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Faraone SV, Newcorn JH, Wozniak J, Joshi G, Coffey B, Uchida M, Wilens T, Surman C, Spencer TJ. In Memoriam: Professor Joseph Biederman's Contributions to Child and Adolescent Psychiatry. J Atten Disord 2024; 28:550-582. [PMID: 38334088 PMCID: PMC10947509 DOI: 10.1177/10870547231225818] [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: 02/10/2024]
Abstract
OBJECTIVE To provide an overview of Joe Biederman's contributions to child and adolescent psychiatry. METHOD Nine colleagues described his contributions to: psychopharmacology, comorbidity and genetics, pediatric bipolar disorder, autism spectrum disorders, Tourette's and tic disorders, clinical and neuro biomarkers for pediatric mood disorders, executive functioning, and adult ADHD. RESULTS Joe Biederman left us with many concrete indicators of his contributions to child and adolescent psychiatry. He set up the world's first pediatric psychopharmacology clinic and clinical research program in child adolescent psychiatry. As a young faculty member he began a research program that led to many awards and eventual promotion to full professor at Harvard Medical School. He was for many years the most highly cited researcher in ADHD. He achieved this while maintaining a full clinical load and was widely respected for his clinical acumen. CONCLUSION The world is a better place because Joe Biederman was here.
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Affiliation(s)
| | | | - Janet Wozniak
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Gagan Joshi
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Mai Uchida
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Timothy Wilens
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Craig Surman
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Thomas J. Spencer
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
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Stein J, Jorge BC, Nagaoka LT, Reis ACC, Manoel BDM, Godoi AR, Fioravante VC, Martinez FE, Pinheiro PFF, Pupo AS, Arena AC. Can exposure to lisdexamfetamine dimesylate from juvenile period to peripubertal compromise male reproductive parameters in adult rats? Toxicol Appl Pharmacol 2024; 484:116867. [PMID: 38378049 DOI: 10.1016/j.taap.2024.116867] [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: 11/13/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/22/2024]
Abstract
Lisdexamfetamine (LDX) is a d-amphetamine prodrug used to treat attention deficit and hyperactivity disorder, a common neurodevelopmental disorder in children and adolescents. Due to its action mediated by elevated levels of catecholamines, mainly dopamine and noradrenaline, which influence hormonal regulation and directly affect the gonads, this drug may potentially disrupt reproductive performance. This study evaluated the effects of exposure to LDX from the juvenile to peripubertal period (critical stages of development) on systemic and reproductive toxicity parameters in male rats. Male Wistar rats (23 days old) were treated with 0; 5.2; 8.6 or 12.1 mg/kg/day of LDX from post-natal day (PND) 23 to 53, by gavage. LDX treatment led to reduced daily food and water consumption, as well as a decrease in social behaviors. The day of preputial separation remained unaltered, although the treated animals exhibited reduced weight. At PND 54, the treated animals presented signs of systemic toxicity, evidenced by a reduction in body weight gain, increase in the relative weight of the liver, spleen, and seminal gland, reduction in erythrocyte and leukocyte counts, reduced total protein levels, and disruptions in oxidative parameters. In adulthood, there was an increase in immobile sperm, reduced sperm count, morphometric changes in the testis, and altered oxidative parameters, without compromising male sexual behavior and fertility. These findings showed that LDX-treatment during the juvenile and peripubertal periods induced immediate systemic toxicity and adversely influenced reproductive function in adult life, indicating that caution is necessary when prescribing this drug during the peripubertal phase.
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Affiliation(s)
- Julia Stein
- Department of Structural and Functional Biology, Morphology sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Bárbara Campos Jorge
- Department of Structural and Functional Biology, Morphology sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Lívia Trippe Nagaoka
- Department of Structural and Functional Biology, Morphology sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Ana Carolina Casali Reis
- Department of Structural and Functional Biology, Morphology sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Beatriz de Matos Manoel
- Department of Structural and Functional Biology, Morphology sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Alana Rezende Godoi
- Department of Structural and Functional Biology, Anatomy sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Vanessa Caroline Fioravante
- Department of Structural and Functional Biology, Anatomy sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Francisco Eduardo Martinez
- Department of Structural and Functional Biology, Anatomy sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Patrícia Fernanda Felipe Pinheiro
- Department of Structural and Functional Biology, Anatomy sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - André Sampaio Pupo
- Department of Biophysics and Pharmacology, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Arielle Cristina Arena
- Department of Structural and Functional Biology, Morphology sector, Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil; Center of Information and Toxicological Assistance (CIATOX), Institute of Biosciences of Botucatu, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
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Bozkurt A, Yıldırım Demirdöğen E, Kolak Çelik M, Akıncı MA. An assessment of dynamic facial emotion recognition and theory of mind in children with ADHD: An eye-tracking study. PLoS One 2024; 19:e0298468. [PMID: 38329958 PMCID: PMC10852339 DOI: 10.1371/journal.pone.0298468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Deficits in social cognition in attention deficit hyperactivity disorder (ADHD) have been associated with difficulties in functioning. Since recognizing emotional facial expressions is essential for developing the perceptual components of the theory of mind (ToM), it is important to assess this relationship in children with ADHD. This study therefore compared the recognition of emotional stimuli and gaze patterns between children with ADHD and healthy children using eye-tracking with dynamic facial images. It also examined the relationship between facial emotion recognition accuracy, gaze patterns, ToM scores, and ADHD symptoms. Children with ADHD aged 8-13 (n = 47) and a control group (n = 38) completed a facial emotion recognition test, ToM tests, and the Conners' Parent Rating Scale. Participants' gaze patterns in response to dynamic facial emotion expressions were recorded using eye-tracking technology. Children with ADHD exhibited significantly lower accuracy in the recognition of the facial expressions of disgust and anger. The percentage fixation in the eye region was also significantly lower for happy, angry, sad, disgusted, and neutral emotions in the children with ADHD compared to the control group. No relationship was determined between the percentage of fixations on facial areas of interests and ADHD symptoms or ToM tests. This study provides evidence that children with ADHD experience deficits in visual attention to emotional cues. In addition, it suggests that facial emotion recognition deficits in children with ADHD represent a separate domain of social cognition that develops independently of ToM skills and core symptoms. Understanding and treating the social difficulties of individuals with ADHD may help improve their social functioning.
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Affiliation(s)
- Abdullah Bozkurt
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
| | | | - Müberra Kolak Çelik
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
| | - Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
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Eng AG, Nirjar U, Elkins AR, Sizemore YJ, Monticello KN, Petersen MK, Miller SA, Barone J, Eisenlohr-Moul TA, Martel MM. Attention-deficit/hyperactivity disorder and the menstrual cycle: Theory and evidence. Horm Behav 2024; 158:105466. [PMID: 38039899 PMCID: PMC10872410 DOI: 10.1016/j.yhbeh.2023.105466] [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: 08/16/2023] [Revised: 11/14/2023] [Accepted: 11/24/2023] [Indexed: 12/03/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that exhibits striking sex differences in symptoms, prevalence, and associated problems across development. Etiological factors and mechanisms underlying these sex differences remain one of the most understudied aspects of this disorder. The current paper seeks to provide a novel theoretical framework for understanding this phenomenon by reviewing evidence that females with ADHD may experience a "double whammy" of organizational and activational pubertal hormonal effects. We propose a novel theory of activational effects of cyclical circulating ovarian hormones on ADHD with increasing risk at times of rapid declines in estrogen. These declines may decrease executive function and trait control at two points of the cycle characterized by biphasic affective risk: (1) increases in approach/risk-taking behaviors at mid-cycle (periovulatory) and (2) increases in avoidance/negative affect perimenstrually. Low estrogen and control may then interact with increases in positive and negative affect, respectively, to increase hyperactivity-impulsivity symptoms post-ovulation and inattention symptoms perimenstrually. These interactions may be exacerbated by organizational pubertal effects on relatively overdeveloped limbic circuitry and adolescent-specific social pressures magnified in females with ADHD.
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Affiliation(s)
- Ashley G Eng
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America.
| | - Urveesha Nirjar
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Anjeli R Elkins
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Yancey J Sizemore
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Krystina N Monticello
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Madeline K Petersen
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Sarah A Miller
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
| | - Jordan Barone
- University of Illinois Chicago at Chicago College of Medicine, Department of Psychiatry, 912 S. Wood St, Chicago, IL 60612, United States of America
| | - Tory A Eisenlohr-Moul
- University of Illinois Chicago at Chicago College of Medicine, Department of Psychiatry, 912 S. Wood St, Chicago, IL 60612, United States of America
| | - Michelle M Martel
- University of Kentucky, Department of Psychology, 106-B Kastle Hall, Lexington, KY 40506-0044, United States of America
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Targeting Neuroinflammation with Abscisic Acid Reduces Pain Sensitivity in Females and Hyperactivity in Males of an ADHD Mice Model. Cells 2023; 12:cells12030465. [PMID: 36766806 PMCID: PMC9914171 DOI: 10.3390/cells12030465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental syndrome characterized by dopaminergic dysfunction. In this study, we aimed to demonstrate that there is a link between dopaminergic deficit and neuroinflammation that underlies ADHD symptoms. We used a validated ADHD mice model involving perinatal 6-OHDA lesions. The animals received abscisic acid (ABA), an anti-inflammatory phytohormone, at a concentration of 20 mg/L (drinking water) for one month. We tested a battery of behavior tests, learning and memory, anxiety, social interactions, and pain thresholds in female and male mice (control and lesioned, with or without ABA treatment). Postmortem, we analyzed microglia morphology and Ape1 expression in specific brain areas related to the descending pain inhibitory pathway. In females, the dopaminergic deficit increased pain sensitivity but not hyperactivity. In contrast, males displayed hyperactivity but showed no increased pain sensitivity. In females, pain sensitivity was associated with inflammatory microglia and lower Ape1 levels in the anterior cingulate cortex (ACC) and posterior insula cortex (IC). In addition, ABA treatment alleviated pain sensitivity concomitant with reduced inflammation and normalized APE1. In males, ABA reduced hyperactivity but had no significant effect on inflammation in these areas. This is the first study proving a sex-dependent association between dopamine dysfunction and inflammation in specific brain areas, hence leading to different behavioral outcomes in a mouse model of ADHD. These findings provide new clues for potential treatments for ADHD.
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Internalizing-Externalizing Comorbidity and Impaired Functioning in Children. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101547. [PMID: 36291483 PMCID: PMC9600065 DOI: 10.3390/children9101547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/30/2022] [Accepted: 10/05/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The comorbidity of mental illnesses is common in child and adolescent psychiatry. Children with internalizing-externalizing comorbidity often experience worse health outcomes compared to children with a single diagnosis. Greater knowledge of functioning among children with internalizing-externalizing comorbidity can help improve mental health care. OBJECTIVE The objective of this exploratory study was to examine whether internalizing-externalizing comorbidity was associated with impaired functioning in children currently receiving mental health services. METHODS The data came from a cross-sectional clinical sample of 100 children aged 4-17 with mental illness and their parents recruited from an academic pediatric hospital. The current mental illnesses in children were measured using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), and the level of functioning was measured using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. Linear regression was used to estimate the association between internalizing-externalizing comorbidity and level of functioning, adjusting for demographic, psychosocial, and geographic covariates. RESULTS Internalizing-externalizing comorbidity in children was associated with worse functioning compared to children with strictly internalizing comorbidities, β = 0.32 (p = 0.041). Among covariates, parent's psychological distress, β = 0.01 (p = 0.004), and distance to the pediatric hospital, β = 0.38 (p = 0.049) were associated with worse functioning in children. CONCLUSIONS Health professionals should be mindful that children with internalizing-externalizing comorbidity may experience worsening functioning that is disruptive to daily activities and should use this information when making decisions about care. Given the exploratory nature of this study, additional research with larger and more diverse samples of children is warranted.
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Nejati V. Reading mind from the eyes in individuals with attention deficit-hyperactivity disorder (ADHD): A meta-analysis. Expert Rev Neurother 2022; 22:889-896. [PMID: 36420829 DOI: 10.1080/14737175.2022.2151899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Individuals with ADHD struggle with social impairments. The present study aimed to find out the inconsistent results of theory of mind skill in individuals with ADHD. METHODS The current meta-analysis reviewed 17 empirical studies that compared theory of mind in individuals with and without ADHD based on reading mind from the eyes test (RMET). RESULTS Finding from 1620 participants with ADHD and 1249 healthy controls showed a significant impairment in theory of mind in individuals with ADHD (Hedges' g = 0.66). Moderator analyses indicated that the impaired theory of mind was not affected by age and gender. CONCLUSION These findings describe impaired theory of mind in individuals with ADHD and provide an insight to pay attention to theory of mind in respective clinical assessments and treatments.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, 1983969411 Tehran, Iran
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8
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Faheem M, Akram W, Akram H, Khan MA, Siddiqui FA, Majeed I. Gender-based differences in prevalence and effects of ADHD in adults: A systematic review. Asian J Psychiatr 2022; 75:103205. [PMID: 35878424 DOI: 10.1016/j.ajp.2022.103205] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/02/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that starts from childhood and lasts through adulthood. Historically thought as male dominant disorder, researches now emphasized that ADHD also effects females equally. Despite the ascending research on gender differences of ADHD, there is little known about its differences in prevalence and effects and there is a dearth of reviews that can draw a firm conclusion especially in adults. Data from the available medical literature published in English language literature of all time was reviewed systematically and tabulated to evaluate the gender-based differences in prevalence and effects of ADHD in adults. The studies revealed gender differences in adult ADHD in prevalence, and effects. Results showed that males have more prevalence as compared to females but females too have a significant presence of disorder. Females were more impaired as compared to men in most of the effects of ADHD like social functioning, time perception, stress tackling and mood disorder. Males were more impaired in working memory and educational functioning as compared to females. The review shows sufficient evidence of gender differences in adult ADHD in prevalence, and effects, that similarity across genders should not be assumed. It is concluded that there are plenty of conflicting evidence regarding gender differences in many areas of adult ADHD research, and to remove such discrepancies, the existing research is the need for more studies on gender differences and similarities in functioning of adults with ADHD.
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Affiliation(s)
- Muhammad Faheem
- Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan.
| | - Waqas Akram
- Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan.
| | - Hadiqa Akram
- Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan.
| | - Mahtab Ahmad Khan
- Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan.
| | | | - Imtiaz Majeed
- Faculty of Pharmacy, University of Central Punjab, Lahore, Pakistan.
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Hinshaw SP, Nguyen PT, O'Grady SM, Rosenthal EA. Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. J Child Psychol Psychiatry 2022; 63:484-496. [PMID: 34231220 DOI: 10.1111/jcpp.13480] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 01/13/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) - and its underlying behavioral dimensions of inattention and hyperactivity-impulsivity - have been understudied in females. We first cover the conceptual issues of prevalence, diagnostic practices, diversity, comorbidity, and causal factors, plus forces limiting awareness of ADHD in females. After a narrative review of cross-sectional and longitudinal findings, we conclude the following. (a) Girls meet diagnostic criteria for ADHD at just under half the rates of boys, a ratio that becomes much closer to equal by adulthood. (b) Girls and women with ADHD show a predominance of inattention and associated internalizing problems; boys and men display greater levels of hyperactive-impulsive symptoms and associated externalizing problems. (c) Sex differences in ADHD symptoms and related outcomes depend heavily on the clinical versus nonreferred nature of the samples under investigation. (d) Females with ADHD experience, on average, serious impairments, with a particularly heightened risk for problems in close relationships and engagement in self-harm. (e) Clinicians may overlook symptoms and impairments in females because of less overt (but still impairing) symptom manifestations in girls and women and their frequent adoption of compensatory strategies. Our review of predictors and mediators of adult outcomes highlights (a) the potential for heterotypically continuous pathways in females with childhood ADHD and (b) developmental progressions to self-harm, intimate partner violence, unplanned pregnancy, and comorbid psychopathology. Focusing on ADHD in females is necessary to characterize causal and maintaining mechanisms with accuracy and to foster responsive interventions, as highlighted in our closing list of clinical implications and research priorities.
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Affiliation(s)
- Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Phuc T Nguyen
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Sinclaire M O'Grady
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Emily A Rosenthal
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
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Abstract
Although autism spectrum disorder (ASD) is the prototypical psychiatric disorder of social impairment, several if not most psychiatric disorders are characterized by prominent impairments in social functioning. A challenge in clinically assessing and describing social impairment is that it has been variably defined and can be difficult to measure. In this article we consider the psychiatric differential diagnosis of social impairment within the DSM-5 framework. We describe the features of social impairment in 13 DSM-5 disorders from a developmental perspective and highlight diagnostic factors that differentiate among the disorders, including the main features of social impairment, verbal communication, nonverbal communication, course of social impairment, social cognition, and key features of accompanying neuropsychiatric symptoms. We conclude by describing an approach for assessing social impairment across the lifespan.
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Meinzer MC, Felton JW, Oddo LE, Rubin KH, Chronis-Tuscano A. Do ADHD Symptoms and Relationship Quality With Mothers and Best Friends Across High School Predict Depressive Symptoms for Adolescents? J Atten Disord 2021; 25:1699-1711. [PMID: 32506994 DOI: 10.1177/1087054720923088] [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: Symptoms of ADHD place adolescents at increased risk for depression. The transition from middle to high school may magnify depression risk. This study examined whether changes in adolescents' negative relationship quality with their mothers and best friends from eighth to 12th grades mediated the longitudinal relations between ADHD and depressive symptoms. Method: 368 adolescents (48.5% male) were initially recruited. Results: Boys with elevated ADHD symptoms in the eighth grade reported steeper increases in negative relationship quality with their mothers relative to girls, and that this trajectory mediated the relation between ADHD and depressive symptoms. ADHD symptoms were also associated with increases in negative friendship quality across high school for boys; however, this did not mediate the relation between ADHD and depressive symptoms for either sex. Conclusion: Growth in mother-adolescent negative relationship quality may be one mechanism that explains the development of depressive symptoms in adolescent boys with elevated ADHD symptoms.
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Dellapiazza F, Audras-Torrent L, Michelon C, Baghdadli A. Clinical characteristics of children with ASD and comorbid ADHD: Association with social impairment and externalizing and internalizing behaviours. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103930. [PMID: 33690105 DOI: 10.1016/j.ridd.2021.103930] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are frequently occurring conditions that are often associated (ASD + ADHD). However, there are few comparative studies concerning the clinical presentation in patients formally diagnosed with both ASD and ADHD. Here, we aimed to 1) compare social impairment and externalizing/internalizing behavioural problems across four groups of children: ASD + ADHD, ASD alone, ADHD alone, and typical development and 2) examine their bidirectional relationship with ASD and/or ADHD symptoms. METHODS This study included 186 participants from 6 to 12 years of age: single ASD (n = 98), ASD + ADHD (n = 29), single ADHD (n = 28), and TD (n = 31). RESULTS The results showed that children in the ASD + ADHD and single ASD groups had a higher level of social impairment than those in the single ADHD group. In addition, children in the single ADHD group presented a greater attention deficit than those in the single ASD group. Externalizing /internalizing behaviours were more frequent in all groups with neuro-developmental disorders than in typical development. In addition, externalizing behavioural problems were related to ADHD severity in the ASD + ADHD and single ADHD groups, whereas internalizing behaviours were related to ASD severity. CONCLUSIONS These findings highlight the specific needs of children who have both ASD and ADHD and underscore the necessity of individualizing their interventions.
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Affiliation(s)
- Florine Dellapiazza
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Lee Audras-Torrent
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Cécile Michelon
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neurodéveloppementaux, CHU Montpellier, Montpellier, France; Faculté de Médecine, Université de Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
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Abstract
Once considered a condition of hyperactive boys, our knowledge and understanding of attention deficit hyperactivity disorder (ADHD) and has dramatically evolved.1 Landmark studies by Biederman, Kessler, Faraone, and others have changed and deepened our understanding of ADHD to include a condition which not only affects boys but quite often affects girls.1–5 The evolution of symptoms across the lifespan and the concomitant neurologic changes which underlie this symptomatic expression has similarly evolved.6 Studies by Dalsgaard and others have brought to light the significantly increased morbidity and mortality associated with preschoolers, children, and adults struggling with ADHD and associated conditions.7,8
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DaWalt LS, Taylor JL, Bishop S, Hall LJ, Steinbrenner JD, Kraemer B, Hume KA, Odom SL. Sex Differences in Social Participation of High School Students with Autism Spectrum Disorder. Autism Res 2020; 13:2155-2163. [PMID: 32881417 PMCID: PMC7749043 DOI: 10.1002/aur.2348] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/01/2020] [Accepted: 05/24/2020] [Indexed: 12/27/2022]
Abstract
There is lack of consensus in the literature regarding sex differences in social outcomes for individuals on the autism spectrum. Furthermore, little research has focused on the social experiences of high school students with autism spectrum disorder (ASD) during the school day. Using a large racially/ethnically diverse sample of high school students with ASD receiving special education services (n = 547; 76 females, 471 males), we examined sex differences in social interactions of youth both during and after school. We also tested for sex differences in background and phenotypic characteristics including autism severity, IQ, adaptive behavior, and mental health. Results indicated few statistically significant differences between males and females in social interactions and phenotypic characteristics (including raw scores of autism symptom severity). However, analysis of standardized scores of autism symptoms suggested that symptom scores for females with ASD diverged more from same-sex peers in the normed sample than scores of males with ASD. Lack of sex difference in social participation for youth with ASD in this study stands in contrast to patterns of sex differences in the general population. Findings suggest that few differences between males and females with ASD, both in social participation and autism symptom severity, might result in females with ASD being more dissimilar to their same-sex peers than males with ASD. Implications of findings for understanding sex differences in ASD across the life course are discussed. LAY SUMMARY: The present study examined sex differences in social participation in a large, diverse sample of high school students with autism spectrum disorder (ASD). Males and females were very similar in their social interactions both at school and outside of school, based on reports by teachers and parents. Level of autism symptoms was also similar for males and females. However, standardized scores of autism symptoms, which take into account age and sex specific norms, suggested that females with ASD may have behaviors that are more divergent from their same-sex peers than males with ASD.
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Hollingdale J, Woodhouse E, Young S, Fridman A, Mandy W. Autistic spectrum disorder symptoms in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analytical review. Psychol Med 2020; 50:2240-2253. [PMID: 31530292 DOI: 10.1017/s0033291719002368] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Research identifies highly variable prevalence estimates for autism spectrum disorder (ASD) in children and adolescents with attention deficit hyperactivity disorder (ADHD), particularly between community and clinical samples, warranting quantitative meta-analyses to investigate the true prevalence of ASD in children and adolescents with ADHD. METHODS Studies were identified through a systematic literature search of PsycINFO, MEDLINE and Web of Science through January 2018. Twenty-two publications met inclusion criteria (total N = 61 985). Two random effects meta-analyses were conducted: (1) to identify the proportion of children and adolescents with ADHD that met criteria for ASD; and (2) to compare the severity of dimensionally-measured ASD symptomology in children and adolescents with and without ADHD. RESULTS The overall pooled effect for children and adolescents with ADHD who met threshold for ASD was 21%. There was no significant difference between community samples (19%) and clinical samples (24%) or between US studies v. those from other countries. Children and adolescents with ADHD had substantially more dimensionally-measured ASD traits compared with those who did not have ADHD (d = 1.23). CONCLUSION The findings provide further evidence that ADHD and ASD are associated in nature. Clinical and research implications are discussed.
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16
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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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17
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Nguyen PT, Hinshaw SP. Understanding the Stigma Associated with ADHD: Hope for the Future? ACTA ACUST UNITED AC 2020. [DOI: 10.1521/adhd.2020.28.5.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Phuc T. Nguyen
- Research Assistant at WestCoast Children's Clinic and a Psychological Assistant at the UC Berkeley Psychology Clinic
| | - Stephen P. Hinshaw
- Professor of Psychology at the University of California, Berkeley, where he was Department Chair from 2004-2011. He is also Professor of Psychiatry and Vice-Chair for Child and Adolescent Psychology at the University of California, San Francisco
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18
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Golubchik P, Weizman A. Poor performance of the 'child Reading the Mind in the Eyes Test' correlates with poorer social-emotional functioning in children with attention-deficit/hyperactivity disorder. Int Clin Psychopharmacol 2020; 35:105-108. [PMID: 32000178 DOI: 10.1097/yic.0000000000000299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The performance of the 'child Reading the Mind in the Eyes Test' (cRMET), a measure of Theory of Mind (ToM), was assessed in children with attention-deficit/hyperactivity disorder (ADHD) with relation to social-emotional functioning and ADHD severity. The impact of a single dose of methylphenidate on cRMET performance was evaluated. A group of 25 children aged 7-17 years diagnosed with ADHD were assessed at baseline by cRMET, the Strengths and Difficulties Questionnaire (SDQ) and the ADHD-rating scale. cRMET assessment was repeated after administration of a single dose of methylphenidate. Significant correlation was found between the age of the participant and baseline cRMET levels (r = 0.56; P = 0.0037). Significant correlation was found between poorer cRMET performance and worse socioemotional functioning, as reflected by higher baseline SDQ scores (r = -0.39, P = 0.048). No significant correlations were found at baseline between cRMET scores and ADHD severity. No significant improvement in cRMET was detected following administration of a single methylphenidate dose. Poor baseline ToM functioning is associated with lower social-emotional functioning. The ToM functioning improves with age in children with ADHD, but is not affected by a single methylphenidate administration.
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Affiliation(s)
- Pavel Golubchik
- Child and Adolescent Outpatient Clinic, Geha Mental Health Center, Petah Tikva
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Abraham Weizman
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
- Research Unit, Geha Mental Health Center
- Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel
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19
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Tu JW, Owens EB, Hinshaw SP. Positive Illusory Bias Still Illusory? Investigating Discrepant Self-Perceptions in Girls with ADHD. J Pediatr Psychol 2019; 44:576-588. [PMID: 30649391 PMCID: PMC7967872 DOI: 10.1093/jpepsy/jsy109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine whether girls with attention deficit/hyperactivity disorder (ADHD) demonstrate positive illusory self-perceptions during adolescence and young adulthood. METHODS We tested, across a 5-year longitudinal span, whether self-perceptions versus external-source ratings were more strongly predictive of young adulthood impairment and depressive symptoms. Participants included an ethnically diverse sample of 140 girls with ADHD and 88 comparison girls, aged 11-18 years (M = 14.2) at adolescent and 19-24 years (M = 19.6) at young adult assessment. RESULTS Although girls with ADHD rated themselves more positively than indicated by external ratings, their self-reports still did not differ significantly from external ratings in both scholastic competence and social adjustment domains. Comparison girls, on the other hand, rated themselves significantly less positively than indicated by external ratings in social adjustment. Positive discrepancy scores in adolescence did not significantly predict depressive symptoms in young adulthood and vice versa. Crucially, measures of actual competence in adolescence were more strongly associated with young adulthood impairments than were inaccurate self-perceptions for girls with ADHD. CONCLUSIONS Our findings continue to challenge the existence of a positive illusory bias among girls with ADHD, including any association of such bias with key indicators of impairment.
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Affiliation(s)
| | - Elizabeth B Owens
- Institute of Human Development, University of California, Berkeley and
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20
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Milledge SV, Cortese S, Thompson M, McEwan F, Rolt M, Meyer B, Sonuga-Barke E, Eisenbarth H. Peer relationships and prosocial behaviour differences across disruptive behaviours. Eur Child Adolesc Psychiatry 2019; 28:781-793. [PMID: 30387006 DOI: 10.1007/s00787-018-1249-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/27/2018] [Indexed: 12/28/2022]
Abstract
It is unclear if impairments in social functioning and peer relationships significantly differ across common developmental conditions such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and associated callous-unemotional traits (CU traits). The current study explored sex differences and symptoms of parent- and teacher-reported psychopathology on peer relationships and prosocial behaviour in a sample of 147 referred children and adolescents (aged 5-17 years; 120 m). The results showed that increases in parent-reported ADHD Inattentive symptoms and teacher-reported ADHD Hyperactive-Impulsive symptoms, CD, ODD, and CU traits were significantly associated with peer relationship problems across sex. At the same time, teacher-reported symptoms of ODD and both parent- and teacher-reported CU traits were related to difficulties with prosocial behaviour, for both boys and girls, with sex explaining additional variance. Overall, our findings show a differential association of the most common disruptive behaviours to deficits in peer relationships and prosocial behaviour. Moreover, they highlight that different perspectives of behaviour from parents and teachers should be taken into account when assessing social outcomes in disruptive behaviours. Given the questionable separation of conduct problem-related constructs, our findings not only point out the different contribution of those aspects in explaining peer relationships and prosocial behaviour, but furthermore the variance from different informants about those aspects of conduct problems.
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Affiliation(s)
- Sara V Milledge
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Samuele Cortese
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Margaret Thompson
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Fiona McEwan
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Michael Rolt
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Brenda Meyer
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, Kings College, London, SE5 9RJ, UK
| | - Hedwig Eisenbarth
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK. .,School of Psychology, Victoria University of Wellington, Wellington, 6011, New Zealand.
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21
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Chromik LC, Quintin EM, Lepage JF, Hustyi KM, Lightbody AA, Reiss AL. The Influence of Hyperactivity, Impulsivity, and Attention Problems on Social Functioning in Adolescents and Young Adults With Fragile X Syndrome. J Atten Disord 2019; 23:181-188. [PMID: 25731183 PMCID: PMC5758425 DOI: 10.1177/1087054715571739] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Individuals with fragile X syndrome (FXS) present primarily with cognitive and social deficits in addition to symptoms of ADHD. The relationship between symptoms of ADHD, cognitive functioning, and social skills has never been explicitly studied. METHOD Here, we analyzed both longitudinal ( n = 70; Time 1: ages 6-18; Time 2: ages 15-26) and cross-sectional ( n = 73; Time 2 only) data using hierarchical linear regression to assess how global intellectual functioning (IQ) and symptoms of ADHD influence social functioning in individuals with FXS. RESULTS We found that ADHD symptoms at Times 1 and 2 consistently predict social functioning in both males and females with FXS at Time 2. CONCLUSION Our results suggest that addressing ADHD symptoms in childhood may have positive, long-term effects on the social functioning of adolescents and young adults with FXS.
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Affiliation(s)
- Lindsay C. Chromik
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
| | - Eve-Marie Quintin
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA,Educational and Counselling Psychology Department, McGill University, Montreal, Quebec, Canada
| | - Jean-François Lepage
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
| | - Kristin M. Hustyi
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
| | - Amy A. Lightbody
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
| | - Allan L. Reiss
- Center for Interdisciplinary Brain Sciences Research, Stanford University, CA, USA
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22
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Mahendiran T, Brian J, Dupuis A, Muhe N, Wong PY, Iaboni A, Anagnostou E. Meta-Analysis of Sex Differences in Social and Communication Function in Children With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. Front Psychiatry 2019; 10:804. [PMID: 31749718 PMCID: PMC6844182 DOI: 10.3389/fpsyt.2019.00804] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 10/08/2019] [Indexed: 01/01/2023] Open
Abstract
Background: Sex differences in the prevalence of neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are well documented, but studies examining sex differences in social and communication function remain limited and inconclusive. Objectives: The objective of this study is to conduct a meta-analysis of sex differences in social-communication function in children with ASD or ADHD and typically developing controls. Methods: Using PRISMA, a search was performed on Medline and PSYCHINFO on English-language journals (2000-2017) examining sex differences in social and communication function in ASD and ADHD compared to controls. Inclusion criteria: 1) peer reviewed journal articles, 2) diagnosis of ASD or ADHD and controls, 3) age 6-18 years, 4) measures of social-communication function, and 5) means, standard deviations, and sample sizes reported in order to calculate standardized mean differences (SMD). Results: Eleven original/empirical studies met inclusion criteria for ASD and six for ADHD. No significant sex differences were found between ASD and controls in social (SMD = -0.43; p = 0.5; CI: -1.58-0.72), or communication function (SMD = 0.86; p = 0.5 CI; -1.57--3.30) and between ADHD and controls in social function (SMD = -0.68: p = 0.7, CI: -4.17-2.81). No studies evaluated sex differences in communication in ADHD. Significant heterogeneity was noted in all analyses. Type of measure may have partially accounted for some variability between studies. Conclusions: The meta-analysis did not detect sex differences in social and communication function in children with ASD and ADHD; however, significant heterogeneity was noted. Future larger studies, controlling for measure and with adequate numbers of female participants are required to further understand sex differences in these domains.
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Affiliation(s)
- Tania Mahendiran
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Jessica Brian
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Applied Psychology and Human Development, OISE; University of Toronto, Toronto, ON, Canada
| | - Annie Dupuis
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Nadia Muhe
- Map and Data Library, University of Toronto, Toronto, ON, Canada
| | - Pui-Ying Wong
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Alana Iaboni
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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23
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Mahendiran T, Dupuis A, Crosbie J, Georgiades S, Kelley E, Liu X, Nicolson R, Schachar R, Anagnostou E, Brian J. Sex Differences in Social Adaptive Function in Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder. Front Psychiatry 2019; 10:607. [PMID: 31572228 PMCID: PMC6751776 DOI: 10.3389/fpsyt.2019.00607] [Citation(s) in RCA: 15] [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] [Received: 03/09/2019] [Accepted: 07/30/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Social-communication difficulties, a hallmark of ASD, autism spectrum disorder (ASD) are often observed in attention - deficit/ hyperactivity disorder (ADHD), although are not part of its diagnostic criteria. Despite sex differences in the prevalence of ASD and ADHD, research examining how sex differences manifest in social and communication functions in these disorders remains limited, and findings are mixed. This study investigated potential sex differences with age in social adaptive function across these disorders, relative to controls. Method: One hundred fifteen youth with ASD, 172 youth with ADHD, and 63 typically developing controls (age range 7-13 years, 75% males) were recruited from the Province of Ontario Neurodevelopmental Disorder (POND) Network. Social adaptive function was assessed using the Adaptive Behavior Assessment System-Second Edition (ABAS-II). The proportions of adaptive behaviors present in each skill area were analyzed as a binomial outcome using logistic regression, controlling for age, and testing for an age-by-sex interaction. In an exploratory analysis, we examined the impact of controlling for core symptom severity on the sex effect. Results: Significant sex-by-age interactions were seen within ASD in the communication (p = 0.005), leisure (p = 0.003), and social skill areas (p < 0.0001). In all three areas, lower scores (indicating poorer function) were found in females compared to males at older ages despite females performing better at younger ages. There were significant differences in the sex-by-age interactions in the social and leisure domains between those with ASD and typically developing controls, with typically developing females showing better scores at older, compared to younger, ages. There were also significant differences in the sex-by-age interactions between ASD and ADHD on the social and leisure domains, as females with ADHD consistently scored higher on social skills than males across all ages, unlike those with ASD. Sex differences across age in the social domains for ADHD were similar to those in the typically developing group. Conclusion: Sex differences in social and communication skill areas were observed between ASD and ADHD, and typically developing controls, with females with ASD performing worse than males at older ages, despite an earlier advantage. These findings reinforce the need to take a developmental approach to understanding sex differences which may have diagnostic, prognostic, and treatment implications.
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Affiliation(s)
- Tania Mahendiran
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada
| | - Annie Dupuis
- University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, ON, Canada
| | - Xudong Liu
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Robert Nicolson
- Department of Psychiatry, Western University and Children's Health Research Institute, London, ON, Canada
| | - Russell Schachar
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Jessica Brian
- Autism Research Centre, Bloorview Research Institute, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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24
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Abstract
OBJECTIVE The present study investigated differences in emotional face processing between adolescents (age 15-18) with ADHD-Combined type (ADHD-CT) and typically developing controls. METHOD Participants completed a visual emotional task in which they were asked to rate the degree of negativity/positivity of four facial expressions (taken from the NimStim face stimulus set). RESULTS Participants' ratings, ratings' variability, response times (RTs), and RTs' variability were analyzed. Results showed a significant interaction between group and the type of presented stimuli. Adolescents with ADHD-CT discriminated less between positive and negative emotional expressions compared with those without ADHD. In addition, adolescents with ADHD-CT exhibited greater variability in their RTs and in their ratings of facial expressions when compared with controls. CONCLUSION The present results lend further support to the existence of a specific deficit or alteration in the processing of emotional face stimuli among adolescents with ADHD-CT.
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Affiliation(s)
- Orrie Dan
- 1 Yezreel Valley College, Emeck Yezreel, Israel
| | - Sivan Raz
- 1 Yezreel Valley College, Emeck Yezreel, Israel.,2 Psychology Department, Tel-Hai College, Israel
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25
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Faraone SV, Hammerness PG, Wilens TE. Reliability and Validity of the Before-School Functioning Scale in Children With ADHD. J Atten Disord 2018; 22:1040-1048. [PMID: 25575616 DOI: 10.1177/1087054714564623] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Children with ADHD frequently manifest behavioral difficulties in the morning prior to school. We sought to assess the reliability and validity of the Before-School Functioning Questionnaire (BSFQ) as a measure of morning behaviors impaired by ADHD. METHOD We used pre-treatment data from a randomized crossover study of 6- to 12-year-old participants comparing the methylphenidate transdermal delivery system (MTS) with a placebo transdermal system (PTS) for a total of 4 weeks. RESULTS The BSFQ investigator-rated scale shows very good internal homogeneity (Cronbach's α = .91), good test-retest reliability ( r = .60), good concurrent validity ( r range = .42-.86), and a strong treatment effect (effect size = -.93). The self-rated BSFQ showed lower levels of reliability and validity. CONCLUSION The investigator-rated BSFQ should be used in future trials of ADHD medications aimed at assessing efficacy in the morning before school.
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Affiliation(s)
- Stephen V Faraone
- 1 State University of New York Upstate Medical University, Syracuse, USA
| | - Paul G Hammerness
- 2 Massachusetts General Hospital, Boston, USA.,3 Harvard Medical School, Cambridge, MA, USA
| | - Timothy E Wilens
- 2 Massachusetts General Hospital, Boston, USA.,3 Harvard Medical School, Cambridge, MA, USA
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26
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Bul KCM, Doove LL, Franken IHA, der Oord SV, Kato PM, Maras A. A serious game for children with Attention Deficit Hyperactivity Disorder: Who benefits the most? PLoS One 2018; 13:e0193681. [PMID: 29543891 PMCID: PMC5854282 DOI: 10.1371/journal.pone.0193681] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 01/24/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The aim of the current study was to identify which subgroups of children with Attention Deficit Hyperactivity Disorder (ADHD) benefitted the most from playing a Serious Game (SG) intervention shown in a randomized trial to improve behavioral outcomes. METHOD Pre-intervention characteristics [i.e., gender, age, intellectual level of functioning, medication use, computer experience, ADHD subtype, severity of inattention problems, severity of hyperactivity/impulsivity problems, comorbid Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) symptoms] were explored as potential moderators in a Virtual Twins (VT) analysis to identify subgroups for whom the SG intervention was most effective. Primary outcome measures were parent-reported time management, planning/organizing and cooperation skills. RESULTS Two subgroups were identified. Girls (n = 26) were identified as the subgroup that was most likely to show greater improvements in planning/organizing skills as compared to the estimated treatment effect of the total group of participants. Furthermore, among the boys, those (n = 47) with lower baseline levels of hyperactivity and higher levels of CD symptoms showed more improvements in their planning/organizing skills when they played the SG intervention as compared to the estimated treatment effect of the total group of participants. CONCLUSION Using a VT analysis two subgroups of children with ADHD, girls, and boys with both higher levels of CD and lower levels of hyperactivity, were identified. These subgroups mostly benefit from playing the SG intervention developed to improve ADHD related behavioral problems. Our results imply that these subgroups have a higher chance of treatment success.
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Affiliation(s)
- Kim C. M. Bul
- Yulius Academy, Yulius Mental Health Care Organization, Barendrecht, the Netherlands
- Department of Clinical Psychology, Erasmus University of Rotterdam, Rotterdam, the Netherlands
- Centre for Innovative Research across the Life Course, Coventry University, Coventry, United Kingdom
| | - Lisa L. Doove
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Ingmar H. A. Franken
- Department of Clinical Psychology, Erasmus University of Rotterdam, Rotterdam, the Netherlands
| | - Saskia Van der Oord
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Developmental Psychology, University of Amsterdam, Amsterdam, the Netherlands
- Cognitive Science Centre Amsterdam, University of Amsterdam, Amsterdam, the Netherlands
| | - Pamela M. Kato
- Faculty of Engineering, Environment and Computing, Coventry University, Coventry, United Kingdom
| | - Athanasios Maras
- Yulius Academy, Yulius Mental Health Care Organization, Barendrecht, the Netherlands
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27
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Hesson J, Fowler K. Prevalence and Correlates of Self-Reported ADD/ADHD in a Large National Sample of Canadian Adults. J Atten Disord 2018; 22:191-200. [PMID: 25749874 DOI: 10.1177/1087054715573992] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to examine the prevalence and correlates of self-reported attention deficit disorder (ADD)/ADHD in Canadian adults. METHOD Prevalence of self-reported ADD/ADHD was examined in a large national sample of Canadians ( n = 16,957). Demographic variables, lifetime, and current psychiatric comorbidities were then compared in a group of adults with self-reported ADD/ADHD ( n = 488) and an age- and gender-matched control group ( n = 488). RESULTS The prevalence of self-reported ADD/ADHD was 2.9%. Significantly higher lifetime and current prevalence rates of major depressive disorder, bipolar I and II disorders, generalized anxiety disorder, and substance use disorders were observed in the ADD/ADHD group compared with the control group. Within the ADD/ADHD group, lifetime and 12-month prevalence rates of major depressive disorder and generalized anxiety disorder were significantly higher in women, whereas lifetime and current rates of some substance use disorders were significantly higher in men. CONCLUSION In a national sample of Canadian adults, self-reported ADD/ADHD was associated with significant psychiatric comorbidity. Gender differences were also noted.
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Affiliation(s)
| | - Ken Fowler
- 1 Memorial University of Newfoundland, St. John's, Canada
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O'Neill S, Rajendran K, Mahbubani SM, Halperin JM. Preschool Predictors of ADHD Symptoms and Impairment During Childhood and Adolescence. Curr Psychiatry Rep 2017; 19:95. [PMID: 29082443 PMCID: PMC6349372 DOI: 10.1007/s11920-017-0853-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW This paper summarizes key, recently published research examining longitudinal outcomes for preschoolers with high levels of inattention and/or hyperactivity/impulsivity. RECENT FINDINGS Symptom trajectories show that hyperactivity/impulsivity declines across childhood. At the group level, the course of inattention appears more variable. However, identification of subgroups of children showing stable, rising, and falling inattention over time is promising. Early ADHD-like symptoms portend risk for academic and social difficulties, as well as comorbid emotional and behavioral problems in childhood and adolescence. Several early risk factors appear to moderate these relations, including comorbid symptoms, parental psychopathology, socioeconomic disadvantage, and perhaps neuropsychological dysfunction. Furthermore, high levels of inattention and/or hyperactivity/impulsivity during the preschool period appear to compromise development of regulatory and neuropsychological functions, which in turn increases risk for negative outcomes later in childhood. Identified risk factors are targets for novel interventions, which ideally would be delivered early to at-risk children.
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Affiliation(s)
- Sarah O'Neill
- The City College and The Graduate Center, City University of New York, New York, NY, USA.
- Department of Psychology, The City College and The Graduate Center, The City College of New York, 160 Convent Avenue, New York, NY, 10031, USA.
| | - Khushmand Rajendran
- Department of Social Sciences, Human Services and Criminal Justice, Borough of Manhattan Community College, City University of New York, New York, NY, USA
| | | | - Jeffrey M Halperin
- Department of Psychology, Queens College and The Graduate Center, City University of New York, Flushing, NY, USA
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Modesto-Lowe V, Charbonneau V, Farahmand P. Psychotherapy for Adolescents With Attention-Deficit Hyperactivity Disorder: A Pediatrician's Guide. Clin Pediatr (Phila) 2017; 56:667-674. [PMID: 27895149 DOI: 10.1177/0009922816673308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) presents with high levels of inattention, impulsiveness, and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. ADHD symptoms lead to decreased functionality in various life domains and result in poor academics, behavioral challenges, delayed independence, and strained relationships. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. This article aims to provide a review of the psychotherapeutic interventions available for teens that receive pharmacotherapy but continue to struggle with the residual symptoms of ADHD that interfere with academic function, relationship formation, and psychological development.
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Affiliation(s)
- Vania Modesto-Lowe
- 1 Connecticut Valley Hospital, Middletown, CT, USA.,2 University of Connecticut School of Medicine, Farmington, CT, USA.,3 Quinnipiac University, Hamden, CT, USA
| | | | - Pantea Farahmand
- 4 New York-Presbyterian Hospital/Columbia-Cornell, Child and Adolescent Psychiatry, New York, NY, USA
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Golubchik P, Weizman A. The Possible Effect of Methylphenidate Treatment on Empathy in Children Diagnosed with Attention-Deficit/Hyperactivity Disorder, Both With and Without Comorbid Oppositional Defiant Disorder. J Child Adolesc Psychopharmacol 2017; 27:429-432. [PMID: 28398816 DOI: 10.1089/cap.2016.0111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess the Empathizing Quotient (EQ) of patients diagnosed with attention-deficit/hyperactivity disorder (ADHD) only or comorbid with oppositional defiant disorder (ODD) and compare the two groups' responses to methylphenidate (MPH) treatment. METHODS Fifty-two children (8-18 years) diagnosed with ADHD, 26 of whom were also diagnosed with comorbid ODD (ADHD/ODD), were treated with MPH for 12 weeks. The level of EQ was assessed with the Children's version of the Empathizing Quotient (EQ-C) and the severity of ADHD symptoms with the ADHD Rating Scale (ADHD-RS). Assessments were done at baseline and at end point. RESULTS A significant increase in EQ scores was obtained in both groups following MPH treatment (p = 0.003 for ADHD/ODD; p = 0.002 for ADHD). Significant correlation was found in the ADHD group between the changes in ADHD-RS and those in EQ, following MPH treatment (p = 0.015), but not in the ADHD/ODD group (p = 0.48). CONCLUSIONS A correlation exists between MPH-related improvement in ADHD symptoms and between more empathy in children with ADHD not comorbid with ODD.
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Affiliation(s)
- Pavel Golubchik
- 1 Child and Adolescent Outpatient Clinic, Geha Mental Health Center , Petah Tikva, Israel .,2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Abraham Weizman
- 2 Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel .,3 Research Unit, Geha Mental Health Center , Petah Tikva, Israel .,4 Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University , Petah Tikva, Israel
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Abstract
Our knowledge and understanding of the underlying neurobiology and symptomatic expression of ADHD has advanced dramatically over the past decade. Associated with these advances has been a similar explosion of new treatment options to individualize treatment for our patients. This article will: ∙ review strategies to measure ADHD symptoms and functional difficulties while seeking to achieve full symptomatic remission throughout the day ∙ summarize recent findings regarding the management and prioritization of ADHD and comorbid conditions and ∙ discuss the various pharmacologic treatment options with a focus on recently developed molecules and novel delivery systems.
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Problematic Peer Functioning in Girls with ADHD: A Systematic Literature Review. PLoS One 2016; 11:e0165119. [PMID: 27870862 PMCID: PMC5117588 DOI: 10.1371/journal.pone.0165119] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 10/06/2016] [Indexed: 12/20/2022] Open
Abstract
Objective Children with attention deficit hyperactivity disorder (ADHD) experience many peer interaction problems and are at risk of peer rejection and victimisation. Although many studies have investigated problematic peer functioning in children with ADHD, this research has predominantly focused on boys and studies investigating girls are scant. Those studies that did examine girls, often used a male comparison sample, disregarding the inherent gender differences between girls and boys. Previous studies have highlighted this limitation and recommended the need for comparisons between ADHD females and typical females, in order to elucidate the picture of female ADHD with regards to problematic peer functioning. The aim of this literature review was to gain insight into peer functioning difficulties in school-aged girls with ADHD. Methods PsychINFO, PubMed, and Web of Knowledge were searched for relevant literature comparing school-aged girls with ADHD to typically developing girls (TDs) in relation to peer functioning. The peer relationship domains were grouped into ‘friendship’, ‘peer status’, ‘social skills/competence’, and ‘peer victimisation and bullying’. In total, thirteen studies were included in the review. Results All of the thirteen studies included reported that girls with ADHD, compared to TD girls, demonstrated increased difficulties in the domains of friendship, peer interaction, social skills and functioning, peer victimization and externalising behaviour. Studies consistently showed small to medium effects for lower rates of friendship participation and stability in girls with ADHD relative to TD girls. Higher levels of peer rejection with small to large effect sizes were reported in all studies, which were predicted by girls’ conduct problems. Peer rejection in turn predicted poor social adjustment and a host of problem behaviours. Very high levels of peer victimisation were present in girls with ADHD with large effect sizes. Further, very high levels of social impairment and social skills deficits, with large effect sizes, were found across all studies. Levels of pro-social behaviour varied across studies, but were mostly lower in girls with ADHD, with small to large effect sizes. Overall, social disability was significantly higher among girls with ADHD than among TD girls. Conclusion Congruous evidence was found for peer functioning difficulties in the peer relationship domains of friendship, peer status, social skills/competence, and peer victimisation and bullying in girls with ADHD.
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Childhood Attention-Deficit/Hyperactivity Disorder Predicts Intimate Partner Victimization in Young Women. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 44:155-66. [PMID: 25663589 DOI: 10.1007/s10802-015-9984-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with interpersonal dysfunction during childhood and adolescence, yet little is known about the romantic relationships of young women with childhood ADHD. In the present study, we draw from a longitudinal sample of girls followed prospectively into young adulthood, comparing those with (n = 114) and without (n = 79; comparisons) childhood ADHD in terms of their risk for physical victimization by an intimate partner (physical IPV; e.g., slapping, punching) by 17-24 years of age. We examined ADHD both diagnostically and dimensionally, at the same time establishing reliable indicators of young adult physical IPV. Externalizing and internalizing problems, and academic achievement during adolescence, were tested as potential mediators. Overall, participants with a childhood diagnosis of ADHD experienced more physical IPV than did comparisons (30.7% vs. 6.3%). In parallel, IPV was associated with higher levels of childhood ADHD symptomatology (d = 0.73). Young women with persistent ADHD stood the highest risk of experiencing IPV (37.3%), followed by those with transient ADHD (19.0%) and those never-diagnosed (5.9%). Academic achievement measured during adolescence was a significant partial mediator of the childhood ADHD symptomatology-young adult IPV relationship, even with control of sociodemographic, psychiatric, and cognitive factors, including childhood reading and math disorders. Findings indicate that in young women, childhood ADHD is a specific and important predictor of physically violent victimization in their intimate relationships. This vulnerable population requires IPV prevention and intervention, with academic empowerment as a key target.
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Diamantopoulou S, Henricsson L, Rydell AM. ADHD symptoms and peer relations of children in a community sample: Examining associated problems, self-perceptions, and gender differences. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2016. [DOI: 10.1177/01650250500172756] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined children's peer relations in relation to gender, symptoms of attention-deficit/ hyperactivity disorder (ADHD), associated behaviour problems, prosociality, and self-perceptions, in a community sample. Six hundred and thirty-five 12-year-old children (314 girls) provided peer nominations and rated feelings of loneliness and self-perceptions regarding global self-worth and behavioural conduct. We obtained teacher ratings of ADHD symptoms, conduct and internalising problems, and prosociality. ADHD symptoms, conduct problems, internalising problems, and low levels of prosociality were all related to higher levels of peer dislike. Despite ADHD symptoms being related to more peer dislike, children with high levels of ADHD symptoms did not report more feelings of loneliness. The self-perceptions of children with high levels of ADHD were not related to peer dislike. Although high levels of ADHD symptoms were not related to peer dislike in girls, peers tolerated higher levels of ADHD symptoms among boys than among girls, providing support for the “gender appropriateness hypothesis” regarding the impact and influence of ADHD symptomatology upon the peer relations of children within a community sample.
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Longitudinal Associations Between Internalizing and Externalizing Comorbidities and Functional Outcomes for Children with ADHD. Child Psychiatry Hum Dev 2015; 46:736-48. [PMID: 25341948 DOI: 10.1007/s10578-014-0515-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study examined functional outcomes for children with ADHD by comorbidity status. Children with ADHD (5-13 years) were recruited from 21 pediatric practices and followed up 12 months later (n = 199). Parent and teacher-reported baseline and 12 month surveys measured peer problems, daily functioning, quality of life (QoL), parent mental health, and family QoL. The Anxiety Disorders Interview Schedule for Children IV assessed mental health comorbidities at baseline. Linear regression models were conducted, adjusting for socio-demographics, ADHD severity, and baseline functioning (where possible). In adjusted analyses, children with ADHD and co-occurring internalizing and externalizing comorbidities had poorer QoL, greater peer problems, and poorer family QoL, compared to children with ADHD alone. The parents of children with ADHD and internalizing and externalizing comorbidities alone, also reported poorer family QoL, compared to children with ADHD alone. Children with ADHD and co-occurring internalizing and externalizing comorbidities appear particularly vulnerable to poorer functioning.
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Stephens HF, Kistner JA, Lynch RJ. The Calculation of Discrepancy Scores in the Context of Biased Self-Perceptions of Acceptance. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014. [DOI: 10.1007/s10862-014-9466-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord 2014; 16:13r01596. [PMID: 25317366 DOI: 10.4088/pcc.13r01596] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/27/2014] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To describe the clinical presentation of attention-deficit/hyperactivity disorder (ADHD) in women and girls and factors influencing proper diagnosis and treatment. DATA SOURCES A PubMed search was conducted in April 9, 2012 for English-language publications from the previous 10 years. Search terms included attention deficit hyperactivity disorder, attention deficit/hyperactivity disorder, ADHD, and AD/HD combined with gender, girls, females, women, continuity, discontinuity, gap, treatment, untreated, and lack of treatment. STUDY SELECTION/DATA EXTRACTION A total of 41 articles were reviewed for relevance. Reference lists from relevant articles were reviewed for additional publications; sources known to the authors were also included. RESULTS Attitudes about ADHD among individuals with ADHD and knowledgeable informants (families, teachers, colleagues) vary on the basis of the diagnosed individual's gender. The ADHD prevalence rates are higher among boys than girls. A low index of clinical suspicion exists for girls; their presentation is considered "subthreshold" because inattentiveness is more prominent than hyperactivity/impulsivity. Females with ADHD may develop better coping strategies than males to mask their symptoms. Lastly, anxiety and depression, common comorbidities in female patients with ADHD, can lead to missed or misdiagnosis. If not properly diagnosed and treated, girls with ADHD experience the same negative consequences as boys, including poor academic performance and behavioral problems. Unique issues related to hormonal effects on ADHD expression and treatment response are also experienced by women and girls. CONCLUSIONS Accurate ADHD diagnosis in women and girls requires establishing a symptom history and an understanding of its gender-specific presentation. Coexisting anxiety and depression are prominent in female patients with ADHD; satisfactory academic achievement should not rule out an ADHD diagnosis.
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Affiliation(s)
- Patricia O Quinn
- National Center for Girls and Women With ADHD, Washington, DC (Dr Quinn); and Neuroscience Medical Strategy, Shire Development LLC, Wayne, Pennsylvania (Dr Madhoo)
| | - Manisha Madhoo
- National Center for Girls and Women With ADHD, Washington, DC (Dr Quinn); and Neuroscience Medical Strategy, Shire Development LLC, Wayne, Pennsylvania (Dr Madhoo)
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Mueller AK, Tucha L, Koerts J, Groen Y, Lange KW, Tucha O. Sluggish cognitive tempo and its neurocognitive, social and emotive correlates: a systematic review of the current literature. J Mol Psychiatry 2014; 2:5. [PMID: 25945249 PMCID: PMC4416322 DOI: 10.1186/2049-9256-2-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 07/16/2014] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Since the elimination of items associated with Sluggish Cognitive Tempo (SCT) during the transition from DSM-III to DSM-IV from the diagnostic criteria of Attention-deficit Hyperactivity Disorder (ADHD), interest in SCT and its associated cognitive as well as emotional and social consequences is on the increase. The current review discusses recent findings on SCT in clinical as well as community based ADHD populations. The focus is further on clinical correlates of SCT in populations different from ADHD, SCT's genetic background, SCT's association with internalizing and other behavioral comorbidities, as well as SCT's association with social functioning and its treatment efficacy. METHOD A systematic review of empirical studies on SCT in ADHD and other pathologies in PsycInfo, SocIndex, Web of Science and PubMed using the key terms "Sluggish Cognitive Tempo", "Cognitive Tempo", "Sluggish Tempo" was performed. Thirty-two out of 63 studies met inclusion criteria and are discussed in the current review. RESULTS/CONCLUSION From the current literature, it can be concluded that SCT is a psychometrically valid construct with additive value in the clinical field of ADHD, oppositional defiant disorder (ODD), internalizing disorders and neuro-rehabilitation. The taxonomy of SCT has been shown to be far from consistent across studies; however, the impact of SCT on individuals' functioning (e.g., academic achievement, social interactions) seems remarkable. SCT has been shown to share some of the genes with ADHD, however, related most strongly to non-shared environmental factors. Future research should focus on the identification of adequate SCT measurement to promote symptom tailored treatment and increase studies on SCT in populations different from ADHD.
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Affiliation(s)
- Anna Katharina Mueller
- />Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Lara Tucha
- />Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Janneke Koerts
- />Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Yvonne Groen
- />Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
| | - Klaus W Lange
- />Department of Experimental Psychology, University of Regensburg, Regensburg, Germany
| | - Oliver Tucha
- />Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands
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Distinguishing among disruptive behaviors to help predict high school graduation: does gender matter? J Sch Psychol 2014; 52:407-18. [PMID: 25107411 DOI: 10.1016/j.jsp.2014.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 04/04/2014] [Accepted: 05/17/2014] [Indexed: 02/07/2023]
Abstract
This study examined unique predictive associations of aggressive and hyperactive-inattentive behaviors in elementary school with high school graduation. The current study also investigated whether these associations were moderated by gender. At Time 1, 745 children in the 3rd through 5th grades completed peer ratings on their classmates' disruptive behaviors. At Time 2, school records were reviewed to determine whether students graduated within four years of entering high school. Results showed that gender and hyperactivity-inattention are uniquely associated with high school graduation, but childhood aggression is not. Results also indicated that gender moderated associations between hyperactivity-inattention and graduation. Among boys, hyperactive-inattentive behaviors were not significantly associated with graduation, above and beyond aggression. In contrast, among girls, hyperactive-inattentive behaviors in childhood were significantly associated with graduation even after controlling for aggression. These findings suggest that in middle childhood, hyperactive-inattentive behaviors may be a more meaningful predictor of high school graduation than other forms of early disruptive behavior (e.g., aggression), especially for girls. Such findings could have significant implications for prevention and intervention programs designed to target children at risk for dropping out of school.
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Shiri S, Tenenbaum A, Sapir-Budnero O, Wexler ID. Elevating hope among children with Attention deficit and hyperactivity disorder through virtual reality. Front Hum Neurosci 2014; 8:198. [PMID: 24847233 PMCID: PMC4019862 DOI: 10.3389/fnhum.2014.00198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Accepted: 03/20/2014] [Indexed: 11/25/2022] Open
Affiliation(s)
- Shimon Shiri
- Department of Physical Medicine and Rehabilitation, Hadassah University Hospital Jerusalem, Israel
| | - Ariel Tenenbaum
- Department of Physical Medicine and Rehabilitation, Hadassah University Hospital Jerusalem, Israel
| | - Orly Sapir-Budnero
- Department of Physical Medicine and Rehabilitation, Hadassah University Hospital Jerusalem, Israel
| | - Isaiah D Wexler
- Department of Physical Medicine and Rehabilitation, Hadassah University Hospital Jerusalem, Israel
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Ludlow AK, Garrood A, Lawrence K, Gutierrez R. Emotion Recognition From Dynamic Emotional Displays in Children With ADHD. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2014. [DOI: 10.1521/jscp.2014.33.5.413] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Sciberras E, Lycett K, Efron D, Mensah F, Gerner B, Hiscock H. Anxiety in children with attention-deficit/hyperactivity disorder. Pediatrics 2014; 133:801-8. [PMID: 24753534 DOI: 10.1542/peds.2013-3686] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Although anxiety is common in children with attention-deficit/hyperactivity disorder (ADHD), it is unclear how anxiety influences the lives of these children. This study examined the association between anxiety comorbidities and functioning by comparing children with ADHD and no, 1, or ≥2 anxiety comorbidities. Differential associations were examined by current ADHD presentation (subtype). METHODS Children with diagnostically confirmed ADHD (N = 392; 5-13 years) were recruited via 21 pediatrician practices across Victoria, Australia. Anxiety was assessed by using the Anxiety Disorders Interview Schedule for Children-IV. Functional measures included parent-reported: quality of life (QoL; Pediatric Quality of Life Inventory 4.0), behavior and peer problems (Strengths and Difficulties Questionnaire), daily functioning (Daily Parent Rating of Evening and Morning Behavior), and school attendance. Teacher-reported behavior and peer problems (Strengths and Difficulties Questionnaire) were also examined. Linear and logistic regression controlled for ADHD severity, medication use, comorbidities, and demographic factors. RESULTS Children with ≥2 anxiety comorbidities (n = 143; 39%) had poorer QoL (effect size: -0.8) and more difficulties with behavior (effect size: 0.4) and daily functioning (effect size: 0.3) than children without anxiety (n = 132; 36%). Poorer functioning was not observed for children with 1 anxiety comorbidity (n = 95; 26%). Two or more anxiety comorbidities were associated with poorer functioning for children with both ADHD-Inattentive and ADHD-Combined presentation. CONCLUSIONS Children with ADHD demonstrate poorer QoL, daily functioning and behavior when ≥2 anxiety comorbidities are present. Future research should examine whether treating anxiety in children with ADHD improves functional outcomes.
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Affiliation(s)
- Emma Sciberras
- Community Child Health, Murdoch Childrens Research Institute, Parkville, Australia; The Royal Children's Hospital, Parkville, Australia;
| | - Kate Lycett
- Community Child Health, Murdoch Childrens Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Daryl Efron
- Community Child Health, Murdoch Childrens Research Institute, Parkville, Australia; The Royal Children's Hospital, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Fiona Mensah
- Community Child Health, Murdoch Childrens Research Institute, Parkville, Australia; Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, The Royal Children's Hospital, Parkville, Australia
| | - Bibi Gerner
- Community Child Health, Murdoch Childrens Research Institute, Parkville, Australia
| | - Harriet Hiscock
- Community Child Health, Murdoch Childrens Research Institute, Parkville, Australia; The Royal Children's Hospital, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
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Altin M, El-Shafei AA, Yu M, Desaiah D, Treuer T, Zavadenko N, Gao HY. Pharmacological treatment for attention deficit hyperactivity disorder: functional outcomes in children and adolescents from non-Western countries. Drugs Context 2013; 2013:212260. [PMID: 24432046 PMCID: PMC3884848 DOI: 10.7573/dic.212260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 05/10/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Functional outcomes were measured over a 12-month period in children and adolescents with attention deficit hyperactivity disorder (ADHD) after they received monotherapy. DESIGN Prospective, observational, noninterventional study. SETTING Conducted in six non-Western countries. PARTICIPANTS Outpatients 6 to 17 years of age with a verified diagnosis of ADHD in accordance with the Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR), together with their physicians, decided to initiate or switch treatment for ADHD. Patients were prescribed pharmacological monotherapy: methylphenidate (n=221), nootropic agents (n=91), or atomoxetine (n=234). MEASUREMENTS Patients were followed for changes in their functional status and quality of life, which were assessed with the Child Health and Illness Profile-Child Edition (CHIP-CE) Achievement domain. RESULTS At the end of the study, a mean improvement on the CHIP-CE Achievement domain score was observed for all countries and therapies except in Taiwan, where patients received atomoxetine, and in Lebanon, where patients received methylphenidate. No patient experienced a serious adverse event during the study. Four patients discontinued due to a treatment-emergent adverse event. CONCLUSION After 12 months of treatment, clinical and functional outcomes were improved in children and adolescents from non-Western countries who initiated and remained on their prescribed pharmacological monotherapy.
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Affiliation(s)
- Murat Altin
- Eli Lilly Neuroscience, Eli Lilly & Company Turkey, Lilly İlaç Ticaret Ltd. Şti. Kuşbakişi Caddesi, Rainbow Plaza No:4 Kat:3,34662; Altunizade, İstanbul, Turkey
| | - Ahmed A El-Shafei
- Eli Lilly, 1229 El Sheikh Aly Gad El Haq St., Floor 6 Sheraton Bldgs, Heliopolis, Cairo, Egypt
| | - Maria Yu
- Eli Lilly Canada, 3650 Danforth Ave, Toronto, Ontario, Canada
| | - Durisala Desaiah
- Lilly Research Laboratories, Lilly Corporate Center, Indianapolis, IN
| | - Tamas Treuer
- Neuroscience Research, Eli Lilly and Company, 1075 Budapest, Madách u. 13-14, Hungary
| | - Nikolay Zavadenko
- Dept. of Neurology, Neurosurgery and Medical Genetics of Pediatric Faculty, Russian State Medical University, Ostrovityanova Str. 1, Moscow, Russian Federation
| | - Hong Yun Gao
- Dept. of Psychological Medicine, Children's Hospital of Fudan University, 399 Wanyuan Lu, Shanghai, China
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Becker SP, McBurnett K, Hinshaw SP, Pfiffner LJ. Negative social preference in relation to internalizing symptoms among children with ADHD predominantly inattentive type: girls fare worse than boys. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2013; 42:784-95. [PMID: 23978167 DOI: 10.1080/15374416.2013.828298] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Despite distinct peer difficulties, less is known about the peer functioning of children with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I) in comparison to the peer functioning of children with ADHD combined type. Our purpose was to examine whether child sex moderated the relations between negative social preference and internalizing/externalizing problems in children with ADHD-I. Participants included 188 children diagnosed with ADHD-I (110 boys; ages 7-11; 54% Caucasian). Teacher ratings of the proportion of classmates who "like/accept" and "dislike/reject" the participating child were used to calculate negative social preference scores. Children, parents, and teachers provided ratings of anxious and depressive symptoms, and parents and teachers provided ratings of externalizing problems. Boys and girls did not differ on teachers' negative social preference scores. As hypothesized, however, the relation between negative social preference and internalizing symptoms was moderated by sex such that negative social preference was consistently and more strongly associated with internalizing symptoms among girls than in boys. In terms of externalizing problems, negative social preference was associated with teacher (but not parent) ratings, yet no moderation by child sex was found. Negative social preference is associated with teacher-report of externalizing problems for both boys and girls with ADHD-I, whereas negative social preference is consistently associated with girls' internalizing symptoms across child, parent, and teacher ratings. Implications for future research and interventions are discussed.
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An NY, Lee JY, Cho SM, Chung YK, Shin YM. Difficulty in Facial Emotion Recognition in Children with ADHD. Soa Chongsonyon Chongsin Uihak 2013. [DOI: 10.5765/jkacap.2013.24.2.83] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Gow RV, Sumich A, Vallee-Tourangeau F, Crawford MA, Ghebremeskel K, Bueno AA, Hibbeln JR, Taylor E, Wilson DA, Rubia K. Omega-3 fatty acids are related to abnormal emotion processing in adolescent boys with attention deficit hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids 2013; 88:419-29. [PMID: 23660373 PMCID: PMC5559876 DOI: 10.1016/j.plefa.2013.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/21/2013] [Accepted: 03/23/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND In addition to the core symptoms, attention deficit hyperactivity disorder (ADHD) is associated with poor emotion regulation. There is some evidence that children and young adults with ADHD have lower omega-3 levels and that supplementation with omega-3 can improve both ADHD and affective symptoms. We therefore investigated differences between ADHD and non-ADHD children in omega-3/6 fatty acid plasma levels and the relationship between those indices and emotion-elicited event-related potentials (ERPs). METHODS Children/adolescents with (n=31) and without ADHD (n=32) were compared in their plasma omega-3/6 indices and corresponding ERPs during an emotion processing task. RESULTS Children with ADHD had lower mean omega-3/6 and ERP abnormalities in emotion processing, independent of emotional valence relative to control children. ERP abnormalities were significantly associated with lower omega-3 levels in the ADHD group. CONCLUSIONS The findings reveal for the first time that lower omega-3 fatty acids are associated with impaired emotion processing in ADHD children.
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Affiliation(s)
- Rachel V Gow
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, United Kingdom.
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Friendship Intimacy Exchange Buffers the Relation between ADHD Symptoms and Later Social Problems among Children Attending an After-School Care Program. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2012. [DOI: 10.1007/s10862-012-9334-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Classi P, Milton D, Ward S, Sarsour K, Johnston J. Social and emotional difficulties in children with ADHD and the impact on school attendance and healthcare utilization. Child Adolesc Psychiatry Ment Health 2012; 6:33. [PMID: 23035861 PMCID: PMC3489829 DOI: 10.1186/1753-2000-6-33] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Accepted: 09/26/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The objective of this study was to examine the impact of co-occurring social and emotional difficulties on missed school days and healthcare utilization among children with attention deficit/hyperactivity disorder (ADHD). METHODS Data were from the 2007 U.S. National Health Interview Survey (NHIS) and were based on parental proxy responses to questions in the Sample Child Core, which includes questions on demographics, health, healthcare treatment, and social and emotional status as measured by questions about depression, anxiety, and phobias, as well as items from the brief version of the Strength and Difficulties Questionnaire (SDQ). Logistic regression was used to assess the association between co-occurring social and emotional difficulties with missed school days and healthcare utilization, adjusting for demographics. RESULTS Of the 5896 children aged 6-17 years in the 2007 NHIS, 432 (7.3%) had ADHD, based on parental report. Children with ADHD and comorbid depression, anxiety, or phobias had significantly greater odds of experiencing > 2 weeks of missed school days, ≥ 6 visits to a healthcare provider (HCP), and ≥ 2 visits to the ER, compared with ADHD children without those comorbidities (OR range: 2.1 to 10.4). Significantly greater odds of missed school days, HCP visits, and ER visits were also experienced by children with ADHD who were worried, unhappy/depressed, or having emotional difficulties as assessed by the SDQ, compared with ADHD children without those difficulties (OR range: 2.2 to 4.4). CONCLUSIONS In children with ADHD, the presence of social and emotional problems resulted in greater odds of missed school days and healthcare utilization. These findings should be viewed in light of the limited nature of the parent-report measures used to assess social and emotional problems.
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Affiliation(s)
- Peter Classi
- Eli Lilly and Company, Indianapolis, IN, USA
- Global Health Outcomes – Neuroscience, Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Sarah Ward
- Eli Lilly and Company, Indianapolis, IN, USA
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Becker SP, Luebbe AM, Langberg JM. Co-occurring Mental Health Problems and Peer Functioning Among Youth with Attention-Deficit/Hyperactivity Disorder: A Review and Recommendations for Future Research. Clin Child Fam Psychol Rev 2012; 15:279-302. [PMID: 22965872 DOI: 10.1007/s10567-012-0122-y] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Stephen P Becker
- Department of Psychology, Miami University, Oxford, OH 45056, USA.
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Rapee RM, Bőgels SM, van der Sluis CM, Craske MG, Ollendick T. Annual research review: conceptualising functional impairment in children and adolescents. J Child Psychol Psychiatry 2012; 53:454-68. [PMID: 22067073 DOI: 10.1111/j.1469-7610.2011.02479.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Functional impairment is a key factor in the clinical importance of mental health problems in children. Yet, the nature of impairment and criteria for defining and assessing impairment in childhood disorders has been surprisingly overlooked in much of the literature. The current article examines the extant literature on the conceptualisation, nature and assessment of impairment in childhood disorders. Relations between diagnostic symptoms and functional impairment are discussed together with the influence of impairment on diagnostic decisions and prevalence rates. Several factors influencing impairment in childhood such as culture, development and gender are considered. This article concludes with a discussion of the utility of separating judgements of impairment from specific diagnoses, which is proposed for consideration in the forthcoming DSM-5.
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Affiliation(s)
- Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia University of Amsterdam, The Netherlands
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