected youth, particularly those from vulnerable populations and in moments of increased mortality and decreased social mobility. Results underscore the need for allocation of resources to services and the continuous monitoring of mental health problems among children and adolescents.
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Saito A, Matsumoto S, Sato M, Sakata Y, Haraguchi H. Relationship between parental autistic traits and parenting difficulties in a Japanese community sample. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 124:104210. [PMID: 35259653 DOI: 10.1016/j.ridd.2022.104210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/21/2022] [Accepted: 02/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Previous studies have suggested an association between higher levels of parental autistic traits and negative aspects of parenting; however, the domain of autistic traits specifically associated with parenting difficulties has not been investigated yet. Moreover, it remains to be determined whether this association exists even after controlling for children's characteristics. AIMS This study examined the relationship between each domain of parental autistic traits and parenting difficulties after controlling for children's characteristics in a Japanese community sample. METHODS AND PROCEDURES Surveys were administered to 1373 Japanese adults who were parents to children in kindergartens, nursery schools, and elementary schools. OUTCOMES AND RESULTS The results showed that parents with higher levels of autistic traits had more parenting difficulties. Even after controlling for children's sex, age, and emotional/behavioral problems, paternal impaired communication and maternal poor attention switching, impaired communication, and lack of imagination were related to higher parenting difficulties, while a higher maternal level of attention to detail was associated with lower difficulties in parenting. CONCLUSIONS AND IMPLICATIONS The findings of this study highlight the importance of focusing on parental autistic traits and providing appropriate parenting support considering these traits.
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Affiliation(s)
- Aya Saito
- Human Science Division, Faculty of Core Research, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; Institute for Education and Human Development, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan; Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan.
| | - Satoko Matsumoto
- Institute for Education and Human Development, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan
| | - Minori Sato
- Faculty of Human Sciences and Cultural Studies, Yamanashi Eiwa College, 888, Yokone-machi, Kofu, Yamanashi 400-8555, Japan
| | - Yukina Sakata
- Department of Human and Social Sciences, Faculty of Letters and Education, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 112-8610, Japan
| | - Hideyuki Haraguchi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan
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Cavicchioli M, Stefanazzi C, Tobia V, Ogliari A. The role of attachment styles in attention-deficit hyperactivity disorder: A meta-analytic review from the perspective of a transactional development model. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1080/17405629.2022.2069095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Marco Cavicchioli
- Faculty of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Chiara Stefanazzi
- Faculty of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Child in Mind Lab, University “Vita-Salute San Raffaele”, Milan, Italy
| | - Valentina Tobia
- Faculty of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Child in Mind Lab, University “Vita-Salute San Raffaele”, Milan, Italy
| | - Anna Ogliari
- Faculty of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Child in Mind Lab, University “Vita-Salute San Raffaele”, Milan, Italy
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Lee YJ, Kim J. Effect of Maternal Anxiety on Parenting Stress of Fathers of Children With ADHD. J Korean Med Sci 2022; 37:e89. [PMID: 35315600 PMCID: PMC8938609 DOI: 10.3346/jkms.2022.37.e89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/17/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Hyperactivity, inattention, and impulsivity of children with attention deficit hyperactivity disorder (ADHD) increase parenting stress and familial conflict. Among parent-related factors, maternal mental health has been studied in-depth, but studies on paternal factors in this context are scarce. This cross-sectional study was conducted of children with ADHD and their parents in South Korea. We investigated the relationships between ADHD symptom severity of children and the mental health of their mothers and fathers. METHODS The study included 70 children with ADHD and their 140 married heterosexual parents (70 fathers and 70 mothers). Children completed the Child Depression Inventory and State-Anxiety Inventory for children, and their parents completed the Korean ADHD rating scale-IV, Adult ADHD self-report scale, State-Anxiety Inventory, Patient Health Questionnaire-9, and Parental Stress Scale. RESULTS There was a significant positive correlation between children's ADHD symptoms and maternal anxiety symptom severity, whereby more severe ADHD symptoms were associated with more severe maternal anxiety symptoms. There was also a significant positive correlation between maternal anxiety symptom severity and paternal parenting stress severity, whereby more severe maternal anxiety was associated with more severe paternal parenting stress. A mediation model showed that paternal parenting stress severity was not directly related to children's ADHD symptoms, but the severity of maternal anxiety mediated this relationship. CONCLUSION The present study found the importance of mental health in mothers of children with ADHD and the interrelatedness of mental health within families. Future assessments and treatment of children with ADHD should include both the children and their parents.
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Affiliation(s)
- Yeon Jung Lee
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, College of Medicine, Seoul, Korea.
| | - Jungho Kim
- Department of Nursing, Masan University, Masan, Korea
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Siebelink NM, Bögels SM, Speckens AEM, Dammers JT, Wolfers T, Buitelaar JK, Greven CU. A randomised controlled trial (MindChamp) of a mindfulness-based intervention for children with ADHD and their parents. J Child Psychol Psychiatry 2022; 63:165-177. [PMID: 34030214 PMCID: PMC9292876 DOI: 10.1111/jcpp.13430] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/07/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Family mindfulness-based intervention (MBI) for child attention-deficit/hyperactivity disorder (ADHD) targets child self-control, parenting and parental mental health, but its effectiveness is still unclear. METHODS MindChamp is a pre-registered randomised controlled trial comparing an 8-week family MBI (called 'MYmind') in addition to care-as-usual (CAU) (n = 55) with CAU-only (n = 48). Children aged 8-16 years with remaining ADHD symptoms after CAU were enrolled together with a parent. Primary outcome was post-treatment parent-rated child self-control deficits (BRIEF); post hoc, Reliable Change Indexes were explored. Secondary child outcomes included ADHD symptoms (parent/teacher-rated Conners' and SWAN; teacher-rated BRIEF), other psychological symptoms (parent/teacher-rated), well-being (parent-rated) and mindfulness (self-rated). Secondary parent outcomes included self-ratings of ADHD symptoms, other psychological symptoms, well-being, self-compassion and mindful parenting. Assessments were conducted at post-treatment, 2- and 6-month follow-up. RESULTS Relative to CAU-only, MBI+CAU resulted in a small, statistically non-significant post-treatment improvement on the BRIEF (intention-to-treat: d = 0.27, p = .18; per protocol: d = 0.33, p = .11). Significantly more children showed reliable post-treatment improvement following MBI+CAU versus CAU-only (32% versus 11%, p < .05, Number-Needed-to-Treat = 4.7). ADHD symptoms significantly reduced post-treatment according to parent (Conners' and SWAN) and teacher ratings (BRIEF) per protocol. Only parent-rated hyperactivity impulsivity (SWAN) remained significantly reduced at 6-month follow-up. Post-treatment group differences on other secondary child outcomes were consistently favour of MBI+CAU, but mostly non-significant; no significant differences were found at follow-ups. Regarding parent outcomes, significant post-treatment improvements were found for their own ADHD symptoms, well-being and mindful parenting. At follow-ups, some significant effects remained (ADHD symptoms, mindful parenting), some additional significant effects appeared (other psychological symptoms, self-compassion) and others disappeared/remained non-significant. CONCLUSIONS Family MBI+CAU did not outperform CAU-only in reducing child self-control deficits on a group level but more children reliably improved. Effects on parents were larger and more durable. When CAU for ADHD is insufficient, family MBI could be a valuable addition.
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Affiliation(s)
- Nienke M. Siebelink
- Donders Institute for Brain, Cognition and BehaviourDepartment of Cognitive NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands,Karakter Child and Adolescent Psychiatry University CenterNijmegenThe Netherlands
| | - Susan M. Bögels
- Department of Developmental PsychologyUniversity of AmsterdamAmsterdamThe Netherlands,Research Institute of Child Development and EducationUniversity of AmsterdamAmsterdamThe Netherlands
| | - Anne E. M. Speckens
- Radboudumc Centre for MindfulnessDepartment of PsychiatryRadboud University Medical CentreNijmegenThe Netherlands
| | - Janneke T. Dammers
- Donders Institute for Brain, Cognition and BehaviourDepartment of Cognitive NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands,Karakter Child and Adolescent Psychiatry University CenterNijmegenThe Netherlands
| | - Thomas Wolfers
- Donders Institute for Brain, Cognition and BehaviourDepartment of Cognitive NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands,Norwegian Centre for Mental Disorders ResearchUniversity of OsloOsloNorway
| | - Jan K. Buitelaar
- Donders Institute for Brain, Cognition and BehaviourDepartment of Cognitive NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands,Karakter Child and Adolescent Psychiatry University CenterNijmegenThe Netherlands
| | - Corina U. Greven
- Donders Institute for Brain, Cognition and BehaviourDepartment of Cognitive NeuroscienceRadboud University Medical CentreNijmegenThe Netherlands,Karakter Child and Adolescent Psychiatry University CenterNijmegenThe Netherlands,Social, Genetic and Developmental PsychiatryInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
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Ji Y, Choi TY, Lee J, Yoon S, Won GH, Jeong H, Kang SW, Kim JW. Characteristics of Attention-Deficit/Hyperactivity Disorder Subtypes in Children Classified Using Quantitative Electroencephalography. Neuropsychiatr Dis Treat 2022; 18:2725-2736. [PMID: 36437880 PMCID: PMC9697401 DOI: 10.2147/ndt.s386774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/11/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study used quantitative electroencephalography (QEEG) to investigate the characteristics of attention-deficit/hyperactivity disorder (ADHD) subtypes in children. PATIENTS AND METHODS There were 69 subjects (42 with ADHD and 27 neurotypical (NT)) in this study. A semi-structured interview was conducted with each participant for psychiatric diagnostic evaluation. We measured the absolute and relative power in 19 channels and analyzed QEEG using the following frequency ranges: delta (1-4 Hz), theta (4-8 Hz), alpha 1 (8-10 Hz), alpha 2 (10-12 Hz), beta 1 (12-15 Hz), beta 2 (15-20 Hz), beta 3 (20-30 Hz), and gamma (30-45 Hz). Group analyses and EEG noise preprocessing were conducted using iSyncBrain, a cloud-based, artificial intelligence EEG analysis platform. Analysis of covariance adjusted for IQ, age, and sex was used. RESULTS QEEG analysis revealed three ADHD subtypes, characterized by (A) elevated relative fast alpha and beta power, (B) elevated absolute slow frequency (delta and theta power), or (C) elevated absolute and relative beta power. A significant difference was found in the Korean ADHD Rating Scale (K-ARS) among the four groups (df=3, F=8.004, p<0.001); group C had the highest score (25.31±11.16), followed by group A (21.67±13.18). The score of group B (12.64±7.84) was similar to that of the NT group (11.07±6.12) and did not reach the cut-off point of the K-ARS. In the Wender-Utah Rating Scale (WURS), group B score (55.82±23.17) was significantly higher than the NT group score (42.81±13.26). CONCLUSION These results indicate that children with ADHD do not constitute a neurophysiologically homogenous group. Children with QEEG subtype B (elevated slow frequency) may be difficult to distinguish from normal children using the K-ARS, which is the most common screening tool for ADHD. Moreover, parents of children with this subtype may be less sensitive to observing ADHD symptoms.
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Affiliation(s)
- Yoonmi Ji
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Tae Young Choi
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Jonghun Lee
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Seoyoung Yoon
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Geun Hui Won
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | | | - Seung Wan Kang
- iMediSync Inc, Seoul, Republic of Korea.,National Standard Reference Data Center for Korean EEG, Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Jun Won Kim
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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Belo-Tomic S, Quinlan E, Read E. Young Adult’s Perception of Their Relationship with an ADHD Parent: A Qualitative Study. CONTEMPORARY FAMILY THERAPY 2021. [DOI: 10.1007/s10591-021-09566-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lugo-Candelas C, Corbeil T, Wall M, Posner J, Bird H, Canino G, Fisher PW, Suglia SF, Duarte CS. ADHD and risk for subsequent adverse childhood experiences: understanding the cycle of adversity. J Child Psychol Psychiatry 2021; 62:971-978. [PMID: 33289088 PMCID: PMC8169708 DOI: 10.1111/jcpp.13352] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children with adverse childhood experiences (ACEs) are more likely to develop Attention-Deficit/Hyperactivity Disorder (ADHD). The reverse relationship - ADHD predicting subsequent ACEs - is vastly understudied, although it may be of great relevance to underserved populations highly exposed to ACEs. METHODS Participants were 5- to 15-year-olds (48% females) with (9.9%) and without ADHD (DSM-IV criteria except age of onset) in a longitudinal population-based study of Puerto Rican youth. In each wave (3 yearly assessments, W1-3), ten ACEs (covering parental loss and maladjustment and child maltreatment) were examined, plus exposure to violence. Logistic regression models examined ADHD (including subtypes) and subsequent risk for ACEs. Also considered were interactions by age, sex, number of W1 ACEs, and recruitment site. RESULTS Children with W1 ADHD were more likely to experience subsequent adversity (OR: 1.63; 95% CI: 1.12-2.37) accounting for child age, sex, public assistance, maternal education, site, disruptive behavior disorders, and W1 ACEs. Inattentive (OR: 2.00; 95% CI: 1.09-3.66), but not hyperactive/impulsive or combined ADHD, predicted future ACEs. CONCLUSIONS ADHD predicts subsequent risk for ACEs, and the inattentive presentation may confer the most risk. Inattentive presentations could pose a bigger risk given differences in symptom persistence, latency to access to treatment, and treatment duration. The present study suggests a pathway for the perpetuation of adversity, where bidirectional relationships between ADHD and ACEs may ensnare children in developmental pathways predictive of poor outcomes. Understanding the mechanism underlying this association can help the development of interventions that interrupt the cycle of adversity exposure and improve the lives of children with ADHD.
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Affiliation(s)
- Claudia Lugo-Candelas
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Thomas Corbeil
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Melanie Wall
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Jonathan Posner
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Hector Bird
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, PR,USA
| | - Prudence W. Fisher
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
| | | | - Cristiane S. Duarte
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY,USA
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Li D, Cui X, Yan T, Liu B, Zhang H, Xiang J, Wang B. Abnormal Rich Club Organization in Hemispheric White Matter Networks of ADHD. J Atten Disord 2021; 25:1215-1229. [PMID: 31884863 DOI: 10.1177/1087054719892887] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Brain network studies have revealed abnormal topology asymmetry of white matter (WM) in ADHD. Recently, rich club organization was proposed to be a key feature of brain network topology. However, abnormalities in the rich club organization of hemispheric WM networks in ADHD remain unclear. Method: Forty ADHD patients and 51 normal controls participated in this study. Structural networks were reconstructed based on diffusion tensor imaging (DTI) and analyzed with graph theory. Results: The two groups exhibited different patterns of asymmetry in connectivity measures of rich club connections. ADHD patients showed more feeder connections than normal controls. Reduced rightward asymmetry was observed in connectivity measures of local connections involving several peripheral regions of the ADHD patients. In addition, abnormal regional asymmetry scores were associated with ADHD symptoms. Conclusion: The topological changes in rich club organization provide a novel insight into the alteration of WM connections in ADHD.
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Affiliation(s)
- Dandan Li
- Taiyuan University of Technology, China
| | | | - Ting Yan
- Shanxi Medical University, Taiyuan, China
| | - Bo Liu
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hui Zhang
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Jie Xiang
- Taiyuan University of Technology, China
| | - Bing Wang
- Taiyuan University of Technology, China
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Approach to Evaluating and Managing Adult Attention-Deficit/Hyperactivity Disorder in Primary Care. Harv Rev Psychiatry 2021; 28:100-106. [PMID: 32134834 DOI: 10.1097/hrp.0000000000000248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Requests for the evaluation of potential adult attention-deficit/hyperactivity disorder (ADHD) is on the rise across primary care clinics. Many health care providers, however, may feel ill equipped to diagnose and manage adults presenting with inattention and impulsivity. The diagnosis of ADHD is often complicated by medical and psychiatric conditions that can contribute to inattention symptoms. In this article, the authors provide a pragmatic clinical approach for evaluating and managing adult ADHD in the primary care setting.
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Gómez-Álzate AM, Hidalgo-López C, García-Valencia J, Martínez-Zamora M, Aguirre-Acevedo DC, Cuartas-Arias M, Arcos-Burgos M, Valencia-Evhecerry J, Lopez-Jaramillo C, Palacio-Ortiz JD. Psychopathological Risk in Siblings of Subjects with Attention-Deficit/Hyperactivity Disorder: A cross-Sectional Study. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00077-9. [PMID: 34147265 DOI: 10.1016/j.rcp.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/20/2021] [Accepted: 03/23/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We aim to determine the prevalence of mental disorders in siblings of children with attention deficit hyperactivity disorder (ADHD), and to determine how psychosocial adversity factors relate to this psychopathology, in a low-middle income country (Colombia). METHODS We evaluated subjects with ADHD diagnosed according to the DSM-5 criteria, one of their parents and one of their siblings (ages 8-19). We used the ADHD rating scale and a set of instruments to assess the presence of mental disorders as well as psychosocial adversity. RESULTS We evaluated 74 trios formed by the index case with ADHD, one sibling and one of the parents. We found that 24.3% of the participating siblings also met the criteria for ADHD and another 24.3% for other psychiatric disorders. The risk of these siblings having ADHD increased further when one of the parents reported a history of ADHD. We also found that 28.3% of the families faced high levels of psychosocial adversity as per their scores in the Rutter Adversity Index. CONCLUSIONS Siblings of subjects with ADHD showed a significant risk for ADHD and other mental disorders. That risk increased if a parent reported a history of ADHD and also when two or more psychosocial adversity factors were present. This study supports the importance of early detection in efforts to decrease the risk for other siblings.
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Affiliation(s)
- Alejandra María Gómez-Álzate
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Catalina Hidalgo-López
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jenny García-Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Instituto de Investigaciones Médicas, Universidad de Antioquia, Medellín, Colombia
| | | | | | - Mauricio Cuartas-Arias
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mauricio Arcos-Burgos
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Johanna Valencia-Evhecerry
- Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Carlos Lopez-Jaramillo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia. Hospital Universitario San Vicente de Paúl, Medellín, Colombia; Grupo de investigación en psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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Gómez-Cano S, Zapata-Ospina JP, Arcos-Burgos M, Palacio-Ortiz JD. The role of psychosocial adversity in the aetiology and course of attention deficit hyperactivity disorder. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 52:S0034-7450(21)00048-2. [PMID: 33849717 DOI: 10.1016/j.rcp.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/05/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Attention deficit/hyperactivity disorder (ADHD) has genetic and environmental aetiological factors. There are few publications on the environmental factors. The objective of this review is to present the role of psychosocial adversity in the aetiology and course of ADHD. METHODS A search was carried out in the following databases: PubMed, ScienceDirect, SciELO, ClinicalKey, EMBASE, Lilacs, OVID, APA and PsycNET. English and Spanish were selected without being limited by type of study or year of publication. Finally, a qualitative synthesis was conducted. RESULTS ADHD development could be related to exposure to adverse factors in the family, school or social environment. It has been proposed as an explanatory mechanism that adversity interacts with genetic variants and leads to neurobiological changes. There may also be a gene-environment correlation whereby individual hereditary characteristics increase the risk of exposure to adversity, and indirectly increase the probability of developing ADHD. Research on psychosocial adversity represents a big challenge, not only due to the complexity of its construct, but also to the effect of subjective perception of a given event. CONCLUSIONS ADHD aetiology is complex and involves the interaction of both genetic and environmental factors, in which these factors correlate and cause the disorder. The study of the role of psychosocial adversity in ADHD is fundamental, but it remains a task that entails great difficulties.
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Affiliation(s)
- Sujey Gómez-Cano
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan Pablo Zapata-Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mauricio Arcos-Burgos
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan David Palacio-Ortiz
- Hospital San Vicente de Paúl, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia; Grupo de Investigación en Psiquiatría (GIPSI), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
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McDonnell CG, DeLucia EA. Pregnancy and Parenthood Among Autistic Adults: Implications for Advancing Maternal Health and Parental Well-Being. AUTISM IN ADULTHOOD 2021; 3:100-115. [PMID: 36601267 PMCID: PMC8992883 DOI: 10.1089/aut.2020.0046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Strikingly little research has considered how autistic adults experience pregnancy and parenthood, two key transition periods in adult development with potentially far-reaching implications for physical and psychosocial health outcomes across the lifespan. This article reviews the research on pregnancy and parenthood among autistic adults, to summarize existing research and identify future directions to advance this critical area of study. Methods We conducted a systematic review of the literature on pregnancy and parenthood among autistic adults. Researchers extracted selected articles for key information, including methodology and sample size, study location, demographic characteristics of participants, measurement approaches, and key study findings. Results Overall, we identified 13 studies that used a range of quantitative and qualitative approaches to study pregnancy experiences and outcomes and parenthood among autistic adults. The findings show that autistic adults (1) experience difficulties and dissatisfaction communicating with health care providers throughout pregnancy and birth, (2) are more likely to experience depression during and after pregnancy, and (3) experience higher rates of pregnancy complications, including preterm birth, cesarean delivery, and pre-eclampsia. During parenthood, autistic adults report lower parenting competence, experience parenthood as isolating, have difficulty communicating with professionals about their child and are questioned by providers about their ability to parent, experience high rates of involvement with child protective services, and express a desire for increased parenting support. Autistic adults also reported parenting strengths, including high levels of finding parenthood rewarding and putting their children's needs ahead of their own. Conclusions A key limitation of the literature is the significant lack of sociodemographic diversity among participants, the small number of existing studies, and reliance on cross-sectional mono-method designs. Future research should be conducted in partnership with autistic adults to develop assessment and intervention approaches for supporting pregnancy health and parental well-being among diverse and underserved communities. Lay summary Why is this topic important?: Very little is known about how autistic adults experience pregnancy and parenthood. Better understanding these experiences is important, because pregnancy and parenthood are key transition periods in adult development that are associated with a range of health outcomes later in life.What is the purpose of this article?: This article reviews the existing research on pregnancy and parenthood among autistic adults. We wanted to summarize what is already known, evaluate how that knowledge was created, and consider who has and who has not been included in this research to inform future research. We summarized 13 studies that considered pregnancy or parenthood among autistic adults.What did the authors find about pregnancy among autistic adults?: One study used data from hospital and birth records in Sweden, and showed that autistic women experience higher rates of pregnancy complications, such as preterm birth (early delivery before 37 weeks), cesarean delivery, and pre-eclampsia (a condition defined by high blood pressure during pregnancy). Two studies had autistic and nonautistic adults fill out online surveys about their experiences, and found that autistic adults are more likely to have depression during and after pregnancy, have more difficulty interacting with health care professionals at pregnancy appointments and during the birth process, and feel that information and support services for pregnancy do not always meet their needs. Autistic women also reported that sensory differences can make health care visits during pregnancy especially difficult, and described that they may experience anxiety and confusion when interacting with health care staff.What did the authors find about parenthood among autistic adults?: The research we reviewed showed that autistic adults experience strengths and difficulties in parenting. Many autistic adults found parenthood rewarding, but also felt isolated as parents and had difficulty communicating with health care professionals about their children. Autistic adults also had high rates of interacting with child protective services (CPS). Some research also found that autistic adults had lower self-confidence in parenting, although findings are mixed.What are the recommendations for future research and practice?: We need to develop support strategies to promote pregnancy health and parenting satisfaction in partnership with autistic adults. For example, it may be helpful to develop communication tools that can support autistic adults during pregnancy, labor, and birth. We also recommend that future research develop questionnaires to ask autistic adults about their pregnancy and parenting experiences in sensitive ways, so that in the future providers can regularly ask autistic adults about their support needs. Most importantly, it is critical that future research also include more diverse autistic participants in their research, including racial/ethnic and sexual and gender minorities.How will these findings help autistic adults now or in the future?: We hope that this article will help guide future research that strives to better understand how autistic adults experience pregnancy and parenthood. Ultimately, we believe this research can lead to supports and intervention strategies that can improve pregnancy health and parental well-being for autistic adults.
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Affiliation(s)
- Christina G. McDonnell
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA.,Address correspondence to: Christina G. McDonnell, PhD, Department of Psychology, Virginia Polytechnic Institute and State University, Williams Hall, Virginia Tech, Blacksburg, VA 24061, USA
| | - Elizabeth A. DeLucia
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
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Woods KE, Mazursky-Horowitz H, Thomas SR, Dougherty LR, Chronis-Tuscano A. The Unique Effects of Maternal ADHD Symptoms and Emotion Dysregulation on Parenting Behavior. J Atten Disord 2021; 25:672-684. [PMID: 30762448 DOI: 10.1177/1087054719829820] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Separate literatures have examined the associations between maternal ADHD symptoms and parenting and maternal emotion regulation (ER) and parenting. This study examined the effects of both maternal ADHD symptoms and ER on parenting. Method: This cross-sectional study used a multi-method evaluation of parenting behavior to examine the independent and interactive effects of maternal ADHD symptoms and ER on self-reported and observed parenting among 79 demographically diverse families of 5- to 10-year-old children. Results: There were significant main effects of maternal ER difficulties on negative parenting and of maternal ADHD symptoms on harsh responses to children's negative emotions. Maternal ADHD symptoms and ER were not significantly associated with positive parenting behavior. No interaction effects were observed. Conclusion: Maternal ADHD symptoms and emotion dysregulation may uniquely contribute to parenting difficulties. Maternal ADHD symptoms were associated with difficulties responding to children's negative emotions, whereas maternal ER was associated with difficulties with discipline practices.
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Roigé-Castellví J, Morales-Hidalgo P, Voltas N, Hernández-Martínez C, van Ginkel G, Canals J. Prenatal and perinatal factors associated with ADHD risk in schoolchildren: EPINED epidemiological study. Eur Child Adolesc Psychiatry 2021; 30:347-358. [PMID: 32242248 DOI: 10.1007/s00787-020-01519-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 03/22/2020] [Indexed: 11/29/2022]
Abstract
The aim of this study is to assess the relationship between pre- and perinatal factors and ADHD in a sample of scholars exploring differences between ADHD presentations and spectrum of severity. A total of 6720 scholars (aged 3-4 and 10-11) participated in a double-phase epidemiologic cross-sectional study (Epidemiological Study of Neurodevelopmental Disorders, EPINED), and a sample of 646 scholars (ADHD risk, ASD risk and controls without risk) were individually assessed in the second phase of the study. The ADHD diagnosis, based on DSM-5 criteria, was performed with the Kiddie-Schedule for Affective Disorders & Schizophrenia, Present & Lifetime Version. Associations for the different ADHD presentations between prenatal, perinatal and postnatal factors and ADHD (n = 168), subclinical ADHD (n = 88) and non-ADHD (n = 310) were analysed. Logistic regression models showed that gestational diabetes (p = 0.012), instrumental delivery (p = 0.011), family history of psychopathology (p = 0.033) and maternal ADHD phenotype (p = 0.023) were associated with ADHD. These factors were related to the hyperactive-impulsive and combined presentations, but they were not related to the inattentive presentation. Maternal weight gain was associated with subclinical ADHD. In conclusion, metabolic disorder in the pregnancy, difficulties in childbirth and specific family phenotype were related to ADHD, specifically with hyperactive-impulsive presentation, but not in subclinical ADHD.
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Affiliation(s)
- Joana Roigé-Castellví
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Paula Morales-Hidalgo
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Núria Voltas
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Carmen Hernández-Martínez
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Georgette van Ginkel
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain
| | - Josefa Canals
- Department of Psychology, Facultat de Ciències de l'Educació i Psicologia, Research Center for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili, Carretera de Valls, s/n, 43007, Tarragona, Spain.
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Sharp W, Mangalmurti A, Hall C, Choudhury S, Shaw P. Associations between neighborhood, family factors and symptom change in childhood attention deficit hyperactivity disorder. Soc Sci Med 2021; 271:112203. [PMID: 30857751 PMCID: PMC6748875 DOI: 10.1016/j.socscimed.2019.02.054] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 01/28/2019] [Accepted: 02/27/2019] [Indexed: 11/27/2022]
Abstract
Transactional theories view development as partly shaped by processes proximal to a child, which in turn interact with more distal neighborhood and societal contexts. Here we apply this theory to parse the interplay between neighborhood and familial factors on age-related change in symptoms of inattention and hyperactivity-impulsivity (ADHD). A cohort of 190 children (96 with ADHD) had a range of neighborhood and familial factors ascertained and had repeated clinical assessments over an average of 2.5 years at a U.S. research center. Using mixed model regression, we found an association between neighborhood wealth, but not the built environment, and the annual rate of change of inattentive but not hyperactive-impulsive symptoms. Following the transactional model, we asked if familial processes explain (mediate), modify (moderate), or act alongside this effect of neighborhood wealth on the change in a child's symptoms of inattention with age. We found evidence for moderation. Specifically, several family level variables - parental economic/education status and degree of family conflict and order moderated the effects of neighborhood wealth on the change in a child's inattentive symptoms. Children living in relatively affluent neighborhoods showed improvement with age in inattention, largely independent of variation in a wide range of familial factors. By contrast, children living in less affluent neighborhoods showed clinical deterioration only if the family had high levels of conflict or if the parents were of lower economic/educational status. Such work might help identify children whose familial and neighborhood contexts place them at risk of having ADHD symptoms persist or increase with age.
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Affiliation(s)
- Wendy Sharp
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD, 20892, USA.
| | - Aman Mangalmurti
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, Bldg 31 B137, Bethesda, 20892, USA
| | - Carlisha Hall
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, Bldg 31 B137, Bethesda, 20892, USA
| | - Saadia Choudhury
- Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, Bldg 31 B137, Bethesda, 20892, USA
| | - Philip Shaw
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD, 20892, USA; Neurobehavioral Clinical Research Section, Social and Behavioral Research Branch, National Human Genome Research Institute, Bldg 31 B137, Bethesda, 20892, USA
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Zaidman-Zait A, Shilo I. Parental ADHD Symptoms and Inhibitory Control in Relation to Parenting Among Mothers of Children With and Without ADHD. J Atten Disord 2021; 25:389-402. [PMID: 30442044 DOI: 10.1177/1087054718808063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: The study examined how the interplay between maternal ADHD symptoms and maternal inhibitory control and child ADHD is related to parenting behaviors. Method: The sample included 141 mothers and their 8- to 12-year-old children, 61 children with ADHD and 80 without. Parenting was measured using self-reports (i.e., overreactive and lax parenting) and observation (i.e., negative and supportive parenting). Maternal inhibitory control was measured using a neurocognitive task. Hierarchical multiple regressions were conducted to predict parenting, controlling for child sex, conduct behaviors, and parenting distress. Results: Interactions between maternal ADHD symptoms and maternal inhibitory control suggested that hyperactive-impulsive symptoms were linked to parenting negativity only when inhibitory control was low, and maternal inattention symptoms were related to lax parenting only when maternal inhibitory control was high or when children did not have ADHD. Conclusion: Results indicate the importance of maternal regulation processes in the mechanisms linking maternal ADHD with parenting.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel.,The University of British Columbia, Vancouver, Canada
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Prenatal and Postnatal Predictive Factors for Children's Inattentive and Hyperactive Symptoms at 5 Years of Age: The Role of Early Family-related Factors. Child Psychiatry Hum Dev 2021; 52:783-799. [PMID: 32951139 PMCID: PMC8405488 DOI: 10.1007/s10578-020-01057-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 11/06/2022]
Abstract
We examined several parent-reported prenatal and postnatal factors as potential risk factors for attention-deficit and hyperactivity disorder (ADHD) symptomatology in 5-year-old children. Our study is based on the CHILD-SLEEP birth cohort. Several parental questionnaires were collected prenatally (32nd pregnancy week) and postnatally (i.e. child aged 3, 8, and 24 months and at 5 years). At 5 years of age, ADHD symptoms were assessed using questionnaires. Our main results showed that being a boy, parental depressive symptoms, more negative family atmosphere or a child's shorter sleep duration, and maternal authoritarian parenting style predicted inattentive/hyperactive symptoms. Maternal and paternal authoritative parenting style predicted less inattentive/hyperactive symptoms. Children with several risk factors together had the highest risk for inattentive/hyperactive symptoms. Our findings emphasise the need for early screening and treatment of parental mental health, and early evidence-based targeted parental support, to enable early intervention in those children at a risk of developing ADHD.
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Abstract
Objective: The aim of this study is to examine the role of parental emotion regulation (ER) and parental mentalization as possible contributors to hostile and coercive parenting in families of children with ADHD. Method: Seventy-four Israeli families (64 mothers and 48 fathers) seeking parent training for child ADHD completed measures during the intake session. Measures included parental ER; parental mentalization; hostile, coercive, and submissive parenting; and child symptoms. Results: Findings suggested a relationship between parental ER and coercive parenting independent of child age, symptom level, and parental mentalization. Parental mentalization appeared to buffer against hostility specifically among parents with low ER capacities. Patterns were parallel for mothers and fathers. Conclusion: Study findings highlight the importance of evaluating and addressing parental ER in interventions attempting to reduce coercive parenting. The findings also highlight the potential role of parental mentalization as a protective mechanism against hostile parenting in families of children with ADHD.
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Kroeger RA, Umberson D, Powers DA, Forrest DL. The Effects of Family Transitions on Depressive Symptoms: Differences among Young Adults with and without Childhood Symptoms of Attention-Deficit/ Hyperactivity Disorder. SOCIETY AND MENTAL HEALTH 2020; 10:237-256. [PMID: 34540341 PMCID: PMC8445594 DOI: 10.1177/2156869319859402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is tied to higher levels of depression, but the social factors that shape these associations are not well understood. This study considers whether family transitions affect depressive symptoms differently for young adults with and without childhood symptoms of ADHD at subthreshold or diagnostic levels. Between-within regression analysis of nationally representative longitudinal survey data shows that transitions into cohabitation and parenthood affect depressive symptoms differently for young adults with and without childhood symptoms of ADHD. Specifically, within-person effects indicate that transitions into cohabitation and parenthood are tied to decreases in depressive symptoms, but only for young adults without childhood symptoms of ADHD. In contrast, transitions into marriage are tied to decreases in depressive symptoms, and transitions out of coresidential unions are tied to increases in depressive symptoms, regardless of childhood symptoms of ADHD. The results suggest that some family transitions may work to widen ADHD disparities in depression, under-scoring the importance of family contexts for shaping mental health throughout the life course.
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The Longitudinal Relation between Observed Maternal Parenting in the Preschool Period and the Occurrence of Child ADHD Symptoms in Middle Childhood. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:755-764. [PMID: 30417251 PMCID: PMC6469827 DOI: 10.1007/s10802-018-0492-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In this longitudinal population-based cohort (N = 547) we examined the relation between maternal discipline and sensitivity in the preschool period and the occurrence of attention-deficit hyperactivity disorder (ADHD) symptoms in middle childhood, taking into account pre-existing child attention and executive function (EF) problems, and oppositional defiant disorder (ODD) symptom comorbidity. Maternal parenting was observed during a ‘do not touch task’ (positive and negative discipline) and a teaching task (sensitivity) at age 3. Parents reported on the occurrence of ADHD and ODD symptoms at age 8 using the Conners’ Parent Rating Scale. Attention and executive function problems were assessed using parent questionnaires at age 4. Important covariates such as harsh discipline and maternal depression were also taken into account. Maternal sensitivity significantly predicted later ADHD symptoms beyond pre-existing child attention and EF problems, and comorbid ODD symptoms. However, maternal negative and positive discipline did not significantly predict later ADHD symptoms over and above these covariates. This study demonstrates the importance of maternal sensitivity in the etiology of core ADHD symptoms above and beyond pre-existing child attention and EF problems, and comorbid ODD symptoms.
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Young S, Adamo N, Ásgeirsdóttir BB, Branney P, Beckett M, Colley W, Cubbin S, Deeley Q, Farrag E, Gudjonsson G, Hill P, Hollingdale J, Kilic O, Lloyd T, Mason P, Paliokosta E, Perecherla S, Sedgwick J, Skirrow C, Tierney K, van Rensburg K, Woodhouse E. Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry 2020; 20:404. [PMID: 32787804 PMCID: PMC7422602 DOI: 10.1186/s12888-020-02707-9] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/31/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is evidence to suggest that the broad discrepancy in the ratio of males to females with diagnosed ADHD is due, at least in part, to lack of recognition and/or referral bias in females. Studies suggest that females with ADHD present with differences in their profile of symptoms, comorbidity and associated functioning compared with males. This consensus aims to provide a better understanding of females with ADHD in order to improve recognition and referral. Comprehensive assessment and appropriate treatment is hoped to enhance longer-term clinical outcomes and patient wellbeing for females with ADHD. METHODS The United Kingdom ADHD Partnership hosted a meeting of experts to discuss symptom presentation, triggers for referral, assessment, treatment and multi-agency liaison for females with ADHD across the lifespan. RESULTS A consensus was reached offering practical guidance to support medical and mental health practitioners working with females with ADHD. The potential challenges of working with this patient group were identified, as well as specific barriers that may hinder recognition. These included symptomatic differences, gender biases, comorbidities and the compensatory strategies that may mask or overshadow underlying symptoms of ADHD. Furthermore, we determined the broader needs of these patients and considered how multi-agency liaison may provide the support to meet them. CONCLUSIONS This practical approach based upon expert consensus will inform effective identification, treatment and support of girls and women with ADHD. It is important to move away from the prevalent perspective that ADHD is a behavioural disorder and attend to the more subtle and/or internalised presentation that is common in females. It is essential to adopt a lifespan model of care to support the complex transitions experienced by females that occur in parallel to change in clinical presentation and social circumstances. Treatment with pharmacological and psychological interventions is expected to have a positive impact leading to increased productivity, decreased resource utilization and most importantly, improved long-term outcomes for girls and women.
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Affiliation(s)
- Susan Young
- Psychology Services Limited, PO 1735, Croydon, London, CR9 7AE, UK.
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.
| | - Nicoletta Adamo
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
- Service for Complex Autism and Associated Neurodevelopmental Disorders, South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, London, UK
| | | | | | | | | | | | - Quinton Deeley
- National Autism Unit, Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, Beckenham, UK
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Emad Farrag
- South London & Maudsley NHS Foundation Trust, Maudsley Health, Abu Dhabi, UAE
| | - Gisli Gudjonsson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Peter Hill
- Independent Consultant in Child and Adolescent Psychiatry, Private Practice, London, UK
| | - Jack Hollingdale
- Michael Rutter Centre, South London and Maudsley Hospital, London, UK
| | | | | | - Peter Mason
- ADHD and Psychiatry Services Limited, Liverpool, UK
| | | | | | - Jane Sedgwick
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, UK
- Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Caroline Skirrow
- Cambridge Cognition, Cambridge, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Kevin Tierney
- Neuropsychiatry Team, National Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kobus van Rensburg
- Adult ADHD and AS Team & CYP ADHD and ASD Service in Northamptonshire, Northampton, UK
| | - Emma Woodhouse
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
- Compass, London, UK
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Park JL, Johnston C. The Relations Among Stress, Executive Functions, and Harsh Parenting in Mothers. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:619-632. [PMID: 31997129 DOI: 10.1007/s10802-020-00622-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Stress is a common experience that can spillover into parenting, which in turn has important implications for child behavior. Parents' executive functioning (EF) may buffer the association between feelings of stress and parenting. However, using lower socioeconomic status (SES) and household chaos as indicators of stress, research has demonstrated inconsistent patterns with regard to this moderating role of EF. This study's first aim examined the moderating role of maternal EF on the associations between SES and household chaos, and harsh parenting. The second aim investigated the effects of experimentally induced stress on harsh parenting and whether maternal EF moderated these effects. A final sample of 101 mothers of 6 to 10-year-old children participated by completing measures of EF, household chaos, SES, and harsh parenting. Additionally, mothers were randomly assigned to either a stress group or a control group. Throughout the stress (or control) induction, mothers rated their harsh parenting in response to child misbehavior vignettes. Findings revealed that stronger EF reduced the association between household chaos and harsh parenting. There were no significant effects of SES or experimentally induced stress on harsh parenting, and EF was not a significant moderator for these stressors. These results highlight the buffering role of EF for more chronic stressors such as household chaos. SES and more acute stress, as manipulated by the TSST, at least in the current sample, may be less relevant.
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Affiliation(s)
- Joanne L Park
- Department of Psychology, The University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada.
| | - Charlotte Johnston
- Department of Psychology, The University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
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Insa Pineda I, Huguet Miguel A, Chamorro Fernández M, Espadas Tejerina M, González CLG, Alda JA. ADHD Symptoms, Academic and Social Difficulties in Parents of Children with ADHD. Psychiatry 2020; 83:231-243. [PMID: 32729785 DOI: 10.1080/00332747.2020.1762395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: To evaluate the prevalence of ADHD in a group of parents of children with ADHD compared with the general population. To compare academic level, unemployment aid rate and marital separations/divorce of this parents sample. Methodology: The experimental group was formed by the parents of 60 children with ADHD. The control group was formed by the parents of 60 healthy children. To assess the retrospective and current ADHD symptomatology among the parents of the sample the Wender Utah Rating Scale (WURS) and the Attention Deficit Hyperactivity Disorder-rating scale (ADHD.rs) were used. Also, the Hollingshead Four-Factor Index of Socioeconomic status (SES-Child) was used. Results: 20.33% of the mothers in the case group met criteria for a retrospective diagnosis of ADHD, while none of the control group mothers met criteria (p < .01). Regarding fathers, there was a retrospective ADHD diagnosis in 25% of the case group compared to 10% in the control group (p < .01). In terms of the current symptoms, 25.42% of the mothers and 21.43% of fathers in the case group met diagnostic criteria for probable ADHD compared to 1.67% in the control group (p < .01 in both genders). Parents in the case group had a lower academic level (p < .01), received more unemployment aid (p = .02) and reported a higher rate of marital separation or divorce (p = .02). Conclusions: Parents of children with ADHD have a higher incidence of retrospective and current ADHD diagnosis and they also present worse socioeconomic factors.
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Tedgård E, Tedgård U, Råstam M, Johansson BA. Parenting stress and its correlates in an infant mental health unit: a cross-sectional study. Nord J Psychiatry 2020; 74:30-39. [PMID: 31553257 DOI: 10.1080/08039488.2019.1667428] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: An infant's development is closely linked to the relationship they have with their parents. Parenting stress, affective disorder, and an upbringing with substance-abusing parents can affect parenting quality and increase the risk of children developing behavioral, mental and social problems. The overall aim of the study was to investigate how parents of children attending an outpatient Infant Mental Health (IMH) unit rate their own psychological health and parenting stress, and to explore predictors of parenting stress.Methods: The sample comprised 197 parents, 129 mothers and 68 fathers, referred with their infant/toddler to an outpatient IMH unit for interplay treatment. On admission, the parents completed self-report questionnaires concerning their own mental health problems and parenting stress.Results: The mothers reported significantly more psychiatric symptoms and parenting stress than the fathers. Fathers with substance-abusing parents had often experienced divorce in the family of origin, had a low level of education, and had often experienced trauma. Depression was a predictor for parenting stress for both mothers and fathers.Conclusion: The parents' situation was strained, presenting a variety of psychiatric symptoms and high levels of parenting stress, making assessment of parental health before starting treatment important. The mothers' situations were more serious compared with the fathers', and for both parents depression was a significant predictor for parenting stress. To increase the chances of a positive treatment outcome for the child, both parents should be included in the treatment.
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Affiliation(s)
- Eva Tedgård
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden.,Child and Adolescent Psychiatry, Infant and Toddler Unit, Skåne University Hospital, Malmö, Sweden
| | - Ulf Tedgård
- Department of Pediatric Hematology and Oncology, Skåne University Hospital, Lund, Sweden.,Department of Clinical Sciences Lund, Pediatrics, Lund University, Lund, Sweden
| | - Maria Råstam
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden.,Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Björn Axel Johansson
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden.,Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, Skåne University Hospital, Malmö, Sweden
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48
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Schwörer MC, Nitkowski D, Petermann† F, Petermann U. Belastungserleben von Müttern mit Kindern mit ADHS. KINDHEIT UND ENTWICKLUNG 2020. [DOI: 10.1026/0942-5403/a000299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Zusammenfassung. Eltern von Kindern mit ADHS berichten von einer hohen psychischen Belastung, die durch die eigene und die kindliche Symptomatik bedingt scheint. Ziel der Studie ist es erstens zu prüfen, ob sich die mütterliche Belastung in Abhängigkeit davon unterscheidet, welche ADHS-Erscheinungsform bei den Kindern vorliegt und ob eine komorbide Symptomatik einer Störung mit oppositionellem Trotzverhalten (SOT) besteht. Zum zweiten soll untersucht werden, welche kindlichen und welche elterlichen Faktoren am besten die Gesamtbelastungen der Mütter aufklären können. An der Studie nahmen 207 Kinder ( M = 9.00 Jahre; SD = 1.52; 65.2 % männlich) teil. Von diesen wurden 138 Kinder nach dem ADHS-Erscheinungsbild (DSM-5) und nach der SOT in vier Untergruppen eingeteilt (unaufmerksames und gemischtes Erscheinungsbild mit/ohne SOT). Bei 157 Kindern wurden die mütterlichen (ADHS, Depression und Erziehungsstatus) und kindlichen Faktoren (ADHS, SOT und die Anzahl der im Haushalt lebenden Kinder) erhoben. Die Ergebnisse belegen, dass Mütter von Kindern, die neben einer ADHS eine zusätzliche SOT aufweisen, die größte Belastung berichten. Die mütterliche Depression und die gemischte ADHS-Erscheinungsform mit komorbider SOT des Kindes sagten die Belastung der Mütter am besten vorher. Im klinischen Kontext sollte bei Müttern von Kindern, die ein gemischtes ADHS-Erscheinungsbild mit SOT aufweisen, gezielt eine depressive Symptomatik abgeklärt werden.
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Affiliation(s)
| | - Dennis Nitkowski
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann†
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Ulrike Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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49
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Newlove-Delgado T, Ford TJ, Hamilton W, Janssens A, Stein K, Ukoumunne OC. Resumption of attention-deficit hyperactivity disorder medication in early adulthood: findings from a UK primary care prescribing study. Eur Child Adolesc Psychiatry 2019; 28:1589-1596. [PMID: 30949828 PMCID: PMC6861538 DOI: 10.1007/s00787-019-01325-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/26/2019] [Indexed: 11/30/2022]
Abstract
This study aimed to examine the resumption of attention-deficit hyperactivity disorder (ADHD) prescriptions in early adulthood in young people whose ADHD prescriptions stopped in adolescence. Whilst prescribing studies indicate that the proportion of those with ADHD stopping treatment in late adolescence remains in excess of the proportion expected to be symptom free, very few studies have examined patterns of resumption amongst young adults previously prescribed medication. Primary care records from the UK Clinical Practice Research Datalink from 2008 to 2013 were used to examine the outcome of resumption of ADHD prescriptions from age 20 years in a sample of cases with ADHD whose prescriptions stopped aged 14-18 years. A Cox regression model was fitted to explore variables that could theoretically be associated with resumption of prescriptions. Of 1440 cases, 109 (7.6%) had their ADHD prescriptions resumed. Characteristics associated with an increased probability of resumption included female gender, learning disability, referral to adult mental health services, and prescription of antipsychotic medication. In this study, only a small proportion of adolescents who stopped ADHD medication subsequently resumed their prescriptions in primary care. Those that did resume were a more complex group. As many vulnerable individuals with ongoing ADHD symptoms may not have the resources required to surmount the barriers to re-enter services, the implication is that not all those who could benefit from resuming medication are able to do so. The findings raise questions around whether current care models are flexible enough and whether primary care services are adequately supported in managing this group.
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Affiliation(s)
- Tamsin Newlove-Delgado
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
| | - Tamsin J Ford
- Child and Adolescent Psychiatry, University of Exeter Medical School, Exeter, UK
| | - Willie Hamilton
- Primary Care Diagnostics, University of Exeter Medical School, Exeter, UK
| | - Astrid Janssens
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ken Stein
- Public Health, NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Obioha C Ukoumunne
- Medical Statistics, NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
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50
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Zaidman-Zait A. The contribution of maternal executive functions and active coping to dyadic affective dynamics: Children with autism spectrum disorder and their mothers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:645-657. [PMID: 31647318 DOI: 10.1177/1362361319854653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Parenting is a cognitive, emotional, and behavioral endeavor, where parents' control capacities, including executive functions and active control coping, help parents to guide and regulate interactions with their children; yet limited research investigates how these capacities are associated with parent-child affective regulation processes during parent-child interactions. This study examined whether maternal executive functions (sustained attention, interference inhibitory control, working memory) and active engaged coping were related to dyadic affective flexibility and positive mutual affective interactions between mothers and their young children with autism spectrum disorders (N = 40). Dyadic flexibility and mutual positive affect were measured using dynamic systems-based modeling of second-by-second affective patterns during a mother-child interaction. The results showed that higher levels of maternal sustained attention and inhibitory control were related to increased dyadic affective flexibility. In addition, higher levels of maternal sustained attention and higher use of engaged coping were related to dyadic mutual positive affect. The findings highlight the importance of maternal cognitive control capacity in promoting adaptive parent-child dyadic regulatory processes.
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Affiliation(s)
- Anat Zaidman-Zait
- Tel Aviv University, Israel.,The University of British Columbia, Canada
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