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Cavicchioli M, Stefanazzi C, Tobia V, Ogliari A. The role of attachment styles in attention-deficit hyperactivity disorder: A meta-analytic review from the perspective of a transactional development model. European Journal of Developmental Psychology 2022. [DOI: 10.1080/17405629.2022.2069095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Marco Cavicchioli
- Faculty of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Chiara Stefanazzi
- Faculty of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Child in Mind Lab, University “Vita-Salute San Raffaele”, Milan, Italy
| | - Valentina Tobia
- Faculty of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Child in Mind Lab, University “Vita-Salute San Raffaele”, Milan, Italy
| | - Anna Ogliari
- Faculty of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Child in Mind Lab, University “Vita-Salute San Raffaele”, Milan, Italy
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Abstract
This study aims at examining the possible moderating role of attachment style in the association between ADHD and psychological distress, namely, anxiety and depression symptoms. Study included ninty nine participants: Sixty adults with ADHD diagnosis and thirty nine adults without ADHD or other neurological and/or psychiatric disorders. All participants completed the Patient Health Questionnaire (PHQ-9), State-Trait Anxiety (STAI) questionnaires, Emotion in Close Relationships (ECR-R) questionnaire and Adult ADHD Self-Report Scale-Version 1.1 (ASRS-v1.1). Adults with ADHD had greater symptoms of depression (p < .001) and anxiety (p < .001) than adults without ADHD. Process analysis yielded that attachment anxiety moderated the association between ADHD, anxiety and depression, therefore only adults with ADHD that had moderate to high attachment anxiety exhibited higher levels of depression (p < .01) and anxiety (p < .001). No moderating effect was observed for attachment avoidance. Moreover, we did not find correlations between ADHD, anxiety and depression when secure attachment was the moderator; indicating that secure attachment could serve as a "protective factor" against psychological distress among ADHD individuals. Among anxiously attached adults, ADHD was associated with higher levels psychological distress. These findings highlight the important role of attachment style in mental health of adults with ADHD.
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Abstract
Child and adolescent psychiatry involves simultaneously balancing duties to various vulnerable parties. Balancing autonomy and protection for adolescents is complex; state laws governing these situations often add confusion. Common prescribing patterns in child psychiatry lack robust evidence, and utilization of stimulants, atypical antipsychotics, and polypharmacy has skyrocketed. Significant concerns about distributive justice arise from alarming patterns in psychiatric treatment of vulnerable populations, like those affected by poverty, racism, adverse childhood experiences, and certain legal statuses. Principles of justice and respect for persons support the need for safe, adequate, and appropriate psychiatric treatment, including psychosocial interventions and resources, for all children.
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Affiliation(s)
- Rachel Conrad
- Department of Psychiatry, Harvard Medical School, Harvard Medical School Center for Bioethics, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, USA.
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Dekkers TJ, Hornstra R, van den Hoofdakker BJ, de Jong SRC, Schaaf JV, Bosmans G, van der Oord S. Attachment Representations in Children with and without Attention-Deficit/Hyperactivity Disorder (ADHD). Brain Sci 2021; 11:1516. [PMID: 34827515 DOI: 10.3390/brainsci11111516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) in children is associated with several adverse family characteristics, such as higher parenting stress, more conflicted parent–child relationships, lower parental competence, and higher levels of parental psychopathology. Hence, children with ADHD more often grow up under suboptimal circumstances, which may impact the development of their attachment representations. Here, we investigated whether children with ADHD have more insecure and disorganized attachment representations than their typically developing peers, and which factors could explain this association. We included 104 children between 4 and 11 years old, 74 with ADHD (without Conduct Disorder) and 30 typically developing control children. Children completed a state-of-the-art story stem task to assess their attachment representation, and we measured parents’ expressed emotion (as an index of parent–child relationship quality), parents’ perceived sense of competence, parental education levels, and parent-rated ODD symptoms of the child. We found that, after controlling for multiple comparisons, children with ADHD had less secure and more ambivalent and disorganized attachment representations relative to their typically developing peers. These group differences were independent of comorbid ODD and parental education levels. There were no group differences on avoidant attachment representations. Explorative analyses within the ADHD group showed that attachment representations were not related to parent–child relationship quality, perceived parenting competence, parental education levels, and comorbid ODD symptoms. We conclude that children with ADHD disproportionately often have attachment problems. Although this conclusion is important, treatment implications of this co-occurrence are yet unclear as research on ADHD and attachment is still in its infancy.
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Rüfenacht E, Pham E, Nicastro R, Dieben K, Hasler R, Weibel S, Perroud N. Link between History of Childhood Maltreatment and Emotion Dysregulation in Adults Suffering from Attention Deficit/Hyperactivity Disorder or Borderline Personality Disorder. Biomedicines 2021; 9:1469. [PMID: 34680586 DOI: 10.3390/biomedicines9101469] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 01/26/2023] Open
Abstract
Childhood maltreatment (CM) may have a long-term effect on emotion regulation. This study aimed to explore the relationship between CM and emotion dysregulation (ED) in a heterogeneous population. Four hundred seventy French-speaking outpatients (N = 279 ADHD, N = 70 BPD, N = 60 ADHD + BPD, N = 61 clinical controls) completed the Emotion Reactivity Scale (ERS), the Cognitive Emotional Regulation Questionnaire (CERQ), the Childhood Trauma Questionnaire (CTQ), and the Relationship Scales Questionnaire (RSQ). Reports of childhood maltreatment experiences were significantly associated with increased levels of emotion reactivity in all our groups and in the whole population, with a greater use of non-adaptive cognitive emotion regulation strategies and insecure attachment patterns. Emotional abuse showed the strongest effect. Further analysis indicated that an anxious attachment style significantly mediated the relationship between CM and the use of non-adaptive cognitive emotion regulation strategies and emotion reactivity. The results of our study suggest an impact of CM on ED and a potentially marked effect of emotional abuse. They also indicate a potentially mediating role of insecure attachment in the relationship between a history of childhood abuse and emotion reactivity and a higher use of non-adaptive cognitive emotion regulation strategies in adulthood.
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Kissgen R, Franke S, Susewind M, Krischer M. Attachment Representation and Emotion Recognition Ability in Children with ADHD and Their Parents: A Study Protocol. Int J Environ Res Public Health 2021; 18:ijerph18052277. [PMID: 33668949 PMCID: PMC7956444 DOI: 10.3390/ijerph18052277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 11/16/2022]
Abstract
Background: Few studies in clinical attachment research to date have examined children with an attention-deficit/hyperactivity disorder (ADHD) diagnosis. This is surprising for two reasons: first, there are a number of parallels between the behaviors of children with an insecure and disorganized attachment and the behaviors of children with an ADHD diagnosis. Second, secure attachment has a positive effect on the development of skills in areas in which children with ADHD demonstrate problems (e.g., attention span, impulse control). There are currently no findings on whether or not and how insecure and disorganized attachment and ADHD affect children’s emotion recognition ability. Methods: This is a cross-sectional study, part exploratory and part hypothesis-driven in the context of basic research. A clinical sample of 5- to 10-year-old children with an ADHD diagnosis and their parents is to be compared to a non-clinical unaffected control group. Over a period of 3 years, 80 subjects and their parents are to be recruited in each group for participation in the study. Discussion: This study is the first to examine links between attachment, emotion recognition ability, and ADHD. It is also the first to include not just children with ADHD but also their mothers and fathers in its design. The findings should help reduce the research gap and generate more knowledge for family interventions in the case of ADHD.
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Affiliation(s)
- Ruediger Kissgen
- Developmental Science and Special Education, Department of Educational Sciences and Psychology, University of Siegen, 57068 Siegen, Germany;
- Correspondence: ; Tel.: +49-271-740-4093
| | - Sebastian Franke
- Developmental Science and Special Education, Department of Educational Sciences and Psychology, University of Siegen, 57068 Siegen, Germany;
| | - Moritz Susewind
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University of Cologne, 50931 Cologne, Germany; (M.S.); (M.K.)
| | - Maya Krischer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University of Cologne, 50931 Cologne, Germany; (M.S.); (M.K.)
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Manzari N, Matvienko-Sikar K, Baldoni F, O'Keeffe GW, Khashan AS. Prenatal maternal stress and risk of neurodevelopmental disorders in the offspring: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1299-309. [PMID: 31324962 DOI: 10.1007/s00127-019-01745-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Exposure to prenatal stress has been reported to affect the risk of adverse neurodevelopmental outcomes in the offspring; however, there is currently no clear consensus. The aim of this systematic review and meta-analysis was to examine the existing literature on the association between prenatal stress and autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) in the offspring. METHODS Based on a registered protocol, we searched several electronic databases for articles in accordance with a detailed search strategy. We performed this study following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). RESULTS Prenatal stress was significantly associated with an increased risk of both ASD (pooled OR 1.64 [95% CI 1.15-2.34]; I2 = 90%; 15 articles) and ADHD (pooled OR 1.72 [95% CI 1.27-2.34]; I2 = 85%; 12 articles). CONCLUSIONS This study suggests that prenatal stress may be associated with ASD and ADHD; however, several limitations in the reviewed literature should be noted including significant heterogeneity and there is a need for carefully controlled future studies in this area.
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Pallini S, Morelli M, Chirumbolo A, Baiocco R, Laghi F, Eisenberg N. Attachment and attention problems: A meta-analysis. Clin Psychol Rev 2019; 74:101772. [PMID: 31739122 DOI: 10.1016/j.cpr.2019.101772] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 10/25/2022]
Abstract
Attachment theorists have argued that securely attached children tend to exhibit flexible attention; the attention of children with resistant attachments is centered on attachment-related worries; children with avoidant attachments defensively focus attention away from attachment-related emotions/thoughts; and children with disorganized attachments exhibit the collapse of attention and disorientation. In this meta-analysis, a relation between attachment security status and attention problems (APs) in children (18 years and younger) was found. In total, 62 studies (67 samples) met the inclusion criteria. Children with insecure attachments were higher in APs than those with a secure attachment (r = 0.21); those with avoidant or resistant attachments were higher than securely attached children (rs = 0.10 and 0.21, respectively); children with disorganized attachments were higher than those with organized attachments (r = 0.27). Effects were larger when attachment and APs were measured concurrently/closer in time (for secure versus all; disorganized versus organized attachment); for representational versus observational measures of attachment, non-parental reports of APs, and attachment assessed at an older age (for disorganized versus organized attachment); for samples with proportionally fewer boys (secure versus resistant attachment); in recent studies (secure versus avoidant attachment); and when disorganized children were in a high-risk sample or resistant children were in a low-risk condition.
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Hornstra R, Bosmans G, van den Hoofdakker BJ, De Meyer H, van der Oord S. Self-reported attachment styles in children with and without attention-deficit/hyperactivity disorder (ADHD). Eur Child Adolesc Psychiatry 2019; 28:1277-1280. [PMID: 30770984 DOI: 10.1007/s00787-019-01288-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/04/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Rianne Hornstra
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Guy Bosmans
- Research Group Parenting and Special Education, KU Leuven, Leuven, Belgium
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hasse De Meyer
- Research Group Clinical Psychology, KU Leuven, Tiensestraat 102-bus 3720, 3000, Leuven, Belgium
| | - Saskia van der Oord
- Research Group Clinical Psychology, KU Leuven, Tiensestraat 102-bus 3720, 3000, Leuven, Belgium.
- Developmental Psychology, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands.
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Niazof D, Weizman A, Weinstein A. The contribution of ADHD and attachment difficulties to online pornography use among students. Compr Psychiatry 2019; 93:56-60. [PMID: 31349137 DOI: 10.1016/j.comppsych.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/07/2019] [Accepted: 07/07/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There is a high rate of ADHD among individuals with compulsive sexual behavior disorder (CSBD). There is also evidence for an association between compulsive sexual behavior disorder, sensation seeking and attachment difficulties. Problematic pornography use may be considered as a subtype of CSBD hence it merits investigation. The aim of the current study was to investigate the relationships between ADHD, attachment style, sensation seeking and problematic use of pornography online in the general population. METHODS The sample was comprised of 85 participants [38 men (44.7%) and 47 women (55.3%)] with mean age 25. 66 (SD = 4.63) and 26.42 (SD = 6.94) years, respectively. There were 30 participants (35%) with ADHD and 55 participants (65%) without ADHD. They were recruited on-line via social network sites. They filled in a demographic questionnaire, Zukerman's Sensation Seeking Scale, Experience in Close Relationship (ECR) questionnaire that assessed anxious and avoidant attachment and the Cyber Pornography Use Inventory (CPUI). RESULTS Individuals with self-reported ADHD had higher scores of avoidant attachment on the ECR and CPUI compared with individuals without ADHD. Multivariate linear regression analysis has indicated that male gender, ADHD and anxious attachment on the ECR contributed significantly to the variance of cyber pornography use, and explained 34% of the variance. CONCLUSIONS The results indicate that males with ADHD and anxious attachment show an extensive use of pornography online. Males with ADHD who have difficulties in close relationship may use online pornography excessively that in turn may exacerbate their difficulty in forming secure attachment at adult life, a finding that has major clinical implications.
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Yavuz M, Aluç N, Tasa H, Hamamcıoğlu İ, Bolat N. The relationships between attachment quality, metacognition, and somatization in adolescents: The mediator role of metacognition. J Child Adolesc Psychiatr Nurs 2019; 32:33-39. [DOI: 10.1111/jcap.12224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Mesut Yavuz
- Department of PsychologyFrench Lape Hospital, Child and Adolescent Psychiatry, İstanbul Aydin Universityİstanbul Turkey
| | - Nurşah Aluç
- Department of Psychologyİstanbul Aydin Universityİstanbul Turkey
| | - Hande Tasa
- Department of Psychologyİstanbul Aydin Universityİstanbul Turkey
| | - İrem Hamamcıoğlu
- Department of Child and Adolescent PsychiatryYalova State HospitalYalova Turkey
| | - Nurullah Bolat
- Department of Child and Adolescent PsychiatryÇanakkale Onsekiz Mart University School of MedicineÇanakkale Turkey
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Abstract
IMPORTANCE Attention-deficit/hyperactivity disorder (ADHD) is common in US children and adolescents. It is important to understand the most recent prevalence of ADHD and its long-term trends over the past decades. OBJECTIVE To estimate the prevalence of diagnosed ADHD and 20-year trends from 1997 to 2016 among US children and adolescents using nationally representative data. DESIGN, SETTING, AND PARTICIPANTS In this population-based, cross-sectional survey study (National Health Interview Survey), surveys were conducted annually from 1997 to 2016. A total of 186 457 children and adolescents aged 4 to 17 years from 1997 to 2016 were included in this analysis. Data were collected through in-person household interviews with a parent or guardian. The data analysis was performed in January 2018. MAIN OUTCOMES AND MEASURES Attention-deficit/hyperactivity disorder diagnosed by a physician or other health care professional. RESULTS Among the included 186 457 children and adolescents (96 017 boys [51.5%], 51 350 Hispanic [27.5%], 91 374 non-Hispanic white [49.0%], 28 808 non-Hispanic black [15.5%], 14 925 non-Hispanic other race [8.0%]), 14 704 children and adolescents (7.9%; 10 536 boys [71.7%], 2497 Hispanic [17.0%], 9010 non-Hispanic white [61.3%], 2328 non-Hispanic black [15.8%], and 869 non-Hispanic other race [5.9%]) were reported to have ever been diagnosed with ADHD. The weighted prevalence of diagnosed ADHD was 10.2% (95% CI, 9.6%-10.8%) in 2015-2016. There were significant sex and racial/ethnic disparities in the prevalence of diagnosed ADHD. The prevalence was 14.0% (95% CI, 13.1%-15.0%) in boys and 6.3% (95% CI, 5.6%-7.0%) in girls, 6.1% (95% CI, 5.2%-7.0%) in Hispanic individuals, 12.0% (95% CI, 11.1%-12.9%) in non-Hispanic white individuals, and 12.8% (95% CI, 11.0%-14.5%) in non-Hispanic black individuals. Over the 20-year period, the estimated prevalence of diagnosed ADHD in US children and adolescents increased from 6.1% in 1997-1998 to 10.2% in 2015-2016 (P for trend <.001). All subgroups by age, sex, race/ethnicity, family income, and geographic regions showed a significant increase in the prevalence from 1997-1998 to 2015-2016. CONCLUSIONS AND RELEVANCE This study's findings suggest that among US children and adolescents, the estimated prevalence of diagnosed ADHD increased significantly between 1997-1998 and 2015-2016. This study suggests that additional research is needed to better understand the cause of this apparent rise in prevalence.
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Affiliation(s)
- Guifeng Xu
- Center for Disabilities and Development, University of Iowa Stead Family Children’s Hospital, Iowa City
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Lane Strathearn
- Center for Disabilities and Development, University of Iowa Stead Family Children’s Hospital, Iowa City
- Division of Developmental and Behavioral Pediatrics, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Binrang Yang
- Center for Disabilities and Development, University of Iowa Stead Family Children’s Hospital, Iowa City
- Department of Developmental and Behavioral Pediatrics, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
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Bolat N, Eliacik K, Yavuz M, Kanik A, Mertek H, Guven B, Dogrusoz B, Bakiler AR. Adolescent mental health, attachment characteristics, and unexplained chest pain: a case–control study. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1454374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Nurullah Bolat
- Department of Child and Adolescent Psychiatry, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Turkey
| | - Kayi Eliacik
- Division of Adolescent Medicine, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Mesut Yavuz
- Department of Psychology, İstanbul Aydin University, İstanbul, Turkey
- Child and Adolescent Psychiatry, French Lape Hospital, İstanbul, Turkey
| | - Ali Kanik
- Department of Paediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Hilal Mertek
- Department of Paediatrics, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Baris Guven
- Department of Paediatric Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Buket Dogrusoz
- Department of Paediatric Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ali Rahmi Bakiler
- Department of Paediatric Cardiology, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
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Abstract
PURPOSE OF REVIEW To systematically review the literature on the prevalence and pharmacological treatment of ADHD in looked-after children (LAC). RECENT FINDINGS LAC are a very challenging population from a clinical and psychosocial standpoint, with higher mental health needs compared to non LAC. To date, no systematic review on the prevalence of ADHD, and its treatment, in LAC is available. SUMMARY We searched Pubmed, PsycInfo EMBASE + EMBASE CLASSIC, OVID Medline and Web of Science up to November 9 th, 2016. We found 24 papers meeting our criteria. The vast majority of the retained studies are from the USA and show rates of ADHD and of its pharmacological treatment substantially higher in LAC than those reported in national estimates. Future studies from countries other than the USA, aiming to understand the most cost-effective strategies, in the short as well as long term, to manage symptoms of ADHD in LAC are needed.
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Affiliation(s)
- Renece Willis
- Academic Unit of Psychology, University of Southampton, Southampton, UK
| | | | - Samuele Cortese
- Academic Unit of Psychology, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- The Child Study Center, New York University Langone Medical Center, New York, NY 10016 USA
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Delker BC, Bernstein RE, Laurent HK. Out of harm's way: Secure versus insecure–disorganized attachment predicts less adolescent risk taking related to childhood poverty. Dev Psychopathol 2018; 30:283-96. [PMID: 28508736 DOI: 10.1017/s0954579417000621] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractAlthough some risk taking in adolescence is normative, evidence suggests that adolescents raised in conditions of socioeconomic disadvantage are disproportionately burdened with risk taking and its negative consequences. Using longitudinal data from the NICHD Study of Early Child Care and Youth Development, we investigated quality of the early caregiving environment as a potential prospective buffer against the long-term association between childhood poverty and adolescent risk taking. Multicategorical moderation model results indicated that if raised in poverty across age 1–54 months (average family income to needs ratio ≤ 1.02), relative to affluence (income to needs ratio ≥ 6.16), adolescents with histories of secure attachment to caregivers exhibited two times the number of risk behaviors at age 15, whereas adolescents with insecure–disorganized histories exhibited nearly five times the number of risk behaviors. Both early family economic hardship and history of insecure–disorganized attachment remained significant predictors of increased adolescent risk taking, alongside the interactive effect. Probing the interaction's region of significance revealed that history of secure (vs. insecure–disorganized) attachment is associated with protective reductions in risk taking below a family income to needs ratio of 2.24, or about 220% poverty level. Findings support a diathesis–stress model in which children with secure attachment histories are less deleteriously impacted by early socioeconomic adversity than their insecure–disorganized peers.
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