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Siddiqui U, Conover MM, Voss EA, Kern DM, Litvak M, Antunes J. Sex Differences in Diagnosis and Treatment Timing of Comorbid Depression/Anxiety and Disease Subtypes in Patients With ADHD: A Database Study. J Atten Disord 2024:10870547241251738. [PMID: 38756010 DOI: 10.1177/10870547241251738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Our study examined the impact of sex, ADHD subtype, and comorbid illnesses (depression/anxiety) on the timing of diagnosis and treatment for ADHD. METHOD To analyze ADHD patients, four health databases were used to assess subtype, comorbid mood, and antidepressant or anxiolytic drug exposure. Analyses were stratified by sex and age. Standardized mean differences measured intergroup differences. RESULTS Females with ADHD were identified at older ages and had higher rates of depression and anxiety diagnoses and treatments before and after their initial ADHD diagnosis. Predominantly inattentive ADHD patients were diagnosed later and more likely to receive mood disorder diagnosis and treatment than hyperactive impulsive ADHD patients. CONCLUSIONS Results suggest a more complex ADHD presentation in females, potentially causing late diagnosis and delayed treatment.
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Affiliation(s)
- Uzma Siddiqui
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | | | - Erica A Voss
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | - David M Kern
- Janssen Research & Development, LLC, Titusville, NJ, USA
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Dhamala E, Rong Ooi LQ, Chen J, Ricard JA, Berkeley E, Chopra S, Qu Y, Zhang XH, Lawhead C, Yeo BTT, Holmes AJ. Brain-Based Predictions of Psychiatric Illness-Linked Behaviors Across the Sexes. Biol Psychiatry 2023; 94:479-491. [PMID: 37031778 PMCID: PMC10524434 DOI: 10.1016/j.biopsych.2023.03.025] [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: 12/19/2022] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Individual differences in functional brain connectivity can be used to predict both the presence of psychiatric illness and variability in associated behaviors. However, despite evidence for sex differences in functional network connectivity and in the prevalence, presentation, and trajectory of psychiatric illnesses, the extent to which disorder-relevant aspects of network connectivity are shared or unique across the sexes remains to be determined. METHODS In this work, we used predictive modeling approaches to evaluate whether shared or unique functional connectivity correlates underlie the expression of psychiatric illness-linked behaviors in males and females in data from the Adolescent Brain Cognitive Development Study (N = 5260; 2571 females). RESULTS We demonstrate that functional connectivity profiles predict individual differences in externalizing behaviors in males and females but predict internalizing behaviors only in females. Furthermore, models trained to predict externalizing behaviors in males generalize to predict internalizing behaviors in females, and models trained to predict internalizing behaviors in females generalize to predict externalizing behaviors in males. Finally, the neurobiological correlates of many behaviors are largely shared within and across sexes: functional connections within and between heteromodal association networks, including default, limbic, control, and dorsal attention networks, are associated with internalizing and externalizing behaviors. CONCLUSIONS Taken together, these findings suggest that shared neurobiological patterns may manifest as distinct behaviors across the sexes. Based on these results, we recommend that both clinicians and researchers carefully consider how sex may influence the presentation of psychiatric illnesses, especially those along the internalizing-externalizing spectrum.
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Affiliation(s)
- Elvisha Dhamala
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, New York; Department of Psychology, Yale University, New Haven, Connecticut; Kavli Institute for Neuroscience, Yale University, New Haven, Connecticut.
| | - Leon Qi Rong Ooi
- Centre for Sleep and Cognition and Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore; Integrative Sciences and Engineering Programme, National University of Singapore, Singapore
| | - Jianzhong Chen
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore; Integrative Sciences and Engineering Programme, National University of Singapore, Singapore
| | - Jocelyn A Ricard
- Department of Psychology, Yale University, New Haven, Connecticut
| | | | - Sidhant Chopra
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Yueyue Qu
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Xi-Han Zhang
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Connor Lawhead
- Department of Psychology, Yale University, New Haven, Connecticut
| | - B T Thomas Yeo
- Centre for Sleep and Cognition and Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore; Integrative Sciences and Engineering Programme, National University of Singapore, Singapore; Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Avram J Holmes
- Department of Psychology, Yale University, New Haven, Connecticut; Kavli Institute for Neuroscience, Yale University, New Haven, Connecticut; Department of Psychiatry, Yale University, New Haven, Connecticut; Wu Tsai Institute, Yale University, New Haven, Connecticut; Department of Psychiatry, Brain Health Institute, Rutgers University, Piscataway, New Jersey.
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Antunes R, Alexandre J, Guedes M, Filipe MG, Veríssimo M. Assessing the benefits of the "Intergalactic World" social emotional learning program for 8-12-year-old children in Portugal: perspectives from teachers and caregivers. Front Psychol 2023; 14:1233335. [PMID: 37701869 PMCID: PMC10493273 DOI: 10.3389/fpsyg.2023.1233335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/04/2023] [Indexed: 09/14/2023] Open
Abstract
Introduction "Intergalactic World" is a new social-emotional program designed to reduce psychopathological symptoms and improve social and emotional skills in children aged 8-12. This study aims to evaluate the program's benefits from teachers' and caregivers' perspectives, focusing on internalizing and externalizing behaviors. Methods The findings were obtained through self-reported measures using a pretest-posttest design with a follow-up period, but with no control group. One hundred fifty-four children (M age = 9.66, SD = 0.78) participated in this intervention study. Eleven teachers completed the Teacher's Report Form (TRF) for these children, and 133 caregivers completed the Child Behavior Checklist (CBCL). Participants without caregivers' reports were excluded from the analysis. Data were collected at three-time points: before the intervention (T1), immediately after (T2), and 6 months after the implementation of the program (T3). Results Results (n = 133) showed an effect of time on the Internalization scores (at T3 for teachers and T2 and T3 for caregivers) with no gender effect and a decrease in the perception of externalizing behaviors with a gender effect: Boys were perceived as exhibiting more externalizing behaviors than girls. However, these behaviors significantly decrease at T3 for teachers and at T2 and T3 for caregivers. Discussion Despite its limitations, this study highlights the benefits of employing social-emotional programs to help reduce children's internalizing and externalizing behaviors. A multi-informant approach enables a comprehensive analysis and provides insights into the child's significant contexts and interactions with adults.
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Affiliation(s)
- Rita Antunes
- Center for Research in Psychology for Positive Development, Lusíada University of Lisbon, Lisbon, Portugal
- CUF Descobertas Hospital, Lisbon, Portugal
- William James Center for Research—ISPA, Instituto Universitário, Lisbon, Portugal
| | - Joana Alexandre
- ISCTE, University Institute of Lisbon, CIS_ISCTE, Lisbon, Portugal
| | - Maryse Guedes
- William James Center for Research—ISPA, Instituto Universitário, Lisbon, Portugal
| | - Marisa G. Filipe
- Center of Linguistics, School of Arts and Humanities, University of Lisbon, Lisbon, Portugal
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Lin HY, Chiu EC, Hsieh HC, Wang PJ. Gender Differences in Auditory and Visual Attentional Performance in Children with and without ADHD. Arch Clin Neuropsychol 2023; 38:891-903. [PMID: 36796801 DOI: 10.1093/arclin/acad019] [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] [Accepted: 01/20/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Despite the relatively high prevalence of attention deficit hyperactivity disorder (ADHD), the impairment of ADHD in women is underestimated due to the different ways the phenomenon manifests compared to traditional male symptoms. In order to close the gender gap in diagnosis and treatment, this study aims to explore the impact of gender on auditory and visual attention in children with and without ADHD. METHOD A total of 220 children with and without ADHD participated in this study. Their auditory and visual attention performances were analyzed by comparative computerized auditory and visual subtests. RESULTS Auditory and visual attention performance in children with and without ADHD did affect by gender, including typically developing (TD) boys are better than TD girls at distinguishing visual targets from non-target stimuli. When performing attention tasks, TD girls generally maintained a cautious response, which was different from TD boys, who generally adopted positive response methods. ADHD girls suffered from more serious auditory inattention problems than ADHD boys; however, ADHD boys suffered from more auditory and visual impulsive problems than ADHD girls. The internal attention problems of female ADHD children were broader than that of their male ADHD peers and were also more severe, especially in problems of auditory omission and auditory response acuity. CONCLUSIONS ADHD children had a significant gap in auditory and visual attention performance compared to TD children. The research results support the impact of gender on the performance of auditory and visual attention in children with and without ADHD.
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Affiliation(s)
- Hung-Yu Lin
- Department of Occupational Therapy, Asia University, Taichung, Taiwan
| | - En-Chi Chiu
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Hsieh-Chun Hsieh
- Department of Special Education, National Tsing Hua University, Hsinchu City, Taiwan
| | - Pei-Jung Wang
- Department of Physical Therapy, Asia University, Taichung, Taiwan
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Rozgonjuk D, Blinka L, Löchner N, Faltýnková A, Husarova D, Montag C. Differences between problematic internet and smartphone use and their psychological risk factors in boys and girls: a network analysis. Child Adolesc Psychiatry Ment Health 2023; 17:69. [PMID: 37309011 DOI: 10.1186/s13034-023-00620-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/23/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Problematic internet and smartphone use are significant health challenges for contemporary adolescents. However, their mutual relationship is unclear because studies investigating these phenomena are scarce. The present study aimed to investigate the psychological risks and protective factors associated with problematic internet and smartphone use. METHOD A representative sample of Slovak adolescents (N = 4070, Mage = 14.38, SDage = 0.77, 50.5% girls) from the Health Behavior in School-aged Children project was analyzed using network analysis separately for boys and girls. RESULTS The results showed weak (for boys) and moderate (for girls) associations between problematic internet use and problematic smartphone use. Risk factors showed stronger associations with problematic internet use than problematic smartphone use, with the exception of fear of missing out, which was strongly associated with problematic smartphone use. The central nodes were externalizing problems for boys and internalizing problems, externalizing problems, and resilience for girls. CONCLUSION The study concluded that while problematic internet use and problematic smartphone use are somewhat related, they differ at the psychological level. In addition, the phenomena are rather different between boys and girls.
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Affiliation(s)
- Dmitri Rozgonjuk
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany
- Institute of Mathematics and Statistics, University of Tartu, Tartu, Estonia
| | - Lukas Blinka
- Psychology Research Institute, Faculty of Social Studies, Masaryk University, Joštova 10, 60200, Brno, Czech Republic.
| | - Nana Löchner
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany.
| | - Anna Faltýnková
- Psychology Research Institute, Faculty of Social Studies, Masaryk University, Joštova 10, 60200, Brno, Czech Republic
| | - Daniela Husarova
- Department of Health Psychology and Methodology Research, Faculty of Medicine, P.J. Safarik University in Kosice, Košice, Slovakia
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Helmholtzstraße 8/1, 89081, Ulm, Germany
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Efstratopoulou M, Opoku MP, El Howeris H, AlQahtani O. Assessing children at risk in the United Arab Emirates: Validation of the Arabic version of the Motor Behaviour Checklist (MBC) for use in primary school settings. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104489. [PMID: 36958128 DOI: 10.1016/j.ridd.2023.104489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 02/26/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The Motor Behaviour Checklist (MBC) was designed to assist classroom and physical education (PE) teachers in assessing their students' motor-related behaviours. Studies on identification and behaviour problems among children in classrooms are rare in the Arabian context, including in the United Arab Emirates (UAE). AIM This study examines the structural and discriminant validity of the Arabic version of the MBC and assesses the effects of gender, age and type of disability on children's behaviour. METHODS Three groups of children (N = 304) aged 6-12 years were rated by their teachers based on 59 items in the Arabic version of the MBC. RESULTS The results of exploratory and confirmatory factor analyses, as well as a configural invariance analysis of the data, indicated that the Arabic version of the MBC is a valid measurement for assessing behavioural problems in children in the UAE. The results of the multivariate analysis of variance showed gender differences among the children rated by their teachers; the boys in the sample scored higher on all problem scales. The results also showed differences according to the type of disability: children with autism spectrum disorder and attention disorder hyperactivity disorder scored higher than their typically developing peers on most of the problem scales. CONCLUSION The findings of the study provide theoretical support for the use of MBC as a valid instrument to assess children at risk in the UAE. The implications of the study and recommendations for tailored interventions in children with diverse needs and characteristics are discussed.
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Affiliation(s)
- Maria Efstratopoulou
- Department of Special Education, College of Education, United Arab Emirates University, United Arab Emirates.
| | - Maxwell Peprah Opoku
- Department of Special Education, College of Education, United Arab Emirates University, United Arab Emirates
| | - Hala El Howeris
- Department of Special Education, College of Education, United Arab Emirates University, United Arab Emirates
| | - Omniah AlQahtani
- Department of Special Education, College of Education, United Arab Emirates University, United Arab Emirates
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Wang Z, Tao Z, Lan Y, Chen Y, Xie Q, Li Q, Lu C, Zhang W. Different mechanisms mediating cybervictimization and internalizing/externalizing problems: The moderating role of emotion regulation strategies. COMPUTERS IN HUMAN BEHAVIOR 2023. [DOI: 10.1016/j.chb.2023.107748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
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Yang CC, Hinshaw SP. Associations Between Dimensional Persistence of ADHD and Adult Sleep Quality in a Prospective Study of Girls. J Atten Disord 2023; 27:777-785. [PMID: 36799481 DOI: 10.1177/10870547231155439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVES We investigated the prospective association between (a) ADHD symptom dimensions, including their persistence and (b) adult sleep quality in a female sample, covarying adult depressive symptoms. METHODS Participants comprised four persistence groups (persisters, partials, desisters, and comparison) based on overall ADHD diagnosis and separate dimensions of inattention and hyperactivity/impulsivity (HI) in childhood, late adolescence, and early adulthood, featuring girls with (n = 140) and without (n = 88) carefully diagnosed ADHD. RESULTS Only persistence of inattention predicted lower adult sleep quality when covarying young-adult depression, which was also a significant predictor. When additionally covarying stimulant medication use in adulthood, inattention persistence lost significance, although depression maintained significance, with medication use predicting worse sleep quality. CONCLUSIONS Persistence of inattentive (but not HI) symptoms was significantly related to adult sleep quality in the context of concurrent depression. Sleep quality is an important outcome for research on and treatment for ADHD.
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Affiliation(s)
| | - Stephen P Hinshaw
- University of California, Berkeley, USA.,University of California, San Francisco, USA
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De Rossi P, D'Aiello B, Pretelli I, Menghini D, Di Vara S, Vicari S. Age-related clinical characteristics of children and adolescents with ADHD. Front Psychiatry 2023; 14:1069934. [PMID: 36778635 PMCID: PMC9911799 DOI: 10.3389/fpsyt.2023.1069934] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) has been associated with difficulties in regulating aversion states, high functional impairment, and a high risk of psychopathology across the lifespan. ADHD is clinically heterogeneous, with a wide spectrum of severity and associated symptoms. Clinical characteristics need to be carefully defined in different periods of life as ADHD course, symptoms, and comorbidities may fluctuate and change over time. Adolescence usually represents the transition from primary to secondary education, with a qualitative and quantitative change in environmental and functional demands, thus driving symptoms' change. METHODS In order to characterize age-related clinical features of children (<11 years) and adolescents (≥11 years) with ADHD, we conducted a naturalistic study on 750 children and adolescents assessed for ADHD at our Neuropsychiatry Unit over the course of 3 years (2018-2020). RESULTS We found that ADHD symptoms were significantly higher in children than adolescents. More importantly, we found worse global functioning, lower adaptive skills, higher levels of anxiety and depressive symptoms, somatic complaints, emotional dysregulation, social problems, and aggression in adolescents, despite a lower severity of ADHD-specific symptoms. CONCLUSION These results should be confirmed in longitudinal observational studies of adequate sample size in order to reliably describe a potential course characterized by worsening of functioning, reduction in ADHD-specific symptoms and increase in general psychopathology during the transition from childhood to adolescence.
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Affiliation(s)
- Pietro De Rossi
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Barbara D'Aiello
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.,Department of Human Sciences, Libera Università Maria Santissima Assunta University, Rome, Italy
| | - Italo Pretelli
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Silvia Di Vara
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.,Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
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Sex Differences in Substance Use, Prevalence, Pharmacological Therapy, and Mental Health in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Brain Sci 2022; 12:brainsci12050590. [PMID: 35624977 PMCID: PMC9139081 DOI: 10.3390/brainsci12050590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/18/2022] [Accepted: 04/29/2022] [Indexed: 12/03/2022] Open
Abstract
Sex differences are poorly studied within the field of mental health, even though there is evidence of disparities (with respect to brain anatomy, activation patterns, and neurochemistry, etc.) that can significantly influence the etiology and course of mental disorders. The objective of this work was to review sex differences in adolescents (aged 13–18 years) diagnosed with ADHD (according to the DSM-IV, DSM-IV-TR and DSM-5 criteria) in terms of substance use disorder (SUD), prevalence, pharmacological therapy and mental health. We searched three academic databases (PubMed, Web of Science, and Scopus) and performed a narrative review of a total of 21 articles. The main conclusions of this research were (1) girls with ADHD are more at risk of substance use than boys, although there was no consensus on the prevalence of dual disorders; (2) girls are less frequently treated because of underdiagnosis and because they are more often inattentive and thereby show less disruptive behavior; (3) together with increased impairment in cognitive and executive functioning in girls, the aforementioned could be related to greater substance use and poorer functioning, especially in terms of more self-injurious behavior; and (4) early diagnosis and treatment of ADHD, especially in adolescent girls, is essential to prevent early substance use, the development of SUD, and suicidal behavior.
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Xu P, Chen JS, Chang YL, Wang X, Jiang X, Griffiths MD, Pakpour AH, Lin CY. Gender Differences in the Associations Between Physical Activity, Smartphone Use, and Weight Stigma. Front Public Health 2022; 10:862829. [PMID: 35425758 PMCID: PMC9001944 DOI: 10.3389/fpubh.2022.862829] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background Physical activity (PA) is important for health. However, there is little evidence on how weight stigma, time spent on sedentary activities (including smartphone, social media, online learning), time spent on outdoor activity, and nomophobia associate with PA among Chinese individuals with consideration of gender. The present study examined the aforementioned associations in the COVID-19 pandemic era. Methods University students (N = 3,135; 1,798 females, 1,337 males) with a mean age of 19.65 years (SD = 2.38) years completed an online survey from November to December, 2021. The online survey assessed weight stigma (using the Perceived Weight Stigma Scale and Weight Bias Internalization Scale), PA (using the International Physical Activity Questionnaire Short Form), time spent on different activities (using self-designed items for time on smartphone, outdoor activity, social media, and online learning), and nomophobia (using the Nomophobia Questionnaire). Parallel mediation models were constructed (dependent variable: PA; mediators: perceived weight stigma, weight-related self-stigma, time spent on smartphone, time spent on outdoor activity, time spent on social media, and time spent online learning; independent variable: nomophobia) and evaluated using Hayes' Process Macro Model 4 (IBM SPSS 20.0). Results Weight-related self-stigma (β = −0.06; p = 0.03), time spent on outdoor activity (β = 0.21; p < 0.001), time spent on social media (β = 0.07; p = 0.02), time spent on online learning (β = 0.06; p = 0.03), and nomophobia (β = −0.07; p = 0.01) were all significant factors explaining the PA among female participants. Perceived weight stigma (β = −0.07; p = 0.01), time spent on outdoor activity (β = 0.27; p < 0.001), and time spent on online learning (β = 0.10; p = 0.002) were all significant factors explaining PA among male participants. Conclusion Chinese healthcare providers should design programs on weight stigma reduction and outdoor activity improvement to enhance PA among university students.
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Affiliation(s)
- Ping Xu
- Department of Educational Psychology, School of Leisure Sports and Management, Guangzhou Sport University, Guangzhou, China
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan
| | - Yen-Ling Chang
- Department of Family Medicine, Cardinal Tien Hospital, New Taipei, Taiwan
| | - Xiaodong Wang
- School of Leisure Sports and Management, Guangzhou Sport University, Guangzhou, China
| | | | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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